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PTA 160 > Week 7: Gait > Flashcards

Week 7: Gait Flashcards

1
Q

Terminology

Gait cycle

Two phases

A

Period of time from when the heel strikes the ground to when the same heel strikes the ground again

Stance phase
Swing phase

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2
Q

Terminology

Stance phase

What percentage of the gait cycle does this phase take up?

A

total time foot is in contact with the floor

60%

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3
Q

Terminology

Swing phase

What percentage of the gait cycle does this phase take up?

A

total time foot is off the floor

40%

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4
Q

Terminology

Double support

Does double support occur while running?

A

period during stance phase when both feet are on the floor

No, weight is being transferred directly from one foot to the other.

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5
Q

Terminology

Single support

A

one foot is in contact with the floor

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6
Q

Terminology

What is the normal width for base of support (BOS)?
What is the normal degree of toe out?

A
  • 2-4 inches
  • 7°

Wider base = more stability

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7
Q

Terminology

Stride length

A

Distance between heel strike of one foot to heel strike of the same foot

shorter legs = shorter stride

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8
Q

Terminology

Step length

A

Distance between heel strike of one foot to heel strike of opposite foot

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9
Q

Terminology

Cadence

What else is it called?

A

Number of steps per minute

walking speed

normal cadence: 70-130 steps per minute

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10
Q

Terminology

What is the amount of lateral pelvic tilt during normal gait?

When does it occur?

A

<5°

toe off/pre-swing

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11
Q

Terminology

What is the amount of pelvic rotation during normal gait?

When does this occur?

A

swing leg 4° anteriorly
stance leg 4° posteriorly

swing phase

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12
Q

Terminology

What is the amount of vertical displacement during normal gait?

When does this occur?

A

2 inches

midstance

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13
Q

Terminology

What is the amount of horizontal displacement during normal gait?

When does the greatest amount of horizontal displacement occur?

A

2 inches

single support phase at midstance

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14
Q

What is the Rancho los Amigos term?

heel strike

A

initial contact

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15
Q

What is the Rancho los Amigos term?

foot flat

A

loading response

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16
Q

What is the Rancho los Amigos term?

midstance

A

midstance

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17
Q

What is the Rancho los Amigos term?

heel off

A

terminal stance

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18
Q

What is the Rancho los Amigos term?

toe off

A

pre-swing

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19
Q

What is the Rancho los Amigos term?

acceleration

A

initial swing

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20
Q

What is the Rancho los Amigos term?

midswing

A

midswing

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21
Q

What is the Rancho los Amigos term?

deceleration

A

terminal swing

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22
Q

Components of Gait Cycle

What is heel strike?

A

heel makes contact with the ground

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23
Q

Components of Gait Cycle

What is foot flat?

A

anterior tibialis works eccentrically to lower foot to the ground

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24
Q

Components of Gait Cycle

What is midstance?

A

entire foot in contact with the floor
body accelerating forward

Rancho los Amigos: foot flat to midstance

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25
Q

Components of Gait Cycle

What is initial contact?

A

first contact with the ground

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26
Q

Components of Gait Cycle

What is loading response?

A

initial contact until opposite foot is lifted for swing

heel strike to foot flat

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27
Q

Components of Gait Cycle

What is heel off?

A

heel lifts off the floor

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28
Q

Components of Gait Cycle

What is terminal stance?

A

begins with heel rise, continues until other foot strikes ground

midstance to heel off

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29
Q

Components of Gait Cycle

What is toe off?

A

toe lifts off floor

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30
Q

Components of Gait Cycle

What is pre-swing?

A

begins with initial contact of opposite limb, ends with ipsilateral toe

toe off

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31
Q

Components of Gait Cycle

What is acceleration?

A

toe off to midwing when swinging LE is directly under the body

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32
Q

Components of Gait Cycle

What is initial swing?

A

begins with foot lifting from floor, ends with swing foot opposite stance foot

toe off to acceleration

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33
Q

Components of Gait Cycle

What is midswing?

Traditional terminology & Rancho los Amigos

A

Traditional: LE passes directly under the body

RLA: acceleration to midswing - begins with swinging limb opposite stance leg and ends with swinging leg forward and tibia vertical

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34
Q

Components of Gait Cycle

What is deceleration?

