GAIT

 Walk and gait ??

 Define Gait??
 Walking pattern
 Complex system
 The ability to initiate or terminate
 Gait Cycle - Definitions
►Normal Gait =
 Series of rhythmical , alternating movements of the
trunk & limbs which result in the forward progression
of the center of gravity
 Series of ‘controlled falls’
 Pre requisite
There are (4) major criteria essential to walking.

 Equilibrium:
The ability to assume an upright posture and maintain balance.

 Locomotion:
The ability to initiate and maintain rhythmic stepping

 Musculoskeletal Integrity:
Normal bone, joint, and muscle function

 Neurological Control:
Must receive and send messages telling the body how and when
to move. (visual, vestibular, auditory, sensori-motor input)
Phases of Gait
Step and stride length and
stride width
 Gait Cycle - Subdivisions:

A. Stance phase:
1. Heel contact: ‘Initial contact’
2. Foot-flat: ‘Loading response’,
3. Midstance:
4. Heel-off: ‘Terminal stance’
5. Toe-off: ‘Pre-swing’
Gait Cycle - Subdivisions:

B. Swing phase:
1. Acceleration: ‘Initial swing’
2. Midswing: swinging limb overtakes the limb in stance
3. Deceleration: ‘Terminal swing’
►Time Frame:
A. Stance vs. Swing:
►Stance phase = 60% of
gait cycle
►Swing phase = 40%
B. Single vs. Double support:
►Single support= 40% of
gait cycle
►Double support= 20%
►With increasing walking speeds:
►Stance phase: decreases
►Swing phase: increases
►Double support: decreases

►Running:
►By definition: walking without double support
►Ratio stance/swing reverses
►Double support disappears. ‘Double swing’ develops
Saggital kinematics

Initial contact
(Heel strike)

 Hip 25-30 flexion

 Knee 0-5
 Ankle 0 (90)

 Muscle work
 Stabilizers
 Loading Response Phase
(Heel Strike to Foot Flat)

 KNEE: 0° → 15° flexion

 ANKLE: 0° → 10° plantar flexion
 1st rocker : Calcaneus

 Muscle work
 Quards ---Eccentric
 DF….Eccentric
 T.Antand Post….Eccentric
 Hip extensors
Mid stance
(Foot Flat to mid stance)
 HIP: 25° → 0°
 KNEE: 15° →0°
 ANKLE: 10PF→5°dorsiflexion
 2nd rocker ankle

 Muscle work
 Hip extensors
 Soleus and gastro…eccentric
Terminal Stance
Mid stance to Heel off
 HIP: 0 - 20° Ext.
 KNEE: 0°
 ANKLE: 5° → 10°DF
 At end of terminal stance, Begin
3rd rocker MTP

 Muscle work
 Planter flexors
 No quards and hamstring
Pre swing
(Heel Off to Toe Off)

 HIP: 20° Ext → 0°F

 KNEE: 0° → 40°F
 ANKLE: 10° dorsi flexion → 20°
plantar flexion

 Muscle work
 Planter flexors
 Push off
 Passive knee flexion
Initial swing
Toe Off to early
 HIP: 15 °F
 KNEE: 60°F
 ANKLE: 10° plantar flexion

 Muscle work

 Hip flexors
 Knee flexors
 DF
Mid swing

 HIP: 25 °F
 KNEE: 25°F
 ANKLE: 0°

 Muscle work
 Hip flexors
 Quards
Terminal Swing
Mid-swing-deceleration

 HIP: 25 °F
 KNEE: 0°-5
 ANKLE: 0°

 Muscle
 Hip extensors
 Hamstring
PARAMETERES OR
VARIABLES OF GAIT
Temporal (time)
Distance(spatial) Factors
Temporal variable

1. Single limb support time

2. Double support time
3. Cadence
4. Speed
Distance variable

1. Stride length
2. Step length
3. Degree of toe out
Velocity– 1.46 m/second (3.26 miles/hour)
Step length – 76.3 cm (30.05 inches)
Cadence – 1.9 steps /second
Stride length –
Walking speed – men-110 steps/minute ,
women-115 steps/minute
 Gait Parameters
Males Females

Step Length (cm) 79 66

Stride Length (cm) 158 132

Cadence (steps/min) 117 (60-132) 117 (60 132

Velocity (m/sec) 1.54 1.31

Walking Base (cm) 8.1 7.1

Foot angle 7 6
Stride length

26
Step length

27
 Degree of toeout
It represents the angle of foot placement and
may be found by measuring the angle formed
by each foot’s line of progression and a line
intersecting the center of heel and second toe.
The angle for men is about 7 degree. the
degree of toe out decreases as the speed
of walking increases in normal men.

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29
KINEMATICS AND KINETICS OF GAIT

• Path of Center of Gravity

– midway between the hips
– Few cm in front of S2
– Least energy consumption
if CG travels in straight line
Path of Center of Gravity
Path of Center of Gravity
 HEEL STRIKE TO FOOT FLAT
• Heel strike to forefoot loading
• Foot pronates at subtalar joint
• Only time (stance phase) normal
pronation occurs
• This absorbs shock & adapts foot to
uneven surfaces
• Ground reaction forces peak
• Leg is internally rotating
• Ends with metatarsal heads
contacting ground
FOOT FLAT TO MIDSTANCE
MIDSTANCE TO HEEL
OFF
HEEL OFF TO TOE OFF
 DETERMINANTS OF GAIT
• Six optimizations used to minimize excursion of
CG in vertical & horizontal planes
• Reduce significantly energy consumption of
ambulation
• The six determinants are
 Lateral pelvis tilt
 Knee flexion
 Knee, ankle and foot interactions
 Forward and backward rotation of pelvis
 Physiological valgus of knee
 DETERMINANTS OF
GAIT
1) Pelvic rotation:
– Forward rotation of the pelvis in the horizontal
plane approx. 8o on the swing-phase side
– Reduces the angle of hip flexion & extension
– Enables a slightly longer step-length w/o further
lowering of CG
(2) Pelvic tilt:
– 5 degree dip of the swinging side (i.e. hip
adduction)
– In standing, this dip is a positive
Trendelenberg sign
– Reduces the height of the apex of the
curve of CG
(3) Knee flexion in stance phase:
– Approx. 20o dip
– Shortens the leg in the middle of stance phase
– Reduces the height of the apex of the curve of
CG
(4) Ankle mechanism:
– Lengthens the leg at heel contact
– Smoothens the curve of CG
– Reduces the lowering of CG
• Physiological valgus of knee
Reduces the base of support, so only little lateral
motion of pelvis is necessary.
 RUNNING GAIT
• Require greater balance, muscle strength,
ROM than normal walking.
• Difference b/w running and walking
• Reduced BOS
• Absence of double support
• More coordination and strength needed

• Divided into flight and support phase.

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 STAIR
GAIT
• Ascending and
descending stairs is
a basic body
movement
required for ADL

• Stair gait involved

stance and swing
phase
kinematics
• STANCE PHASE(64%) • SWING PHASE(36%)

• Weight acceptance • Foot clearance

• Pull up • Foot placement
• Forward continuance