Session 4- Gait

Question 1

Define gait

Answer 1

Mechanism by which body is transported using co-ordinated movements of the major lower limb joints

Question 2

Describe phases of gait cycle

Answer 2

Stance phase: 60%, main weight bearing

Swing phase: 40%, foot not in contact with ground

Question 3

Define step, stride and cadence

Answer 3

Step- distance from initial contact with one leg to initial contact with opposite leg

Stride- distance from initial contact with one leg to next initial contact with same leg

Cadence- steps per minute

Question 4

Describe differences between walking and running

Answer 4

Running- time in gait cycle when neither foot on ground (double float)

Question 5

Identify muscles used in normal gait

Answer 5

Heel strike- tibialis anterior contracts and lengthens
Mid-stance (next foot flat on ground)- tibialis anterior relaxes

Terminal stance- gastrocnemius and soleus power propulsion by plantarflexing the ankle

Question 6

Trendelenburg gait

Answer 6

Mechanism: hip abductors (glut min and med) cannot contract to prevent pelvis dropping on unsupported side. Like waddling.

Causes: Superior gluteal nerve lesions, muscle pain, trauma, biomechanical hip instability

Question 7

Hemiplegic gait

Answer 7

Mechanism:Continuous contraction of affected side of body (flexor muscles of upper limb and extensor muscles of lower limb). Must lean towards unaffected side then circumduct paralysed leg.

Cause: paralysis of one side of body e.g. stroke, cerebral palsy or trauma

Question 8

Diplegic gait

Answer 8

Mechanism: walk with narrow-based gait, dragging legs and scarping toes, scissoring potentially. Forefoot makes initial contact. Spasticity in hamstrings means that the knees are slightly flexed, in gastrocnemius and soleus causes plantar-flexion of ankles.

Cause: spasticity affects both lower limbs

Question 9

High-steppage gait

Answer 9

Mechanism: When foot raised in swing phase, foot assumes plantarflexion. Hip must flex. Foot slaps down onto ground. May compensate with eversion flick.

Cause: seen in patients with weakness of ankle dorsiflexion, resulting in foot drop. Common fibular nerve palsy, sciatica, neuromuscular disease.

Question 10

Parkinsonian gait

Answer 10

Mechanism: difficult to initiate movement. Flex their neck and trunk forward to move centre of gravity in front of lower limbs. Shuffling gait, may have festinant gait (accelerating steps). Loss of arm swing.

Cause: Nerve cells in subtantia nigra degenerate, leading to reduction in dopamine

Question 11

Ataxic gait

Answer 11

Mechanism: clumsy, staggering movements with a broad-base. Arms held outwards, may sway (titubation). Cannot walk in straight line.

Causes: proprioceptive, cerebellar disease (inherited or acquired, due to being drunk), vestibular damage

Question 12

What is gait cycle

Answer 12

Period of time from initial contact to next initial contact on same side of body

Question 13

5 important attributes for normal gait

Answer 13

• stability in stance
• foot clearance during swing phase
• pre-positioning for initial contact
• adequate step length
• energy conservation

Question 14

What makes initial contact in normal gait

Answer 14

Heel

Question 15

What are period of double support

Answer 15

When both feet are in contact with ground

Question 16

Stance phase sub divisions

Answer 16

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

Question 17

Swing phase sub divisions

Answer 17

Initial swing, mid-swing, terminal swing

Question 18

Two elements to gait analysis

Answer 18

Kinematics (motions), kinetics (forces that cause motion)

Question 19

Gait abnormalities can occur as a result of

Answer 19

Nerve lesions, joint instability, immobility of joints and pain

Question 20

Antalgic gait

Answer 20

• Walk in manner that reduces pain e.g. OA
• Limp (shorten stance phase of painful limb)
• Walking stick on hand opposite painful limb