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Kinesiology chap 22 Gait 2014
Terms in this set (80)
is a manner or way in which you move from place to place with your feet.
is the process or components of walking
Also called Stride; is the activity that occurs between the time one foot touches the floor & the time the same foot touches the floor again.
is the distance traveled during the gait cycle.
is one-half of a stride
How many steps does it take to complete a stride or gait cycle:
it takes two steps to complete a stride or gait cycle.
is the distance between the heel strike of one foot & the heel strike of the other foot.
Cadence or walking:
is the number of steps taken per minute.
Regardless of speed your gait cycle will always be what:
Gait cycle will remain the same no matter what your speed is.
What are the two phases of gait cycle:
Stance phase and Swing phase
Stance Phase 60% of gait cycle:
Occurs when the foot is in contact with the ground. It begins with heel strike of one foot & ends when the foot leaves the ground.
Swing Phase 40% of gait cycle:
Occurs when the foot is not in contact with the ground. It begins as soon as the foot leaves the floor and ends when the heel of same foot touches the floor again.
What are the 3 tasks that need to be accomplished during the phases of gait cycle:
1. Weight acceptance
2. Single leg support
3. Leg advancement
Occurs at the beginning of stance phase, when the foot touches the ground & the body weight begins to shift onto that leg.
Single Leg Support:
Occurs after weight acceptance, as the body weight shifts onto the stance leg so that the opposite leg can swing forward.
occurs during swing phase
Occurs when both feet are in contact with the ground at the same time. This happens when one leg is beginning its stance phase & the other leg is ending stance phase.
Each period of double support takes up what percentage of gait cycle:
10% of average walking speed
the time when neither foot is in contact with the ground; does not occur during walking; normally occurs during running.
occurs when only one foot is in contact with the ground. This happens twice during the gait cycle, takes up 40% of gait cycle.
What are the differences in Traditional and RLA terms:
Traditional terms refer to points in time & RLA refers to period of time.
Traditional: Heel Strike
Heel contacts the ground
RLA: Initial Contact
Heel contacts the ground
Traditional: Foot Flat
Plantar surface of the foot in contact with the ground
RLA: Loading response
Beginning: just after initial contact when body wt. is being transferred onto leg & entire foot makes contact with the ground.
Ending: Opposite foot leave the ground
Point at which the body passes over the weight-bearing leg
Beginning: Opposite foot leaves the ground
Ending: Body is directly over the weight-bearing limb
Heel leaves the ground, while ball of the foot & toes remain in contact with the ground.
RLA: Terminal Stance
Beginning: as the heel of weight-bearing leg rises
Ending: Initial contact of the opposite foot, the body has moved in front of the weight-bearing leg
Toes leave the ground, ending stance phase
Beginning: initial contact & wt. shifted onto the opposite leg
Ending: Just before toes of weight-bearing leg leave the ground
The swing leg begins to move forward
RLA: Initial swing
Beginning: the toes leave the ground
Ending: the swing foot is opposite the weight-bearing foot, & the knee is in maximum flexion
The swing (non-weight-bearing) leg is directly under the body.
Beginning: the swing foot is opposite the weight-bearing foot
Ending: the swing leg has moved in front of the body & the tibia is in a vertical position.
The leg is slowing down in preparation for heel strike
RLA: Terminal swing
Beginning: the tibia is in a vertical position
Ending: just prior to initial contact
Traditional Stance Phase in order:
1. Heel strike
2. Foot flat
Heel strike= RLA initial contact
Signals the beginning of stance phase, the moment the heel comes in contact with the ground. The point when the body is at it's shortest. The hip is at 25° of flexion.
Foot Flat= RLA loading respone
when the entire foot is in contact with the ground, occurs after heel strike. Ankle is in 15° of Plantar Flexion & Knee is in 20° of flexion.
Midstance= RLA Midstance
the point when the body passes over the weight-bearing foot. Ankle moves into slight dorsiflexion.
