lecture 25: anatomy of gait II (abnormal) Flashcards
understnd slide 5 about the motions forces and muscles patterss
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another name for heel strike
initial contact
another name for loading response
foot flat
antoher name for terminal stance
heel off
another name for preswing
toe off
what is the definition of abnormal or atypical gaits
deviations from the kinematic patterns of a normal gait cycle
true or false: abnormal gaits can only be permanent and explain
false, can be temporary (injury) or permanent (eg: palsy, amputation)
are abnormal gaits unilateral, bilateral
can be eithre
abnormal gaits may affect what two things
1) timing of gait cycling eevents and/r
2) movement of limb segments /trunk
what are the 3 causes/types of abnormal gaits
1) muscle weakness
2) joint range of motion issues due to underlying factors (contractures, fusion, arthritis)
3) neurological disorders (parkinsons, hemiplegia)
what is the challange with gluteal maximus gait
weak/paralyzed glute maxius (ie: injury to inferior gluteal n) cant prevent (control) hip flexor torque at inittial contact/loading response, causing hip to buckle into flexion
weak/paralyzed glute maxius is due to what
injury to inferior gluteal n
what would a weak/paralyzed glute maxius (ie: injury to inferior gluteal n) do in terms of walking (glute max gait)
cant prevent (control) hip flexor torque at inittial contact/loading response, causing hip to buckle into flexion
weak/paralyzed glute maxius (ie: injury to inferior gluteal n) cant prevent (control) hip flexor torque at inittial contact/loading response, causing hip to do what
buckle into flexion
weak/paralyzed glute maxius (ie: injury to inferior gluteal n) cant prevent (control) what, causing hip to do what
hip flexor torque at inittial contact/loading response
what is the function of glute max in walking
glute max helps extend hip at the end of swing and controls hip flexion due to ground reaction force/toque at initial contact
glute max helps extend hip at the end of swing and controls hip flexion due what
to ground reaction force/toque at initial contact
what is the compensation of the gluteus maximus gait
quickly shift the trunk posteriorly, which moves GRF line of action posterior to hip joint, reducing or eliminated hip flexion torque due to GRF
what does quickly shifting the trunk posteriorly, do
which moves GRF line of action posterior to hip joint, reducing or eliminated hip flexion torque due to GRF
by quickly shifting the trunk posteriorly, which moves GRF line of action posterior to hip joint,what does this do
reducing or eliminated hip flexion torque due to GRF
be able to recognize picture of gluteus maximus gait
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what do hip abductors control during gait
contralateral drop of the pelvis (pelvis tilt) during single support in stance
what is the challenge of muscle weakness/paralysis in the hip abductors
weak/paralyzed gluteus meduis, minimus or TFL prevents smooth control of pelvis tilt, leading to an abnormal amount of drop (due to trunk weight)
weak/paralyzed gluteus meduis, minimus or TFL prevents what
smooth control of pelvis tilt, leading to an abnormal amount of drop (due to trunk weight)
weak/paralyzed gluteus meduis, minimus or TFL prevents smooth control of pelvis tilt, leading to what
an abnormal amount of drop (due to trunk weight)
weaknesess of what muscles leads to tredenlenburg gait
glute med, min or TFL
what is the compensation for a weak/paralyzied hip abductors
shift the trunk over the stance leg to reduce the tprque created by the trunk during single support
in compensation for weak/paralyzed hip abductors we shift the trunk over the stance leg to do what
reduce the torque created by the trunk during single support
explain tredelenburg gait
noticeable lateral shift of trunk over stance leg and excessive pelvic drop, indicative of weakness in hip abduction
noticeable lateral shift of trunk over stance leg and excessive pelvic drop are indicative of what
indicative of weakness in hip abduction
be able to recognize tredelenburg gait
knee extensors (vastus group) cotrol what
control knee flexion during loading response (due to GRF being psoterior to knee creating a flexion force)
why do knee extensors (vastus group) control knee flexion during loading response (
due to GRF being psoterior to knee creating a flexion force)
what is the challange with quadriceps gait/paralyzed quads
weak/paralyzed quadricepts (ie: injury/compression of femoral nerve under injuinal ligmanet) prevents smooth control of knee flexion during the loading repsonse, leading to knee buckling
weak/paralyzed quadricepts is due to what
ie: injury/compression of femoral nerve under injuinal ligmanet)
weak/paralyzed quadricepts (ie: injury/compression of femoral nerve under injuinal ligmanet) prevents what
smooth control of knee flexion during the loading repsonse, leading to knee buckling
weak/paralyzed quadricepts (ie: injury/compression of femoral nerve under injuinal ligmanet) prevents smooth control of knee flexion during the loading repsonse, leading to. what
to knee buckling
what is the compensation for for the quadriceps gait
rapidly shift the trunk forward over the stance leg (lurch), shifting GRF into an extension torque, and/or physically push on knee to lock into extension
rapidly shifting the trunk forward over the stance leg (lurch), does what
shifting GRF into an extension torque, and/or physically push on knee to lock into extension
what is the challange of having weak/paralyzed dorsiflexors
weak/paralyzed dorsiflexors (eg: injury/compression of common fibular n, compartment syndrom) prevents smooth control of plantar flexion during the loading response, leading to foot slap and increases risk of tripping during swing due to drop foot
