Interpreting Spatiotemporal Parameters, Symmetry, and Variability in Clinical Gait Analysis
Spatiotemporal parameters (STP) are widely studied variables in clinical gait analysis. Yet they often remain underutilized despite the rich information they provide about organization and control of the patient's progress. Building on them requires a broad knowledge of the "normal" gait, before to being able to understand the impact of pathological disorders. We hope to provide information to better grasp and understand the STP while highlighting important points. Through this chapter, we will introduce basics of the gait cycle, before considering the components for which the STP may be informative: rhythm, pace, phases, postural control, asymmetry, and variability. We will define main parameters for each component and discuss their use regarding state of the art. Then factors influencing STP will be addressed to understand how these parameters change during life, when a child learns to walk or when the advance in age affected gait in the elderly, as well as the influence of diseases. Indeed, various pathologies affect the walk, and the most relevant STP are not always the same. We will consider Friedreich ataxia, which is a neurodegenerative disease, in which combination of cerebellar, pyramidal syndromes, and axonal neuropathy cause a rapid degeneration of the walking ability and therefore lead to various observable gait patterns. We will also illustrate how PST can be useful to A. Gouelle Gait and Balance Academy, ProtoKinetics, Havertown, PA, USA e mail: arnaud.gouelle@gmail.com F. Megrot Unite Clinique d'Analyse de la Marche et du Mouvement, Centre de Medecine Physique et de Readaptation pour Enfants de Bois Larris Croix Rouge Francaise, Lamorlaye, France UMR CNRS 7338: Biomecanique et Bioingenierie, Sorbonne Universites, Universite de Technologie de Compiegne, Compiegne, France e mail: fabrice.megrot@croix rouge.fr Springer International Publishing AG 2016 B. Muller, S.I. Wolf (eds. Handbook of Human Motion, DOI 10.1007/978 3 319 30808 1_35 1 1 document the most appropriate time for a patient to change from one assistive device to another. The final portion will aim to give paths for clinical interpretation while thinking about the concepts of limitation and adaptation.