toe drag

(ACC-MSW-DEC)

  toes do not clear the floor

•  weak hip, kne, +/or ankle flexors
• weak DF/toe extensors

• gait prob/goal

 decrease DF during swing phase on RoL LE due to weak DF/increase RoL ankle DF during swing phase.

• gait excercise

 pt. in // bars. have pt. stand on contralateral LE and swing affected side through swing phase, keeping toes pointed up.

varus

(ACC-MSW-DEC)

excessive inversion

• weak DF+/or everters

• gait prob/goal

decrease ankle eversion in swing phase on RoL LE due to weak everters/increase RoL ankle eversion during swing phase.

• gait excercise

  ---

  pt in // bars standing on contralateral LE with focus on maintaining affected foot in neutral during swing phase.

limited knee flexion

(MSW)

knee flexion less than approximatley 65 degrees

• pain
• LOM in knee flexion

• gait prob/goal

  ---

  decrease knee flexion on RoL LE during swing phase @ MSW due to LOM in knee flexion /increase RoL knee flexion during swing @ MSW.

  ---

• gait excercise  

  ---

pt. in // bars standing on contralateral LE, swinging affected LE through ACC-DEC with focus on bending knee.

circumduction

(ACC-MSW-DEC)

excessive ABD possibly with ER to ADD possibly with IR

• weak flexors at hip, knee +/or ankle
• LOM in hip, knee +/or ankle DF

• gait prob/goal gait

decrease in knee flexion on RoL LE during swing phase due to weak knee flexors/increase RoL knee flexion during swing phase.

• excercise

  ---

  pt. in // bars standing on contralateral LE. swinging affected LE through ACC-DEC with focus on bending knee during swing.

hip hiking

(ACC-MSW-DEC)

 pelvic elevation with no knee flexion

• weak flexors at hip, knee +/or ankle
• LOM in hip, knee +/or ankle DF

• gait prob/goal

decreas in RoL LE hip flexion during swing due to weak hip flexors/increase RoL LE hip flexion during swing.

• gait excercise

  ---

  pt. stands in // bars, standing on contralateral LE with affected LE in swing from ACC-DEC with focus on flexing hip.

steppage gait

(MSW)

 excessive hip flexion greater than ≈ 25°

• foot drop (weak DF)
• PF contractures (LOM in DF)

• gait prob/goal

  ---

  decrease in RoL ankle DF during swing phase @ MSW due to weak DF/increase RoL ankle DF during swing phase @ MSW.

  ---

• gait excercise

  ---

  pt. stands in // bars on contralateral LE while swinging affected LE through ACC-DEC with focus on pointing toes up during swing.

vaulting

(ACC-MSW-DEC)

 exaggerated plantar flexion of contralateral LE to enable the affected limb to swing forward

• weak hip flexors
• weak dorsiflexors

• gait prob/goal

  ---

  decrease RoL hip flexion during swing phase from ACC-DEC due to weak hip flexors./increase RoL hip flexion during swing @ ACC-DEC.

  ---

• gait excercise

  ---

  pt. stands in // bars on contralateral LE while swinging affected LE through ACC-DEC with focus on bending hip.

foot slap

(HS-FF)

forefoot slaps the ground after hell strke going into foot flat. 

•  Weak DF 

• gait prob/goal

  ---

  decrease eccentric contraction on RoL ankle during stance phase from HS-FF due to a decrease in eccentric control of ankle DF/increase control of eccenteric of RoL ankle during stance phase from HS-FF

  ---

•  gait excercise

  ---

  pt. stands in // bars on contra. LE while maintaing eccentric control of ankle from HS-FF.

foot drop (toes first)

(DEC-HS)

absent heel strike as toes have initial contact, not the heel. 

• heelcord/PF contratures

• gait prob/goal

  ---

  decrease in RoL ankle DF during stance phase from DEC-HS due to heelcord contractures/increase RoL ankle DF during stance from DEC-HS.

  ---

•  gait excercise

  ---

  pt. stands in // bars on contra. LE, with focus on DF affected foot in stance from DEC-HS, landing on heel.

foot flat

(DEC-HS)

Absent heel strike as entire foot contacts ground at heel strike.

• Weak DF

• gait prob/goal

  ---

  decrease in RoL ankle DF during stance from DEC-HS due to weak ankle DF/increase RoL ankle DF during stance from DEC-HS.

  ---

• gait excercise

  ---

  pt. stands in // bars on contra LE with focus on DF and landing on heel of affected ankle.

excessive knee flexion

(HS-FF-MST)

knee buckles

•  weak quads
• pain in knee

• gait prob/goal

  ---

  decrease stability on RoL LE during stance from HS-MST due to weak quads/ increase RoL LE stability during stance from HS-MST

  ---

•  gait excercise

  ---

  pt. stands in // bars on ipsilateral/affected LE while swinging contra/unaffected LE with focus on only slightly bending affected knee while WB.

genu recurvatum

(HS-FF-MST)

knee hyperextends

•  weak quads
• PF contratures 

• gait prob/goal 

  ---

  decrease RoL knee flexion in stance from HS-MST due to PF contractures/increase RoL knee flexion during stance from HS-MST.

  ---

• gait excercise

  ---

  pt. stands in // bars on ipsi/affected LE while swinging contra/unaffected LE with focus on slightly bending affected LE.

excessive hip flexion

(HS-FF)

hip flexion greater than ≈25°

•  hip/knee flexion contractures
• weak soleus or quads 

• gait prob/goal

  ---

  decrease RoL hip extension during stance from HS-FF due to weak quads./increase RoL hip extension during stance from HS-FF.

