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Pathological gait

  1. 1. Pathological gait Rabia Mustafa King Edward medical university
  2. 2. 2 Table of content Pathological gait .............................................1 Types ............................................................2 Types due to pain ........................................3 Due to abnormal deformities ........................4 Due to leg length discrepancy.......................5 Basal ganglia dysfunction ...........................6
  3. 3. 3 Pathological gait: There are numerous causes of abnormal gait. There can be great variations depending upon the severity of the problem. Normal walking is the standard against which pathology is measured Efficiency is often reduced in pathology Abnormality in gait can be cause by  Pain  Joint muscle range of motion limitation  Muscular weakness , paralysis , neurological involvement  Leg length discrepancy Types of pathological gait: Due to pain Antalgic or limping gait (psoatic gait)  Muscular paralysis  It may be Spastic (circumductory gait , scissoring gait , dragging gait, or paralytic gait , robotic gait , quadriplegic ) Flaccid (lurching gait, waddling gait, gluteus maximus gait, quadriceps gait , foot drop or stapping gait) Cerebellar dysfunction Ataxic gait Loss of kinaesthetic sensation Stamping gait
  4. 4. 4 Basal ganglia dysfunction Festinaut gait Due to abnormal deformities:  Equinus gait  Equinovarus gait  Calcaneal gait  Knock and bow knee gait  Genu recurvatum gait Due to leg length discrepancy:  Equinus gait Antalgic gait: This is a compensatory gait pattern adopted in order to remove or diminish the discomfort caused by pain in the LL or pelvis Characteristic features:  Decrease in duration of stance phase of the affected limb  There is a lack of weight shift laterally over the stance limb and also to keep weight off the involve limb Decrease in stance phase in affected side will result in a decrease in swing phase of sound Psoatic gait: Psoas bursa may be inflamed and endemalous which cause limitation of movements due to pain and produce a typical gait  Hip externally rotated  Hip adducted  Knee in slight flexion  Gluteus maximus gait:  Gluteus maximus act as a restraint for forward progression  The trunk quickly shifts posteriorly at heel strike  This will shift the body s’ COG posteriorly over the gluteus maximus moving the line of force posterior to hip joint
  5. 5. 5  Gluteus medius gait :  It is also known as trendelenberg gait or lurching gait when one side affected  The individual shifts the trunk over the affected side during stance phase  Bilateral paralysis , waddling gait or duck gait  The patient lurch to both sides while walking
  6. 6. 6 Quadriceps gait: Quadriceps action is needed during heel strike and foot flat when there is a flexion movement acting at the knee Compensation  With quadriceps weakness the individual may lean forward over the quadriceps  This will force the knee backward Genu recurvatum gait:  Hamstrings are weak, 2 things may happen  During stance phase – knee will go in hyper extension During the deceleration – hamstrings slow down the swing forward
  7. 7. 7 Hemiplegic gait:  Hip into extension , adduction , medial rotation  Knee in extension  Ankle in foot drop
  8. 8. 8 Scissoring gait:  It results from spasticity of bilateral adductor muscle of hip  One leg cross directly over other
  9. 9. 9 Dragging or paralytic gait:  There is a spasticity of both hip and knee  In order to clear the ground the patient has to drag his both lower limb swings them and place it forward Drunkards’ gait:  Abnormal function of cerebellum result in a disturbance of normal mechanism controlling balance and therefore patient walks with wider BOS  This result in irregular side way to a tendency to fall with each slip Sensory ataxic gait:  This is a typical gait pattern  The patient will loss his joint sense and position for his limb or space  Because of loss of joint sense the patient abnormally rise his leg so it is called stamping gait. Foot drop or stapping gait:  This is due to dorsiflexors weakness caused by paralysis of common peroneal nerve  There won’t be normal heel instead the foot comes in contact with ground as a whole with a slapping sound  Due to plantar flexion of ankle there will be relatively lengthening at the loading extremity Equinus gait:  Toe walking patho mechanical gait of childhood, characterized by habitual tiptoe walking; may occur simply  from habit, or characterize talipes equinovarus, spasticity or other neuromuscular disorders leading to posterior muscle group contracture, or loss of function of the anterior muscle group of the lower limb .
  10. 10. 10 Equinus foot:  A club foot or clubfoot, also called congenital talipes equinovarus (CTEV), is a congenital deformity involving one foot or both. The affected foot looks like it has been rotated internally at the ankle. Without treatment, people with club feet often appear to walk on their ankles or on the sides of their feet.  It is a relatively common birth defect, occurring in about one in every 1,000 live births. Approximately half of people with clubfoot have it affect both feet, which is called bilateral club foot. In most cases it is an isolated dysmelia (disorder of the limbs). It occurs in males twice as frequently as in females. Calcaneal gait: A gait disturbance, characterized by walking on the heel, due to paralysis of the calf muscles, seen following poliomyelitis and in some other neurologic diseases. Knock knee gait: In a normal standing position, if someone’s knees are touching, then their ankles will also touch. In a person with genu valgum, when the knees touch, a good distance separates the ankles and their knees “knock” into one another. It is the opposite as someone who is bow legged Most of those with knock knees are also overpronators.
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