Atypical Gait

Question 1

what are some significant correlates of community ambulation?

Answer 1

Balance
Gait velocity
strength
falls self-efficacy
depression
fatigue

Question 2

describe paralysis/paresis/weakness

Answer 2

due to neural (insufficient supraspinal recruitment of MNs) and on

Question 3

what are some observed deviations of PF weakness

Answer 3

lack of controlled DF during stance
reduced pushoff

Question 4

what are some compensations of PF weakness

Answer 4

knee jyperextension
flexed knee gait

Question 5

what are some observed deviations of quad weakness

Answer 5

knee instability
(3+-4 MMT) difficulty controlling knee flexion in LR
(o to 3MMT) trouble stabilizing the knee is MS

Question 6

what are some compensations of quad weakness

Answer 6

knee hyperextension (MS)
forward trunk lean

Question 7

what are some observed deviations of hip flexor weakness

Answer 7

limited hip flexion in swing

Question 8

what are some compensations of hip flexor weakness

Answer 8

hip hiking
controlateral vaulting
lateral lean
posterior pelvic tilt
circumduction

Question 9

how much hip flexor muscle strength is needed for proper gait

Answer 9

2+

Question 10

what are some observed deviations of hip extensor weakness

Answer 10

forward trunk lean
greater frontal pelvis motion

Question 11

what is a compensation of hip extensor weakness

Answer 11

backward lean

Question 12

after a stroke, what weakness is positively correlated with gait velocity

Answer 12

hip extensor

Question 13

what are some observed deviations of hip abductor weakness

Answer 13

trendelenburg
frontal plane instability

Question 14

what are some compensations of hip abductor weakness

Answer 14

step width adjustments (wider BOS) lateral lean of trunk toward stance leg (reduced moment arm)

Question 15

what are some consequences of ROM/joint mobility deficits

Answer 15

stance: limit stability and progression
swing: reduce foot clearance/weight acceptance
limit ability to modify movement strategies

Question 16

what are ROM/joint mobility deficits of big concern

Answer 16

ankle DF
knee/hip extension
pelvis
spine

Question 17

what are some observed deviations of PF contractures

Answer 17

forefoot/midfoot IC
limited tibia advance (MS)
limited DF in TS
reduced foot clearance in swing

Question 18

how would someone compensate from a PF contracture

Answer 18

knee hyperextension in mid TS
hip flex/circumduction/hiking in swing
short step length

Question 19

what are some observed deviations of.a knee flexion contracture

Answer 19

knee flexion
no extension at TS

Question 20

what are some compensations of a knee flexion contracture

Answer 20

trunk shift over stance limb
short step
early heel rise

Question 21

what are some observed deviations of a hip flexion contracture

Answer 21

no hip extension in MS -> TS
no trailing limb
crouched gait

Question 22

what are some compensations of a hip flexion contracture

Answer 22

short step length
spinal compensation (lumbar lordosis)

Question 23

what are some ways that impaired coordination can manifest itself as

Answer 23

abnormal synergies
lack of intersegmental coordination
coactivation of muscles
increased muscle activation (not spasticity)

Question 24

what are some ways that someone can compensate from an abnormal synergy

Answer 24

slow, stereotypical gait
trunk deviations

Question 25

if someone presents with guarding and stiff/overly controlled joints, what might you think is the problem

Answer 25

increased activation of muscles unrelated to spasticity

Question 26

how might someone compensate from increased activation of muscles (not spasticity) or from impaired segmental coordination

Answer 26

freezing DOF sub at other joints

Question 27

if someone has impaired segmental coordination, how might they present

Answer 27

fault timing, overly large/small amplitudes, increased or decreased speed

Question 28

with no intersegmental coordination, what deviations may you observe

Answer 28

delay in timing between segments increase/decrease magnitude of joint segments relative reduced coordination

Question 29

what can cause coactivation

Answer 29

pathologically disorganized CPGs immature gait patterns compensation to increase stiffness

Question 30

what role do sensory inputs play in controlling locomotion

Answer 30

trigger for initiation of swing adapting patterns to changes in environment

Question 31

what deficits may be present with somatosensory issues

Answer 31

ataxia delayed swing initiation delayed push off in preswing

Question 32

what deviations may be present with visual deficits

Answer 32

gait velocity obstacle clearance route finding

Question 33

if someone has scheme disorders, what deviations may occur

Answer 33

asymmetrical trunk lean inappropriate foot placement veering

Question 34

what compensations can occur with antalgic gait

Answer 34

step length change altered velocity up the chain deviations

Question 35

if someone has pain, which leg is it in

Answer 35

find the short step and pain is usually in the opposite leg *need to corroborate with test

Question 36

cognitive deficits can lead to what deficits

Answer 36

slow walking speed, dual task deficits, impaired judgment, difficulty with initiation/termination

Question 37

what are some typical gait dysfunctions in those with cerebellar dysfunction

Answer 37

staggering, veering, irregular stepping, reduced step length, freezing DOF, etc.

Question 38

what are some typical gait dysfunctions in those with MSK problems

Answer 38

focal weakness, ROM deficit, pain, impaired inter-segmental coordination

Question 39

what are some typical gait dysfunction in those with PD

Answer 39

slowed gait velocity, freezing of gait, visual reliance, cocontraction, uncontrolled progression

Question 40

what are some typical gait dysfunctions in those with stroke

Answer 40

paresis, spasticity, sensory impairments, slowed velocity, asymmetry

Question 41

what are the major aspects of gait re-training

Answer 41

gait modification + motor learning = retention

Question 42

what pop have gait retraining been shown to work in

Answer 42

stroke PD SCI CP knee and hip OA PF pain Tibial stress fx IT band syndrome

Question 43

what else is very important when it comes to gait function other than strength

Answer 43

ROM mobility coordination accessory systems application

Question 44

what are some common gait deficits in stance

Answer 44

claw toes varus foot flat foot foot slap limited hip flexion trendelenburg forward trunk lean knee hyperextension excessive pronation

Question 45

what are some common gait deficits in swing

Answer 45

foot drop varus/inverted foot equinovarus hip hiking circumduction excessive knee flexion insufficient pelvic rotation

Question 46

what is one of the first signs of dysfunction

Answer 46

mobility deficits