This document discusses gait assessment and analysis. There are two main ways to analyze gait: the Los Ranchos Amigos method and the standard/classic method. Gait can be affected by various musculoskeletal issues like hip, knee, foot/ankle pathology, leg length discrepancy, or pain. Specific conditions may cause deviations like "hip hiking" from arthritis, "scissor gait" from hip adductor contractures, or a Trendelenburg gait from hip abductor weakness. Common gait assessment tests are described like the Timed Up and Go, 6-Minute Walk Test, and Tinetti Test which evaluates gait and balance in older adults.

1. GAIT ASSESSMENT
By: Brina Kitts

2. Gait Analysis
There are two acceptable ways to analyze gait
pattern:
A. Los Ranchos Amigos:
o Initial contact
o Loading response
o Midstance
o Terminal stance
o Preswing
o Initial swing
o Midswing
o Terminal swing
B. Standard
(Classic):
o Heel strike
o Foot flat
o Midstance
o Heel off
o Toe off
o Midswing
o Heel strike

3. Gait Pattern Deviations
There are many different musculoskeletal causes for deviation within a gait pattern:
Hip Pathology
Knee pathology
Foot and ankle pathology
Leg length discrepancy
Pain

4. Affects of gait due to hip
pathologies:
◦ Arthritis- An arthritic hip has reduced range of movement during swing phase which causes
an exaggeration of movement in the opposite limb that is known as ‘hip hiking’
◦ Excessive hip flexion- alters gait pattern most commonly due to: Hip flexion contractures, IT
band contractures, Hip flexor spasticity, Compensation for excessive knee flexion and ankle DF,
Hip pain, Compensation for excess ankle plantar flexion in mid swing
◦ Hip abductor weakness- will cause the hip to drop towards the side of the leg swinging
forward. This is also known as Trendelenburg gait.
◦ Hip adductor contracture- during swing phase the leg crosses mid-line due to the weak
adductor muscles, this is known as ‘scissor gait’
◦ Weak hip extensors- will cause a person to take a smaller step to lessen the hip flexion required
for initial contact, resulting in a lesser force of contraction required from the extensors
◦ Hip flexor weakness- results in a smaller step length due to the weakness of the muscle to
create the forward motion. Gait will likely be slower and may result in decreased floor
clearance of the toes and create a drag

5. Affects of gait due to knee pathologies:
o Weak quadriceps- weakness of these muscles causes the hip extensors
to compensate by bringing the limb back into a more extended position,
reducing the amount of flexion at the knee during stance phase. Instead
heel strike will occur earlier, increasing the ankle of plantar flexion at
the ankle, preventing the forward movement of the tibia, to help
stabilize the knee joint
o Severe quadriceps weakness- instability will present in hyperextension
during the initial contact to stance phase. The knee joint will ‘snap’ back
into hyperextension as the body weight moves forward over the limb
o Knee flexion contraction- knee is restricted in extension, meaning heel
strike is limited and step length reduced. To compensate the person is
likely to ‘toe walk’ during stance phase

6. Affects of gait due to ankle
pathologies:
◦ Ankle dorsiflexion weakness- results in a
lack of heel strike and decreased floor
clearance
◦ Calf tightening or contractures- will cause
reduced heel strike due to restricted
dorsiflexion. The compensated gait result
will be ‘toe walking’ on stance phase,
reduced step length and excessive knee
and hip flexion during swing phase to
ensure floor clearance

7. Leg Length Discrepancy
◦ Leg length discrepancy can be as a result of
an asymmetrical pelvic, tibia, or femur
length or for other reasons, such as a
scoliosis or contractures.
◦ The gait pattern will present as a pelvic dip
to the shortened side during stance phase
with possible ‘toe walking’ on that limb.
◦ The opposite leg is likely to increase its
knee and hip flexion to reduce its length

8. Antalgic Gait
Knee pain-presents with decreased weight
bearing on the affected side
Ankle pain- may present with a reduced
stride length and decreased weight bearing
on the affected limb
Hip pain- results in reduced stance phase
on that side

9. Common Neurological Causes of
Pathological Gait
◦ Hemiplegic gait
◦ Diplegic gait
◦ Parkinsonian gait
◦ Ataxic gait
◦ Myopathic gait
◦ Neuropathic gait

10. Hemiplegic Gait
◦ often seen as a result of a stroke

11. Diplegic Gait
◦ Spasticity is normally associated with both lower limbs

12. Parkinsonian Gait
◦ often seen in Parkinson’s disease or associated with conditions which cause Parkinson’s

13. Ataxic Gait
◦ seen as uncoordinated steps with a wide base of support and swaying foot placement

14. Myopathic Gait
◦ Due to weakness of hip muscles- if it is bilateral the presentation will be a ‘waddling gait’,
unilaterally will present as a Trendelenburg Gait

15. Neuropathic Gait
◦ High stepping gait to gain floor clearance often due to foot drop

16. Common Tests for Gait Assessment
◦ 6 Minute Walk Test - measures the distance an individual is able to walk over a total of six
minutes on a hard, flat surface. The goal is for the individual to walk as far as possible in six
minutes. Patient is allowed to self-pace and rest as needed as they navigate back and forth
along a marked walkway
◦ Tinetti-Test – assesses the gait and balance in older adults. It is therefore also called:
performance-oriented mobility assessment. Good indicator of fall-risk assessment

17. Tinetti Test

18. Common Tests for Gait Assessment
(cont.)
Timed Get Up and Go (TUG)- the patient is to wear their regular footwear and can use a
walking aid if needed. Begin by having the patient sit back in a standard arm
chair and identify a line 3 meters or 10 feet away on the floor.
Instructions to the patient:
◦ When I say “Go,” I want you to:
◦ 1. Stand up from the chair
◦ 2. Walk to the line on the floor at your normal pace
◦ 3. Turn
◦ 4. Walk back to the chair at your normal pace
◦ 5. Sit down again

19. That concludes this in-service on gait
assessment!
Thank You!!