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while walking at a constant speed, these 3 things occur
forward motion (constantly accelerating and decelerating), rise/fall of COM (5 cm of vertical displacement, most in loading), side/side motion
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functional tasks in Weight Acceptance
stability, forward progression, shock absorption
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functional tasks in Single Limb Stability
stability, forward progression
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functional tasks in Swing Limb Advancement
foot clearance, limb advancement
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forward progression is aka
stance
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limb advancement is aka
swing
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4 general observations to start looking at in gait
velocity, step length/symmetry, arm swing, if pt looks stable
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phase and joint to start with when looking at gait
IC, at ankle jt; then move proximal
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forefoot contact
instead of landing w/ heel, land w/ forefoot due to inadequate DF
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foot flat contact
whole foot lands, result of inadequate knee ext in TSW
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excess DF
more DF than normal for that particular phase (eg, neutral at LR); tibia should never go past neutral for LR; due to weakness at hips and knees
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excess PF
compensation for weak quads
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drag
happens in ISW when lacking knee flex; won't correct w/ AFO bc not a problem at the ankle
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C/L vaulting
when in swing, go up on tip toes of other leg
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4 potential causes of deviations in gait
motor control, ROM, sensation, pain
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motor control subgroups that cause deviations
strength, spasticity, patterned movement, balance
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ROM subgroups that cause deviations
contractures, joint fusions, ligament laxity
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sensation subgroup that causes deviations
proprioception
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IC definition
moment when the foot contacts the ground
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LR definition
weight is rapidly transferred onto outstretched limb, the first period of double-limb support
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MST definition
body progresses over single, stable limb
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TST definition
progression over stance limb continues; body moves ahead of the limb and weight is transferred onto the forefoot
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PSW definition
rapid unloading of the limb occurs as weight is transferred to the C/L limb, the 2nd period of double limb support
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ISW definition
thigh begins to advance as the foot comes up off the floor
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MSW definition
thigh continues to advance as knee begins to extend; the foot clears the ground
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TSW
knee extends; the limb prepares to contact the ground for IC
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2 phases of weight acceptance
IC, LR
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2 phases of single limb support
MST, TST
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4 phases of swing limb advancement
PSW, ISW, MSW, TSW
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phases and % of time in stance
IC, LR, MST, TST, PSW; 62%
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phases and % of time in swing
ISW, MSW, TSW; 38%
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