Orthotic Gait Deviation

Question 1

Circumduction

Answer 1

• during swing
• causes: locked knee, excessive plantar flexion, weak hip flexors or DF –> all can also cause vaulting

Question 2

Lateral trunk bending

Answer 2

• patient leans to orthotic side during stance
• possible causes: KAFO medial upright too high; insufficient shoe lift, hip pain, weak or tight abductors on orthotic side, short leg, foot balance

Question 3

anterior trunk bending

Answer 3

• patient leans forward during stance
• causes: inadequate knee lock, weak quads, hip or knee flexion contracture

Question 4

posterior trunk bending

Answer 4

• pt leans backward during stance
• causes: inadequate hip lock, weak glute max, knee ankylosis

Question 5

hyperextended knee

Answer 5

• excessive extension during stance
• causes: inadequate PF stop; inadequate knee lock, poor fit of calf band (too deep), weak quads, loose knee ligaments or extensor stability, pes equinus

Question 6

knee instability

Answer 6

• excessive knee flexion during stance
• causes: inadequate DF stop, inadequate knee lock, knee and/or hip flex contracture, weak quads; knee pain

Question 7

foot slap

Answer 7

• causes: inadequate DF assist, inadequate PF stop, weak DF

Question 8

on toes during stance

Answer 8

causes: inadequate heel lift, inadequate DF assist, heel pain, extensor spasticity, short leg, pes equinus

Question 9

flat foot

Answer 9

-inadequate longitudinal arch support
- pes Plans

Question 10

pronation

Answer 10

causes: transverse plane malalignment; weak inverters, pes valgus, spasticity, genu valgum

Question 11

supination

Answer 11

transverse plane malalignment, weak evertors, pes varus, genu varum

Question 12

excessive stance width

Answer 12

• KAFO height of medial upright too high
• HKAFO hip joint aligned in excessive abduction
• knee is locked
• abduction contracture
• poo balance
• sound limb too short