FINAL: Gait deviations Flashcards
What may cause foot drop with a forefoot-heel contact?
common fibular nerve palsy and peripheral neuropathy
- this results in very weak DFs and/or pes equinus
T/F: There is no active dorsiflexion during swing for a foot drop with forefoot-heel contact.
true, just passive DF during stance, no active DF during swing
Why would one have a foot flat gait?
common fibular nerve palsy and peripheral neuropathy
What does the deep fibular n. innervate?
anterior compartment of leg (DFs)
What does superficial n. innervate?
lateral compartment of leg (everter/PFs)
What can cause a foot slap or drop?
weak DFs from common fibular nerve palsy or peripheral neuropathy
What major issues may follow at the ankle with a common fibular nerve palsy or peripheral neuropathy?
- foot slap/drop
- flat foot
- foot drop with forefoot heel contact
- all these are issues with the DFs
What are some ways we can compensate to help clear the floor?
hip hike, circumduct, vault, more KF/HF/DF
What likely impairments cause a forefoot-delayed heel contact gait?
spastic PFs or PF contracture; pes equinus
What happens at the tibia with a forefoot-delayed heel contact gait?
it needs to be thrust backwards to get the foot down, so you go into a good amount of extension at knee
What likely impairments occur with a foot flat gait?
- markedly weak DFs, knee flexion contracture, overactive hamstrings
What pathological precursors can cause a forefoot-delayed heel contact gait?
UMN lesion, CP, CVA
Why would someone be a toe walker?
- due to calcaneal pain
- upper motor neuron lesion, CP, CVA causing PF contracture or PF spasticity
What does a crouched gait look like?
may present in a toe walker: HF, KF, PF
What other excessive motions may accompany plantar flexor weakness during gait?
hip flexion and knee flexion
- no PF = no tibia control, causing more KF
Delayed heel rise is due to what deformity?
weak PFs, due to peripheral or CNS disorders
- or lengthening of Achilles tendon
What happens to gait when you have weak PFs?
no push off, shortened step length, prolonged heel contact
What can cause lateral foot weight bearing?
a supinated foot position (pes cavus) due to SCI, congenital structural deformity
With what gait deviation may you see reduced midfoot mobility?
lateral foot weightbearing
Dynamic excessive pronation can be due to a weak ___________ muscle.
tibialis posterior
In dynamic excessive pronation, the foot stays pronated too long in what stance?
midstance: should be moving from pronation to supination here and it doesn’t
What can cause static excessive pronation?
floppy foot can be caused by paralyzed inverters or pes planus deformity
- can be due to UMN lesion or congenital structural deformity
T/F: Subtalar joint is constantly everted with a floppy foot.
true
During what phase of gait does vaulting present?
midstance
An overall excessive internal rotation of the lower extremity in stance can be seen in what gait deviation?
floppy foot, or static excessive pronation
Why might someone present with a backward lurch during their gait?
to bring the LoG posterior to help the gluts not work as hard, they may be paralyzed or weak
- decreases forward progression of body
- this lurch can also help bring the swing limb forward
Excessive toe out can be caused by what bony alignment issue?
retroversion
Inadequate knee flexion affects what stages?
loading and most of swing phases
LR = no shock absorption PSw = toe off is difficult ISw = dragging toe here MSw = continued toe drag
What can cause a knee extensor thrust?
upper motor neuron lesion causing spastic quads
What can cause weak quads?
UMN lesion, femoral nerve palsy, arthritis pain, L3-4 compression neuropathy
What does a person with weak quads present like?
knee stays extended during loading, may not be in recurvatum during stance
What other compensation can accompany weak quads?
anterior trunk lean
What can cause chronic KE weakness?
poliomyelitis
Constant recurvatum in stance and swing is labeled as what?
chronic quad weakness
Which gait deviation results in a vertical thigh? Why does this happen?
no HF results in vertical thigh
- can be caused by femoral nerve lesion
With hip flexor weakness, what must happen at the knee now?
increased flexion from BFSH
What can cause a varus thrust in gait?
laxity of lateral and posterior knee ligaments, also traumatic injury
T/F: A varus thrust is typically accompanied by genu recurvatum.
true
A flexor synergy can be found in what gait deviation?
flexed knee during stance and swing
What can cause excessive knee flexion throughout stance and swing?
- KF contracture, KF spasticity due to UMN lesion
- knee pain/effusion due to arthritis or trauma
What can cause an excessively extended knee throughout stance and swing?
KE contracture/spasticity via UMN lesion or through surgical fusion