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363 Cards in this Set

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  • Back
when the foot is flat, which way does the external moment want to push the ankle?
into plantarflexion
when the foot is flat, which way is the internal moment?
dorsiflexion
when the foot is flat, is there a flexion or extension external moment on the knee?
flexion
when the foot is flat, is there an external flexion or extension moment on the hip?
flexion
at midstance, is the external ankle moment towards dorsiflexion or plantarflexion?
dorsiflexion
at midstance, is the external knee moment towards flexion or extension?
slight extension
at midstance, is the external moment of the hip towards flexion or extension?
extension
at heel off, is the external moment of the hip towards flexion or extension?
extension
at heel off, is the external moment of the knee towards flexion or extension?
slight extension
what percentage of the gait cycle is the stance phase?
60%
what percentage of the gait cycle is the swing phase?
40%
this is considered heel to heel on the same side
gait cycle
how many steps are there per gait cycle?
2
how many stride lengths are there per gait cycle?
1
this side step length is from right heel contact to left heel contact
left step length
this is the angle between the longitudinal axis of the foot and gait progression
foot angle
what is the approximate normal foot angle value?
about 7º
this is the number of steps per minute
cadence
what is the normal cadence of walking?
about 110 steps per minute
what is the surgeon general's walking recommendation?
about 10,000 steps (5 miles) per day
this is the measure of gait distance over time
velocity
what is the normal range of walking velocity for adults?
1.2-1.5 m/s (about 3 mph)
at least how much hip extension is needed for walking?
10º
at least how much knee flexion is needed for walking
70º (but ideally want 90 or more)
at least how much ankle dorsiflexion is needed for walking?
10º
at heel strike, does the tibia internally or externally rotate?
internally
at heel strike, does the subtalar joint invert or evert?
evert
what position is the ankle in at heel strike?
dorsiflexion
what position is the ankle in at push off?
plantarflexion
about how many degrees does the pelvis rotate in the transverse plane during gait?
about 4º in each direction
during what phase of gait does the hip drop to cause frontal plane pelvic rotation?
swing
what are five kinematic strategies that help to minimize energy expenditure and control the center of mass during gait?
(1) horizontal plane pelvic rotation
(2) sagittal plane ankle rotation
(3) stance phase knee flexion
(4) frontal plane pelvic rotation
(5) step width; knee valgus
this is the tendency of a force to make a rigid body rotate around an axis
moment/torque
moment x angular velocity
power
the sum of the net extensor moments at the ankle, knee, and hip; prevents collapse during the weight bearing stage of gait
support moment
what are three ways to shift the GRF anteriorly to extend the knee?
(1) use gluts to extend hips
(2) use quads to extend knee
(3) use gastroc/plantarflexors
this moment is the effect of gravity/outside forces
external
this moment is the way that the body responds to outside forces
internal moment
what type of muscle contraction has a positive power, or creates energy?
concentric
what type of muscle contraction has a negative power, or absorbs energy?
eccentric
at 0% of the gait cycle (heel strike) how is the tibialis anterior acting/what motion is it doing/controlling?
eccentrically controlling plantarflexion
at 60% of the giat cycle, how is tibialis anterior acting/what motion is it doing/controlling?
concentrically dorsiflexing
at 30-50% of the gait cycle, how is the gastroc acting/what motion is it doing/controlling?
eccentrically controlling dorsiflexion
between 50 and 60% of the gait cycle, how is the gastroc acting/what motion is it doing/controlling?
concentrically plantarflexing
at 40-60% of the gait cycle, how is the fibularis longus acting and what motion is it doing/controlling?
concentrically plantarflexing and stabilizing the transverse arch and first ray
from 80% of the gait cycle until heel strike of the next cycle, how is the vastus lateralis acting to accept weight?
eccentrically
starting at about 80% and continuing into 10% of the next gait cycle, how is the gluteus medius working/what motion is it doing/controlling?
working eccentrically to control hip drop (R glut med eccentrically acts to control L lateral pelvic drop)
is most muscle activity at the beginning of gait eccentric or concentric?
eccentric
what type of muscle activity dominates after 30% of the gait cycle?
concentric
force/area
pressure
what shape is the neonate's spine in?
