Gait Abnormalities - Class 6 Flashcards
common reasons for gait deviations
pain
weakness
deformity
sensory disturbances
disorders of muscle activity
pain
when a person has pain
–> they avoid movements or activities that increase pain
pain results in
fxnal decrease in ROM
leads to more pain and greater dysfxn
ex of pain
decreasing stance time to minimize stress on a painful joint or decreasing limb movements
weakness
when the muscles are weak
effects of weakness is seen in
decrease eccentric ability
decrease concentric activity
loss of DF eccentric activity at heel strike or toe drag during mid-swing
loss of DF eccentric activity at heel strike or toe drag during mid-swing
d/t insufficient concentric activity of anterior ankle muscles
if lateral hip muscles are weak
will experience hip drop on left side during right midstance
trunk lean ipsilaterally
deformity may be the result of
muscle imbalance
increased muscle activity
congenital abnormalities
amputation
other examples that could cause a deformity
increased muscle activity like spasticity
limited ROM –> contracture
a deformity could be
very significant or very minor
either way it causes changes to the structures –> pts will compensate and it will affect gait
deformities lead to
stress being placed in on other areas
deformity ex: limited DF ROM
puts more stress somewhere else
may increase deformity and further affect gait
most debilitating sensory disturbance on gait
loss of proprioception or position sense
loss of proprioception or position sense
very difficult to ambulate if you can’t feel the floor or don’t know where your foot is in space
disorders of muscle activity
disturbance in motor fxn
will greatly affect gait
what are limb movements usually limited by
synergies of flexion or extension
synergies prevent
motor movement combos
such as hip flexion and knee extension –> w/o these normal gait isnt possible
disorders of muscle activity may include
spasticity and muscle rigidity
antalgic gait
self protective
antalgic gait is a result of
pain caused by injury to the hip, knee or foot
what is affected in antalgic gait
stance phase of affected foot is shorter
antalgia =
pain
why is stance phase shorter
why would we want to stand on a painful leg
spending more time on the opposite limb
ex of antalgic gait: hip is painful
the pt may shift over the painful hip –> COG gets closer to the axis –> moment are for gravity is less
ex of antalgic pain: moment arm for gravity is less
decreasing the pull of the ABDs
decreasing forces on the joint
less compression on the painful joint
step length and swing on the unaffected side –> antalgic gait
shorter
what could we do to help someone with antalgic gait
give them an AD
reinforce normal gait pattern
AD will be opposite of the pain
how with the AD be lined up –> antalgic gait
with the foot and take some of the weight off of the painful foot
arthrogenic gait
d/t stiffness or deformity
may be painful or painless
anthrogenic gait is a
decrease in hip or knee flexion
will cause the pt to vault
valuting
done to clear the unaffected limb
pt raises the affected hip and PF of the unaffected side
ataxic gait
pt with poor sensation or who lacks muscle coordination
will have a tendency towards poor balance
wide BOS
cerebellar ataxia
has a lurch or stagger w/ exaggerated movements
sensory ataxis
results in foot drop or slap
pt may watch their feet when they’re walking
ex: MS
gluteus maximum gait
gluteus maximus is weak
gluteus maximum gait –> pt will have
difficulty achieving hip extension from heel strike to midstance
what will pts do with gluteus maximum gait
thrust the thorax posteriorly to maintain hip extension and support on the stance leg
gluteus medium gait is
Trendelenburg
gluteus medium gait
gluteus medius on the stance leg is weak
in someone with gluteus medium gait
the opposite pelvis will drop
–> results in a lateral thrust of the thorax towards the weak side to compensate and maintain balance
trendelenberg gait is named for the
weak side
compensated Trendelenburg
side the pt is leaning towards is the side of weakness
uncompensated Trendelenburg
no trunk lean
hemiplegic gait
the affected leg circumducts or is pushed ahead by the hip in order to swing through
affected upper limb –> hemiplegic gait
carried across the trunk for balance
what may we observe with hemiplegic gait
excessive hip rotation
d/t poor muscle control around the pelvis
parkinsonian gait
neck, trunk and knees are in a flexed position
parkinsonian gait is characterized by
shuffling or short rapid steps
festinating gait pattern
arm sing shows unassociated movements or my not swing at all
what might we give a pt with parkinsonian gait
a walker not with wheels
pts have a hard time stopping
this will slow down rapid progression once motion is initiated
scissor gait results from
spastic paralysis of the hip ADDs
results in the knees being pulled closer together
some knee flexors as well
to swing the knees forward –> scissor gait
takes alot of effort
compensate with trunk rotation
scissor gait occurs with
CP pts
short leg gait
one leg is shorter than the other
pt with short leg gait will
demonstrate a trunk lean to the same side –> to get your foot on the ground
steppage or foot drop gait
d/t weak or paralyzed DFs
steppage or foot drop gait compensate to
clear the foot during swing phase
pt will lift the knee excessively high
at initial contact –> steppage or foot drop
foot slaps on the ground d/t loss of control of DFs
