intro to gait

Question 1

list the 3 requirements for gait?

Answer 1

1. support head, arms, and trunk by maintaining a semirigid lower limb
2. maintain upright posture and balance
3. controls the foot to allow it to clear obstacles and enables gentle heel or toe loading through eccentric muscle action

Question 2

what are the two main tasks for walking/gait?

Answer 2

1. generates mechanical energy by concentric muscle contraction to initiate, maintain and if desired, forward velocity
2. provides shock absorption and stability and decreases forward velocity of the body

Question 3

what age does gait start to become regular?

Answer 3

around age 7

Question 4

what do toddlers beginning to walk resemble?

Answer 4

an elderly person

Question 5

what are the functional tasks accomplished in normal gait?

Answer 5

forward progression, balance, and support of the upright body

Question 6

what is the gait cycle?

Answer 6

the sequence of motion that includes one stance and one swing phase on the same limb. also could be described as ipsilateral heel strike to heel strike

Question 7

what are the two phases of the gait cycle?

Answer 7

stance and swing

Question 8

what percent is the stance phase?

Answer 8

60%

Question 9

what percent is the swing phase?

Answer 9

40%

Question 10

what are the stages in the traditional gait cycle?

Answer 10

heel strike, foot flat, midstance, heel off, acceleration, midswing, deceleration, heel strike.

Question 11

what are the stages in the swing phase?

Answer 11

initial swing (acceleration), midswing, and terminal swing (deceleration)

Question 11

what are the stages in the stance phase?

Answer 11

initial contact (heel strike), load response (foot flat), midstance (single leg stance), terminal stance (heel off), and preswing (toe off)

Question 12

where is the center of gravity approximately located?

Answer 12

2 inches anterior to the second sacral vertebrae

Question 13

what are some contributing factors to common gait deviations?

Answer 13

pain/discomfort during weight bearing
muscle weakness/tone abnormalities
limitation of joint ROM
incoordination of movement
changes in bone or soft tissue

Question 14

where may compensations for injury or pathology occur?

Answer 14

on the contralateral limb or ipsilateral limb

Question 15

what is an antalgic gait?

Answer 15

pain in the lower extremities that causes a limp. may see a shortened stance phase relative to the swing phase of the affected side

Question 16

what is a trendelenburg gait?

Answer 16

weakness in the glute medius muscle that causes movement pattern changes in the contralteral hip during swing phase

Question 17

what is an uncompensated gait?

Answer 17

contralateral hip drop; lean away from weak side

Question 18

what is a compensated gait?

Answer 18

contralateral hip hike displacing the center of mass over the axis or rotation on the affected side; lean towards/over weak side

Question 19

what is a hemiparetic gait?

Answer 19

changes in gait pattern from normal that may include decreased cadence, prolonged swing duration on the paretic side, prolonged stance duration on the nonparetic side, and step length asymmetry

Question 20

what is a scissoring gait?

Answer 20

increased muscle tone of the adductor muscles that causes the knees and thighs to be pressed together or crossing each other while walking

Question 21

what is a circumduction gait?

Answer 21

weakness of the hip flexors, contralateral hip dysfunction, or leg length discrepancy that causes a combination of hip hiking, forward rotation of the pelvis, and abduction of the hip

Question 22

what is vaulting gait?

Answer 22

ankle dorsiflexion weakness or leg length discrepancy requiring plantar flexion of the contralateral ankle during the single-limb support phase to assist swing leg clearance

Question 23

what is foot slap gait?

Answer 23

ankle dorsiflexion weakness causing the forefoot to rapidly decent during initial contact; or no ankle dorsiflexion clearance during swing which results in a steppage gait

Question 24

what is an ataxic gait?

Answer 24

a failure of muscle coordination causing an irregular foot placement, wide base, and instability during ambulation

Question 25

what is a festinating gait?

Answer 25

often observed in those with parkinson’s diagnosis; gait appears shuffling, it is slow with a short step length and a narrow base, also present, a difficulty performing smooth turning or freezing at obstacles or passing through narrow areas such as doors

Question 26

describe non weight bearing (NWB)

Answer 26

0% involved LE does not touch the ground

Question 27

describe toe touch weight bearing (TTWB)

Answer 27

for balance only, foot may rest on the floor but no weight bearing. must maintain hip and knee flexion on involved LE

Question 28

describe partial weight bearing (PWB)

Answer 28

20-50% body weight in stance phase as per MD orders. interpretations vary

Question 29

describe weight bearing as tolerated (WBAT)

Answer 29

50-100% limited only by patients tolerance