C shaped
how is the pelvis tilted in a neonate?
posteriorly
what two positions are the hips of a neonate in?
flexion and lateral rotation
what three positions are the femurs of a neonate found in?
coxa valga, antetorsion, and mild varus bowing
what three positions are the knees of a neonate found in?
flexion contracture, internal genicular position, and genu varum
what two positions are the ankles of a neonate found in?
excessive dorsiflexion and hindfoot/forefoot varus
at 12 months, how is the pelvis tilted?
anteriorly
at 12 months, what three positions are the hips found in?
flexion, abduction, and lateral rotation
at 12 months, what position is the knee in?
genu varum
at 12 months, what two positions are the ankle found in?
lateral rotation and pronation
the angle of normal weight-bearing stance in young children; is the calcaneal valgus relative to the sagittal plane
relaxed calcaneal stance
this formula is used to determine the relaxed calcaneal stance of a child
Valmassy's formula; 7-chiild's age in years
is the reciprocal arm swing present or absent at the beginning walking at 12 months?
absent
there is persistent hip __ throughout the stance and swing phase of a child at 12 months/beginning walking
hip abduction
what is the average step length of a child of 12 months who is beginning walking?
20 cm
what is the average duration of the single limb stance during the gait cycle of a child of 12 months who is just beginning walking?
32% (low)
what is the average cadence of a child of 12 months who is just beginning walking?
180 steps/minute (high)
what is the average walking velicyt of a child of 12 months who is just beginning walking?
60 cm/sec (low)
what motion does the pelvis do on the swing side in a beginning walker?
hip hiking
what motion does the hip do in a beginning walker?
flexion
what motion does the femur do during both the swing and stance phase in a beginning walker?
lateral rotation
what motion does the knee do in a beginning walker?
flexion (but mature knee flexion wave not seen)
what motions do the tibia and fibula do in a beginning walker?
immediate medial followed by lateral rotation
what motion does the ankle do in a beginning walker?
exaggerated dorsiflexion
what are three characteristics of a normal 12 month old beginning walker's gait?
(1) steppage gait
(2) wide BOS
(3) high guard position of UEs
what is the average genu varum of a child at 15 months (it is decreasing)?
at what age does emergence of the reciprocal muscle action in the LEs occur?
15 months
at what age does the anterior tib begin to activate prior to foot contact (but foot flat contact persists)?
15 months
at what age do the lumbar lordosis and pot belly emerge?
2 years
at what age of gait development is the hip flexion contracture reduced to about 3 degrees and the range of lateral rotation become equal to medial rotation?
2 years
at what age does the knee begin to exhibit physiologic valgum?
2 years
at what age is the tibia and fibula rotated 10-15º lateral relative to the frontal plane?
2 years
at what age does the child increase their walking velocity from 60-85 cm/s?
2 years
at 2 years, the single limb support increases to __% of the gait cycle
35
at what age does the base of support and cadence during gait begin to decrease?
2 years
at what age does the emergence of reciprocal arm swing occur?
2 years
at what age does the knee flexion wave emerge in gait?
2 years
at what age does the heel strike begin to occcur, accompanied with decrease of foot drop in the swing phase?
2 years
at what age does genu valgum peak?
3 years
at what age does hyperextension of the knee often occur, which exaggerates the apperance of genu valgum?
3 years
at what age does the ankle dorsiflexion range begin to decrease as the plantar flexors gain strength?
3 years
at what age does the medial longitudinal arch become apparent in standing?
3 years
what does the velocity between 36 and 42 months rise to?
nearly 105 cm/sec
between 3 and 7 years, the single limb support increases to __% of the gait cycle
37%
does cadence increase or decrease steadily with age?
decreases
at what age are the rotation patterns of the pelvis and lower limb and patterns of knee and heel strike adult like?
3 years
at what age is toe stepping a significant feature of walking, rather than walking in consistent plantigrade?
3 years
what are the four primary determinants that distingush the gait in a child of 3 years from that of an adult?
(1) shortened step length
(2) high cadence
(3) low walking velocity
(4) limited duration of single-limb stance
what are the two primary requirements for resolution of deficits for achievement of a mature gait pattern?
(1) increased leg length
(2) improvement unilateral limb and foot stability
what parameter of gait is the best predictor of falls, hospitalization, disability, and longevity in the elderly?
walking speed
this is the lateral distance between heels of 2 successive steps from each foot
step width
what parameter of gait is a good indicator of stability?
stance time
elderly adults have decreased peak ankle __ at toe-off/preswing
plantarflexion
elderly adults have decreased ankle __ in swing and stance at self-selected speeds
dorsiflexion
there is decreased peak hip __ at midstance in older adults, which is related to an increased pelvic tilt
extension
what are five normal changes in gait as a part of aging?
