From the Guidelines
To analyze a patient's gait effectively, I recommend using a systematic approach that includes both observational assessment and objective measurements, as supported by the most recent evidence from 1. When analyzing a patient's gait, it is essential to consider the potential impact on morbidity, mortality, and quality of life. Gait abnormalities can indicate underlying neurological conditions, musculoskeletal problems, pain, or compensation patterns, which can significantly affect a patient's overall health and well-being.
Key Components of Gait Analysis
The analysis should focus on key components, including:
- Step length
- Cadence
- Base width
- Arm swing
- Posture
- Weight transfer Documenting specific deviations such as foot drop, circumduction, trendelenburg gait, or antalgic patterns is also crucial.
Objective Measurements
For more detailed analysis, consider using:
- Video recording from multiple angles (front, back, and sides) to review the gait cycle in slow motion
- Quantitative tools like pressure mats, motion capture systems, or simple timed walking tests (such as the 10-meter walk test) to provide objective measurements, as mentioned in 1 for patients with specific conditions like epidermolysis bullosa.
Importance of Gait Analysis
Understanding gait mechanics is essential because abnormalities can indicate neurological conditions, musculoskeletal problems, pain, or compensation patterns, as highlighted in 1. Regular reassessment using consistent methods helps track changes over time and evaluate treatment effectiveness. This comprehensive approach ensures you capture both obvious and subtle gait abnormalities that might provide important diagnostic clues.
Clinical Application
In clinical practice, gait analysis can be used to monitor and evaluate therapy intervention, as mentioned in 1. It can also help identify patients at risk of falls, which is a significant concern in older adults, as discussed in 1. By prioritizing gait analysis, healthcare providers can take a proactive approach to preventing falls, reducing morbidity, and improving quality of life.
From the Research
Gait Analysis
- Gait analysis is the assessment of a patient's gait, which can provide information about the body and the capability of the musculoskeletal system to adjust to physical stressors 2, 3.
- A basic analysis of a patient's gait and posture provides information about the body and the capability of the musculoskeletal system to adjust to physical stressors 3.
- The gait cycle can be broadly divided into the stance and swing phases, and additional features are assessed to identify specific patterns and generate a provisional diagnosis 2.
Factors to Evaluate
- A range of factors should be evaluated, including posture, walking aids and footwear 2.
- General practitioners can detect faulty postural syndromes and abnormal gait by visual scanning and awareness of pain referral patterns 3.
- Awareness of pain that can arise from faulty gait and posture will assist GPs to shift their focus away from structural diagnoses and unhelpful radiological investigations 3.
Common Gait Patterns and Aetiologies
- Patients with a variety of neuromuscular pathologies may present with gait abnormalities 2.
- Accurate assessment of each pattern, coupled with appropriate investigations, facilitates diagnostic accuracy followed by treatment or referral, as required 2.
- Common musculoskeletal conditions and their association with abnormal gait and posture should be understood to identify and treat musculoskeletal pain 3.
Assessment Tools
- The United Parkinson's Disease Rating Scale (UPDRS) III can be used to evaluate the efficacy of different drugs on non-motor symptoms of Parkinson's disease 4.
- A portable device can be used to assess reaction time (RT) and stop signal reaction time (SSRT) to measure the speed to initiate and stop a movement 5.
- Electromyographic (EMG) signals and kinematic signals can be recorded and analyzed to assess motor symptoms of Parkinson's disease 6.