Observational Gait analysis Flashcards
what is heel rocker
the heel acts as a fulcrum, rolls the limb forward. pre-tibial muscles decelerate foot drop, also drawing the tibia forward
what is ankle rocker
the ankle becomes the fulcrum once the forefoot strikes the ground. tibial procession is controlled by eccentric contraction of the soleus
forefoot rocker
as the heel rises, the fulcrum for tibial advancement shifts to the metatarsals heads. Progression is accelerated as body weight falls beyond the area of foot support
during phase 1, what is happening at the Hip, Knee, and ankle?
- 20 flexion
- 5 flexion
- 0
true or false: as soon as weight is accepted by the leg, initial contact is over
true
Objectives of phase 1 is? which rocker?
- heel contact to advance COM forward
- heel rocker
Objectives of phase 2
- shock absorption
- controlled weight transfer to stance limb
- preservation of progression
true or false: during phase 2, you’re using heel as rocker, knee flexes more for shock absorption
true
when do you have the first period of double limb support
loading response (phase 2)
name all the phases of the gait cycle
- IC
- LR
- MS
-TS - PS
-IS
-MS - TS
during loading response what’s happening at the hip, knee, ankle?
- 20 flexion
- 15 flexion
- 5 flexion
objectives of phase 3 and which rocker is being applied?
- controlled forward progression over the stationary foot
- dynamic stability over the plantigrade foot
- ankle rocker
during phase 3, what’s happening at the Hip, knee and ankle?
- 0
- 5 flexion
- 5 DF
objectives of phase 4 and which rocker is being applied?
- dynamic stability over the forefoot
- controlled forward progression of the COM anterior to foot
- forefoot rocker
what’s happening at the hip, ankle and knee during phase 4?
- 20 hyperextension
- 5 flexion
- 10 DF
what is the 2nd terminal double limb support?
Pre swing
during phase 5, what’s happening at the hip, knee, and ankle?
- 10 hyperextension
- 40 flexion
- 15 PF
Objectives of phase 5
- position the limb for swing (thigh/knee flex)
- accelerate progression
Objective of phase 6
- thigh advances forward
- knee flexion to achieve toe clearance
what’s happening at the hip, knee, and ankle during phase 6
- 15 flexion
- 60 flexion
- 5 PF
during phase 7, what’s happening at the hip, knee and ankle
- 25 flexion
- 25 flexion
- 0
Objectives of phase 7
- thigh continues advancing
- ankle DF to neutral for toe clearance
during phase 8, what’s happening at the hip, knee, and ankle?
- 20 flexion
- 5
- 0
objectives of phase 8
- knee extends to prepare for heel contact
what phase of cycle is the hip most flex and extend?
- Midswing
- Terminal stance
At what phase of the gait cycle is the knee most flexed
initial swing
during terminal stance what degree is the ankle DF?
10
at what phase of the gait does the toes get 60 degree of MTP extension
preswing
possible causes for toes or forefoot contact deviation during initial contact?
- leg length discrepancy
- PF contracture/spasticity
- DF weakness
- painful heel
- impairments that limits ability to achieve neutral ankle
possible causes for foot flat contact deviation at initial contact?
- PF contracture
- weak DF
- knee flexion contracture
possible causes for foot slap
weakness in dorsi flexors
possible causes fo excess plantarflexion
- PF contracture
- spastic PF
- intentional to avoid ankle/knee collapse if PF and vasti are weak
possible causes fo excessive DF
- inability of PF to control tibial advance
- knee flexion or hip flexin contracture
possible causes for early heel rise
- spasticity or contracture of PF
possible causes for no heel off
- weak PF
- weak investors (fail to lock middfot in terminal stance)
- inadequate toe extension ROM
- painful forefoot/toes
possible causes for toe clawing
- spasticity of toe flexors
- excessive activation of toe flexors to compensate for weak gastric/soleus
- PF grasp reflex
possible causes excessive inversion or eversion deviation
- excessive inversion: overactive/contracted investors; reduced activity of evertors; primitive extensor pattern
- excessive eversion: overactiivty/contracture of evertors; reduced activity/strength of investors; primitive flexor pattern
possible causes for drag deviation
- pretrial weakness
- PF spasticity/contracture
- inadequate knee/hip flexion
possible causes for excessive knee flexion
- knee flexor spasticity
- contracture that exceeds position required for given phase
- painful or effused knee
- hip flexion contracture
possible causes for limited knee flexion
- intentional to decrease demands on weak quads
- quad tone
- spasticity
- contracture
possible causes for hyperextension
- structural abnormality
possible causes for wobble
consider proprioceptive impairments or alternating spasticity of knee flexors and extensors
excessive flexion of the hip could be due to
single it hip extensor weakness with compensation by hamstring
- hip and/or knee flexion contractures
limited flexion of the hip may be due to
- intentionally to limit demand on weak hip extensors during LR
- weak hip flexors
- hamstring spasticity
- contracture
possible causes for hip circumduction
- compensation for weak flexors
- inability to shorten leg for limb clearance
possible causes for hip internal rotation
- spasticity or contractures of internal rotators
- weakness of external rotators
- excessive forward rotation of contralateral pelvis
possible causes for hip external rotation
- spasticity or contractures of ER
- possible tightness of PF
- brace that is too stiff to allow DF
- weakness of IR
possible causes for hip abduction
- contracture of glute med or ITB
possible causes for hip adduction
- hip adductor plasticity/contracture
- excessive contralateral pelvic drop
possible cause for backward trunk lean
- purposeful to reduce demands on weak stance limb glute max or to assist with limb advancement when hip flexion capability is limited
possible causes for forward trunk lean
- compensate for quad weakness
- forward lean reduces knee extensor moment and thus demand on vastii
- accommodate hip or knee flexion contractures
possible causes for ipsilateral trunk lean
- occurs during reference limb stance
- compensation for ipsilateral hip abductor weakness
- hip joint pain
- ITB tightness or scoliosis
possible causes for contralateral trunk lean
- assist with pelvic elevation in swing to ensure foot clean race
- compensate for contralateral hip abductor weakness, hip joint pain, iliotibial band tightness
possible causes for ipsilateral pelvic drop
- contralateral hip abductor weakness
- hip adductor spasticity or hip adduction contracture
possible causes for pelvic hike
- action of quadrates lumborum to assist with limb clean race when hip flexion, knee flexion and/or ankle DF are inadequate for limb clearance
what is normal gait speed
1.2 m/sec to 1.4m/sec
street crossing speed for rural
45 m/min (0.7m/sec)
street crossing speed for urban
48 m/min (0.8 m/sec)
street crossing speed for busy city street
70m/min (1.17m/sec)
step width should range around
7-10cm
6 min walk test range
400m to 700m
cadence mean is
113 steps/minute
velocity aver for men
1.37 m/sec (3mi/hr)
velocity average for women
1.30 m/sec (2.9mi/hr)