Week 3 Flashcards
Define locomotion
An individual’s capacity to move from one place to another (point A to B)
Define gait
The manner in which a person walks
(cadence, step length, stride length, speed and rhythm)
Define ambulation
the act, action, or an instance of moving about or walking
What is the foundation of movement analysis?
Gait analysis
What is the purpose of gait analysis?
1) To assess deviation from normal or less efficient pattern
2) To identify dysfunction that could lead to (functional decline, an increased fall risk, ROM and/or strength loss)
3) Identify impairments that impact gait (Poor balance, Lack of endurance or energy expenditure, Altered motor control, Reduced safety)
4) Help diagnose movement dysfunction (mechanism of gait deviation, impact of impairment on function)
5) Establish if the gait deviations could be characteristic or diagnostic of a larger clinical picture (Parkinson’s)
List important steps when assessing gait/locomotion
1) Observes patient from all directions
2) Analyze gait/locomotion characteristics with and without use of assistive, adaptive, orthotic, prosthetic or protective devices
3) Check the effects of various terrain and environments
4) Identify deviations and their effect on gait/locomotion
5) Hypothesize and verify cause(s) of deviations through specific examination (e.g. MMT, ROM, muscle tone, flexibility, pain)
What are the divisions of the gait cycle?
Stance: constitutes approximately 60% of the gait cycle and is defined as the interval in which the reference foot is in contact with the ground
Swing: comprises approximately 40% of the gait cycle and occurs when the reference limb is not in contact with the ground
What is a Double limb support/stance?
when both limbs are in contact with the ground at the same time
What is a Single limb support/stance?
It arises between the two double limb stance periods
Explain the stance phase
1) initial contact: the moment in time when the outstretched limb first hits the ground (heel strike)
2) loading response: body weight is rapidly accepted onto the outstretched limb (foot flat)
3) Midstance: body weight progresses forward over a single stable limb usually when the leg is underneath the trunk
4) terminal stance: the heel rises from the ground, the leg achieves a “trailing limb” posture, and the trunk advances well in front of the reference foot. (Heel off)
5) Pre-swing: the last phase of stance. During pre-swing, body weight transfers from the trailing limb to the contralateral lead limb, which is experiencing initial contact and loading response. (Toe off)
Explain swing phase
1) initial swing: lifting of the foot from the ground reflects the onset of the first phase of swing. (Acceleration)
2) midswing: the thigh continues to advance into flexion
3) terminal swing: further thigh flexion is curtailed; however, the knee continues to extend until it observationally appears neutral. (Deceleration)
What phases are double/single limb?
1) Initial double limb stance: initial contact, loading response
2) Single limb stance: mid stance, terminal stance
3) Terminal double limb stance: pre swing
Label the stances
1) initial contact
2) Loading response
3) mid stance
4) terminal stance
5) pre swing
List some gait variables
1) Spatial, Temporal
2) Symmetry, Planes of movement
3) Assistive Device, Level of Assistance, Environment
Describe step length and step time
1) Step length: distance between the heel contact to the point of the heel contact of the other foot
2) Step time: time to complete one step
Describe stride length and stride time
1) Stride length: stride length is the distance between the point of contact of the heel and the next contact of the same heel
2) Stride time: time to complete one stride
Describe cadence and velocity
1) Cadence: number of cycles in a period of time (steps/min)
2) Velocity: Distance covered in a period of time (m/s), gait speed
What is the normal toe out angle?
angle of the foot (5 – 13 deg)
What is closely linked to overall function?
Gait speed
List assistive device considerations of effects on pt’s mobility and stability
1) Attention and neuromotor demands
2) Interference with limb movement during balance recovery
3) Metabolic demands
4) Change in center of gravity from S2 to more anterior-superior which results in postural changes
What are the levels of the functional independence measure?
7 = Independent: safe & timely, no device
6 = Modified independence: device without supervision, more than reasonable time, or concern for safety
5 = Supervision or set up (also known as stand by assist – SBA)
4 = Minimal assistance (min A): patient performs 75% or more of effort
3 = Moderate assistance (mod A): 50 – 74% of effort
2 = Maximal assistance (max A): 25 – 49% of effort
1 = Total assistance: < 25% of effort or assist of 2 persons (also known as dependence)
List the various weight bearing statuses
1) Full weight bearing (FWB)
2) Partial weight bearing (PWB) – an established % of FWB
3) Touch down weight bearing (TDWB): Can put foot on the ground for balance but not put any weight on it
4) Toe-Touch weight bearing (TTWB): Toe can be on the ground (not commonly used)
5) Weight bearing as tolerated (WBAT): Up to the discretion of the patient
6) Non-weight bearing (NWB): Usually have foot elevated
Define balance, static balance, and dynamic balance
1) Balance: all forces acting on the body are balanced (equilibrium). COM is within stability limits and boundaries of BOS
2) Static balance: maintaining the COM within a fixed BOS
3) Dynamic balance: maintaining the COM within a moving BOS
Explain Reactive/Proactive
1) Reactive: postural control occurs in response to external forces acting on the body displacing the COM or moving the BOS (moveable platform)
2) Proactive: (anticipatory) postural control occurs in anticipation of internally generated, destabilizing forces imposed on the body’s own movements (catching a weighted ball).