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Prosthetics, Orthotics, and Gait > Normal Gait > Flashcards

Normal Gait Flashcards

1
Q

What phase makes up ~60% of the gait cycle?

A

Stance Phase

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2
Q

What phase makes up ~40% of the gait cycle?

A

Swing Phase

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3
Q

What 4 subphases make up Stance Phase?

A
  1. Initial Contact (IC)
  2. Loading Response (LR)
  3. Midstance (MSt)
  4. Terminal Stance (TSt)
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4
Q

What 4 subphases make up Swing Phase?

A
  1. Pre Swing (PSw)
  2. Initial Swing (ISw)
  3. Mid Swing (MSw)
  4. Terminal Swing (TSw)
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5
Q

What are the 3 functional tasks of gait?

A
  1. Weight Acceptance
  2. Single Limb Support
  3. Swing limb advancement
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6
Q

What subphases make up the functional task of Weight Acceptance? What are characteristics of this functional task?

A

IC and LR

forward progression, stability, shock absorption

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7
Q

What subphases make up the functional task of Single Limb Support? What are characteristics of this functional task?

A

MSt and TSt

Forward progression, stability

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8
Q

What subphases make up the functional task of Swing Limb Advancement? What are characteristics of this functional task?

A

PSw, ISw, MSw, TSw

Foot clearance, limb advancement

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9
Q

What are the 4 biomechanical subcomponents of gait?

moving away from an impairment-based model –> function-based approach for treating gait

A
  1. Stance Control
  2. Limb Advancement
  3. Propulsion
  4. Postural Stability
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10
Q

Which subcomponent does this describe:
“absence of vertical limb or trunk collapse during stance”?

A

Stance Control

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11
Q

Which subcomponent does this describe:
“adequate foot clearance and a positive step length bilaterally”?

A

Limb Advancement

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12
Q

Which subcomponent does this describe:
“ability to move center of mass in a specific direction (forward, backward, etc.) during stance, separate from limb advancement”?

A

Propulsion

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13
Q

Which subcomponent does this describe:
“maintaining upright in sagittal and frontal planes, keeping center of mass within base of support”?

A

Postural Stability

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14
Q

Which rockers are for deceleration

A
  • heel rocker
  • ankle rocker
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15
Q

Which rockers are for acceleration?

A
  • forefoot rocker
  • toe rocker
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16
Q

In Initial Contact, what position is the ankle in? What’s the muscle activity?

A

Neutral
* Muscle activity: isometric pre-tibials

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17
Q

In Initial contact, what is the knee doing? What’s the muscle activity?

A

5 degrees of flexion AKA “neutral soft knee”
* Muscle activity: quadriceps (preparation for LR)

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18
Q

In Initial Contact, what is the hip doing? What is the muscle activity?

A

20 degrees hip flexion
* GRF anterior to hip
* Muscle Activity: hip extensors to stabilize the thigh during LR

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19
Q

What is the critical event of Initial Contact?

A

Heel first contact

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20
Q

What is the ankle doing in Loading Response? What is the muscle activity? What rocker is here?

A

5 degrees PF
* Muscle activity: eccentric pre-tibials
* Heel rocker

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21
Q

What is the knee doing in LR? What is the muscle activity?

A

15 degrees flexion (from 5 degrees in IC)
* Muscle Activity: eccentric quadriceps

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22
Q

What is the hip doing in LR? What is the muscle activity?

A

20 degrees flexion (same as before)
* Muscle activity: hip extensors/abductors

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23
Q

What is the critical event in LR?

A
  • Hip stability
  • Controlled knee flexion
  • Ankle PF (heel rocker)
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24
Q

Where are GRF in LR compared to IC?

A

In IC, they are both anterior to knee and hip

In LR, GRF is anterior to hip, posterior to knee

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25
Q

What signals the beginning of MidStance?

A

Once we go from double leg support to single limb support = start of MSt

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26
Q

What is the ankle doing in Midstance? What is the muscle activity? What is the rocker here?

A

5 degrees DF (from 5 deg PF in LR)
* Muscle Activity: eccentric plantarflexors
* Ankle rocker

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27
Q

What is the knee doing in midstance? What is the muscle activity?

A

5 degrees flexion (from 15 degrees in LR)
* Muscle Activity: quads intially then off

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28
Q

What is the hip doing in midstance? What is the muscle activity?

A

Neutral (from 20 deg flexion in LR)
* Muscle activity: hip abductors

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29
Q

What is the critical event in Midstance?

A

Controlled tibial advancement

30
Q

What are the toes doing in terminal stance?

A

20-30 degrees extension

31
Q

What is the ankle doing in terminal stance? What is the muscle activity? What is the rocker?

A

10 degrees DF (from 5 deg DF in MSt)
* Muscle activity: eccentric PF
* Forefoot rocker

32
Q

What are the knees doing in TSt? What is the muscle activity?

A

5 degrees flexion (neutral)
* Muscle activity: NONE

33
Q

What are the hips doing in TSt? What is the muscle activity?

