This document discusses various types of gait abnormalities and their causes. It begins by covering normal gait and the gait cycle. It then describes different types of abnormal gaits such as antalgic, propulsive, hemiplegic, myopathic, steppage, sensory ataxia, festinating, scissor, frontal lobe, ataxic, choreic, dystonic, and cautious gaits. It discusses anatomical structures involved in gait and balance as well as disorders that can cause gait abnormalities like pain, joint issues, weakness, and neurological impairments. The document provides details on evaluating patients with gait disorders.
This document discusses various types of gait abnormalities and their causes. It begins by covering normal gait and the gait cycle. It then describes different types of abnormal gaits such as antalgic, propulsive, hemiplegic, myopathic, steppage, sensory ataxia, festinating, scissor, frontal lobe, ataxic, choreic, dystonic, and cautious gaits. It discusses anatomical structures involved in gait and balance as well as disorders that can cause gait abnormalities. The document provides details on evaluating patients with gait disorders.
GAIT and it abnormality by Dr Umar Mohammed NOHIL ssuser72e0cf
The document discusses gait and its abnormalities. It begins with definitions of gait and an overview of the importance of gait analysis in orthopedics. It describes the normal gait cycle and phases. Abnormalities are then discussed, including causes such as injuries, diseases, and neurological conditions. Specific abnormal gait patterns are explained, such as antalgic gait, Trendelenburg gait, spastic gaits in conditions like cerebral palsy, and gaits due to muscle weakness. The conclusion emphasizes the importance of understanding normal gait and specific pathologies for accurate diagnosis and treatment.
Recurrent dislocation of patella DR, MOHAMMED BASHEERdrmb65
This document provides information on the anatomy and biomechanics of the patella and knee. It describes the forces that act on the patella, including the pull of the vastus medialis longus and vastus medialis obliqus muscles. It discusses causes of patellar dislocation such as trochlear dysplasia, incompetence of the medial patellofemoral ligament, and abnormalities that increase the Q angle. The document outlines approaches for evaluating the patella through medical history, physical examination, imaging, and surgical treatment options for patellar instability.
This document provides an overview of the clinical examination of the spine. It describes examining the patient's history, general examination including inspection of posture and deformities, and localized palpation of the cervical, thoracic, lumbar, and sacral spine. Specific tests are outlined to assess the range of motion and integrity of the spine as well as nerve root tension including the straight leg raise test. A neurological examination of motor function, sensation, and reflexes is also recommended to evaluate for any neurological deficits.
Gait analysis involves studying normal walking patterns and identifying deviations. The normal gait cycle is divided into stance and swing phases for each limb. Gait analysis includes measuring spatial and temporal parameters like step length, stride length, and stance/swing times. It also analyzes joint angles and determines components like cadence and speed. Gait analysis is used clinically and in research to identify abnormal walking patterns.
This document provides an overview of gait disorders, including normal gait cycle components and subdivisions, physiological and anatomical aspects of gait, common causes and types of abnormal gait, clinical symptoms and examination of gait. Key points covered include definitions of stance and swing phases, centers of pressure and gravity, neurological structures involved in locomotion, epidemiology of gait disorders in older adults, gait abnormalities due to weakness, spasticity, sensory deficits and imbalance. Classification of gait patterns such as myopathic, neurogenic, sensory ataxia, vestibular imbalance and spastic hemiparetic gaits are described.
Clinical examination of the spine/back covering the following sections:
INSPECTION
PALPATION
MOVEMENTS
MEASUREMENTS
SPECIAL TESTS
(Neurological examination covered separately in another slideshow : SPINE EXAMINATION - PART 2)
This document summarizes gait disorders and their causes. It discusses that 15% of those over 65 have gait disorders, and risk of falls increases with age. The physiology of gait and various brain centers involved in locomotion are described. Examination of gait and station involves assessing base of support, arm swing, stride length, and ability to walk tandem or on toes/heels. Common gait disorders include spastic, parkinsonian, frontal, cerebellar, and sensory ataxias. Causes can be neurological, non-neurological, or non-organic. Specific gait patterns like steppage, waddling, and psychogenic gaits are also outlined.
This document discusses various types of gait abnormalities and their causes. It begins by covering normal gait and the gait cycle. It then describes different types of abnormal gaits such as antalgic, propulsive, hemiplegic, myopathic, steppage, sensory ataxia, festinating, scissor, frontal lobe, ataxic, choreic, dystonic, and cautious gaits. It discusses anatomical structures involved in gait and balance as well as disorders that can cause gait abnormalities. The document provides details on evaluating patients with gait disorders.
GAIT and it abnormality by Dr Umar Mohammed NOHIL ssuser72e0cf
The document discusses gait and its abnormalities. It begins with definitions of gait and an overview of the importance of gait analysis in orthopedics. It describes the normal gait cycle and phases. Abnormalities are then discussed, including causes such as injuries, diseases, and neurological conditions. Specific abnormal gait patterns are explained, such as antalgic gait, Trendelenburg gait, spastic gaits in conditions like cerebral palsy, and gaits due to muscle weakness. The conclusion emphasizes the importance of understanding normal gait and specific pathologies for accurate diagnosis and treatment.
Recurrent dislocation of patella DR, MOHAMMED BASHEERdrmb65
This document provides information on the anatomy and biomechanics of the patella and knee. It describes the forces that act on the patella, including the pull of the vastus medialis longus and vastus medialis obliqus muscles. It discusses causes of patellar dislocation such as trochlear dysplasia, incompetence of the medial patellofemoral ligament, and abnormalities that increase the Q angle. The document outlines approaches for evaluating the patella through medical history, physical examination, imaging, and surgical treatment options for patellar instability.
This document provides an overview of the clinical examination of the spine. It describes examining the patient's history, general examination including inspection of posture and deformities, and localized palpation of the cervical, thoracic, lumbar, and sacral spine. Specific tests are outlined to assess the range of motion and integrity of the spine as well as nerve root tension including the straight leg raise test. A neurological examination of motor function, sensation, and reflexes is also recommended to evaluate for any neurological deficits.
Gait analysis involves studying normal walking patterns and identifying deviations. The normal gait cycle is divided into stance and swing phases for each limb. Gait analysis includes measuring spatial and temporal parameters like step length, stride length, and stance/swing times. It also analyzes joint angles and determines components like cadence and speed. Gait analysis is used clinically and in research to identify abnormal walking patterns.
