Normal Gait Flashcards
What phases of gait are double limb stance?
IC, LR, PSw
In initial contact, what position are the following joints in:
Ankle, subtalar, knee, and hip
Ankle - 0 degrees PF/DF
Subtalar - pronation
Knee - 5 degrees flexion
Hip - 30 degrees flexion, 10 degrees adduction
In loading response, what position are the following joints in:
Ankle, subtalar, knee, and hip
Ankle - neutral to 5-10* PF
Subtalar - pronation
Knee - flexion to 15* (IR of tibia)
Hip - starts extending, 15* adduction
In midstance, what position are the following joints in:
Ankle, subtalar, knee, and hip
Ankle - 5-10* PF to 5* DF
Subtalar - moves into supination
Knee - Flexion to 20, then extends to 12
Hip - Still extending, relative abduction occurs when going back to neutral
In terminal stance, what position are the following joints in:
Ankle, subtalar, knee, and hip
Ankle - 5* DF to 10 DF (max DF)
Subtalar - supination
Knee - continue to full extension and then back to 5-10* flex
Hip - Extends to 10 degrees (max ext)
In preswing, what position are the following joints in:
Ankle, knee, and hip
Ankle - Rapid PF to 10-20*
Knee - flexion to 40*
Hip - goes from extension to neutral, starts flexion (peak ER)
In initial swing, what position are the following joints in:
Ankle, knee, and hip
Ankle - starts DFing to 5* PF
Knee - Flexion to 60* (max)
Hip - continued flexing
In midswing what position are the following joints in:
Ankle and knee
Ankle - neutral
knee - extending
In terminal swing, what position are the following joints in:
Ankle, knee, and hip
Ankle - Neutral
Knee - full extension at end of phase
Hip - up to 30* flexion
What phases are single limb stance?
Mst, Tst, Isw, Msw, Tsw
What starts initial contact?
heel touches floor
When does LR begin and end?
Begins with IC
Ends when opposite foot comes off ground
When does midstance begin and end?
Begins when other foot is lifted
Ends when body weight is over the forefoot
When does Tst begin and end?
Begins with heel rise
Ends when at double limb stance
When does Psw begin and end?
Begins with contralateral IC
Ends with toe off
When does Isw begin and end?
Begins with lifting foot off the floor
Ends when swing foot is opposite the stance foot
When does Msw begin and end?
Begins when the swinging limb is opposite the stance limb
Ends when the tibia is vertical
When does Tsw begin and end?
Begins when the tibia is vertical
Ends when the foot strikes the floor
In what phase of gait does the pelvis, femur and tibia internally rotate?
IR begins at Psw, continues through swing and LR
-switches back to ER at end of Mst
In what phase of gait does the pelvis, femur and tibia begin to ER as subtalar joint is supinating?
starts at the end of Mst and continues through Tst
- IR starts at Psw
What is the average cadence?
110 steps/ min in men
115 steps/ min in women
What is the average foot angle?
5-7* of toe out
What is the average velocity?
- 1 mpg or
1. 27 m/s
What is the average step and stride distance? step width?
Step = .75 m stride = 1.5 m width = 8 cm
What percentage of the gait cycle is stance? swing?
Stance = 60% Swing = 40%
If the body vector falls posterior to the hip, which way will it be pushed?
into extension
If the body vector falls posterior to the knee, which way will it be pushed?
into flexion
If the body vector falls anterior to the ankle, which way will it be pushed into?
into DF
What phase has the most torque based on lever arm distance?
Terminal stance
- where gastroc works most to hold us back
What is the moment when the GRF is lateral to the hip? Does this occur during single or double limb stance?
- Valgus force/ abduction moment
- single limb stance
What is the moment when the GRF is medial to the hip? Does this occur during single or double limb stance?
- Varus force/ adduction moment
- double limb stance
What phases does the heel rocker aid in motion?
IC/ LR
What phases does the ankle rocker aid in motion?
midstance
What phases does the forefoot rocker aid in motion?
terminal stance
What phase of gait is the fatiguing phase of gait and has the highest EMG activity?
LR
- most amount of falls occur during this gait
What is the primary load bearers for each of the following phases of gait:
LR, Mst, Tst, Psw
LR - heel
Mts - heel and MT heads
Tst - forefoot (MT heads)
Psw - large toe
What phase of gait is peak ER achieved? when is peak IR achieved?
Peak IR = end of LR
Peak ER = end of Psw
Which way is the pelvis tilted during double limb support? single limb?
Double = posterior pelvic tilt Single = Anterior pelvic tilt
What phase of gait do the PF work to their greatest amount of EMG activity?
Terminal stance
- 80% MMT, switches to concentreic
What muscle decelerates pronation in early stance and then concentrically supinates the food at Mst?
