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Kinesiology II > Abnormal gait > Flashcards

Abnormal gait Flashcards

1
Q

What are the 3 causes of abnormal gait?

A
  1. Pain
  2. Central nervous system disorders
  3. Musculoskeletal impairments
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2
Q

Stance due to: Generalized ligamentus laxity, weak quads, plantarflexor contracture, extensor spasticity

A

Genu recurvatum

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3
Q

The excessive elevation of the iliac crest on the side of swing limb; Gait deviation due to: Weak hip flexors. Weak knee flexors, hamstrings. Limited knee flexion ROM. Painful knee. Extensor spasticity.

A

Hip hiking

- muscles involved = abductors of stance limb, quad lumborum and possible abdominals and extensors of swing limb side

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4
Q

Gate deviation due to: Weak PF, pain in forefoot. Limited ROM at hip, knee or ankle

A

Inadequate push- off (stance)(shuffling)

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5
Q

due to Painful knee, weak quads

A

knee wobbling or buckling (stance)

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6
Q

Excessive hip and knee flexion; Weak Dorsiflexion. Plantarflexion Spasticity.

A

Steppage gait

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7
Q

IC with ground made by forefoot followed by heel region; due to severely weak DF, PF contracture, Knee flexion contracture, PF spasticity, Painful heel, LE too short

A

Toes first at initial contact

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8
Q

toe drag (swing phase); Weak DF, Plantarflexion spasiticity, can also see lowering of pelvis due to weakness of gluteus medics on stance side

A

Foot drop

- usually compensated by excessive hip and knee flexion (steppage gait)

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9
Q

Rapid ankle plantar flexion occurs after heel contact; due to weak DF

A

foot slap

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10
Q

weak quads, hip flexion contracture, knee flex contracture

A

forward trunk lean

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11
Q

What are the causes of too much PF/ not enough DF

A
  1. Spasticity (gastroc)
  2. Weakness (DF)
  3. Contracture (gastroc, posterior tib)
  4. Too Much Knee Extension (can’t have PF without ext in closed chain)
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12
Q

Irregular, jerky and weaving
2 types:
- Cerebellar-broad base, poor balance, lurches and staggers
- Sensory-broad base-slaps floor as can’t feel feet and looks down

A

Ataxic gait

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13
Q

With too much plantar flexion, one limb is too long. How do you compensate in gait?

A
  1. Steppage gait
  2. Circumduction
  3. Vaulting
  4. Hip hiking
  5. Contralateral lean
  6. Forward trunk lean
  7. Knee hyperextension
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14
Q

What do weak dorsiflexor gait deviations result in?

A
  1. Foot slap in initial contact/loading response

2. Toe drag in initial and mid swing

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15
Q

What causes too much DF or not enough PF?

A
  1. AFO or ankle fusion (Blocks ankle PF)
  2. Soleus Weakness
  3. Too much knee flexion
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16
Q

What two patterns are seen with decreased PF and what is their cause?

A
  1. Sudden DF at LR and then maintained until TSt; AFO or ankle fusion- Lose ankle rocker
  2. Progressive increase in DF from MSt to TSt -Too much DF caused by weak soleus
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17
Q

What gait deviations are seen with too much DF/ decreased PF?

A

Seen during IC through LR:
- Increased heel rocker and forward progression
- Increased demand on quads
Destabilizing effect on knee during MSt & TSt
- Decreased step length on contralateral limb

  • biggest problem is demand placed on quads
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18
Q

What are non contractile causes of too much DF?

A
  1. Talipes Calcaneus
  2. Joint Contracture
  3. Knee flexion contracture
  4. AFO
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19
Q

What are AFO gait deviations?

A
  1. Obstruction of heel rocker
  2. Quick foot flats leads to increased knee flexion which increases quad demand and a destabilized knee
  3. MSt - knee stays in flexion instead of extending
  4. Forefoot rocker - gone
  5. TSt - load is greater on plantar flexors
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20
Q

What are causes of too much pronation or supination?

