BEJASA, NICOLE P.

Walking is a part of our life, it is the basic means of transferring from one
place to another. During this activity we tend to do a repetitive action without
realizing it, the interval between that repetitive action is called GAIT CYCLE. Gait
is simply the pattern of how we walk, OTs, PTs and other medical professionals
can tell if there is a problem within that person by just observing how he walks.
Neurologic, muscular or even skeletal problems can reflect to our way of walking.
The Gait Cycle is consist of 2 phases; the stance phase and swing phase.
The stance phase is when the foot is in contact with the ground, all the
activities while it touches the ground are included in this phase. It begins with
the heel strikes and ends with the toe off. This phase contributes to 60% of the
gait cycle while the swing phase contributes to 40% of the cycle. On the other
hand, the swing phase is the phase when our foot is not in contact with the
ground, it typically begins when the foot leaves the ground and ends when the
heel strikes. There are a total of 8 sub-phases under the gait cycle; the first 5
belongs to stance phase and the remaining 3 belongs to swing phase. The
combination of the sub-phase enables our limb to accomplish the 3 basic task
such as weight acceptance, single limb support and limb advancement.

Gait Cycle
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WEIGHT ACCEPTANCE
most demanding task in the whole cycle since there are 3 functional
patterns needed; shock absorption, initial limb stability and
preservation of progression
1. INITIAL CONTACT
position: hip is flexed, knee is extended and the ankle is dorsiflexed to
neutral in position
the contact from the ground is made by the heel
this is the moment when our foot just touches the ground
2. LOADING RESPONSE
position: knee is flexed (for shock absorption), ankle plantar flexed
(limits heel rocker)
body weight is transferred to the forward limb
Begins with the initial contact on the floor and continues until the foot
is lifted to swing

INITIAL LOADING MIDSTANCE TERMINAL PRESWING

CONTACT RESPONSE STANCE
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SINGLE LIMB SUPPORT

In this task is needed to lift the other foot for swinging, it then continues
until the opposite foot contacts the ground.
In the interval, the other limb is responsible for supporting the body
weight.
3. MIDSTANCE
position: ankle is dorsiflexed, knee and hip is extended
begins once the other foot is lifted, until the body's weight is aligned over
the forefoot
limb opposite is advancing in its mid swing phase
4. TERMINAL STANCE
position: heel is rise, limb advances over the forefoot (rocker), knee
increases in extension and begins to slightly flex, hip extension is
increased
in this phase, our body weight moves ahead of the forefoot

INITIAL LOADING MIDSTANCE TERMINAL PRESWING

CONTACT RESPONSE STANCE
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LIMB ADVANCEMENT (SECOND DOUBLE LIMB SUPPORT)

Involved 4 sub-phases; pre-swing, initial swing, mid swing and
terminal swing
when the stance limb prepares in leaving the ground, opposite
limb will then contact the ground while accepting our body's
weight
5. PRESWING
position: increases ankle plantar flexion, increases knee flexion,
decrease hip extension
starts with the initial contact of limb in opposite side, and ends
with a toe-off
also known as weight release and weight transfer phase

INITIAL LOADING MIDSTANCE TERMINAL PRESWING

CONTACT RESPONSE STANCE
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LIMB ADVANCEMENT (SECOND DOUBLE LIMB SUPPORT)

1. INITIAL SWING
position: increase hip and knee flexion, ankle is partially dorsiflexed, foot is
lifted and opposite limb is in early mid stance
begins with lifting the foot from the ground and ends with swinging the foot
2. MID SWING
position: increased hip flexion, knee is extended while ankle is dorsiflexed to
neutral in position.
begins when the swinging limb is opposite the stance limb and ends once the
swinging limb is in forward position while the tibia is verticaly positioned.
2. TERMINAL SWING
position: knee is flexed, hip remains flexed and ankle is dorsiflexed to neutral in
position while the other limb is in terminal stance phase.
begins when the tibia is in vertical position and ends when the foot strikes the
ground
phase where the limb advancement is completed

INITIAL SWING MID SWING TERMINAL SWING

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From the name itself, this is a type of gait exhibited by the patients
suffering from Parkinson's Disease. It is described by a feeling of being
stuck while initiating a step. It is characterized by slow and small shambled
steps or even a loss of movement in some cases. Typically, persons affected
are using assistive devices or equipment to help them avoid falling.
These kinds of patients exhibit gait characteristics that are far from the
normal gait. In the affected person's gait, the feet is in flat strike or it is
flatly placed on the ground at the same time unlike the normal gait (stance
phase) where in the heel strikes the ground before the toes. In addition,
there a is a reduction of foot lifting in the swing phase since they
experience muscle hypertonicity, this creates a smaller interval between each
step. On the other hand, these individuals often loss arm swing motion and
pelvic rotation due a higher relative loads in the forefoot regions added to
the load shift from the medial areas of the foot which contributes to their
slowness and postural imbalance.

VIDEO
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This type of gait abnormality is characterized by an ankle equinus

or foot drop in which there is a limited range of motion in the ankle
joint. This causes the foot to hang its toes down, so when walking, it
tends to scrape the ground. This is due to the paralysis of the anterior
tibial and fibular muscle or absence of dorsiflexors.
Therefore, it is impossible to dorsiflexed and evert the foot. Another
thing individuals do when suffering from steppage gait is to lift their
feel using their flexed knee and bring them down with a slap on the
ground during swing phase. This is appearing to be like walking up
stairs since they cannot walk using their heels. As compared to the
normal gait pattern, we can say that during the initial contact, the
affected foot slaps the ground. And since they can't dorsiflexed or evert
their foot, most of the stance and swing phase task cannot be done by
people who suffers from this kind of gait abnormality.

VIDEO