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Pathological gaits.pptx
- 1. Pathological Gaits BY – BPT 2ND YEAR (Batch 2020-21)
- 2. Group 1 : hemiplegic gait Members ; Jesse rai Simran basnet M.d kaisher Tapashna subba Devangsh rai This Photo by Unknown Author is licensed under CC BY-NC
- 3. HEMIPLEGIC GAIT Disruption of the corticospinal tract above the medulla results in contralateral abnormal tone, posture, and hemiplegic gait. The ipsilateral side is involved if the lesion occurs below the decussation of fibers in the medulla. Tone is often increased. Posture is characterized by leg extension or slight knee flexion. Hemiplegic gait includes impaired natural swing at the hip and knee with leg circumduction. The pelvis is often tilted upward on the involved side to permit adequate circumduction. With ambulation, the leg moves forward and then swings back toward the midline in a circular movement. The heel-walking exercise is impaired as the patient scuffs the lateral sole and the toe of the shoe while dragging the foot. With more severe involvement, the movements are markedly slow and require great effort.
- 4. Phases of gait ROM in hip , knee, ankle Temporal variables Spatial variables Muscle involved rockers 1. Initial contact Hip extension 11 deg. Ankle plantar flexed , knee flexed 1. step time: increases 2. Stride time: increases 1. Stride length: increased Hip extensors , plantar flexors , knee flexors Forefoot rocker 2.Loading response Hip extension ,knee extension 3.Stance: decreased 2. Step length: increases hip extensors , knee extensors . 3. Mid stance Excessive knee flexion , hip flexion 4.Swing duration : increased 3. Step width: increased Hip extensors , knee flexors 4. Terminal stance Knee flexion, ankle plantar flexion , hip flexion 5. Cadence : decreased 4. Foot angle : excessive plantar flexion Knee flexors plantar flexors hip flexors , plantar flexors 5.Pre swing Hip flexion decreases , knee flexion decreases . P.F Concentric conc. Of hip flexors 6. Initial swing Hip flexion at 8 deg. Of ext. P.F, knee extension Hip flexors , plantar flexors 7. Mid swing Hip flexion by 19 deg. , knee ext. decreased . Dec. D.F. P.F Knee extensors ,hip flexors , plantar flexors 8. Terminal swing Hip flexion increased . Hyperextension of knee . Substantial hip extensors , knee extensors
- 5. ANTALGIC GAIT Group 2 SAMEEN RAI ROSHNI PRADHAN SERINA GURUNG ROHAN PRADHAN TSHERING MIT LEPCHA
- 6. Normal Gait
- 8. Temporal Spatial Speed (decrease) Stride length ( decrease) Intial contact ( terminal stance) Step length decrease Single load Support( mid swing) With of the base increase Cadence ( decrease) Degree of toe out Double limb support( terminal stance and terminal swing) Variables…
- 10. Group 3
- 11. PARKINSONIAN GAIT DONE BY- “Group 4” ANJEELINA ALE KHYATI CHOUDHURY ASHMITA RAI PALZOR GYATSO DORJEE BHUTIA TSHERING NEDUP BHUTIA SNEHA GURUNG
- 13. Phases of gait Temporal variables Spatial variables ROM in Hip, knee ankle Muscles involved Rockers INITIAL CONTACT : Heel contact absent, Toe to heel progression STEP TIME : REDUCED STEP LENGTH : DECREASED Hip extensors, knee extensors work extensively because knee is flexed throughout the gait, Rigid Ankle dorsiflexors causes foot drop FOREFOOT ROCKER LOADING RESPONSE STRIDE TIME : REDUCED STRIDE LENGTH : DECREASED Hip extensors, Knee extensors(eccentri c), plantar flexors(eccentric) and reduced progression to dorsiflexion ANKLE ROCKER
- 14. TERMINAL STANCE : Late heel off and toe off. SINGLE LIMB TIME : REDUCED FOOT ANGLE : INTOEING Hip adductors work slightly to flex hip, reduced action of knee flexors, reduced action of plantar flexors(concentri c) due to rigidity. FOREFOOT ROCKER MID STANCE STANCE DURATION : INCREASED BASE OF SUPPORT : REDUCED Frontal plane muscles Hip adductors, knee extensors to control motion, plantar flexors(eccentric ) ANKLE ROCKER
- 15. TERMINAL SWING:ABSEN T WALKING SPEED : INCREASED MID SWING CADENCE(110- 115steps/min) : INCREASED Decreased Hip flexors action which causes foot dragging, knee flexors, reduced dorsiflexors action causes foot drop and dragging INITIAL SWING :ABSENT SWING TIME : REDUCED PRE SWING DOUBLE SUPPORT TIME : INCREASED Hip flexors, Rectus femoris, PF work but relaxes quickly as weight releases quickly
- 16. SPASTIC OR CEREBRAL PALSY GAIT GROUP “5” PRESENTATION Garima Chawla Sunita Subba Tenzing Yankee Tenzing Chekey Yasaswi Pradhan Ritika Panthi
- 17. Spastic Diplegia • form of cerebral palsy (CP) that is a chronic neuromuscular condition that primarily affects motor control in legs. Characterstics :- • Hypertonia & Spasticity • “Tightness” or ‘Stiffness” in the muscles of lower extremity of human body • Muscle weakness & Delayed developmental milestones • Challenges with Balance, Walking and Growth.
