Table 1.
Gait Assessment and Intervention Tool (G.A.I.T.)
| Name____________________________________ Date_______________ Examiner_____________________ | |
| Diagnosis___________________ Limb assessed_____ Device/Orthosis/Assist_________________________ | |
| Stance and Swing Phases | |
| Score | |
| 1. Shoulder position 0 = normal. 1 = abnormal position (check all that apply __ depressed, __ elevated, __ retracted, or __ protracted). |
_____ |
| 2. Elbow flexion 0 = < 45° (normal = ~ 10°). 1 = 45 – 90° elbow flexion. 2 = > 90° elbow flexion. |
_____ |
| 3. Arm swing 0 = normal. 1 = abnormal – reduced or absent arm swing. |
_____ |
| 4. Trunk alignment (Static) 0 = normal erect posture (absence of flexion, extension or lateral flexion). 1 = trunk statically in __ flexion or __ extension. 2 = trunk statically in lateral flexion to the __ right or __ left. 3 = trunk in both __ flexion or __ extension, & lateral flexion to __ right or __ left. |
_____ |
| Stance Phase | |
| 5. Trunk posture/movement (Dynamic) (sagittal plane) (lateral view) 0 = normal (static trunk alignment maintained). 1 = trunk __ flexes or __ extends (check one) < 30°. 2 = trunk __ flexes or __ extends (check one) 30° or more. |
_____ |
| 6. Trunk posture/movement (Dynamic) (coronal plane) (front/back view) 0 = normal (static trunk alignment maintained). 1 = trunk laterally flexes to __ right or to __ left (check one) < 30°. 2 = trunk laterally flexes to __ right or to __ left (check one) 30° or more. |
_____ |
| 7. Weight shift (lateral displacement of head, trunk and pelvis) (coronal plane) (front/back view) 0 = normal weight shift (~ 25 mm shift over stance limb). 1 = reduced weight shift. 2 = almost none or no weight shift. 2 = excessive weight shift. |
_____ |
| 8. Pelvic position (coronal plane) (front/back view) 0 = normal (no Trendelenberg sign) 1 = mild pelvic drop on contralateral side. 2 = severe or abrupt pelvic drop on contralateral side. |
_____ |
| 9. Hip extension (sagittal plane) (lateral view) 0 = normal (moves from 30° of hip flexion at initial contact to neutral by midstance, then to 20° of extension past neutral in terminal stance). 1 = hip extends to neutral by midstance but lacks further hip extension during terminal stance. 2 = abnormal throughout stance (hip remains in flexion or marked extension). |
_____ |
| 10. Hip rotation (coronal plane) (front/back view) 0 = normal (remains in neutral) 1 = abnormal, internal rotation 1 = abnormal, external rotation |
_____ |
| 11. Knee – initial contact phase (sagittal plane) (lateral view). Choose __ A or __ B (check selection) A. Knee flexion 0 = normal (knee in neutral/not hyperextended). 1 = 5° – 15° knee flexion. 2 = > 15°, but < 30° knee flexion. 3 = > 30° knee flexion. B. Knee extension 0 = normal (knee in neutral/not in flexion). 1 = 5° – 15° knee hyperextension. 2 = > 15° up to 30° knee hyperextension. 3 = > 30° knee hyperextension. |
_____ |
| 12. Knee – loading response phase (sagittal plane) (lateral view). Choose __ A or __ B (check selection) A. Knee flexion 0 = normal (up to 15° knee flexion). 1 = > 15°, but < 30° knee flexion. 2 = ≥ 30° knee flexion B. Knee extension 0 = normal (up to 15° knee flexion). 1 = no knee flexion, up to 15° knee hyperextension. 2 = ≥ 15° knee hyperextension. |