A

tibia passes beyond perpendicular to the knee extending to prepare for heel strike

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35
Q

Components of Gait Cycle

What is terminal swing?

A

begins with tibia in vertical position and ends with foot striking the floor

midswing to deceleration

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36
Q

Which muscle groups are used?

Acceleration/initial swing

Concentric or eccentric?

What are the working muscles?

A
  • hip flexors - concentric
  • knee flexors - concentric
  • ankle dorsiflexors - concentric

hip flexors: iliopsoas, rectus femoris
knee flexors: hamstrings
DF: anterior tib

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37
Q

Which muscle groups are used?

Midswing

Concentric or eccentric?

What are the working muscles?
(Hint: same as acceleration)

A
  • hip flexors - concentric
  • knee flexors - concentric
  • ankle dorsiflexors - concentric

hip flexors: iliopsoas, rectus femoris
knee flexors: hamstrings
DF: anterior tib

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38
Q

Which muscle groups are being used?

deceleration/terminal swing

Concentric or eccentric?

What are the working muscles?

A
  • knee extensors - concentric
  • knee flexors - eccentric
  • ankle dorsiflexors - concentric

knee extensors: quadriceps
knee flexors: hamstrings
DF: anterior tib

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39
Q

Which muscle groups are being used?

heel strike/initial contact

Concentric or eccentric?

What are the working muscles?

A
  • knee extensors - eccentric
  • ankle dorsiflexors - concentric

knee extensors: quadriceps
DF: ant tib

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40
Q

Which muscle groups are being used?

foot flat/loading response

Concentric or eccentric?

What are the working muscles?

A
  • hip extensors - eccentric
  • knee extensors - eccentric
  • ankle dorsiflexors - eccentric

hip extensors: glute max
knee extensors: quadriceps
DF : ant tib

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41
Q

Which muscle groups are being used?

midstance

Concentric or eccentric?

What are the working muscles?

A
  • knee extensors - concentric
  • ankle plantarflexors - eccentric

knee extensors: quadriceps
(PF unspecified)

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42
Q

What muscles groups are being used?

heel off/terminal stance

Concentric or eccentric?

What are the working muscles?

A

ankle plantarflexors - concentric

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43
Q

What muscle groups are being used?

toe-off/pre-swing

Concentric or eccentric?

A
  • hip flexors - concentric
  • ankle plantarflexors - concentric
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44
Q

Range of Motion

What ROM is required at heel strike/initial contact?

(hip, knee, and ankle)

A
  • hip flex: 25°
  • knee: 0°
  • ankle: 0°
45
Q

Range of Motion

What ROM is required at foot flat/loading response?

(hip, knee, and ankle)

A
  • hip flex: 15°
  • knee flex: 15°-20°
  • ankle PF: 15°
46
Q

Range of Motion

What ROM is required at midstance?

(hip, knee, and ankle)

A
  • hip: 0°
  • knee flex: 5°
  • ankle DF: 5°-10º
47
Q

Range of Motion

What ROM is required at heel off/terminal stance?

(hip, knee, and ankle)

A
  • hip: 10º-20º ext
  • knee: 0º
  • ankle: 10º-15º DF
48
Q

Range of Motion

What ROM is required at toe off/pre-swing?

(hip, knee, and ankle)

A
  • hip: 10º-20º ext
  • knee: 30º-40º flex
  • ankle 15º-20º PF
49
Q

Range of Motion

What ROM is required at acceleration/initial swing?

(hip, knee, and ankle)

A
  • hip: 25º-30º flex
  • knee: 60º flex
  • ankle: 10º-20º PF
50
Q

Range of Motion

What ROM is required for midswing?

(hip, knee, and ankle)

A
  • hip: 25º flex
  • knee: 60º-65º flex
  • ankle: 0º
51
Q

Range of Motion

What ROM is required for deceleration/terminal swing?

(hip, knee, and ankle)

A
  • hip: 30º flex
  • knee: 0º
  • ankle: 0º
52
Q

Abnormal Gait

What is “limping?”

Description/Cause

A

Antalgic Gait

  1. reduced time spent on affected leg in order to reduce weight on affected leg*
  2. cause: pain

* How does this affect step length?

