Pathological Gait

1. Pathological Gait

2. Excessive Plantarflexion Causes • Triceps surae contracture • Triceps surae spasticity • Pre-tibial weakness • Voluntary/compensatory 20 weak quadriceps

3. Loading Response Deviations FF contact sustained FF contact  foot flat (rigid ankle)  knee hyperextension FF contact  rapid foot flat (flexible ankle) FF = fore foot

4. Midstance Deviations Foot flat w/ restrained tibia Fwd. trunk lean, short contralateral step Premature heel rise

5. Terminal Stance Deviations Pelvic obliquity  high on side of deviation Excessive heel rise

6. Mid Swing Deviations Compensatory  hip and/or knee flexion Toe Drag

7. Excessive Dorsiflexion • Weak triceps surae • Ankle joint fusion at neutral • Excessive knee flexion

8. Loading Response Deviations Higher heel rocker  knee    quad demand

9. Loading Response Deviations 20 Rigid AFO Rigid AFO  knee and hip flexion

10. Terminal Stance Deviations Prolonged heel contact  knee  w/ heel rise OR

11. Pre Swing Deviations Sustained heel contact   plantarflexion

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

13. Pre Swing and Initial Swing  ankle dorsiflexion w/ prolonged heel contact Toe Drag

14. Midstance Retraction of tibia (soleus) and femur (gluteus max) when knee lacks hyperextension range

15. Inadequate knee flexion 20 excessive plantarflexion Overall disruption of normal coordination between the knee and ankle

16. Inadequate Knee Extension / Excessive Knee Flexion Causes • Hamstring spasticity • Knee flexion contracture • Soleus weakness • Excessive ankle plantarflexion

17. Excessive Knee Flexion - Loading Response Resulting in  ankle dorsiflexion

18. Excessive Knee Flexion - Midswing As a compensation for  ankle plantarflexion

19. Inadequate Knee Extension – Midstance and Terminal Stance Accompanied w/  ankle dorsiflexion   limb and body advancement

20. Inadequate Knee Extension – Terminal Swing Loss of terminal reach

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

22. Inadequate Hip Extension – TSt Contracture  step length and body advancement

23. Excessive Hip Flexion - MSw Compensation for  ankle plantarflexion

24. Inadequate Hip Flexion • Hip flexor weakness • Hip joint arthrodesis

25. Inadequate Hip Flexion - TSw Rapid hip / Rapid hip  Compensation for weak quadriceps that cannot extend the knee (flaccid knee)

26. Compensations for Inadequate Hip Flexion – PSw/ISw Compensatory posterior pelvic tilt

27. Compensations for Inadequate Hip Flexion – PSw/ISw Voluntary excessive (magnitude & velocity) knee flexion

28. Excessive Hip Adduction Causes: • Ipsilateral abductor weakness • Adduction contracture or spasticity • Using adductors as hip flexors • Contralateral hip abduction contracture

29. Deviations Swing  “Scissor Gait” Combined hip  & IR

30. Deviations 20 adductor contracture or spasticity 20 adductors used as hip flexors 20 glute med weakness

31. Excessive Hip Abduction Causes • Ipsilateral abduction contracture • Contralateral adduction contracture • Scoliosis w/ pelvic obliquity

32. Deviations Compensation for inadequate knee flexion 20 contralateral abduction or ipsilateral adduction contracture

33. Excessive Hip External Rotation Causes • Gluteus maximus overactivity • Excessive ankle plantarflexion

34. Excessive Hip Internal Rotation Causes • Medial hamstring overactivity • Adductor overactivity • Anterior abductor overactivity • Quadriceps weakness