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Exam 2: Pathological Gait Flashcards

(62 cards)

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1
Q

What are the 5 functional categories of pathological gait

A
  1. Deformities
  2. Muscle weakness
  3. Sensory Loss
  4. Pain
  5. Impaired Control
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2
Q

When does a functional deformity exist?

A

When the tissues do not allow sufficient passive mobility for patients to attain the normal postures and ranges of motion used in walking

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3
Q

What is the most common type of deformity

A

Contractures

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4
Q

_____ represents structural changes in the fibrous connective tissue component of muscles, ligament, or joint capsule following prolonged inactivity or scarring from injury

A

Contracture

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5
Q

(Elastic/Rigid) contracture yields to forceful manual stretch

A

Elastic

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6
Q

(Elastic/Rigid) contracture resists all stretching efforts

A

Rigid

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7
Q

What is the term for insufficient muscle strength to meet the demands of walking

A

Muscle weakness

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8
Q

Disuse muscular atrophy and neurological impairments are both reasons why a patient could be experiencing _____ _____

A

muscle weakness

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9
Q

True or False:

Some patients will have the ability to substitute for weak muscle groups depending on cause of weakness

A

True

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10
Q

Impaired _______ obstructs walking because it deprives the patient of know the exact location of their hip, knee, ankle or foot and the type of contact with the floor

A

proprioception

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11
Q

Sensory Loss-

If the patient has good motor control, they may substitute by ______ ___ or hitting ground harder to know heel contact.

A

Locking knee

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12
Q

Sensory Loss-

People with poor motor control tend to walk (slow/fast) and (cautious/reckless)

A

slow and cautious

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13
Q

What is the primary cause of musculoskeletal pain

A

Excessive tissue tension

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14
Q

Physiological reactions to pain introduce what two obstacles to effective walking?

A

Deformity and muscular weakness

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15
Q

_____ results from natural resting positions of swollen joints

A

deformity

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16
Q

____ _____ occurs secondary to the pain of joint swelling causing reduced muscle activity

A

muscular weakness

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17
Q

What are the 5 functional deficits of central neurological lesion that results in spastic paralysis

A
  1. Muscle weakness
  2. Selective motor control is impaired
  3. Primitive locomotor patterns emerge
  4. Muscles change their phasing
  5. Spasticity
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18
Q

What are the most common causes of spastic gait

A

CP, strokes, brain injury, incomplete SCI and MS

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19
Q

Spasticity Gait-

Lack of selective muscle control prevents the patient from controlling the ____ and _____ of muscle action

A

timing and intensity

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20
Q

True or False:

In spastic gait, loss is more evident proximally

A

False, it is more evident distally

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21
Q

Spastic Gait-

Primitive patterns such as mass (flexion/extension) during swing and mass (flexion/extension) during stance

A

flexion, extension

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22
Q

Spastic gait obstructs the yielding quality of (concentric/eccentric/isometric) muscle action

A

eccentric

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23
Q

What are the general categories of foot gait deviations

A

Floor contact, ankle deviations, ST joint deviations, Toe Deviations

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24
Q

What are the different floor contact deviations

A

forefoot contact, delayed heel contact, foot-flat contact, low heel, foot slap

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25
Which deviation of floor contact is when the forefoot is the initial point of contact with the ground during weight acceptance
Forefoot contact
26
Which phase of gait does forefoot contact occur in
initial contact
27
What is the functional significance of forefoot contact
Disrupts heel rocker, forward progression of tibia, and shock absorption at the knee
28
What are the underlying causes of forefoot contact
Inadequate pre-tibial strength, PF contracture, excessive knee flexion and PF combined, heel pain, or short leg
29
Which deviation of floor contact happens when the forefoot precedes heel in contacting ground
delayed heel contact
30
Which phases of gait does delayed heel contact occur in
Initial contact, loading response, or mid stance
31
What is the functional significance of delayed heel contact
disrupts heel rocker and forward progression
32
What are the underlying causes of delayed heel contact
Yielding PF contracture or spasticity
33
Which deviation of floor contact happens when the heel and forefoot simultaneously contact the floor
foot flat contact
34
Which phase of gait does foot flat contact happen in
initial contact
35
what is the functional significance of foot flat contact
limited heel rocker and forward progression
36
What are the underlying causes of foot flat contact
any impairment contributing to excess knee flexion, and compensation for weak quads
37
Which deviation of floor contact happens when the forefoot is very close to the floor as the heel makes IC
low heel
38
which phase of gait does low heel occur in
initial contact
39
What is the functional significance of low heel
reduces the heel rocker and forward progression
40
What are the underlying causes of low heel
any impairment contributing to excess PF
41
Which deviation of floor contact is uncontrollable PF at the ankle following initial heel contact, often accompanied by an audible slap
foot slap
42
Which phases of gait does foot slap happen in
IC and LR
43
What is the functional significance of foot slap
disrupts heel rocker, forward progression, and shock absorption
44
What is the underlying cause of foot slap
Pre-tibial weakness especially anterior tibialis
45
What are the deviations of ankle deviations
Excess PF, excess DF, prolonged heel only, premature heel off, no heel off/delayed heel off, drag, contralateral vaulting
46
Which deviation of the ankle is when PF exceeds normal for a particular phase
Excess plantar flexion
47
Which phases does excess plantar flexion happen in
all except pre swing
48
What is the functional significance of excess plantar flexion
disrupts rockers during stance, foot clearance and limb advancement during swing
49
What are the underlying causes of excess plantar flexion
PF contracture, pre tib weakness, quad weakness, proprioception deficits or ankle pain
50
Which ankle deviation has DF that exceeds normal for a particular phase
excess dorsiflexion
51
Which phases does excess dorsiflexion occur in
all phases of stance
52
Which deviation of the ankle happens when the heel only period extends beyond loading response
prolonged heel only
53
Which phases does prolonged heel only affect
LR, MS, TS, and preswing
54
What are the underlying causes of prolonged heel only
painful forefoot or toe clawing
55
Which deviation of ankle happens when the heel is not contact with the ground when it should be
premature heel off
56
Which phases does premature heel off happen in
LR and MS
57
Which deviation of ankle is the absence of a heel rise when the heel should be off the ground
No heel off/delayed heel off
58
Which phases of no heel off/delayed heel off occur in
TS, and pre swing
59
Which deviation of ankle is when the contact of toes, forefoot, or heel with the ground during swing
drag
60
Which phases of gait does drag occur in
initial swing, mid swing, terminal swing
61
What deviation of the ankle is prematurely rising onto the forefoot of the contralateral stance limb during SLA of the reference limb
contralateral vaulting
62
which phases of gait does contralateral vaulting happen in
initial swing, mid swing, terminal swing

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