Movement: Gait Flashcards
(94 cards)
1
Q
What gait phases are double limb?
A
IC
LR
PSw
2
Q
What gait phases are single limb?
A
MSt
Tst
ISw
MSw
TSw
3
Q
what phase of gait is the opposite limb in during initial contact
A
pre-swing
4
Q
what phase of gait is the opposite limb in during loading response
A
preswing
5
Q
what phase of gait is the opposite limb in during mid stance
A
initial swing and mid swing
6
Q
what phase of gait is the opposite limb in during terminal stance
A
terminal swing
7
Q
what phase of gait is the opposite limb in during preswing
A
initial contact and loading response
8
Q
what phase of gait is the opposite limb in during initial swing and mid swing
A
mid stance
9
Q
what phase of gait is the opposite limb in during terminal swing
A
terminal stance
10
Q
How much hip extension is required for gait?
How much hip flexion?
A
20 ext
30 flx
11
Q
How much knee flex/ext is required for normal gait
A
0-60
12
Q
How much plantar and dorisflexion is required for gait?
A
10 DF
20 PF
13
Q
Moment definition
A
rotation around an axis
external vs internal
14
Q
external moment
A
created by gravity, inertia, GRF
in relation to joint center
15
Q
internal moment
A
direction opposite of the external moment
- how the body reacts to external moment
16
Q
Power generation is accomplished with muscles ______
Power absorption is accomplished with muscles ______
A
shortening, concentric
Lengthening, eccentric
17
Q
center of pressure during initial contact
A
Posterio-lateral
18
Q
center of pressure during loading response
A
lateral mid foot
19
Q
center of pressure during terminal stance
A
medial ball of foot
20
Q
The center of pressure is over the ______ during pre-swing
A
First and second toes
21
Q
where does the line of gravity fall for IC, LR, MSt, TSw and PSw for the hip, knee and ankle?
A
hip: A, A, P, P, P
knee: A, P, A, A, P
ankle: P, P, A, A, A
*hip and ankle are opposites
22
Q
What are the internal moments at the hip, knee, and ankle during initial contact?
A
Hip Ext (GRF A)
Knee Flexion (GRF A)
Ankle DF (GRF P)
23
Q
What are the interal moments at the hip, knee, and ankle during loading response?
A
Hip Ext (GRF A)
Knee EXT (GRF P)
Ankle DF (GRF P)
24
Q
What are the interal moments at the hip, knee, and ankle during midstance?
A
Hip FLX (GRF P)
Knee FLX (GRF A)
Ankle PF (GRF A)
25
What are the interal moments at the hip, knee, and ankle during terminal stance?
Hip FLX (GRF P)
Knee FLX (GRF A)
Ankle PF (GRF A)
26
What are the interal moments at the hip, knee, and ankle during preswing?
Hip FLX (GRF P)
Knee EXT (GRF P)
Ankle PF (GRF A)
27
What are the 3 external forces in gait
Intertia
Gravity
Ground Reaction Force
28
The goal of gait training is to
teach patient to use as little energy as possible
32% oxygen consumption in healthy 20-30y/o
48% oxygen consumption in 75y/o or person with medical condition
29
T or F, limbs contribute more to total energy during walking than head and trunk
True
30
At the initial contact → loading response phase, where is the fulcrum/rocker?
Fulrum/rocker at the heel
The calcaneous moves from inversion to eversion
31
During loading response → terminal stance, what structure is the fulcrum/rocker?
ankle fulcrum
32
During terminal stance, where is the rocker/fulcrum?
leg rotates over forefoot
- increased MTP extension
33
During pre-swing, what is the rocker/fulcrum?
Leg rotates over toes
- increased toe extension
34
How does the rocker/fulcrum of the foot move throughout gait?
