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Table 2 Orthopedic gait analysis form

From: Reliability of videotaped observational gait analysis in patients with orthopedic impairments

    

STANCE PHASE

SWING PHASE

 

Item

Question

 

Early

Mid

Late

Early

Late

General

1

Is a shortened stance phase present?

Left

 

Yes / No

 

NA

   

Right

 

Yes / No

 

NA

Trunk

2

Is the trunk anterior to the hips?

   

Yes / No

  
 

3

Is the trunk posterior to the hips?

   

Yes / No

  
 

4

Is lateral flexion present?

Left

 

Yes / No

 

NA

   

Right

 

Yes / No

 

NA

 

5

Is arm-swing reduced?

Left

  

Yes / No

  
   

Right

  

Yes / No

  

Pelvis

6

Is the posterior rotation excessive?

Left

NA

Yes / No

NA

   

Right

NA

Yes / No

NA

Hip

7

Is the extension reduced?

Left

NA

Yes / No

NA

   

Right

NA

Yes / No

NA

Knee

8

Is the extension reduced?

Left

NA

NA

Yes / No

   

Right

NA

NA

Yes / No

 

9

Is the flexion movement absent ?

Left

Yes / No

NA

NA

   

Right

Yes / No

NA

NA

 

10

Is the flexion reduced?

Left

Yes / No

NA

NA

   

Right

Yes / No

NA

NA

 

11

Is the extension absent?

Left

NA

Yes / No

NA

NA

   

Right

NA

Yes / No

NA

Ankle

12

Is the plantar flexion reduced?

Left

NA

Yes / No

NA

   

Right

NA

Yes / No

NA

  1. NA = not applicable