Gait - Movement Exam 1

gait cycle starts with...

heel contact of one foot

gait cycle ends with...

another heel contact of some foot

what are the 2 primary phases of a normal walking gait cycle?

stance phase, swing phase

what phase accounts for 60% of the gait cycle?

stance

what phase accounts for 40% of the gait cycle?

swing

what are the individual components/phases of the normal gait cycle?

contact, midstance, propulsion, midswing

major determinants of gait are factors that influence _______ and ______ of movement

efficiency and economy

main determinants of gait result from minimizing what?

center of mass (CoM) movement and overall energy expenditure

what happens during exaggerated knee flexion?

metabolically expensive: high caloric cost, more oxygen consumption

During pelvic list/drop, is it the stance leg hip or swing leg hip that drops downward

swing leg

why does pelvic list/drop occur?

minimize vertical movement of CoM

how much lateral movement/translation of pelvis is normal?

1 inch

what mechanism helps dissipate breaking forces?

posterior pelvic rotation

what direction does the talus move during pronation of the subtalar joint?

medially

how many degrees of 1st ray (MTP) dorsiflexion is considered normal during walking gait?

>60 degrees

why is extension of the big toe so important?

windlass effect of plants fascia and subsequent support of foot during weight-bearing activities

how many degrees of ankle dorsiflexion are considered normal?

40 degrees (only need 10-20 during normal gait)

what plane of motion do the upper gluteus maximus fibers control?

frontal

what plane of motion do the lower gluteus Maximus fibers control?

sagittal and transverse

key areas to evaluate during gait evaluation?

arm swing, hip flexion/extension, knee flexion/extension, ankle mortise, calcaneus, forefoot, 1st ray, toe-in/out

What is recommended: singling out isolated events in a systemic approach or completing a global assessment looking at all gait biomechanics at once?

singling out isolated events in a systemic approach

what should we do as a double-check for gait analysis findings?

ask patient to change their gait in specific ways

common dysfunctions that may be present during gait assessment

asymmetrical arm swing, excessive elbow flexion, excessive CoM vertical movement, excessive hip drop or lateral translation, inadequate hip extension, excessive femoral antiversion and adduction, excessive knee valgus, excessive/inadequate knee flexion mid stance, excessive toe-out, inadequate ankle dorsiflexion, excessive subtalar eversion from heel strike to end of mid-stance phase, excessive forefoot pronation, inadequate 1st ray dorsiflexion

when might stride length need to be altered?

to run faster

runners who strike the ground with their ________ absorb more force at the ankle and less at the knee

forefeet

runners who strike the ground with their ______ have reduced muscular strain at ankle with increased strain at knee

heel

mid foot strikers absorb form in their _______ while heel strikers absorb more force with the _______

arches and calves ; quadriceps

walking with a heel-first strike pattern reduces metabolic cost of walking by how much?

53%

potential injuries of mid foot strikers

Achilles and plantar fascial injuries

potential injuries of heel strikes

hip and knee pain

what type of strike pattern is the most efficient at lower speeds?

heel strike

during recreational running you should try to keep your hips almost level during mid stance as excessive frontal plane motion of hips correlates with:

development of tibial stress fractures and iliotibial band friction syndromes

what strike pattern is more efficient for running at faster speeds?

forefoot strike

our tissues can adapt to a progressive overload of approximately ___-____% per week

7-10%

do people with high or low arches pronate more rapidly through larger ranges of motion?

low

do people with high or low arches hit the ground harder and pronate through very small ranges?

high

what arch height has the highest injury prevalence?

very-low

what type of injuries do low-arched runners exhibit?

soft tissue injuries and injuries along inside of their foot and leg (knee and ankle)

what type of injuries do high-arched runners exhibit?

bony injuries and injuries along outer foot and leg (iliotibial band friction syndrome, ankle sprains)

what may be helpful in the short term to relieve pain and stress on the foot/ankle to facilitate proper rehabilitation and may help prevent overuse injuries?

orthotics

What impact does transitioning to minimalist shoes have on running injuries?

increase injuries

types of injuries that may be common while using minimalist shoes

tibial stress factor

it has been demonstrated that if you take runners who routinely stretch and assign them to a non-stretch protocol, there are nearly ________ as likely to sustain a running injury

twice

can stretching be generalized as a recommendation to reduce injury risk?

no

if you are very flexible or very stiff, you are more prone to injuries, so what is ideal?

in between flexible and stiff

does strength training increase or reduce prevalence of running injuries?

reduce

according to the recreational running checklist, slow runners should strike the ground with the _____ heel while faster runners should consider making initial ground contact with the ______ side of the mid foot

outer

according to the recreational running checklist, knees must always flex in which plane?

sagittal

according to the recreational running checklist, people with a history of retropatellar pain should do what?

flex their knees as little as possible and try to develop a relatively stiff-legged gait

according to the recreational running checklist, people with a history of stress fractures should focus on what?

absorbing shock with smooth flexion of knees and posterior rotation of pelvis

what is the first thing to look at when assessing a running injury?

training logs in conjunction with running experience