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PT 632 Motor Control > Normal Gait Biomechanics and Gait Analysis > Flashcards

Normal Gait Biomechanics and Gait Analysis Flashcards

1
Q

what are the 3 requirements for successful human locomotion and what is the order in which they emerge

A

progression
postural control
adaptability

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2
Q

ability to generate a rhythmic stepping pattern to move the body forward, is present in limited form at birth and refined during 1st year of life

A

progression

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3
Q

ensures orientation and stability, emerges toward the end of the first year of life

A

postural control

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4
Q

ability to adapt gait to changing task and environmental requirements; refined in the first years of life after onset of locomotion

A

adaptability

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5
Q

when do rhythmic pattern generation of gait being

A

prenatally
(isolated head and arm movements at 9 months in embryo, alternating leg movements similar to walking develop in embryo by 16 weeks)

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6
Q

reciprocal kicking/turns head

A

1 month

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7
Q

may roll supine to prone, midline head

A

2-3 months

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8
Q

pivot prove, rocking in quadruped and push backwards, bears weight in standing

A

4-5 months

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9
Q

moves forward with arms with or without abdomen elevated, rolls, stands with assist

A

6-7 months

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10
Q

crawls, creeps, pulls to stand at support, walks with assist

A

8-9 months

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11
Q

sidesteps/cruises with external support, stands alone, walking with one hand held

A

10-11 months

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12
Q

independent walking with high guard and wide BOS, lowers self with control from standing, may move in/out out squat position

A

12 months

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13
Q

newborn stepping emerges from a reflex; reflex disappears when higher neural centers in the cortex inhibit spinal motor centers; erect independent walking occurs when equilibrium and postural reflexes emerge

A

hierarchical model

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14
Q

locomotion occurs as a result of interactions between developing sensory, motor, perceptual respiratory, cardiac and anatomic systems in infant; neonatal stepping pattern disappears because of changes in the weight of infant limbs in the first few months of life

A

dynamic systems model

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15
Q

what are some unique challenges to gait development in children

A
  • children are top heavy (head and trunk are large)
  • lack motor experience (inability to fractionate movement)
  • rapid physical growth requires ongoing adaptation
  • early walking experiences occur over a variety of locations and surfaces
  • motivation to walk varies
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16
Q

what are some key characteristics of early infant gait

A
  • higher ratio of hip/knee flexion to keep COG lower
  • no heel strike during initial loading response (flat footed)
  • wide BOS
  • arms held away from body (high guard)
  • erratic joint motions (variable step rates and step lengths, inconsistent timing of muscle actions)
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17
Q

what are the two processes for learning how to walk

A
  • control of balance
  • refinement of locomotor pattern
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18
Q

when does control of balance occur

A

3-6 months after onset of walking

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19
Q

period of double limb support time decreases gradually as postural control improves; step length increases as step width decreases (gait velocity increases)

A

control of balance

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20
Q

do we have more stability when walking faster or slower

A

faster

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21
Q

when does refinement of locomotor pattern occurs

A

over 5 years after onset of walking

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22
Q

decreased hip flexion, anterior pelvic tilt and hip abd/ER during swing occurs by age

A

2 yrs

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23
Q

when does reciprocal arm swing become present in 75% of kids

A

3 yrs

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24
Q

when does mature knee pattern from initial contact to terminal stance observed by

A

4 yrs

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25
Q

when is push off seen

A

2 yrs

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26
Q

at what age does most muscle and movement patterns look very similar to adult gait cycle

A

7 yrs

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27
Q

progression of stair climbing

A

(depends on opportunity/access to stairs)
starts quadruped –> ascend with greater control –> standing will do step-to stepping before reciprocal stepping

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28
Q

when does reciprocal stepping emerge

A

3 yrs

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29
Q

progression of more advanced running/hopping motions

A

run –> gallop –> hop –> skip

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30
Q

is often described as an exaggerated form of walking except for a brief flight phase in each steps

A

running

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31
Q

at what age does running develop

A

2 yrs

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32
Q

at what age do children begin to hop and gallop

A

age 4 (galloping precedes hopping)

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33
Q

requires asymmetrical gait with unusual timing and force production in each limb

A

galloping

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34
Q

requires one limb balance reactions and additional force to lift the body off the ground

