Pathologic Gait Flashcards
Waddling gait cause & presentation
Bilateral hip abductor weakness (gluteus medius)
Lateral and posterior trunk lean towards stance limb
Trendelenburg gait cause & presentation
Hip abductor weakness (gluteus medius/minimus, superior gluteal nerve)
Uncompensated - pelvic drops toward contralateral limb (stance limb affected)
Compensated - trunk lean toward affected stance limb to maintain CoG over BOS
Antalgic gait cause & presentation
Pain
Shortened stance phase of affected limb, limp
Ataxic gait cause & presentation
Cerebellum injury, sensory deficits, disturbed proprioception, extrapyramidal CP
Unsteady/uncoordinated, wide BOS, exaggerated movements, inconsistent, use of visual cues
Hyperkinetic (choreiform) gait cause & presentation
CP - damage to extrapyramidal tract, athetosis, dystonia, Huntington’s
Irregular, jerky, involuntary movements in all extremities
Diplegic gait cause & presentation
CP - damage to pyramidal tract
Bilateral leg extension and adduction, scissoring w/tight or spastic hip adductors
Quadriplegic gait cause & presentation
CP - damage to pyramidal tract
Spasticity in all extremities, narrow base/scissor from adductor tightness, dragging legs and toes
Hemiplegic gait cause & presentation
CVA or CP
Unilateral weakness or spasticity on affected side
Hip/knee extension, ankle PF, IR
Arm IR, elbow flexed, thumb in palm
Circumduction
Lurch gait cause & presentation
Hip extensor weakness (gluteus maximus, inferior gluteal nerve)
Backward trunk lurch through stance phase (esp. LR) to push hip into more stable extended position
Dropfoot cause & presentation
Weak or paralyzed DF - damage to common peroneal nerve
PF in swing phase without heel strike; audible slap from lack of eccentric DF at heel strike
Festinating gait cause & presentation (Parkinsonian)
Parkinson’s disease, other basal ganglia disorders
Bradykinesia, tremor, and rigidity
Small, shuffling steps
Difficulty initiating steps, turning
Festination - involuntary inclination to increase cadence
Leg length discrepancy cause & presentation
Functional or structural causes
Vaulting, circumduction, pelvic drop
Circumduction motions & possible causes
Hip hiking, forward pelvic rotation, hip abduction
Weak hip flexors (L2-L3 nerves)
LLD’cy (functional or structural)
Steppage gait cause & presentation
Weak/paralyzed DF (common peroneal nerve)
Excessive knee and hip flexion
Unable to stand or walk on heel
Crouch gait presentation & possible causes
Hip flexion, knee flexion, ankle dorsiflexion
Due to weak PF (eg. spina bifida)
Due to spastic hamstrings, knee flexion contracture, etc. (eg. spastic CP) - likely also have excessive pronation
Excessive pronation presentation
WB: HF valgus, MF collapse, FF abduction
(eversion, dorsiflexion, and abduction)
NWB: FF varus
Excessive supination
WB: HF varus, MF elevated, FF adduction
(inversion, plantarflexion, and adduction)
NWB: FF valgus
CMT presentation
Pes cavus, drop foot, hammer toes
Knee hyperextension (genu recurvatum) possible causes
Weak quads (L4 femoral nerve), PF contracture, Polio
Normal thigh and shank inclination through stance
IC: thigh and shank are reclined
Toe off: thigh reclined, shank vertical
MS: thigh vertical, shank inclined (10-12˚)
TS: thigh and shank are inclined
Effect of abnormal thigh and shank inclinations in stance
Changes GRF vector causing compensation at various joints to maintain CoM over BOS
