2 - Gait Deviations Flashcards
Define Gait Deviations
common movement observations that are observed in individuals who have an atypical gait pattern.
Using the combination of different gait deviations, the physical therapist can predict an indibidual’s ___ based on understanding pattterns of gait patterns related to particular impairments.
impaired body function or structure
Different gait deviations are identified best in specific
planes of motion.
For efficient gait analysis, the therapist should organize the analysis around ____ observations and ___ observations
frontal and sagittal plane
The analysis of gait should being from a ___ perspective followed by a ___ perspective.
Broad followed by detailed.
Match the broad plane deviation with the plane:
Inability to control multiple DOF
a) Frontal Plane
b) Sagittal Plane
c) A and B
C) A and B
Match the broad plane deviation with the plane:
Asymmetry in walking pattern
a) Frontal Plane
b) Sagittal Plane
c) A and B
c) A and B
Match the broad plane deviation with the plane:
Limited step width
a) Frontal Plane
b) Sagittal Plane
c) A and B
a) Frontal Plane
Match the broad plane deviation with the plane:
Excessively large step width
a) Frontal Plane
b) Sagittal Plane
c) A and B
a) Frontal Plane
Match the broad plane deviation with the plane:
Insufficient step length
a) Frontal Plane
b) Sagittal Plane
c) A and B
b) Sagittal Plane
Match the broad plane deviation with the plane:
Slow or fast pace
a) Frontal Plane
b) Sagittal Plane
c) A and B
b) Sagittal Plane
Match the broad plane deviation with the plane:
Excessive positive foot progression angle
a) Frontal Plane
b) Sagittal Plane
c) A and B
a) Frontal Plane
Match the broad plane deviation with the plane:
Slow or rapid cadence
a) Frontal Plane
b) Sagittal Plane
c) A and B
b) Sagittal Plane
Match the broad plane deviation with the plane:
Insufficient positive foot progression angle
a) Frontal Plane
b) Sagittal Plane
c) A and B
a) Frontal Plane
Match the broad plane deviation with the plane:
Negative foot progression angle
a) Frontal Plane
b) Sagittal Plane
c) A and B
a) Frontal Plane
Define Inability to simultaneously control multiple degrees of freedom
excessive or limited variability is identified throughout the gait pattern.
Define Asymmetry in walking pattern
differences in timing or amplitude of motion between right and left side.
Define Excessively large step width
the interfoot distance is greater than expected
Define Excessively narrow step width
the interfoot distance is smaller than expected
Define Excessively positive foot progression angle
the toe out position is greater than expected given the age of the individual
Define Insufficient positive foot progression angle
the toe out position of the individual is less than expected given the age of the individual, but is not a toe in position.
Define Negative foot progression angle
the individual has a toe in position during stance phase.
Define Insufficient step length
step length is less than expected given the individuals age.
Define slow pace of walking
the individual walks with a slower gait speed than expected given their age.
Define fast pace of walking
the individual cannot control their pace of walking.
Define slow cadence
there is less number of steps per minute than expected.
Define fast cadence
there is greater number of steps per minute than expected
If the individual has greater motion than you’d expect for the given phase - it is described as
excessive motion
If the individual has less motion than would be expected for that phase, it is described as
insufficient motion.
Define Forefoot Contact. In what phase does it occur?
the forefoot touches the ground prior to the midfoot or hindfoot at initial contact.
Define Flatfoot Contact. In what phase does it occur?
the midfoot touches the ground at the same time as the hindfoot at initial contact.
Define Foot Slap contact.
uncontrolled, rapid plantarflexion following heel first contact; usually related to audible slap.
Define Excess plantarflexion. In what phase COULD it be seen?
when there is greater plantarflexion than would be expected given the phase of walking.
Could be seen at loading response with the tibia backwards in knee hyperextension.
Define Excess dorsiflexion. In what phases COULD it be seen?
when there is greater dorsiflexion than would be expected given the phase of walking.
Could be seen in stance phases; loading response, mid stance, terminal stance. Tibia is angled forward in these phases.
Define Excess Inversion.
when the calcaneus is inverted.
Define Excess Eversion.
when the calcaneus is everted. (seen in stance and swing phase)
Define Heel off. In what phases is it seen?
when the heel is off the ground during LR and MSt (IC too?)
