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Year 3: Prosthetics and Orthotics > Lecture 1: Gait > Flashcards

Lecture 1: Gait Flashcards

1
Q

traditional vs nachos terminology for all stages of gait

A

traditional = rancho

heel strike = initial contact
foot flat = loading response
midstance = midstance
heel off = terminal stance
toe off = pre swing
acceleration = initial swing
midswing = midswing
deceleration = terminal swing

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2
Q

% of gait cycle in stance vs swing

A

stance = 60%
swing = 40%

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3
Q

temporal spatial variables of gait

A

velocity = rate of linear fwd motion (m/sec)

cadence = # steps per unit time (steps/min)

stride length = heel strike to ipsilateral heel strike

step length = heel strike to contralateral heel strike

step width = width of base of support

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4
Q

kinematic variables of gait

A

sagittal plane = flx/ext

frontal plane = ABD/ADD

trans plane = RT

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5
Q

kenetic variables of gait

A

forces = vertical, fore-aft, medial-lateral

moments, powers

center of pressure

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6
Q

external forces of gait

A

produce external torque/moment

i.e. ground reaction forces, gravity, air, resistance, friction

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7
Q

internal forces of gait

A

produces internal moment/torque

usually in response to external torque created by GRF

can control or generate movement

possible contributions from ligaments, joint capsules, mm, or bony structures

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8
Q

newton’s 1st law

A

every object in a state of uniform motion tends to remain in that state of motion unless an external force is applied

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9
Q

newtons 3rd law

A

for every action there is an equal and opposite reaction

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10
Q

components of GRF

A

vertical
anterior-posterior
medial-lateral

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11
Q

describe the vertical component of GRFs

A

2 peaks: 110% body weight

  • F1 = at weight acceptance, due to action of body momentum
  • F3 = at terminal stance, caused by push of ankle PFs against floor in combo with the downward acceleration of COG

1 valley: 80% body weight

  • F2 = at midstance, created by rise of COG

faster walking speeds created higher peaks and lower valleys

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12
Q

define moment/torque

A

potential for a force acting a distance from the axis of RT to produce RT of segment

Units = N x m or kg x m

Torque = Force x moment arm

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13
Q

functional tasks of stance phase

A

weight acceptance
single limb support
fwd progression

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14
Q

functional tasks of swing

A

swing limb advancement
foot clearance

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15
Q

objectives of initial contact

A

start of 1st rocker (heel rocker)
impact deceleration

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16
Q

objectives of loading response

A

shock absorption
weight bearing stability
preservation of progression
foot flat achieved

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17
Q

ankle during IC

A

held in neutral by pre tibial mm

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18
Q

knee during IC

A

full extension (5 deg flexion)
provide stability

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19
Q

hip during IC

A

peak flexion (20 deg)

positioned for optimal fwd progression and stability

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20
Q

critical event of IC

A

heel contact

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21
Q

what kind of moment is present at each joint of the LE during IC

A

hip = flexion

knee = extension

ankle = PF

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22
Q

muscle activity at hip, knee, and foot at IC

A

hip = HS and glutes for hip stability

knee = quads for knee stability

foot = pre-tibial to counterbalance PF moment

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23
Q

what is happening at the ankle during loading response

A

pre tibial mm eccentrically control PF (5 deg PF)

subtalar eversion

heel (1st) rocker

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24
Q

what is happening at the knee during loading response

A

20 deg flex for shock absorption

quads active to control knee flexion moment

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25
Q

what is happening at the hip during loading response

A

maintained in flexion (20 deg)
hip extensors active to stabilize

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26
Q

moments of the LE at loading response

A

hip = flexion

knee = flexion

ankle = PF

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27
Q

mm activity at hip, knee, and ankle during loading response

A

hip = HS and glutes for hip stability

knee = quads to counterbalance flexion moment

ankle = pre-tibial to counterbalance PF; calf for stance stability

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28
Q

objectives of midstance

A

progression over stationary foot
limb and trun stability

29
Q

terminal stance objectives

A

progression of body beyond supporting foot

trunk and limb stability

30
Q

what is happening at the ankle during midstance

A

DF controlled eccentrically by gastric and soleus (CRITICAL EVENT)

ankle (2nd) rocker

31
Q

what is happening at the knee during midstance

A

extension

32
Q

what is happening at the hip during midstance

A

neutral

33
Q

external moments of the joints of the LEs during midstance

A

hip = extension

knee = extension

ankle = DF

34
Q

mm activity at the hip, knee, and ankle during midstance

A

hip = none

knee = quads for stance stability

ankle = calf for stance stability and to counterbalance DF moment

35
Q

what is happening at the ankle during terminal stance

A

noted by heel rise (trailing limb = critical event!)