_____ |
| 13. Knee – midstance phase (sagittal plane) (lateral view). Choose __ A, __ B, __ C, or __ D (ck. select) A. Knee flexion 0 = normal (knee in 4° flexion at heel strike, increasing to 15° flexion at 14% of gait cycle). 1 = 5 – 15° flexion throughout midstance; does not achieve neutral at midstance. 2 = > 15°, but < 30° knee flexion 3 = ≥ 30° knee flexion. B. Knee extension 0 = normal (knee in 4° flexion at heel strike, increasing to 15° flexion at 14% of gait cycle). 1 = knee extended through midstance phase; not hyperextended. 2 = up to 15° knee hyperextension during midstance phase. 3 = > 15° knee hyperextension during midstance phase. |
_____ |
| C. Knee flexion moving to extension 0 = normal (knee in 4° flexion at heel strike, increasing to 15° flexion at 14% of gait cycle). 1 = normal knee flexion during early midstance phase, then knee extends to neutral. 2 = knee flexion during early midstance phase, then knee extends to full extension range (neutral or beyond) in uncontrolled manner, but not snapping back. 3 = knee in flexion during early midstance phase, then knee abruptly and forcefully extends into end range in an uncontrolled manner. D. Knee extension moving to flexion 0 = normal (knee in 4° flexion at heel strike, increasing to 15° flexion at 14% of gait cycle). 1 = knee remains in extension in early midstance, then knee flexes late, but retains control. 2 = knee remains in extension in early midstance, then knee flexes, losing control and regaining control. 3 = knee remains in extension in early midstance, then knee buckles with failure to regain control and requires use of compensatory strategies. |
|
| 14. Knee – terminal stance phase/pre-swing phase (heel-rise to toe-off) (sagittal plane) (lateral view) 0 = normal (knee flexion position in sagittal plane 35 – 45°). 1 = knee flexes < 35° or > 45°. 2 = knee flexes 35 – 45°, then extends. 3 = knee remains in full extension throughout. |
_____ |
| 15. Ankle movement (sagittal plane) (lateral view). Choose __ A or __ B. (Check selection). A. Ankle plantar flexion 0 = normal (from ankle neutral position at initial heel contact, moving to 10° plantarflexion before midstance, then moving to 10° dorsiflexion at heel off). 1 = normal from initial contact (with heel strike) to midstance, but in plantarflexion after midstance. 1 = foot flat at initial contact, moving to slight plantarflexion before midstance, but in plantarflexion after midstance. 2 = foot flat at initial contact with plantarflexion to heel off. 3 = no heel contact with excessive plantarflexion to heel off. 3 = either heel contact or no heel contact followed by excessive and/or early (midstance) plantarflexion (i.e., vaulting). B. Ankle dorsiflexion 0 = normal (from ankle neutral position at initial heel contact, moving to 10° plantarflexion before midstance, then moving to 10° dorsiflexion at heel off). 1 = normal just prior to midstance, but > 10° dorsiflexion after midstance 2 = 15 – 20° dorsiflexion at midstance and to terminal stance (heel off). 3 = excessive ankle dorsiflexion (> 20°) throughout stance. |
_____ |
| 16. Ankle inversion (coronal plane) (front/back view) 0 = normal (slight inversion/supination at initial stance; then eversion/pronation until heel-off). 1 = excessive ankle inversion/supination present at initial contact. 2 = excessive ankle inversion/supination present at initial contact and at midstance. 3 = excessive ankle inversion/supination throughout stance. |
_____ |
| 17. Plantarflexion during terminal stance/pre-swing (heel-rise to toe-off) (sagittal plane) (lateral view) 0 = normal (adequate push-off at pre-swing for moving from dorsiflexion position to 10° plantarflexion. 1 = partial/weak push-off while moving into plantarflexion at toe-off. 2 = absent/lack of plantarflexion; no push-off. |
