Ms2 Flashcards
Heel strike
0-11%
Heel strike and foot flat
IC and LR
Midstance
12-40
Push off
40-60%
Heel off and toe off
TS and PS
Acceleration
60-75%
Mid swing
75-85
Deceleration
85-100
Normal cadence
110-116 steps/min
Normal speed
1.23-1.37 m/sec
Normal stride length
1.27-1-48m
Normal step width
1-5”
Normal Toe out
7
Ankle movement
5 inv, 5 ev and 15 inv
Minimal rom for gait
Hip 20 flx and 20 ext
Knee 0-60
Ankle pf 25 and df 7
Gait initiation from erect standing
- inhibition of gastroc followed by activation of ant tib bilaterally inclines body forward
- COP shifts from swing foot to stance foot
- Glut med accepts weight on stance limb
Termination of gait
- stance limb reduces push off w hip ext, knee ext and ant tib
- swing limb brakes at IC w soleus, quads and erector spinae
Sinusoidal pattern in Sagittal plane
Up and down (4-5cm) low at IC high at MS
Head stability
Postural righting
Head stability
Gait UE ROM
Shoulder 30
- 6 flx, 24 ext
Elbow 20-45
Stairs gait
Stance-up and forward Swing Vertical work ^^^ Quad work ^^^^ Knee torque 3x in accent and descent Head motion ^^^
Running gait
Swing, stance and float phase
ROM INCREASE FOR ALL FLEXION
Baby gait
11-15 mos
Research in baby motor dev: McGraw
Phases and transitional patterns (neuromaturational)
5 task of gait
Support hat Maintain posture and balance Control foot trajectory Generate mechanical energy Absorption of mechanical energy
Robert Halverson
Used descriptive analysis and divided a pattern into its component parts (physical development)
Adolph
Stresses the role of peripheral, biome gal factors and the role of experience .
Walking hands held
8-10 mos
Initial phase of gait
3-6 mos after walking onset
Control balance
Gait 2nd phase
3-5 years
Locomotor pattern is refined
Gait maturation
22 wks after ind walking
Heel strike and reciprocal arm swing
Baby gait
70 stance
30 swing
1st days of walking
No push off stage Step width is wide Arms in high guard Propels by leaning forward at trunk Very short swing phase
Toddler
Ind ambulation but not mature
Inconsistency
Increase in walking speed
Decrease in cadence (bigger steps)
1st year walking
Increased step freq Absent arm swing Flexed knee in stance Ankle plantar flexion Increased hip flexion Decreased limb stance
2 year old
Pelvic tilt, abd and ext rot are decreased
Knee-flexion wave occurs
Heel strike is present at 18mos
Ankle df in swing
Reciprocal arm swing begins (matures at 4yo)
End of 2nd year push off
3 yo gait
Reciprocal arm swing in 90% Lordosis with ant pelvic tilt May have knee hyper ext Hip ext Increased sls, step length, and stride length Genu valgun present
4-6
Balance and posture disequilibrium
Normal propulsion
6 yo heel to toe gait
7 yo
Mature
COM slightly higher
Heel position is neutral
Motor milestone
Head control Rolling Sit Creep Walk Run Gallop Hop Skip
Fast walk
18-19 mos
Early running stages
2 yo
Limited hip ext (up to 3yo)
Flatfoot
Arms in middle guard
Advanced stage running
Peaks at
14-15 females
17 boys
Galloping
4yo 43%
6.5yo most all are proficient
Hopping
4yo 33%
6.5yo proficient
Skipping
4yo 14% can skip
Young old
65-74
Older old
75-84
Oldest old
_>85
Abnormal gait
Temp or spatial changes beyond expectations Asymmetries Inability to change speed or direction Inability to dual task Postural sway with external support
Level of ind
FIM
ability to perform instrumental ADL
Quality
Gait analysis
Dynamic gait index
Berg balance scale
Endurance
Community >2000
6 min or 400 m
Accelerometer/pedometer
Efficiency
Gait speed
Tug
Short physical performance battery SPPB
SPPB
Balance, speed, chair stand ups
0-12
Spatial
Step length
Stride length ~1.2
BOS
Meaningful change .25cm or .1” for step length
Temporal
Gait speed ~1m/s (3.28'/sec) MDC small .05 lrg .1 Cadence ~105 steps/min Decrease swing/increase dls Swing .4 sec/ stance .8 sec MDC .01 sec Dls ~25%
Household distance
150’
Community distance
> 300’
Independent
1.24m/s
Sedentary
1.1
Disability
.75
Increase fall risk
.7
Increase mortality
.6m/s
Recurrent falls
.55m/s
Hospital
.35 m/s