Gait

Question 1

What gait phases are double limb?

Answer 1

IC

LR

PSw

Question 2

What gait phases are single limb?

Answer 2

MSt

Tst

ISw

MSw

TSw

Question 3

How much hip extension is required for gait?

How much hip flexion?

Answer 3

20 ext

30 flx

Question 4

How much knee flex/ext is required for normal gait

Answer 4

0-60

Question 5

How much plantar and dorisflexion is required for gait?

Answer 5

10 DF

20 PF

Question 6

Moment definition

Answer 6

rotation around an axis

external vs internal

Question 7

Power generation is accomplished with muscles ______

Power absorption is accomplished with muscles ______

Answer 7

shortening, concentric

Lengthening, eccentric

Question 8

During gait, the center of pressure starts ___________ on the heel, and moves _______ onto the ball of the foot

Answer 8

Posterio-lateral

anterio-medial

Question 9

The center of pressure is over the ______ during pre-swing

Answer 9

First and second toes

Question 10

What are the internal moments at the hip, knee, and ankle during initial contact?

Answer 10

Hip Ext, Knee Flexion, Ankle DF

Question 11

What are the interal moments at the hip, knee, and ankle during loading response?

Answer 11

Hip Ext, Knee EXT, Ankle DF

Question 12

What are the interal moments at the hip, knee, and ankle during midstance?

Answer 12

Hip FLX, Knee FLX, Ankle PF

Question 13

What are the interal moments at the hip, knee, and ankle during terminal stance?

Answer 13

Hip FLX, Knee FLX, Ankle PF

Question 14

What are the interal moments at the hip, knee, and ankle during preswing?

Answer 14

Hip FLX, Knee EXT, Ankle PF

Question 15

What are the 3 external forces in gait

Answer 15

Intertia

Gravity

Ground Reaction Force

Question 16

The goal of gait training is to

Answer 16

teach patient to use as little energy as possible

32% oxygen consumption in healthy 20-30y/o

48% oxygen consumption in 75y/o or person with medical condition

Question 17

T or F, limbs contribute more to total energy during walking than head and trunk

Answer 17

True

Question 18

the balance of concentric and eccentric
forces produce movement of segments and also control speed of moment

Answer 18

Power generation and absorption

Question 19

At the initial contact -> loading response phase, where is the fulcrum/rocker?

Answer 19

Fulrum/rocker at the heel

The calcaneous moves from inversion to eversion

Question 20

During loading response to terminal stance, what structure is the fulcrum/rocker?

Answer 20

ankle fulcrum

Question 21

During terminal stance, where is the rocker/fulcrum?

Answer 21

leg rotates over forefoot
-increase MTP extension

Question 22

During pre-swing, what is the rocker/fulcrum?

Answer 22

Leg rotates over toes
increase toe extension

Question 23

How does the rocker/fulcrum of the foot move throughout gait?

Answer 23

Heel -> ankle -> forefoot -> toes

Question 24

Trunk stays erect during free speed walking

slight trunk ________ at initial contact

slight trunk __________ during single leg stance

Answer 24

flexion
-HAT acceleration is counteracted by hip and back extensor

extension during SLS

Question 25

During gait, the adductor moment of the head+arm+trunk is counteracted by __________

Answer 25

abductors minimizing mvmt @ stance leg -prevention of contra hip drop

Question 26

What kind of movement occurs in the sagittal plane during gait?

Answer 26

sinusoidal pattern up and down 4-5cm with eachstep

Question 27

Where is the low point of the sinusoidal pattern

Answer 27

low at initial contact high at mid-stance

Question 28

What kind of motion occurs in the frontal plane during gait

Answer 28

pelvic side to side motion of 4-5cm and a 5 degree pelvic drop with trunk lean 5cm

Question 29

what kind of motion occurs in the transverse plane during gait

Answer 29

pelvic rotation 4-8 degrees with opposite trunk rotation

Question 30

During gait Frontal plane motion: Saggital plane motion: Transverse plane motion:

Answer 30

Saggital: Sinusoidal pattern Frontal: Pelvic side to side Motion Transverse: Pelvic rotation w/ trunk rotation

Question 31

During what part of gait is the erector spinae most active? NOTE: I think this will be a test Q because of how much Dr. Dice mentioned it.

