Evaluation 226

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Author:
wssokol
ID:
170638
Filename:
Evaluation 226
Updated:
2012-09-13 06:57:54
Tags:
Gait Assessment
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Description:
Exam One
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  1. The Gait Cycle - walking
    • wider stance
    • shorter stride
    • bipedal phase
    • no flight phase
    • approximately 60% stance phase
  2. The Gait Cycle - running
    • narrow stance
    • longer stride
    • never in a bipedal phase
    • airborne phase
    • approximately 30% stance phase
    • increased GRF
  3. Breakdown of Gait (walking)
    • Stance phase - often termed the "active phase"; accounts for 60% of gait, closed chain
    • Swing phase - often termed "recovery phase"; accounts for 40% of gait, open chain
  4. Initial Contact of stance phase
    • heel contacts with ground at lateral aspect
    • foot in supinated position (5 degrees)
    • gradual decent of foot as body weight shifted
    • Comprises of 20% of total gait cycle
  5. Loading Response in stance phase
    • eccentric contractions of lower leg and foot to decelerate and control foot motion
    • Ground Reaction Forces are absorbed here
    • Foot moves to a pronated position (10 degrees)
  6. Midstance of stance phase
    • body moves over the top of foot
    • foot is pronated but moves toward supination
    • ground contact moves from lateral foot to medial foot at the metatarsal heads
  7. Terminal Stance of stance phase
    • unipod to bipod transition at end of phase
    • continued supination with ground contact moving along the 1st ray
    • body ahead of foot with concentric contractions pushing it forward to begin another phase
  8. Preswing of stance phase
    • bipod phase as other foot continues with heel contact
    • ground contact is through the great toe
  9. Initial Swing of swing phase
    • muscle activity concentrates in thigh and hip as leg is lifted off ground
    • foot recovers from preswing and clears the ground
  10. Midswing of swing phase
    • mid-point of swing
    • momentum carries leg as foot prepares for inital contact with ground in next cycle
  11. Terminal Swing in swing phase
    • knee extends fully
    • foot is isometrically stabilized in supination awaiting heel contact
    • foot is in front of body once again
  12. Weight Bearing Static Assessment
    • hip width stance
    • assess rearfoot alignment
    • navicular height
    • 1st Ray alignment
    • Tibial alignment
  13. Non-Weight Bearing Static Assessment
    • Prone position - subtalar neutral, rearfoot and midfoot alignment, callus/blister/shoe wear
    • Seated position - navicular height, midfoot and toe alignment
  14. Ground Reaction Forces
    • May be horizontal or vertical
    • running can generate 2-3 times BW (the wider the stride, the greater the GRF)
    • GRF's affect soft and osseous tissues
  15. Acustep
    • records pressure distributions
    • requires assessment to still be done
  16. Static View of Gait Assessment
    • lateral, anterior, and posterior
    • hindfoot, forefoot, and toes
    • spacing of feet and toes
    • possibly check with squat
  17. Dynamic View of Gait Assessment
    • person's normal gait must be attempted
    • concentrate on Stance phase
    • limb position
    • ROM
    • speed of motion
  18. Biomechanical Process of Initial Contact
    • 5 degrees of supination at subtalar joint
    • eccentric dorsiflexors/Inactive plantarflexors
    • full knee extension
  19. Biomechanical Process of Loading Response
    • Movement to 10 degrees of pronation
    • Eccentric dorsiflexors/Concentric plantarflexors
    • Near flat foot
    • Center of gravity still behind foot
  20. Biomechanical Process of Midstance
    • Pronation ceases and movement back toward supination begins
    • Dorsiflexors and plantarflexors are isometric stabilizers
    • Majority of weight is at metatarsal heads
    • Center of gravity is above foot
  21. Biomechanical Process of Terminal Stance
    • Continued movement of supination with hindfoot
    • Dorsiflexors now inactive/Plantarflexors concentric
    • Ground contact mostly with met. heads and toes
  22. Biomechanical Process of Preswing
    • Mild supination continues
    • Weight transference at 80% great toe
    • Lift off from ground and into swing phase

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