Comprehensive Study Notes on Gait Analysis and Manipulation

Gait Manipulation and Analysis

Goals of the Session

  • Understand analyzing someone's gait in rehabilitation settings, particularly by physical therapists.

  • Identify different phases of walking patterns.

  • Become familiar with gait terminology and variables.

  • Learn how to document and assess gait abnormalities.

Phases of Gait

  1. Initial Contact

    • First moment of foot landing on the ground.

  2. Mid Stance

    • Period when one foot is in contact with the ground, supporting the body's weight.

    • Notable for balance challenges.

  3. Late Stance

  4. Terminal Stance

    • Just before toe-off.

  5. Toe Off

    • The foot lifts off the ground after the last point of contact.

  6. Initial Swing

    • The phase where the foot travels forward off the ground.

  7. Mid Swing

    • The leg is swinging forward, with the tibia moving horizontally.

  8. Terminal Swing

    • The leg is preparing to make initial contact again.

Key Gait Definitions

  • Stride: The distance covered in two steps, i.e., from the initial contact of one foot to the next initial contact of the same foot.

  • Single Support: Phase where only one leg is in contact with the ground.

  • Double Support: Phase where both feet are in contact with the ground.

  • Stance Time: Period when a foot is in contact with the ground (approximately 60% of the gait cycle).

  • Swing Time: Time when a foot is not in contact with the ground (approximately 40% of the gait cycle).

  • Cadence: Number of steps taken per minute; recommended cadence is around 110 steps/min.

  • Speed: The distance covered over a certain period, often measured in meters per second.

Variables Affecting Gait

  • Gait Variables

    • Time (quick or slow)

    • Step length variability

    • Horizontal or vertical displacement during movement

Normal vs. Abnormal Gait

  • Recognizing what constitutes normal gait is essential for identifying abnormalities.

  • Observation of gait can inform rehabilitation approaches to restore normalcy.

Standardized Gait Tests

  • Various tests are used to evaluate and document patient walking.

  • Importance of observing gait from multiple angles: anterior, posterior, and lateral.

Abnormal Gait Patterns

  1. Antalgic Gait

    • Compensation due to pain resulting in a shorter stance time on the affected leg.

    • Characterized by an attempt to minimize weight on the painful side.

  2. Trendelenburg Gait

    • Associated with weak gluteus medius, causing lateral hip drop during stance phase.

    • Commonly observed in older individuals or those with hip stability issues.

  3. Genu Recurvatum (Hyperextension Gait)

    • Occurs when weak knee extensors lead to excessive hyperextension of the knee.

  4. Hemiplegic Gait

    • Characterized by arm and leg adaptations seen in patients post-stroke, with an affected arm often bent and leg extending awkwardly.

  5. Scissor Gait

    • A gait characterized by crossing of the legs due to adductor spasticity, often seen in cerebral palsy.

  6. Cerebellar Ataxia (Drunkard Gait)

    • Uncoordinated movement pattern due to cerebellar dysfunction; may resemble intoxicated walking.

  7. Parkinsonian Gait

    • Characterized by short, shuffling steps with potential to present rigidity.

  8. Foot Drop or Steppage Gait

    • Occurs due to loss of dorsiflexion control, causing the front of the foot to drag or slap on the ground without proper lift during walking.

Importance of Gait Analysis

  • Integral part of functional assessment in rehabilitation.

  • Helps diagnose underlying issues, assess treatment progress, and tailor rehabilitation plans.

  • Observations can highlight compensatory mechanisms in patients with pain or dysfunction.

Final Notes for Study

  • Familiarize with key terms: step, stride, single support, double support.

  • Understand the significance of stance and swing time, as well as gait terminology from both traditional and Rancho Los Amigos perspectives.

  • Focus on the observable phases of gait as they relate to clinical assessments.

  • Be prepared for questions on the implications of different gait abnormalities in a clinical setting.