53
Q

Abnormal Gait

What is circumducted gait?

Description/Cause

A
  1. bringing leg out and around
  2. cause: knee immobilizer, knee flexor/DF weakness, limited hip flex/knee flex/DF ROM
54
Q

Abnormal Gait

What is Glute Max Gait?

Description/Cause

What else is this gait pattern called?

A
  1. trunk shifts posteriorly to shift COG back in order to maintain hip ext
  2. cause: glute max weakness

  1. Extensor Lurch
  2. Rocking Horse
55
Q

Abnormal Gait

What is Glute Med Gait?

Description/Cause

What else is it called?

A
  1. trunk SB over stance leg to prevent swing leg hip from dropping
  2. cause: glute med weakness

  1. ABD lurch
56
Q

Abnormal Gait

What are the two types of Glute Med Gait?

A
  • Compensated
  • Uncompensated (a.k.a. Trendelenburg gait)
57
Q

Abnormal Gait

What is Anterior Trunk Lean?

Description/Cause

A
  1. forward lean & pushing with anterior thigh to hold knee into ext during stance phase
  2. cause: quad weakness, paralysis*

*especially caused by polio

58
Q

Abnormal Gait

What is Genu Recurvatum Gait?

Description/Cause

A
  1. hyperext of knee at midstance OR deceleration
  2. cause: quads (midstance), hamstrings (deceleration)
59
Q

Abnormal Gait

What are the four abnormal gait patterns caused by DF weakness?

A
  1. Equinas Gait
  2. Steppage Gait
  3. Foot Slap
  4. Drop Foot
60
Q

Abnormal Gait

What is Equinas Gait?

Description/cause

A
  1. toes contact ground before heel strike
  2. cause: DF weakness, lack DF ROM
61
Q

Abnormal Gait

What is Steppage?

Description

A

excessive hip/knee flex during swing phase to prevent foot from dragging

62
Q

Abnormal Gait

What is Foot Slap?

Description/cause

A
  1. foot slapping from heel strike to foot flat
  2. cause: DF weakness (inability to eccentrically lower)
63
Q

Abnormal Gait

What is Vaulting Gait?

Description/Cause

A
  1. pelvic elevation and PF of stance leg
  2. cause: decreased hip/knee ROM of swing leg
64
Q

Abnormal Gait

What is Drop Foot?

Description/Cause

A
  1. foot drop during swing phase when foot is off the ground
  2. cause: DF weakness
65
Q

Abnormal Gait

What is Scissor’s Gait?

Description/Cause

A
  1. unsupported leg swings across or against stance leg during swing phase
  2. cause: spasticity in hip abductors
66
Q

Abnormal Gait

What is Hemiplegic Gait?

Description/Cause

A
  1. LE ext/UE flex synergy which leads to reduced WB on affected side
  2. cause: spasticity in LEs/UEs
67
Q

Strength Grade

What is the minimal strength grade of the hip flexors during the swing phase?

A

2+/5 to 3-/5

68
Q

Strength Grade

What is the minimal strength grade of the hip extensors during the stance phase?

A

4/5

69
Q

Strength Grade

What is the minimal strength grade of the knee flexors during the swing phase?

A

2+/5 to 3-/5

70
Q

Strength Grade

What is the minimal strength grade of the knee extensors during the stance phase?

A

4/5

71
Q

Strength Grade

What is the minimal strength grade of the ankle dorsiflexors during the swing phase?

A

3-/5 to 3/5

72
Q

Strength Grade

What is the minimal strength grade of the ankle plantarflexors during the stance phase?

A

2+/5 to 3-/5

73
Q

Strength Grade

Which muscle groups require a strength grade of 2+/5 to 3-/5?

During which phases do they occur?

A
  • hip flexors during swing phase
  • knee flexors during swing phase
  • ankle PF during stance phase
74
Q

Strength Grade

Which muscle group requires a strength grade of
3-/5 to 3/5?

During which phase does it occur?

A

ankle DF in swing phase

75
Q

Strength Grade

Which muscle groups require a strength grade of 4/5?

During which phases do they occur?

A
  • hip extensors during stance phase
  • knee extensors during stance phase
76
Q

Abnormal Gait

Which abnormal gaits are caused by muscular weakness?

