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CP 2 > Gait Deviation > Flashcards

Gait Deviation Flashcards

1
Q

List some large umbrella causes of gait deviations

A
  1. Pain
  2. Joint and/or muscle ROM limitations
  3. Muscular weakness/paralysis
  4. Impaired motor control
  5. Neurological involvement (UMN or LMN)
  6. Impaired balance
  7. Leg length discrepancy
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2
Q

what are some key questions to ask yourself as you analyze gait?

A
  1. Am I seeing hypo/hyper motion in a joint during gait?
    • is that joint hypo/hypermobile independent of gait?
  2. Am I seeing a deviation or a compensation for a deviation?
  3. Why are they walking like that? What could be contributing? Did I assess that area already?
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3
Q

What is antalgic gait?

A

compensatory pattern to remove/decrease discomfort/pain in the LE, pelvis or lumbar spine

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4
Q

what are the characteristic features of antalgic gait?

A
  1. decrease duration of stance phase on affected limb
  2. lack of weight shift laterally over the stance limb to keep weight off involved limb
  3. decrease in stance phase in affected side = decrease in swing phase of uninvolved side = shortened step length on uninvolved side
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5
Q

list some specific gait pattern deviations

A
  1. Waddling gait (Tunk Lean)
  2. Widened BOS
  3. Narrow BOS
  4. Hemiplegic gait
  5. Sensory ataxic gait
  6. Festinating gait
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6
Q

list some causes for the hip deviation Forward Lean

A
  1. weak quads (decreases flexor moment of knee)
  2. Hip flexor contracture
  3. weak lumbar or hip extensors
  4. hypomobile joint capsule
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7
Q

list some hip deviations in gait

A
  1. Forward trunk lean
  2. decreased hip extension
  3. Glute max gait/backward trunk lean
    • “Rocking horse gait”
  4. Hip drop/glute medius gait
    • “trendelenburg gait”
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8
Q

what are some possible causes of the gait deviation decreased hip extension?

A
  1. tight hip flexors
  2. decreased joint mobility
  3. weak glutes
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9
Q

what is the role of the glute max during IC?

A

contracts at IC, slowing forward motion of the trunk by resisting flexion of the hip and initating extension

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10
Q

if the glute max is weak, how does the body compensate during gait (IC)?

A

the trunk will quickly shift posteriorly during IC to try and offset forward momentum and promote hip extension

(this is called rocking horse gait)

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11
Q

list some knee deviations in gait

A
  1. knee hyperextension
    • “genu recurvatum gait”
  2. Decreased knee extension
  3. Excessive genu valgum
    • “knock knee gait”
  4. Excessive genu varum
    • “bow leg gait”
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12
Q

what are some causes of the gait deviation knee hyperextension?

A
  1. weak quads → thrust knee backwards so their knee doesn’t buckle due to weak quads
  2. weak hamstrings
  3. increased tone of quads
  4. compensation for PF contracture or spasticity
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13
Q

what are some causes for the gait deviation, decreased knee extension?

A
  1. weak quads
  2. tibiofemoral joint hypomobility
  3. hamstring contracture or stiffness
  4. strategy to avoid heel rocker
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14
Q

what are some potential impairments/sources of the gait deviation excessive genu valgum?

A
  1. boney deformity (most likely arthitis)
  2. pain
  3. excessive foot pronation
  4. glute med weakness
  5. excessive femoral adduction
  6. ipsilateral trunk lean
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15
Q

what are some potential impairments/sources of the gait deviation excessive genu varum?

A
  1. degenerative changes
  2. pain
  3. boney deformity (arthritis)
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16
Q

list some foot and ankle deviations in gait

A
  1. Excessive PF during gait
    • “equinus gait”
  2. Increased DF
    • “calcaneal gait”
  3. Equinovarus gait
    • “club foot”
  4. Foot drop
    • “foot slap gait”
  5. Foot flat
  6. Excessive supination (pes cavus)
  7. Excessive pronation
  8. Inadequate push off
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17
Q

what are some potential causes for excessive plantarflexion during gait (equinus gait)?

A
  1. tibialias anterior weakness
  2. PF contracture
  3. hypomobility of talocrural joint
  4. compensation for short leg/short stride leg
  5. painful heel/avoiding heel rocker
18
Q

how would excessive plantarflexion impact gait? what would it make difficult?

