Gait abnormality

Normal gait is defined as (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 . It is a series of rhythmic alternating motion of arms, legs, and trunk that create forward motion

In 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

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

Specific gait abnormality Lateral trunk bending 1- Trendelenburg gait 2- waddling gait Standing 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

Unilateral stance

Trendelenburg gait

Causes of Trendelenburg gait Painful hip Abductor weakness Abnormal hip joint, CDH Unequal Leg length Coxa vara

Angle of inclination of the femur

Anterior trunk bending At heel contact, the trunk bend forward to compensate for knee extensor weakness Posterior 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

Anterior trunk bending Posterior trunk bending

Increased lumbar lordosis Due to flexion contracture of the hip joint

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

Abnormal hip rotation

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

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

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

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

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

4- Compensatory lateral lean of the trunk

5- Use of cane contralaterally

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