Gait and Limp Flashcards
What do we need for to have a normal gait
- functioning muscles
- balance
- stability
- energy conversation
- adequate step length
- sufficient foot clearance in swing
- appropriate pre-positioning of foot in swing
What affects gait?
- Joints: Arthritis
- Bone: deformity
- Muscle: Muscular dystrophy and spasticity
- Nerve: Trauma
What causes a Trendelenburg gait?
- muscle hip abductors stop working
- hip replacement surgery (hemiarthroplasty)
- Shortening of femoral neck
- Subluxed/dislocated hip
- Pain
Features of an antalgic gait
- Shortened stance phase
- Avoids weightbearing on that side
- Avoids heelstrike
- Hip: lurches over the painful side to reduce lever arm and hence joint reaction forces
- Knee: held slightly flexed
How do you manage abnormal gait?
- history
- examination
- investigation: xray, muscle biopsy etc.
- treat underlying cause e.g weight reduction, physiotherapy, orthotics and aids, walking stick, long moment arm,
contralateral hand, - surgery e.g joint replacement, reshaping bone, lengthen/divide/transfer muscles
When is a disease described as rare?
If it affects approx 1 in 2000
Symptoms of duchenne muscular dystrophy
MUSCLE WEAKNESS IN HIPS,PELVIS AND LEGS
- waddling gait
- walking on the toes
- frequent falls
- trouble running and jumping
Symptoms of Becker Muscular dystrophy
- Severe upper extremity muscle weakness
- calf hypertrophy
- Myalgia
- Cognitive destruction
Symptoms of Friedrich Ataxia
- scoliosis
- slurred speech
- unsteady posture> frequent falls
- impaired ability to coordinate voluntary movements
Symptoms of Autosomal Dominant Cerebellar Ataxia
- poor movement coordination (usually jerky and waddling gait)
- dysarthria (clearness of speech) is affected
Definition of Ataxia
Group of disorders that affect co-ordination, balance and speech
Definition of Dystrophy
Muscle deformity and tissue degeneration
Describe a diplegic gait
Swinging of foot on both sides (heel doesnt swing of the ground only the toes)
Type of Mutation in Autosomal Dominant Cerebellar Ataxia
- Inherited in an autosomal recessive pattern.
- Caused by Trinucleotide repeat expansion mutation. (
Type of Mutation in Friedrich Ataxia
Mutation in the FXN gene codes for a protein called frataxin
- inherited in an autosomal recessive gene