This document provides an overview of gait disorders, including normal gait cycle components and subdivisions, physiological and anatomical aspects of gait, common causes and types of abnormal gait, clinical symptoms and examination of gait. Key points covered include definitions of stance and swing phases, centers of pressure and gravity, neurological structures involved in locomotion, epidemiology of gait disorders in older adults, gait abnormalities due to weakness, spasticity, sensory deficits and imbalance. Classification of gait patterns such as myopathic, neurogenic, sensory ataxia, vestibular imbalance and spastic hemiparetic gaits are described.
Clinical examination of the spine/back covering the following sections:
INSPECTION
PALPATION
MOVEMENTS
MEASUREMENTS
SPECIAL TESTS
(Neurological examination covered separately in another slideshow : SPINE EXAMINATION - PART 2)
This document summarizes gait disorders and their causes. It discusses that 15% of those over 65 have gait disorders, and risk of falls increases with age. The physiology of gait and various brain centers involved in locomotion are described. Examination of gait and station involves assessing base of support, arm swing, stride length, and ability to walk tandem or on toes/heels. Common gait disorders include spastic, parkinsonian, frontal, cerebellar, and sensory ataxias. Causes can be neurological, non-neurological, or non-organic. Specific gait patterns like steppage, waddling, and psychogenic gaits are also outlined.
This document discusses various gait patterns seen in hip disorders. It begins by defining normal gait and describing the gait cycle. It then examines pathological gaits such as spastic, antalgic, Trendelenburg, and short limb gaits. Specific characteristics of each abnormal gait are provided. The document also discusses gait analysis methods and how various hip problems can affect gait and muscle function.
Gait -Normal and Abnormal gait :Physiology and Management mrt23
This document discusses normal and abnormal human gait. It begins with definitions of gait, stance, and balance. It then covers the three components and three systems required for normal gait. The document discusses the physiology and neural control of gait, including central pattern generators and higher brain centers. It provides a classification system for gait disorders and describes approaches to clinical assessment. Specific gait abnormalities are defined, including those related to upper and lower motor neuron dysfunction. Treatment approaches for gait disorders are also mentioned.
This document provides guidance on evaluating a limping child. It discusses that limp can be caused by pain, weakness or deformity and management depends on the underlying cause. A thorough history, physical exam, and investigations may be needed. The physical exam involves assessing gait, leg length, range of motion, and neurological function. Potential investigations include blood tests, imaging like x-rays, ultrasound and MRI to identify causes such as fractures, infections, tumors or developmental disorders. The goal is to determine the cause and provide appropriate treatment ranging from reassurance to surgery.
This document discusses various spinal deformities including scoliosis, kyphosis, and lordosis. It describes the anatomy, causes, classifications, treatments, and outcomes of each condition. Infantile, juvenile, and adolescent idiopathic scoliosis are addressed. Scheuermann's kyphosis and congenital kyphosis are also summarized. Lordosis is defined and clinical features and treatments are provided.
This document discusses peripheral nerve injuries of the lower limb, summarizing the anatomy and clinical presentation of injuries to the femoral nerve, sciatic nerve, common peroneal nerve, and tibial nerve. It describes the formation, motor and sensory innervation, and typical course of each nerve. Common sites of injury and resulting functional deficits are outlined. Physical exam maneuvers to test motor and sensory function are also provided.
Gait disorders can arise from diseases of the nervous system that disturb walking patterns. The maintenance of posture and walking involves brainstem centers that control muscle tone and spinal centers that coordinate limb and trunk movements in a repetitive stepping pattern. Higher brain regions like the motor cortex, parietal cortex, and cerebellum provide additional control. Gait is evaluated through history of symptoms like weakness, slowness, imbalance, falls, and sensory or cognitive changes, and physical exam of walking parameters. Characteristic gait patterns provide clues to localizing neurological lesions.
A presentation aimed to educate First-year studeb=nts of undergraduate physiotherapy course. The presentation includes Introduction and Analysis of Gait Cycle, Walking Aids & Gait Re-education Principles using the aids.
The document discusses the evaluation of limping in children. It defines different types of limps and their causes. A normal gait in children is described. Common pathologic gaits seen in children include antalgic, toe-walking, stooping, Trendelenburg, steppage, and vaulting gaits. Evaluation of a limp includes history of present illness, pain characteristics, associated symptoms, and physical examination. Management depends on findings, with most children having a benign cause managed as outpatients. Further evaluation is warranted for children younger than 3, signs of infection, limited joint movement, inability to walk, or history of chronic limp.
Foot drop is the inability to lift the front part of the foot. It can be caused by injuries or conditions that damage the common peroneal nerve. Symptoms include difficulty lifting the foot and dragging the toes. Treatment depends on the underlying cause but may include bracing, nerve stimulation, tendon transfers, or joint fusions. The goal is to improve mobility and gait.
This document provides an overview of the anatomy, articulations, ligaments, muscles, blood supply, and examination of the shoulder joint. It discusses the key bones (clavicle, scapula, humerus), joints (glenohumeral, acromioclavicular), ligaments (glenohumeral, coracohumeral), muscles (rotator cuff, deltoid), and nerves (brachial plexus, axillary, suprascapular) involved. It outlines the process for examining a patient with shoulder pain, including inspection, palpation, active and passive range of motion testing, and special tests (e.g. impingement tests, apprehen
This document discusses the phases of the human gait cycle. It is divided into two main phases - the stance phase, when the foot is in contact with the ground, and the swing phase, when the foot is not in contact with the ground. The stance phase makes up 60% of the gait cycle and can be further divided into initial contact, foot flat, midstance, heel rise, and toe off. The swing phase makes up the remaining 40% and includes acceleration, midswing, and deceleration. Key gait parameters like stride length, cadence, and walking velocity are also defined.
The document defines normal human gait and describes its key components and cycles. It also discusses pathological gait patterns that can result from musculoskeletal issues. Normal gait involves rhythmic movement of the limbs and trunk to propel the body forward with minimal energy expenditure. The gait cycle consists of stance and swing phases on each side. Several factors work to minimize vertical and lateral displacement of the center of gravity during walking. Pathological gaits can occur due to problems in the hips, knees, feet or ankles and result in deviations from normal gait patterns.
Shoulder joint (Biomechanics, Anatomy, Kinesiology) by Muhammad Arslan Yasin,
Anatomy Of Shoulder Joint,
Muscles Of Shoulder Joint,
Biomechanics Of Shoulder Joint,
Common Injuries Of Shoulder Joint.
1) The document discusses different management options for subtalar arthritis, including conservative and surgical approaches.
2) Conservative options involve limiting movement and loading of the subtalar joint through shoes, bracing, weight control and activity modification. However, surgery is often required.