A

walking/running without tripping

19
Q

what could cause increased DF with gait (calcaneal gait)?

A
  1. tib anterior contracture
  2. weak gastroc
  3. hypomobile talocrural
20
Q

describe the gait deviation equinovarus

A

club foot

ankle PF + subtalar inversion

they will be walking on the outside of their foot

21
Q

what is the most often cause of foot drop?

A

DF weakness caused by paralysis of common peroneal nerve

22
Q

what muscle should you MMT with foot drop gait?

A

Tibialis anterior

23
Q

how is the talocrural joint invovled with foot drop/foot slap gait?

A

this deviation isn’t normally caused by the joint capsule being tight

but over time expect the posterior capsule to become tighter

24
Q

what might cause the gait deviation foot flat?

A
  1. weak DF
  2. limited ROM/hypomobility
  3. normal immature gait pattern (neonatal)
25
Q

what may cause pes cavus during gait?

A

(excessive supination)

  1. hypomobility of subtalar and or midtarsal joints
  2. spastic invertors or intrinsic foot muscles
  3. weak evertors
  4. genu varum
26
Q

what may cause the gait deviation excessive pronation at the ankle?

A
  1. weak foot intrinsic muscles
  2. weak posterior tibialis
  3. weak hip abductors
  4. hypomobile subtalar or midtarsal joints
27
Q

what are some possible causes of the gait deviation inadequate push off?

A
  1. weak PF
  2. tight/spastic DF
  3. hypomobile talocrural joint
  4. pain in forefoot
28
Q

list some pelvic deviations in gait

A
  1. excessive anterior pelvic tilt
  2. excessive posterior pelvic tilt
29
Q

what is normal for anterior pelvic tilt during gait?

A

10-30 degrees

30
Q

what are some potential causes of excessive anterior pelvic tilt during gait?

A
  1. weak hip extensors
  2. hip flexor contracture
  3. abdominal muscle weakness
  4. limited hip extension ROM
31
Q

what are some causes of excessive posterior pelvic tilt during gait?

A
  1. most commonly caused by tight hamstrings
  2. hip flexor weakness
  3. LBP
  4. limited lumbar extension ROM
32
Q

define anatomical LLD

A

legs are actually different lengths as confirmed with x-rays or tape measurements

33
Q

define functional LLD

A

functional LLD means on x-ray the leg lengths are equal, but for some reason they appear longer

could be due to tightness, weakness, or compenstations

34
Q

List some gait compensations for LLD

A
  1. Circumduction
  2. Hip hiking
  3. steppage gait
  4. vaulting
35
Q

what is waddling gait?

A

done when someone is trying to regain balance

lots of trunk lean

36
Q

what are some causes of waddling gait?

A
  1. tight IT band
  2. contralateral hip abductor weakness
  3. limited hip or knee flexion → leans to contralateral side to compensate to clear foot
  4. commonly seen with pain in hip related to arthritis
37
Q

what types of populations will you observe an abnormal BOS and what can it suggest?

A

observed with decreased proprioception, cerebellar ataxia, etc.

may indicate imbalance or fear of falling

38
Q

what is a narrow BOS during gait clinically referred to?

A

scissoring gait

39
Q

what are some clincal correlations to scissoring gait?

A
  1. adduction deformity of the hip
  2. valgus deformity at the knee
  3. increased hip adduction
    • increased tone, muscle tightness during swing causing swing limb to cross over stance limb for contact
  4. commonly observed in those with CP
40
Q

describe hemiplegic gait

A
  • hip into extension, adduction and IR
  • knee in extension
  • ankle in drop foot w/PF and Inversion
    • present during both stance and swing phase
  • spastic muscles wont allow the hip and knee to flex to clear the foot
  • usually no reciprocal arm swing
  • step length tends to be lengthened on involved side and shortened on uninvolved side
41
Q

describe sensory ataxic gait

A

defined as presence of abnormal and uncoordinated movements

referred to as ataxic because walking is uncoordinated and appears to be “not ordered”

often seen in individuals with cerebellar disorders

42
Q

describe festinating gait

A

due to rigidity all joints will want to flex forward

displaces COG anteriorly

in order to keep COG within BOS patient will shuffle their steps

CP 2 (13 decks)

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