Gait!!

Question 1

what are the 3 functional tasks of gait?

Answer 1

weight acceptance,single limb support, and swing limb advancement

Question 2

what are the component of weight acceptance

Answer 2

forward progression, stability (preventing collapse), shock absorption

Question 3

what are the components of single limb stance

Answer 3

forward progression and stability

Question 4

what are the components of swing limb advancement

Answer 4

foot clearance and limb advancement

Question 5

define gait cycle.

Answer 5

initial heel contact of one foot to the heel contact of the SAME foot.

Question 6

Describe the distribution of time spent in stance phase and swing phase. Dual limb and single limb?

Answer 6

Stance (60%)+(Swing (40%)

Single (80) +Double (20%)

Question 7

Stride length

Answer 7

Distance between 2 successive heel contacts of same foot (2 steps)
Normal=1.48M and 1.32F

Question 8

Step length

Answer 8

Distance between successive heel contacts of different feet> informs gait symmetry

Question 9

degree of toe out

Answer 9

angle between the line of progression of the body and a line that goes through the heel and second toe; can accommodate to increase BOS
normal: 5-7

Question 10

step width

Answer 10

the lateral distance between heel centers of 2 consecutive foot contacts
normal: 3.5 inches

Question 11

what are the spatial descriptors of gait?

Answer 11

stride length
step length
degree of toe-out
step width

Question 12

what are the temporal descriptors of gait?

Answer 12

stance time
stride time
step time
cadence

Question 13

stance time

Answer 13

amount of time in stance phase

Question 14

stride time

Answer 14

time for a full gait cycle, usually around 1 sec is normal

Question 15

step time

Answer 15

time for completion of a R or L step -whichever is affected

Question 16

cadence aka step rate

Answer 16

number of steps/min

normal: 111 steps/minM and 121 steps/minF

Question 17

gait velocity (m/s or mph)

Answer 17

most relevant test of gait-walking efficiency

normal: 1.37m/s M and 1.32m/s F

Question 18

What are the 8 common terms of Rancho Los Amigos Terminology?

Answer 18

Stance Phase:
initial contact, loading response, midstance, terminal stance, Pre-swing

Swing phase:
initial swing, mid swing, terminal swing

Question 19

initial contact (critical event, functional task, muscles involved )

Answer 19

critical event: heel first contact
muscles: hip ext, knee ext, ant tib A
Position (hip,knee,ankle) : 20>5>0

Question 20

loading response (critical event, functional task, muscles involved )

Answer 20

critical event: hip stability, controlled knee flex, and ankle PF
»shock absorbed, momentum preserved, flat foot
muscles: hip and knee ext, hip add, pretibials
Position (hip,knee,ankle) : 20>15>5

Question 21

combined, what do IC and LR do functionally:

Answer 21

weight acceptance
shock absorption 
stable base for the body to progress over 
GRF absorbed
Dual limb support

Question 22

midstance (critical event, functional task, muscles involved )

Answer 22

critical event:controlled body and tibial advancement
muscles: abductors (hip), lessening ext (knee),PF (ankle)
Position (hip,knee,ankle) : 0>5>5

Question 23

terminal stance (critical event, functional task, muscles involved )

Answer 23

critical events; controlled DF with heel rise as body passes forefoot of stance limb
muscles : only the PF @ ankle
Position (hip,knee,ankle) : 20>5>10

Question 24

preswing (critical event, functional task, muscles involved )

Answer 24

weight transfer>second pd of dual limb support
critical events: passive knee flex to 40 degrees and ankle PF at 60, MTP ext

muscles: hip adductors, beginning pretib activation at ankle
Position (hip,knee,ankle) : 10>40>15PF

Question 25

Initial swing

Answer 25

critical events: hip flexion and knee flexion to clear the floor functional task:limb advancement muscles: hip and knee flexors, pretibials

Question 26

mid-swing (critical event, functional task, muscles involved )

Answer 26

thigh advancing, knee extending critical events: continued hip flexion and foot clearance muscles: hip and knee flexors, pretibials Position (hip,knee,ankle) : 25>25>0

Question 27

terminal swing (critical event, muscles involved )

Answer 27

where the leg reaches to achieve step length critical event: knee ext muscles:hip and knee ext, pretibials Position (hip,knee,ankle) : 20>5>0

Question 28

What phases make up weight acceptance?

Answer 28

Initial contact | loading response

Question 29

what phases make up single limb support?

Answer 29

mid stance and terminal stance

Question 30

What compensations might you observe in someone with decreased great toe ext? What might have caused it?

Answer 30

observed: incomplete forefoot rocker, shortened stance phase causE: joint hypomobility, plantar fasciitis, pain, bone spur, etc

Question 31

What compensations might you observe in someone with steppage gait/increased knee flexion? What might have caused it?

Answer 31

observation: increased hip/knee flexion and no DF; prolonged swing causes: foot drop, nerve disorder, equinus deformity

Question 32

What compensations might you observe in someone with foot flat contact? What might have caused it?

Answer 32

observation: absent heel rocker> mid/forefoot contact ground first causes: excessive knee flexion in late swing , weak DF

Question 33

What compensations might you observe in someone with circumduction? ? What might have caused it?

Answer 33

observation: lateral whipping of the leg due to an elongated swing limb causes: likely no knee flexion but at least impaired, impaired DF ROM

Question 34

What compensations might you observe in someone with increased lordosis? What might have caused it?

Answer 34

observation: lack on hip ext in TS> lumbar lordosis for terminal stance phase causes: hip flexor contracture, hip OA

Question 35

clinical application: what are the 5 characteristics of muscular dysfunction:

Answer 35

``` weakness loss of power decreased endurance spasticity contracture ```

Question 36

Key roles of the ankle joint:

Answer 36

dorsiflexors: eccentric control of PF at IC plantarflexors: eccentric control during tibial advancement; concentric @Tst invertors: eccentrically control pronation until MSt; concentrically supinate for push off evertors: co-contract to counter stronc inversion during LR/MSt

Question 37

Key roles of the hip joint:

Answer 37

extensors: initiate hip ext and prep for IC flexors: advance LE during ISw; conc lift LE for toes clearance abductors: eccentrically ctrl lowering of contrala pelvis + stability in stance adductors: conc assist hip flexion after toe off

Question 38

What compensations might you observe in someone with trendelenburg gait? What might have caused it?

Answer 38

observation: longer swing limb and potentially decreased stance time w/ excessive downward drop of contralat pelvis causes: mild glute med weakness

Question 39

What might you observe in someone with compensated trendelenburg gait? What might have caused it?

Answer 39

observation: reduced Gmed demand by trunk lean over stance limb to level pelvis causes: moderate to severe glute med

Question 40

What compensations might you observe in someone with foot slap? What might have caused it?

Answer 40

observation: rapid PF after IC (can be audible) bc PF is unchecked by pretibials causes: Tib ant weakness

Question 41

What compensations might you observe in someone with knee extension thrust? What might have caused it?

Answer 41

observation: rapis and excessive knee extension during LR causes: quat spasticity for UMN lesion