Lecture 57 - Gait Assessment Flashcards
What are the 4 purposes of a gait assessment
What is the difference between a step and a stride?
Step: Each time a leg goes forward
Stride: When one of each left foot and right foot occur in succession
T or F: We are in stance more than swing because we have 2 legs increasing our stance time
T
What is indicated by the purple band in the figure
It indicates dual contact time, which occurs 10% of the time, that is responsible for providing more stability and is a critical weight shift
Step length vs stride length
What are 5 spatial and temporal gait parameters
What is the division of the gait cycle
Gait Kinematics
Describes movement patterns without regard for the forces involved in producing the movement (based on observational gait analysis = qualitative)
Describe the gait kinematics of the ankle
Describe the gait kinematics of the knee
Describe the gait kinematics of the hip
Describe the gait kinematics of the pelvis
When extending, the hip pelvis is going to rotate and swing forward which drops the pelvis
Describe the gait kinematics of the upper extremities
Arm goes behind the leg that is swinging forward and vice versa
Is it important to check arm kinematics during a gait analysis
Yes, there should be critical periods of shoulder extension and elbow flexion during gait cycle
What are the 3 main muscle groups involved in gait
What are the actions of eccentric and concentric contraction of the ankle, hip and knee joint during the gait cycle
NOTE: Red circle indicates eccentric contraction while the rest of the black lines are concentric
-Every muscle group has dead zones and breaks and doesn’t load the entire time
-Each muscle group works in different patterns (eccentric vs concentric)
-Muscles work eccentrically not to just push off but to provide control
-Need all muscles of the chain to work or else they will cause overcompensation and problems in other areas
Describe the contractility of the ankle during gait
-During plantar flexion they work eccentrically initially and move into concentric to push off
-There is a dead zone in between PF and DF where momentum carries us through into swing phase
Describe the contractility of the knee during gait
-Quadricep is eccentric to prevent collapsing of the knee during extension and then at end of gait the quad works concentrically to bring the leg to the ground at terminal swing
-Flexion would be using hamstring
Describe the contractility of the hip during gait
-Hip works eccentrically for loading to prevent a loss of pelvic alignment (would tip too forward)
-Pre-swing phase we need concentric contraction (hip flexor like iliopsoas and rectus femoris) to clear the ground and bring leg forward
-Then work eccentrically to prevent overcompensation and swinging too far to maintain a neutral pelvis
Quiet Standing
Ability to stand still which is a preliminary requirement for walking
Is the BOS changing in quiet standing?
No it is not changing so the center of gravity should fall within the BOS, if not = gait problems
NOTE: Base of support is checkered circle
Is the BOS changing during walking?
Yes BOS is continually changing and so is the contact surface of the foot. The COG never makes it quite over the BOS so walking is a series of falling and catching because our COG is caught before going outside the BOS to maintain stability
Is propulsion needed to allow progression of the body forward?
Yes
What are the 3 determinants of progression (propulsion)
- Action of “foot rockers” -> foot behaves like a pivot system
- Forward fall of body weight
- Generation of propulsive forces
What are the joints concentric muscle action during the gait cycle and when does it occur (to create propulsive forces to continue gait)
What is observational gait analysis (OGA)
A qualitative visual description of an individuals upper and lower extremities, pelvis, and trunk motion during ambulation
What are the 2 stages of OGA
What 4 things should you include in an OGA
What are 4 common quantitative clinical gait measures and what do they measure
Describe the 10-m walk test including how to perform it, equipment required, settings, outcomes, and limitations
Limiting factor:
-Distance is too far to implement in many clinics
-Only about speed not quality
Describe the 4-meter walk test and its benefits
Benefit: Better for smaller environments
What are the normative values for a 4-meter walk test
NOTE: Normative value ONLY tells you if you hit the speed or not
Describe the 6-minute walk test in terms of its equipment used, configuration, outcome, limitations, and its recommendations
Describe the 2-minute walk test in terms of its equipment, configuration and outcomes
Describe the Timed Up and Go Test in terms of equipment used, configuration, outcomes, and limitations
Note: Tells us about mobility/stability = fall risk
Describe the dual task gait testing
What are the the 2 theoretical frameworks of dual-task gait analysis
What are the 2 types of secondary tasks for dual-task gait testing
What are 5 types of cognitive secondary tasks and describe them
What are a few things to keep in mind when picking cognitive secondary tasks
What are the 5 steps to include in notes for a dual-task gait test
What are normative values for dual-task testing
Describe the velocity calculation for dual-task gait testing and what it means
Compare gait comparison of normal individuals and those with early dementia in terms of a single task and dual-task gait testing
What is task prioritization and can it be linked to an increase fall risk
Should dual task testing be used to evaluate falls risks
No, it should only be used to evaluate the role of cognition in gait for a specific individual
