Gait Patterns – Summary According to Various Sources

 
Two-point gait:  one crutch and opposite extremity move together followed by the
opposite crutch and extremity; requires use of two assistive devices (canes or
crutches); allows for natural arm and leg motion during gait, good support and
stability from two opposing points of contact. 
 
Three-point gait:  both crutches and involved leg are advanced together, then
uninvolved leg is advanced forward; requires use of two assistive devices (crutches
or canes) or a walker; indicated for use with involvement of one extremity , e.g.
lower extremity fracture.
 
Four-point gait:  a slow gait pattern in which one crutch is advanced forward and
placed on the floor, followed by advancement of the opposite leg; then the
remaining crutch is advanced forward followed by the opposite remaining leg;
requires the use of two assistive devices (crutches or canes); provides maximum
stability with three points of support while one limb is moving.
 
Swing-to gait:  both crutches are advanced forward together; weight is shifted onto
hands for support and both legs are then swung forward to meet the crutches;
requires the use of two crutches or a walker; indicated for individuals with limited
use of both lower extremities and trunk instability.
 
Swing-through gait: both crutches are advanced forward together; weight is
shifted onto the hands for support and both legs which are swung forward beyond
the point of crutch placement; requires the use of two crutches; both swing-to and
swing-through gaits are used for bilateral lower extremity involvement, and trunk
instability, e.g. patient with paraplegia, spina bifida.  Not as safe as swing-to gait. 
 
O’Sullivan, Susan b., Raymond p. Siegelman.  National Physical Therapy
Examination Rview and Study Guide.  International Educational Resources 2001. 
p. 234.
___________________________________________________________________
___________
 
Two-point gait:  This gait pattern is similar to the four-point gait.  However, it is
less stable because only two points of floor contact are maintained.  Thus, use of
this gait requires better balance.  The two-point pattern more closely simulates
normal gait, inasmuch as the opposite lower and upper extremity move together. 
Two additional, less commonly used crutch gaits are the swing-to and swing-
through patterns.  These gaits are often used when there is bilateral lower extremity
involvement, such as in spinal cord injuries. The swing-to gait involves forward
movement of both crutches simultaneously, and the lower extremities “swing to”
the crutches.  In the swing-through gait, the crutches are moved forward together,
but the lower extremities are swung beyond the crutches.
 
Three-point gait:  in this type of gait three points of support contact the floor.  It is
used when a non-weight-bearing status is required on one lower extremity.  Body
weight is borne on the crutches instead of on the affected lower extremity.
 
Four-point gait:  This pattern provides a slow, stable gait as three points of floor
contact are maintained.  Weight is borne on both lower extremities and typically is
used with bilateral involvement due to poor balance, incoordination, or muscle
weakness. In this gait pattern on crutch is advanced and then the opposite lower
extremity is advanced. For example, the left crutch is moved forward, then the right
lower extremity, followed by the right crutch and then the left lower extremity.
 
O’Sullivan, Susan B., Thomas J. Schmitz.   Physical Rehabilitation Assessment and
Treatment. 4th  ed. F. A. Davis Company.  1994.  p. 430-431.
___________________________________________________________________
___________
 
Two-Point Gait:  used to describe a pattern in which a patient uses two crutches or
canes.  The patient ambulates moving the left crutch forward while simultaneously
advancing the right lower extremity and vice-versa.  Each step is “ one point” and a
complete cycle is two points. 
 
Three- point gait:  This pattern can be seen with a walker, crutches or canes (two
canes).  It involves one injured lower extremity that may have decreased weight
bearing.  The assistive device is advanced followed by the injured lower extremity
and then the uninjured lower extremity.  The assistive device and each lower
extremity are considered separate points.  (Three points refers to two assistive
devices and one extremity in contact during stance - JM).
 
 
Giles, Scott M. , A Guide to Success: Review for Licensure in Physical
Therapy.  Mainely Physical therapy.  1999. p. 137
 
___________________________________________________________________
___________
 
Ambulating Using One Cane: The gait pattern and sequence when using one
standard cane or one quad cane are the same. 
            Positioned in stride, behind and to one side of the patient, the therapist
grasps the patient’s gait belt and shoulder.  The patient’s feet are side by side, with
the cane next to the small toe. 
            The cane is advanced first, approximately one stride length ahead.  The
therapist steps forward with his left, or outside, foot. 
            The patient advances the lower extremity on the side opposite the cane up to
the cane. 
            The patient advances the lower extremity on the same side as the cane.  The
therapist advances his right, or inside, foot as the patient moves here lower
extremity.  Initially, the patient may only step to the other lower extremity and
cane, but should be encouraged to step beyond the other lower extremity and cane. 
This encourages the patient to develop a more normal rhythm and pattern of gait. 
The sequence is repeated for continued progression.  As the patient improves, she
may move the cane and involved lower extremity at the same time, permitting a
faster pace of gait.  As the patient is able, she uses the can on the involved side,
moving the cane and involved lower extremity simultaneously.
 
(So note – cane when used singly is considered its own sequence.  JM)
 
Ambulating using two cane—Three-point gait pattern:  to ambulate, both canes
and the involved lower extremity are advanced simultaneously and the same
amount.  The therapist advances his left, or outside, foot, either at the same time or
immediately after the canes are advanced. The patient advances here uninvolved
lower extremity beyond the canes.  Initially, the patient may “step-to” here
involved lower extremity, rather than “step-through.”  Stepping through is the
normal gait pattern, and should be encouraged.  The therapist advances his right , or
inside, foot  as the patient moves here uninvolved lower extremity.  The sequence
is repeated for continued progression.
 
Duesterhaus Minor, Mary Alice; Scott Duesterhaus Minor.  Patient Care Skills.
4th  ed.  Appleton and Lange.  1999.  p. 420-421, 444-445.