Musculoskeletal System - Gait

Question 1

What are the ROM requirements for normal gait (at the hip, knee and ankle)?

Answer 1

• Hip: 10-0-30
• Knee: 0-60
• Ankle: 10-0-20

Question 2

Compare standard vs Rancho Los Amigos terminology. For example, Heel strike : Initial contact.

Answer 2

Heel Strike : Initial Contact
Foot Flat : Loading Response
Midstance : Midstance
Heel Off : Terminal Stance
Toe Off : Pre-Swing
Acceleration : Initial Swing
Midswing : Midswing
Deceleration : Terminal Swing

Question 3

Average cadence during gait?

Answer 3

110-120 steps per minute

Question 4

Degree of toe-out during gait?

Answer 4

7*

Question 5

Amount of pelvic rotation during gait?

Answer 5

8* (4 fwd, 4 back)

Question 6

Average step length and stride length during gait?

Answer 6

28* and 56*, respectively

Question 7

List the biomechanics at the PELVIS during normal full gait cycle.

Answer 7

Initial Swing: Backward rotation 4-5*
Midswing: Neutral rotation
Terminal Swing: Forward rotation 4-5*
Initial Contact: Forward rotation 4-5*
Loading Response: Less forward rotation
Midstance: Neutral rotation
Terminal Stance: Backward rotation 4-5*
Pre-Swing: Backward rotation 4-5*

Question 8

List the biomechanics at the HIP during normal full gait cycle.

Answer 8

Initial Swing: Flexion 20*
Midswing: Flexion 20-30*
Terminal Swing: Flexion 30*
Initial Contact: Flexion 30*
Loading Response: Flexion 30*
Midstance: Extending to neutral
Terminal Stance: Apparent hyperextension 10*
Pre-Swing: Neutral extension

Question 9

List the biomechanics at the KNEE during normal full gait cycle.

Answer 9

Initial Swing: Flexion 60*
Midswing: Flexion 60-30*
Terminal Swing: Extension to 0*
Initial Contact: Full extension
Loading Response: Flexion 15*
Midstance: Extending to neutral
Terminal Stance: Full extension
Pre-Swing: Flexion 35*

Question 10

List the biomechanics at the ANKLE during normal full gait cycle.

Answer 10

Initial Swing: PF 10*
Midswing: Neutral
Terminal Swing: Neutral
Initial Contact: Neutral heel first
Loading Response: PF 15*
Midstance: PF to 10* DF
Terminal Stance: Neutral with tibia stable and heel off prior to initial contact opposite foot
Pre-Swing: PF 20*

Question 11

Describe an antalgic gait pattern.

Answer 11

• Stance time decreased

- Rapid and shorter swing phase of uninvolved limb

Question 12

Describe an ataxic gait pattern

Answer 12

• Staggering and unsteadiness
• Wide BOS
• Movements exaggerated

Question 13

Describe a cerebellar gait pattern.

Answer 13

• Staggering gait pattern seen in cerebellar disease

Question 14

Describe a circumduction gait pattern.

Answer 14

• Circular motion to advance the leg during swing phase

- Used to compensate for lack of hip or knee flexion or dorsiflexion

Question 15

Describe a double step gait pattern.

Answer 15

• Alternate steps are of a different length or at a different rate

Question 16

Describe an equine gait pattern.

Answer 16

• High steps; usually involves excess gastrocnemius activity.

Question 17

Describe a festinating gait pattern.

Answer 17

• Patient walks on toes as though pushed. Starts slowly, increases, and may continue until the patient grasps an object in order to stop.

Question 18

Describe a hemiplegic gait pattern.

Answer 18

• Patients abduct the paralyzed limb, swing it around, and bring it forward so the foot comes to the ground in front of them.

Question 19

Describe a Parkinsonian gait pattern.

Answer 19

• Increased forward flexion of the trunk and knees; gait is shuffling with quick, small, festinating steps.

Question 20

Describe a scissoring gait pattern.

Answer 20

• Legs cross midline upon advancement.

Question 21

Describe a spastic gait pattern.

Answer 21

• Stiff movement, toes seeming to catch and drag, legs held together, and hip and knee joints slightly flexed.

Question 22

Describe a steppage gait pattern.

Answer 22

• Feet and toes are lifted through hip and knee flexion to excessive heights; usually 2* to DF weakness. The foot will slap at initial contact with ground 2* to decreased control.

Question 23

Describe a tabetic gait pattern.

Answer 23

• A high stepping ataxic gait pattern in which the feet slap the ground.

Question 24

Describe a trandelenberg gait pattern.

Answer 24

• A gait pattern that denotes gluteus mediums weakness; excessive lateral trunk flexion and weight shifting on the stance leg.

Question 25

Describe a vaulting gait pattern.

Answer 25

• Swing leg advances by compensating through the combination of elevation of the pelvis and plantarflexion of the stance leg.