A

hopping

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35
Q

requires increased coordination and is most difficult to reproduce

A

skipping

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36
Q

navigation over and around obstacles on different surfaces and while performing other tasks requires 2 strategies

A
  • reactive strategies
  • proactive strategies
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37
Q

integration of postural responses into the gait cycle; children initially respond to perturbations with both an automatic postural response and a monosynaptic stretch reflex

A

reactive strategies

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38
Q

stepping to recover balance beings to develop in infants within ______ of walking experience and is refined by ___ of walking experience

A

1-3 months
6 months

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39
Q

ability to use sensory information from the environment to modify gait patterns in advance of encountering obstacles to gait may not emerge until 3-4 y/o and continues to mature up to age 9

A

proactive strategies

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40
Q

children develop feedback control of balance before feedforward control

A
  • because you need experience for feedforward
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41
Q

until about age 6 children rely heavily on ______ from their feet and the support to modify gait pattern (bottom up control)

A

sensory cues

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42
Q

after age 7 children gain mastery control over the _____ in space and have increased vestibular and visual processing allowing for top-down control of gait

A

head position

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43
Q

balance between HS and quads is evident by age

A

2

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44
Q

swing phase activity of calf muscles disappears by age 2 resulting in unopposed activity of

A

anterior tibialis (heel strike pattern emerges)

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45
Q

_____ is directly proportional to walking speed at all ages

A

energy cost

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46
Q

children have a ____ energy expenditure during walking than teenagers and adults

A

higher

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47
Q

walking contributes to a child’s health by improving what

A

aerobic capacity, resting metabolic rate, body composition, fat metabolism

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48
Q

upright mobility increases what

A

bone mineral density

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49
Q

complex motor skill acquisition results in what; learning a complex motor skill results in what

A
  • neuroplasticity and dendritic aboritization
  • cortical organization and reorganization
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50
Q

independent mobility has impact on what aspects of development and what are examples

A

cognitive, perceptual, socioemotional
- visual attention to environment
- wariness of heights
- working memory
- object permanence
- transfer of information
- independent decision making

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51
Q

what are the phases of the gait cycle

A

initial contact, loading response, mid-stance, terminal stance, pre-swing, initial swing, mid swing, terminal swing

52
Q

single limb cycle consists of two main phases and what are they

A
  • stance phase: when the foot strikes the ground (60%)
  • swing phase: when the foot leaves the ground (40%)
53
Q

the last 10% of stance phases when both feet are touching the ground

A

double support

54
Q

what phases of the gait cycle compose the stance phase

A
  • initial contact
  • loading response
  • mid-stance
  • terminal stance (40%)
  • preswing
55
Q

the instant the foot contacts the ground (usually at heel)

A

initial contact (0-2%)

56
Q

the first interval of double limb stance when weight is transferred to the supporting limb

A

loading response (0-10%)

57
Q

the first half of single limb support is initiated by limb toe off; COM progresses dynamic stability over a plantigrade foot

A

mid-stance (10-30%)

58
Q

the second half os SLS; COM progresses anterior to the ankle joint axis towards the metatarsal axis; heel rise normally occurs

A

terminal stance (30-50%)

59
Q

the second interval of double limb support when the support limb is unloaded in preparation for swing and weight is transferred to the other limb (the other limb is in initial contact)

A

pre-swing (50-60%)

60
Q

what phases make up the swing phase and what type of support are they

A

single limb support
- initial swing
- mid-swing
- terminal swing

61
Q

foot is lifted off the support surface and begins to advance forward; the contact limb is in the first 1/2 of midstance

A

initial swing (60-73%)

62
Q

midpoint of the phase, minimal toe clearance is achieved, tibia reaches vertical; the contact limb is in late midstance and early terminal stance

A

mid-swing (73-87%)

63
Q

final part of the phase, foot continues to advance forward in preparation for initial contact

A

terminal swing (87-100%)

64
Q

how much clearance do we need to clear the toes during initial swing

A

2 cm

65
Q

how much DF do we need for initial contact

A

5 deg

66
Q

stabilizes the limb for weight acceptance and shock absorption and generates propulsive forces for continued motion