A

20 degrees extension (from neutral in MSt)
* Muscle Activity: NONE

34
Q

What signifies the end of Terminal Stance?

A

Opposite foot’s heel touches the ground

35
Q

What is the critical event of Terminal Stance?

A
  • Calf muscles control ankle DF allowing heel rise
  • Trailing limb
36
Q

In what phase could we see hip drop?

37
Q

When do we commonly see knee hyperextension thrust?

A

Loading Response
Midstance

38
Q

When do we see the highest torque demand on the ankle?

A

Terminal Stance

39
Q

What is the hallmark of Terminal Stance?

A

the upside down “V”

40
Q

What is happening at the toes in preswing? What is the rocker?

A

55-60 degrees extension (from 20-30 degrees in TSt)
* Toe rocker

41
Q

What is happening at the ankle in Preswing? What is the muscle activity?

A

15 degrees PF (from 10 degrees DF)
* muscle activity: NONE

42
Q

What is happening at the knee in Preswing? What is the muscle activity?

A

40 degrees flexion (from 5 degrees flexion)
* Muscle activity: NONE
* If no big V in TSt, then no KF in this phase

43
Q

What is happening at the hip in Preswing? What is the muscle activity?

A

10 degrees extension (from 20 degrees ext. in TSt)
* Muscle activity: adductors

44
Q

Is everything passive or active in Preswing?

45
Q

What is the critical event in Preswing?

A
  • Passive knee flexion
  • Ankle PF assists with passive knee flexion
46
Q

What is happening at the ankle in Initial Swing? What is the muscle activity?

A

5 degrees PF (From 15 deg PF in PSw)
* Muscle activity: pre-tibials concentrically

47
Q

What is happening at the knee in Initial Swing? What is the muscle activity?

A

60 degrees flexion (from 40 deg in PSw)
* Muscle activity: knee flexors

48
Q

What is happening at the hip in Initial Swing? What is the muscle activity?

A

15 degrees flexion (from 10 deg ext in PSw)
* Muscle activity: concentric hip flexors

49
Q

What is the critical event of Initial Swing?

A
  • Hip flexion 15 degrees
  • Knee flexion to 60 degrees
50
Q

What is happening at the ankles in Midswing? What is the muscle activity?

A

Neutral (from 5 deg PF)
* Muscle Activity: isometric pre-tibials

51
Q

What is happening at the knee in midswing? What is the muscle activity?

A

25 degrees flexion (from 60 deg in ISw)
* Muscle activity: silent then hamstring initiate to eccentrically decelerate the lower limb

52
Q

What is happening at the hip in midswing? What is the muscle activity?

A

25 degrees flexion (from 15 deg in ISw)
* Muscle activity: concentric hip flexors initially them hamstrings eccentrically

53
Q

What is the critical event in midswing?

A
  • Further hip flexion
  • DF to neutral
54
Q

What is happening at the ankles in Terminal Swing? What is the muscle activity?

A

Neutral
* Muscle activity: isometric pre-tibials

55
Q

What is happening at the knee in terminal swing? What is the muscle activity?

A

Neutral (5 degrees - from 25 degrees in MSw)
* Muscle activity: quadriceps concentrically; hamstrings eccentrically decelerate the lower limb

56
Q

What is happening at the hip in Terminal Swing? What is the muscle activity?

A

20 degrees flexion (from 25 deg in MSw)
* Muscle activity: hamstrings eccentrically decelerate the lower limb

57
Q

What is the critical event in Terminal Swing?

A

Knee extension

58
Q

What happens if there is no Knee extension in Terminal Swing?

A

Foot flat or knee bent in IC

59
Q

What are the 4 major causes of pathological gait?

A
  1. abnormal joint ROM
  2. impaired motor control
  3. impaired sensation
  4. pain
60
Q

In LR, if we don’t have the critical event of ankle PF, what might you see instead?

A
  • foot drop
  • forefoot contact
61
Q

If we don’t see the critical event of “calf muscles control ankle DF allowing heel rise” in Terminal Stance, what might we see?

A

short shuffle step / avoidance of TSt

62
Q

What gait phase requires 60 degrees of toe ext

63
Q

what gait phase has the critical event of a neutral ankle

64
Q

which gait phase has the critical event of passive knee flexion

65
Q

which gait phase has the critical event of Calf muscles controlling DF to allow heel rise + trailing limb

A

terminal stance

66
Q

which gait phase has the critical event of 60 degrees of knee flexion and 15 degrees of hip flexion

A

initial swing

67
Q

Which gait phase has the critical event of controlled tibial advancement

A

mid stance

68
Q

Which gait phases include eccentric control by the hamstrings

A

midswing

terminal swing

69
Q

which gait phase includes the critical event of: hip stability, controlled knee flexion, and PF control of the heel rocker

A

loading response

70
Q

What muscles assist with knee flexion during pre swing

71
Q

What gait phase do you see the big upside down V?

A

terminal stance

Prosthetics, Orthotics, and Gait (10 decks)

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