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PHTH 534: Gait > Pathology in Gait > Flashcards

Pathology in Gait Flashcards

1
Q

Why do clinicians assess gait?

A
  • to discern whether the problem is from the skeletal, muscular or neurologic system
  • to discern whether pain is attributing to the gait issue (antalgic gait)
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2
Q

What are the next clinical steps after performing the observational gait analysis?

A

Skeletal: less likely for PT interventions to adapt or change skeletal system. Orthotics, gait adaptation or assisted devices are necessary (offer a variety of places for freedom of choice)

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3
Q

When a pt has painful acute and chronic skeletal issues who would you as a PT refer them to?

A

the orthopedics

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4
Q

How does the skeletal system contribute to gait?

A

It sets the framework for movement and gait.
1. supports body against gravity
2. supports body when standing
3. works together as a level system

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5
Q

How do you discern skeletal gait problems?

A
  1. skeletal length in lower limbs (leg length discrepancy in 10% of pop)
  2. Limbs move in predictable but abnormal pattern (consistent gait deviation)
  3. Observe and perform standing alignment, ROM, and various limb alignment assessments
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6
Q

What are two common skeletal gait abnormalities?

A
  1. leg length discrepancy
  2. foot progression angle (intoe v outtoe)
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7
Q

In which plane is it easiest to spot limb discrepancy?

A

-frontal view (rear view may be better to see unequal heights)

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8
Q

How much discrepancy is too much?

A
  • over 2 cm
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9
Q

What may cause limb length discrepancy?

A
  • the culprit can be tibia or femur
  • previous broken bone
  • bone infections, juvenile arthritis or arthropathies
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10
Q

How to assess standing posture?

A
  • is scoliosis present?
  • pelvis/shoulder height
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11
Q

How to measure supine leg length?

A
  • tape measure (ASIS to medial malleolus)
  • hook lying (w/ straight edge)
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12
Q

How to measure pain assessment?

A
  1. LBP
  2. hip or knee
    (Orthodist for shoe lift)
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13
Q

What is an internal foot progression angle?

A

when the toe point inward (IR)

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14
Q

What is an external foot progression angle?

A

when the toe points outward (ER)

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15
Q

What is a normal foot progression angle?

A

13-15 degrees in adults

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16
Q

What are skeletal issues that lead towards out toe gait?

A

Caused by skeletal issues
- pronation (1st common)
- external tibial torsion (2nd common)
- passive hip IR

17
Q

What can cause the feet to externally rotate while the patella faces forward?

A
  • a collapsed midfoot (pronation)
  • abnormal foot progression angle
18
Q

In which population is in toe gait most common?

A
  • in children up to 4 (toe walking)
  • typically children grow out of posture
19
Q

In toe gait can be caused by…

A
  1. Femoral anteversion
  2. Tibial Torsion
  3. In toe posture in the foot (club foot)
20
Q

What is femoral anteversion?

A

excessive rotation of the hip (>15 degrees)

21
Q

How do you check for femoral anteversion?

A

Position pt in prone, bend knees, and move them out laterally.
If hip IR is greater than 50 degrees femoral anteversion is usually present.

22
Q

What is tibial torsion?

A

rotation of the tibial relative to the femur

23
Q

What are some exams to assess foot progression angles?

A
  1. Walking assessment
  2. Standing assessment
  3. Femoral anteversion
  4. Tibial torsion
  5. Foot or forefoot in toeing (prone)
24
Q

Can PT’s improve skeletal issues?

A

No

25
Q

How do you assess pronation during gait?

A
  • The line along the achilles tendon to the calcaneus should be straight
26
Q

Overpronation results in…

A
  • ineffective push off
  • abnormal/increased pressure in medial knee
  • creates IR of tibia
  • over pronation can be seen moving up the chain
27
Q

Describe the center of pressure through the gait cycle

A

inner toe to lateral midfoot, to mid heel (S)

28
Q

Gait deficits steaming from neurologic diagnoses

A

CVA/Stroke/TBI: creates synergistic pattern in limbs

PHTH 534: Gait (10 decks)

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