Normal Gait Flashcards
(42 cards)
A physical therapist is examining the gait of a patient and suspects a leg
length discrepancy. Which of the following gait deviations is MOST
LIKELY seen by the therapist?
A. Increased dorsiflexion of the short limb during swing and increased plantarflexion of the long limb during stance
B. Decreased knee flexion and increased dorsiflexion of the long limb during stance and increased dorsiflexion of the short limb during swing
C. Increased dorsiflexion with early heel rise of the long limb at heel off and increased plantarflexion of the short limb during stance
D. Increased plantarflexion of the long limb at heel strike and decreased knee flexion of the short limb during heel off
C. Increased dorsiflexion with early heel rise of the long limb at heel off and increased plantarflexion of the short limb during stance
leg length compensates:
longer leg compensates = increase DF to shorten limb length
shorter leg compensates = increase PF to elongate limb length
Gait:
Manner or style of walking
Gait cycle:
Beginning of a walking event by
one limb and continuing until the event is repeated with the same limb
̶Time from heel strike to the next
ipsilateral heel strike
Stride:
One complete gait cycle
R to L then L to R
Step:
Beginning of an event by one limb until the beginning of the same event with the contralateral limb
R to L
1/2 stride
Cadence:
The number of steps a person takes per minute
It’s a measure of walking rhythm or step rate
↓ Cadence = slower gait speed, fall risk, deconditioning
↑ Cadence = shorter step length (e.g., Parkinson’s shuffling gait)
Cadence × Step Length = Walking Speed
Phases of Gait Cycle
stance phase: 60%
> initial contact = Heel strikes ground
> loading response = Weight transfers onto limb
> mid stance = Body moves over foot
> terminal stance = Heel lifts as body moves forward
> pre swing = Toe pushes off ground (aka toe-off)
swing phase: 40%
> initial swing = Foot lifts off the ground
> mid swing = Leg swings under the body
> terminal swing = Knee extends, foot prepares for contact
Weight acceptance →
Initial contact + loading response
Single limb support →
Midstance + terminal stance
Limb advancement →
Preswing + swing phase
Rancho Los Amigos (RLA) vs Standard Terminology
stance phase:
RLA- Initial contact
Traditional - Heel strike
RLA - Loading response
Traditional - Foot flat
RLA - Mid stance
Traditional - Mid stance
RLA - Terminal stance
Traditional - Heel off
RLA - Pre swing
Traditional - Toe off
Rancho Los Amigos (RLA) vs Standard Terminology
swing phase:
RLA - Initial swing
Traditional - Acceleration
RLA - Mid swing
Traditional - Mid swing
RLA - Terminal swing
Traditional - Deceleration
Rockers =
pivot points during the stance phase of gait that help smoothly move the body forward over the foot
3 main ones
> heel
> ankle
> forefoot
Heel Rocker
Phase: IC → LR
Pivot: Calcaneus (heel)
Purpose: Smooth contact & shock absorption
If impaired: Foot slap or hard heel strike
Ankle Rocker
Phase: Midstance
Pivot: Talocrural joint (ankle)
Purpose:
Tibia rolls forward over a fixed foot - Controlled by eccentric gastroc/soleus to stabilize
If impaired: Limited dorsiflexion → short step length, early heel rise
Forefoot Rocker
Phase: TSt → PSw
Pivot: Metatarsal heads
Purpose:
Heel lifts, body rolls over forefoot = Drives push-off for limb advancement
If impaired: Poor propulsion, shortened stride, “flat foot” gait
Following surgery of the right hip, a patient ambulates with L pelvic drop. Toimprove the gait pattern, functional electrical
stimulation should be initiated for which of the following?
A. Right abductors during swing on the right
B. Right abductors during stance on the right
C. Left abductors during stance on the left
D. Left abductors during swing on the left
B. Right abductors during stance on the right
L pelvis drop -> weal R glute med
- pelvis falls away from weak side
- trunk leans to weak side
- trendelnburg
ROM at hip needed for normal gait:
Stance phase: 0-30° flexion and 0-10-20° hyperextension
Swing phase: 20-30° flexion
ROM at knee needed for normal gait:
Stance phase: 0-40° flexion
Swing phase: 0-60° flexion
ROM at ankle needed for normal gait:
Stance phase: 0-10° DF, 0-20° PF
Swing phase: 0-20° DF
A clinician decides to use functional electrical stimulation to improve gait of a patient with weak tibialis anterior muscle. Stimulation should be initiated in which phase of the gait cycle?
A. Mid stance to terminal stance
B. Initial contact to mid stance
C. Loading response to mid stance
D. Initial swing to mid swing
D. Initial swing to mid swing
not able to keep DF -> going to drag on ground
= no clearance
= no moving forward
FES = best for concentric contractions
prob = weak DF
On evaluating a patient’s range of motion 3 weeks post total knee arthroplasty, the clinician notes that the patient has 45 of hip flexion, 40 of knee flexion, 20 of plantarflexion, and 15 of dorsiflexion. In which phase of gait will the patient MOST LIKELY
compensate based on their range of motion values?
A. Initial swing
B. Terminal swing
C. Pre swing
D. Mid stance
A. Initial swing
knee is lacking flexion = trying to clear the ground
While evaluating the gait cycle of this patient, the clinician
observes that the patient swings their right lower extremity in a semicircular arc while walking. Which of the
following condition is MOST LIKELY to cause this gait deviation?
A. Right ankle dorsiflexor weakness
B. Right hip flexor tightness
C. Right ankle dorsiflexor tightness
D. Right ankle plantarflexor weakness
A. Right ankle dorsiflexor weakness
circumduction
weak
- hip flexors
- knee flexors
- ankle DF
tight
- PF
- quads