- 18. Common Abnormal Gait Patterns in indivials with Spastic Diplegia include: • Scissor Gait – walking with the knees turned inwards • Tip-Toeing Gait – walking on toes • Crouch Gait – walking with continuously bent knees, hips and ankles. Scissor + Tip- toeing Gait
- 19. Anterior View...
- 20. Lateral View…
- 21. Phases Of Gait Phase Characteristics Temporal Variable Spatial Variable Muscles Involved Rockers Initial Contact Increased knee flexion, hip flexion & Ankle plantar flexed Step Length = decreased Step time = decreased Knee flexors, hip flexors, trunk flexors, plantar flexors(Gastrosoleus, tibialis posterior) and ankle inverters (Tibialis Ant & post) Forefoot Rocker Loading response Increased PF Step width = increased Walking speed = decreased Knee flexors, hip flexors, ankle extensors and inverters Mid Stance Limited hip extension, knee Hyper-extension, DF Stride length = decreased Stride time = decreased Knee flexors, hip flexors, ankle extensors and inverters Terminal stance Increased Knee Flexion, PF Foot angle = internally deviated (Pes VARUS) Cadence = decreased Knee flexors, hip flexors, ankle extensors and inverters Reduced Forefoot Rocker Pre swing Reduced knee flexion & Ankle PF Right & Left SLS = Decreased Knee flexors, hip flexors, ankle extensors and inverters Initial swing Reduced knee flexion Right & left Initial DLS = Increased Knee flexors, hip flexors, ankle extensors and inverters Mid swing Limited Knee flexion Right & left Terminal DLS = Increased Knee flexors, hip flexors, ankle extensors and inverters
- 22. GENU RECURVATUM GAIT Presentation by:- “GROUP 6” Kunsang Dechen Anushka Pradhan Sukhmanpreet Kaur Priya Chettri Karma Tashi Bhutia Neharika Thapa
- 23. Genu recurvatum is a deformity in the knee joint, in which the knee bends backwards . In this deformity, excessive extension occurs in the tibio-femoral joint. Genu recurvatum is also called knee hyperextension and back knee. This gait is more common in women. CAUSES: physeal arrest , soft tissue laxity, complications related to fractures, such as prolonged immobilization and mal-alignment.
- 25. Phases of gait Temporal variables Spatial variables ROM in Hip, knee ankle Muscles involved Rockers Initial Contact Decreases Decreases HIP- Anterior pelvic tilt KNEE- excessive hyperextension ANKLE- Increase plantar flexion Weak Quadriceps and gastrocnemius Heel rocker Loading Response ---- ---- ---- ---- ---- Mid Stance ---- ---- ---- ---- ---- Terminal Stance Decreases Decreases HIP- hyperextension KNEE- excessive hyperextension ANKLE- dorsiflexion Weakness of hip adductor and flexor, gastrosoleus, T.posterior, FDL Ankle rocker Pre Swing ---- ---- ---- ---- ---- Initial Swing ---- ---- ---- ---- ---- Mid Swing ---- ---- ---- ---- ---- Terminal Swing Decreases Decreases HIP- slight flexion KNEE- excessive hyperextension ANKLE- dorsiflexion Weak hamstrings, quadriceps, gastrocnemius Heel rocker
- 26. Group 7
- 27. GROUP 8 ‘CALCANEAL GAIT’ SIMRAN SHERPA SHALINI CHETTRI CHUDIMIT LEPCHA PEMBA L LEPCHA ADITYA CHETTRI
- 28. Phases of Gait Temporal Variables Spatial variables ROM In Hip Knee Ankle Muscles Involved Rockers INITIAL CONTACT Stance time- decreases Stride Length - short Gluteus medius LOADING RESPONSE Single limb time- Reduced/short Step Length- small Quadriceps femoris MID STANCE Step time- decreased Step Width-less Triceps Surae TERMINAL STANCE Triceps Surae PRE SWING Deep Plantarflexors INITIAL SWING Iliopsoas and Rectus femoris MID SWING Iliopsoas and Rectus femoris TERMINAL SWING Hamstrings,Qua driceps femoris,Tibialis ant
- 30. NORMAL GAIT
- 32. Thankyou!