Gait-Lecture 7 Flashcards Preview

Lower Extremity III > Gait-Lecture 7 > Flashcards

Flashcards in Gait-Lecture 7 Deck (30)
Loading flashcards...
1

What are the two periods of the gait cycle?

Swing and Stance

2

What are the two tasks in stride?

Weight acceptance
Single limb support

3

What is the task in swing?

Limb Advancement

4

What are the phases of weight acceptance?

Initial contact
Loading response

5

What are the phases of single limb support?

Mid-stance
Terminal Stance
Pre-swing

6

What are the phases of limb advancement?

pre-swing
initial swing
mid-swing
terminal swing

7

What is normal movement of the trunk in all phases of gait?

Erect
Neutral

8

What is the normal position of the Hip, Knee, Ankle, and Toes at initial swing?

Hip: 20 degrees Flexion
Knee: 60 degrees Flexion
Ankle: 10 degrees Plantarflexion
Toes: Neutral

9

What is the normal position of the Hip, Knee, Ankle, and Toes at midswing?

Hip: 20-30 degrees Flexion
Knee: 60-30 degrees Flexion
Ankle: Neutral
Toes: Neutral

10

What is the normal position of the Hip, Knee, Ankle, and Toes at Terminal swing?

Hip: 30 degrees Flexion
Knee: 0 degrees Extension
Ankle: Neutral
Toes: Neutral

11

What is the normal position of the Hip, Knee, Ankle, and Toes at initial contact?

Hip: 30 degrees Flexion
Knee: Full Extension
Ankle: Neutral, Heel first
Toes: Neutral

12

What is the normal position of the Hip, Knee, Ankle, and Toes at Loading Response?

Hip: 30 Degrees Flexion
Knee: 15 Degrees Flexion
Ankle: 15 degrees Plantarflexion
Toes: Neutral

13

What is the normal position of the Hip, Knee, Ankle, and Toes at Mid-stance?

Hip: Extending to Neutral
Knee: Extending to Neutral
Ankle: Plantarflexion to 10 degrees Dorsiflexion
Toes: Neutral

14

What is the normal position of the Hip, Knee, Ankle, and Toes at Terminal stance?

Hip: 10 degrees hyperextension
Knee: Full Extension
Ankle: Neutral with stable tibia
Toes: Neutral IP, extended MP

15

What is the normal position of the Hip, Knee, Ankle, and Toes at Pre-swing?

Hip: Neutral Extension
Knee: 35 degrees Flexion
Ankle: 20 Degrees Plantarflexion
Toes: Neutral IP, Extended MP

16

What are the 6 determinants of gait?

Pelvic Rotation
Pelvic tilt
Knee Flexion to Mid-stance
Ankle Motion
Knee Motion
Lateral Pelvic Motion

17

What's the transverse kinematics of the pelvis?

4 degrees

18

What's the transverse kinematics of the femur?

7 degrees

19

What's the transverse kinematics of the tibia?

9 degrees

20

What are the 5 possible patient causes of gait deviations?

Muscle weakness
Contracture
Pain
Decreased confidence in the prosthesis or residual limb
Habitual/learned behavior

21

What are the 2 prosthetic causes of gait deviations?

Prosthetic misalignment
Poor prosthetic fit

22

What are the gait considerations from Dr. Perry?

Ability to ambulate
Quality of the prosthesis
Quality of the residual limb
Knee flexion contracture less than 10 degrees
Kinematic peak differ from normal (motions)
Kinetic peaks differ and are stronger than normal (forces)

23

What is normal Hip and Hemi gait at initial contact?

•  Hip joint motion is 15 degrees or less. Hip
flexion is limited by hip flexion control strap or
spring.
•  Axis of support passes from heel up through hip
joint, anterior to knee, producing stability.
•  Prosthesis becomes a simple “peg”.
•  Sound side is at foot flat.

24

What is normal hip and hemi gait at initial contact to loading response?

•  Trunk advances forward
•  Foot-floor reaction moves forward
•  Knee stability maintained by T.K.A.
line
•  Axis of support continues to pass
anterior to knee
•  Hip extension bumper not in contact

25

What is normal hip and hemi gait at Loading Response to Mid-stance?

•  Trunk advances further forward
•  Foot-floor reaction point still forward,
maintaining knee stability
•  Opposite leg lifts
•  At Mid Stance: Alignment essentially the
same as static alignment.
•  Momentum carries body forward.
•  Hip joint contacts.
•  Hip flexion control strap or spring relaxes.
•  Opposite foot off.

26

What is normal hip and hemi gait at mid-stance to terminal stance?

•  Trunk remains vertical. Increased pressure on posterior upper
edge of socket.
•  Increases pressure on hip joint bumpers.
•  Axis of support falls posterior to knee joint, therefore knee,
and knee flexes.
•  Opposite foot flat on floor

27

What is normal hip and hemi gait at terminal stance to mid-swing?

•  Toe off - heel rises during knee flexion and pulls the hip joint against the posterior(extension) stop.
•  Thigh remains vertical until the knee reverses direction and
contacts the knee stop.
•  Then the thigh segment rotates anteriorly, causing hip flexion.
•  Prosthesis is at full length during mid-swing,
and since no voluntary control, shorten 1cm for ground clearance.

28

What are common Hip and Hemi gait deviations?

Insufficient Knee Flexion
Insufficient Hip Flexion
Excessive Knee Flexion
Excessive Hip Flexion
Excessive Lumbar Lordosis
Lateral Trunk Bending

29

What are common Trans-tibial gait deviations?

Inadequate flexion
Inadequate extension
Medial leaning pylon
Lateral leaning pylon
Drop off
Erratic movement
Heel lever too short/long
Toe lever too short/long
Whip(s)

30

What are common trans-femoral gait deviations?

Foot slap
Knee Instability
Delayed progression
Unequal step length
Eternal rotation
Lateral trunk bend
Abducted gait
Pelvic elevation
Knee hyper extension
Medial/lateral whip
Excessive heel rise
Inadequate heel rise
Circumduction
Pistoning
Vaulting
Terminal impact
Reduced velocity