3) Surgical options include subtalar arthrodesis (fusion) which can be done through various approaches and may require deformity correction procedures like osteotomies. Proper planning, exposure, fixation and implant placement are essential for successful fusion.
This document provides an overview of gait and gait analysis. It defines gait and describes the gait cycle, which consists of the stance and swing phases. The document outlines various gait terminologies including temporal variables like single limb support time and double limb support time. It also discusses spatial variables such as step length and stride length. The document then covers causes of gait impairment, stair gait, running gait, and objective and subjective methods for analyzing gait.
The document provides an overview of gait analysis, including both subjective and objective analysis techniques. It discusses measuring kinematic parameters like joint angles and kinetic parameters like ground reaction forces. Key aspects of gait like temporal-spatial measures, determinants of gait, and gait physiology are explained. Common gait analysis equipment is also outlined, including force plates, motion capture systems, and EMG. The document concludes with an example case study of calculating joint moments and loads at the knee for a person using a trans-tibial prosthesis.
This document discusses pes cavus, or a high arched foot condition. It defines pes cavus as a foot type where the sole is distinctly hollow when bearing weight. It describes related conditions like pes cavovarus and pes calcaneocavus. Common symptoms include high arches, hammer toes, and foot pain. Causes can be neuromuscular weakness, clubfoot residuals, or diseases. Treatment involves using a semi-rigid shell orthotic with a deep heel cup and valgus extension to increase contact area and resist excessive motion. The orthotic aims to make the patient more comfortable walking.
This document summarizes gait abnormalities in children with cerebral palsy. It begins by defining cerebral palsy and describing the three main types: spastic, dyskinetic, and ataxic. For each type, it outlines the characteristic neuromuscular deficits that affect gait. It then describes normal gait cycle and determinants. Key factors that influence gait in CP are weaknesses, shortened muscles, spasticity, and bone deformities from altered forces. Gait abnormalities range from mild toe-walking to severe crouched gait. Prognosis for walking depends on CP type, severity, and age of independent walking. Over time, walking ability tends to decline in adolescents and adults with CP
The document describes the medical history and examination of a 40-year-old male patient. He was in a motor vehicle accident 2 months ago which resulted in a cervical spine injury at C4-C5 and fractures to his left tibia and fibula. On examination, he had generalized muscle wasting, weakness, and diminished sensory and motor function in his limbs. MRI findings confirmed a cervical spine injury at C4-C5 with disc protrusions and spinal stenosis. The provisional diagnosis was an incomplete cervical spine injury at C4-C5 (central cord syndrome) with fractures of the left tibia and fibula. His treatment plan involved cervical collar, catheterization, physiotherapy, and plaster immobilization of the
Gait deviations in UMN and LMN conditionsJanhavi Atre
This document summarizes different abnormal gait patterns seen in upper motor neuron and lower motor neuron conditions. It describes the characteristics of hemiplegic, parkinsonian, ataxic, spastic and poliomyelitic gaits. For each gait pattern, it outlines the deviations seen during the stance and swing phases, including abnormalities at the hip, knee and ankle joints. It also mentions changes in various gait variables and concludes by listing references.
This document summarizes a seminar on stance and gait abnormalities. It begins with an outline of the topics to be covered, including the anatomical and physiological bases of stance and gait, the gait cycle, and common gait abnormalities. The document then reviews normal and abnormal stances and gaits, caused by conditions such as hemiplegia, diplegia, cerebellar dysfunction, foot drop, and myopathies. It provides guidance on evaluating patients with gait disorders through history, physical exam testing of gait, balance, and posture.
Gait involves the rhythmic movement of limbs and trunk during walking. It has distinct stance and swing phases on each side. Many conditions can cause abnormal gaits including weakness, injury, neurological disorders and more. Common abnormal gaits include antalgic (painful), Trendelenburg (gluteal weakness), scissors (hip adduction spasticity), foot drop and Parkinsonian gaits. Precise evaluation of gait deviations provides clinical insights into musculoskeletal and neurological health.
This document discusses various gait patterns seen in hip disorders. It begins by defining normal gait and describing the gait cycle. It then examines pathological gaits such as spastic, antalgic, Trendelenburg, and short limb gaits. Specific characteristics of each abnormal gait are provided. The document also discusses gait analysis methods and how various hip problems can affect gait and muscle function.
Gait -Normal and Abnormal gait :Physiology and Management mrt23
This document discusses normal and abnormal human gait. It begins with definitions of gait, stance, and balance. It then covers the three components and three systems required for normal gait. The document discusses the physiology and neural control of gait, including central pattern generators and higher brain centers. It provides a classification system for gait disorders and describes approaches to clinical assessment. Specific gait abnormalities are defined, including those related to upper and lower motor neuron dysfunction. Treatment approaches for gait disorders are also mentioned.
This document provides guidance on evaluating a limping child. It discusses that limp can be caused by pain, weakness or deformity and management depends on the underlying cause. A thorough history, physical exam, and investigations may be needed. The physical exam involves assessing gait, leg length, range of motion, and neurological function. Potential investigations include blood tests, imaging like x-rays, ultrasound and MRI to identify causes such as fractures, infections, tumors or developmental disorders. The goal is to determine the cause and provide appropriate treatment ranging from reassurance to surgery.
This document discusses various spinal deformities including scoliosis, kyphosis, and lordosis. It describes the anatomy, causes, classifications, treatments, and outcomes of each condition. Infantile, juvenile, and adolescent idiopathic scoliosis are addressed. Scheuermann's kyphosis and congenital kyphosis are also summarized. Lordosis is defined and clinical features and treatments are provided.
This document discusses peripheral nerve injuries of the lower limb, summarizing the anatomy and clinical presentation of injuries to the femoral nerve, sciatic nerve, common peroneal nerve, and tibial nerve. It describes the formation, motor and sensory innervation, and typical course of each nerve. Common sites of injury and resulting functional deficits are outlined. Physical exam maneuvers to test motor and sensory function are also provided.
Gait disorders can arise from diseases of the nervous system that disturb walking patterns. The maintenance of posture and walking involves brainstem centers that control muscle tone and spinal centers that coordinate limb and trunk movements in a repetitive stepping pattern. Higher brain regions like the motor cortex, parietal cortex, and cerebellum provide additional control. Gait is evaluated through history of symptoms like weakness, slowness, imbalance, falls, and sensory or cognitive changes, and physical exam of walking parameters. Characteristic gait patterns provide clues to localizing neurological lesions.
A presentation aimed to educate First-year studeb=nts of undergraduate physiotherapy course. The presentation includes Introduction and Analysis of Gait Cycle, Walking Aids & Gait Re-education Principles using the aids.
