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Description
At heel strike, forefoot slaps the ground Toes contact ground instead of heel Tip-toe posture may be maintained through-out phase, or heel may contact ground Entire foot contacts ground at heel strike Tibia does not advance to neutral from 10 PF -
Toes First
Foot Flat
Mid-stance
Excessive positional PF
Toe Clawing
Heel does not contact ground in mid-stance Tibia advances too rapidly over foot, creating greater than normal amount of DF Toes flex and grab floor
Push-Off
(heel off to toe off)
No roll off
Check ROM at ankle and foot Check muscle function and tone at ankle Look at dissociation between posterior foot and forefoot
Description
Insufficient DF (and toe extension) so that forefoot and -
Varus
Inadequate knee or hip flexion Spasticity of invertors Flaccidity or weakness of DF and invertors Extensor pattern
muscle tone at hip, knee, and ankle Check for muscle tone of invertors and PF Check strength of DF and evertors Check for extensor pattern of lower extremity
Description
Knee flexes or buckles rather than extends as foot contacts ground A greater than normal extension at the knee -
Foot Flat
Mid-stance
Push-Off
During single limb support, tibia remains in back of ankle mortice as BW moves over foot Ankle is PF Knee flexes to more than 40 during push-off
Same as above
Center of gravity is unusually far forward of pelvis Could be due to rigid trunk, knee/hip flexion contractures Flexion withdrawal reflex Dominance of flexion synergy in middle recovery from CVA Spastic/over-active quads and/or PF
Look at trunk posture, knee and hip ROM, and flexor synergy
Description
Knee flexes more than 65 -
Description
Flexion exceeding 30 -
Hip does not attain a neutral position An internally rotated position of the extremity An externally rotated position of the extremity An abducted position of lower extremity An adducted position of lower extremity
Adduction (ADD)
Description
A lateral circular movement of entire lower extremity consisting of ABD, ER, ADD, and IR Shortening of swing leg by action of the quadratus lumborum Flexion greater than 20-30 -
Hip hiking
Description
A lean of trunk over the stance extremity (Gluteus medius gait/Trendelenberg gait) -
Backward leaning of the trunk, resulting in hyperextension at the hip (Gluteus maximus gait) A forward leaning of the trunk, resulting in hip flexion