Overview of Impairment
Professor of Clinical Gait Analysis
Within the competence of the authors
Stage 1: Look at the graphs and identify
Stage 2: Interpret what these features
• There are only a certain number of ways
you can interpret and report on gait
• Methods have been developed primarily
for use in assessing children with CP for
multi-level surgery (May need to be
adapted for other contexts).
• This presentation focuses purely on the
interpretation of biomechanical data -
other types of data are important but are
not specific to the gait analysis process.
Impairment focussed interpretation
• The aim of clinical gait analysis is to:
identify the impairments which are most likely
to be affecting the gait pattern.
• This is achieved by:
recognising features in the gait data and
relating these to supplementary data
A problem in body structures or functions
such as significant deviation or loss1.
• Hip flexion contracture
• Gastrocnemius spasticity
• Excessive femoral anteversion
• Gluteus medius weakness
1WHO International Classification of Functioning, Disability and Health, 2001
A specific aspect of the gait traces that is
clinically important (something you can see on a
• Increased anterior pelvic tilt throughout the gait
• Too much plantarflexion at initial contact
• Reduced rate of knee flexion in late stance
• Hip rotation within normal limits throughout cycle
• Increased plantarflexor moment in early stance
Terminology: Supplementary data
Information which is not represented in the
• Limited range of hip extension of clinical
• Increase in resting tone of plantarflexors
• Excessive anteversion as measured by
Impairment focussed reporting
• One of the impairments affecting the walking pattern is:
– a tight left hip flexor.
This is suggested by:
– “Single bump pattern” of left pelvic tilt
– Too little left hip extension in late stance.
– restricted hip extension on clinical exam
Orientation to patient
General impression of gait
• Temporal spatial parameters
• Gait classification(?)
• Impressions from video
Orientation to walking pattern
Hof, A., Scaling gait data to body size.
Gait and Posture, 1996. 4: p. 222-223.
Orientation to data
• Temporal spatial parameters
• Is the data likely to be representative of
the person’s usual walking pattern?
• Are there concerns regarding consistency
• Is there any evidence of measurement
artefact in the data?
• Group features and supplementary data
that might be related to an impairment.
• Identify that impairment.
• Fluid process (may require adjustment of
groups as understanding of gait data
Add relevant comments
• Depends on competence of analyst.
“Current AFOs are cast in plantarflexion and then posted
(this is within the shoe so not apparent on gait graphs).
Sam has a good range of dorsiflexion and it is not clear
why this is required. Holding the ankle in plantarflexion
allows a little more knee extension in middle stance but this
might reduce the stretch on the gastroc during walking
which might not be helpful in the long run”.