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What are temporal characteristics of gait?
- - velocity
- - cadence
- - step time
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What are spatial characteristics of gait?
- - step length
- - step width
- - stride length
- - foot angle
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What are the 5 phases of stance?
- - heel contact- initial contact
- - foot flat- loading response, initial contact of forefoot
- - midstance- greater trochanter in alignment with vertical bisetor of foot
- - heel off- terminal stance
- - toe off- pre-swing
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What are the three parts of swing phase?
- - acceleration (initial swing)
- - midsing- swinging limb overtakes limb in stance
- -deceleration- terminal sswing
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How big should your BOS be when you walk?
- small
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How much velocity and medial lateral displacement should we experience when we walk?
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How many steps does it take until a steady state walking speed is reached?
- 3
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What is are the common problems for pts with hemiplegic gait?
- - decreased walking velocity
- - decreased step/ stride lengths
- - uneven step and stride lengths- shorter stance pahse and longer swing phase on affected leg. Unaffected leg compensates with longer stance phase and shorter swing phase
- - increase stride width
- - toe strie
- - decreased amplitude of movement
- - UL flexion and adduction, decreased swing
- - use of arms for support or balance
- - gait is laborious- harder
- - hip hiking
- - trunk lean to contralateral side
- - circumduction
- -excessive hip and knee flexion
- - vaulting
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What are the common gait defects of swing phase?
- - decreased hip flexion
- - decreased knee flexion to shorten leg for toe clearance as the leg swings forward
- - decreased ankle DF as a contribution to toe clearance
- - decreased knee ext and ankle DF for heel contact (foot flat or toe first and short step length)
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How do you know if there is inadequate DF control in stance phase (heel contact)?
- foot slap
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How do you know if there is inadequate DF control in swing phase (mid swing)?
- toe drag
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How can you tell if someone had poor knee control- thus going into knee hyperextension?
- - biggest problems
- - knee may go into hyperextension
- - loss of normal knee flexion during stance phase
- due to:
- - quads weak in mid stance
- - spasticity mid- stance
- - knee flexor weakness (end- stance)
- THIS SHOULD BE CORRECTED FIRST!
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What is the rinciples of gait retraining?
- - maximize weight bearing through the legs
- - optimize sensory cues
- - maximise recovery not compensation
- - evidence suggests that training at faster speeds is better
- - use the least restricitve device or no device
- - start early, maximise intensity and volume
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What is the main limitiation of gait retraining?
- - requires many therapists
- - can be injured
- - often limited due to therapists endurance
- - time consuming
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Points for training?
- - importance of speed
- - effort of mobilising- 2 times harder
- - practice tasks in entire movement- as single step is harder as it requires more energy- you dont have to momentum
- - flexible envts
- - cognitive ability
- - ability to self monitor
- - CV fitness
- - aids?
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What are the biomechanics of running?
- - free- float/ flight phase- when both feet are in the air
- - increasing stride length
- - increasing stride frequency
- - proportionally greater swing phase
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What muscle is used a great deal in running?
- hip flexor
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Where does the trunk move when you are walking and running?
- - walking- posteriorly and laterally at heel strike, opposite erroector spinae more active
- - running- trunk is moving anteriorly at heel strike, symmetrical erector spinae activity
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Where is your COG when walking and running?
- - walking- midstance coresponds to a high point
- - running- mistance sorresponds to a low point
- - overal lowering of COG
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What are somethings to watch for?
- - decreased push of- overcomp with hip flexors
- - decrease postural stability- wide BOS
- -decrease arm symmetry
- - low tone
- - spastic rec fem
- - fatigue
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What do you need to do with gait retraining?
- - dcide main problems
- - possible causes
- - possible intervention
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