Gait in Rehabilitation: Clinics in Physical Therapy.

The purpose of this text, to serve as a comprehensive treatise on gait, is definitely achieved. The authors of each chapter are well-known contributors to their area of specialty. The initial chapters set the stage for the review of normal and abnormal gait. Chapter 1 establishes the foundation for understanding basic gait terminology, such as temporal and distance factors, and briefly reviews the history of gait study. Chapter 2 is an overview of methods used to study gait, ranging from observational to quantitative assessments. A description of the kinetic and kinematic parameters of normal gait and their potential applications are covered in chapter 3. In chapter 4, energy expenditure in normal walking and the influence of elocity are discussed. The author describes the energy cost of different gait patterns, the use of assistive devices, and the differences seen in a wide variety of pathological conditions. Chapter 5, "Electromyographic Patterns in Normal Adult Locomotion," is a concise summary of muscle activity in gait. The investigator describes differences in techniques that result in varying conclusions regarding the electromyographic activity of major muscle groups during gait. A brief description of data acquisition and handling is included. The sixth chapter presents current concepts in early motor behaviors and the development of mature locomotor patterns. Application of neurophysiological theory to physical therapy interventions and further areas for research are suggested.

In chapter 7, the purpose, use, and adjustment of typical assistive devices are addressed. A standard reporting system used to describe gait patterns with an assistive device is presented. The authors discuss the clinical implications of various gait patterns.

"Gait in Children," chapter 8, summarizes the development of gait in children 1 to 7 years of age. The investigator discusses time-distance parameters that show age-related differences and are also sensitive measures of pathological gait abnormalities when compared with noral pediatric data. Other gait maturation factors such as joint angle changes, arm swing, and timing of muscle activity are presented. At the opposite end of the age spectrum, chapter 9 describes the changes in gait seen with aging. The problem of falls, particularly on stairs, is related to the age changes seen in locomotion.

Chapters 10 through 12 describe gait patterns and problems seen in a variety of pathological conditions, including musculoskeletal disorders, hemiplegia, and cardiac conditions. When available, results of therapeutic intervention on gait are presented. Chapter 13 covers prosthetic and orthotic gait. Typical gait deviations and their prosthetic, orthotic, or anatomic causes are presented through discussions and tables.

The final chapter is a discussion of clinical gait assessment and training. The author recommends an observational analysis format for reporting clinical data. An indicator of walking ability, the Smidt Number, based on preferred and maximum gait velocity, is presented.

This volume is an excellent reference on gait that physical therapists in a variety of settings will find relevant. The illustrations and tables are generally clear and enhance the written text. Each chapter includes an extensive bibliography appropriate to the topic.