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Clinical Gait > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Gait

A

any method of locomotion characterized by periods of loading and unloading of the limbs

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2
Q

Characteristics of Gait

A
  1. Goal Oriented
  2. Efficient
  3. Involves Multiple Systems
  4. Integral to Daily Life
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3
Q

Stride

A

period from one heel strike to the next strike of the SAME foot

  • ~144 cm for adult males
    ex) R stride = R heel contact to next R heel contact
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4
Q

Step

A

period from one heel strike to the next heel strike of the OPPOSITE foot

  • named by the leading foot
  • ~72 cm for adult males
    ex) R step = L heel contact to R heel contact
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5
Q

Stance

A

period when reference foot is on the ground

- FIRST 60% of the gait cycle

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6
Q

Swing

A

period when reference foot is in the air

- LAST 40% of the gait cycle

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7
Q

Double Limb Support

A

2 periods when BOTH feet are on the ground

  • 1) Loading Response (0-10%)
  • 2) Pre-swing (50-60%)
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8
Q

Single Limb Support

A

period when only 1 foot is on the ground

  • 1 period for each foot - 2 periods/cycle
  • 1) Reference Limb (10-50%)
  • 2) Opposite Limb (60-100%)
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9
Q

Step Width

A

medial-lateral distance between heels

- Normal: 8-10cm

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10
Q

Fick Angle

A
  • angle of foot relative to the line of progression

- Normal: 7 degrees (toes OUT)

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11
Q

Cadence

A

steps/min

  • Males: 110 steps/min
  • Females: 116 steps/min
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12
Q

Walking Speed

A

good predictor of FUNCTION

  • 1.37 m/s (3 mph) = FUNCTIONAL
  • *generally increase step length BEFORE increasing cadence to increase speed
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13
Q

Functional Tasks

A

1) Weight Acceptance (0-10%)
2) Single Limb Support (10-50%)
3) Limb Advancement (50-100%)

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14
Q

Weight Acceptance

A

a) shock absorption
b) initial limb stability
c) preservation of forward progression

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15
Q

Single Limb Support

A

a) body weight support

b) preservation of forward progression

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16
Q

Limb Advancement

A

a) limb elevation
b) limb FORWARD advancement
c) preparation for stance

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17
Q

Initial Contact

A

% of Cycle: 0%
Key Event: heel contact
Functional Task: weight acceptance

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18
Q

Loading Response

A

% of Cycle: 0-10%
Key Events: SAME heel contact –> OPPOSITE toe-off
Functional Task: weight acceptance

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19
Q

Mid-Stance

A

% of Cycle: 10-30%
Key Events: OPPOSITE toe-off –> SAME heel rise
Functional Task: single limb support

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20
Q

Terminal Stance

A

% of Cycle: 30-50%
Key Events: SAME heel rise –> OPPOSITE initial contact
Functional Task: single limb support (last)

21
Q

Pre-Swing

A

% of Cycle: 50-60%
Key Events: OPPOSITE initial contact –> SAME toe-off
Functional Task: limb advancement

22
Q

Initial Swing

A

% of Cycle: 60-73%
Key Events: SAME toe-off –> feet adjacent
Functional Task: limb advancement

23
Q

Mid-Swing

A

% of Cycle: 73-87%
Key Events: feet adjacent –> tibia vertical
Functional Task: limb advancement

24
Q

Terminal Swing

A

% of Cycle: 87-100%
Key Events: tibia vertical –> SAME heel contact
Functional Task: limb advancement

