Ndt Exam 2 Gait Deviation Table

Front 1

initial contact- foot slap

Back 1

Flaccid or weak dorsiflexors or reciprocal inhibition of dorsiflexors; atrophy of dorsiflexors

Front 2

I.C.- toes first

Back 2

Leg length discrepancy; contracted heel cord; plantarflexion contraction; spasticity of plantarflexors; flaccidity of dorsiflexors; painful heel.

Front 3

I.C. Foot flat

Back 3

Excessive fixed dorsiflexion; flaccid or weak dorsiflexors; neonatal/proprioceptive walking.

Front 4

midstance- excessive positional PF

Back 4

No eccentric contraction of plantarflexors; could be due to flaccidity/weakness in plantarflexors; surgical overrelease, rupture, or contracture of Achilles tendon.

Front 5

heel lift in mid stance

Back 5

Spasticity of plantarflexors

Check for spasticity in plantarflexors, quadriceps, hip flexors, and ADD.

Front 6

midstance- excessive positional DF

Back 6

Inability to plantarflexors to control tibial advance. Knee flexion or hip flexion contractures.

Front 7

midstance-toe clawing

Back 7

Could be due to a plantar grasp reflex that is only partially integrated; could be due to positive supporting reflex; spastic toe flexors.

Front 8

heel-off to toe-off- no roll off

Back 8

Mechanical fixation of ankle and foot. Flaccidity or inhibition of plantarflexors, inverters, and toe flexors. Rigidity/cocontraction of plantarflexors and dorsiflexors. Pain in forefoot.

Front 9

swing-toe drag

Back 9

Flaccidity or weakness of dorsiflexors and toe extensors. Spasticity of plantarflexors. Inadequate knee or hip flexion.

Front 10

swing-varus

Back 10

Spasticity of the invertors. Flaccidity or weakness of dorsiflexors and evertors. Extensor pattern.

Front 11

I.C.- Excessive knee flexion

Back 11

Painful knee; spasticity of knee flexors or weak or flaccid quadriceps. Short leg on contralateral side

Front 12

Foot flat- genu recurvatum

Back 12

Flaccid/weak quadriceps and soleus compensated for by pull of gluteus maximus. Spasticity of quadriceps. Accommodation to a fixed ankle plantarflexion deformity.

Front 13

Midstance- genu recurvatum

Back 13

Flaccid/weak quadriceps and soleus compensated for by pull of gluteus maximus. Spasticity of quadriceps. Accommodation to a fixed ankle plantarflexion deformity.

Front 14

Heel-off to toe-off- excessive knee flexion

Back 14

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.

Front 15

heel off to toe off- limited knee flexion

Back 15

Spastic/overactive quadriceps and/or plantarflexors.

Front 16

acceleration of mid swing- excessive knee flexion

Back 16

Diminished preswing knee flexion, flexor-withdrawal reflex, dysmetria

Front 17

acceleration of mid swing- limited knee flexion

Back 17

Pain in knee, diminished range of knee motion, extensor spasticity. Circumduction at the hip.

Front 18

Heel strike to foot flat- excessive hip flexion

Back 18

Hip and/or knee flexion contractures. Knee flexion caused by weak soleus and quadriceps. Hypertonicity of hip flexors.

Front 19

Heel strike to foot flat- Limited hip flexion

Back 19

Weakness of hip flexors. Limited range of hip flexion. Gluteus maximus weakness.

Front 20

FOOT FLAT TO MIDSTANCE- Limited hip extension

Back 20

Hip flexion contracture, spasticity in hip flexors.

Front 21

FOOT FLAT TO MIDSTANCE- IR

Back 21

Spasticity of internal rotators. Weakness of external rotators. Excessive forward rotation of opposite pelvis.

Front 22

FOOT FLAT TO MIDSTANCE- ER

Back 22

Excessive backward rotation of opposite pelvis.

Front 23

FOOT FLAT TO MIDSTANCE- abduction

Back 23

Contracture of the gluteus medius. Trunk lateral lean over the ipsilateral hip.

Front 24

FOOT FLAT TO MIDSTANCE- adduction

Back 24

Spasticity of hip flexors and ADD such as seen in spastic diplegia. Pelvic drop to contralateral side.

Front 25

Swing- circumduction

Back 25

A compensation for weak hip flexors or a compensation for the inability to shorten the leg so that it can clear the floor.

Front 26

swing- hip hiking

Back 26

A compensation for lack of knee flexion and/or ankle dorsiflexion. Also may be a compensation for extensor spasticity of swing leg.

Front 27

swing- excessive hip flexion

Back 27

Attempt to shorten extremity in presence of foot drop. Flexor pattern

Front 28

stance- lateral trunk lean

Back 28

A weak or paralyzed gluteus medius on the stance side cannot prevent a drop of pelvis on the swing side, so a trunk lean over the stance leg helps compensate for the weak muscle. A lateral trunk lean over the affected hip also may be used to reduce force on hip if a patient has a painful hip.

Front 29

stance- backward trunk lean

Back 29

Weakness or paralysis of the gluteus maximus on the stance leg. Anteriorly rotated pelvis.

Front 30

stance- forward trunk lean

Back 30

Compensation for quadriceps weakness. The forward lean eliminates the flexion moment at the knee. Hip and knee flexion contractures.