Gait

Aka: Gait, Abnormal Gait, Antalgic Gait, Nonantalgic Gait

1. See Also
   1. Gait Evaluation in Children
   2. Pediatric Limp
2. Physiology
   1. Gait has 2 phases
      1. Stance Phase (foot in contact with ground)
         1. Sub-phase 1: Initial double-limb support
         2. Sub-phase 2: Subsequent single-limb stance
         3. Sub-phase 3: Return to double-limb support
      2. Swing Phase (foot in air)
   2. Age-related changes
      1. Mature gait is established by age 3 years, and is adult-like by age 7 years
      2. With age comes increased walk velocity, step length and duration of single-limb stance
3. Pathophysiology: Antalgic Gait
   1. Stance phase duration shortens to compensate pain in the affected leg
4. Pathophysiology: Nonantalic Gait (children)
   1. Steppage Gait
      1. Cause: Neurologic deficit interferes with foot dorsiflexion
      2. Hip and knee joints are flexed excessively during swing phase (allows toes to clear ground)
   2. Trendelenburg Gait
      1. Cause: Developmental dysplasia of hip interferes with hip abduction
      2. Tests: Trandelenburg Test is positive
      3. Pelvis tilts downward toward the unaffected side during the swing phase
   3. Circumduction Gait
      1. Causes
         1. Limb-length discrepancy (Galeazzi Sign positive)
         2. Knee or ankle stiffness due to underlying neurologic or mechanical disorder
      2. Appearance
         1. Stance phase: Knee is hyperextended and locked
         2. Swing phase: Affected leg is abducted or circumducted
   4. Equinus Gait
      1. Causes
         1. Cerebral Palsy
         2. Achilles tendon tight
         3. Calcaneal Fracture
         4. Foot foreign body
         5. Limb-length discrepancy
      2. Appearance
         1. Toe walking