05-08: Gait Flashcards Preview

05 - Tests and Measurements > 05-08: Gait > Flashcards

Flashcards in 05-08: Gait Deck (59):
1

Phases of Gait (2)

- Stance Gait
- Swing Gait

2

Stance Gait

- Stability Phase
- 60% of gait cycle
- Foot is in contact with the ground; starts when one heel hits the ground, ends when that foot leaves the ground

3

Swing Gait

- 40% of gait cycle
- Starts when toe of one LE leaves the ground, ends when heel of same LE hits the ground

4

Standard terminology - Stance (spot)

- Heel strike
- Foot flat
- Midstance
- Heel off
- Toe off

5

Rancho Los Amigos - Stance (mobility)

- Initial contact
- Loading response
- Midstance
- Terminal stance
- Pre-swing

6

Foot slap

- Impairments
- Happens if dorsiflexors (tibialis anterior) are impaired

7

Standard Terminology - Swing

- Acceleration
- Midswing
- Deceleration

8

Rancho Los Amigos - Swing

- Initial swing
- Midswing
- Terminal swing

9

Heel Strike (ST)

Instant heel touches the ground to the beginning of stance phase

10

Foot Flat (ST)

Entire foot makes contact with the ground

11

Midstance (ST)

Entire body weight is directly over the stance limb

12

Heel off (ST)

Heel of stance limb leaves the ground

13

Toe off (ST)

Only toe of the stance limb remains on ground

14

Acceleration (ST)

Toe off is complete and the reference limb swings until positioned directly under the body

15

Midswing (ST)

Swing limb is directly under the body

16

Deceleration (ST)

Swing limb begins to extend and ends just prior to heel strike

17

Initial contact (RLA)

- Foot touches the ground
- H = 30˚ Flexion, K = 0˚, A = 0˚, T = 0˚

18

Loading response (RLA)

- The period of time between initial contact and the beginning of the swing phase for the other leg
- H = 25˚ Flexion, K = 15˚ Flexion, A = 10˚ Plantar flexion, T = 0˚

19

Midstance (RLA)

- The point when other foot is off the floor until the body is directly over the stance limb
- H = 0˚, K = 0˚, A = 5˚ Dorsiflexion, T = 0˚

20

Terminal Stance (RLA)

- Begins when stance limb's heel rises and ends when the other foot touches the ground
- H = 10˚ Extension, K = 0˚, A = 10˚ Dorsiflexion, T = 30˚ MTP Extension

21

Pre-Swing (RLA)

- Begins when the other foot touches the ground and ends when the stance foot reaches toe off
- H = 0˚, K = 40˚ Flexion, A = 20˚ Plantar flexion, T = 60˚ MTP Extension

22

Initial Swing (RLA)

- Begins when stance leg lifts from the floor and ends when maximal knee flexion during swing
- H = 15˚ Flexion, K = 60˚ Flexion, A = 10˚ Plantar flexion, T = 0˚

23

Midswing (RLA)

- Begins when maximal knee flexion during swing and ends when the tibia is perpendicular to the ground
- H = 25˚ Flexion, K = 25˚ Flexion, A = 0˚, T = 0˚

24

Terminal Swing (RLA)

- Begins when the tibia is perpendicular to the ground and ends when the foot touches the ground
- H = 35˚ Flexion, K = 0˚, A = 0˚, T = 0˚

25

Tibialis Anterior (Peak activity)

- Just after heel strike
- Eccentric lowering of the foot into plantarflexion

26

Gastroc-Soleus Group (Peak activity)

- Late stance phase
- Concentric raising of the heel during toe off

27

Quadriceps Group (Peak activity)

- 1st: Single limb support during stance phase
- 2nd: Just before toe off to initiate swing phase

28

Hamstring Group (Peak activity)

- Last part of swing phase
- Deceleration of the unsupported limb

29

ROM Requirements (Gait)

- Hip Flexion: 0-35˚
- Hip Extension: 0-10˚
- Knee Flexion: 0-60˚
- Knee Extension: 0˚
- Ankle dorsiflexion: 0-10˚
- Ankle plantar flexion: 0-20˚

30

Gait Cycle

Sequence of motions that occur from one initial contact of the heel to the next consecutive initial contact of the same heel

31

Base of Support/Width of Walking Base/Step Width

- Distance measured b/t the midpoints of heel contact of the L foot and R foot during consecutive steps in gait
- Distance decreases as cadence increases
- Avg. adult step width = 2-4 inches (5-10 cm)

32

Step Length

- Distance measured b/t R heel strike and L heel strike
- Includes double support, single support, stance and swing of one LE
- Avg. adult step length = 13-16 inches

33

Stride Length

- Distance measured b/t R heel strike and the following R heel strike
- Avg. adult stride length = 26-32 inches

34

Cadence

- Walking speed
- Number of steps a person will walk over a period of time
- Walking slowly = increases time both feet on ground
- Walking quickly = decreases time both feet on ground
- Avg. adult cadence = 110-120 steps per minuteea

35

Walking velocity

- Rate of linear forward motion of the body
- Walking velocity = distance/time
- Recorded in meters per second, feet per second, etc.

