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Gait Training - I.

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Presentation on theme: "Gait Training - I."— Presentation transcript:

1 Gait Training - I

2 Normal Gait & Abnormal Gait

3 60% 40%

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8 Abnormal gait Stance phase Antalgic gait Lateral trunk bending
Anterior trunk bending Posterior trunk bending Lordosis Hyperextended knee Excessive knee flexion Excessive Genu Valgum or Varum Inadequate Dorsi-flexion control Insufficient Push-off Abnormal walking base Internal or external limb rotation Excessive medial or lateral foot contact Vaulting

9 Swing phase Circumduction Hip hiking
Internal or external limb rotation Inadequate Dorsiflexion control Abnormal walking base

10 Antalgic gait Pain in stance phase : knee, hip, foot pain

11 Lateral trunk bending Hip abductor weakness
Hip dislocation, coxa vara, slipped capital femoral epiphysis Hip pain Involved limb relatively shorter Compensation for abducted gait

12 Trendelenberg gait Gluteus Medius Gait

13 Anterior Trunk Bending
Quadriceps weakness combined with weakness of gluteus maximus, gastrocnemius, or both Pushing backward with the hand / lateral rotation

14 Posterior Trunk Bending
Gluteus Maximus (Lurch) Gait Hip-extensor weakness Knee ankylosis, spasticity or orthotic knee lock Hip-extensor spasticity

15 Hyper-extended knee Quadriceps weakness Capsular ligament laxity
Quadriceps spasticity Plantar-flexion contracture or spasticity Compensation for contralateral limb shortening (hip-flexion or knee-flexion contracture)

16 Excessive knee flexion
Knee-flexion or hip-flexion contracture Knee-flexor spasticity Uncompensated quadriceps weakness Ankle ankylosis Plantar-flexor weakness Involved limb relatively longer

17 Steppage gait - Ankle dorsiflexor weakness : compensate by exaggerated hip and knee flexion Foot drop / dragging

18 Slap foot Ankle dorsiflexor weakness : early stance phase

19 Insufficient Push-Off
Flat foot gait Plantar-flexor weakness Rupture of the Archilles tendon or the triceps surae Metatarsal pain, hallux rigidus

20 Internal or External Limb Rotation
Internal rotation Biceps femoris weakness spasticity External rotation Quadriceps weakness Inner hamstring weakness Spasticity

21 Abnormal walking base Wide Base (> 4 inch)
Hip-abduction contracture Instability due to fear, proprioceptive deficit, cerebellar problem Narrow base (< 2 inch) Spasticity Genu varum Genu valgum

22 Vaulting Swing-phase limb is relatively longer

23 Hip hiking Increased ipsilateral length:
hip -flexor or dorsiflexor weakness hip, knee, ankle ankylosis or spasticity insufficient hip or knee flexion Contralateral shortness

24 Circumduction Spasticity Hip flexor weakness Hamstring paralysis
Knee or ankle ankylosis / orthotic knee lock Dorsiflexor weakness Plantar-flexion contracture

25 Scissor gait In spastic CP with spasticity of adductor m.

26 Crouched Gait Excessive flexion of hip and knee due to spasticity, muscle tightness or contracture Spastic CP

27 Parkinsonian gait Trunk ,head ,neck forward and knee flexed
wide base ,small shuffling step trend to fall forward and to increase speed (festination)

28 Hemiplegic gait Abnormal arm swing : adduction with flexion at shoulder ,elbow ,wrist and fingers extensor synergy of lower limb: leg extension ,adduction and hip IR ,knee extension ,ankle and foot plantarflexion and inversion.


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