Define No heel off. In what phases can it be seen?
when the heel is on the groun during TSt and PSw.
Define Drag. In what group of phases can it been seen?
when the foot touches the ground during SLA.
Define Contralateral Vault. In what group of phases can it be seen?
when the contralateral limb rises up onto the toes during SLA to clear the reference limb
Define Limited knee flexion. In what phases COULD it be seen?
when there is less knee flexion than would be expected given a particular phase of gait.
Seen at loading response, preswing, initial swing, and midswing.
Define Knee hyperextension. In what phases can it be seen?
knee extension is greater than 0 during any stance phase.
Seen at Weight Acceptance: Initial Contact and Loading response, and Single Limb Support: Midstance and Terminal Stance
Define Extensor Thrust. At what phase is it seen?
forcefull knee extension
Seen at weight acceptance, if didnt use then would fall into knee flexion.
Define Excessive knee flexion. In what phases could it be seen?
greater knee flexion than would be expected given a particular phase of gait.
Seen in Stance Phases: Initial Contact, Loading Response, Midstance, and Terminal Stance
Define Knee wobble. In what group of phases can it be seen?
is a jerky motion in the sagittal plane (flexion/extension).
Seen in Stance Phases: Initial Contact, Loading Response, Midstance, and Terminal Stance
Define Knee Varus. In what plane is it observed?
is varus position (excessive lateral angulation) of the knee joint observed in the frontal plane.
Define Knee Valgus. In what plane is it observed?
is a valgus position (excessive medial angulation) of the knee joint observed in the frontal plane.
Can be seen in all phases but apparent in stance.
Define Excessive contralateral knee flexion. In what phase is it observed
knee flexion is greater than would be expected during stance in the limb contralateral to the reference limb, when the reference limb is in SLA.
Define limited hip flexion. In what phases could it be seen?
less hip flexion than would be expected is occurring during a specific phase of gait.
Seen in Initial Swing, Midswing, Terminal Swing, Initial Contact, Loading Response.
Define excess hip flexion. In what phase could it be seen?
more hip flexion than would be expected is occurring during a specific phase of gait.
(insufficient hip extension at terminal stance)
Define past retract. In what phase IS it seen?
observed during terminal swing where there is first excessive hip flexion followed by rapid backward motion of the thigh.
Define internal hip rotation. Where should you look for further reference and at what phase?
the patella is facing medially during walking
look for internal foot progression angle and patella at loading response
Define external hip rotation.
the patella is facing laterally during walking.
look for internal foot progression angle and patella at loading response
Define Hip adduction. In what phase COULD it be seen?
observation that the thigh is adducted more than a neutral position.
Seen during swing limb advancement. “Scissoring”
Define Hip abduction. In what phase COULD it be seen?
observation that the thigh is abducted more than a neutral position.
Seen during swing limb advancement. “circumduction”
Define Pelvic Hike. In what phase COULD it be seen?
elevation of one side of the pelvis
Seen during swing limb advancement.
Define Ipsilateral pelvic drop.
downward motion of the pelvis in the reference limb greater than would be expected given the phase of gait.
Define Contralateral pelvic drop. In what phases COULD it be seen?
downward motion of the pelvis in the limb contralateral to the reference limb greater than would be expected in the given phase of gait.
Seen in phases of single leg stance
A contralateral pelvic drop is due to a weakness in the ipsilateral/contralateral ___
ipsilateral (reference limb) gluteus medius
Define posterior pelvic tilt. What does it do to the lumbar spine?
tilting of the pelvis such that there is a flattening of the lumbar spine.
Define anterior pelvic tilt. What does it do to the lumbar spine?
tilting of the pelvic such that there is greater lumbar lorodsis.
Define Lacking forward pelvic rotation. What phases have forward pelvic rotation?
the observation that there is less forward pelvic rotation than would be expected given that phase of gait.
Initial Contact, Loading Response, Terminal Swing
Define Lacking backward pelvic rotation. What phases have backward pelvic rotation?
the observation that there is less backward pelvic rotation than would be expected given that phase of gait.
