Abnormal Gait

Question 1

causes of different gait patterns x2

Answer 1

pathology
age
- toddlers, adults, elders

Question 2

toddler gait patterns x7

Answer 2

wide BOS
faster cadence
UE held out & partially flexed (high guard)
shorter stride length
IC - flat foot or on toes
increased knee extension
minimal head, neck, & trunk rotation

Question 3

older adult gait patterns x4

Answer 3

decreased cadence
- increased 2x limb support
wider BOS
decreased mm strength
- decreased foot clearance
decreased pelvic rotation
- decreased step length & arm swing

Question 4

gluteus maximus gait

Answer 4

weak glut max muscles
compensation - trunk extension
- COG is posterior to hip axis
presentation - quick trunk extension movement @ IC

Question 4

gait deviations

Answer 4

abnormal, or pathological gait patterns

Question 4

causes of abnormal gait x5

Answer 4

limb length discrepancy
muscle weakness or paralysis
neurological involvement
pain
ROM limitations

Question 5

compensated gluteus med gait

Answer 5

• severe weak glut meds = lateral flexion of trunk over stance limb
  results in pelvic elevation of side of swing limb
• w/o compensation pt will fall to unsupported side

Question 6

quadriceps weakness

Answer 6

decreased knee extension @ IC & in stance
compensations =
- ipsilateral hand pushes POST on thigh
- glute max activation -> pulls thigh POST
- gastroc activation -> pulls femur POST
- leaning forward @ IC -> pulls LOG ANT to knee axis

Question 6

gluteus medius gait “uncompensated”

Answer 6

weak glut medius muscles
glut mm control lateral pelvic tilt to unsupported side; if > 5 degrees = Trendelenburg sign

Question 7

genu recurvatum gait

Answer 7

hamstring weakness
deceleration of limb at swing phase is decreased
knee extension occurs early
hyperextension of knee from IC to midstance

Question 8

steppage gait

Answer 8

lifting knee higher than usual to clear foot
- d/t weak Dorsiflexors

Question 9

triceps surae weakness

Answer 9

weak gastrocnemius & soleus mm
- lack of eccentric PF contraction = rapid DF from LR to Midstance - increases knee flexion also increasing quad activity

• lack of concentric PF contraction = lack of propulsion into pre-swing - shorter step length on the uninvolved side

Question 9

foot slap gait

Answer 9

foot “slaps” floor after IC - no muscular compensation, only use of orthotic

Question 10

waddling gait

Answer 10

common w pts who have muscular dystrophies
changes =
- shoulders behind hips, APT & lumbar lordosis to maintain hip ext.
- no trunk/pelvic rotation
- steppage gait (weak DF)
- excessive trunk lateral flexion ( weak hip and)
- entire side of body pivots forward to advance limb

Question 11

vaulting

Answer 11

stance limb rises onto the forefoot early
- fused knee

Question 12

ROM limitations caused by: x2

Answer 12

bony limitation: arthritis or orthopedic injury
ST limitation: shortening of mm, capsules, ligaments or skin

Question 13

fused hip

Answer 13

bony limitation limits limb advancement
compensation=
- swing phase: limb advances via PPT
- stance phase: limb moves backward via APT

Question 14

fused knee

Answer 14

knee in extension = limb is too long for foot clearance
compensation =
- vaulting
- circumduction

Question 15

knee flexion contracture

Answer 15

prevents full knee extension -> shortens limb
compensation = quick, short step of uninvolved limb

Question 16

circumduction

Answer 16

abduction of involved limb during swing

Question 17

triceps surae contracture

Answer 17

stiff PF
IC -> forefoot rather than heel
compensation =
- knee hyperextended @ midstance
- increased hip flex for clearance @ swing phase

Question 18

fused ankle

Answer 18

loss of supination & pronation w DF/PF limitations
hard to adapt to uneven surfaces
compensation = short step lengths

Question 20

hemiplegia gait

Answer 20

loss of function to one side of body
deviations =
- DF/inversion @ swing
- hip add @ swing
- IC with forefoot
- lack of knee control
- loss of movement of tibia over foot during stance

Question 21

ataxic gait

Answer 21

injury to cerebellum = lack of coordinated movement compensations = - wider step width - exaggerated arm swing - cant walk in straight line - inconsistent foot placement at IC

Question 22

festinating gait

Answer 22

parkinson's disease -> diminished overall movement - flexed posture is initiated by small steps in place - after initiation, weight is over BOS - short, quick steps taken - rate of forward progression increases risk of falling, OR halt after a few steps

Question 23

scissoring gait

Answer 23

hip adduction @ swing phase cause = spastic hip adductors - swing limb crosses in front of stance limb - hard to advance limb d/t stance limb blocking path - results in narrow BOS & lack of smooth limb advancement -> instability

Question 24

crouch gait

Answer 24

seen w cerebral palsey / spastic diplegia - appear in crouch d/t excessive DF & hip/knee flexion in gait - hip add & IR - little counterroation compensations = - exaggerated arm swing - lateral pelvic tilt

Question 25

antalgic gait

Answer 25

gait deviations from PAIN - depends on cause, location, & intensity compensations = - decreases in duration of SLS - decrease swing phase of uninvolved limb - shorter step length of uninvolved limb - decreased WB in involved leg

Question 26

limb leg discrepancy

Answer 26

> 2 inches of difference compensations = - increased lateral pelvic tilt - shoe inserts - vaulting during swing - knee felxion of long limb PR of SL during stance