Normal and Abnormal Gait Flashcards
Pros/cons of visual gait analysis
-simplest form of analysis BUT -no permanent records -unable to perform on high speed movements -limited to movements we can see -depends on skills of observer -only "moderately reliable"
Full gait assessment includes
links gait abnormalities to other information about the patient
Video recording
30-60 up to 120 frames/sec
- provides permanent record
- helps view high speed movements
- limits # walks a patient has to complete
- able to show to patient
- helps teaching gait analysis to someone else
Camera position
- A/P and lateral views
- 4 to 5 meters from patient
- whole body and then zoom in from waist down
Max co-contract bw hamstrings and quads occurs at what degree knee flexion?
30 degrees
Pronation consists of…
DF in sagittal plane
Eversion in frontal plane
Abduction in transverse plane
Supination consists of…
PF in sagittal plane
Inversion in frontal plane
Adduction in transverse plane
Planes/axes review
Sagittal- M/L
Frontal- A/P
Transverse - vertical
Movement of the foot in loading response
- lands in supination and rolls to pronation (provides shock absorption)
Gait cycle in walking: stance. vs. swing
Stance - 60%
Swing - 40%
1 second to complete entire gait cycle
Stance Phase
60%
- initial contact/loading response
- midstance/opp toe off
- terminal stance/heel rise
- pre-swing/opp initial contact
Swing Phase
40%
- toe off/initial swing
- feet adjacent/mid swing
- tibia vertical/terminal swing
Step vs. Stride length
Step length is from (R) initial contact to (L) initial contact
Stride length is from (R) initial contact to (R) initial contact
Cadence
- Temporal
- # of footfalls in a given time period
- normal: 90-130 steps/minute
Stride Length
- Spatial
- normal: 1.1 to 1.7 meters
Speed
- Spatial-temporal
- rate of forward progression
- normal: 0.9-1.7 m/s
Base of Support
- spatial
- space between feet
- normal: 4 inches
Hip ROM during gait
- max flexion in late swing and initial contact (25 degrees)
- extends during most of stance (20 degrees)
- flexes from late stance to late swing
Knee ROM during gait
- full extension at initial contact (0 degrees)
- flexes then extends in stance (shock absorption)
- full extension in late stance
- flexes then extends in swing
Amount of knee flexion required for normal swing phase
40-50 degrees
Ankle ROM during gait
- neutral at initial contact
- PF during loading response (10 degrees)
- DF as stance progresses (10 degrees)
- PF during pre-swing (25 degrees)
- neutral in early swing
Toe extension required for normal gait
60-70 degrees
Glut max EMG muscle activation
- contracts end swing through stance
- concentric at initial contact
- concentric at opposite toe off
Iliopsoas EMG muscle activation
- contracts late stance into swing
- concentric
Quad EMG muscle activation
- contracts end stance and beginning of swing, then again in end swing to stance
- eccentric during loading response
HS EMG muscle activation
- contracts in late swing and early stance
- mostly eccentric to slow the knee down during stance
Triceps surae EMG muscle activation
- contracts during stance
- initially eccentric to slow everything down, then concentric for push off
Tib anterior EMG muscle activation
- all swing and early/late stance
- eccentric during initial contact/stance, concentric during swing
Ground reaction forces
Behind the ankle: plantarflexion
Behind the knee: flexion
Behind the hip: extension
Common trunk gait abnormalities
- lateral trunk bend (hip and/or knee patho)
- anterior trunk bend (knee patho)
- posterior trunk bend (glut max weak/hip patho)
Common hip gait abnormalities
- limb length inequality resulting in:
- circumduction
- hip hike
- steppage
- vaulting
Common knee gait abnormalities
- excessive knee extension (weak quads)
- excessive knee flexion (quads weak/knee patho)
Common ankle gait abnormalities
- inadequate DF
- inadequate push off
Lateral trunk bending
- Trendelenburg
- trunk moves sideways over supporting leg
- decreases trunk’s lever arm
- decreases moment generated
- abductors don’t have to generate such a high moment
Anterior trunk bend
- brings line of force in front of knee at initial contact
- compensates for weak knee extensors
Posterior trunk bend
- brings line of force behind hip joint at initial contat
- compensates for weak hip extensors
