Flashcards in Gait, Stairs & Running Deck (92):
what is stride length?
the distance between heel strike to heel strike of the SAME leg
what is step length?
the distance between the heel strike of one leg to the heel strike of the OPPOSITE leg
which term constitutes an entire gait cycle?
what is step width?
horizontal distance between the heel centers of consecutive heel strikes
what is foot angle?
the amount of toe out; angle between line of progression of the body and long axis of the foot
what is stride time?
the time it takes to cover one full stride, or gait cycle (right heel strike to next right heel strike)
what is step time?
the time it takes to cover one step (right heel strike to left heel strike)
what is cadence, or step rate when referring to gait?
steps per minute
do men or women tend to have a higher step rate?
what is the average step rate?
110 steps per minute
how is walking speed calculated? what is the average walking speed?
(1) step length x step rate
(2) 1.37 m/sec (3 mph)
what are the average step length, stride length, and step width?
(1) step length: 72 cm (28 inches)
(2) stride length: 144 cm
(3) step width: 8-10 cm
what percentage of the gait is spent in the stance phase? what percentage is spent in the swing phase?
in abnormal gait patterns due to injury or pathology, what is typically increased to walk faster, step rate or step length?
what are the RLA (Rancho Los Amigos) phases of gait and their corresponding percentage of the gait cycle?
(1) inital contact: 0%
(2) loading response: 0-10%
(3) mid stance: 10-30%
(4) terminal stance: 30-50%
(5) pre swing: 50-60%
(6) initial swing: 60-75%
(7) mid swing: 75-85%
(8) terminal swing: 85-100%
what is the traditional nomenclature used for gait?
(1) heel strike
(2) foot flat
(3) mid stance
(4) heel off
(5) toe off
(7) mid swing
when the right limb is at 25% of the gait cycle, what percentage of the gait cycle should the left leg be at?
what are the purposes of normal gait? (5)
(1) weight acceptance
(2) single limb support
(3) swing limb advancement
(4) generate mechanical energy to move forward
(5) absorb energy for shock absorption and stability
how is foot angle measured? what is considered a normal foot angle?
(1) center of heel to 2nd metatarsal
(2) 5-7 degrees
how fast does a person need to walk in order to cross a street safely?
> 1.3 m/s
what walking speed is a person considered a fall risk?
< 0.7 m/s
what walking speed is a person dependent? independent?
(1) dependent: < 0.4 m/s
(2) independent: > 0.9 m/s
during normal walking, what muscles expend the most energy? what muscles expend the least energy?
FROM MOST TO LEAST
(1) plantar flexors (most)
(2) hip flexors
(3) hip extensors
(4) hip abductors
(5) knee extensors (least)
when the foot is flat during initial contact or the loading response, where does this indicate weakness?
what clinical populations commonly have trouble dorsiflexing their foot? (3)
(2) L4 nerve root compression
(3) common peroneal nerve injury (fracture of fibular head)
what compensations will be observed in a patient with foot drop? (2)
(1) excessive knee flexion
(2) excessive hip flexion
when the heel remains in contact with the ground late in the terminal stance, where does this indicate weakness?
what clinical populations commonly have trouble plantar flexing their foot? (2)
(1) achilles tendon tear
(2) peripheral or CNS (S1, S2) damage
when initial contact occurs at the forefore, what are potential causes for this gait deviation? (3) what are common patient populations with this gait deviation? (4)
(1) heel pain
(2) plantar flexion contracture
(1) ankle fracture
(2) plantar fasciitis
when initial contact occurs at the forefore AND the heel makes contact at midstance, what are potential causes for this gait deviation? (2)
what are common patient populations with this gait deviation? (3)
(1) pes equinus
(1) congenital abnormality
what compensations will be observed in a patient with a plantarflexor contracture? (2)
(1) knee hyperextension (midstance)
(2) forward trunk lean (terminal stance
what compensations will be observed in a patient with weak knee extensors? (1)
forward trunk lean (increased hip and trunk flexion)
*this is to move the COM anterior to the knee's axis of rotation*
what compensations will be observed in a patient with a knee flexion contracture? (2)
(1) excessive *contralateral* knee flexion
(2) excessive *contralateral* hip flexion
what compensations will be observed in a patient with functional shortening of a leg? (1)
vaulting (exaggerated plantarflexion) of the *contralateral* leg
what compensations will be observed in a patient with reduced knee flexion AND/OR dorsiflexion? (1)
what compensations will be observed in a patient with weak hip extensors? (1) what population is this common in? (1)
(1) extend the lumbar spine
(this is done to prevent trunk flexion, because hip extensors control flexion moments)
what patient populations present with weak hip abductors (Trendelenburg
what is the purpose of a person who walks with a wider base of support during gait? what are common causes? (2)
improves balance during gait
(1) LE muscle weakness
(2) CNS problems (coordination / balance)
which way do people lean when they have pain in a limb during gait? how does this affect the gait cycle?