Heel -> ankle -> forefoot -> toes
35
Trunk stays erect during free speed walking
slight trunk ________ at initial contact
slight trunk __________ during single leg stance
flexion
extension
36
During gait, the adductor moment of the head+arm+trunk is counteracted by __________
abductors
- prevents contralateral hip drop
37
What kind of movement occurs in the sagittal plane during gait?
sinusoidal pattern up and down 4-5cm with eachstep
38
Where is the low and high point of the sinusoidal pattern
low at initial contact
high at mid-stance
39
What kind of motion occurs in the frontal plane during gait
pelvic side to side motion of 4-5cm and a 5 degree pelvic drop with trunk lean 5cm
40
what kind of motion occurs in the transverse plane during gait
pelvic rotation 4-8 degrees with opposite trunk rotation
41
During what part of gait is the erector spinae most active?
NOTE: I think this will be a test Q because of how much Dr. Dice mentioned it.
LOADING RESPONSE
42
How much shoulder and elbow flx is normal during gait?
Shoulder ROM: 30 degrees total ( 6 flx 24 ext)
elbow rom: 20-45
43
UE muscle activity and movement is ____________
primarily driven by gravity and highly variable
44
during gait, are the triceps or biceps more active?
the triceps because they are slowing the arm down
45
During stair gait, greater _______ activation is necessary
torque at the knee is _____ greater for ascent vs descent
quad
x3
46
How is initial contact on stairs different than on ground?
Anterior to posterior foot
level ground: Posterior to anterior foot
47
What stage of stair gait is most knee flexion needed?
foot clearance
48
what stage of stair gait is most hip flexion needed?
foot placement
49
What are the 5 stages of stair gait
weight acceptance
pull up
foward continuance
foot clearance
foot placement
50
What are the 3 stages of running gait?
Stance
Float
Swing
51
During running gait, most torque generated is at the ______ during impact
Knee
note: Ground reaction force at center of pressure is over 200% of BW
52
What are the primary muscle groups used for running
Hip extensors
Quadriceps
Gastroc/Soleus
53
During running you need increased ________________ in lower extremity
joint ROM
54
Neuro changes seen by age 90: Brain Mass, Muscle atrophy
decreased brain mass 10-20%, 1% muscle loss per year in healthy adults
estimated 20-40% loss of maximal strength by age 65
atrophy of slow twitch fibers w/ inactivity
overall diminished functional reserve
55
Gait speed declines _____________ per decade
12-16%
Decreased strike/step length
More time w/ doublelimb support 30% instead of 18%
deceased dorsiflexion
56
Older patients gait will have a wider ____________
_____ toe clearance during swing phase
_____ trunk flexion during gait
and difficulty with obstacle avoidance
Base of support
Less
Foward
57
Abnormal elderly gait includes
______ in gait measures
Gait Variability
________ to change gait speed/direction
postural sway that requires ________
inability to ________ while walking
Asymmetry
Inability
External Support
Multitask
58
Community functional benchmarks:
Gait speed: ____
Distance ______
curb height ______
4ft/sec
>300m
Curb height >8in
59
Gait using a rolling walker might lead to slower speed: ________
smaller step length
and ________ stance time/ ______ swing time
1.5 f/s (instead of 4 ft per second)
Increased stance time/ Decreased swing time
Note: Pattern becomes more apparent the longer an individual uses a RW
60
Foward lean during gait might be due to:
____ hip flexors
a compensation for _______ quads (Increased plantarflexion)
or ______ visual cues for __________ propriocepton
Or assistive devices
Tight hip flexors
Compensate for weak quads
Increased visual cues for decreased proprioception
Note: Shifts LOG in front of Knee and Ankle
61
Backward lean in gait might be due to
Weak _______during weight acceptance and Single Limb Support
or weak ___________ during single leg advancement
Hip Extensors (Leaning back takes the hip extensors out of the movement when supporting weight)
Hip flexors ( Leaning back assists the weak hip flexors to swing the leg foward)
62
Lateral lean of the trunk during gait might be due to
