Gait board Preppers

stance phase - standard terminology

The stance phase represents approximately 60% of the gait cycle and comprises the following five stages: heel strike, foot flat, mid-stance, heel-off, and toe-off.

stance phase - Ranch Los Amigos terminology

The stance phase accounts for approximately 60% of the gait cycle and consists of the following five stages: initial contact, loading response, mid-stance, terminal stance, and pre-swing.

swing phase - standard terminology

The swing phase constitutes 40% of the gait cycle and consists of three distinct stages: acceleration, midswing, and deceleration.

swing phase - Ranchos Los Amigos terminology

The swing phase accounts for 40% of the gait cycle and consists of three distinct stages: initial swing, midswing, and terminal swing.

What percentage of the gait cycle are we in single limb support?

80%

what percentage of the gait cycle are we in double limb support?

20%

stride

right heel strike to right heel strike. approx 56 inches in length.

step length

right heel strike to left heel strike. approx 28 inches.

cadence

Cadence refers to the number of steps taken per minute. A normal cadence typically ranges from 110 to 120 steps per minute, with 113 steps per minute being the average.

BOS or step width

normal is 2 to 4 inches

How much hip flexion is required for normal gait and what is impacted if the hip is limited?

To achieve normal gait, 30 degrees of hip flexion is required; limited hip flexion will negatively impact the swing phase.

How much hip extension is required for normal gait and what is impacted if the hip is limited?

To achieve a normal gait, 10 degrees of hip extension is required; limited hip extension will negatively impact the stance phase.

How much knee flexion is required for normal gait and what is impacted if the knee is limited?

To achieve normal gait, 60 degrees of knee flexion is required; limited knee flexion will negatively impact the swing phase.

How much knee extension is required for normal gait and what is impacted if the knee is limited?

To achieve normal gait, 0 degrees of knee extension is required; limited knee extension will negatively impact the stance phase.

How much plantar flexion is required for normal gait and what is impacted if the ankle is limited?

To achieve normal gait, 20 degrees of plantar flexion is required; limited ankle PF will negatively impact the stance phase.

How much dorsiflexion is required for normal gait and what is impacted if the ankle is limited?

To achieve normal gait, 10 degrees of dorsiflexion is required; limited ankle dorsiflexion will negatively impact the swing phase.

circumducted - swing leg deviation

When the knee is locked in 0 degrees of extension, the gait pattern is referred to as circumduction.

hip hike - swing leg deviation

The quadratus lumborum muscle initiates a 2-inch elevation of the hip on the swing side to facilitate limb clearance during gait.

stappage gait - swing leg deviation

Characterized by foot drop caused by weakness in the tibialis anterior muscle, which primarily affects the limb during the midswing phase of the gait cycle.

vaulting gait - swing leg deviation

A gait pattern where the individual rises onto the toes of the stance limb to provide extra clearance for the swinging limb, typically used to compensate for foot drop or weakness in the opposite leg.

trendelenburg - swing leg deviation

Characterized by a pelvic drop on the side opposite the stance leg due to weakness of the gluteus medius; when strength is normal, the individual maintains pelvic stability by leaning over the stance leg to compensate.

hip - stance leg deviation

During the stance phase, individuals lean toward the side of weakness to reduce the moment arm. Conversely, during the swing phase, compensation involves leaning toward the side of tightness to assist in clearing the limb.

knee - stance leg deviation

During the stance phase, knee buckling or hyperextension indicates quadriceps weakness, typically involving the L2-L4 nerve roots of the femoral nerve.

ankle/foot: (foot slap/drop) - stance leg deviation

Dorsiflexor weakness, specifically of the tibialis anterior, affects the stance phase during initial contact and loading response. Dorsiflexion contractures are rare; however, plantarflexion weakness results in a shortened swing phase, while plantarflexion contractures lead to an equinus gait pattern.

antalgic gait

A gait pattern characterized by a limp or pain, which leads to a shortened stance phase on the affected side to minimize weight-bearing time.

ataxic gait

A gait pattern associated with cerebellar dysfunction or balance deficits, characterized by an increased base of support, shortened stride length, and a "drunk-like" appearance with arms often held in "high guard" to maintain stability.

equinus gait

toe walker, can be bilateral or unilateral.

festinating gait

seen in Parkinson's disease characterized by an involuntary increase in pace (shuffling steps), reduced stride length, and frequent episodes of freezing, especially during transitions like starting, stopping, or turning.

hemiplegic gait

Characterized by unilateral weakness often seen following a stroke, this gait pattern involves compensatory movements such as hip hiking, circumduction of the affected leg, scissoring, and potential Trendelenburg signs due to hip abductor weakness.

spastic gait

Characterized by stiff, jerky movements caused by increased muscle tone, often presenting with adductor spasticity that leads to a scissoring gait pattern, commonly observed in individuals with cerebral palsy.

shuffling gait

Characterized by a significantly decreased stride length often leading to freezing episodes, this gait pattern lacks both heel strike and toe-off, resulting in a short-stepped, slow-velocity walking style.

tibialis anterior

eccentric: heel strike to foot flat. concentric: after toe off until heel strike (swing phase). gait impacts: foot slap in stance and foot drop in swing.

gastroc/soleus

Concentric action occurring from heel-off through toe-off; gait impacts include a shortened swing phase and decreased stride length.

quads during gait

concentric: heel strike. eccentric: from loading response through mid-stance. concentric: right at toe off to help initiate swing. Gait impacts: knee buckling at mid-stance and hyperextension of the knee at initial contact

hamstrings during gait

concentric: at initial swing to midswing - lifts foot

eccentric: midswing through terminal swing - slows knee into extension

gait impacts: knee slap

glute max during gait

concentric: at heel strike through toe-off - whole stance pahse

gait impacts: posterior lean during stance and short step/stride

glute med during gait

concentric: on stance leg while other leg is in swing - foot off the ground

gait impacts: pelvic drop on opposite side - trendelenburg

average width required of a hallway for a WC?

commercial: 60 inches

residential: 36 inches

average width of a standard WC?

25 to 26 inches

average height for grab bars?

commercial: 36 inches

residential: 33 to 38 inches

required ramp elevation

1:1 inches to feet ratio. For every inch of elevation there must be 1 foot of ramp. with the average height of a step being 7 inches, average number of steps into a home is 2, 14 inches of elevation and 14 feet ramp length.