Gait_Pathological

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  1. If hip flexion tightness is an issue - observe what phase of gait?
    Heel off (Terminal stance) - hip moves towards extension
  2. Waddling, toe walking gait - what pathology
    Duchenne’s muscular dystrophy
  3. Wide-based gait - what pathology
    • Cerebellar damage
    • Ataxic CP
  4. “Crouched gait” w/scissoring - describe + what pathology
    • Hip flex/IR + knee flex
    • Spastic CP
  5. Festinating gait - define; cadence; stride length; step length + Tx
    • Abnormal & involuntary INC in SPEED of walking - seen w/Parkinson’s
    • INC cadence
    • DEC stride length
    • DEC step length
    • Tx - Correct posture
  6. Tabes dorsalis gait - describe; d/t loss of what? damage where?
    • High-stepping gait person's feet slap ground as they strike floor
    • D/t loss of proprioception
    • Damage in posterior column from syphylis
  7. Gait - where is PF the most important
    Terminal stance
  8. Steppage gait - Excessive hip & knee flexion - result of what?
    Weak DF (e.g., diabetic neuropa­thy of fibular nerve)
  9. Stance Phase - Antalgic gait - stance time; step length
    • Stance time - short on painful limb
    • Step length - shortened on uninvolved side
  10. PT for gait - to promote hip ABD; to promote knee extension
    • Promote hip ABD - sitting hip ABD on therapy ball
    • Promote knee extension - pushing backward on rolling stool
  11. Tibia advancement – midstance to heel-off - contraction of what? what type of contraction
    Eccentric contraction of PF
  12. AFO - which one to control for buckling knee? which one to control recurvatum?
    • Knee buckling - DF stop
    • Recurvatum - PF stop @ 5 deg
  13. In order to maintain COG - DF/PF of ankle jt is associated w/knee flexion/extension
    If too much of DF/PF what is result?
    • Knee flexion - DF - too much DF --> knee buckling
    • Knee extension - PF - too much PF --> recurvatum
  14. Toes first @ initial contact - orthotic causes - 3
    • Inadequate heel lift
    • Inadequate DF assist
    • Inadequate PF stop
  15. Toes first @ initial contact - anatomical causes - 4
    • Heel pain
    • Extensor spasticity
    • Pes equinus
    • Short leg
  16. Excessive knee flexion @ initial contact - orthotic causes - 4
    • Too much DF - Inadequate DF stop
    • Insufficient PF - PF stop
    • Short contralateral leg - Inadequate shoe lift
    • Inadequat knee lock
  17. Excessive knee flexion @ initial contact - anatomical causes - 2
    • Knee &/or hip flexion contracture - weak quads
    • Knee pain
  18. Excessive knee flexion @ initial contact - compensation - 1
    Forward trunk bending
  19. Hyperextended knee @ initial contact - orthotic causes - 3
    • Inadequate PF stop
    • Pes equinus (too much PF) - uncompensated by contra shoe lift
    • Inadequate knee lock
  20. Hyperextended knee @ initial contact - anatomical causes - 3
    • Weak quads
    • Extensor synergy
    • Short contralateral leg - knee/hip flexion contracture
  21. Forward trunk lean @ initial contact - 1 orthotic + 2 anatomical
    • KNEE FLEXION ISSUES
    • Inadequate knee lock
    • Quad weakness
    • Hip/knee flexion contracture
  22. Backward trunk lean @ initial contact - 1 orthotic + 2 anatomical
    • Inadequate hip/knee lock 
    • Knee ankylosis
    • Weak gluteus max on stance leg
  23. Delayed/absent transfer of weight over forefoot @ late stance - 2 orthotic + 2 anatomical
    • PF stop + Weak PF
    • Inadequate DF stop
    • Pes calcaneus
    • Forefoot pain
  24. Circumduction/vaulting/hip hiking @ swing - 3 orthotic + 4 anatomical
    • ORTHOTIC:
    • Locked knee
    • Inadequate DF - Weak DF; Inadequate DF assist
    • Excessive PF (inadequate PF stop, PF contracture)
    • ANATOMICAL:
    • Weak hip flexors
    • Pes equinus
    • Short contralateral leg
    • ABD contracture
  25. Circumduction/vaulting/hip hiking @ swing - AKA - prosthetic reasons - 6
    • Long prosthesis
    • Locked knee unit
    • Loose knee friction
    • Inadequate suspension
    • Small or loose socket
    • PF foot
  26. BKA - Excessive knee flexion @ initial contact + early knee flexion @ late stance - socket what? heel cushion? DF stop how? PF?
    • Insufficient PF
    • Stiff heel cushion
    • DF stop too soft
    • Socket - too anterior + excessively flexed
  27. BKA - Insufficient knee flexion @ initial contact + delayed knee flexion @ late stance - socket what? heel cushion? DF stop how? PF?
    • Excessive PF
    • Soft heel cushion
    • DF stop too stiff
    • Socket - too posterior; not flexed enough
  28. BKA - Lateral/Medial thrust at midstance - foot how?
