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Chapter 22 gait
Terms in this set (74)
What is the gait cycle?
Activity that occurs between:
Time the heel of one extremity touches the floor and
Time the same foot touches floor again
Distance of the gait cycle
Distance between heel strike of one leg and its subsequent heel strike
What is the difference between walking and gait?
Walking is moving from place to place. Gait is the style or manner of walking. Each person has a unique style.
Activity that occurs when the foot is in contact with the ground
60% of gait cycle
Activity that occurs when the foot is NOT in contact with the ground
Begins when foot leaves the ground
Ends when heel of same foot touches the ground
40% of gait cycle
When both feet are in contact with ground at same time
Occurs between heel-off and toe-off of one limb and heel strike and foot flat on the opposite side
10% of gait cycle
Time when neither foot is in contact with the ground
When does nonsupport occur?
Does not occur during walking
Occurs during running, hopping, skipping, and jumping
Occurs when only one foot is in contact with the ground
Two periods of single support occur
When right foot is on the ground
When left foot on the ground
Each single support period ~40% of gait cycle
How does the left and right steps differ?
Right and left step times are equal
What support and phases make up a step?
Period of double support
Distance between heel strike of one limb and heel strike of the other
Cadence (walking speed)
Number of steps taken/minute
What is the difference between slow/fast walking?
Slow walking = 70 steps/minute
Fast walking = 130 steps/minute
What are the 5 components of the stance phase?
1. Heel strike (HS)
2. Foot flat (FF)
3. Midstance (MS)
4. Heel-off (HO)
5. Toe-off (TO)
What is the period of the stance phase?
when foot in contact with the floor
When does the heel strike begin?
Moment heel comes in contact with the ground.
Body weight begins to shift onto the stance leg.
What is the position of the joints when in heel strike?
Ankle neutral, not dorsiflexion or plantar flexion
Knee begins to flex
Trunk rotated to opposite side
Opposite arm forward
Same-side are shoulder hyperextension
When is the flat foot phase?
When the entire foot is in contact with the ground
When does the mid stance occur?
Point at which the body passes over the weight-bearing foot
When is the body at its highest point of the gait cycle?
During the midstance
When does the heel off phase begin?
When the heel rises off the floor.
What phase also occurs during the heel off?
Beginning of push off phase
When does the to off phase occur?
Period just before and including when the toes leave the ground
Signals the end of stance phase and beginning of swing phase
What are the 3 components of the swing phase?
Acceleration, midswing, deceleration
During acceleration what is occurring at the leg?
Limb is behind the body and moving to catch up
During midswing what do the ankle dorsi flexors do? Why?
Bring the ankle into neutral so foot clears the ground as it swings through
During deceleration what do the ankle dorsi flexors do? What do the hamstrings do?
Ankle dorsiflexors active to keep the ankle in neutral position preparatory for heel strike.
Hamstrings contracting eccentrically to slow down the leg.
What is the normal amount of vertical displacement?
Highest in midstance, lowest in heel strike.
What is horizontal displacement?
Center of gravity as the body weight shifts from side-to-side.
Greatest during single support phase at midstance.
What is the average range of the width of the walking base?
When does the lateral pelvic tilt occur?
Occurs when weight is taken off the limb at toe-off
What muscles limit the amount of the lateral pelvic tilt?
Hip abductors on the opposite side.
Erector spinae on the same side.
During muscular weakness/paralysis how does the body compensate?
Body compensates by shifting the center of gravity over or toward the part involved.
What does the trunk do during the gluteus Maximus gait?
Trunk quickly shifts posteriorly at heel strike.
What is the shifting referred to as in the gluteus Maximus gait?
Rocking horse gait
What is the gluteus medius gait also referred to as? How is the trunk shifting?
Shifts the trunk to the affected side during stance phase.
How will and individual compensate when only the quadriceps are weak?
the individual may use hip extensors and triceps surae to pull the knee into extension at heel strike
If the quads, hip extensors, and plantar flexors are weak how may an individual compensate?
the person may physically push the knee into extension during stance
What is another term for the gait if the hamstrings are weak?
Genu recuvartum gait
What happens during hamstring weakness?
During stance phase, the knee will go into excessive hyperextension.
