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At least 307 records · Page 17Linked to original sources
PubMed2006

[Optoelectronic gait analysis after metatarsophalangeal arthrodesis of the hallux: fifteen cases].

PURPOSE OF THE STUDY: Degeneration of the metatarsophalangeal joint of the hallux is a frequent secondary lesion of the first ray subsequent to hallux valgus. Different surgical techniques have been proposed for cure, including metatarsophalangeal arthrodesis. Joint fusion relieves pain but sacrifices joint motion. The purpose of this work was to assess changes observed in gait after metatarsophalangeal arthrodesis of the hallux using a three-dimensional optoelectronic system. MATERIAL AND METHODS: Gait analysis was performed with a Vicon 3D system with five cameras and two AMTI force platforms in twelve patients who had undergone metatarsophalangeal arthrodesis more than six months earlier. The kinetic and kinematic curves and ground reaction forces were analyzed. Changes in the gait cycle and any compensations observed in the talocrural and interphalangeal joints were noted in the three dimensions. Wilcoxon test for paired series was applied for the statistical analysis. RESULTS: The general gait parameters and kinetic and kinematic values were not modified (excepting a non-significant decline in maximal dorsiflexion of the ankle joint). There was a significant decrease in propulsion force in the anteroposterior and vertical planes, with significantly later heal lift-off and systematic displacement of ground reaction forces anterior to the metatarsophalangeal joint on the arthrodesis side. Reflectors positioned on the distal extremity of the hallux demonstrated that the essential part of compensation occurred at the level of the interphalangeal joint. DISCUSSION: Gait analysis after tibiotalar arthrodesis has been widely reported in the literature. The consequence of joint fusion on the rear foot and/or the torsion couple have also been studied. However, to our knowledge, there has been only one report using a different methodology devoted to metatarsophalaneal arthrodesis of the hallux. In this study, only step length and interphalangeal moment as well as ankle force were found to be decreased. Function of the interphalangeal joint was not assessed. The Vicon system enabled an adapted study of gait after metatarsophalangeal arthrodesis. This method offers several perspectives: study of the effect of the position of the arthrodesis in the sagittal plane on gait, changes over time in interphalangeal joint motion, or consequences of fusion on walking up and down stairs. CONCLUSION: Metatarsophalangeal arthrodesis of the hallux does not modify general gait parameters nor the kinetic and kinematic values. Compensation is achieved via the interphalangeal joint.

Aged↗
PubMed2003

[Three dimensional gait analysis and controlling spastic foot on stroke patients].

INTRODUCTION: The purpose of this work is to assess the interest of three dimensional gait analysis in measuring the effect of orthesis and of selective tibial neurotomy without visual analysis. METHOD: After clinical examination, gait in the two groups was recorded by a three dimensional motion system (Vicon-Oxford Metrics) with free velocity. The gait of ten stroke patients was compared bare-foot and with ankle-foot orthesis. The gait of nine stroke patients was compared bare-foot before and six month after selective tibial neurotomy. Kinematics data were studied in the sagittal plane, and muscular electrical activity was detected on the affected side by a ten-channel telemetry system using surface electrodes. An analogic visual scale ( EVA) was used by the patient, to assess discomfort during walking. RESULTS: In the "orthesis" group, calf spasticity was 2.5 on the Ashworth scale. With ankle-foot orthesis, the walking discomfort on EVA was significantly reduced from 4.25 to 1.16. Gait speed increased significativelly at 0.42 m s(-1) to 0.59 m s(-1). In swing phase, equinus disappeared. In stance phase equinus and recurvatum were controlled, anterior pelvic tilt decreased and hip extension increased. In the "neurotomy" group, 6 months after the tibial neurotomy, calf spasticity decreased from 3.4 to 0. The walking discomfort on EVA, was significantly reduced from 5.97 to 3.6. Gait speed increased from 0.51 m s(-1) to 0.54 m s(-1). Ankle dorsiflexion on the affected side, was possible during stance for five patients and residual motricity was released during swing phase for two patients. Stance knee recurvatum was corrected in five patients. CONCLUSION: Three dimensional analysis specifies the functional gait disability in stroke patients. It specifies the degree of correction provided by orthesis or tibial neurotomy in the various gait cycle phases and the impact on the superior joints.

Adult↗
PubMed2000

Three-dimensional gait analysis in women with a total hip arthroplasty.

