This presentation delineates an overview of basics, pathology of gait and how to analyze it. It defines key terminology like the gait cycle, stride, step, and phases of gait. The major determinants of normal gait are described, including pelvic rotation and tilt, knee flexion, and foot and muscle mechanics. Pathologies are discussed for each phase of gait, such as foot slap, genu recurvatum, and Trendelenburg gait. Causes and clinical presentations of various gait deviations are outlined. In summary, the document serves as a comprehensive reference for understanding normal and abnormal human locomotion.

1. Dr Md. Mamunul ABEDIN
MBBS, BCS (Health),
FCPS trainee (Physical Medicine and Rehabilitation)
Assistant Registrar
Dept of Physical Medicine & Rehabilitation
ShSMCH, Dhaka, Bangladesh
GAIT
Basics, Pathology, Analysis

2. Dr Abedin MM
▪ Gait: Series of rhythmical, alternating movements
of the trunk & limbs which result in the forward
progression of the center of gravity.
▪ The Gait Cycle: A single sequence of functions of
one limb. Heel strike to subsequent heel strike of
the same foot.
2

3. Two Phases:
Stance Phase: limb is in contact with the ground.
- 5 subdivisions
- 60%
Swing Phase: foot is in the air.
- 3 subdivisions
- 40%
3
Dr Abedin MM

4. ▪ Initial contact (IC): Instant the foot contacts the ground.
▪ Loading response (LR): Initial contact to contralateral toe
off.
▪ Midstance (MSt): Contralateral toe off to ipsilateral heel off.
▪ Terminal stance (TSt): Ipsilateral heel off to initial contact
of the contralateral limb.
▪ Preswing (PSw): Initial contact of the contralateral limb to
just prior to toe off of ipsilateral limb.
4
Dr Abedin MM

5. Right Initial Contact
5
Both Feet on the Ground
2%
Dr Abedin MM

6. 6
Left Toe Off
Right
LOADING
RESPONSE
Both Feet on the Ground
10%
Dr Abedin MM

7. 7
Left foot is still on air
Right
MIDSTANCE
Right Heel Off
30%
Dr Abedin MM

8. Dr M M Abedin
8
Right
TERMINAL
STANCE
Both Feet on the Ground
Left Initial Contact
50%
Dr Abedin MM

9. 9
Right
PRESWING
Left
LOADING RESPONSE
Both Feet on the Ground
Right Toe Off
60%
Dr Abedin MM

10. 10
Dr Abedin MM

11. ▪ Initial swing: Lift of the extremity from the ground to
position of maximum knee flexion.
▪ Midswing: Immediately following knee flexion to vertical
tibia position.
▪ Terminal swing: Following vertical tibia position to just
prior to initial contact.
11
Dr Abedin MM

12. 12
Right
INITIAL
SWING
Both
FOOT ALIGNED
73%
Dr Abedin MM

13. 13
Right
MIDSWING
Right Tibia
VERTICAL
87%
Dr Abedin MM

14. 14
Right
TERMINAL
SWING
100%
Right Initial
CONTACT
Dr Abedin MM

15. 15
Dr Abedin MM

16. 16
Phase Knee Tibia on
Femur
Calcaneus Subtalar
Motion
Midfoot
Function
Forefoot
IC Extended Laterally
Rotated
2° Inverted Supinated Locked Adducted
LR Flexing Medially
Rotated
Everting to
5° Ev
Pronating Unlocking
(Absobing
Shock)
Abducting
Early
MSt
Extending Laterally
Rotated
Everting to
7° Ev
Pronating Unlocking Abducting
Late
MSt
Extending Laterally
Rotated
Inverting to
5° Iv
Supinating Locking Adducting
TSt Extended Laterally
Rotated
Inverting to
5° Iv
Supinated Locked Adducted
PSw Flexing Medially
rotating
6° Iv Supinated Unloading Adducted
Dr Abedin MM

17. 18
Dr Abedin MM

18. 1. Initial Contact
2. Initial Contact through Midstance
3. Initial Contact through Preswing
4. Loading Response through Preswing
5. Midstance through Preswing
6. Swing Phase
19
Stance
Phase
Dr Abedin MM

