ABNORMAL GAIT
Abnormal Gait Syndromes
In general gait deviations fall under four headings:
Those caused by weakness
Those caused by abnormal joint position or range of
motion
Those caused by muscle contracture
Those caused by pain
Abnormal Gait Types
Pain
Antalgic gait
Gonalgic gait
Podalgic gait
Leg length discrepancy
Short leg
Musculoskeletal
Trunk bending
Anterior trunk bending
Posterior trunk bending
Lateral trunk bending
Hyperlordosis
Abnormal Gait
Hip region Knee region
Hip hiking Knee Flexion
Hip flexion contracture contracture
Psoatic weakness Quadriceps weakness
Vaulting Knee joint stiffness
Hip joint stiffness
Toe in gait
Toe out gait Ankle region
Toe walking
Equinaus walking
Flat foot
Planterflexiors weakness
Abnormal Gait
Neurological abnormal gait
Cerebellar Ataxic
Sensory ataxic
Vestibular ataxic
Parkinson gait
Propulsive gait
Steppage gait
Scissors gait
Myopathic gait
Hemiplegic gait
Hysterical gait
Abnormal Gait: Pain
Antalgic Gait: Painful hip
Gonalgic Gait: painful knee
Podalgic Gait: painful foot
Decrease single limb support period
(less time on bad leg)
Limp adopted
To avoid pain
Avoid weight-bearing
Very short stance phase
Short Leg Gait/ leg length discrepancy
True short leg
False Short leg
Pelvis raised
Foot supinated
Scoliosis
Below 1 inch no modification
Shoe modification
Trunk bending
Lateral trunk bending
Anterior trunk bending
Posterior trunk bending
Hyper lordosis gait
Lateral trunk bending
Trenlenberg’s sign
Anterior trunk bending
Posterior trunk bending
Hip Hiking
Vaulting
Hip region
Hip flexion contracture…….Increase lumbar lordosis
Psoatic weakness ….Pelvis raised
Hip joint stiffness
Toe in gait …..Internal Rotators
Toe out gait……External Rotators
Excessive knee flexion or Crouched Gait
Hamstring spasticity
Excessive knee flexion
Knee buckles
Knee region
Quadriceps weakness ……anterior trunk bending
Knee joint stiffness
Ankle region
Toe walking…….Tight TA
Equinaus walking……Tight DF
Flat foot
Planterflexiors weakness …..lack of push
Abnormal Gait
Neurological abnormal gait
Sensory ataxic
Vestibular ataxic
Cerebellar Ataxic
Parkinson gait
Propulsive gait
Steppage gait
Scissors gait
Myopathic gait
Hemiplegic gait
Hysterical gait
Proprioceptive Loss: Sensory Ataxia
Wide, irregular, uneven steps
Unsteady, wide based gait
Throw feet forward and out and bring them down
first on heels and then toes (double tapping sound)
Watch ground
Positive Romberg (cannot stand with feet together
and eyes closed)
Friedrich ataxia
Vestibular system
Gait unsteadiness
Inability to walk down stairs independently
Decreased ocular fixation during motion leading to
sense that world is “jiggling”
May be unable to drive, or need to stop walking to
read a sign
“Vestibular Ataxia”
Vertigo or nystagmus with standing/walking
Balance Loss due to Cerebellar problems
Wide based
Unsteadiness
Irregularity of steps
Lateral veering
Motor ataxia
Eye open Romberg sign
ATAXIC GAIT
An unsteady
Uncoordinated
Wide base
Feet thrown out
FESTINATING/PARKINSONIAN GAIT
Involuntarily moves
Short steps
Accelerating steps
Difficult to start
Difficult to stop
Parkinson Gait
Shuffling: small stepped gait without arm
swing with high speed.
Festinating: short quick stepped gait with
stooped posture due to displaced centre of
gravity.
Freezing: sudden brief inability to move
during mid stance.
Flat foot strike instead of heel strike
Propulsive Gait
• Stiff neck and head
• Excessive force to
propel body
• Upper trunk stiffness
Steppage or foot drop
Steppage Gait
Foot drop
Leg is lifted high so
Toes can clear the ground
Foot slap at initial contact
Waddling gait or Myopathic Gait
Abductor weakness
Trenlenberg sign positive
Pelvis drop opposite
Trunk sway same
Lurching Gait
Wadding gait
Scissor Gait
Legs cross midline
Adductors Spasticity
Toe walk
Planter flexor spastic
Spastic Cerebral palsy
Hemiplegic Gait
► Foot clearance
► Hip flexor weakness
► Pelvis retracted
Hysterical Gait
HIP
Hip flexion excessive……Contracture
Limited HF……weakness …..Tight HE
HE limited…..HF contracture
External rotation…..Pelvis retracted
Hip hiking……Weak DF, Spastic extensor
Circumduction….weak HF
Deviations at Hip
Position Deviation Description Possible cause
Heel strike to FF Excessive flexion More than 30 Contracture
Limited HF Less than 30 Weakness of flexors
FF to MS Limited HE Not neutral HF contracture
Internal rotation Spastic
External rotation Pelvis rotation
Abduction Spastic
Adduction Spastic
Swing Circumduction Semicircle Weak HF
Hip hiking Quadus lamborum Extensor spastic
Excessive hip
flexion More than 30 Foot drop
Deviations at Knee
Position Deviation Description Possible cause
Heel strike Excessive KF Buckles Spastic flexors
Foot flat Knee hyperextend Hyperextend Weak Quads, Spastic
Quads
Mid stance Knee hyperextend Hyperextend As above
Push off Excessive KF More than 40 Flexor contracture
(CVA)
Limited KF Less than 40 Spastic Quads
Swing
Excessive KF More than 65 Flexor withdrawl ,
Dysmetria
Limited KF Less than 65 Extensor spasticity ,
Circumduction
Deviation at Ankle
Position Deviation Description Possible cause
Initial contact Foot slap Foot slap Weak DF
Toes first Tip toe Spastic PF , Length
Foot flat Entire foot Weak DF, Neonatal
Mid stance Excessive positional Tibia does not Ecc.Weak PF or tight
PF advance move
Heel lift Not with ground Spastic PF
Excessive DF Tibia more advance Weak PF,KF or HF
contracture
Toe clawing Grab floor Spastic flexor, grasp
reflex
Push off No roll off Insufficient weight Weakness of PF
shift
Swing Toe drag Insufficient DF Weak DF
Varus Inverted Spastic invertors
Deviation of Trunk
Position Deviation Description Possible cause
Stance Trunk lateral lean Trenlenberg gait Weak Abd
Backward trunk Hyperextension at Weak GM
lean hip
Forward trunk lean Forward Weak Quad
