Walking and Posture

Question 1

what does the lower limb do

Answer 1

• Supports and propels body forward

* Combines strength and mobility

Question 2

when are the hip and knee in the most stable position

Answer 2

when standing up

Question 3

when you standing at rest describe your position

Answer 3

• Standing at rest feet slightly apart

- Hip and knee are extended (most stable position)

Question 4

where is the centre of pressure at

Answer 4

• 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

Question 5

what happens when you stand on one leg

Answer 5

 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

Question 6

what is trendelenburgs sign

Answer 6

• 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

Question 7

what are the causes of the pelvis dropping on the unsupported side

Answer 7

• hip abductors are weak on supporting side (most common cause)
• fracture of neck of the femur or greater trochanter,
• dislocation of femoral head

Question 8

what does trendelenburgs sign show

Answer 8

weak gluteus medium and gluteus minibus

Question 9

is walking a simple or complex motion

Answer 9

• Learned complex behaviour involving balancing body over one leg while controlling forward motion

Question 10

what is the definition of walking

Answer 10

one foot must always be in contact with the ground at any time

Question 11

what is the major propelling force in walking

Answer 11

falling forward

Question 12

what is the walking cycle divided into

Answer 12

stance and swing phases

Question 13

what is a whole phase of walking divide into

Answer 13

• 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

Question 14

how many phases of stance are there

Answer 14

5 segments

Question 15

describe stance phase

Answer 15

• Begins with heel strike and ends when toe leaves the ground
• 60% of cycle

Question 16

describe the stages of stance phase

Answer 16

1. Intintial contact (Heel strike) - Foot inverted and dorsiflexed as heel makes contact on lateral side
2. Loading response - Foot brought into full contact, ankle rocker action begins
3. Midstance - Body weight brought over to the planted foot
4. Terminals stance – (heel off) Heel lifted off ground (foot everted and plantar flexed). Body weight advances ahead of single-supporting foot
5. Pre-swing (toe off) - Lower limb positioned to quickly swing forward beneath body, transfer of weight from one limb to other

Question 17

describe swing phase

Answer 17

• 40% of walking cycle

- Begins with toe off

Question 18

how many segments are there of swing phase

Answer 18

3

Question 19

describe the stages of swing phase

Answer 19

1. Initial swing - foot pushed off ground, limb accelerates forward
2. Mid swing - Limb moves beneath body until tibia of leg is vertical. Foot dorsiflexed to prevent toes dragging on ground
3. Terminal swing - Limb decelerates forward movement, prepares for initial contact again

Question 20

what is the muscles involved in the stance phase

Answer 20

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

Question 21

what are the muscles involved in mid stance to toe off

Answer 21

– Plantar flexors active at toe off to power forward thrust.

– Hip flexors and knee extensors start to prepare to lift leg

Question 22

what are the muscles involved in swing phase

Answer 22

• 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

Question 23

what are the causes of gait problems

Answer 23

can be mechanical or neurological

Question 24

what are the mechanical causes of gait

Answer 24

• osteoarthritis, muscle strains, blisters

Question 25

what are the neurological causes of gait

Answer 25

• perception deficits, nerve damage

Question 26

how do analysis gait

Answer 26

- Balance - Co-ordination - Walking rhythm - Change of speed/direction - Stride length

Question 27

what effects the way you walk

Answer 27

- 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

Question 28

describe parkinsons gait

Answer 28

* 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

Question 29

describe scissor gait

Answer 29

- 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

Question 30

what causes scissor gait

Answer 30

- Can be unilateral (stroke or cerebral palsy) or bilateral (cerebral palsy)

Question 31

describe high stepping gait

Answer 31

- dorsiflexor paralysis = ‘foot drop’, unless leg is lifted higher by exaggerated knee bend - Whole foot tends to slapped on ground rather than heel strike

Question 32

what can cause high stepping gait

Answer 32

- 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

Question 33

what does the tibial nerve innervate

Answer 33

- Tibial nerve innervates the plantar flexors

Question 34

what is the tibial nerve protected by

Answer 34

- It is well protected runs in the popliteal fossa

Question 35

what happens if you have tibial nerve damage

Answer 35

- End up with plantarflexor paralysis and there is no forward thrust - Plantarflexor paralysis = no forward thrust

Question 36

describe staccato gait

Answer 36

- 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

Question 37

what is the weigh of the upper body transmitted to

Answer 37

- Weight of upper body is transmitted centrally through vertebral column - Ilium transfers weight to femurs

Question 38

what does the pubic symphysis do

Answer 38

- Force dissipated by the fibrocartilage punchi symphysis | - Any excess force is braced and taken to the pubic symphysis

Question 39

why is the head of the femur slightly medial

Answer 39

- 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.