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INTRODUCTION

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LEARNING OBJECTIVES

  1. Define the terms used to describe normal gait.

  2. Explain reliability, validity, sensitivity, and specificity in relation to gait analysis.

  3. Describe the variables that are examined in each of the following types of gait analyses: kinematic qualitative analysis, kinematic quantitative analysis, and kinetic analysis.

  4. Describe and provide examples of some of the most commonly used types of gait profiles.

  5. Compare and contrast the advantages and disadvantages of kinematic qualitative and kinematic quantitative gait analyses.

  6. Using the case study example, apply clinical decision making skills in evaluating gait analysis data.

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One of the major purposes of rehabilitation is to help patients achieve the highest level of function given their specific impairments so they can participate optimally in activities of interest. Human ambulation, or gait, is one of the basic components of independent function commonly affected by either disease processes or injury. Consequently, the desired outcome of many physical therapy interventions is to either restore or improve a patient's ambulatory status. Gait, defined as the manner in which a person walks (e.g., cadence, step length, stride length, speed, and rhythm) differs from locomotion, which refers to an individual's capacity to move from one place to another.1 Although there are many specific reasons for performing a gait analysis, all of them require some information about the walking capacity of either an individual or a group of people with a particular disability. Because there are multiple approaches to gait analysis, ranging from very simple to extremely complex, the therapist must carefully consider how information obtained from a gait analysis is to be used. General as well as specific clinical indications for conducting a gait analysis may be found in the Guide to Physical Therapist Practice, some of which are included below.1

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PURPOSES OF GAIT ANALYSIS

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  1. To assist with understanding the gait characteristics of a particular disorder. This includes the following:

    • Obtaining accurate descriptions of gait patterns and gait variables typical of different conditions

    • Identifying and describing gait deviations present, or typically present in specific disorders

    • Determining balance, endurance, energy expenditure, and safety

    • Determining the functional ambulation capabilities of the patient in relation to functional ambulation demands of the home, community, and work environments

    • Classifying the severity of disability

    • Predicting a patient's future status

  2. To assist with movement diagnosis by:

    • Identifying and describing gait deviations and describing the differences between a patient's performance and the parameters of normal gait

    • Analyzing gait deviations and identifying the mechanisms responsible for producing them

    • Examining balance, endurance, energy expenditure, and safety and determining their impact on gait

  3. To inform selection of intervention(s) by guiding the therapist in:

    • Proposing appropriate treatment of impairments that may improve gait performance

    • Determining the need for adaptive, assistive, orthotic, prosthetic, protective, or supportive devices or equipment

  4. To evaluate the effectiveness of treatment and guide the therapist in:

    • Determining how interventions such as therapeutic exercise, endurance activities, developmental activities, strengthening or stretching, ...

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