Gait And Gait Cycle

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 Gait
Normal Gait
Series of rhythmical , alternating
movements of the trunk & limbs which
result in the forward progression of the
center of gravity…

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 Gait is style , manner or a pattern
of walking.
 Walking pattern may differ from
individual to individual

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 Gait Cycle

• Defined as the period of time

from one heel strike to the next
heel strike of the same limb

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 Gait Cycle
The gait cycle consists of two
phases…
1) STANCE PHASE
2) SWING PHASE

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• Gait is style , manner or a pattern of walking.
• Walking pattern may differ from individual to
individual

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 STANCE PHASE

 Begins when the heel of one leg

strikes the ground and ends when the
toe of the same leg lifts off.
 Constitutes approximately 60% of
the gait cycle.

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 SWING PHASE

 Swing phase represents the period

between a toe off on one foot ad heel
contact on the same foot.
 Constitutes approximately 40%
of the gait cycle.

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Comparison of gait terminology
 Traditional –  RLA –
1) Heel strike 1) Initial contact
2) Foot flat 2) Loading response
3) Mid-stance 3) Mid-stance
4) Heel off 4) Terminal stance
5) Toe off 5) Pre-swing
6) Acceleration 6) Initial swing
7) Mid-swing 7) Mid-swing
8) Deceleration 8) Terminal swing

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 RLA phases of gait

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 Initial contact
 It refer to the initial contact of the foot of
leading lower limb.
 Normally the heel pointed first to contact.
 In abnormal gait it is possible to either
whole foot or toes rather than the heel to
strike.

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 Load response
 Begins at initial contact &
ends when the contra lateral
extremity lifts off the ground
at the end of the double-
support phase.
 It occupies about 11% of gait

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 Mid-stance phase (RLA)
 Begins when the contra-lateral
extremity lifts off the ground at
about 11% of the gait cycle
 Ends when the body is directly
over the supporting limb at
about 30% of the gait cycle.

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 Terminal stance (RLA)
 Begins when the body is
directly over the supporting
limb at about 30% of the gait
cycle
 Ends just before initial contact
of the contra-lateral extremity at
about 50% of the gait cycle.

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 Pre-Swing (RLA)
 It is the last 10% of stance
phase and begins with initial
contact of the contra-lateral
foot (at 50% of the gait
cycle) and ends with toe-off
(at 60%).

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 Initial swing (RLA)
 Begins when the toe leaves
the ground & continues until
max knee flexion occurs.

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 Mid-Swing (RLA)
 The period from maximum
knee flexion until the tibia is
in a vertical position.

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 Terminal swing (RLA)
 Includes the period from
the point at which the tibia
is in the vertical position
to a point just before initial
contact.

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• Base of support
– At heelstrike, you are in double limb support
– In the middle of stance phase, you are in single
limb support
– After opposite heelstrike, you are once again in
double limb support

SWING SWING
SWING
 GAIT TERMINOLOGIES
 Time and distances are two basic
parameters of motion.

1. Temporal (Time) variables

2. Distance (Spatial) variables

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TEMPORAL VARIABLES

1. Single limb support time

2. Double support time
3. Cadence
4. Speed

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 Single Limb Support Time

Amount of time that spent

during the period when only
one extremity is on the
supporting surface is a gait
cycle.

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 Double Support Time
Amount of the time spent with both
feet on the ground during one gait
cycle.
 The time of double support may be
increased in elder patients and in
those having balance disorders
 The time of double support
decreases when speed of walking
increases and absent in running.
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 CADENCE

– number of steps taken per minute

– about 110 steps/min for normal adults
– Cadence is inversely proportional to it’s length, so
shorter people have a higher cadence.
 SPEED/VILOCITY
• Distance covered by body per unit time
• Usually measured in m/s
– about 1.5 m/s or 5 km/hr in normal adults
• Velocity = stride length x cadence
120
• and therefore:

• Stride length = 120 x velocity

cadence
 Distance Variables

1. Step length
2. Stride length
3. Degree of toe out

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 STEP LENGTH
 It is the linear distance from the heel strike of one
lower limb to the next heel strike of opposite limb.
 about 0.75 m for normal adults

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 STRIDE LENGTH
 It is the linear distance from the heel strike of one
lower limb to the next heel strike of the same limb.
 about 1.5 m for normal adults

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 Degree of toe out
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 is about 7 degree.
the degree of toe out decreases as the
speed of walking increases.

