[2Y2T2S] [PT1019] [8] Common Gait Deviations Associated with Orthotic Device Issues

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35 Terms

1
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What are the eight (8) phases of the gait cycle?

  1. Initial contact

  2. Loading response

  3. Mid stance

  4. Terminal stance

  5. Pre-swing

  6. Initial swing

  7. Mid swing

  8. Terminal swing

<ol><li><p>Initial contact</p></li><li><p>Loading response</p></li><li><p>Mid stance</p></li><li><p>Terminal stance</p></li><li><p>Pre-swing</p></li><li><p>Initial swing</p></li><li><p>Mid swing</p></li><li><p>Terminal swing</p></li></ol><p></p>
2
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The period when the reference limb is in contact with the ground

Stance period

<p>Stance period</p>
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The period when the limb is off the ground

Swing period

<p>Swing period</p>
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GAIT DEVIATIONS — EARLY STANCE

Two (2) orthotic causes of foot slap

  1. Inadequate dorsiflex assist

  2. Inadequate plantarflexion stop

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GAIT DEVIATIONS — EARLY STANCE

Four (4) orthotic causes of tiptoe posture (toes first)

  1. Inadequate heel life

  2. Inadequate dorsiflexion assist

  3. Inadequate plantarflexion stop

  4. Inadequate relief of heel pain

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GAIT DEVIATIONS — EARLY STANCE

Three (3) orthotic causes of flat foot contact

  1. Inadequate traction from sole

  2. Requires walking aid (ex. cane)

  3. Inadequate dorsiflexion stop

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GAIT DEVIATIONS — EARLY STANCE

One (1) orthotic cause of excessive medial/lateral foot contact

  1. Transverse plane malalignment

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GAIT DEVIATIONS — EARLY STANCE

Four (4) orthotic causes of excessive knee flexion

  1. Inadequate knee lock

  2. Inadequate dorsiflexion stop

  3. Plantarflexion restriction (stop)

  4. Inadequate contralateral shoe lift

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GAIT DEVIATIONS — EARLY STANCE

Four (4) orthotic causes of hyperextended knee

  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

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GAIT DEVIATIONS — EARLY STANCE

One (1) orthotic cause of anterior trunk bending

  1. Inadequate knee lock

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GAIT DEVIATIONS — EARLY STANCE

Two (2) orthotic causes of posterior trunk bending

  1. Inadequate hip lock

  2. Knee lock

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GAIT DEVIATIONS — EARLY STANCE

Four (4) orthotic causes of lateral trunk bending

  1. Excessive height of medial upright of KAFO

  2. Excessive abduction of hip joint of HKAFO

  3. Required walking aid (ex. cane)

  4. Insufficient shoe lift

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GAIT DEVIATIONS — EARLY STANCE

Five (5) orthotic causes of wide walking base

  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. Required walking aid (ex. cane)

14
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GAIT DEVIATIONS — EARLY STANCE

Two (2) orthotic causes of internal/external rotation of LE

  1. Uprights incorrectly aligned in transverse plane

  2. Requires orthotic control (ex. rotation control straps, pelvic band)

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GAIT DEVIATIONS — LATE STANCE

Two (2) orthotic causes for inadequate transition

  1. Plantarflexion stop

  2. Inadequate dorsiflexion stop

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GAIT DEVIATIONS — SWING

Two (2) orthotic causes for toe drag

  1. Inadequate dorsiflexion assist

  2. Inadequate plantarflexion stop

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GAIT DEVIATIONS — SWING

Three (3) orthotic causes for circumduction

  1. Knee lock

  2. Inadequate dorsiflexion assist

  3. Inadequate plantarflexion stop

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GAIT DEVIATIONS — SWING

Three (3) orthotic causes for hip hiking

  1. Knee lock

  2. Inadequate dorsiflexion assist

  3. Inadequate plantarflexion stop

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GAIT DEVIATIONS — SWING

Three (3) orthotic causes for vaulting

  1. Knee lock

  2. Inadequate dorsiflexion assist

  3. Inadequate plantarflexion stop

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GAIT DEVIATIONS — EARLY STANCE

Forefoot slaps the ground

Foot slap

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GAIT DEVIATIONS — EARLY STANCE

Tiptoe posture may or may not be maintained throughout stance

Toes first

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GAIT DEVIATIONS — EARLY STANCE

Entire foot contacts ground initially

Flat foot contact

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GAIT DEVIATIONS — EARLY STANCE

Medial (or lateral) border contacts floor

Excessive medial (or lateral) foot contact

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GAIT DEVIATIONS — EARLY STANCE

Knee collapses when foot contacts ground

Excessive knee flexion

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GAIT DEVIATIONS — EARLY STANCE

Knee hyperextends as weight is transferred to LE

Hyperextended knee

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GAIT DEVIATIONS — EARLY STANCE

Patient leans forward as weight is transferred to LE

Anterior trunk bending

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GAIT DEVIATIONS — EARLY STANCE

Patient leans backward as weight is transferred to LE

Posterior trunk bending

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GAIT DEVIATIONS — EARLY STANCE

Patient leans toward stance leg as weight is transferred to LE

Lateral trunk bending

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GAIT DEVIATIONS — EARLY STANCE

Heel centers more than 4 in (10 cm) apart

Wide walking base

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GAIT DEVIATIONS — EARLY STANCE

LE internally (or externally) rotated

Internal (or external) rotation

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GAIT DEVIATIONS — LATE STANCE

Delayed or absent transfer of weight over the forefoot

Inadequate transition

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GAIT DEVIATIONS — SWING

Toes maintain contact with ground

Toe drag

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GAIT DEVIATIONS — SWING

LE swings outward in a semicircular arc

Circumduction

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GAIT DEVIATIONS — SWING

LE elevated at pelvis to enable the limb to swing forward

Hip hiking

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GAIT DEVIATIONS — SWING

Exaggerate plantarflexion of contralateral LE to enable the limb to swing forward

Vaulting