Intro to gait Flashcards

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1
Q

How does walking and gait change through the life span

A

-as a kid it is hard too balance because the head is a large percentage of our weight
-as an adult you have a better walking pattern and balance
-in the elderly, posture changes to a forward and flexed posture and they take smaller strides.

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2
Q

What are requirements for gait

A

-to balance HAT in erect posture
-transfer HAT from one LE to the other
-lift each LE and move it forward
-coordination
-balance
-kinesthetic and proprioceptive senses
-integrity of joints and muscles

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3
Q

What are the tasks involved in walking

A

-weight acceptance: the leg has two hold the body
-single limb support: this way the other limb can advance
-swing limb advancement

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4
Q

Tasks for ambulation (what is required to happen for normal gait)

A

-maintenance of support of HAT against gravity
-maintenance of upright posture and balance (spine, head and hip position)
-control of foot trajectory: straight in front

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5
Q

Ways to analyze gait

A

-cinematography: videos and pictures
electrogoniometry: track ROM
force plate: look at ground contact
EMG: what muscles are active
observations

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6
Q

What is 1 gait cycle

A

right heel contact to the next right heel contact

OR

left heel contact to the next left heel contact

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7
Q

What is right step length

A

right heel to left heel (1/2 the stride)

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8
Q

what is left step length

A

left heel to right heel (1/2 the stride)

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9
Q

stride

A

distance from right heel to right heel

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10
Q

foot angle

A

how much toe out there is
-measured from the line of progression to the 2nd toe (the angle)

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11
Q

what is step width

A

distance between heel contracts o left and right (BOS)

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12
Q

What happens to the gait generally where one limb is in pain

A

decrease time in stance on that LE which affects how far the opposite LE can step
-decrease step length for opposite side

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13
Q

What happens generally to gait for a hemiparesis patient

A

cannot advance involved side or stand on involved side
-decrease step length on both sides

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14
Q

What happens generally to gait in Parkinson’s patients

A

not a lot of single leg stance
-shuffle feet

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15
Q

What are the time or temporal variables of gait

A

-stance time
-single support time
-double support time
-stride time
-cadence
-walking speed
-acceleration

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16
Q

Stance time

A

amount of time the LE is in the stance phase
-in total about 60%

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17
Q

single support time

A

total amount of time reference leg is in stance with the other LE in the swing phase
-COM is at its highest
-about 40% of the time

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18
Q

Double support time

A

Total amount of time reference leg is in stance phase with the other LE not in the swing phase
-COM is lowest
-about 20% of the time

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19
Q

Stride time

A

0-88-1.2 seconds ~ 1 second for a normal gait cycle
(time of one gait cycle)

20
Q

Step time

A

0-44-0.6 seconds
-should be about half the time of the stride time

21
Q

cadence

A

1.87 steps/sec (100 steps/min)
-how many contacts per second
-females tend to be quicker and males tend to take longer steps.

22
Q

walking speed

A

1.37 m/sec (3mph)

23
Q

acceleration

A

change in speed/direction

24
Q

How can you get more speed with your gait

A

more speed can be achieved by bringing the weight closer to the joint axis
-the body does this by increasing hip, knee and dorsiflexion

25
Q

What are the 2 general main phases of gait

A

swing phase 40% and stance phase 60%

26
Q

What are the phases of stance relative to the support and how long are you in those phases

A

double limb support -20%
single limb support - 80 %

27
Q

What are the steps of gait from older gait textbooks

A

heel contact
-foot flat
-mid stance
-heel off
-toe off
(heel off and toe off make up the push off phase)
-early swing
-mid swing
-late swing

28
Q

Loading response

A

accepting the weight onto the limb

29
Q

pre swing

A

getting ready to advance

30
Q

initial swing

A

toe off ground

31
Q

mid swing

A

limb is bring brought forward to about even with the other foot
-need to be able to clear the floor

32
Q

terminal swing

A

the LE is being swung out in front of body
-reaching forward to put the foot down

33
Q

What are the stance periods in order

A

-initial contact: normally the heel
-loading response: accepting the weight
-midstance: from opposite LE toe off to when it is level with the stance leg
-terminal stance: from mid stance to opposite initial contact
-pre swing: getting ready to advance
-toe off: normally 1st or 2nd toe is most of push up

34
Q

Determinants of Gait

A

COM- they minimize the movement of COM to make it more effective
-pelvic rotation
-lateral pelvic tilt
-knee flexion at mid stance
-ankle mechanisms
-foot mechanism
-physiologic valgus at the knee

35
Q

How is pelvic rotation a determinant of gait

A

occurs in the transverse plane and is necessary for limb advancement

36
Q

How is lateral pelvic tilt a determinant of gait

A

occurs in the frontal plane
-as one foot steps, the pelvis drops slightly to keep the COM from going up too much

37
Q

How is knee flexion at mid stance a determinant of gait

A

drops the COM a little

38
Q

How is ankle and foot mechanisms a determinant of gait

A

related to limb length

39
Q

How is valgus of the knee a determinant of gait

A

keeps COM closer to the center of the BOS

40
Q

Energy requirements

A

-need energy to accelerate and decelerate segments of the body
-therefore speed of gait is based on energy - changing the speed will cost more energy for the body because they either have to speed up and accelerate or they have to the hold the limb in a decelerated sate
-metabolic energy to mechanical energy
-energy costs is the O2 consumption

41
Q

Mechanical energy of walking (where is potential and kinetic highest and lowest)

A

the minimum potential energy is when COM is at its lowest
the Maximum potential energy is when COM Is at its highest

the minimum kinetic energy is when COM is at its highest
The maximum kinetic energy is when COM is at its lowest

42
Q

Inertia and its relation to gait

A

-arises from internal properties of segments (the closer to the axis the distal end is the faster you move)
-directly proportional to mass of segment
-energy require to alter the velocity of the body

43
Q

Describe the path of the center of pressure on the plantar surface of the foot

A

-COM goes through the foot
-heel then goes more laterally and then goes back medially through the big toe and some of the second toe

44
Q

where do you get the ground reaction force

A

during the heel strike and then toe off phase

45
Q

Describe the toques generated by ground reaction forces at the heel contact

A

-plantar flexion torque: external plantar flexion moment
-eversion torque goes medial towards the knee from the posterior view causing a varus torque at the knee

46
Q

what do moments do

A

cause a rotation at a joint in a particular direction