what are some explanations for weak/paralyzed dorsiflexors
(eg: injury/compression of common fibular n, compartment syndrom)
weak/paralyzed (eg: injury/compression of common fibular n, compartment syndrom) prevents what
smooth control of plantar flexion during the loading response, leading to foot slap and increases risk of tripping during swing due to drop foot
weak/paralyzed dorsiflexors (eg: injury/compression of common fibular n, compartment syndrom) prevents smooth control of plantar flexion during the loading response, leading to what
foot slap and increases risk of tripping during swing due to drop foot
what is the 2 functions of ankle dorsiflexors during gait
control plantarflexion in the initial contact/;loading response of the stance
help clear foot/toes from ground throughout swing
what is the compensation for weak or paralyzed ankle dorsiflexors
1) exagerrate knee and hip flexion in early swing phase to clear ground (steppage gait)
2) shift to striking ground with midfoot or forefoot to avoid foot slap (equinus fait)
explain steppage gait and be able to recognize it
exagerrate knee and hip flexion in early swing phase to clear ground
explain equinus gait and be able to recognize it
shift to striking ground with midfoot or forefoor to avoid foot slap
hamstrings (knee flexors) usually help in what phase and how
in swing phase (clearing ground and swinging limb) but also “check activity ofthe knee extensors during the loading response)
hamstrings (knee flexors) usually help in what phase and how
in swing phase (clearing ground and swinging limb) but also “check activity ofthe knee extensors during the loading response)
what is the challagne with weak hamstrings
weak hamstring will be unable to balance the activity of the knee extensors, leading to rapid locking of the knee into extension (genu recurvatum)
weak hamstring will be unable to do what
balance the activity of the knee extensors, leading to rapid locking of the knee into extension (genu recurvatum)
weak hamstring will be unable to balance the activity of the knee extensors, leading to what
rapid locking of the knee into extension (genu recurvatum)
what is rapid locking of the knee into extension called
genu recurvatum
what is genu recurvatum
rapid locking of the knee into extension called
what is genu recurvatum
wrapid locking of the knee into extension called
what is the compensation for weak hamstrings in gait
none
what is the only gait that has no compensation
gait with genurecurvatum due to weak hamstrings
what are joint contractures
limitations to the normal range of motion of a joint due to stiffening/shortening of soft tissues around it (tendon, muscle, joint capsule)
what is joint contractures due to
due to stiffening/shortening of soft tissues around it (tendon, muscle, joint capsule)
when do hip and or knee flexion contratures occur
when the tightness or stiffness of a joint prevents full extension of those joints
hip and/or knee flexion contractures will manifest how
mafinest as crouched gait, typically with shorter step length for the unaffeted side because the affect side cannot complete a fully extended arc
hip and or knee flexion contracture will manifest as what gait
crouched gait
hip/knee flexion contractures will mafinest as crouched gait, typically with shorter step length for the unaffeted side
why
because the affect side cannot complete a fully extended arc
in joint fusion, what happens to joint surfaces
joint surfaces calcify and fuse, preventing any motion at the joint
in joint fusion, joint surfaces calcify and fuse, preventing
any motion at the joint
what are some examples of how joint fusions can be patholigical
ankylosing spondylitis, heterotopic bone formation
what are the 2 ways to get joint fusions
pathological
surgery performed to alleivate pain related to arthritis=arthrodesis
what is arthrodesis
Arthrodesis refers to the fusion of two or more bones in a joint
to alleviate pain related to arthristus
explain hip fusion
the flexion/extension role normally played by the hip in walking is replaced by a dynamic change in lumbar lordosis and pelvic tilt
in hip fusion, the flexion/extension role normally played by the hip in walking is replaced by what
by a dynamic change in lumbar lordosis and pelvic tilt
explain the by a dynamic change in lumbar lordosis and pelvic tilt in hip fusion
decreased lordosis and poserior pelvic tilt at loading phase
increased lordosis and anterior pelvic tilt at terminal stance
there there increased/decreased lordosis and poserior/anterior pelvic tilt at loading phase
decreased
posterior
is there increased/decreased lordosis and /posterior anterior pelvic tilt at terminal stance
increased
anterior
is there increased/decreased lordosis and /posterior anterior pelvic tilt at terminal stance
increased
anterior
explain knee fusion
clearing foot in swing phase becomes challenging, leading to vaulting gait or circumduction gait
in knee fusion what becomes difficult and what does that lead to
clearing foot in swing phase becomes challenging, leading to vaulting gait or circumduction gait
knee fusion leads to what two f=gaits
vaulting gait
circumduction gait
true or false: vaulting gait or circumduction gait are only appearnt in knee fusion
false, may also be apprent in knee extension contractures
what is vaulting gait
Vaulting gait is a compensatory strategy where someone will rise up on their toe (plantar flex) in order to swing the leg through without it hitting the floor
what is circumduction gait
To compensate, the patient abducts her thigh and swings her leg in a semi-circle to attain adequate clearance of the ground
