Gait abnormality

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Gait abnormality
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• Normal gait
• is defined as
• (form of bipedal locomotion)
• or as a method of locomotion involving the use of
  the two legs, alternately , to provide both
  support and propulsion at least one foot being in
  contact with the ground at all times .
• It is a series of rhythmic alternating motion of
  arms, legs, and trunk that create forward motion

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• In order to walk
• 1- each leg able to support body wt without
  collapse
• 2- maintain static and dynamic balance during
  single leg stance maintenance of upright posture.
• 3- sufficient power for limb motion and to
  advance the trunk.
• 4- the swing leg able to advance to a position
  where it can take over the supporting role.
• For proper gait
• 5- proper proprioceptive system
• 6- normal vision

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Causes of gait abnormality

• Weakness , spasticity , balance disturbances,
  leg length discrepancy ...or deformity which
  disturbs the motion
• The motion is a compensation to correct for some
  other problem

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Specific gait abnormality

• Lateral trunk bending
• 1- Trendelenburg gait
• 2- waddling gait
• Standing on one leg lead to increase load on
  the stance leg due to
• 1- whole wt on one leg
• 2- the wt of swing leg
• 3- gluteus medius reaction force

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Unilateral stance
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Trendelenburg gait
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• Causes of Trendelenburg gait
• Painful hip
• Abductor weakness
• Abnormal hip joint, CDH
• Unequal Leg length
• Coxa vara

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Angle of inclination of the femur
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• Anterior trunk bending
• At heel contact, the trunk bend forward to
  compensate for knee extensor weakness
• Posterior trunk bending
• At heel contact, the trunk bend backward to
  compensate for hip extensor weakness or to propel
  the swing leg forward to compensate for hip
  flexor weakness or spasticity of hip extensor
  weakness or ankylosed hip

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Anterior trunk bending Posterior trunk bending
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• Increased lumbar lordosis
• Due to flexion contracture of the hip joint

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• Functional leg length discrepancy
• Not true discrepancy
• 1- circumduction
• 2- hip hiking
• 3- high steppage
• 4- vaulting

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Abnormal hip rotation
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Causes of toe in- out gait

• Increased range of internal rotation
• Decreased range of external rotation
• Ms imbalance
• Mechanical effects of femur Anteversion
• N.B The opposite is true for hip retroversion

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• Excessive knee extension due to knee extensor
  weakness
• Excessive knee flexion due to
• 1- knee flexion contracture
• 2- knee flexor spasticity
• 3-ankle stiffness
• 4- Functional leg length discrepancy

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• Toe drag and foot slap due to inadequate foot
  dorsiflexor control
• Abnormal foot contact due to
• 1- talipes calcaneus
• 2- talipes equinus
• 3- excessive medial contact
• 4- excessive lateral contact
• 5- Stamping gait- loss of sensation

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• Insufficient push off
• Due to calf muscles weakness
• Abnormal walking base
• 1- increased base (abducted hip deformity-valgus
  knee- instability)
• 2- decreased base (adducted hip deformity-varus
  knee)

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How to reduce muscle force in unilateral stance
?1- reduce body weight2- Carrying a load
ipsilaterally3- Use of a cane ipsilaterally
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4- Compensatory lateral lean of the trunk
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5- Use of cane contralaterally
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Thanks