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COMPS:ALL THINGS GAIT > KnB Normal Gait > Flashcards

KnB Normal Gait Flashcards

1
Q

Gait Cycle Mnemonic

A

I Love Many Types of Pussy In My Tesla

  • I
    • Initial Contact
  • Love
    • Loading phase
  • Many
    • Midstance
  • Types of
    • Terminal stance
  • Pussy
    • Pre swing
  • In
    • Initial swing
  • My
    • Mid swing
  • Tesla
    • Terminal swing
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2
Q

Gait basics:

A
  • Cyclical
  • coordinated jt motion, sensory INput, motor OUTput
  • “controlled forward fall”
    • coord
    • balance
    • strength
    • sensory INput
    • jt integrity
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3
Q

Stance phase is

A

60%

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4
Q

Swing phase is

A

40%

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5
Q

Gait BEGINS and ENDS w/ what?

A

Consecutive ground contact of SAME FOOT

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6
Q

2 Phases of Gait Cycle:

A
    1. Stance
      * Time reference foot is on GROUND
      * 60^
    1. Swing
      * Time reference foot is NOT TOUCHING GROUND
      * 40%
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7
Q

Limb phases of gait

A
  • Double limb support
    • TWO brief pds when BOTH limbs in contact w/ ground
      • 20%
  • Single limb support
    • Rest of cycle
      • 80%
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8
Q

Stance Phase

Rancho Los Amigos

60% of Gait

I Love Many Types of Pussy

A

Initial contact

Loading response

Midstance

Terminal swing

Preswing

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9
Q

What are the Tasks of Stance Phase?

A
  • support/fall prevent
  • wt. acceptance
  • shock absorb
  • force prod. to produce forward progress
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10
Q

Normal Gait “Rockers”: 3

Only in STANCE !!!

A
  1. Heel rocker
  2. Ankle rocker
  3. Forefoot rocker
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11
Q

Initial Contact

A

moment foot touches floor

  • Heel contact
  • Tasks:
    • ​proper pos. of foot to begin stance phase
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12
Q

Loading Response

A

IC until opposite foot comes OFF floor

*1st of TWO double limb support pds

  • Tasks:
    • ​wt. acceptance, shock absorption
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13
Q

Midstance

*start of Single limb support

A
  • Begins when non-reference (opp. foot) lifts off and continues until body is aligned directly over foot on ground
  • Tasks:
    • ​progression from heel-ankle rocker
    • momentum transfer
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14
Q

Terminal Stance

A
  • Concludes single limb support
  • Begins when reference limb heel rises and ENDS when opp foot hits ground
  • Tasks:
    • ​progression of body PAST forefoot rocker
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15
Q

Preswing

*Reference leg ABOUT TO swing

A
  • 2nd of 2 double limb support phases
  • BEGINS w/ IC of opp foot and ENDS w/ toes off on reference limb
  • Tasks:
    • ​position limb for swing
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16
Q

Swing phase

Rancho Los Amigos

In My Tesla

A
  • Initial swing
  • Mid swing
  • Terminal Swing
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17
Q

Tasks of Swing Phase

A
  1. limb clearance
  2. Limb placement
  3. momentum transfer
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18
Q

Initial Swing

A
  • begins w/ lift off of reference foot ENDS w/ ref foot is just OPP non-ref stance limb
  • Tasks:
    • ​limb advancement, foot clearance
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19
Q

Midswing

A
  • STARTS when ref limb is OPP non-ref stance limb ENDS when the tibia is VERT to ground (ref leg)
  • Tasks:
    • ​limb advance, foot clearance
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20
Q

Terminal Swing

A
  • BEGINS when tibia is vertical to ground, ENDS w/ next initial contact
  • Tasks:
    • ​completeslimb advance,preps limb for wt acceptance
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21
Q

NO wt. acceptance during________

A

Stance phase!!!

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22
Q

Step length===

A

dist b/w ground contact of one foot TO opp foot

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23
Q

Stride length ====

A

1 complete gait cycle

dist. b/w consecutive steps

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24
Q

Clinical issues related to Foot angle and Gait

A
  • In-Toeing
    • ​pigeon toed
    • INCs motion needed @ ankle (talocrural) jt
    • narrows BOS
  • Out-Toeing
    • ​DECd motion needed @ ankle BUT INCs subtalar motion
    • INCs BOS
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25
Q

