Normal and Abnormal Gait

Question 1

Pros/cons of visual gait analysis

Answer 1

-simplest form of analysis
BUT
-no permanent records
-unable to perform on high speed movements
-limited to movements we can see
-depends on skills of observer
-only "moderately reliable"

Question 2

Full gait assessment includes

Answer 2

links gait abnormalities to other information about the patient

Question 3

Video recording

Answer 3

30-60 up to 120 frames/sec

• provides permanent record
• helps view high speed movements
• limits # walks a patient has to complete
• able to show to patient
• helps teaching gait analysis to someone else

Question 4

Camera position

Answer 4

• A/P and lateral views
• 4 to 5 meters from patient
• whole body and then zoom in from waist down

Question 5

Max co-contract bw hamstrings and quads occurs at what degree knee flexion?

Answer 5

30 degrees

Question 6

Pronation consists of…

Answer 6

DF in sagittal plane
Eversion in frontal plane
Abduction in transverse plane

Question 7

Supination consists of…

Answer 7

PF in sagittal plane
Inversion in frontal plane
Adduction in transverse plane

Question 8

Planes/axes review

Answer 8

Sagittal- M/L
Frontal- A/P
Transverse - vertical

Question 9

Movement of the foot in loading response

Answer 9

• lands in supination and rolls to pronation (provides shock absorption)

Question 10

Gait cycle in walking: stance. vs. swing

Answer 10

Stance - 60%
Swing - 40%
1 second to complete entire gait cycle

Question 11

Stance Phase

Answer 11

60%

• initial contact/loading response
• midstance/opp toe off
• terminal stance/heel rise
• pre-swing/opp initial contact

Question 12

Swing Phase

Answer 12

40%

• toe off/initial swing
• feet adjacent/mid swing
• tibia vertical/terminal swing

Question 13

Step vs. Stride length

Answer 13

Step length is from (R) initial contact to (L) initial contact
Stride length is from (R) initial contact to (R) initial contact

Question 14

Cadence

Answer 14

• Temporal
• # of footfalls in a given time period
• normal: 90-130 steps/minute

Question 15

Stride Length

Answer 15

• Spatial

- normal: 1.1 to 1.7 meters

Question 16

Speed

Answer 16

• Spatial-temporal
• rate of forward progression
• normal: 0.9-1.7 m/s

Question 17

Base of Support

Answer 17

• spatial
• space between feet
• normal: 4 inches

Question 18

Hip ROM during gait

Answer 18

• max flexion in late swing and initial contact (25 degrees)
• extends during most of stance (20 degrees)
• flexes from late stance to late swing

Question 19

Knee ROM during gait

Answer 19

• full extension at initial contact (0 degrees)
• flexes then extends in stance (shock absorption)
• full extension in late stance
• flexes then extends in swing

Question 20

Amount of knee flexion required for normal swing phase

Answer 20

40-50 degrees

Question 21

Ankle ROM during gait

Answer 21

• neutral at initial contact
• PF during loading response (10 degrees)
• DF as stance progresses (10 degrees)
• PF during pre-swing (25 degrees)
• neutral in early swing

Question 22

Toe extension required for normal gait

Answer 22

60-70 degrees

Question 23

Glut max EMG muscle activation

Answer 23

• contracts end swing through stance
• concentric at initial contact
• concentric at opposite toe off

Question 24

Iliopsoas EMG muscle activation

Answer 24

• contracts late stance into swing

- concentric

Question 25

Quad EMG muscle activation

Answer 25

- contracts end stance and beginning of swing, then again in end swing to stance - eccentric during loading response

Question 26

HS EMG muscle activation

Answer 26

- contracts in late swing and early stance | - mostly eccentric to slow the knee down during stance

Question 27

Triceps surae EMG muscle activation

Answer 27

- contracts during stance | - initially eccentric to slow everything down, then concentric for push off

Question 28

Tib anterior EMG muscle activation

Answer 28

- all swing and early/late stance | - eccentric during initial contact/stance, concentric during swing

Question 29

Ground reaction forces

Answer 29

Behind the ankle: plantarflexion Behind the knee: flexion Behind the hip: extension

Question 30

Common trunk gait abnormalities

Answer 30

- lateral trunk bend (hip and/or knee patho) - anterior trunk bend (knee patho) - posterior trunk bend (glut max weak/hip patho)

Question 31

Common hip gait abnormalities

Answer 31

- limb length inequality resulting in: * circumduction * hip hike * steppage * vaulting

Question 32

Common knee gait abnormalities

Answer 32

- excessive knee extension (weak quads) | - excessive knee flexion (quads weak/knee patho)

Question 33

Common ankle gait abnormalities

Answer 33

- inadequate DF | - inadequate push off

Question 34

Lateral trunk bending

Answer 34

- Trendelenburg - trunk moves sideways over supporting leg - decreases trunk's lever arm - decreases moment generated - abductors don't have to generate such a high moment

Question 35

Anterior trunk bend

Answer 35

- brings line of force in front of knee at initial contact | - compensates for weak knee extensors

Question 36

Posterior trunk bend

Answer 36

- brings line of force behind hip joint at initial contat | - compensates for weak hip extensors