A
  1. Spasticity (usually of PFs and inverters; excessive supination)
  2. Weakness of inverters (too much pronation; pes planus)
  3. Foot deformity
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21
Q

What are the causes of too much knee extension and not enough knee flexion

A
  1. Quadriceps Weakness (#1, Changes the BV)
  2. Knee Pain
  3. Quadriceps Spasticity or Extensor Synergy
  4. Plantar flexion contracture or spasticity
  5. Extension Contractures
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22
Q

What 3 phases are most affected by too much knee extension

A
  1. LR - large amount of force driven up the chain
  2. Pre swing
  3. Initial swing - causes dragging foot on the ground
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23
Q

What are the causes of too much knee flexion and not enough knee extension

A
  1. Spasticity
  2. Knee Flexion Contracture
  3. Soleus Weakness (too much ankle DF)
  4. If it is in swing-could be too much plantar flexion
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24
Q

What phases of gait are affected with knee flexion greater than 30 degrees (contracture)?

A

All phases of gait, with exception of initial swing

  • with less thank 10* contracture, there are no deviations in gait
  • above 10, under 30 = due to quads IC/LR, due to motion at terminal stance and terminal swing
25
Q

What causes too much hip flexion/ not enough hip extension?

A
  1. Hip Flexion Contracture
  2. Hip Flexor spasticity
  3. IT band contracture
  4. Excess knee flexion and ankle DF
  5. Pain
  6. Arthrodesis or ankylosis
  7. Ankle plantar flexion contracture (in mid swing)
26
Q

What are potential gait deviations with reduced hip extension?

A
  1. Shortened stride
  2. Decreased step length
  3. Increased pelvic rotation
27
Q

What are postural compensations seen with too much hip flexion?

A
  1. Forward trunk lean (elderly)
  2. Ant. Pelvic tilt increases relative ROM – can only account for 15* hip flexion; Can use lumbar lordosis to reduce force demands of hip ext.
  3. Flexion knee
28
Q

What causes too much hip extension/ not enough hip flexion?

A
  1. Hip flexor weakness
  2. Hip extensor weakness - Keeping BV back and use Y ligament for stability
  3. Arthrodesis (rare)
29
Q

What are potential gait deviations with not enough hip flexion?

A
  1. Use of abdominal muscles to advance thigh (post tilt)
  2. Circumduction
  3. Contralateral vaulting
  4. Lateral lean to the opposite side
  5. Hip hiking
  6. Substituting the Abductors or the Adductors
  7. T4T5 paraplegic walking
30
Q

What are causes of excessive adduction? abduction?

A 
Adduction:
1. Ipsilateral Abductor weakness
2. Ipsilateral Adductor tightness
3. Contralateral Abductor tightness
Abduction:
1. Ipsilateral Abduction contracture
2. Ipsilateral Short leg
31
Q

What are causes of excessive lateral rotation? medial?

A 
Lateral:
1. Too much plantar flexion
2. Use of adductors as hip flexors
Medial:
1. Spasticity in medial hamstrings
2. Abductors as hip flexors
3. Quad weakness - resting on LCL for stability
32
Q

Decreased weight on same side, Decreased step length on opposite side; Pain in LE, protecting painful leg with

A

Antalgic gait

33
Q

Backward trunk Lean (stance), lurch back; Weak hip extensors

A

Glut max gait

34
Q

Swings leg in an arc away from the body; Weak hip flexors, Weak knee flexors, Limited hip or knee flexion ROM. Painful knee. Knee extensor spasticity.

A

Circumduction

35
Q

Flexed neck, trunk and knees. Shuffling gait, reduced arm swing; Festination-lean forward with progressively faster gait

A

Parkinson’s gait

36
Q

Arm across the trunk adducted at the shoulder with flexion of elbow, wrist and MCP joints; Leg extended at hip and knee with either circumduction or pushing leg ahead. (from weak hip flexors, using adductors - very little activehip flexion and DF - ER and PF toes

A

Hemiplegic gait

37
Q

Ipsilateral trunk bending during stance/ Contralateral hip drop; Compensated = lat flex on affected side; Weak gluteus medius, abductors or Painful hip.

