normal gait pt 2 Flashcards
what are the minimal range requirements for gait ..
hip extension
hip flexion
knee
ankle PF
ankle DF
hip extension- 20°
hip flexion - 30°
knee - 0 to 60°
ankle PF- 20°
ankle DF- 10°
define forces applied to the foot by the ground during stance phase
ground reaction forces
what moment is created by gravity, inertia, GRF; in relation to joint center
external
power generation is accomplished with muscles ___
shortening (concentric contraction ) PUSH
power absorption is accomplished by muscles ____
lengthening (eccentric contraction) CUSH
where is the COP during IC
posterior lateral heel
when is the COP during the loading response
thru lateral midfoot
when is the COP during the terminal stance
medially across ball of foot as heel lifts
when is the COP during pre swing
1st and 2nd toes
• Inertia
• Gravity
• GRF
these are examples of what kind of forces
external
what counteract external forces
internal forces
so during IC what are the 3 moments happens
hip extensor moments (bc leg going into hip flexion)
knee flexion moment (bc knee going into extension)
DF moments (bc foot going into PF)
what are the moments during LR at the hip knee and ankle
hip extensor moments
knee extensor moment
ankle DF moment
what are the moments during mid stance at the hip , knee and ankle
hip flexor moments
knee flexor moment
PF moment
what are the moments during terminal stance at the hip , knee, ankle and toes
hip flexor moment
knee flexor moment
PF flexor moment
toes flexor moment
what are the moments during pre swing at the hip , knee, ankle and toes
hip flexor moments
knee extensor moment
PF flexor moment
toe flexor moment
what are the internal moments during initial contact
hip extensions , knee flexion and ankle DF
what are the internal moments during LR
hip extension, knee extension and ankle df
what are the internal moments during mid stance
Hip FLX, Knee FLX, Ankle PF
what are the internal moments during terminal stance
Hip FLX, Knee FLX, Ankle PF
what are the internal moments during pre swing
Hip FLX, Knee EXT, Ankle PF
how does the GRF move during IC (from ankle to knee to hip)
posteior , anterior , anterior
how does the GRF move during loading response (form ankle to knee to hip)
post, post , ant
how does the GRF move during mid stance (form ankle to knee to hip)
ant , ant , post
how does the GRF move during terminal stance to prevent swing (form ankle to knee to hip
ant , ant , pos
how does the GRF move during initial swing (form ankle to knee to hip
ant , post , post
what is the O2 consumption of walking for 20-32 years olds as compares to 75 year olds or with chronic medical conditions
32%
48%
what happens are the calcaneal during initial contact to loading response with a fulcrum at the heel
calcaneal inversion to calcaneal eversion
where is the fulcrum during loading response to terminal stance
ankle
during terminal stance the left rotates over what ? and there is an increased MTP ____
forefoot
extension
during pre swing the left rotates over what ? and there is a an increased toe ___
toes
extension
there is a slight trunk ___ during IC
flexion
there is a slight trunk ___ during single leg stance
extension
head, arm and trunks acceleration is counteracted by what
hip and back extensors
adductors moment of HAT is counteracted by what
hip abductors to minize movement at the stance leg
what is the pelvic and trunk motion in the sagittal plane
sinusoidal pattern up and down
4-5 cm with each step
how is the pelvis during IC and at midstnace
low at IC and high during mid stance
what is the pelvic and trunk motion in the frontal plane during gait
pelvic side to side motion of 4-5 cm and 5° drop of pelvis and trunk leans 5 cm
what is the pelvic and trunk motion during gait in the transverse plane
pelvic rotation 4-8* with opposite trunk rotation in relation to reference leg
ex. if you step with the right leg the pelvic rotates 4-8 to the left and left UE rotates to the right
how much does the contralateral arm swing during gait ( if you step with the right how much does the left arm swing forward) what about the ipsilaterla side
6°
swings back 24°
when is the pelvis the lowest and highest during stance
low. IC
high - mid stance
when mm have Two periods of activation coinciding with each Initial Contact (heel strike) and
at Pre Swing (toe off).
