Hip hiking and circumduction - Quantitative definitions

Objective: To define and propose clinically useful quantitative measurement s of hip hiking and circumduction using standard three-dimensional motion a nalysis techniques. Design: We studied pelvic, hip, and thigh motions in 23 subjects with hemip aretic, stiff-legged gait as a result of stroke and compared these motions with those obtained from 23 able-bodied controls. Results: We observed significantly increased hip abduction on the unaffecte d limb during stance, with simultaneous elevation of the affected side of t he pelvis during swing. We define these differences as hip hiking and, thus , can quantify the degree to which hip hiking occurs by measuring the unaff ected coronal hip angle and/or the coronal pelvic angle when the affected l imb is in midswing. We also observed a greater than normal coronal thigh an gle 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. Conclusions: 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 c ommunicate and understand the implications of these gait patterns, and can serve as the basis for clinically meaningful quantitative assessment and ou tcome measurement tools.