pathological gait

1. Pathological gait
Rabia Mustafa
King Edward medical university

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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

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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

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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

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
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

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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

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Hemiplegic gait:
 Hip into extension , adduction , medial rotation
 Knee in extension
 Ankle in foot drop

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Scissoring gait:
 It results from spasticity of bilateral adductor muscle of hip
 One leg cross directly over other

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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 .

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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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