What is a gait analysis?

What is a gait analysis?

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Gait analysis is a systematic assessment of an individual's walking pattern or gait. It involves the observation, measurement, and analysis of various components of a person's gait cycle, including the movement of the limbs, trunk, and pelvis. 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 process or injury. Consequently, the desired outcome of many physical therapy interventions is to either restore or improve a patient's ambulatory status. Gait analysis helps identify abnormalities, imbalances, or dysfunctions in the walking pattern, which can be associated with musculoskeletal, neurological, or biomechanical issues.

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The type of gait analysis that is selected depends not only on the purpose of the analysis, but also on the type of equipment available and the experience, knowledge and skills of the physical therapist. The equipment necessary for performing a specific type of gait analysis, in turn, depends on the purpose of the analysis, equipment availability and the amount of time the therapist can expend. Equipment used in gait analysis may be either as simple as pencil, paper, and stopwatch, or as complex as an electronic imaging system with force plates embedded in the floor and electromyography electrodes placed on the clients.

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There are two main types of gait analysis:

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1. Visual Gait Analysis: This is also known as “observational gait analysis”, the most common method used in clinical settings. It involves a physical therapist or healthcare professional visually observing and analyzing the individual's gait. This method usually requires only a small amount of equipment and a minimal amount of time. They assess various aspects of the walking pattern, such as stride length, step width, foot position, posture, and movement of the limbs and trunk as well as joint angles at specific points in the gait cycle. Visual gait analysis provides valuable insights into general gait abnormalities and can help identify gross issues or asymmetries, and plan an intervention and assess the outcome.
2. Instrumented Gait Analysis: Instrumented gait analysis utilizes specialized equipment and technology to obtain more detailed and objective data about the gait. This often involves the use of motion capture systems, force plates, pressure sensors, electromyography (EMG), and other devices. These tools provide quantitative measurements of parameters such as joint angles, ground reaction forces, muscle activity, center of pressure, joint reaction forces, center of mass and timing of gait events. Instrumented gait analysis allows for a more precise and comprehensive assessment of gait abnormalities and can assist in diagnosing specific gait-related conditions or disorders.

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Regardless of the type or method, a gait analysis of individual patients should provide accurate, reliable, and valid data that can be used as a basis for describing present status (performance limitation and strengths), planning and implementing interventions, evaluating effectiveness and progress over time, evaluating outcomes, and in some instances, predicting future status.

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What causes gait problems?

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Gait problems or abnormalities can have various causes, including musculoskeletal, neurological, and biomechanical factors. Some common causes of gait problems include:

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1. Musculoskeletal Conditions: Musculoskeletal conditions affecting the bones, joints, muscles, or ligaments of the lower extremities (e.g. hip, knee, ankle and foot) can lead to gait abnormalities. Examples include osteoarthritis, rheumatoid arthritis, fractures, muscle weakness or imbalances, joint instability, or post-surgical impairments.
2. Neurological Disorders: Gait abnormalities are commonly associated with neurological conditions that affect the brain, spinal cord, or peripheral nerves. These may include Parkinson's disease, multiple sclerosis, stroke, cerebral palsy, peripheral neuropathy, or spinal cord injuries. Neurological conditions can result in muscle weakness, abnormal muscle tone, balance and coordination deficits, spasticity, joint contractures and sensory impairments that affect gait.
3. Balance and Vestibular Disorders: Conditions affecting balance and the vestibular system, such as inner ear disorders or vestibular dysfunction, can cause gait disturbances. These conditions may lead to dizziness, unsteadiness, or loss of balance while walking.
4. Foot and Ankle Problems: Issues related to the feet and ankles, such as foot deformities, plantar fasciitis, Achilles tendonitis, or ankle instability, can impact gait mechanics and cause abnormalities.
5. Pain: Chronic pain, particularly in the lower back, hips, knees, or feet, can alter gait patterns. Individuals may adopt compensatory movements or avoid weight-bearing on affected areas, leading to changes in their walking pattern.
6. Medications: Certain medications, such as those prescribed for pain management, muscle relaxation, or psychotropic medications, have side effects that can affect coordination, balance, or muscle control, resulting in gait abnormalities.
7. Aging: Natural age-related changes in the musculoskeletal and neurological systems can contribute to gait problems in older adults. Factors such as decreased muscle strength, performance, endurance, joint stiffness, balance deficits, and reduced proprioception can affect walking patterns.
8. Psychogenic Factors: Psychological factors can sometimes contribute to gait abnormalities. Psychological conditions like anxiety, depression, or conversion disorder can affect balance, coordination and posture leading to gait impairments. 

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It's important to note that gait problems are often multifactorial, meaning they can be influenced by a combination of factors. Identifying the underlying cause or causes of gait abnormalities requires a comprehensive assessment by healthcare professionals, including physical therapists, physicians, neurologists, or orthopedic specialists. Treatment and management of gait problems will depend on addressing the specific underlying causes and may involve a combination of therapies, medications, assistive devices, and lifestyle modifications.

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The important role of gait analysis in physical therapy

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The information obtained from gait analysis helps guide treatment planning and interventions for individuals with gait abnormalities or those recovering from injuries or surgeries. Physical therapists can use gait analysis to:

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1. Identify Biomechanical Issues: Gait analysis can reveal abnormal movement patterns, muscle imbalances, joint restrictions, or faulty mechanics that contribute to gait abnormalities. Obtaining accurate descriptions of gait patterns and gait variables typical of different conditions helps in developing targeted treatment plans to address these issues.
2. Determine Treatment Progress: Gait analysis is used to evaluate the effectiveness of treatment and track an individual's progress during rehabilitation or treatment. By comparing pre- and post-intervention gait analysis, therapists can objectively measure improvements and make necessary adjustments to the treatment plan.
3. Understand the Gait Characteristics: Gait analysis assist in understanding the gait characteristics of a particular disorder through identifying and describing gait deviations present, or typically present in specific disorders as well as determining the functional ambulation capabilities of the patient in relation to functional ambulation demands of the home, community and work environments.
4. Assist in Orthotic or Prosthetic Prescription: Gait analysis can aid in determining either the need for or the effectiveness of an orthotic or prosthetic device. It can also aid in the selection and fitting of orthotic devices or prostheses by providing objective data on the individual's gait mechanics and requirements. This ensures proper alignment and function as well as joint protection and support of the devices, reducing energy expenditure and promoting safe locomotive function.
5. Enhance Performance: Athletes and individuals involved in sports or physical activities can benefit from gait analysis to optimize their performance. Identifying areas of improvement and implementing targeted interventions can enhance efficiency, reduce injury or reinjury risk, and improve overall athletic performance.

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Gait analysis is a valuable tool in the field of rehabilitation, sports medicine, and biomechanics. It provides valuable insights into the complex interaction of various body segments during walking and helps healthcare professionals develop tailored treatment plans to address gait abnormalities and improve functional mobility.

Trust PeteHealth for gait analysis

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