19. Probable Causes:
• Weak Dorsi-flexors (3/5)
20
Pathology: Foot Slap
Dr Abedin MM

20. Pathology:
 Genu Recurvatum
 Excessive Foot Supination
 Excessive Trunk Extension
 Excessive Trunk Flexion
21
Dr Abedin MM

21. Pathology:
Genu Recurvatum
 Excessive Foot Supination
 Excessive Trunk Extension
 Excessive Trunk Flexion
22
Dr Abedin MM
Probable Causes:
 Weak, short, or spastic quadriceps
 Compensated hamstring weakness
 Achilles tendon contracture
 Plantar flexor spasticity

22. Pathology:
 Genu Recurvatum
Excessive Foot Supination
 Excessive Trunk Extension
 Excessive Trunk Flexion
23
Dr Abedin MM
Probable Causes:
 Compensated forefoot valgus deformity
 Pes cavus
 Short limb

23. Pathology:
 Genu Recurvatum
 Excessive Foot Supination
Excessive Trunk Extension
 Excessive Trunk Flexion
24
Dr Abedin MM
Probable Causes:
 Weak hip extensor or flexor
 Hip pain
 Decreased knee ROM
Reason for deviation: Leaning backwards during stance phase shifts body’s
COG posterior to hip  reducing need for active hip extension torque.

24. Pathology:
 Genu Recurvatum
 Excessive Foot Supination
 Excessive Trunk Extension
Excessive Trunk Flexion
25
Dr Abedin MM
Probable Causes:
 Weak gluteus maximus and quadriceps
 Hip flexion contracture

25. Pathology:
 Excessive Knee Flexion
 Excessive Medial Femur Rotation
 Excessive Lateral Femur Rotation
 Wide Base of Support
 Narrow Base of Support
26
Dr Abedin MM

26. Pathology:
Excessive Knee Flexion
 Excessive Medial Femur Rotation
 Excessive Lateral Femur Rotation
 Wide Base of Support
 Narrow Base of Support
27
Dr Abedin MM
Probable Causes:
 Hamstring contracture
 Increased ankle DF
 Weak PF
 Long limb
 Hip flexion contracture

27. Pathology:
 Excessive Knee Flexion
Excessive Medial Femur Rotation
 Excessive Lateral Femur Rotation
 Wide Base of Support
 Narrow Base of Support
28
Dr Abedin MM
Probable Causes:
 Tight medial hamstrings
 Anteverted femoral shaft
 Weakness of opposite
muscle group
(In Toe)

28. Pathology:
 Excessive Knee Flexion
 Excessive Medial Femur Rotation
Excessive Lateral Femur Rotation
 Wide Base of Support
 Narrow Base of Support
29
Dr Abedin MM
(Out Toe)
Probable Causes:
 Tight lateral hamstrings
 Retroverted femoral shaft
 Weakness of opposite muscle group

29. Pathology:
 Excessive Knee Flexion
 Excessive Medial Femur Rotation
 Excessive Lateral Femur Rotation
Wide Base of Support
 Narrow Base of Support
30
Dr Abedin MM
Probable Causes:
 Hip abductor muscle contracture
 Instability
 Genu valgum
 Leg length discrepancy

30. Pathology:
 Excessive Knee Flexion
 Excessive Medial Femur Rotation
 Excessive Lateral Femur Rotation
 Wide Base of Support
Narrow Base of Support
31
Dr Abedin MM
Probable Causes:
 Hip adductor muscle contracture
 Genu varum

31. Pathology:
 Pelvic Drop (Uncompensated Trendelenburg Gait)
 Excessive Trunk Lateral Flexion (Compensated Trendelenburg Gait)
 Waddling Gait
32
Dr Abedin MM

32. Pathology:
Pelvic Drop (Uncompensated
Trendelenburg Gait)
 Excessive Trunk Lateral Flexion (Compensated Trendelenburg Gait)
 Waddling Gait
33
Dr Abedin MM
Probable Causes:
 Ipsilateral gluteus medius
weakness

