Analysis and treatment of gait deficits:

Differentiating between "primary errors and useful substitutions"

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Impairments of

• range of motion
• muscle activity, including weakness , spasticity, or disorders of timing
• pain
• sensation

limit a person’s ability to:

• maintain stability against gravitational and inertial forces
• propel the body forward
• minimize costly changes in kinetic or potential energy

and require compensations, deviations, or substitutions in the gait pattern

“Treatment is indicated when the compensations are inadequate or when they introduce penalties in energy cost, joint strain, or muscle overuse. In determining appropriate treatment, gait analysis is used to ... differentiate between primary errors and useful substitutions.”

Perry, J. (1990). Pathological gait. Instructional Course Lectures, 39, 325.

“In stance, a substitution is judged to be unwanted or useful according to the value of the body vector created at the lower joints, whether it adds stability or creates an additional load to be controlled. In swing, the determining factor is whether or not the motion assists limb advancement.”

Perry, J. (1990). Pathological gait. Instructional Course Lectures, 39, 331.

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Last updated 5-15-98 ©Dave Thompson PT