Walking Quiz PDF

**Outline normative values for walking** - Stride duration: ≈1.1s/stride - Stance/swing time: 60/40% gait cycle - Double/single support time: 20/80% stride time - Cadence: ≈110 step/min - Velocity: 70-90m/min (4.2-5.4 km/h)  - Step length: ≈1/3 height (60-65 cm)  - BOS: ≈2-12 cm...

**Outline normative values for walking** - Stride duration: ≈1.1s/stride - Stance/swing time: 60/40% gait cycle - Double/single support time: 20/80% stride time - Cadence: ≈110 step/min - Velocity: 70-90m/min (4.2-5.4 km/h)  - Step length: ≈1/3 height (60-65 cm)  - BOS: ≈2-12 cm between heels - Toe out: ≈7 deg **Outline the different phases (initial contact, loading response....) of the gait cycle, muscle actions and joint movements involved in each.** +-----------------------------------+-----------------------------------+ | **Phases of gait** | **Muscles active ** | +===================================+===================================+ | *Initial contact* | Hip extensors, knee flexors and | | | extensors, ankle dorsiflexors  | +-----------------------------------+-----------------------------------+ | *Loading response* | Knee extensors working | | | eccentrically and eccentrical | | | control of dorsiflexors | +-----------------------------------+-----------------------------------+ | *Mid-stance* | Ankle plantar flexors working | | | eccentrically and knee flexors | | | | | | \*often a lot of pts hyperextend  | +-----------------------------------+-----------------------------------+ | *Terminal stance* | knee flexors and ankle plantar | | | flexors stretch | | | | | | - This stage is important for | | | swing phase  | +-----------------------------------+-----------------------------------+ | *Pre-swing* | Hip flexors and dorsiflexors to | | | clear the foot  | +-----------------------------------+-----------------------------------+ | *Initial swing* | Mainly dorsiflexors active + hip | | | flexors | +-----------------------------------+-----------------------------------+ | *Mid swing * | Hip extensors, dorsiflexors and | | | knee flexors working | | | eccentrically to slow down foot | | | in preparation for heel contact | +-----------------------------------+-----------------------------------+ | *Terminal swing* | Heel strike- ankle dorsiflexors, | | | knee extensors, knee flexors, hip | | | extensors | +-----------------------------------+-----------------------------------+ **Outline how specific impairments could affect each phase of the walking cycle ** **[Initial Alignment]** **Missing essential components** **Adaptive strategies /compensations** **Possible underlying impairments ** ---------------------------------- ----------------------------------------------------- ------------------------------------------------------------------- Decrease R ankle dorsiflexion  Decreased PF length (contracture/spasiticity) Hips NOT neutral rotation Hips externally rotated bilaterally (increased BOS) Weak hip int rot + hip add/short ext rotations + hip abd/balance  Uneven BOS (weight shifted to L) Balance (sensory issues) + weak R LL **[Stance ]** +-----------------------+-----------------------+-----------------------+ | **Missing essential | **Adaptive strategies | **Possible underlying | | components** | /compensations** | impairments ** | +=======================+=======================+=======================+ | Lack of dF on initial | | Weak dF (ecc control) | | contact  | | pF contracture) | +-----------------------+-----------------------+-----------------------+ | Lack of knee flexion | Knee hyperextension | Weak R LL + impaired | | on loading response  | | balance (sensory | | | | issues) Weak dF (ecc | | | | control) | +-----------------------+-----------------------+-----------------------+ | Decreased | Trunk included | Decreased | | dorsiflexion through | forward during stance | dorsiflexion pF | | stance  | (hip F)  | length | | | | (contracture/spastici | | | | ty) | +-----------------------+-----------------------+-----------------------+ | Lack of appropriate | Trunk incline forward | Decreased | | knee | during stance (hip F) | dorsiflexion pF | | extension/flexion | | length length | | through stance | | | +-----------------------+-----------------------+-----------------------+ | Decreased hip | Increased time Iin | Short hip F / short | | extension (end | double support/quick | pF | | stance) | step with L leg | | +-----------------------+-----------------------+-----------------------+ | Lack of knee flexion | Short step length  | Weak knee F | | prior to push off | | | | | Circumduction | | +-----------------------+-----------------------+-----------------------+ | Lack of pF at | Increase hip flexion | Short hip F / weak | | push-off | ++ in swing to clear | ankle pF / decreased | | | leg  | dorsiflexion pf | | | | length | +-----------------------+-----------------------+-----------------------+ **[Swing ]** +-----------------------+-----------------------+-----------------------+ | **Missing essential | **Adaptive | **Possible underlying | | components ** | strategies/compensati | impairments** | | | ons ** | | +=======================+=======================+=======================+ | Decreased knee | Excessive hip flexion | Insufficient push off | | flexion (initial | | due to weak and/or | | swing) | | short PF  | | | | | | | | Short hip F | | | | | | | | Wea hip F | +-----------------------+-----------------------+-----------------------+ | Appropriate hip F (he | Elevation of the | Impaired clearance | | has too much) | pelvis and abduction | mechanisms at ankle | | | of the leg | due to weak ankle | | | | dorsiflexors + short | | | | pF | | | | (contracture/spastici | | | | ty) | | | | | | | | Weak hip contract abd | | | | and or knee flexion | | | | and/or Df | +-----------------------+-----------------------+-----------------------+ | Decreased knee | Terminal swing with | Lack of control of | | extensions prior to | knee flexed | hip F  | | heel strike | | | | | | Lack of control (knee | | | | F/knee E) Co | | | | contraction | | | | | | | | Weak knee E | +-----------------------+-----------------------+-----------------------+ | Lack of ankle dF | Terminal swing with | Weak quadriceps | | prior to heel strike | knee flexed | and/or hamstring | | | | (decreased ecc | | | | control weak dF/tight | | | | pF) | +-----------------------+-----------------------+-----------------------+