Gait and Walking

sensory; motor

gait is an interaction between _____ and _____ functions

true

T/F: the gait cycle is a repetitive pattern involving steps and strides

heel strike

the gait cycle begins at _____ _____

same

the gait cycle ends with the ______ heel strike

stride

sequence of movements between successive heel strikes of the same foot

stride length

distance between two successive heel strikes of the same foot

step

sequence of movements between successive heel strikes of opposite foot

step length

sequence of movements between heel strikes of opposite foot

step width

the lateral distance between heel centers

3-4 in

what is normal step width when walking?

foot angle

the amount of toe out during gait cycle

5-7 degrees

what is the normal amount of toe out during gait?

3 mph

what is normal walking speed?

110 steps/min

what is normal step rate?

28 in

what is normal step length?

2-3 in

what is normal step width when running?

0%

the first heel strike is at what percent of the gait cycle?

100%

the second heel strike is at what percent of the gait cycle?

60%

stance phase makes up what percent of the gait cycle?

40%

swing phase makes up what percent of the gait cycle?

10%

only ______ percent of the gait cycle is double limb contact/support

AP

the pelvis has a small short arc rotation in _____ tilt during gait

- subject to hyper/hypo mobility of SI joints and lumbar spine

30; 10

what is the normal amount of hip flexion and extension during gait?

pelvic; lumbar

hip restrictions during gait usually manifest as _____ and ______ deviations

5 degrees

how many degrees of knee flexion is there at heel strike?

20 degrees

after heel strike, how much does the knee flex during the stance phase?

35 degrees

how many degrees of knee flexion is there during toe-off?

0-5 degrees

how many degrees of PF is there at the ankle during heel strike?

10 degrees

how many degrees of DF is there during the stance phase at the ankle?

20 degrees

how many degrees of PF is there during push off at the ankle?

extended

the first MTP is slightly _______ at heel strike

60 degrees

what is the normal amount of MTP extension during heel off?

consequences

______ to great toe abnormality:

- toe out gait pattern

- inefficient push off phase

- medial knee and medial foot arch strains

true

T/F: at heel strike, the joints and muscles of the LE (and trunk) are reaching forward to propel the body

upper

at stance phase, controlled ankle and knee motions cushion weight transfer to the _____ kinetic chain

extend

during stance phase, the LE joints and muscles _____ to allow swing phase of the other limb

half

toe clearance at swing phase is less than _____ an inch

shortens

the swing limb (opposite to stance limb) _____ to clear the ground (hip/knee flexion)

drops

at right heel strike the left iliac crest ______ slightly before progressively moving upward

lowering

during the second half of the gait cycle, the relatively higher left iliac crest during the initial part of right swing phase reflects the controlled _____ of the right iliac crest by the left hip abductors when a person initially stands on the left LE

adduction

a drop in the left iliac crest contributes to right hip _____

abduction

a raise in the left iliac crest contributes to right hip _____

falls

during right LE weight acceptance the left iliac crest ____ due to gravity and eccentric contraction of the R hip abductors

concentric

when the left iliac crest is elevated above the right side after weight acceptance on the right, this is due to _____ hip abductor contraction

weakness

_____ of the hip abductors:

- poor eccentric control of contralateral glute med

- compensated trendelenburg

hip hiking

this occurs to clear the toe during the swing phase

limb

_____ length discrepancy:

- due to coxa valga/vara, congenital, h/o fx

-can be observed via palpation of iliac crests or supine to sit SI testing

- results in increased side flexion during each portion of gait cycle

small

due to ligaments and knee geometry, the total motion in the frontal plane at the knee is usually ______ but can have a large impact on regions above and below

valgus

we tend to have more _____ at the knee during swing

inverted; everts

the subtalar joint is _____ 2-3 degrees at heel strike and then rapidly _____ throughout stance phase (about 2 degrees)

inverts

the subtalar joint ______ just before heel off

internally

during heel strike through stance phase the pelvis, femur, and tibia all ____ rotate

externally; neutral

during toe-off through swing phase the femur and tibia _____ rotate and the pelvis gets closer to _____ rotation

internally; externally

during stance the hip ____ rotates and in toe off through the swing phase the hip ____ rotates

hypomobility

if there is no rotation at the hip it may signal _____ from OA, joint infection, capsular tightness, etc.

externally; internally

during heel strike the tibia _____ rotates and then from heel off to toe off the tibia ____

everts; inverts; everts

the subtalar joint _____ from heel strike to stance and then ____ from heel off to swing and then _____ again

pliability; stability

the midfoot has increased _____ from heel strike to mid-stance and has increased ____ from mid stance to heel off

1.33

the lowest energy expenditure per meter walked is at a speed of approximately _____ m/s (80 m/min)

increased

at higher and lower walking speeds there is _____ energy expenditure due to more muscle and ventilation force and co-contraction of muscles

decrease

canes/crutches/walkers can _____ efficiency of gait

high; increase

vertical GRFs are _____ at heel strike and then dip during stance due to forces being dispersed and then _____ again during push-off

anterior; posterior

AP GRFs are more _____ during heel strike and more ______ during push-off

increased

if there is rearfoot dysfunction there will be _____ ML GRF curves and higher energy expenditure

medial

the CoP follows the contours of the _____ arch of the foot

medially

if someone has pes planus the CoP moves ______

medial arch

tendons and plantar fascia work with bony structures to maintain the ______ _____ guiding the CoP path

posterior; PF

at heel strike the GRF falls _____ to the axis of rotation of the talocrural joint creating a ____ torque at the ankle. this requires an opposing DF torque to control the motion

laterally; eversion

at heel strike the GRF on the calcaneus is located _____ to the axis of rotation causing an _____ torque at the subtalar joint. this is partially controlled by the action of tib anterior (supinates/inverts foot)

PF; flexion; flexion

GRF at heel strike promotes ankle _____, knee ______, and hip ______

PF contracture

patient makes initial contact with the ground with the forefoot region

at mid-stance , bringing heel to the ground will result in knee hyperextension

forward lean of the trunk occurs in terminal stance as a strategy to maintain forward progression of the COM

will also have lumbar extension compensation at initial contact

weak ankle DF

may result in foot drop during swing phase

requiring excessive hip flexion for the toes to clear the ground during swing phase (hip hike on impaired side as well)

quad weakness

weakness in this muscle leads to anterior trunk lean to move COM of the body anterior to the axis of rotation of the knee

- weakness with active hip flexion

knee flexion contracture

results in a crouched gait of the stance limb

to clear the toes during swing the unaffected CL side must compensate with exaggerated knee and hip flexion

hip circumduction

used to compensate for the inability to shorten the swing limb because of inadequate knee flexion or ankle DF