Module 7 Flashcards
(20 cards)
What are the phases of gait?
Initial contact Loading response Mid-stance Terminal stance Pre-swing Initial swing Mid-swing Terminal swing
What is the definition of gait?
A manner of walking, stepping, or running.
What’s a gait cycle?
Initial contact to ipsilateral initial contact.
What is a step length?
Initial contact to contralateral initial contact
What is cadence?
Number of steps per unit of time
What is step width?
Distance between feet (2-4 inches in adult)
What are some rehabilitation considerations for the gait sequence?
COG and BOS
Appropriate weight shift
Trajectory during transfer (diagonal forward movement towards other leg)
Clinician position and handling
How much time is spent in stance and swing?
Stance- 60%
Swing- 40%
What is the start of pre-gait?
Patient standing
Place patient’s weaker knee between clinicians’s knees
Posterior hand obliquely on clavicles or on weaker hip to control pelvis.
Slowly and smoothly guide patient through pre-gait sequence.
What is the pre-gait sequence?
Weight shift onto lower extremity, release weaker knee, return to midline.
Weight-shift onto stabilized weaker LE, release stronger side, return to midline.
Bend knees as much as are able then return to neutral.
Weight-shift onto stabilized weaker LE, release stronger knee, take small step forward with stronger leg.
What is the second part of the pre-gait sequence?
Weight-shift onto stronger leg, weight shift back to the stabilized weaker leg, step back with stronger leg and return to midline
Weight shift onto stronger leg, release weaker knee, take small step forward with weaker leg. Guide weaker leg forward using anterior dorsal forefoot under patient’s lateral mid-foot or posterior calcaneus.
What is the third part of the pre-gait sequence?
Weight shift onto stabilized weaker leg, weight shift back to stronger leg, step back with weaker leg, and return to midline. Guide weaker leg backward using anterior-inferior forefoot on patient’s talus.
What should be kept in mind when performing the pre-gait sequence?
Don’t pull patient towards you with posterior hand.
Allow weaker knee to bend when patient advancing towards forward stronger leg.
Allow weaker tibia to advance forward and reach a vertical position before stopping it’s movement when advancing toward forward weaker leg.
What is the forward gait sequence?
Weight shift onto stabilized weaker leg and take small step forward with stronger leg.
Weight shift onto stronger leg allowing weaker knee to release.
Patient advances assistive device as they take small step forward with weaker leg.
Clinician may need to move chair prior to having patient weight-shift onto weaker leg.
What is the backward gait sequence?
Weight shift onto weaker leg and take small step backward with stronger leg.
Weight shift onto stronger leg allowing weaker knee to release.
Patient advances assistive device as they take small step backward with weaker leg.
Weight shift onto stabilized weaker leg.
Clinician moves chair prior to weight shift onto weaker leg.
What is the sideward sequence?
Weight shift onto stabilized weaker leg and take small step sideward with stronger leg.
Weight shift onto stronger leg allowing weaker knee to release.
Patient advances assistive device as they take small step sideward with weaker leg.
Clinician moves chair prior to weaker leg weight shift.
What is the turning gait sequence?
Weight shift onto stabilized weaker leg, advance assistive device, and take small step forward and inward with stronger leg.
Weight shift onto stronger leg allowing weaker knee to release and weaker leg to pivot.
Weight shift onto stabilized weaker leg.
Clinician moves chair prior to weight shift onto weaker leg.
What is the stair ascent gait sequence?
Weight shift onto stabilized weaker leg, advance assistive device, and take step upward onto step with stronger leg.
Weight shift onto stronger leg allowing weaker knee to release
Step upward onto step with weaker leg.
Weight shift onto stabilized weaker leg.
Clinician one step lower then patient at all times.
What is the stair descent gait sequence?
Weight shift onto stronger leg, advance assistive device, and take step downward onto step with weaker leg dynamically stabilizing it.
Step downward onto step with stronger leg.
Clinician one step below patient at all times.
What is the fall recovery sequence?
Assist patient into side lying on stronger side if medically stable.
Place chair directly behind patient’s back.
Patient’s hips and knees flexed and tucked in close to their chest. Patient pushes up onto stronger elbow then hand. Patient pushes into quadruped. Patient places stronger hand on chair and assumes a tall kneeling position. Patient weight shifts onto weaker knee while maintaining kneel position and advances stronger foot forward. Patient pushes through arm and leg and pivots into chair.