ASSESSMENT And physiotherapy management of Diplegic Gait.pptx

Diplegic gait

1. ASSESSMENT And physiotherapy management of Diplegic Gait Dr. Madhu(PT)

2. Overview Diplegic gait is typically observed in individuals with cerebral palsy (CP), particularly those with spastic diplegia , characterized by bilateral lower extremity involvement. This gait pattern is characterized by abnormal muscle tone, primarily spasticity in the hip adductors, hamstrings, and calves, leading to a variety of motor impairments that affect balance, coordination, and overall mobility.

3. Kinematic Analysis Kinematic analysis assesses movement patterns during walking, including joint angles and timing of movement : Pelvic Motion: Reduced pelvic rotation and lateral tilting, leading to a shuffling gait pattern. - Asymmetrical movement may occur, especially during the swing phase.

4. Kinematic Analysis 2. Hip Movement: - Limited hip flexion and adduction during the swing phase can lead to scissoring gait where the legs cross over each other. - There may be increased hip flexion and adduction during the stance phase due to spasticity ..

5. Kinematic Analysis 3. Knee Motion: The knee may exhibit excessive flexion during the stance phase, often referred to as knee flexion contracture, which affects weight-bearing stability. - Limited extension can also lead to difficulties in achieving a smooth gait cycle

6. Kinematic Analysis 4. Ankle Movement - Equinus gait is common due to tightness in the gastrocnemius , limiting dorsiflexion and resulting in toe walking. - The foot may not clear the ground properly during the swing phase, increasing the risk of tripping ..

7. Kinematic Analysis 5 . Trunk and Upper Body Motion: The trunk may lean forward to assist with balance, resulting in a less efficient gait pattern. - Arm swing may be limited, contributing to reduced overall coordination

8. Kinetic Analysis Kinetic analysis involves examining the forces acting on the body during movement : Ground Reaction Forces (GRF ): GRF patterns may demonstrate increased asymmetry between the two legs due to uneven loading during the gait cycle. - Higher vertical forces can be observed as individuals try to compensate for stability issues .

9. Kinetic Analysis 2 . Muscle Activation: There may be hyperactive muscle groups (e.g., adductors and hamstrings) causing uncontrolled movements. - This increased activation often leads to fatigue and decreased endurance.

10. Kinetic Analysis 3. Joint Moments: Increased moments at the hip, knee, and ankle joints due to the need to stabilize the body against the effects of spasticity. - This can lead to joint pain and increased risk of secondary complications, such as osteoarthritis ..

11. Kinetic Analysis 4 . Energy Expenditure: - Individuals with diplegic gait typically exhibit increased energy expenditure due to inefficient movement mechanics, leading to fatigue during prolonged ambulation

12. List of Problems in Diplegic Gait*1. *Muscle spasticity and weakness*, leading to poor control and movement patterns.2. *Limited range of motion* in joints, particularly the hips and ankles.3. *Increased risk of falls* due to balance issues and poor coordination.4. *Joint pain and discomfort* from abnormal loading patterns.5. *Fatigue* during walking due to inefficient energy expenditure.6. *Decreased walking speed* and *variability in stride length*, impacting overall mobility.7. *Social and psychological challenges* due to limited mobility and participation in activities.