To define and propose clinically useful quantitative measurements of hip hiking and circumduction using standard three-dimensional motion analysis techniques.
We studied pelvic, hip, and thigh motions in 23 subjects with hemiparetic, stiff-legged gait as a result of stroke and compared these motions with those obtained from 23 able-bodied controls.
We observed significantly increased hip abduction on the unaffected limb during stance, with simultaneous elevation of the affected side of the pelvis during swing. We define these differences as hip hiking and, thus, can quantify the degree to which hip hiking occurs by measuring the unaffected coronal hip angle and/or the coronal pelvic angle when the affected limb is in midswing. We also observed a greater than normal coronal thigh angle during midswing of the affected limb that we can use to quantitatively define circumduction. Of note, hip abduction during swing was not increased on the affected swing limb, compared with the control.
Hip hiking can be defined precisely as unaffected coronal hip and/or pelvic angle when the affected limb is in midswing and circumduction can be defined as greater than normal coronal thigh angle during midswing of the affected limb. These precise definitions should allow us to better communicate and understand the implications of these gait patterns, and can serve as the basis for clinically meaningful quantitative assessment and outcome measurement tools.
From the Department of Physical Medicine and Rehabilitation (DCK, EPF, POR), Harvard Medical School, and Spaulding Rehabilitation Hospital (DCK, EPF, SR, POR), Boston, Massachusetts.
Reprints: All correspondence and requests for reprints should be addressed to D. Casey Kerrigan, MD, Department of Physical Medicine and Rehabilitation, Harvard Medical School, 125 Nashua Street, Boston, MA 02114.
Disclosure: Supported, in part, by United States Public Health Service Grant NIH HD01071-05, by the Ellison Foundation, and by the Davis Foundation.