36

Single limb phase/support

Only one foot is on the ground and occurs twice during a single gait cycle

37

Double limb phase/support

- Both feet are on the ground at the same time
- Time of double limb support increases as speed of gait increases
- Does not exist during running
- Occurs twice during the gait cycle

38

Degree of toe-out

- Angle formed by each foot's line of progression and a line of intersecting the center of the heel and second toe
- Avg. adult degree of toe-out = 7˚

39

Pelvic rotation

- Rotation of the pelvis opposite to the thorax
- Maintains balance, regulates speed
- Avg. adult = 8˚ (4˚ forward, 4˚ backward), with stance leg
- Counter rotation of thorax helps maintain balance

40

Arm swing during gait

- Help maintain balance
- Opposite UE and LE simultaneously
- Can be altered by Ue injury, trunk rotation problem or LE limitation

41

COG during gait

- Moves vertically and horizontally displaced equally around 2" each
- Pelvic lateral tilt up and down (frontal plane) minimizes displacement of COG

42

Antalgic gait

- "Painful gait"
- Protective gait pattern: Shortened stance time; fast, short step on uninvolved side
- Involved step length is decreased: Avoid WB on involved side b/c of pain

43

Ataxia

- Wide BOS
- Jerky, unsteady movements
- Difficulty walking in straight line; staggering
- Drunken sailor

44

Circumduction

- Circular motion to advance the LE during swing phase
- Compensates for insufficient hip flexion, knee flexion, dorsiflexion
- Limb can be too long

45

Double step

- Alternate steps are of different length or different rate
- Not a controlled gait pattern

46

Equine (or Equinus) gait

- High steps
- Caused by excessive gastroc activity or leg length descrepancy (LLD)

47

Festinating gait

- Starts slow, increases and may continue until pt grasps an objective
- Difficulty controlling acceleration and deceleration
- Pt might progress to walking to toes

48

Parkinsonian gait

- Shuffling gait
- Flexed trunk ( --> fwd COG), flexed LEs, decreased UE swing, decreased stride length
- Short rapid steps --> attempt to regain balance and prevent falling
- Impaired initiation of movement

49

Scissor gait

- Legs cross midline when advanced
- Caused by spastic hip adductors

50

Spastic gait

- Stiff movement
- Toes catch and drag, LE adducted, hip and knee joints slightly flexed

51

Foot drop

- "Steppage Gait"
- Deep peroneal nerve impairment
- Inability to clear foot during swing b/c DF weakness
- Compensate with excessive hip and knee flexion to advance the LE
Foot slaps on initial contact ---> decrease control

52

Trendelenburg gait

- Usually gluteus medius weakness
- Excessive lateral trunk flexion and WS over stance LE

53

Vaulting

- Uninvolved stance LE elevates at pelvis and PF to allow the involved LE to swing and advance
- Vault on short side, or side that can't flex

54

Crouch gait

- Limited trunk rotation
- Lumbar lordosis, anterior pelvic tilt, hip and knee flexion, ankle plantar flexion, exaggerated arm swing

55

Rocking horse gait

- Caused by gluteus maximus weakness
- Hip tends to go into flexion during stance without good stabilization by hip extensors
- Trunk shifts posterior to compensate
- Excessive forward and backward trunk shifting resembles rocking horse

56

Quadriceps weakness gait

- Inability to extend knee during stance
- Compensates with trunk forward flexion and plantar flexion --> knee hyperextension

57

Hamstring weakness gait

- Both stance and swing affected
- Stance: Knee in genu recurvatum (pushed backward)
- Swing: During deceleration, knee slaps into extension b/c hamstring not strong enough to slow down the forward swing of the LE

58

Foot slap

- Foot slaps on the ground during heel strike
- Weak dorsiflexors; ankle not able to suppport weight of body at heel strike

59

Waddling gait

- Shoulder behind hips
- Little or no reciprocal pelvis or trunk rotation
- Compensation of excessive lateral WS to advance LE
- Often accompanied by lumbar lordosis and foot drop
- Seen in Muscular dystrophy