Orthotic Gait

Question	Answer
Initial Contact (Early Stance): Foot Slap;Forefoot Slaps the Ground (orthotic cause)	-inadequate DF assist -inadequate PF stop
Initial Contact (Early Stance): Foot Slap;Forefoot Slaps the Ground (anatomic cause)	-flaccid or weak DF
Initial Contact (Early Stance): Toes first; tiptoe posture may be held through stance (orthotic cause)	-inadequate heel lift -inadequate DF assist -inadequate PF stop -inadequate relief of heel pain
Initial Contact (Early Stance): Toes first; tiptoe posture may be held through stance (anatomic cause)	-short leg -pes equinus (toes extremely flexed) -extensor spasticity -heel pain
Initial Contact (Early Stance): Foot Flat contact; entire foot contacts ground at heel strike (orthotic cause)	-inadequate traction from sole -requires walking aid (ex: cane) -inadequate DF stop
Initial Contact (Early Stance): Foot Flat contact; entire foot contacts ground at heel strike (anatomic cause)	-poor balance -pes calcaneus (heel)
Initial Contact (Early Stance): Excessive medial (lateral) foot contact; medial (lateral) border contacts the floor (orthotic cause)	-transverse plane malalignment
Initial Contact (Early Stance): Excessive medial (lateral) foot contact; medial (lateral) border contacts the floor (anatomic cause)	-weak inverters (evertors) -pes valgus (varus) -genu valgum (varum)
Initial Contact (Early Stance): Excessive knee flexion; knee flexes or buckles as foot hits the ground (orthotic causes)	-inadequate knee lock -inadequate DF stop -PF stop -inadequate contralateral shoe lift
Initial Contact (Early Stance): Excessive knee flexion; knee flexes or buckles as foot hits the ground (anatomic causes)	-knee pain -short contralateral leg -knee or hip flexion contracture -weak quads: flexor synergy
Initial Contact (Early Stance): Hyperextended knee; knee hyperextends as weight is transferred to leg (orthotic cause)	-genu recurvatum inadequately controlled by PF stop -excessive concave calf band -pes equinus (flexed toes) uncompensated by contralateral shoe lift -inadequate knee lock
Initial Contact (Early Stance): Hyperextended knee; knee hyperextends as weight is transferred to leg (anatomic cause)	-weak quads -lax knee ligaments -extensor synergy -pes equinus -short contralateral leg -contralateral knee or hip flexion contracture
Initial Contact (Early Stance): Forward trunk lean; patient leans forward as legs accepts weight (orthotic cause)	-inadequate knee locks
Initial Contact (Early Stance): Forward trunk lean; patient leans forward as legs accepts weight (anatomic cause)	-compensation for quad weakness -hip and knee flexion contractures
Initial Contact (Early Stance): Backward trunk lean; patient leans backward as leg accepts weight (orthotic cause)	-inadequate hip lock -inadequate knee lock
Initial Contact (Early Stance): Backward trunk lean; patient leans backward as leg accepts weight (anatomic cause)	-weakness of the gluteus maximus on the stance leg -knee ankylosis (fusion of knee bones)
Initial Contact (Early Stance): Lateral trunk lean; patient leans toward stance leg with weight (orthotic cause)	-excessive height of medial upright of KAFO -excessive ABDuction of hip joint of HKAFO -insufficient shoe lift -requires walking aid
Initial Contact (Early Stance): Lateral trunk lean; patient leans toward stance leg with weight (anatomic cause)	-weak gluteus medius -ABDuction contracture -dislocated hip -hip pain -poor balance -short leg
Initial Contact (Early Stance): Wide walking base; heel centers more than 10cm (4") apart (orthotic cause)	-excessive height of medial upright of KAFO -excessive ABDuction of hip joint of HKAFO -insufficient shoe lift -cane, knee lock
Initial Contact (Early Stance): Wide walking base; heel centers more than 10cm (4") apart (anatomic cause)	-ABDuction contracture -poor balance -short contralateral leg -requires waking aid
Initial Contact (Early Stance): Internal (external) rotation of limb (orthotic cause)	-uprights incorrectly aligned in transverse plane -requires orthotic control (rotation control straps, pelvic band)
Initial Contact (Early Stance): Internal (external) rotation of limb (anatomic cause)	-internal (external) hip rotators spastic -external (internal) hip rotators weak -antetorsion (forward hip) -retroversion (backward hip) -weak quads: external rotation
Late Stance: Inadequate transition; delayed or absent transfer of weight over the forefoot (orthotic cause)	-PF stop -inadequate DF stop
Late Stance: Inadequate transition; delayed or absent transfer of weight over the forefoot (anatomic cause)	-weak PF -Achilles tendon sprain or rupture -pes calcaneus -forefoot pain
Swing: Toe drag; toes maintain contact with ground (orthotic causes)	-inadequate DF assist -inadequate PF stop
Swing: Toe drag; toes maintain contact with ground (anatomic causes)	-weak DF -PF Spasticity -weak hip flexors
Swing: Circumduction: leg swings outward in a semicircular arc (orthotic cause)	-knee lock -inadequate DF assist -inadequate PF stop
Swing: Circumduction: leg swings outward in a semicircular arc (anatomic cause)	-Extensor -Extensor synergy -knee or ankle ankylosis -weak DF -pes equinus
Swing: Hip Hiking: leg elevated at pelvis to enable the limb to swing forward (orthotic cause)	-knee lock -inadequate DF assist -inadequate PF stop
Swing: Hip Hiking: leg elevated at pelvis to enable the limb to swing forward (anatomic cause)	-short contralateral leg -contralateral knee or hip flexion contracture -weak hip flexors -extensor synergy -knee or ankle ankylosis -weak DF
Swing: Vaulting: exaggerated PF of the contralateral leg to enable the limb to swing forward (orthotic cause)	-knee lock -inadequate DF assist -inadequate PF stop
Swing: Vaulting: exaggerated PF of the contralateral leg to enable the limb to swing forward (anatomic cause)	-weak hip flexors -extensor spasticity -pes equinus -short contralateral leg -contralateral knee or hip flexion contracture -knee or ankle ankylosis -weak DF