NPTE, orthotic gait problems, physical therapy IER
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| Initial Contact (Early Stance): Foot Slap;Forefoot Slaps the Ground (orthotic cause) | -inadequate DF assist
-inadequate PF stop
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| Initial Contact (Early Stance): Foot Slap;Forefoot Slaps the Ground (anatomic cause) | -flaccid or weak DF
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| 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
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| 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
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| 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
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| Initial Contact (Early Stance): Foot Flat contact; entire foot contacts ground at heel strike (anatomic cause) | -poor balance
-pes calcaneus (heel)
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| Initial Contact (Early Stance): Excessive medial (lateral) foot contact; medial (lateral) border contacts the floor (orthotic cause) | -transverse plane malalignment
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| 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)
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| 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
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| 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
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| 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
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| 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
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| Initial Contact (Early Stance): Forward trunk lean; patient leans forward as legs accepts weight (orthotic cause) | -inadequate knee locks
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| 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
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| Initial Contact (Early Stance): Backward trunk lean; patient leans backward as leg accepts weight (orthotic cause) | -inadequate hip lock
-inadequate knee lock
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| 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)
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| 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
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| 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
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| 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
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| 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
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| 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)
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| 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
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| Late Stance: Inadequate transition; delayed or absent transfer of weight over the forefoot (orthotic cause) | -PF stop
-inadequate DF stop
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| 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
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| Swing: Toe drag; toes maintain contact with ground (orthotic causes) | -inadequate DF assist
-inadequate PF stop
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| Swing: Toe drag; toes maintain contact with ground (anatomic causes) | -weak DF
-PF Spasticity
-weak hip flexors
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| Swing: Circumduction: leg swings outward in a semicircular arc (orthotic cause) | -knee lock
-inadequate DF assist
-inadequate PF stop
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| Swing: Circumduction: leg swings outward in a semicircular arc (anatomic cause) | -Extensor
-Extensor synergy
-knee or ankle ankylosis
-weak DF
-pes equinus
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| Swing: Hip Hiking: leg elevated at pelvis to enable the limb to swing forward (orthotic cause) | -knee lock
-inadequate DF assist
-inadequate PF stop
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| 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
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| 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
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| 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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jen_p99
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