Heel-off= RLA Terminal Stance
the heel rises off the floor. Ankle is dorsiflexed at 15° & then begin to plantar flex.
begins after Heel-off phase; also called the propulsion phase, because the ankle plantar flexors are actively pushing the body forward.
Toe-off= RLA Preswing
Toe leaves the floor
The Swing Phase consists of what 3 components which are all non-weight bearing activities:
Acceleration= RLA Initial Swing
The leg is behind the body & moving to catch up.
Midswing= RLA Midswing
The ankle dorsiflexors have brought the ankle to a neutral position. The knee is at its max flexion at 65° & hip 25° of flexion. These motions act to shorten the leg allowing the foot to clear the ground as it swings through.
Deceleration= RLA Terminal Swing
The ankle dorsiflexors are active to keep the ankle in a neutral position in preparation for heel strike. the knee is extending and the hams are contracting eccentrically to slow down the leg keeping it from snapping into extension.
normal amount is 2in, being highest at midstance & lowest at heel strike. Ex. when you walk a straight line you walk in a wavelike fashion.
There is a equal amount of this displacement of the COG as the body wt. shifts from side to side. This displacement is greatest during the single support phase at midstance usually about 2in.
Width of walking base:
lines that are drawn through the midpoints of heel contact on each foot, this distance would range from 2 to 4 in.
Lateral Pelvic Tilt:
Occurs when weight is removed from the leg at toe-off (pre-swing). This drop is sometimes referred to as the Trendelenburg sign.
Gluteus Maximus Gait:
The trunk quickly moves posteriorly at heel strike. (AKA-rocking horse gait), because of the extreme forward & backward movement of the trunk.
Gluteus Medius gait:
Caused by weakness of glut med or hip abductor & is characterized by pelvic instability with resultant lateral trunk/weight shift over side of weakness during stance on the weak side. Also referred as the Trendelenburg Gait.
Push the leg in extension when walking; the person may lean the body forward over the quads mm during stance phase. By leaning forward at the hip, the COG is shifted forward & the line of force now falls in front of the knee.
during stance phase, the knee will go into hyperextension, referred to as genu recurvatum gait. Wthout the hamstrings to slow forward swing of the lower leg during deceleration part of the swing phase the knee will snap into extension.
Ankle Dorsiflexors Weakness:
If there is insufficient strength to move the ankle into dorsiflexion at the beginning of stance phase, the foot will land with a flat foot. Person does not have a heel strike, but instead lands on the foot in a flat position.
if there is no ankle dorsiflexion the toes will strike 1st.
Equinus Gait Lab Definition:
Gait pattern because of leg length discrepancy. (you will need to wear a high heel shoe on the un-involved side). Dropping of the pelvis on the affected side, so the person usually walks on the ball of the foot on the involved side.
Ankle Dorsiflexors can't support the body wt. after heel strike & will thus move toward foot flat as they eccentrically contract.
During swing phase person may not be able to dorsiflex the ankle, so gravity will cause the the foot to fall into plantar flexion when if is off the ground.
As a result of drop foot the knee will need to be lifted higher for the dropped foot to clear the floor causing this gait pattern. Seen by a drum major in a marching band.
Steppage Gait Lab:
LE advances with excess ht. d/t limited dorsiflexion, as in pt with foot drop, then foot slaps as it makes floor contact due to decrease eccentric control of anterior tibialis. Seen in peroneal nerve injury, MS, & any other pathology that weakens the DF mm.
Triceps surae group (gastroc & soleus) is weak:
There is no heel rise at push-off resulting in a shortened step length on the unaffected side. Sometimes referred to as sore foot limp.
Person stands with the shoulders behind the hips, much like a person with paraplegia would balance on the Y ligament. Little or no reciprocal pelvis & trunk rotation occurs. To swing the leg forward, that entire side of the body must swing forward, hence the waddling nature of the gait. Lumbar lordosis is present.
