Flashcards in MSK - Gait Deck (28)
The mechanism by which the body is transported using coordinated movements of the major lower limb joints. It is an energy efficient interaction between musculoskeletal and neurological systems
What are the five attributes of normal gait?
- stability in stance
- foot clearance in swing
- pre-positioning for initial contact
- adequate step length
- energy conservation
Define gait cycle
The period of time from initial contact to the next initial contact on the same side
How much of a normal gait cycle is made up of stance phase and how much is made up of swing phase?
60% is stance phase, 40% is swing phase
What are the periods between stance and swing called in the gait cycle of walking?
'Double support' - this is where both feet are on the ground simultaneously
What is the period between stance and swing called in the gait cycle of running?
'Double float', where both feet are off the ground
What are the five stages of the stance phase (walking)?
- initial contact (heel strike)
- loading response
- mid-stance (foot flat)
- terminal stance (heel off)
- pre-swing (toe off)
What are the three components of the swing phase (walking)?
- initial swing
- terminal swing
The distance from initial contact on right foot to the next initial contact on the right foot
Distance from initial contact on the right foot to initial contact on the left foot
The number of steps taken per minute
What is the difference between kinetics and kinematics?
Kinematics describe motion - joint angles, displacements, velocities, accelerations etc.
Kinetics describe the things that cause motion - forces and moments etc.
What can be examined while looking at gait in the sagittal plane?
- pelvic tilt
- flexion/extension of hip, knee and ankle
What can be examined while looking at gait in the coronal plane?
- adduction/abduction of the pelvis, hip, knee and ankle
What can be examined while looking at the body in the transverse plane?
Rotational position of the body and limbs
What are the 'three rockers' of ankle kinematics?
- heel rocker: heel is fulcrum as initial contact occurs
- ankle rocker: ankle is fulcrum as centre of gravity shifts
- forefoot rocker: forefoot is fulcrum as heel begins to lift
What is the main role of a muscle that is concentric (shortening)?
What is the main role of a muscle that is eccentric (lengthening)?
What is the role of a muscle that remains isometric during the gait cycle?
How is energy conserved in the gait cycle?
- minimise excursion of centre of gravity
- control momentum
- transfer energy between body segments
- phasic muscle action
What is an antalgic gait?
This occurs when there is pain in one leg. There is a short stance phase on the affected leg, and a lack of body weight shift to it. There will be a short swing phase in the unaffected leg, resulting in an uneven gait.
When might a hemiplegic gait be observed?
Following hemi-brain injury, eg due to stroke, cerebral palsy or trauma
What are the characteristics of a hemiplegic gait?
- flexed upper limb
- extended lower limb
- short step in the unaffected leg
- circumduction of the affected leg
When is a diplegic gait seen?
Often in children with cerebral palsy
What is the appearance of a diplegic gait?
- 'scissoring' due to tight psoas, adductors, hamstring and calf muscles
- ankle is plantar flexed
- forefoot makes initial contact
When is a high steppage gait often seen?
In sciatica, common perineal nerve palsy, other neuromuscular disorders
What are the characteristics of a 'high steppage gait'?
They have 'foot drop' where the toe hangs down, so they have excessive hip flexion on the affected side to avoid tripping over feet. They also have a foot slap as their foot hits the floor