Assessment of Posture and Gait

Assessment of Posture and Gait

The nurse inspects the patient’s sitting and standing posture as well as gait. This assessment can begin with the initial patient contact as the nurse observes the individual’s unconscious, natural movements (Schoen, 2000). The nurse can also ask the patient to walk across the room to assess gait and posture more deliberately. The gait should have
a smooth rhythm with steady, well-balanced movements. Normally the length of stride is approximately 15 inches, with the heels about 2-4 inches apart from each other as the patient walks. The arms normally swing freely in rhythm with the stride. Posture is erect (Casteel, 2003; Schoen, 2000).

To adequately assess the patient’s posture, the entire length of the spine, buttocks, and legs should be exposed for inspection (Liddel, 2000a). The nurse closely examines the spinal alignment, both laterally and posteriorly, with the patient standing to detect any abnormal curvatures and deformities. Normally, the spine will be convex in the thoracic area and concave in the cervical and lumbar areas. The height of the shoulders and iliac crests should be symmetrical. Gluteal folds should also be symmetric. The nurse also asks the patient to bend forward to detect any spinal curvature or rising scapula.

Some common abnormalities that might be detected in the spine are scoliosis, lordosis, and
kyphosis (Liddel, 2000a). Scoliosis, a lateral curvature of the spine, commonly develops in adolescents. Lordosis (swayback) is an exaggeration of the concave curvature of the lumbar area. Kyphosis is an exaggeration of the convex curvature of the thoracic spine. Kyphosis results in a rounded back that is frequently associated with the development of osteoporosis
and the collapse of thoracic vertebrae.

Any abnormalities noted by the nurse are documented.

Orthopedic Nursing : Caring for Patients with Musculoskeletal Disorders
Dr. Judith A. Halstead

Tweet