Assessment of Gait Flashcards
what would you expect to find on exam if someone has lesions on the upper motor neurons
increased muscle tone and DTRs
what would you expect to find on exam if someone has lesions on the lower motor neurons
decreased muscle done and DTR
arthridities
joint inflmmation
peripheral neuropathy
weakness, numbness, and pain from nerve damage usually in the hands and feet
what are four common signs and symptoms of gait abnormalities?
- abnormal posture
- decreased or altered speed of ambulation (fast or slow)
- disordered balance
- tripping, stumbling, frequent falls
discuss the stance phase of gait
60% of normal gait cycle
- foot strike
- foot flat
- midstance (weight on midstance foot)
- toe off
discuss the swing phase of gait
40% of normal gait cycle
- acceleration (foot just after toe off)
- midswing
- deceleration (foot about to heel strike)
what is the normal amount by which the center of gravity oscillates vertically during gait?
2 inches
what is the normal pelvic rotation during the swing phase of gait?
40 degrees forward
antalgic gate
limping due to pain in a limb, pt. will stand on the unaffected limb longer than the affected limb
ataxic gait
“drunken sailor” gait, occurs as a loss of sensory info from feet or from cerebellar disorders
pelvis and trunk shift
lateral shifting of pelvis and trunk during gait. should shift laterally approximately one inch to the weight-bearing side over the hip
what should you consider or check if the patient falls during Romberg test?
- check vestibular functions and vision
- consider CV disease
- consider neurologic disease
abductor lurch
AKA Trendelenburg’s gait: weakened gluteus medius, forces pt. to lurch toward involved side to place center of gravity over the hip. (pelvis tilts away from involved side)
extensor lurch
AKA gluteus maximus gait: weakened gluteus maximus forces pt. to thrust thorax posteriorly to maintain hip extension during stance phase
steppage/foot drop gait
loss of ankle dorsiflexion, can cause pt. to scape toe on floor, knee is lifted higher than normal
short leg gait
true anatomical leg length discrepancy, shift in trunk toward longer extremity, pelvis tilts toward shorter leg
Gowers sign
proximal muscle weakness or pain, difficulty in getting up normally, may be a sign of muscular dystrophy
apraxic gait
pt. may freeze to ground, unable to start movements, common in Parkinson’s disease
flat foot (pes planus) gait
painful calluses over metatarsal heads, painful during midstance
spastic diplegia
slow gait w/ short steps, stiff-legged appearance, hip circumduction, toes may scrape the floor, knees may rub or cross each other, commonly seen in cerebral palsy
spastic hemiplegia
one sided spastic diplegia, stiff-legged appearance, hip circumduction, toes may scrape the floor, common in cerebral palsy
waddling gait
wide-based gait >4 over normal. pt. widens gait when dizzy or unsteady, can be due to decreased sensation on soles of feet or balance probs due to cerebellar abnormalities
weak quadriceps gait/back knee gait
causes knee to be unstable at heel strike, pt. may manually push knee into extension w/ every step, knee is normally slightly flexed druring midstance.
