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NPTE, orthotic gait problems, physical therapy IER

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
Initial Contact (Early Stance): Foot Slap;Forefoot Slaps the Ground (orthotic cause)   -inadequate DF assist -inadequate PF stop  
Initial Contact (Early Stance): Foot Slap;Forefoot Slaps the Ground (anatomic cause)   -flaccid or weak DF  
Initial Contact (Early Stance): Toes first; tiptoe posture may be held through stance (orthotic cause)   -inadequate heel lift -inadequate DF assist -inadequate PF stop -inadequate relief of heel pain  
Initial Contact (Early Stance): Toes first; tiptoe posture may be held through stance (anatomic cause)   -short leg -pes equinus (toes extremely flexed) -extensor spasticity -heel pain  
Initial Contact (Early Stance): Foot Flat contact; entire foot contacts ground at heel strike (orthotic cause)   -inadequate traction from sole -requires walking aid (ex: cane) -inadequate DF stop  
Initial Contact (Early Stance): Foot Flat contact; entire foot contacts ground at heel strike (anatomic cause)   -poor balance -pes calcaneus (heel)  
Initial Contact (Early Stance): Excessive medial (lateral) foot contact; medial (lateral) border contacts the floor (orthotic cause)   -transverse plane malalignment  
Initial Contact (Early Stance): Excessive medial (lateral) foot contact; medial (lateral) border contacts the floor (anatomic cause)   -weak inverters (evertors) -pes valgus (varus) -genu valgum (varum)  
Initial Contact (Early Stance): Excessive knee flexion; knee flexes or buckles as foot hits the ground (orthotic causes)   -inadequate knee lock -inadequate DF stop -PF stop -inadequate contralateral shoe lift  
Initial Contact (Early Stance): Excessive knee flexion; knee flexes or buckles as foot hits the ground (anatomic causes)   -knee pain -short contralateral leg -knee or hip flexion contracture -weak quads: flexor synergy  
Initial Contact (Early Stance): Hyperextended knee; knee hyperextends as weight is transferred to leg (orthotic cause)   -genu recurvatum inadequately controlled by PF stop -excessive concave calf band -pes equinus (flexed toes) uncompensated by contralateral shoe lift -inadequate knee lock  
Initial Contact (Early Stance): Hyperextended knee; knee hyperextends as weight is transferred to leg (anatomic cause)   -weak quads -lax knee ligaments -extensor synergy -pes equinus -short contralateral leg -contralateral knee or hip flexion contracture  
Initial Contact (Early Stance): Forward trunk lean; patient leans forward as legs accepts weight (orthotic cause)   -inadequate knee locks  
Initial Contact (Early Stance): Forward trunk lean; patient leans forward as legs accepts weight (anatomic cause)   -compensation for quad weakness -hip and knee flexion contractures  
Initial Contact (Early Stance): Backward trunk lean; patient leans backward as leg accepts weight (orthotic cause)   -inadequate hip lock -inadequate knee lock  
Initial Contact (Early Stance): Backward trunk lean; patient leans backward as leg accepts weight (anatomic cause)   -weakness of the gluteus maximus on the stance leg -knee ankylosis (fusion of knee bones)  
Initial Contact (Early Stance): Lateral trunk lean; patient leans toward stance leg with weight (orthotic cause)   -excessive height of medial upright of KAFO -excessive ABDuction of hip joint of HKAFO -insufficient shoe lift -requires walking aid  
Initial Contact (Early Stance): Lateral trunk lean; patient leans toward stance leg with weight (anatomic cause)   -weak gluteus medius -ABDuction contracture -dislocated hip -hip pain -poor balance -short leg  
Initial Contact (Early Stance): Wide walking base; heel centers more than 10cm (4") apart (orthotic cause)   -excessive height of medial upright of KAFO -excessive ABDuction of hip joint of HKAFO -insufficient shoe lift -cane, knee lock  
Initial Contact (Early Stance): Wide walking base; heel centers more than 10cm (4") apart (anatomic cause)   -ABDuction contracture -poor balance -short contralateral leg -requires waking aid  
Initial Contact (Early Stance): Internal (external) rotation of limb (orthotic cause)   -uprights incorrectly aligned in transverse plane -requires orthotic control (rotation control straps, pelvic band)  
Initial Contact (Early Stance): Internal (external) rotation of limb (anatomic cause)   -internal (external) hip rotators spastic -external (internal) hip rotators weak -antetorsion (forward hip) -retroversion (backward hip) -weak quads: external rotation  
Late Stance: Inadequate transition; delayed or absent transfer of weight over the forefoot (orthotic cause)   -PF stop -inadequate DF stop  
Late Stance: Inadequate transition; delayed or absent transfer of weight over the forefoot (anatomic cause)   -weak PF -Achilles tendon sprain or rupture -pes calcaneus -forefoot pain  
Swing: Toe drag; toes maintain contact with ground (orthotic causes)   -inadequate DF assist -inadequate PF stop  
Swing: Toe drag; toes maintain contact with ground (anatomic causes)   -weak DF -PF Spasticity -weak hip flexors  
Swing: Circumduction: leg swings outward in a semicircular arc (orthotic cause)   -knee lock -inadequate DF assist -inadequate PF stop  
Swing: Circumduction: leg swings outward in a semicircular arc (anatomic cause)   -Extensor -Extensor synergy -knee or ankle ankylosis -weak DF -pes equinus  
Swing: Hip Hiking: leg elevated at pelvis to enable the limb to swing forward (orthotic cause)   -knee lock -inadequate DF assist -inadequate PF stop  
Swing: Hip Hiking: leg elevated at pelvis to enable the limb to swing forward (anatomic cause)   -short contralateral leg -contralateral knee or hip flexion contracture -weak hip flexors -extensor synergy -knee or ankle ankylosis -weak DF  
Swing: Vaulting: exaggerated PF of the contralateral leg to enable the limb to swing forward (orthotic cause)   -knee lock -inadequate DF assist -inadequate PF stop  
Swing: Vaulting: exaggerated PF of the contralateral leg to enable the limb to swing forward (anatomic cause)   -weak hip flexors -extensor spasticity -pes equinus -short contralateral leg -contralateral knee or hip flexion contracture -knee or ankle ankylosis -weak DF  


   


 

 

 
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Created by: jen_p99 on 2011-01-06




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