The document discusses the evaluation of limping in children. It defines different types of limps and their causes. A normal gait in children is described. Common pathologic gaits seen in children include antalgic, toe-walking, stooping, Trendelenburg, steppage, and vaulting gaits. Evaluation of a limp includes history of present illness, pain characteristics, associated symptoms, and physical examination. Management depends on findings, with most children having a benign cause managed as outpatients. Further evaluation is warranted for children younger than 3, signs of infection, limited joint movement, inability to walk, or history of chronic limp.
Foot drop is the inability to lift the front part of the foot. It can be caused by injuries or conditions that damage the common peroneal nerve. Symptoms include difficulty lifting the foot and dragging the toes. Treatment depends on the underlying cause but may include bracing, nerve stimulation, tendon transfers, or joint fusions. The goal is to improve mobility and gait.
This document provides an overview of the anatomy, articulations, ligaments, muscles, blood supply, and examination of the shoulder joint. It discusses the key bones (clavicle, scapula, humerus), joints (glenohumeral, acromioclavicular), ligaments (glenohumeral, coracohumeral), muscles (rotator cuff, deltoid), and nerves (brachial plexus, axillary, suprascapular) involved. It outlines the process for examining a patient with shoulder pain, including inspection, palpation, active and passive range of motion testing, and special tests (e.g. impingement tests, apprehen
This document discusses the phases of the human gait cycle. It is divided into two main phases - the stance phase, when the foot is in contact with the ground, and the swing phase, when the foot is not in contact with the ground. The stance phase makes up 60% of the gait cycle and can be further divided into initial contact, foot flat, midstance, heel rise, and toe off. The swing phase makes up the remaining 40% and includes acceleration, midswing, and deceleration. Key gait parameters like stride length, cadence, and walking velocity are also defined.
The document defines normal human gait and describes its key components and cycles. It also discusses pathological gait patterns that can result from musculoskeletal issues. Normal gait involves rhythmic movement of the limbs and trunk to propel the body forward with minimal energy expenditure. The gait cycle consists of stance and swing phases on each side. Several factors work to minimize vertical and lateral displacement of the center of gravity during walking. Pathological gaits can occur due to problems in the hips, knees, feet or ankles and result in deviations from normal gait patterns.
Shoulder joint (Biomechanics, Anatomy, Kinesiology) by Muhammad Arslan Yasin,
Anatomy Of Shoulder Joint,
Muscles Of Shoulder Joint,
Biomechanics Of Shoulder Joint,
Common Injuries Of Shoulder Joint.
1) The document discusses different management options for subtalar arthritis, including conservative and surgical approaches.
2) Conservative options involve limiting movement and loading of the subtalar joint through shoes, bracing, weight control and activity modification. However, surgery is often required.
3) Surgical options include subtalar arthrodesis (fusion) which can be done through various approaches and may require deformity correction procedures like osteotomies. Proper planning, exposure, fixation and implant placement are essential for successful fusion.
This document provides an overview of gait and gait analysis. It defines gait and describes the gait cycle, which consists of the stance and swing phases. The document outlines various gait terminologies including temporal variables like single limb support time and double limb support time. It also discusses spatial variables such as step length and stride length. The document then covers causes of gait impairment, stair gait, running gait, and objective and subjective methods for analyzing gait.
The document provides an overview of gait analysis, including both subjective and objective analysis techniques. It discusses measuring kinematic parameters like joint angles and kinetic parameters like ground reaction forces. Key aspects of gait like temporal-spatial measures, determinants of gait, and gait physiology are explained. Common gait analysis equipment is also outlined, including force plates, motion capture systems, and EMG. The document concludes with an example case study of calculating joint moments and loads at the knee for a person using a trans-tibial prosthesis.
This document discusses pes cavus, or a high arched foot condition. It defines pes cavus as a foot type where the sole is distinctly hollow when bearing weight. It describes related conditions like pes cavovarus and pes calcaneocavus. Common symptoms include high arches, hammer toes, and foot pain. Causes can be neuromuscular weakness, clubfoot residuals, or diseases. Treatment involves using a semi-rigid shell orthotic with a deep heel cup and valgus extension to increase contact area and resist excessive motion. The orthotic aims to make the patient more comfortable walking.
This document summarizes gait abnormalities in children with cerebral palsy. It begins by defining cerebral palsy and describing the three main types: spastic, dyskinetic, and ataxic. For each type, it outlines the characteristic neuromuscular deficits that affect gait. It then describes normal gait cycle and determinants. Key factors that influence gait in CP are weaknesses, shortened muscles, spasticity, and bone deformities from altered forces. Gait abnormalities range from mild toe-walking to severe crouched gait. Prognosis for walking depends on CP type, severity, and age of independent walking. Over time, walking ability tends to decline in adolescents and adults with CP
The document describes the medical history and examination of a 40-year-old male patient. He was in a motor vehicle accident 2 months ago which resulted in a cervical spine injury at C4-C5 and fractures to his left tibia and fibula. On examination, he had generalized muscle wasting, weakness, and diminished sensory and motor function in his limbs. MRI findings confirmed a cervical spine injury at C4-C5 with disc protrusions and spinal stenosis. The provisional diagnosis was an incomplete cervical spine injury at C4-C5 (central cord syndrome) with fractures of the left tibia and fibula. His treatment plan involved cervical collar, catheterization, physiotherapy, and plaster immobilization of the
Gait deviations in UMN and LMN conditionsJanhavi Atre
This document summarizes different abnormal gait patterns seen in upper motor neuron and lower motor neuron conditions. It describes the characteristics of hemiplegic, parkinsonian, ataxic, spastic and poliomyelitic gaits. For each gait pattern, it outlines the deviations seen during the stance and swing phases, including abnormalities at the hip, knee and ankle joints. It also mentions changes in various gait variables and concludes by listing references.
This document summarizes a seminar on stance and gait abnormalities. It begins with an outline of the topics to be covered, including the anatomical and physiological bases of stance and gait, the gait cycle, and common gait abnormalities. The document then reviews normal and abnormal stances and gaits, caused by conditions such as hemiplegia, diplegia, cerebellar dysfunction, foot drop, and myopathies. It provides guidance on evaluating patients with gait disorders through history, physical exam testing of gait, balance, and posture.
