INTRODUCTION

• LOCOMOTION - POWER TO MOVE FROM A PLACE TO PLACE BY A SERIES OF STEPS.

• HIGHLY COMPLEX MECHANISM – REQUIRES CONTROLLED & SYNCHRONISED ACTION OF VARIOUS MUSCLES ALONG
WITH THE COORDINATED ADAPTATION IN THE SKELETAL COMPONENTS OF THE BODY, PARTICULARLY THE LOWER
LIMBS.
• GAIT – TRANSLATORY PROGRESSION OF BODY PRODUCED BY COORDINATED, ROTATOR MOVTS OF BODY SEGMENTS.
• LL MOVEMENTS SUPPORT HEAD,ARMS & TRUNK – 75% OF TOTAL BODY WEIGHT – HAT
- 25% OF TOTAL BODYWEIGHT - LL
• 3 ASPECTS OF GAIT
• GAIT CYCLE
• KINETICS OF GAIT
• KINEMATICS OF GAIT
I . GAIT CYCLE – 2 SUCCESSIVE EVENTS OF THE SAME LIMB( RT HEEL STRIKE TO NEXT RT HEEL STRIKE)

• 2 PHASES
• STANCE PHASE – 6O%- 5 PHASES – HS, FF, MS, HOFF, TOFF- FOOT IN CONTACT WITH THE FLOOR
• SWING PHASE - 40% - 3PHASES – ACC, MDS, DECL- FOOT NOT IN CONTACT WITH THE FLOOR
DOUBLE SUPPORT (DS) – WHEN ONE LIMB MAKES INTIAL CONTACT & THE OTHER ONE LEAVES THE FLOOR AT TOE
OFF, THAT IS , BOTH FEET ON CONTACT WITH THE FLOOR.
- TOTAL 2 DOUBLE SUPPORT OCCURS IN A GAIT CYCLE.
- FIRST DS AT 11% OF GAIT CYCLE; SECOND DS AT 22% OF GAIT CYCLE
- IN GAIT CYCLE, SINGLE LIMB SUPPORT IS 80% & DOUBLE LIMB SUPPORT IS 20%.

•STANCE PHASE
1.HEEL STRIKE – HEEL STRIKES GROUND TO MAKE INTIAL CONTACT OR EARLY STANCE WITH THE GROUND.

- HEEL OF THE LEADING EXTREMITY STRIKES THE GROUND.

- OCCURS AT 0 %

- NORMAL GAIT – HEEL IS THE POINT OF CONTACT

- ABNORMAL GAIT – WHOLE FOOT/ TOES THAN THE HEEL.

2. FOOT FLAT – OCCURS AFTER HEEL STRIKE. FOOT IS FLAT ON THE GROUND.

- WHOLE FOOT REST ON THE THE GROUND & BODY WEIGHT BEGINS TO TRANSFER FROM FOOT.

- OCCURS AT 7% OF GAIT CYCLE.

3. MIDSTANCE- POINT AT WHICH BODY WEIGHT IS LOADING DIRECTLY OVER THE STANCE LEG.

- THE LOADING OF THE BODY WEIGHT REACHES THE MAXIMUM.

- OCCURS AT 30% OF THE GAIT CYCLE.

4. HEEL OFF – HEEL OFF REFERENCE / LEADING EXTREMITY LEAVES THE GROUND.

- TERMINAL STANCE ; HEEL BEGINS TO RAISE FROM THE GROUND.

- OCCURS AT 40 % OF GAIT CYCLE.

5. TOE OFF / PUSH OFF – WHEN THE TOES BEGIN TO PREPARE TO BE ( EARLY SWING)RAISED OFF THE GROUND.

- TOE OFF REFERENCE/ LEADING EXTREMITY LEAVES THE GROUND.

- OCCURS AT 60% OF GAIT CYCLE.

• SWING PHASE

1. ACCELERATION - EARLY SWING ( INTIAL STAGE OF SWING BEGINS WITH ACCELERATION OF LEG).

- BEGINS WHEN THE TOE LEAVES THE GROUND UNTIL MID SWING.

