Name
Date
-
Month
-
Day
Year
Date
Ankle Stiffness Left
Please Select
Sufficient
Absent
Ankle Stiffness Right
Please Select
Sufficient
Absent
Knee Extension Pre-swing Left
Please Select
Reactive
No extension
Hyperextension
Knee Extension Pre-swing Right
Please Select
Reactive
No extension
Hyperextension
Hip Lock Left
Please Select
Lock
OK
Drop
Hip Lock Right
Please Select
Lock
OK
Drop
Positive Running Toe-off Left
Please Select
Positive
Negative
Positive Running Toe-off Right
Please Select
Positive
Negative
Swing Leg Recovery Left
Please Select
Fierce
Slow
Swing Leg Recovery Right
Please Select
Fierce
Slow
Knee Flexion Mid Swing Left
Please Select
OK
Obtuse
Knee Flexion Mid Swing Right
Please Select
OK
Obtuse
Swing Leg Retraction Left
Please Select
Active
Passive
Swing Leg Retraction Right
Please Select
Active
Passive
Scissors Motion Left
Please Select
Ok
Fair
Late
Scissors Motion Right
Please Select
Ok
Fair
Late
Foot Plant from Above Left
Please Select
Ok
Poor
Foot Plant from Above Right
Please Select
Ok
Poor
Projection Foot Plant Left
Please Select
Ok
Poor
Projection Foot Plant Right
Please Select
Ok
Poor
Knee Flexion Midstance Left
Please Select
Ok
Collapse
Knee Flexion Midstance Right
Please Select
Ok
Collapse
Positive Running Midstance Left
Please Select
Positive
Negative
Positive Running Midstance Right
Please Select
Positive
Negative
Pendulum Left
Please Select
Round
Straight
Pendulum Right
Please Select
Round
Straight
Respect to Sagittal Plane Left
Please Select
OK
No
Respect to Sagittal Plane Right
Please Select
OK
No
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