Gait analysis is basically evaluation of the walking pattern. It is also used as a tool in athletes to assess the running pattern or other functionalities. Smallest of the injury can predispose a person to abnormal gait pattern. Study of gait pattern is important as it helps in identifying the biomechanical faults causing the abnormal walking or running pattern.
Abnormal gait pattern causes sheering force on one side of a joint while compressive force on the other side of the joint. As a result, the joint itself and joints above and below are susceptible to injuries over a period of time. For e.g. in ankle an overpronated foot deformity over a period of time may cause knee and hip pain.
Gait abnormalities could be because of nerve injuries, neurological disorders, pain in lower limb, limb discrepancies, spinal abnormalities (scoliosis), muscle tightness or biomechanical faults etc.
The picture shows that an abnormal gait pattern can be due to faulty alignment of hip, knee or foot abnormalities. It can be acquired or genetic.
Common Gait Problems are
Trendelenburg gait – Body sways sideways on one side due to weakness in gluteus medius and minimus. The sway is on the side of weakness to prevent pelvic drop on the opposite side.
Waddling gait – This is due to weakness of abductors on either sides. Patient sways on both sides. It typically appears as duck waddles.
Lurching gait – This is due to weak gluteus maximus muscle (which produces extension at hip joint). In these cases patients either extends the back or uses the hand to push pelvis forward on affected side to cause extension. At times also referred as “pregnant women gait”, as commonly seen in them.
High stepping gait-This is seen in patients with weak dorsiflexors ( unable to bring foot towards shin) or in cases of foot drop (peroneal nerve injury). Patients uses high stepping gait to clear the foot off the ground and to produce forcible dorsiflexion of foot.
Antalgic gait – It is also known as painful gait. Patient walks in clinic with a limp due to any traumatic or systemic painful condition of lower limb or back.
Circumduction gait – Seen mainly is stroke patients. As a result of abnormal movement pattern patient is unable to flex the hip and knee (pertaining to spasticity) properly so the limb is moved ahead in a circular manner using mainly the hip abductors.
Parkinson’s gait/ Festinating gait – Patients with Parkinsonism have difficulty maintaining the centre of gravity within the base of support i.e. area inbetween both legs. So these patients either have slow sluggish gait maintaining centre of gravity within the steps or fast stepping gait to catch up with the centre of gravity that lies ahead (out of base) because of stooping posture.
People can have altered gait pattern as a result of muscle insufficiencies/ biomechanical abnormalities as seen in tibialis posterior insufficiency cases. Patient walks or run with a hyperpronated foot which predisposes the individual to other abnormalities above or below the joint.
Gait analysis can be done in various ways.
- An experienced physiotherapist with good observational skills will be able to detect gait abnormalities purely via observing walking or running pattern.
- Video analysis of gait pattern can be done by slowing down the walking action for both assessment and correction purposes.
- Software based computer analysis can also be used.
Gait analysis helps Physiotherapists make necessary changes in gait pattern, design an appropriate exercise regime to correct the faults and prescribe necessary orthoses to correct the abnormalities.