pathological gait Flashcards
What are the 5 requirements for normal gait to occur
Phase stability Swing phase clearance Adequate foot pre-positioning Adequate step length Energy conservation
What does damage to the motor cortex cause
Spasticity
What does damage to the cerebellum cause
Ataxia
What does damage to the basal ganglia cause
Dyskinesia
What is the difference between spasticity and rigidity
Spasticity is an increase in muscle contraction that occurs in response to stretch and can be abolished by posterior root section
Rigidity is sustained involuntary contraction that is not dependent upon stretch and is not abolished by posterior root section
What are 4 factors other than abnormal tone that can contribute to gait abnormalities
Loss of selective muscle control
Dependence on primitive patterns
Imbalance of agonists/antagonists
Deficient equilibrium reactions
Give examples of abnormal growth seen in neuro conditions
Generalised body growth deformity (e.g. cerebral palsy) Limb length discrepancy Muscle shortening (due to abnormal tone) Iatrogenic Torsional abnormality
What are two main causes of weakness
LMN lesions
Reciprocal inhibition due to abnormal tone
Causes of increased oscillation of the pelvis with anterior lean and hyper-lordosis
Contracture/spasticity of hip flexors
Contracture/spasticity of hamstrings
Weakness of hip extensors/anterior abdo muscles
Balance compensation for distal muscle weakness
Use of walking aids
Causes of pelvic tilt
Contraction/spasticity of hamstrings
Fixed lumbar kyphosis
Causes of decreased hip extension in terminal stance
Contracture/spasticity of flexors
Inability to transfer weight onto forefoot (pain, muscle weakness/spasticity)
Poor knee extension of the contralateral limb in swing
Slow walking
What are 2 ways of compensating for persistent hip flexion
Flexed knees
Anteriorly tilted pelvis
Causes of plantarflexion in terminal swing/initial contact
Weak/inactive dorsiflexors
Contracture/spasticity of plantarflexors
Contracture/spasticity of hamstrings
Causes of varus/valgus of the hindfoot or forefoot at ground contact
Imbalance between invertors and evertors of the foot
Fixed skeletal deformity of the foot
Causes of toe flexion in swing
Inactive toe extensors
Spastic toe flexors
Cause of hallux extension in swing
Weakness of tibialis anterior = extensor hallucis longus takes over action
Causes of increased pelvic oscillation in the frontal plane with excessive arm motion
Weakness of the pelvic/trunk musculature
Causes of Trendelenburg gait
Weak abductors
Spastic adductors in stance
How can leg length discrepancy present at the pelvis
Persistent pelvic drop to the short side
Causes of increased hip abduction in swing
Foot clearance compensation for restricted knee/ankle motion
Inactive adductors or abductor/adductor imbalance
Causes of increased hip adduction in stance
Femoral anteversion
Weakness of abductors
Spasticity of adductors
Compensation for upper trunk movement over the pelvis
Causes of forefoot adduction in stance/swing
Imbalanced activity of tibialis anterior, extensor digitorum and tibialis posterior
Causes of hindfoot valgus
Inactive tibialis posterior
Overactive peronei
Secondary to mid-foot break
Cause of supination in terminal stance
Compensation for restricted dorsiflexion
