Gait - gait PDF

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Worksheet - Week 27 Sheet 1 – ‘Stance phase of gait’ Name the joints in the lower limb involved in this activity, including those in the foot. Hip, Knee, inferior and superior Tib.fib joints, Ankle, Subtalar, Midtarsal joints ,MetaTarsal Phanalngel joint, Inter Phalangel joint Name what movement is occurring at the hip joint. Flexion to extension Estimate in degrees the angle that the hip starts and finishes. Approx. 30degrees flexion to 30-40 degrees of extn. Identify the muscle groups for bringing about this movement and identify the prime mover. Flexors of hip-Iliopsoas, Rectus Femoris ,Sartorious, (Pectinus and Gracilis) (Prime mover= Iliopsoas) Stance phase of gait involves standing on one leg; explain how this is an example of a 1st class lever.

Effort=Abductors of the standing (supporting) leg Fulcrum=Hip joint of the standing leg Resistance= Gravity acting over the opposite (unsupported leg). Name the attachments of Gluteus Medius. Name the actions of Gluteus Medius. Gluet Medius – O = Underneath iliac crest,

I = greater trochanter

Actions = abduction, medially rotation, When standing on one leg, if no medial rotation is seen to occur, why might this be. Because the lateral rotators (gluet med & min) on the supporting leg cancel this action out as they are true neutraliser. They work isometrically. What type of contraction is Gluteus Medius performing when standing on one leg. Define this type of muscle contraction. Isometric. This is when the joint angle and muscle length do not change during contraction

At initial contact, what is the prime mover holding the ankle in dorsiflexion? Name the attachments of this muscle. Dorsiflexors- Tibalis anteria , Extensor Hallious Longus ,Extendsor Digitorium Longus and Peroneus tertius.( Prime mover= Tib Ant) Explain the range this muscle is in throughout the stance phase of gait. Inner to midrange to outer range What axes and planes do the movements of dorsifexion and plantarflexion occur in. Sagittal plane / frontal axis. How is the calcaneum an example of anatomical torque? (T equation =Force × perpendicular distance). The insertion point position of Tendo Achilles (i.e posterior tuberosity of calcaneum) moves the point of application of the tendon away from the axis of movement of the ankle joint. This has the effect of increasing the effort arm of the calf muscles. Since Torque = Fx d [perpendicular distance from axis of movement] then to move any given load calf muscle needs to generate less torque ) Give the attachments of Gastrocnemius. O = medial and lateral epicondyle of the femur I = calcaneous via achillies tendon Put Gastrocnemius into a position of passive insufficiency. Dorsiflxing the ankle with the knee fully extended to/ test the ROM of ankle or flexibility of the gastroc. The hamstrings are a two joint muscle; explain the range they are working in during stance phase – do they maintain an optimal length/approach insufficiency. Outer to midrange. Give an example of a stabiliser in the stance phase of gait. Abductors working to maintain the stability of the pelvis.

Explain what you understand by origin to insertion reversed and give an example in the stance phase of gait. From foot flat to mid stance to the beginning of heal off stage- Dorsiflexion occurs at the ankle. This happens in closed kinetic chain, where the foot is fixed and the tibia moves forward

Worksheet - Week 27 Sheet 2 – ‘Swing phase of gait’

Name the joints in the lower limb involved in this activity, including those in the foot. Hip, Knee, Tib.fib joints, Ankle, Subtalar, Midtarsal joints ,MTP,IP Name what movement is occurring at the knee joint and approximately what angle the knee joint is in. Flexion to extension From initial swing to terminal swing: Approx.20 to 90 degrees of flexion and back to full extension at knee occurs. What axes and planes do these movements occur in. Sagittal plane / frontal axis. Identify the muscle groups for bringing about this movement. Flexion-Hamstrings and Extension-Quadriceps Name the muscles that make up the hamstring muscle group and name the attachments of Biceps Femoris. Refer to the notes/book. Name all the actions of the Hamstrings. Extension at hip, Flexion at knee and Medial rotation lateral rotation at knee when it is in flexed position. During flexion of the knee at the start of swing phase the hamstrings are an example of helping neutralisation – define this term and explain this example. All three hamstring muscles are agonists for this movement, but the biceps femoris is also a lateral rotator of the knee via its attachment to the head of fibula while the semimembranosis and semitendinosis are medial rotators of the knee from their attachments to the tibia. Where only knee flexion is required, the semimembranosis and semitendinosis working with biceps

femoris to cancel out the rotation to just leave knee flexion. They are all therefore agonists for knee flexion but are also helping neutralisers for knee rotation During flexion of the knee at the start of swing phase the hamstrings are an example of a 3rd class lever – define this term and explain this example.

Fulcrum=Knee joint of the swing leg Effort=Insertion of Hamstrings (Medial tibial condyle and fibula head) Resistance= Gravity/wt acting over lower leg. What type of muscle contraction are the hamstrings making at the end of swing phase to decelerate the knee? Define this type of muscle contraction. Eccentric contraction. What do the terms internal and external torque mean and how are they related with reference to type of muscle contraction. Isometric-Internal torque= external torque Concentric-Intrinsic torque ˃ extrinsic toque Eccentric - extrinsic toque ˃ Intrinsic torque What attaches to the navicular tuberosity? Tibialis Posterior What are the actions of this muscle. Inversion and also help plantaflexion. Using an example around the ankle define and demonstrate an example of neutralisation identifying if it is true or helping. (Helping neutraliser = a muscle/group of muscles that prevents unwanted action of the agonist but ALSO contributes to the desired action of the agonist). e.g while doing dorsiflexion at ankle- Tib Ant being invertor by itself can prevent the opposite unwanted eversion happening. Peroneus tertius prevents unwanted inversion but both these muscles help with the wanted dosiflexion and hence act as the helping neturalisers.

(True neutraliser = muscle/group of muscles that prevents an unwanted action of the agonist and but does NOT contribute to the desired action of the agonist) e.g while inverting the foot-Tibialis anterior is the main invertor. It will also tend to doriflex the ankle, however this is not happening in the example and hence the dorsiflexion action of Tib Ant is been cancelled by the opposite group plantar flexors(i.e Gastroc/Soleus) but gastroc do not help with wanted movment i.e inversion of foot,hence act as True Neutraliser.

Identify what range the EHL muscle is in during swing phase of gait. Inner to mid range....