What is the definition of a gait abnormality or deviation?
Any variation from the standard gait phases that involves the arms, trunk, pelvis, hip, knee, or ankle.
What are some possible contributing factors to gait abnormalities?
- normal aging
- pharmaceutical
- disease
- injury
Gait deviations can be… (3)
- biomechanical (joint/skeletal)
- muscular
- neuromuscular (cortex, brain, cerebellum, peripheral nerves)
What can assist a PT in the gait analysis?
The diagnosis or condition can assist the PT in determining whether the problem stems from a muscular, skeletal or nervous system problem
Which clinical assessment is the most important in terms of gait deviations?
- ROM (more power & strength)
- MMT, sensation, reflexes, pain, gait observation can also be used throughout the clinical assessment to determine gait deviations
3 parts to a gait deviation clinical assessment
- An observational gait analysis is always performed
- Note whether it is a swing or stance phase deviation
- Additional outcome measures are performed: gait velocity and specific gait measures (functional gait analysis, stride length, cadence, step length)
Trunk gait deviation terminology (3)
- lateral lean (L/R)
- lateral lean (back/forward)
- lateral rotation (L/R)
Pelvic gait deviation terminology (2)
- excessive pelvic rotation (pelvis and hip move together in 1 motion)
- anterior pelvic tilt
Pelvic elevation
Elevating pelvis during swing phase provides a method to swing limb forward. Consider how much the ASIS is moving.
Gluteus medius and pelvic/trunk deviations (4)
- Abductor lurch or gluteus medius gait: lateral lean toward involved side
- Trendelenburg gait: contralateral pelvic drop
- Short limb syndrome: ipsilateral pelvic drop from leg length discrepancy
- Bilateral pelvic drop: waddling gait
Hip gait deviations (3)
- glute max gait: hip comes forward and trunk leans back when leg comes forward
- hip hike & circumduction
- circumduction
Knee Gait deviations (3)
- knee hyperextension (SLS)
- knee flexion during stance (SLS)
- knee varus (SLS)
Ankle gait deviations (5)
- foot drop: no dorsiflexion present
- flat foot gait: making contact with whole foot
- vaulting : excessive plantarflexion during stance phase
- foot slap: foot slaps floor
- heel off: heel does not make contact with floor
Foot Drop
Various etiologies: peripheral nerve injury, neuro-musuclar diseases and neuromuscular diseases
Deviations: observed throughout the gait cycle especially with the major deviation occurring throughout entire swing phase
