Gait Deviations

Question 1

What is the definition of a gait abnormality or deviation?

Answer 1

Any variation from the standard gait phases that involves the arms, trunk, pelvis, hip, knee, or ankle.

Question 2

What are some possible contributing factors to gait abnormalities?

Answer 2

1. normal aging
2. pharmaceutical
3. disease
4. injury

Question 3

Gait deviations can be… (3)

Answer 3

• biomechanical (joint/skeletal)
• muscular
• neuromuscular (cortex, brain, cerebellum, peripheral nerves)

Question 4

What can assist a PT in the gait analysis?

Answer 4

The diagnosis or condition can assist the PT in determining whether the problem stems from a muscular, skeletal or nervous system problem

Question 5

Which clinical assessment is the most important in terms of gait deviations?

Answer 5

• ROM (more power & strength)
• MMT, sensation, reflexes, pain, gait observation can also be used throughout the clinical assessment to determine gait deviations

Question 6

3 parts to a gait deviation clinical assessment

Answer 6

1. An observational gait analysis is always performed
2. Note whether it is a swing or stance phase deviation
3. Additional outcome measures are performed: gait velocity and specific gait measures (functional gait analysis, stride length, cadence, step length)

Question 7

Trunk gait deviation terminology (3)

Answer 7

• lateral lean (L/R)
• lateral lean (back/forward)
• lateral rotation (L/R)

Question 8

Pelvic gait deviation terminology (2)

Answer 8

• excessive pelvic rotation (pelvis and hip move together in 1 motion)
• anterior pelvic tilt

Question 9

Pelvic elevation

Answer 9

Elevating pelvis during swing phase provides a method to swing limb forward. Consider how much the ASIS is moving.

Question 10

Gluteus medius and pelvic/trunk deviations (4)

Answer 10

1. Abductor lurch or gluteus medius gait: lateral lean toward involved side
2. Trendelenburg gait: contralateral pelvic drop
3. Short limb syndrome: ipsilateral pelvic drop from leg length discrepancy
4. Bilateral pelvic drop: waddling gait

Question 11

Hip gait deviations (3)

Answer 11

• glute max gait: hip comes forward and trunk leans back when leg comes forward
• hip hike & circumduction
• circumduction

Question 12

Knee Gait deviations (3)

Answer 12

• knee hyperextension (SLS)
• knee flexion during stance (SLS)
• knee varus (SLS)

Question 13

Ankle gait deviations (5)

Answer 13

• foot drop: no dorsiflexion present
• flat foot gait: making contact with whole foot
• vaulting : excessive plantarflexion during stance phase
• foot slap: foot slaps floor
• heel off: heel does not make contact with floor

Question 14

Foot Drop

Answer 14

Various etiologies: peripheral nerve injury, neuro-musuclar diseases and neuromuscular diseases
Deviations: observed throughout the gait cycle especially with the major deviation occurring throughout entire swing phase