Gait Analysis: Normal and Pathological Function - A Review of the Best Book on Gait

Gait Analysis Normal And Pathological Function Pdf Download

Have you ever wondered how we walk, run, jump, or dance? How do we coordinate our movements, balance our body, and adapt to different terrains and speeds? How do we detect and correct any abnormalities or impairments in our gait? And how can we use this knowledge to improve our function and quality of life?

Gait Analysis Normal And Pathological Function Pdf Download

If you are interested in these questions, then you need to learn about gait analysis. Gait analysis is the systematic study of human locomotion, which involves measuring, recording, interpreting, and evaluating the movement patterns of the lower limbs and the whole body during walking or other forms of locomotion.

In this article, we will introduce you to the basics of gait analysis, explain the difference between normal and pathological gait patterns, show you how gait analysis can help you in various fields and situations, and guide you to the best book on gait analysis that you can download for free in PDF format.

What is gait analysis and why is it important?

Gait analysis is a multidisciplinary field that combines biomechanics, kinesiology, anatomy, physiology, neurology, orthopedics, physical therapy, engineering, computer science, and more. It aims to understand how humans move from one place to another using their legs and feet, as well as how they interact with their environment.

Definition and purpose of gait analysis

Gait analysis can be defined as "the measurement of body motion during locomotion" (Perry & Burnfield, 2010). It involves collecting data on various aspects of gait, such as joint angles, muscle activity, ground reaction forces, pressure distribution, energy expenditure, speed, cadence, stride length, step width, etc. These data can be obtained using various instruments and devices, such as cameras, sensors, electrodes, force plates, treadmills, etc.

The purpose of gait analysis is to provide objective information about the performance and function of the lower extremities and the whole body during locomotion. This information can be used for several purposes:

• To describe normal or abnormal gait patterns

• To identify the causes or consequences of gait deviations

• To evaluate the effects of diseases or injuries on gait

• To monitor the progress or outcomes of treatments or interventions

• To design or prescribe assistive devices or orthoses

• To optimize athletic performance or prevent injuries

• To develop or improve prosthetic or robotic devices

• To simulate or predict human motion

Types and methods of gait analysis

Gait analysis can be classified into two main types: qualitative and quantitative. Qualitative gait analysis is based on visual observation and subjective judgment of the examiner. It can be done in a clinical setting or in a natural environment, using simple tools such as a stopwatch, a ruler, a goniometer, etc. Qualitative gait analysis can provide a quick and easy assessment of the overall appearance and function of gait, but it has some limitations, such as low reliability, low accuracy, and low sensitivity.

Quantitative gait analysis is based on numerical measurements and objective analysis of the data. It requires specialized equipment and facilities, such as a motion capture system, a force platform, an electromyography system, etc. Quantitative gait analysis can provide a detailed and accurate description and evaluation of the biomechanical parameters of gait, but it has some challenges, such as high cost, high complexity, and high variability.

Both types of gait analysis have their advantages and disadvantages, and they can complement each other in different situations. Depending on the purpose and scope of the gait analysis, different methods and protocols can be used to collect and process the data. Some of the common methods and protocols are:

• The Gait Cycle: The gait cycle is the basic unit of gait analysis. It is defined as the time interval between two successive events of the same foot during walking, such as heel strike, foot flat, heel off, toe off, etc. The gait cycle can be divided into two phases: stance phase and swing phase. The stance phase is the period when the foot is in contact with the ground, and it accounts for about 60% of the gait cycle. The swing phase is the period when the foot is in the air, and it accounts for about 40% of the gait cycle.

• The Gait Parameters: The gait parameters are the variables that describe the characteristics and features of gait. They can be classified into temporal parameters, spatial parameters, kinematic parameters, kinetic parameters, electromyographic parameters, etc. Some examples of gait parameters are speed, cadence, stride length, step width, joint angles, joint moments, joint powers, muscle activity, etc.

