Gait kinematics

1. Distinguish between kinematic and kinetic measures of walking, and list the types of data obtained from the two approaches to gait analysis.

2. Name the phases of the gait cycle, and the beginning and ending point of each phase.

3. Describe the vertical and lateral displacements of the body's center of gravity (COG) during ambulation.

4. Explain how movements at the pelvis, lower extremity, hip, knee, ankle, and subtalar joints interact during stance
   • to conserve energy by minimizing the COG's vertical displacement.

   • to protect one from injuries that might otherwise result from the repetitive stresses that occur during gait.

5. Use an observational checklist to describe the gait patterns of videotaped subjects.

6. Explain how therapists can maximize the reliability of observational gait analysis.

7. List and define the distance and time measurements involved in stride analysis, and calculate them in a patient using simple stride analysis techniques.

8. List the maximum values for normal pelvic, hip, knee, and ankle motion and the corresponding gait events at which they occur.

Gait kinetics

1. Explain ground reaction forces and their effect on joint motion during each phase of the gait cycle.

2. Describe normal activity in the major trunk and lower extremity muscle groups during each phase of the gait cycle and explain how it contributes to stability, efficiency, or propulsion.

3. Identify and state possible reasons for these common gait deviations:
   • foot slap
   • foot flat contact
   • excessive toe-out during stance
   • knee hyperextension in stance
   • inadequate knee flexion in swing
   • forward trunk lean
   • backward trunk lean
   • lateral trunk lean
   • asymmetrical step length (decreased stance phase)

4. Predict the gait deviations that may result from decreased strength in the:
   • ankle plantar flexors
   • ankle dorsiflexors (pretibial muscles)
   • knee extensors (quadriceps)
   • knee flexors (hamstrings)
   • hip extensors (esp. gluteus maximus)
   • hip flexors (esp. iliopsoas)
   • hip abductors (esp. gluteus medius and minimus)

5. Predict the gait deviations that may result from decreased active or passive range of motion in the pelvis or any lower extremity joint.

Principles of lower extremity orthoses

Describe the orientation of the subtalar joint axis and the joint's triplane motion in either open or closed chain activities.

Describe and perform two static methods of estimating the subtalar joint's neutral position with the person positioned in prone.

Describe the structural foot deformities called rearfoot varus, forefoot varus, and forefoot valgus. Describe the compensations that people make when they display the deformity, the consequences for the compensations, and the type of orthotic insert that is intended to eliminate the compensations.

Describe how ankle equinus (either a structural or soft-tissue limitation in passive ankle dorsiflexion) leads to compensatory pronation during stance. Describe the consequences of the compensatory pronation, and suggest treatment approaches to eliminate the need for the compensation.

Explain the biomechanical reasons why an ankle-foot orthosis (AFO) can substitute for weak plantar flexors when a person walks. Explain why an AFO may be ineffective in substituting for weak plantar flexors if its ankle is hinged or articulated.

Explain how alterations in an AFO's design can influence the knee joint's motion when a person walks.

Changes in the gait pattern across the lifespan

1. Desribe the changes that normally occur in the gait pattern over a person's lifespan.

Energy and power during the gait cycle

1. List the major points in the gait cycle at which energy is generated or absorbed by the lower extremity muscles, as illustrated by energy and power analysis.

2. Given a power curve for the hip, knee, or ankle, distinguish between periods of eccentric and concentric muscle activity during the gait cycle, and infer which muscles might be active during each period.

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Last updated 4-15-02 ©Dave Thompson PT
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