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ExplanatoryNotes
The P&O Clinical Movement DATA software can assist you in calculating the Edinburgh Visual Gait Score
(EVGS).Usetheonscreenmeasurementanddrawingtoolstohelpyoutoevaluateeachitemofthescoreand
entertheresultsintheEVGSpaneonthelefthandsideofthescreen.ThesoftwarewillthengenerateaEVGS
report,withillustrativeimagesfromthevideoifdesired,inPDFformat.
Foot
1. InitialContactinStance
Theheelnormallycontactsfirst.Thetoedescribesthatportionofthefootdistaltothemetatarsophalangeal
joints.Simultaneouscontactwiththeheelandtoecomprisesflatfootcontact.
Observation
Score
Heelcontact
Flatfootcontact
Toecontact
2. HeelLiftinStance
Ifthereisnoheelcontactduringstance,therecanbenoheellift(i.e.,"Noheelcontact").Heelliftnormally
occursbetweenoppositefootlevelandoppositefootcontact("Normal")."Early"heelliftindicatesthatheel
liftprecedestheoppositefootbeinglevelwiththestancefoot."Delayed"heelliftispresentifheelliftoccurs
withorafteroppositefootcontact."Noforefootcontact"describestherareoccasionofacalcaneousfoot
whentheforefootdoesnotcontactduringstance.
Observation
Score
Noforefootcontact
Delayed
Normal
Early
Noheelcontact
3. MaximumAnkleDorsiflexioninStance
Thereisnormalforwardprogressionofthetibialovertheplantedhindfootfromslightplantarflexionatinitial
contacttodorsiflexionatterminalstance.
Describethemaximumangleofdorsiflexionbetweenhindfootandshaftofthetibiaduringstance.
In pathological gait, lack of heel contact may be caused by either excessive plantarflexion of the foot or
excessivekneeflexion.Thetibialhindfootangleisthereforeanalysedirrespectiveofthepositionofthefoot
onthefloor.
Observation
Score
Excessivedorsiflxn(>40df)
Increaseddorsiflxn(2640df)
Normaldorsiflxn(525df)
Reduceddorsiflxn(10pl4df)
Markedplantarflxn(>10pl)
4. HindfootVarus/ValgusinStance
Inthecoronalplane,thenormalhindfootisinneutralorveryslightvalgus.
Observation
Score
Severevalgus(morethan15valgus)
Modvalgus(6to15valgus)
Neutral/slightvalgus(0to5valgus)
Mildvarus(1to10varus)
Severevarus(morethan10varus)
5. FootRotationinStance
ThenormalfootisslightlyexternallyrotatedrelativetotheKneeProgressionAngle(KPA,i.e.,thedirectionin
whichthekneepointsduringgait).
Observation
Score
Markedext>KPA(by>40)
Modext>KPA(by2140)
SImoreextthanKPA(by020extn)
Modint>KPA(by125)
Markedint>KPA(by>25)
6. ClearanceinSwing
Thewholefootincludingthetoeshouldclearthefootandnotmakecontactduringswingphase.
"None" should be recorded if there is continuous contact between some part of the foot and the floor
throughoutswingphase.
"Reduced"indicatesthatthereisashortenedbutdefiniteperiodofclearanceduringsomepartoftheswing
phasebetweenthewholefootandthefloor.
"Full"ornormalclearanceiswhenthefootdoesnottouchatallinswing;however,normalclearanceisavery
smallamount.
"Highsteps"describesexcessiveliftingofthefootfromthefloor.Whenthereisreducedclearancefollowed
byhighstepping,circleboth,givingascoreof2forthiscombinationoffeatures.
Observation
Score
HighSteps
Full
Reduced
None
7. MaximumAnkleDorsiflexioninSwing
Theankleisnormallyapproximatelyneutralinswing,butveryslightplantarflexion(5)isacceptable.