2. MID SWING - OCCURS WHEN THE EXTREMITY PASSES DIRECTLY BENEATH THE BODY .

- FROM ACCELERATION TO START OF DECELERATION (THE SWING REACHES ITS MAXIMUM)

3. DECELERATION- THE SWING BEGINS TO SLOW DOWN (DECELERATE) & HEEL GETS READY FOR THE HEEL STRIKE
WITH THE GROUND ,THUS COMPLETING A GAIT CYCLE .

- OCCURS AFTER MID SWING WHEN LIMB DECELERATES & PREPARES FOR HEEL STRIKE.

# IN NORMAL GAIT , EACH LEG ALTERNATIVELY MOVES THROUGH A STANCE & SWING PHASE.
II. KINETICS OF GAIT
- IT IS THE STUDY OF THE FORCES THAT PRODUCE / CHANGE THE MOTION.

- CONCERNED WITH * INTERNAL FORCES DEVELOPED WITHIN THE BODY BY MUSCULAR REACTION.
* EXTERNAL MECHANICAL STRESSES ACTING ON BODY – GRAVITATIONAL FORCES
- GROUND REACTION FORCES
A) COG (CENTRE OF GRAVITY) – IMAGINARY POINT AT WHICH ALL THE BODY WEIGHT IS ASSUMED TO BE
CONCENTRATED.
- LIES ANT TO S2.
- IMP IN MAINTAINING BALANCE OF THE BODY.

TYPES OF COG
a. LATERAL DISPLACEMENT – SHIFT OF PELVIS & TRUNK TO SIDE OF WB LEG DISPLACE COG LATERALLY TO THAT SIDE α
WIDTH OF WALKING BASE.
- 5 CM IN NORMAL WALKING.
- CAUSE: SHIFT OF PELVIS & TRUNK TO THE SIDE OF STANCE LEG.
b. VERTICAL DISPLACEMENT OF COG - HIGHEST POINT OF DISPLACEMENT WHEN SUPPORTING LIMB IS IN MIDSTANCE.
- LOWEST AT THE TIME OF DOUBLE LIMB SUPPORT.
- 5 CM IN NORMAL WALKING
c. HORIZONTAL TILTING OF PELVIS & COG – 5 IN NORMAL WALKING.
- CONTINOUS HORIZONTAL DIPPING OF THE PELVIS ON THE SIDE OF WB LIMB.
- CONTINOUS HORIZONTAL TILT OF PELVIS ON STANCE SIDE DURING MID STANCE.
d. TRANSVERSE ( ANT ) ROTATION OF PELVIS & COG - 8
- THIS FACILLITATES THE ADVANCING LEG WITHOUT LATERAL
DISPLACEMENT OF COG.
B) GROUND REACTION FORCE (GRF)

- IT IS A LINE THAT REPRESENTS THE DIRECTION & MAGNITITUDE OF FORCE ENCOUNTED BY THE BODY AT HEEL
STRIKE.

- AT HEEL STRIKE THE VECTOR ACTS ANT TO HIP CAUSING HIP FLEXION ,ANT TO KNEE CAUSING KNEE EXTENSION &
POST TO ANKLE CAUSING PLANTAR FLEXION MOVEMENTS.

- AT HEEL STRIKE & SINGLE LEG STANCE THE VERTICAL GROUND REACTION FORCE IS 1.2 TIMES OF BODY WEIGHT.

-IT IS AROUND .8 OF THE BODY AT MIDSTANC E & NEARLY 3 TIMES OF THE BODY WEIGHT IN RUNNING.

* FORCES APPLIED TO THE FOOT BY THE GROUND WHEN A PERSON TAKES A STEP .

- NO GRF DURING SWING PHASE.

CENTRE OF PRESSURE (COP) - POINT OF APPLICATION OF GRF IS COP.

- IN U/L STANCE – IN FOOT
- IN B/L STANCE – B/W 2 FOOT
EARLY STANCE – AT HEEL STRIKE – POSTEROLATERAL OF HEEL
- FOOT FLAT – MID FOOT AREA ( LAT TO MID LINE)
- HEEL OFF – MEDIALLY ACROSS THE BALL OF FOOT
LATE STANCE – TOE OFF – B/W FIRST & SECOND TOES
III. KINEMATICS OF GAIT
- STUDY OF THE PATTERN OF ANGULAR MOVEMENTS & THEIR EXCURSION BY SMOOTH COORDINATED MUSCULAR CONTROL.

