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Gait 2
| Question | Answer |
|---|---|
| (OGA) stands for | Observational Gait Analysis |
| is used by the PT to identify structural and activity limitations of the patient It is also used to plan interventions and assess the outcomes of those interventions | OGA |
| tools that are designed to help document the results of observational gait analysis | RLA Observational Gait Analysis system |
| It provides an opportunity to get a permanent record of a patient’s gait and to analyze it repeatedly without fatiguing a patient or risking a fall | Observational Gait Analysis (OGA)-Digital Video |
| The first step in OGA is the accurate | identification and description of the patient’s gait pattern and any existing deviations |
| The second step in OGA | involves a determination of the causes of the deviations |
| After the second step in OGA | Then a treatment plan aimed at correcting or minimizing the cause of the deviation is created and implemented |
| why is accurate descriptions of what is happening as well as when in the gait cycle it is happening are important in the process | Muscle demands vary in different phases of gait, so causes of a specific gait deviation will vary depending on the phase of the gait |
| Excessive plantar flexion in swing phase is generally due to | weakness in the dorsiflexor mm |
| Excessive plantar flexion during mid to terminal stance is usually the result | spastic plantar flexors |
| Excessive plantar flexion in both phases may be due to | a joint contracture at the ankle |
| If you are observing to determine if an intervention was helpful, then you only need to pay attention to | the gait deviation you were addressing |
| Normal Gait- Sagittal Plane: Hip Knee Ankle Pelvis Toes | Hip: Flex(30)/Ext.(10) Knee: Flex(60)/Ext. (near full) Ankle: DF(10)/PF(20) Pelvis: 2-3 (APT&PPT) Toes: Ext. (60) |
| Normal Gait-Frontal Plane: Hip Pelvis Ankle | Hip: Add.(10-stance & 15-intial contact) Ab.-5 Pelvis: drop (8) / Elevates (3) Ankle: inv.(8-preswing) / Ever.(5-loading) |
| Normal Gait- Transverse Plane: Pelvis Hip Knee | Pelvis: 4 Protract/Retract Hip: LR/MR (8-14) Knee: 5(MR) / 5 (LR) |
| Toes or forefoot contact at initial contact Possible Causes: | Leg length discrepancy PF mm contracture or spasticity DF mm weakness Heel pain |
| Foot flat contact at initial contact Possible causes: | PF contracture Weak DF mm Knee flexion contracture |
| Foot Slap during loading response Possible causes: | Weak DF mm |
| Excess PF during mid and/or terminal stance Possible causes: | PF contracture PF mm spasticity |
| Excess DF Possible causes: | Inability of PF muscles to control tibial advance Increased knee flexion or hip flexion |
| Early heel rise at mid stance Possible causes: | Spasticity of PF mm Contracture of PF mm |
| No heel off at terminal stance or pre-swing Possible causes: | Weak PF mm Weak invertor mm Hypomobile toe extension ROM Painful forefoot or toes |
| Foot drag during swing Possible causes: | Weakness in DF Spasticity or contracture in PF Inadequate knee or hip flexion Decreased 1st MTP joint extension |
| Excessive knee flexion – all phases Possible causes: | Knee flexor mm spasticity or contracture Shorter LE on contralateral side Painful or swollen knee |
| Limited knee flexion Possible causes: | During loading – weak quadriceps, increased quadriceps or plantar flexor tone During preswing or initial swing-Quad or PF spasticity, knee pain or swelling, weakness in hip flexors |
| Knee hyperextension Possible causes: | Stance-Quadricep spasticity, PF contracture, secondary to quad weakness Swing-weakness of HS to decelerate knee extension |
| Wobble in knee during stance Possible Causes: | Impaired proprioception Weakness in quads or HS or both |
| Excess Hip flexion Possible causes: | Initial contact / loading: hip ext. weakness, hip flex. contracture, hypertonic hip flexor mm Mid stance - preswing: hip flex. or knee flex. contractures or spasticity, weak PF (tibial advancement) Swing: to assist with limb clearance if LE is too long |
| Hip Circumduction in swing Possible causes: | Weak hip flexors Inability to shorten leg for limb clearance |
| Hip ABDuction all phases Possible causes: | To assist with foot clearance Widen base of support Excessive soft tissue in thighs |
| Hip ADDuction all phases Possible causes: | Spasticity in adductors Contracture in adductors |
| Backward trunk lean Possible causes: | During stance to compensate for weak gluteus maximus During swing to assist with limb advancement for weak hip flexors |
| Forward trunk lean in stance Possible causes: | Compensation for quad weakness In response to hip flexion contractures |
| Ipsilateral trunk lean during stance Possible causes: | Hip ABD mm weakness To clear opposite leg during swing |
| Contralateral pelvic drop during stance Possible causes: | Ipsilateral hip ABD weakness |
| Excessive pelvic hike during swing Possible causes: | to help clear a limb that is too long (inadequate hip flexion, knee flexion, dorsiflexion, toe extension) |
| Gait Due to pain in the LE is called: Goal of this gait is to decrease time in weight bearing | Antalgic gait |
| This gait is Due to weak hip ABD or leg length issues Manifests itself in one of two ways: Ipsilateral trunk lean, contralateral pelvic drop | Trendelenburg Gait |
| Usually involves UE in flexion synergy and LE in extension synergy This leads to decreased knee flexion, retracted pelvis on the involved side, decreased step length on the involved side, and various strategies to try to clear the LE during swing | Hemiplegic gait |
| Common with Parkinson’s syndrome Characterized by short choppy steps in place before moving | Festinating gait |
| toe walking | Equinus gait |
| An unsteady, staggering gait / walking is uncoordinated and appears to be 'not ordered' | Ataxic gait |
| Standardized tools: (FIM) | Functional Independence Measure |
| (POMA) | Tinetti Performance Oriented Mobility Assessment ( |
| (DGI) | Dynamic Gait Index |
| TUG) | Timed Up and Go |
| (HiMAT) | High-Level Mobility Assessment Tool |
| (6MWT) | 6 Minute Walk Test |
| Community _________ and M_________ Scale | Community Balance and Mobility Scale |
Created by:
Cainta