Hemiplegic Gait - Case Study 13

Video includes both a lateral view and an anterior-posterior view.

Case studies are strictly for educational purposes.

[anthonysoares]

I'm an SPT in Springfield, MA, I used this video for an assignment for my gait class. Thank you for the post and thank you pt for allowing me to learn from you!

[kapitan]

(caution, wall of text). Physio here. My visual assessment of this movement pattern: Weakness right side trunk, abdominal muscles failing to bring right side pelvis sufficiently forward in line with left. Hip is thus falling down and back. Hip flexors get no grip, can't do their job. Swing only possible through (poor) pelvic circumduction (using lower back muscles), with hip in external rotation (hip adductors changing jobs to flexors). Right side trunk and arm thrusts backwards to help leg forward. Ankle and toe dorsiflexors weak, no synergy with hip flexors and quadriceps - foot unable to clear, toes drag on floor, awkward foot placement. Discourages weight bearing on right (understandably). Pelvis and hip slips further back, glutes - hamstrings unable to work in that position, quads turn off and knee locks back in hyperextension. Next to none muscular control of knee, weight bearing relying on passive structures like ligaments and bones. Brain does the math, reluctant to bring weight over foot, owner powers through with effort. Ankle presses slightly down in plantar flexion. Shortened stance with ankle collapsing inward - "let's get it over with" - no eccentric right ankle dorsiflexion, so left foot jumps forward quickly as possible. Repeat until tired / falls over. Intervention: Activate and strengthen abdominal muscles right side, exercises for stable pelvic control. Activate gluteal muscles, hamstrings and hip flexors, stretch and exercise hip external rotators and abductors, lessen stress on adductors. Practice swing phase with proper muscles; place foot in direction of travel - make sure hip is properly forward. Employ light orthosis that allows passive dorsiflexion for ankle (do strengthen dorsiflexors if possible). Practice loading right foot, let knee slide forward over foot, rock slowly back and forth, working up control over knee flexion and extension. Clench butt muscles as foot loading increases. Eventually, step forward with left foot. Strive for equal step length. Repeat.

[simpsonjenny]

I had a stroke 8 months ago I'm doing great, but this is the way I walk. I can't bend my knee

[최인애-du]

Hello. I'm a professor of occupational therapy. If you allow me to use this video for my class, it would be very helpful for my students. Would you do that?

[shroukmohamed]

May Allah treat you and give you better than you deserve .amen

[jagaljagal]

I am a physical therapist in Korea. If you allow, I would like to make a video that analyzes the motion using Case 17 and Case 23 with this video. Can I do that?

[nora]

Thank u, I want to ask u about the case, this after treatment right? And he before was walked in toes am right?

[dashingshaky]

Is Hemiplegia treatable please reply ? If yes where is the best treatment available

[jasongooden]

maybe i could do this if i had something to lock me knee from bending

[tenchan-love]

I am paralyzed on the right side due to cerebral hemorrhage.
😊