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What is a linear or translatory motion produced by a series of rotary mvmts of the jts of the body?
locomotion
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What is the rhythmical, alternating mvmts of the limbs and trunk?
normal human locomotion
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What is a gait cycle?
point of initial heel contact of one LE to the point at which the heel of the same extremity contacts the ground again
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What is the stance phase of a gait cycle?
(heel strike)initial ground contact of one LE and comtinues until that LE is no longer in contact with the ground (toe off)
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What is the swing phase of a gait cycle?
instant from toe off until heel strikes the ground (or ground contact)
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What is double limb support?
when one limb is beginning stance and the other is ending stance
occurs twice in a gait cycle
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What is the distribution of the stance phase of a gait cycle?
60%
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What is the distribution of the swing phase of a gait cycle?
40%
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What is the distribution of the double support of a gait cycle?
20-22%
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What does RLA stand for?
rancho los amigos
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In traditional gait, what is the order of the stance phase?
- heel strike
- foot flat
- midstance
- heel off
- toe off
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In traditional gait, what is the order of the swing phase?
- acceleration
- mid swing
- deceleration
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In RLA, what is the order of the stance phase?
- initial contact
- loading response
- midstance (single limb support)
- terminal stance
- pre-swing
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In RLA, what is the order of the swing phase?
- initial swing
- mid swing
- terminal swing
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In RLA, what is the time period of inital contact until the opposite extremity is off the ground?
loading response
ends at foot flat, loading weight to other limb
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In RLA, what is the time frame from the end of midstance to initial contact of the opposite leg or heel (shifting weight)?
terminal stance
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In RLA, what is the time frame from initial contact of the opposite leg or heel to just before the toes leave the ground?
pre-swing
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What is the initial swing time fram of RLA?
begins when toes leave the ground until maximum knee flexion occurs
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What is the mid swing time frame of RLA?
from maximum knee flexion until tibia is vertical
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What is the terminal swing time frame of RLA?
from vertical tibia to just prior to initial contact
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What is stance time?
stance phase time of one leg during a gait cycle
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What is single support time?
time when one leg is supporting body weight during gait cycle
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What is double support time?
amount of time that both feet are one the ground during gait cycle
as speed increases, double support decreases
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What is the length from heel strike to heel strike of the same foot?
stride length
distance traveled during one gait cycle
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What is the time required to perform one stride length?
stride duration
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What is the distance from heel strike of one foot to heel strike of the opposite foot?
step length
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What is the time spent during a single step?
step length
on a weak or painful leg, the step duration may decrease
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What is cadence?
- number of steps per unit of time
- cadence= #steps/time
- shorter steps will increase cadence at any velocity
- slow walking= 70/min
- fast walking= 130/min
- running starts at 180
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What is the rate of change of velocity with respect to time?
acceleration
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What is the width of BOS?
from mid heel to mid heel
2-4 inches
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What is the normal degree of toe out?
7degrees
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What provides counterbalance with gait?
arm swing
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What is a painful gait called, and what are the causes?
antalgic gait
weakness, inflammation, injury, jt deformities
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What is vertical displacement of COG?
- lowest pt of COG during one gait cycle is during double support
- highest pt occurs at midstance
normal displacement is 2 inches
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What is lateral displacement of COG?
- horizontal displacement of COG as body weight shifts side to side
- greatest during the single support phase of gait at midstance
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What is horizontal dip of the pelvis?
- lateral pelvic tilt
- pelvic drops slightly on the NWB side during swing phase
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What muscles work to keep the pelvis level during gait?
- hip abductors contract on opposite side
- erector spinae group contracts on same side (swing leg)
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What is the normal amt of knee flexion during stance phase?
15-20 degrees
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What widens BOS, and results in little lateral motion of the body to be necessary to shift COG from one leg to another over BOS?
valgus at the knee
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What are some reasons why we analyze gait?
- determine nature and severity of condition
- provide basis for implemantation of ther ex program
- provide a basis for use of orthotics to improve walking pattern
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How does age affect gait?