(8)

A
  1. Circumducted gait
  2. Glute max gait
  3. Glute med gait
  4. Trendenlengburg gait
  5. Anterior trunk lean
  6. Genu recurvatum
  7. Equinas gait
  8. Steppage gait
  9. Foot slap
  10. Drop foot
77
Q

Abnormal Gait

Which abnormal gaits are caused by ROM limitations?

(3)

A
  1. Vaulting gait
  2. Circumducted gait
  3. Equinas gait
78
Q

Abnormal Gait

Which abnormal gait is caused by pain?

(1)

A

antalgic gait

79
Q

Abnormal Gait

What muscle weakness causes circumducted gait?

A
  • hip flexors
  • knee flexors
  • dorsiflexors
80
Q

Abnormal Gait

What muscle weakness causes extensor lurch/posterior trunk lean?

A

glute max

81
Q

Abnormal Gait

What muscle weakness causes glute med gait?

A

glute med

82
Q

Abnormal Gait

What are the two types of glute med gait and what are they called?

A
  1. compensated - abductor lurch
  2. uncompensated - Trendelenburg gait
83
Q

Abnormal Gait

Describe compensated glute med gait.

A

trunk sidebends over weak leg to compensate for glute med weakness to avoid hip of opposite leg from dropping

84
Q

Abnormal Gait

Describe uncompensated glute med gait.

What is it called?

What amount of hip drop is considered excessive?

A

weakness of glute med on affected leg causes hip to drop on opposite side

Trendelenburg gait

> 5º

85
Q

Abnormal Gait

How is Trendelenburg gait named?

A

named after the weak side

86
Q

Abnormal Gait

Which side is weak during R Trendelenburg gait? Which hip drops?

A
  • R side is weak
  • L hip dropsROM
87
Q

Range of Motion

What ROM is required of the hip during initial contact?

A

25º of flexion

88
Q

Range of Motion

What ROM is required of the hip during terminal stance?

A

10º-20º of extension

89
Q

Range of Motion

What ROM is required of the hip during initial swing?

A

25º-30º of flexion

90
Q

Range of Motion

What ROM is required at the knee during pre-swing?

A

30º-40º of flexion

91
Q

Range of Motion

What ROM is required at the knee during midswing?

A

65º of flexion

92
Q

Range of Motion

What ROM is required at the ankle during terminal stance?

A

10º-15º of DF

93
Q

Range of Motion

What ROM is required at the ankle at heel off?

A

10º-15º of DF

94
Q

Range of Motion

What ROM is required at the ankle during pre-swing?

A

15º-20º of PF

95
Q

Range of Motion

What ROM is required at the ankle during initial swing?

A

10º-20º of PF

96
Q

Range of Motion

What ROM of hip flexion is required for normal gait?

A

25º-30º

97
Q

Range of Motion

What ROM of hip extension is required for normal gait?

A

10º-20º

98
Q

Range of Motion

What ROM of knee flexion is required for normal gait?

A

65º

99
Q

Range of Motion

What ROM of knee extension is required for normal gait?

A

0º

100
Q

Range of Motion

What ROM of ankle DF is required for normal gait?

A

10º-15º

101
Q

Range of Motion

What ROM of ankle PF is required for normal gait?

A

15º-20º

102
Q

Components of Gait Cycle

What is this stage?
During which phase does it occur?

A

Heel strike/initial contact during stance phase

103
Q

Components of Gait Cycle

What is this stage?
During which phase does it occur?

A

foot flat/loading response during stance phase

104
Q

Components of Gait Cycle

What is this stage?
During which phase does it occur?

A

midstance during stance phase

105
Q

Components of Gait Cycle

What is this stage?
During which phase does it occur?

A

heel off/terminal stance during stance phase

106
Q

Components of Gait Cycle

What is this stage?
During which phase does it occur?

A

toe off/pre-swing during stance phase

107
Q

Components of Gait Cycle

What is this stage?
During which phase does it occur?

A

acceleration/initial swing during swing phase

108
Q

Components of Gait Cycle

What is this stage?
During which phase does it occur?

A

midswing during swing phase

109
Q

Components of Gait Cycle

What is this stage?
During which phase does it occur?

A

deceleration/terminal swing during swing phase

PTA 160 (11 decks)

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