weak hip ____________ or hip pain during weight acceptance or single limb support
or a __________ stance limb
Or a use of an assistive device
Abductors
Short Stance Limb
63
Gait deviations: Trunk rotations
One example of a deviation is that trunk moves w/ pelvis due to decreased disassociation
Use of assistive device
Rotation of the trunk backwards during gait can compensate for ______ plantarflexion
Rotation of the trunk foward during gait can help to _____________
Compensate for increased plantarflexion
Rotation Foward to advance limb
64
Pelvic deviations during gait: A hike can be used to ________ the swinging limb using _____ quadratus lumborum
Clear swinging limb
using ipsilateral quadratus lumborum
65
Pelvic deviation: Vault is simular to hike with an addition of _______
Plantarflexion
66
Anterior Pelvic Tilt might be due to _______ hip extensors
______ Abdominals
and _____ hip flexors
Weak hip extensors
Weak Abdominals
Tight Hip Flexors
67
Posterior Pelvic tilt during gait might be due to _____ hip flexors
______ hip extensors
_____ hamstrings
shifts the Line of gravity ___________
Hip Flexor weakness
hip extensor weakness
tight HS
Shifts LOG posteriorly
68
Pelvic deviations: if you're lacking rotation foward or backward it can be due to ____________
Back Pain
Decreased step length
potential surgical fusion
69
Excessive foward pelvic rotation can be due to ____________
Excessive backward pelvic rotation can be due to ___________--
Compensation to help advance limb
Weak Calf, No heel Off (During terminal Stance)
Or Excessive hip flexion (During single limb support)
70
Pelvic drop during gait is likley to lead to ________
and can be due to weak ___________
Back pain during stance
Weak calf (Ipisilateral during single limb support)
Or scoliosis
71
Hip drop due to a shorter LE will appear as _______ during single leg advancement and ______________ during single limb support
Ipsilateral to single limb advancement
Contralateral to single limb support (trendelenberg)
72
Weak hip abductors lead to a __________ hip drop during single limb support
Adductor spasticity will lead to an ____________ drop in single limb advancement
Adductor spasticity will lead to a ___________ drop in single limb support
Contralateral
Ipsilateral
Contralateral
73
Past retract gait
voluntary excessive hip flexion and it's release in order to __________
rapidly extend a flaccid knee using inertia
74
Decreased hip flexion during gait might be due to
Hip flexor _______
hamstring _____________-
hip pain
compensation for Hip Extensor weakness
or a result of foot drag
Hip Flexor Weakness
Hamstring spasticity
75
During initial swing decreased ________ reduces step length
Hip Flexion
Limited hip flexion may also limit knee flexion during swing
76
Decreased hip flexion due to gait is most impactful during ________, clearance of the LE needed
Most impactful durng Midswing
77
internal rotation hip deviation
-anteversion
-compensation for weak quads
78
external rotation hip deviation
-retroversion
- compensation for weak IP, PF contracture, swing limb too long
79
adduction contracture hip deviation
-ipsi glute med weakness → contra hip drop
- compensation for weak hip flexors
80
abduction contracture hip deviation
long contra limb
81
decreased knee flexion is due to
-weak quads
-knee pain
-extension contracture
-hip flexor weakness
82
genu recurvatum causes
- weak quads (LR)
- weak quads/PFs (SLS)
- PF contracture
83
thrust
PF contracture with forefoot with IC (instead of heel)
84
increased knee flexion
- PF weakness
- contracture
- knee pain
- compensation: increased DF in LR, Mst, Tst
85
genu valgus
knees in
-ipsi abductor weakness
-ipsi trunk lean
86
genu varus
knees out
87
forefoot contact during IC
-PF contracture
-DF weakness
-increased knee flexion
- compensation for short leg
88
flat foot contact with IC
-weak quads → excess knee flexion
89
foot slap
weak TA
90
increased PF
-contracture
-weak quads
-weak pretibials
-toe drag
91
increased inversion
-varus contracture
-high arch
-internal tibial rotation
92
increased eversion
-valgus deformity
-low arch
93
toes up
compensation for lack of DF
94
claw/hammer toes
compensation for weak PF