Hip Flexion Contracture:
the involved hips is unable to go into hip extension & hyperextension during the midstance & push-off phases. To compensate, the person will assume the salutation or greeting position in which the hip is flexed & the person's trunk leans forward as if bowing.
Increased motion of the lumbar spine & pelvis can compensate for hip motion. A decreased lordosis & posterior pelvic tilt will allow the leg to swing forward, whereas an increased lordosis & anterior pelvic tilt will swing the leg posteriorly. Also referred to as the the Bell-Clapper Gait.
Knee Flexion Contracture:
will result in excessive dorsiflexion during midstance & an early heel rise during push-off . There is also a shortened step length of the unaffected side.
The lower leg will be at a fixed length. If the knee is in extension, the leg will be unable to shorten during swing phase. To compenstate the person may:
1.rise up on the toes of the uninvolved leg as in vaulting
2.Hike the hip of the involved side
3.swing the leg out to the side
4.do some variation of the 3 methods
the leg begins near the midline at push-off, swings out to the side during swing phase, then returns to the midline for heel strike.
Pattern in which the knee has been fused in an extended position. the person will not have knee flexion at all. Ambulate, maintaining the LE in a abducted position.
is called a triple arthrodesis because of fusion of the subtalar joint & the 2 articulations making up the transtarsal joint. this will result in loss of ankle pronation, supination & stride length.
Staggering & unsteady with a wide BOS & exaggerated movements. Seen with cerebral palsy, brain injury. Step length is lengthened on the involved side & shortened on the uninvolved side.
person has tremors; forward flexion of trunk, crouched posture with hip & knee flexion. Gait is shuffling with small steps & decreased base of support, may lead to festinating. This shuffling gait tends to start slowly & increase in speed, & the person often can't get stopped.
Forward leaning trunk; pt walks on toes as though being pushed. starts slowly and builds to out of control speed & may only cease when grabbing or hitting an object. Seen in Parkinson's disease.
Spasticity in the hip adductors; seen w/abnormal high tone in LE extensors & adductors as in CP. Leads to LE's crossing midline as they advance. Leads to poor balance & small BOS.
Often seen with Bilateral involvement of the LEs. Excesive lumbar lordosis & anterior pelvic tilt, flexion of the hips, knees & plantar flexion of the ankles occurs. The reciprocal arm swing is exaggerated.
A protective gait pattern where the involved step length is decreased in order to avoid wt. bearing on the involved side, usually d/t pain. (limp)
Normal Leg Length Discrepancy measurment:
one-quarter inch between the right & left legs.
between 3 & 5 inches depending on the person ht. dropping the pelvis on the affected side will no longer be effective.
RLA terms for swing phase periods:
initial swing, midswing, terminal swing
swing leg advances by compensation of elevation of the pelvis & PF of the stance leg. Seen under similar circumstances to circumduction, such as leg length discrepancy or prosthesis that is too long. (happy walk)
Gait characterized by a circular motion to advance the leg during swing phase, results of decreased hip/knee flexion. High tone, limited dorsiflexion, leg length discrepancy, prosthesis that is too long, fused knee.
Staggering pattern seen with cerebellar dysfuncion.
Tibialis Anterior Peak activity:
is just after heel strike & is responsible for eccentric lowering of the foot into foot flat position.
Gastroc-Soleus Peak activity:
is during late stance phase & is responsible for concentric raising of the heel during toe-off/push off.
Quadriceps Peak activity:
1. during single support during early stance (eccentric control of quads as gravity tends to pull knee into flexion at heel strike) & just before toe-off to initate swing phase (concentric as hip is flexing & knee is extending).
Hamstrings Peak activity:
is during the late swing phase to decelerate the unsupported limb as it prepares for heel strike. this is eccentric control as the limb is moving into hip flexion & knee extension.
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