Pathologic Gait Analysis Flashcards
what are the steps to go through a gait analysis?
identify the major problem of gait
identify what is affected at each joint
identify the stage of gait the abnormalities are in
identify what issue may be driving the abnormality
identify what test/assessment may be done to rule in/out an abnormality
what are the major problems of gait?
weight acceptance
single limb support
swing limb advancement
what are kinematic changes in gait as we age?
Decreased vertical movement of COM
Decreased arm swing
Decreased hip, knee, ankle flexion
Increased incidence of foot flat at IC (not striking with the heel)
Decreased dynamic stability during stance
what are temporal characteristics of gait changes with aging?
Decreased velocity
Increased stance time; double limb support
Decreased swing time
what are the characteristics of cerebral palsy?
increased hip flexion / adduction / medial rotation (largely driven by tone)
weak hip extensors / abductors / quadriceps and leg muscles
increased energy cost of ambulation
spastic “scissoring” of gait (swing limb adducts across midline)
what is crouch gait in spastic diplegia?
forefoot strike at IC
exaggerated hip flexion, knee flexion, pf, adduction, med rot in stance
weak gastrocnemius, lack of dorsiflexion push-off
pervasive weakness, spasticity
what are the characteristics of hemiplegia?
decreased velocity
increased energy expenditure to cover same distance as an unimpaired individual as it takes longer
asymmetrical between involved
and uninvolved sides in step length, stance time
pelvic retraction
knee instability
unilateral spasticity
limited stance time on hemiplegic side
step length lessened on uninvolved side
what are the charactersics of parkinson type gait abnormalities?
decreased hip and knee extension
decreased dorsiflexion at ankle
trunk and pelvic motions are diminished
“festinating” or shuffling
what are gait abnormalities in ataxia?
uneven step length
high steppage
step width is irregular (dysmetria)
“rhythm” is absent
what are common causes of ataxia?
chiari and cerebellar stroke
what are characteristics of quad weakness
knee placed in full extension as quadriceps may not be strong enough to control knee flexion
knee achieves extension with aid of hip extensors and/or forward motion of trunk ‘pulling’ femur over tibia – extension in latter is maintained by calf
knee may have tendency to hyperextend
notice for retraction in pelvis
may go into genu recurvatum
what are characteristics of glut med weakness?
contralateral (swing side) pelvis drops in frontal plane
trendelenberg Gait
compensation occurs by leaning towards affected side
uncompensation demonstration
assistive device (cane) recommended on unaffected side
what are the characteristics of flexion weakness?
toe drag
foot slap
steppage gait
vaulting (rising up on the toe on the stance limb to clear the swing limb)
what are some compensatory strategies?
lurch back for glute weakness to prevent the hip from collapsing (common in SCIs)
circumduction: (hamstring weakness, tone, PFPS, leg length discrepancy, dorsiflexion weakness or ROM restrictions)
