Gait Analysis and Deviations Flashcards
Initial Contact normal motion
Heel strikes the ground
Hip is flexed 20° and slight external rotation
Knee extended
Ankle at 90° (or neutral)
Initial Contact mm action
Hip-glut max/hamstrings to reduce flexion
Erector spinae to resist trunk flexion
Ankle dorsiflexors
Initial Contact Problems
No heel strike (step on flat foot)
Foot slap (L4, dorsiflexors)
Excessive trunk extension (glut max)
Equinus deformity
Plantar flexor spasticity
Loading Response Normal Motion
Hip in ER moving toward IR
Knee has slightly flexed and begins extension
Ankle plantar flexed moving toward dorsiflexion.
Foot moves into pronation
Loading Response mm Actions
Glut max, hamstrings resisting flexion moment
Knee extensors extending knee
Triceps surae eccentric
Loading Response Problems
Backward trunk lean
Anterior trunk lean
Plantar flexion contracture/spasticity
Knee remains flexed
Midstance normal motion
Trunk has moved over foot - Weight evenly distributed
Slight drop in contralateral pelvis
Maximum extension of hip (10-15°)
Knee reaches full extension - Just before heel off at terminal stance
Ankle rolls into dorsiflexion (closed chain)
Foot pronation
Midstance mm Actions
Iliopsoas eccentrically working
Gluteus medius
Quads beginning to decrease with extension
Gastroc eccentrically working
Midstance Problems
Trendelenburg sign (of stance leg) - Compensated/uncompensated
Antalgic gait (shortened stance)
Forward trunk bend (contracture)
Excessive lordosis (contracture)
Genu recurvatum (weak quad)
Flexed knee > 10°(Contracture of capsule or Spasticity of hamstring)
Premature heel off (hypomobile ankle)
Excessive supination
Excessive pronation (Invertor weakness, Rearfoot valgus, or Forefoot varus)
Terminal Stance Normal Motion
Hip is in full extension, external rotation - Continued eccentric iliopsoas, (hip extension moment)
Knee moving toward full extension at toe off
Pronation moving toward supination - External rotation of tibia and femur, Maximum dorsiflexion (15°), Moving toward maximum (20°) plantar flexion
Terminal Stance mm Actions
Eccentric iliopsoas
Ankle plantar flexors (concentric)
Terminal Stance Problems
Problems:
Trendelenburg sign
Excessive lumbar lordosis/forward trunk (Hip pain or contracture or Forward bending from pes equinus)
Trunk lurches backward during terminal stance (Passive flexion of hip (hip flexor weakness))
Genu recurvatum
Flexed knee (Pain, contracture, hamstring spasticity)
Lack of ankle dorsiflexion
Weak plantar flexors
Excessive pronation (Weak invertors or Rearfoot valgus/forefoot varus)
Preswing Normal motion
Slight posterior pelvic rotation
Hip back at 0° flexion
Knee moving toward 40° flexion
Ankle 20° plantar flexion, pushing off
MTP 60° extension
Preswing mm actions
Increasing concentric hip flexors
Concentric plantar flexors
Minimal eccentric quads, glut medius - 2 leg support
Preswing problems
Weak plantar flexors (S1-2) - Reduced contralateral step length
MTP dysfunction/pain - Turf toe, hallux rigidus; Shift weight to lateral portion of foot
Backward trunk lurch (L2-3) - Passive hip flexion
Initial Swing normal motion
Slight posterior rotation 5°
15° hip flexion, increasing
60° knee flexion, decreasing
10° plantar flexion, decreasing
Goal is to clear foot, advance limb
Initial swing mm actions
Ankle dorsiflexors L5, deep peroneal
Hip flexors L2-3, femoral nerve
Initial swing problems
Posterior pelvic tilt/backward trunk lean (Passive hip flexion, Hip flexor weakness)
Vaulting and circumducting (Knee stiffness, contracture)
Drop foot/steppage gait
Midswing and terminal swing normal motion
Hip flexion to about 30°
25° knee flexion moving to 0°
Foot remains in neutral dorsiflexion
Midstance and terminal swing mm action
Concentric quads extending knee
Eccentric hamstrings and gluteus max (Slowing limb)
Isometric dorsiflexion
Midswing and terminal swing Problems
Weak hamstrings/gluteals (Backward lurch just before initial contact)
Quad weakness (Forward trunk just before initial contact)
Vaulting and circumducting (Knee stiffness, contracture)
Drop foot/steppage
Antalgic Gait
Decreased weight bearing
Normal ipsilateral step length
Short contralateral step length
Ataxic Gait
Staggering with wide BOS
Equinus Gait
Toe walking
Spastic or shortened triceps surrae
Club foot
Gluteus Maximus Gait
Backward lurch at IC
Gluteus Medius Gait
Trendelenburg sign
Contralateral hip drop during stance
If bilateral, wobbling pelvis
If compensated, lateral trunk lean
Hemiplegic Gait
Circumducted
Possible spastic plantar flexors
Often requires an AFO
Parkinsonian Gait
Festinating
Short rapid steps
Difficulty initiating movement
Weak Quadriceps Gait
Forward lurch during IC
Attempts to extend/hyperextend knee
Shift COG ahead of axis of rotation
Scissor Gait
Spastic adductors
Steppage Gait
Increased knee and hip flexion
Weak dorsiflexors
Increased Toe In Gait
Femoral anteversion
Increased Toe Out Gait
Femoral Retroversion
What phase of gait would Trendelenburg be seen?
Terminal stance (according to PTFE)
