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Normal gait is defined as is defined as (form of bipedal locomotion) (form of bipedal locomotion) or as a method of locomotion involving the use of.

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Presentation on theme: "Normal gait is defined as is defined as (form of bipedal locomotion) (form of bipedal locomotion) or as a method of locomotion involving the use of."— Presentation transcript:

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3 Normal gait is defined as is defined as (form of bipedal locomotion) (form of bipedal locomotion) or as a method of locomotion involving the use of the two legs, alternately, to provide both support and propulsion at least one foot being in contact with the ground at all times.or as a method of locomotion involving the use of the two legs, alternately, to provide both support and propulsion at least one foot being in contact with the ground at all times. It is a series of rhythmic alternating motion of arms, legs, and trunk that create forward motionIt is a series of rhythmic alternating motion of arms, legs, and trunk that create forward motion

4 In order to walkIn order to walk 1- each leg able to support body wt without collapse 2- maintain static and dynamic balance during single leg stance maintenance of upright posture. 3- sufficient power for limb motion and to advance the trunk. 4- the swing leg able to advance to a position where it can take over the supporting role. For proper gait 5- proper proprioceptive system 6- normal vision

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7 Causes of gait abnormality Weakness, spasticity, balance disturbances, leg length discrepancy ……...…or deformity which disturbs the motionWeakness, spasticity, balance disturbances, leg length discrepancy ……...…or deformity which disturbs the motion The motion is a compensation to correct for some other problemThe motion is a compensation to correct for some other problem

8 Specific gait abnormality Lateral trunk bendingLateral trunk bending 1- Trendelenburg gait 2- waddling gait Standing on one leg lead to increase load on the stance leg due toStanding on one leg lead to increase load on the stance leg due to 1- whole wt on one leg 2- the wt of swing leg 3- gluteus medius reaction force

9 Unilateral stance

10 Trendelenburg gait

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12 Causes of Trendelenburg gait Painful hipPainful hip Abductor weaknessAbductor weakness Abnormal hip joint, CDHAbnormal hip joint, CDH Unequal Leg lengthUnequal Leg length Coxa varaCoxa vara

13 Angle of inclination of the femur

14 Anterior trunk bendingAnterior trunk bending At heel contact, the trunk bend forward to compensate for knee extensor weakness Posterior trunk bendingPosterior trunk bending At heel contact, the trunk bend backward to compensate for hip extensor weakness or to propel the swing leg forward to compensate for hip flexor weakness or spasticity of hip extensor weakness or ankylosed hip

15 Anterior trunk bending Posterior trunk bending

16 Increased lumbar lordosisIncreased lumbar lordosis Due to flexion contracture of the hip joint

17 Functional leg length discrepancyFunctional leg length discrepancy Not true discrepancy 1- circumduction 2- hip hiking 3- high steppage 4- vaulting

18 Abnormal hip rotationAbnormal hip rotation

19 Causes of toe in- out gait 1.Increased range of internal rotation 2.Decreased range of external rotation 3.Ms imbalance 4.Mechanical effects of femur Anteversion N.B: The opposite is true for hip retroversion

20 Excessive knee extension due to knee extensor weaknessExcessive knee extension due to knee extensor weakness Excessive knee flexion due toExcessive knee flexion due to 1- knee flexion contracture 2- knee flexor spasticity 3-ankle stiffness 4- Functional leg length discrepancy

21 Toe drag and foot slap due to inadequate foot dorsiflexor controlToe drag and foot slap due to inadequate foot dorsiflexor control Abnormal foot contact due toAbnormal foot contact due to 1- talipes calcaneus 2- talipes equinus 3- excessive medial contact 4- excessive lateral contact 5- Stamping gait- loss of sensation

22 Insufficient push offInsufficient push off Due to calf muscles weakness Abnormal walking baseAbnormal walking base 1- increased base (abducted hip deformity-valgus knee- instability) 2- decreased base (adducted hip deformity-varus knee)

23 How to reduce muscle force in unilateral stance ? 1- reduce body weight 2- Carrying a load ipsilaterally 3- Use of a cane ipsilaterally

24 4- Compensatory lateral lean of the trunk

25 5- Use of cane contralaterally

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