VIVA - gait Flashcards
(8 cards)
Describe features of normal stance phase of gait
Initial Contact (Heel Strike)
Heel makes contact with the ground.
Controlled by eccentric contraction of dorsiflexors (e.g., tibialis anterior).
Loading Response (Foot Flat)
Body weight is transferred onto the leg.
Quadriceps control knee flexion; hip abductors stabilize the pelvis.
Mid Stance
Body progresses over the stable foot.
Calf muscles begin to control tibial advancement.
Terminal Stance (Heel Off)
Heel lifts off as body moves forward.
Plantarflexors (e.g., gastrocnemius, soleus) generate forward propulsion.
Pre-Swing (Toe Off)
Toe pushes off the ground to initiate swing.
Hip and knee flexors activate to lift the limb.
Observations that might be present if person has an impairment affecting stance phase of gait
Trendelenburg gait - pelvis drop on contralateral side due to weak hip abductors (glute med, min).
Compensated trendelenburg gait - pelvis drop contralateral side WITH ipsilateral trunk lean on stance leg to keep CoM over BoS
Foot slap due to weak dorsiflexors
Hyperextension may indicate quad weakness or proprioceptive loss
Reduced step length on affected side due to pain, weakness, or instability
Lateral trunk lean over weak hip abductors
Delayed/absent heel off due to PF weakness or joint ROM issue
Instability may mean proprioception, balance or motor control problems
Describe the features of normal swing phase of gait
Initial Swing
Begins at toe-off.
Hip flexion and knee flexion help lift the foot.
Ankle dorsiflexes to clear the toes from the ground.
Mid Swing
Thigh continues to advance forward.
Knee begins to extend.
Ankle remains dorsiflexed to maintain toe clearance.
Terminal Swing
Knee extends fully in preparation for initial contact.
Hamstrings decelerate the forward motion of the tibia.
Ankle remains neutral for proper heel strike.
give examples of key observations that might be present if a person has impairments affecting swing phase of gait
Foot Drop / Toe Drag
Due to weak dorsiflexors (e.g., tibialis anterior), or reduced ankle DF PROM
Ax: MMT, PROM, AROM
No heel-off in terminal stance - weak PF or reduced PF PROM
Ax: MMT, PROM
Reduced Knee Flexion (pre-swing)
Weak gastroc, reduced knee PROM
Ax: MMT gastroc, PROM knee
Contralateral hemipelvis drop
Weakness hip abductors
Ax: MMT glute med
Knee hyperextension
Weak quads / poor control / compensation
Ax: observation, MMT
3 things involved in gait mechanics - KKG
- Kinematics – joint movements (e.g., flexion angles)
- Kinetics – forces and torques (e.g., ground reaction forces)
- Ground Reaction Force (GRF) – drives muscle activation
Typical gait parameters
- Speed: ~1.4 m/s
- Cadence: 110–120 steps/min
- Step Length: ~70 cm
- Step Width: 3–8 cm
- Step length reflects confidence in swing and stance phases
Gait observation and goal setting
- Observe aids, environment, stability, cadence
- Goals: increase speed, reduce aid, improve balance and step symmetry
How to document GAIT
- Independence: Independent / standby / assisted (1–2 people)
- Aids: Walking stick, frame, AFO, KAFO, braces
- Environment: Indoors/outdoors, predictable/unpredictable
- General description: Speed, cadence, step length, width, symmetry, balance
- Specific features: Initial contact, stance/swing deviations, foot clearance
- Outcome measures: 10m walk, 6-min walk, TUG, DGI
