Gait assessment

GAIT-DEFINITION
 Word meaning is manner of
walking
 Highly controlled,coordinated and
repetitive series of limb movements
whose function is to advance the body
from place to place with minimum
expenditure of energy
 GAIT CYCLE

 One gait cycle is the movement of a single limb from heel

strike (initial contact ) to next heel strike
 SUBDIVISIONS OF GAIT CYCLE

 Stance phase and swing phase

 Stance phase begins with initial contact of
heel and ends with toe off
SUBDIVISIONS OF GAIT CYCLE

Initial contact occurs at 0% and 100% of gait
cycle and toe off occurs at 60%

So stance phase is about 60% and swing phase
40% of gait cycle
 STANCE PHASE
 Period when foot is on the ground
 Sub divisions
1) initial contact
2) loading response
3) mid stance
4) terminal stance and
5) pre swing
 INITIAL CONTACT
 Occur at 0% of gait cycle
 Principal objective of body
is to position the foot
correctly as it comes in
contact with the floor
 Body is about to begin
deceleration
 LOADING RESPONSE
 Occupies 0 to 10% of gait cycle
 Maintain smooth progression
while decelerating the body mass as it
travels from its zenith at mid stance of
opposite limb
 Opposite limb toe off occurs at end of
loading response . So this is a period of
double limb support
 MID STANCE
 Utilize momentum to maintain
stability of the hip and knee while
advancing the body over a stationary
foot
 The centre of gravity has
reached its zenith and forward velocity
is minimum
 Initial swing has begun on
opposite side
 TERMINAL STANCE
 Occupies 30 to 50% range of
gait cycle
 Provide acceleration & to
ensure an adequate step length

Acceleration is provided by
1) forward fall of centre of mass of
body
2) concentric contraction of triceps
surae
Constitutes 80 -85% of total energy
generated
 PRE SWING

 Occupies 50-60% range of gait

cycle
 Period of double limb
support
 Goal is to prepare the limb
for swing
 Initial contact of opposite
limb marks beginning of pre
swing
 SWING PHASE
 Limb is off the ground
 Divided into
1) initial swing
2) mid swing
3) terminal swing
 INITIAL SWING
 Occupies 60-70% range of gait
cycle
 Critical function is to allow
foot clearance & variable
cadence
 Varying cadence requires
CNS control & precise
timing of two joint muscles
 MID SWING

 Occupies 70 to 85% range of gait cycle

 Critical function is to maintain foot
clearance
 MID SWING (contd)
 Foot clearance depends on
maintaining a relatively level
pelvis, sufficient hip flexion &
adequate ankle dorsiflexion
 In normal gait foot clearance is
only 0.87cm
 TERMINAL SWING
 Occupies 85-100%
range of gait cycle
 Function is deceleration of
shank & correct pre-
positioning of foot for contact
 Complete knee extension &
neutral position of foot are
critical for heel strike
NORMAL PARAMETERS OF GAIT

 Base width
 Step length
 Stride length
 Cadence
 Walking velocity
 Center of gravity
 KINEMATICS
 It denotes movements observed and
measured at the pelvis, hip, knee, and
ankle during stance and swing phases
 It can be observed in 3 planes
sagittal
coronal
transverse
 GAIT ANALYSIS
 Systematic description
and assessment of qualities that
characterize human locomotion
 Mainly used in pre operative planning
and documentation of post operative
outcome in patients with cerebral palsy
 Gait analysis

kinetic kinematic
 Gait analysis

observational computerized
 GAIT DEVIATIONS
 Due to pain
 weak muscle
 abnormal muscle activity
 joint abnormalities
 Contractures around joints
 limb length discrepancies
 GAIT DEVIATIONS
1)antalgic gait - dec stance phase avoiding wt.
Bearing on involved limb
2) Short limb gait – dipping of shoulder and pelvis
on affected side & inc flexion of hip , knee and
ankle of opposite limb.
3) Trendelenburg gait –patient lurches on affected
side & pelvis drops on opp side- gluteus medius
weakness.
 GAIT DEVIATIONS

4)Waddling gait – patient lurches on both

sides during walking

5)High stepping gait – patient flexes foot

and knee excessively to clear the ground
GAIT DEVIATIONS
6)Scissoring gait – one leg crosses
directly over the other with each step

7)Calcaneus gait –walks on broadened heel

with tendency to external rotation and
genu recurvatum. No calcaneal pick up
and push off
 GAIT DEVIATIONS
8)Stiff hip gait – no movements at affected
hip , excess movements in spine &
unaffected hip

9)Stiff knee gait – no flexion at knee, so

pelvis raised during swing
 GAIT DEVIATIONS
10)Gluteus maximus gait – patient lurches
backwards due to weak gluteus maximus
11)Quadriceps gait / hand to knee gait – patient
stabilizes hips & knee for weight bearing by
leaning on affected side & pressing over
lower thigh by his hand