Hip Circumduction

Demonstration

Demonstration

Gait Task

Swing Limb Advancement

Gait

Task

• The gait task during which the deviation occurs is in swing limb advancement
• Pre-swing, initial swing, mid swing, terminal swing
• Goal: acceleration of swing limb to propel body forward
• Critical areas
• Hip and pelvis motion to allow rotation over support limb
• Propulsion to move limb and body forward
• Contraction speed to shorten limb for clearance
• Muscles
• Release of tension in RF and GS as GRF moves

behind hip/knee

Gait Phase

Gait

Phase

• Initiates during pre-swing, occurs during swing phases, and ends moving into terminal swing
• Causes movement in the frontal plane when the movement should be mostly in the sagittal plane, which allows the foot to clear the ground with a stiff knee
• Inefficient, energy-demanding deviation that produces abnormal torque coupling of knee flexion/ extension and hip abduction that could lead to additional knee damage.

• Arm swing is affected

Joint - ROM limitation (hip, knee, ankle (talocrural)

Hip

Knee

Ankle

Leg length discrepancy

Possible

Impairments

Muscle Weakness

Limit flexion

Limit flexion

Dorsiflexion limited ; which can be presented by excessive plantar flexion

Hip obliquity - developmental

Due to fracture - femoral shaft fracture treated with intramedullary nailing

Appropriate

Measures/Assessments

Appropriate

Measures/Assessments

• Gait analysis on the Treadmill

• MMT - hip flexion, knee flexors, and dorsiflexor

• ROM hip flexion, knee flexors, and dorsiflexor

• Ely's test - Rectus femoris

Q&A

Q&A

Works Cited

References

Adams JM, Cerny K. Observational Gait Analysis : A Visual Guide. SLACK Incorporated; 2018. Accessed February 27, 2022.

Akbas T, Prajapati S, Ziemnicki D, Tamma P, Gross S, Sulzer J. Hip circumduction is not a compensation for reduced knee flexion angle during gait. J Biomech. 2019;87:150-156. doi:10.1016/j.jbiomech.2019.02.026

https://www-sciencedirect-com.dewey.umhb.edu/science/article/pii/S0021929019301654

This article talks about excessive plantar flexion (ex: equinus deformity) being an impairment that could cause hip circumduction. Also talks about abnormal coordination.

Kerrigan DC, Frates EP, Rogan S, Riley PO. Hip hiking and circumduction: quantitative definitions. Am J Phys Med Rehabil. 2000;79(3):247-252. doi:10.1097/00002060-200005000-00006

Li S, Francisco GE, Zhou P. Post-stroke hemiplegic gait: New perspective and insights. Frontiers. https://www.frontiersin.org/articles/10.3389/fphys.2018.01021/full. Published January 1, 1AD. Accessed March 3, 2022.

Harris I, Hatfield A, Walton J. Assessing leg length discrepancy after femoral fracture: clinical examination or computed tomography?. ANZ J Surg. 2005;75(5):319-321. doi:10.1111/j.1445-2197.2005.03349.x

Neumann DA, Kelly ER, Kiefer CL, Martens K, Grosz CM. Kinesiology of the Musculoskeletal System : Foundations for Rehabilitation. Third edition. Elsevier; 2017. Accessed February 27, 2022.

Sheha ED, Steinhaus ME, Kim HJ, Cunningham ME, Fragomen AT, Rozbruch SR. Leg-Length Discrepancy, Functional Scoliosis, and Low Back Pain. JBJS Rev. 2018;6(8):e6. doi:10.2106/JBJS.RVW.17.00148

Sulzer JS, Gordon KE, Dhaher YY, Peshkin MA, Patton JL. Preswing knee flexion assistance is coupled with hip abduction in people with stiff-knee gait after stroke. Stroke. 2010;41(8):1709-1714. doi:10.1161/STROKEAHA.110.586917

https://www.ahajournals.org/doi/10.1161/STROKEAHA.110.586917?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&