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INTRODUCTION

Gait is the manner a person walks or runs. As a key component of an individual’s functional assessment, gait evaluation can provide diagnostic information about underlying conditions, such as functional ankle instability, traumatic brain injury, and low back pain, which disrupt gait.

OBSERVATIONAL GAIT ANALYSIS

Gait can be evaluated qualitatively, by assessing and describing the quality of movement without the use of specialized instruments, and quantitatively, in which aspects of gait are measured objectively. Clinicians who are professionally trained in gait analysis can combine these two methods to yield comprehensive results that serve as the basis for intervention planning. This chapter focuses on qualitative evaluation using observational gait analysis (OGA) (Box 7-1).

Box 7-1 Guidelines for Observational Gait Analysis

Use an OGA written tool to identify the presence or absence of the critical events in the gait cycle. When preparing for and conducting 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. Ask the patient to 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 of the gait cycle (e.g., 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 patient from multiple views (i.e., anterior, posterior, and both lateral views), but not from an oblique angle. When possible, video record gait to allow for multiple viewing opportunities.

  7. Observe the individual body parts first, then the whole body, and then the individual parts again.

  8. Conduct multiple observations or trials.

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

  10. Document all pertinent findings and label all video files.

OGA is a functional evaluation of a person’s walking or running style in which gait deviations are identified from gross observation. Several tools have been developed to guide and organize an OGA, such as Rancho Los Amigos Medical Center’s Observational Gait Analysis Handbook1 and the Rivermead Visual Gait Assessment (RVGA).2 The patient is asked to walk and/or run with and without shoes on a treadmill or in a designated area. Although this is the most common3 method of gait analysis, it has poor to moderate intrarater reliability.4 Reliability improves with training, experience, by using recorded video that can be studied in slow motion and replay, and by using a specific observational tool (Fig. 7-1).

FIGURE 7-1

Sample observational gait analysis tool.

image Practical Evidence

Using a formal approach to an OGA and recording on a structured form improves reliability.2

OGA tools can be helpful to identify gross gait deviations such as ...

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