Gait Analysis and Its Role in Modern Physiotherapy

Gait analysis is an important aspect of creating the best recovery strategy for your patients. It reveals where current problems exist, teaches proper movement for faster recovery, and can even point to major underlying issues that need to be addressed.

And yet, since a gait analysis is such a routine and simple procedure, your patients may not grasp its full value.

That’s why, in this article, we’re going to cover how to talk to patients about gait analysis. The goal is to cover the topic in a way that helps patients understand why and how this small diagnostic test can play such a large role in achieving more positive outcomes.

What is gait analysis?

Gait analysis is a diagnostic test that finds and measures abnormalities or inefficiencies in a person’s gait (i.e., the way a person walks/runs). The analysis itself is done through a variety of methods, including:

• Observation: A physical therapist will observe as the patient walks or runs, looking for any apparent abnormalities in the gait cycle.
• Gait speed measurement: A PT will measure the speed of a patient’s gait with a tool (sometimes as simple as just a stopwatch).
• Balance and strength tests: A PT will test a patient’s balance and look for any limitations to physical strength.
• Range of motion and reflex tests: A PT will test a patient’s joints for their range of motion, usually with some kind of tool (a goniometer, for example).

Gait analysis is necessary for most physical therapy patients, though it’s particularly impactful for elderly or at-risk patients looking to improve their form or recovery from a previous injury.

Why is gait analysis important in physical therapy?

Abnormalities in gait patterns and stride length can hinder a patient’s recovery, lower everyday quality of life, and be a contributor to other serious issues, such as body pain, poor posture, inflammation, and muscle weakness. These gait abnormalities can either be caused by or eventually lead to more serious gait dysfunctions, including things like:

• Spastic gait: when someone drags their legs while walking
• Scissors gait: when someone’s legs bend inward while walking
• Steppage gait: when someone’s toes point toward the ground while walking (usually scraping the toes along the ground with each step)
• Waddling gait: when someone moves side to side while walking, like they’re waddling
• Propulsive gait: when someone walks with their head and neck pushed forward

It’s important that your patients understand exactly why and how these gait abnormalities can have an impact on overall recovery. Make it clear that observational gait analysis is a crucial aspect of physical therapy for three reasons.

First, it helps PTs treat a known injury. Measuring gait can give PTs more data on the best rehabilitation strategy for patients and identify which exercises would best support recovery outcomes.

Second, consistently and accurately measuring gait can help patients avoid future injuries. Proper motion analysis will teach patients good form while walking/running, including the best way to distribute their body weight. As patients improve their gait form, they’ll reduce unnecessary strain on muscles, joints, and bones. And for at-risk or geriatric patients, improving gait will reduce the chances of costly slips and falls that can set recovery times back significantly. It’s one of the many reasons why PTs are advised to use gait analysis as part of a routine fall risk assessment among elderly patients.

Finally, measuring a patient’s gait can help PTs diagnose a larger underlying issue. Research has shown, for example, that slowing gait speed in elderly patients can be linked to cardiovascular diseases and even premature death. As such, it’s crucial that your patients understand the importance of accurate and routine gait analysis.

How to explain the importance of measuring gait to patients

One of the difficulties with measuring a patient’s gait is that you usually need expensive and non-transportable equipment to get accurate measurements with reliable data. That means you can only measure a patient’s gait in fixed locations where the equipment exists, which can be harder for older or at-risk patients who are less mobile. And many patients don’t routinely measure their own gait with any amount of accuracy because they don’t:

• Have access to the right equipment
• Fully grasp how important gait measurement actually is for their recovery

That’s why you need to teach patients why a gait analysis can positively impact recovery outcomes. Not only will it help patients be more engaged with routine gait analyses, but it will help them recognize any changes in gait and be more cognisant of their movements. To get started, below we’ve outlined three concrete reasons you can share with patients to help them understand what makes a simple gait analysis so impactful. 

1. Gait dysfunctions can be a symptom of a larger problem

Gait disorders can be caused by something as simple as a foot injury or an inner-ear infection. But they can also be related to larger issues related to nervous system disorders, muscle diseases, or other musculoskeletal abnormalities. A shuffling gait, for example, an be an early sign of Parkinson’s disease that a quality PT would be able to catch early on during treatment.

In your first session with a new patient, emphasize the importance of gait analysis as a preventative measure against future illness and injury. The goal here is to strike the right balance with your explanation. On the one hand, you want to make it clear that a gait analysis is a valuable test that, over time, can either signal a larger underlying issue or help prevent future injuries (slips, falls, muscle strains, etc.).

