gait assessment

Question 1

how should you look at the patient?

Answer 1

• from the front, back and side

Question 2

what could you do with gair analysis to help spark a discussion with the patient?

Answer 2

• can record gait analysis to watch it in slo mo and have a discussion

Question 3

what percentage of gait is double stance?

Answer 3

• 20%

Question 4

what is a step?

Answer 4

• starts with the initial contact of one foot and ends with the initial contact of the other

Question 5

what is a stride?

Answer 5

• starts with the initial contact of one foot and ends with the initial contact of the same foot
• 2 steps

Question 6

what are the two phases of the gait cycle?

Answer 6

• stance
• swing

Question 7

what percentage of the gait cycle is the stance phase?

Answer 7

• 60%

Question 8

what are the 5 steps of the stance phase?

Answer 8

• initial contact
• loading response
• mid-stance
• terminal stance
• pre swing

Question 9

what percentage is initial contact at?

Answer 9

• 0%

Question 10

what happens to the hip, knee and ankle in the initial contact step?

Answer 10

• hip flexed 25 degrees
• knee fully extended
• ankle in plantigrade

Question 11

what happens to the pelvis in initial contact?

Answer 11

• pelvis rotated slightly forwards in transverse plane

Question 12

what percentage is the loading response?

Answer 12

• 0 to 10%

Question 13

what does the leg accept in the loading response?

Answer 13

• leg has to accept body weight in heel strike

Question 14

when does the loading response end?

Answer 14

• ends when the contralateral foot lifts off the ground so now in single limb support

Question 15

what happens to the hip and knee in the loading response?

Answer 15

• hip begins to extend
• knee flexes to 15 degrees

Question 16

what happens to the ankle in the loading response?

Answer 16

• ankle plantarflexes until foot flat (1st rocker) then dorsiflexes on a fixed foot to bring shank forwards over ankle (2nd rocker)

Question 17

what percentage is mid-stance?

Answer 17

• 10 to 30%

Question 18

when does the mid stance end?

Answer 18

• ends when the heel comes off

Question 19

what happens to the hip and knee in mid-stance?

Answer 19

• hip moves into extension
• knee moves back into extension

Question 20

what happens to the ankle in mid-stance?

Answer 20

• ankle dorsiflexes further and there is slight supination in the frontal plane

Question 21

what percentage is the terminal stance?

Answer 21

• 30 to 50%

Question 22

what leg has the initial contact with the ground during terminal stance?

Answer 22

• contralateral leg

Question 23

what happens to the hip and knee in the terminal stance?

Answer 23

• hip continues to extend
• knee begins to flex

Question 24

what happens to the ankle in the terminal stance?

Answer 24

• ankle dorsiflexes until full dorsiflexion reached at which point 3rd foot rocker starts as heel lift

Question 25

what percentage is pre-swing?

Answer 25

- 50 to 60%

Question 26

what happens to the right leg in pre-swing stage?

Answer 26

- right leg lifts off further

Question 27

what stance occurs in pre-swing stage?

Answer 27

- double stance occurs - weight transferred to contralateral limb

Question 28

what happens at the end of the pre-swing phase?

Answer 28

- toe off

Question 29

what happens to the knee and ankle in pre-swing?

Answer 29

- knee continues to flex - ankle plantarflexes

Question 30

what happens to the hip in the pre-swing stage?

Answer 30

- reaches greatest extension then begins to flex

Question 31

what percentage of the gait cycle is made up of the swing phase?

Answer 31

- 40%

Question 32

what are the three stages of the swing phase?

Answer 32

- initial swing - mid swing - terminal swing

Question 33

what percentage is the initial swing?

Answer 33

- 60 to 73%

Question 34

what does the initial swing involve?

Answer 34

- involves toe off until the feet are adjacent

Question 35

what happens to the hip in initial swing? what does this help?

Answer 35

- hip flexion to swing leg through

Question 36

what happens to the knee in initial swing?

Answer 36

- knee reaches maximum flexion (up to 60degrees) then begins to extend

Question 37

what happens to the ankle in initial swing?

Answer 37

- ankle dorsiflexion to plantar grade so toes clear floor

Question 38

what is the average ground clearing in the initial swing?

Answer 38

- only 1cm

Question 39

what percentage is the mid-swing?

Answer 39

- 73 to 87%

Question 40

what is the mid-swing?

Answer 40

- short period that lasts until the tibia is verticle

Question 41

what happens to the hip and knee in mid-swing?

Answer 41

- hip continues to flex - knee moves from flexion to extension

Question 42

what happens to the ankle in mid-swing?

Answer 42

- ankle remains dorsiflexed to neutral

Question 43

what percentage is the terminal swing?

Answer 43

- 87 to 100%

Question 44

what does the terminal swing end with?

Answer 44

- ends with the heel strike of the right leg

Question 45

what happens to the knee, hip and ankle in terminal swing?

Answer 45

- furthest hip flexion (25) - knee fully extends - ankle in neutral to ensure foot in optimal position for initial contact

Question 46

what happens to the pelvis in the terminal swing?

Answer 46

- some pelvic rotation forwards on swing leg side in transverse plane

Question 47

what are the 6 common gait deviations?

Answer 47

- shortened stance phase e.g., limping - reduced arm swing - excessive posterior rotation of the pelvis - reduced hip extension - absent knee flexion - reduced plantarflexion

Question 48

what are the three trunk kinematics?

Answer 48

- sagittal - frontal - transverse

Question 49

what should you observe in gait? (7)

Answer 49

- arm swing - equal weight transfer - stride length - stance duration - consistency of movement - head position and reliance on vision - steadiness of path

Question 50

what are the 4 common gait outcome measures?

Answer 50

- 10 metre walk test - 2minute walk test - timed up and go - functional gait assessment

Question 52

what element does the 6 minute walk test assess?

Answer 52

- endurance