Clinical Gait Analysis

Question 1

Visual Gait Analysis

Answer 1

Simplest form of gait analysis –using your eyes
limitations
-no permanent record ( your memory) (video)
-unable to perform high speed movements (video)
limited to movements (unable to see forces) (sound all you got)
depends on the skill of the individual observer
+visual gait analysis has been found to be only moderately (intrarater–only one observer) reliability!!!

Question 2

Clinical Gait Assessment

Answer 2

How many walks
Length 10M
Walking speed -(at your normal/ comfortable speed-10 M walk test)
vantage point ( 1st frontal walk to you and from you from look for consistency) (Saggital a little harder. You have to follow them as they walk for a perpendicular vantage point)
what to look for

Question 3

Clinical Gait Assessment (test question typical)

Answer 3

A full gait assessment links gait abnormalities to other information about the patient, such as history/physical exam

Question 4

Video Recording

Answer 4

Video recording help with two limitations of visual gait analysis
—provides permanent record
–helps with viewing high-speed events
Other advantages
–limits the number of walks the patient has to perform
–able to show gait abnormalities to the patient
–Helps in teaching visual gait analysis to someone else

Question 5

Video recording

Answer 5

Patient
-wear shorts to expose as much of the limb as possible, wear their own shoes
Camera
-lateral and frontal views
-approximately 4-5 meters from the patient if possible
-whole body first and then zoom in from waist down
Other
=minimize background distractions

Question 6

2+/5 right hip abductors

Answer 6

Trunk lean or Trendelenburg or a combination of the two.

Question 7

Trunk lean but muscles are still strong (4/5)

Answer 7

Expected Joint pathology

Question 8

Video Recording:Treadmill

some people may have a fear of running on the treadmill so that may change some of the dynamics of their gait

Answer 8

Treadmill helps minimize the space needed for gait analysis
However, people walk slightly different on treadmill compared to overground
Place camera a far away as possible and zoom in on patient
–(whole body first, then waist level down)

Question 9

Video Recording: Hindfoot motion

Answer 9

Perform with patient on treadmill
place camera as far back as possible and zoom in on hindfoot
Placement of lines or tape on distal leg and shoes may be helpful (old days)

Question 10

Tips

Answer 10

*Observation From General to Specific
*Use sound feature (may be helpful with footfalls on treadmill)
*Provide adequate time for patient to become acclimated to treadmill
What you see in the first 5 minutes of running not always what you see later in the run

Question 11

What is the primary biomechanical role of the foot during the…..

Answer 11

Loading Phase–absorb shock and adapt to ground
Midstance- single leg stance need a good arch base of support
Terminal and Pre-swing–pushoff need a rigid layer

Question 12

Main purpose of all hip/knee/ and ankle joint in the loading phase

Answer 12

Absorption of Shock

Question 13

Inverted to everted

Answer 13

Pronation

Question 14

Everted to Neutral posture

Answer 14

Supination

Question 15

Video #1

Answer 15

Abnormal Pronation and Eversion–excessive to start and prolonged…
will eventually have hallux valgus bilaterally

Question 16

Pronation is normal when

Answer 16

Pronation during loading phase turns into supination during gait cycle and then comes back

Question 17

Unilateral Hallux Valgus

Answer 17

may be due to a assymetrical posture of the big toe and could be caused by an overpressure or over use…Bilaterally it can be typically genetics