OBJECTIVES: The purposes of this study were: (1) to identify the primary (hip) and secondary (neighboring joints) impairments during gait in subjects with a total hip arthroplasty total hip arthroplasty, (2) to determine which impairments persist when controlling for gait speed and (3) to study the relationships between primary and secondary impairments in order to describe the locomotor strategies used by these patients.DESIGN. This cross-sectional study compared the gait patterns of women with a total hip arthroplasty to those of healthy women.BACKGROUND. Several studies have reported residual hip impairments in the sagittal plane during gait after a total hip arthroplasty. There is, however, a substantial lack of knowledge in regard to the changes at the neighboring joints and in the other planes of movement.METHODS. Subjects have been examined during a gait laboratory testing session including the simultaneous recording of three-dimensional kinematics and ground reaction forces on one side, and bilateral activation of six lower limb muscles.RESULTS. A significant decrease of 20% in the hip extensor moment of force during the early stance phase was correlated (R(2)=43%) with a significant decrease of 14% in gait speed. Moreover, a significant decrease of 59% in the range of hip extension at the end of the stance phase was observed together with secondary impairments such as a significant increase in the anterior pelvic rotation, in knee flexion and in ankle dorsiflexion. Lastly, a significant increase in ipsilateral bending of the trunk during the single limb support on the operated limb was concomitant with a significant decrease in the hip abductor moment of force.CONCLUSIONS. The decrease in gait speed and the persistence of abnormal gait patterns one year after the total hip arthroplasty were associated respectively with a decrease in the hip extensor moment of force and with a decrease in the range of hip extension (sagittal plane) or in the hip abductor moment of force (frontal plane). RelevanceThe data provided in this paper may serve as guidelines to establish rehabilitation programs designed to restore optimal locomotor function.

Adaptation, Physiological↗
PubMed2002

Gait mechanics in chronic ACL deficiency and subsequent repair.

OBJECTIVE: To determine how normal gait patterns may change as a result of chronic anterior cruciate ligament deficiency and subsequent reconstructive surgery. DESIGN: Gait testing of 10 chronic anterior cruciate ligament deficient subjects prior to and 3 months following reconstructive surgery, and 10 uninjured controls. BACKGROUND: There is controversy whether persons with chronic anterior cruciate ligament deficiency develop a "quadriceps avoidance" pattern and how anterior cruciate ligament reconstructive surgery influences gait mechanics in these same individuals. METHODS: Gait analysis was employed to determine kinematic, kinetic, and muscle Electromyographic data. RESULTS: Prior to surgery, no anterior cruciate ligament deficient subject exhibited a quadriceps avoidance pattern. Following surgery, the subjects exhibited a significantly greater knee extensor moment during early stance as compared to the control group. Prior to and following surgery, anterior cruciate ligament deficient subjects demonstrated a significantly greater hip extensor moment possibly to reduce anterior tibial translation. CONCLUSIONS; These data suggest that (1) development of a quadriceps avoidance pattern is less common than previously reported, (2) anterior cruciate ligament deficient subjects accommodate through alterations of hip joint mechanics, (3) surgical repair significantly alters lower extremity gait patterns, and (4) re-establishment of pre-injury gait patterns takes longer than 3 months to occur. RELEVANCE: The results suggest that chronic anterior cruciate ligament deficient subjects do not exhibit a quadriceps avoidance gait pattern. Surgical intervention significantly alters lower extremity gait mechanics in a population that has accommodated to anterior cruciate ligament deficiency.

Adult↗
PubMed2000

Intra-articular knee joint effusion induces quadriceps avoidance gait patterns.

OBJECTIVES: (1) To identify adaptations caused by intra-articular knee joint effusion during walking and (2) to determine if knee joint effusion may be a causative factor in promoting quadriceps avoidance gait patterns. DESIGN: Gait testing of 14 healthy individuals who underwent incremental saline injections of the knee joint capsule.Background. Gait adaptations have been reported in the literature for knee injured and rehabilitating individuals. Knee joint capsular afferent activity can influence knee joint function. METHODS: Gait analysis was employed in a pre- and post-test, repeated measures design to determine lower extremity joint kinematics, kinetics, energetics and thigh EMG adaptations due to intra-articular knee joint effusion. RESULTS: Knee effusion caused an increase in hip and knee flexion through the stance phase. Knee extensor torque, impulse and negative and positive work were diminished with increased effusion levels. Quadriceps activity decreased and hamstring activity increased due to intra-articular knee joint effusion. DISCUSSION: These adaptations cannot be attributed to an injury, surgery or rehabilitation. Thus, the results of this experiment suggest knee joint capsular distention, via knee joint effusion, may be responsible for many gait adaptations reported for knee injured individuals in previous investigations. CONCLUSIONS: Knee joint effusion and the subsequent capsular distention can cause major alterations in the normal gait cycle and can be considered a causative factor promoting the acquisition of quadriceps avoidance gait patterns. RELEVANCE: This study provides reference data on the effects of intra-articular knee joint effusion on gait parameters by which future studies of injured or rehabilitating individuals can be compared.

