L23_The Anatomy of Gait Flashcards
Tell me the phases of gait cycle and the subcategories of each
STANCE PHASE (60%)
- Double support :
- Initial contact (IC) -> heel strike
- Loading response (LR)
- Single support:
- Mild stance (MST)
- Terminal stance (TST)
- Double support:
- Pre-swing (PSW) -> toe off
SWING PHASE (40%)
- Single support:
- Initial swing (ISW)
- Mid swing (MSW)
- Terminal swing (TSW) -> heel strike
What are the major muscle groups involved in the stance phase?
(heelstrike + footflat)
Dorsiflexors:
- Prepare foot for heel strike
Knee Extensors:
- Extends the leg to prepare for heel strike
- Extends the leg to accept/support the body weight in single stance
Hip Extensors:
- Recruitment gluteus maximus and hamstrings (3) to slow down the forward movement of swing limb to prepare for heel-strike (decelerators) -> counteract the hip flexors
Plantarflexors:
- Lowers the foot to the ground after heel strike
What are the major muscle groups involved in the stance phase?
(Midstance, Pushoff)
Hip Extensors:
- Recruitment of gluteus maximus & hamstrings (3) to extend hip into mid-stance and continue to push-off
Plantarflexors:
- Allows for push-off to assist in propelling the body forward
Hip abductors (Gluteus medius, minimus and tensor fascia lata)
- Involved in contralateral pelvic abduction keeping pelvis level during opposite swing phase.
- > to keep the pelvis stable (no dropping)
What are the major muscle groups involved in the swing phase?
Knee flexors:
- Hamstring recruited to lift the swinging leg
Accelerators = Hip Flexors:
- Iliopsoas etc… raises swinging lower limb
- Assists in accelerating the limb into the swing phase
Dorsiflexors:
- Lifts the foot to clear the floor and prepare for heel strike during deceleration
Knee Extensors:
- Extends the leg to prepare for heel strike
Decelerators = Hip Extensors:
- Recruitment of extensors: gluteus maximus and hamstring
Explain pes planus gait
- Difficulties with toe-off causing joint and back pain.
- Flat feet
- over pronated feet
- pronated foot positioning
- wiggle of the foot at toe-off
Explain pes cavus gait
- Difficulties with toe-off causing joint and back pain
- too high arch
- over supinated foot
- supinated foot positioning
- toes go off to the side at toe-off
Describe the Trendelenburg gait
- Pelvic Drop occurs during mid-stance - contralateral to the side of muscle weakness or nerve injury.
- Injury to the superior gluteal nerve affecting abductors of the thigh or weakness in gluteus medius and /or minimus
Describe the gluteus maxius gait
- Backward lurching of the trunk at heel strike
- Weak gluteus maximus muscle or injury to inferior gluteal nerve
Describe the quadriceps femoris gait
- Forward lurching at beginning of stance phase (loading response)
- Helps to shift the center of gravity forward to
Describe genu recurvatum
- hyperextended knees
- hyperextension of the knee while standing
- snapping of the knee into hyperextended position at heel strike and into mid-stance
Causes:
- skeletal deformity
- ligament laxity
- weakness in either hamstring or quadriceps, or gluteal muscles
- more common in children and in females
More prone to ACL injuries
Describe vaulting gait
- Vaulting is associated with limb-length discrepancy or a stiff leg
- Weak hip flexors or knee flexors - Mechanisms to assist in lifting the limb during swing phase
Describe the circumduction gait
- Patients with a circumduction gait are unable to achieve adequate clearance for the foot to move through the swing phase on the affected side.
- the patient abducts her thigh and swings her leg in a semi-circle to attain adequate clearance.
- difficulty with hip flexion, knee flexion, or ankle dorsiflexion.
Describe slap foot gait
- weakness in the foot/ankle dorsiflexors, rapid plantar flexion at heel strike leads to loud “slap” sound of the foot
Describe steppage gait
- paralysis or dorsiflexors, over flexion of the hip or knee to avoid dragging toes on the ground
