Assessment of Gait

Question 1

what would you expect to find on exam if someone has lesions on the upper motor neurons

Answer 1

increased muscle tone and DTRs

Question 2

what would you expect to find on exam if someone has lesions on the lower motor neurons

Answer 2

decreased muscle done and DTR

Question 3

arthridities

Answer 3

joint inflmmation

Question 4

peripheral neuropathy

Answer 4

weakness, numbness, and pain from nerve damage usually in the hands and feet

Question 5

what are four common signs and symptoms of gait abnormalities?

Answer 5

1. abnormal posture
2. decreased or altered speed of ambulation (fast or slow)
3. disordered balance
4. tripping, stumbling, frequent falls

Question 6

discuss the stance phase of gait

Answer 6

60% of normal gait cycle

1. foot strike
2. foot flat
3. midstance (weight on midstance foot)
4. toe off

Question 7

discuss the swing phase of gait

Answer 7

40% of normal gait cycle

1. acceleration (foot just after toe off)
2. midswing
3. deceleration (foot about to heel strike)

Question 8

what is the normal amount by which the center of gravity oscillates vertically during gait?

Answer 8

2 inches

Question 9

what is the normal pelvic rotation during the swing phase of gait?

Answer 9

40 degrees forward

Question 10

antalgic gate

Answer 10

limping due to pain in a limb, pt. will stand on the unaffected limb longer than the affected limb

Question 11

ataxic gait

Answer 11

“drunken sailor” gait, occurs as a loss of sensory info from feet or from cerebellar disorders

Question 12

pelvis and trunk shift

Answer 12

lateral shifting of pelvis and trunk during gait. should shift laterally approximately one inch to the weight-bearing side over the hip

Question 13

what should you consider or check if the patient falls during Romberg test?

Answer 13

1. check vestibular functions and vision
2. consider CV disease
3. consider neurologic disease

Question 14

abductor lurch

Answer 14

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)

Question 15

extensor lurch

Answer 15

AKA gluteus maximus gait: weakened gluteus maximus forces pt. to thrust thorax posteriorly to maintain hip extension during stance phase

Question 16

steppage/foot drop gait

Answer 16

loss of ankle dorsiflexion, can cause pt. to scape toe on floor, knee is lifted higher than normal

Question 17

short leg gait

Answer 17

true anatomical leg length discrepancy, shift in trunk toward longer extremity, pelvis tilts toward shorter leg

Question 18

Gowers sign

Answer 18

proximal muscle weakness or pain, difficulty in getting up normally, may be a sign of muscular dystrophy

Question 19

apraxic gait

Answer 19

pt. may freeze to ground, unable to start movements, common in Parkinson’s disease

Question 20

flat foot (pes planus) gait

Answer 20

painful calluses over metatarsal heads, painful during midstance

Question 21

spastic diplegia

Answer 21

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

Question 22

spastic hemiplegia

Answer 22

one sided spastic diplegia, stiff-legged appearance, hip circumduction, toes may scrape the floor, common in cerebral palsy

Question 23

waddling gait

Answer 23

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

Question 24

weak quadriceps gait/back knee gait

Answer 24

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.

Question 25

dystonia

Answer 25

difficulty in relaxing muscles, can contribute to gait abnormalities

Question 26

where are most problems w/ gait apparent?

Answer 26

stance phase

Question 27

what is a normal gait length?

Answer 27

12-15 inches

Question 28

what is a normal gait width?

Answer 28

2-4 inches

Question 29

what 9 factors should you assess when evaluating gait?

Answer 29

1. posture
2. speed
3. balance
4. tripping
5. length of stance and swing phases
6. gait width and length
7. pelvic oscillation and rotation
8. trunk shift
9. supportive devices