Gait Flashcards
(63 cards)
1
Q
Rockers of Gait Cycle
A
- Heel rocker
- Ankle rocker
- Toe rocker
2
Q
Heel Rocker
A
preserves momentum generated by falling onto stance limb
3
Q
Ankle Rocker
A
advances tibia over stationary foot
4
Q
Toe Rocker
A
Serves as axis for progression of body vector to advance beyond are of foot support
5
Q
Normal Progression of Gait on Plantar Surface
A
- contact begins at midline of heel
- slight lateral deviation through midfoot
- progression is between 1st & 2nd rays
6
Q
Closed-Chain Supination
A
- calcaneus inverts
- talus abducts & DF
- lower leg ER
- knee extension
(high arch)
7
Q
Closed-Chain Pronation
A
- calcaneus everts
- talus adducts & PF
- lower leg IR (knee valgus)
- knee flexion
(flat foot)
8
Q
Purpose of STJ Motion***
A
- allows foot to adapt to ground on flat foot
- dissipates forces at heel strike
- prepares for rigid lever at push-off
9
Q
STJ Neutral
A
- position where neither pronation or supination occurs
- 2:1 inversion:eversion
10
Q
Plntarflexed 1st Ray
A
- functional forefoot valgus if rigid
- associated with uncompensated rearfoot farus
- doesn’t absorb shock well
11
Q
Forefoot Varus
A
- Rays 2-4 inverted relative to bisector of calcaneus
12
Q
Forefoot Valgus
A
- Rays 2-4 everted relative to bisector of calcaneus
13
Q
Compensated Foot Type
A
- total amount of varus needs to be equal to amount of calcaneal eversion for the foot to be on the ground
14
Q
Faulty Cuboid Pulley
A
- when STJ remains abnormally pronated in late stance
- cuboid tunnel orientation is altered
- lose advantage of peroneus longus, which decelerates PF/inversion
- leads to ankle sprains
- MTP joint unstable
15
Q
Morton’s Toe
A
- 2nd ray longer than 1st
- abnormal axis of motion
- unstable foot
16
Q
Intrinsic Orthosis
A
posting added within orthosis
17
Q
Extrinsic Orthosis
A
posting added onto orthosis
18
Q
Orthosis Uses***
A
- control, guide, limit, and/or immobilize body segment
- restrict movement in given direction
- prevent deformity
- assist general movement
- reduce axial load bearing forces
- aid rehab from fractures after cast removal
19
Q
Negative Mold
A
- plaster impression of body part
- remove cast while maintaining impression
- gravity eliminated
20
Q
Positive Mold
A
- pouring plaster into negative cast & smoothing out imperfections
- make orthosis by heating up material & using vacuum press to form around positive mold
21
Q
Trim Line***
A
- line where orthosis ends
- longer = more control/stability
- anterior to malleoli = inversion/eversion controlled
- posterior to malleoli = inversion/eversion allowed
22
Q
Functional Foot Orthosis
A
- orthopedic device designed to promote structural integrity by resisting GRF’s that cause abnormal skeletal motion during stance phase
23
Q
Accommodative Orthosis
A
- doesn’t alter alignment
- supports foot in WB position
- unload areas by dissipating force over entire SA of foot
- total contact
- diabetic/insensitive foot
24
Q
Biomechanical Orthosis
A
- alters alighment with intrinsic or extrinsic posting
25
Shoe Function
- Stability: height & density of heel counter, flares to heel
- Flexibility: enhance toe rocker for progression of gait
- Traction: leather = slick
- Heel Height: WB on met heads increased with more than 1.5"
26
Medial Heel Wedge
- controls rearfoot
| - decelerate pronation
27
Shoe type with V-shaped closure
- tongue is separate piece sewn into vamp
28
Shoe type with open closure 1/2 way down shoe
- tongue is extension of vamp & can be opened slightly wider
- allows for more modification
29
Shoe type with open closure all the way to toe
- for patients with fixed deformity or fragile neuropathic feet
30
Sole Purpose
- protects plantar surface of foot
- allows for normal progression of gait
- leather = slippery
- thick = interfere with proprioception
31
Effect of Obesity on Gait
- increase 1 full size with increase of 9 lbs in 5 years
| - impacts gait pattern
32
Effect of Edema on Gait
- increase foot size & alter shoe fit
33
Goal of Shoe Prescription for Metatarsalgia
- transfer weight away from met heads
- encourage flexion of MTP joints
- encourage extension of PIP joints
34
Metatarsal Bar
- prevents undue pressure at met heads during push off in late stance
- facilitates normal progression of gait
35
Rocker Bottom Shoe
- facilitates gait rockers
| - can cause rolling too far & hyperextension of knee (ACL)
