Strategies for the assessment of pediatric gait in the clinical setting

Rehabilitation Services, Newington Children's Hospital, CT 06111.

Clinical gait analysis is a term that can be applied to numerous methods of evaluating a subject's walking pattern. These methods may include observation, videotaping, electromyography, kinematics, kinetics, and energetics. Modern gait analysis is based on the integration of these component methods of measurement to derive a complete analysis of gait. The data may then be used to help determine the treatment course of a patient with ambulatory problems or to document the effects of treatment. The purpose of this article is to provide an overview of the individual components of gait analysis. Emphasis will be placed on the type of information that can be derived from each component and how the information may be used clinically. Normal pediatric kinematics and kinetics are provided with literature references for phasic electromyography and temporal and stride variables. Two case examples illustrate the clinical utility of gait analysis information applied to cerebral palsy in surgical decision making and orthotic assessment. Guidelines are also provided for the referral of patients to a gait analysis laboratory.

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