Pathological Gait. Excessive Plantarflexion Causes Triceps surae contracture Triceps surae...
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Transcript of 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