(1) walking speed
(2) stride length
(3) base of support
(4) joint excursion
(5) joint moment/power
the changes in what joint mechanics occur first with respect to gait and aging?
ankle
what are two reasons for a change in gait as adults age?
(1) to promote greater stability
(2) to adapt to impairments (such as decreased strength and ROM)
what is the characteristic gait impairment/spatiotemporal change seen in a person with hemiparesis?
decreased stance phase on the affected limb (longer time in double limb support)
what three ways are the ankle motions of gait changed in a person with hemiparesis?
(1) reduced dorsiflexion
(2) excessive plantarflexion during initial contact
(3) reduced plantarflexion at toe-off
what three ways are the knee motions of gait changed in a person with hemiparesis?
(1) excessive knee flexion at heel strike
(2) knee hyperextension
(3) decreased knee flexion in swing phase
what three ways are the hip motions of gait changed in a person with hemiparesis?
(1) decreased peak hip flexion at heel strike
(2) increased peak hip flexion at toe-off
(3) reduced hip flexion during mid-swing
what type of gait strategy do hemiparesis patients tend to prefer?
hip strategy
what are four spatiotemporal changes in gait that occur with diabetic peripheral neuropathy?
(1) reduced gait speed
(2) reduced step length
(3) increased step width
(4) increased stance time
what two ways are the ankle motions of gait changed in a person with diabetic peripheral neuropathy?
(1) reduced plantarflexion at push off
(2) reduced dorsiflexion during stance
what type of gait strategy do people with diabetic peripheral neuropathy use?
hip (use hip flexors to pull leg forward rather than pushing with plantar flexors)
what are the five general spatiotemporal changed for amputees in gait?
(1) reduced walking speed
(2) reduced cadence
(3) asymmetric step length (increased on involved LE of transtibial amputees)
(4) increased step width
(5) reduced stride length
what way is the ankle motion of gait changed in a person with an amputation?
reduced plantarflexion at late stance
what muscles help to generate energy to compensate for the lack of plantarflexion energy generation during pushoff in an amputee?
hip extensors
for a transfemoral amputation, what are the three ways that the hip mechanics change during gait?
(1) increased pelvic drop on the unloaded side
(2) lateral trunk lean
(3) reduced hip abduction moment
amputees demonstrate a tendency to use the hip during what two phases to compensate for functional loss of the ankle joint?
late stance/early swing
what are seven common impairments seen in someone with Parkinson's disease?
(1) bradykinesia/hypokinesia
(2) muscle rigidity
(3) tremor
(4) flexed posture
(5) shuffling gait
(6) difficulty turning
(7) freezing episodes
what are the seven spatiotemporal changes to gait seen in someone with Parkinson's disease?
(1) reduced walking speed
(2) reduced step length
(3) reduced stride length
(4) increased stride/step width
(5) increased cadence with controlled walking speed
(6) increased stance duration
(7) increased double limb support
what are the two things that you have to do to increase your gait speed?
(1) increase stride length
(2) increase cadence
what change is seen to ankle ROM during gait in someone with Parkinson's disease?
reduced plantarflexion at push-off
what two changes are seen to ankle moments during gait in someone with Parkinson's disease?
(1) decreased internal dorsiflexor moment at heel strike
(2) decreased internal plantarflexor moment at push off
what two changes are seen to the hip moment during gait in someone with Parkinson's disease?
(1) reduced internal flexion moment in stance
(2) reduced internal hip extension during stance
what parameter of the step is increased in patients with Parkinson's disease?
step width
most kinematic and kinetic changes in Parkinson's disease occur at what joint?
the ankle
what are six common impairments seen in someone with cerebral palsy?
(1) delayed motor development
(2) postural abnormalities (crouched)
(3) abnormally high muscle tone
(4) spasticity
(5) increased muscle coactivation
(6) cognitive delays
what are the four general spatiotemporal changes in gait that occur with cerebral palsy?
(1) reduced walking speed
(2) reduced stride length
(3) increased step width
(4) reduced cadence
what are the five common gait deviations that are observed in children with CP?
