■ Swing—when the foot moves forward and does not bear weight (40% of the cycle)
Observe the gait for the width of the base, the shift of the pelvis, and flexion of the knee. The width of the base should be 2 to 4 inches from heel to heel. Normal gait has a smooth, continuous rhythm, achieved in part by contraction of the abductors of the weight-bearing limb. Abductor contraction stabilizes the pelvis and helps maintain balance, raising the opposite hip. The knee should be flexed throughout the stance phase, except when the heel strikes the ground to counteract motion at the ankle.
A wide base suggests cerebellar disease or foot problems.
Hip dislocation, arthritis, or abductor weakness can cause the pelvis to drop on the opposite side, producing a waddling gait.
Lack of knee flexion interrupts the smooth pattern of gait.
Observe the lumbar portion of the spine for slight lordosis and, with the Loss of lordosis may reflect parapatient supine, assess the length of the legs for symmetry. (To measure leg vertebral spasm; excess lordosis sug-length, see Special Techniques, pp. 520-521). gests a flexion deformity of the hip.
Changes in leg length are seen in abduction or adduction deformities and scoliosis. Leg shortening and external rotation suggest hip fracture.
Inspect the anterior and posterior surfaces of the hip for any areas of muscle atrophy or bruising.
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