Clinical Gait Assessment by Video Observation and 2D Techniques

  • Andreas Kranzl
Reference work entry


Observational gait analysis, in particular video-based gait analysis, is extremely valuable in the daily clinical routine. Certain requirements are necessary in order to be able to perform a high-quality analysis. The walking distance must be sufficiently long enough (dependent on the type of patient), the utilized equipment should meet the requirements, and there should be a recording log. The quality of the videos for evaluation is dependent on the recording conditions of the video cameras. Exposure time, additional lighting, and camera position all need to be adjusted properly for sagittal and frontal imaging. Filming the video in a room designated for this purpose will help to ensure constant recording conditions and quality. The recordings should always be carried out based on a recording log. The test form can act as a guide for the evaluation of the video. This provides an objective description of the gait. It is important to always keep in mind that the evaluation must remain subjective to a certain degree. Based on the gait parameter, the reproducibility of this value (intra- and inter-reliability) is moderate to good. In addition to a database function, current video recording software is able to measure angles and distances. It should also be possible to play back two videos in parallel, in order to, for example, play back both the presurgical and postsurgical gait simultaneously. Despite the implementation of three-dimensional measurement systems for gait analysis, observation or video-supported gait analysis is justified in daily clinical operations.


Database Observational gait Reliability Room size Video camera 


  1. Alton F, Baldey L, Caplan S, Morrissey MC (1998) A kinematic comparison of overground and treadmill walking. Clin Biomech 13:434–440CrossRefGoogle Scholar
  2. Borel S, Schneider P, Newman CJ (2011) Video analysis software increases the interrater reliability of video gait assessments in children with cerebral palsy. Gait Posture 33:727–729CrossRefGoogle Scholar
  3. Brunnekreef JJ, van Uden CJ, van Moorsel S, Kooloos JG (2005) Reliability of videotaped observational gait analysis in patients with orthopedic impairments. BMC Musculoskelet Disord 6:17CrossRefGoogle Scholar
  4. Button K, van Deursen R, Price P (2008) Recovery in functional non-copers following anterior cruciate ligament rupture as detected by gait kinematics. Phys Ther Sport 9:97–104CrossRefGoogle Scholar
  5. Chan MO, Sen ES, Hardy E, Hensman P, Wraith E, Jones S, Rapley T, Foster HE (2014) Assessment of musculoskeletal abnormalities in children with mucopolysaccharidoses using pGALS. Pediatr Rheumatol Online J 12:32CrossRefGoogle Scholar
  6. Chantraine F, Filipetti P, Schreiber C, Remacle A, Kolanowski E, Moissenet F (2016) Proposition of a classification of adult patients with hemiparesis in chronic phase. PLoS One 11:e0156726CrossRefGoogle Scholar
  7. Clarke L, Murphy A (2014) Validation of a novel 2D motion analysis system to the gold standard in 3D motion analysis for calculation of sagittal plane kinematics. Gait Posture 39(Suppl 1):S44–S45Google Scholar
  8. Coutts F (1999) Gait analysis in the therapeutic environment. Man Ther 4:2–10CrossRefGoogle Scholar
  9. Davis R, Ounpuu S, Tyburski D & Deluca P (1991) A comparison of two dimensional and three dimensional techniques for the determination of joint rotation angles. Proceedings of international symposium on 3D analysis of human movement. p 67–70.Google Scholar
  10. Deltombe T, Bleyenheuft C, Gustin T (2015) Comparison between tibial nerve block with anaesthetics and neurotomy in hemiplegic adults with spastic equinovarus foot. Ann Phys Rehabil Med 58:54–59CrossRefGoogle Scholar
  11. Eastlack ME, Arvidson J, Snyder-Mackler L, Danoff JV, McGarvey CL (1991) Interrater reliability of videotaped observational gait-analysis assessments. Phys Ther 71:465–472CrossRefGoogle Scholar
  12. Esposito G, Venuti P (2008) Analysis of toddlers’ gait after six months of independent walking to identify autism: a preliminary study. Percept Mot Skills 106:259–269CrossRefGoogle Scholar
  13. Fatone S, Stine R (2015) Capturing quality clinical videos for two-dimensional motion analysis. J Prosthet Orthot 27:27–32CrossRefGoogle Scholar