33. Pathology:
 Pelvic Drop (Uncompensated Trendelenburg Gait)
Excessive Trunk Lateral Flexion
(Compensated Trendelenburg Gait)
 Waddling Gait
34
Dr Abedin MM
Probable
Causes:
 Ipsilateral gluteus
medius weakness
 Hip pain
 Hip dislocation, Coxa
vara
 Relatively Shorter Limb

34. Pathology:
 Pelvic Drop (Uncompensated Trendelenburg Gait)
 Excessive Trunk Lateral Flexion (Compensated Trendelenburg Gait)
Waddling Gait
35
Dr Abedin MM
Probable Causes:
 Bilateral gluteus medius
weakness

35. Pathology:
 Excessive Foot Pronation
 Bouncing or Exaggerated
 Insufficient Push-off
 Inadequate Hip Extension
36
Dr Abedin MM

36. Pathology:
Excessive Foot Pronation
 Bouncing or Exaggerated
 Insufficient Push-off
 Inadequate Hip Extension
37
Dr Abedin MM
Probable Causes:
 Compensated forefoot/ hindfoot varus deformity
 Uncompensated forefoot valgus deformity
 Pes planus
 Decreased ankle dorsiflexion
 Increased tibial varum
 Long limb
 Uncompensated internal rotation of tibia or femur
 Weak tibialis posterior

37. Pathology:
 Excessive Foot Pronation
Bouncing or Exaggerated
 Insufficient Push-off
 Inadequate Hip Extension
38
Dr Abedin MM
Probable Causes:
 Achilles tendon contracture
 Gastroc-soleus spasticity

38. Pathology:
 Excessive Foot Pronation
 Bouncing or Exaggerated
Insufficient Push-off
 Inadequate Hip Extension
39
Dr Abedin MM
Probable Causes:
 Gastroc-soleus weakness
 Achilles tendon rupture
 Metatarsalgia
 Hallux rigidus

39. Pathology:
 Excessive Foot Pronation
 Bouncing or Exaggerated
 Insufficient Push-off
Inadequate Hip Extension
40
Dr Abedin MM
Probable Causes:
 Hip flexor contracture
 Weak hip extensor

40. 41
Dr Abedin MM

41. Pathology:
 Steppage Gait/ Foot Drop
 Circumduction
 Hip Hiking
42
Dr Abedin MM

42. Pathology:
Steppage Gait/ Foot Drop
 Circumduction
 Hip Hiking
43
Dr Abedin MM
Probable Causes:
 Severely weak dorsiflexors
 Equinus deformity
 Plantar flexor
 Spasticity

43. Pathology:
 Steppage Gait/ Foot Drop
Circumduction
 Hip Hiking
44
Dr Abedin MM
Probable Causes:
 Long limb
 Abductor muscle shortening or
overuse
 Stiff knee

44. Pathology:
 Steppage Gait/ Foot Drop
 Circumduction
Hip Hiking
45
Dr Abedin MM
Probable Causes:
 Long Limb
 Quadratus Lumborum shortening
 Weak Hamstring
 Stiff Knee

45. 46
Dr Abedin MM

46. ▪ Observe the patient/client’s gait from both sagittal and
frontal views
▪ Identify the major deviations
▪ Determine Velocity, Cadence, Stride
▪ Develop hypotheses of the likely causes
▪ Plan and perform a clinical examination to determine
impairments
▪ Determine the cause of the deviations
▪ Set reasonable goals, develop and implement a treatment
plan
47
Dr Abedin MM

47. ▪ Directly observe or obtain a videotape
▪ Minimal, tight clothing should be worn
▪ Instruct the patient to walk barefoot at a comfortable speed
▪ Observe the client’s walking from multiple views
▪ Identify prominent gait deviations
▪ Determine the reference limb for analysis
▪ Identify the deviations (Start at the foot)
48
Dr Abedin MM