A

stance phase

67
Q

reposition the limb to continue forward progression and clears the toes

A

swing phase

68
Q

force exerted on body by surface being walked on

A

ground reaction force (GRF)

69
Q

every action has an equal and opposite reaction

A

newton’s 3rd law

70
Q

where is the GRF during initial contact and what muscles are firing

A

posterior to ankle, anterior to knee and hip
- hip: hip extensors working eccentrically to resist flexion, erector spinae eccentrically to resist trunk flexion
- knee: quad femoris eccentric to control knee flexion and prevent buckling
- ankle: DF eccentrically to slow PF (foot slap)

71
Q

where is the GRF during loading response and what muscles are firing

A

posterior to ankle and knee, anterior to hip
- hip: hip extensors concentrically to extend hip, erector spinae resist flexion
- knee: after flat foot, quad fire concentrically to bring femur over tibia
- ankle: decrease DF; tib post, FHL, FDL fire eccentrically to control pronation

72
Q

where is the GRF during midstance and what muscles are firing

A

anterior to ankle, moves posterior to anterior on knee, move anterior to posterior on hip
- hip: iliopsoas fires eccentrically to resist extension, glut med contracts to stabilize opposite hip
- knee: quad activity reduced, gastroc eccentrically to control excessive knee ext
- ankle: PF (GS and peroneal) fire eccentrically to control DF of tibia over fixed foot and control pronation

73
Q

where is the GRF during terminal stance and what muscles are firing

A

anterior to ankle, anterior ot knee, posterior to hip
- hip: none
- knee: gastroc starts to fire concentrically to start knee flexion
- ankle: PF start to fire concentrically to prepare push off

74
Q

where is the GRF during pre-swing and what muscles are firing

A

anterior to ankle, posterior to knee and hip
- hip: adductor longus, rectus femoris, iliopsoas
- knee: quads eccentrically
- ankle: PF/elastic recoil/concentric of PF

75
Q

how much knee flexion is needed during gait

A

60 deg

76
Q

where is the GRF during initial and mid-swing and what muscles are firing

A

no GRF bc foot not on ground
- hip: add longus to initiate hip flexion in pre-swing, rectus femoris later in pre-swing to flex hip while limiting knee flexion; iliacus and sartorius fire during initial swing and mid-swing; LHBF and SM late in mid-swing to decelerate limb
- knee: rectus femoris to decelerate knee flexion
- ankle: DF fire to clear toes

77
Q

where is the GRF during terminal swing and what muscles are firing

A

no GRF
- hip: hip extensors to decelerate leg and prepare initial contact
- knee: vastii muscles fire in preparation for initial contact and counteract HS activity
- ankle: DF

78
Q

ROM needed at hip during gait

A
  • flex: 25 deg
  • ext: 15 deg
  • some rotation and add/abd required
79
Q

ROM needed at knee during gait

A
  • ext: full 0 deg
  • flex: 60 deg (initial swing)
80
Q

ROM needed at ankle during gait

A
  • PF: 15 deg (preswing)
  • DF: 10 deg (terminal stance); 5 deg to clear toes during swing phase
81
Q

ROM needed at foot during gait

A
  • great toe ext: 50 deg
82
Q

at ankle/foot: initial contact made with forefoot

A

forefoot contact

83
Q

at ankle/foot: initial contact made with forefoot and hindfoot

A

flatfoot contact

84
Q

at ankle/foot: rapid PF after initial contact (heel strike); makes audible

A

foot slap

85
Q

at ankle/foot: excessive inversion of calcaneous or forefoot in any phase

A

excessive inversion/pes cavus

86
Q

at ankle/foot: excessive eversion of calcaneous or forefoot in any phase

A

excessive eversion/pes planus

87
Q

at ankle/foot: inadequate 1st MTP ext in pre-swing

A

inadequate MTP ext

88
Q

at ankle/foot: with or without hammer toes

A

excess IP flexion (clawed toes)

