Gait Abnormalities - Class 6 Flashcards by Victoria Caridi

common reasons for gait deviations

pain

weakness

deformity

sensory disturbances

disorders of muscle activity

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pain

when a person has pain

–> they avoid movements or activities that increase pain

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pain results in

fxnal decrease in ROM

leads to more pain and greater dysfxn

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ex of pain

decreasing stance time to minimize stress on a painful joint or decreasing limb movements

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weakness

when the muscles are weak

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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

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loss of DF eccentric activity at heel strike or toe drag during mid-swing

d/t insufficient concentric activity of anterior ankle muscles

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if lateral hip muscles are weak

will experience hip drop on left side during right midstance

trunk lean ipsilaterally

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deformity may be the result of

muscle imbalance

increased muscle activity

congenital abnormalities

amputation

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other examples that could cause a deformity

increased muscle activity like spasticity

limited ROM –> contracture

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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

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deformities lead to

stress being placed in on other areas

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deformity ex: limited DF ROM

puts more stress somewhere else

may increase deformity and further affect gait

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most debilitating sensory disturbance on gait

loss of proprioception or position sense

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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

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disorders of muscle activity

disturbance in motor fxn

will greatly affect gait

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what are limb movements usually limited by

synergies of flexion or extension

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synergies prevent

motor movement combos

such as hip flexion and knee extension –> w/o these normal gait isnt possible

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disorders of muscle activity may include

spasticity and muscle rigidity

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antalgic gait

self protective

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antalgic gait is a result of

pain caused by injury to the hip, knee or foot

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what is affected in antalgic gait

stance phase of affected foot is shorter

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antalgia =

pain

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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