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PCM Exam 1 - Spring > Intro to Normal Gait > Flashcards

Intro to Normal Gait Flashcards

1
Q

What is normal gait?

A

A sequence of pattern of limb-motions that serve to progress the body along a desired path while maintaining weight bearing stability, conserving energy, and absorbing shock of impact

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2
Q

What are the periods of the gait cycle in Rancho Los Amigos?

A

Loading response –> Mid Stance –> Terminal Stance –> Pre Swing –> Initial Swing –> Mid Swing – Terminal Swing

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3
Q

What is a gait cycle?

A

A heel strike on one limb to the next ipsilateral heel strike

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4
Q

What is the stance phase?

A

Entire period the limb is in contact with the ground

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5
Q

What percentage of the gait cycle is the stance phase?

A

60% of the gait cycle

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6
Q

What is the swing phase?

A

Begins when the foot comes off the ground

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7
Q

What percentage of the gait cycle is swing phase?

A

40% of the gait cycle

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8
Q

What periods are apart of stance phase?

A

Loading response, mid stance, terminal stance, pre swing

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9
Q

What are the events of a gait cycle?

A

Initial contact –> opposite toe off –> heel rise –> opposite initial contact –> toe off –> feet adjacent –> tibia vertical –> next initial contact

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10
Q

What are the phases of the gait cycle in standard terminology?

A

Heel strike –> foot flat –> midstance –> heel off –> toe off –> midswing –> heel strike

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11
Q

What is double limb support?

A

When both feet are in contact with the ground

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12
Q

What is single limb support?

A

When only one foot is in contact with the ground

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13
Q

What should be happening during the functional task of weight acceptance?

A
  • Initial contact and loading response
  • Weight is rapidly loaded on an outstretched limb
  • Impact of the GRF is absorbed
  • Body continues on a forward path while stability is maintained
  • Both feet are in contact with the ground
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14
Q

What should be happening during the functional task of single limb support?

A
  • Mid stance and terminal stance
  • Period where body progresses over a single, stable limb
  • Weight is transferred from metatarsal heads and the heels come off the ground
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15
Q

What should be happening during the functional task of swing limb advancement?

A
  • Pre-swing, initial swing, mid swing, and terminal swing
  • Limb is unloaded and the foot comes off the ground
  • Limb is moved from behind the body to in front of the body, reaching out to take the next step
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16
Q

What is the objective of initial contact?

A

Positioning of the limb to start stance

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17
Q

What is the objective of loading response?

A
  • Shock absorption
  • Weight bearing stability
  • Forward progression
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18
Q

What is the objective of mid stance?

A
  • Progression of COG over BOS
  • Limb and trunk stability
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19
Q

What is the objective of terminal stance?

A

Progression of COG beyond the BOS

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20
Q

What is the objective of pre-swing?

A

Position limb for swing

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21
Q

What is the objective of initial swing?

A
  • Foot clerance of the floot
  • Limb advancement from trailing position
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22
Q

What is the objective of mid swing?

A
  • Limb advancement
  • Foot clearance from the floor
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23
Q

What is the objective of terminal swing?

A
  • Complete limb advancement
  • Preparation for stance
24
Q

What is the normal gait speed (velocity)?

A

1.37 m/sec

25
Q

With aging does our gait speed (velocity) increase or decrease?

A

Decrease

26
Q

Who has a faster gait speed (velocity), males or females?

A

Males

27
Q

If you have a gait speed (velocity) less than 1 m/s what does that mean?

A
  • Might benefit from fall prevention
  • Greater than 0.67 m/s to complete self care
  • Greater than 0.89 m/s to complete house hold activities
28
Q

If you have a gait speed (velocity) greater than 1 m/s what does that mean?

A
  • Greater than 1.1 m/s it is predictive of completing yard work
  • Greater than 1.3 m/s it is predictive of climbing a flight of stairs
29
Q

If you have a gait speed (velocity) less than 0.6 m/s m/s what does that mean?

A
  • Predicts future risk of falls and hospitalizations
  • Tend to require assistance with ADLs and IADLs
30
Q

What speed is required to cross the street safely?

A

Greater than 0.49 m/s

31
Q

If you have a gait speed (velocity) less than 0.4 m/s m/s what does that mean?

A
  • Longer length of stay in acute care
  • Likely to discharge to a skilled nursing, inpatient rehab, or nursing home setting or with home health services
32
Q

What is the “6th vital sign”?

A

Walking speed

33
Q

If you walk slow are you more independent or dependent?

A

Dependent

34
Q

What is a gait cadence?

A

Number of steps per minutes

35
Q

What is the average adult cadance?

A

110-120 steps/ min

36
Q

What are some temporal variables of gait?

A
  • Cadence
  • Stance time
  • Swing time
  • Double support time
  • Single support time
37
Q

What are some spatial variables of gait?

A
  • Stride length
  • Step length
  • Step/ base width
38
Q

What is stride length?

A

Point from initial contact to the next initial contact on the same foot… equal to the gait cycle

39
Q

What is step length?

A

Initial contact of the right foot to the initial contact of the left foot… two steps equal a stride

40
Q

What is step base/ width?

A

How far apart the two feet are… the wider they are typically the more stable they are and vice versa

41
Q

What is the average stride length?

A

56 inches

42
Q

What is the average step length?

A

28 inches

43
Q

How much hip flexion is needed for normal gait?

A

0 - 30 degrees

44
Q

How much hip extension is needed for normal gait?

A

0 - 10 degrees

45
Q

How much knee flexion is needed for normal gait?

A

0 - 60 degrees

46
Q

How much knee extension is needed for normal gait?

A

0 degrees

47
Q

How much ankle dorsiflexion is needed for normal gait?

A

0 - 10 degrees

48
Q

How much ankle plantarflexion is needed for normal gait?

A

0 - 20 degrees

49
Q

What is a foot slap?

A
  • Lack of eccentric activation of the dorsiflexors
  • Foot drops “slapping” the ground
  • Tibialis anterior cannot control foot
50
Q

What is a high stepping gait?

A
  • Has to lift leg higher than usual to clear foot
  • Increased hip and knee flexion
  • Weak dorsiflexors
  • Foot drop present
51
Q

What is a vaulting gait?

A
  • Associated with a limb length discrepancy or a stiff leg
  • Spends stance phase of shorter leg on toes
52
Q

What is a weak quadriceps gait?

A

Instability in the knee joint or weak quads causing hyper extension of knee and a forward lean to move the base of support forward

53
Q

What is a trendelenberg gait?

A
  • Glut med weakness
  • Back pain, pelvic pain, hip dysfunction, lumbar spine surgery
  • Bottoming out: hip cannot (glute med) contract to pull body of base of support
  • Contralateral pelvic drop (ex: left side is weak or right pelvis drops)
  • If compensating then the patient will bend to weaker side and decrease the moment arm
54
Q

What is a posterior lurch gait?

A

Trunk lead posterior with a hyper extended hip during loading response due to a weak glute max

55
Q

What are things to watch for?

A
  • Sagittal, frontal, and transverse plane movement
  • Joint angles (ex: increase
  • Increased movement of trunk and/ or pelvis in various planes
56
Q

What is the goal of observational gait analysis?

A

to design and implement appropriate treatment interventions based on deviations seen

PCM Exam 1 - Spring (3 decks)

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