Gait Analysis Video Project. Allison Lee & Jessica O Leary ATPE 302 Fall 2005

Transcription

1 Gait Analysis Video Project Allison Lee & Jessica O Leary ATPE 302 Fall 2005

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4 Gait Cycle 34 frames total = 1.13 sec/frame 0% - Initial contact = 0 s/f 15% - Loading response = 6.78 s/f 3% - Mid-stance = 2.26 s/f * 15% - Terminal stance = 2.26 s/f * 15% - Pre-swing = 6.78 s/f * 15% - Initial swing = 6.78 s/f 4% - Mid-swing = 2.65 s/f 12% - Terminal swing = 5.65 s/f

5 Initial Contact Hip Hamstrings, adductor magnus, gluteus maximus Helps propel the body forward Gluteus Medius and Minimus and Tensor Fascia latae Helps control pelvic drop Knee Quadriceps Helps control rapid knee flexion Ankle Tibialis anterior and Extensors Helps control passive plantarflexion

6 Loading Response Hip Gluteus maximus, medius, tensor fascia latae, and hamstrings Spinal extensor muscles Helps decelerate forward lean of the trunk Knee Quadriceps Maximum activity Hamstrings Hip extensors Ankle Tibialis anterior and extensors Continuing to control passive plantarflexion Tibialis posterior Eccentrically controls rapid pronation of subtalar joint

7 Mid-stance Hip Hip abductors Gluteus Medius and Maximus Tensor Fascia latae Knee Gastrocnemius Increases the demand on the quadriceps Assists in knee flexion Soleus Helps control knee extension and stabilizes the tibia Quadriceps Inactive when knee is extended Ankle Plantarflexors are eccentrically contracted Gastrocnemius and Soleus Contract to slow the advancement of the tibia Tibialis posterior and Flexors Supinate the subtalar joint

8 Terminal Stance Hip Tensor Fascia Latae Helps prevents pelvic drop Hip flexors Prevents further extension Knee Gastrocnemius and popliteus Work together to resist hyperextension The popliteus helps unlock the knee and initiate knee flexion Ankle Plantarflexors At their peak activity level when the heel is lifted to help stabilize the ankle

9 Pre-swing Hip Iliacus and rectus femoris Initiate the swing Knee Gastrocnemius Knee flexor Rectus femoris Determines the amount of knee flexion Sartorius and gracilis Helps initiate knee flexion Ankle Helps with propulsion as a result of momentum

10 Initial Swing Hip Hip flexors Knee Sartorius, gracilis, and short head of the biceps femoris Flexion of the knee Ankle Tibialis anterior and Extensors Dorsiflex the foot to allow the toes to clear the ground

11 Mid-Swing Hip Hip Flexors Quadratus lumborum and thoracolumbar paraspinal Assist the abductors to prevent pelvic drop Knee Hamstrings and gracilis Controls the rate of knee extension Ankle Tibialis anterior and Extensors Still contracting, but with less force

12 Terminal Swing Hip Hamstring Decelerates hip flexion and knee extension Gluteus maximus, adductor magnus, and gleuteus medius Help with stabilization Knee Quadriceps and hamstrings Help provide smooth control of the knee Ankle Tibialis anterior and Extensors Help maintain a neutral position At peak activity level before the eccentric contraction that takes place at initial contact

13 Normal Joint Angles:STANCE Initial contact Loading response Midstance Terminal Stance HIP 30 flexion 30 flexion extension 10 hyperextension KNEE 0-15 flexion 15 flexion full extension 5 extension ANKLE 0 dorsiflexion to 10 plantarflexion Slightly plantarflexed 5 dorsiflexion 10 dorsiflexion

14 Joint Angles Initial contact Hip = 30 degrees Knee = 30 degrees Ankle = 5 degrees Loading response Hip = 15 degrees Knee = 13 degrees Ankle = 3 degrees

15 Joint Angles Mid-stance Hip = 15 degrees Knee = 10 degrees Ankle = 5 degrees Terminal stance Hip = 15 degrees Knee = 10 degrees Ankle = 7 degrees

16 Normal Joint Angles: SWING SWING Pre-swing Initial swing Midswing Terminal swing HIP flexion 10 degrees further 30 flexion KNEE 5-40 flexion flexion flexion to extension 30-0 extension ANKLE dorsiflexion 20-5 plantarflexion Neutral 3-5 plantarflexion

17 Joint Angles Pre-swing Hip = 0 degrees Knee = 60 degrees Ankle = 15 degrees Initial swing Hip = 25 degrees Knee = 40 degrees Ankle = 5 degrees

18 Joint Angles Mid-swing Hip = 25 degrees Knee = 17 degrees Ankle = 0 degrees Terminal swing Hip = 20 degrees Knee = 10 degrees Ankle = 7 degrees

19 Abnormalities Supination Caused by IR of tibia or femur Tight ER of hip Tight in the rearfoot Quick plantarflexion Slight foot slap Not enough dorsiflexion

20 Abnormalities Internal rotation of femur and tibia during swing Left more than the right Poor posture Slouched position Shoulders are rounded Forward lean position

21 Abnormalities During Weight Acceptance FOOT SLAP Causes: weak dorsiflexors, common peroneal nerve palsy, and/or peripheral neuropathy The name is derived from the slapping sound made by the forefoot hitting the ground

22 Abnormalities During Weight Acceptance FORWARD LEAN POSITION The primary muscle group responsible for controlling the forward lean is the hamstrings When an excessive forward lean occurs, the hamstrings require a greater muscle activation The excessive lean may also be due to weak quadriceps.

23 Abnormalities During Single Limb Support CONTRALATERAL DROP in pelvis This condition is also commonly known as Trendelenburg s Sign Cause: Weak gluteus medius during the stance leg When standing or walking, a drop in the pelvis can be seen

24 Abnormalities During Single Limb Support EXCESSIVE FLEXION of the knee Causes: Problems at the ankle or hip Pes calcaneus deformity, weak plantarflexion, and decreased hip flexion

25 Abnormalities During Swing Limb Advance HIP HIKE Causes: Leg length discrepancy, coxa valga, fracture of the femur Inability of the knee and/or ankle to clear the floor of the swing leg

26 Abnormalities During Swing Limb Advance EXCESSIVE PLANTARFLEXION Causes heel pain Crouched Gait

27 Abnormalities Tight Achilles Tendon Results in a bounce step because of limited dorsiflexion