Gait

Question 1

what is gait

Answer 1

mechanism by which the body is transported using co-ordinated movements of the major lower limb joints.

Question 2

what are the two phases of gait and how much of the gait cycle are they

Answer 2

stance phase - 60%. foot is in contact with the ground and is bearing weight.
swing phase- 40%. the foot in not in contact with the ground.

Question 3

what does the gait cycle describe

Answer 3

the period of time from initial contact to next initial contact on the same side of the body

Question 4

what are the five important attributes needed for normal gait

Answer 4

stability in stance - need to be able to transfer weight from one foot to another so stand on one foot.
foot clearance in swing- raising the foot off the ground as we bring it forward
pre-positioning for initial contact-preparing foot for the next stance phase
adequate step length- lower limb needs to be brought forward by a suitable distance during the swing phase before making contact with the ground during the next stance phase.
energy conservation

Question 5

what is double support and double float

Answer 5

when walking there is a point where both feet are in contact with the ground and that is double support. as the speed of your gait increases the period of double support decreases and there is double float which is a period where both feet aren’t in contact with the ground.

Question 6

Define running

Answer 6

when the swing phase is longer than the stance phase and there is a period of double float.

Question 7

what are the steps in the stance phase

Answer 7

initial contact
loading response 
mid-stance (foot flat)
terminal stance(heel off)
pre-swing (toe off)

Question 8

what are the steps of-swing phase

Answer 8

initial swing- knee flexes to enable the foot to clear the ground
mid-swing- hip flexes and the pelvis swings forward to enable forward progression. there is dorsiflexion of ankle to neutral position
terminal swing- knee extends, foot is brought close to the ground in preparation for the initial contact

Question 9

define stride

Answer 9

distance from initial contact with one leg to the next initial contact with the same leg

Question 10

define step

Answer 10

distance from initial contact with one leg to initial contact with the opposite leg

Question 11

define cadence

Answer 11

number of steps per min

Question 12

difference between kinematics and kinetics

Answer 12

kinematics describes the motions themselves and kinetics describes the forces and moments that cause motion

Question 13

kinetics of the ankle joint during the state phase

Answer 13

tibialis anterior is working eccentrically in initial contact and then relaxes when the foot is flat on the ground
during terminal space phase gastrocnemius and coleus take over to generate power needed for propulsion by powerfully plantar flexing the ankle.

Question 14

how is energy conserved in normal gait

Answer 14

Minimising the excursion of the centre of gravity of the body
 Controlling momentum e.g. by eccentric muscle contraction
 Transferring energy passively between body segments by using some of the
elasticity that is inherent in the tendons and ligaments of the
musculoskeletal system
 Phasic muscle action: using muscles intermittently e.g. using the example
above, tibialis anterior ‘switches on’ for some phases of the gait cycle (e.g. mid-swing) and ‘switches off’ during others (e.g. mid-stance). If a muscle contracts continuously during the gait cycle, it will fatigue much more rapidly than if it is used intermittently.

Question 15

what is antalgic gait

Answer 15

patients walk in a manner to reduce pain
limping- shortening stance phase of painful limb
shorten swing phase of normal limb
uneven gait
use walking stick in hand opposite to painful limb so they can lean towards walking stick and shift their centre of gravity away from painful limb

Question 16

describe hemiplegic gait

Answer 16

due to paralysis of one side of the body
commonly as a result of stroke
patients have spasticity of the affected side of the body so patients have a flexed upper limb and an extended lower limb.
cannot flex hip, knee or ankle so need to lean towards the unaffected side of the body then circumduct the paralysed leg.

Question 17

describe diplegic gait

Answer 17

spasticity affects both lower limbs

The patient walks with a very narrow-based gait (feet close together), dragging both legs and scraping their toes on the ground. Spasticity in the hip adductors can cause the legs to cross the midline – this is referred to as scissoring (figure 4.40)
Spasticity in the hamstrings means that the knees are slightly flexed and spasticity in the gastrocnemius and soleus results in plantar-flexion of the ankles

Question 18

describe high-steppage gait

Answer 18

When the foot is raised from the ground in the swing phase, the absence of active dorsiflexion means that the foot, under gravity, assumes a position of plantarflexion. The patient therefore has to flex the hip much more than usual in order to lift their foot high off the ground and stop their toes from dragging along the floor. During ‘initial contact’, the normal eccentric contraction of the tibialis anterior muscle is absent so the foot also tends to slap down onto the ground.

Question 19

describe parkinsonian gait

Answer 19

flex their neck and trunk forwards to move their centre of gravity in front of their lower limbs
shuffling gait
festinate gait- take accelerating steps
loss of arm swing while walking

Question 20

describe ataxic gait

Answer 20

An ataxic gait is characterised by clumsy, staggering movements with a broad-base (feet wide apart). Patients often hold their arms outwards to help them to balance. Whilst standing still, the patient’s body may sway back and forth and from side to side – this is called titubation. Patients will not be able to walk heel-to- toe or in a straight li