Gait Abnormalities

Gait Abnormalities : 

Gait Abnormalities - Edrish Contractor

GAIT : 

GAIT Translatory progression of the body as a whole, produced by coordinated, rotatory movements of the body segments Lower extremities – carry the weight of the head, arms & trunk ( HAT )

Purposes of gait : 

Purposes of gait Support of the HAT Maintenance of upright posture & balance of the body Achieve safe ground clearance & a gentle heel or toe landing Generation of mechanical energy to maintain the present forward velocity or to increase the forward velocity Absorption of mechanical energy for shock absorption & stability or to decrease the forward velocity of the body - Winter -

Kinematics of the gait : 

Kinematics of the gait Phases of the gait cycle:

Events in Stance Phase : 

Events in Stance Phase Traditional: Heel Strike Foot Flat - 7% Midstance- 30% Heel off – 40% Toe off – 60% Rancho Los Amigos Initial Contact Loading response Midstance Terminal Stance Preswing

Events in Swing Phase : 

Events in Swing Phase Traditional Acceleration Midswing Deceleration Rancho Los Amigos Initial Swing Midswing Terminal swing

Double Support : 

Double Support In normal walking speed – each period of double support occupies about 11% of the gait cycle - 22 % for full cycle The body supported – by only one limb for nearly 80 % of the gait cycle

GAIT TERMINOLGY : 

GAIT TERMINOLGY Temporal Variable Stance time Single limb & double time Swing time Stride & Step time Cadence Speed Distance Variable Stride length Step length Width Degree of toe-out

Distance Variables : 

Distance Variables Stride length: is the linear distance between two successive events that are accomplished by the same lower extremity It is measured from the point of one heel strike of one lower extremity to the point of the next heel strike of the same extremity ↓ - elderly pts & ↑ - speed of gait increases

Distance Variables : 

Distance Variables Stride duration: amount of time it takes to complete one stride Stride duration & gait cycle are synonymous For normal adult the stride duration lasts for 1 sec

Distance Variables : 

Distance Variables Step length: is the linear distance between two successive points of contact of opposite extremities Measured from the heel of one extremity to the heel strike of the opposite extremity Step duration: amount of time spent during single step If there pain in an extremity, step duration ↓ ed on the affected side & ↑ ed on the normal side

Distance Variables : 

Distance Variables Cadence – no of steps / unit of time, it is usually measured steps / min Adult men – 110 steps / min Adult women – 116 steps / min

Gait terminology : 

Gait terminology Step width – measuring the linear distance between the mid point of the heel of one foot & the same point on the other foot Step width ↑ in elderly persons & children as they demand more stability In young children, COG is higher than in adults, as wide base of support is necessary for stability Normal width – 3.5 inches & varies between 1 – 5 inches

Double Support time : 

Double Support time Increased in elderly persons & in those with balance disorders Decreases as the speed of walking increases

Assesment of gait : 

Assesment of gait History Posture of head, neck, thorax, lumbar spine Musculoskeleton pathology Muscle weakness Pain Altered ROM

Observation : 

Observation Anterior View Posterior View Lateral View Foot wear Bare feet Normal foot wear

Examintion : 

Examintion Gait Parameters

Abnormal Gait : 

Abnormal Gait Antalgic ( Painful Gait ) Self – protective gait Injury to plvis, hip, knee, ankle, foot Stance phase of affected leg is reduced to reduce weight Swing phase of unaffected is decreased Trunk bending

Slide 20: 

Tredelenburg gait Hip dislocation Coxa vara Hip pain Short limb Knee flexion contracture Weak abductors

Lateral Bending Gait : 

Lateral Bending Gait

Lurching Gait : 

Lurching Gait Also known as Posterior trunk bending Inability to extend hip Gluteus max weakness Jack knife gait

Jack Knife Gait : 

Jack Knife Gait

HAND TO KNEE GAIT : 

HAND TO KNEE GAIT Seen in Post Polio Patients Paralysis of quadriceps Weakness of gastro- soleus Weakness of gluteus max To avoid buckling knee, pt bends anteriorly

GENU RECURVATUM GAIT : 

GENU RECURVATUM GAIT Paralysis of Quadriceps Compensation by gastro soleus & gluteus max

Orthosis : 

Orthosis

Circumductory Gait : 

Circumductory Gait Hemiplegic Patients Extensors Spasticity Abnormal reflex Abnormal synergy pattern Swing phase Knee flexion – 30 -60 degree Hip flexion – 20-30 degree

Hip Hiking Gait : 

Hip Hiking Gait Hip Flexors Weakness Knee Ankylosed Hamstrings weakness

Foot Drop Gait High Steppage Gait : 

Foot Drop Gait High Steppage Gait Weakness or Paralysis of DF No heel to toe pattern Excessive Hip and Knee Flexion

Flexed knee Gait : 

Flexed knee Gait Contracture of Hamstrings Knee remains in flexion Excessive DF of foot

Ataxia Gait : 

Ataxia Gait Cellebellar ataxia Walks with wide base Poor balance Exaggerates all movement

Calcaneal Gait : 

Calcaneal Gait Weakness of PF of foot Metatarsalgia Rupture of TA No Toe touch

Parkinson Gait : 

Parkinson Gait Stereotype Decrease Generalised extension of LL Walks with Flexed trunk Short steps Running to catch COG

Scissors Gait : 

Scissors Gait Spastic Diplegic CP Child walks on forefeet

Equinus Gait : 

Equinus Gait Pt walks on forefoot Contracture or spastic TA No heel contact CP CTEV