Gait involves the rhythmic movement of limbs and trunk during walking. It has distinct stance and swing phases on each side. Many conditions can cause abnormal gaits including weakness, injury, neurological disorders and more. Common abnormal gaits include antalgic (painful), Trendelenburg (gluteal weakness), scissors (hip adduction spasticity), foot drop and Parkinsonian gaits. Precise evaluation of gait deviations provides clinical insights into musculoskeletal and neurological health.
The document discusses various types of abnormal gaits including hemiplegic, scissors, myopathic, steppage, Parkinsonian, propulsive, and sensory gaits. Key points are:
1) Hemiplegic gait is seen in stroke and is characterized by unilateral weakness, hip extension/adduction/rotation, knee extension, ankle drop foot, and circumduction to clear the foot.
2) Scissors gait in cerebral palsy involves legs crossing midline due to adductor spasticity, toe walking, and planterflexor spasticity.
3) Myopathic gait shows pelvis dropping on opposite side (Trendelenburg sign) or
The document discusses various types of abnormal gaits seen in different medical conditions. It begins by defining the normal gait cycle and its phases. It then describes common causes of abnormal gaits including pain, joint/muscle limitations, weakness, and neurological involvement. Specific gaits are then outlined, including hemiplegic gait seen in stroke, scissor gait in cerebral palsy, myopathic gait in muscular diseases, steppage gait in foot drop conditions, Parkinsonian gait, and sensory gait related to proprioceptive loss.
Gait refers to the manner of walking or moving on foot. There are four essential criteria for normal gait: equilibrium, locomotion, musculoskeletal integrity, and neurological control. The gait cycle describes the sequence of foot movements from initial heel contact to the next contact of the same heel. Abnormal gaits can be caused by pain, weakness, tightness, loss of balance, or range of motion issues. Specific abnormal gaits include hemiplegic, diplegic, neuropathic, sensory, myopathic, choreiform, parkinsonian, and age-related gaits. Doctors evaluate gait through physical exam, performance tests, and imaging to diagnose underlying causes and prognosis depends on the medical condition.
This document discusses how various orthopedic conditions can affect gait. It describes 14 different conditions, including how each condition impacts gait mechanics and common compensatory strategies. For example, it notes that knee flexion contractures can cause limping and "toe walking" due to limited heel strike and step length. The document provides details on gait phases, terminology, and treatment approaches for optimizing gait with various orthopedic issues.
localization and control of gait and posture disorders DevashishGupta30
This document discusses localization and control of posture and gait disorders. It provides details on:
1. The anatomical systems responsible for equilibrium and locomotion, including brainstem and spinal locomotor centers, frontal cortex, parietal cortex, and cerebellum.
2. Evaluation of gait, including weaknesses, slowness and stiffness, imbalance, falls, sensory symptoms, urinary incontinence, and cognitive changes.
3. Examination of posture and gait, including arising from sitting, stance, walking, and specific postural responses.
4. Classification of gait patterns into lower, middle, and higher level disorders based on neurological functions.
This document discusses changes in gait that can occur due to various orthopedic conditions. It describes 14 different pathologies including how they impact gait patterns, their causes and mechanisms, and examples of treatment approaches. The pathologies involve the hip, knee, ankle, and include conditions like arthritis, leg length discrepancies, contractures, and muscle weaknesses that can result in antalgic, Trendelenburg, toe walking and other abnormal walking patterns. The document provides detail on gait analysis and the phases and terminology used to describe normal and pathological walking motions.
The cerebellum is located in the posterior cranial fossa beneath the tentorium cerebelli. It is part of a distributed sensorimotor network involved in coordinating muscular contractions and maintaining balance. The cerebellum has three lobes - anterior, posterior, and flocculonodular - which are connected to different parts of the brainstem and are involved in muscle tone/posture, appendicular coordination, and eye movement control respectively. The cerebellum receives input from various pathways and integrates this information to correct motor irregularities. Dysfunction of the cerebellum can cause dysarthria, nystagmus, ataxia of gait and limb movements, and hypotonia.
The document describes different types of abnormal gaits seen in various medical conditions. It discusses hemiplegic, diplegic, myopathic, choreic, ataxic, antalgic and Trendelenburg gaits. It explains the pathomechanisms, causes and treatments for each gait type. Important muscles for normal gait include hip extensors, knee extensors, plantar flexors and dorsiflexors. Abnormalities in these muscle groups can significantly affect one's walking pattern.
Human locomotion, or walking, involves alternating between a stance phase where one foot is on the ground and a swing phase where the foot is off the ground. The gait cycle can be divided into these two phases and further subdivided. There are many types of gait deviations that can occur due to injuries, diseases or other impairments affecting the nervous system, muscles or bones. Common causes of gait deviations include stroke, cerebral palsy, spinal cord injuries or tumors, neurological conditions like Parkinson's disease or multiple sclerosis, and musculoskeletal problems. Kinesiotherapists evaluate gait to identify deviations and their causes in order to develop treatment plans.
Pty 4304 pathokinesiology gait & pathological gait bSani Tijjani
The document discusses normal and pathological gait patterns. It describes the normal horizontal dip of the pelvis, pelvic and trunk rotation in the transverse plane, and arm swing during gait. It then examines several pathological gaits including high steppage gait, hip hike gait, Trendelenburg gait, calcaneal gait, Parkinson's gait, and hemiplegic gait. It also discusses antalgic gait and how spinal, hip, knee, and ankle pain can affect gait. Rehabilitation strategies aim to address muscle weaknesses, reduce flexor synergies, and relieve pain.
The document discusses gait and the gait cycle. It defines gait as a series of rhythmic movements that result in forward body progression. The gait cycle is defined as the period from one heel strike to the next heel strike of the same limb. The gait cycle consists of the stance phase, which is 60% of the cycle, and the swing phase, which is 40% of the cycle. The stance phase begins at heel strike and ends at toe off, while the swing phase is the period between toe off and heel contact.
This document provides an overview of gait analysis. It discusses the phases of gait, temporal parameters, neurological control, kinematics, kinetics, and how to assess gait. Abnormal gaits such as hemiplegic, diplegic, neuropathic, myopathic, Parkinsonian, ataxic, sensory ataxic, choreiform, and antalgic gaits are described. The document is intended as an educational guide for orthopedic residents on evaluating a patient's gait.
Waddling gait- definition|role of muscle|gait analysis|kinematic and spatiote...jasna ok
This document discusses waddling gait, which is an abnormal gait pattern seen when there is bilateral weakness of the gluteus medius muscles, the primary hip abductors. During walking, individuals with waddling gait are unable to stabilize the pelvis and it drops on both sides, causing the trunk to laterally bend and the person to walk with a wide base like a duck. Treatment focuses on strengthening exercises for the hip abductors and gluteal muscles, gait training, and balance exercises. Physiotherapy aims to improve muscle strength, correct posture, and retrain a normal walking pattern.