(1) away from the painful side (moves COP away from painful limb)
(2) a shorter stance phase will be observed on the affected side
when is the foot pronated? when is it supinated during the gait cycle?
(1) generally speaking, when the foot is in contact with the ground, the foot is pronated (right at initial contact) and remains pronated until the heel lifts off the ground (preswing) the foot supinates
(2) when the toes dorsiflex, the foot supinates
why are the intrinsic muscles of the foot active from loading response to pre-swing?
to stabilize the arches of the foot
when are the peroneal muscles most active during the gait cycle? why?
terminal stance; shifting the weight from the lateral border of the foot to the medial border of the foot (going from supinated to pronated position before toe off)
from initial contact to loading response, what is the predominate activity occurring?
extensor activity (hip and knee extensors are active)
from midstance to pre-swing, what is the predominate activity occurring?
flexor activity (plantar flexors and hip flexors)
what do eccentric muscle contractions do during gait?
decelerates and lowers cog (absorbs energy)
what does concentric muscle contractions do during gait?
accelerates the limb and raises the cog (generates power)
when are the hip extensors active during the gait cycle?
(1) concentric: early stance hip extension for propulsion
(2) eccentric: terminal swing for deceleration
when are the hip flexors active during the gait cycle?
(1) eccentric: controls hip extension after midstance
(2) concentric: flexes the hip during first half of swing phase (starting at initial swing)
when are the hip abductors active during the gait cycle?
(1) eccentric: initial contact through loading response to decelerate pelvis (ipsilateral)
(2) concentric: from loading response to midstance to control pelvis
(3) eccentric: deceleration at very end of terminal swing
when are the hip adductors active during the gait cycle?
(1) frontal plane: co-contract with abductors
(2) assist glutes with hip extension in early stance phase
(3) assists hip flexors with hip flexion during swing phase
when are the knee extensors active during the gait cycle?
(1) eccentric: initial contact to loading response; controls knee flexion
(2) concentric: extends knee to midstance
when are the knee flexors active during the gait cycle?
(1) concentric: hamstrings contract in early stance to extend hip
(also may assist with knee flexion in swing phase)
(2) eccentric: terminal swing decelerates knee extension
when are the plantar flexors active during the gait cycle?
(1) eccentric: midstance to slow down tibial moving on the ankle
(2) concentric: terminal stance to pre-swing to push off the ground (until toe comes up)
when are the dorsi flexors active during the gait cycle?
(1) eccentric: initial contact to prevent foot from slapping the ground
(2) eccentric: initial contact to loading response deceleration of foot pronation
(3) concentric: during swing to clear the foot from the ground
when do the highest vertical GRF for the foot, knee, and hip occur?
terminal stance (at push-off)
what are the external and internal moments that occur during gait?
(1) external moment: GRF moment
(2) internal moment): muscle moment
if motion is occurring in the same direction as the GRF moment, what type of contraction is occurring? what about opposite direction as the GRF moment?
(1) same direction: eccentric contraction
(2) opposite direction: concentric contraction
when does the pelvis rotate forward during gait? when does it rotate backwards during gait?
(1) forward rotation: terminal stance through loading response
(2) backwards rotation: terminal stance to initial swing
when during the gait cycle is the knee the most flexed?
initial swing to midswing (60 degrees)
when during the gait cycle is MTP extension the greatest?
from terminal stance to pre-swing (pushing off)
what are the stages of stair ascent?
(1) weight acceptance
(3) forward continuance
(4) foot clearance
(5) foot placement
when during stair ascent does the stance phase occur?
First 3 Phases
(1) weight acceptance
(3) forward continuance
when during stair ascent does the swing phase occur?
