Pathological Gait Flashcards
4 Major Causes of Pathological Gait
-Abnormal ROM
-Impaired motor control
-Impaired sensation
-Pain
Abnormal ROM
-excessive or limited
-Joint contractures
-Bony misalignments
-Compensations (knee hyperextension)
Impaired Motor Control
-spasticity
-lack of selective control
-Primitive patterns
-weakness
Impaired Sensation
-impaired proprioception
-Perceptual deficits
-balance disorders
Deviations: Ankle
-forefoot contact
-foot-flat contact
-foot slap
-excessive PF
-excessive DF
-Excessive IN/EV
-No heel off
-foot drag
-vaulting
Deviations: Toes
-ext toes
-no ext
-clawed toes
Deviations: Knee
-Limited flx
-Excessive flx
-hyperextension
-extension thrust
-varus/valgus
-excessive contra flexion
Deviations: Hip
-limited flx
-limited ext
-IR/ER
-ADD/ABD
-circumduction
Deviations: Pelvis
-hike
-posterior tilt
-anterior tilt
-abnormal rotation
-ipsilateral drop
-contralateral drop
Deviations: Trunk
-backward lean
-forward lean
-lateral lean
Deviations: Hemiplegia Stance Phase
-dec hip and knee ext
-knee hyperext
-knee crouching
-dec weigh shift and stance time
Deviations: Hemiplegia Swing Phase
-hip ER
-hip circumduction
-hip hiking
-pelvic retraction
-dec knee and hip flx
-trunk lean
Deviations: Pediatric Disorders
Spatic Diplegic Cerebral Palsy
-Crouch gait
-Scissoring gait
Spina Bifida
-flaccid paralysis
Deviations: Parkinson’s
-short step length
-dec stance duration
-festinating or propulsive gait pattern
-dec UE motions
-forward trunk lean
-forefoot and foot flat contact
Forefoot or Foot-flat Contact
-seen during Initial contact
Cause:
-excessive knee flx
-weak quads
-excess plantar flexion
Effect:
-no heel rocker
-dec forward tibia
-dec shock absorption
-dec knee flexion
Footslap
-seen during Initial contact
Cause:
-weak anterior tib
Effect:
-dec forward tibia
-dec shock absorption
Excessive PF
-seen during Initial contact, SLS, SLA
Cause:
-PF contracture/spasticity (IC)
-weak quads (SLS)
-weak anterior tibs (SLA)
-dec proprioception
Effect:
-no heel rocker
-dec forward tibia
-dec shock absorption
-dec foot clearance for swing
Excess DF
-seen during Initial contact, SLS
Cause:
-excessive knee or hip flx (IC)
-weak calves (SLS)
Effect:
-inc demand on hip and knee extensors
-dec stability
-dec step length
Excessive Inversion
-seen during Initial contact, SLS, SLA
Cause:
-Tib ant, tib post, and soleus overactivity (IC)
-Contracture (SLS and SLA)
-IR tibial torsion
Effect:
-dec stability
-dec shock absorption due to rigid foot
Excessive Eversion
-seen during Initial contact, SLS, SLA
Cause:
-Tib ant, tib post, and soleus weak (IC)
-contracture (SLS)
-knee valgus
-weak tib ant (SLA)
-fibilaris hyper
Effect:
-dec shock absorption
No Heel Off
-seen during SLS, SLA
Cause:
-weak calves (SLS)
-excessive DF (SLA)
Effect:
-dec step length
-limited knee flx
-dec progression over forefoot
Foot Drag
-seen during SLA
Cause:
-Excess PF
-dec hip flx
-dec knee flx
-impaired proprioception
Effect:
-dec limb advancement
-LOB
Contralateral Vaulting
-seen during SLA
Cause:
-compensatory for dec flexion
-compensatory for longer limb
Effect:
-inc demand on PFs
Limited Knee Flexion
-seen during Initial contact, SLA
Cause:
-weak quads
-forefoot contact w/ tight calves
-spasticity in quads
-excess hip flexion (SLA)
-PFs spasticity/contracture
Effect:
-dec shock absorption
-dec forward momentum of tibia
-dec foot clearance
-dec flx in Initial swing
Excessive Knee Flexion
-seen during Initial contact, SLS, SLA
Cause:
-knee flexion contracture (IC)
-Knee hyper (SLS)
-excessive hip flx
-weak quads (SLA)
-hamstring hyper
Effect:
-inc demand
-dec stability
Knee Hyperextension
-seen during Initial contact, SLS, SLA
Cause:
-PF tightness (IC)
-weak quads (compensation)
-quads hyper
-excessive PF (SLS)
Effect:
-dec shock absorption
-dec tibial progression
Excessive Contralateral Knee Flexion
-seen during SLA
Cause:
-intentionally lower for excessive knee flexion
Effect:
-lengthens reference limb
-inc energy demands
Limited Hip Flexion
-seen during Initial contact, SLA
Cause:
-intentional dec on hip ext (IC)
-weak hip flexors (SLA)
-dec ROM
Effect:
-dec step length
-clearance of foot
Excessive Hip Flexion
-seen during Initial contact, SLS, SLA
Cause:
-Hip flexion conttracture (IC/SLS)
-excessive DF
-No heel off (SLS)
-Intentional for dec knee flx (SLA)
Effect:
-inc demand on quads
-dec stability
-inc energy cost