(1) equinus
(2) crouch gait
(3) stiff knee
(4) scissoring
(5) rotational malalignment
this deformity is associated with excessive plantarflexion of the talocrural joint and is related to spasticity and tightness of the plantarflexors in children with CP
equinus deformity
this type of equinus gait pattern occurs because of posterior calf tightness or spasticity
true
this type of equinus gait pattern occurs because of excessive knee and hip flexion at heel strike, with a relatively normal ankle range of motion
apparent
this posture is excessive flexion of all lower extremity joints due to muscle tightness or contracture, and is commonly seen in people with CP
crouch posture
what are six characteristics that are seen in a crouch gait that is observed in people with CP?
(1) patella alta
(2) plantarflexor weakness
(3) excessive ankle dorsiflexion
(4) excessive knee and/or hip flexion
(5) hamstring spasticity
(6) reduced knee moment and power
this type of gait observed in people with CP occurs because of reduced peak knee flexion during swing secondary to spasticity of the rectus; impairs foot clearance
stiff knee gait
this gait pattern commonly seen in people with CP is characterized by excessive hip adduction due to hip adductor spasticity or contracture and hip abductor weakness
scissoring
what two factors most likely cause rotational deformities in people with CP?
(1) excessive femoral anteversion
(2) excessive internal or external tibial torsion
what are three common impairments seen in someone with CP who exhibits rotational deformities?
(1) reduced plantarflexor power at push off
(2) more hip medial rotation
(3) persistent toeing in
sequence of events between successive heel strikes of the same foot
stride
sequence of events within successive heel strikes of opposite feet
step
distance between successive heel contacts of opposite feet
step length
lateral distance between heel centers of two consecutive foot contacts
step width
amount of toe out (angle between line of progression of the body and long axis of the foot)
foot angle
what is the average step width?
8-10 cm
what is the average foot angle?
5-7º
the number of steps per minute
cadence
what is considered the best, most functional measure of an individual's walking ability?
walking speed
phase of gait when the foot is on the ground, supporting body weight
stance
this occurs when the entire plantar surface of the foot comes into contact with the ground and represents about 8% of the gait cycle
foot flat
this occurs when the body's weight passes directly over the LE and represents 30% of the gait cycle or 50% of the stance phase of gait cycle
mid stance
at what percentage range of gait cycle does heel off occur?
30-40%
what percentage of gait cycle does toe off occur?
60%
this phase of gait occurs when the foot is in the air, being advanced forward for the next ground contact
swing phase
this phase of swing is from toe off to mid swing
early swing
what percentage of the gait cycle does early swing phase occur at?
60-75%
what percentage of the gait cycle does mid swing occur at?
75-85%
what percentage of the gait cycle does terminal swing occur at?
85-100%
this phase of swing occurs when the swing limb passes the stance limb
mid swing
this phase of swing occurs just past the passage of the stance limb until the foot contacts the ground
terminal
how many periods are there of double and single limb support during gait?
2 each
from 0-10% of the gait cycle, is it double or single limb support (weight transfer)?
double
from 10-50% of the gait cycle, is it double or single limb support?
single
from 50-60% of the gait cycle, is it double or single limb support (transferring weight between LEs)?
double
from 60-100% of the gait cycle, is it double or single limb support?
single
the COM of the body is located just anterior to what vertebrae?
S2
vertically, the COM oscillates up and down for how many full sine waves?
2
horizontally, the COM oscillates side to side for how may full sine waves?
1
during what type of support is the COM of the body the lowest during gait?
double limb support
on the right leg, during what phase does the COM reach its highest and most lateral position, and then starts to fall away from that supporting limb
mid stance
when the supporting LE is __ to the body's COM, the body slows down
anterior
when the supporting LE is __ to the body's COM, the body speeds up
posterior
at what phase of gait does the lowest velocity occur?
midstance
at what phase of gait does the highest velocity occur?
double limb support
at what phase of gait is the maximum kinetic energy being used?
double limb support
at what percentages of gait does posterior pelvic tilt occur?
0-10% and 30-60%, terminal swing
at what percentages of gait does anterior pelvic tilt occur?
30% and 60-87%
what is the position of the hip at initial contact?
