PTA 110: Functional & Applied Anatomy

Name: PTA 110: Functional & Applied Anatomy
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Description: PTA 110: Functional & Applied Anatomy

PTA 110: Functional & Applied Anatomy
Gait PTA 110: Functional & Applied Anatomy Concorde Career College

Overview It is not clear whether gait is learned or is pre-programmed at the spinal cord level. However, once mastered, gait allows us to move around our environment in an efficient manner, requiring little in the way of conscious thought, at least in familiar surroundings. Walking involves the alternating action of the two lower extremities The walking pattern is studied as a gait cycle The gait cycle is defined as the interval of time between any of the repetitive events of walking. Such an event could include the point when the foot initially contacts the ground, to when the same foot contacts the ground again

Ambulation Most fundamental human locomotion Bipedal
Reciprocal movement behavior Symmetrical (displacement and timing) Concorde Career College

Gait Cycle Describes important events occurring between two successive heel contacts of same limb Gait cycle is described as occurring between 0% and 100% and includes 2 primary phases, the stance phase and the swing phase

Stance Phase Heel contact Foot flat Mid stance
The instant the lower limb contacts the ground (0% of gait cycle) Foot flat The period that the entire plantar aspect is on ground (8% of gait cycle) Mid stance The point where the body’s weight passes directly over supporting lower extremity (30% of gait cycle) Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

The Gait Cycle The gait cycle consists of two periods: stance and swing The stance period Constitutes approximately 60% of the gait cycle Describes the entire time the foot is in contact with the ground and the limb is bearing weight Begins with the initial contact of the foot on the ground, and concludes when the ipsilateral foot leaves the ground The stance period takes about 0.6 sec during an average walking speed

Subdivisions of the Gait Cycle
Concorde Career College

Stance Phase – cont’d Heel off Toe off Push off
The instant the heel comes off ground (40% of gait cycle) Toe off The instant the toe leaves ground (60% of gait cycle) Push off Describes combined actions of heel off and toe off, when stance foot is literally “pushing off” toward next step Within the stance period, two tasks and four intervals are recognized The two tasks include weight acceptance and single limb support The four intervals include loading response, mid stance, terminal stance and pre-swing Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Stance Phase Weight acceptance
The weight acceptance task occurs during the first 10% of the stance period The loading response interval begins as one limb bears weight while the other leg begins to go through its swing period. This interval may be referred to as the initial double stance period and consists of the first 0- 10% of the gait cycle

Stance Phase Single Leg Support
The middle 40% of the stance period is divided equally into mid stance and terminal stance The mid stance interval representing the first half of the single limb support task, begins as one foot is lifted, and continues until the body weight is aligned over the forefoot The terminal stance interval is the second half of the single limb support task. It begins when the heel of the weight bearing foot lifts off the ground and continues until the contralateral foot strikes the ground

Weight Transmission During Walking

Swing Phase Early swing Mid swing Late/Terminal swing
Period from toe off to mid swing (65% of gait cycle) Mid swing Period when foot of swing leg passes next to foot of stance leg (75% of gait cycle) Late/Terminal swing Period from mid swing until heel contacts ground (85% of gait cycle) Swing period Constitutes approximately 40% of the gait cycle Describes the period when the foot is not in contact with the ground Begins as the foot is lifted from the ground and ends with initial contact with the ipsilateral foot Within the swing period, one task and four intervals are recognized The task involves limb advancement The four intervals include pre-swing, initial swing, mid-swing, and terminal swing Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Additional Terminology of Gait
Step Events occurring between successive heel contacts of opposite feet Step length Distance traveled in one step Step width Distance between heel centers of two consecutive foot contacts Stride length Step length is measured as the distance between the same point of one foot on successive footprints (ipsilateral to the contralateral foot fall). Stride length, on the other hand, is the distance between successive points of foot-to-floor contact of the same foot A stride is one full lower extremity cycle Two step lengths added together make the stride length Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Additional Terminology of Gait
Stride Events that take place between successive heel contacts of same foot Stride length Distance traveled in one stride—two consecutive heel contacts of same foot Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Concorde Career College