25
Generators of Forward Progression
1) Initial Step - preparation >> weight shift >> progresssion 2) Foot Rockers - heel, ankle, forefoot, & toe 3) Propulsive Forces - CONCENTRIC mm activity to maintain forward progression (minimal b/c gait is efficient)
26
Shock Absorption
ECCENTRIC mm activity as a part of weight acceptance - a) Ankle - b) knee - c) hip
27
Vertical CoM Displacement
- 2 sine waves/cycle Low: midpoint of double limb support (5% - LR & 55% - PSw) High: midpoint of single limb support (30% - MSt & 80% MSw) Normal: 5 cm
28
Horizontal CoM Displacement
- 1 sine wave/cycle MAX: midpoint of stance (30% - ipsilateral & 80% - contralateral) Normal: 4 cm **reduced by pelvic obliquity; physiologic valgus; momentum/inertia
29
Minimize Vertical RISE of CoM
1) Pelvic Obliquity - ADDuction of WBing hip | 2) Knee flexion during LR/MSt
30
Minimize Vertical DROP of CoM
1) Pelvic Frontal Rotation - forward/backward motion 2) Ankle Sagittal Plane Rotation - DF/PF * *functionally LENGTHEN the limb
31
Selective Muscle Control
activation of particular muscles at specific times for specific purposes - requires intact proprioception & kinesthesia
32
GRF Components
1. ) Vertical - perpendicular to ground/supporting surface (120% BW) 2. ) A-P - parallel to supporting surface (20% BW) a) POSTERIOR at IC b) ANTERIOR at toe-off 3. ) Medial-Lateral - parallel to supporting surface (5% BW) - direction depends on location of CoM to foot
33
Center of Pressure
point of application of GRF - midpoint of heel (lateral) at IC - lateral midfoot region at MSt - medial forefoot >> great toe from TSt >> TO
34
Inverse Dynamic Equations - Linear: FORCES summed about the CoM - Angular: MOMENTS summed about the CoM - Joint reaction force & joint moment are only UNKNOWNS in the equation - calculated from the ground up
Inverse Dynamic Equations - Linear: FORCES summed about the CoM - Angular: MOMENTS summed about the CoM - Joint reaction force & joint moment are only UNKNOWNS in the equation - calculated from the ground up
35
Assumptions of JRFs
1) No Friction 2) Degrees of Freedom vary 3) Rigid Body Segments - masses concentrated at their CoM 4) No Co-Contraction of agonist/antagonists
36
Effect of Movement Speed | INCR speed -->> INCR body segment acceleration -->> INCR JRFs/GRFs -->> INCR joint moments
Effect of Movement Speed | INCR speed -->> INCR body segment acceleration -->> INCR JRFs/GRFs -->> INCR joint moments
37
Moment
external joint moments as a function of time
38
Initial Contact - Ankle Sagittal Plane
ROM: neutral Torque Demand: external PF Muscle Activity: pretibial mm (tibialis anterior & EDL) Functional Significance: foot position for LR
39
Loading Response - Ankle Sagittal Plane
ROM: neutral >> 5 deg PF Torque Demand: external PF Muscle Activity: pretibial mm (eccentrically) Functional Significance: heel rocker
40
Midstance - Ankle Sagittal Plane
ROM: 5 deg PF >> 5 deg DF Torque Demand: external DF Muscle Activity: gastroc & soleus (eccentric) Functional Significance: ankle rocker
41
Terminal Stance - Ankle Sagittal Plane
ROM: 5 deg DF >> 10 deg DF; MTP extend 30 deg Torque Demand: external DF (MAX) Muscle Activity: gastroc & soleus (MAX - eccentric) Functional Significance: forefoot rocker
42
Pre-Swing - Ankle Sagittal Plane
ROM: 10 deg DF >> 15 deg PF; MTP extend 60 deg Torque Demand: external DF DECR >> no GRF Muscle Activity: gastrocsoleus decreases rapidly - elastic recoil of PF thrusts tibia forward Functional Significance: toe rocker
43
Initial Swing - Ankle Sagittal Plane
ROM: 15 deg PF >> 5 deg PF Torque Demand: external PF (gravity) Muscle Activity: pretibial mm (concentric - against gravity into DF) Functional Significance: foot clearance contributes to single limb advancement
44
Mid Swing - Ankle Sagittal Plane
ROM: 5 deg PF >> neutral Torque Demand: LOW level external PF (gravity) Muscle Activity: pretibial mm (against gravity) Functional Significance: foot clearance contributing to limb advancement
45
Terminal Swing - Ankle Sagittal Plane
ROM: neutral Torque Demand: LOW external PF Muscle Activity: pretibial mm (isometric) Functional Significance: neutral foot position assures heel contact at IC
46
LR through MSt - Ankle Frontal Plane
ROM: 2 deg inversion >> 2-3 deg eversion Torque Demand: external eversion Muscle Activity: inverters - tib anterior & posterior (eccentric) Functional Significance: subtalar PRONATION assists w/ push-off
47
TSt through PSw - Ankle Frontal Plane
ROM: 2-3 deg eversion >> 4-6 deg inversion Torque Demand: eversion DECR >> inversion INCR Muscle Activity: posterior tib (concentric); soleus & peroneals (eccentric) - rigid foot for push-off Functional Significance: SUPINATION provides rigid lever for push-off
48
ISw through TSw - Ankle Frontal Plane
ROM: 4-6 deg inversion >> slight eversion Torque Demand: negligible Muscle Activity: pretibial & ankle inverters (eccentric) - controlling slight eversion Functional Significance: prepare foot for initial contact

Clinical Gait (1 decks)

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