Gait and posture

Question 1

What does normal gait rely on? (4).

Answer 1

Joints.
Muscles.
Nerves.
Vision.

Question 2

When does walking with assistance occur?

Walking without assistance?

Answer 2

6-14 months.

8-18 months.

Question 3

How does gait change in the elderly? (5).

Answer 3

Decreased stride length.
Decreased velocity.
Decreased arm swing.
Decreased rotation of the pelvis.
Flat footed approach to heel strike and push off.

Question 4

Where does the human centre of gravity lie when standing? (3).

Answer 4

Anterior to S2 vertebrae.
Posterior to hip joints.
Anterior to knee and ankle joints.

Question 5

What effect does the centre of gravity have on human gait?

How is this acted against?

Answer 5

Forward sway.

Plantar flexor muscle contraction - esp soleus.

Question 6

How is the gait cycle divided into two?

Answer 6

Stance phase: 60%, foot on ground.
Swing phase: 40%, foot in air.

Start and end of stance phase marked by double support.

Question 7

What are the five stages of stance phase?

Answer 7

Heel strike.
Loading respsone.
Mid-stance.
Terminal stance.
Pre-swing.

Question 8

What are the three stages of swing phase?

Answer 8

Initial swing.
Mid swing.
Terminal swing.

Question 9

Differentiate between concentric and eccentric contraction.

Answer 9

Concentric: muscle shortens while contracting.
Eccentric: muscle lengthens while contracting.

Question 10

What happens during heel strike? (2).

Answer 10

Eccentric contraction of tibialis anterior controls lowering.
Deceleration through hip extension by gluteus maximus.

Question 11

What happens during loading response? (3).

Answer 11

Weight transferred to stance limb.
Contraction quadriceps femoris extends knee to prevent buckling.
Continued hip extension.

Question 12

What happens in the mid-stance phase?

Answer 12

Opposite limb swings past stance limb.

Abduction of hip keeps pelvis level - gluteus medium, minus and tensor fascia lata.

Question 13

What happens in the terminal stance phase? (2).

Answer 13

Heel lifts off from the ground - soleus + gastrocnemius.

Accelerates mass forwards.

Question 14

What happens in the pre-swing phase?

Answer 14

Powerful plantar flexion of digits to push off.

Eccentric rectus femoris contraction to slow hip extension + prepare for flexion.

Question 15

What happens in the initial and mid swing phase? (3).

Answer 15

Iliopsoas and rectus femoris flex hip to pull leg forward.
Tibialis anterior flexes the foot to allow clearance.
Hamstrings flex the knee to shorten the limb.

Question 16

What happens in the terminal swing phase? (3).

Answer 16

Quadriceps extends knee ready for heel strike.
Tibialis anterior dorsiflexes ankle.
Eccentric contraction of hamstrings decelerates limb.

Question 17

Who gets limited knee flexion and how is it compensated for?

Answer 17

Stroke patients.

Limb circumduction - increases ground clearance.

Question 18

How does foot drop occur and how is it compensated for?

Answer 18

Common fibular/peroneal nerve damage.

High stepping gait - shorten limb using hip and knee.

Question 19

How is vertical drop in centre of gravity reduced in walking?

Answer 19

Pelvic rotation.
Stance limb: internal rotation.
Swing limb: external rotation.

Question 20

How is vertical rise in centre of gravity reduced in walking?

Answer 20

Knee flexion.

Abductors - pelvic abduciton on stance side.

Question 21

When does Trendelenberg gait occur? (4).

Answer 21

Stroke.
Hip Osteoarthritis.
Cerebral Palsy.
Superior gluteal nerve damage.

Question 22

Which muscles minimise lateral shift in centre of gravity during walking?

Answer 22

Adductors pull knee into midline.

Question 23

What is essential for toe off?

Consequences of it missing?

Answer 23

Hallux (big toe).

Shorter stride length + decreased velocity.