Week 7 Flashcards
gait cycle
- from initial heel contact of one foot to heel contact of the same foot
- aka stride
- has 2 steps
stride length
- distance between 2 successive heel contacts of the same foot
- normal - 1.51 m for males and 1.32 for females
step length
Distance between successive heel contacts of 2 different feet
Degree of toe-out
- Angle between line of progression of the body and a line intersecting the center of the heel and second toe
- normal - 5-7 degrees
step width
- Lateral distance between heel centers of 2 consecutive foot contacts
- average is 7-10 cm
stride time
Time for a full gait cycle
step time
Time for completion of a R or a L step
cadence
- aka step rate
- # of steps per minute
- normal - 108 steps/min for males and 118 steps/min for females
walking speed
- Distance covered in a given amount of time
- normal - 1.37 m/sec for males and 1.30 m/sec for females
What is the best and most functional measurement of individuals walking ability?
walking speed
What % of time is spent in stance phase while walking?
60%
What % of time is spent in swing phase while walking?
40%
What % of time is spent in single-limb support while walking?
80%
What % of time is spent in double-limb support while walking?
20%
What % of time is spent in stance phase while running?
30%
What % of time is spent in swing phase while running?
70%
What % of time is spent in single-limb support while running?
60%
What % of time is spent in float period while running?
40%
What % of time is spent in double-limb support while running?
0%
What are the 8 stages of gait?
1) initial contact
2) loading response
3) midstance
4) terminal swing
5) preswing
6) initial swing
7) mid swing
8) terminal swing
What stages of gait occur during stance?
1) initial contact
2) loading response
3) midstance
4) terminal swing
5) preswing
What stages of gait occur during swing?
6) initial swing
7) mid swing
8) terminal swing
What are the 3 functional tasks of gait?
- weight acceptance
- single limb support
- swing limb advancement
What phases of gait are associated with weight acceptance?
1) initial contact
2) loading response
What phases of gait are associated with single limb support?
3) midstance
4) terminal stance
What phases of gait are associated with swing limb advancement?
5) preswing
6) initial swing
7) mid swing
8) terminal swing
What are the accomplishments of weight acceptance?
- forward progression
- stability
- shock absorption
What are the accomplishments of single limb support?
- stability
- forward progression
What are the accomplishments of swing limb advancement?
- foot clearance
- limb advancement
In what direction is the center of mass (CoM) displaced?
- forward direction
- vertical direction
- side-to-side direction
What is normal CoM vertical displacement?
~ 5 cm
What is normal CoM side-to-side displacement?
~ 4 cm
When is CoM at its lowest during vertical displacement?
midpoint of both periods of double-limb support
When is CoM at its highest during vertical displacement?
midpoint of both periods of single limb support
When is maximum right shift during side-to-side displacement?
end of midstance
When is maximum left shift during side-to-side displacement?
midswing of right leg
define initial contact phase
the moment when the foot contacts the ground
What “rocker” is associated with initial contact
heel rocker (1st rocker) - when calcaneus contacts surface
What is ROM of Hip/Knee/Ankle during initial contact?
- hip - 20 degrees of flexion
- knee - 5 degrees of flexion
- ankle - 0 degrees of dorsiflexion
What is the critical event during initial contact?
heel first contact - foot rotates forward using heel as fulcrum
define the loading response phase
weight is rapidly transferred onto the outstretched limb, the first period of double-limb support
What “rocker” is associated with the loading phase
heel rocker continues
What is ROM of Hip/Knee/Ankle during the loading response?
- hip - 20 degrees of flexion
- knee - 15 degrees of flexion
- ankle - 5 degrees of plantarflexion
What is the critical event during the loading response?
Hip stability, controlled knee flexion & ankle plantarflexion
define the mid stance phase
the body progresses over a single, stable limb
What “rocker” is associated with mid stance?
ankle rocker (2nd rocker) - when tibia rotates forward over talus
What is ROM of Hip/Knee/Ankle during mid stance?
- hip - 0 degrees
- knee - 5 degrees of flexion
- 5 degrees of dorsiflexion
What is the critical event during mid stance?
controlled tibial advancement
define the terminal stance phase
- progression over the stance limb continues
- the body moves ahead of the limb and weight is transferred onto the forefoot
What “rocker” is associated with terminal stance?