Observation
Score
Excessivedorsiflxn(>30df)
Increaseddorsiflxn(1630df)
Normaldorsiflxn(15df5pl)
Modplantarflxn(620pl)
Markedplantarflxn(>20pl)
Knee
8. KneeProgressionAngleinMidStance
Thekneenormallypointsforwardduringgait.Recordthepositioninwhichthekneeappearstopointduring
most of the stance phase. When either internal or external rotation is present but the whole knee cap is
visible,score1.Whenrotationispresenttosuchanextentthatthekneecapispartiallyoutofview(external
orinternal,partcapvisible),score2.
Observation
Score
External,partkneecapvisible
External,allkneecapvisible
Neutral,kneecapmidline
Internal,allkneecapvisible
Internal,partkneecapvisible
9. PeakExtensionStance
Thekneeapproachesfullextensioninterminalstance.Inpathologicalgait,thekneemayremainmoreflexed
throughoutstance.Alternatively,hypertensioncanoccurasfemoralprogressionproceedsoveranarrested
tibia.
Observation
Score
Severeflexn(>25)
Modflexn(1625)
Normal(015flexn)
Modhyperextn(110)
Severehyperextn(<10)
10.TerminalSwingPosition
Thekneeisnormallyinslightflexionimmediatelybeforeheelstrike.
Observation
Score
Severeflexn(>30)
Modflexn(1630)
Normal(515flxn)
Modoverextn(4flx10xtn)
Severehyperextn(>10xtn)
11.PeakKneeFlexioninSwing
Thenormalrangeis50to70.
Observation
Score
Severelyincreased(>85flxn)
Modincreased(7185flxn)
Normal(5070flxn)
Modreduced(3549flxn)
Severelyreduced(<35flxn)
Hip
12.PeakHipExtensioninStance
Thehipnormallyextendsinstancetobetweenneutraland20ofextension.
Observation
Score
Modflexn(115flxn)
Modflexn(115flxn)
Normal(020extn)
Modhyperextn(2135extn)
Markedhyperextn(>35)
13.PeakHipFlexionduringSwing
Normalflexionisbetween25and45.
Observation
Score
Markedincrease(>60flxn)
Increasedflexn(4660flxn)
Normalflexn(2545flxn)
Reducedflexn(1024flxn)
Severelyreduced(<10flxn)
Pelvis
14.ObliquityatMidStance
The pelvis normally drops slightly on the opposite side during loading, becoming level by terminal stance.
Estimatethepositioninmidstance."Up"and"down"refertotheposition oftheASISonthestanceside,
relativetotheoppositesideASIS.
Observation
Score
Markeddown(>10)
Moddown(110)
Normalobliquity(05up)
Modup(615)
Markedup(>15)
15.PelvicRotationatMidStance
In mid stance, the pelvis should be at approximately neutral rotation, between 5 backward rotation
(retraction)ofthestanceleg,and10forwardrotation(protraction).
Observation
Score
Markedretraction(>15)
Modretraction(615)
Normal(5retr10pro)
Modprotraction(1120)
Severeprotraction(>20)
Trunk
16.PeakSagittalPositioninStance
Thetrunkiserectduringstanceandswingphases.Suggestedvalueshereare:
0
=Ver calto5forwardorbackward
1
=morethan5backwardsorbetween6and15forward
2
=morethan15forward
Observation
Score
Marked
Moderate
Normal
Reduced
17.MaximumLateralShift
Normallythetrunkdisplaceslaterallyapproximately25mmduringstance,towardsthestanceleg.
"Excessive"thoracicshiftlaterallyorlateralflexionshouldbeconsideredwhenrecordingobservations.
"Reduced"describesthosecasesinwhichthetrunkremainsleaningovertheswingingleg.
Observation
Score
Excessive
Normal
Reduced
Summary
Totalallthecores:
?Initialcontact
?Heellift
?Maxankledorsiinstance
?Hindfootvarus/valgus
?Footrotation
?Clearanceinswing
?Maxankledorsiinswing
?Kneeprogressionangle
?Peakkneeextninstance
?Kneeextninterminalswing
?Peakkneeflexninswing
?Peakhipextninstance
?Peakhipflexninswing
?Maxpelvicobliquityinmidstance
?Pelvicrotationinmidstance
?Peaksagittaltrunkposition
?Maxlateralshiftoftrunk
??TOTAL