Time-Distance Parameters

Stride (cycle) time

A

​1.0-1.2 m/sec​​

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26
Q

Time-Distance Parameters

Stride Length

A

1.2-1.9m

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27
Q

Time-Distance Parameters

Step Length

A

.56-1.1 m

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28
Q

Time-Dist parameters

Step Width

A

7.7-9.6cm

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29
Q

Time-Dist parameters

Cadence

A

90-140 step/min

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30
Q

Time-Dist parameters

Velocity

A

.9-1.8 m/sec

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31
Q

Tips for Gait Analysis

A
  • Dynamic process
  • think about direction things are moving, NOT STATIC POS.
  • Be clear w/ eccentric vs. concentric
    • ​gait is mostly eccentric ****
  • Recognize that in stance we are talking Closed Chain and in swing we are talking Open Chain
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32
Q

Ankle in terms of Gait

A

Talocrural joint

33
Q

Subtalar joint

aka

Talocalcaneal

A

just inferior to Talocrural

talus+calcaneus

34
Q

These 2 joints are crucial in transmitting rotational forces b/w foot (horizontal) and leg (vertical)

A

Talocrural

+

Subtalar (talocalcaneal)

35
Q

Initial Contact

Sagittal plane

Goal: proper pos. to begin stance w/ heel rocker

A
  • MTP== up to 25o EXT (DF)
  • Ankle== neutral
  • Knee== neutral
  • Hip== 20o flex
  • Pelvis== 5o ant. rot.
  • Trunk== neutral

Forward facilitation ==> Heel Rocker

36
Q

IC–> Loading Response

Sagittal Plane

  • Goal:
    • ​shock absorb
    • stable wt accept
    • preserve progression via heel rocker
A
  • MTP== 25ext—> neutral
  • Ankle== 0 –> 10 PF (eccentric DF)
  • Knee== 0–> 20 flex
  • Hip== 20 flex
  • Trunk== neutral
37
Q

LR—> Midstance

  • Goal:
    • ​progression from heel to ankle rocker
      • ​keeps COM over BOS
    • forward progress. of HAT
      • via hip and knee EXT
A
  • MTP== neutral
  • Ankle== 10 PF–> 5 DF
    • closed chain
    • tibia moving forward
  • Knee== 20 flex–> neutral
  • Hip== 20 flex–> neutral
  • Pelvis== moves to neutral
  • Trunk== neutral
38
Q

MST–> Terminal Stance

  • Goal:
    • ​progress of body past the forefoot rocker
    • contralat. limb catches forward fall
A
  • ​MTP== neutral–> 20 ext
  • Ankle== 5–> 10 DF
  • Knee== neutral
  • Hip== 0–> 20 EXT
  • Trunk== neutral
39
Q

TST–> Pre Swing

  • Goal:
    • ​pos. limb for swing (limb advance)

NOTE: despite “swing” preswing is STILL A STANCE SUBPHASE

A
  • MTP== 20–> 55 EXT
    • closed-chain
  • Ankle== 10 DF–> 20 PF
  • Knee== 0–> 40 flex
  • Hip== 20 ext–> neutral
  • Trunk== neutral
40
Q

Initial Swing:

  • Goals:
    • ​limb advance
    • Foot clearance
A
  • MTP== neutral
  • Ankle== 20–> 5 PF
    • leg shortening
  • Knee== 40–> 60 flex
    • leg shortening
  • Hip== 0–> 10 flex
    • leg shortening
  • Trunk== neutral
41
Q

ISW–> Mid Swing

  • Goals:
    • ​limb advance
    • foot clearance
A
  • MTP== neutral
  • Ankle== 5 PF–> neutral
  • Knee== 60–> 30 flex
    • make leg long again
  • Hip== 10–> 20 flex
    • make leg long again
  • Trunk== neutral
42
Q

MSW–> Terminal Swing

  • Goals:
    • ​fulfills limb advance needs for forward progress
    • preps limb for wt accept.
A
  • MTP== neutral–> 25 ext
  • Ankle== neutral
  • Knee== 30–> 0 flex (neutral)
  • Hip== maints 20 flex
  • Trunk== neutral
43
Q

Sagittal plane drives _______

44
Q

Initial Contact

Frontal plane

A

Subtalar=== inverted

Foot=== supinated

Knee=== neutral

Hip/pelvis=== neutral

Trunk=== neutral

45
Q

LR–> Midstance

Frontal Plane

A

Subtalar=== everted

Foot=== pronated

Knee=== neutral

Hip=== neutral–> 5 adduction

Pelvis=== elevated

Trunk=== neutral

46
Q

Terminal Stance

Frontal plane

A

Subtalar== neutral

Foot== neutral

Knee== neutral

Hip/Pelvis== neutral–> 5 Adduction

Trunk== neutral

47
Q

NOTE: Subtalar joint

Motion in Stance

A
  • motion in Stance allows foot to adapt to varied surfs.
  • Transfers tibial rotation to the foot in the form of inversion/eversion
48
Q

