Gait Analysis (Basic) Flashcards
head position observations
tilted to the left or right rotated to either side shifted anteriorly changes during the different phases of the gait cycle
head position abnormal findings can suggest what conditions
LLD, shoulder or neck injury, muscle spasms or tightness
or natural difference in muscle bulk from dominant to non-dominant sides
shoulders and scapula observations
are they level
if one side is higher than the other
if the difference changes throughout the gait cycle
shoulders and scapula abnormal findings can suggest what conditions
LLD, shoulder or neck injury, muscle
spasms or tightness
or a natural difference in muscle
bulk from dominant to non-dominant sides
arm swing observations
do the arms swing equally
if one arm looks longer or is swinging a greater distance in the sagittal plane or is swinging further
from the body in the frontal plane
arm swing abnormal findings can suggest what conditions
lumbar shifts or spinal deformities
muscle inequality due to injury shoulder injury
or dominant vs. non-dominant side
trunk position observations
if the entire trunk has a side bend to the left or right
if the waist contours are symmetrical curvature of the spine
trunk bending posteriorly or anteriorly
trunk position abnormal findings can suggest what conditions
if a curvature of the spine such as scoliosis or kyphosis is present
inadequate gluteus maximus strength
to stop the trunk from bending posteriorly
inadequate quadricep strength to stop the trunk from anteriorly bending
hip and pelvis observations
pelvis vertical shift
pelvis lateral
pelvis forward rotation
hip and pelvis abnormal findings can suggest what conditions
hip hiking or vaulting gait patterns due to LLD, or limited hip, knee or ankle flexion
Trendelenburg gait due to gluteus medius weakness, leg length difference or scoliosis
increased rotation on the swing leg due to pain, stiffness or limited motion of the hip on the stance leg
hip only observations
equal hip flexion
excessive hip flexion
excessive hip internal rotation
hip only abnormal findings can suggest what conditions
excessive hip flexion in a steppage gait pattern
excessive hip internal rotation related to increased subtalar joint pronation, femoral anteversion, or weak gluteus medius or weak hip external rotators
knee observations
varus / valgus
knee abnormal findings can suggest what conditions
congenital or compensation for
degenerative knee problems, past trauma or LLD
tibia observations
excessive rotation esp. compared to foot motion
tibia abnormal findings can suggest what conditions
TBC
in-toeing / out-toeing
heel observations
heel strike, position of calcaneus at foot strike
varus, valgus or neutral calcaneus
midfoot or forefoot strikers
heel abnormal findings can suggest what conditions
TBC LLD, flexible flatfoot
foot from heel strike through stance phase observations
when the pronation begins – beginning of stance phase or after heel strike
underpronate or supinate (navicular tubercle reference point)
foot from heel strike through stance phase abnormal findings can suggest what conditions
TBC tight Achilles tendon
foot or leg injury
foot at toe-off observations
propulsion from hallux in addition to the 2nd and 3rd lesser toes
excessively medially off hallux
excessively laterally off the lateral lesser toes
MTP joints dorsiflexing
foot at toe-off abnormal findings can suggest what conditions
TBC hallux deformities
base of gait observations
narrow, wide, normal
base of gait abnormal findings can suggest what conditions
Narrow = typically neurological or neuromuscular pathologies
Wider = compensation related
to pathology/illness such as dizziness, unsteady balance, decreased sensation on the soles of the feet (neuropathy), ataxic gait patterns, or aging
step length observations
normal, shortened
L vs R
step length abnormal findings can suggest what conditions
injury/pathology, muscular imbalances, fatigue, advancing age,
disease such as Parkinson’s
angle of foot in the transverse plane relative to the leg observations
Excessive abduction
Excessive adduction
angle of foot in the transverse plane relative to the leg abnormal findings can suggest what conditions
Excessive abduction = lack of
ankle dorsiflexion, weakness of the hip musculature, or limitation in hip internal rotation.
Excessive adduction = hip musculature imbalance or limitation in hip external rotation
When should duration of walking be increased/decreased?
Decreased = patient is in a
great deal of pain
Increase = patient has a unique or unusual gait pattern that requires more time to make observations
Should patient be encouraged to change cadence
Depends on the comfort of the patient and the condition that they are presenting with
If permitted, change up cadence while walking to see if this
changes gait pattern
Footwear during assessment
If footwear is contributing to patient symptoms, ask them to put their
shoes on and compare their gait with and without footwear
If patient is having trouble relaxing or gait is guarded
DISTRACTION for normal gait
trouble relaxing = make small talk
with them, or ask more questions about their problems
guarded/tense gait = ask them to perform a task
2 benefits to recording all findings (esp. outside of normal)
1 give you clues as to why a patient is functioning the way they do
2 for comparison if the patient returns to see you in upcoming years
