Abnormal Gait

Question 1

How will Contracture change ROM? What side is affected?

Answer 1

Will decrease ROM of OPPOSITE motion.

i.e hip flexion contracture will lead to decreased hip extension and decreased in step length on opposite side.

Question 2

How will Weakness change ROM? What side is affected?

Answer 2

Will cause a decrease in ROM of the SAME motion.

i.e Weakness of hip flexor will cause decreased hip flexion and decreased step length on same side.

Question 3

How will a hip flexion contracture affect step length? What side is affected?

Answer 3

Decrease in step length on opposite side.

Question 4

How will a hip flexor weakness affect step length? What side is affected?

Answer 4

Decrease in step length on same side.

Question 5

If an event is occurring early in the gait cycle what may this be a sign of?

Answer 5

Sign of tightness or contracture

i.e early toe off during terminal stance, may be due to tight hip flexors

or

i.e early heel off during midstance, may be due to tight plantar flexors

Question 6

General rules for causes of trunk lean? Stance phase: Contracture vs Muscle Weakness

Answer 6

Trunk lean during stance phase:

Towards the weak muscle (Agonist)
Away from Contracture (Antagonist)

Question 7

What are causes of Backward Trunk Lean?

Answer 7

Weak Hip Extensors (Stance)
Hip Flexor Contracture (Stance)

Weak Hip Flexors (Swing)

Question 8

What are causes of Forward Trunk Lean?

Answer 8

Weak Hip Flexors (Stance)
Hip Extensor Contracture (stance)

Weak Hip Extensors (Swing) maybe

Question 9

What are causes of Lateral Trunk Lean?

Answer 9

Weak Hip Abductors (same Side)

Question 10

Causes of Excessive Knee Extension; Knee Hyperextension; Genu Recurvatum?

Answer 10

Excessive Ankle Plantar Flexion

Quad Weakness

• Pelvis and Ankle go in the same direction.

Question 11

What muscle is weak during toe drag?

Answer 11

Swing phase dorsiflexors. Common peroneal nerve injury.

Question 12

What may cause delayed heel contact?

Answer 12

Severe weakness of ankle dorsiflexors.

Common peroneal nerve palsy. Forefoot makes initial contact first followed by the heel.

Question 13

What may cause foot slap?

Answer 13

Dorsiflexor weakness during stance phase.

• May be due to common peroneal nerve palsy

Question 14

What are the 3 substitutions that occur due to Excessive Plantar flexion?

Answer 14

Premature heel off
Knee Hyperextension
Forward Trunk Lean

Question 15

How can excessive plantar flexion affect stride length and velocity?

Answer 15

Shortens stride length and reduces velocity

Question 16

How would a dorsiflexion contracture affect the knee joint during midstance?

Answer 16

Will cause excessive knee flexion.

Question 17

Why do we place an assistive device on the unaffected side?

Answer 17

To help decrease activity of the affected side, i.e decrease torque/stress/demands of the affected side.

Question 18

What is Steppage Gait?

Answer 18

Secondary to weak ankle dorsiflexors. (Foot Drop)

• hip flexes excessively so that toes clear the ground

Question 19

What is vaulting? What causes it?

Answer 19

Excessive vertical movement of the body.

Any impairment of the contralateral LE that reduce hip flexion, knee flexion or ankle dorsiflexion during swing.

Question 20

What kind of gait abnormality can be present secondary to weakness of dorsiflexors. (Gait pattern type)

Answer 20

Steppage Gait

Question 21

How can a Hip Abductor Contracture Affect Gait?

Answer 21

Cause Pelvic Drop on the Ipsilateral Side of the Contracture

R sided Abductor Contracture = R Pelvic drop

Question 22

Most common compensation for an inadequate ankle rocker?

Answer 22

Excessive knee flexion in swing

(lack of ankle dorsiflexion)