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Pathological Gait PowerPoint PPT Presentation


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Pathological Gait. Excessive Plantarflexion. Causes Triceps surae contracture Triceps surae spasticity Pre-tibial weakness Voluntary/compensatory 2 0 weak quadriceps. Loading Response Deviations. FF contact sustained. FF contact  foot flat (rigid ankle)  knee hyperextension. - PowerPoint PPT Presentation

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Pathological Gait

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Pathological gait l.jpg

Pathological Gait


Excessive plantarflexion l.jpg

Excessive Plantarflexion

Causes

  • Triceps surae contracture

  • Triceps surae spasticity

  • Pre-tibial weakness

  • Voluntary/compensatory 20 weak quadriceps


Loading response deviations l.jpg

Loading Response Deviations

FF contact sustained

FF contact  foot flat (rigid ankle)  knee hyperextension

FF contact  rapid foot

flat (flexible ankle)

FF = fore foot


Midstance deviations l.jpg

Midstance Deviations

Foot flat w/ restrained

tibia

Fwd. trunk lean, short contralateral step

Premature

heel rise


Terminal stance deviations l.jpg

Terminal Stance Deviations

Pelvic obliquity  high on side of deviation

Excessive heel rise


Mid swing deviations l.jpg

Mid Swing Deviations

Compensatory  hip and/or knee flexion

Toe Drag


Excessive dorsiflexion l.jpg

Excessive Dorsiflexion

  • Weak triceps surae

  • Ankle joint fusion at neutral

  • Excessive knee flexion


Loading response deviations8 l.jpg

Loading Response Deviations

Higher heel rocker

 knee    quad demand


Loading response deviations 2 0 rigid afo l.jpg

Loading Response Deviations 20 Rigid AFO

Rigid AFO  knee and hip flexion


Terminal stance deviations10 l.jpg

Terminal Stance Deviations

Prolonged heel contact

 knee  w/ heel rise

OR


Pre swing deviations l.jpg

Pre Swing Deviations

Sustained heel contact   plantarflexion


Inadequate knee flexion excessive extension l.jpg

Inadequate Knee Flexion / Excessive Extension

  • Quadriceps weakness

  • Pain

  • Quadriceps spasticity

  • Excessive ankle plantarflexion


Pre swing and initial swing l.jpg

Pre Swing and Initial Swing

 ankle dorsiflexion w/

prolonged heel contact

Toe Drag


Midstance l.jpg

Midstance

Retraction of tibia (soleus)

and femur (gluteus max)

when knee lacks

hyperextension range


Inadequate knee flexion 2 0 excessive plantarflexion l.jpg

Inadequate knee flexion 20 excessive plantarflexion

Overall disruption of normal coordination

between the knee and ankle


Inadequate knee extension excessive knee flexion l.jpg

Inadequate Knee Extension / Excessive Knee Flexion

Causes

  • Hamstring spasticity

  • Knee flexion contracture

  • Soleus weakness

  • Excessive ankle plantarflexion


Excessive knee flexion loading response l.jpg

Excessive Knee Flexion - Loading Response

Resulting in  ankle dorsiflexion


Excessive knee flexion midswing l.jpg

Excessive Knee Flexion - Midswing

As a compensation for

 ankle plantarflexion


Inadequate knee extension midstance and terminal stance l.jpg

Inadequate Knee Extension – Midstance and Terminal Stance

Accompanied w/  ankle dorsiflexion   limb

and body advancement


Inadequate knee extension terminal swing l.jpg

Inadequate Knee Extension – Terminal Swing

Loss of terminal reach


Inadequate hip extension excessive hip flexion l.jpg

Inadequate Hip Extension – Excessive Hip Flexion

  • Hip flexion contracture

  • Iliotibial band contracture

  • Hip flexor spasticity

  • Pain

  • Voluntary/Compensatory


Inadequate hip extension tst l.jpg

Inadequate Hip Extension – TSt

Contracture

 step length and

body advancement


Excessive hip flexion msw l.jpg

Excessive Hip Flexion - MSw

Compensation for 

ankle plantarflexion


Inadequate hip flexion l.jpg

Inadequate Hip Flexion

  • Hip flexor weakness

  • Hip joint arthrodesis


Inadequate hip flexion tsw l.jpg

Inadequate Hip Flexion - TSw

Rapid hip /

Rapid hip 

Compensation for weak quadriceps that

cannot extend the knee (flaccid knee)


Compensations for inadequate hip flexion psw isw l.jpg

Compensations for Inadequate Hip Flexion – PSw/ISw

Compensatory posterior

pelvic tilt


Compensations for inadequate hip flexion psw isw27 l.jpg

Compensations for Inadequate Hip Flexion – PSw/ISw

Voluntary excessive (magnitude &

velocity) knee flexion


Excessive hip adduction l.jpg

Excessive Hip Adduction

Causes:

  • Ipsilateral abductor weakness

  • Adduction contracture or spasticity

  • Using adductors as hip flexors

  • Contralateral hip abduction contracture


Deviations l.jpg

Deviations

Swing  “Scissor Gait”

Combined hip  & IR


Deviations30 l.jpg

Deviations

20 adductor contracture

or spasticity

20 adductors used as hip flexors

20 glute med weakness


Excessive hip abduction l.jpg

Excessive Hip Abduction

Causes

  • Ipsilateral abduction contracture

  • Contralateral adduction contracture

  • Scoliosis w/ pelvic obliquity


Deviations32 l.jpg

Deviations

Compensation for

inadequate knee flexion

20 contralateral

abduction or ipsilateral

adduction contracture


Excessive hip external rotation l.jpg

Excessive Hip External Rotation

Causes

  • Gluteus maximus overactivity

  • Excessive ankle plantarflexion


Excessive hip internal rotation l.jpg

Excessive Hip Internal Rotation

Causes

  • Medial hamstring overactivity

  • Adductor overactivity

  • Anterior abductor overactivity

  • Quadriceps weakness