Additional Terminology of Gait – cont’d
Cadence Also called step rate, defined as number of steps Walking velocity Speed at which an individual walks Cadence Cadence is defined as the number of separate steps taken in a certain time Normal cadence is between 90 and 120 steps per minute The cadence of women is usually 6-9 steps per minute slower than that of men Cadence is also affected by age, with cadence decreasing from the age of 4 to the age of 7, and then again in advancing years Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Stance Phase: Heel Contact
Gait cycle beginning, when heel first contacts the ground Center of gravity of body is at its lowest point Ankle is held in neutral dorsiflexion Ankle transitions toward foot-flat stance and the ankle dorsiflexor muscles are eccentrically activated to assist with lowering the ankle into plantarflexion Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Stance Phase: Heel Contact – cont’d
The knee is slightly flexed, positioned to absorb shock of initial weight bearing Quadriceps are eccentrically active to allow a slight “give” to the flexed knee and help prevent the knee from buckling Hip extensors are isometrically active to prevent the trunk from jackknifing forward Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Stance Phase: Foot Flat
Point in which the entire plantar surface of foot contacts the ground Loading-response phase of gait Muscles and joints of lower limb assist with shock absorption, as the lower extremity continues to accept increasing amounts of body weight Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Stance Phase: Foot Flat – cont’d
The ankle has just rapidly moved into degrees of plantar flexion Knee continues to flex to about 15 degrees, acting as a shock absorbing “spring” Quadriceps continue to function eccentrically, and the hip extensors guide hip toward increasing extension Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Stance Phase: Mid Stance
Occurs as the leg approaches vertical position Leg is in single-limb support, as the other limb is freely swinging forward The ankle dorsiflexor muscles are inactive; plantar flexor muscles are eccentrically active, controlling the rate at which the lower leg advances over the foot Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Stance Phase: Mid Stance – cont’d
Knee reaches near-fully extended position Hip abductors play an important role in stabilizing the pelvis in the frontal plane, preventing the opposite side of pelvis from dropping excessively Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Essentials of Kinesiology Ch.12 p. 342

Stance Phase: Heel Off Occurs just after mid stance as the lower leg and ankle begin “pushing off,” continuing to propel body forward Begins as the heel breaks contact with the ground Plantarflexor muscles and the Achilles tendon stretch in preparation for propulsion At heel off, the plantarflexor muscles have switched their activation from eccentric to concentric Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Stance Phase: Heel Off – cont’d
Extended knee prepares to flex, usually driven by short burst of activity from the hamstring muscles Hip continues to extend, ending in about 10 degrees of extension Eccentric activation of hip flexors, particularly iliopsoas, help control the amount of hip extension that occurs Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Stance Phase: Toe Off Final event of stance phase of gait
Toe off ends when toes break contact with the ground Toes are in marked hyperextension at the metatarsophalangeal joints, supported by activation of the intrinsic foot muscles Ankle continues plantarflexing through concentric activation of plantarflexor muscles Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Stance Phase: Toe Off – cont’d
At toe off, knee is flexed 30 degrees, but hamstrings are only minimally active Most knee flexion arises as a result of inertia produced, as hip is pulled into flexion In final stage of toe off, hip is in nearly-neutral position, with thigh nearly perpendicular to ground Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Stance Phase Limb Advancement
Pre-swing. This interval begins with initial contact of the contralateral limb and ends with ipsilateral toe-off. As both feet are on the floor at the same time during this interval, double support occurs for the second time in the gait cycle.