Adaptation, Physiological↗
PubMed2000

Symmetry and limb dominance in able-bodied gait: a review.

As one of the most universal of all human activities, gait in the able-bodied has received considerable attention, but many aspects still need to be clarified. Symmetry or asymmetry in the actions of the lower extremities during walking and the possible effect of laterality on gait are two prevalent and controversial issues. The purpose of this study was to review the work done over the last few decades in demonstrating: (a) whether or not the lower limbs behave symmetrically during able-bodied gait; and (b) how limb dominance affects the symmetrical or asymmetrical behavior of the lower extremities. The literature reviewed shows that gait symmetry has often been assumed, to simplify data collection and analysis. In contrast, asymmetrical behavior of the lower limbs during able-bodied ambulation was addressed in numerous investigations and was found to reflect natural functional differences between the lower extremities. These functional differences were probably related to the contribution of each limb in carrying out the tasks of propulsion and control during able-bodied walking. In current debates on gait symmetry in able-bodied subjects, laterality has been cited as an explanation for the existence of functional differences between the lower extremities, although a number of studies do not support the hypothesis of a relationship between gait symmetry and laterality. Further investigation is needed to demonstrate functional gait asymmetry and its relationship to laterality, taking into consideration the biomechanical aspects of gait.

Biomechanical Phenomena↗
PubMed2000

Reduction of gait data variability using curve registration.

Timing in peak gait values shifts slightly between gait trials. When averaged, the standard deviation (S.D.) in gait data may increase due to this inter-trial variability unless normalization is carried out beforehand. The objective of this study was to determine how curve registration, an alignment technique, can reduce inter-subject variability in gait data without perturbing the curve characteristics. Twenty young, healthy men participated in this study each providing a single gait trial. Gait was assessed by means of a four-camera high-speed video system synchronized to a force plate. A rigid body three-segment model was used in an inverse dynamic approach to calculate three-dimensional muscle powers at the hip, knee and ankle. Curve registration was applied to each of the 20 gait trials to align the peak powers. The mean registered peak powers increased by an average of 0.10 +/- 0.13 W/kg with the highest increases in the sagittal plane at push-off. After performing curve registration, the RMS values decreased by 13.6% and the greatest reduction occurred at the hip and knee, both in the sagittal plane. No important discontinuities were reported in the first and second derivatives of the unregistered and registered curves. Curve registration did not have much effect on the harmonic content. This would be an appropriate technique for application prior to any statistical analysis using able-bodied gait patterns.

Adult↗
PubMed2002

The attentional demands of preferred and non-preferred gait patterns.

The purpose of this study was to determine the attentional demands of natural and imposed gait, as well as the attentional costs of transitions between the walking and running co-ordination patterns. Seven healthy young men and four healthy young women undertook an auditory probe reaction time task concurrently with self-selected gait (Experiment 1) and imposed walking and running (Experiment 2) at different speeds on a motor-driven treadmill. In Experiment 1, where participants were free to choose their own movement pattern to match the speed of travel of the treadmill, normal gait control was shown to have a significant attentional cost, and hence not be automatic in the classical sense. However, this attentional cost did not differ between the two gait modes or at the transition point. In Experiment 2, where participants were required to maintain specific gait modes regardless of the treadmill speed, the maintenance of walking at speeds normally associated with running was found to have an attentional cost whereas this was not the case for running at normal walking speeds. Collectively the findings support a model of gait control in which the normal switching between gait modes is determined with minimal attention demand and in which it is possible to sustain non-preferred gait modes although, in the case of walking, only at a significant attentional/cognitive cost.

Adult↗
PubMed1999

Bootstrap prediction and confidence bands: a superior statistical method for analysis of gait data.

