In the rehabilitation of the child or adult with lower limb weakness or paralysis as the result of congenital anomaly, disease or accident, orthoses are often an important adjunct to the rehabilitation modalities employed in the management of this challenging population. A keen appreciation of normal and abnormal bio-mechanics is key to the effective prescription of lower limb orthotic devices. This lecture will provide a review of normal and abnormal gait from an orthotists perspective. A clear understanding of the impact of the ground reaction force on the moments generated around the joints of the lower limb in normal and pathological gait is imperative in the effective understanding of the design criterion needed to effectively prescribe these devices. In addition observational gait analysis and the basics of orthoses design will be presented in a logical progression. The goal is to enable you to break down and analysis pathological gait into its component parts and then use that information in the design of a lower limb orthosis.


Pre-conference preparation (6 hours of online lectures) and 1 day at a clinical site.

Target Audience: Intermediate level course open to licensed physical therapists.

Credits: 14 contact hours (6 online and 8 on-site) from EIM Institute of Health Professions

Program Applicability: Neurologic Physical Therapy Residency, Certification, and Postprofessional DPT (NR 202A; 1 credit)

Prerequisites: None

Appropriate dress: Participants are asked to bring appropriate attire for lab sessions (i.e. shorts and t-shirts and sports bras for women) and air-conditioned environments throughout the day (i.e. warm-up or work-out clothes).


  1. Describe the impact of the ground reaction force on the direction and magnitude of the moments around the ankle, knee and hip in each stance period of gait.
  2. Understand the layered progression of gait pathology based upon the level and severity of injury or disease and its impact on brace design.
  3. Understand and employ the principles of Perry’s Observational Gait Analysis.
  4. Understand the design criteria associated with the successful design and implementation of a lower limb orthosis in this population.
  5. Differentiate between the typical applications of various lower limb orthoses and their contraindications.
  6. Appreciate the criteria used to make decisions on device height, ankle control mechanisms and joint crossed.
  7. Have a working understanding of the prescription criteria associated with the decision used to use one device or the other.

Most importantly – be able to apply this stuff to your clinical practice next week!

References Required and supplementary articles are listed in each weekly module and can be downloaded from the Moodle Learning Management System.