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Neurologic PT > Gait and Locomotion > Flashcards

Gait and Locomotion Flashcards

1
Q

What is the difference between gait and locomotion?

A

Gait: manner in which a person walks, characterized by rhythm, cadence, step, stride, and speed

Locomotion: ability to move from one place to another

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2
Q

What percentage of the gait cycle is spent in stance?

A

62%

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3
Q

What percentage of the gait cycle is spent in swing?

A

38%

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4
Q

List the 3 functional tasks involved in the gait cycle.

A

Weight acceptance (stance)
Single limb support (stance)
Swing limb advancement (swing)

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5
Q

What 2 sub-phases fall within the functional task of weight acceptance?

A

Initial contact

Loading response

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6
Q

What 2 sub-phases fall within the functional task of single limb support?

A

Midstance

Terminal stance

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7
Q

What 4 sub-phases fall within the functional task of swing limb advancement?

A

Pre-swing
Initial swing
Mid-swing
Terminal swing

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8
Q

What are the 3 task accomplishments during weight acceptance?

A

Stability
Forward progression
Shock absorption

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9
Q

What are the 2 task accomplishments during single limb support?

A

Stability

Forward progression

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10
Q

What are the 2 task accomplishments during swing limb advancement?

A

Foot clearance

Forward progression

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11
Q

Kinematics describe _____.

A

Movement

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12
Q

Kinetics describe ____.

A

Forces

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13
Q

List 1 example of a qualitative kinematic measure.

A

Observational Gait Analysis (OGA)

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14
Q

List 4 quantitative kinematic SPATIAL measures.

A
  1. Step length
  2. Stride length
  3. Step width
  4. Foot angle
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15
Q

List 3 quantitative kinematic TEMPORAL measures.

A
  1. Cadence
  2. Velocity
  3. Stride time
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16
Q

List the 4 prerequisites of functional gait.

A
  1. Stance stability: LE must be stable enough to accept and support body weight, especially during SLS
  2. Clearance in swing: Swing limb must “shorten” enough to clear the ground and advance forward
  3. Swing phase pre-positioning: Foot must be positioned during swing in preparation for contact and loading
  4. Adequate step length: Motion and control must occur at all segments to promote forward progression
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17
Q

What is the overall goal of functional gait?

A

Minimize energy expenditure and maximize efficiency

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18
Q

Explain the stance phase rocker progression.

A

Foot complex acts as a pivoting system to promote forward progression while maintaining stability

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19
Q

What are the critical events that take place during initial contact and loading response during weight acceptance?

A

Initial contact: heel first contact

Loading response

  1. Hip stability
  2. Controlled knee flexion
  3. Ankle PF
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20
Q

What are the critical events that take place during midstance and terminal stance during single limb support?

A

Midstance: Controlled tibial advancement

Terminal stance

  1. Controlled ankle DF with heel rise
  2. Trailing limb posture
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21
Q

What are the critical events that take place during preswing, initial swing, midswing, terminal swing during swing limb advancement? (ROM)

A

Preswing

  1. Passive knee flexion (40 deg)
  2. Ankle PF

Initial Swing

  1. Hip flexion (15 deg)
  2. Knee flexion (60 deg)

Midswing

  1. Hip flexion (25 deg)
  2. Ankle DF (0 deg)

Terminal Swing
1. Knee extension to neutral (5 deg)

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22
Q

What 3 tasks are affected by excessive PF?

A
  1. Weight acceptance
  2. Single limb support
  3. Swing limb advancement
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23
Q

What is the significance of excess PF in stance? (3)

A
  1. Poor position for heel rocker
  2. Decreases shock absorption
  3. Decreases forward tibial progression
24
Q

What is the significance of excess PF in swing? (2)

A
  1. Limits foot clearance

2. Interferes with foot position for contact

25
Q

List 6 possible causes for excessive PF.

A
  1. PF contracture
  2. PF hypertonicity
  3. Weak quads/pretibials
  4. Impaired proprioception
  5. Ankle pain
  6. Lack of selective DF control in TSw
26
Q

What task is affected by forefoot/foot flat contact?

A

Weight acceptance

27
Q

What is the significance of forefoot/foot-flat contact? (3)

A
  1. Poor position for heel rocker
  2. Limits forward momentum of tibia
  3. Decreases shock absorption (limits knee flexion)
28
Q

What are 3 possible causes of forefoot contact?

A
  1. Inc knee flexion in TSw
  2. Weak quads (avoiding LR)
  3. Excess PF in TSw
29
Q

What task is affected by a foot slap?

