Gait Examination and Intervention

Question 1

Signs of Plantar Flexor Weakness

Answer 1

SLS: lack of heel rise
SLA: lack of rapid ankle PF

Question 2

Signs of Quadriceps Weakness

Answer 2

WA: forward trunk lean, lack of controlled knee flexion

Question 3

Signs of Hip Flexor Weakness

Answer 3

SLA: Limited hip flexion, circumduction, vaulting, trunk lean (contralateral)

Question 4

Signs of Hip Extensor Weakness

Answer 4

WA: backward trunk lean

Question 5

Signs of Hip ABDuctor Weakness

Answer 5

WA & SLS: poor pelvic stability (pelvic drop), trunk lean (contralateral)

Question 6

Signs of Plantar Flexor Spasticity

Answer 6

WA: Forefoot contact, lack controlled ankle pf
SLS: lack of ankle rocker, early heel rise
SLA: lack of df to neutral (compensations related to clear foot)

Question 7

Signs of Hamstring Spasticity

Answer 7

SLA: excessive knee flexion

Question 8

Signs of Quadriceps Spasticity

Answer 8

WA: lack of controlled knee flexion
SLS: excessive knee extension
SLA: lack of knee flexion

Question 9

Signs of Hip ADDuctor Spasticity

Answer 9

WA & SLS: lack of pelvic stability (pelvic drop)

SLA: Excessive hip adduction (“Scissor gait” if bilateral)

Question 10

Signs of Plantar Flexors Contracture

Answer 10

WA: forefoot contact, lack of controlled knee extension
SLS: lack of ankle rocker, early heel rise, knee extension
SLA: lack of ankle df to neutral

Question 11

Signs of Hamstring Contracture

Answer 11

WA: forefoot or flat foot contact, excessive knee flexion
SLA: lack of full knee extension

Question 12

Signs of Hip Flexor Contracture

Answer 12

WA: poor hip stability (excessive flexion)
SLS: Limited hip extension

Question 13

Remediation - Increase Force Production

Answer 13

High-intensity resistance training
Resistance exercise
Strength and power training (ankle DF/PF)

Question 14

Remediation - Improve Postural Control

Answer 14

Control HAT segment
Extensor support
Foot placement at initial contact
Normal BOS vs wide BOS
Balance during double and single limb support

Question 15

Remediation - Specific Gait Skill

Answer 15

Uses part and whole practice
Progress from assistance to facilitation to independent
Progress to variable tasks and environment

Question 16

Remediation - Cognition

Answer 16

Begin with less demanding environment and minimal novel learning