Tib post
- this m can raise ML arc, supinate foot and ER tib simultaneously
What muscle counteracts the inverters of the foot an depresses the first metatarsal head for proper toe off?
Fibularis longus
Where is the body vector during Mst, and Tst in terms of the knee?
moves anteriorly during Mst and is ant during Tst
During Tsw, the hamstrings are active. What are they doing?
Contracting eccentrically (most m torque produced) to decelerate and prevent excessive knee extension - very active during speed work
What phases is glut max on?
IC, LR, and Tsw
What muscles are active at the knee during IC/LR?
- Quads(eccentric) and hamstrings still active from Tsw
2. TFL eccentrically contracts to counteract IR of tibia and ADDuction (various) torque
What muscles are active at the ankle during IC/LR?
DF, eccentrically to stop foot slap
What muscles are active at the hip during LR?
- Hip extensors are all active (hamstrings, add mag, and glut max)
- Glut med fires when unsupported side of pelvis drops
- IR decelerated by the glut max
What muscles are active at the ankle during Mst?
PF minimally (25% MMT) eccentrically to control tibia from ant translation over foot
What muscles are active at the knee during Mst?
- Quads active until BV moves ant
- ITB concentrically provides lateral stability
- Soleus lightens the load on quads by restraining tibia (prevets ant translation of tibia, allows for better knee ext)
What muscles are active at the hip during Mst?
BV moves posteriorly; glut med still working, TFL helps
What muscles are active at the ankle during Tst?
PF (to 80% MMT), switches to concentric
- BV far away from BOS
What muscles are active at the knee during Tst?
- 3 extensor forces on the knee:
- Strong soles activity
- BV anterior
- ITB
(counteracting these forces are popliteus and gastro - unlocks knee then start to see hamstring activity) - End of Tst knee starts to flex
- tibial stability is lost
- gastro and popliteus keeps firing
What muscles are active at the hip during Tst?
TFL continues to supply abductor force
What muscles are active at the ankle during Psw?
Decrease in PF activity
What muscles are active at the knee during Psw?
- no more foot stability and knee rolls forward
1. gastroc and popliteus still active
2. Rectus femoris (active for hip flexion and keeps knee from flexing too far)
What muscles are active at the hip during Psw?
rectus femoris concentrically
What muscles are active at the ankle during Isw?
DF active to 25% MMT
What muscles are active at the knee during Isw?
- knee flexes further from rapid hip flexion momentum
1. short head of biceps femurs causes further knee flexion
2. sartorius and gracilis help knee flexion
3. eccentric rectus to check flexion
What muscles are active at the hip during Isw?
Active gracilis and sartorius
- momentum also helping
What muscles are active at the ankle during Msw?
DF to 40% concentric, then switches to isomentric
What muscles are active at the knee during Msw?
none, passive extension
What muscles are active at the ankle during Tsw?
DF still firing
What muscles are active at the knee during Tsw?
- Quads activate to lift tibia and foot
2. hamstrings activate eccentrically to decelerate and prevent excessive knee ext
What muscles are active at the hip during Tsw?
- hamstrings concentrically contract to stop leg
- Glut max and adductor mag also fire
- Glut med activates at end of the phase
When is the erector spinae m’s active?
Just after heel contact and Psw (corresponding with heel contact of opposite limb)
- controls the forward angular momentum of the trunk relative to the hips
When is the rectus abdominis active?
when the hip flexors are actively flexing the hip
- stabilizes the pelvis and lumbar spine for a stable fixation point for the hip flexor muscles
What is the primary fxn of the rectus femoris?
- active during transition to swing phase
- initiate hip flexion and control knee flexion
When is tib ant active?
- Heel contact - eccentric activation controls passive PF and pronation of foot (weakness = foot slap)
- Swing phase - concentric activation to clear foot (weakness = drop foot)
When are the PF m’s active during stance?
- NOT active during IC/LR - PF occurs passively
- Eccentric control during midstance
- major burst of concentric activity during Tst and shuts off at toe off
- soleus = primary PF, gastroc active at Isw (produces a knee flexion force if active during stance)
When is tib post active?
- Eccentrically during 5-35% of gait (LR to midstance) to decelerate pronation
- Concentrically at 35-55% of gait (end of Mst to Psw) to supinate foot
The posteriorly directed GRF at __[gait phase]__ momentarily [speeds up/ slows down] the forward progression of the body. Conversely, the body momentarily [speeds up/ slows down] the forward progression of the body at __[gait phase]__ as a result of an anteriorly directed GRF.
heel contact; slows down
speeds up; toe off
- note: braking from contra limb occurs during double limb support which is balanced buy the toe off of the ipsi limb
- speeding up or slowing down requires greater breaking force or propulsive force, respectively
During stance, an internal abduction torque at the knee counters the ______ torque created by the GRF.
Adduction (varus) torque
- created by GRF passing medial to the knee
