Week 5 - Gait

Question 1

What are the two phases of the gait cycle?

Answer 1

Stance and swing

Question 2

What are the 5 stages of the stance phase?

Answer 2

1. Heel contact
2. Foot flat
3. Mid stance
4. Heel off
5. Toe off

Question 3

What are the 3 sections of the swing phase?

Answer 3

1. Early swing
2. Mid swing
3. Terminal swing

Question 4

What is hip hiking a sign of? How to strengthen it?

Answer 4

A compensatory strategy for weak hip flexors or limited knee flexion
- Strengthen hip flexors (perform resisted hip flexion exercises like resisted knee raises or marches)
- Strengthen core muscles (core stability exercises like planks to improve pelvic control)
- Improve knee flexion ROM (stretching the quadriceps and performing exercises like heel slides or active knee flexion)
- Hip and pelvic mobility (use pelvic tilt exercises, hip circles, and side leg lifts to improve ROM and coordination around the hip)

Question 5

What is trunk lean? What are some ways to improve it?

Answer 5

Trunk lean indicate glute weakness on stance leg or an attempt to reduce load on the affected leg
- Strengthening gluteus medius (lateral band walks, clamshell, single leg deadlifts)
- Core stability
- Single leg balance (improve stance leg control)
- Gait re-education (weight shifting drills, focusing on even weight distribution keeping trunk upright)

Question 6

What is circumduction and how to improve it?

Answer 6

Typically due to difficulty clearing the foot during swing, often from weak hip flexors or dorsiflexors
- Strengthening hip flexors (mini lunge, resisted knee raises to help lift leg during swing)
- Improving ankle dorsiflexion strength (strengthen TA with heel raises and toe raises)
- Improving knee flexion strength and ROM (hamstring curls, bridge variation)
- Gait reducation (step through drills with cues to lift the knee)

Question 7

List some ways to help with excessive hip and knee flexion

Answer 7

Often a compensatory movement to avoid foot drag, indicating weakness in dorsiflexors or hip/knee control
- Strengthen dorsiflexors (toe raises)
- Improve hip extension and stability
- Improve knee stability (strengthen quads and hamstrings with step-ups)

Question 8

Causes of knee hyperextension

Answer 8

Quad spasticity, PF spasticity, quad weakness, PF contracture

Question 9

Causes of excessive knee flexion

Answer 9

Hamstring spasticity, knee flexion contracture, hip flexion contracture, ankle PF weakness

Question 10

Causes of inadequate hip extension

Answer 10

Hip arthrodesis, joint contracture, IT band tightness, hip flexor spasticity, pain, anterior pelvic tilt, compensations for knee/ankle issues

Question 11

What would you expect to see with someone with weak quads?

Answer 11

Increased hip flexion or external rotation to stabilise the knee