Lecture 7

Question 1

Normal Gait Cycle Phases

Answer 1

1. Initial Contact
2. Loading Response
3. Midstance
4. Terminal-stance
5. Pre-swing
6. Initial Swing
7. Mid-swing
8. Terminal Swing

Question 2

Initial Contact in Gait Cycle

Answer 2

• Heel makes contact with the ground
• Objective: Position foot for loading & begin shock absorption

Question 3

Loading Response in Gait Cycle

Answer 3

• Body weight is transferred onto the leg
• Shock absorption, controlled knee flexion
• Foot fully contacts the ground

Question 4

Midstance in Gait Cycle

Answer 4

• Body weight moves directly over the supporting foot
• Contralateral leg in swing phase
• Tibia advances over stationary foot

Question 5

Terminal-Stance in Gait Cycle

Answer 5

• Heel begins to lift off as body moves ahead of foot
• Weight shifts to forefoot
• Hip extension occurs

Question 6

Pre-swing in Normal Gait Cycles

Answer 6

• Rapid unloading of the limb
• Toe pushes off ground
• Knee starts to flex for swing phase

Question 7

Initial Swing in Gait Cycle

Answer 7

• Foot leaves the ground
• Hip flexion, knee flexion, and ankle dorsiflexion to clear foot

Question 8

Mid-swing in Gait Cycle

Answer 8

• Thigh continues advancing
• Knee extends, foot clears the ground

Question 9

Terminal Swing in Gait Cycle

Answer 9

• Knee fully extends
• Leg prepares for initial contact again

Question 10

How much does walking speed decline in the elderly?

Answer 10

0.7% per year along with significant changes in cadence and step length

Question 11

What does the aging population exhibit in their gait?

Answer 11

• Lower knee extension at heel-strike
• Knee flexion during swing phase

Question 12

Hypokinetic-rigid Gait Disorders

Answer 12

• Characterized by shuffling with reduced step height and stride length
• Reduced arm swing and slow turning
• Festination: rapid, small steps to keep up with forward-leaning trunk
• Ataxic features: wide stance, variable step timing and size
• Seen in conditions like Parkinson’s, cerebrovascular disease, and ventricular enlargement

Question 13

Cautious Gait

Answer 13

• Slow walking, wide base, short strides
• Minimal trunk movement, flexed knees and elbows

Question 14

Careless Gait

Answer 14

• Overly fast, confident walking
• Often due to confusion or delirium in older adults

Question 15

Post-Anoxic Encephalopathy Gait:

Answer 15

• Bouncing gait and stance
• Seen in post-anoxic states and Parkinson’s, linked to excessive trunk movement and falls

Question 16

Dystonic Gait:

Answer 16

Toe-walking due to involuntary muscle contractions causing abnormal postures

Question 17

Psychogenic Gait Disorder:

Answer 17

• Often caused by drug side effects
• Includes extrapyramidal symptoms, sedation, orthostatic hypotension, ataxia, and behavioral issues

Question 18

Pathological Gait in Alzheimers

Question 19

Pathological Gait in Parkinsons

Question 20

Pathological Gait in Multiple Sclerosis

Question 21

Pathological Gait in Amyotrophic Lateral Sclerosis

Question 22

Pathological Gait in Huntingtons Disease

Question 23

Pathological Gait in Diabetic Peripheral Neuropathy

Question 24

Pathological Gait in Post-stroke

Question 25

What are the stages of gait assessment?

Answer 25

1. Observation 2. Gait Cycle Breakdown 3. Documentation

Question 26

Observation in Gait Cycle

Answer 26

- Observe patient while they stand still - Observe gait cycle as the walk from side, anterior & posterior view - Analyze any observed gait deviations.

Question 27

Gait Cycle Breakdown in Gait Assessment

Answer 27

Divide gait cycle into its phases and for each phase, observe: - Joint movement - Muscle activation - Foot placement

Question 28

Documentation in Gait Assessment

Answer 28

- Record all observations and abnormal findings - Pay attention to foot wear (can contribute to abnormal gaits.

Question 29

What can we think about through each gait phase?

Answer 29

- Muscles - Joint movement - Ligaments - Hypermobility - Hypomobility - Quality of motion

Question 30

Hemiplegic Gait

Answer 30

- Unilateral weakness - Arm is flexed, internally rotated and adducted - Affected leg makes semicircular motions

Question 31

Diplegic Gait

Answer 31

- Debilitated involvement on both sides where lower extremities are worse - Walks with affected toes, pulling both legs and narrow base

Question 32

Neuropathic Gait

Answer 32

- A drop in foot (attempt to lift leg high)

Question 33

Choreiform Gait

Answer 33

- Jerky, involuntary, irregular movements

Question 34

Myopathic Gait

Answer 34

- Weakness in Hip Girdle muscles - Drop contralateral side of the pelvis

Question 35

Ataxic Gait

Answer 35

- Body of patient may drop back and forth

Question 36

Parkinsonian Gait

Answer 36

- Suffer from bradykinesia and rigidity - Head and neck bent down - Knees flexed - Upper extremity is in flexion and has extended fingers