CHS 371 Exam 2 - Normal Gait

The act of moving from place to another

the manner of walking

a smooth, high coordinated, rhythmical, undulating, reciprocal movement by which the body moves step by step in the required direction at the necessary speed

the period of time from one event (usually initial contact) of one foot to the following occurrence of the same event with the ipsilateral foot

right foot touches ground then right foot touches ground again.

= 1 gait cycle

is described as the period from the intial contact of a particular lim to the point of initial contact of the same limb and is equivalent to one gait cycle

the period from initial contact of one limb to the initial contact of the contralateral limb. (two steps in each stride/gait cycle

The period of time when the foot is in contact with the ground

the period of time when the foot is not in contact with the ground.

where the foot never leaves the ground (foot drag) when all portions of the foot are in forward motion

both feet are in contact with the ground

occurs twice in the gait cycle at the beginning and end of the stance phase

only one foot is in contact with the ground

this is = to the swing phase of the other limb

the pint in the gait cycle when the foot initially makes contact with the ground.

beginning of stance phse

(foot strike)

when the foot leaves the gorund

the end of the stance phase/beginning of swing phase (foot off)

when terminal contact is made with the toe

the point in time in the stance phase when the full foot is in contact with the ground

the point in the stance phase when the heel leaves the ground

the distance from a point of contact with the ground of one foot to the following occurrence of the same point of contact with the other foot.

the right step length is the distance from the left heel to the right heel when both feet are in contact with the ground. Measured in meters

the period of time taken for one step and is measured from an event of one foot to the following occurrence of the same event with the other foot expressed in seconds

the distance from initial contact of one foot to the following initial contact of the same foot

(cycle length meters)

the period of time from initial contact of one foot to the following initial contact of the same foot (seconds)

the rate of change of linear dislacement along the direction of progression measured over one or more strides, expressed in m per second

Rate at which a person walks expressed in steps per minute

the ratio of stance period to the swing period

the side to side distance between the feet which is typically measured from ankle joint center

the rate of walking that is voluntarily assumed

controlled be the central nervous system

afferent stimuli -tactile impulses from the sole of the foot

proprioceptive impulses from the lower limb, trunk and neck

The body can stand upright and bear weight evenly on both limbs

the body can alternate weight on one limb while bringing the other limb forward

the movements necessary for walking are present and coordinated (trunk and arms)

constitutes 60% of gait cycle

constitutes 40%of the gait cycle

• initial contact
• loading response
• mid-stance
• terminal stance
• pre-swing

double support

the initial contact of the leading stance foot and the toes of the other foot are both on the ground

weight transferred onto the outstretched limb

the first period of double support

opposite limb leaves the floor until body weight is aligned over forefoot

body progresses over a single, stable limb

the heel is raised as the body moves forward over the stance limb

body moves ahead of the limb

second double support stance period

initial contact of contralateral limb to ipsilateral toe off

unloading limb occurs as weight is transferred to the contralateral limb

• Initial swing
• mid-swing
• terminal-swing

non-weightbearing phase of the reference limb

begins when the foot of the reference limb leaves the ground after foot off, and finishes just prior to initial contact of the same limb

begins once the foot of the swing limb leaves the ground until the swing limb is directly under the body or at maximum knee flexion

begins from maximum knee flexion )when the swing limb is under the body) until the swing limb passes the stance limb

limb moves into the stance phase again

tibia is in vertical position

• ankle: neutral
• knee: flexed
• hip: flexed

• ankle:plantarflexed
• knee: flexed
• hip: flexed

• ankle:dorsiflexed
• Knee: extended
• hip:neutral

• Ankle: plantarflexed
• Knee: flexed
• Hip:extended

• ankle:plantarflexed
• knee:flexed
• hip:neutral

• ankle:plantarflexed
• knee:flexed
• hip:flexed

• ankle:dorsiflexed
• knee:extended
• hip:flexed

• ankle:dorsiflexed
• knee:extended
• hip:flexed

ankle: tibialis anterior and toe extensor

knee: quads contract

hip: hip extensors

ankle: plantarflexion torque

Knee: eccentric quads

hip:extensor muscles, gluteus

ankle: soleus and gastrocnemius

knee:quads, calves

hip: pelvis, hip abductors

ankle: calf muscles

knee: calf muscles

hip: TFL

ankle: residual plantar flexion

knee: gracilis

hip: adductor longus

ankle: pre-tibial muscles

knee: biceps femoris short head, sartorius and gracilis

Hip: illiacus, gracilis, and sartorius

ankle: pretibial muscles

knee: hamstrings

hip: hamstrings

ankle: pretibial muscles

knee: quads, hamstrings

hip: hamstrings, gluteus muscles and TFL

congenital, developmental, metabolic, neoplastic

sensory,motor,spastic, paralytic

contractures, fibrosis, laxity, metabolic

lack of coordination, neuromuscular

• pain during movement
• loss of muscle power
• increased or fluctuating muscle tone
• lack of muscle coordination
• skeletal deformities
• pregnancy
• brain injury
• spinal cord injury
• peripheral nerve injuries
• fractures of bones
• degenerative conditions

a spastic child with marked bilateral adductor spasm at the hips and equinus spasm in the ankle

AKA festinating gait

increase in cadence,shortened stride, lack of heel strike and toe off, diminished arm swing, hunched over, foot is flat

coordinating functions of the cerebella are interfered with, so the person walks with a wide base of gait with an unsteady, irregular gait, even if watching feet.

Spinal - proprioceptive pathways of the spine or brainstem are interrupted

• loss of position and motion sense
• ambulates with a wide base of gait with foot slab at heel contact

often watch feet as they walk

AKA gluteus maximus lurch

individual will throw hip backwards with a lurch using abdominal and paraspinal muscle activation just after heel strike on the affected side

also seen in dislocated hip and muscular dystrophy

major accelerators in swing phase

results in a limp starting during the stance phase at push off persisting throughout the swing phase of the affected side

person will demonstrate a trunk lurch backward and toward the unaffected side from push off to midswing

AKA tredelenberg gait

drop of the pelvis more than usual 5* on the unaffected side beginning with initial contact on the affected side and continuing until initial contact on the unaffected side

lateral excursion occurs on affected side

may compensate by laterally bending trunk to the affected side

most apparent during initial contact through the stance phase of gait

affected knee must be locked in hyperextension at or preceding initial contact by compensatory activity of the gluteus maximus extending femur and soleus which extends the tibia

repetitive hyperextension of the knee results in stretching of the ligaments and capsule of the knee and resultant recurvatum of the knee during the stance phase

results in loss of ankle plantarflexion control

foot off will be delayed and the push off phase will be decreased

AKA drop foot, slap foot, steppage gait

with mild weakness, the gait abnormality will be noted at heel strike and results in loss of plantarflexion control

loss of dorsiflexion produces a high knee lift to raise the foot clear off the ground

• cause
• Genetic: excess hip IR or Genu Valgus
• compromise of the medial longitudinal arch
• injury/weakness to tibialis posterior muscle

person tries to avoid pain associated with weight-bearing and ambulation

often quick, short and soft foot steps