Clinical Gait Analysis and Its Role in Treatment Decision-Making

Roy B. Davis, III, PhD, Sylvia Õunpuu, MSc, Peter A. DeLuca, MD, Mark J. Romness, MD

August 14, 2002

How Are Gait Data Interpreted?

The process of gait data collection, as described above, yields the following:

video recordings,
clinical measures,
stride and temporal gait data, such as step length, cadence, and walking speed,
three-dimensional joint and segment motion plots (kinematics),
three-dimensional joint torque or moment and power (kinetics) results,
electromyographic (EMG) tracings, and
a measurement of metabolic energy expenditure.

These parameters are then evaluated to identify abnormalities using a database of normal ambulators and knowledge of normal gait biomechanics as baseline. Deviations from normal are always interpreted in the context of their relative impact on gait function. These multiple sources of data provide useful redundancy, allowing corroborating information to be identified and conflicting observations to be understood.

References

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Table 1. Summary of Ankle Dorsiflexion in the Clinical Examination of Patients 1, 2 and 3
Patient	Knee Position	Side	Passive Motion	Dorsiflexion Strength
1	fully extended	left	0°	2 out of 5
1	flexed to 90°	left	5°	2 out of 5
2	fully extended	left	5°	2 out of 5
2	flexed to 90°	left	10°	2 out of 5
3	fully extended	left	0°	1 out of 5
3	flexed to 90°	left	10°	1 out of 5

Table 2. EMG Pattern of Activity in Three Patients to Determine Tibialis Posterior and Tibialis Anterior Function
Patient	Muscle	Pattern of Activity
1	tibialis posterior	active in terminal swing with variable activity in stance
1	tibialis anterior	active in late stance, at toe off and in initial swing
2	tibialis posterior	negligible activity
2	tibialis anterior	active in late stance, at toe off and in initial swing with variable activity in late swing and from initial contact through mid-to-late stance
3	tibialis posterior	continuous activity in swing through mid-to-late stance depending on the gait cycle
3	tibialis anterior	variable premature activity of a late stance burst and normal activity in swing and prolonged activity through mid stance

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Clinical Gait Analysis and Its Role in Treatment Decision-Making

How Are Gait Data Interpreted?

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

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