Walking Gait Cycle

prior to assessing someones gait, we should first assess their

body posture

body posture is defined by

the alignment of body segments or the position of segments in relation to an activity or task

what is a plumb line

line down the center of the body dividing it in right and left halves- helping to determine if it is symetrical

cephalocaudal order

approaching posture assessment from head to toe

when assessing an individuals posture we should assess for symmetries

anteriorly, posteriorly and latterly

gait can be defined as

a manner or style of walking

stance phase

60% of gait cycle

1. heal strike

the heel makes contact with the ground

2. leading response

the entire plantar surface of the foot is on the ground

3. midtance

the weight of the body is positioned over the foot

4. terminal stance

the heel begins to lift off the ground

5. toe off

toe leaves the ground

swing phase

40% of gait cycle

6. Initial Swing

foot no longer in contact with the ground

7. mid swing

tibia is perpendicular with the ground

8. terminal swing

the heel prepares to make contact with the ground

posture assessment

1. assess alignment before motion

2. know what to look for while in motion

foot ankle assessment

position/direction of feet

arch type (visual observation & foot mapping)

calcaneal alignment

femoral anteversion

"Toe in"

Femoral Retroversion

"Toe Out"

femoral anteversion may be present in individuals with

cerebral palsy

both femoral retroversion and anteversion cause an increase in

articular cartilage and labrum becoming more prone to tearing

people with femoral retroversion and anteversion may experience

general knee pain

osteoarthritis of the hip

patellofemoral maltracking

joint instability

difficulty walking/ running

increased likelihood of tripping or falling

rearfoot/ calcaneal valgus

eversion of calcaneus

-pronator

rearfoot/ calcaneal valgus causes

elevated hip right, medial rotation, increased pressure in patellofemoral joint, depressed left hip

rearfoot/calcaneal varus

calcaneal inversion

-supinator

rearfoot/calcaneal varus causes

elevated/ depressed hip, lateral rotation, increased pressure of patellofemoral joint, supination

pes cavus

high arch

pes planus

flat foot

normal patellar tracking

superior and inferior pole of the patella "sits" close to the femur and above the tibia

patella baja

inferior pole of patella sits on tibial tuberosity

patella alta

superior and inferior pole of the patella sit above the distal aspect of femur (look for camel sign)

Insall-Salvati Ratio Normal

normal: Patella length = tendon length

Insall-Salvati Ratio Alta

tendon length > patella length

Insall-Salvati Ratio baja

tendon length < patella length

grenu valgum

knock knee

Genu Recruvatum

lock knee - knee hyper extension

genu varum

bow legged

Hip Postural Assessment

neutral pelvis

anterior tilt

posterior tilt

forward shifted pelvis

anterior pelvic tilt "lordotic back"

pelvis tilts forward pulls lumbar spine into hyper-lordosis

posterior pelvic tilt "flat back"

pelvis tilts backwards pulls lumbar spine flat

forward shifted pelvis "swayback"

upper truck shifts backward to compensate, hip joints hyper-extended, pelvis shifts forward, knees hyper-extended

anterior pelvic tilt

associated with tight hip flexors and weak abbs

posterior pelvic tilt

associated with tight ebbs and tight hamstrings

forward shifted pelvis swayback

tight hamstrings, weak abbs, knee ligament laxity, weak gluteus Maximus

Adam's forward bending test

definitive clinical screening test for scoliosis