-IT ANALYSES THE GAIT IN TERMS OF TIME, SPACE , VELOCITY & ACCELERATION.

MOVEMENT COMPONENTS AT BOTH THE PHASES OF A GAIT CYCLE

STANCE PHASE
~SPINE & PELVIS – PELVIS ROTATES TOWARDS OPPOSITE SIDE.
- PREVENT DROPPING OF PELVIS ON THE UNSUPPORTED SIDE.

~HIP – REDUCTION OF FLEXION & ER FOLLOWED BY SLIGHT IR.

- PREVENT ABDUCTION OF THIGH & DROPPING OF PELVIS TO THE OPPOSITE SIDE.

~KNEE – SLIGHT FLEXION AT THE MOMENT OF CONTACT FOLLOWED IMMEDIATELY BY EXTENSION.

~ANKLE & FOOT – SLIGHT PF FOLLOWED BY SLIGHT DF & PREVENTION OF FURTHER DF CAUSED BY BODY WEIGHT, PF OF
ANKLE & HYPEREXTENSION OF MTP JOINTS AT THE END OF PROPULSIVE PHASE.

SWING PHASE
~SPINE & PELVIS – ROTATION OF PELVIS TOWRADS OPPOSITE SIDE ; PREVENTION OF DROPPING OF PELVIS ON THE UNSUPPORTED
SIDE.

~HIP FLEXION ; ER – DUE TO PELVIC ROTATION; ADDUCT AT BEGINNING ; END PHASE ABDUCTION.

~KNEE FLEXION – FLEXION DURING FIRST HALF; EXTENSION DURING SECOND HALF

~ANKLE & FOOT – DF TO PREVENT TOE DRAG

• METHODS OF GAIT ANALYSIS
• OBSERVATIONAL METHOD
• PHOTOGRAPHIC METHOD
• EMG METHOD
• FORCE STUDY METHOD
• ELECTROGONIOMETRIC METHOD
• ENERGY COST & ENERGY REQUIREMENT
METHOD
• SPATIAL & TEMPORAL MEASUREMENT METHOD
• COMBINATION METHOD
• MULTI CHANNEL FUNCTIONAL STIMULATOR
•EVALUVATION OF TEMPORAL & SPATIAL COMPONENT OF GAIT

SPATIAL (DISTANCE VARIABLE)

- STRIDE LENGTH – LINEAR DISTANCE B/W 2 SUCCESSIVE POINT OF CONTACT OF THE STANCE LEG DURING GAIT.

-STEP LENGTH – LINEAR DISTANCE B/W 2 SUCCESSIVE POINT OF CONTACT OF THE OPPOSITE LIMBS.

-STEP WIDTH – WIDTH OF WALKING BASE ; LINEAR DISTANCE B/W MID POINT OF HEEL OF ONE FOOT & THE SAME POINT
ON THE OTHER FOOT ; RANGE 1-5 INCHES (3.5 INCH AVG).

-DEGREE OF TOE OUT – IT IS THE ANGLE FORMED BY EACH FOOT`S LINE OF PROGRESSION & A LINE INTERSECTING
THE CENTRE OF HEEL & 2ND TOE

TEMPORAL (TIME VARIABLE)

-STANCE TIME – AMOUNT OF TIME TAKEN DURING THE STANCE PHASE OF ONE EXTREMITY IN A GAIT CYCLE.

- SWING TIME – TIME TAKEN DURING THE SWING PHASE.

- SINGLE LIMB SUPPORT TIME – TIME TAKEN DURING THE PERIOD WHEN ONLY ONE EXTREMITY IS ON THE
SUPPORTING SURFACE IN A GAIT CYCLE.

- DOUBLE SUPPORT TIME – TIME SPENT WITH BOTH FEET ON THE GROUND DURING ON GAIT CYCLE.
- STRIDE TIME – STRIDE – HEEL STRIKE TO NEXT HEEL STRIKE OF SAME LEG)
- STRIDE TIME IS TIME TAKEN TO COMPLETE 1 STRIDE – 1 SEC

-STEP TIME – TIME SPENT DURING A SINGLE STEP.