- decrease speed
- shorter stride
- shorter step length
- longer duration of double support
- smaller swing to support phase ratio
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What effects does parkinsons disease (festinating gait) have on gait?
rigid and nonreciprocal
- increased cadence
- shorter stride
- lack of heel strike and toe off
- decreased arm swing
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What disorder causes a large BOS, balance and control problems,and large side-to-side deviations of COG?
ataxic gait (cerebellum disorder)
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What muscle weakness causes the pelvis to drop on the unsupported side when single leg support is on weak side?
gluteus medius gait (trendelenburg gait)
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What type of muscle weakness causes you to lean backward at heel strike?
gluteus maximus gait (rocking horse gait)
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What does quadricep weakness casue you to do?
lean forward
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What does plantarflexion weakness cause?
increased dorsiflexion and knee flexion
no heel rise during push off resulting in a shortened step length on the unaffected side
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What does dorsiflexion weakness cause?
increased hip and knee flexion or toe drag
decreased heel strike period, may result in foot slap or steppage gait
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What are some common causes of gait deviations?
- pain/discomfort
- m. weakness
- limitations of jt motion
- decreased coordination
- deformities of bone or soft tissue (amputees, contractures)
- instability (leg length discrepancy)
- psychological (not wanting to work, loss of motivation)
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What is the analysis of lateral trunk bending/trendelenburg?
gluteus medius gait, abductor lurch
- stance phase
- pt leans trunk over stance leg
- observe post./ant.
- -possible leg length discrepancy, weak gluteus medius and minimus
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What is the analysis of hip hiking?
quadratus lumborum does it
- swing phase
- hip is hiked during swing
- observe post./ant.
- -possible long extremity, ankle/knee are fused (knee immobilizer, OA), hamstring weakness
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What is the analysis of internal/external rotation?
all phases
- excessive intenal/external rotation of leg
- observe post./ant.
- -possible CVA=externally rotated, CP= internally rotated
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What is the analysis of cirumduction?
swing phase
- pt brings leg out and around
- observe post.
- -possible weak hip or knee flexors, knee or ankle fused (knee immobilizer, OA), leg length discrepancy
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What is the analysis of excessive medial (lateral) foot contact?
stance phase
- excessive weight medial/lateral
- observe post./ant.
- -possible inversion weakness, eversion contracture, genu valgum (medial), eversion weakness, inversion contracture, genu varum (lateral)
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What is the analysis of abnormal BOS?
swing and stance
- more/less than 2-4"
- observe post.
- -possible balance, tight abductors, genu valgum, obesity (wide), spasticity (holds together), tight adductors, genu varum (narrow)
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What is the analysis of anterior trunk bending?
stance
- forward lean of the trunk
- observe from side
- -possible quad weakness
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What is the analysis of posterior trunk bending?
- gluteus maximus gait/ extensor lurch
- stance
- pt hyperextends the trunk
- observe from side
- -possible weak gluts, and maybe hamstrings
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What is the analysis of hyperextended knee?
- back knee gait genu recurvatum
- stance
- hyperextended knee
- observe from side
- -possible quad weakness, plantar flexor contracture
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What is the analysis of inadequate dorsiflexion control?
- swing and stance foot slap
- foot flat
- toe drag
- observe from side
- -possible weak ant. tibia and dorsiflexors
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What is the analysis of insufficient push-off?
- stance, terminal, pre-swing
- drop off at end of stance
- no push off
- observe from side
- -possible fused ankle (cant plantarflex), sprained ankle, weak gastroc-soleus
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What is the analysis of vaulting?
involved side swing
- rise up on contralateral leg for clearance
- observe from side
- -possible swing limb too long, hip flexor weakness, knee fusion (wont bend)
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What is the analysis of excessive knee flexion?
- steppage gait - weak DF
- swing
- excessive hip and knee flexion
- observe from side
- -possible leg length discrepancy, anterior tibia weakness
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What is the analysis of abnormal arm motion?
swing and stance
- abnormal arm swing
- observe side, front, back
- -possible shoulder hurts, imbalance, may be excessive or none
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What is the analysis of abnormal pronation (supination) of the transverse tarsal jt?
stance
- cant accommodate to uneven surfaces (sand, stone)
- observe post.
- -possible osteoarthritis, arthritis
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What is the normal amt of toe extension during terminal stance?
35 degrees
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What is the normal amt of toe extension during pre-swing?
65 degrees
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