Walking Impediments and Gait Inefficiencies in the CVA Patient

The use of motor activity parameters for patients results in arbitrary values of acceptance for measuring balance, alignment, range of motion, walking, and other functional activities. Statistical analysis of each measure results in an averaged value, and the synthesis of all averaged measures creates the ethereal and elusive “normal model.” This model is useful in providing general direction and goal setting strategies; however, clinicians must recognize acceptable limits of combined measures for providing the most effective structural and functional outcomes. This article considers the functional and dysfunctional components of gait in patients who have had a cerebrovascular accident. Often, these two types of patterns (i.e., functional and dysfunctional) are interdependent and difficult to differentiate. As a result, each patient must be evaluated and treated individually to maintain the integrity of the structural components and produce the maximum level of functional independence.