Answer 31

LOADING RESPONSE

Question 32

erector spinae muscles two periods of activation coinciding with each

Answer 32

IC and pre-swing

Question 33

abs muscles activity is ___ and ___ related to ____ trunk movement

Answer 33

activity low and variable related to lateral trunk movement

Question 34

How much shoulder and elbow flx is normal during gait?

Answer 34

Shoulder ROM: 30 degrees total ( 6 flx 24 ext) elbow rom: 20-45

Question 35

UE muscle activity and movement is ____________

Answer 35

primarily driven by gravity and highly variable

Question 36

During stair gait, greater _______ activation is necessary torque at the knee is _____ greater for ascent vs descent

Answer 36

quad x3

Question 37

How is intial contact on stairs different than on ground?

Answer 37

Anterior to posterior foot level ground: Posterior to anterior foot

Question 38

What stage of stair gait is most knee flexion needed?

Answer 38

foot clearance

Question 39

what stage of stair gait is most hip flexion needed?

Answer 39

foot placement

Question 40

What are the 5 stages of stair gait

Answer 40

weight acceptance pull up foward continuance foot clearance foot placement

Question 41

What are the 3 stages of running gait?

Answer 41

Stance Float Swing

Question 42

During running gait, most torque generated is at the ______ during impact

Answer 42

Knee note: Ground reaction force at center of pressure is over 200% of BW

Question 43

What are the primary muscle groups used for running

Answer 43

Hip extensors Quadriceps Gastroc/Soleus

Question 44

During running you need increased ________________ in lower extremity

Answer 44

joint ROM

Question 45

stance % in running float % swing % in running

Answer 45

stance 40% float 10% swing 40% float 10%

Question 46

Neuro changes seen by age 90: Brain Mass, Muscle atrophy

Answer 46

decreased brain mass 10-20%, 1% muscle loss per year in healthy adults estimated 20-40% loss of maximal strength by age 65 atrophy of slow twitch fibers w/ inactivity overall diminished functional reserve

Question 47

Gait speed declines _____________ per decade

Answer 47

12-16% Decreased strike/step length More time w/ doublelimb support 30% instead of 18% deceased dorsiflexion

Question 48

estimated ____ % loss of maximal strength by age 65 without exercise

Answer 48

20-40%

Question 49

greater loss in __ fibers

Answer 49

fast type II

Question 50

atrophy of ____ fibers

Answer 50

slow twitch type 1 with inactivity

Question 51

extensors are affected more than flexors true or false

Answer 51

T

Question 52

Older patients gait will have a wider ____________ _____ toe clearance during swing phase _____ trunk flexion during gait and difficulty with obstacle avoidance

Answer 52

Base of support Less Foward

Question 53

Abnormal elderly gait includes ______ in gait measures Gait Variability ________ to change gait speed/direction postural sway that requires ________ inability to ________ while walking

Answer 53

Asymmetry Inability External Support Multitask

Question 54

Community functional benchmarks: Gait speed: ____ Distance ______ curb height ______

Answer 54

>4ft/sec >300m (984 ft) Curb height >8in

Question 55

important to doc an older person's gait speed/endurance a regular intervals to detect preclincal disability use ____ as a vital sign

Answer 55

gait

Question 56

Gait using a rolling walker might lead to slower speed: ________ smaller step length (1.1 ft) and ________ stance time/ ______ swing time

Answer 56

1.5 f/s (instead of 4 ft per second) Increased stance time/ Decreased swing time Note: Pattern becomes more apparent the longer an individual uses a RW

Question 57

Foward lean during gait might be due to: (weight acceptance & single limb support) ____ hip flexors a compensation for _______ quads (Increased plantarflexion) or ______ visual cues for __________ propriocepton abdominal pain Or assistive devices

Answer 57

Tight hip flexors Compensate for weak quads Increased visual cues for decreased proprioception Note: Shifts LOG in front of Knee and Ankle

Question 58

Backward lean in gait might be due to (weight acceptance & single limb support) Weak _______during weight acceptance and Single Limb Support or weak ___________ during swing (single leg advancement)

Answer 58

Hip Extensors (Leaning back takes the hip extensors out of the movement when supporting weight) Hip flexors ( Leaning back assists the weak hip flexors to swing the leg foward)

Question 59

Lateral lean of the trunk during gait might be due to weak hip ____________ or hip pain during weight acceptance or single limb support or a __________ stance limb Or a use of an assistive device

