THE SULTAN REVIEW

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SRG E-Learning NPTE Module: Gait Analysis

Gait
 qualitative term
 rhythmical alternating movement of UE (reciprocal arm swing) and LE with trunk
Gait cycle
 quantitative term
 heel strike of one foot to heel strike of the same foot
 functional unit of gait
 Other name: Stride length: Normal: 30 inches vs. Step length – Heel strike of one foot to heel strike of the
opposite foot: N: 30 inches
 Sinusoidal

Elements/Variables in Gait analysis:

1. Kinematics – ROM, position
2. Kinetics – Internal kinetics – muscle responsible
i. Hip – Flexors (iliopsoas); Extensors (gluteus maximus)
ii. Knee – Quadriceps Femoris; hamstrings
iii. Ankle – Pre-tibials; Gastrocnemius-Soleus Complex
-- External Kinetics – Ground Reaction Force (moment)
*Concentric movements: power and speed
*Eccentric movements: controlled, slow, antagonist of ground reaction force

Ground Reaction Force

ANT POST
Hip F E
Knee E F
Ankle D PF

STANCE VS. SWING

Stance: 60% of Gait Cycle
Swing: 40% of Gait Cycle

Traditional Rancho Los Amigos

Heel strike Initial Contact
Footflat Loading Response
STANCE Midstance Midstance
Heel off Terminal stance
Toe off Pre-swing
Acceleration Initial swing
SWING Midswing Mid-swing
Deceleration Terminal swing

SINGLE VS. DOUBLE SUPPORT

Single support: 80 %
Double support: 20 %
 Part of the gait cycle with the lowest COG (muscle don’t spend much energy)
o To avoid decrease in COG: pelvis rotation (4 deg on each side)
o Versus: Highest COG: Midstance
 To avoid increase in COG: pelvic list, drop, tilt (any determinant that INC COG is
occurring at midstance)
 Gluteus medius & Gluteus minimus (2 mm, 4 deg) peak of activity

SRG E-Learning NPTE Module: Gait Analysis

This material is for the exclusive use of SULTAN REVIEW GROUP and its students. No part of this material may be reproduced
without permission from SULTAN REVIEW GROUP.
 GAIT ANALYSIS

HIP KNEE ANKLE

Heel strike 30 F Ecc of G E Ecc of Ham Neutral Con of PT

Foot flat 20 F Ecc of G 20 F Ecc of Quad 15 PF Ecc of PT

Midstance N 10-15 F Ecc of Quad 5 DF Ecc of Calf

Heel off 10 HE Ecc of IP 0 15 DF Ecc of Calf

Toe off 20 HE Ecc of IP 40 F Ecc of Quad 20 Con of Calf

Acceleration N Con of IP 50 F Con of Ham N Con of PT

Midswing 20 F Con of IP 60 F Con of Ham N Con of PT

Deceleration 30 F Ecc of G E Ecc of Ham N Con of PT

PEAK OF ACTIVITY

HIP
Iliopsoas: Toe off: to oppose flexor moment: 2 nd: initial swing
Gluteus Maximus: Heel strike to oppose extensor moment

KNEE
Quadriceps: After heelstrike; @ toe off
Hamstrings: Deceleration

ANKLE
Pre-tibials:After heel trike  foot slapping
 Steppage gait: during swing  compensatory  increase hip and knee flexion
Gastroc-Soleus Complex: Push-off  calcaneal gait – no push off

SRG E-Learning NPTE Module: Gait Analysis

This material is for the exclusive use of SULTAN REVIEW GROUP and its students. No part of this material may be reproduced
without permission from SULTAN REVIEW GROUP.
DETERMINANTS OF GAIT

1. Pelvic rotation
 Period of double support on stance side
 INC COG
 INC step length
2. Heel rise
 DEC COG
 6-8 mm
3. Pelvic tilt/list; pelvic obliquity
 COG 2 mm; Gmed & Gmin
4. Knee flexion on stance phase
 DEC COG
5. Ankle foot mechanism
F E
Knee DF PF
Eve Inv

6. Lateral displacement of the pelvis

 Side to side
 Movement of pelvis on stance side

PATHOLOGIC GAIT

A. Ankle
a. Foot slap – after heelstrike; weakness of Pre-tibials
b. Foot drag - swing
c. Steppage gait – swing; compensatory (excessive hip and knee flexion)
d. Equinus gait – toes first (PT paralysis)
e. Calcaneal gait – (-) push off (GS complex paralysis)
B. Knee
a. Buckling gait – after heel strike; Quadriceps weakness; Femoral nerve lesion
b. Cheerleader’s gait – toe off; to prevent foot from reaching thigh
c. Stiff knee: no decelaration; weak hamstrings
d. Genu recurvatum  Swedish Knee Cage
i. PF spasticity
ii. Achilles tendon shortening
iii. Quads spasticity
iv. Hamstring weakness
e. Excessive knee flexion
i. DF spasticity
ii. PF weakness
iii. Hamstring contracture
iv. Quadriceps weakness
v. Long limbs
vi. Hip flexion contracture
C. Others
a. Lurching gait/Jacknife gait: heel strike; weakness of Gmax  compensation: hyperextension of trunk
b. Gmed gait: Unilateral: Trendelenburg; Bilateral: Waddling gait/wobbling gait/maewest gait
c. Antalgic Gait: due to pain
i. DEC stance
ii. DEC step length
d. Psoatic Limp: FABER; LCPD
e. Ataxic Gait: Motor or sensory – awkward gait
i. Motor: cerebellum; hypotonicity; station gait/staggering gait/drummer’s gait
ii. Sensory: posterior column: tabetic gait/gait of spinal ataxia
f. Parkinsonian gait
i. Festinating gait
ii. Shuffling gait
g. Circumduction Gait/Helicopad
i. Hip hiking with circumduction

SRG E-Learning NPTE Module: Gait Analysis

This material is for the exclusive use of SULTAN REVIEW GROUP and its students. No part of this material may be reproduced
without permission from SULTAN REVIEW GROUP.
 ii. Arthrogenic Gait (stiff hip and knee gait)

NORMAL:
1. Cadence: 90-120 steps per minute; INC in Females
2. Walking speed: 3ph
3. Toe out: 7 degrees; DEC in INC speed of walking

SRG E-Learning NPTE Module: Gait Analysis

This material is for the exclusive use of SULTAN REVIEW GROUP and its students. No part of this material may be reproduced
without permission from SULTAN REVIEW GROUP.