Amputee Gait Analysis & Training

Analysing Amputee Gait Patterns

In many clinical settings, observational gait analysis is the most commonly used form of analysis. Objective measures are crucial for goal setting and to show progress over time, but often there is neither the time, nor equipment, for a detailed biomechanical analysis. Good observational skills, combined with sound clinical reasoning, can provide sufficient information to determine the cause of gait faults, and contribute to generation of a targeted training regime.

The steps for analysing gait are:

  • Observation of gait abnormalities
    • View the subject walking from the front or rear, and from the sides.
    • Be aware of the normal gait kinematics, and what you should expect to see from each view. For example, view frontal plane motions like lateral shift or abduction / adduction from in front or behind. View sagittal plane motions such as knee or hip flexion / extension from the sides.
    • Look for the presence or absence of normal kinematics, and also for adaptive behaviours that may signify difficulties with certain kinematics. For example, a forward trunk lean could be used to help with forward progression due to lack of hip extension, or a wide base of support indicative of poor control over lateral pelvic shift.
    • Compare the pattern observed with normal gait patterns.
  • Measurement of gait abnormalities
    • Consider whether to use global measures of gait, or measures that are specific to what has been observed.
    • For goal setting related to improvement of certain kinematics, the objective measures should be reflective of those kinematics. For example, a 10m walk test will not highlight improvement or otherwise in lateral pelvic shift, whereas measures of step width or base of support (including placement of aids) might.
    • See our page on Measurement Tools, which provides a guide on common assessment tools.
  • Determining the cause of gait abnormalities
    • It is important to ascertain whether the abnormality is due to the prosthesis, or the patient.
    • Knowledge of gait kinetics can be useful in determining causes for gait abnormalities. This knowledge can then be used within clinical reasoning to decide upon further tests to confirm or eliminate potential causes. For example, reduced hip extension could be due to a number of causes, including inability to activate the hip extensors with correct force & timing, shortened hip flexors, or a lack of dorsiflexion. Each potential cause can be tested to find the root cause(s), so that intervention strategies can be specifically targeted.
    • See our Gait Abnormalities page for discussion over causes of gait deviations.

Resources

YouTube has many videos available to allow practice at observing what particular deviations may look like. Links are provided for reference, for cases where access to YouTube is blocked by the Health Service. Many of the following videos were posted by dcraig35, for the VA National Prosthetics Gait Laboratory. Many of the videos contain commentary explaining what the deviations are and how they occur.

 

Other Youtube Videos:

Links & Resources

Analysis of Amputee Gait, Berger N. Atlas of Limb Prosthetics: Surgical, Prosthetic, and Rehabilitation Principles, Ch 14. www.oandplibrary.org/alp/chap14-01.asp

Observation and Analysis of Hemiplegic Gait: Stance Phase. Moseley A et al, (1993). Australian Journal of Physiotherapy, 39, 4, p259.

Observation and Analysis of Hemiplegic Gait: Swing Phase. Moore S et al (1993). Australian Journal of Physiotherapy, 39, 4, p271.