Gait Assessment of

Neurologically
g y Challenged
g
Patients
Cathelyn Timple, PT, DPT, NCS, ATP
Casa Colina Centers for Rehabilitation
 Objectives
Understand normal gait mechanics and terminology

Recognize pathological gait patterns commonly associated with

visual and vestibular deficits in neurologically
g y challenged
g
patients.

Administer the Functional Gait Assessment and the 10-Meter

W lk Test
Walk T t
Normal Gait
“repetitious sequence of limb motion to move the body
forward while simultaneously maintaining stance
stability
Observational
Gait Analysis
•Qualitative visual description
of an individual’s upper and
lower extremities, pelvis and
trunkk motions d
during
ambulation.
 Normal Human Gait
Stride

Stance Swing

Weight Acceptance Single Limb

AdvancementLimb
Support

Initial Contact Loading Response Mid Stance Terminal Stance PreSwing Initial Swing Mid Swing Terminal Swing
 Normal Human Gait
STANCE: 62% SWING 38%

IC LR MSt TSt PSw ISw MSw TSw

Weight Single Limb Swing Limb Advancement

Acceptance Support
 Stance Phase
Initial Contact (IC):
(IC) The moment when the foot
contacts the ground
 Stance Phase
Loading Response (LR):
(LR) Weight is rapidly transferred
onto the outstretched limb, the first period of double-
limb support
 Stance Phase
Mid-Stance
Mid Stance (MSt): The body progresses over a single,
single
stable limb.
 Stance Phase
Terminal Stance (TSt): Progression over the stance
limb continues. The body moves ahead of the limb
and weight is transferred onto the forefoot.
 Stance Phase
Pre-Swing
Pre Swing (PSw): A rapid unloading of the limb
occurs as weight is transferred to the contralateral limb.
 Swing Phase
Initial Swing (ISw): The thigh begins to advance as
the foot comes up off the floor.
 Swing Phase
Mid-Swing
Mid Swing (MSw): The thigh continues to advance as
the foot comes up off the floor.
 Swing Phase
Terminal Swing (TSw): The knee extends;
extends the limb
prepares to contact the ground for Initial Contact.
Pathological Gait
Analysis
Common Descriptive
p Terms for
Abnormal Gait
Antalgic Hiking

Ataxic Trendelenberg

Athetoid Toe Drag

Festinating Vaulting

Scissoring Unstable

Shuffling Extensor syngery

Steppage Flexor syngery

Qualitative Gait Analysis
Form
Quantitative Gait Analysis
Functional Gait Assessment
Standardized test for assessing postural instability
during various walking tasks

10- item gait assessment based on the Dynamic Gait

10
Index

Equipment: Stopwatch,
Equipment Stop atch marked walking
alking area,
area shoe box
bo
for obstacle, set of steps

Scoring:
S i g 0 ffor severe iimpairment
i t tto 3 ffor normall
performance; maximum score possible is 30.
Functional Gait Assessment
Gait Level Surface Step over Obstacle

Change in Gait Speed Gait with Narrow Base of

Support
pp
Gait with Horizontal
Head Turns Gait with Eyes Closed

Gait with
G h Vertical
V l Head
H d A b l
Ambulation B
Backwards
k d
Turns
Steps
G it and
Gait d Pivot
Pi t Turn
T
 Functional Gait Assessment
Reference Group Data
Age N Min Max Mean SD CI
Score Score
40-49 27 24 30 28.9 1.5 28.2-29.5
50 59
50-59 33 25 30 28 4
28.4 16
1.6 27 9 29 0
27.9-29.0
60-69 63 20 30 27.1 2.3 26.5-27.7
70-79 44 16 30 24.9 3.6 23.9-26.0
80-89 33 10 28 20.8 4.7 19.2-22.6
TOTAL 20 10 30 26.1 4.0 25.5-26.6
 10-Meter Walk Test
Examines gait speed

To administer test:
Measure a 10 meter course and
M d markk ends
d with
i h tape
Position subject 3 feet behind tape
Instruct the subject to walk at a comfortable rate until
he is 3 feet past the time line
Repeat up to 3 times and average the times
Instruct the
h subject
b to walk
lk as above
b , but
b as fast
f as
possible
Repeat
p up p to 3 times and averageg the times
 10-Meter Walk Test
Comfortable (m/min) Maximum (m/min)

Gender/Deca Men Women Men Women

d
de
20s 83.6 84.4 151.9 148.0
30s 87.5 84.9 147.4 140.5
40s 88.1 83.5 147.7 127.4
50s 83.6 83.7 124.1 120.6
60s 81.5 77.8 115.9 106.4
70s 79.5 76.3 124.7 104.9
CASE STUDY
QUESTIONS????
 REFERENCES
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