Professional Documents
Culture Documents
Ogg 1965
Ogg 1965
Ogg 1965
GAIT DEVIATIONS
Date: Date:
1
Rotation of foot at
heel strike
Weight on medial
border of foot
Ham
Noise
"Hill-rise" sensation
Comment
The patient may complain of pain; or one may Hip D isar+iculafion Prostheses
hear noise, which indicates improper function of The Canadian hip disarticulation prosthesis is
the mechanical parts. perhaps the most difficult to fabricate and align
of all the lower-extremity devices. The infant
Causes of Gait Defects or toddler does not yet have well-defined bony
The major causes of deviations in walking pat structures for anchor points for the socket, and the
terns are changes resulting from growth, or the residual '"baby fat" of small children compounds
wear of parts from use. Any of the gait devia the problem. Adjustable hip joints for children un
tions can occur as a result of faulty alignment der the age of eight or nine years are not commer
of the limb during fabrication; however, some de cially available, and knee joints are not available
viations of gait must be accepted as maximum for those under two to three years of age. An adjust
performance because of a physical problem of the able mechanism for aligning the hip joint is also
patient. These are most commonly related to not available. These problems make proper align
the presence of contractures or the malformation ment much more difficult, and are a common
of joint structures which cause hypermob ; lity or source of gait defects. It is very important for
instability. the physical therapist to recognize alignment prob-
TABLE 2
Deviation Description
following the satisfactory check-out of the pros can expect certain gait defects to appear concur
thesis. Two months later, movies of his gait were rent with early independent walking.
taken. At that time, he was noted to have increased The boy in Figure 3 was plagued with all of
lateral trunk bending and lateral pelvic tilt be these problems. When he began to walk inde
cause of the shortness of his limb. Hyperextension pendently, he exhibited uneven timing of steps and
of the knee was present during the mid-stance uneven step length, because of tenderness and pain
phase because he had begun to wear tennis shoes in the stump during full weight bearing. The
without a hard heel wedge to compensate for the weakness of his entire right lower extremity, par
change in heel height. He had terminal impact ticularly in the quadriceps muscles, contributed to
of the shin sufficient in intensity to jar the extrem the instability of the knee joint and to lordosis
ity at the end of the swing phase. This was because during the mid-stance phase. There was an ob
of the loss of the friction which was originally vious exaggeration and unevenness of arm swing
set in the constant-friction knee unit. Because of which was caused by all of the above deviations.
these deviations, this boy had an exaggeration of
his normally present uneven arm swing. Pylons
The use of pylon extension prostheses is com
Below-Knee Prostheses mon practice for replacement of leg-length dis
Optimum performance of a below-knee am crepancy in lower-extremity phocomelia.
putee, when wearing a patellar tendon-bearing The amount of instability of the hip joint is
prosthesis which is adequately aligned, is very primarily dependent upon the degree of loss in
close to the normal gait pattern of an individual the structure of the femur. Also, the strength of
with two normal extremities. the hip flexor muscles varies with the malformation
If there is localized weakness from prolonged of the femur.
disuse, pain or tenderness of the stump, and gen A child with a special phocomelia prosthesis
eral lack of good general physical condition, one will have a pylon gait. He can be expected to
REFERENCES
SELECTED BIBLIOGRAPHY
In summary, there are several important factors Specific helps in preparing original manu
which must be considered in an adequate gait eval scripts, case reports, suggestions from the
uation: range of motion, muscular strength, bony
structure, and the developmental level of the pa field, clinic notes, and Annual Reports,
tient's gait pattern must be known. The general and other contributions are included.
condition of the prosthesis, its static alignment, Reserve your copy now!
and the alignment of the limb relative to the pa
tient are pertinent to gait patterns. The pros American Physical Therapy Association
thesis and its function on the patient are the final 1790 Broadway, New York, New York 10019 |
aspects in consideration of the problem. Movies