Terminal Stance, Preswing, Initial Swing
Define Excessive forward/backward pelvic rotation. In what phases COULD it be seen?
the observation that greater forward or backward rotation would be expected given that phase of gait.
Excessive backward rotation seen in terminal stance and excessive forward rotation seen in initial contact and loading response.
Define backward trunk lean.
observation that the trunk is leaning backward compared to vertical.
Define forward trunk lean.
observation that the trunk is leaning forward compared to vertical.
Define lateral trunk lean. In what phase COULD it be seen?
leaning of the trunk to the side compared to vertical.
Seen during stance phase.
Define Trunk rotating forward.
rotation of the shoulder forward more than would be expected given that phase of gait.
Define Trunk rotating backward. In what phase COULD it be seen?
rotation of the shoulder back more than would be expected given that phase of gait.
Seen during swing limb advancement.
In what phases could you indicate a forefoot contact?
Initial Contact
In what phases could you indicate a foot flat contact?
Initial Contact
In what phases could you indicate a Heel Off?
In phases where the heel is typically on the ground: Loading Response and Midstance.
In what phases could you indicate No Heel Off?
In phases where the typically the heel is off the ground: Terminal Stance and Preswing
In what phases could in indicate Drag?
In phases where the foot is off the ground: Initial Swing, Midswing, Terminal Swing
In what phases could you indicate Contralateral Vaulting?
In phases where the reference swing limb is being advanced: Preswing, Inital Swing, Midswing, Terminal Swing
In what phases could you indicate Limited Knee Flexion?
In phases where there is knee flexion: Loading Response, Preswing, Initial Swing
In what phases could you indicate Excess Knee Flexion?
Throughout the gait cycle.
What Knee deviations typically interefere in stance phases? (4)
- Wobbles
- Hyperextends
- Extensor Thrust
- Varus/Valgus
In what phases could you indicate Excess Contralateral Knee Flexion?
In phases of Swing Limb Advancement of the reference limb.
How would you indicate limited hip extension?
Excessive hip flexion.
What is the only phase which you can indicate past/retract?
Terminal Swing
Which phases can IR/ER, Adduction/Abduction be observed?
Any phase of the gait cycle except initial contact.
In what phases can you indicate Pelvic hike and why?
SLA because it is a way to clear the swing limb.
In what phases could you indicate Tilt: P/A?
In all phases of the gait cycle except initial contact.
In what phases could you indicate Lacks Forward Rotation?
Phases with forward rotation: Loading Response Terminal Swing.
In what phases could you indicate Lacks Backward Rotation?
Phases with backward rotations: Terminal Stance, Preswing, Initial Swing
Which of the following is considered atypical for a 20 year old individual?
a) Symmetrical walking pattern
b) Gait speed = 1.39 m/s
c) Foot progression angle = 0
d) Step Width = 5cm
c) Foot progression angle = 0
An individual contacts the ground with only the forefoot during all phases of gait. Which of the following gait deviations should be identified in addition to forefoot contact?
a) Heel off at Terminal Stance and Preswing
b) Heel off at loading response and midstance
c) Heel off at preswing and initial swing
d) Heel off at midstance and terminal stance
b) Heel off at loading response and midstance
Which of the following gait deviations at the ankle would be associated with knee hyperextension at loading response if the individual has their entire foot in contact with the ground?
a) Excessive eversion
b) Excessive inversion
c) Excessive dorsiflexion
d) Excessive plantarflexion
d) Excessive plantarflexion
Which of the following phases will be MOST problematic for an individual who has limited knee flexion?
a) IS, MS, TS, IC
b) LR, PS, IS, MS
c) IC, LR, MS, TS
d) MS, TS, TS, IC
b) LR, PS, IS, MS
Which of the following gait deviations describes observations that the individual has jerky motion at the knee in the sagittal plane during loading response and midstance?
a) Knee wobble
b) Excessive contralateral knee flexion
c) Excessive knee flexion
d) Limited knee flexion
a) Knee wobble
Which of the following gait deviations would most likely be marked on a Rancho Form for an individual who has only 5 degrees of passive hip extension?
a) Excessive hip flexion at midswing
b) Limited hip flexion at terminal stance
c) Excessive hip flexion at terminal stance
d) Limited hip flexion at midswing
c) Excessive hip flexion at terminal stance