- CADENCE – NUMBER OF STEPS TAKEN BY A PERSON PER MIN /SEC

- NORMAL – 80 – 120 STEP/MIN
- MALES – 110 STEPS(LONG STEPS)
- FEMALE – 116 STEPS ( SHORT & FAST STEPS)

TYPES: STEP CADENCE – CADENCE BY BOTH LEGS

: STRIDE CADENCE – CADENCE BY ONE LEG

WALKING VELOCITY (W V) – RATE OF LINEAR FORWARD MOTION OF THE BODY IN M/ SEC OR CM/SEC OR MPH

- W V = DISTANCE WALKED
TIME (SEC)
EFFECTS ON GAIT
1 . AGE
INDEPENDENT WALKING : THE ABILITY TO MOVE 10 SUCCESSSIVE STEPS WITHOUT SUPPORT .
: STARTS AROUND 1 YEAR.

IN INFANT – NO HEEL STRIKE, NO RECIPROCAL ARM SWING , NO TRUNK ROTATION, WIDE BOS , DECREASED SINGLE
LIMB SUPPORT TIME, SHORT STEP LENGTH, HIGH CADENCE.

AT 3 YRS – HEEL STRIKE BEGINS

- RECIPROCAL ARM & TRUNK MOVEMENT BEGINS.

AT 7 YRS – RESEMBLES ON ADULT GAIT

ELDERLY – DECREASE IN NATURAL WALKING SPEED.

- SHORT STRIDE & STEP LENGTH
- LONG STANCE
- LONG DOUBLE SUPPORT
- SWING:STANCE – RATIO IS SMALL (GAIT SPEED LOW)
- HORIZONTAL HEEL VELOCITY INCREASE AT HEEL STRIKE (CHANCE OF STEP INDUCED FALL)
- DECREASED PF (DUE TO PF WEAKNESS)
- DECREASED HIP EXTENSION (DUE TO HIP FLEXION CONTRACTURE)
CHARACTERISTICS OF ELDERLY GAIT : LESS PUSH OFF
: KINETIC POTENTIAL EXCHANGE DECREASE
: CO –CONTRACTION OF ANTAGONISTICS MUSCLES
2.GENDER

FEMALES MALES
~MORE FLEXIBLE :INCREASED HIP FLEXION ROM ~ LESS FLEXIBLE
~LESS KNEE EXTENSION AT HEEL STRIKE ~ COMPLETE EXTENSION AT HEEL STRIKE
~SHORT STEP LENGTH ~ LONG STRIDE LENGTH
~HIGH CADENCE ~ LESS CADENCE COMPARE TO FEMALES
~SPEED IS SLOW ~ FASR SPEED

3. ASSISTIVE DEVICES
~CANES ARE USED ON CONTRALATERAL SIDE
~REASONS – INCREASE BOS
- TO INCREASE THE GRF ACTING AT THE AFFECTED HIP
- SO, LOW ABDUCTOR FORCE IS ONLY NEEDED TO BALANCE THE UPPER BODY ON THE AFFECTED SIDE.
- EG: AFO IN CP

4. ORTHOSIS
~ FUNCTION – (ALTER THE MECHANICS OF WALKING)
~PREVENT UNWANTED MOTION
~PREVENT DEFORMITY
~DECREASE UNWANTED FORCE/ MOMENTS
~TO ALIGN JOINT POWER
 • PATHOLOGICAL GAIT
CAUSES – STRUCTURAL

- FUNCTIONAL - PAIN

- ABNORMALITY OF MUSCULAR & NS

- COMPENSATIONS / ADAPTATIONS

A)STRUCTURAL IMPAIREMENTS

~STRUCTURAL MALFORMATION DUE TO CONGENITAL INJURY ,STRUCTURAL CHANGES SECONDARY TO INJURY.

~ EG: LEG LENGTH DISCREPANCY – IF 2 CM DIFFERENCE – ASYMMETRICAL GAIT

- CAUSES CHANGES IN THE ARTICULAR STRUCTURE

~ COMPENSATORY STRATERGIES : EQUINUS POSITION OF ANKLE & FOOT OF SHORT(TOE WALKING) .SO COG RISES (LESS STABILITY).

