KINESIOLOGY: GAIT PART IV (EXAM V)

_____ may be:

- direct reflection of a specific impairment

- a compensation for some other impairment

Dysfunction

Cost is typically _____ energy expenditure and application of abnormal stresses on the body

Increased

Gait _____ reflects an effort to preserve ambulation through adaptation

Dysfunction

Common causes of ____ gait patterns:

- pain

- CNS disorders

- MSK impairments

Pathological

_____:

- antalgic gait

- lateral displacement of the head & trunk toward the painful WB LE of hip pain

- trunk lean toward stance limb if pain other than hip

Pain

____ gait:

- shorter step length

- decreased stance time

Antalgic

_____ disorders:

- inability to generate and control muscle force

- spasticity

- festinating gait

- apraxia

CNS

_____ gait is associated with Parkinson's disease

Festinating

______:

- increased tone & resistance to stretch

- CVA and CP (circumduction & scissoring)

Spasticity

______ impairments:

- excessive or limited joint ROM

- limited muscle strength

MSK

_____ or ____ joint ROM

- injury, tightness, contracture

- abnormal joint structure, joint instability

- congenital connective tissue laxity

Excessive or limited

_____ muscle strength:

- disuse atrophy

- peripheral neural injury

Limited

Ankle ____ contracture:

- knee hyperextension (midstance)

- forward trunk lean (terminal stance)

PF

____ ___:

- excessive knee & hip flexion

Foot drop

Reduced ____ ____:

- vaulting

Knee flexion

Weak ____:

- forward trunk lean

Quads

Knee ____ contracture:

- exaggerated knee & hip flexion

Flexion

Reduced knee ____ and/or ankle ____:

- hip circumduction

Flexion; DF

_____ & _____ impairments:

- foot slap, foot flat, or initial contact with forefoot followed by heel (weakness of DF)

- initial contact with forefoot and no heel contact (heel pain, PF contracture or spasticity)

- initial contact with forefoot, heel brought to ground by posterior displacement of tibia at midstance (PF contracture or spasticity)

- premature elevation of heel (lack of DF)

- heel in contact with the ground at terminal stance (weakness/flaccid paralysis of PF)

- supinated foot in stance (pes cavus deformity)

- excessive pronation in stance, arch present in swing (rearfoot varus and/or forefoot varus)

- excessive pronation in stance, no arch in swing (weakness of ankle inverters, pes planus deformity)

- inversion & PF in swing (pes equinovarus deformity 2 degrees spasticity of PF/invertors)

- drop foot (weakness of DF, pes equinus deformity, common peroneal nerve palsy)

Ankle & foot

____ impairments:

- rapid extension of knee after initial contact (spasticity of quads, UMN lesion)

- knee extended during loading response (weak quads, knee pain)

- genu recurvatum in stance (knee extensor weakness)

- varus thrust during stance (laxity of posterior and lateral ligaments of the knee)

- flexed knee in stance, not extension at terminal swing (knee flexion contracture > 10 degrees, hamstrings overactivity)

- reduced or absent knee flexion in swing (spasticity of knee extensors, knee extension contracture)

Knee

____/____ or contralateral LE impairments:

- knee in flexion during stance, normal knee ROM available (pes calcaneus deformity, PF weakness, hip flexion contracture)

- hyperextension of knee in stance (ankle PF contracture, spasticity of PF)

- antalgic gait (painful stance LE)

- excessive knee flexion in swing (lack of ankle DF of swing limb or short stance limb)

Ankle/hip

____, _____ & _____ impairments:

- backward lean in loading response (weak hip extensors)

- lateral trunk lean toward stance LE (compensated trendelenburg (unilateral) and waddling gait (bilateral), marked weakness of hip ABD or hip pain)

- downward drop of the contralateral pelvis in stance (mild weakness of glute med on stance limb)

- forward bending of the trunk in mid/terminal stance (hip flexion contracture, hip pain)

- excessive lumbar lordosis in terminal stance (hip flexion contracture)

- trunk lurches backward and forward unaffected stance limb (hip flexor weakness)

- posterior tilt of pelvis in initial swing (hip flexor weakness)

- hip circumduction (hip flexor weakness)

Hip, pelvis & trunk

____, ____, ____, ____, ____ or contralateral LE impairments:

- forward bending of trunk in loading response (weak quads)

- forward bending or trunk in mid/terminal stance (pes equinus deformity)

- excessive hip & knee flexion during swing (lack of ankle DF of swing limb, short contralateral stance LE)

- hip circumduction in swing (lack of shortening of swing limb)

- hip hiking (lack of shortening of swing limb or short stance limb)

- excessive backward horizontal rotation of pelvis on stance LE (ankle PF weakness)

Hip, pelvis, trunk, ankle, knee