scissoring gait physiotherapy management

scissoring gait

This type of gait abnormality is associated with spastic type of cerebral palsy or upper motor neuron lesion.

Features of the following gait:

•  it is a progressive contractures of all the spastic muscle
•  causing rigidity and excessive adduction of the leg in swing   phase
•  in which hip will be adducted and internally rotated
•  knee in flexion
•  and ankle at plantar flexion
•  thus a complicated assisting movement of the upper limb is seen during walking
•  inward pointed toe while walking

Gait analysis

•  due to contracture of muscles at hip, knee and ankle it will result in excessive adduction and crossing of leg in scissor manner may touch while walking
• subject walks on toes because of spasticity of tendoachilis
• during walk to maintain balance they try to lift the arms and hands outwards away from the body

   PT management

To improve muscle power

 Electrical stimulation

 Strengthening exercise of weak group of muscle by resisted        exercise

Strengthening of knee extensor muscle helps to improve stride length

Aquatic therapy

To prevent contractures to reduce spasticity

To reduce the flexed postures of the body the patient should be advice to lying in prone position

Encourage to sit near the corner side of hall it will reduce the spasticity of muscle and helping the child to sit in correct position

Proper relaxation positioning

Active ROM exercise of the entire joint

Gentle stretching to increase the ROM

 Gait and balance training

First make the patient to walk with support on even surface and the progress to an uneven surface

Improve the heel to toe gait pattern

Improve side stepping

Increase the BOS during walking and progress from wide to narrow BOS

It should be noticed while the leg is kept slightly apart from each other