30º of flexion
when does maximum hip extension of 10º occur in the gait cycle?
just before toe-off
when does maximum flexion of the hip occur during gait cycle?
just before heel contact
how can apparent hip extension be achieved?
anterior pelvic tilt and increase in lumbar lordosis
how can apparent hip flexion be achieved?
posterior pelvic tilt with flattened lumbar spine
what is the position of the knee at heel contact?
flexed 5º
during the initial 15% of the gait cycle, how does the knee move?
into an additional 10-15º of flexion
at the knee, what muscle is activating eccentrically during heel strike to absorb shock and accept body weight?
quadriceps
after the initial 15% of gait, what motion is the knee in until heel off?
near full extension
what position is the knee in by heel off?
35º of flexion
at what phase of gait does max knee flexion of 60º occur?
mid swing
what position is the ankle in at heel contact?
slight plantarflexion
what position is the ankle in during stance phase, as the tibia moves forward over the foot?
up to 10º of dorsiflexion
after heel off, what does the ankle begin to do, and continue to do to a maximum of 15-20º just after toe-off?
plantarflexion
how much dorsiflexion do you generally need for gait?
10º
how much plantarflexion do you generally need for gait?
20º
at what percentage of gait cycle is the left iliac crest elevated by concentric activation of the right hip abductors?
20-60%
what three factors could cause excessive hip motion in the frontal plane during gait?
(1) weakness of hip abductors
(2) reduced shortening of swing limb
(3) leg length discrepancy
at the knee, in the frontal plane, 5º of adduction occurs at what phase of gait?
in the last 20% of stance
when does maximum knee abduction in the frontal plane occur?
near the maximum knee flexion angle
what motion does the ankle do in the frontal plane at heel contact?
inversion 2-3º
what motion does the ankle do in the frontal plane after heel contact until midstance?
eversion
after midstance, what motion is the ankle doing in the frontal plane?
inversion
at what percentage of the gait cycle is the neutral position of the calcaneus reached?
40-45%
what motion does the femur do after heel contact through the first 20% of the gait cycle?
internal rotation
after 20% of the gait cycle, what motion does the femur do, until shortly after toe off?
external rotation
what motion is the femur doing during most fo the swing phase?
internal rotation
the metabolic efficiency of walking is greatest at what speed?
3 mph
what is the way to save energy during walking?
reduce the displacement of the COM
what muscle activates at terminal swing to initiate hip extension and to accept weight, and remains active from heel contact to midstance to support the body and extend the hip?
gluteus maximus
what muscle group activates to advance the LE forward during swing in preparation for the next step and lift the LE to allow for toe clearance?
hip flexors
initially, hip flexor muscle activity is __ as the hip extends, and then __ as the hip flexes just before toe off
eccentric, concentric
hip flexor muscles are active only in the first __% of swing phase, after that hip flexion is a result of forward momentum
50
they key role of this muscle group is to control the slight lowering of the contralateral pelvis on the side of the swing limb (eccentric), then act concentrically to initiate relative abduction; also control alignment of femur in frontal plane
hip abductors
the key role of this muscle group is to stabilize the hip at heel strike through coactivation with the hip extensors and abductors; likely assist with extension and assist with flexion after toe off
hip adductors
this muscle group helps to advance the swing limb, along with the hip flexors
internal rotators
this muscle group is mostly active during early stance to control alignment of the hip in the horizontal plane
external rotators
when are the quads active in the gait cycle to prepare for heel strike?
very late swing stage
at midstance, what type of muscle contraction are the quads undergoing in order to extend the knee and support body weight?
concentric
before heel contact, what muscle group decelerates knee extension in preparation for heel strike?
hamstrings
in the initial __% of gait, the hamstrings actively assist hip extension and provide stability to the knee
10
what part of what mucsle assists with knee flexion during the swing phase of gait?
short head of the biceps femoris
the tibialis anterior undergoes a strong __ contraction at heel contact to decelerate the passive plantarflexion of the ankle
eccentric
from heel contact to foot flat, which muscle eccentrically assists in decelerating foot pronation?
tibialis anterior
during which phase of gait is the tibialis anterior activating concentrically (to help with toe clearance)?
swing phase
these two muscles are supplemental to the tibialis anterior in helping to decelerate plantarflexion of the ankle at heel contact
(1) extensor digitorum
(2) extensor hallucis longus
during __ phase, the extensor digitorum and extensor hallucis longus muscles assist with dorsiflexion of the ankle and toe extension
swing
between __and__% of gait cycle, the soleus and gastrocnemius muscles eccentrically control forward movement of the tibia/fibula relative to the talus
10-40%
at 10-40% of the gait cycle, which two muscles eccentrically control forward movementof the tibia/fibula relative to the talus?