48. ▪ Primary: directly caused by an impairment
(4 major categories)
▪ 1. Deformity
▪ 2. Weakness
▪ 3. Impaired motor control
▪ 4. Pain
▪ Secondary: results from an abnormal posture at adjacent
joint
▪ Compensatory: movements accommodating for an
impairment
49
Dr Abedin MM

49. 50
Excess dorsiflexion (DF) in
Mid Stance due to weak
calf muscles
Excess DF in Mid Stance
due to a knee flexion
contracture rather than
weak calf muscles. Secondary
Primary
Dr Abedin MM

50. 51
Contralateral pelvic
drop due to weak hip
abductors
Ipsilateral
trunk lean in
stance to
compensate for
weak hip
abductors
Primary
Compensatory
Dr Abedin MM

51. 52
Forefoot contact at
Initial Contact due
to inadequate knee
extension in
Terminal Swing
Secondary
Forefoot contact at
Initial Contact due to
Plantar flexion (PF)
contracture
Primary
Hyperextension
of Knee during
Midstance
Compensatory
Dr Abedin MM

52. ▪ Injuries (e.g.: Sprains, strains, tendinosis, fractures,
dislocations, overuse, peripheral nerve injury)
▪ Degenerative diseases (e.g.: osteoarthritis)
▪ Systemic diseases (e.g.: RA)
▪ History of poliomyelitis
▪ Spina bifida
▪ Guillain-Barre syndrome
▪ Muscular dystrophy
53
Dr Abedin MM

53. ▪ Stroke
▪ Multiple sclerosis
▪ Spinal cord injury
▪ Traumatic or acquired brain injury
▪ Parkinson’s disease
▪ Cerebral palsy
▪ Amyotrophic lateral sclerosis
54
Dr Abedin MM

54. 55
Dr Abedin MM

55. 56
Deviation Definition
ForefootContact Initialgroundcontactwithforefoot
FlatfootContact Initialgroundcontactwithbothforefoot&hindfoot
Abbr.HeelContact AtIC,intervalofheelonlyisshortened
FootSlap RapidPFafterheelstrike
Inadeq.DF LessthannormalDF
Inadeq.PF LessthannormalPF
ExcessIv(PesCavus) Morethannormalcalcaneal/forefootinversion
ExcessEv(PesPlanus) Morethannormalcalcaneal/forefooteversion
EarlyHeelOff HeeloffinMid-stance
NoHeelOff HeeldoesnotriseinTerminalStance
InaeqMTPX LessthannormalMTPextinTSt&PSw
ExcessIPFlex(Clawed) MorethannormalIPflexionwith/outMTPextension
ToeDrag Contactoffootwiththegroundduring ISw/MSw
ContralateralVault(PF) ExcessanklePF+prolongedwtbearingofcontralimb
Dr Abedin MM

56. Gait Phase Possible causes
IC Primary:
- Weak DF (<3/5)
- PF contracture/ Hypomobility
- Abnormal plantar flexor activity
Secondary:
- To inadequate knee extension in TSw
- To a knee flexion contracture
- Abnormal hamstring activity
Compensatory:
- To reduce the effects of the heel rocker due
to weak Quadriceps
57
Abbreviated Heel Contact (Abb HC): At IC, the interval
of heel only is shortened.
Flatfoot Contact (Flat Ft): IC made with both hind &
forefoot.
Dr Abedin MM

57. Gait Phase Possible causes
IC Primary:
- Weak DF
- Weak Knee Extension
- Combination
Compensatory:
- To accommodate for a shorter limb
- To avoid heel pain
58
Forefoot Contact: Initial ground contact made
with the forefoot
Foot Slap: Rapid PF after heel strike
Gait Phase Possible causes
LR Primary:
- Weak DF (3/5)
Dr Abedin MM