During the deceleration part of swing phase, without the hamstrings to slow down the forward swing of the lower leg, the knee will snap into extension.
How does an individual compensate if the he ankle dorsi flexors are weak?
"Foot slap" - not able to slow descent of the foot.
Excessive knee flexion
What is weakness in the ankle dorsiflexors also referred to?
"Foot drop" or "Steppage" gait during swing
What does it look like if the triceps surae group is weak?
No heel rise at push off.
Shortened step length on the unaffected side.
What is it also referred to as if the tricep surae group is weak?
Sore foot limp
Most pronounced when walking up an incline
When is a waddling gait seen?
Seen with muscular and other types of dystrophies
What is the individual's stance during a waddling gait?
Person stands with the shoulders behind the hips, rests on iliofemoral ligament of the hips
What is the gait referred to as when there is a hip flexor contraction?
What is the compensation of the hip flexion contracture?
increase anterior pelvic tilt and lumbar lordosis.
Involved limb may also have knee flexion.
What does a knee flexion contraction look like?
Excessive dorsiflexion during midstance.
Early heel rise during push-off.
Shortened step length on unaffected side.
With a Knee fusion the lower limb is fixed. What is this gait also referred to as?
"Abducted gait" - leg remains abducted throughout the gait cycle
Several things may occur during a tricep surae contracture. What is this gait also referred to as and what are the components?
Early heel rise during push-off
Knee lifted higher during swing phase
Toes will land first during heel strike
What happens to the stride length with an ankle fusion?
Shortens. Difficulty walking on uneven surface
What can occur with a hemiplegic gait?
Person usually shift body primarily to uninvolved side.
Circumducts affected limb during swing.
Lacks reciprocal arm swing.
Step length longer on involved side, shorter on uninvolved side.
What part of the brain is involved with a ataxic gait and what is disrupted?
What does an ataxic gait look like?
Wide base of support - abducted gait
Jerky, unsteady movements.
Difficulty walking in a straight line
Tends to stagger.
Reciprocal arm motion jerky and uneven.
What does a parkinsonian gait look like?
Posture of lower extremities and trunk tends to be flexed.
Reciprocal arm swing and stride.
length are greatly diminished.
What is a parkinsonian gait also referred to as?
What gait is seen the lower extremities are bilaterally involved?
What are the characteristic of a crouch gait?
Excessive lumbar lordosis and anterior pelvic tilt, hip and knee flexion,
ankle plantar flexion
Exaggerated arm swing
What are the characteristics of a pain/antalgic gait?
Rapid and shortened step length of uninvolved side.
May be exaggerated and abducted.
Reciprocal arm swinging shortened.
What is the gait with a minimal leg discrepancy? (Up to 3inches)
Compensation occurs by dropping pelvis on affected side.
Places stress on low back.
What is the gait with a moderate leg discrepancy? (3-5 inches)
"Equinnus gait"= Walk on ball of foot on shorter side
What is the gait with a severe leg discrepancy? (Greater than 5 inches)
Drop pelvis, equinnus gait, AND flex uninvolved knee
Compare and contrast walking and running.
Both have the same components and sequence of events. Walking has a period of double support while running does not. Running has a period of nonsupport that walking does not have.
What are the main differences between the traditional terminology and the rancho Los Amigos terminology?
Traditional terminology referees to single points in a time frame, whereas RLA referees to period within a time frame
What is the phase used for the period that occurs between heel strike and toe off?
What is the time period called when both feet are in contact with the ground? What part of stance phase is each foot in during this period?
Period of double support; between heel-off and toe-off of one foot and heel strike and foot flat on the opposite foot.
At what period of stance phase is a persons overall vertical height the greatest?
Midstance of the stance phase
During which phase is the persons foot not in contact with the ground?
What will happen to the step length and cadence when a person increases his walking speed?
Step length lengthens and cadence increases
If unsteady, how does a person tend to adjust his walking?
Walk with feet farther apart to widen the base of support.
If foot drop is present, which parts of the swing and stance phases of the persons gait will be altered?
Heel strike of stance phase and midswing of swing phase
If a person has an unrepaired rupture Achilles' tendon, which phase of the gait will be altered?
Push-off stance phase
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