Walking and Gaits

Question 1

Stages of walking

Answer 1

• Stance phase - 60% gait cycle, heel strike, support, toe-off phases
• Swing phase - 40% gait cycle, leg lift and swing phases

Question 2

Heel strike

Answer 2

Foot hits ground heel first

• Gluteus maximus - acts on hip, decelerates lower limb
• Quadriceps femoris - keeps leg extended at knee/hip
• Anterior compartment of the leg - maintains ankle dorsiflexion

Question 3

Support

Answer 3

Leading leg hits the ground, force passes through leg

• Quadriceps femoris - keeps leg extended, accepts weight of body
• Foot invertors/everters - contract to stabilise foot
• Gluteus minimus, medius and tensor fascia lata - abduct lower limb keeping pelvis level by counteracting the imbalance by having most of the weight on one leg

Question 4

Toe-off

Answer 4

Foot prepares to leave the ground, toes last

• Hamstring muscles - extends leg at hip
• Quadriceps femoris - maintains extended position of knee
• Posterior compartment of leg - plantarflexes the ankle, prime movers = gastrocnemius, soleus and tibialis posterior

Question 5

Leg lift

Answer 5

Lower limb is raised in preparation for the swing stage

• Iliopsoas and rectus femoris - flex lower limb at hip, drive knee forwards
• Hamstring muscles - flex lower limb at knee
• Anterior compartment of leg - dorsiflexes ankle

Question 6

Swing

Answer 6

Raised leg propelled forward

• Iliopsoas and rectus femoris - keep hip flexed, resist gravity
• Quadriceps femoris - extends the knee, positioning foot for landing
• Anterior compartment of leg - maintains ankle dorsiflexion so heel is in place for landing

Question 7

Trendelenberg gait

Answer 7

Trendelenberg sign - pelvis drops towards side of raised limb when standing on one leg
Abductor muscles on standing limb greatly weakened or paralysed
Due to lesion in superior gluteal nerve
As pelvis drops during walking, the trunk lurches to opposite side in effort to maintain steady pelvis
On next step trunk whipped back over pelvis towards centre, often overcompensates and falls slightly past centre to opposite side

Question 8

Footdrop

Answer 8

Damage to common or deep fibular nerve
Blunt trauma or fracture to head of fibula (common fib. nerve wraps round here)
Deep fibular nerve innervates anterior leg muscles -> damage = no dorsiflexion

Question 9

Antalgic gait

Answer 9

Painful gait
Shortened stance phase
Often seen in patients with chronic musculoskeletal pain