FROM MY PT SCHOOL NOTES · FOUNDATIONS OF CLINICAL SKILLS · CHAPTER 10
What Should You Watch During Gait Observation?
Gait phases help describe what you see; a ‘normal’ diagram is not a substitute for observing the person walking.
Name the phases and functional tasks
The gait notes use both traditional stance/swing terminology and Rancho Los Amigos phases. A gait cycle is described from one foot’s initial contact to its next initial contact; two steps form one stride. The material discusses step length, stride length, cadence, velocity, base of support, double- and single-limb support, symmetry and gait timing.
Eight-phase terminology from the class: initial contact, loading response, mid stance, terminal stance, pre swing, initial swing, mid swing and terminal swing. The lectures also group these phases by functional tasks: weight acceptance, single-limb support and advancement of the swing limb. Learn the order and purpose from the course rather than memorizing one person’s exact percentage timing as universal.
Describe step and timing features
Three stance “rockers” in the original gait unit are the heel rocker during initial loading, ankle rocker as the body progresses over the fixed foot, and forefoot rocker later in stance. Their contribution depends on ankle-foot motion, muscle control, footwear, speed and patient characteristics.
Joint-level notes: ankle dorsiflexors assist toe clearance during swing and control foot lowering after initial contact; plantar flexors help control tibial advancement and late-stance progression. The knee contributes controlled flexion for loading and limb clearance. The hip and pelvis contribute weight acceptance, advancement and trunk/pelvic stability. The ground-reaction-force vector changes relative to joints throughout the cycle.
Connect observation to function
Observational gait checklist from the third student-gait lecture: set a clear walkway; watch the same task from useful angles; choose one body segment and one gait phase at a time; describe what is seen before deciding why it happens. Check timing and symmetry, foot contact/clearance, ankle motion, knee stability, pelvis/trunk motion, arm swing and changes when the patient turns or speeds up.
Qualitative gait observations help identify patterns but can be subjective. Quantitative measures such as speed, distance and other consistent performance measures can track meaningful functional change. As the source emphasizes, the same gait deviation can have several causes, so observational gait analysis belongs alongside relevant examination findings.
Source notes: “Student Introduction to Gait” Parts 1–3 and “Gait Lecture 1–3.” The original teaching slides incorporate material and figures attributed to Perry/Burnfield and Rancho Los Amigos; those copyrighted images are not reproduced in this companion.
Test your reasoning: Is reduced step length a diagnosis of one particular muscle problem?
No. Step length reflects many influences including speed, task constraints, balance, pain, strength and available motion.
Apply it to a clinical situation
Scenario: During initial loading response, a walker user shows abrupt knee flexion and needs more upper-limb support. The same person walks with shorter steps later in the session.
What changes your decision?
Reasoning: Describe when and where the observation occurs, task conditions, device use and assistance. Consider available knee control, fatigue, pain, speed and other factors before inferring a muscle diagnosis from the gait pattern alone.
Common mistake: Listing a gait deviation without its phase, circumstances or functional consequence. Remember: A gait observation becomes useful when it is specific and testable.
Source: my Foundations of Clinical Skills companion notes, Chapter 10, summarized from the corresponding lecture and lab materials. Original student check; not a transfer credential, diagnosis or substitute for current facility procedures.
