Gait Flashcards
(29 cards)
what are 5 attributes for normal walking?
1- stability in stance
2- sufficient foot clearance in swing
3- appropriate preposition of the foot for initial contact
4- adequate step length
5- energy conservation
what are prerequisites for gait?
adequate motor control
CNS maturation
intact neuro system
adequate ROM
adequate strength
adequate bone structure
composition
sensation (proprioception)
mature gait occurs through what?
Neurological
- CPG’s
- myelination
Biomechanical
-skeletal structure, size, body mass
Psychological
-motor learning
Environmental
-opportunity
what are determinants of mature gait?
duration of single limb stance
walking velocity
cadence
step length
ration of pelvic span to ankle spread
what are gait pattern changes?
wide BOS decreased to width of pelvic span
stride length correlates with age, leg length and height
cadence decreased, velocity increased
reciprocal arm swing: 4-5 months after I walking
heel strike occurs about 5-6 months after I walking although HS with DF and knee ext by 2 y/o
plantar flexion with knee flexion occurs by age 2
gait patten changes in cadence and velocity
cadence decreased, velocity increased
12 months:
- 175 steps/min
- 64 cm/sec
3 years:
- 153 steps/min
- 86 cm/sec
7 years:
- 143 steps/min
- 114 cm/sec
adult:
- 114 steps/min
- 122 cm/sec
refinement of gait at 0-9 months:
body fat composition
femoral anteversion
tibiofemoral angle: varus
everted heels with WBing
postural control and antigravity muscle strength
active kicking in supine
prone, creeping, kneeling, cruising
refinement of gait at 9-15 months:
wide BOS, hips ABD, flexed, ER, full foot initial contact
relative foot drop in swing
increased cadence. decreased stride length
mild internal tibial torsion
tibiofemoal angle: varus
heels everted in WBing
body composition
slippery surface (stiff extremities, high guard)
refinement of gait at 18-24 months:
increase in strength
neurological maturation
walking experience
tibiofemoral angle: STRAIGHT
decreased BOS, normal ABD
knee flexion wave emerging
heel strike developing (consistent at 24 months)
decreased co-contractions of antagonists
refinement of gait at 3-3.5 years old:
joint anges mature, adult-like
tibiofemoral angle: max valgus
EMG activity is mature
refinement of gait at 6-7 years:
fully mature gait pattern
tibiofemoral angle: neutral
femoral anteversion resolved
heel position neutral
refinement of gait:
most adult patterns of movement are present by 3-4 y/o
changes in velocity, step length and cadence continue until 7 y/o
by 7, the child’s gait and posture is nearly identical to that of an adult
what are prerequisites for normal gait? how are they…?
achieving forward progression?
achieving foot clearance?
loading their foot?
maintain stability in stance?
achieving adequate step length?
achieving energy conservation?
toe walking:
normal variation during the learning to walk period of development
usually changes in 3-6 months
what to do if toe walking is significant?
HC stretch
gait training
SLC- serial casting
surgery
toe walking diagnosis:
habitual or idiopathic (by exclusion)
most are capable of heel-toe gait
HS/ADD tightness for CP
other factors:
- sensory/tactile defensiveness
- autism
- severe MR
correlate with language delay
what are common hip deformities?
femoral anteversion
femoral retroversion
what is femoral anteversion?
excessive hip IR, in toeing
tx: leg tuck sleeping position; W sit for TV watching
what is femoral retroversion?
excessive ER, out toeing, SCFE
what are common knee deformities?
genu valgus
genu varus
genu recarvatum
tibital torsion
what is genu valgus?
tibia positioned laterally relative to femur
what is genu varus?
lateral bowing of the tibia
what is genu recurvatum?
knee hyperextension
what is tibial torsion?
excessive rotation of tibia related to femur (usually medially)
