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Analysis of Movement > Ankle/Foot deviations in gait > Flashcards

Ankle/Foot deviations in gait Flashcards

1
Q

What gait phases are affected by excessive plantarflexion?

A

IC, MS,TS, Msw, Tsw

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2
Q

If someone has bone spurs on the bottom of their heel, what position may they keep their foot during gait?

A

in voluntary excessive plantarflexion to avoid heel contact

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3
Q

What is a low heel strike?

A

When the foot hits the ground not at 90 degrees; hits more flat and loses the heel rocker

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4
Q

What compromises can be made in midswing to allow an excessively plantar-flexed foot to clear floor? (4)

A

1) increase KF and HF
2) circumduction
3) lateral trunk lean toward unaffected foot
4) contralateral vaulting
- toe drag may occur

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5
Q

What can cause excessive DF?

A
  • AFO
  • soleus weakness
  • ankle locked (PF stop)
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6
Q

Excessive DF can lead to what?

A
  • too much heel rocker, causing too much knee flexion

- limb instability

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7
Q

How does a limb that has excessive dorsiflexion present in midstance?

A

decreased knee extension, unstable limb

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8
Q

How does excessive dorsiflexion affect the load response?

A

too much heel rocker, causing increased KF

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9
Q

What happens to the heel with increased dorsiflexion?

A

delayed heel rise and prolonged heel contact

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10
Q

With a child who has excessive plantarflexion, what do you expect to see during initial contact?

A

initial contact = forefoot contact or low heel strike

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11
Q

What rocker(s) do you lose with excessive plantar flexion?

A

ankle and heel rockers

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12
Q

With what presentation at the foot may you see a forward trunk lean?

A

excessive plantarflexion: tibia not advancing forward, so trying to get body to go forward another way

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13
Q

With what foot deviation do you see a premature heel rise?

A

excessive plantar flexion

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14
Q

What gait phases does excessive dorsiflexion impact?

A

loading, midstance, terminal stance, preswing

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15
Q

Which indicates more severe DF weakness, foot slap or foot drop?

A

foot slap

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16
Q

Describe foot slap/drop.

A
  • weakness of the ankle DFs results in the foot slapping or dropping into immediate plantar flexion upon initial contact
  • instead of DFs controlling the plantar flexion that occurs after initial contact, the foot just falls to the ground
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17
Q

What can cause a foot slap or foot drop?

A

common fibular nerve palsy and peripheral neuropathy

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18
Q

Delayed heel rise: what is it? What gait deviation causes this?

A
  • delayed heel rise = heel stays on floor well into terminal stance
  • weakness or paralysis of the plantar flexors can cause delayed heel rise
  • can be from CNS or PNS disorder, or achilles tendon lengthening surgically
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19
Q

With an achilles tendon repair, what may you see in this patient?

A

Delayed heel rise b/c not much plantar flexion

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20
Q

What can cause a foot flat gait deviation?

A

foot flat = hitting ground this way

- marked weakness of ankle dorsiflexors, overactive hams, KF contracture

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21
Q

Will you see normal ROM for DF in a foot flat gait deviation?

A

yes: normal stance dorsiflexion occurs if ROM is there. Just can’t get dorsiflexion to occur after initial contact, so you lose

22
Q

In what gait deviation(s) will you see knee hyperextension and a forward trunk lean?

A

1) plantarflexion contractures
- knee hyperextension in midstance to get heel to hit ground after forefoot initial contact
- forward trunk lean maintains the forward progression

2) weak quads (basically same scenario except you throw leg back into extension to get stability in loading)

23
Q

T/F: A correction for weak quads can simply be a forward trunk lean.

A

true, because this moves CoM anterior to knee, making extensors not work as hard, which is what these patients want

24
Q

What is a spatial-temporal descriptor of gait?

A

walking speed, normally 1.37 m/s

25
Q

When an increase in walking speed is needed, what can we increase in our gait to make this happen?

A

increase step/stride, increase cadence

26
Q

All values obtained from measurements of walking vary based on what?

A

walking speed

27
Q

At what percentage of gait does toe off occur?

A

60% of gait

28
Q

At what percentage of gait cycle does preswing occur?

A

50-60%

29
Q

At what point in gait is a point of minimal kinetic energy and max potential energy?

A

mid stance

30
Q

When is CoM the lowest, and thus at the least potential energy?

A

in the middle of double limb support

31
Q

T/F: No active dorsiflexion during swing with a foot drop and forefoot-heel contact deviation.

A

true; only get to neutral DF during swing, nothing more

32
Q

What causes foot flat?

A

markedly weak DF or KF contracture or overactive hams

- can also be voluntary to increase stability

33
Q

What do you see in crouched gait at the hip, knee, and ankle?

A

HF, KF, PF

34
Q

What can cause foot drop with forefoot-heel contact?

A

severe weakness of DF and/or PF contracture (pes equinus)

35
Q

What causes forefoot-delayed heel contact?

A

PF contraction or spasticity of PFs

- can be the result of upper motor lesion from CP or CVA, or from the fusion of the ankle in a plantar flexed position

36
Q

What happens at the knee with forefoot-delayed heel contact?

A

hyperextension to drive the tibia back to get the heel down

37
Q

What happens in terminal stance for forefoot-delayed heel contact?

A

hip flexion and forward trunk lean during terminal stance occur to shift body weight over foot

38
Q

T/F: Excessive knee extension can cause toes or forefoot only contact with gait.

A

false, excessive knee flexion

39
Q

Toes or forefoot only contact leads to what kind of specific gait, often found in kids with CP?

A

crouched gait: HF, KF, PF

40
Q

Lateral foot weight bearing can occur with what foot deformity?

A

soleus contracture or pes cavus, like matthew!

41
Q

T/F: Rearfoot valgus can cause excessive dynamic pronation.

A

false: rearfoot varus and forefoot varus can cause excessive dynamic pronation, as well as a weak tib posterior and soleus

42
Q

What causes delayed heel rise?

A

weakness or paralysis of PFs, or pes calcaneus deformity

43
Q

To avoid weight bearing on the heel, what gait deviation might you observe?

A

toes or forefoot only contact, can lead to crouched gait

44
Q

What’s the difference between “foot drop and forefoot-heel contact” vs “forefoot-delayed heel contact”?

A

1) foot drop and forefoot-heel contact: due to severely weak DFs or PF contracture, caused by common fibular nerve palsy/peripheral neuropathy

2) forefoot-delayed heel contact = PF contracture or spasticity, caused by upper motor lesion, CP, CVA
- you see knee hyperextension here

45
Q

When would one “vault”?

A

any time the contralateral limb needs to be “lengthened” to clear the floor; maybe if it’s not getting enough DF, HF, or KF

46
Q

What causes foot flat?

A

markedly weak DFs or KF contracture or overactive hams

47
Q

T/F: The medial longitudinal arch is not present during swing in dynamic excessive pronation.

A

false, it is

- it’s not present in static excessive pronation

48
Q

Which deviation presents with a constantly floppy foot?

A

static excessive pronation

49
Q

Excessive anteversion causes what to happen at the toe?

A

toe in

50
Q

What can cause static excessive pronation? What causes dynamic pronation?

A

static pronation = upper motor lesion, congenital deformity

dynamic = congenital deformity

51
Q

What likely impairments are found with static pronation vs dynamic pronation?

A
  • static = weak/paralyzed ankle inverters, pes planus deformity
  • dynamic = rearfoot varus, forefoot varus, soleus/tib posterior weakness

Analysis of Movement (14 decks)

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