Answer 59

Abductors Short Stance Limb

Question 60

Gait deviations: Trunk rotations One example of a deviation is that trunk moves w/ pelvis due to decreased disassociation Use of assistive device Rotation of the trunk backwards during gait can compensate for ______ plantarflexion Rotation of the trunk foward during gait can help to _____________

Answer 60

Compensate for increased plantarflexion Rotation Foward to advance limb

Question 61

Pelvic deviations during gait: A hike can be used to ________ the swinging limb using _____ quadratus lumborum

Answer 61

Clear swinging limb using ipsilateral quadratus lumborum

Question 62

Pelvic deviation: Vault is simular to hike with an addition of _______

Answer 62

Plantarflexion

Question 63

Anterior Pelvic Tilt might be due to _______ hip extensors ______ Abdominals and _____ hip flexors

Answer 63

Weak hip extensors Weak Abdominals Tight Hip Flexors

Question 64

Posterior Pelvic tilt during gait might be due to _____ hip flexors ______ hip extensors _____ hamstrings shifts the Line of gravity ___________

Answer 64

Hip Flexor weakness hip extensor weakness tight HS Shifts LOG posteriorly (backward trunk lean)

Question 65

Pelvic deviations: if you're lacking rotation foward or backward it can be due to ____________

Answer 65

Back Pain Decreased step length potential surgical fusion

Question 66

Excessive foward pelvic rotation can be due to ____________ Excessive backward pelvic rotation can be due to ___________--

Answer 66

Compensation to help advance limb Weak Calf, No heel Off (During terminal Stance) Or Excessive hip flexion (During single limb support)

Question 67

Pelvic drop during gait is likley to lead to ________ and can be due to weak ___________

Answer 67

Back pain during stance Weak calf (Ipisilateral during single limb support) Or scoliosis

Question 68

Hip drop due to a shorter LE will appear as _______ during single leg advancement and ______________ during single limb support

Answer 68

Ipsilateral to single limb advancement Contralateral to single limb support (trendelenberg)

Question 69

Weak hip abductors lead to a __________ hip drop during single limb support Adductor spasticity will lead to an ____________ pelvic drop in single limb advancement Adductor spasticity will lead to a ___________pelvic drop in single limb support

Answer 69

Contralateral Ipsilateral Contralateral

Question 70

excessive hip flexion due to -HF ___ -IT band ______ -hip pain -compensatory for increase ____ and ____ -compensatory for increase _____ MSw

Answer 70

-HF contracture or spascity -IT band tight/contracture -hip pain -compensatory for increase KF and ankle DF (SLS) -compensatory for increase PF in MSw

Question 71

decrease hip extension due to

Answer 71

-iliopsoas contracture -hip capsule contacture -decrease knee extension hip pain

Question 72

Past retract gait voluntary excessive hip flexion and it's release in terminal swing in order to __________

Answer 72

rapidly extend a flaccid knee using inertia

Question 73

Decreased hip flexion during gait might be due to Hip flexor _______ hamstring _____________- hip pain compensation for Hip Extensor weakness during WA synergistic mvmt pattern or a result of foot drag

Answer 73

Hip Flexor Weakness Hamstring spasticity

Question 74

During initial swing decreased ________ reduces step length

Answer 74

Hip Flexion Limited hip flexion may also limit knee flexion during swing

Question 75

Decreased hip flexion due to gait is most impactful during ________, clearance of the LE needed

Answer 75

Most impactful durng Midswing

Question 76

hip IR in transverse plan due to

Answer 76

-anteversion -contracture/spasticity -voluntary to increase knee stability during stance if quad is weak -medial HS spasticty -adductor spasticity

Question 77

adductor spasticity causes hip

Answer 77

hip ir

Question 78

medial HS spasticty causes hip

Answer 78

hip IR

Question 79

retroversion causes hip

Answer 79

ER

Question 80

ER contracture causes

Answer 80

ER

Question 81

weak illiopsoas weak IP causes

Answer 81

ER

Question 82

compensation for PF contracture causes hip IR or ER

Answer 82

ER

Question 83

glute max spasticity cause hip IR or ER

Answer 83

ER

Question 84

compensation for reference limb too long in swing is ER or IR at hip

Answer 84

ER