1
Q
what are the two main stages of gait cycle?
A
- stance
- swing
2
Q
how much of the gait cycle is spent in stance ? how much is double stance?
A
- 60%
- 20% of gait is double stance> this decreases with velocity
3
Q
how much of the gait cycle is spent in the swing ?
A
- 40%
4
Q
where should the centre of mass be?
A
- centre of mass same as height
5
Q
what are the 8 phases of gait?
A
- initial contact
- loading response
- mid stance
- terminal stance
- pre swing
- initial swing
- mid swing
- terminal swing
6
Q
what does initial contact involve? what percentage?
A
- 0%
- heel strike
7
Q
what happens to the hip and knee in initial contact phase?
A
- hip flexed to 25 degrees
- knee fully extended
8
Q
what does the ankle do in initial contact?
A
- ankle in plantigrade
9
Q
what does the pelvis do in initial contact?
A
- pelvis rotated slightly forwards in transverse plane
10
Q
what is the loading response? what is the percentage?
A
- 0 to 10% of stride
- transference of weight
-deceleration to the floor
11
Q
what do the hip and knee do in the loading response?
A
- hip begins to extend, knee flexes to 15 degrees
12
Q
what does the ankle do in the loading response?
A
- ankle plantarflexes until foot flat (1st rocker)
- then dorsiflexes on a fixed foot to bring shank forwards over ankle (2nd rocker)
13
Q
what is the 1st rocker of gait?
A
- heel is the centre of rotation
- foot rotates around this and the ankle joint axis to come to rest in the foot flat position
- PF rate controlled
14
Q
what is the 2nd rocker of gait?
A
- ankle is centre of rotation
- the tibia is brought up and over the talus, rotating around the ankle joint
- ankle DF
15
Q
what does the terminal position of the 2nd rocker signal?
A
- signals powerful triceps surae to fire
16
Q
what is mid stance? what percentage?
A
- 10 to 30%
- weight over leg
17
Q
what does the hip and knee do in the mid stance?
A
- hip moves into extension and knee moves back into extension
18
Q
what happens to the hip in the mid stance and why?
A
- slight adduction at hip to lower contralateral pelvis
19
Q
what happens to the ankle in the mid stance?
A
- ankle dorsiflexes further and there is a slight supination in frontal plane
20
Q
what is terminal stance? what percentage?
A
- 30 to 50%
- heel starts to lift off the floor
21
Q
what does the hip and knee do in the terminal stance?
A
- hip continues to extend
- knee begins to flex
22
Q
what happens to the ankle in the terminal stance?
A
- ankle dorsiflexes until full dorsiflexion reached at which point 3rd foot rocker starts as heel lifts
23
Q
what is the 3rd rocker of gait?
A
- forefoot is the centre of rotation
- ankle plantarflexes over a fixed forefoot
- PF muscles isometrically contract
- heel rises
24
Q
what is pre swing? what percentage?
A
- 50 to 60%
- weight all over the other leg
- double stance has occurred
- weight transferred to contralateral limb
25
what happens to the toe in pre- swing phase?
- toe off at the end of pre- swing phase
26
what does the hip and knee do in pre- swing stage?
-hip reaches greatest extension then begins to flex
- knee continues to flex
27
what does the ankle do in the pre swing phase?
- dorsiflexes
28
what is initial swing? what percentage?
- 60 to 70%
- foot leaves ground
29
what happens to the leg in initial swing?
- it shortens
30
what does the hip and knee do in the initial swing phase?
- hip flexes to swing leg through and knee goes to max flexion (60 degree)
- then the knee extends
31
what does the ankle do in the initial swing phase and why?
- ankle dorsiflexion to plantargrade
- ensures toes clear floor
32
what is the average ground clearance?
- only 1cm
33
what is the mid swing? what percentage?
- 70 to 85%
- involves the forward swing
34
what happens to the hip and knee in mid swing?
- hip continues to flex
- knee moves from flexion into extension
35
what does the ankle do in mid swing?
- ankle remains dorsiflexed to neutral
36
what is the terminal swing? what percentage?
- 85 to 100%
- slows down the swing so controlled landing for next stance
37
what muscle works the most in terminal swing? what does it do?
- hamstrings work eccentrically
- they do this in order to slow the movement down
38
what happens to the hip and knee in the terminal phase? - give the degrees they move to
- furthest hip flexion (25)
- knee fully extends
39
what does the ankle do in the terminal swing and why?
- ankle in neutral
- ensures foot in optimal position for initial contact
40
what does the pelvis do in the terminal swing?
- some pelvic rotation forwards on swing leg side in transverse plane
41
what are the three main planes of the trunk kinematics?
- sagittal
- frontal
- transverse
42
in the sagittal plane, is inclination forwards greater than in standing?
- yes inclination forwards is greater than in standing by 3-4 degrees
43
in the frontal plane, what increases towards swing leg?
- lateral flexion
44
when do you reach greatest extent in frontal plane?
- lateral flexion reaches greatest extent in double stance
45
what happens to the trunk, shoulder and pelvis in the transverse plane?
- rotation of upper trunk/ shoulders contralateral to pelvis
- pelvis rotation occurs around stance limb- hip rotation
46
what planes should you observe gait in?
- sagittal
- frontal
47
what need to be considered when observing gait?
- consider safety> do you need another person?
- consider whether you want the person to use existing walking aids and orthotics
48
what can be helpful if appropriate when observing gait?
- videoing
49
what is important to observe in gait?
- kinematics of both limbs
50
what should you look for regarding the arms in gait observation?
- arm swing
e.g., excessive swing
51
what should be equal in gait? what should be consistent?
- equal weight transfer
- consistency of movement
52
what can you measure in gait observation?
- stride length
- step distance from right to left and left to right
- stance duration e.g., quick on one side
53
what may people rely on in gait? how can we observe this?
- head position and reliance on vision
e.g., eyes fixed on floor for sensory feedback
54
what should the path of gait be?
- should be steady
55
what are the 4 spatiotemporal aspects of gait?
- speed level
- endurance measure
- cadence
- stride length
56
what is speed level?
- timing walking a set distance
57
what is cadence?
- count steps per min
58
what does stride length involve?
- video analysis
- mark out strides
59
what are the 4 main gait outcome measures?
- 10 metre walk tests (speed)
- 2 minute/ 6 minute walk test (endurance)
- timed up and go
- functional gait assessment
60
what is antalgic gait?
- disruption in walking patter due to pain
- standing phase shorter than swing
61
what is hemiplegic gait?
- hip abduction instead of knee flexion/ hip flexion
62
why does hemiplegic gait occur?
- lack of strength
- increased spasticity
Clinical skills
flashcards
Decks in class (13)
# Cards
-
subjective assessment27
-
objective assessment43
-
muscle strength, length and power53
-
clinical reasoning28
-
outcome measures71
-
joint mobility and extensibility65
-
muscle strengthening22
-
cardiorespiratory assessment37
-
gait analysis62
-
walking aids65
-
sit to stand analysis48
-
balance29
-
physiological measurements67
