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Flashcards in Fundamentals of Gait Deck (44)
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1
Q

Why evaluate Gait?

A
  • most common physical activity
  • inability to walk limits participation
  • disease/trauma disrupts precision, coordination, speed, and versatility [Decrease efficiency Increase energy cost]
  • abnormal gait effects lower extremities
  • insight to prederred movements/advanced movements
2
Q

Clinical indications for Gait Analysis

A
painful 
unstable
inability to walk quick
inability to walk efficient
inability to walk distances
3
Q

Basic functions of Locomotor Unit during gait

A
  • shock absorption- impact forces
  • stance stability- active or passive (frontal/sag planes)
  • forward progression
  • energy conversation

above pelvis is passenger (no big impact), below pelvis is locomotor!

4
Q

Passive shock absorption

A

Bones and Cartilage– non-contractile
results in hitting ground harder
ex: flat footed heavy walking

5
Q

Active shock absorption

A

Muscles–Eccentric muscle contractions
absorbs energy and is a smoother process
ex: knee ~20 degrees +/- 5 flexion
in gait eccentric contraction of quads :)

6
Q

Passive Stance Stability

A

vector aligned w/ joint centers

decreased torque (decreased lever arms)
minimum muscle activity

COM over joint centers

7
Q

Dynamic Stance Stability

A

walking is mostly dynamic
muscles are active to stabilize system

lever arms constantly changing=changing torque!

8
Q

Sagital vs. Frontal plane regarding Gait Stability

A

Frontal- unstable
Sagital- more stable

inherately good sagiatl control-> most muscles have sagital action

frontal plane relies heavily on DYNAMIC stability!!

9
Q

Forward Progression

1.Heel rocker

A

Loading response phase
Ant Tib controls
!!creates INSTABILITY and need for DYNAMIC stability!!

normal: heel first contact
pivot point- calcaneus hits, tibia rocks forward!

flat foot: no foward progression= compensations
ppl w/ balance issues- scared tendency

10
Q

Forward Progression

2.Ankle rocker

A

Midstance
Calf controls
Allows COM to translate over foot!!

!pivot point: ankle joint!
tibia moves over flat foot
action: ankle dorsiflexion

11
Q

Forward Progression

3.Forefoot/Toe Rocker

A

!Pivot point: metatarsal heads!!
!Allows COM to move over BOS!

creates a fall
heave to catch yourself-> need shock absorbers

12
Q

Forward Progression

4.Forward fall of bodyweight

A

mini fall-> creates small impact force

13
Q

Forward Progression

5.Swing limb momentum

A

other limb moves forward

14
Q

5 stages of forward progression

A
  1. heel rocker
  2. ankle rocker
  3. forefoot/toe rocker
  4. forward fall of bodyweight
  5. swing limb momentum

if any are bad- lowers stability, increases energy expen

15
Q

Energy conservation of gait

A

minimizes displacement of center of mass and muscle activation

16
Q

Normal vs. abnormal gait energy conservation

A

normal: very small; unilateral, forward movement

excessive displacement: increase energy to walk

COM decreases at both feet on ground; increases single limb support
COM shifts as transition medial to lateral

17
Q

What is a phase

A

portion of given movement cycle

ex: loading response
ex: mid stance

18
Q

What is an objective

A

basic requirement of given phase

ex: shock absorption
ex: ankle rock

19
Q

What is a critical event

A

joint or segment motion or positions that are require to accomplish objective for given phase

ex: measureable angle 20 deg of knee flex
ex: 10 degree dorsiflex

20
Q

Objective of LOADING RESPONSE

A

shock absorption- (knee flexion)
forward progression- heel rocker
weight bearing stability-( hip)

21
Q

Objective of MID STANCE

A

progression of COM over BOS- ankle rocker- dorsiflexion

Single limb stance stability

22
Q

Objective of TERMINAL STANCE

A

progression of COM beyond BOS- forefoot rocker

23
Q

Objectives of PRE-SWING

A

initiate limb advancement- transition phase (hip)

24
Q

Objective of INITIAL SWING

A

limb advancement

foot clearance- trip/hitting foot happens here or mid swing

25
Q

Objective of MID-SWING

A

continued limb advancement

continued foot clearance

26
Q

Objective TERMINAL SWING

A

complete limb advancement

prepare limb for stance

27
Q

Start-finish of gait cycle is?

A

first heel contact on reference foot to the next heel strike of same foot
~1 second

28
Q

Percentage of Swing vs. Stance

A

60% stance- reference foot IN CONTACT with floor

40% swing- reference foot NOT in contact with floor

29
Q

Three parts of STANCE w/ percentages

A

Initial double limb support- 10% BOTH on ground
Single limb support- 40% ONE on ground
Terminal double limb support- 10% Both on ground

30
Q

Parts of initial double limb support

A

Loading response- 10%

31
Q

Parts of single limb support

A

Mid-stance- 20% (foot flat)

Terminal stance- 20% (heel off ground)

32
Q

Parts of terminal double limb support

A

Pre-swing- 10%

33
Q

Parts of SWING w/ percentages

A

Initial: 13/3%
Mid: 13.3%
Terminal: 13.3%

34
Q
  1. Loading Response
A

Ipsilateral (ref) INITIAL contact—->Contralateral TOE OFF

refernce contact; opposite toe off

35
Q
  1. Mid-stance
A

Contralateral TOE OFF—> Ref heel rise or contralat VERT TIB

swing limb tib is vertical
flat foot single limb support
ANKLE rocker

36
Q
  1. Terminal Stance
A

Ipsolat heel rise or VERT TIB on swing leg—> Contralat INITIAL contact

heel off ground single limb support
FOREFOOT rocker

37
Q
  1. Pre-swing
A

contralat INITIAL contact—> ipsilat toe off

terminal double limb support

38
Q
  1. Initial swing
A

ref toe off —> point where swing limb (ref) foot crosses stance limb foot (contralat)

39
Q
  1. Mid swing
A

swing limb cross stance limb—> tibia vertical on swing limb

40
Q
  1. Terminal swing
A

vertical tibia on swing—> ref foot initial contact

41
Q

Stride charachteristics

A

velocity
cadence
stride length

ALL interrelated

42
Q

Gait velocity

A

indicates walking ability- most common outcome measure–> measure over 10 m
DISTANCE/TIME

avg. is 80m/min (3 mph)

speed is a function of stride length and cadence

43
Q

Cadence

A

STEPS/MIN

men: 108 steps/min
women: 116 steps/min

men less because longer stride length

count heal contacts (regardless of side)

44
Q

Step vs. stride length

A

step: initial heel contact on 1 side to contact of other side
stride: initial contact on one side to next contact on that SAME side
(2 steps=stride)

tall people have longer strides but in turn usually slower cadence

if avoid heel rocker-> increase cadence and decrease stride length