58. Inadequate Plantar flexion:
59
Inadequate Dorsi-flexion: Inadequate DF for the
phase.
Phase Ankle
Motion
IC 0°
LR 5° PF
MSt 5° DF
TSt 10° DF
PSw 15° PF
ISw DF to 5° PF
MSw DF to 0°
TSw 0°
Probable Causes:
Primary:
- Weak DF (<3/5)
- PF contracture/ Spasticity
- Ankle pain, joint effusion
Compensatory:
- To avoid the ankle rocker secondary to
weak plantar flexors.
Secondary:
- To absent/ short heel rocker
Dr Abedin MM

59. Gait Phase Possible causes
Mid Stance Primary:
- Skeletal Deformity
- Over activity of plantar flexors
- PF contracture/ Hypomobility
Secondary:
- To excess knee flexion
Compensatory:
- Voluntary PF to accommodate for a short
reference limb
61
Early Heel Off: Heel off in Mid-Stance
Dr Abedin MM

60. Gait Phase Possible causes
Terminal Stance Primary:
- Weak plantar flexors (<4/5)
- Forefoot pain
Secondary:
- To inadequate toe extension
- To excess ankle DF
- To knee hyperextension
62
No Heel Off: Heel does not rise in Terminal
Stance
Dr Abedin MM

61. Gait Phase Possible causes
Stance & Swing Primary:
- Hindfoot varus, Uncompensated Forefoot
varus
- Impaired AT/PT/Soleus activity
- Equinovarus contracture
Secondary:
- To genu varum
- To hip rotational deformities
Swing Only Primary:
- All of the above
- Flaccid paralysis of pretibials (AT, EHL,
EDL)
63
Excess Inversion (Pes Cavus): More than
normal calcaneal/forefoot inversion for the
phases
Dr Abedin MM

62. Gait Phase Possible causes
Stance Primary:
- Hindfoot valgus, Uncompensated Forefoot
valgus
- Weak invertors (AT, PT)
Secondary:
- To a compensated forefoot varus
- To a genu valgus
- To hip rotational deformities
Compensatory:
- For limited ankle DF ROM
64
Excess Eversion (Pes Planus): More than
normal calcaneal/forefoot eversion for the
phases
Dr Abedin MM

63. Gait Phase Possible causes
Initial Swing Primary:
- Inadequate Knee flexion
Secondary:
- To excess contralateral knee flexion
Mid Swing Primary:
- Inadequate DF (3/5)
Secondary:
- To inadequate hip flexion
- Excess contralateral knee flexion
65
Toe drag: Contact of foot with the ground
during Initial/ Midswing.
Dr Abedin MM

64. Gait Phase Possible causes
Swing Compensatory:
- Voluntary contralateral PF (heel rise or toe
walking) to lengthen stance limb and
achieve swing limb toe clearance when
there is:
- A longer Swing limb
- Inadequate knee flexion in Initial
swing
- Inadequate DF in Mid Swing
66
Contralateral Vault: Excess ankle PF with
prolonged forefoot weight bearing of the
contralateral stance limb during reference limb
swing.
Dr Abedin MM

65. Gait Phase Possible causes
Terminal Stance &
Pre Swing
Primary:
- Hallux rigidus
- Abnormal FHL & FDL
Secondary:
- To avoid forefoot pain
- To no heel off
67
Inadequate MTP extension: Excess ankle PF with
prolonged forefoot weight bearing of the
contralateral stance limb during reference limb
swing.
Dr Abedin MM

66. 68
Dr Abedin MM

67. Gait Phase Possible causes
Stance Primary:
- Knee flexion contracture
- Abnormal knee flexors
- Knee pain, Joint effusion
Secondary:
- To excess DF posture
- To excess hip flexion posture
Swing Primary:
- + Weak Quadriceps + above
Compensatory:
- To allow forefoot/flatfoot contact
69
Inadequate Extension: Less than normal
extension for the phase.
Phase Knee
F/X
IC 0° + 5°
LR 15°
MSt 0°
TSt 0°
PSw 40°
ISw 60°
MSw 25°
TSw 0°
Dr Abedin MM

