Gait Anaylsis: A Cornerstone of Medical Exercise Training

Gait Analysis: A Cornerstone of Medical Exercise Training

This segment on gait analysis is drawn from the Advanced Medical Exercise Specialist Manual, a vital resource for fitness professionals aiming to offer specialized training to clients with medical conditions or injuries. By providing a structured approach to exercise prescription—including assessments, program design, and tailored progression strategies—the manual equips professionals to meet each client’s unique needs.

This post delves into the essential role of gait analysis as a skill for medical exercise specialists. Through systematic observation of a client’s walking patterns, gait analysis uncovers deviations that often reveal underlying musculoskeletal or neurological impairments. With this understanding, professionals can craft targeted exercise interventions that address specific limitations, fostering improved mobility, reducing discomfort, and enhancing clients’ overall quality of life.

Understanding the Gait Cycle

Human gait is a complex, cyclical process with two primary phases: stance and swing.

• The stance phase begins when the heel strikes the ground and ends when the same foot lifts off, supporting body weight.
• The swing phase starts when the foot leaves the ground and ends with the same foot making contact again, swinging the non-weight-bearing leg forward.

Both phases have sub-phases with distinct joint movements and muscle activations.

Conducting a Gait Analysis

Gait analysis requires a well-lit area with space for natural walking. Professionals observe from various angles (posterior, lateral, anterior), focusing on asymmetries and deviations. The assessment should be structured, evaluating the:

• Pelvis/Trunk: Look for tilting, rotation, or excessive movement.
• Hip: Note range of motion, limitations, or abnormal movements.
• Knee: Assess flexion and extension, noting instability or deviations.
• Ankle/Foot: Observe dorsiflexion, plantarflexion, heel strike, toe-off, and any signs of foot drop or dragging.

Common Gait Deviations and Their Causes

Gait deviations, and abnormalities in walking patterns, can stem from muscle weakness, joint restrictions, pain, or neurological conditions. Here are some common deviations and potential causes:

Hip Deviations:

• Excessive hip flexion: Often caused by weak ankle dorsiflexors, leading to a "steppage gait."
• Hip abductor weakness: Results in the Trendelenburg sign, with the hip dropping on the non-weight-bearing side.
• Hip adductor contracture: Causes a "scissor gait," increasing fall risk.

Knee Deviations:

• Quadriceps weakness: Can cause instability and difficulty with knee extension.
• Severe quadriceps weakness: May lead to hyperextension and a "knee slap."
• Knee flexion contracture: Characterized by toe-walking and limited knee extension.

Ankle Deviations:

• Weak dorsiflexors: Lead to a steppage gait and lack of heel strike.
• Calf tightness: Results in toe-walking and limited heel strike.

Applying Gait Analysis to MET Programming

After identifying deviations, professionals use this information to create targeted exercise programs, addressing specific weaknesses, improving joint mobility, and enhancing gait mechanics. The sources highlight the importance of a phased approach to programming, which often includes:

• Assessment: Comprehensive evaluation of medical history, limitations, and deviations.
• Phase 1 (Strength, Stability, and Mobility): Establishing baseline strength, mobility, and endurance.
• Phase 2 (Functional Strength/Stability): Progressing to exercises mimicking daily activities.
• Phase 3 (Functional Conditioning): Challenging cardiovascular fitness and endurance.
• Phase 4 (Human Performance): Advanced training for those seeking higher performance levels.

For example, weak hip abductors would benefit from exercises like hip abductions in various positions and resistances.

Tracking Progress with Functional Outcome Measures

Functional Outcome Measures (FOMs) are crucial for tracking progress and program effectiveness. Examples of FOMs relevant to gait analysis include:

• Tinetti Gait/Balance Scale: A standardized tool for evaluating balance and gait, providing a quantifiable score to monitor progress.
• Functional Assessment Scales: Specific scales for assessing functional abilities and limitations related to various body regions or conditions.
• Pain Scale, Goniometry, and Manual Muscle Testing: Regularly assessing these can help determine the program's effectiveness on pain management, flexibility, and muscle strength.

Integrating Gait Analysis into Practice

To effectively incorporate gait analysis:

• Develop a strong understanding of gait mechanics and deviations.
• Use standardized tools and procedures.
• Create a library of exercises targeting specific deviations.
• Regularly reassess gait and track progress using FOMs.
• Communicate effectively with clients and medical professionals.

Conclusion

Gait analysis is a powerful tool for medical exercise professionals, offering insights to help clients improve mobility, reduce pain, and enhance their quality of life. By mastering the principles and techniques detailed in the Advanced Medical Exercise Specialist Manual, you’ll be better equipped to manage clients effectively and achieve positive functional outcomes. Gait analysis is just one of the many valuable tools in this manual, empowering you to deliver evidence-based, individualized exercise programs tailored to each client’s unique needs. Investing in this comprehensive resource elevates your professional expertise and supports your client’s overall well-being and independence.

Integrate gait analysis into your MET practice with the AMES Manual. Learn more and purchase your copy of the Advanced Medical Exercise Specialist Manual using the link below.