forefoot (3rd) rocker

decline in gastric/soleus mm activity

36
Q

what is happening at the knee during terminal stance

A

full ext to max step length

37
Q

what is happening at the hip during terminal stance

A

20 deg apparent hyperext for max step length

38
Q

external moments of the LE during terminal stance

A

hip = ext

knee = ext

Ankle = DF

39
Q

mm activity of hip, knee, and ankle during terminal stance

A

hip = none

knee = none

ankle = calf to counterbalance DF moment

40
Q

pre-swing objective

A

position of limb for swing

accelerated progression

41
Q

initial swing objective

A

foot clearance

advancement of limb from trailing limb position

42
Q

midswing objective

A

limb advancement

foot clearance

43
Q

terminal swing objective

A

complete limb advancement

prepare limb for stance

44
Q

what is happening at the ankle during pre swing

A

2nd arc of PF (15 deg)

toe rocker

no gastroc/soleus activity

45
Q

what is happening at the knee during pre swing

A

passive knee flexion (CRITICAL EVENT)

prepares limb for toe clearance

46
Q

what is happening at the hip during pre swing

A

10 deg apparent hyper extension

47
Q

external moments of the LE during pre swing

A

hip = ext

knee = flx

ankle = DF

48
Q

mm activity of hip, knee, ankle during pre swing

A

hip = hip flexors to counterbalance extensor moment and initiate swing

knee. = no mm activity

ankle = calf to counterbalance DF moment (early) and pretrials for foot clearance (late)

49
Q

what is happening at the ankle during initial swing

A

nearly neutral

50
Q

what is happening at the knee during initial swing

A

peak flexion (60 deg) for toe clearance - CRITICAL EVENT

peak mm activity of biceps femoris SH, sartorius, and gracilis

51
Q

what is happening at the hip during initial swing

A

15 deg flexion - CRITICAL EVENT

peak mm activity of gracilis and sartorius

52
Q

what is happening at the ankle during midswing

A

neutral to slight DF - CRITICAL EVENT

53
Q

what is happening at the knee during midswing

A

passive extension caused by momentum of hip flexion

54
Q

what is happening at the hip during midswing

A

peak flexion 25 deg

55
Q

what is happening at the ankle during terminal swing

A

at natural to prepare for heel strike

56
Q

what is happening at the knee during terminal swing

A

extension to neutral (5 deg flex) - CRITICAL EVENT

ext controlled eccentrically by HS

quads turn on in late terminal swing to prepare for weight bearing

57
Q

what is happening at the hip during terminal swing

A

subtle retraction to 20 deg of flexion

58
Q

pelvis motion in sagittal plane during gait

A

netral pelvis = 10 deg anterior tilt

slight increase in ant pelvic tilt during terminal stance and terminal swing

59
Q

pelvis motion in frontal plane during gait

A

during WA, 4 deg contralateral pelvic drop

during pre-swing 4 deg ipsilateral pelvic drop

60
Q

pelvis motion in transverse plane during gait

A

max pelvic protraction (4 deg) during terminal swing and IC

max pelvic retraction (4 deg) during terminal stance

netral RT at midswing and midstance

61
Q

trunk movement during gait

A

avg vertical displacement = 4.2 cm

avg lateral displacement = 4.5 cm to R and L

multifidus acts B during IC

low level of rectus abdominis and external obliques

62
Q

describe UE movement during Gait

A

arms provide counterforce to oppose excessive RT of body

peak flexion (shoulder = 8 deg) during contralateral IC - passive movement

peak ext (shoulder = 24 deg) during ipsilateral IC- posterior deltoid and teres major

arm swing range (increased ext) increased with increasing walking velocity

63
Q

critical joint angles/timing for the ankle

A

neutral ankle during swing

20 deg DF in terminal stance

64
Q

critical joint angles/timing for the knee

A

60 deg flexion in initial swing

20 deg flexion in loading response

0 deg in initial contact and midstance

65
Q

critical joint angles/timing for the hip

A

25 deg flexion in midswing

20 deg extension in terminal stance

66
Q

critical mm activity at ankle during gait

A

anterior tib during loading response (eccentric)

anterior tip during swing (concentric)

gastroc during stance (eccentric); turns off in preswing

67
Q

critical mm activity at knee during gait

A

no HS or quad mm activity during midswing

quads active during stance to control knee flexion moment

68
Q

critical mm activity at hip during gait

A

hip flexors during swing (concentric)

hip abductors active during single limb support to prevent hip drop

69
Q
A

Year 3: Prosthetics and Orthotics (10 decks)

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