PT 432 CH17 P1 Gait

If someone is a slow walker,
• ____ stance phase
• ____ swing phase
• ____ step length
• ____ cadence
• ____ double limb support

• longer stance phase
• shorter swing phase
• shorter step length
• low cadence
• longer double limb support

• __% stance phase
• __% swing phase

• 60% stance phase
• 40% swing phase

Which stage in the gait cycle is the moment when the foot contacts the ground?

initial contact (heel strike)

Which stage in the gait cycle is when shock is absorbed as forward momentum is preserved and a foot-flat position is achieved?

loading response

What happens at the beginning and end of loading response?

• beginning: heel strike
• ending: foot flat and contralateral heel off

What are the 3 phases of the gait cycle that are in DLS?

• IC
• LR
• PSw

Which stage in the gait cycle is when the body progresses over a single, stable limb?

midstance

What happens at the beginning and ending of midstance?

• beginning: foot flat and contralateral heel off
• ending: contralateral toe off

Which stage in the gait cycle is when the body moves ahead of the limb and weight is transferred into the forefoot? (heel off)

terminal stance

Which stage in the gait cycle combines anterior pelvic tilt, posterior pelvic rotation, and hip extension?

terminal stance

What is the beginning and ending of terminal stance?

• beginning: contralateral toe off
• ending: heel off and contralateral IC

Which stage in the gait cycle is when the forefoot remains on the floor and the knee rapidly flexes while weight is shifted to the other limb?

preswing

Which stage in the gait cycle is when maximum foot plantarflexion occurs?

preswing

What is the beginning and ending of preswing?

• beginning: heel off and contralateral IC
• ending: toe off

Which stage in the gait cycle is when the thigh begins to advance as the knee continues to flex and the foot clears the ground?

initial (early) swing

Which stage in the gait cycle is the acceleration phase?

initial swing

Which stage in the gait cycle is when the knee reaches the peak flexion?

initial swing

Which stage in the gait cycle is when dorsiflexion in the ankle occurs to prevent foot drag?

initial swing

What is the beginning and ending of initial swing?

• beginning: toe off
• ending: feet adjacent

Which stage in the gait cycle is when the thigh continues to advance as the knee begins to extend and foot clearance is maintained?

mid swing

Which stage in the gait cycle is when peak hip flexion occurs?

mid swing

What is the beginning and ending of midswing?

• beginning: feet adjacent
• ending: vertical tibia

Which stage in the gait cycle is when the knee extends and the limb prepares to contact the ground?

terminal swing

Which stage in the gait cycle is the deceleration phase?

terminal swing

What is the beginning and ending of terminal swing?

• beginning: vertical tibia
• ending: initial contact

Initial Contact
- Hip:
- Knee:
- Ankle:

- Hip: 20° flexion
- Knee: 5° flexion
- Ankle: 0°

Loading Response
- Hip:
- Knee:
- Ankle:

- Hip: 20° flexion
- Knee: 15° flexion
- Ankle: 5° plantarflexion

Midstance
- Hip:
- Knee:
- Ankle:

- Hip: 0°
- Knee: 5° flexion
- Ankle: 5° dorsiflexion

Terminal Stance
- Hip:
- Knee:
- Ankle:

- Hip: 20° apparent hyperextension
- Knee: 5° flexion
- Ankle: 10° dorsiflexion

Pre Swing
- Hip:
- Knee:
- Ankle:

- Hip: 10° apparent hyperextension
- Knee: 40° (35°) flexion
- Ankle: 15° plantarflexion

Initial Swing
- Hip:
- Knee:
- Ankle:

- Hip: 15° flexion
- Knee: 60° flexion
- Ankle: 5° plantarflexion

Mid Swing
- Hip:
- Knee:
- Ankle:

- Hip: 25° flexion
- Knee: 25° flexion
- Ankle: 0°

Terminal Swing
- Hip:
- Knee:
- Ankle:

- Hip: 20° (30°) flexion
- Knee: 0°-5° flexion
- Ankle: 0°

Which type of limb support occurs at the beginning and the end of the stance phase?

double

• Single limb support: __%
• Double limb support: __%

• Single limb support: 80%
• Double limb support: 20%

Which type of limb support decreases as gait speed increaes?

double

Which type of limb support often increases as balance and stability decrease?

double

delete

delete

What is the difference between step length, stride length, and step width?