68. Gait Phase Possible causes
LR Primary:
- Weak/ Abnormal Quadriceps
- Tibiofemoral/ Patellofemoral
pain
- Skeletal deformity
Secondary:
- To excess PF posture
- To forefoot/flatfoot contact
Compensatory: For anterior
cruciate ligament deficiency
70
Inadequate Flexion: Less than normal flexion for
the phase.
Phase Knee
F/X
IC 0° + 5°
LR 15°
MSt 0°
TSt 0°
PSw 40°
ISw 60°
MSw 25°
TSw 0°
Dr Abedin MM

69. Gait Phase Possible causes
Swing Primary:
- Same as Loading
Secondary:
- To inadequate hip flexion, kne
flexion in pre-swing hip
extension in terminal stance
- To ‘no heel off’ in Terminal
Stance
71
Inadequate Flexion: Less than normal flexion for
the phase.
Phase Knee
F/X
IC 0° + 5°
LR 15°
MSt 0°
TSt 0°
PSw 40°
ISw 60°
MSw 25°
TSw 0°
Dr Abedin MM

70. Gait Phase Possible causes
Swing Primary:
- Abnormal hip & knee flexor activity
Compensatory:
- To assure toe clearance
72
Excess Flexion: More than normal flexion for the
phase
Dr Abedin MM

71. Gait Phase Possible causes
Stance Primary:
- Weak quadriceps
Secondary:
- To a PF posture
Compensatory:
- To increase limb stability with weak quadriceps
and plantar flexors
73
Hyperextension: More than normal extension for
the phase
Extensor thrust: Rapid movement toward
extension
Dr Abedin MM

72. 74
Varus (Bow-Leg): Adduction of distal tibia relative to femur.
Valgus (Knock-Knee): Abduction of distal tibia relative to
femur.
Dr Abedin MM

73. Varus Valgus
Primary:
- Skeletal deformity
- Ligamentous laxity
- OA
Secondary:
- To an uncompensated
hindfoot varus deformity
- To a compensated forefoot
valgus deformity
Primary:
- Skeletal deformity
- Ligamentous laxity
- RA
Secondary:
- To an uncompensated hindfoot
varus deformity
- To a compensated forefoot valgus
deformity
- To an ipsilateral trunk lean
75
Varus (Bow-Leg): Adduction of distal tibia relative to femur.
Valgus (Knock-Knee): Abduction of distal tibia relative to
femur.
Dr Abedin MM

74. 76
Dr Abedin MM

75. Gait Phase Possible causes
Stance Primary:
- Hip flexion contracture
- Abnormal hip flexors
- Hip pain, Joint effusion
Secondary:
- To excess knee flexion
- To ‘no heel off’ in Terminal
stance
77
Inadequate Extension (Crouched Gait):
Inadequate extension in Stance phase.
Phase Thigh
F/X
IC 25°
LR 25°
MSt 0°
TSt 15° X
PSw Flexing
ISw 15° F
MSw 25° F
TSw 25°
Dr Abedin MM

76. Gait Phase Possible causes
IC & LR Primary:
- Impaired motor control
- Skeletal deformity
Secondary:
- To inadequate hip flexion in
Terminal swing
Compensatory: to decrease
demand on weak hip extensors in
LR
78
Inadequate Flexion: Less than normal flexion for
the phase.
Phase Thigh
F/X
IC 25°
LR 25°
MSt 0°
TSt 15° X
PSw Flexing
ISw 15° F
MSw 25° F
TSw 25°
Dr Abedin MM

77. Gait Phase Possible causes
Swing Primary:
- Weak hip Flexors
- Abnormal Hamstring activity
Secondary:
- To toe drag
Compensatory: to decrease
demand on weak hip extensors in
preparation for IC & LR
79
Inadequate Flexion: Less than normal flexion for
the phase.
Phase Thigh
F/X
IC 25°
LR 25°
MSt 0°
TSt 15° X
PSw Flexing
ISw 15° F
MSw 25° F
TSw 25°
Dr Abedin MM

78. Gait Phase Possible causes
Swing Compensatory:
- For inadequate knee flexion in initial swing for
toe clearance
- For inadequate DF in Midswing for toe
clearance
- For a longer swing limb
- For CL knee flexion, which functionally
shortens the stance limb.
80
Excess Flexion: More than normal flexion for the
Swing phase.
Dr Abedin MM