A

Weight acceptance

30
Q

What is the significant of foot slap? (2)

A
  1. Decreases forward tibial progression

2. Decreases shock absorption

31
Q

What is a possible cause of foot slap?

A

Weak pretibials

32
Q

What 3 tasks are affected by excessive knee flexion?

A
  1. Weight acceptance
  2. Single limb support
  3. Swing limb advancement
33
Q

What is the significance of excessive knee flexion in stance? (2)

A
  1. Increases demand on PFs, quads, hip extensors

2. Decreases limb stability

34
Q

What is the significance of excessive knee flexion in swing? (2)

A
  1. Decreases step length of reference limb

2. Interferes with heel first contact

35
Q

What 3 tasks are affected by excessive knee extension?

A
  1. Weight acceptance
  2. Single limb support
  3. Swing limb advancement
36
Q

What is the significance of excessive knee extension in stance? (3)

A
  1. Decreases shock absorption
  2. Decreases forward progression of tibia
  3. Potential injury to posterior knee structures
37
Q

What is the significance of excessive knee extension in swing?

A
  1. May assist in achieving maximal knee extension
38
Q

What is an extension thrust?

A
  1. Forceful motion of knee towards extension

2. Reduces demand on weak quads

39
Q

List 6 possible causes of excessive knee extension.

A
  1. Weak quads
  2. Impaired proprioception
  3. Quad hypertonicity
  4. Intentional to increase limb stability/extend the knee
  5. Secondary to forefoot contact with excess PF tightness
  6. Secondary to excess PF
40
Q

What 2 tasks are affected by limited hip flexion?

A
  1. Weight acceptance

2. Swing limb advancement

41
Q

What is the significance of limited hip flexion (2)

A
  1. May disturb normal LR by limiting knee flexion and ankle PF
  2. Interferes with ability to clear foot, advance limb, and create forward momentum
42
Q

List 10 possible causes of limited hip flexion.

A
  1. Limited hip flexion achieved in TSw
  2. Intentional to decrease demand on hip extensors
  3. Weak hip flexors
  4. Impaired motor control: inability to rapidly flex hip
  5. ROM of straight leg raise < 40°
  6. Hip extensor hypertonicity
  7. Hip pain
  8. Limited hip flexion ROM
  9. Secondary: to foot drag
  10. Secondary: to past retract in TSw
43
Q

What is past retract?

A

A visible forward and then backward movement of the thigh during terminal swing

44
Q

What task is affected by past retract? What is the significance?

A

Task affected: Swing limb advancement

Significance: Decreases step length

45
Q

A lateral trunk lean is typically seen with ____ gait.

A

Trendelenburg gait

46
Q

Backward/forward rotation of the trunk during gait occurs secondary to inability to _____ the trunk/pelvis.

A

Disassociate the trunk and pelvis

47
Q

Backwards trunk lean reduces the demands on the ____.

A

Hip extensors

48
Q

Forward lean reduces demands on ______, allows “forward progression” over plantarflexed ankle.

A

Quadriceps

49
Q

Ataxia is common with ____ pathology. List 2 characteristics of this gait pattern.

A

Common with cerebellar pathology

  1. Staggering and unsteadiness
  2. Wide BOS and exaggerated movements
50
Q

Festinating gait is common with ____. List 2 characteristics of this gait pattern.

A

Common with PD

  1. Walking on toes as though pushed
  2. Starts slowly and increases in speed/frequency
51
Q

Scissoring gait is common with ____, _____ and ____. List 2 characteristics of a scissoring gait pattern.

A

Common with CP, CVA, TBI.

  1. Legs cross midline upon advancement
  2. Tends to accompany adductor spasticity
52
Q

List 3 characteristics of steppage gait.

A
  1. Feet and toes are lifted through excess hip and knee flexion
  2. Usually accompanied by a footslap on IC
  3. Common with DF weakness, sensory/ proprioceptive deficits, and chronic polyneuropathies
53
Q

_____ and _____ are very important principles of neuroplasticity that should be emphasized in locomotor training.

A

Specificity

Intensity

54
Q

Explain the leap frog effect. (2)

A
  1. Training of one motor task may affect performance of biomechanically separate tasks that utilize overlapping neural circuits
  2. Improvements in non-walking tasks following intensive LT
55
Q

True or False: The STEPS trial found that resisted cycling is better than task specific locomotor training in improving gait speed and walking distance.

A

FALSE

Task specific locomotor training > resisted cycling

56
Q

_____ may be an effective in treating foot drop.

A

Peroneal nerve FES

57
Q

_____ is the 6th vital sign.

A

Gait speed

Neurologic PT (11 decks)

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