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What are temporal characteristics of gait?
- - velocity
- - cadence
- - step time
What are spatial characteristics of gait?
- - step length
- - step width
- - stride length
- - foot angle
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
What are the three parts of swing phase?
- - acceleration (initial swing)
- - midsing- swinging limb overtakes limb in stance
- -deceleration- terminal sswing
How big should your BOS be when you walk?
How much velocity and medial lateral displacement should we experience when we walk?
How many steps does it take until a steady state walking speed is reached?
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
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)
How do you know if there is inadequate DF control in stance phase (heel contact)?
- foot slap
How do you know if there is inadequate DF control in swing phase (mid swing)?
- toe drag
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!
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
What is the main limitiation of gait retraining?
- - requires many therapists
- - can be injured
- - often limited due to therapists endurance
- - time consuming
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?
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
What muscle is used a great deal in running?
- hip flexor
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
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
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
What do you need to do with gait retraining?
- - dcide main problems
- - possible causes
- - possible intervention
What would you like to do?
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