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. 2014 Nov;9(6):827-38.

Gait considerations in patients with femoroacetabular impingement

Dirk Kokmeyer, Melissa Strzelinski, Bryan J Lehecka

Gait considerations in patients with femoroacetabular impingement

Dirk Kokmeyer et al. Int J Sports Phys Ther. 2014 Nov.

Abstract

The literature describing the characteristic features of femoroacetabular impingement (FAI) has been on the rise, increasing awareness of this pathology in the young, active population. The physical therapist should consider FAI as a contributing factor to anterior hip pain, impairments, and functional deficits of the lower quarter. The dynamic interplay of anatomical variations, pain, and muscle function and their effects on gait in patients with FAI, however, is poorly understood. Small sample populations and variability in radiological, demographic, and clinical presentations in those with FAI have precluded meaningful insight into gait analysis and FAI, reiterating the need for further research in this domain. The purpose of this clinical commentary is to review the literature that defines normal gait at the hip joint and abnormal gait as a result of FAI and labral pathology or surgery aimed at correcting it. Secondarily, the authors aim to offer clinicians a strategy to progress the post-surgical patient to normal, unassisted gait while reducing the risk for anterior hip pain. Lastly, the authors of this commentary aim to identify specific areas for future research directed at therapeutic interventions in patients with FAI and those who have undergone surgery to correct it.

Level of evidence: 5.

Keywords: Anterior hip pain; biomechanics; femoroacetabular impingement; gait; gait analysis.

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Figures

Figure 1.
Figure 1.
Graphic representation of the gait cycle. (Adapted from Perry J, Burnfield JM. Hip. Gait Analysis: Normal and Pathological Function. 2nd ed. Thorofare, NJ: SLACK; 2010:103‐127.)
Figure 4.
Figure 4.
Perturbations are applied by the therapist to the patient's pelvis while standing with with feet staggered (a) or with a leg pressed to the wall to facilitate the hip extensors (b). This may be done with the involved limb to the front or rear. Perturbations should be applied through the pelvis and bilateral lower extremities in varying positions, intensities and speeds, based on the patient's tolerance and ability.
See this image and copyright information in PMC

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