Know Your Angles
What is the angle of the knee during initial contact?
5 degrees of knee flexion
Name this gait deviation
Backward Lean/Myopathic Gait
What does the body do to control the LE during initial contact?
hint: internal moment
Internal hip extension moment, internal knee flexion moment (brief), internal dorsiflexion moment
What muscle contraction occurs in the Gluteus Maximus and Adductor Magnus during initial contact?
Isometric contraction
What is the second highest torque demand in the gait cycle?
Loading Response at the Hip and Pelvis
What is the angle of the pelvis during MSt?
List 2 things a forward lean deviation is most likely to cause?
Limited trunk extension (ROM)
Secondary to excess hip flexion in WA or SLS (ROM)
Intentional to progress over an excessively plantarflexed ankle (ROM)
Intentional to reduce demand on the quadriceps (mm weakness)
Abdominal pain (pain)
Intentional to substitute visual input for impaired proprioception
Where is the vGRF acting on the right hip, knee and ankle during loading response?
Anterior to the hip joint, Posterior to the knee joint, Posterior to the ankle joint
What type of contraction is present in the FDL and FHB during terminal stance?
eccentric contraction
What phases do the initial and terminal double limb support occur?
Initial: IC and LR
Terminal: TSt and PSw
True or False: The angle of the hip at MSw is 15 degrees
False
Correct answer: 25 degrees
List 2 significances of the ipsilateral pelvic drop?
May decrease opposite stance limb stability
Increases the relative length of the reference limb
May result in back pain
increase energy cost
How does the vGRF act at the right hip, knee and ankle during terminal stance?
External hip extension and rapid decline in adduction moment, External knee extension moment, external dorsiflexion moment (peak)
Why do the iliopsoas, sartorial, iliacus, gracilis and adductor longus concentrically contract during the initial swing (ISw) phase?
These muscles contract to assist hip flexion
Define the terms step length, stride length and step width?
Step length is the distance measured between right heel strike and left heel strike
Stride length is the distance measured between two consecutive heel strikes on the same foot
Step width is the distance between parallel line intersecting the midpoint of the left and right heel
At what phases of the gait cycle is the ankle at a 0 degree angle/neutral?
IC,MSw and TSw
What is the knee wobble most likely to cause?
Quad hypertonicity
PF hypertonicity
Impaired proprioception
What are the knee muscle activity functional obligations?
1. shock absorption during weight acceptance
2. extensor stability for secure weight bearing during weight acceptance
3. rapid flexion for foot clearance
4. knee extension to ensure optimal limb advancement
What is the role and type of contraction of the FDL during mid stance (MSt)?
Isometric to maintain arch of foot and stabilize forefoot
True or False: When the asymmetry index=0, gait is perfectly symmetrical
True
List the angles of knee throughout all the phases of gait
IC-5 degrees, LR-15 degrees, MSt-5 degrees, TSt-5 degrees, PSw- 40 degrees, ISw-60 degrees, MSw-25 degrees, TSw- 5 degrees
What are the 2 significances of toes up?
May help with foot clearance
May cause skin irritation or callouses on the dorsum of the toes from rubbing against the shoe
What are the ankle muscle functional obligations?
1. shock absorption during weight acceptance
2. progression of body weight across foot
3. preparation for swing-facilitation of passive knee flexion
4. foot clearance
List 6 muscles involved in Loading Response and the type of contraction they undergo?
Glut. Max., Glut Med., Glut Min. (isometric)
Adductor Magnus, TFL (Isometric)
Biceps Femoris, Semitendinosus. & Membranosus.(isometric/hip)
Quadriceps (eccentric)
Ant. Tib.,EDL, EHL (eccentric)
Gastroc/Soleus, Tibialis Post., Peroneals, FDL
(All Late LR) (eccentric to control Ev/Pro)
Rectus Abd. (isometric)
What is the gait speed for a household walker, limited community walker and community walker?
<0.40 m/s, 0.40-0.80 m/s, >0.80 m/s