Swing Phase: Early Swing
Leg begins to accelerate forward Plantarflexed ankle begins to dorsiflex, clearing the ground as it is advanced forward Knee continues to flex, and hip flexors continue to contract, pulling the extended thigh forward Limb Advancement Pre-swing. In addition to representing the final portion of the stance period and single limb support task, the pre-swing interval is considered as part of the swing period Initial swing. This interval begins with the lift of the foot from the floor and ends when the swinging foot is opposite the stance foot. Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Swing Phase: Mid Swing Midpoint of swing phase
Contralateral leg is in mid stance, supporting the body weight Ankle is held in neutral position Knee is flexed about degrees, helping advance the lower limb Hip approaches 35 degrees of flexion, continuing to be pulled forward through concentric hip flexor activation Limb Advancement Mid-swing. This interval begins as the swinging limb is opposite the stance limb, and ends when the swinging limb is forward and the tibia is vertical Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Swing Phase: Terminal Swing
Limb begins to decelerate in preparation for heel contact Leg is placed well in front of body, preparing for transition to accept body weight Ankle dorsiflexors are activated isometrically, positioning foot for heel contact Knee has moved from flexed position of mid swing to almost full extension Terminal swing. This interval begins with a vertical tibia of the swing leg with respect to the floor, and ends the moment the foot strikes the floor Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Swing Phase: Terminal Swing – cont’d
Hamstrings are active eccentrically at this time to slow rapidly extending knee Hip flexor muscles become inactive in terminal swing Hip extensors decelerate forward leg progression leg through eccentric activation Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Muscle and Joint Interactions in Frontal Plane
Abductor muscles play an important role in frontal plane hip stability Without activation of hip abductors on the stance leg, the opposite side of pelvis would drop under the force of gravity, known as a positive Trendelenburg sign Activation of the stance leg’s hip abductors holds the pelvis level Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Muscle and Joint Interactions in Frontal Plane – cont’d
Strong medial and lateral collateral ligaments of knee provide natural stability to knee in frontal plane Loss of this stability may lead to issues such as genu valgus, potentially altering normal gait mechanics Instability of knee may arise from impairments at hip or foot Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Muscle and Joint Interactions in Frontal Plane – cont’d
While walking, subtalar and transverse tarsal joints cooperate to transform the foot from pliable platform at early stance to more rigid platform at late stance Position of supination arranges bones of foot to their most stable position, forming rigid lever for push-off Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Muscle and Joint Interactions in Horizontal Plane
Much of the lower limb control within the horizontal plane during walking occurs at hip and foot During walking, the pelvis rotates in the horizontal plane about a vertical axis of rotation through hip joint of stance leg Because the trunk remains relatively stationary during walking, the lumbar spine must rotate slightly to de-couple the rotating pelvis from thorax Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Joint Motions in Gait Pelvis
For normal gait to occur, the pelvis must both rotate and tilt

Joint Motions in Gait Sacroiliac Joint
As the right leg moves through the swing period, the position of the right innominate changes from one of extreme anterior rotation at the point of pre-swing to a position of posterior rotation at the point of initial contact As the right extremity moves through the loading response to mid stance, the ilium on that side begins to convert from a posteriorly rotated position to a neutrally rotated position. From mid stance to terminal stance, the ilium rotates anteriorly, achieving maximum position at terminal stance

Joint Motions in Gait Sacroiliac Joint
The sacrum rotates forward around a diagonal axis during the loading response, reaching its maximum position at mid stance (e.g., right rotation on a right oblique axis at right mid stance), and then begins to reverse itself during terminal stance

Joint Motions in Gait Hip Knee
Hip motion occurs in all three planes during the gait cycle Knee The knee flexes twice and extends twice during each gait cycle: once during weight bearing and once during non-weight bearing

Joint Motions in Gait Foot and ankle
Ankle joint motion during the gait cycle occurs primarily in the sagittal plane At initial contact with the ground the ankle is dorsiflexed During the loading response interval, plantar flexion occurs at the talocrural joint, with pronation occurring at the subtalar joint At the end of the mid stance interval, the talocrural joint is maximally dorsiflexed, and the subtalar joint begins to supinate From the mid stance to the terminal stance interval the foot is in supination Once the ankle is fully close-packed, the heel is lifted by a combination of passive force and contraction from the taut gastrocnemius, and the soleus

