Gait Deviations Orthotic/Anatomic

Question 1

Initial Contact:

Foot Slap: forefoot slaps the ground

Answer 1

• Orthotic Causes:
  
  • inadeq. dorsiflexion assist
  • inadeq. plantarflexion stop
• Anatomic Causes:
  
  • flaccid or weak dorsiflexors

Question 2

initial contact:

Toes First: tip toe posture held through stance

Answer 2

• Orthotic Causes:
  
  • inadeq heel lift
  • inadeq DF assist
  • inadeq PF stop
  • inadeq relief of heel p!
• Anatomic Causes:
  
  • short leg
  • pes equinas
  • extensor spasticity
  • heel pain

Question 3

initial contact:

excessive medial foot contact;

medial border contacts the floor

Answer 3

• Orthotic Causes:
  
  • transverse plane malalignment
• Anatomic Causes:
  
  • weak inverters
  • pes valgus
  • genu valgum

Question 4

initial contact:

excessive lateral foot contact;

lateral border contacts the floor

Answer 4

• Orthotic Causes:
  
  • transverse place malalignment
• Anatomic Causes:
  
  • weak evertors
  • pes varus
  • genu varum

Question 5

initial contact:

excessive knee flexion;

knee flexes or buckles as foot hits the ground

Answer 5

• Orthotic Causes:
  
  • inadeq knee lock
  • inadeq dorsiflexion stop
  • plantarflexion stop
  • inadeq contralateral shoe lift
• Anatomic Causes:
  
  • knee pain
  • short contralateral leg
  • contralateral knee/hip flexion contracture

Question 6

Initial contact:

forward trunk lean;

patient leans forward as leg accepts weight

Answer 6

• Orthotic Causes:
  
  • inadeq knee lock
• Anatomic Causes:
  
  • compensation for quads weakness
  • hip/knee flexion contracture

Question 7

Initial Contact:

Backward Trunk Lean;

patient leans back as leg accepts weight

Answer 7

• Orthotic Causes:
  
  • inadeq hip lock
  • inadeq knee lock
• Anatomic Causes:
  
  • weak glut maximus on stance leg
  • knee ankylosis

Question 8

Initial Contact:

Lateral Trunk Lean

patient leans toward stance leg with weight

Answer 8

• Orthotic Causes:
  
  • excessive height of medial upright KAFO
  • excessive ABD of hip joint of HKAFO
  • insufficient shoe lift
  • requires walking aid
• Anatomic Causes:
  
  • weak glut medius
  • abduction contracture
  • dislocated hip
  • hip pain
  • poor balance
  • short leg

Question 9

Initial Contact:

Wide Walking Base;

heel centers more than 10 cm (4 in) apart

Answer 9

• Orthotic Causes:
  
  • excessive height medial upright KAFO
  • Excessive abduction of hip joint of HKAFO
  • insufficient shoe lift (e.g. cane, knee lock)
• Anatomic Causes:
  
  • abduction contracture;
  • poor balance
  • short contralateral leg
  • requires walking aid

Question 10

Initial Contact:

Internal Rotation of Limb

Answer 10

• Orthotic Causes:
  
  • uprights incorrectly aligned in transverse pl
  • requires orthotic contol (rot straps, pelvic band)
• Anatomic Causes:
  
  • spastic internal hip rotators
  • weak external hip rotators
  • antetorsion

Question 11

Initial Contact:

External Rotation of Limb

Answer 11

• Orthotic Causes:
  
  • uprights incorrectly aligned in transverse pl
  • requires orthotic control
• Anatomic Causes:
  
  • spastic external rotators of hip
  • weak internal rotators
  • retroversion
  • weak quads

Question 12

Late Stance:

Inadequate Transition;

delayed or absent transfer of weight over forefoot

Answer 12

• Orthotic Causes:
  
  • plantarflexion stop
  • inadueqate DF stop
• Anatomic Causes:
  
  • weak plantarflexors
  • achilles tendos sprain or rupture
  • pes calcaneus
  • forefoot pain

Question 13

Swing:

Toe Drag;

toes maintain contact with ground

Answer 13

• Orthotic Causes:
  
  • inadeq DF assist
  • inadeq PF stop
• Anatomic Causes:
  
  • weak DF
  • PF spasticity
  • pes equinus
  • weak hip flexors

Question 14

Swing:

Circumduction;

leg swings outward in a semicircular arc

Answer 14

• Orthotic Causes:
  
  • knee lock
  • inadeq DF assist
  • inadeq PF stop
• Anatomic Causes:
  
  • extensor ?
  • extensor syndergy
  • knee or ankle ankylosis
  • weak DF
  • pes equinus

Question 15

Swing:

Hip Hiking;

leg elevated at pelvis to enable the limb to advance

Answer 15

• Orthotic Causes:
  
  • knee lock
  • inadeq DF assist
  • inadeq PF stop
• Anatomic Causes:
  
  • short contralateral leg
  • contralateral knee/hip flexion contracture
  • weak hip flexors
  • extensor synergy
  • knee or ankle ankylosis
  • weak dorsiflexors

Question 16

Swing:

Vaulting;

exaggerated PF of the contralateral leg to enable the limb to swing forward

Answer 16

• Orthotic Causes:
  
  • knee lock
  • inadequate DF assist
  • inadequate PF stop
• Anatomic Causes:
  
  • weak hip flexors
  • extensor spasticity
  • pes equinus
  • short contralateral limb
  • contralateral knee/hip flexion contracture
  • knee or ankle ankylosis
  • weak DF