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DETERMINANTS OF GAIT

During walking the body weight gets shifted from side to side
as the limbs alternately play their supportive roles.





Also the vertical alignment of the limbs changes as the limbs
alternate between single and double support leading to
change in the height of the pelvis and thus displacing the
center of mass.


Displacement of COM in
accordance with phases of gait.
Initial and Terminal stance: In this phase of gait the
limbs are obliquely inclined and the body is at its
lowest point.

Midstance: In this phase of gait the limbs are
vertically aligned and the bodys center of mass is
raised.

Displacement of COM

The difference in the highest and the lowest points
in vertical displacement is around 9cms.


The side to side displacement amounts to 8cms
(which is about an average stride width).










Continuously lifting the body up through
this range would be very exhaustive.
To fathom a task like this you need to
conserve your energy
So how does
your body help
you to achieve
that ?
This feat is achieved through six patterns of
motion called DETERMINANTS OF GAIT.

Due to Determinants of gait

Vertical and horizontal displacement of center
of mass is reduced to just about 2.3cms on
each side.

Sudden changes in direction are prevented.



Six determinants of gait
Pelvic rotation
Pelvic obliquity
Knee flexion in stance phase
Ankle mechanism
Foot mechanism
Lateral displacement of body
Pelvic rotation
During the stance phase the hip joint not only
moves in flexion and extension but also rises
and falls.
The amount of displacement that the hip joint
undergoes is the total angle of
flexion/extension which equals the stride
length.
The greater the stride length=greater the angle
between flexion and extension=greater the
displacement of hip joint.
Pelvic Rotation
Now if the pelvis moved forward and backward
during stance, it would bring the hip joint more
forward during flexion and backward during
extension.
This means that the pelvic motion will
contribute to the stride length and help
reducing the angle that the hip moves through
in flexion and extension.
Lesser the angle =lesser the displacement of
the hip joint= Reduction in vertical
displacement of the hip.
Pelvic obliquity
Second determinant of gait reduces this
vertical displacement of trunk by tipping the
pelvis on one side.

During walking when the hip joint of the stance
leg rises vertically upwards the pelvis tips on
the side of the swing phase leg.

This pelvic obliquity makes the hip joint on the
swing side to be lower than the stance side.
If the pelvis was kept parallel to the ground the upward and
downward motion of the hip joint would have lead to
movement of the trunk in this sinusoidal manner
Contra lateral pelvic drop on the swing side.
KNEE FLEXION IN STANCE
PHASE
Knee flexion during stance phase begins in the
loading response and continues until the
beginning of midstance.
Knee from its nearly fully extended position at
initial contact, the knee flexes during loading
response , initiating the stance phase flexion.
This is accompanied by eccentric contraction of
the quadriceps, to limit the speed and magnitude
of flexion.
It helps to reduce the excessive vertical
displacement of COM during the stance phase of
gait cycle.
The magnitude of the stance phase flexion is
very sensitive to walking speed; it disappears
in a very slow walk.
Quadriceps contraction (eccentric then
concentric) permits the knee to act like a
spring, preventing the vertical force from
building up too rapidly (Perry, 1974).
During Loading Response
At the knee, the
force vector lies
behind the joint,
producing an
external flexor
moment. This is
opposed by an
internal extensor
moment , generated
by the quadriceps
muscles .These
contract
eccentrically,
absorbing power.
During mid-stance, the knee reaches its peak
of stance phase flexion and starts to extend
again, initially through concentric contraction
of the quadriceps.
The peak generally occurs at between 15%
and 20% of the gait cycle. Its magnitude is
variable, both from one individual to another
and with the speed of walking, but it is
commonly between 10 and 20.
During Midstance
During Midstance- Moments
and Power
At the knee, the force vector remains
behind the joint, producing an external
flexor moment, opposed by an internal
extensor moment due to quadriceps
contraction.
According to Perry (1992), only the vasti,
and not the rectus femoris, are active at
this time.
As the direction of knee motion changes
from flexion to extension power generation
takes place.
Energy Absorption and
Generation
Ankle Mechanism
It lengthens the leg at the time of initial
contact.

The ankle is generally close to its neutral position in
plantarflexion/dorsiflexion at the time of initial contact.
Since the tibia is sloping backwards, the foot slopes
upwards and only the heel contacts the ground. The
foot is usually slightly supinated (inverted, adducted or
varus) at this time and most people show a wear
pattern on the lateral side of the heel of the shoe.
Tibialis anterior is active throughout swing and in early
stance, having maintained dorsiflexion during the
swing phase and in preparation for the controlled
movement into plantarflexion which occurs following
initial contact.
The heelstrike involves an absorption of
energy by the elastic tissues of the heel and
by compliant materials in footwear, very little
of which could be recovered later in the
stance phase.
The amount of energy lost to the
environment as sound and heat in this way
is probably fairly small.
Functions
It reduces the sudden lowering of COG during
the stance phase of gait cycle-Initial contact.

Research:

Reference:
DETERMINANTS OF GAIT: APPLIED TO
CHILDREN WITH CEREBEL PALSEY
Russell, S.D., Bennett, B.C., Abel, M.F.
Motion Analysis and Motor Performance
Laboratory
University of Virginia, Charlottesville VA, USA
E-mail: sdr2n@virginia.edu Web:
www.healthsystem.virginia.edu/internet/motion_l
ab/
Recent Advcances
Presently new theories are coming up to
explain the nature of gait.
The 2 Major Theories- Determinants Of Gait
and Inverted Pendulum Theory fail to correctly
explain the nature of interaction of forces
during gait.
Determinants of Gait Theory predicts high
energy expenditure and Inverted Pendulum
Theory predicts NONE.
For Obvious reasons both these theories fail to
explain the exact mechanics of gait and
related energy expenditure.


Therefore a new theory proposed to explain
this discrepancy is the Dynamics Walking
Approach which predicts the movement of
COM like a flight ball in parabolic pathway and
supplements the Inverted Pendulum Theory by
explaining the forces and menchanical
interactions that are testable.

TWO Popular Approaches
Dynamic Walking Approach

Reference
Human Movement Science 26 (2007) 617656
The six determinants of gait and the inverted
pendulum analogy: A dynamic walking
perspective
Arthur D. Kuo *
Department of Mechanical Engineering and
Biomedical Engineering, University of Michigan,
2350 Hayward Street, Ann Arbor, MI 48109-
2125, USA
Available online 6 July 2007
www.sciencedirect.com