Walking and Posture Flashcards
what does the lower limb do
- Supports and propels body forward
* Combines strength and mobility
when are the hip and knee in the most stable position
when standing up
when you standing at rest describe your position
- Standing at rest feet slightly apart
- Hip and knee are extended (most stable position)
where is the centre of pressure at
- Front of ankle
- Just in front of knee
- Just behind the hip
- Just behind the ear
- there is a combination of weight being behind and in front of the centre of gravity
what happens when you stand on one leg
When one leg lifted off the group muscles around the hip of the supporting leg becomes active
These are the up abductors – gluteus Medius and minimus
This prevents the pelvis from dropping onto the unsupported side
Move the body weight over supporting leg
Prevents pelvis from dropping on unsupported side
what is trendelenburgs sign
- Normally when standing on one leg the hip abductors prevent the pelvis dropping to the unsupported side
- It pulls the unsupported side up
- Hip abductors help to move body weight
- Pelvis drops on unsupported side if – hip abductors are weak on supporting side
what are the causes of the pelvis dropping on the unsupported side
- hip abductors are weak on supporting side (most common cause)
- fracture of neck of the femur or greater trochanter,
- dislocation of femoral head
what does trendelenburgs sign show
weak gluteus medium and gluteus minibus
is walking a simple or complex motion
- Learned complex behaviour involving balancing body over one leg while controlling forward motion
what is the definition of walking
one foot must always be in contact with the ground at any time
what is the major propelling force in walking
falling forward
what is the walking cycle divided into
stance and swing phases
what is a whole phase of walking divide into
- Divided into strides activities between successive heel strikes on same side
- When the leg first makes contact with the heel and the group and then where the heel makes contact with the ground again
how many phases of stance are there
5 segments
describe stance phase
- Begins with heel strike and ends when toe leaves the ground
- 60% of cycle
describe the stages of stance phase
- Intintial contact (Heel strike) - Foot inverted and dorsiflexed as heel makes contact on lateral side
- Loading response - Foot brought into full contact, ankle rocker action begins
- Midstance - Body weight brought over to the planted foot
- Terminals stance – (heel off) Heel lifted off ground (foot everted and plantar flexed). Body weight advances ahead of single-supporting foot
- Pre-swing (toe off) - Lower limb positioned to quickly swing forward beneath body, transfer of weight from one limb to other
describe swing phase
- 40% of walking cycle
- Begins with toe off
how many segments are there of swing phase
3
describe the stages of swing phase
- Initial swing - foot pushed off ground, limb accelerates forward
- Mid swing - Limb moves beneath body until tibia of leg is vertical. Foot dorsiflexed to prevent toes dragging on ground
- Terminal swing - Limb decelerates forward movement, prepares for initial contact again
what is the muscles involved in the stance phase
Stance phase: Heel strike to flat foot
– Dorsiflexors active at heel strike
– Gluteus maximus and hamstrings extend hip early in stance.
– Quadriceps extend knee early in stance.
– Hip abductors active when going from double to single support
what are the muscles involved in mid stance to toe off
– Plantar flexors active at toe off to power forward thrust.
– Hip flexors and knee extensors start to prepare to lift leg
what are the muscles involved in swing phase
• Hip flexors help lift leg off ground, early swing phase
• Thigh momentum checked by hip extensors at end of swing
– Gluteus maximus
• Hamstrings flex knee, lift swinging leg off ground
• Dorsiflexors active throughout to prevent toes dragging
what are the causes of gait problems
can be mechanical or neurological
what are the mechanical causes of gait
• osteoarthritis, muscle strains, blisters
what are the neurological causes of gait
• perception deficits, nerve damage
how do analysis gait
- Balance
- Co-ordination
- Walking rhythm
- Change of speed/direction
- Stride length
what effects the way you walk
- Stance phase gets shortened and there is longer leg time in the air as this is when the pain is less
- If you cant feel the sole of the foot then this effects the way that you walk
- If you have perception deficits such as being blind so your not able to see the surface that you are walking towards then this effects the way that you walk
describe parkinsons gait
- Short shuffling steps
- Rigidity in hip and knee extensors
- Stooped forward posture – moves there body anteriorly and can fall forwards more
- Arm swing reduced
- Turning is rigid like a statue
- Have problems change in direction as they have problems initiating movements therefore sometimes walk into walls
- Have muscle imbalance in the lower limb
describe scissor gait
- Thigh swings across body during swing phase
- Difficulty in putting heel on ground – toe walking and is unstable
- Difficulty putting the foot on the group
- Hip is rigid
- Hard to flex the knee
- Toe walking and unstable need walking frame to help them
what causes scissor gait
- Can be unilateral (stroke or cerebral palsy) or bilateral (cerebral palsy)
describe high stepping gait
- dorsiflexor paralysis = ‘foot drop’, unless leg is lifted higher by exaggerated knee bend
- Whole foot tends to slapped on ground rather than heel strike
what can cause high stepping gait
- Common peroneal nerve injury – effects dorsiflexors of the leg
- Common peroneal innervates the dorsiflexor muscle group also effects the everts
- The dorsiflexors allow us to lift the dorsum of the foot of and the toes of the group
- Can’t lift the foot of the ground
- Need to be dorsiflexed when going into initial contact
what does the tibial nerve innervate
- Tibial nerve innervates the plantar flexors
what is the tibial nerve protected by
- It is well protected runs in the popliteal fossa
what happens if you have tibial nerve damage
- End up with plantarflexor paralysis and there is no forward thrust
- Plantarflexor paralysis = no forward thrust
describe staccato gait
- Quadriceps paralysed - knee can only be stabilised by being locked in full extension by bending trunk forward or holding knee back with one hand
o Compensation by iliacus and pectineus for hip flexion the adductors for knee extension – they push back ionto the thigh or onot the knee itself, the extension of the knee is only possible by pushing the knee back - Get the same effect from someone who has damaged there achielies tendon they may have weakened plantarflexion
what is the weigh of the upper body transmitted to
- Weight of upper body is transmitted centrally through vertebral column
- Ilium transfers weight to femurs
what does the pubic symphysis do
- Force dissipated by the fibrocartilage punchi symphysis
- Any excess force is braced and taken to the pubic symphysis
why is the head of the femur slightly medial
- The head of the femur is slightly medial – need to take the weight out and put it underneath the body so that we can do bipedal moving
- Diagonal angle of femurs re-centres support directly
- Under the body to make bipedal standing more
- efficient and to help walking.
