PTRS 745 Exam 2 > Gait Analysis and Abnormal Gait > Flashcards

Gait Analysis and Abnormal Gait Flashcards

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1
Q

Normal Gait Patterns:

  1. Base width
  2. Step length
  3. Stride Length/Gait cycle
  4. Cadence
  5. Gait speed
A
  1. 5-10 cm
  2. 72 cm or 23 inch
  3. 144 cm
  4. 90-120 steps/min

5 1.4 m/sec

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2
Q

Events in the gait cycle (8)

A
  1. Initial Contact (IC)
  2. Loading Response (LR)
  3. Heel Off (HO)
  4. Opposite Initial Contact
  5. Toe Off (TO)
  6. Feet Adjacent
  7. Tibia Vertical
  8. Next Initial Contact
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3
Q

At what percent of the gait cycle does the following occur?

  1. Initial Contact (IC)
  2. Loading Response (LR)
  3. Heel Off (HO)
  4. Opposite Initial Contact
  5. Toe Off (TO)
  6. Feet Adjacent
  7. Tibia Vertical
  8. Next Initial Contact
A
  1. 0
  2. 10
  3. 30
  4. 50
  5. 60
  6. 73
  7. 87
  8. 100
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4
Q

Periods in the gait cycle (7)

A
  1. Loading response
  2. Mid stance
  3. Terminal stance
  4. Pre Swing
  5. Initial Swing
  6. Mid Swing
  7. Terminal Swing
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5
Q

Task in the gait cycle (3)

A
  1. Weight acceptance
  2. Single limb support
  3. Limb advancement
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6
Q

Phases in the gait cycle (2)

A
  1. Stance
  2. Swing
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7
Q

Q: When does the loading response begin and end?

A

B: Initial contact

E: Loading Response

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8
Q

Q: When does Mid Stance begin and end?

A

B: Loading Response

E: Heel Off

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9
Q

Q: When does Terminal Stance begin and end?

A

B: Heel Off

E: Opposite Initial Contact

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10
Q

Q: When does Pre Swing begin and end?

A

B: Opposite Initial Contact

E: Toe Off

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11
Q

Q: When does Initial Swing begin and end?

A

B: Toe off

E: Feet Adjacent

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12
Q

Q: When does Mid Swing begin and end?

A

B: Feet Adjacent

E: Tibia Vertical

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13
Q

Q: When does Terminal Swing begin and end?

A

B: Tibia Vertical

E: Next Initial Contact

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14
Q

Diagram: Intervals of Gait

A
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15
Q

Q: During _________, the supporting limb provides an ______________ base that rolls __________ over the foot.

A

stance, advancing, forward

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16
Q

Q: During ________, the limb advances itself to the next position for ________ ____________.

A

swing, weight, acceptance

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17
Q

Q: Describe pelvic rotation on the stance and swing leg during gait.

A

Stance Leg: 4 degrees posteriorly

Swing Leg: 4 degrees forward

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18
Q

Q: Rotation of the pelvis with the ________ limb adds to ______ length.

A

swing, step

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19
Q

Q: What is the lateral displacement of trunk during the stride?

A

2.5 to 5 cm

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20
Q

Q: How is lateral displacement tracked/measured?

A

Indicated by head location

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21
Q

Diagram: Ground reaction force with walking and running

A

With Running: Higher GRF in shorter time

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22
Q

Diagram: Joint angle during normal gait

A

Hip Low Point = ~60% gait

Knee and Ankle High Point = ~70% gait

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23
Q

Q: What periods of the gait cycle are of single limb support?

A

Mid stance and Terminal Stance

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24
Q

Q: What periods of the gait cycle are of weight acceptance?

