Abnormal Gait Flashcards
causes of different gait patterns x2
pathology
age
- toddlers, adults, elders
toddler gait patterns x7
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
older adult gait patterns x4
decreased cadence
- increased 2x limb support
wider BOS
decreased mm strength
- decreased foot clearance
decreased pelvic rotation
- decreased step length & arm swing
gluteus maximus gait
weak glut max muscles
compensation - trunk extension
- COG is posterior to hip axis
presentation - quick trunk extension movement @ IC
gait deviations
abnormal, or pathological gait patterns
causes of abnormal gait x5
limb length discrepancy
muscle weakness or paralysis
neurological involvement
pain
ROM limitations
compensated gluteus med gait
- 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
quadriceps weakness
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
gluteus medius gait “uncompensated”
weak glut medius muscles
glut mm control lateral pelvic tilt to unsupported side; if > 5 degrees = Trendelenburg sign
genu recurvatum gait
hamstring weakness
deceleration of limb at swing phase is decreased
knee extension occurs early
hyperextension of knee from IC to midstance
steppage gait
lifting knee higher than usual to clear foot
- d/t weak Dorsiflexors
triceps surae weakness
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
foot slap gait
foot “slaps” floor after IC - no muscular compensation, only use of orthotic
waddling gait
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
vaulting
stance limb rises onto the forefoot early
- fused knee
ROM limitations caused by: x2
bony limitation: arthritis or orthopedic injury
ST limitation: shortening of mm, capsules, ligaments or skin
fused hip
bony limitation limits limb advancement
compensation=
- swing phase: limb advances via PPT
- stance phase: limb moves backward via APT
fused knee
knee in extension = limb is too long for foot clearance
compensation =
- vaulting
- circumduction
knee flexion contracture
prevents full knee extension -> shortens limb
compensation = quick, short step of uninvolved limb
circumduction
abduction of involved limb during swing
triceps surae contracture
stiff PF
IC -> forefoot rather than heel
compensation =
- knee hyperextended @ midstance
- increased hip flex for clearance @ swing phase
fused ankle
loss of supination & pronation w DF/PF limitations
hard to adapt to uneven surfaces
compensation = short step lengths
hemiplegia gait
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
ataxic gait
injury to cerebellum = lack of coordinated movement
compensations =
- wider step width
- exaggerated arm swing
- cant walk in straight line
- inconsistent foot placement at IC
festinating gait
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
scissoring gait
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
crouch gait
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
antalgic gait
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
limb leg discrepancy
> 2 inches of difference
compensations =
- increased lateral pelvic tilt
- shoe inserts
- vaulting during swing
- knee felxion of long limb
PR of SL during stance
