Magee-Gait Deviations @ Hip/Pelvis/Trunk 2* Specific Impairments

Question 1

Observed Gait Deviation

Backward trunk lean during LR
1. Likely Impairment:
2. Selected Patho Precursors:
3. Mech. Rationale and/or Assocd Comps

Answer 1

1. Weak hip ext’s
2. Paralysis of poliomyelitis
3. This action moves line of gravity of the trunk BEHIND the hip and reduces need for hip EXT torque

Question 2

Observed Gait Deviation:

Lateral trunk lean toward stance leg; this mvmt compensates for a weakness, often called Compensated Trendelenberg gait–referred to as a waddling gait if B/L
1. Likely impairment: 2
2. Selected patho precursors: 2
3. Mechanical rationale and/or assocd comps:

Answer 2

1. Marked weakness of hip ABDs OR Hip pain
2. GBS/poliomyelitis OR arthritis
3. If marked weakness–> Shifting trunk over the supporting limb reduces demand on hip ABDs; If hip pain–> Shifting the trunk over the supporting LE reduces compressive jt forces assocd w/ the action of hip ABDs

Question 3

Observed gait deviation

Excessive downward drop of the contralateral pelvis during Stance–referred to as (+) Trendelenberg sign if present during SL standing
1. Likely impairment
2. Pathologic precursor
3. Mechanical rationale and/or assocd comps:

Answer 3

1. Mild weakness of the glute med on stance leg
2. GBS or poliomyelitis
3. Although Trendelenberg sign may be seen in SL standing, a compensated Trendelenberg gait is often seen in severe weakness of hip ABDs

Question 4

Observed gait deviation

Forward bending of the trunk during MSt and TSt, as the hip is moved over the foot
1. Likely impairments: 2
2. Pathologic precursors
3. Mechanical rationale and/or assocd comps:

Answer 4

1. Hip flex contracture; Hip pain
2. Hip OA (both)
3. Hip flex contracture–> Forwrd trunk lean used to compensate for **lack of hip EXT; **alternative adaptation could be excessive lumbar lordosis;Hip Pain–> Keeping hip @ 30deg of flexion minimizes intraarticular pressure

Question 5

Observed gait deviation

Excessive lumbar lordosis in TSt
1. Likely impairment
2. Patho precursor
3. Mech rationale and/or assocd comps:

Answer 5

1. Hip flex contracture
2. Arthritis
3. Lack of hip EXT in TSt is compensated for by incd lordosis

Question 6

Observed gait deviation

Trunk lurches backward and toward the unaffected stance legfrom heel off (TSt) to MSw
1. Likely impairment
2. Patho precursor
3. Mech rationale and/or assocd comps:

Answer 6

1. Hip flexor weakness
2. L2-L3 nerve compresion
3. Hip flexion is passively generated by a backward mvmt of trunk

Question 7

Observed gait deviation

Posterior tilit of pelvis during ISw
1. Likely impairment
2. Patho precursor
3. Mech rationale and/or assocd comps:

Answer 7

1. Hip flexor weakness
2. L2-L3 nerve compression
3. Abdoms are used during ISw to advance swing leg

Question 8

Observed gait deviation

Hip circumduction: semicircle mvmt of the hip during Swing–combining hip flexion, hip ABD, and forward rotation of pelvis
1. Likely impairment
2. Patho precursor
3. Mech rationale and/or assocd comps:

Answer 8

1. Hip flexor weakness
2. L2-L3 nerve compression
3. Semicircular mvmt combo’ing hip flex, hip ABD, and forward rotation of pelvis