Gait Pathology Flashcards
Decrease Joint Motion
Contracture (elastic, rigid)
Joint Stiffness ip
Impaired feedback
- Proprioception (joint position sense)
- Vestibular (balance)
- Sensory (foot)
- Visual
Impaired Motor Control
Lack of selective muscle control
Mass flexor and extensor pattern
Spasticity
Response to stretch
Abnormal response to a quick or slow stretch
Penalties related to abnormal gait
- Decreased shock absorption
- Excessive COM motion
- Energy expenditure causing muscle overuse
- Decrease prep for swing during preswing
- Decrease prep for stance terminal swing
- Decrease limb advancement (swing)
- Decrease forward progression (stance)
- Decrease stability
- Decrease stride length
- Decrease foot clearance
- Increase soft tissue stress/strain ‘
Sagittal view of ankle/foot causes of excessive PF
From terminal swing to initial contact
Weak dorsi flexors Calf tightness or contracture Excessive calf activity Purposeful to help decrease heel rocker (muscle weakness, poor balance) heel pain
Sagittal view Initial Contact Excessive PF Penalties
Decrease stance phase progression (lack of heel rocker)
Sagittal view excessive PF in midstance to terminal stance Causes
- Calf tightness and/or contracture
- Excessive PF activity
- Shortened step length
- Excessive calf activation (compensating for weak hip/knee extensors, “pushes” body forward rather than the hip/knee extensors pulling body forward)
Sagittal view excessive PF in midstance to terminal stance Penalties
- Decrease forward progression due to lack of ankle rocker
- Requires compensatory strategies to augment forward progression (hyperextension knee, midfoot pronation, Early heel rise and elevated COM)
Compensation for Excessive PF Midstance to Terminal Stance
- Knee hyperextended
- Midfoot pronation
- Early heel rise and elevated center of mass
Sagittal view excessive PF Midswing to Terminal Swing Causes
- DF weakness
- Calf tightness and/or contracture
- Excessive Calf Activity
Sagittal view excessive PF in Midswing to Terminal Swing Penalties
Diminished foot clearance
Sagittal view excessive PF in Midswing to Terminal Swing Compensations
Excessive Knee and Hip Flexion
Sagittal View Excessive Ankle DF Initial Contact to Loading Response Causes
- Ankle foot orthosis
2. Prosthetic Foot (normally put in 5-8degree of DF)
Sagittal View Excessive Ankle DF Initial Contact to Loading Response Penalties
- Excessive heel rocker
2. Excessive knee flexion and quadricep activity
Sagittal View Excessive Ankle DF Midstance, Terminal stance, Preswing Causes
- Calf weakness
Sagittal View Excessive Ankle DF Midstance, Terminal stance, Preswing Penalties
- Quad overuse
- Excessive lowering of center of mass
(Knee contracture, heel never comes off ground)
Frontal View abnormal foot pronation
- In expected phase (loading, midstance)
2. In wrong phase (terminal stance)
Frontal View excessive Foot Pronation loading to terminal stance Causes
- Limited DF (compensation of Midfoot break)
- Hypo mobile subtalar joint motion (compensation of Midfoot motion)
- Hypermobile Rearfoot and Midfoot
- Inverters weak
- Rearfoot/forefoot Varus
- Dynamic Knee Valgus
Frontal View Limited Foot Pronation Causes
- Hypomobile Rearfoot
- Medial point of contact
- Dynamic “splitting”
- Cavus Foot
Frontal View excessive Foot Pronation loading to terminal stance Penalties
- Excessive motion
Stress on: inverters, and plantar fascia, intertarsal lig
Hallux Valgus
Increase tibia rotation and stress on knee - Limited motion (poor shock absorption)
General Causes of Gait Abnormality
- Decrease joint motion
- Weakness
- Pain
- Impaired feedback
- Impaired motor control