Gait Analysis Oleh Sugijanto

TUJUAN INSTRUKSIONAL Mahasiswa memahami gait analisis dengan cara : Mengkaji faktor-faktor penilaian Analisis jalan. Mangkaji dan memperagakan tahapan gait cycle. Mengkaji pembebanan (bearing) dan ayunan (swinging). Mengkaji tentang ritme jalan. Mengkaji Sagital, transversal dan horizontal cadens. Mengkaji tentang foot stride. Mendiagnosis penyimpangan gait cycle. Mendiagnosis penyimpangan pembebanan-ayunan, ritme, cadens.

Pertanyaan studi Jelaskan Kajian Analisis jalan. Jelaskan dan peragakan tahapan gait cycle. Jalaskan tentang pembebanan (bearing) dan ayunan (swinging). Jelaskan tentang ritme jalan. Jelaskan tentang Sagital, transversal dan horizontal cadens. Jelaskan tentang foot stride. Jelaskan tentang penyimpangan gait cycle. Jelaskan penyimpangan pembebanan-ayunan, ritme, cadens.

Pendahuluan Tujuan pemeriksaan FT: Menegakkan diagnosa FT Correction gait Penggunaan sepatu

Gait Analysis

GAIT ANALYSIS Perhatikan gait cycles: saat initial contact, foot flat, loading respons, terminal contact, asceleration, mid swing, desceleration dan kembali initial contact Perhatikan rhythm, feet distance, cycle phase, sagital – tranversal – horizontal cadens, speed etc.

Siklus normal berjalan Stance phase Initial contact = Heel strike Loading response = Foot flat Mid stance = Mid stance Terminal stance = Heel off Pre swing = Toe off

Swing phase Initial swing = Acceleration Mid Swing = Mid swing Terminal swing = Deceleration

Pemeriksaan Observasi Initial contact to loading response Pelvic drops : trendelen berg  kelemahan hip abductor HIP : Deviasi  Anterior pelvic tilt  kelemahan extensor hip/kontraktur fleksi hip. Knee :Insufisiensi knee/hyper extensi  Kelemahan knee extensor/ kontraktur knee extension Ankle : early foot flat kelemahan foot dorsal flexor/peroneus nerve lesion

Mid stance HIP KNEE Ankle Badan condong kebelakang  kelemahan hip extensor Panggul bergeser ipsilateral  kelemahan abduktor  Hip Adductor spasticity KNEE Hyper extensi  Kelemahan ekstensor knee Ankle Excessive plantar fleksi  Kontraktur/spastik plantar flexor

Terminal stance HIP KNEE Ankle Badan condong ke Ipsilateral  kelemahan abduktor KNEE Hiper ekstensi knee  kelemahan ekstensor knee Excessive plantar fleksi  Kontraktur/spastik plantar flexor Ankle Excessive ankle dorso flexion  kelemahan soleus

Pre swing HIP KNEE ANKLE Excessive hip flexion  spastic hip flexor Insufficient knee flexion  kelemahan knee extensor ANKLE Excessive ankle dorsiflexion  kelemahan soleus

INITIAL SWING HIP KNEE ANKLE Circumduction hip  kelemahan hip flexor Insufficient hip flexion  kelemahan hip flexor ANKLE Excessive ankle plantar flexion  kontraktur plantar flexion

MID SWING HIP KNEE ANKLE Excessive hip flexion  kelemahan dorsiflexor ankle dikompensasi hip flexion\ KNEE Insufficient knee flexion  kelemahan hip flexor ANKLE Excessive ankle plantar flexion  kelemahan dorsi flexor ankle

TERMINAL SWING HIP KNEE ANKLE Circumduction hip  kelemahan hip flexor Insufficient knee flexion  kelemahan knee extensor ANKLE Excessive plantar flexion ankle  kelemahan dorsi flexor ankle

Pathological gait Pathological gait seperti: duchene gait, weddling’s gait, paralytic gait, parkinsonian’s gait, dll. Hip Joint: Antalgic gait, torsion gait, flexion contracture gait, duchene gait, trendelen’s gait, scissor gait, leg dicrepancy gait dll Knee joint: Antalgic gait, knee flexion contracture gait, Bow leg gait, Knock knee gait, hyper extension gait, dll Ankle and foot: Early foot flat gait, horse gait, stappage gait, dll

PENGGUNAAN SEPATU Shoe lift untuk leg discrepancy Penggunaan medial dan lateral arc support Splinting jari kaki Plantar stop

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