wk 8- paeds gait, footwear/flatfoot

Question 1

tempo spatial parameter changes with age

Answer 1

velocity increases
stride length increases
time spent in single limb stance increases

cadence decreases
time in double support decreases

the most rapid changes occur during 1 - 3 years

Question 2

gait patterns of a 2 year old

Answer 2

foot flat, fails to supinate
hips still externally rotated
lowered carriage but minimal arm swing
audible foot slap
decreased cadence (156 steps per min)
increased stride length (55cm)

Question 3

gait patterns of a 3 year old

Answer 3

internal hip position

decreased base of gait with hip rotation

increased arm swing/coordination

tibial valgum

foot slap but resupination is visualised

cadence 153steps/min
stride 68cm

heel strike at IC

increased single limb stance time

hip extension during terminal stance

Question 4

gait patterns in a 5/6 year old

Answer 4

active propulsion
full arm swing
increased stride length to 129cm
cadence 114 steps/min

Question 5

what are examples of abnromal gait patterns

Answer 5

trendelenburg
spastic
ataxic
steppage
limp
toe walking

Question 6

what is trendelenburg gait

Answer 6

opposite side of the pelvis dropping in relation to the weightbearing side

caused by weakness in glute medius and minimus

if bilateral than a waddling gait appears

Question 7

what is spastic gait

Answer 7

hypertonicity with muscular imbalance

may walk with flatfoot, toe heel or equinas gait, depends on what muscles are involved

for example, spasticity in peroneals will cause a valgus/flatfoot will arise

Question 8

what is spastic hemiplegia gait

Answer 8

cerebral motor cortex lesion

arm of affected side is stiff with shoulder abducted and elbow flexed

lower body, knee/hip flexion, plantarflexion and inversion of foot

patient circumducts affected leg in semi circle through swing phase

Question 9

spastic diplegic gait

Answer 9

lesion affecting the cerebral motor cortex

flexed at hip and knee, stride is short scissor type gait with a crossing of the legs

Question 10

ataxic gait

Answer 10

posterior column disease causing a lack of proprioception/ sensory input

results in a fall or awkward walk without visual aid

wide base of gait with legs being flung abruptly forward/ outward and audible stampling of feet on ground

Question 11

cerebellar ataxic gait

Answer 11

lesion affecting cerebellum which is responsible for coordination

staggering broad based gait with swaying/ lurching
cant walk in straight line
audible foot slaps
gait consistent with eyes open or closed

Question 12

drop foot/steppage gait

Answer 12

weakness/paralysis of anterior tib muscles

unable to dorsiflex foot during swing phase so compensates with hip and knee flexion and external limb rotation

Question 13

toe walking can be caused by

Answer 13

habit
cerebral palsy
intellectual diability
clumsy child syndrome
autism
muscular dystrophy
peroneal muscular atrophy
posterior soft tissue contracture
talipes equino varus

Question 14

classifying flatfoot

Answer 14

rigid/flexible
symptomatic/asymptomatic
acquired/congenital

Question 15

causes of rigid flatfoot

Answer 15

trauma
iatrogenic
coalition
vertical talus
spastic peroneals

Question 16

causes of flexible flatfoot

Answer 16

neurological conditions (CP, nerve damage)
muscular dystrophies
connective tissue conditions (EDS, marfans)
muscular weakness/dysfunction

Question 17

how could u measure someones flat foot

Answer 17

rearfoot angle bisection
navicular height
FPI
emed- arch index

Question 18

RCSP is what at 2 years old

Answer 18

10 degs everted that reduces by one degree every year until 10 years

Question 19

what is normal RCSP range for a kid over 10 years with flatfoot

Answer 19

0-2 deg everted

Question 20

what clinical measurement can help determine if a childs flatfoot is of concern

Answer 20

FPI ready rocker

Question 21

when do you treat paeds flatfoot

Answer 21

1. symptomatic (Pain/disability)

Question 22

symptomatic means

Answer 22

pain
loss of function
gait issues
tripping/falling
significant muscle weakness

Question 23

treatment for symptomatic flatfoot

Answer 23

-footwear
-orthotics
-stretching/strengthening
-surgery

Question 24

8 principles to fitting a kids shoe

Answer 24

9-15mm toe allowance

adjustable fastenings

straight last if you can find

clearance of heel collar at malleolar

little finger fits down lat mall space

finger fits retro-tongue

removable insole

firm heel counter

Question 25

shoes do what for kids gait?

Answer 25

improve function including gait parameters
Reduce MTPJ ROM
Faster walking
Heel strike

Question 26

treatment options for kids

Answer 26

footwear first - fit the most important factor

in shoe padding

customised prefab devices

customised full length devices

custom cast lab devices

Question 27

benefits of in shoe padding

Answer 27

elevates potential of shoe
cost effective
high compliance - bright colours helps also
nil adjustment/wear in issues
easy replacement/adjustment

Question 28

why choose EVA for in shoe padding

Answer 28

more resilient
greater recovery
buoyant
comes in a range of colours
easy to grind and alter

Question 29

benefit of custom prefab devices

Answer 29

-reduces time and effort making padding/orthotics
-can apply intrinsic posting at all levels
-cost effective compared to custom othortic, especially considering child is still growing
-high range functional impact

Question 30

when are adult gait patterns achieved by

Answer 30

4-5 years