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Abnormal Gait Biomechanics

The document discusses different types of abnormal gaits including those caused by pain, leg length discrepancy, musculoskeletal issues, neurological conditions, and more. Specific gaits covered include antalgic, gonalgic, podalgic, short leg, vaulting, toe walking, Parkinson's, propulsive, steppage, and hysterical gaits.

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Najm Khan
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33 views42 pages

Abnormal Gait Biomechanics

The document discusses different types of abnormal gaits including those caused by pain, leg length discrepancy, musculoskeletal issues, neurological conditions, and more. Specific gaits covered include antalgic, gonalgic, podalgic, short leg, vaulting, toe walking, Parkinson's, propulsive, steppage, and hysterical gaits.

Uploaded by

Najm Khan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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ABNORMAL GAIT

Abnormal Gait Syndromes


 In general gait deviations fall under four headings:

 Those caused by weakness


 Those caused by abnormal joint position or range of
motion
 Those caused by muscle contracture
 Those caused by pain
Abnormal Gait Types
 Pain
 Antalgic gait

 Gonalgic gait

 Podalgic gait

 Leg length discrepancy


 Short leg

 Musculoskeletal
 Trunk bending

 Anterior trunk bending


 Posterior trunk bending
 Lateral trunk bending
 Hyperlordosis
Abnormal Gait
Hip region Knee region

Hip hiking Knee Flexion


Hip flexion contracture contracture
Psoatic weakness Quadriceps weakness
Vaulting Knee joint stiffness
Hip joint stiffness
Toe in gait
Toe out gait Ankle region

Toe walking
Equinaus walking
Flat foot
Planterflexiors weakness
Abnormal Gait
 Neurological abnormal gait
 Cerebellar Ataxic
 Sensory ataxic
 Vestibular ataxic
 Parkinson gait
 Propulsive gait
 Steppage gait
 Scissors gait
 Myopathic gait
 Hemiplegic gait

 Hysterical gait
Abnormal Gait: Pain
 Antalgic Gait: Painful hip
 Gonalgic Gait: painful knee
 Podalgic Gait: painful foot

 Decrease single limb support period


(less time on bad leg)

 Limp adopted

 To avoid pain
 Avoid weight-bearing
 Very short stance phase
Short Leg Gait/ leg length discrepancy

 True short leg


 False Short leg

 Pelvis raised
 Foot supinated

 Scoliosis

 Below 1 inch no modification


 Shoe modification
Trunk bending
 Lateral trunk bending
 Anterior trunk bending
 Posterior trunk bending

 Hyper lordosis gait


Lateral trunk bending
Trenlenberg’s sign
Anterior trunk bending
Posterior trunk bending
Hip Hiking
Vaulting
 Hip region
 Hip flexion contracture…….Increase lumbar lordosis
 Psoatic weakness ….Pelvis raised

 Hip joint stiffness


 Toe in gait …..Internal Rotators
 Toe out gait……External Rotators
Excessive knee flexion or Crouched Gait

Hamstring spasticity

Excessive knee flexion

Knee buckles
 Knee region

 Quadriceps weakness ……anterior trunk bending

 Knee joint stiffness


Ankle region

 Toe walking…….Tight TA
 Equinaus walking……Tight DF

 Flat foot

 Planterflexiors weakness …..lack of push


Abnormal Gait
 Neurological abnormal gait
 Sensory ataxic
 Vestibular ataxic
 Cerebellar Ataxic

 Parkinson gait
 Propulsive gait

 Steppage gait
 Scissors gait

 Myopathic gait
 Hemiplegic gait

 Hysterical gait
Proprioceptive Loss: Sensory Ataxia

 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)
 Watch ground
 Positive Romberg (cannot stand with feet together
and eyes closed)
 Friedrich ataxia
Vestibular system
 Gait unsteadiness
 Inability to walk down stairs independently
 Decreased ocular fixation during motion leading to
sense that world is “jiggling”
 May be unable to drive, or need to stop walking to
read a sign
 “Vestibular Ataxia”
 Vertigo or nystagmus with standing/walking
Balance Loss due to Cerebellar problems

 Wide based
 Unsteadiness
 Irregularity of steps
 Lateral veering

 Motor ataxia
 Eye open Romberg sign
ATAXIC GAIT

An unsteady
Uncoordinated
Wide base
Feet thrown out
FESTINATING/PARKINSONIAN GAIT

Involuntarily moves

Short steps
Accelerating steps

Difficult to start
Difficult to stop
Parkinson Gait
 Shuffling: small stepped gait without arm
swing with high speed.

 Festinating: short quick stepped gait with


stooped posture due to displaced centre of
gravity.

 Freezing: sudden brief inability to move


during mid stance.
 Flat foot strike instead of heel strike
Propulsive Gait

• Stiff neck and head

• Excessive force to
propel body

• Upper trunk stiffness


Steppage or foot drop
Steppage Gait

Foot drop

Leg is lifted high so


Toes can clear the ground

Foot slap at initial contact


Waddling gait or Myopathic Gait

Abductor weakness

Trenlenberg sign positive

Pelvis drop opposite


Trunk sway same

Lurching Gait
Wadding gait
Scissor Gait

Legs cross midline


Adductors Spasticity

Toe walk
Planter flexor spastic

Spastic Cerebral palsy


Hemiplegic Gait
► Foot clearance

► Hip flexor weakness

► Pelvis retracted
 Hysterical Gait
HIP
 Hip flexion excessive……Contracture
 Limited HF……weakness …..Tight HE

 HE limited…..HF contracture
 External rotation…..Pelvis retracted
 Hip hiking……Weak DF, Spastic extensor

 Circumduction….weak HF
Deviations at Hip
Position Deviation Description Possible cause
Heel strike to FF Excessive flexion More than 30 Contracture

Limited HF Less than 30 Weakness of flexors

FF to MS Limited HE Not neutral HF contracture


Internal rotation Spastic
External rotation Pelvis rotation
Abduction Spastic
Adduction Spastic
Swing Circumduction Semicircle Weak HF
Hip hiking Quadus lamborum Extensor spastic
Excessive hip
flexion More than 30 Foot drop
Deviations at Knee
Position Deviation Description Possible cause
Heel strike Excessive KF Buckles Spastic flexors

Foot flat Knee hyperextend Hyperextend Weak Quads, Spastic


Quads
Mid stance Knee hyperextend Hyperextend As above

Push off Excessive KF More than 40 Flexor contracture


(CVA)
Limited KF Less than 40 Spastic Quads
Swing
Excessive KF More than 65 Flexor withdrawl ,
Dysmetria

Limited KF Less than 65 Extensor spasticity ,


Circumduction
Deviation at Ankle

Position Deviation Description Possible cause


Initial contact Foot slap Foot slap Weak DF

Toes first Tip toe Spastic PF , Length

Foot flat Entire foot Weak DF, Neonatal

Mid stance Excessive positional Tibia does not Ecc.Weak PF or tight


PF advance move
Heel lift Not with ground Spastic PF

Excessive DF Tibia more advance Weak PF,KF or HF


contracture
Toe clawing Grab floor Spastic flexor, grasp
reflex
Push off No roll off Insufficient weight Weakness of PF
shift
Swing Toe drag Insufficient DF Weak DF
Varus Inverted Spastic invertors
Deviation of Trunk
Position Deviation Description Possible cause

Stance Trunk lateral lean Trenlenberg gait Weak Abd

Backward trunk Hyperextension at Weak GM


lean hip

Forward trunk lean Forward Weak Quad

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