Gait

Question 1

Average step length and stride length

Answer 1

Step: 14-16 inches

Stride: 28-32 inches

Question 2

General factors that may change gait

Answer 2

Age
Pain
Disease
Fatigue

Question 3

Avg cadence?

How is this different in women vs. men?

Answer 3

Avg cadence = 90-120 steps/min

Women higher by 6-9 steps/min

Question 4

Avg gait speed

Answer 4

3 mph

Question 5

Gait cycle

Answer 5

From heel strike to next heel strike of SAME foot

Question 6

What are the 2 main phases of gait

Answer 6

Stance - period when foot is in contact with ground

Swing - period when foot is not in contact with ground

Question 7

4 sub-phases of gait

Answer 7

[stance] = contact –> midstance –> propulsion

[swing] = swing

Question 8

Define contact

Answer 8

Lateral calcaneus strikes ground and at point of impact, tibia internally rotates, causing calcaneus to evert and talus to drop and adduct to unlock midtarsal joints and provide max shock absorption

Foot is lowered eccentrically to ground by extensor digitorum longus and tibialis anterior

Question 9

Define mid-stance

Answer 9

Cycle progresses from flat foot to heel off, as rearfoot fully pronates, metatarsals hit ground to bring foot flat on ground, body’s center of gravity passes from behind to over foot

During this phase, subtalar joint resupinates (calcaneus everts and talus abducts) and locks midtarsal joints, transforming foot from shock absorber to rigid lever

Posterior tibialis is an important restraint to overpronation and is an active foot supinator. As body passes over midfoot, it places ankle in max dorsiflexion, putting maximal preload on the gastroc/soleus complex

Question 10

Define propulsion

Answer 10

Heel lift progresses to toe off

Question 11

Define swing

Answer 11

Last phase of gait - foot dorsiflexes to keep toes from hitting ground and supinates to position foot for lateral calcaneus to make contact aat heel strike

Cycle then repeats

Question 12

How much of the gait cycle is spent in stance phase?

Answer 12

60%

Question 13

During which phase of gait do most problems occur?

Answer 13

Stance phase

Question 14

Stance phase consists of initial contact, loading response, midstance, terminal stance, and pre-swing. Which of these comprises the majority of stance phase?

Answer 14

Pre-swing 50-60% of stance phase

Question 15

Which part of stance phase is heel strike?

Answer 15

Initial contact

Question 16

Which part of stance phase is foot flat?

Answer 16

Loading response

Question 17

Which part of stance phase is heel off?

Answer 17

Terminal stance

Question 18

Which part of stance phase is toe off?

Answer 18

Pre-swing

Question 19

Swing phase makes up 40% of total gait cycle. What are the components of swing phase?

Answer 19

Initial swing
Midswing
Terminal swing

Question 20

When the right leg is in initial contact(heel strike), the left side is ___________

Answer 20

Terminal stance (heel off)

Question 21

When the right leg is in loading response (foot flat), the left side is ___________

Answer 21

Pre-swing (toe off)

Question 22

When the right leg is in midstance, the left side is ___________

Answer 22

Midswing

Question 23

When the right leg is in terminal stance (heel off), the left side is ___________

Answer 23

Initial contact (heel strike)

Question 24

When the right leg is in pre swing (toe off), the left side is ___________

Answer 24

Loading response (foot flat)

Question 25

Function of initial contact phase of gait

Answer 25

Establish contact with leading foot, begin stance

Question 26

Function of loading response (phase 2 of gait)

