week 3

Question 1

Weight Acceptance (occurs in IC,LR) allows for

Answer 1

Smooth transfer of body weight to lead limb requires
* Shock absorption
* Stability
* Forward progression

Question 2

Single Limb Support (MSt, TSt)

Answer 2

Advancing body weight over single limb requires
* Stability
* Forward progression

Question 3

Swing Limb Advancement
(PSw, ISw, MSw, TSw)

Answer 3

Preparing and advancing limb through swing
- Foot clearance
- Forward progression

Question 4

Altered Range of Movement

Answer 4

Excessive or insufficient joint ROM
Limits ability to achieve postures & ROM required for normal gait

Question 5

why may someone have Altered Range of Movement

Answer 5

Abnormal joint contours or congenital disorders
Joint laxity/instability
Reduced Muscle length
Contracture

Question 6

Altered Sensory Function

Answer 6

Impaired proprioception or sensory loss affects gait pattern because unable to feel exact position of limb & type of contact with floor

Question 7

how may a person with Altered Sensory Function subsitiute

Answer 7

using visual system to provide information about limb position or walking slower or
walking with a wider base of support

Question 8

Stride length

Answer 8

Linear distance between successive points
of initial contact of the same foot
average= 144cm

Question 9

Step length

Answer 9

Linear distance between successive points of initial contact of opposite feet

Question 10

Foot progression angle

Answer 10

Degree of in-turning or out-turning of the foot

Question 11

Duration in re to gait

Answer 11

Amount of time spent, eg during stance/swing/step/stride

Question 12

Cadence

Answer 12

The number of steps (foot falls) per minute

Question 13

Gait speed

Answer 13

Distance covered in a given time (distance / time)

Question 14

Kinematics

Answer 14

Examines the forces acting on a system, such
as the human body
Forces cannot be seen, but effects of forces can be observed
what you see

Question 15

motion

Answer 15

Description of position, velocity, acceleration

Question 16

INERTIA

Answer 16

Inertial forces due to acceleration of body segment eg swinging leg

Question 17

GRAVITY

Answer 17

Weight of the body segment eg weight of the foot

Question 18

GROUND REACTION FORCE

Answer 18

Forces acting between the foot & ground (surface)

Question 19

MUSCLE FORCES

Answer 19

The muscle activity required is often to brake or control the motion of the body parts as well
as generate movement.

Question 19

LIGAMENTS/OTHER SOFT TISSUE FORCES

Answer 19

Tension generated in stretched tissue such as ligaments, joint capsule

Question 20

Kinematics (alignment & ROM) ways to measure

Answer 20

• 3D motion analysis
• Electrogoniometers
• Instrumented walkways eg. Gaitrite

Question 21

Kinetics (forces & muscle actions)

Answer 21

• Force sensor or platform systems
• EMG

Question 22

Outcome Measures

Answer 22

Timed 10m Walk
Timed Up & Go (TUG)
Dynamic Gait Index
Modified Elderly Mobility Scale (MEMS)
High level Mobility Assessment Tool (HiMAT)

Question 23

Lower Extremity Functional Scale

Answer 23

measure of function if have a lower limb problem ability to walk/run measured in some items

Question 24

Patient Specific Functional Scale

Answer 24

measure of functional outcome for people with any orthopaedic condition

Question 25

* Inadequate dorsiflexion (Excessive plantar flexion) * Inadequate plantar flexion (Excessive dorsiflexion) * Inadequate MTP extension

Answer 25

* Inadequate dorsiflexion (Excessive plantar flexion) * Inadequate plantar flexion (Excessive dorsiflexion) * Inadequate MTP extension

Question 26

Coronal plane primary deviations

Answer 26

* Excessive Eversion * Excessive Inversion

Question 27

Inadequate DF/Excessive PF Impact of deviation

Answer 27

Will result in forefoot contact & altered loading of foot Will disrupt tibial advancement Will result in poor foot clearance, impaired limb advancement & compromised preparation of foot for contact

Question 28

Inadequate DF/Excessive PF 2ndary deviations during midstance

Answer 28

Often internal rotation of entire limb Associated knee deviation frontal plane Often excessive external rotation of entire limb Premature heel lift “bouncy gait” Knee hyperextension + Forward trunk lean & anterior pelvic tilt

Question 28

Inadequate DF/Excessive PF 2ndary deviations during initial contact

Answer 28

– knee will remain more flexed – to get heel to the ground knee will hyperextend

Question 29

Inadequate DF/Excessive PF 2ndary deviations during swing

Answer 29

Will result in poor foot clearance, impaired limb advancement & compromised preparation of foot for contact Compensate by increasing hip and/or knee flexion

Question 30

Inadequate DF/Excessive PF 2ndary deviations during terminal stance

Answer 30

* Prolonged heel contact – body will be well forward of foot but heel on ground * Shortens limb & reduces support to pelvis – excessive ipsilateral pelvic drop

Question 31

Excessive eversion Impact of deviation

Answer 31

Foot placement compromised for initial contact. Increased rotary stress in ankle mortise. Increase rotary stress in ankle mortise & lower limb. Loss of rigid lever for heel off and forward progression.

Question 32

Excessive eversion Secondary deviations initial contact

Answer 32

* Subtalar joint rapidly everts as weight is loaded onto limb * Coupled to internal rotation of tibia which may in turn affect femoral position * Excessive tibial & femoral internal rotation

Question 33

Excessive eversion Secondary deviations mid stance

Answer 33

* Coupled to internal rotation of tibia which may in turn affect femoral position * Excessive tibial & femoral internal rotation

Question 34

Excessive eversion Secondary deviations terminal stance

Answer 34

* Disrupted heel rise * Possibly increased hip & knee flexion due to inefficient pushoff

Question 35

Excessive inversion Impact of deviation

Answer 35

Rigid midfoot impairs shock absorbing capacity Rigid midfoot impairs shock absorbing capacity. Weight towards lateral side of foot provides unstable BOS Difficulty with foot clearance as lateral side of foot drops

Question 36

Excessive inversion Secondary deviations initial contact

Answer 36

* Increased knee & hip flexion to provide shock absorption that is lacking at foot & ankle

Question 37

Excessive inversion Secondary deviations mid stance

Answer 37

* Possibly increased knee & hip flexion to provide shock absorption * Increased lateral shift of pelvis and trunk * Possible varus thrust

Question 38

Excessive inversion Secondary deviations swing

Answer 38

* Increased hip and knee flexion to improve foot clearance

Question 39

Limited toe extension Impact of deviation

Answer 39

Interferes with forefoot and toe rockers

Question 39

Limited toe extension Secondary deviation terminal swing

Answer 39

* Foot displaced into varus * Early toe-off * Impaired push-off & forward progression of body results in reduced contralateral step length