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Define Gait (also known as stride). What is stride length?
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What is the difference between step and step length?
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Gait
Chapter 22 - Gait
| Question | Answer |
|---|---|
| Define Gait (also known as stride). What is stride length? | Gait: the activity that occurs between the time one foot touches the floor and the time the same foot touches the floor again. Stride Length: the distance traveled during a gait cycle. |
| What is the difference between step and step length? | Step: one-half of a stride. Step length: the distance between a heel strike of one foot and the heel strike of the other foot. |
| Define cadence. | The walking speed, or number of steps taken per minute. |
| What are the two phases of the gait cycle? | The stance phase and the swing phase. The stance phase accounts for 60% of the gait cycle (swing being the other 40%). |
| What are the three tasks that must be accomplished during the gait cycle for successful completion? | 1: weight acceptance. 2: single leg support. 3: leg advancement. |
| A gait cycle has two periods of double support. How much time (in percent) does each instance of double leg support take during a normal cycle? What happens when the gait speed increases? Decreases? | Each period is about 10 percent. The percent decreases when stride speed increases, and increases when you slow down. |
| When do periods of nonsupport occur during a walking stride? | They do not occur during walking, but will occur during running. This is one of the big differences between walking and running. |
| What are the five traditional components of the stance phase? | 1: heel strike. 2: foot flat. 3: midstance. 4: heel-off. 5: toe-off. |
| What are the five RLA terms used to describe the same portions of the stance phase? | 1: initial contact. 2: loading response. 3: Midstance. 4: terminal stance. 5: preswing. |
| Terminology - Stance Phase/RLA & Traditional : Initial Contact (Heel Strike). | Heel contacts ground. (Heel contacts ground) |
| Loading Response (flat foot). | Beginning: Just after initial contact when body weight is being transferred onto leg and entire foot makes contact with ground. Ending: Opposite foot leave the ground. (Plantar surface of the foot in contact with ground) |
| Midstance (Midstance). | Beginning: Opposite foot leave the ground. Ending: Body is directly over the weight-bearing limb. (Point at which the body passes over the weight bearing leg) |
| Terminal Stance (Heel-off). | Beginning: As the heel of weight-bearing leg rises. Ending: Initial contact of opposite foot; the body has moved in front of the weight-bearing leg. (Heel leaves the ground, while ball of foot and toes remain in contact with the ground) |
| Preswing (Toe-off). | Beginning: Initial contact and weight shifted onto the opposite leg. Ending: Just before toes of weight-bearing leg leave the ground. (Toes leave the ground, ending stance phase) |
| Terminology - Swing Phase/ RLA & Traditional. Initial Swing (Acceleration). | Beginning: The toes leave the ground. Ending: The swing foot is opposite the weight-bearing foot, and the knee is in maximum flexion. (The swing leg begins to move forward) |
| Midswing (Midswing) | Beginning: The swing foot is opposite the weight-bearing foot. Ending: The swing leg has moved in front of the body and the tibia is in a vertical position. (The swing (non-weight bearing) leg is directly under the body) |
| Terminal Swing (Deceleration) | Beginning: The tibia is in a vertical position. Ending: Just prior to initial contact. (The leg is slowing down in preparation for heel strike) |
| Vertical Displacement (of the center of gravity) | The normal "bob" up and down as a person walks. Normally 2 inches. Bob is highest during midstance, lowest during heal strike (initial contact). |
| Horizontal Displacement (of the center of gravity) | There is an equal amount (2") of side to side displacement as the body shifts. Greatest displacement is during the single support phase at midstance. |
| Width of walking base. | The distance in width (2" to 4")between successive midpoint heel contacts during a normal walk. |
| Lateral Pelvic Tilt | Occurs when weight is removed from the leg at toe-off. This drop is sometimes referred to as the "Trendelenburg sign". |
| How does an average elderly adult gait change as they get older? | An older adult looses muscle mass, are less active, and often have poorer vision. Security/fear of falling have an affect. The walk is slower, with more double stance time. Steps are shorter (Less vertical displacement/ more horizontal displacement). |
| How is muscle weakness usually compensated for during walking? | The body tends to compensate by shifting the center of gravity over, or toward, the involved part. This reduces the moment of force (torque) on the joint. The gait portion affected will be the portion where the muscles or joints have a major role. |
