One gait cycle is measured from heel-strike to heel-strike and consists of a stance phase where the foot is on the ground (~60% of cycle) and a swing phase where the foot is off the ground moving forward (~40% of cycle). An antalgic gait develops to avoid pain and is characterized by a shortened stance phase relative to swing phase. Steppage gait involves lifting the leg high and dropping the foot due to drop foot. The Trendelenburg sign indicates abductor weakness through a contralateral hip drop during weight bearing. The Thomas test evaluates for fixed hip flexion contractures by assessing contralateral hip lift. Limb length discrepancies can be measured in supine by

1. Gait Cycle
One gait cycle is measured from heel-strike to heel-strike
Consists of
 stance phase
o period of time that the foot is on the ground
o ~60% of one gait cycle is spent in stance
o during stance, the leg accepts body weight and provides single limb support
 swing phase
o period of time that the foot is off the ground moving forward
o ~40% of one gait cycle is spent in swing
o the limb advances
An antalgic gait is a gait that develops as a way to avoid pain while walking (antalgic = anti- + alge,
"against pain"). It is a form of gait abnormality where the stance phase of gait is abnormally
shortened relative to the swing phase. It is a good indication of weight-bearing pain. It is the most
common type of limp people can have.
Steppage gait. A “high stepping” type of gait in which the leg is lifted high, the foot drops
(appearing floppy), and the toes points downward, due to drop foot.

2. Special tests of the HIP
ROM of the Hip: (Simplified numbers)
Flexion
120-135 deg (Thomas test evaluates hip flexion contractures)
Extension
30 deg
Abduction
50 deg
Adduction
30 deg
Internal rotation
30 deg
External rotation
50 deg
Trendelenburg sign
 secondary to abductor weakness
 weight bearing on the affected hip leads to a contralateral hip drop

3. Thomas Test
 With patient supine, fully flex one hip.
 if contralateral hip lifts off table, there is likely a fixed flexion deformity

4. Lower Limb measurement and limb length discrepancy:
In the supine position, the true and apparent leg lengths can be measured using a tape measure.
The apparent leg length is measured from umbilicus to medial malleolus. The true leg length is
measured from the anterior superior iliac spine to the medial or lateral malleolus.
Apparent length: Pelvis + Lower limb
True length: Lower limb

5. The Galeazzi sign is elicited by placing the child supine with both hips and knees flexed
(Figure 3). An inequality in the height of the knees is a positive Galeazzi sign
With the feet on the table, tibial length differences are apparent (red arrows). With the hips flexed
and the feet free, note the differences in femoral lengths (blue lines). This test can also be
performed with the patient prone. This allows the knees to be flexed to a full 90°.