Flashcards in Gait abnormalities Deck (17)
Name general possible causes for gait abnormalities.
- nerve lesions
- joint instability
- joint immobility
What is the medical term for a limp?
What causes an antalgic gait?
i) painful leg/joint
ii) stiffness or reduced mobility of a joint
Describe the mechanism of an antalgic gait.
Uneven due to:
1. shorter stance phase of affected leg (to reduce its weight bearing time)
2. lack body weight shift to affected leg
3. shorter swing phase of unaffected leg (in order to take over weight again)
In what hand should patients with an antalgic gait hold a walking stick?
opposite hand (allows shifting of body weight onto stick)
What causes a hemiplegic gait?
hemi-brain injury, e.g.
- cerebral palsy
Describe the mechanism of a hemiplegic gait.
Problem with 1 lower limb.
1. flexed upper limb (stronger flexors)
2. extended lower limb as extensors overwhelm flexors... causes foot plantarflexion and so lengthened limb...
3. ... circumduction of affected leg in order to clear toes of floor and place affected leg in midline
4. short step of unaffected leg
What causes a diplegic gait?
Neuromuscular disorders, e.g.
- cerebral palsy
Describe the mechanism of a diplegic gait.
1. hypertonia in legs, hips and pelvis causes flexion of these areas
2. scissoring due to tight muscle groups - psoas, adductors, hamstrings and calves - knees and thighs hit/cross-over
3. ankle plantarflexion - walk on tip toes so forefoot = initial contact
What is foot drop? What type of gait does it cause?
Foot drop = inability to dorsiflex ankle so toes hand down during swing phase.
Causes high steppage gait.
What causes a high steppage gait?
Can be CNS or PNS problem
- neuromucular disorders
- sciatica (CNS)
- common peroneal nerve palsy (affects tibialis anterior)
Describe the mechanism of a high steppage gait.
1. toes hang down during swing phase - risk of tripping so excessive hip flexion of affected limb
2. foot slap
Suggest a possible treatment for foot drop.
splint to control plantarflexion
What causes a parkinsonian gait?
neurological disease - Parkinson's
Describe the mechanism of a parkinsonian gait.
1. shuffling/short step
2. no arm swing
3. forward flexed - shift forward of centre of gravity
4. festinant - rapid, almost falling due to shift in C of G
What causes a Trendelenberg gait?
i) lesion of superior gluteal nerve (and consequent muscle paralysis)
ii) hip instability (as in congenital dislocation of the hip)