Muscle Actions in Gait Spine and pelvis
During the swing period, the semispinalis, rotatores, multifidus, and external oblique muscles are active on the side toward which the pelvis rotates The erector spinae and internal oblique abdominal muscles are active on the opposite side The psoas major and quadratus lumborum help to support the pelvis on the side of the swinging limb, while the contralateral hip abductors also provide support

Muscle Actions in Gait Knee
During the swing period, there is very little activity from the knee flexors The knee extensors contract slightly at the end of the swing period prior to initial contact. During level walking the quadriceps achieve peak activity during the loading response interval (25% maximum voluntary contraction) and are relatively inactive by mid stance as the leg reaches the vertical position and ‘locks’, making quadriceps contraction unnecessary

Muscle Actions in Gait Hip
During the early to mid portion of the swing phase, the iliopsoas is the prime mover with assistance from the rectus femoris, sartorius, gracilis, adductor longus, and possibly the tensor fascia latae, pectineus, and the short head of the biceps femoris during the initial swing interval In terminal swing, there is no appreciable action of the hip flexors when ambulating on level ground. Instead the hamstrings and gluteus maximus are strongly active to decelerate hip flexion and knee extension

Muscle Actions in Gait Hip
The adductor magnus muscle supports hip extension and also rotates the pelvis externally toward the forward leg In mid stance, coronal plane muscle activity is greatest as the abductors stabilize the pelvis. The muscle activity initially is eccentric as the pelvis shifts laterally over the stance leg. The gluteus medius and minimus remain active in terminal stance for lateral pelvic stabilization

Muscle Actions in Gait Knee
Hamstring involvement is also important to normal knee function. The co activation of the antagonist muscles about the knee during the loading response aid the ligaments in maintaining joint stability, by equalizing the articular surface pressure distribution, and controlling tibial translation.

Muscle Actions in Gait Foot and ankle
During the beginning of the swing period, the tibialis anterior, extensor digitorum longus (EDL), extensor hallucis longus (EHL), and possibly the peroneus tertius contract concentrically with slight to moderate intensity tapering off during the middle of the swing period

At the point where the leg is perpendicular to the ground during the swing period, the tibialis anterior, EDL and EHL group of muscles contract concentrically to dorsiflex and invert the foot in preparation for the initial contact

Following initial contact, the anterior tibialis works eccentrically to lower the foot to the ground during the loading response interval Calcaneal eversion is controlled by the eccentric activity of the posterior tibialis, and the anterior movement of the tibia and talus is limited by the eccentric action of the gastrocnemius and soleus muscle groups as the foot moves towards mid stance Pronation occurs in the stance period to allow for shock absorption, ground terrain changes, and equilibrium

The triceps surae become active again from mid stance to the late stance period contracting eccentrically to control ankle dorsiflexion as the COG continues to move forward In late stance period the Achilles tendon is stretched as the triceps surae contracts and the ankle dorsiflexes At this point the heel rises off the ground and the action of the plantar flexors changes from one of eccentric contraction, to one of concentric contraction

Characteristics of Normal Gait
Gait involves the displacement of body weight in a desired direction utilizing a coordinated effort between the joints of the trunk and extremities and the muscles that control or produce these motions Any interference that alters this relationship may result in a deviation or disturbance of the normal gait pattern

Normal Gait Five priorities of normal gait:
Stability of the weight bearing foot throughout the stance period Clearance of the non-weight bearing foot during the swing period Appropriate pre-positioning (during terminal swing) of the foot for the next gait cycle Adequate step length Energy conservation

Walking Through the Life-Span
Infant-Child Crawling Toddler – not mature gait pattern About age 5 – mature gait pattern Increase in absolute stride length Heel-toe pattern through foot flat to toe-off Narrowing base of support Control over terminal knee extension Full pelvic rotation Improved balance and postural alignment Reciprocal arm leg gait pattern