  ---

•  gait excercise

  ---

  pt. stands in // bars on contra side while moving into HS-FF on affected side with focus on keeping trunk erect.

limited hip flexion

(HS-FF)

hip flexion less than ≈ 30°

•  weak hip flexors
• LOM in hip flexion
• gluteus maximus weakness 

• gait prob/goal

  ---

  decrease RoL hip flexion during stance from HS-FF due to weak hip flexors/increase RoL hip flexion during stance from HS-FF.

  ---

•  gait excercise

  ---

  pt. stands in // bars on contra LE while moving into HS-FF on affected LE with focus on standing erect.

limited hip extension

(FF-MST)

unable to attain neutral extension or hyperextension

•  hip flexor contratures 

• gait prob/goal 

  ---

  decrease RoL hip extension in stance from FF-MST due to hip flexor contractures/ increase RoL hip extension during stance from FF-MST

  ---

• gait excercise

  ---

  pt. stands in // bars on ipsi/affected LE while swinging contra/unaffected LE from MSW-DEC with focus on extending ipsi/affected LE while WB and swinging ipsi/unaffected LE past Affected LE.

excessive internal rotation

(FF-MST)

IR beyond neutral

• weak ER'ors

• gait prob/goal 

  ---

  decrease in RoL ankle ER during stance from FF-MST due to weak ER'ors/ increase ER in RoL ankle during stance from FF-MST.

  ---

• gait excercise

  ---

  pt. stands in // bars on contra LE while affected side  focuses on lowering toes and maintaing foot in neutral.

excessive external rotation

(FF-MST)

ER beyond neutral

•  tight piriformis 

• gait prob/goal 

  ---

  decrease in RoL ankle IR during stance from FF-MST due to tight piriformis/ increase IR in RoL ankle during stance from FF-MST.

  ---

• gait excercise

  ---

  pt. stands in // bars on contra LE while affected side  focuses on lowering toes and IRing and maintaing foot in neutral.

excessive abduction 

(FF-MST)

excessive step width

[leg stays ABD throughout swing & stance, as compared to circumduction which is swing phase only.]

•  contractures of gluteus medius 

• gait prob/goal 

  ---

  decrease in RoL hip ADD during stance and swing due to contractures of RoL Glute medius/increase RoL hip ADD during stance and swing.

  ---

• gait excercise

  ---

  pt. stands in // bars on contra working onn RoL hip Add during stance and swing

excessive adduction

(FF-MST)

narrow step width

•  tight ADDuctors 

• gait prob/goal 

  ---

  decrease in RoL hip Abduction in stance from FF to MST due to tight RoL hipp ADD/ increase RoL hip ABD during stance and swing.

  ---

• gait excercise

  ---

  pt stands in // bars on contra LE while swinging affected leg from HO-FF with focus on ABD LE keeping it in neutral.

uneven step lengths

(DEC-HS of each leg)

long step with involved leg and shortened step lenght with univolved leg

•  tight hip flexors in involved leg
• pain on weight bearing. (antalgic gait)
• habit 

• gait prob/goal 

  ---

  decrease RoL step lenght during stance from DEC-HS due to tight hip flexors/increase RoL step lenght during stance from DEC-HS.

  ---

• gait excercise

  ---

  pt stands in // bars on ipsi/affected LE with focus on taking a longer step that passes affected LE while WB on affected leg.

lateral trunk lean

(HS-FF-MST)

sideways lean of the trunk over the weight bearing leg (ipsilaterla side) during stance.

•   weak gluteus medius (on the weight bearing leg) [compensated]
• pain in hip 

• gait prob/goal 

  ---

  decrease in stability on RoL hip dueto weak gluteus medius in stance fom HS-FF-MST./increase stability in RoL hip during stance.

  ---

• gait excercise

  ---

  pt. stands ipsi/affected LE while swinging contra/unaffected LE through swing, focusing on maitaining trunk straight.

trendelenberg gait

(HS-FF-MST)

drop of pelvis on the contralateral side during weight beariing on affected side. [uncompensated]

•  weak gluteus medius (on the weight bearing side) [uncompensated] 

• gait prob/goal

  ---

  decrease in stability on RoL hip due to weak GM during stance from HS-FF-MST./increase stability in RoL hip during stance.

  ---

• gait excercise

  ---

  pt. stands ipsi/affected LE while swinging contra/unaffected LE through swing, focusing on maitaining trunk leveled.

backward trunk lean

(HS-FF-MST)

posterior lean during weight bearing on affected side

•  weak gluteus max
• anterior pelvic tilt 

• gait prob/goal

  ---

  decrease in stability on RoL hip due to weak GM during stance from HS-FF-MST/increase stability in RoL hip during stance.

  ---

• gait excercise

  ---

  pt. stands in // bars on contra/unaffected LE while moving HS-MST on ipsi/affected LE with focus on maintaining trunk straight.

forward trunk lean

(HS-FF-MST)

anterior lean during weight bearing on affected side.

•  weak quads
• hip and knee flexion contractures 

• gait prob/goal

  ---

  decrease in stability on RoL hip due to weak quads during stance from HS-FF-MST/increase stability in RoL hip during stance.

  ---

• gait excercise

  ---

  pt. stands in // bars on contra/unaffected LE while moving HS-MST on ipsi/affected LE with focus on maintaining trunk straight.