Quantitative gait analysis: principles and clinical applications

S. Lobet, C. Hermans , Ch. Detrembleur Published in the journal : April 2016 Category : Physical and Rehabilitation Medicine

Summary :

Walking is a set of repetitive cyclical movements in the three planes of space. This complex process involves not only the lower-limb joints, but also the entire body. Walking may be impaired by a variety of musculoskeletal disorders of peripheral/central neurological, muscular, or osteoarticular origin, associated with compensatory mechanisms such as limping.

Owing to medical and technical advances, gait laboratories have been implemented, pursuing the following objectives: 1) to accurately assess locomotor disorders so as to optimize therapeutic options, especially in children with cerebral palsy; 2) to quantify the effects of therapeutic procedures such as neurotomy or total ankle arthroplasty; 3) to better understand the impact of these diseases on walking mechanics and eventually on patients’ functional limitations. Gait analysis requires the joint acquisition of global and segmental kinematic variables, dynamic variables, as well as energetic and electromyographic variables. Segmental kinematic variables are used to describe the displacements of body segments in the three planes. The latter are recorded using infrared cameras, allowing for the patient gait to be reconstructed in three dimensions. While recorded using a force platform, dynamic variables determine the movementproducing muscular forces as well as the type of muscle contraction performed. Unconsciously, we walk using minimum energy consumption. Energetic variables, which record the amount of oxygen consumed per unit of distance traveled, are an excellent indicator of the “strenuousness” encountered by patients while moving. Electromyography is used to identify the muscles involved in movements.

What is already known about the topic?

1. Walking requires combined action of several muscles and joints in order to allow the body to move forward with an optimum efficiency, i.e., minimum energy consumption.
2. Gait efficiency is impaired to a greater or lesser extent by a variety of orthopedic and neurological disorders, which substantially increase the metabolic cost of walking.
3. These disorders are mostly assessed by means of radiological or clinical examinations, i.e., in static position without leaning on the damaged limb.

What does this article bring up for us?

1. The originality of gait analysis lies in the accurate assessment of the joints’ functional component under dynamic conditions.
2. Gait analysis also enables a more comprehensive assessment of articular disorders’ impact on mechanical parameters and energy consumption.
3. A good mobility of the lower limbs and pelvic joints is critical to an efficient gait.

Key Words

Gait analysis, kinematics, kinetics, metabolic cost