79. Gait Phase Possible causes
81
Medial Rotation: Position of the Femur with
femoral condyles facing medially.
Dr Abedin MM

80. Gait Phase Possible causes
82
Lateral Rotation: Position of the Femur with
femoral condyles facing laterally.
Dr Abedin MM

81. Gait Phase Possible causes
Stance Primary:
- Skeletal deformity
Secondary:
- To a pelvic obliquity
- To a contralateral pelvic hike
- To a spinal deformity (Scoliosis)
- To increase base of support
Compensatory: for longer reference limb
(LLD)
83
Abduction: Abduction of the femur beyond
neutral.
Dr Abedin MM

82. Gait Phase Possible causes
Swing Compensatory:
- To clear a longer swing limb
- To clear a functionally longer swing limb
(Inadequate hip/ knee flexion, inadequate
DF)
84
Abduction: Abduction of the femur beyond
neutral.
Dr Abedin MM

83. Gait Phase Possible causes
85
Adduction (Scissoring Gait): Adduction of the
femur beyond neutral.
Dr Abedin MM

84. Gait Phase Possible causes
86
Contralateral Drop (Trendelenburg Gait): > 5° of
iliac crest on swing limb during stance on the
reference limb.
Dr Abedin MM

85. Gait Phase Possible causes
87
Ipsilateral Drop: Adduction of the femur beyond
neutral.
Dr Abedin MM

86. 88
Dr Abedin MM
https://www.youtube.com/watch?v=FFki8FtaByw

87. 89
▪ Knee: Held in extension
▪ Leg: Swings away from the center of the body
▪ Hip: hikes upward (Circumduction)
▪ Foot: Drop
▪ UL: Shoulder adduction, elbow & wrist flexion with Clenched fist
Unilateral upper motor neuron lesions with spastic hemiplegia
Dr Abedin MM

88. 90
▪ Hypertonia in the legs and hips: flexion -> Crouched stance
▪ Overactive Hip adductors: causing the knees and thighs to touch or cross in
a “Scissor-like” movement
▪ In cerebral palsy, ankle plantar flexion: forcing the patient to tiptoe walk
Bilateral corticospinal tract lesions: CP, incomplete SCI, and MS
Dr Abedin MM

89. 91
▪ Broad-based stance and irregular step and stride length
▪ Tendency to sway
▪ Tandem gait exacerbate cerebellar ataxia
Cerebellar dysfunction or severe sensory loss
Dr Abedin MM

90. 92
▪ Broad-based gait and a “waddling-type” appearance
▪ When going from floor to standing, the patient will use their
arms and hands to climb up their legs—known as Gowers sign
Weakness of the proximal leg muscles
Dr Abedin MM

91. 93
During the stance phase, the abductor muscle allows the pelvis to tilt down
on the opposite side. To compensate, the trunk lurches to the weakened side
to maintain the pelvis level during the gait cycle. This results in a waddling-
type gait with an exaggerated compensatory sway of the trunk toward the
weight-bearing side.
Weakness of the abductor muscles (glut. medius and glut. minimus)
Dr Abedin MM

92. 94
▪ Stooped posture, narrow base of support, and a shuffling gait with
small steps
▪ Slowing of the gait (Bradykinesia)
▪ Lean forward while walking so the steps become hurried, resulting in
shuffling of the feet (Festination)
▪ loss of normal arm swing
Parkinson disease and other disorders of the basal ganglia
Dr Abedin MM

93. 95
▪ Foot drop
▪ Compensation: by lifting the affected extremity higher than
normal to avoid dragging the foot
▪ Leads to poor heel strike with the foot slapping on the floor
Diseases of the peripheral nervous system including L5 radiculopathy,
lumbar plexopathies, and peroneal nerve palsy
Dr Abedin MM

94. 96
Dr Abedin MM

95. 97
Dr Abedin MM

96. Dr Abedin MM 98

97. Dr Abedin MM 99