Gait analysis

1
Gait analysis
2

• Visual gait analysis
• Walk minimum 8m with different speed. It is
  simplest gait analysis but has serious
  limitations
• 1- transitory, no permanent record
• 2- eye can not observe high speed events
• 3- possible to observe the motion not the force
• 4- depend on the skills of the observer.

3
The best viewpoint for observation of gait
abnormality

• Side view anterior and posterior trunk
  bending, increased lumbar lordosis, steppage,
  excessive knee flexion and extension, vaulting,
  insufficient push off and dorsiflexion control .
• Front and behind view circumduction, hip
  hiking, vaulting, abnormal foot contact , hip
  rotation and walking base

4
Anterior trunk bending Posterior trunk bending
5
(No Transcript)
6
Videotape examinations

• Overcome two of the visual limitations,
• 1- transitory, no permanent record
• 2- eye can not observe high speed events
• And confer the following advantages
• 3- reduce the number of walk the subjects need to
  do
• 4- show subjects how they are walking
• 5- used to teach visual gait analysis to someone
  else

7

• General gait parameters
• Cadence no of steps/known period time. 10-15
  sec is enough time
• Stride length by direct measurement (foot print)
  or indirect from velocity and cadence
• Step length, walking base, toe out angle, foot
  contact pattern.
• Foot print ( water , talcum powder, and felt
  adhesive pads soaked in different colored dye and
  a stripe of paper )

8

• Velocity distance/time .( 610 m ) are enough
• The subject should be to walk at their natural
  speed and their stride before measurements
• Foot switches to record timing of gait
• Electrogoniometer

9

• Electromyography
• Force platform with size 45X60cm
• 3D motion analysis system

10
Walking aids

• Waling aids modify the gait pattern
• Reduce pain in painful joint
• Increased the functions
• Gait training (underwater, between parallel bars,
  use assistive devices )

11
Canes

• Canes are the means of forces transmitted to
  ground by the wrist and hand
• They are used for the following purposes
• 1- to improve stability
• 2- to generate moment (on the opposed side )
• 3- to take part of the load from the leg

12
Types of canes

• Straight cane
• Tripod canes
• Tetrapod canes
• L shape handle
• U shape handle
• Angular shaped handle
• Adjustable in height

13
Crutches

• They differ from canes, because they able to
  transmit significant force in the horizontal
  plane
• Types of crutches
• Axillary crutches, may add plateform
• Forearm crutches or elbow crutches
• Ortho crutches

14
Walkers (rollators)

• The most stable walking aids
• Types
• 1- regular walkers
• 2- adjustable walkers
• 3- folded walker
• 4- rolling walker
• 5- walker with plateform for forearm support
• 6- reciprocal walker

15
Gait pattern with walking aids

• Gait with single aid
• Three point swing through gait
• Three point swing to gait (the feet are advanced
  by a much shorter distance and placed behind the
  level of crutches)
• Four point gait
• Three point gait
• Two point gait

16
Planning for gait training

• 1- safety measures
• Gait belt
• Dry surface
• Slippers or shoes
• Therapist beside the affect side
• Turning around the good leg

17

• 2- point to start with
• According to static and dynamic balance, starts
  from easy to hardest
• Underwater
• Use parallel bars
• Walker
• Crutches
• Canes
• Independent

18

• 3- Weight bearing status
• NWB
• TTWB
• PWB
• WBAT
• FWB
• 4- Mental status good level of awareness and
  orientation to understand the instructions

19

• 5- Preparing for the treatment area
• Usage mirror
• Draw line on the floor in case of dynamic balance
• Decide the distance of walking
• The level of the surface

20
Amputee gait

• The mechanical coupling between the stump and the
  prosthetic limb can not be good as in the normal
  because
• 1- the lever arm between the hip and the socket
  is small
• 2- the relative motion between the stump and the
  socket
• 3- uncomfortable socket prevent applying large
  forces on the prosthetic limb

21
Up and down stairs

• Up with good leg first and down with the affected
  one
• With cane , Up with good leg first then cane
  then the affected one and vise versa going down
• The same with the crutches

22
Thanks