(4) foot clearance
(5) foot placement
what ROM occurs at the hip during each phase of stair ascent?
(1) weight acceptance: 60* flexion
(2) pull-up: 60* to 5* flexion
(3) forward continuance: 5* flexion
(4) foot clearance: 5* flexion
(5) foot placement: 60* flexion
what ROM occurs at the knee during each phase of stair ascent?
(1) weight acceptance: 80* flexion
(2) pull-up: 80* to 10* flexion
(3) forward continuance: 10* flexion
(4) foot clearance: 10* - 100* flexion
(5) foot placement: 100* - 85* flexion
what ROM occurs at the ankle during each phase of stair ascent?
(1) weight acceptance: 20-25* PF
(2) pull-up: 25* DF to 15* PF
(3) forward continuance: 15* PF
(4) foot clearance: 10* PF
(5) foot placement: 20* DF
when during stair ascent is considered a time of instability which requires the most muscle activation? what muscles are most active?
(1) pull-up phase
(2) glute med, glute max, quadriceps, plantarflexors
what are the two phases of stair descent?
(1) support phase
(2) placement phase
during stair descent what muscle actions are occurring during the support phase?
(1) gmax: eccentric contraction
(2) quads: eccentric contraction
(3) gastroc/soleus: eccentric contraction
(4) toe flexors: eccentric (toe extending)
during stair descent what muscle actions are occurring during the placement phase?
(1) gmax: concentric
(2) quads: concentric
(3) gastroc/soleus: concentric PF
(4) gastroc/soleus: eccentric DF
during which phase of stair ascent is knee flexion the greatest?
how much knee flexion is required for walking? what about running?
(1) walking: 60*
(2) running: 80-130*
how much hip flexion is required for walking? what about running?
(1) walking: 30*
(2) running: 55-65*
how much ankle dorsi and plantarflexion is required for walking? what about running?
(1) DF: 10*
(2) PF: 20*
(1) DF: 10-30*
(2) PF: 20-30*
how much more trunk flexion is required for stair ascension compared to normal gait?
twice as much
what can be said about hip and knee flexion with stair ascension compared to normal gait?
stair ascension requires much more ROM than normal gait
(1) 100* of knee flexion for stairs
(2) 60* of hip flexion for stairs
how much larger is the internal moment created by the knee extensors in stair ascension compared to normal gait?
what factors may explain why PF syndrome and tibiofemoral OA is worse with climbing stairs? (2)
(1) higher knee extensor moment
(2) larger knee ROM
(more stress placed on the PF joint)
what are considered the workhorse muscles during regular gait? what are the workhorse muscles during stair ascension?
(1) gait: plantarflexors
(2) stairs: knee extensors (quads)
what percentage of running is the stance phase?
40% at most
(as low as 22% during sprinting)
what are 3 main differences in running when compared to gait?
(1) stance phase is shorter in running
(2) no double support
(3) floating periods
what can be said about the posture of running when compared to gait?
more flexed posture during running
is the vertical displacement and side to side displacement higher in walking or running?
(1) vertical displacement is higher in running
(2) side to side displacement is higher in gait
what is the GRF in gait and running?
(1) gait: 1.5x BW
(2) running: 2.5x BW
what makes the loading rate of impact force greater during running? (3)
(1) running downhill
(2) slower cadence
(3) marginal rearfoot strike
when does toe off occur in running? when does it occur in walking?
(1) running: 40% gait cycle
(2) walking: 60% gait cycle
as speed increases (running), what muscle activity is decreased? what muscle activity increases?
(1) ankle plantarflexors
(2) hip flexors
(1) hip extensors
(2) knee extensors
what is the difference between potential and kinetic energy in walking vs. running? what are these theories called for each?
(1) walking: KE & PE are out of phase (pendulum theory)
(2) running: they are synchronized; combined energy to move faster and improved propulsion (spring/coil theory)
what type of foot strike has the highest GRF at inital contact?
rear foot stike
generally speaking, when are the most muscles active during running? when are the least number of muscle active during running?
(1) most active: inital contact and terminal swing
(2) least active: toe off
(muscle contraction is most important right before and at initial contact than push-off)
what can be said about power and ROM in running when compared to gait?
running requires a larger ROM and more power than gait