A

Initial contact and loading response

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25
Q: What periods of the gait cycle are under limb advancement? (4)
Pre, Initial, Mid and Terminal Swing
26
Gait Joint Angles for the Trunk during: 1. Initical Contact 2. Loading response 3. Mid stance 4. Terminal stance 5. Pre Swing 6. Initial Swing 7. Mid Swing 8. Terminal Swing
Erect for all periods of the gait cycle
27
Gait Joint Angles for the Pelvis during: 1. Initical Contact 2. Loading response 3. Mid stance 4. Terminal stance 5. Pre Swing 6. Initial Swing 7. Mid Swing 8. Terminal Swing
1. 5 degrees F 2. 5 degrees F 3. 0 4. 5 degrees B 5. 5 degrees B 6. 5 degrees B 7. 0 8. 5 degrees F
28
Gait Joint Angles for the Hip during: 1. Initical Contact 2. Loading response 3. Mid stance 4. Terminal stance 5. Pre Swing 6. Initial Swing 7. Mid Swing 8. Terminal Swing
1. 25 Flex 2. 25 Flex 3. 0 4. 20 Hyper Ext 5. 0 6. 15 Flex 7. 25 Flex 8. 25 Flex
29
Gait Joint Angles for the Knee during: 1. Initical Contact 2. Loading response 3. Mid stance 4. Terminal stance 5. Pre Swing 6. Initial Swing 7. Mid Swing 8. Terminal Swing
1. 0 2. 15 Flex 3. 0 4. 0 5. 40 Flex 6. 60 Flex 7. 25 Flex 8. 0
30
Gait Joint Angles for the Ankle during: 1. Initical Contact 2. Loading response 3. Mid stance 4. Terminal stance 5. Pre Swing 6. Initial Swing 7. Mid Swing 8. Terminal Swing
1. 0 2. 10 PF 3. 5 DF 4. 10 DF 5. 20 PF 6. 10 PF 7. 0 8. 0
31
Gait Joint Angles for the Toes during: 1. Initical Contact 2. Loading response 3. Mid stance 4. Terminal stance 5. Pre Swing 6. Initial Swing 7. Mid Swing 8. Terminal Swing
1. 0 2. 0 3. 0 4. 30 MTP Ext 5. 60 MTP Ext 6. 0 7. 0 8. 0
32
Diagram: Gait Joint Angles
33
Diagram: Activation of Muscles During Stance Phase
Hams \> Tibialis Anterior \> Gluts/Add \> Quads \> Calf \> Toes During IC - proximal muscle engage IC indicated by black line
34
Digram: Activation of Muscles During Swing Phase
Adductor \> Rectus Femoris (Quads) \> Sartorius/Iliacus/Gracilis \> Biceps Femoris (Hams)\> Anterior Tib \> Toes Anterior Tibia important for foot to clear the floor (prevent foot drop) Toe off indicated by black line
35
Content: Causes of Abnormal Gait (4)
1. Deformity 2. Muscular Weakness 3. Pain 4. Sensory and Motor Impairments
36
Content: Types of Deformity Affecting Gait (3)
1. Contractures 2. Abnormal Joint Contours 3. Anklyosis (Joint Stiffness/Fixation)
37
Content: Types of Muscular Weakness Affecting Gait (3)
1. Insufficient Muscle Strength 2. Disuse Muscular Atrophy 3. Neurological Problems (ex. stroke)
38
Content: Pains Affect on Gait (2)
Pain and edema causes excessive tissue tension due to 1. Deformity 2. Muscle Weakness (Using a position of comfort during gait may cause an antalgic gait (limp))
39
Content: Types of Sensory/Motor Impairments Affecting Gait (3)
1. Proprioceptive 2. Spasticity 3. Lack of selective control of the muscles (timing and intensity \< may be difficult to visualize)
40
Content: Plantar Flexion Deformity (limited dorsiflexion) (4)
1. Effects Mid swing - causing gait deviations due to excessive ankle PF 2. Toe drag is the immediate reaction 3. Substitution with increased hip and knee flexion is common 4. Another subsitution is leg circumduction
41
Q: What is the effect an ankle orthosis locking the ankle into neutral?
1. Causes excessive ankle DF during loading 2. Causes excessive knee flexion as the tibia follows the tibia
42
Content: Knee extension deformity (limited knee flexion) (2)
1. Pre-Swing: knee flexion limited, causing excessive DF and heel contact is prolonged 2. Initial Swing: knee flexion limited, causing toe drag and leg/foot not lifted enough
43
Content: Knee flexion deformity (limited knee extension)
Compensation: Excessive ankle DF allows an upright posture in the presence of a fixed knee flexion contracture
44
Term: Knee is displaced medially from the line between hip and ankle because tibia is tilted laterally
Knee Valgus
45
Term: Knee is displaced laterally from the line between hip and ankel because tibia is tilted medially
Knee Varus
46
Content: Hip flexion deformity (limited hip extension)
Must retract limb and lean trunk forward to place center of gravity over supporting limb
47
Content: Spine or Knee Compensation - Describe what happens in a, b, and c with inadequate hip extension during mid stance (due to limited hip extension)