• step: distance between heel contact to different foot (72 cm)
• stride: distance between heel contact of same foot (144 cm)
• step width: lateral measurement between two heels

Which spatial parameter is the angle between the body progression line and the long axis of the foot which is a line that intersects the center of the heel and the second toe?

foot angle (5-7°)

What is the difference between walking/gait speed and cadence?

• walking speed: distance covered in a given amount of time (m/s)
• cadence: step rate/steps per minute (110 step/min)

Inadequate foot clearance is caused by limited hip flexion (__° MSw), knee flexion (__° ISw), or dorsiflexion (__° MSw-TSw)

hip - 25° flexion
knee - 60° flexion
ankle - 0° dorsiflexion

Ankle External Torque
• IC --> LR:
• MSt --> PSw:
• ISw --> TSw:

• IC --> LR: plantar flexion
• MSt --> PSw: dorsiflexion torque
• ISw --> TSw: very low plantarflexion torque

Ankle Muscle Activity: (muscle and type of contraction)
• IC --> LR:
• MSt --> TSt:
• PSw:
• ISw --> TSw:

• IC -> LR: dorflexors (iso/eccentric)
• MSt --> TSt: plantarflexors (eccentric)
• PSw: passive tension at Achilles tendon
• ISw --> TSw: dorsiflexors (concentric/iso)

Knee External Torque
• IC:
• LR:
• MSt --> TSt:
• PSw --> ISw:
• TSw:

• IC: extension
• LR: flexion
• MSt --> TSt: extension
• PSw --> ISw: flexion
• TSw: extension

Knee Muscle Action (muscle and type of contraction)
• IC + LR:
• LR:
• MSt:
• TSt:
• PSw:
• ISw:
• MSw:
• TSw:

• IC + LR: flexors (extensors)
• LR: extensors (eccentric)
• MSt: extensors (concentric)
• TSt: none
• PSw: extensors (eccentric)
• ISw: flexors (concentric)
• MSw: flexors (eccentric)
• TSw: *flexors (eccentric); extensors (concentric)

Hip External Torque
• IC --> LR:
• MSt:
• TSt --> ISw:
• MSw + TSw:
• IC --> ISw:

• IC --> LR: flexion
• MSt: flexion to extension
• TSt --> ISw: extension
• MSw --> TSw: flexion
• IC --> ISw: adduction

Hip Muscle Activity (muscle and type of contraction)
• IC:
• LR --> PSw:
• ISw --> MSw:
• MSw --> TSw:

• IC: extensors (isometric)
• LR --> PSw: extensors (concentric) and abductors (eccentric)
• ISw --> MSw: flexors (concentric)
• MSw --> TSw: extensors (eccentric)

When does the ground reaction force peak?

• after heel contact (LR)
• push off at TSt to PSw

When is the ground reaction force the lowest?

at MSt

GRF Initial Contact
• ____ to the ankle => ____ torque
• ____ to the knee => ____ torque
• ____ to the hip => ____ torque

• posterior to the ankle => plantarflexion torque
• anterior to the knee => extension torque
• anterior to the hip => flexion torque

GRF Loading Response
• ____ to the ankle => ____ torque
• ____ to the knee => ____ torque
• ____ to the hip => ____ torque

• posterior to the ankle => plantarflexion torque
• posterior to the knee => flexion torque
• anterior to the hip => flexion torque

GRF Midstance
• ____ to the ankle => ____ torque
• ____ to the knee => ____ torque
• ____ to the hip => ____ torque

• anterior to the ankle => dorsiflexion torque
• anterior to the knee => extension torque
• posterior to the hip => extension torque

GRF Terminal Stance
• ____ to the ankle => ____ torque
• ____ to the knee => ____ torque
• ____ to the hip => ____ torque

• anterior to the ankle => dorsiflexion torque
• anterior to the knee => extension torque
• anterior to the hip => extension torque

GRF Preswing
• ____ to the ankle => ____ torque
• ____ to the knee => ____ torque
• ____ to the hip => ____ torque

• anterior to the ankle => dorsiflexion torque
• poisterior to the knee => flexion torque
• posterior to the hip => extension torque