Spark Motion Gait Assessment
Name
First Name
Last Name
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email
example@example.com
1. Initial Contact Phase
Rows
Right
Left
Hip Flexion
20-30 degrees ideal
Knee Flexion 0-5 Degrees
Ankle Neutral
2. Load Response Phase
Rows
Right
Left
Knee Flexion
20-25 degrees ideal
3. Mid Stance Phase
Rows
Right
Left
Anterior View Hip Adduction 5-7 degrees
Posterior View Hip Drop 3-4 degrees
4. Terminal Stance Phase
Rows
Right
Left
Hip Extension
15-20 degrees ideal
Ankle Dorsiflexion 10 degrees
Observations
Should be Empty: