Gait deviations in Stance Phase

Question 1

Lateral trunk bend

Answer 1

• result of weak glute med
• will see bending to same side as weakness (trendelenburg gait)
• also seen with hip pain

Question 2

backward trunk lean

Answer 2

• result of weak glute max
• also difficulty going up stairs or ramps

Question 3

forward trunk lean

Answer 3

result of weak quads and hip/ knee flexion contractures
- decreases flexor moment at knee

Question 4

limited hip extension

Answer 4

reset of tight or spastic hip flexors

Question 5

limited hip flexion

Answer 5

result of weak hip flexors or tight extensors

Question 6

abnormal synergistic activity

Answer 6

excessive hip adduction combined with hip and knee extension, PF
- scissoring or adducted gait pattern

Question 7

antalgic gait

Answer 7

• painful gait
• stance time is shortened on painful limb which results in asymmetrical gait pattern
• uninvolved limb has shortened step length as WBing occurs sooner than normal

Question 8

excessive knee flexion

Answer 8

• result of weak quads (knee buckles) or knee flexor contracture
• will see difficulty going down stairs or ramps
• forward trunk bending can compensate for weak quads

Question 9

knee hyperextension

Answer 9

• result of weak quads, PF contracture, or extensor spasticity

Question 10

Forefoot initial contact

Answer 10

results from weak DFs, spastic or tight PFs, may also be caused by a shortened leg

Question 11

Foot slap

Answer 11

forefoot contacts floor with audible slap after initial contact
- result of weak DFs or hypotonia

Question 12

foot flat

Answer 12

• heel and forefoot contact the ground simultaneously
• result of weak DFs, limited ROM, immature gait pattern

Question 13

calcaneus gait

Answer 13

• loading predominantly on heel with excessive DF and uncontrolled forward motion of tibia
• due to weak PFs

Question 14

equinus gait

Answer 14

• heel does not touch the ground
• spasticity or contracture of PFs

Question 15

supination

Answer 15

• varus calcaneus and excessive lateral loading of foot
• may occur at initial contact and correct at foot flat with weight acceptance or remain throughout stance
• causes: spastic investors, weak evertors, pes varus, genu varum

Question 16

hyperpronation

Answer 16

• excessive medial contact of foot during stance with valgus position of calcaneus
• causes: weak investors, spasticity, pes valgus

Question 17

clawed toes

Answer 17

• result of spastic toe flexors, possibly a hyperactive plantar gasp reflex

Question 18

inadequate push off

Answer 18

result of weak PFs, decreased ROM into PF, or pain in the forefoot