a. Without compensation pelvis and trunk are tilted forward b. lumbar lordosis can restore an erect trunk c. knee flexion equal to fixed hip flexion can right both the pelvis and trunk
48
Q: What can cause a hip flexion deformity? (2)
1. Capsular tightness/restriction 2. Iliotibial band tightness
49
T/F: Iliotibial band contracture can mimic a rigid joint contracture.
True
50
Content: Hip Extension Deformity (limited hip flexion) (2)
1. Voluntary posterior pelvic tilt to advance the thight when hip flexion is inadequate 2. Voluntary excessive knee flexion (and ankle) to flex the flaccid/contracted hip by changing the limb's center of gravity
51
Content: Excessive Hip Adduction (Pelvis Drop) (4)
1. Weak hip abductors causing excessive hip adduction causing the contralateral hip to drop as swing limb is lifted 2. Ipsilateral adductor muscle contracture casuing excessive hip adducation causing contralateral hip drop 3. The same posture can be caused by a contralateral hip abduction contracture 4. Weakness of gluteus medius on contralateral side
52
Content: Pelvic Drop (trunk deviation) (3)
1. Contralateral hip drop, side opposite reference limb drops as swing limb lifted, center of gravity displaced laterally 2. Contralateral hip drop due to weak ipsilateral abd, center of gravity displaced away from stance limb 3. Contralateral hip drop due to weak ipsilateral abd, compensating trunk lean with a change in pelvic posture, center or gravity moves toward stance limb
53
Diagram: Normal Foot/Floor Contact
54
Diagram: Inversion/Varus Foot/Floor Contact (3)
1. Lateral heel = prolonged contact 2. Lateral foot = more contact 3. Medial foot = weak or missing contact
55
Diagram: Eversion/Valgus Foot/Floor Contact (3)
1. Medial heel = prolonged contact 2. Medial foot = more contact 3. Lateral foot = weak or missing contact
56
Content: Describe Inversion/Varus for Foot/Floor Contact (2)
1. Lack of 1st MT contact and premature onset of 5th MT switch 2. Only 5th MT makes contact
57
Content: Describe Eversion/Valgus for Foot/Floor Contact
1. Foot switches occur (i.e. 1st, heel, 5th, repeat)
58
Content: Antalgic gait (5)
1. Stance phase of affected limb is shorter 2. Swing phase of uninvolved side is shorter 3. Shorter step length on uninvolved side 4. Decreased walking velocity 5. Decreased cadence \*\* Inhibition the involved muscles and weakness
59
Diagram: Pressure through ROM on a swollen ankle
Least pressure at 15 degrees PF
60
Diagram: Pressure through ROM on a swollen knee
Least pressure at 30 (to 60) degrees flexion
61
Diagram: Pressure through ROM on a swollen hip
Least pressure at 30-60 degrees flexion
62
Content: Soleus weakness (4)
1. Soleus fails to stabilize tibia 2. Causes sustained knee flexion 3. Without a stable base, the quads can't extend the flexed knee 4. Assume a pattern of knee flexion
63
Content: Substitution for Qaudriceps weakness (3)
1. Hyperextension of the knee, vector is anterior to the knee providing extensor torque 2. Overactivity can inhibit loading response/knee flexion and create hyperextension 3. Overall effect is HYPERextension
64
Content: Gait grade 1 from research (3)
1. Extreme difficulty walking or bearing weight on the fx limb 2. Obvious antalgia 3. Inability to walk quickly (\< 1 m/s) or needing crutches
65
Content: Gait grade 2 from research (3)
1. Antalgic or normal gait 2. Walking speed \< 1 m/s 3. Obvious antalgia when walking more quickly
66
Content: Gait grade 3 from research (2)
1. Normal gait regardless of speed 2. Antalgia when jogging
67
Content: Gait grade 4 from research?
Normal ability to walk and jog
68
Q: What periods are part of the stance phase? (4)
1. Loading Response 2. Mid Stance 3. Terminal Stance 4. Pre Swing
69
Q: What periods are part of the swing phase? (3)
1. Initial Swing 2. Mid Swing 3. Terminal Swing
70
Defn: "Rocking"
Ankle movement during gait
71
Q: What can knee valgus and varus effect?
Width of stance - widened with valgus - narrowed with varus
72
T/F: If you have a valgus/varus knee on one side you may have trunk lean discripancies.
True
73
Q: What is the name of the sign for hip drop?
Trendelenburg sign
74
Q: Ankle injuries happen more commonly on an _________ foot.
Inverted
75
Q: What at the hip can cause eversion at the foot?
IR (adduction would have the same effect)
PTRS 745 Exam 2
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