Gait analysis is the study of human locomotion, specifically walking and running. A single gait cycle, known as a stride, involves a stance phase where one foot is in contact with the ground and a swing phase where the foot is not in contact. Gait involves complex movements of the pelvis, hips, knees, and ankles in three planes. Kinetics examines the internal and external forces that produce motion during gait, including the center of gravity and ground reaction forces. Gait deviations can occur due to musculoskeletal or neurological impairments.
Steppage gait (High stepping, Neuropathic gait) is a form of gait abnormality characterised by foot drop or ankle equinus due to loss of dorsiflexion. The foot hangs with the toes pointing down, causing the toes to scrape the ground while walking, requiring someone to lift the leg higher than normal when walking
The document summarizes a seminar presentation on gait analysis and abnormalities in gait patterns in orthopedics. It defines normal gait and its requirements. It describes the gait cycle and its phases including stance, swing, and subphases. It covers temporal parameters, cadence, ground reaction forces, and the center of gravity. Factors affecting gait are discussed for different age groups. The benefits and types of clinical gait analysis are highlighted.
1. There are many types of neurological gait disorders that can arise from damage or dysfunction in different parts of the brain or nervous system.
2. Hemiplegic gait results from weakness on one side of the body, like after a stroke, causing the affected leg to drag and circumduct during walking.
3. Parkinsonian gait is slow, stiff, and shuffling, with loss of arm swing and difficulty initiating movement.
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Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
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2. Introduction
• The maintenance of an upright posture and the act of walking are
among the first, and ultimately most complex, motor skills humans
acquire
• individual's pattern of walking may be so distinctive they can be
recognized by the characteristics of their gait or even the sound of
their steps.
• Many diseases of the nervous system are identified by the
disturbances of gait and posture.
3. ANATOMICAL ASPECTS OF GAIT
Neuroanatomical structures responsible for equilibrium and
locomotion
1. Brainstem (subthalamic, midbrain)
2. Cerebellar locomotor regions project through
descending reticulospinal pathways from the
pontomedullary reticular formation into ventromedial
spinal cord.
4. • Prefrontal cortex - modulates midbrain and
cerebellar locomotor regions-
• Parietal cortex - integrates sensory inputs
indicating position.and orientation in space, the
relationship to gravitational forces,the speed and
direction of movement.
• Cerebellum - modulates the rate, rhythm,
amplitude, and force of stepping.
5. DISORDERS OF BALANCE
Balance is the ability to maintain equilibrium
The reflexes required to maintain upright posture require input from cerebellar,
vestibular, and somatosensory systems;
the premotor cortex and corticospinal and reticulospinal tracts mediate output to
axial and proximal limb muscles.
These responses are physiologically complex.
Failure can occur at any level and presents as difficulty maintaining posture while
standing and walking.
(1) vertigo
(2) nystagmus
(3) impaired standing balance.
6. ESSENTIALS OF GAIT
There are four major criteria essential to walking.
Equilibrium: The ability to assume an upright posture and maintain
balance. Locomotion The ability to initiate and maintain rhythmic
stepping
Musculoskeletal Integrity: Normal bone, joint, and muscle function
Neurological Control: Must receive and send messages telling the body
how and when to move. (visual, vestibular, auditory, sensori-motor input)
Forces for gait: Muscular force ,Gravitational force. Forces of
momentum. Floor reaction force.
7. There are four neurological components to maintaining
balance/gait and preventing falls:
1.Inner ears (vestibular system): This gives us equilibrium,
specifically by providing information to the brain as to where
each inner ear is in three dimensions. When the vestibular
system is not working, typically the patient will experience
vertigo (room spinning phenomenon).
2.Vision: This allows us to see where the horizon is and
irregularities in the walking surface. Low vision is more
problematic when patients attempt to get out of bed and walk
(e.g., to the restroom) in the middle of the night without
turning on a light.
8. 3.Brain (frontal lobes, basal ganglia and cerebellum): This provides
for the motor program of walking, as well as coordination. A motor
program is what enables the brain to cohesively put together the
alternating flexion and extension of hip, knee and ankle joints and other
joints, to create the proper stride length, stance, posture, arms wing and
gait speed.
4.Peripheral nerves, muscles and spinal cord: This provides the
strength and sensation to enact the walking program.
In addition to these broad categories of neurological causes, there are
many non-neurological causes such as osteoarthritis (wear-and-tear
arthritis) affecting the back, hips, knees or ankles. This may cause an
antalgic gait, i.e. limping, where the patient reduces the amount of time
pressure is placed on the painful leg.
9. GAIT & GAIT CYCLE
Human gait refers to locomotion achieved through the movement of
human limbs.
Gait is a series of rhythmical & alternating movements of trunk & limbs
which result in forward progression of center of gravity & the body.
Gait is a sequence of foot movements by which aperson moves
forward.
The gait cycle is a repetitive pattern involving steps and strides.
10. NORMAL GAIT CYCLE-
Single gait cycle or stride is defined:
• Period of when one foot contacts the ground to that same
foot contacts the ground again
-Each stride has 2 phases:
• Stance Phase Foot in contact with ground
• Swing Phase Foot not in contact with ground
11. • Initiation of gait
by a series of shifts in the center of pressure beneath the
feet first posteriorly, then laterally toward the stepping
foot, and finally toward the stance foot to allow the stepping
foot to swing forward.
• Center of Gravity (CG)
⚫ Midway between the hips Few cm in front of S2 SACRUM
12.
13.
14. GAIT CYCLE
An alternative classification of gait involves the
following eight phases:
• Initial Contact
• Loading Response
• Midstance
• Terminal Stance
• Pre swing
• Initial Swing
• Mid Swing
• Late Swing
20. What are the types of gait
abnormalities ?
There are several different types of gait abnormalities, the most common
include
• Antalgic gait: An antalgic gait is the result of pain.
It’s the most common type of abnormal gait. It
you limp (avoiding stepping with or putting pressure
on your affected leg or foot).
• Propulsive gait (Parkinsonian gait): This type of gait
affects people diagnosed with parkinsonism or
Parkinson’s disease. Characteristics of a propulsive
include a stooping, rigid posture and your head and
neck bending forward. Your steps are usually short
fast to maintain your center of gravity (festinating
21. SPASTIC HEMIPARETIC GAIT
• Arm is adducted, internally rotated at the shoulder, and flexed at the
elbow, with pronation of the forearm and flexion of the wrist and fingers.