Subtalar joint

Eversion (Closed Chain)

A
  • JUST LIKE PRONATION
    • ​tibia medially rotates
    • talus add’s
    • calcaneus everts
    • usually causes knee flex
49
Q

Subtalar Joint

Inversion (Closed Chain)

A
  • Just like SUPINATION
    • ​tibia laterally rotates
    • talus ABD’s
    • calcaneus inverts
  • Usually causes Knee Extension
  • rigid foot
50
Q

Subtalar Joint

Eversion

A

mostly passive

unlocks midtarsal jt to allow flexible forefoot to adapt to contact surf.

after IC and peaks early Midstance

51
Q

Subtalar Joint

Inversion (forefoot rigid and locked)

A
  • begins TSw
  • Peaks first in IC
  • peaks again PSw
  • neutral in MSw
52
Q

Midtarsal or “arches”

A
  • Arch flattens
    • ​Midstance w/ pronation
  • Arch restored
    • ​as heel rises/PSw w/ supination
53
Q

LR–> Midstance

transverse plane

A

Femur== IR 5-7

tibia== IR 5-7

54
Q

Midstance–> Term stance

transverse plane

A

femur== ER to neutral

tibia== ER to neutral

55
Q

In stance, ______________ are acting to COUNTER the __________

A

Muscles Forces (internal moments) acting to COUNTER the GRF’s (external moments)

56
Q

IC–> Loading Response

Sag. plane mm control

A

Hip

Knee

Ankle

57
Q

LR–> Early Midstance

Sag. plane mm control

A

Hip

Knee

Ankle

58
Q

Early Midstance–> Late Midstance

A

Hip and Knee negligible

  • Ankle
    • ext moment== DF
    • Int moment (mm)== PFs
    • mm activity == Eccentric

**mostly momentum here**

59
Q

Terminal Stance

60
Q

Pre Swing

61
Q

Key Points for Swing Phase Muscular Control

A
  • NO EXT moments bc Open Chain
  • Primary role of mm’s of LE
    • control momentum of swinging limb
      • ​mostly eccentric
    • maintain clearance of foot
  • Magnitude of mm contract depends on gait speed
  • Secondary role of LE mm’s is to control limb in all planes and pos. properly for NEXT IC and WBing
62
Q

Initial Swing

63
Q

MidSwing

64
Q

Terminal Swing

65
Q

DF’s

A

Tib ant

EDL + peroneus

EHL

66
Q

Dorsiflexors

Biphasic

A
  • begins IC to LR
    • eccentric control of foot slapping down
  • peaks again PSw to MSw
    • concentric to clear foot
67
Q

DF’s

EHL

*mechanical advantage bc easier to contract FIRST

A
  • Initiates DF act. in PSw
68
Q

DF’s

Tib Ant

A
  • produces greatest amt of torque
69
Q

PF’s and control of Talocrural joint

A
  • Soleus + Gastroc == 93% PF torque
    • soleus first THEN gastroc @ end of LR
      • ​eccentric
    • ​rises thru Midstance
    • declines in PSw bc DFs want to pull UP foot so PFs relax
70
Q

Other PF’s

A

FHL, FDL, FL, FB, TP

*FHL prod’s most torque of these 5

71
Q

LR–> Midstance

Frontal Plane

A
  • Subtalar/foot
    • ext mom== PRO (subtalar eversion)
    • mm’s== TP, TA, FHL, FDL
    • Eccentric
  • Knee
    • ext mom== varus
    • mm’s== IT band
    • passive tension
  • Hip
    • ext mom== ADD.
    • mm’s==
    • eccentric
72
Q

Midstance–> Term Stance

A
  • Subtalar/Foot
    • ext mom== pro–> sup
    • mm’s== inverters
    • concentric
  • Knee
    • ext mom== varus
    • mm’s== IT band
    • passive tension
  • Hip
    • ext mom== add.
    • iso/eccentric
73
Q

Pronation w/ IR of Knee

74
Q

Supination w/ ER of Knee

75
Q

LR–> Term Stance

A
  • Tibia
    • mom== IR-ER
    • lat. HS, ACL controls IR
    • eccentric
  • Femur
    • mom==IR
    • Glute max, piriformis, hip ERs
    • eccentric
76
Q

Path of Center of Mass during Gait

A
  • Biphasic
  • IC–> LR
    • low and centered
  • MidStance
    • ​moves SUP and IPSILAT (stance foot)
  • CONTRALAT IC
    • ​drops
  • CONTRALAT MidStance
    • ​rises
77
Q

DECd gait speed=====

A

DECd arm swing

COMPS:ALL THINGS GAIT (6 decks)

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