gastroc and soleus
between which two gait phases is there a major plantarflexion torque/propulsion of the body for push off?
heel off and toe off
between 5-35% of gait, which muscle works to decelerate pronation?
tibialis posterior
between 35-55% of gait, which muscle works to supinate the foot, and its tension may assist in raising the medial longitudinal arch to add necessary rigidity to the foot for push off?
tibialis posterior
from 10% of gait until just before toe off, what muscles are active as plantarflexors and pronators to counteract strong inversion effect of the posterior tibialis?
fibularis muscles
which muscle holds the 1st ray rigidly to the ground for stability at terminal stance?
fibularis longus
what muscles of the foot are active from mid stance to toe off to stabilize the forefoot and raise the medial longitudinal arch to provide a rigid lever for ankle plantarflexion?
intrinsics
these are the forces that are applied to the foot by the ground during gait
ground reacting forces (GRFs)
at what phase of gait are the ground reaction forces less than body weight as a result of the relative unweighting caused by upward momentum of the body gained during the early part of stance?
midstance
at what parts of gait are the ground reaction forces slightly greater than body weight?
loading and terminal stance
what type of ground reaction forces are applied parallel to the supporting surface (e.g. the foot)?
shear
a __ directed ground reaction force at heel contact momentarily slows forward progression of the body
posteriorly
a ground reaction force directed __ causes the body to be momentarily accelerated forward at toe off
anteriorly
during gait, the ground reaction forces applied under the foot generate what type of torque on the joints of the LE?
external
to prevent collapse of the LE during gait, external torques are resisted by what type of torques of the muscles?
internal
internal torques are associated with __ muscle contraction when the joint moves in the direction of the muscle's action
concentric
internal torques are associated with __ muscle contraction when the joint moves opposite the muscle's action
eccentric
what does a positive value of joint power indicate?
power generation
what does a negative value of joint power indicate?
power absorption
in early stance, hip __ torque is generated that serves to accept body weight and control forward momentum of the trunk, and to extend the hip
extension
in the second half stance, hip __ torque is generated to decelerate hip extension and initiate hip flexion before toe off
flexion
what type of torque is there in the hip at intiial swing?
small hip flexion torque
what type of torque is there at the hip in the second half of swing to decelerate hip flexion and initiate hip extension?
hip extension torque
at heel contact, at the knee there is a brief initial __ torque followed by a large __ torque for loading response
flexion, extension
during terminal swing at the knee, there is an internal __ torque generated to decelerate knee extension
flexion
the instant of weight application on the foot during gait creates a (varus, valgus) torque at the knee, resulting in abduction
varus
a small __ torque is generated at the ankle just after heel contact to control movement of plantarflexion generated by application of body weight on the calcaneus (power is absorbed)
dorsiflexion
there is a __ torque at the ankle through the rest of the stance phase (eccentric activation as the tibia is advanced over the foot)
plantarflexion
there is a small __ torque at the ankle during swing in order to clear the toes
dorsiflexion
what is the likely impairment involved if someone has a foot slap-rapid plantarflexion of the ankle occurring after heel contact?
mild weakness of ankle dorsiflexors
what is the likely impairment if someone has a foot flat deformity-the entire plantar aspet of the foot touches the ground at initial contact (instead of just the heel)?
marked weakness of the ankle dorsiflexors
what is the likely impairment if someone makes initial contact first with their forefoot followed by the heel
severe weakness of ankle dorsiflexors
what is the likely gait impairment if someone makes initial contact with their forefoot and no contact with their heel
heel pain/pes equinus
what is the likely gait impairment if someone prematurely elevates their heel in mid/terminal stance?
lack of ankle dorsiflexors
what is the likely gait impairment if someone's heel remains in contact with the ground late in terminal stance?
weakness/paralysis of ankle plantarflexors
what is the likely gait impairment if someone has a supinated foot and wegiht bears on the lateral aspect of the foot during stance?
pes cavus (supinated foot)
what is the likely gait impairment if someone demonstrates excessive foot pronation during stance, with failure of the foot to supinate in mid stance?
rearfoot and/or forefoot varus
what is the likely gait impairment if someone has excessive foot pronation with weightbrearing on the medial portion of the foot during stance, and the medial longitudinal arch is absent during swing?
weakness/paralysis of ankle invertors, or pes planus (pronated foot)
what is the likely gait impairment if someone has ankle in plantarflexion during swing, and exhibits drop foot?
