Gait Flashcards
antalgic gait
compensatory gait adopted to remove or decrease the discomfort caused by pain in the lower leg, pelvis or lumbar spine
characteristics of antalgic gait
- decreased duration of stance phase on affected limb
- lack weight shift laterally over stance limb to keep weight off involved limb
- decrease in stance phase in affected side = decrease in swing phase of uninvolved limb = shortened step length on uninvolved side
what causes forward trunk lean
- weak quads
- hip flexor contracture
- weak lumbar or hip ext
- hypomobile joint capsule
what are causes of decreased hip extension
- tight hip flexors
- decreased joint mobility
- weak glutes
gluteus maximus gait/backward trunk lean
- rocking horse gait
- if weak glute max, trunk will shift posteriorly during initial contact to try and offset forward momentum, this requires less muscle strength to maintain the hip ext during stance phase
hip drop/glute medius gait/tredelenberg gait
- hip drop on contralateral side
how would you compensate tredelenberg gait
- trunk lean
- hip hike
causes of genu recurvatum gait
- weak quads
- weak hamstring
- increased tone of quads
- compensation for PF contracture or spasticity
causes of decreased knee ext
- weak quads
- anterior knee joint hypomobility
- hamstring contracture or stiffness
- avoiding heel rocker
what will you see difficulty with decreased knee ext gait
going down stairs
impairments/sources of genu valgum
- boney deformity
- pain
- excessive foot pronation
- glute med weakness
- excessive femoral adduction
- ipsilateral trunk lean
impairments/sources of genu varum
- degenerative changes
- pain
- boney deformity
equinus gait
excessive PF
what point of body will land at initial contact during equinus gait
toes
cause of equinus gait
- tib ant weakness
- PF contracture
- hypo mobility of talocrural
- compensation for short leg/short stride length
- painful heel/avoiding heel rocker
what is difficult to do with equinus gait
walk and run without tripping
calcaneal gait
increased DF
causes of calcaneal gait
- contracture tib anterior
- weak gastroc
- hypo mobility talocrural joint
deviations of calcaneal gait
walking on heel
equinovarus gait
- club foot
- ankle PF and subtalar inversion
- walk on outside of foot
foot slap gait
DF weakness caused by paralysis of common peroneal nerve
what does foot slap gait look like
not normal heel strike, foot comes in contact with ground as a whole with slapping sound
what muscles would you MMT for foot slap
tib anterior
what muscle are you cautious about becoming tight with foot slap
plantar flexors
how might someone compensate foot slap gait
- steppage gait
- circumduction
- vaulting
what causes pes cavus
- hypomobility of subtalar and/or midtarsal joints
- spastic invertors or intrinsic foot muscles
- weak evertors
- genu varum
what causes pes planus
- weak foot intrinsic muscles
- weak posterior tib
- weak hip abd
- hypomobility of subtalar and/or midtarsal jt
what causes inadequate push off
- weak PF
- tight/spastic DF
- hypomobile talocrural jt
- pain in forefoot (common)
causes of excessive anterior pelvic tilit
- lead to lumbar lordosis and low back pain
- weak hip ext
- hip flexion contracture
- abdominal weakness
- limited hip ext ROM
causes of excessive posterior pelvic tilt
- tight hamstrings
- weak hip flexor
- low back pain
- limited lumbar ext ROM
anatomical LLD
legs are actually different lengths as confirmed with x-ray or tape measure
functional LLD
- on x-ray the leg lengths are equal, but for some reason they appear longer could be due to tightness, weakness, compensation, etc.
- correctable
how does someone compensate for LLD with circumduction
during swing phase, clears leg by swinging out in circular pattern
how does someone compensate for LLD with hip hiking
during swing phase, activate lateral trunk to clear the lengthened leg
how does someone compensate for LLD with steppage gait
during swing phase, exaggerated hip and knee flexion to compensate for excess PF at the ankle
how does someone compensate for LLD with vaulting
pt will rise up in stance phase to clear contralateral leg for swing phase
what is it and what are the causes of waddling gait
- trying to regain balance
- tight IT band
- weak hip abd contralateral
- limited hip or knee flexion, leans to contralateral side to clear foot
when do you commonly see waddling gait
in pt’s with pain in hip related to arthritis
what are clinical correlations for a widened BOS
- results in more lateral movements of the trunk
- could indicate imbalance or fear of falling
- observed with decreased proprioception, cerebellar ataxia, etc.
what are clinical correlations to a narrow BOS, scissoring gait
- adduction deformity of the hip
- valgus deformity of the knee
- increased hip adduction (tone, tightness) during swing causing swing limb to cross over stance limb for contact
when is a narrow BOS gait commonly seen
pt’s with CP
what is the hip doing in hemiplegic gait
extension, adduction, medial rotation
what is the knee doing in hemiplegic gait
extension
what is the ankle doing in hemiglegic gait
ankle in drop foot with PF and inversion, present during both stance and swing phase
hemiplegic gait
- spastic muscle wont allow hip and knee to flex to clear the floor
- pt often performs circumduction
- usually with no reciprocal arm swing
- step length tends to be lengthened on involved side and shortened on uninvolved side
sensory ataxic gait
- presence of abnormal and uncoordinated movements
- walking is uncoordinated and appears to be not ordered
- cerebellar disorders
festinating gait
- parkinsons disease
- rigid joints causing forward flexion which displaces COG anteriorly
- shuffle steps to stay within BOS
- walk faster to avoid losing balance