  14. Guzik A, Druzbicki M, Przysada G, Kwolek A, Brzozowska-Magon A, Wolan-Nieroda A (2017) Analysis of consistency between temporospatial gait parameters and gait assessment with the use of Wisconsin gait scale in post-stroke patients. Neurol Neurochir Pol 51:60–65Google Scholar
  15. Hillman SJ, Donald SC, Herman J, McCurrach E, McGarry A, Richardson AM, Robb JE (2010) Repeatability of a new observational gait score for unilateral lower limb amputees. Gait Posture 32:39–45CrossRefGoogle Scholar
  16. Johnson L, Burridge JH, Demain SH (2013) Internal and external focus of attention during gait re-education: an observational study of physical therapist practice in stroke rehabilitation. Phys Ther 93:957–966CrossRefGoogle Scholar
  17. Krebs DE, Edelstein JE, Fishman S (1985) Reliability of observational kinematic gait analysis. Phys Ther 65:1027–1033CrossRefGoogle Scholar
  18. Lura DJ, Wernke MM, Carey SL, Kahle JT, Miro RM, Highsmith MJ (2015) Differences in knee flexion between the Genium and C-Leg microprocessor knees while walking on level ground and ramps. Clin Biomech (Bristol, Avon) 30:175–181CrossRefGoogle Scholar
  19. Maathuis KG, van der Schans CP, van Iperen A, Rietman HS, Geertzen JH (2005) Gait in children with cerebral palsy: observer reliability of physician rating scale and Edinburgh visual gait analysis interval testing scale. J Pediatr Orthop 25:268–272CrossRefGoogle Scholar
  20. Mackey AH, Lobb GL, Walt SE, Stott NS (2003) Reliability and validity of the observational gait scale in children with spastic diplegia. Dev Med Child Neurol 45:4–11CrossRefGoogle Scholar
  21. Moseley AM, Descatoire A, Adams RD (2008) Observation of high and low passive ankle flexibility in stair descent. Percept Mot Skills 106:328–340CrossRefGoogle Scholar
  22. Nielsen D, Daugaard M (2008) Comparison of angular measurements by 2D and 3D gait analysis. Dissertation, Jonkoping University.Google Scholar
  23. Obembe AO, Olaogun MO, Adedoyin R (2014) Gait and balance performance of stroke survivors in south-western Nigeria – a cross-sectional study. Pan Afr Med J 17(Suppl 1):6Google Scholar
  24. Perry J (1992) Gait analysis, normal and pathological function. SLACK, ThorofareGoogle Scholar
  25. Rathinam C, Bateman A, Peirson J, Skinner J (2014) Observational gait assessment tools in paediatrics – a systematic review. Gait Posture 40:279–285CrossRefGoogle Scholar
  26. Satila H, Pietikainen T, Iisalo T, Lehtonen-Raty P, Salo M, Haataja R, Koivikko M, Autti-Ramo I (2008) Botulinum toxin type A injections into the calf muscles for treatment of spastic equinus in cerebral palsy: a randomized trial comparing single and multiple injection sites. Am J Phys Med Rehabil 87:386–394CrossRefGoogle Scholar
  27. Taylor P, Barrett C, Mann G, Wareham W, Swain I (2014) A feasibility study to investigate the effect of functional electrical stimulation and physiotherapy exercise on the quality of gait of people with multiple sclerosis. Neuromodulation 17:75–84. Discussion 84CrossRefGoogle Scholar
  28. Toro B, Nester CJ, Farren PC (2003) The status of gait assessment among physiotherapists in the United Kingdom. Arch Phys Med Rehabil 84:1878–1884CrossRefGoogle Scholar
  29. Viehweger E, Zurcher Pfund L, Helix M, Rohon MA, Jacquemier M, Scavarda D, Jouve JL, Bollini G, Loundou A, Simeoni MC (2010) Influence of clinical and gait analysis experience on reliability of observational gait analysis (Edinburgh gait score reliability). Ann Phys Rehabil Med 53:535–546CrossRefGoogle Scholar
  30. Vrieling AH, van Keeken HG, Schoppen T, Otten E, Halbertsma JP, Hof AL, Postema K (2007) Obstacle crossing in lower limb amputees. Gait Posture 26:587–594CrossRefGoogle Scholar
  31. Wass E, Taylor NF, Matsas A (2005) Familiarisation to treadmill walking in unimpaired older people. Gait Posture 21:72–79CrossRefGoogle Scholar
  32. Williams G, Morris ME, Schache A, Mccrory P (2009) Observational gait analysis in traumatic brain injury: accuracy of clinical judgment. Gait Posture 29:454–459CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Laboratory for Gait and Human Motion AnalysisOrthopedic Hospital SpeisingViennaAustria

Section editors and affiliations

  • Sebastian I. Wolf
    • 1
  1. 1.Movement Analysis LaboratoryClinic for Orthopedics and Trauma Surgery; Center for Orthopedics, Trauma Surgery and Spinal Cord Injury;Heidelberg University HospitalHeidelbergGermany

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