• Leg is slightly flexed at the hip and extended at the knee, with plantar
flexion and inversion of the foot. Swing phase of each step is
accomplished by slight lateral flexion of the trunk toward the unaffected
side and hyperextension of the hip on that side to allow slow
circumduction of the extended paretic leg as it swings forward from the
hip, dragging the foot
22. Hemiplegic Gait.
Weakness in distal muscles(foot drop
extensor hypertonia in lower limb.)
and
Most commonly seen in stroke.
with mildhemepresis, loss of
normal arm swing.
⚫ Slight circumduction may be the
only abnormalities
HEMIPLEGIC/ SPASTIC/ CIRCUMDUCTION GAIT
23. Myopathic Gait
• Hip girdle muscles are responsible for keeping the pelvis level when
walking. If you have weakness on one side, this will lead to a drop in the
pelvis on the contralateral side of the pelvis while walking (Trendelenburg
sign). With bilateral weakness, you will have dropping of the pelvis on
both sides during walking leading to waddling. This gait is seen in patient
with myopathies, such as muscular dystrophy
Abductor weakness OF ONE
SIDE
TRENDELENBERG sign
positive Pelvis drop ON
OPPOSITE SIDE
25. MYOPATHIC GAIT(waddling gait)
•Weakness of proximal leg and hip-
girdle muscles interferes with
stabilizing the pelvis and legs on the
trunk.
Exaggerated rotation of the pelvis
with each step
Hips are slightly flexed as a result of
weakness of hip extension, and an
exaggerated lumbar lordosis occurs.
Gower's sign.
26. Steppage Gait
• Seen in patients with foot drop (weakness of foot dorsiflexion),
the cause of this gait is due to an attempt to lift the leg high
enough during walking so that the foot does not drag on the
floor.
• PROPULSIVE GAIT. If unilateral, causes include peroneal nerve
palsy and L5 radiculopathy.
• If bilateral, causes include amyotrophic lateral sclerosis, Charcot-
Marie-Tooth disease
29. SENSORY ATAXIA (SLAPPING/STAPMING GAIT)
• Adopt a wide base and advance cautiously, taking slow steps under
visual guidance.
• Feet are thrust forward with variable direction and height.
• Sole of the foot strikes floor forcibly with a slapping sound (slapping
gait).
• Walking on uneven surfaces and dark is particularly difficult.
• Romberg test.
• Large-diameter peripheral neuropathies, posterior root or dorsal root
ganglionopathies, and dorsal column lesions.
31. Proprioceptive Loss:
• Sensory Ataxia As our feet touch the ground, we receive proprioceptive
information .
• The sensory ataxic gait occurs when there is loss of this proprioceptive
input. POSTERIOR COLUMN
• This gait is also sometimes referred to as a stomping gait since patients
may lift their legs very high to hit the Wide, irregular, uneven steps ,
Unsteady, wide based gait
• Throw feet forward and out and bring them down first on heels and then
toes (double tapping sound).
• Positive Romberg (cannot stand with feet together and eyes closed)
Friedrich ataxia
32. FESTINATING/ PARKINSONIAN GAIT
•In this gait, the patient will have rigidity and bradykinesia.
•He will be stooped with the head and neck forward, with flexion at the
knees.
•The whole upper extremity is also in flexion with the fingers usually
extended.
•The patient walks with slow little steps
•Patient may also have difficulty initiating steps.
•The patient may show an involuntary inclination to take accelerating
steps, known as festination. This gait is seen in Parkinson's disease or any
other condition causing parkinsonism, such as side effects from drugs.
Involuntarily moves Short steps, Accelerating steps Difficult to start Difficult to stop
33. • Parkinson Gait Shuffling:
• small stepped gait without arm swing with high speed.
• Festinating: short quick stepped gait with stooped posture
due to displaced center of gravity.
• Freezing: sudden brief inability to move during mid stance.
• • Flat foot strike instead of heel strike
35. HYPOKINETIC (PARKINSONIAN) GAIT
• Posture stooped, with flexion of the shoulders, neck, trunk ,
and knees.
• Asymmetrical reduction of arm swing and slowing in gait,
particularly when turning ,
• Start hesitation with small, shallow steps on a narrow base.-
Freezing Festination.
36. Scissor Gait/ Diplegic Gait
Patients have involvement on both sides with spasticity in lower extremities
worse than upper extremities.
The patient walks with an abnormally narrow base, dragging both legs and
scraping the toes
This gait is seen in bilateral periventricular lesions and cerebral palsy.
Extreme tightness of hip adductors which can cause legs to cross the midline
referred to as a ✂SCISSORS gait.
Legs cross midline Adductors Spasticity
38. FRONTAL LOBE GAIT DISORDERS
• Cautious gait, a consequence of compensatory adjustments in response
to real or perceived disequilibrium -Isolated gait ignition failure,
• It is characterized by difficulty initiating or maintaining locomotion, and
caused by lesions in the frontal lobe, white matter connections, or basal
ganglia
• Frontal gait disorder(Magnetic gait) characterized by
• variable base (narrow to wide),
• decreased foot clearance,
• short shuffling steps,
• disequilibrium,
• start and turn hesitation,
40. • cerebellar ataxia
FLOCCULONODULAR LOBE
• Exhibit multidirectional body sway, disequilibrium , and severe
impairment of body and truncal motion.
• Standing and even sitting can be impossible, although when lying
down, the heel-shin test may appear normal, and upper limb
function may be relatively preserved .
• Limb ataxia due to involvement of the cerebellar hemispheres
• Steps are irregular and variable in timing (dyssynergia), length, and
direction (dysmetria).
42. CHOREIC GAIT / HYPERKINETIC GAIT
• Random movements of chorea are often noticeable during
walking.
• Superimposition of chorea on the trunk and leg
movements of the walking cycle gives the gait a dancing
quality ,owing to the exaggerated motion of the legs and
arm swing .
• Chorea can also interrupt the walking pattern, leading to
a hesitant gait.
44. DYSTONIC GAIT
Childhood-onset primary torsion dystonia - sustained
abnormal posturing of the foot (typically plantar flexion and
inversion) on attempting to run.
Walking forward or backward or even running backward
may be normal at an early stage .
Early stages - tonic extension of the great toe (striatal toe)
when walking .
Birdlike (peacock) gait - excessive flexion of the hip and
knee and plantar flexion of the foot [during the swing
phase]
46. ■ CAUTIOUS GAIT
• The term cautious gait is used to describe the patient who walks with
an abbreviated stride, widened base, and lowered center of mass,
• If walking on a slippery surface. Arms are often held abducted. This
disorder is both common and nonspecific.
