This document outlines the principles and process of impairment-focused gait analysis interpretation. It discusses key terminology like impairment, feature, and supplementary data. The process involves four steps: orientation to the patient, walking pattern and data; marking features on graphs; grouping features and data into potential impairments; and reporting findings and interpretations. The goal is to identify impairments likely affecting the gait pattern by recognizing features in the data and relating them to other exam information.

1. Overview of Impairment
Focussed Interpretation
Richard Baker
Professor of Clinical Gait Analysis
1

2. Principles
Relevant
Succinct
Transparent
Evidence based
Comprehensive
Within the competence of the authors
Time efficient
2

3. Practice
Stage 1: Look at the graphs and identify
gait features
Stage 2: Interpret what these features
mean.
3

4. Disclaimers
• There are only a certain number of ways
you can interpret and report on gait
analysis data.
• Methods have been developed primarily
for use in assessing children with CP for
multi-level surgery (May need to be
adapted for other contexts).

5. Disclaimers
• This presentation focuses purely on the
interpretation of biomechanical data -
other types of data are important but are
not specific to the gait analysis process.

6. Impairment Focussed
Interpretation
6

7. Impairment focussed interpretation
• The aim of clinical gait analysis is to:
identify the impairments which are most likely
to be affecting the gait pattern.
• This is achieved by:
recognising features in the gait data and
relating these to supplementary data

8. Terminology: Impairment
A problem in body structures or functions
such as significant deviation or loss1.
• Hip flexion contracture
• Gastrocnemius spasticity
• Excessive femoral anteversion
• Gluteus medius weakness
1WHO International Classification of Functioning, Disability and Health, 2001

9. Terminology: Feature
A specific aspect of the gait traces that is
clinically important (something you can see on a
graph)
• Increased anterior pelvic tilt throughout the gait
cycle
• Too much plantarflexion at initial contact
• Reduced rate of knee flexion in late stance
• Hip rotation within normal limits throughout cycle
• Increased plantarflexor moment in early stance

10. Terminology: Feature

11. Terminology: Supplementary data
Information which is not represented in the
gait graphs.
• Limited range of hip extension of clinical
exam
• Increase in resting tone of plantarflexors
• Excessive anteversion as measured by
CT

12. Impairment focussed reporting
• One of the impairments affecting the walking pattern is:
Impairment
– a tight left hip flexor.
This is suggested by:
– “Single bump pattern” of left pelvic tilt
Features
– Too little left hip extension in late stance.
and
– restricted hip extension on clinical exam
Supplementary data

13. Process

14. Process
Four steps:
Orientation
Mark-up
Grouping
Reporting

15. Orientation
• Get to know the patient
• Get to know the walking pattern
• Get to know the data

16. Orientation to patient
• Diagnosis
– GMFCS
– Topography
• Level of function
– Functional Assessment Questionaire
– Functional Mobility Scale
• Reason for referral
• Relevant history

17. Orientation to patient

18. Orientation to patient
General impression of gait
• Temporal spatial parameters
• Gait classification(?)
• Impressions from video

19. Orientation to walking pattern
Hof, A., Scaling gait data to body size.
Gait and Posture, 1996. 4: p. 222-223.

20. Orientation to data
• Temporal spatial parameters
• Quality

21. Quality
• Is the data likely to be representative of
the person’s usual walking pattern?
• Are there concerns regarding consistency
of traces?
• Is there any evidence of measurement
artefact in the data?

22. Quality

23. Process
Four steps:
Orientation
Mark-up
Grouping
Reporting

24. Mark-up
5 characteristics
Side: Left
Variable: Hip flexion
Type: Too much
Timing: Late stance
Magnitude: Marked

25. Mark-up

26. Process
Four steps:
Orientation
Mark-up
Grouping
Reporting

27. Grouping
• Group features and supplementary data
that might be related to an impairment.
• Identify that impairment.
• Fluid process (may require adjustment of
groups as understanding of gait data
progresses).

28. Grouping

29. Process
Four steps:
Orientation
Mark-up
Grouping
Reporting

30. Report
• List findings (impairments)
• Arrange information in correct order
• Add any relevant comments

31. Findings

32. Arrange information

33. Add relevant comments
• Depends on competence of analyst.
“Current AFOs are cast in plantarflexion and then posted
(this is within the shoe so not apparent on gait graphs).
Sam has a good range of dorsiflexion and it is not clear
why this is required. Holding the ankle in plantarflexion
allows a little more knee extension in middle stance but this
might reduce the stretch on the gastroc during walking
which might not be helpful in the long run”.

34. Sample
report

35. Sample
report

36. Sample
report

37. Sample
report

38. Sample
report