A

Glut medius gait (compensated)/ trendelenberg gait (uncompensated)

38
Q

What gait deviations are seen with too much PF/ decreased DF?

A
  1. Shortened step (ipsilateral)
    - Lose rockers, so momentum is lost
  2. Foot flat contact
  3. Absent or decreased heel and ankle rocker
  4. Early heel rise in MSt
  5. ER of stance leg to utilize pronation range
  6. Toe Drag
  7. Forward trunk lean
  8. Excessive hip and knee flexion with possible lateral trunk lean to clear the toes in swing
  9. Excessive plantarflexion in TSw
39
Q

What are contractile causes of too much DF

A
  1. Soleus Weakness-disuse, paralysis, or poor surgical outcome with Achilles tendon lengthening surgery
  2. Primitive flexion patterns – neurological lesions esp seen during swing phase
40
Q

Calcaneus is rotated inward and associated with pronation

A

Calcaneovalgus

41
Q

Rigid supinated foot; starts with Achilles tendon tightening; pushes weight forward and laterally; causes too much rigidity in the foot; shock absorption is limited so risks stress fxs up the chain (especially 4th and 5th MT)

A

equinovarus AKA club foot

- contact with ground made with lateral border of the forefoot; WB on lateral border of foot during stance

42
Q

What muscle is overworked in a supinated, flexible foot?

A

fibularis longus

43
Q

What are the causes of too much hip extension/not enough flexion?

A
  1. Hip flexor weakness
  2. Hip extensor weakness
    - Keeping BV back and use Y ligament for stability
  3. Arthrodesis (rare)
44
Q

What are causes of excessive adduction?

A
  1. Ipsilateral Abductor weakness
  2. Ipsilateral Adductor tightness
  3. Contralateral Abductor tightness
45
Q

What are causes of excessive abduction?

A
  1. Ipsilateral Abduction contracture

2. Ipsilateral Short leg

46
Q

What are causes of too much lateral rotation?

A
  1. Too much plantar flexion

2. Use of adductors as hip flexors

47
Q

What are causes of too much medial rotation?

A
  1. Spasticity in medial hamstrings
  2. Abductors as hip flexors
  3. Quad weakness - resting on LCL for stability
48
Q

What are causes of ipsilateral pelvic hike?

A
  1. Too much plantar flexion, knee extension -Weakness of DF

2. Long limb

49
Q

What are causes of contralateral pelvic hike?

A

Weak abductors or tight adductors

50
Q

What are causes of ipsilateral pelvic drop?

A
  1. Tight abductors

2. Short limb (excessive DF or knee flexion)

51
Q

What are causes of excessive forward rotation?

A

Weak hip flexors

52
Q

What are causes of excessive backward rotation?

A

Lack of heel rise on reference limb

53
Q

What are causes of lack of pelvic rotation?

A
  1. Back pain, lack of hip extension

2. Wide base of support - Excessive soft tissue in thighs

54
Q

Entire plantar aspect of the foot touches the ground at initial contact, followed by normal passive ankle dorsiflexion during the rest of stance; due to marked weakness of dorsiflexors

A

foot flat

55
Q

congenital structural deformity; Supinated foot positioning WB on lateral aspect of the foot during stance; high ML arch is noted with reduced mid foot mobility throughout swing and stance

A

Pes cavus deformity

56
Q

Compensatory mechanism demonstrated by exaggerated ankle plantar flexion during Mst; ends to excessive vertical body movements; due to contralateral limb having not enough DF, not enough knee flexion, or not enough hip flexion during swing

A

Vaulting

57
Q

What is the result of retroversion of the neck of the femur or tight hip external rotators?

A

toeing out

58
Q

What is the result of excessive femoral ante version or spasticity of the hip adductors and/or hip internal rotators?

A

toeing in

59
Q

What compensations are often seen with a PF contracture?

A
  1. IC made with forefoot region
  2. Knee hyperextension in Mst
  3. forward trunk lean in Tst to maintain forward propulsion

Kinesiology II (6 decks)

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