| Gluteus maximus gait (rocking horse gait) | The trunk quickly shifts posteriorly during heel strike. Center of gravity is posteriorly over the Glut Max, moving the line of force behind the hip joints. Less muscle needed to maintain hip extension. |
| Gluteus medius gait | Trunk weight is shifted over affected side during stance phase. Glut Med (hip abductor) is weak on affected side, causing the opposite side of the pelvis to drop when that leg leave the ground and begins swing phase. TRENDELENBURG gait. |
| Quadricep weakness compensation strategy | Body may lean the body forward over the quad muscles early in the stance phase onto the stance leg. Forward body lean ships COG from the hip to the knee, forcing the knee backward into extension. |
| Hamstrings weakness | During stance phase, the knee will go into excessive hyperextension (genu recurvatum gait). Without hamstring strength, the knee will snap into extension during the swing phase. |
| Ankle dorsiflexors - no ankle dorsiflexion results in what? | Equinus gait. The toe will strike first. |
| Insufficent dorsiflexion strength during beginning of stance phase will result in what? | Flat foot landing. |
| Weak dorsiflexion after heel strike (cannot support body weight) results in what? | Foot slap. |
| What happens if gravity is too strong to enable dorsiflexion during the swing phase? How does one compensate? | This will result in foot drop. Compensation is to lift the knee higher for the dropped foot to clear the floor. This is called STEPPAGE GAIT (Drum majors use this) |
| Weakness in the Triceps Surae group (gastrocnemius and soleus) during step off results in no heel rise at push-off. What is the result? | A shortened step length on the unaffected side. Also known as the "sore foot limp". Most pronounced when walking up an incline. |
| What causes "Waddling gait"? | Commonly seen with muscular and other types of dystrophies, because there is a diffuse weakness of many muscle groups. |
| Joint/Range of motion limitations. Hip flexion contracture. | The involved hip is unable to go into extension/hyperextension during midstance and push-off. Compensation: the "Greeting position". Hip is flexed and person's trunk leans forward as if bowing. |
| Fused hip. | Bell-clapper gait. Motion of lumbar spine and pelvis greatly compensate for hip motion. Leg swings forward/ decreased lordosis/posterior pelvic tilt allow leg to swing forward. Increased lordosis/anterior pelvic tilt swings the leg back. |
| Knee Fusion | Results in "vaulting gait". Combination of toe rise of uninvolved leg, hiking of involved hip, and outward swing of involved leg. |
| Circumducted gait | The leg begins near the midline at push-off, swings out to the side during the swing phase, then returns to midline for heel strike. May be called an "abducted gait" if the leg remains in an abducted position throughout the gait cycle. |
| Triceps Surae contracture | Insufficient gastrocnemius length to allow stretching over both knee and ankle. When walking, weight forces some dorsiflexion, causing full knee extension. Knee must be lifted higher due to early heel rise at pushoff. Toes land first during heel strike. |
| Ankle fusion (triple arthrodesis) | Loss of ankle pronation and supination. Limited dorsiflexion and plantar flexion. Results: difficulty walking on uneven ground, shortened stride length. |
| Neurological involvement. Muscle spasticity and flaccidity tend to put the foot in what positions? | Muscle spasticity (varus/inward position). Muscle flaccidity (valgus/outward position) |
| Hemiplegic gait | Normally causes spasticity in involved extremity. Hip goes into extension, adduction,and medial rotation. Knee is extended. Ankle has foot drop with plantar flexion and inversion. Usually no reciprocal arm swing. |
| Ataxic gait | due to celebellar involvement, causes jerky movements and poor balance (wide base of support and staggering gait). |
| Parkinsonian gait | Causes tremors and diminished movement. Lower extremities and trunk tend to be flexed, as is elbow. Person walks with shuffling gait with the feet flat and weight mostly on toes. Gait starts slowly, then increases. Difficulty stopping (festinating gait). |
| Scissors gait | Due to spasticity in the hip adductors. Most evident during the swing phase, when the unsupported leg swings against or across teh stance leg. |
| Crouch gait | Describes the bilateral lower extremity involvement seen in spastic diplegia associated with cerebral palsy. |
| Pain - how does it affect gait? | tendency is to shorten the stance phase. Results in a shortened and rapid set length on the uninvolved side (due to pain on the involved side). Also known as "Antalgic gait" |
| Leg length discrepancy. What can the body usually accommodate without severe problem? | Body can usually accomodate discrepancies of up to 3 inches. |
| Moderate discrepancy - define. What problem will develop if not corrected? | From 3 to 5 inches. Equinus gait. |
| Techniques of compensaton for leg length discrepancy | Dropping of pelvis. Flexing of knee on uninvolved side for entire gait cycle. |
Created by:
pbryant2019