On the other hand, you don’t want your patients to leave their session feeling afraid. You can imagine how scary it would be for a 67-year-old patient in an assisted living facility to learn that a slowing gait speed is heavily linked to mortality rates. Though this patient would be likely to be fully engaged with their routine gait analysis, the added stress from the perceived outcomes may end up doing more harm than good.

As you strike this balance with your patients, try to convey the following information (and in this order):

• “Since walking and running require effort from so many different areas (legs, core, spine, arms, etc.), a gait analysis is helpful for identifying problems or weaknesses in gait form
• With that knowledge, we can find the best exercises to help your specific injury and prevent risk of injury in the future
• Over time, improving gait means more fluid movements, proper weight distribution, and better form while walking. This translates into less pain as you go about your day-to-day activities.
• Plus, we’ll be able to keep an eye out for any underlying problems a gait dysfunction may indicate, such as a cardiovascular disease (but let’s just cross that bridge when we get there)”

Your objective is to explain gait analysis to patients in a way that helps them understand what you’re looking for without letting them worry before you’ve actually found anything.

2. Gait dysfunctions can hinder your patient’s overall recovery

Depending on the condition of your patient’s gait, any abnormalities in their walking can seriously hinder recovery times. That’s because, as we just mentioned, the movements made while walking involve input from so many parts of the body. But since most of us have been walking all our lives, we often take these movements for granted without ever thinking about them.
For example, a common problem with gait (particularly among aging runners) is overpronation, where the foot rolls inward as the foot strikes the ground and transfers weight to the inner edges of the feet:

This causes poor gait posture and can lead to serious problems, such as chronic lower back pain, shin splints, stress factors, and Achilles tendonitis, among others. Correcting this movement to proper gait form and rhythm are major components to recovery, especially for joint injuries or surgeries in the ankles, knees, or hips. As a person walks or runs, these lower extremity joints take the brunt of the pressure, particularly if bodyweight is unevenly distributed.

Your patients should understand how proper gait form reduces the stress placed on these high-impact joints, which ultimately helps speed recovery times.

3. Gait dysfunctions can lower their quality of life

One of the hardest aspects of dealing with gait dysfunction during physical therapy is that it’s negatively impacting your patient’s quality of life. Common practices they used to love — running, tennis, or even taking the dog for a walk — can prove too painful for the patient to continue. This can lead to emotional issues like feelings of depression, isolation, or a general sense of hopelessness. And it’s no wonder why chronic pain would have such a negative impact on one’s mental health: it’s connected to everything.

People who are in chronic pain have added stress coming at them from nearly all fronts. Pain makes it harder to sleep, which can make us less productive at work. This can lead to anxiety around job security and other financial concerns. Chronic pain also makes it harder to sustain positive relationships because it’s a constant distraction from enjoyable interactions with the ones we love.

Finally, chronic pain prevents patients from being fully active. This is a major problem because exercise has been proven to help fight depression and will be a necessary component of your patient’s recovery. But the solution they need (guided exercise) becomes infinitely harder as depression sets in.

It’s not hard to see how a negative cycle forms:

• A patient gets injured and finds recovery an isolating process
• As a result of not being able to do the things they love, this patient becomes depressed
• That depression strips the patient’s motivation to continue with recovery
• The injury worsens over time which leads to a deeper sense of depression
• Now the patient is in both physical and emotional pain, which negatively impacts their job, relationships, and recreational activities

Outline this cycle with your patients at the very first session with them. Then emphasize how gait analysis can be the first step in avoiding or breaking that cycle for good because it allows you to identify the best exercises that will get this patient mobile again.

Using AI to measure gait speed

Routinely measuring gait speed shouldn’t be an afterthought for either the patient or PT. It’s an important test that helps PTs create smarter recovery exercises and to catch underlying problems early on. The best approach is to helping patients understand the importance of running routine gait analysis and leveraging intuitive AI-driven tools like Exer Gait to make the entire process easier on everyone:

Gait is an app that provides you with real-time data, allowing you to more accurately measure a patient’s gait using any tablet or device with a camera. Instead of keeping one eye on the stopwatch and the other eye on the patient, you’ll be fully present while your patient’s gait is recorded with a machine learning tool that gives you clear, instant, and reliable gait metrics. Plus, the results are documented in an easy-to-read dashboard, so you can continuously measure improvements or weaknesses in your patient’s gait.

This flexible technology can be used for a range of different purposes, such as:

• Working with at-risk or elderly patients in assisted living facilities
• Helping your knee, hip and ankle post-op patients recover effectively
• Guiding professional or elite athletes through an injury in sports medicine
• Measuring risk factors among factory workers at manufacturing companies
• Running fall-risk assessments to prevent serious, costly, and often unnecessary slips and falls

In the end, a smart tool like Gait helps you predict the best strategy for recovery, prevent future injuries from occurring, and protect your patient’s overall quality of life.