• The Gait Events: The gait events are the specific points or instances that mark the transitions or changes in the phases or segments of the gait cycle. They can be identified by using various sensors or markers attached to the body or the footwear. Some examples of gait events are heel strike, foot flat, heel off, toe off, initial contact, midstance, terminal stance, preswing, initial swing, midswing, terminal swing, etc.

• The Gait Patterns: The gait patterns are the distinctive or typical modes or styles of walking or running that can be observed or measured in different individuals or groups. They can be influenced by various factors such as age, gender, height, weight, health status, injury history, footwear type, terrain type, locomotion mode (walking vs running), locomotion speed (slow vs fast), etc. Some examples of gait patterns are normal gait pattern, pathological gait pattern (e.g., antalgic gait, hemiplegic gait, trendelenburg gait, parkinsonian gait, ataxic gait, etc.), athletic gait pattern (e.g., sprinting, jogging, marathon running, etc.), adaptive gait pattern (e.g., walking with crutches, walking with a prosthesis, walking on sand, walking on stairs, etc.), etc.

Benefits and limitations of gait analysis

Gait analysis has many benefits for various fields and applications. Some of the benefits are:

• It can provide objective and reliable information about the function and performance of the lower limbs and the whole body during locomotion.

• It can help diagnose or monitor various diseases or disorders that affect gait (e.g., stroke, cerebral palsy, multiple sclerosis, osteoarthritis, diabetic neuropathy, etc.).

• It can help evaluate or compare the effects or outcomes of different treatments or interventions that aim to improve gait (e.g., surgery, medication, physical therapy, exercise, biofeedback, etc.).

• It can help design or prescribe appropriate assistive devices or orthoses that can enhance or restore mobility and function (e.g., crutches, walkers, wheelchairs, canes, braces, splints, etc.).

• It can help optimize athletic performance or prevent injuries by identifying and correcting biomechanical flaws or imbalances in gait (e.g., overpronation, oversupination, overstriding, heel striking, etc.).

It can help develop or improve prosthetic or robotic devices that can mimic or augment human motion (e.g., artificial limbs, exoskeletons, bionic legs, What are normal and pathological gait patterns?

Normal and pathological gait patterns are two broad categories of gait patterns that can be distinguished by their characteristics and causes. Normal gait pattern is the standard or ideal mode of walking that is efficient, smooth, symmetrical, and functional. Pathological gait pattern is any deviation or abnormality from the normal gait pattern that is caused by a disease, injury, or impairment that affects the musculoskeletal or nervous system.

Characteristics and phases of normal gait

Normal gait pattern has several characteristics that make it optimal for human locomotion. Some of these characteristics are:

• It minimizes the energy expenditure and maximizes the energy recovery during walking.

• It maintains the stability and balance of the body and prevents falls or injuries.

• It preserves the alignment and integrity of the joints and muscles and prevents wear and tear or degeneration.

• It adapts to different speeds, terrains, and tasks and allows for smooth transitions and variations.

Normal gait pattern can be described by using the six determinants of gait, which are the factors that influence the shape and motion of the gait cycle. These determinants are:

• Pelvic rotation: The pelvis rotates about 8 degrees in the horizontal plane in the direction of the swing leg. This reduces the angular displacement of the hip joint and decreases the lateral displacement of the body.

• Pelvic tilt: The pelvis tilts about 5 degrees in the frontal plane toward the stance leg. This lowers the center of gravity and reduces the vertical displacement of the body.

• Knee flexion: The knee flexes about 15 degrees during midstance and about 60 degrees during swing phase. This shortens the length of the leg and decreases the vertical displacement of the body.

• Ankle mechanism: The ankle plantarflexes at toe off and dorsiflexes at heel strike. This increases the length of the leg and propels the body forward.

• Lateral displacement of the foot: The foot follows a curved path during stance phase, moving medially at heel strike and laterally at toe off. This reduces the lateral displacement of the body.

