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Gait Training - I

Gait Training - I. Mazyad Alotaibi. Normal Gait & Abnormal Gait. 60%. 40%. Abnormal gait. Inadequate Dorsi -flexion control Insufficient Push-off Abnormal walking base Internal or external limb rotation Excessive medial or lateral foot contact Vaulting. Stance phase Antalgic gait

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Gait Training - I

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  1. Gait Training - I MazyadAlotaibi

  2. Normal Gait & Abnormal Gait

  3. 60% 40%

  4. Abnormal gait • Inadequate Dorsi-flexion control • Insufficient Push-off • Abnormal walking base • Internal or external limb rotation • Excessive medial or lateral foot contact • Vaulting • Stance phase • Antalgic gait • Lateral trunk bending • Anterior trunk bending • Posterior trunk bending • Lordosis • Hyperextended knee • Excessive knee flexion • Excessive Genu Valgum or Varum

  5. Swing phase • Circumduction • Hip hiking • Internal or external limb rotation • Inadequate Dorsiflexion control • Abnormal walking base

  6. Antalgic gait • Pain in stance phase : knee, hip, foot pain

  7. Lateral trunk bending • Hip abductor weakness • Hip dislocation, coxa vara, slipped capital femoral epiphysis • Hip pain • Involved limb relatively shorter • Compensation for abducted gait

  8. Trendelenberg gait • Gluteus Medius Gait

  9. Anterior Trunk Bending • Quadriceps weakness combined with weakness of gluteus maximus, gastrocnemius, or both Pushing backward with the hand/ lateral rotation

  10. Posterior Trunk Bending • Gluteus Maximus (Lurch) Gait • Hip-extensor weakness • Knee ankylosis, spasticity or orthotic knee lock • Hip-extensor spasticity

  11. Hyper-extended knee • Quadriceps weakness • Capsular ligament laxity • Quadriceps spasticity • Plantar-flexion contracture or spasticity • Compensation for contralateral limb shortening (hip-flexion or knee-flexion contracture)

  12. Excessive knee flexion • Knee-flexion or hip-flexion contracture • Knee-flexor spasticity • Uncompensated quadriceps weakness • Ankle ankylosis • Plantar-flexor weakness • Involved limb relatively longer

  13. Steppage gait • - Ankle dorsiflexor weakness : compensate by exaggerated hip and knee flexion Foot drop / dragging

  14. Slap foot • Ankle dorsiflexor weakness : early stance phase

  15. Insufficient Push-Off • Flat foot gait • Plantar-flexor weakness • Rupture of the Archilles tendon or the triceps surae • Metatarsal pain, hallux rigidus

  16. Internal or External Limb Rotation • Internal rotation • Biceps femoris weakness • spasticity • External rotation • Quadriceps weakness • Inner hamstring weakness • Spasticity

  17. Abnormal walking base • Wide Base (> 4 inch) • Hip-abduction contracture • Instability due to fear, proprioceptive deficit, cerebellar problem • Narrow base (< 2 inch) • Spasticity • Genu varum • Genu valgum

  18. Vaulting • Swing-phase limb is relatively longer

  19. Hip hiking • Increased ipsilateral length: • hip -flexor or dorsiflexor weakness • hip, knee, ankle ankylosis or spasticity • insufficient hip or knee flexion • Contralateral shortness

  20. Circumduction • Spasticity • Hip flexor weakness • Hamstring paralysis • Knee or ankle ankylosis / orthotic knee lock • Dorsiflexor weakness • Plantar-flexion contracture

  21. Scissor gait • In spastic CP with spasticity of adductor m.

  22. Crouched Gait • Excessive flexion of hip and knee due to spasticity, muscle tightness or contracture • Spastic CP

  23. Parkinsonian gait • Trunk ,head ,neck forward and knee flexed • wide base ,small shuffling step • trend to fall forward and to increase speed (festination)

  24. Hemiplegic gait • Abnormal arm swing : adduction with flexion at shoulder ,elbow ,wrist and fingers • extensor synergy of lower limb: leg extension ,adduction and hip IR ,knee extension ,ankle and foot plantarflexion and inversion.

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