USA - Neuromuscular I Gait Exam II

What is considered as forward walking which includes a series of losses and recoveries of balance?

Dynamic balance activity

(T/F) Anterior sway causes the bodies' center of mass to move forward and beyond the foot's location on the ground in order to prevent a fall, a forward step is taken and balance is regained.

True

What are 3 essential requirements of successful gait?

1. Progression
2. Stability
3. Adaptation

What term describes the ability to maintain upright posture against gravity and against perturbations during gait?

Stability

What term is described as the ability to alter the gait pattern to meet the demands of the environment?

Adaptation

What is the rhythmic patterns of muscle activation advance the body in the desired direction?

Progression

What components/functions are included in the progression requirement of successful gait?

The ability to initiate, terminate, and guide movement in a desired direction

(T/F) The 3 essential requirements of gait must be accomplished with maximum efficiency and maximum stress to the body.

False, must be accomplished with maximum efficiency and minimum stress to the body.

What is the period of time when the foot is on the ground and occupies 60% of the gait cycle?

Stance phase

What is also known as the stance phase?

Support phase

What are the sub-phases of stance phase?

1. Initial contact
2. Loading response
3. Mid-stance
4. Terminal stance
5. Pre-swing

What is described as the period of time when the foot is off the ground and occupies 40% of the gait cycle?

Swing phase

What is also known as initial contact in traditional terms?

Heel Strike

What is also referred to as loading response of the gait cycle in traditional terms?

Foot flat

(T/F) Terminal stance of the Rancho Los Amigos terminology is also referred to as foot flat in traditional terms.

False, terminal stance is also known as heel off

What is the pre-swing phase of the gait cycle also called in traditional terms?

Toe off

What are the sub-phases of the swing phase?

1. Initial swing
2. Mid-swing
3. Terminal swing
4. Double support
5. Single support

The Initial swing of the the swing phase is also called _________ in traditional terms.

Acceleration

What is the terminal swing of the swing phase also referred to as in traditional terms?

Deceleration

When does the double support phase of the swing phase occur?

Takes place during the first (initial contact and loading response) and the last (pre-swing)

What occupies 10% of the stance phase?

Double support phase

What phase of gait occurs when the opposite limb is in swing phase?

Single support

During initial contact of the stance phase, what is the normal range of motion of the ankle and knee?

0 degrees

(T/F) During the loading response of stance phase, the ankle undergoes 0-35 degrees of dorsiflexion.

False, 0-15 degrees of plantar flexion

What joint experiences 30 degrees of flexion during both the initial contact and loading response of the stance phase?

Hip

What rotates forward 5 degrees during the initial contact and loading response of the stance phase?

Pelvis

What is controlled during the loading response of the stance phase?

The knee and ankle motion

Single limb support is composed of what components/phases of the gait cycle?

Mid-stance, terminal stance, pre-swing

(T/F) During mid-stance the pelvis rotates 5 degrees.

False, 0 degrees

What does the pelvis do during terminal stance?

5 degrees of backward rotation

During pre-swing, the knee flexes _________.

0-35 degrees

What motion are the toes in during terminal stance?

0-30 extension

(T/F) The ankle undergoes 15 degrees of plantar flexion to 10 degrees of dorsiflexion

True

The ankle moves _________ during the pre-swing phase.

0 - 20 degrees plantar flexion

Describe the motion of the ankle during terminal stance.

10 degrees of dorsiflexion to 0 degrees (neutral)

Describe the motion of the hip during terminal stance.

0 - 10 degrees of extension

What is a critical element/function of mid-stance?

Ankle rocker to pull the body up and over

During terminal stance, what occurs that is essential for successful gait?

Ankle is locked with heel rise and hip in extension

(T/F) The pre-swing phase of gait passively flexes the knee

True

What is the swing phase composed of?

Initial swing, mid-swing, and terminal swing

The pelvis ________ during the initial swing of the swing phase.

Rotates backwards 5 degrees

(T/F) The hip extends from 10 - 30 degrees during Mid-swing.

False, the hip undergoes 20-30 degrees flexion

Describe the motion of the hip during terminal swing of the swing phase.

30 degrees flexion

The pelvis experiences ________ during terminal swing of the swing phase.

5 degrees forward rotation

During swing phase of the gait cycle is the knee flexed, extended, or both?

35-60 degrees flexed during initial swing, 60 - 30 degrees flexed during mid-swing, and 30 - 0 degrees flexed during terminal swing

Describe the motion of the ankle during initial swing of the swing phase.

20-10 degrees plantar flexion

What is the motion of the ankle during mid-swing of the swing phase?

10 degrees plantar flexion to 0 degrees (neutral)

What is the step length of gait?

The distance from the initial contact of one foot to initial contact of the other foot.

What is considered as the distance covered from initial contact of one foot to the following initial contact by the same foot?

Stride length

What is the step width of normal gait?

Horizontal distance between the middle heel of one foot and the middle heel of the opposite foot

What is the term used to describe the number of steps per unit of time?

Cadence

(T/F) Gait Velocity/Speed is the average horizontal speed of the body

True

(T/F) A person's preferred walking speed is at his/her point of minimal energy expenditure with swing phase which requires very little energy expenditure

True

What are the directional displacements of the body's COM during normal gait?

1. Vertical
2. Medial-lateral

Referring to vertical displacement, where should maximal height occur and minimal height occur?

Max: Mid-stance
Min: Double limb support phase

Maximal displacement to the left during gait occurs during _________, while the right maximal displacement occurs during _________.

Left LE mid-stance, right LE mid-stance

What is the amount of dorsiflexion needed to prevent toe drag during mid-swing?

o (neutral)

What phase of gait requires the most ankle dorsiflexion?

Terminal stance

What can occur at the loading response phase with weak quadriceps?

Knee buckle

What issues can result from weak hip flexors?

1.Shortened step length
2. Limb advancement and knee flexion limited in swing phase

What are the 2 outcomes that would occur with tight plantar flexors?

Flat foot at initial contact and toe drag during mid-swing

What is the resultant gait pattern for weak hip extensors?

Forward trunk lean during stance phase

What is the result during swing phase if you have a stiff-knee gait pattern?

Toe drag

What compensations might you observe to clear the toe in swing phase?

Circumduction on the ipsilateral side, vaulting on the contralateral side, contralateral trunk lean

What compensation would you see for a trendelumburg gait pattern occurring on the left?

Trunk lean to the left due to ipsilaterally weak left hip abductors causing right pelvis to drop

What do you observe when someone is compensating for weak hip extensors?

Result is forward trunk lean and the compensation is posterior trunk lean

What compensatory gait pattern will occur for flaccid ankle during swing phase?

Steppage

What is the critical event for initial contact?

Heel strike

Controlled knee and ankle motion is important at what phase of gait?

Loading response

Locked ankle with heel rise and hip extension occurs during _________.

Terminal Stance

What are the critical elements for initial swing?

Hip flexion and knee flexion (60 degrees)

What does the ankle act as during mid-stance to help translate the body forward?

A Rocker