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Human Gait > Foot/Ankle Pathological Joint Deviations > Flashcards

Foot/Ankle Pathological Joint Deviations Flashcards

1
Q

what are some causes of increased plantarflexion (equinus)?

A
  • PF contracture - equinus – bony or spastic
  • PF hypertonicity - Extensor synergy pattern – esp in swing
  • Weak dorsiflexors (or lack of selective DF control in TSw)
  • Compensation for weak quads to limit LR
  • Ankle/heel pain
  • decreased proprioception
  • To vault
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2
Q

what are some effects of increased plantarflexion at IC/LR w/ forefoot contact?

A
  • loss of heel rocker // absent ankle rocker if progresses into stance
  • decreased tibial advancement
  • decreased shock absorption by limited knee flexion
  • poor position for heel rocker
  • decreased BOS
  • decreased stride length
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3
Q

What are the differences between increased PF @ IC/LR with Foot Slap vs forefoot contact?

A

uncontrolled PF after heel contact, makes a slapping sound and associated w/ steppage gait

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4
Q

what are the three major compensations of increased PF in stance?

A
  • premature heel rise
  • knee hyperextension
  • forward trunk lean
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5
Q

effects of increased PF in terminal stance?

A
  • increased heel rise
  • decreased BOS 2° decreased WB surface
  • increases pressure on MT heads
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6
Q

effects of increased PF in swing?

A
  • interferes w/ foot clearace
  • req’s circumduction/vaulting/hip hike/flex to clear foot
  • interferes w/ foot position for IC
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7
Q

wffects of increased PF in foot drop/toe drag?

A

compensates with increased hip/knee flexion
- may cause LOB
- may cause toe injury
- interferes w limb advancement

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8
Q

what are postural compensations for increased PF?

A

Ankle Equinus
Hip Flexion
Genu Recurvatum
Lumbar Lordosis

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9
Q

What happens with Equinus Foot when the arch flattens and foot pronates?

A
  • aggravates plantar fasciitis and bunions
  • create posterior tibial tendonitis
  • can cause achille’s tendonitis, calf cramps, shin splints
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10
Q

what are the conservative treatments for equinus foot?

A

calf stretches, night splints, heel lifts, orthotics

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11
Q

what are the surgical treatments for equinus foot?

A

sometimes surgery is needed to correct

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12
Q

what are the causes / effects of vaulting on the reference limb?

A

Causes:
- Assists to clear swing limb
- Compensation for:
- limited DF or knee flexion (contra LE)
- longer swing limb (contra LE)
- increased PF stance limb

Effect
- increased demand on PF’s on stance limb
- increases COG trajectory
- decreased step length

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13
Q

what are the three primary causes for increased dorsiflexion?

A
  • 1° cause = soleus weakness unable to stabilize tibia
  • 2° cause = fixation of ankle at neutral (AFO/bony fusion)
  • 3° cause = stance knee flexion beyond midstance
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14
Q

what are the effects of increased DF in IC/LR?

A
  • Increased heel rocker effect on knee (req’s 30° vs 15°flex)
  • increased demand on hip & knee extensors
  • Accelerated tibial advancement
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15
Q

what are the effects of increased DF in stance?

A
  • increased demand on hip & knee extensors as tibia pulled forward
    a) Prolonged heel contact – w/ increased fwd tibial movement OR
    b) Excessive knee flexion with heel rise may hide increased fwd tibial mvt
    c) Loss of normal PF in Pre-swing
  • Interferes w/heel rise and decreases step length on opposite limb (TSt)
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16
Q

what are the effects of increased DF in impaired heel rise/heel off?

A
  • Interferes w/forward progression over forefoot
  • decreases step length opposite limb
  • decreases stability of tibia –> sustained knee flexion thru preswing,
    delayed knee flexion in swing
17
Q

what are the causes of excessive ankle inversion (supination)

A
  • midfoot stiffness
  • increased ant. tib., post. tib., soleus activity
  • varus contracture
  • PF contracture (in SLS)
  • decreased selective control of dorsis
  • weak peroneals
18
Q

what are the effects of excessive ankle inversion (supination)

A
  • Poor positioning for IC/LR
  • decreased stability in single leg stance
  • decreased foot clearance in swing
  • Rigid foot results in decreased shock absorption and increased IR ROM ipsi hip
  • Flexible foot takes more stance time to complete pronation ROM
19
Q

what are the causes of excessive ankle eversion (pronation)

A
  • weak post tib (WA & SLS)
  • weak soleus (SLS)
  • PF contracture (SLS)
  • valgus deformity
  • weak tib ant (SLA)
  • increased peroneal activity (SLA)
20
Q

what are the effects of excessive ankle eversion (pronation)

A
  • increased rotary strain on ankle then knee
  • interferes w rigid lever for forefoot rocker

Human Gait (21 decks)

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