Common Gait Deviations

Question 1

backward trunk during stance

Answer 1

• weak glute max
• difficulty going up stairs or ramps

Question 2

lateral trunk bending during stance

Answer 2

• weak glute med (Trendelenburg gait)
• will see bending to the same side as the weakness

Question 3

forward trunk lean during stance

Answer 3

• decreased flexor moment at the knee
• weak quads; hip and knee flexion contractures

Question 4

excessive hip flexion during stance

Answer 4

• weak hip ext or tight hip and/or knee flexors

Question 5

limited hip ext during stance

Answer 5

tight or spastic hip flexors

Question 6

limited hip flex during stance

Answer 6

weak hip flexors or tight extensors

Question 7

abnormal synergistic activity during stance

Answer 7

ex: stroke w/ LE extensor synergy
- excessive hip ADD combined w/ hip and knee ext, PF
- scissoring gait pattern (spastic CP)

Question 8

antalgic gait during stance

Answer 8

• short stance time
• uninvolved leg has shortened step length as weight-bearing occurs sooner than normal

Question 9

excessive knee flexion during stance

Answer 9

• weak quads or knee flexion contracture
• difficulty w/ going down stairs or ramps

compensate w/ fwd trunk bending

Question 10

hyperextension of knee during stance

Answer 10

• weak quads, PF contracture, or extensor synergy

Question 11

forefoot initial contact during stance

Answer 11

• weak DF, spastic or tight PF
• shortened leg (leg length discrepancy)

Question 12

foot slap during stance

Answer 12

• weak DF or hypotonia

Question 13

foot flat during stance

Answer 13

• weak DF, limited ROM; immature gait pattern

Question 14

calcaneus gait during stance

Answer 14

• excessive DF and uncontrolled forward motion of tibia
• weak PF

Question 15

equinus gait during stance

Answer 15

• spasticity or contracture of PF

Question 16

supination of foot

Answer 16

spastic inverters, weak everters, pes varus, genu varum

Question 17

hyperprontation of foot

Answer 17

weak inverters, spasticity, and pes valgus

Question 18

clawed toes

Answer 18

• spastic toe flexors
• hyperactive planta grasp reflex

Question 19

inadequate push-off

Answer 19

• weak PF, decreased ROM into PF, or pain in forefoot

Question 20

insufficient forward pelvic rotation during swing phase

Answer 20

• weak abs, weak flexor muscles (stroke)

Question 21

insufficient hip and knee flexion during swing phase

Answer 21

• weak hip and knee flexors
• inability to lift leg and move it forward

Question 22

hip circumduction during swing

Answer 22

• weak hip and knee flexors or extensor synergy

Question 23

excessive hip and knee flexion (steppage gait) during swing phase

Answer 23

• compensatory response to shorten the leg
• weak DF

Question 24

abnormal synergistic activity during swing phase

Answer 24

stroke w/ LE flexor synergy

• excessive hip flexion/ABD, knee flexion w/ ankle DF/inversion

Question 25

insufficient knee flexion during swing phase

Answer 25

• extensor spasticity, pain/decreased ROM, or weak hamstrings

Question 26

excessive knee flexion during swing phase

Answer 26

• flexor spasticity; flexor withdrawal reflex

Question 27

foot drop (equinus) during swing phase

Answer 27

• weak or delayed contraction of DF
• spastic PF

Question 28

varus or inverted foot during swing phase

Answer 28

• spastic inverters (anterior tib)
• weak fibularis longus/brevis, or abnormal synergistic pattern (stroke)

Question 29

equinovarus during swing phase

Answer 29

• spasticity of posterior tib and/or gastroc-soleus
• developmental abnormality

Question 30

too many toes sign

Answer 30

tib posterior dysfunction
- rearfoot pronation and forefoot ABD

Question 31

Excessive foot pronation during midstance to toe off is the result of

Answer 31

compensated rearfoot (or forefoot) varus deformity

Question 32

Weakness in the gastrocnemius-soleus muscle results in

Answer 32

excessive knee flexion during stance phase

Question 33

Excessive ankle eversion during stance is most frequently associated with marked weakness

Answer 33

inverters such as the tibialis anterior and tibialis posterior
- results in forefoot or rearfoot varus/valgus
OR
Other causes of excessive eversion include plantar flexion contracture, fibular (peroneal) hypertonicity, and valgus deformity

Question 34

excessive activation of the tibialis posterior muscle during walking (as would occur with spasticity)

Answer 34

excessive inversion