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PT Science > Exam 2: Pathological Gait > Flashcards

Exam 2: Pathological Gait Flashcards

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1
Q

What are the 5 functional categories of pathological gait

A
  1. Deformities
  2. Muscle weakness
  3. Sensory Loss
  4. Pain
  5. Impaired Control
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2
Q

When does a functional deformity exist?

A

When the tissues do not allow sufficient passive mobility for patients to attain the normal postures and ranges of motion used in walking

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3
Q

What is the most common type of deformity

A

Contractures

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4
Q

_____ represents structural changes in the fibrous connective tissue component of muscles, ligament, or joint capsule following prolonged inactivity or scarring from injury

A

Contracture

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5
Q

(Elastic/Rigid) contracture yields to forceful manual stretch

A

Elastic

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6
Q

(Elastic/Rigid) contracture resists all stretching efforts

A

Rigid

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7
Q

What is the term for insufficient muscle strength to meet the demands of walking

A

Muscle weakness

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8
Q

Disuse muscular atrophy and neurological impairments are both reasons why a patient could be experiencing _____ _____

A

muscle weakness

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9
Q

True or False:

Some patients will have the ability to substitute for weak muscle groups depending on cause of weakness

A

True

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10
Q

Impaired _______ obstructs walking because it deprives the patient of know the exact location of their hip, knee, ankle or foot and the type of contact with the floor

A

proprioception

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11
Q

Sensory Loss-

If the patient has good motor control, they may substitute by ______ ___ or hitting ground harder to know heel contact.

A

Locking knee

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12
Q

Sensory Loss-

People with poor motor control tend to walk (slow/fast) and (cautious/reckless)

A

slow and cautious

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13
Q

What is the primary cause of musculoskeletal pain

A

Excessive tissue tension

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14
Q

Physiological reactions to pain introduce what two obstacles to effective walking?

A

Deformity and muscular weakness

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15
Q

_____ results from natural resting positions of swollen joints

A

deformity

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16
Q

____ _____ occurs secondary to the pain of joint swelling causing reduced muscle activity

A

muscular weakness

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17
Q

What are the 5 functional deficits of central neurological lesion that results in spastic paralysis

A
  1. Muscle weakness
  2. Selective motor control is impaired
  3. Primitive locomotor patterns emerge
  4. Muscles change their phasing
  5. Spasticity
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18
Q

What are the most common causes of spastic gait

A

CP, strokes, brain injury, incomplete SCI and MS

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19
Q

Spasticity Gait-

Lack of selective muscle control prevents the patient from controlling the ____ and _____ of muscle action

A

timing and intensity

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20
Q

True or False:

In spastic gait, loss is more evident proximally

A

False, it is more evident distally

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21
Q

Spastic Gait-

Primitive patterns such as mass (flexion/extension) during swing and mass (flexion/extension) during stance

A

flexion, extension

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22
Q

Spastic gait obstructs the yielding quality of (concentric/eccentric/isometric) muscle action

A

eccentric

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23
Q

What are the general categories of foot gait deviations

A

Floor contact, ankle deviations, ST joint deviations, Toe Deviations

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24
Q

What are the different floor contact deviations

A

forefoot contact, delayed heel contact, foot-flat contact, low heel, foot slap

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25
Q

Which deviation of floor contact is when the forefoot is the initial point of contact with the ground during weight acceptance

A

Forefoot contact

26
Q

Which phase of gait does forefoot contact occur in

A

initial contact

27
Q

What is the functional significance of forefoot contact

A

Disrupts heel rocker, forward progression of tibia, and shock absorption at the knee

28
Q

What are the underlying causes of forefoot contact

A

Inadequate pre-tibial strength, PF contracture, excessive knee flexion and PF combined, heel pain, or short leg

29
Q

Which deviation of floor contact happens when the forefoot precedes heel in contacting ground

A

delayed heel contact

30
Q

Which phases of gait does delayed heel contact occur in

A

Initial contact, loading response, or mid stance

31
Q

What is the functional significance of delayed heel contact

A

disrupts heel rocker and forward progression

32
Q

What are the underlying causes of delayed heel contact

A

Yielding PF contracture or spasticity

33
Q

Which deviation of floor contact happens when the heel and forefoot simultaneously contact the floor

A

foot flat contact

34
Q

Which phase of gait does foot flat contact happen in

A

initial contact

35
Q

what is the functional significance of foot flat contact

A

limited heel rocker and forward progression

36
Q

What are the underlying causes of foot flat contact

A

any impairment contributing to excess knee flexion, and compensation for weak quads

37
Q

Which deviation of floor contact happens when the forefoot is very close to the floor as the heel makes IC

A

low heel

38
Q

which phase of gait does low heel occur in

A

initial contact

39
Q

What is the functional significance of low heel

A

reduces the heel rocker and forward progression

40
Q

What are the underlying causes of low heel

A

any impairment contributing to excess PF

41
Q

Which deviation of floor contact is uncontrollable PF at the ankle following initial heel contact, often accompanied by an audible slap

A

foot slap

42
Q

Which phases of gait does foot slap happen in

A

IC and LR

43
Q

What is the functional significance of foot slap

A

disrupts heel rocker, forward progression, and shock absorption

44
Q

What is the underlying cause of foot slap

A

Pre-tibial weakness especially anterior tibialis

45
Q

What are the deviations of ankle deviations

A

Excess PF, excess DF, prolonged heel only, premature heel off, no heel off/delayed heel off, drag, contralateral vaulting

46
Q

Which deviation of the ankle is when PF exceeds normal for a particular phase

A

Excess plantar flexion

47
Q

Which phases does excess plantar flexion happen in

A

all except pre swing

48
Q

What is the functional significance of excess plantar flexion

A

disrupts rockers during stance, foot clearance and limb advancement during swing

49
Q

What are the underlying causes of excess plantar flexion

A

PF contracture, pre tib weakness, quad weakness, proprioception deficits or ankle pain

50
Q

Which ankle deviation has DF that exceeds normal for a particular phase

A

excess dorsiflexion

51
Q

Which phases does excess dorsiflexion occur in

A

all phases of stance

52
Q

Which deviation of the ankle happens when the heel only period extends beyond loading response

A

prolonged heel only

53
Q

Which phases does prolonged heel only affect

A

LR, MS, TS, and preswing

54
Q

What are the underlying causes of prolonged heel only

A

painful forefoot or toe clawing

55
Q

Which deviation of ankle happens when the heel is not contact with the ground when it should be

A

premature heel off

56
Q

Which phases does premature heel off happen in

A

LR and MS

57
Q

Which deviation of ankle is the absence of a heel rise when the heel should be off the ground

A

No heel off/delayed heel off

58
Q

Which phases of no heel off/delayed heel off occur in

A

TS, and pre swing

59
Q

Which deviation of ankle is when the contact of toes, forefoot, or heel with the ground during swing

A

drag

60
Q

Which phases of gait does drag occur in

A

initial swing, mid swing, terminal swing

61
Q

What deviation of the ankle is prematurely rising onto the forefoot of the contralateral stance limb during SLA of the reference limb

A

contralateral vaulting

62
Q

which phases of gait does contralateral vaulting happen in

A

initial swing, mid swing, terminal swing

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