Case Study; Jilly, 68 year old walker with arthritis has developed a gait pattern with dropped hips

Jilly is a 68-year-old who has become very active in the community since retirement. Jilly volunteers a few days a week at the local pets home, where she looks after pets waiting for their forever home. Typically this involves feeding upwards of 100 dogs, cats, birds, and any other little creatures that need some shelter. Jilly walks the dogs twice a day and often this is dozens of dogs! Jilly loves staying active in this way and credits the walks for her good health – other than a little arthritis, she has a clean bill of health from her doctor. She has also formed good friendships with the other volunteers, the meet for coffee or the odd meal after they finish volunteering for the day.

Recently one of her friends who Jilly volunteers with joked that Jilly ‘struts’ around the yard with the dogs and enquired if it was to impress one of the handsome male volunteers. Jilly replied, “I only have eyes for the boys wearing fur and I do not strut!” The friend insisted that Jilly did indeed strut and mimicked her by walking around dropping her hips as she went. Jilly followed suit and did a walk to demonstrate this wasn’t the case although found that putting her hands on her hips she could feel she was indeed dropping her hips slightly! Jilly noticed that when she stood on her right leg, her left hip dropped and vice versa.

Jilly proceeded to walk infront of a full length mirror at home. If she tried to keep her hips level then it was improved but they still dropped somewhat with every step. She also noticed that her trunk would lean slightly towards the hip that was dropping. At first Jilly wondered if the arthritis was to blame although with it being summer the arthritis hadn’t flared up at all recently in the warmer weather. Jilly decided that increasing the amount she was walking may help reduce the “strut” in due course.

* Why do you think Jilly has developed a “strut”? What is the name of this gait pattern?

*During single-limb support, Jilly’s contralateral pelvis drops. What muscle is likely to be weak? Can you suggest some exercises that could strengthen the muscle.

*Jilly has an uncompensated gait pattern. How might a client compensate for this deficit? Stand up and practice both gait patterns to feel the difference.

* Jilly’s plan is to walk more each day. Do you think this will help to improve her gait deviation? Give reasons for why or why not?

* Do you agree that Jilly’s arthritis the only contributing factor to her gait pattern? In which other diagnoses might you see this issue?

Adapted from Dr. Tawny Chamberlain, PT, DPT, Department Chair and Program Director, Physical Therapist Assistant Program, South University, Richmond

Previous Case Studies...