weakness of dorsiflexors and/or pex equinus
what is the likely gait impairment if someone exhibits vaulting (exaggerated plantarflexion during midstance) causing excessive vertical movement of the body?
any impairment of the contralateral LE that reduces hip flexion, knee flexion, or ankle dorsiflexion during swing
what is the likely gait impairment if someone exhibits toeing out during gait?
femoral retroversion or tight hip lateral rotators
what is the likely gait impairment if someone exhibits toeing in during gait?
femoral anteversion or spasticity of hip adductors and/or medial rotators
what is the likely gait impairment if someone exhibits rapid knee extension after initial contact?
quadriceps spasticity
what is the likely gait impairment if someone's knee remains extended during the loading response, without extensor thrust?
weak quads, or knee pain
what is the likely impairment if someone exhibits genu recurvatum during stance?
knee extensor weakness
what is the likely impairment if someone exhibits varus thrust during stance?
laxity of posterior and lateral ligamentous joint structures
what is the likely impairment if someone exhibits a flexed knee in stance and a lack of knee extension in terminal swing?
knee flexion contracture greater than 10 degres or knee pain and joint effusoin
what is the likely impairment if someone exhibits reduced/absent knee flexion in swing
spasticity of knee extensors/knee extension contracture
what is a likely impairment if someone keeps their knee in flexion during stance, with normal ROM?
impairment at the ankle or hip
what is the likely impairment if someone exhibits hyperextension of the knee from initial contact to pre-swing?
ankle plantarflexion contracture
what is the likely impairment if someone exhibits an antalgic gait?
painful LE stance
what is the likely impairment if someone exhibits excessive knee flexion in swing?
lack of ankle dorsiflexion of the swing limb or short stance limb
what is the likely impairment if someone exhibits backward trunk lean during loading?
weak hip extensors
what is the likely impairment if someone exhibits lateral trunk lean toward the stance lower extremity during gait?
marked weakness of hip abductors
what is the likely impairment if someone exhibits a contralateral hip drop during gait?
mild weakness of gluteus medius in the stance limb
what is the likely impairment if someone exhibits forward bending of the trunk in mid/terminal stance?
hip flexion contracture/hip pain
what is the likely impairment if someone exhibits excesive lumbar lordosis in terminal stance?
hip flexion contracture
what is the likely impairment if someone's trunk lurches backward and towrad the unaffected stance limb from heel off to mid swing?
hip flexor weakness
what is the likely impairment if someone exhibits posterior tilt of the pelvis during initial swing?
hip flexor weakness
what is the likely impairment if someone exhibits hip circumduction?
hip flexor weakness
what is the likely impairment if someone exhibits forward trunk bending during loading?
weak quadriceps
what is the likely impairment if someone exhibits forward bending of the trunk during mid and terminal stance?
pes equinus
what is the likely impairment if someone exhibits excessive hip and knee flexion during swing?
lack of ankle dorsiflexion of the swing limb
what is the likely impairment if someone exhibits hip circumduction or hip hiking during swing?
lack of shortening of swing limb secondary to decreased hip flexion, knee flexion and/or ankle dorsiflexion
what is the likely impairment if someone exhibits excessive backward horizontal rotation of the pelvis on the side of the stance limb in terminal stance?
ankle plantarflexor weakness
the ground reaction forces are about __ times greater in running than walking
3
what is the percentage spent in swing phase during running?
60-70%
during running, hip flexion generally increases from 30 to __º
65
during running, hip extension increases from 10 to __º
20
during running, knee flexion increases from 60 to __º
120-130
during running, dorsiflexion increases from 10 to about __º
25
during running, plantarflexion increases from about 20 to __º
30
what percentage of the running cycle is spent in the stance phase?
40%
during weight acceptance, what type of rotation is the limb experiencing?
internal rotation
during weight acceptance, what type of movement is the foot experiecing?
pronation
during the propulsion phase of running, what type of rotation is the limb experiencing?
external rotation
during the propulsion phase of running, what type of movement is the foot experiencing?
supination
does the weight acceptance phase of running involve mostly concentric or eccentric contractions?
eccentric
does the propulsion phase of running involve mostly concentric or eccentric contractions?
concentric
during the swing phase, what muscles are working at the hip to help get the limb swinging?
flexor
the hip extensors begin to work at __% of the gait cycle; they start to fire to slow down the progression of the hip and to slow down the lower leg
hip extensors
does a shorter or longer step and stride length use more of a hip strategy?
shorter
does a shorter or longer step and stride length use more of an ankle strategy?
longer
what are the six differences in the joints/movements when running with forefoot contact instead of heel contact?
