Download to read offline
Physical Therapy for pathological gait.pptx
- 1. 1 Pathological Gait Lec. 6 Dr.Mark Monir Seddik Lecturer of Physical Therapy Fall Prevention Code: FPR 3130
- 2. 2 PATHOLOGICAL GAIT ➢ Scissoringgait ➢ In toeing gait ➢ Out toeing gait ➢ High stepping gait ➢ Circumduction gait ➢ Waddling gait ➢ Trendelenberg gait ➢ Drunkers gait ➢ Festinant gait ➢ Antalgic gait ➢ Knock knee gait ➢ Genu recurvatum gait ➢ Short limb gait ➢ Quadricep gait ➢ Gluteal medius gait ➢ Gluteal maximus gait ➢ Stiff hip gait
- 3. ANTALGIC GAIT ⚫Gait patternin which stance phase on affected side is shortened due to pain in the weight bearing limb. ⚫There is corresponding increase in stance phase on unaffected side ⚫Common causes: Osteoarthritis, Fractures, tendinitis
- 4. TRENDELENBERG GAIT ⚫Any conditionwhich distrupts the osseo-muscular mechanism between pelvis and femur ⚫Weak abductors (power), acetabulo femoral articulation, defect(fulcrum),defective lever system causes trendelenberg gait. ⚫Here the abductor action in pulling the pelvis downwards in stance phase becomes ineffective and the pelvis drops on the opposite side causing instability to prevent this body lurches on the same side.
- 5. Trendelenberg gait ⚫Usually unilateral ⚫Ifbilateral = waddling gait ⚫Causes : 1. Weak abductors :poliomyelitis . muscular dystrophies, motor neuron disease 2. Defective fulcrum: Congenital dislocaion of hip(CDH), pathological dislocation of hip 3. Defective lever : Fracture neck of femur, Perthes disease, Coxa vara.
- 6. Circumduction gait ⚫In hemiplegicpatients ⚫To avoid the foot from scrapping the ground, the hip and the lower limb rotates outward.
- 7. High stepping gait ⚫Dueto foot drop ⚫On attempt of heel strike, the toe drops to the ground first. ⚫To avoid this the patient flexes the hip and knee extensively to raise the foot and slaps it on the floor forcibly.
- 8. Scissoring gait ⚫Here oneleg crosses directly over the other with each step due to adductor tightness. ⚫Seen in Cerebral palsy
- 9. Drunkers or reelinggait ⚫Patient tends to walk irregularly on wide base, swinging sideways without stability and balance. ⚫Caused due to cerebellar lesion. ⚫With unilateral lesion of cerebellum, balance is lost towards the side of the lesion.
- 10. Genu recurvatum gait ⚫InParalysis of hamstring muscles, the knee goes in for hyper extension while transmitting the weight in mid stance phase. ⚫Seen in poliomyelitis
- 11. Short limb gait ⚫Shorteningless than 1.5 cm compensated by pelvic tilt, and shortening upto 5 cm compensated by equinus. ⚫Shortening more than 5 cm the patient dips his body on that side.
- 12. Festinant gait ⚫Seen inParkinson's disease ⚫Steps are short that the feet barely clears the ground.
- 13. Quadriceps gait ⚫Normally theknee is locked by the quadriceps contraction while transmitting weight to the lower limb during midstance. ⚫Hence patient with weak quadriceps stabilizes his knee by leaning forward on the affected side & pressing over lower thigh by his Ispilateral hand or fingers.
- 14. Gluteus maximus gait(BACKWARD LURCH) ⚫Due to weakness in gluteus maximus muscle, while the body propels forward during midstance phase,trunk is lurched posterior to effect posterior pelvic and shifting the centre of gravity towards stance hip. ⚫Seen in poliomyelitis and above knee
- 15. Stiff hip gait ⚫Whenthe hip is ankylosed, it is not possible to flex at the hip joint during walking to clear the ground in the swing phase. ⚫Hence the person with stiff hip, lifts the pelvis on that side and swings the leg with the pelvis in circumduction and moves it forward.
- 16. STAMPING/ATAXIC GAIT: ⚫It occursin sensory ataxia in which there is loss of sensation in lower extremity due to disease processes in peripheral nerves, dorsal roots, dorsal column of spinal cord. ⚫Due to absence of deep position sense,the patient constantly observes placing of his feet. ⚫Hip is hyperflexed & externally rotated & forefoot is dorsiflexed to strike ground with a Stamp. ⚫Seen in peripheral neuritis & brain stem lesion in children, tabes dorsalis in adults.
- 17. Alderman’s gait: • Seenin Tuberculosis of spine in lower dorsal and upper lumbar vertebra. • Patient walk with head and chest thrown backward and protuberant abdomen and legs thrown wide apart.
- 18. GAIT TRAINING ⚫AIM: Toachieve safe, easy, effortless normal gait pattern. Non ambulatory phase 1. Assess and improve the range of movement 2. Treat contractures 3. Improve the cardiorespiratory status 4. Shadow walking 5. Assisted device
- 19. Ambulatory phase 1. Supportby orthotics and prosthesis 2. Parallel bar walking 3. Encourage reciprocal arm swinging 4. Follow other forms of walking o Turning sidewalk o back walk o Squatting getting up o Walking on uneven rough surface
- 20. 20 Parallel bar walking reciprocalarm swinging
- 21.