Gait analysis is a medical procedure used primarily in orthopedics. The human gait results from a complex interaction of balance and coordination as well as the function of the musculature and joint mobility. In order to determine possible disorders or diseases on the basis of an altered gait pattern, both an observational gait analysis and an apparative gait analysis can be performed.
Indications (areas of application)
- Diagnosis and assessment of locomotor and gait behavior.
- Incorrect loads and posture errors
- Muscle weaknesses
- Muscle contractures (permanent shortening of a muscle).
- Pelvic obliquity (= leg length difference < 2 cm) in scoliosis (lateral deviation of the spine).
- Balance disorders
- Bone and soft tissue changes
- Joint arthrosis (joint wear and tear)
- Spasticity (muscle spasms), paresis (paralysis) and polyneuropathies (destruction of nerve pathways, which leads to numbness and incoordination; for example, in diabetes mellitus – diabetes).
- Injuries to muscles, tendons and ligaments
- Preventive stress analysis – e.g. in athletes.
- Orthopedic shoe and insole care
- Rehabilitation planning
- Assessment of prostheses – e.g. hip joint prosthesis.
- Operative aftercare
- Therapy documentation
- Long-term monitoring of MS patients
- Running shoe test
The procedure
In addition to the apparative, computer-assisted gait analysis, just the clinical gait observation by the doctor or physiotherapist provides initial diagnostic findings. Prior to observation of the gait pattern, a medical history is taken followed by a physical examination. The following observation criteria are used to record the gait pattern:
- Position of the longitudinal axis of the body – this should be almost vertical in space.
- Posture of the head – the head should be placed in the body axis.
- Mobility
- Spatial movement and posture of the chest
- Gait tempo – normal are ca.110/120 steps/min
- Gait rhythm and gait economy – the gait should be fluid and harmonious
- Stride length – about 2-3 foot lengths; it should be both appropriate to the pace and side to side.
- Track width
- Walking motion of the pelvis – pelvic rotation and phase-dependent lateral tilt.
- Walking movement of the legs – leg axes, free leg and stance leg phase.
- Feet – attachment, position and roll-off
- Position of the shoulder girdle
- Activity of the arms
The apparative gait analysis allows an evaluation of dynamic components of the gait pattern and a recording of non-visible functions such as the torque of the joints. It is used primarily for the documentation of therapeutic progress and the review of technical-orthopedic fittings. Video recordings make it easier for the patient to understand the analysis. The patient walks a distance of approx. 8 m while being filmed. The apparative gait analysis includes the following elements:
- Film recordings in several planes (2- and 3-dimensional).
- Photographs
- Light trail recordings – reflective markers are placed at defined points on the body that allow continuous registration of body movements
- Measurement of ground contact during gait
- Measurement of the forces acting on the ground
- Registration of the joint position, acceleration and articulation of the body.
- Measurement of muscle activity via electromyography (EMG), which records the electrical excitation of the muscles.
Complementary oxygen consumption measurement is performed to record the patient’s workload through the analysis. Apparatus gait analysis provides accurate, reproducible, diagnostic information about the patient’s musculoskeletal system.
Benefits
Both gait observation and apparative gait analysis represent very complex and informative procedures. The assessment of the gait pattern enables functional diagnostics of the musculoskeletal system and contributes, among other things, to therapy planning and therapy control.
