Knowledge base for diagnostic gait assessments

Clinical gait laboratories have proliferated over the past two decades and an increasing number of research papers are reporting 'assessments' of pathological gait. Some criticisms have been levied at the value of most of these assessments, and some of their arguments are justified. Unfortunately, their review of the pathological gait literature was too superficial for them to justify their main conclusions. The purpose of this review is three fold. The first goal is to show that clinical gait assessments, properly done, do yield valuable diagnostic information to assist surgeons in planning orthopaedic procedures, in the planning of rehabilitation and in the assessment of prosthetic devices. The second goal is to present specific examples of pathological gait assessment to demonstrate the need to understand the fundamental goals and sub-tasks involved in walking, normal gait synergies and the value of a normalized data base. Finally, a generalized strategy will be demonstrated through the use of a diagnostic checklist that has been developed for all gait pathologies. This latter goal is logistically and financially important when we consider the high equipment and personnel costs of running a diagnostic gait service.