The functional significance of spasticity as assessed by gait analysis

Various atypical gait patterns are commonly associated with spasticity in certain muscle groups; however, these generalizations do not apply to all patients. The presence and degree of spasticity in a particular muscle group often has little relevance to the gait pattern. An algorithm using quantitative gait analysis to determine the actual mechanism of an atypical gait pattern is presented. A muscle is considered functionally significantly spastic only if it fulfills a number of criteria in the algorithm. We discuss the use of this algorithm for each of several common atypical gait patterns, including stiff-legged gait, ankle equinus, knee recurvatum, crouched gait, foot varus, scissoring, and reduced hip extension. The primary purpose of this article is not to explain how to perform a quantitative gait analysis but rather to describe the algorithm to assess a patient with an atypical gait pattern associated with an upper motor neuron pathology.