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Chapter 4: Evaluation of Gait

Monique Mokha

Observational Gait Analysis

Box 4-1 Observational Gait Analysis

Using an OGA written tool, the presence or absence of the critical events in the gait cycle can be determined. When preparing for your analysis, refer to the following OGA guidelines:

  1. Prepare the area and materials ahead of time.

  2. Avoid clutter in the viewing background.

  3. Have the patient wear clothing that does not restrict viewing of joints.

  4. Ensure that the patient is at a self-selected walking pace; otherwise, gait will be altered.

  5. Position yourself so you can view the individual segments (i.e., if you are observing for forefoot pronation and supination, then squat down so your eyes are in line with the patient's feet).

  6. Observe the subject from multiple views (anterior, posterior, and both lateral views) but not from an oblique angle.

  7. Look at the individual body parts first, then the whole body, then the individual parts again.

  8. Conduct multiple observations or trials.

  9. Conduct the analysis with the patient barefoot and wearing shoes.

  10. Label all video files.

Gait Terminology

Box 4-2 Common Spatial Gait Terminology

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  Definition Significance Adult Norm

Step Length

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 Linear distance between successive points of contact of contralateral feet Should be symmetrical right to left; shortens in attempt to decrease contact time; shortens on one side with limb injury or pain; shortens bilaterally with injury (e.g., low back pain) or complex disorders such as multiple sclerosis; increases typically as velocity increases 75 ± 1.6 cm

Step Width

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 Mediolateral distance between successive points of contact of contralateral feet A function of balance; if increased, suspect pathology (e.g., traumatic brain injury, tight hip abductors, inner ear infection); decreases typically as velocity increases and may even see a crossover 8.2 ± 0.8 cm

Stride Length

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 Linear distance between points of contact of ipsilateral foot; length of two sequential steps See step length 150 ± 3.2 cm

Foot Angle

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 Angle of the foot (imaginary line from heel to second toe) relative to the line of progression Negative value can indicate internal rotation (toeing in), and positive value can indicate external rotation (toeing out) of the lower extremity during stance +10 degrees indicating slight external rotation is normal

Box 4-3 Common Temporal Gait Terminology

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  Definition Significance Adult Norm
Cadence Walking rate measured in the number of steps per minute

Slow <70 steps/min

Fast >120 steps/min

 ~107 steps/min
Velocity Distance walked per unit time such as meters or centimeters per second Overall predictor of functional disability ~140 ± 4.8 cm/s
Comfortable Walking speed "Free speed," or the speed selected by the patient that feels most natural The speed that expends the least amount of energy; decreases with age 80 m/min
Stance Time Amount of time spent in contact with surface by single limb Increases at slower walking velocities; decreases with faster walking velocities; decreases on side with ...

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