S2 L11: Common Gait Deviations Associated w/ Orthotic Device Issues

Question 1

FOREFOOT SLAPS THE GROUND

Answer 1

Foot Slap

Question 2

Foot Slap Orthotic Causes

Answer 2

1. Inadequate dorsiflexion assist
2. Inadequate plantarflexion stop

Question 3

Foot Slap Anatomical Causes

Answer 3

Weak dorsiflexors because cannot control lowering of foot to the ground

Question 4

TIPTOE POSTURE MAY OR MAY NOT BE MAINTAINED THROUGHOUT STANCE

Answer 4

Toes First

Question 5

Toes First Orthotic Causes

Answer 5

1. Inadequate heel lift
2. Inadequate dorsiflexion assist
3. Pt’s foot is plantarflexed, hence the tiptoe position
4. Inadequate plantarflexion stop
5. Inadequate relief of heel pain

Question 6

Toes First Anatomical Causes

Answer 6

1. Short LE
2. Pes Equinus
3. Extensor Spasticity
4. Heel Pain

Question 7

ENTIRE FOOT CONTACTS GROUND INITIALLY (No heel strike)

Answer 7

FLAT FOOT CONTACT

Question 8

Flat Foot Contact Orthotic Causes

Answer 8

1. Inadequate traction from sole
2. Requires walking aid (e.g., cane)
3. Inadequate dorsiflexion stop

Question 9

Flat Foot Contact Anatomical Causes

Answer 9

Poor balance and Pes Calcaneus

Question 10

MEDIAL (OR LATERAL) BORDER CONTACTS FLOOR

Answer 10

EXCESSIVE MEDIAL (OR LATERAL) FOOT CONTACT

Question 11

Excessive Medial (or Lateral) Foot Contact Orthotic Cause

Answer 11

Transverse Plane Malalignment

Question 12

Excessive Medial (or Lateral) Foot Contact Anatomical Causes

Answer 12

1. Weak Invertors/Evertors
2. Pes Valgus/Varus
3. Genu Valgum/Varum

Question 13

KNEE COLLAPSES WHEN FOOT CONTACTS GROUND

Answer 13

EXCESSIVE KNEE FLEXION

Question 14

Excessive Knee Flexion Orthotic Causes

Answer 14

1. Inadequate knee lock
2. Inadequate dorsiflexion stop
3. Plantarflexion restriction (stop)
4. Inadequate contralateral shoe lift

Question 15

Excessive Knee Flexion Anatomical Causes

Answer 15

1. Weak quadriceps (buckling of the knee)
2. Short contralateral LE
3. Knee Pain
4. Knee and or hip flexion contracture
5. Flexor Synergy
6. Pes Calcaneus

Question 16

KNEE HYPEREXTENDS AS WEIGHT IS TRANSFERRED TO LE

Answer 16

HYPEREXTENDED KNEE

Question 17

Hyperextended Knee Orthotic Causes

Answer 17

1. Genu recurvatum inadequately controlled by plantarflexion stop
2. Excessively concave (deep) calf band
3. Pes equinus uncompensated by contralateral shoe lift
4. Inadequate knee lock

Question 18

Hyperextended Knee Anatomical Causes

Answer 18

1. Weak quadriceps
2. Lax knee ligaments
3. Extensor synergy
4. Pes equinus
5. Short contralateral LE
6. Contralateral knee and/or hip flexion contracture

Question 19

PATIENT LEANS FORWARD AS WEIGHT IS TRANSFERRED TO LE

Answer 19

ANTERIOR TRUNK BENDING

Question 20

Anterior Trunk Bending Orthotic Causes

Answer 20

Inadequate Knee Lock

Question 21

Anterior Trunk Bending Anatomical Causes

Answer 21

1. Weak quadriceps (Pt shifts forward)
2. Hip flexion contracture
3. Knee flexion contracture

Question 22

PATIENT LEANS BACKWARD AS WEIGHT IS TRANSFERRED TO LE

Answer 22

POSTERIOR TRUNK BENDING

Question 23

Posterior Trunk Bending Orthotic Causes

Answer 23

1. Inadequate Hip Lock
2. Knee Lock

Question 24

Posterior Trunk Bending Anatomical Causes

Answer 24

1. Weak gluteus maximus
2. Knee Anylosis

Question 25

PATIENT LEANS TOWARD STANCE LEG AS WEIGHT IS TRANSFERRED TO LE

Answer 25

LATERAL TRUNK BENDING

Question 26

Lateral Trunk Bending Orthotic Causes

Answer 26

1. Excessive height of medial upright of KAFO 2. Excessive abduction of hip joint of HKAFO 3. Requires walking aid (ex. Cane) 4. Insufficient shoe lift

