Kin191 A.Ch.9. Evaluation Of Gait

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  • Kin191 A.Ch.9. Evaluation Of Gait

    1. 1. KIN 191A Evaluation of Gait
    2. 2. INTRODUCTION <ul><li>OBSERVATION TECHNIQUES </li></ul><ul><li>GAIT CYCLE </li></ul><ul><li>QUALITATIVE OBSERVATION OF GAIT </li></ul><ul><li>WALKING vs. RUNNING GAIT </li></ul><ul><li>COMPENSATORY GAIT DEVIATIONS </li></ul>
    3. 3. OBSERVATION TECHNIQUES <ul><li>Limb position </li></ul><ul><li>ROM </li></ul><ul><li>Speed of motion </li></ul><ul><li>Force production </li></ul><ul><li>Timing of each event in the gait cycle </li></ul>
    4. 4. GAIT CYCLE <ul><li>STANCE PHASE </li></ul><ul><ul><li>Initial contact: lateral surface of heel (strike) </li></ul></ul><ul><ul><li>Loading response </li></ul></ul><ul><ul><li>Midstance: entire foot on ground </li></ul></ul><ul><ul><li>Terminal stance </li></ul></ul><ul><ul><li>Preswing: just before toe off </li></ul></ul>
    5. 5. <ul><li>SWING PHASE </li></ul><ul><ul><li>Initial swing: immediately after toe-off </li></ul></ul><ul><ul><li>Midswing </li></ul></ul><ul><ul><li>Terminal swing: before heel strike </li></ul></ul>
    6. 7. Initial Contact <ul><li>Foot touches the supporting surface </li></ul><ul><li>Lateral aspect of the plantar surface of the heel </li></ul><ul><li>Opposite limb is ending with toe-off </li></ul><ul><li>Subtalar joint 5 ° supinated and talocrural joint is dorsiflexed </li></ul><ul><li>20% of the total gait cycle </li></ul>
    7. 9. Loading Response <ul><li>Loading response occurs immediately after initial contact </li></ul><ul><li>Talocrural joint plantar flexed and subtalar joint pronated  calcaneal eversion </li></ul><ul><li>Tibial internal rotation  subtalar pronation </li></ul>
    8. 11. Midstance <ul><li>Begins as the body weight moves directly over the stationary support limb </li></ul><ul><li>Talocrural joint continues to dorsiflex </li></ul><ul><li>Subtalar joint supinates  calcaneal inversion </li></ul><ul><li>Tibial external rotation/knee & hip joints move into extension </li></ul>
    9. 12. Midstance
    10. 13. Terminal Stance <ul><li>Begins as the center of gravity passes over the foot and ends just before the contralateral limb makes initial contact with the ground </li></ul><ul><li>Weight-bearing forces placed on the 1 st MTP joint </li></ul><ul><li>In preparation of the swing phase </li></ul>
    11. 14. Terminal Stance
    12. 15. Preswing <ul><li>Final period of the stance phase </li></ul><ul><li>Begins with the initial contact of the contralateral limb and ends with the toe-off of the stance limb </li></ul>
    13. 16. Preswing
    14. 17. SWING PHASE
    15. 18. Initial Swing <ul><li>Begins at the point when the toes leave the ground and </li></ul><ul><li>Continues until the knee reaches its maximum range of flexion ( ≈60°) </li></ul><ul><li>Pronation occurs at the subtalar joint at the beginning of the initial swing </li></ul>
    16. 20. Midswing <ul><li>Knee extends from the point of maximum flexion </li></ul><ul><li>Tibia reaches a vertical position </li></ul><ul><li>Talocrural joint into neutral position or into slight dorsiflexion </li></ul>
    17. 21. Midswing
    18. 22. Terminal Swing <ul><li>Final period of the swing phase </li></ul><ul><li>Occurs from the end of the midswing to the initial contact period of the stance phase </li></ul><ul><li>Supination occurs at the talocrural joint in preparation for initial contact </li></ul>
    19. 24. QUALITATIVE OBSERVATION OF GAIT <ul><li>Center of gravity: men is higher L1-L5, women S1-S2 </li></ul><ul><li>Position of the trunk </li></ul><ul><li>Position of the head </li></ul><ul><li>Movement/Symmetrical of limbs </li></ul><ul><li>Heel strike (initial contact) </li></ul><ul><li>Movement of arms </li></ul><ul><li>Movement of pelvis </li></ul><ul><li>Cadence </li></ul><ul><ul><li>Number of steps per unit of time </li></ul></ul>
    20. 25. WALKING vs. RUNNING GAIT <ul><li>Two distinct differences </li></ul><ul><ul><li>A flight phase during which neither foot is in contact with the supporting surface </li></ul></ul><ul><ul><li>No time are both feet in contact with the surface at the same time </li></ul></ul><ul><li>Stance phase </li></ul><ul><ul><li>Walking (62%) </li></ul></ul><ul><ul><li>Running (33% or depend on the speed) </li></ul></ul>
    21. 26. COMPENSATORY GAIT DEVIATIONS

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