    • Lateral thrust - Foot inset too much
    • Medial thrust - Foot outset too much
  29. BKA - pain on ant distal stump - gait deviation - 1
    Lack of knee flexion in early stance (locking relieves pressure)
  30. BKA - prosthetic foot set too far posteriorly - gait deviation - early stance; midstance
    • Early stance - Rapid & excessive knee flexion in early stance
    • Midstance - Early heel rise
  31. BKA - weak quads - gait deviation + at what phase - 1
    Lack of knee flexion in early stance
  32. AKA - ABD gait - 3 prosthetic + 2 anatomical
    • Long prosthesis
    • Med wall too high
    • ABD lateral wall - Lat wall not ADD enough
    • ABD contracture (esp for shorter AKAs)
    • Anatomical - laterodistal pain
  33. Lateral trunk bending toward stance leg during stance - causes - 3 anatomical + 3 orthotic/prosthetic
    • Too much ABD - ABD contracture; (HKAFO in excessive ABD); Lat wall not ADD enough
    • Medial wall - too high (orthotic - KAFO)
    • Short limb - Short prosthesis (orthotic - insufficient shoes lift)
    • Weak glut med
    • Poor balance
  34. AKA - Lumbar lordosis during stance - causes - 5
    • Inadequate socket flexion
    • Painful ischial WB
    • Hip flexion contracture
    • Weak hip extensors or abdominals
    • Socket not tilted enough post
  35. Heel off - medial/lateral whip - 3
    • MALROTATION @ KNEE - Insufficient knee jt rotation
    • Medial whip - knee ER
    • Lateral whip - knee IR
  36. AKA - Terminal swing impact - causes - 3
    • Insufficient knee friction
    • Taut extension aid
    • Forceful hip flexion
  37. AKA - Uneven step length - causes - 4
    • Socket discomfort
    • Insufficient socket flexion
    • Hip flexion contracture
    • Hip instability
  38. CVA - Hip hiking (QL action) - result of?
    Extensor spasticity of swing leg
  39. Stance Phase - Pronation - causes - 4
    • Weak invertors
    • Spasticity
    • Pes valgus
    • Genu valgum
  40. Foot flat to mid stance - hip IR/ER - 3
    • Spasticity/weakness of IR/ER
    • IR - Excessive forward rotation of opposite pelvis
    • ER - Excessive backward rotation of opposite pelvis
  41. CVA - Stance phase - hip - poor hip position - how?
    ADD & flexion
  42. CVA - Stance phase - 2 major problems
    • Trendelenburg d/t weak ABD on opposite side
    • Scissoring d/t ADD
  43. CVA - Swing phase - trunk/pelvis - 2
    • Insufficient forward pelvic rotation (abdominal weakness)
    • Inclination to sound side for foot clearance
  44. CVA - Stance phase - ankle - unequal step length d/t what?
    Hammer toes d/t spasticity of toe flexors
  45. CVA - Swing phase - ankle/foot - varus position of foot d/t what? - 3
    • Spastic anterior tibialis
    • Weak peroneals
    • Weak toe extensors
  46. CVA - Swing phase - hip - inadequate hip flexion d/t what? - 4
    • Weak hip flexors
    • Poor proprioception
    • Spastic quads - active insufficiency
    • Hip ADD weakness of opposite side
  47. CVA - Swing phase of gait - inclination to sound side for foot clearance d/t what?
    Weak hip flexors
  48. CVA - Genu recurvatum - why? - 3
    • Extensor spasticity
    • Quad weakness (compensatory locking)
    • PF contractures
  49. CVA - Swing phase of gait - exaggerated ankle DF; knee flexion; hip flexion d/t what?
    Strong flexor synergy
  50. Stance phase of gait & forward trunk - d/t what?
    • Weak hip extension
    • Hip flexion contractures
  51. Stance phase @ knee hyperextension during forward progression d/t what? - 3
    • PF contracture past 90 deg
    • Severe spasticity in quads
    • Weak knee extensors (compensotary locking of knee)
  52. Extensor lag at knee - d/t damage of what?
    Femoral nn damage
  53. MMs crucial for successful crutch gait - 3
    • Shoulder depressors - Lower trap; latissimus dorsi
    • Elbow extensors - triceps
  54. Contracted hip flexors - gait deviation
    Shortened stride length - bc contracted illiopsoas limits pt’s ability to extend hip
  55. Contracted hamstrings - gait deviation - 2
    • DEC knee extension @ stance
    • Unstable knee
  56. Weak hip flexors - gait deviation
    DEC limb shortening @ swing —> circumduction
  57. Weak Quads - gait deviation - 2
    • DEC knee extension @ stance
    • Unstable knee
  58. Backward trunk lean - what mm is weak? INC difficulty w/what? Intervention
    • Gluteus maximus gait - weak glute max
    • INC difficulty w/going up stairs/ramps
    • Functional strengthening of hip extensors by bridging

Card Set Information

Author:
Tanuisha
ID:
324126
Filename:
Gait_Pathological
Updated:
2016-12-06 23:39:39
Tags:
Gait Pathological
Folders:
MSK
Description:
Gait_Pathological
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