Atypical Gait Flashcards
what are some significant correlates of community ambulation?
Balance
Gait velocity
strength
falls self-efficacy
depression
fatigue
describe paralysis/paresis/weakness
due to neural (insufficient supraspinal recruitment of MNs) and on
what are some observed deviations of PF weakness
lack of controlled DF during stance
reduced pushoff
what are some compensations of PF weakness
knee jyperextension
flexed knee gait
what are some observed deviations of quad weakness
knee instability
(3+-4 MMT) difficulty controlling knee flexion in LR
(o to 3MMT) trouble stabilizing the knee is MS
what are some compensations of quad weakness
knee hyperextension (MS)
forward trunk lean
what are some observed deviations of hip flexor weakness
limited hip flexion in swing
what are some compensations of hip flexor weakness
hip hiking
controlateral vaulting
lateral lean
posterior pelvic tilt
circumduction
how much hip flexor muscle strength is needed for proper gait
2+
what are some observed deviations of hip extensor weakness
forward trunk lean
greater frontal pelvis motion
what is a compensation of hip extensor weakness
backward lean
after a stroke, what weakness is positively correlated with gait velocity
hip extensor
what are some observed deviations of hip abductor weakness
trendelenburg
frontal plane instability
what are some compensations of hip abductor weakness
step width adjustments (wider BOS) lateral lean of trunk toward stance leg (reduced moment arm)
what are some consequences of ROM/joint mobility deficits
stance: limit stability and progression
swing: reduce foot clearance/weight acceptance
limit ability to modify movement strategies
what are ROM/joint mobility deficits of big concern
ankle DF
knee/hip extension
pelvis
spine
what are some observed deviations of PF contractures
forefoot/midfoot IC
limited tibia advance (MS)
limited DF in TS
reduced foot clearance in swing
how would someone compensate from a PF contracture
knee hyperextension in mid TS
hip flex/circumduction/hiking in swing
short step length
what are some observed deviations of.a knee flexion contracture
knee flexion
no extension at TS
what are some compensations of a knee flexion contracture
trunk shift over stance limb
short step
early heel rise
what are some observed deviations of a hip flexion contracture
no hip extension in MS -> TS
no trailing limb
crouched gait
what are some compensations of a hip flexion contracture
short step length
spinal compensation (lumbar lordosis)
what are some ways that impaired coordination can manifest itself as
abnormal synergies
lack of intersegmental coordination
coactivation of muscles
increased muscle activation (not spasticity)
what are some ways that someone can compensate from an abnormal synergy
slow, stereotypical gait
trunk deviations
if someone presents with guarding and stiff/overly controlled joints, what might you think is the problem
increased activation of muscles unrelated to spasticity
how might someone compensate from increased activation of muscles (not spasticity) or from impaired segmental coordination
freezing DOF
sub at other joints
if someone has impaired segmental coordination, how might they present
fault timing, overly large/small amplitudes, increased or decreased speed
with no intersegmental coordination, what deviations may you observe
delay in timing between segments increase/decrease magnitude of joint segments relative
reduced coordination
what can cause coactivation
pathologically disorganized CPGs
immature gait patterns
compensation to increase stiffness
what role do sensory inputs play in controlling locomotion
trigger for initiation of swing
adapting patterns to changes in environment
what deficits may be present with somatosensory issues
ataxia
delayed swing initiation
delayed push off in preswing
what deviations may be present with visual deficits
gait velocity
obstacle clearance
route finding
if someone has scheme disorders, what deviations may occur
asymmetrical trunk lean
inappropriate foot placement
veering
what compensations can occur with antalgic gait
step length change
altered velocity
up the chain deviations
if someone has pain, which leg is it in
find the short step and pain is usually in the opposite leg *need to corroborate with test
cognitive deficits can lead to what deficits
slow walking speed, dual task deficits, impaired judgment, difficulty with initiation/termination
what are some typical gait dysfunctions in those with cerebellar dysfunction
staggering, veering, irregular stepping, reduced step length, freezing DOF, etc.
what are some typical gait dysfunctions in those with MSK problems
focal weakness, ROM deficit, pain, impaired inter-segmental coordination
what are some typical gait dysfunction in those with PD
slowed gait velocity, freezing of gait, visual reliance, cocontraction, uncontrolled progression
what are some typical gait dysfunctions in those with stroke
paresis, spasticity, sensory impairments, slowed velocity, asymmetry
what are the major aspects of gait re-training
gait modification + motor learning = retention
what pop have gait retraining been shown to work in
stroke
PD
SCI
CP
knee and hip OA
PF pain
Tibial stress fx
IT band syndrome
what else is very important when it comes to gait function other than strength
ROM
mobility
coordination
accessory systems application
what are some common gait deficits in stance
claw toes
varus foot
flat foot
foot slap
limited hip flexion
trendelenburg
forward trunk lean
knee hyperextension
excessive pronation
what are some common gait deficits in swing
foot drop
varus/inverted foot
equinovarus
hip hiking
circumduction
excessive knee flexion
insufficient pelvic rotation
what is one of the first signs of dysfunction
mobility deficits