Question 27

Lateral Trunk Bending Anatomical Causes

Answer 27

1. Weak gluteus medius 2. Abduction contracture 3. Dislocated hip 4. Hip pain 5. Poor balance 6. Short leg

Question 28

HEEL CENTERS MORE THAN 4 IN. (10 CM) APART

Answer 28

WIDE WALKING BASE

Question 29

Wide Walking Base Orthotic Causes

Answer 29

1. Excessive height of medial upright of KAFO 2. Excessive abduction of hip joint of HKAFO 3. Insufficient lift on contralateral shoe 4. Knee Lock 5. Requires walking aid

Question 30

Wide Walking Base Anatomical Causes

Answer 30

1. Abduction contracture 2. Poor balance 3. Short contralateral LE

Question 31

LE INTERNALLY (OR EXTERNALLY) ROTATED

Answer 31

INTERNAL (OR EXTERNAL) ROTATION

Question 32

Internal (or External) Rotation Orthotic Causes

Answer 32

1. Uprights incorrectly aligned in transverse plane 2. Requires orthotic control

Question 33

Internal (or External) Rotation Anatomical Causes

Answer 33

1. Internal (or external) hip rotators spastic 2. External (or internal) hip rotators weak 3. Anteversion (retroversion) of femur 4. Weak quadriceps: leads to external rotation

Question 34

DELAYED OR ABSENT TRANSFER OF WEIGHT OVER THE FOREFOOT

Answer 34

INADEQUATE TRANSITION

Question 35

Inadequate Transition Orthotic Causes

Answer 35

1. Plantarflexion stop 2. Inadequate dorsiflexion stop

Question 36

Inadequate Transition Anatomical Causes

Answer 36

1. Weak plantarflexors 2. Achilles tendon sprain or rupture 3. Pes calcaneus 4. Forefoot pain

Question 37

TOES MAINTAIN CONTACT WITH GROUND

Answer 37

TOE DRAG

Question 38

Toe Drag Orthotic Causes

Answer 38

1. Inadequate dorsiflexion assist 2. Inadequate plantarflexion stop

Question 39

Toe Drag Anatomical Causes

Answer 39

1. Weak dorsiflexors (Pt cannot lift the foot) 2. Plantarflexor spasticity 3. Pes equinus 4. Weak hip flexors

Question 40

LE SWINGS OUTWARD IN A SEMICIRCULAR ARC

Answer 40

CIRCUMDUCTION

Question 41

Circumduction Orthotic Causes

Answer 41

1. Knee Lock 2. Inadequate dorsiflexion assist 3. Inadequate plantarflexion stop

Question 42

Circumduction Anatomical Causes

Answer 42

1. Weak hip flexors 2. Extensor synergy 3. Knee and/or ankle ankylosis 4. Weak dorsiflexors 5. Pes equinus

Question 43

LE ELEVATED AT PELVIS TO ENABLE THE LIMB TO SWING FORWARD

Answer 43

HIP HIKING

Question 44

Hip Hiking Orthotic Causes

Answer 44

1. Knee lock 2. Inadequate dorsiflexion assist 3. Inadequate plantarflexion stop

Question 45

Hip Hiking Anatomical Causes

Answer 45

1. Short contralateral LE 2. Contralateral knee and/or hip flexion contracture 3. Weak hip flexors 4. Extensor synergy 5. Knee and/or ankle ankylosis 6. Weak dorsiflexors 7. Pes equinus

Question 46

EXAGGERATED PLANTARFLEXION OF CONTRALATERAL LE TO ENABLE THE LIMB TO SWING FORWARD

Answer 46

VAULTING

Question 47

Vaulting Orthotic Causes

Answer 47

1. Knee lock 2. Inadequate dorsiflexion assist 3. Inadequate plantarflexion stop

Question 48

Vaulting Anatomical Causes

Answer 48

1. Weak hip flexors 2. Extensor spasticity 3. Pes equinus 4. Short contralateral LE 5. Contralateral knee and/or hip flexion contracture 6. Knee and/or ankle ankylosis 7. Weak dorsiflexors