(1) increased knee flexion
(2) shorter step and stride length
(3) increased cadence
(4) smaller vertical displacement of the body
(5) less eccentric work at the knee
(6) more eccentric work at the ankle
one of the downsides to forefoot running is that it puts a lot of stress on the ankle __ muscles
plantarflexor
what is occurring at 0% of the gait cycle?
heel strike
what is occurring at 10% of the gait cycle?
opposite toe off
what is occurring at 30% of the gait cycle?
heel rise
what is occurring at 50% of the gait cycle?
opposite initial contact
what is occurring at 60% of the gait cycle?
toe off
what is occurring at 73% of the gait cycle?
feet adjacent
what is occurring at 87% of the gait cycle?
tibia vertical
what is occurring at 100% of the gait cycle?
next initial contact
during the loading response, what type of tilt is occurring at the pelvis?
posterior
during mid stance, what type of tilt is occurring at the pelvis?
anterior
during terminal stance, what type of tilt is occurring at the pelvis?
anterior
during pre swing, what type of tilt is occurring at the pelvis?
posterior
during initial swing, what type of tilt is occurring at the pelvis?
anterior
during mid swing, what type of tilt is occurring at the pelvis?
anterior
during terminal swing, what type of tilt is occurring at the pelvis?
posterior
during the loading response, what position is the hip in?
flexion
during mid stance, what position is the hip in?
flexion/neutral
during terminal stance, what position is the hip in?
extension
during pre swing, what position is the hip in?
extension
during initial swing, what position is the hip in?
extension
during mid swing, what position is the hip in?
flexion
during terminal swing, what position is the hip in?
flexion
during the loading response, what position is the knee in?
10º flexion
during mid stance, what position is the knee in?
20º flexion
during terminal stance, what position is the knee in?
neutral-5º flexion
during pre swing, what position is the knee in?
20º of flexion
during initial swing, what position is the knee in?
45º flexion
during mid swing, what position is the knee in?
60 º of flexion
during terminal swing, what position is the knee in?
20-10º flexion
during the loading response, what position is the ankle in?
5-10º plantarflexion
during mid stance, what position is the ankle in?
5-8º dorsiflexion
during terminal stance, what position is the ankle in?
10º dorsiflexion
during pre swing, what position is the ankle in?
10º dorsiflexion to 10º plantarflexion
during initial swing, what position is the ankle in?
20º plantarflexion
during mid swing, what position is the ankle in?
12º plantarflexion to 2º dorsiflexion
during terminal swing, what position is the ankle in?
1º plantarflexion
during the loading response, what position is the subtalar joint in?
2º inversion
during mid stance, what position is the subtalar joint in?
1-2º eversion
during terminal stance, what position is the subtalar joint in?
2º eversion to 2º inversion
during pre swing, what position is the subtalar joint in?
2-6º inversion
what are the five kinematic strategies to minimize energy expenditure during gait?
(1) horizontal plane pelvic rotation
(2) sagittal plane ankle rotation
(3) stance phase knee flexion
(4) frontal plane pelvic rotation
(5) frontal plane hip rotation
these two kinematic strategies help to reduce the downward displacement of the center of mass during gait
(1) horizontal plane pelvic rotation
(2) sagittal plane ankle rotation
these two kinematic strategies help to reduce the upward displacement of the center of mass during gait
(1) stance phase knee flexion
(2) frontal plane pelvic rotation
this kinematic strategy helps to reduce the sid to side excursion of the center of mass during gait
frontal plane hip rotation
what type of moment is created at the hip when the GRF passes anterior to the joint?
flexion
what type of moment is created at the knee when the GRF passes anterior to the joint?
flexion
what type of moment is created at the ankle when the GRF passes anterior to the joint?
dorsiflexion
what type of moment is created at the hip when the GRF passes posterior to the joint?
extension
what type of moment is created at the knee when the GRF passes posterior to the joint?
extension
what type of moment is created at the ankle when the GRF passes posterior to the joint?
plantarflexion
in Parkinson's disease, at what joint does the majority of compensation occur to preserve the other joint patterns?
ankle