Forefoot rocker (3rd rocker) - heel lifts off surface and mid & hindfoot rotate about the extending MTP joints
What is ROM of Hip/Knee/Ankle during terminal stance?
- hip - 20 degrees of apparent hyperextension
- knee - 5 degrees of flexion
- ankle - 10 degrees of dorsiflexion
What is the critical event during terminal stance?
controlled ankle dorsiflexion with heel rise
define the preswing phase
rapid unloading of the limb occurs as weight is transferred to the contralateral limb, the second part of double limb support
What “rocker” is associated with preswing?
toe rocker (4th rocker) - limb is unloading and weight is transferred to contralateral limb resulting in hallux MTP joint extension to 50 degrees
What is ROM of Hip/Knee/Ankle during preswing?
- hip - 10 degrees of apparent hyperextension
- knee - 40 degrees of flexion
- ankle - 15 degrees of plantarflexion
What is the critical event during preswing?
Passive knee flexion to 40 degrees & ankle plantarflexion
define the initial swing phase
the thigh begins to advance as the foot comes up off the floor
What “rocker” is associated with initial swing phase?
None
What is ROM of Hip/Knee/Ankle during initial swing phase?
- hip - 15 degrees of flexion
- knee - 60 degrees of flexion
- ankle - 5 degrees of plantarflexion
What is the critical event during initial swing?
Hip flexion to 15 degrees and knee flexion to 60 degrees
define the mid swing phase
- the thigh continues to advance as the knee begins to extend
- foot clears the ground
What “rocker” is associated with mid swing?
None
What is ROM of Hip/Knee/Ankle during mid swing?
- hip - 25 degrees of flexion
- knee - 25 degrees of flexion
- ankle - 0 degrees
What is the critical event during mid swing?
Further hip flexion to 25 degrees and ankle dorsiflexion to 0 degrees
define the terminal swing phase
the knee extends and the limb prepares to contact the ground for initial contact
What “rocker” is associated with terminal swing?
None
What is ROM of Hip/Knee/Ankle during terminal swing?
- hip - 20 degrees of flexion
- knee - 5 degrees of flexion
- ankle - 0 degrees
What is the critical event during terminal swing?
Knee extension to neutral (possibly 5 degrees of flexion)
What % of the gait cycle is each phase?
1) initial contact - 0%
2) loading response - 0-12%
3) midstance - 12-31%
4) terminal swing - 31-50%
5) preswing - 50-62%
6) initial swing - 62-75%
7) mid swing - 75-87%
8) terminal swing - 87-100%
What is the term “rocker” describing?
the fulcrum of which the body is moving over
In loading response, which motions of the hip, knee and ankle contribute to shock absorption?
- plantarflexion
- knee flexion
- pronation
- hip adduction
Summarize what is happening at the hip in the sagittal plane during the gait cycle.
- hip is flexed at initial contact and moves into extension
- max hip extension occurs at the end terminal stance
- hip flexion is then started and moves into further flexion during swing
How many degrees of hip flexion and extension are needed for normal gait?
30 degrees of hip flexion and 10 degrees of hip extension
Summarize what is happening at the knee in the sagittal plane during the gait cycle.
- knee is flexed ~5 degrees at initial contact and continues to flex 10-15 degrees for shock absorption
- knee goes to full extension when heel comes off ground then moves into flexion
How many degrees of knee flexion occur at pre-swing?
40 degrees
What is max knee flexion and in what phase does it occur?
60 degrees in initial swing
Summarize what is happening at the ankle in the sagittal plane during the gait cycle.
- initial contact, ankle in plantarflexion the moves to flat foot
- as tibia moves forward over foot, ankle moves up to 10 degrees of dorsiflexion
- as heel comes off, ankle plantarflexes to max of 15-20 degrees
- then ankle dorsiflexes during swing to clear foot
How many degrees of dorsiflexion and plantarflexion are needed for normal gait?
- dorsiflexion - ~10 degrees
- plantarflexion - ~20 degrees