Gait analysis studies typically utilize continuous curves of data measured over the gait cycle, or a portion of the gait cycle. Statistical methods which are appropriate for use in studies involving a single point of data are not adequate for analysis of continuous curves of data. This paper determines the operating characteristics for two methods of constructing statistical prediction and confidence bands. The methods are compared, and their performance is evaluated using cross-validation methodology with a data set of the sort commonly evaluated in gait analysis. The methods evaluated are the often-used point-by-point Gaussian theory intervals, and the simultaneous bootstrap intervals of Sutherland et al. The Development of Mature Walking, MacKeith Press, London, 1988 and Olshen et al. Ann. Statist. 17 (1989) 1419-40. The bootstrap bands are shown to provide appropriate coverage for continuous curve gait data (86% coverage for a targeted coverage of 90%). The Gaussian bands are shown to provide inadequate coverage (54% for a targeted coverage of 90%). The deficiency in the Gaussian method can lead to inaccurate conclusions in gait studies. Bootstrap prediction and confidence bands are advocated for use as a standard method for evaluating gait data curves because the method is non-parametric and maintains nominal coverage levels for entire curves of gait data.

Gait↗
PubMed1996

Swing-through gait with free-knees produced by surface functional electrical stimulation.

The swing-through gait is often the gait of choice for those crutch walkers who can perform it. However, a practical (sufficiently low energy and sufficiently fast) gait is usually not achievable by paraplegic individuals with thoracic lesions. Functional electrical stimulation (FES) was used to assist three spinal cord injured (SCI) subjects with complete thoracic lesions at T11, T11 and T6 to ambulate with a swing-through gait patten. Eight channels of surface stimulation were used to bilaterally stimulate knee extensors, knee flexors, hip extensors and hip flexors. The stimulation sequence was controlled by a computer that implemented a finite-state, rule-based control strategy according to sensor inputs. Over a long, level walkway, the T11 subjects averaged 0.40 m/s and 0.38 m/s for distances of 56 m and 51 m; the T6 subject averaged 0.30 m/s for 43 m. Using a motion analysis system, the gait patterns of two of the subjects were compared to those of a trained, non-impaired subject. The SCI subjects spent more time in both double support phases (when both crutches and both feet contact the floor) than did the non-impaired subjects, leading to a loss of momentum and hence a slower and less efficient gait. In conclusion, an FES assisted swing-through gait is shown to be a potentially useful mode of FES gait.

Adult↗
PubMed2002

Gait training in hemiplegia.

Restoration of gait is a major goal in neurological rehabilitation. Before starting therapy, a comprehensive assessment is necessary to evaluate the deficits and remaining functions. A wide variety of therapeutic procedures are available and have to be adapted to the individual situation - different concepts of physiotherapy stress different features like: force exercise, reduction of spasticity, gait symmetry, utilization of equilibrium reflexes, stepping automation, endurance training, repetition of rhythmic movements, etc. The spectrum of available therapies was recently widened by treadmill training, with partial body-weight support, locomotor pharmacotherapy, selective reduction of spasticity by botulinum toxin injections, and by musical biofeedback, which have each proved to be successful in the restoration of gait pattern. Treadmill training based on partial body weight support, combined with enforced stepping movements has proved to be successful in the restoration of gait pattern. A common problem in hemiparetic gait, is the spastic inversion of the foot. If spasticity is not severe, an ankle-foot orthosis (AFO) is the appropriate technical aid. In other cases, botulinum toxin injection into spastic leg muscles has been successfully used to improve gait functions. In hemiparetic stroke patients, auditory (musical) rhythm, as a peripheral pacing signal, resulted in a significant increase in weight-bearing stance time on the paretic side. In addition, there was an improved stride symmetry with rhythmic cueing and a normalizations of gait pattern. These methods directed to gait improvement should be combined and adapted to the individual patient's needs, in order to obtain the best results.

Biofeedback, Psychology↗
PubMed2000

Motor branch block of the rectus femoris: its effectiveness in stiff-legged gait in spastic paresis.

