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CHAPTER OBJECTIVES
At the completion of this chapter, the reader will be able to:
Summarize the various components of the gait cycle.
Apply the knowledge of gait components to gait analysis.
Perform a comprehensive gait analysis.
Categorize the various compensations of the body and their influences on gait.
Recognize the manifestations of abnormal gait and develop strategies to counteract these abnormalities.
Describe and demonstrate many abnormal gait syndromes.
Make an accurate judgment when recommending an assistive device to improve gait and function.
Describe and demonstrate the various gait patterns used with assistive devices.
Evaluate the effectiveness of an intervention for gait dysfunction.
Summarize the components of a postural assessment.
Perform a thorough posture assessment.
Recognize the most common manifestations of abnormal posture.
Make an accurate judgment when recommending postural adjustments.
Evaluate the effectiveness of a postural adjustment.
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Click here to view the video series Introduction to Gait Analysis Rehabilitation for demonstrations of normal and pathological gait.
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OVERVIEW
The assessment of symmetry within locomotion and posture is critical in the evaluation of neuromusculoskeletal dysfunction. For most individuals, gait or posture is an innate characteristic, like their personality or smile. Indeed, many people can be recognized in a group by their gait or posture. This chapter describes the various components of gait and posture and provides the clinician with the necessary tools to analyze each.
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GAIT AND THE GAIT CYCLE
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The lower kinetic chain has two main functions: to provide a stable base of support (BOS) in standing and to propel the body through space with gait. During gait, the body follows the least restrictive pathway in the most efficient manner.1 To maintain this efficiency, the body attempts to maintain a level center of gravity (COG) in all planes. While maintaining a static equilibrium of forces, mobility aims to create and control dynamic, unbalanced forces to move purposefully.2 Thus, gait is an example of controlled instability. It is not clear whether gait is learned or is preprogrammed at the spinal cord level. However, once mastered, gait allows us to move around our environment efficiently, requiring little in the way of conscious thought, at least in familiar surroundings. The evolution of bipedal gait has allowed the arms and hands to be free to explore the environment. Even though gait appears to be a simple process, it is prone to break down.
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Gait is initiated grossly in the spinal cord and then fine-tuned by the higher brain centers.2 Pain, weakness, and disease can all cause a disturbance in the rhythm of normal gait. However, except in obvious cases, abnormal gait does not always equate with impairment.
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In addition to neural input, normal human gait also involves a complex synchronization of the cardiopulmonary and muscular systems in which the ...