Walking Through the Life-Span
Older Adults Weakness, loss of ROM, decrease in sensory motor control, decrease in balance control, postural misalignment Slower walking speed – shorter step length Increased stance phase Increase step width – larger base of support for balance Increase fear of falling Forward flexed close in visual tracking Encourage forward visual tracking

Gait Deviations Concorde Career College

Influences on Gait Pain Posture
Flexibility and the amount of available joint motion Endurance - economy of mobility Base of Support Interlimb coordination Leg-length Gender Pregnancy

Influences on Gait Obesity Age
Lateral and vertical displacement of the COG Properly functioning reflexes Vertical Ground Reaction Forces Medial-Lateral Shear Forces Anterior-Posterior Shear Forces

Abnormal Gait Syndromes
In general gait deviations fall under four headings: Those caused by weakness Those caused by abnormal joint position or range of motion Those caused by muscle contracture Those caused by pain

Foot Slap On heel strike, foot quickly drops into plantar flexion, producing a slapping sound as forefoot impacts ground Impairment Weakness of dorsiflexors May follow injury to common peroneal nerve or hemiplegia Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Foot Slap Reason for deviation
Inadequate strength in dorsiflexor muscles to slowly control plantar flexion following heel contact Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

High Stepping Gait Steppage Gait
Individual appears to be stepping over an imaginary obstacle; initial foot contact is typically made with forefoot or entire plantar surface of foot Impairment Marked weakness of dorsiflexors—resulting in “foot drop” Possibly following injury to common peroneal nerve or hemiplegia Steppage Gait This type of gait occurs in patients with a foot drop A foot drop is the result of weakness or paralysis of the dorsiflexor muscles due to an injury to the muscles, their peripheral nerve supply, or the nerve roots supplying the muscles The patient lifts the leg high enough to clear the flail foot off the floor by flexing excessively at the hip and knee, and then slaps the foot on the floor Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

High Stepping Gait Reason for deviation
In order to clear foot from ground, hip and knee must be excessively flexed to advance leg Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Hip Circumduction Swing leg is advanced in semi- circle arc Impairment
Inability to “shorten” swing leg, possibly due to reduced active or passive hip or knee flexion or as a result of wearing a “straight-leg” brace at knee Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Hip Circumduction Reason for deviation
Circumduction creates extra clearance to advance functionally “long leg” Essentials of Kinesiology Ch.12 p. 348 onwards

Hip Hiking Excessive elevation of pelvis on “swing” side Impairment
Inability to functionally “shorten” swing-leg Possibly due to weak hip flexor muscles Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Hip Hiking Reason for deviation
Elevating or “hiking” pelvis provides extra clearance for advancing leg Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Weak Gluteus Maximus Gait
Backward lean of trunk during foot-flat phase Impairment Weakness of hip extensors— gluteus maximus Reason for deviation Leaning backward during stance phase shifts body’s line of gravity posterior to hip, reducing need for active hip extension torque Gluteus maximus Gait The gluteus maximus gait, which results from weakness of the gluteus maximus, is characterized by a posterior thrusting of the trunk at initial contact in an attempt to maintain hip extension of the stance leg The hip extensor weakness also results in forward tilt of the pelvis, which eventually translates into a hyperlordosis of the spine to maintain posture Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Walking with Hip and/or Knee Flexion Contracture
Flexed position of hip and knee during stance phase of gait, often referred to as a “crouched gait” Impairment Hip or knee flexion contracture Reason for deviation Increased tightness in tissues that allow hip and knee extension Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Weak Hip Abductor Gait During single-limb support, pelvis and trunk lean excessively to opposite (uncompensated) or same (compensated) side as weak hip abductor muscles Impairment Weakness of hip abductor muscles Reason for deviation “Uncompensated” response: hip abductors of stance leg are unable to produce enough force to hold pelvis level “Compensated” response: purposely leaning trunk and pelvis to same side as weak muscles shifts line of gravity closer to stance hip Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Trendelenburg Gait This type of gait is due to weakness of the hip abductors (gluteus medius and minimus) The normal stabilizing affect of these muscles is lost and the patient demonstrates an excessive lateral list in which the trunk is thrust laterally in an attempt to keep the center of gravity over the stance leg