OBJECTIVE: To verify the efficacy of motor branch block of the rectus femoris for stiff-legged gait in spastic patients. DESIGN: Before-after treatment trial. SETTING: University hospital physical medicine and rehabilitation department outpatient clinic. PATIENTS: Thirty-one adult spastic patients with stiff-legged gait. INTERVENTION: Motor branch block of the rectus femoris with 2% lidocaine and 5% phenol. OUTCOME MEASURES: Subjective assessment of gait performance by patients themselves and objective assessment of gait speed and sagittal knee kinematics. RESULTS: Seventy-four percent (23/31) of patients felt an improvement (improved knee bending, disappeared toe dragging) after nerve block with lidocaine. Sixteen of 17 patients with an abnormal swing phase activity of the rectus femoris without that of the vastus medialis or lateralis and 20 of 23 patients with a sufficient hip flexor strength expressed an improvement subjectively. Gait analysis showed increased maximal knee flexion at swing phase and increased slope of knee flexion curve at toe off (p < .05). Phenol block was performed in 19 of 23 patients who had had a subjective improvement in their gait performance after nerve block with lidocaine. Gait speed, maximal knee flexion angle at swing phase, and slope of knee flexion curve at toe off increased significantly after phenol block (p < .05). CONCLUSION: Motor branch block of the rectus femoris can be an effective treatment in stiff-legged gait. Its effect is varied with hip flexor strength and dynamic electromyographic findings of quadriceps.

Adult↗
PubMedDate not supplied

[Gait disorders - assessment and rehabilitation supported by movement analysis].

AIM: The present paper validates the use of two-dimensional pelvis and thorax translation data for the assessment of gait disturbances and evaluates the effects of a real-time visual feedback system based on thoracic spine kinematics for gait rehabilitation. METHODS: To validate the use of two-dimensional gait kinematics, vertical and horizontal displacements of pelvis (S1) and thorax (T12) markers of the twelve healthy individuals (25.9 +/- 2.7 years) were recorded during two gait perturbations: a brace constraining the knee to 30 degrees of flexure and a shoe lift of 3 cm. To investigate the effects of verbal instructions and additional real-time visual feedback on vertical and medial-lateral pelvis and trunk movements, gait kinematics were recorded during three randomized trials (verbal instruction, real-time visual kinematic feedback, free walking). RESULTS: Gait deviations did result in significant (p < 0.05) increases of horizontal and vertical trunk pelvis movements. Significant (p < 0.05) reductions in oscillation amplitudes were noted when verbal cues and visual information were received. However, the major decrease occurred during real-time visual feedback. CONCLUSION: Asymmetric limping, similar to gait disorders of individuals with hip pathologies, could be detected and described by two-dimensional thorax and pelvis translation data. It could be speculated that gait disorders may be addressed by real-time kinematic feedback training.

Adult↗
PubMed2006

Comparison of three definitions of the mid-stance and mid-swing events of the gait cycle in children.

PURPOSE: Different criteria are used to define the terms mid-stance (MST) and mid-swing (MSW) when describing the gait cycle. None of these definitions is universally accepted. This causes difficulties with the interpretation of gait analysis data and hinders the comparison between the different studies. The aim of the present study was to compare three definitions of MST and MSW by examining the gait of a group of healthy children. METHOD: A prospective comparison of three commonly used definitions of the MST and MSW events of the gait cycle. OUTCOME MEASURES: The timing of the temporal, kinematic and kinetic MST and MSW of the gait cycle. RESULTS: Thirty healthy 8 - 10-year-old children were studied. There was no consistent correlation between the timing of the chosen definitions of MST and MSW. However, there was a tendency for the timing of the temporal and kinetic MST and MSW to occur, respectively, at approximately 30 and 80% of the gait cycle. CONCLUSIONS: The temporal definition of MST and MSW as the midpoints in time of the respective phases of the gait cycle appears to be more appropriate than other definitions. The use of this definition may prevent misunderstanding and permit comparison of the results of the different gait analysis studies.

Biomechanical Phenomena↗
PubMed1994

The pathogenesis of gait hypokinesia in Parkinson's disease.