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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
Angular kinematics
 The Function Of The Foot During The Gait
Cycle
 During the early stages of the stance cycle …….
 The foot must be flexible (in open-packed position /
Pronation) to adapt to the uneven surfaces of the ground
 Pronation allows the arches to collapse, thus allowing the
foot to adapt to the contour of the ground/and absorb shock
 During this stage, the foot is in anatomic position and the
plantar fascia is lax
 when the plantar fascia is lax, the arches are more mobile
and the foot becomes supple
 This ability of the plantar fascia to change is created by the
windlass mechanism
 The Function Of The Foot During The
Gait Cycle
 During the later stages of the stance cycle ( Toe-off or
Push-off ) ……..
 The foot must be stiff and stable ( in closed-packed
position / supination ) to propel the body forward
 Supination holds the arches high and creates a more rigid,
stable foot
 During this stage extension occurs at the MTP joints,
because of the windlass mechanism, the plantar fascia is
pulled taut around these joints
 The resulting tension in the plantar fascia is then
transferred to the arches of the foot, causing them to rise,
creating a rigid foot for propulsion
 Muscular Activity During The
Gait Cycle

 The entire body is involved in the gait cycle

 Improper mechanics during the gait cycle often

lead to functional problems throughout the body

 Assessment and appropriate treatment of the

improper mechanics of gait is important
 Demands Placed on the Musculature
And Joints During Walking
 Lower extremity muscle contraction can generally
be stated to occur during the gait cycle for three
conceptual reasons:

1. Muscles concentrically contract to create the

motion needed during the gait cycle
2. Muscles eccentrically contract to decelerate the
momentum motion of the gait cycle
3. Muscles isometrically contract to stabilize and
prevent motion of a body part
 Demands Placed on the Musculature
And Joints during Walking
 During the early to middle stages of the stance phase …
 Muscles of the lower extremity are primarily eccentrically
contracting to slow the momentum of the body's movement
 Joints of the foot must be sufficiently supple to both adapt
to the uneven surfaces of the ground and to absorb the
stresses of the foot striking the ground
 During the middle to late stages of the stance phase …
 Muscles of the lower extremity are primarily concentrically
contracting to create the propulsion force of the body's
movement
 Joints of the foot must be sufficiently rigid to be able to
allow the foot to act as a rigid lever for propulsion of the
body forward
 Hip Joint Flexor Muscles
 Hip joint flexors have two roles during the gait cycle …

1. Act eccentrically to decelerate the extension of hip joint

that is occurring before toe-off of the stance phase
2. Contract concentrically to create the forward swing of the
lower extremity during the swing phase
 Major hip joint flexors:
 Iliopsoas, Sartorius & Rectus Femoris
 Hip Joint Extensor Muscles
 Hip joint extensors have Two roles during the gait cycle ...
1. Contract isometrically on heel-strike of the stance phase
to stabilize the pelvis from anteriorly tilting at the hip
joint.
This contraction is necessary to prevent the pelvis and upper
body from being thrown forward
2. Contract eccentrically to decelerate the forward-swinging
limb at the swing phase (i.e. their force of extension on the
hip joint slows down flexion of the thigh at the hip joint
during the swing phase).
 Major hip joint extensors:
 Hamstrings & Gluteus maximus
 Hip Joint Abductor Muscles
 Hip abductors have Two important Roles ….
1. Primary Role …. Depression of the pelvis on stance side
(particularly during the 1st half of stance phase)
2. Secondary Role …. Stabilization of the pelvis on swing
side

 Depression of Pelvis on stance side …..

