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

What Additional Information is Provided Through Gait Analysis that Augments Observational Analysis?

In order for gait analysis to be a useful tool in clinical decision-making, it must provide information not available in more traditional methods of evaluation. Computerized gait analysis augments visual observations by using:

a quantitative description of complex movements that are not only multi-planar, but which also involve multiple lower extremity joints and the upper body;
an indication of the associated muscle activity;
a consideration of joint kinetic patterns; and
an opportunity to learn from documented treatment outcomes.

With this additional information, the clinician can be more confident about identifying the actual gait deviations, determining their potential causes, and appreciating the treatment outcome. This entire process will ultimately lead to new treatment approaches and a reduction in the use of less effective interventions. The following examples are intended to illustrate how gait analysis can benefit the clinician in treatment decision-making.

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Cite this: Clinical Gait Analysis and Its Role in Treatment Decision-Making - Medscape - Sep 01, 1999.

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