Trendelenburg Gait Concorde Career College

Weak Hip Abductor Gait Co

Vaulting Individual rises up on toes of stance foot while swinging contralateral leg forward Impairment Any impairment of lower extremity that reduces ability to functionally reduce length of limb

Vaulting Reason for deviation
Standing on tiptoes creates extra clearance for contralateral leg to clear ground during swing Concorde Career College

Weak Quadriceps Gait Quadriceps Gait
Knee remains fully extended throughout stance, combined with excessive forward lean of trunk Impairment Weakness or avoidance of activation of quadriceps muscle Reason for deviation Forward lean of trunk shifts line of gravity anterior to medial- lateral axis of knee Quadriceps Gait Quadriceps weakness can result from a peripheral nerve lesion (femoral), a spinal berve root lesion, from trauma, or from disease (muscular dystrophy) Quadriceps weakness requires that forward motion be propagated by circumducting each leg. The patient leans the body toward the other side to balance the center of gravity, and the motion is repeated with each step Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Equinus Gait Equinus gait (toe-walking), one of the more common abnormal patterns of gait of patients with spastic diplegia, is characterized by forefoot strike to initiate the cycle and premature plantar flexion in early stance to midstance

Ataxic Gait The ataxic gait is seen in two principal disorders: cerebellar disease (cerebellar ataxic gait) and posterior column disease (sensory ataxic gait)

Parkinsonian Gait The parkinsonian gait is characterized by a flexed and stooped posture with flexion of the neck, elbows, metacarpophalangeal joints, trunk, hips, and knees The patient has difficulty initiating movements and walks with short steps with the feet barely clearing the ground. This results in a shuffling type of gait with rapid steps k

Genu Recurvatum Excessive hyperextension of knee during stance phase of gait Impairment A: Quadriceps and/or knee flexor paralysis B: Plantar flexion contracture Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Genu Recurvatum: Reasons for Deviation
A: Overstretched posterior capsule of knee and/or paralysis of muscles that cross posterior side of knee (hamstrings) fail to limit knee extension B: Leg deviates posteriorly relative to ankle and forces knee into hyperextension, eventually overstretching posterior capsule Mosby items and derived items © 2009 by Mosby, Inc., an affiliate of Elsevier Inc.

Abnormal Gait Patterns
Propulsive Gait - a stooped, rigid posture with the head and neck bent forward Scissors Gait - legs flexed slightly at the hips and knees, giving the appearance of crouching, with the knees and thighs hitting or crossing in a scissors-like movement Essentials of Kinesiology Ch.12 p but I don’t know where some of these other patterns are found. Concorde Career College

Antalgic Gait Antalgic Gait Pain (Antalgic) Gait Pattern
Pain promotes a modification of the gait pattern to avoid joint motions, muscle contraction and weight bearing that sustains or increase the pain The resulting pattern is termed antalgic gait pattern Changes in gait symmetry – timing and movement Patient should not ambulate “through the pain” Increases guarding Promotes abnormal movement patterns Produces abnormal forces through joint structures Uses much more energy Irritates, inflames and can damage painful involved areas antalgic [ant-al´jik] counteracting or avoiding pain, as a posture or gait assumed so as to lessen pain. Have student demonstrate gait pattern seen with hip pain, ankle pain, knee pain. Antalgic Gait The antalgic gait pattern can result from numerous causes including joint inflammation or an injury to the muscles tendons and ligaments of the lower extremity The antalgic gait is characterized by a decrease in the stance period on the involved side in an attempt to eliminate the weight from the involved leg and use of the injured body part as much as possible

PTA 110: Functional & Applied Anatomy

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