Answer 26

Shock absorption Begin weight bearing Continue progression

Question 27

Function of phase 3 of gait: midstance

Answer 27

Limb and trunk stability | Progression over stationary foot

Question 28

Function of phase 4 of gait: terminal stance

Answer 28

Progression past stationary foot | Prepare for swing

Question 29

Function of phase 5 of gait cycle: preswing

Answer 29

Weight release from stationary foot | Position limb for swing

Question 30

Function of phase 8 of gait cycle: initial swing

Answer 30

Prepare foot for clearance | Advance foot from trailing position

Question 31

Function of phase 7 of gait cycle: midswing

Answer 31

Foot clearance | Limb advancement

Question 32

Function of phase 8of gait cycle: terminal swing

Answer 32

Prepare for stance | Complete limb advancement

Question 33

8 phases of gait

Answer 33

1. Initial contact 2. Loading response 3. Midstance 4. Terminal stance 5. Pre-swing 6. Initial swing 7. Midswing 8. Terminal swing

Question 34

5 requirements of gait

Answer 34

Stability in swing Foot clearance in swing Preposition for initial contact Adequate step length Energy conservation

Question 35

Foot clearance in swing requires what motions of the LE?

Answer 35

Ankle dorsiflexion Knee flexion Hip flexion

Question 36

Adequate step length is a requirement for gait. What happens if steps are too short vs. too long?

Answer 36

Too short: expends energy, minimal progress Too long: lose balance, strain ligaments and muscles

Question 37

How is energy conserved through pelvic List?

Answer 37

In early stance, as weight is being transferred to foot, hip on nonweight bearing side DROPS about 2" (to make up for center of gravity moving about 2" up and down during gait cycle)

Question 38

How is energy conserved in the gait cycle as the foot moves forward for heel strike?

Answer 38

Innominate (pelvic) rotation - innominate will rotate forward in a sagittal plane Effect is to lengthen femur (some compensation for pelvic list) Rotation is about 4 degrees, and reverses in stance phase

Question 39

How does your center of mass compensate to facilitate abduction of the hip during stance phase?

Answer 39

Pelvis shifts laterally about 2"

Question 40

Pathologic gait described as painful

Answer 40

Antalgic

Question 41

Pathologic gait described as stiff

Answer 41

Arthrogenic

Question 42

Pathologic gait described as unsteady

Answer 42

Ataxic

Question 43

Pathologic gait described as semicircle

Answer 43

Hemiplegic

Question 44

Pathologic gait described as shuffling

Answer 44

Parkinsonian

Question 45

Pathologic gait described as foot drop

Answer 45

Steppage

Question 46

_____gait = swing enhanced on affected side, stance phase shortened on affected side, adopted limp to avoid pain on weight bearing structures

Answer 46

Antalgic

Question 47

Causes of antalgic gait

Answer 47

``` Trauma Osteoarthritis Pelvic girdle pain Coxalgia Tarsal tunnel syndrome ```

Question 48

______ gait = due to stiffness in joints; plantar flexion of contralateral foot during stance phase to increase clearance (circumduction)

Answer 48

Arthrogenic

Question 49

Causes of arthrogenic gait

Answer 49

Osteoarthritis of hip/knee joints Post orthopedic surgeries of hip/knee

Question 50

____ gait may lurch or stagger, patient watches feet while walking, needs broad base of support

Answer 50

Ataxic

Question 51

Causes of ataxic gait

Answer 51

``` Vestibular Cerebellar abscess/hemorrhage Friedrichs ataxia Pontine-cerebellar atrophy Chronic mercury poisoning Posterior fossa tumor Wernicke's syndrome (alcohol abuse) Drugs ```

Question 52

_____ gait may be caused by cerebrovascular event. leg is stiff without flexion at knee or hip. Leg rotates away then back towards - semicircle

Answer 52

Hemiplegic

Question 53

Causes of hemiplegic gait

Answer 53

Stroke | Spinal cord injury

Question 54

T/F: parkinsonian gait is found in all patients with parkinsons

Answer 54

False, only some [may also be caused by first generation antipsychotics]

Question 55

Hypokinesia vs. akinesia What pathologic gait are these associated with?

Answer 55

Hypokinesia = generally slow movement Akinesia = total loss of movement Parkinsonian (festinating) gait