_____ |
| 18. Toe position (sagittal plane) (lateral view) 0 = normal (toes in neutral position) 1 = excessive toe extension. 1 = clawing. |
_____ |
| Swing Phase | |
| 19. Trunk posture/movement (Dynamic) (sagittal plane) (lateral view) 0 = normal (static trunk alignment maintained). 1 = trunk __ flexes or __ extends (check one) < 30°. 2 = trunk __ flexes or __ extends (check one) 30° or more. |
_____ |
| 20. Trunk posture/movement (Dynamic) (coronal plane) (front/back view) 0 = normal (static trunk alignment maintained). 1 = trunk laterally flexes to __ right or to __ left (check one) < 30°. 2 = trunk laterally flexes to __ right or to __ left (check one) 30° or more. |
_____ |
| 21. Pelvic position (coronal plane) (front/back view) 0 = normal (relatively level pelvis or slightly lower on swing side). 1 = mild hip hiking. 2 = moderate to severe hip hiking. |
_____ |
| 22. Pelvic position (sagittal plane) (lateral view) 0 = normal (neutral position with respect to anterior or posterior tilt). 1 = anterior pelvic tilt. 1 = posterior pelvic tilt. |
_____ |
| 23. Pelvic rotation as limb swings forward (transverse plane) (top view) 0 = normal (from 5° backward rotation at initiation of swing to 5° forward rotation by terminal swing) 1 = reduced pelvic rotation. 1 = excessive pelvic rotation. 2 = absent pelvic rotation. |
_____ |
| 24. Hip flexion (sagittal plane) (lateral view) 0 = normal (0° hip flexion at initial swing to ~ 35° at peak, then reducing to ~ 25° at terminal swing; hip neutral with respect to hip abduction/adduction). 1 = hip begins swing in flexion, but reaches normal peak. 1 = > 10°, but < 30° hip flexion peak in the sagittal plane. 2 = > 10°, but < 30° hip flexion peak, and with hip abduction (e.g., = circumduction). 2 = > 10°, but < 30° hip flexion peak, and with hip adduction (e.g., = scissoring). 3 = 0 to 10° hip flexion throughout swing. 3 = > 35° hip flexion (excessive hip flexion). |
_____ |
| 25. Hip rotation (coronal plane) (front/back view) 0 = normal (remains in neutral) 1 = abnormal, internal rotation 1 = abnormal, external rotation |
_____ |
| 26. Knee – initial swing (sagittal plane) (lateral view) 0 = normal (40 – 60° of knee flexion). 1 = at least 15° knee flexion, but < 40° knee flexion. 2 = < 15° knee flexion. 3 = knee never flexes. |
_____ |
| 27. Knee – midswing (sagittal plane) (lateral view) 0 = normal (60° knee flexion ± 4°). 1 = 45° - 55° knee flexion. 2 = 25° - 45° knee flexion. 3 = 0 to 25° knee flexion. |
_____ |
| 28. Knee – terminal swing (sagittal plane) (lateral view) 0 = normal (from knee flexed position to full knee extension). 1 = from knee flexed position, remaining in knee flexion throughout. 1 = from knee extension position, remaining in knee extension throughout. |
_____ |
| 29. Ankle movement (sagittal plane) (lateral view) 0 = normal (from initial plantarflexion at terminal stance [toe-off] to neutral by midswing, then slight dorsiflexion just prior to initial contact in stance). 1 = midswing ankle neutral but no terminal swing dorsiflexion. 2 = no midswing ankle neutral and no terminal swing dorsiflexion; plantarflexion throughout. |
_____ |
| 30. Ankle inversion (coronal plane) (front/back view) 0 = normal (ankle remains in neutral regarding inversion/eversion). 1 = ankle in inverted position during swing. |
_____ |
| 31. Toe position (sagittal plane) (lateral view) 0 = normal (toes in neutral position) 1 = inadequate toe extension. 1 = clawing. |
_____ |
| Total Score _______/ 62 | |
| With permission: JJ Daly et al., J Neurosci Methods; 2009. 178:334-339 | |