erector spinae mm
define dynamic process of re-alignment when changing postures
postural righting
define process of maintaining an equilibrium orientation of the head-in-space
head stability
what is the head motion in the sagittal plane during gait
7-12 °
what is the shoulder ROM during gait
30° total (6 flex , 24 ext)
how much elbow ROM is there during gait
20-45
what are the 6 UE mm activity during gait
Anterior Deltoid
Posterior Deltoid
Biceps Brachii
Long head Triceps
Upper Trap
Latissimus Dorsi
is there greater head and neck flexion during stair descent or ascent
descent
torque at the knee is __ greater for ascent and descent stairs
3x
when is there most knee flexion needed during stair cycle
foot clearance
when is hip flexion needed the most during stair gait
foot placement
what are the 3 phases present with running gait
swing , stance and float
GRFs at COP is over ____ of BW for running gait
200%
what percent is stance phase , float phase and swing phase for running gait
stance is 40%
float is 20%
swing is 40%
what is the running ROM for hip flexion at terminal swing and IC and hip extension after toe off (pre swing)
hip flexion- 60° at terminal swing , 45° at IC
hip extension - 20° after toe off
what is running ROM for knee flexion at IC and then during loaded and then during mid swing
flexion = 20° at IC then flexes to 60° during loading, then flexes to 130° in MidSwing
what is the running ROM for ankle DF at IC and then during loading and then PF during initial swing
• 10° of DF at IC and increases to 30° during loading, then PF to 25° by initial swing
where is the LE medial rotation and laterla rotation during running gait
MR during late swing and loading
ER during stance and early seing
neuro changes see decrease in in brain mass by ____ by age 90
10-20°
there is an estimates ____ loss of maximal strength by age ___ w/o exercise
20-40%
65
is there a greater loss in type 1 or 2 fibers
2
as we age are our extensors or flexors affected more
extensors
as we age and look at our EKGs what flattens and decreased
st seg flattens and t wave decreased
is there an increase or decrease in BP as we age
increase
what is the difference in double limb suppport for young people and elderly
18% in young
30% in old
what is the community functional benchmarks for gait speed , distance and curb height
gait speed= > 4ft/sec
distance= >300 m (984ft(
curb height = > 8in
can you use gait as a vital sign to detect preclinical disability
yes to detect preclinical disbailty
during forward lean (WA/SLS) for trunk deviations the LOG shifts in front of __ and ___ , they will have tight hip ___, compensate for weak quads so increase ____, there will increased visual cues and decreased proprioception , abdominal pain and use of assistive devices
knee and ankle
flexors
PF
someone with a backward trunk lean will have weak hip ___ during weight acceptance and single limb support and weak hip ___ during swing (single leg advancement)
extensors
flexors
someone with a lateral trunk lean during gait will have weak hip ___ or hip pain during WA/SLS , a ___ stance limb , advance swinging limb and use of a assistive device
abductors
short
someone with rotations to trunk deviations during gait will have a trunk that moves with the ___ due to decrease dissociation , use of an assistive device .. they will rotate back wards to compensate for increased ___ and rotate forward to ___ limb
pelvis
PF
advance
why might someone hike their pelvis during gait? and what mm are they using
to clear swinging limb
using IPSILATERAL quadratus lumborum
why may a patient have an anterior pelvic tilt during gait
weak hip extensors , weka abdominals and tight anterior hip
why may a patients have a posteior pelvic tilt during gait? and where does they shift their LOG
weak hip flexors
weka hip ext
tight HS
shift posteriorly (backward trunk lean)
why may a patient have excessive foward pelvic rotation during gait
to advance the limb
why may a patient have excessive backward pelvic rotation during gait
weak calf , no heel off during terminal stance or excess hip flexion
if someone has increase hip flexion during gait it can be from ____ contracture or spasticity , ___ ___ tightness , hip pain, compensatory for increased __ ___ and increase ankle DF or compensatory for increased ___ in mid swing
HF
IT band
knee flexion
PF
if someone has decreased hip extension during gait that can mean ___ contracture , hip capsule contracture , ____ Knee extension or hip pain
iliopsoas
decreased
if someone has limited hip flexion during gaite it can be from ___ weakness , hamstring spasticity , ___ movement pattern, hip pain , compensatory for weak ___ ____ or a results of foot ___
HS
synergistic
hip extensors
drag
during initial swing , if someone has limited hip flexors it will reduce what
step length
limited hip flexion can also limit __ ___ during swing
knee flexion
when is decreased hip flexion most impactful and what
during mid swing bc clearance of LE is needed
if someone has IR hip deviations drug in gait it is also called ___ and it can be from contracture/spasticity of __ ___ , medial ___ spasticity, and ___ spasticity
anteversion
internal rotators
hamstring
adductor
if someone has ER hip deviations during gait it is also called ___ and it can be because of __ ___ contracture , __ __ spasticity, compensation for ___ contracture or compensation for reference limb too long in ___
retroversion
external rotators
glute max
‘PF
swing
if someone has adduction hip deviations during gait is can lead to ___ glute med weakness leading to ___ drop , it can be from comopesnaiotn for weak ___ ___ or it can be because of __ ___ ___
ipsilateral
contralateral
hip flexors
LLD
if someone has an abduction hip deviations during gait is can be bc of a long ___ limb or ___ with pelvic obliquity
contra
scoliosis
limited knee flexion in pre swing fails to prevent limb for __ and makes toe ___ tougher
swing
off
limited knee flexion during initial swing lengthens the leg which results in what
toe drag
hyperextension is also known as
genu rectinaculum
if a patient has increase knee flexion deviation what does it lead to during loading response
excessive DF
if a patient has increase knee flexion deviation what does it lead to during mid stance
excessive DF
if a patient has increase knee flexion deviation what does it lead to during terminal stance
excessive DF
if a patient has increase knee flexion deviation what does it lead to during mid swing
compensating for increased PF
genu valgus knee deviation can be from ipsilateral ___ weakness and ___ trunk lean
abductor
ipsilateral
foot flat contact during WA and IC can be from what 2 thing
weak quads
impairments resulting in excess knee flexion
what muscle is weak with foot slap during WA and IC
weak ant tib (eccentrically)
increased PF from ankle deviations will lead to lack of ___ control during which phase of gait
DF during terminal swing
a patient may have a ___ trunk lead to compensate for decreased tibial progression
forward
increased PF during Mid swing will lead to toe ___ and an increase in what
toe drag
increased hip and knee flexion
during terminal stance , excessive PF doesn’t create a toe drag at this point (T/F)
T
during weight acceptance there is ____ DF secondary to ____ KF
increase 2x
if there is no feel off during SLS/ SLA then there can be a ___ calf , ___ MTP/TOE extension and genu ___
weak
decreased
recurvatum
foot drag during SLA can be from what 2 things
decreased hip or knee flex
increased PF
if there is an increased eversion of the ankle during SLA then what mm can be weka
anterior tib
what would happen during excessive DF during IC
exaggerated heel rocker response
excessive DF at pre swing will result in what to PF
loss of normal PF
