pathological gait

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Author:
jsanders4
ID:
160124
Filename:
pathological gait
Updated:
2012-06-26 09:20:02
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pathological gait
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Description:
pathological gait
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  1. what are some major problems at the toes
    • up
    • inadequate extension
    • clawed or hammered
  2. what are the most likely causes of toe up
    • compensatory weakness of tibialis anterior or insufficient dorsiflexion
    • toe extensor hypertonicity
  3. what is the significance of toe up
    • may help with foot clearance
    • may cause irritation or callouses on the dorsum of the toes from rubbing against the shoe 
  4. what are the most likely causes of inadequate toe extension
    • limited toe extension range of motion including hallux valgus, or hallux rididus
    • toe flexor hypertonicity
    • forefoot pain
    • secondary to no heel off
  5. what is the significance of inadequate toe extension
    • interferes with forward progression
    • decreases step length of the opposite limb 
  6. what are the most likely cause of clawed/hammered toes
    • toe flexor or extensor hypertonicity
    • imbalance of the long toe extensors and intrinc foot muscles
    • compensatory for weak plantar flexors  
  7. what is the significance of clawed/hammered toes
    • interferes with forward progression
    • decreases step length of the opposite limb 
  8. what are some major problems at the ankle and foot
    • forefoot or foot-flat contact
    • foot slap
    • excess plantar flexion
    • excess dorsiflexion
    • excess inversion
    • excess eversion
    • heel off
    • no heel off
    • drag
    • contralateral vaulting
  9. what is the most likely cause of forefoot or foot-flat contact
    • secondary to excess knee flexion in TSw
    • compensatory for weak quadriceps to avoid normal LR
    • secondary to excess plantar flexion in TSw
    • heel pain   
  10. what is the significance of forefoot or flat-foot contact
    • (WA)
    • poor position for heel rocker
    • decreases forward momentum of the tibia
    • decreases shock absorption by limiting knee flexion (forefoot contact)
  11. what is the most likely cause of foot slap
    • (WA)
    • weak pretibials
  12. what is the significance of foot slap
    • decreases forward momentum of the tibia
    • decreases shock absorption by limiting knee flexion 
  13. what is the most likely cause of excess plantar flexion
    • (WA & SLS)
    •  contracture
    •  hypertonicity
    • weak quadriceps
    • impaired proprioception
    • ankle pain   
    • (SLA) 
    •  weak pretibials
    • contracture
    • hypertonicity
    • lack of selective dorsiflexion control (TSw)
  14. what is the significance of excess plantar flexion
    • (WA & SLS)
    • poor position for heel rocker
    • decreases shock absorption by limiting knee flexion (WA)
    • decreases forward progression of the tibia over the ankle and forefoot
    • (SLA)
    • interferes with foot clearance
    • interferes with foot position for IC   
  15. what is the most likely cause of excess dorsiflexion
    • (WA)
    • secondary to excess hip or knee flexion
    • (SLS)
    • weak calf
    • secondary to excess hip or knee flexion
    • intentional to lower the opposite limb for contact (TSt)
    • excess midfoot dorsiflexion secondary to limited ankle mobility    
  16. what is the significance of excess dorsiflexion
    • (WA)
    •  increases the demand on the hip and knee extensors
    • decreases limb stability
    • (SLS)
    • increases the demand on the hip and knee extensors
    • interferes with heel rise and decreases step length of the opposite limb (TSt)
  17. what is the most likely cause of excess calcaneal inversion
    • (WA & SLS & SLA)
    •  tibialis anterior, tibialis posterior or soleus overactivity (pull into supination)
    • varus contracture
    • plantar flexion contracture (SLS)  
    • weak peroneals
    • lack of selective motor control of the pretibials
    • variation in skeletal alignment resultin in a high arch
  18. what is the significance of excess inversion
    • poor positon for WA
    • rigid foot resulting indecreased shock absorption
    • decrease stability in SLS
    • decreased foot clearanc in SLA    
  19. what is the most likely cause of excess eversion
    • (WA & SLS)
    • weak tibialis poster (WA &SLS) soleus (SLS)
    • plantar flexion contracture (SLS)
    • valgus deformity
    • referred from the knee or hip joint
    • variations in skeletal alignment resulting in a low arch
    • (SLA)
    • weak tibials anterior
    • peroneal hypertonicity       
  20. what is the significance of excess eversion
    • rotary strain on midfoot and knee
    • interferes with rigid lever for forefoot rocker
    • can be used to gain dorsiflexion range when ankle mobility is limited  
  21. what is the most likely cause of heel off
    • (WA &SLS)
    • secondary to excess plantar flexion
    • heel pain
    • secondary to excess knee flexion  
  22. what is the significance of heel off
    • decreases the base of support due to smaller weight bearing surface
    • increases pressure on the MT heads (Diabetes patients) 
  23. what is the most likely cause of no heel off
    • (SLS & SLA)
    • weak calf
    • ankle or metatarsal head pain
    • secondary to inadequate extension of the toes
    • secondary to excess dorsiflexion 
  24. what is the significance of no heel off
    • interferes with progression over the forefoot
    • decreases step length of the opposite limb
    • results in limited knee flexion in SLA
  25. what is the most likely cause of drag
    • (SLA)
    • secondary to limited hip flexion, knee flexion or excess plantar flexion
    • impaired proprioception
  26. what is the significance of drag
    • may result in loss of balance
    • interferes with limb advancement
    • may cause injury to toes
  27. what is the most likely causes of contralateral vaulting
    • (SLA)
    • compensatory for limited flexion of the swing limb
    • compensatory for longer swimb limb
  28. what is the significance of contralateral vaulting
    increase the demand on the calf muscle

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