Lower Limb Walking and Gait Flashcards
What is locomotion?
The ability to move from one place to another.
What are the two phases of walking?
Stance phase - 60% of cycle, divided into: heel strike, support, and toe-off stages.
Swing phase - 40% of cycle, divided into: leg left, and swing stages.
What are the muscles involved in the heel-strike stage of walking?
Gluteus maximus - acts on the hip to decelerate the lower limb.
Quadriceps femoris - keeps the leg extended at the knee and hip.
Anterior compartment of the leg - maintains the ankle dorsiflexion, position the heel for the strike.
What are the muscles involved in the support stage of walking?
Quadriceps femoris - keeps the leg extended, accepting the weight of the body.
Foot inverter and everters - contract in a balanced manner to stabilise the foot.
Gluteus minimum, medius and tensor fascia lata - abduct the lower limb, keeping the pelvis level by counteracting the imbalance created by having most of the bodyweight on one leg.
What are the muscles involved in the toe-off stage of walking?
Hamstring muscles - extends the leg at the hip.
Quadriceps femoris - maintains the extended position of the knee.
Posterior compartment of the leg - plantarflexes the ankle. The prime movers include gastrocneus, soleus, and tibialis posterior.
What are the muscles involved in the leg-lift stage of walking?
Iliopsoas and rectus femoris - flexes the lower limb at the hip, driving the knee forward.
Hamstring muscles - flexes the lower limb at the knee joint.
Anterior compartment of the leg - dorsiflexes the ankle.
What are the muscles involved in the swing stage of walking?
Iliopsoas and rectus femoris - keep hip flexed, resisting gravity as it tries to pull the leg down.
Quadriceps femoris - extends the knee, positioning the foot for landing.
Anterior compartment of the leg - maintains ankle dorsiflexion so that the heel is in plane for landing.
What is Trendelenburg sign?
When the pelvis drops towards the side of the raised limb in leg lift and swing phases of walking.
What causes Trendelenburg sign?
Abductor muscles on the standing limb are weakened or paralysed from lesion of the superior gluteal nerve which innervates the abductors.
How does Trendelenburg sign present?
During walking, the pelvis drops on one side so the trunk lurches to the opposite side to maintain a steady pelvic level. In the next step, the trunk is pulled towards the centre very quickly - lurching.
What causes footdrop?
Damage to the common or deep fibular nerve. From blunt trauma or fracture of the head of the fibula.
What is the eversion flick and the reasoning for it?
If the deep fibular nerve is damaged, then the foot can’t be dorsiflexed. This means it drags during swing phase and the patient may evert the foot suddenly in eversion flick in that phase.
What is antalgic gait caused by?
Pain on weight-bearing.
What are the characteristics of antalgic gait?
Shortened stance phase, often with chronic musculoskeletal pain.
