Gait

Question 1

What is Gait?

Answer 1

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

Question 2

What systems require an energy efficient interaction between them to achieve a normal gait?

Answer 2

Musculoskeletal system
Neurological system

Question 3

What is the gait cycle?

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 2 phases of the gait cycle?

Answer 4

Stance phase
Swing phase

Question 5

What is the stance phase?

Answer 5

Time foot is in contact with the ground and is weight bearing

Question 6

What is the swing phase?

Answer 6

Time when the foot is not in contact with the ground

Question 7

What is the approximate percentage of time spent in the stance phase and swing phase in normal gait?

Answer 7

Stance phase = 60%
Swing phase = 40%

Question 8

What are the 5 important attributes needed for a normal gait?

Answer 8

Stability in stance
Foot clearance in swing
Pre positioning for initial contact
Adequate step length
Energy conservation

Question 9

What is double support?

Answer 9

Time when both feet are in contact with the floor

Question 10

What is double float?

Answer 10

Time when both feet are off the floor

Question 11

At what point does walking become classified as running?

Answer 11

When double float starts

Question 12

What happens to the period of double float when you run faster?

Answer 12

Double float increases

Question 13

What are the 5 stages of the stance phase?

Answer 13

Initial contact (heel strike)
Loading response (shock of impact absorbed)
Mid stance (foot flat)
Terminal stance (Heel off)
Pre swing (Toe off)

Question 14

What are the 3 stages of swing phase?

Answer 14

Initial swing
Mid swing
Terminal swing

Question 15

What is a stride?

Answer 15

Distance travelled in one gait cycle
Distance from initial contact to initial contact with the same leg
(2 steps)

Question 16

What is a step?

Answer 16

Half a stride
Distance from initial contact on one leg to initial contact o the other leg

Question 17

What is cadence?

Answer 17

Number of steps per minute

Question 18

What is kinematics?

Answer 18

Describing motion

Question 19

What is kinetics?

Answer 19

Describes the things that cause motion

Question 20

What is concentric muscle work?

Answer 20

When muscles shorten generating power

Question 21

What is eccentric muscle work?

Answer 21

When muscles lengthen absorbing power

Question 22

What is isometric muscle work?

Answer 22

When muscles stay the same length providing stability

Question 23

What muscles are working in the leg from when intial contact is made (heel strike) to toe off?

Answer 23

Anterior compartment muscles (Tibialis anterior) dorsiflexor is eccentrically contracting so foot doesn’t slap onto floor
Once foot is flat on ground Tibialis anterior relaxes, Gastrocnemius and Soleus generate propulsion power by plant flexing ankle (posterior compartment muscles of leg)

Question 24

What conserves energy in normal gait?

Answer 24

COG moves relatively little
Momentum controlled by eccentric muscle contractions
Energy transferred between body segments (arms for momentum)
Muscles intermittently used to prevent fatigue

Question 25

What is an Antalgic gait?

Answer 25

Limp Walk/gait that reduces pain

Question 26

How is the gait phases affected in Antalgic gait?

Answer 26

Stance phase of affected leg REDUCED Swing phase of unaffected leg REDUCED

Question 27

How is a walking stick helpful for a patient with Antalgic gait?

Answer 27

Walking stick used is hand OPPOSITE painful limb Patient puts weight on the stick shifting their centre of gravity (COG) This reduces wait put on painful limb

Question 28

What is the Trendelenburg gait?

Answer 28

When pelvis drops on the healthy side in the stance phase Torso swings to affected side to move the COG to help compensate

Question 29

What causes Trendelenburg gait?

Answer 29

Hip ABductor weakness

Question 30

What may be the cause of Hip ABductor weakness causing Trendelenburg gait?

Answer 30

Neurological damage of the Superior gluteal nerve (supplies gluteus medius and minimus) Pain Surgical trauma

Question 31

Describe what you would see if a patient had damage to their left superior gluteal nerve?

Answer 31

LEFT Hip ABductor weakness Pelvis dips to the right Patient may lean their torso to the left to adjust their COG

Question 32

What is a hemiplegic gait caused by?

Answer 32

Paralysis of one side of the body

Question 33

What causes hemiplegic gait?

Answer 33

Hemi-brain injury: -stroke -cerebral palsy -trauma

Question 34

Describe what happens in a hemiplegic gait:

Answer 34

EXTENDED lower limb Circumduction of affected leg (brought forward in circular motion from outside to inside) Upper limb also tends to be flex on the affected side Patient

Question 35

What are the 2 phases of gait like in hemiplegic gait?

Answer 35

Short stance phase on affected leg Short swing phase on healthy leg

Question 36

What is spasticity?

Answer 36

Continuous contraction

Question 37

What is Diplegic gait?

Answer 37

When the spasticity affects both limbs Caused by neurological disorders like cerebral palsy

Question 38

What can diplegic gait also be called and describe why this happens?

Answer 38

Scissoring gait Adductors/Hamstrings/Iliopsoas are contracting flexing knees and bringing them together Ankles also plantar flexed (patient cant put heels on floor)

Question 39

What causes High Steppage gait?

Answer 39

Unilateral neurological damage Common fibular palsy causes food drop and foot slap since anterior muscle compartment weak (weak dorsiflexion) cant support the foot loading

Question 40

What are the tell tale signs of high steppage gait?

Answer 40

Foot drop, Toes hanging down Foot slap Excessive hip Flexion on affected side

Question 41

What causes parkinsonian gait?

Answer 41

Parkinson’s disease (Neurological condition)

Question 42

What are the characteristic features of a parkinsonian gait?

Answer 42

Lean forward for momentum Short shuffling steps Arms flexed NO ARM SWINGS

Question 43

What causes ataxic gait?

Answer 43

Cerebella’s disorders: -Inherited -Sensory -Intoxication

Question 44

Describe an ataxic gait:

Answer 44

Clumsy staggering movements Legs wide apart Patient holds arms out to balance Patients body may sway back and forth side to side