Posture and gait assessment in spastic patients: key points for practice
Dr Etienne ALLARTa
a Service de rééducation neurologique cérébrolésion
Introduction: Posture and gait are frequently disturbed in patients suffering from diseases affecting central nervous system. Whatever the origin of these troubles (neuromotors, sensory, coordination or cognitive deficiencies), they can lead to major impact on activities, participation and quality of life. Thus they represent an important rehabilitation goal for patients.
Method: In order to assess consequences of neuromotor deficiencies, posture and gait evaluations have two main aspects. A first part of assessments are designed to study posture and gait troubles and to search for their determining factors; in a therapeutic point of view, they can help to choose treatment target(s) and tools and to measure their efficacy on gait or posture troubles. The second part is intended to assess the impact of gait and posture disturbances on activity, participation and quality of life; these evaluations allow measuring the overall efficacy of the treatment in daily living. Results: There are multiple clinical and instrumental evaluation tools to deal with these two aspects. The use of these measurements in daily practice must be considered with regards to their feasibility, practical aspects and usefulness.
Discussion: We will make an overview of some of these posture and gait assessment tools in neurological disease, keeping in mind their utility in clinical practice.
Keywords : gait, posture, spasticity, assessment, hemiplegia