Pathologic Gait

Question 1

What are potential causes of altered gait?

Answer 1

Pain
Past injury - spinal learning and reeducation of motor patterns
Peripheral sensory loss
LMNL (loss of tone with weakness)
UMNL (increased tone with weakness)

Question 2

What is the cause of a Trendelenberg gait?

Answer 2

Weak gluteus medius or lateral hip stabilizer

Question 3

What does a Trendelenberg gait look like?

Answer 3

Hip translates laterally while weight bearing on the involved side

Question 4

What peripheral nerve is likely affected in a patient with Trendelenberg gait?

Answer 4

Superior gluteal nerve

Question 5

What nerve root is likely affected in a patient with Trendelenberg gait?

Answer 5

L5

Question 6

What muscles are likely affected in a patient with Trendelenberg gait?

Answer 6

Gluteus medius or lateral hip stabilizers

Question 7

What does a gluteus medius lurch look like?

Answer 7

Torso leans laterally over the affected hip when weight bearing with significant pain and paralysis of the gluteus medius or lateral hip stabilizers

Question 8

What muscles are affected in a patient with a gluteus medius lurch?

Answer 8

Gluteus medius or lateral hip stabilizers

Question 9

What peripheral nerve is likely affected in a patient with a gluteus medius lurch?

Answer 9

Superior gluteal nerve

Question 10

What nerve root is likely affected in a patient with a gluteus medius lurch?

Answer 10

L5

Question 11

What does a gluteus maximus lurch look like?

Answer 11

Lack of leg extension during gait with the torso extending and rotating ipsilaterally while weight bearing on the involved side

Question 12

What peripheral nerve is likely affected in a patient with a gluteus maximus lurch?

Answer 12

Inferior gluteal nerve

Question 13

What nerve root is likely affected in a patient with a gluteus maximus lurch?

Answer 13

S1

Question 14

What are potential causes of a circumduction gait?

Answer 14

Knee fusion, weak quadriceps, spastic paresis (UMNL)

Question 15

What muscle is likely weak in a patient with a circumduction gait?

Answer 15

Quadriceps

Question 16

What peripheral nerve is likely affected in a patient with a circumduction gait?

Answer 16

Femoral nerve

Question 17

What nerve root is likely affected in a patient with a circumduction gait?

Answer 17

L4

Question 18

What does a circumduction gait look like?

Answer 18

Knee remains fixed in extension while hip ABucts/Circumducts to move involved leg forward

Question 19

What does a hip hike gait look like?

Answer 19

QL contracts to lift the foot from the floor allowing for gait flexion while leg moves within the sagittal plane

Question 20

What can cause a hip hike gait?

Answer 20

• knee fusion
• L4 Nerve root
• femoral nerve

Question 21

What muscle is likely weak in a patient with a hip hike gait?

Answer 21

Quadriceps

Question 22

What peripheral nerve is likely weakened in a hip hike gait?

Answer 22

Inferior gluteal nerve

Question 23

What nerve root is likely weakened in a hip hike gait?

Answer 23

S1

Question 24

What does a slappage gait look like?

Answer 24

Foot slaps the floor immediately following heel strike

Question 25

What are potential causes of a slappage gait?

Answer 25

Mild-moderate weakness of ankle dorsiflexors due to a possible strain Possible sensory loss from a dorsal column lesion

Question 26

What type of gait can be caused by a dorsal column lesion?

Answer 26

Slappage gait

Question 27

What peripheral nerves are likely affected in a slappage gait?

Answer 27

Superficial peroneal nerve or deep peroneal nerve

Question 28

What nerve roots are likely affected in a slappage gait?

Answer 28

L4-L5

Question 29

What muscle group is likely weak in a patient with a slappage gait?

Answer 29

Ankle dorsiflexors

Question 30

What does a steppage gait look like?

Answer 30

Increased knee flexion clears foot from the floor with the toe placed down first and then the heel follows with tripping over involved foot

Question 31

What are causes of a steppage gait?

Answer 31

Weakness or paralysis of ankle dorsiflexors

Question 32

What muscles are likely weak in a steppage gait?

Answer 32

Ankle dorsiflexors

Question 33

What peripheral nerves are likely affected in a patient with a steppage gait?

Answer 33

Superficial peroneal nerve or deep peroneal nerve

Question 34

What nerve roots are likely affected in a patient with a steppage gait?

Answer 34

L4-L5

Question 35

What gait can be associated with Charcot Marie tooth disease?

Answer 35

Slappage gait

Question 36

If a patient has ankylosing spondylitis of the knee what gaits may be present?

Answer 36

Circumduction or hip hike