MSK 12 - Gait

Question 1

What is “Gait”?

What are the 5 attributes of a “normal” gait?

Answer 1

• The mechanism by which the body is transported using co-ordinated movements of the major lower limb joints.

1) Stability in stance
2) Foot clearance in swing
3) Pre-positioning for initial impact
4) Adequate step length
5) Energy conservation

Question 2

What is a gait cycle?

What does the gait cycle consist of?

Answer 2

• A gait cycle is the period of time from initial contact to the next initial contact on the SAME side.
• 60% stance phase (foot is on the floor)
• 40% swing phase (when the foot is leaving/off the ground)

Question 3

What is the double support phase during the gait cycle?

How does this phase change during running?

Answer 3

• The small period of time where both legs are in stance phase (feet touching the floor)
• Becomes the double float phase (foot feet of the floor), as swing phase becomes longer than stance phase.

Question 4

Define:

• Stride
• Step
• Cadence

In relation to the gait cycle.

Answer 4

Stride = distance from initial contact (IC) right to IC right
Step = Distance from IC right to IC left 
Cadence = Number of steps per minute

Question 5

What are the 3 ways in which muscles work?

Answer 5

1) Concentric (shortening) - for acceleration
2) Eccentric (lengthening) - for deceleration
3) Isometric (same length) - for stability

Question 6

Which muscles are used during the phases of normal gait?

Answer 6

During IC = Anterior compartment muscles (tibialis anterior)

When foot leaving floor = Posterior compartment muscles (gastrocnemius + soleus)

Question 7

What features are associated with antalgic gait?

What features are associated with trendelenburg gait?

Answer 7

• A limp, painful leg, short stance phase on affected leg, short swing phase on unaffected leg. Use walking stick in opposite hand.
• Hip abductor weakness, pelvis drops on unaffected side and torso swings to affected side, looks like waddling.

Question 8

When does a hemiplegic gait occur + what is seen?

What do diplegic gaits occur + what is seen?

Answer 8

• After hemi-brain injury, e.g.: stroke. See flexed upper limb, extended lower limb + circumduction on unaffected leg, swinging around the straight leg.
• In neuromuscular disorders such as cerebral palsy. See ankles plantarflexed and scissoring of legs. Forefoot makes initial contact.

Question 9

What features are seen in high steppage, parkinsons + ataxic gait?

Answer 9

High steppage = foot drop, toes hanging down and excessive hip flexion on affected side. Due to sciatica or palsy

Parkinsons = A short step, shuffling kind of movement with no arm swing.

Ataxic gait = Arms balancing them, moving side to side in “drunk” fashion.