A biomechanical assessment of walking in physiotherapy typically includes:

1. Subjective Examination:

• • Patient History: Gathering information about the patient’s symptoms, pain location, onset, aggravating/relieving factors, medical history, activity levels, and goals.

2. Objective Examination (Static and Dynamic):

• Static Postural Assessment:
  • Observation of alignment of joints and body segments in standing (e.g., foot arches, knee alignment, pelvic tilt, spinal curves).
  • Checking for leg length discrepancies.
• Range of Motion (ROM) and Muscle Length Assessment:
  • Assessing joint flexibility and muscle extensibility in the lower limbs, trunk, and even upper limbs (as they contribute to arm swing).
• Muscle Strength and Control Assessment:
  • Manual muscle testing to identify weakness or imbalances in key muscles involved in gait (e.g., gluteals, quadriceps, hamstrings, calf muscles, ankle dorsiflexors).
  • Assessing muscle activation patterns and control.
• Balance and Proprioception:
  • Evaluating static and dynamic balance.
  • Assessing the body’s awareness of its position in space.
• Dynamic Gait Analysis (Observational and/or Instrumented):
  • Observational Gait Analysis (OGA): This is the most common clinical tool. The physiotherapist observes the patient walking from various angles (front, back, side) and at different speeds. They look for:
    • Gait Cycle Phases: Assessing how well each phase of the gait cycle (Initial Contact, Loading Response, Mid-Stance, Terminal Stance, Pre-Swing, Initial Swing, Mid-Swing, Terminal Swing) is executed.
    • Spatiotemporal Parameters:
      • Cadence: Steps per minute.
      • Stride Length: Distance covered by one full gait cycle (heel strike of one foot to the next heel strike of the same foot).
      • Step Length: Distance between successive heel strikes of opposite feet.
      • Base of Support/Step Width: Distance between the medial borders of the feet.
      • Speed/Velocity: How fast the person walks.
      • Arm Swing: Symmetry and range.
      • Trunk Movement: Excessive rotation, lurching, or listing.
      • Pelvic Movement: Pelvic drop (Trendelenburg), hiking, or rotation.
      • Joint Angles and Movements:
        • Foot and Ankle: Pronation/supination, dorsiflexion/plantarflexion, eversion/inversion.
        • Knee: Flexion/extension, varus/valgus (bow-legged/knock-kneed).
        • Hip: Flexion/extension, abduction/adduction, rotation (internal/external).
      • Compensatory Patterns: Identifying any alternative movement strategies used to avoid pain or compensate for weakness (e.g., hip circumduction, vaulting, posterior lurch).
      • Symmetry and Smoothness: Assessing the overall flow and balance of movement between both sides of the body.
    • Video Recording: Often used to allow for slow-motion review and repeated analysis without fatiguing the patient.
  • Instrumented Gait Analysis (more advanced): While less common in general clinical practice due to cost and equipment, specialized clinics and research facilities may use:
    • 3D Motion Capture Systems: Using reflective markers and infrared cameras to precisely measure joint angles and movements in three dimensions.
    • Force Plates: Embedded in the floor to measure ground reaction forces (how much force the foot applies to the ground and in what direction).
    • Electromyography (EMG): Measuring muscle activation patterns and timing.
    • Pressure Mapping Systems: Analyzing foot pressure distribution during different phases of gait.