Gait (Part 1 and 2)

What are the criteria for walking?

Shock absorption, stance stability, propulsion, energy conservation

How many steps on average does a person take?

110 steps/min

Approximately how much (percentage) of the gait cycle is single-limb support?

80 %

What are the major aspects of the stance phase?

stability and mobility

What is the major aspect of swing phase?

jmobility

What is 1 stride length equal to?

left step + right step

1 gait cycle =

1 stride length

What are the stages of the stance phase?

initial contact, loading response, midstance, terminal stance, pre-swin

What are the stages of the swing phase?

Initial swing, mid swing, terminal swing

stance phase

entire time the foot is in contact with the ground and limb is bearing weight

Initial contact

moment when initial contact of heel onto ground, double limb support

Describe the joint positions of LE in initial contact

Ankle neutral dorsiflexion

Knee extended

Hip flexed

Loading response

Heel on ground to opposite toe-off, double limb support

Describe the joint positions of LE in loading response

Ankle plantarflexed

Knee flexed

Hip flexed into extension

Midstance

opposite toe-off to same side heel-off, single limb support

Describe the joint positions of LE in midstance

Ankle dorsiflexed

Knee extended

Hip extended

Terminal stance

same side heel off to opposite initial contact, single limb support

Describe the joint positions of LE in terminal stance

Ankle dorsiflexed

Knee extended

Hip extended

Pre-swing

opposite heel contact to same side toe-off, double limb support

Describe the joint positions of LE in pre-swing

Ankle plantarflexed

Knee flexed

Hip extended into flexion

What stages during the stance phase are double limb support?

Initial contact, loading response, pre-swing

Swing phase

entire time the foot is not in contact with the ground and limb is in the air

Initial swing

toe-off to feet adjacent

Describe the joint positions of LE in initial swing

Ankle dorsiflexed

Knee flexed

Hip flexed

Mid swing

feet adjacent to tibia vertical

Describe the joint positions of LE in mid swing

Ankle neutral dorsiflexion

Knee flexed to extension

Hip flexed

Terminal swing

tibia vertical to initial contact

Describe the joint positions of LE in terminal swing

Ankle neutral dorsiflexed

Knee extended

Hip flexed

What are our spatial descriptors for gait?

stride length, step length, step width, foot angle

What are our temporal descriptors for gait?

cadence, stride time, step time

Stride length

distance from initial contact of one foot to initial contact of same foot (one gait cycle)

Stride length normative value

144 cm

Step length

distance from initial contact of one foot to initial contact of opposite foot

What is step length dependent on?

walking speed

Step length normative value

72 cm

Step width

lateral distance between the heel centers of two consecutive foot contacts

Step width normative value

8-10 cm

Foot angle

angle between the line of progression of the body and long axis of the foot (heel to 2nd metatarsal)

What is the foot angle dictated by?

anatomically defined - toe-in or toe-out

Step width normative value

5-7 degrees

Cadence

number of steps per minute

Stride time

time for full gait cycle (initial contact to initial contact on same foot)

Step time

time for completion of one step

Which spatiotemporal descriptor(s) would be most important for a patient with an asymmetrical gait pattern?

step time, step length, foot angle

Gait speed

distance covered in a given amount of time

Gait speed normative value

1.37 m/s or 3.0 mph

What is the necessary ROM in the ankle for normal gait?

Dorsiflexion 0-10

Plantarflexion 0-20

When does peak dorsiflexion necessary during the gait cycle?

midstance and terminal stance

When is peak plantar flexion during the gait cycle?

pre-swing

What is the necessary ROM at the knee for normal gait?

Flexion 0-60

Extension 0

When does max knee flexion occur in the gait cycle?

b/w pre-swing and initial swing

What is the necessary ROM at the hip for normal gait?

Flexion 0-30

Extension 0-10

When does max hip flexion occur?

Initial contact

When does max hip extension occur

terminal stance

What is the necessary ROM at the pelvis for normal gait?

Anterior tilt 0-5

Pelvic tilt 0-5

When does max eversion occur?

Midstance

When does max inversion occur?

pre-swing

Adduction of the knee

genu varum

Abduction of the knee

genu valgum

During initial contact, what occurs at the hip?

neutral to slight adduction

During stance phase, what occurs at the hip?

relative adduction

During the swing phase, what occurs at the hip?

relative abduction

What occurs at the pelvis during midstance?

contralateral pelvic drop

What is the axis of rotation for the pelvis during gait?

L5/S1 junction

Trunk rotation ________ of pelvic rotation

opposite

When does the knee externally rotate?

initial contact and swing phase

When does the knee internally rotate?

stance phase