PhysioU: Gait Case Studies Key Answers

 

20 year-old female with severe right tibial pain

  • Insufficient pronation during loading response (Pes cavus)
  • Appears to walk on outside of feet with callus formation on the outer feet
  • Insufficient dorsiflexion during terminal stance (early heel off)

 

20 year-old male with lateral knee pain- Iliotibial band syndrome

  • Femoral internal rotation
  • Insufficient knee extension during terminal swing
  • Foot flat initial contact

 

21 year-old female with insidious onset central low back pain and anterior knee pain

  • Low back sprain/ patellofemoral. pain
  • Pelvic drop during loading response through mid-stance
  • Inducing repetitive movements in the lumbar spine

 

22 year-old female with heel pain- Plantar fasciitis

  • Increased pronation
  • Reduced dorsiflexion during terminal stance (early heel off)
  • Forefoot abduction

 

23 year-old male with great toe pain and heel pain- Turf toe/plantar fasciitis

  • Decreased right great toe extension during terminal stance
  • Insufficient dorsiflexion during terminal stance

 

27 year-old lateral ankle pain- Peroneal tendon subluxation

  • Excessive pronation during loading response through terminal stance
  • Excessive calcaneal eversion during loading response through terminal stance
  • Lack of resupination during terminal stance
  • Forefoot abduction during loading response through terminal stance

 

55 year-old female 2 years post stroke with left hemiplegia

# Stance phase

  • Left forefoot contact
  • Lack of hip and knee flexion during loading response
  • Insufficient dorsiflexion during terminal stance (early heel off)
  • Knee hyperextension during loading response and mid stance
  • Knee valgus during mid stance
  • Femoral adduction during mid stance
  • Insufficient hip extension during terminal stance

 

# Swing phase

  • Insufficient dorsiflexion during initial swing
  • Insufficient hip and knee flexion during pre swing through mid swing
  • Excessive hip abduction in pre swing and mid swing

 

56 year-old male with challenges during community ambulation- Complete quadriplegia

# Stance

  • Anterior trunk lean
  • Foot flat initial contact, resulting in lack of heel rocker
  • Excessive knee flexion during initial contact thru terminal stance
  • Lack of anterior pelvic translation during stance phase
  • Insufficient hip extension during terminal stance- Increased hip flexion during mid stance
  • Insufficient hip extension during terminal stance
  • Decreased anterior pelvic translation during stance
  • Right trunk posterior lean during stance
  • Bilateral lower extremity external rotation

# Swing

  • Insufficient hip and knee flexion during pre swing through mid swing resulting in decreased step length
  • Right hip hike during swing

 

57 year-old female with medial knee pain

  • Knee Osteoarthritis
  • Varus thrust during loading response, resulting in increased loading of medial compartment of knee
  • Contralateral pelvic drop during loading response and mid stance
  • Inadequate knee extension during terminal swing
  • Inadequate knee flexion during loading response resulting in poor shock absorption
  • Note the joint deformity of the medial compartment of the right knee
  • Subject is >50 years old
  • Stiffness in the morning less than 30 minutes

 

63 year-old with lower extremity paresthesias- Diabetic neuropathy

# Stance phase

  • Toe out gait for increased balance
  • Increased forward trunk lean
  • Decreased trunk rotation
  • Decreased step length bilaterally
  • Right trendelenburg gait (uncompensated)

# Swing phase

  • Decreased hip extension during pre-swing
  • Decreased hip flexion during mid and terminal swing

 

67 year-old female with chronic back and leg pain- Spinal Stenosis

  • Insufficient hip extension
  • Lumbar extension posture which increases neuroforaminal pressures
  • Inability to walk without 9/10 pain for greater than 5 minutes

 

71 year-old male with balance impairments/falls and right knee pain

  • Parkinson’s Disease
  • Toe out gait for improved balance
  • Mild reduction in stride length- Decreased impact on heel strike at initial contact
  • Subject had mild difficulty with initiating and stopping movement
  • Note the tremor in the hand and the flat affect