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    Pathological Gaits: Quadriceps Weakness (Hand 2 Knee Gait)

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    Lakshita Prajapati
    This document describes several pathological gaits caused by different muscle weaknesses: 1. Quadriceps weakness causes a hand-to-knee gait with forward leaning of the trunk for balance. 2. Pretibial muscle weakness leads to foot slapping, which is compensated by hip circumduction, high stepping, or hip hiking of the contralateral leg. 3. Antalgic gait involves lurching of the trunk toward the painful hip for weight distribution and reduced moment arm.

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    Pathological Gaits: Quadriceps Weakness (Hand 2 Knee Gait)

    Uploaded by

    Lakshita Prajapati
    2K views8 pages
    This document describes several pathological gaits caused by different muscle weaknesses: 1. Quadriceps weakness causes a hand-to-knee gait with forward leaning of the trunk for balance. 2. Pretibial muscle weakness leads to foot slapping, which is compensated by hip circumduction, high stepping, or hip hiking of the contralateral leg. 3. Antalgic gait involves lurching of the trunk toward the painful hip for weight distribution and reduced moment arm.

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    All the pathological gaits with pictorial representation

    Original Title

    Pathological Gaits

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    This document describes several pathological gaits caused by different muscle weaknesses: 1. Quadriceps weakness causes a hand-to-knee gait with forward leaning of the trunk for balance. 2. Pretibial muscle weakness leads to foot slapping, which is compensated by hip circumduction, high stepping, or hip hiking of the contralateral leg. 3. Antalgic gait involves lurching of the trunk toward the painful hip for weight distribution and reduced moment arm.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2K views8 pages

    Pathological Gaits: Quadriceps Weakness (Hand 2 Knee Gait)

    Uploaded by

    Lakshita Prajapati
    This document describes several pathological gaits caused by different muscle weaknesses: 1. Quadriceps weakness causes a hand-to-knee gait with forward leaning of the trunk for balance. 2. Pretibial muscle weakness leads to foot slapping, which is compensated by hip circumduction, high stepping, or hip hiking of the contralateral leg. 3. Antalgic gait involves lurching of the trunk toward the painful hip for weight distribution and reduced moment arm.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 8

    Pathological Gaits

    Quadriceps Weakness (Hand 2 knee gait)


    In quadriceps weakness, forces tend to flex the knee. The
    compensatory mechanisms that take place are:
    Patients lean forward to bring the body weight anterior
    to the knee resulting in a straight knee with excessive
    plantar flexion, hip flexion and a forward trunk.

    Pretibial Muscle Weakness (weak dorsiflexors)


    Weakness of the pretibial muscles causes slapping of the
    foot during the stance phase at the time of loading response.
    The compensatory mechanisms that prevent this foot
    slapping are:
    • Ipsilateral circumduction of the limb
    • Ipsilateral high stepping gait (steppage or equine gait)
    (Fig. 4)
    • Contralateral hip hiking
    • Instead of normal heel strike, there is slapping of whole
    Foot

    Antalgic Gait(antalgic = anti- + alge, "against pain").


    When the hip joint is painful, there is lurch of trunk
    towards the painful side. This moves the center of
    gravity of body towards the painful hip decreasing the
    moment arm of body weight to the hip joint. Unlike in
    the Trendelenburg gait, the lurch is to the same side.

    Hip Hiking
    In the swing phase, there is elevation of pelvis by quadratus
    lumborum and abductors to clear the foot.It is seen in cases
    of ipsilateral lengthening as in case of hip
    flexor weakness, ankylosis in extension.
    Circumduction
    It is another mechanism to gain ground clearance. It is seen
    in cases of spasticity, weak hip flexors, weak hamstrings,
    knee ankylosis and weak dorsiflexors of foot.

    Anterior Trunk Bending


    It is seen during mid-stance late swing in cases of quadriceps
    Weakness.

    Hemiplegic Gait
    Arm on affected side is flexed, adducted and internally
    rotated with loss of normal arm swing while walking.
    Affected leg is in extension with plantar flexion of the
    foot and toes. The affected leg is dragged in a semicircle
    (circumduction) due to weakness of distal muscles (foot
    drop) and extensor hypertonia in lower limb. This is most
    commonly seen in stroke.

    Diplegic Gait
    The patient walks with an abnormally narrow base, dragging
    both legs. This gait is seen in bilateral periventricular lesions,
    such as those seen in cerebral palsy. There is tightness of hip
    adductors which can cause legs to cross the midline known
    as a scissors gait
    Parkinsonian Gait
    The patient has rigidity and bradykinesia. He will stoop
    forward with flexion at the knees. The patient walks with
    slow little steps known at marche à petits pas (walk of little
    steps) or shuffling gait. Patient also has difficulty in initiating
    steps. The patient has an involuntary inclination to take
    accelerating steps and finds it difficult to stop once gait is
    initiated known as festination.

    Ataxic (Cerebellar) Gait (Drunkers Gait)


    Ataxic gait is a clumsy, staggering movement with a
    widebased gait. Even while standing still, the patient’s body
    may swagger back and forth and from side to side, known
    as titubation. Patient is not able to walk from heel to toe or
    in a straight line. It is also known as reeling gait.

    Reeling / Drunkers Gait .


    Gluteus Maximus Gait or Rocking Horse Gait
    This is seen in gluteus maximus weakness. Here the trunk
    shifts posteriorly at heel strike to shift the center of gravity
    posterior to gluteus maximus, thus reducing the effort
    required by it to keep hip in extension during stance phase.
    This forward-backward lurching is also known as rocking
    horse gait .

    Gluteus Medius or Trendelenburg Gait


    In normal gait during single stance phase when weight
    of body is on one limb the sag of pelvis to the opposite
    side is prevented by the ipsilateral gluteus medius. When
    this muscle is weak, the trunk is shifted the same side to
    reduce the lever arm of the muscle, thus reducing the effort
    required by it to hold up the pelvis.When this is
    bilateral, it is known as waddling gait or duck gait.

    Hamstring Gait
    During stance phase, the knee hyperextends (genu
    recurvatum gait). During terminal swing, the weak
    hamstring cannot slow the leg and it snaps into extension.

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