36
Heel Lifts
- 3/8" inside shoe
- more lift increase weight of shoe & affects cosmesis
- increases WB on met heads
37
Diabetic Neuropathy
- nerve damage that interferes with ability to sense pain & temperature caused by high sugar levels associated with uncontrolled diabetes
- can affect function of foot muscles, leading to improper alignment & injury
38
Protective Sensation
- amount of sensation to protect from trauma
- 5.07 Semmes-Weinstein monofilament***
- ABI 0.9+
39
ABI
- Ankle/Brachial Index
- ankle systolic pressure / brachial systolic pressure
- <0.45 = unlikely wound healing
40
Clinical Signs of Peripheral Vascular Disease (PVD)
- absent pulses
- cold feet
- dependent rubor
- shiny skin
- intermittent claudication
- hair loss on foot/leg
- atrophy of subcutaneous fat
- dependency relieves rest pain
- delayed capillary filling time
- ischemic lesions
41
Causes of Tissue Damage***
- continuous pressure
- concentrated high pressure
- heat/cold
- repetitive mechanical stress
- pressure on infected tissue
42
Prevention of Damage Due to Repetitive Stress
- frequent foot checks
| - limit repetitive activities
43
Prevention of Damage Due to Continuous Pressure
- frequent foot checks
- correct shoe fit
- change shoes part-way through day
44
Prevention of Damage Due to Heat/Cold
- check water before placing feet in
| - avoid exposure for prolonged periods of time
45
Prevention of Damage Due to Concentrated High Pressure
- always wear shoes
- ideally never wear open toed shoes
- shake out shoes before wearing
46
Prevention of Damage Due to Pressure on Infected Tissue
- never step on infected foot
47
Charcot Foot
- neurogenic arthropathy
- degenerative form of arthritis that progresses rapidly
- causes joint/bone damage
- starts with peripheral neuropathy (true neuropathy takes decades to develop, not weeks/months)
- can lead to amputation
- early stages mimic cellulitis or DVT
48
Symptoms of Charcot Foot
- warmer than normal
- redness
- small hairline fractures
- swelling
- entire foot becomes swollen/inflamed later
-
49
Plantar Fasciitis Differentiation
- pain at medial calcaneal tubercle
- SLR with sensitizer
- severe heel pain in AM or after rest
- windlass
50
Plantar Fasciitis Intervention
- temporary orthosis
- TrP therapy + stretching
- manual therapy to LE & calf
- taping to limit pronation
- night splint
51
Bunions
- caused by injury or varus deformity
| - treated with splints, foot orthosis, or surgery
52
Metatarsalgia
- pain in 1+ met heads
| - treated with orthosis to cushion met head or limit joint
53
Hallux Rigidux
- no 3rd rocker
| - treated with mobilization, orthosis, or surgery
54
Excessive Flexion at Heel Strike
- c/o increased anterodistal tibial pressure
- heel too firm
- foot too posterior
- foot too DF
- socket too flexed
- shoe heel too high
- weak knee extensors
55
Hyperextension at Heel Off
- c/o patella discomfort
- c/o feel like climbing hill
- foot too anterior
- foot too PF
- insufficient socket flexion
- foot heel too long/stiff
- shoe heel too low
- excessive use of knee extensors
- weak quads
56
Foot Whips
- suspension cuff not aligned evenly
- prosthesis rotated
- uncompensated foot deformity
57
Lateral Trunk Bending
- prosthesis too short
- high medial wall of socket
- improper lateral wall shape of socket
- prosthesis in abduction
- poor balance
- hip abduction contracture
- residual limb sensitivity
- short limb
- weak abductors
58
Abducted Gait
- prosthesis too long
- prosthesis in abduction
- high medial wall of socket
- improper lateral wall shape of socket
- hip abduction contractures
- weak quads or hip extensors
59
Circumduction
- prosthesis too long
- excessive knee friction
- hip abduction contracture
- weak quads or hip extensors
60
Vaulting
- prosthesis too long
- inadequate socket suspension
- foot in PF
- lack knee flexion
61
Foot Slap
- too little PF resistance
- heel too soft
- socket flexed too much
- poor knee extension control
- driving foot into floor to ensure knee extension
- weak DF
62
Exaggerated Lordosis
- improper shape of posterior wall
- insufficient socket flexion
- tight hip flexors
- weak abs
- weak hip extensors
63
Prosthetic Knee Instability
- knee joint too medially
- insufficient socket flexion
- PF resistance too great
- inability to limit DF in stance
- weak hip extesnsors
- tight hip/knee flexors