• Knee mechanism: The knee extends slightly at heel strike and flexes slightly at toe off. This increases the length of the leg and stabilizes the knee joint.

Normal gait pattern can also be divided into eight phases based on the position and motion of each foot during one gait cycle. These phases are:

• Initial contact: The moment when the heel of one foot touches the ground at the beginning of stance phase.

• Loading response: The period when the foot is flat on the ground and bears most of the body weight.

• Midstance: The period when the foot is directly under the body and supports all of the body weight.

• Terminal stance: The period when the heel of one foot lifts off from the ground at the end of stance phase.

• Preswing: The period when only the toes of one foot remain in contact with the ground at the beginning of swing phase.

• Initial swing: The period when one foot is lifted off from the ground and swings forward.

• Midswing: The period when one foot passes under the body in midair.

• Terminal swing: The period when one foot approaches the ground at the end of swing phase.

Common gait deviations and their causes

Gait deviations are any variations or differences from the normal gait pattern that can be observed or measured in different segments or parameters of gait. Gait deviations can be classified into primary or secondary deviations. Primary deviations are those that are directly caused by a disease, injury, or impairment that affects the musculoskeletal or nervous system. Secondary deviations are those that are indirectly caused by a compensation or adaptation to a primary deviation or to an external factor such as pain, fatigue, footwear, terrain, etc.

Gait deviations can affect different aspects or components of gait, such as speed, cadence, stride length, step width, joint angles, joint moments, joint powers, muscle activity, etc. Some examples of common gait deviations and their possible causes are:

• Antalgic gait: A gait pattern characterized by a shortened stance phase and a decreased weight bearing on one leg due to pain or discomfort in that leg. It can be caused by various conditions such as arthritis, fracture, infection, inflammation, etc.

• Hemiplegic gait: A gait pattern characterized by a circumduction or outward swing of the affected leg and an arm flexion and abduction of the affected arm due to weakness or paralysis of one side of the body. It can be caused by a stroke, brain injury, spinal cord injury, etc.

• Trendelenburg gait: A gait pattern characterized by a lateral trunk lean toward the stance leg and a hip drop on the opposite side due to weakness or dysfunction of the hip abductor muscles. It can be caused by a nerve injury, muscle atrophy, hip joint disease, etc.

• Parkinsonian gait: A gait pattern characterized by a stooped posture, a shuffling or festinating step, a reduced arm swing, and a difficulty in initiating or stopping movement due to a degeneration of the basal ganglia. It can be caused by Parkinson's disease, medication side effects, etc.

• Ataxic gait: A gait pattern characterized by an unsteady or staggering walk, a wide base of support, and a difficulty in maintaining balance or coordination due to a damage or dysfunction of the cerebellum. It can be caused by a tumor, infection, trauma, alcoholism, etc.

Classification and assessment of pathological gait

Pathological gait patterns can be classified into different types or categories based on their causes, characteristics, or effects. Some of the common classification systems are:

• The Rancho Los Amigos System: This system classifies pathological gait patterns into eight levels based on the degree of motor control and functional ability of the patient. The levels range from level 1 (no voluntary movement) to level 8 (normal movement).

• The Functional Ambulation Categories (FAC): This system classifies pathological gait patterns into six categories based on the amount of assistance or support required by the patient during walking. The categories range from category 0 (non-functional ambulation) to category 5 (independent ambulation).

• The Gait Deviation Index (GDI): This system classifies pathological gait patterns into four groups based on the magnitude of deviation from the normal gait pattern using a numerical score. The groups range from group 1 (severe deviation) to group 4 (normal deviation).

Pathological gait patterns can be assessed using various tools and methods that can measure or evaluate the performance and function of gait. Some of the common tools and methods are:

• The Gait Analysis Laboratory: This is a specialized facility that is equipped with various instruments and devices that can collect and analyze quantitative data on various aspects of gait, such as joint angles, muscle activity, ground reaction forces, pressure distribution, energy expenditure, speed, cadence, stride length, step width, etc.