To identify the fundamental deficit in gait hypokinesia in Parkinson's disease (PD) we conducted a series of experiments that compared PD subjects with age- and height-matched controls in their capacity to regulate either stride length, cadence (steps per minute) or both parameters to three conditions. In the first condition the spatial and temporal parameters of gait were documented for slow, normal and fast walking. The second condition compared parkinsonian gait with the walking pattern of elderly controls whilst controlling for two movement speeds: fast (control preferred) speed and slow (PD preferred) speed. In the third condition we examined the ability of PD subjects to regulate one parameter (e.g. stride length) when the other two parameters (e.g. velocity and cadence) were held at control values. A total of 34 PD subjects and 34 matched controls were tested using a footswitch stride analysis system that measured the spatial and temporal parameters of gait for a series of 10 m walking trials. Parkinsonian subjects exhibited marked gait hypokinesia in each of the experiments. Although they retained the capacity to vary their gait velocity in a similar manner to controls, their range of response was reduced. Within the lower velocity range, PD subjects could vary their speed of walking by adjusting cadence and, to a lesser extent, stride length. However, when the speed of walking was controlled, the stride length was found to be shorter and the cadence higher in PD subjects than in controls. Stride length could not be upgraded by internal control mechanisms in response to a fixed cadence set for age and height-matched velocity. In contrast, cadence was readily modulated by external cues and by internal control mechanisms when stride length was fixed to the values obtained for age- and height-matched controls. It was concluded that regulation of stride length is the fundamental problem in gait hypokinesia and the relative increase in cadence exhibited by PD subjects is a compensatory mechanism for the difficulty in regulating stride length. These findings are discussed in the context of the hypothesized role of the basal ganglia in generating internal cues for the maintenance of the gait sequence and in relation to the structuring of movement rehabilitation strategies.

Aged↗
PubMed1996

Factors associated with changes in gait speed in older adults.

BACKGROUND: The study addressed whether changes in gait speed in community-dwelling older adults were associated with changes in fitness (strength and aerobic capacity), physical health status, and/or depressive symptoms. METHODS: The study sample comprised 152 community-dwelling adults aged 68-85 who had participated in an exercise study. Study measures at baseline and 6-month follow-up included gait speed, a leg strength score, maximal aerobic capacity (VO2max), CES-Depression scale, and physical health status (SIP Physical Dimension). RESULTS: In cross-sectional regression analyses, leg strength, VO2max, weight, and the strength by VO2max interaction term were significant independent predictors of gait speed (R2 = 26%). Based upon the observed 7% increase in VO2max and 8% increase in strength in the exercise groups, the regression model predicted only a 2% (1.5 m/min) increase in gait speed, which did not differ significantly from the observed increase of 0% (.32 m/min). The strongest correlate of change in gait speed was change in CES-D scores (partial R = -.37). Change in physical health status also correlated with change in gait speed (partial R = -.28), while change in fitness did not. CONCLUSIONS: The results suggest, in the range of fitness of the study sample, that changes in gait speed are related to changes in depressive symptoms and physical health status, but not to modest changes in fitness. A model assuming nonlinear relationships may be appropriate for understanding how strength and aerobic capacity affect gait speed.

Aged↗
PubMed1989

Restoration of gait during two to three weeks of therapy with multichannel electrical stimulation.

Multichannel electrical stimulation was applied in 20 patients with hemiplegia secondary to stroke or head injury using a six-channel microprocessor stimulator-stride analyzer to restore independent gait and to reestablish a normal gait pattern in a two- to three-week therapy period. The therapy was followed up at every session by a stride analyzer incorporated into the stimulator. At the beginning and at the end of the therapy period, each subject's gait was measured with a ground reaction measuring system. Statistical results and observations are presented for the group of 20 subjects, and a detailed description of the results is given for one subject who is representative of the whole group. According to the measured gait characteristics, gait improved significantly in all subjects during the therapy period, resulting in a partly or completely independent gait. The subjects' posture and endurance also improved, and they spontaneously learned how to use a crutch. The measurements and visual assessment of the subjects' progress indicate that the described treatment protocol offers good prospects for faster and more efficient gait rehabilitation in severely impaired patients. To determine the efficacy of gait therapy with multichannel electrical stimulation, a comparative study of conventional therapeutic methods and the method described in this article should be conducted.

Adolescent↗
PubMed1999

An algorithm to assess stiff-legged gait in traumatic brain injury.

Spastic paretic stiff-legged gait is a frequently encountered gait problem in patients with traumatic brain injury, as well as in many other patients with upper motor neuron disease. Formerly, spasticity of the quadriceps was considered to be the sole cause of stiff-legged gait. Quantitative gait analysis, however, may implicate hip flexor weakness or poor ankle mechanics as the cause of stiff-legged gait. We discuss the use of an algorithm to evaluate stiff-legged gait in traumatic brain injury using a quantitative gait analysis system such that the specific etiology of stiff-legged gait can be identified and can serve as the basis of a treatment plan.

Algorithms↗