 The abduction of the hip joint occur more frequently than
the lower limb regular actions because Stance phase
accounts for 60% of the gait cycle
 By creating a force of depression on stance side, they
stabilize the pelvis (and upper body) on swing side to stop it
from dropping
 Hip Joint Abductor Muscles
 Stabilization of the pelvis on swing side ….
 The hip abductors usually contract isometrically
 Without this stabilization, the pelvis would fall toward the
swing side, because when the body is in single-limb
support, the center of weight of the body is not balanced
over the support limb but rather located toward the swing
side
 Major hip joint abductors ……
 Gluteus medius & Gluteus minims
 Tensor fasciae latae & Sartorius
 Hip Joint Adductor Muscles
 Hip joint adductors have Two roles during the gait cycle
1. Contract at heel-strike
2. Contract again just after toe-off or during begning of
swing

 Major hip joint adductors ……

 Adductor Longus, Brevis & Magnus
 Pectineus and Gracilis
 Knee Joint Extensor Muscles
 Knee joint extensors have two roles during the gait cycle
1. Contract eccentrically to decelerate the knee joint flexion
in the early stage of stance phase just after heel-strike and
then contract concentrically to create extension of the
knee joint as we approach midstance
2. Contract concentrically at the end of swing phase to
extend the leg at the knee joint to prepare the leg for heel-
strike
• Major knee joint extensors …..
 Quadriceps Femoris (Vastus Lateralis, Vastus Medialis,
Vastus Intermedius and the Rectus Femoris)
 Knee Joint Flexor Muscles
 Knee joint flexors have three roles during the gait cycle ….
1. Contract eccentrically to decelerate knee joint extension at
terminal swing.
2. Contract isometrically just after heel-strike to stabilize the
knee joint in the early stage of the stance phase
3. Contract concentrically during the swing phase to keep the
foot from dragging on the ground
 Major knee joint flexors ……
 Hamstring muscles (Biceps Femoris, Semitendinosus &
Semimembranosus)
 Gastrocnemius muscle
 Ankle Joint Dorsiflexors Muscles
 Ankle joint Dorsiflexors have two roles during the gait cycle …..
1. Contract eccentrically during stance phase as the body weight
transfers over the stance limb
2. Contract concentrically during the swing phase of the gait cycle to
create dorsiflexion of the ankle joint and to keep the toes from
scraping on the ground
 Major ankle joint Dorsiflexors …..
 Tibialis Anterior, Extensor Digitorum Longus, Extensor Hallucis
Longus, Fibularis Tertius
 Ankle Joint Plantarflexor Muscles
 Ankle joint Plantarflexors have two roles during the gait
cycle …..
1. Contract eccentrically during most of the stance phase to
decelerate dorsiflexion of the ankle joint.
During stance phase the foot is fixed to the floor and the
plantarflexion is necessary to decelerate the reverse action
2. Contract more forcefully in a concentric manner at heel-
off during the late stage of the stance phase to help push
the foot off the floor
 Major ankle joint Plantarflexor …..
 Gastrocnemius
 Soleus
 Subtalar Joint Supinator Muscles
• They have two roles during gait cycle …..
1. Contract eccentrically during heel-strike to foot-flat to
decelerate pronation of the foot.
2. Contract concentrically during foot-flat and toe-off to
supinate the foot at the subtalar joint
 Shin Splints …In excessively pronation of the foot, the
supinators will often overwork trying to counter the
pronation during weight bearing. It causes pain and
soreness in the supinator muscles (esp. the Tibialis Post.
and/or Tibialis Ant.). This condition is called shin splints
 Major Subtalar Joint Supinators ……
 Tibialis Post., Tibialis Ant., Flex. Dig. Longus, Flex.
Hall. Longus and the foot’s intrinsic muscles
 Subtalar Joint Pronator Muscles
 Major subtalar joint Pronators ……
 Fibularis Longus and Brevis