• The Goniometer: This is a simple device that can measure the joint angles of the lower limbs during gait using two arms that are aligned with the bones.

• The Visual Gait Analysis: This is a qualitative method that involves observing and judging the appearance and function of gait using visual cues such as posture, symmetry, smoothness, stability, etc.

• The Gait Questionnaire: This is a subjective method that involves asking the patient or the clinician to rate or report various aspects of gait such as pain, comfort, satisfaction, confidence, etc.

How can gait analysis help improve function and quality of life?

Gait analysis can help improve function and quality of life for various individuals or groups who have different needs or goals related to their mobility and well-being. Some examples are:

Applications and examples of gait analysis in different fields

Gait analysis can be applied in different fields such as medicine, rehabilitation, sports, engineering, etc. Some examples are:

• In medicine, gait analysis can help diagnose or monitor various diseases or disorders that affect gait (e.g., stroke, cerebral palsy, multiple sclerosis, osteoarthritis, diabetic neuropathy, etc.).

• In rehabilitation, gait analysis can help evaluate or compare the effects or outcomes of different treatments or interventions that aim to improve gait (e.g., surgery, medication, physical therapy, exercise, biofeedback, etc.).

ait (e.g., overpronation, oversupination, overstriding, heel striking, etc.).

• In engineering, gait analysis can help develop or improve prosthetic or robotic devices that can mimic or augment human motion (e.g., artificial limbs, exoskeletons, bionic legs, etc.).

Recommendations and interventions based on gait analysis results

Gait analysis results can provide useful information and feedback that can guide the decision making and planning of various recommendations and interventions that can improve function and quality of life. Some examples are:

• Based on the gait analysis results, the clinician can prescribe appropriate assistive devices or orthoses that can enhance or restore mobility and function (e.g., crutches, walkers, wheelchairs, canes, braces, splints, etc.).

• Based on the gait analysis results, the physical therapist can design or modify a specific exercise program that can strengthen or stretch the muscles, improve the range of motion of the joints, increase the endurance or speed of gait, etc.

• Based on the gait analysis results, the biofeedback therapist can provide real-time feedback or cues that can help the patient correct or improve their gait pattern, such as auditory, visual, tactile, or electrical stimuli.

• Based on the gait analysis results, the engineer can adjust or optimize the parameters or features of the prosthetic or robotic device that can match or complement the patient's gait pattern, such as weight, size, shape, stiffness, damping, control, etc.

Future trends and challenges in gait analysis research and practice

Gait analysis is a dynamic and evolving field that has many opportunities and challenges for future research and practice. Some of the trends and challenges are:

• The development and integration of new technologies and methods that can enhance the accuracy, reliability, validity, usability, accessibility, affordability, and portability of gait analysis systems and devices.

• The exploration and application of new domains and disciplines that can enrich the understanding and interpretation of gait data and phenomena, such as artificial intelligence, machine learning, big data analytics, etc.

• The establishment and standardization of common protocols and guidelines that can ensure the quality and consistency of gait analysis procedures and outcomes across different settings and populations.

• The dissemination and translation of gait analysis knowledge and evidence into clinical practice and policy making that can improve the health and well-being of individuals and communities.

Where can you find and download the best book on gait analysis?

If you want to learn more about gait analysis in depth and detail, you need to read the best book on gait analysis that is available in the market. The book is called "Gait Analysis: Normal and Pathological Function" by Jacquelin Perry and Judith Burnfield. This book is widely recognized as the authoritative text on gait analysis for students, clinicians, and researchers. It covers all aspects of gait analysis from theory to practice in a comprehensive and systematic way. It also provides numerous examples and illustrations that make it easy to understand and apply.

Introduction and overview of the book "Gait Analysis: Normal and Pathological Function" by Jacquelin Perry and Judith Burnfield

and updated in 2010 by the same publisher. The bo