Observational Gait Analysis

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Observational Gait Analysis

• Alayna George
• Julia Northrop

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Why do it?

• Observational Gait Analysis is used to diagnose
  disorders of the lower limbs and pelvic girdle
• Practitioners compare observed gait to norms
  this helps demonstrate different disorders

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Terminology

• Stance standing on one limb while walking
• Swing a leg moving by itself while walking
• Equinus a deformity of the calf muscles
• Drop foot a condition where patients have
  lessened dorsiflexing ability they are unable to
  pick up the foot

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Basic Components of Stride

• Propulsion
• Pushing off floor
• Support/Progression
• One leg moves/one stands still
• The Loading Response
• As the foot makes contact

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Propulsion

• One foot pushes off floor
• Leg begins to swing
• Weight switches to other leg

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Propulsion

• Leg 1 is in early stages of propulsion
• Norms
• Knee fully extended
• Ankle dorsiflexes through 5-10 angle during push
  off

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Support/Progression

• Swing Limb Advancement
• As one limb stays still, the other swings up to
  take next step

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Support/Progression

• Norms
• The standing knee flexes 20
• The swinging knee flexes 65 less at slower
  speeds
• Trunk stays centered over sagittal plane

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Loading Response

• Weight Acceptance phase of gait
• Heel touches floor and weight is transferred from
  leg to leg (leg 1 to leg 2)

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Loading Response

• Norms
• The ankle (3 in picture) should be at
  approximately a 90 angle when initial contact
  made
• Heel contacts floor first then toe
• Knee is close to fully extended at first contact
  (2 in picture)

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Abnormal Propulsion

• Weak toe-off
• Caused by Weak calf muscles. Often seen after a
  disproportionate tendon lengthening operation to
  correct for Equinus deformity.

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Abnormal Support/Progression

• Standing knee knee stays fully flexed
• Caused by quadriceps weakness, arthritis
  adaptation (lowers bone on bone contact)
• Swinging knee knee stays at constant angle
  through stride
• Caused by fixed knee deformity

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Abnormal Support/Progression Cntd

• Forward flexed Trunk the abdomen leans forward,
  as seen from the side
• Often a compensation for weak hip flexors
• Waddling hip drops on one side and/or abdomen
  leans side to side, viewed from behind
• Often caused by weak abductor muscles

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Abnormal Loading Response

• Foot contact
• Flat foot whole foot touches at same time
• Toe-heel toe hits first, heel succeeds
• Causes may be Equinus deformity or drop foot
• Knee angle
• Flexion the knee is not fully extended
• Causes knee flexion contracture or hamstring
  tightness

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Equinus Deformity

• Equinus is a condition of lessened flexibility in
  the calf muscles
• Patients with equinus deformity generally walk on
  their toes, and sometimes their heel never hits
  the ground

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Case 1

• 9 y-o Female
• Had Achilles tendon lengthening surgery to
  correct Equinus deformity, now tendon is too long

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Case 1
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You Should Have Seen

• 15 fixed knee contracture
• Crouch Gait Pattern
• Flat foot contact

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Case 1
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Case 2

• 2 year old boy
• Video is with orthotic devices on, but some
  disorders still visible

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Case 2
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Case 2

• Notice the trunk waddling in sagittal and coronal
  planes
• Table are the results of manual muscle testing
  does this explain what is going on?

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More Information

• http//www.univie.ac.at/cga/faq/obs.html
• http//sprojects.mmi.mcgill.ca/gait/normal/intro.a
  sp

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References

• http//www.univie.ac.at/cga/
• Bryan Malas, Chairman of National Commission on
  Orthotic and Prosthetic Education, speech to IPRO
  309, October 3, 2006