• There may be an associated fear of falling. This disorder can be
observed in more than one-third of older
• patients with gait impairment. Physical therapy often improves
walking
47. PSYCHOGENIC GAIT DISORDERS
(ATASIA-ABASIA)
1. transient fluctuations in posture while walking,
2. knee buckling without falls,
3. excessive slowness and hesitancy.
4. crouched, stooped or other abnormal posture of the trunk,
5. exaggerated body sway or excessive body motion especially
brought out by tandem walking
49. APPROACH TO THE PATIENT
• onset and progression of disability. Slow onset and progressive
• Initial awareness of an unsteady gait often follows a fall.
• Stepwise evolution or sudden progression suggests vascular disease.
• Gait disorder may be associated with urinary urgency and incontinence,
particularly in patients with cervical spine disease or hydrocephalus.
• use of alcohol and medications that affect gait and balance.
50. • Arthritic and antalgic gaits are recognized by observation, although neurologic
and orthopedic problems may coexist.
• Characteristic patterns of abnormality are sometimes seen
• Cadence (steps per minute), velocity, and stride length can be recorded by timing
a patient over a fixed distance.
• Watching the patient rise from a chair provides a good functional assessment of
balance.
• Brain imaging studies may be informative in patients with an undiagnosed disorder
of gait.
51. • MRI is sensitive for cerebral lesions of vascular or
demyelinating disease and is a good screening test for occult
hydrocephalus.
• Patients with recurrent falls are at risk for subdural
hematoma.
• As mentioned earlier, many elderly patients with gait and
balance difficulty have white matter abnormalities in the
periventricular region and centrum semiovale .
• While these lesions may be an incidental finding
52. HISTORY
COMMON SYMPTOMS AND ASSOCIATIONSWEAKNESS
1 • Hemiplegia /foot drop caused by weakness of ankle
Dorsiflexion Catching or scraping a toe on the ground and a tendency to trip
2 . Weakness of knee extension - sensation that the legs will give way while
standing or walking down stairs.
3. Weakness of ankle plantar flexion - interferes with ability to stride forward,
resulting in a shallow stepped gait.
4• Proximal muscle weakness- Difficulty in climbing stairs or rising from a seated
position.
5. Axial muscle weakness - interfere with truncal mobility
53. SLOWNESSS
Slowness of walking
1. Normal reaction to unstable or slippery surfaces
2. Elderly
3. Those who feel their balance is less secure because of any musculoskeletal or
neurological disorder
4. Parkinson disease (PD) and other basal ganglia diseases
STIFFNESS
• Presenting symptoms of a spastic paraparesis or hemiparesis.
• Leg muscle tone in some upper motor neuron syndromes and dystonia may
be normal when the patient is examined in the supine position but
• stiffness increased during walking.
54. In childhood, an action dystonia of the foot is a
common initial symptom of primary dystonia with
stiffness, inversion, and plantar flexion of the foot
and walking on the toes only becoming evident after
walking or running
Patients with dopa-responsive dystonia typically
develop Symptoms in the afternoon ("diurnal
fluctuation").
55. IMBALANCE
1. Cerebellar ataxia
2. Sensory ataxia
3. Vestibulopathy
4. Vascular lesions of thalamus, and basal ganglia.
5. Wide-based unsteady gait is also feature of frontal lobe diseases
6. Imbalance in subcortical cerebrovascular disease and basal ganglia disorders
manifests when turning while walking . stepping backwards, bending over to
pick up something, or performing several tasks simultaneously.
FALLS
1. Collapsing falls(Tone is lost)- syncope or seizures.
2. Toppling falls (Muscle tone is retained) - impaired
static and dynamic postural responses that control
body equilibrium during standing and walking.
56. SENSORY SYMPTOMS AND PAIN
sensory complaints provides clue to the site of
the lesion producing walking difficulties.
• Radicular pain or paresthesias ,
• Sensations of tight bands around the trunk
• Distal symmetrical paresthesias of the limbs
Neurogenic claudication of the cauda equina
• Skeletal pain due to degenerative joint disease
57.
58. EXAMINATION OF POSTURE AND WALKING
ARISING TO STAND FROM SEATED POSITION
1. Proximal muscle strength
2. Organization of truncal and limb movements
3. Stability
4. Stance base STANDING
1. Posture
2. Stance base
3. Body sway
4. Romberg test
5. Postural reflexes (pull test)
59. WALKING
1. Initiation of stepping
2. Speed
3. Stance base
4. Step length
5. Cadence
6. Step trajectory (shallow, shuffling, or high stepping)
7. Associated trunk and arm movements
8. Trunk posture
60. TURNING WHILE WALKING
1.Number of steps to turn
2.Stabilizing steps
3.truncal and limb movement
4.Freezing
OTHER MANEUVERS
1. Tandem walking
2. Walking backwards
3. Running /Walking on toes, heels
77. DIAGNOSING GAIT AND BALANCE PROBLEMS
• A physical and neurological examination can diagnose gait or
balance problems.
• Performance testing can then be used to assess individual gait
difficulties.
• hearing tests, inner ear imaging, and vision tests including
watching eye movement. Magnetic resonance imaging (MRI) or
a computed tomography (CT) scan can check the brain
• blood pressure/heart rates MONITOR.
78.
79.
80. Toppling falls (Muscle tone is
retained)
Tripping- foot , may also be a consequence of carelessness, secondary
to inattention, dementia, or poor vision.
• Proximal muscle weakness- legs giving way and falls.
• Unsteadiness and poor balance -Impairment of postural
responses.
• Spontaneous falls, especially backward, are an important clue to
diagnoses such as multiple system atrophy and progressive
supranuclear palsy
81. TREATMENT
specific treatment may be possible once a diagnosis is established.
Orthostatic changes in blood pressure and pulse should be recorded.
re-evaluating benefits and burdens of medications that might increase fall risk.
Treatment of cataracts.
A home visit to look for environmental hazards can be helpful.
improved lighting, installation of grab bars and nonslip surfaces, and use of adaptive
equipment.
82. strength training with weights and machines is useful to improve muscle mass, even
in older patients.
Improvements realized in posture and gait should translate to reduced risk of falls
and injury.
Sensory balance training is another approach to improving balance stability.
The National Institute on Aging provides online examples of balance exercises for
older adults.
A Tai Chi exercise program has been demonstrated to reduce the risk of falls and
injury in patients with Parkinson’s disease.
Cognitive training, including dual-task training, may improve mobility in older
adults with cognitive impairment