pathological gait. excessive plantarflexion causes triceps surae contracture triceps surae...

Pathological Gait

Excessive Plantarflexion

Causes Triceps surae contracture Triceps surae spasticity Pre-tibial weakness Voluntary/compensatory 20 weak

quadriceps

Loading Response Deviations

FF contact rapid foot flat (flexible ankle)

FF contact sustained

FF contact foot flat (rigid ankle) knee hyperextension

FF = fore foot

Midstance Deviations

Prematureheel rise

Foot flat w/ restrainedtibia

Fwd. trunk lean, short contralateral step

Terminal Stance Deviations

Excessive heel rise

Pelvic obliquity high on side of deviation

Mid Swing Deviations

Toe DragCompensatory hip and/or knee flexion

Excessive Dorsiflexion Weak triceps surae

Ankle joint fusion at neutral

Excessive knee flexion

Loading Response Deviations

Higher heel rocker knee quad demand

Loading Response Deviations 20 Rigid AFO

Rigid AFO knee and hip flexion

Terminal Stance Deviations

Prolonged heel contact

OR knee w/ heel rise

Pre Swing Deviations

Sustained heel contact plantarflexion

Inadequate Knee Flexion / Excessive Extension Quadriceps weakness Pain Quadriceps spasticity Excessive ankle plantarflexion

Pre Swing and Initial Swing

ankle dorsiflexion w/prolonged heel contact

Toe Drag

Midstance

when knee lackshyperextension range

Retraction of tibia (soleus)and femur (gluteus max)

Inadequate knee flexion 20 excessive plantarflexion

Overall disruption of normal coordinationbetween the knee and ankle

Inadequate Knee Extension / Excessive Knee Flexion

Causes Hamstring spasticity Knee flexion contracture Soleus weakness Excessive ankle plantarflexion

Excessive Knee Flexion - Loading Response

Resulting in ankle dorsiflexion

Excessive Knee Flexion - Midswing

As a compensation for ankle plantarflexion

Inadequate Knee Extension – Midstance and Terminal Stance

Accompanied w/ ankle dorsiflexion limband body advancement

Inadequate Knee Extension – Terminal Swing

Loss of terminal reach

Inadequate Hip Extension – Excessive Hip Flexion Hip flexion contracture Iliotibial band contracture Hip flexor spasticity Pain Voluntary/Compensatory

Inadequate Hip Extension – TSt

step length and body advancement

Contracture

Excessive Hip Flexion - MSw

Compensation for ankle plantarflexion

Inadequate Hip Flexion Hip flexor weakness

Hip joint arthrodesis

Inadequate Hip Flexion - TSw

Compensation for weak quadriceps that cannot extend the knee (flaccid knee)

Rapid hip Rapid hip /

Compensations for Inadequate Hip Flexion – PSw/ISw

Compensatory posteriorpelvic tilt

Compensations for Inadequate Hip Flexion – PSw/ISw

Voluntary excessive (magnitude &velocity) knee flexion

Excessive Hip Adduction

Causes: Ipsilateral abductor weakness Adduction contracture or spasticity Using adductors as hip flexors Contralateral hip abduction

contracture

Deviations

Swing “Scissor Gait” Combined hip & IR

Deviations

20 glute med weakness20 adductor contractureor spasticity

20 adductors used as hip flexors

Excessive Hip Abduction

Causes Ipsilateral abduction contracture Contralateral adduction

contracture Scoliosis w/ pelvic obliquity

Deviations

20 contralateral abduction or ipsilateraladduction contracture

Compensation for inadequate knee flexion

Excessive Hip External Rotation

Causes Gluteus maximus overactivity Excessive ankle plantarflexion

Excessive Hip Internal Rotation

Causes Medial hamstring overactivity Adductor overactivity Anterior abductor overactivity Quadriceps weakness