89
Q

at ankle/foot: foot contact with ground during swing phase

A

toe drag

90
Q

at ankle/foot: excess ankle PF of stance limb to help advance swing limb

A

contralateral vault

91
Q

at knee: less than normal extension

A

inadequate extension/crouched gait

92
Q

at knee: less than normal flexion

A

inadequate flexion/stiff legged gait

93
Q

at knee: extension beyond neutral

A

hyperextension/back knee

94
Q

at knee: rapid movement toward extension (not controlled)

A

extensor thrust

95
Q

at knee: repeated alternating flex/ext (lack of control)

A

wobble

96
Q

at knee: adduction of distal tibia relative to femur

A

varus/bow-legged

97
Q

at knee: abduction of distal tibia relative to femur

A

valgus (knock-knee)

98
Q

at hip: inadequate extension in stance phase

A

inadequate extension/crouched gait

99
Q

at hip: less than normal flexion for phase

A

inadequate flexion

100
Q

at hip: more than normal flexion in swing phase

A

excess flexion/steppage gait

101
Q

at hip: position of femur with excessive rotation

A

medial/lateral rotation

102
Q

at hip: abduction of femur beyond neutral

A

abduction

103
Q

at hip: adduction of femur beyond neutral

A

adduction/scissoring gait

104
Q

at hip: thigh abduction and flexion followed by adduction during swing phase

A

circumduction

105
Q

at pelvis: >5deg drop of iliac crest of swing limb during stance on reference limb

A

contralateral drop/trendelenberg gait

106
Q

at pelvis: elevation of iliac crest of reference limb above neutral during swing phase

A

hike

107
Q

at pelvis: >5deg backward rotation during terminal stance and may continue t/o phases

A

excessive backward rotation/retracted pelvis

108
Q

at pelvis: >5deg forward rotation during mid and terminal swing

A

excess forward rotation/protracted pelvis

109
Q

at pelvis: any excessive tilt

A

excess ant/post tilt (apt/ppt)

110
Q

lateral displacement of the pelvis occurs with each step forming a

A

sinusoidal curve

111
Q

____ shoulder flexion occurs with ipsilateral terminal stance with ipsilateral pelvis rotated backward

A

maximal

112
Q

as walking speed _____, total shoulder movement and arc of pelvis rotation increases

A

increases

113
Q

use the natural shape of the ankle/foot bones to create momentum and smooth movement, it improve efficiency as energy is supplied by momentum

A

ankle-foot rockers

114
Q

at initial contact when calcaneous contacts the surface; the loading response brings the tibia as forward as the knee flexes; the heel lever caused ankle PF 5 deg

A

heel rocker

115
Q

during midstance the tibia rotates forward along the talocrural axis causing 5deg DF; the tibia progresses over the talus moving the GRF anterior to the ankle

A

ankle rocker

116
Q

occurs in terminal stance when heel lifts off support surface and mid/hindfoot rotate about the extending MTP joints; ankle DF increases to 10 deg as tibia advances; also called roll off since PFs eccentrically control DF

A

forefoot rocker

117
Q

during pre-swing, 1st ray extends 50 deg, ankle PF to 15deg, knee flexes to 40deg to prepare for swing

A

toe rocker

118
Q

_______ of the achilles tendon follows eccentric contraction of PFs, this causes the achilles tendon 15 deg of PT as the limb is rapidly unloaded

A

elastic recoil

119
Q

the number of steps taken during a specific time (steps/min) and what is the norms

A

cadence
M: 108 steps/min
F: 118 steps/min

120
Q

walking speed =

A

stride length x 1/2 cadence

121
Q

linear distance between 2 successive events on the same limb (initial contact) and what are the norms

A

stride length
M: 1.51 m
F: 1.32 m

122
Q

stride length =

A

walking speed / 1/2 cadence

123
Q

the linear distance between 2 successive events on opposite limbs and what is the norm

A

step length
.71m

124
Q

the horizontal distance between 2 points on opposite limbs and what is the norm

A

step width
7-10 cm

125
Q

the minimal linear distance from the hallux to the floor during swing phase and what is the norm

A

toe clearance
1.28 cm

126
Q

the distance traverses over a specific time period (m/s or m/min) and what are norms

A

gait speed
M: 82m/min or 1.37 m/sec
F: 78m/min or 1.30 m/sec

127
Q

gait speed =

A

distance / time

PT 632 Motor Control (9 decks)

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