Gait Review

Question 1

What is a gait cycle?

Answer 1

initial heel contact of one foot to heel contact of the same foot

Question 2

T/F Stride is synonymous with a gait cycle

Answer 2

True

Question 3

What is a step?

Answer 3

is sequence of events that occurs within heel contacts of opposite feet

Question 4

How many steps in 1 gait cycle?

Answer 4

2 steps

Question 5

What % of stance phase?

Answer 5

60%

Question 6

What % of Swing phase?

Answer 6

40%

Question 7

What % of single-limb support?

Answer 7

80%

Question 8

What % of double-limb support?

Answer 8

20%

Question 9

What is stride length?

Answer 9

Distance between 2 successive heel contacts of the same foot

Question 10

What is step length?

Answer 10

Distance between successive heel contacts of 2 different feet

Question 11

What is degree of toe-out? What is normal?

Answer 11

Angle between line of progression of the body and a line intersecting the center of the heel and second toe
5-7 degrees is normal

Question 12

What is step width? What is normal?

Answer 12

Lateral distance between heel centers of 2 consecutive foot contacts
Average is 8-10 cm

Question 13

what is a potential cause of Asymmetric step length often observed in prosthetic users?

Answer 13

spending less time in stance phase on involved side

Question 14

Asymmetric step length often observed in prosthetic users results in a shortened what on the noninvolved side?

Answer 14

shortening swing time and step length

Question 15

What is stride time?

Answer 15

Time for a full gait cycle

Question 16

What is step time?

Answer 16

Time for completion of a R or a L step

Question 17

What is cadence?

Answer 17

Number of steps per minute

Also described as step rate

Question 18

What is the best and most functional measurement of individuals walking ability?

Answer 18

Gait speed - Distance covered in a given amount of time

Question 19

Gait speed decreased when what two things occur?

Answer 19

Reduced:

1. step length (early prosthetic users)
2. Cadence

Question 20

T/F Common that individuals using prosthetic and/or orthotic devices have slower gait speed, and expend more energy while walking

Answer 20

True

Question 21

What are some other common reasons for decreased gait speed in this population?

Answer 21

Tentative, poor gait training in early amputee, may not have had normal/quick speed pre surgery

Question 22

What 2 keys features of IC/Loading response?

Answer 22

1. Shock absorption (Plantarflexion, Knee flexion, Pronation, Hip adduction)
2. Forward propulsion through hip extension

Question 23

What 3 keys features of Midstance?

Answer 23

1. Shock absorption
2. Stabilize in single limb support
3. Forward progression of tibia (closed chain dorsiflexion)

Question 24

What 3 keys features of Terminal Stance?

Answer 24

1. Continued stabilization in single limb support
2. Forward propulsion through plantarflexion
3. Forward progression

Question 25

What 2 keys features of Pre-swing?

Answer 25

1. Continued forward propulsion through plantarflexion | 2. Continued forward progression

Question 26

What 2 keys features of initial swing?

Answer 26

1. Forward propulsion of swing leg through hip flexion 2. Foot clearance (functionally shortening limb) - Dorsiflexion - Knee flexion

Question 27

What key feature of mid swing?

Answer 27

Forward propulsion of swing leg through hip flexion

Question 28

What key feature of terminal swing?

Answer 28

Prepare for initial contact | Controlled knee extension, Ankle positioned into less supination

Question 29

Key muscle activity of hip extension?

Answer 29

Activated in terminal swing prior to initial contact to initiate hip extension and prepare LE for weight acceptance at the beginning of stance (TF – initiate knee extension through hip extension )

Question 30

Key muscle activity of hip flexion?

Answer 30

Advance lower extremity forward during initial swing & lift lower extremity to allow for toe clearance during swing

Question 31

Key muscle activity of hip abductors?

Answer 31

Control the slight lowering of the contralateral pelvis on the side of the swing limb

Question 32

Key muscle activity of hip adductors?

Answer 32

Assist with initiation of hip flexion after toe off

Question 33

Key muscle activity of the knee extensors?

Answer 33

Eccentrically control knee flexion in loading response then act concentrically to extend the knee and support body in midstance

Question 34

Key muscle activity of the knee flexors?

Answer 34

Decelerate knee extension in preparation for placement of the foot on the ground (IC)

Question 35

Key muscle activity of the ankle dorsiflexors?

Answer 35

Eccentric activation to control plantar flexion of the ankle at initial contact until foot comes in contact with the ground (amputees don’t have these muscles to control DF)

Question 36

Key muscle activity of the ankle plantar flexors?

Answer 36

1. Eccentric contraction moving into midstance to control tibial advancement 2. Concentric contraction at Terminal Stance and Preswing to propel forward (“push-off”)

Question 37

Key muscle activity of the ankle invertors?

Answer 37

Eccentrically contracts to control pronation until midstance then concentrically contracts to supinate the foot for push-off in terminal stance/preswing

Question 38

Key muscle activity of the ankle evertors?

Answer 38

Also active as co-contraction to counter strong inversion occurring during loading response to midstance

Question 39

Loss of plantar flexors due to amputation or weakness can cause what 3 things during gait?

Answer 39

1. Shorter contralateral step length 2. Reduced gait speed 3. Impaired balance

Question 40

What phase(s) of gait will this be most noticeable with loss of plantar flexors?

Answer 40

Midstance – gastroc most active eccentric to prevent excessive tibial advancement

Question 41

No prosthetic mechanism is needed to produce knee flexion given what two things?

Answer 41

1. The individual can flex the hip – overactive hip flexion/contracture 2. Ambulate fast enough to produce momentum – losing propulsion from ankle joint

Question 42

What general characteristics of prosthetic gait will decrease?

Answer 42

``` Walking speed stride length cadence energy efficiency biomechanical efficiency ```

Question 43

Pistoning, common cause for many TTA deviation caused by poor suspension, results in what 3 things?

Answer 43

1. Decreased stability (feels like limb will fall off) 2. Decreased confidence 3. Excessive pressure/shearing forces

Question 44

T/F For TF prosthetic users, gait cycle will be the same.

Answer 44

False, Shorter (more time in duel limb support to maximize stability)

Question 45

In midstance of TF prosthetic gait, how does the femur help with balance?

Answer 45

Weight shift over prosthetic (balance from femur pushing laterally reducing demand of hip abd) = slow stance

Question 46

During the swing phase of the prosthetic, how does the knee get into extension?

Answer 46

Pendulum effect by force from hip flexors – knee flexion into knee extension

Question 47

T/F No matter the cause or level, amputees have increased metabolic costs for ambulation

Answer 47

True

Question 48

Normal prosthetic gait is a function of what 4 characteristics?

Answer 48

1. socket fit 2. prosthetic alignment 3. components 4. user ability