1. Gait abnormality

2. Normal gait is defined as (form of bipedal locomotion)
or as a method of locomotion involving the use of the two legs, alternately , to provide both support and propulsion at least one foot being in contact with the ground at all times .
It is a series of rhythmic alternating motion of arms, legs, and trunk that create forward motion

3. In order to walk
1- each leg able to support body wt without collapse
2- maintain static and dynamic balance during single leg stance maintenance of upright posture.
3- sufficient power for limb motion and to advance the trunk.
4- the swing leg able to advance to a position where it can take over the supporting role.
For proper gait
5- proper proprioceptive system
6- normal vision

6. Causes of gait abnormality
Weakness , spasticity , balance disturbances, leg length discrepancy ……...…or deformity which disturbs the motion
The motion is a compensation to correct for some other problem

7. Specific gait abnormality
Lateral trunk bending
1- Trendelenburg gait
2- waddling gait
Standing on one leg lead to increase load on the stance leg due to
1- whole wt on one leg
2- the wt of swing leg
3- gluteus medius reaction force

8. Unilateral stance

9. Trendelenburg gait

11. Causes of Trendelenburg gait
Painful hip
Abductor weakness
Abnormal hip joint, CDH
Unequal Leg length
Coxa vara

12. Angle of inclination of the femur

13. Anterior trunk bending
At heel contact, the trunk bend forward to compensate for knee extensor weakness
Posterior trunk bending
At heel contact, the trunk bend backward to compensate for hip extensor weakness or to propel the swing leg forward to compensate for hip flexor weakness or spasticity of hip extensor weakness or ankylosed hip

14. Anterior trunk bending Posterior trunk bending

15. Increased lumbar lordosis
Due to flexion contracture of the hip joint

16. Functional leg length discrepancy
Not true discrepancy
1- circumduction
2- hip hiking
3- high steppage
4- vaulting

17. Abnormal hip rotation

18. Causes of toe in- out gait
Increased range of internal rotation
Decreased range of external rotation
Ms imbalance
Mechanical effects of femur Anteversion
N.B: The opposite is true for hip retroversion

19. Excessive knee extension due to knee extensor weakness
Excessive knee flexion due to
1- knee flexion contracture
2- knee flexor spasticity
3-ankle stiffness
4- Functional leg length discrepancy

20. Toe drag and foot slap due to inadequate foot dorsiflexor control
Abnormal foot contact due to
1- talipes calcaneus
2- talipes equinus
3- excessive medial contact
4- excessive lateral contact
5- Stamping gait- loss of sensation

21. Due to calf muscles weakness Abnormal walking base
Insufficient push off
Due to calf muscles weakness
Abnormal walking base
1- increased base (abducted hip deformity-valgus knee- instability)
2- decreased base (adducted hip deformity-varus knee)

22. How to reduce muscle force in unilateral stance
How to reduce muscle force in unilateral stance ? 1- reduce body weight 2- Carrying a load ipsilaterally 3- Use of a cane ipsilaterally

23. 4- Compensatory lateral lean of the trunk

24. 5- Use of cane contralaterally

25. Thanks