Gait Exam

progression, stability, adaptation

3 requirements for gait

dynamic

walking is a ___ balance activity; series of losses and recoveries of balance

progression

advancement in a desired direction

stability

maintaining upright posture against grav and against perturbations (expected or unexpected)

adaptation

altering of gait pattern to meet env demands in all types of situations (obstacles, uneven terrain, altering speed and direction)

initial contact, loading response, mid stance, terminal stance, pre-swing, initial/mid/terminal swing

ranchos los amigos gait steps

heel strike, foot flat, mid stance, heel off, toe off, acceleration, mid-swing, deceleration

traditional gait steps

GAITRite

computerized mats w/ F plates that record various components of gait

step length

distance from initial contact of 1 foot to initial contact of other foot

stride length

distance from initial contact of 1 foot to initial contact by same foot

step width

horizontal distance btwn middle heel of each foot

# of steps per unit of time (usually steps/min)

cadence

velocity

gait speed; avg horizontal speed of body (usually m/sec)

minimal energy expenditure

indi's preferred walking speed is at their point of ___ w/ swing phase requiring very little energy

S2

CoM is located just ant to ___

CoM displacement

easiest to visualize ___ by tracking head movement (up/down or side/side)

CoM vertical displacement

viewed from side as head bobs up/down; 5cm combined

CoM vertical displacement

CoM movement follows 2 sinusoidal wave patterns per gait cycles

mid-stance

CoM vertical displacement is max ht during ___

double limb support

CoM vertical displacement is minimum ht during ___

CoM medial-lat displacement

viewed from behind, head moves side/side; 4cm total

CoM medial-lat displacement

CoM movement follows 1 wave pattern per gait cycle

mid-stance

Max CoM medial-lat displacement to left or right occurs during ___ (same side)

horizontal pelvic rot, lat pelvic tilt, knee flex, ankle rot

4 strats to minimize CoM vertical displacement energy expenditure

pelvis rots forward 5°

horizontal pelvic rot: as swing leg advances, ___ in horizontal plane to increase relative leg length

horizontal pelvic rot

strat used to minimize CoM downward displacement during gait

lat pelvic tilt

occurs at mid-stance as contralat pelvis drops in frontal plane to lower body

lat pelvic tilt

strat used to minimize CoM outward displacement during gait

knee flex (stand and swing phase)

strat used to minimize CoM upward displacement

ankle rot (DF and PF)

strat used to minimize CoM downward displacement at both ends of stance phase

heel contact

ankle rot: calcaneus protrudes at ___ making contact w/ ground and funcally elongating leg

terminal stance

ankle rot: at ___, LE is elongated via ankle PF

lat pelvic/hip motion

strat to minimize CoM horizontal displacement energy expenditure

step width

reducing ___ minimizes CoM medial lat displacement

step width

for indis w/ impaired balance, increase ___ will increase stability but also reduce energy efficiency