IC

eccentric

LR

concentric

TSW

eccentric

ALL OF THE ABOVE

IC, LR

•Normal function

•GRFV is ant.

counteract GRFV (flexion moment)

•Effects of weakness

• Inability to counteract flexion moment

•Excessive

hip flexion +anterior pelvic tilting

* Possible compensations

• GRFV should pass

--- posteriorly ---

• Lean trunk backward in 1C and LR

(gluteus max. gait)

•In bilateral weakness = lean during whole stride

•Long term effects

•Fatigue

•Low back pain (LBP)

•Excessive lumbar lordosis

all are true

LR

eccentric

in stance limb

بتسمح بسنة بسيطة دروب فى اللى داخلة سوينج

MSt

concentric

in stance limb

بتشد لتحت

TSt

concentric

in stance limb

بتشد الناحية السليمة لتحت عشان تظبط الدفة

gluteus medius work in the stance limb while

quadratus lumborum works on swing limb

•Normal function

• GRFV is medially in LR, MSt & TSt - adduction moment

عشان الفخده التانية متقربش منها

• Hip abductors:

• counteract adduction moment

• Prevent pelvic drop to swing limb

•Effects of weakness

• Inability to counteract adduction moment

•Pelvic drop to swing limb (positive Trendelenburg's sign)

• Possible compensations

• GRFV should pass laterally

•Lean trunk laterally in LR, MSt. & TSt

اكانه بيظبط الكفة بجسمه

(gluteus medius. gait)

•In bilateral weakness = waddling gait مشية البطة

•Degree of lean changes moment arm of GRFV

• Long term effects

•Fatigue

• Low back pain

(LBP)

• scoliosis (unilateral weakness)

mainly LR

eccentric

مرحلة التحميل

ic

concentric

عشان تفرد الركبة

with flexors

tsw

concentric

عشان تفرد الركبة

with flexors

psw

eccentric

عشان يبدأ الاسوينج

•Normal function

• GRFV is posteriorly. In LR causes flexion moment

• Quadriceps:

• LR for shock absorption

• counteract flexion moment

- Extends Knee in 1C

•Effects of weakness

• Inability to counteract flexion moment

• Excessive knee flexion

• Decreased Shock absorption in LR

• Decreased Stability in IC

•Possible compensations

• GRFV should pass anteriorly

1-Forward trunk lean (GRFV ant)

2- Increased activity of hip extensors to pull femur posteriorly and plantar flexors to pull tibia posteriorly

3- hand-knee gait (push femur posterior)

4-Tlirn limb outward to lock knee

5-Contact the ground with plantar flexed foot to move GRFV anteriorly الركبة recurvatum

• Long term effects

• Fatigue

• Genu recurvatum due to knee hyper-extension

• Ligament degeneration

ALL SW, IC

concentric

LR

eccentric

BOTH

•Normal function

• GRFV is posteriorly in 1C &LR causes plantar flexion moment عكسها

• Dorsiflexors:

• Control plantar flexion moment

• Dorsiflex ankle in ISw

• Maintain dorsiflexion in swing

•Effects of weakness

• Inability to counteract plantar flexion moment

• Excessive plantar flexion (foot slap)

• Whole foot contact at 1C

• Sudden LRبيخبط رجله ف الستانس

• Functional lengthening (drop foot)بتحك ف الارض ف السوينج

• Toe drag in swing (MAY SEE لكن الغالب مش بيسيب نفسه)

•Possible compensations

•Stance (from spastic PF)

• Contact ground with foot flat premature heel rise( MST)

• Knee hyperextension (LOCKING + GRFV ANTفى صف العضلة )

• Lean forward &antenor pelvic tilting to move GRFV ant

- Short step legth

•Swing

• High steppage gait (functional shortening)

- Hip hiking

• Circumduction of affected limb بيعد المصابة عن الارض

• Non affected limb: Vaulting on contralateral limb (functional lengthening ) يشب على الرجل السليمة

•Long term effects

• fatigue

• Genu recurvatum due to knee hyper-extension

• LBP due to forward lean

* Normal function

• GRFV is anteriorly in MS, TS,PS causes dorsiflexion moment

• Plantar flexors:

• Control tibial advancement

•Concentric for propulsion

•Effects of weakness

• Inability to counteract dorsiflexion moment

• Excessive dorsiflexion

• Uncontrolled tibial advancement تقع

• Decreased Propulsion

•Possible compensations

• Increased Demand on quadriceps بيحمل على الفخد الامامى

• Knee flexion in terminal stance صعوبة رفع الكعب

• Delayed heel rise (prolonged heel contact)

مفيش حاجة بترفعها

• Short step

• Slow speed

- Long term

effects

FATIGUE

• Substitution is difficult but may cause fatigue

1- GLUETEUS MAX GAIT

2- GLUETEUS MEDIUS GAIT

3- LOCKING GAIT

(HAND KNEE GAIT)

4- HIGH STEPPAGE GAIT الصوابع اللى بتزحف

5- بيرفع الكعب بال ركبة

الكعب اللى مبيترفعش