: VAULTING OVER LONG LIMB

: INCREASED FLEXION OF LONG LIMB

: CIRCUMDUCTION OF LONG LIMB

~Q ANGLE , TIBIAL TORSION (MR) & PRONATION OF FOOT INCREASE : CAUSE PATELLOFEMORAL JOINT DYSFUNCTION (PFPS)
 : IN RUNNING STRESS IS GREATER THAN WALKING.
: PATIENTS FEELS PAIN IN THE PATELLOFEMORAL AREA

~PESCAVUS & PES PLANUS : ABNORMAL WEIGHT DISTRIBUTION IN JOINT → INCREASED STRESS ON HIP / KNEE

EG: IN PES CAVUS – WEIGHT IS MAXIMUM AT HEEL AT METATARSAL AREA

IN PES PLANUS – WEIGHT IS MAXIMUM AT MIDFOOT THAN HINDFOOT, LATERAL MIDFOOT, METATARSALS & TOES.
- HERE PROPULSIVE PHASE (HEEL OFF) OF GAIT GETS AFFECTED.
RUNNING – WEIGHT ON METATARSAL AREA.

B)FUNCTIONAL IMPAIREMENTS
~ IT INCLUDES IMPAIRMENTS WHERE THE TIMING / AMPLITUDE OF MUSCLE ACTIVITY IS ABNORMAL.

1. U/L PARALYSIS OF GLUTEUS MEDIUS (TRENDLENBERG`S GAIT / GLUTEUS MEDIUS GAIT)

- HERE PELVIS DROPS TO THE OPPOSITE SIDE DURING MID STANCE.
COMPENSATION – TRUNK BENDS LATERALLY TO THE STANCE LEG
1. TO MAINTAIN COS WITHIN BOS
2. TO ALLOW SWING LEG TO CLEAR THE GROUND
3. TO DECREASE MOMENT ARM OF GRAVITY
4. DECREASE HIP ABDUCTOR ACTIVITY (IF STRESS DECREASE)
REASON :CANE ON THE OPPOSITE SIDE OF WEAKNESS.
2. B/L PARALYSIS OF GLUTEUS MEDIUS (WADDLING GAIT)

3. PARALYSIS OF GLUTEUS MAXIMUS ( GLUTEUS MAXIMUS GAIT/ LURCHING GAIT)

~ GLUTEUS MAXIMUS PROVIDES STABILITY IN SAGITAL PLANE.
~ IT LIMITS FORWARD PROGRESSION.
~ IT COUNTERACT THE MOMENT PRODUCED BY GRF AT HIP IN EARLY STANCE.
EG : AT HEEL STRIKE IF GLUTEUS MAXIMUS WEAKENS
↓ ↓
TRUNK MORE POSTERIORLY THIS FUNCTION IS LOST
↓
PREVENT FORWARD FALLING OF TRUNK

4.PARALYSIS OF QUADRICEPS (QUADRICEPS GAIT)

COMPENSATED BY – HIP EXTENSORS ~ IT PULLS THE FEMUR POSTERIORLY
- PLANTAR FLEXORS ~ IT PULL THE TIBIA POSTERIORLY
ADDITIONAL COMPENSATION -FORWARD TRUNK BENDING
- RAPID PLANTAR FLEXION AFTER INTIAL CONTACT

5.PARALYSIS OF QUADRICEPS + GLUTEUS MAXIMUS (HAND TO KNEE GAIT)

- COMPENSATE BY PUSHING THE FEMUR POSTERIORLY WITH HAND AT HEEL STRIKE
↓
PUSHES KNEE INTO EXTENSION
↓
PREVENTS HIP FLEXION
6. PARALYSIS OF DORSIFLEXION ( HIGH STEPPING GAIT / TOE WALKING / EQUINUS GAIT)
DORSI FLEXORS – MAINTAIN ANKLE IN NEUTRAL DURING SWING TO PLACE THE FOOT PROPERLY ON THE GROUND .
- CONTROL THE PLANTAR FLEXION MOMENT AT HEEL STRIKE
- DF THE ANKLE IN INTIAL SWING
- MAINTAIN ANKLE IN DF DURING MIDSWING & TERMINAL SWING .
HENCE, IN DORSIFLEXOR PARALYSIS ;
# THE ENTIRE FOOT OR TOES WOULD STRIKE THE FLOOR AT HEEL STRIKE.
#SUDDEN ENTRY INTO STANCE PHASE
# HIP & KNEE FLEXION INCREASE TO CLEAR THE FOOT IN INTIAL SWING
# SHORTENING THE SWING LEG OR LENGTHENING THE STANCE.

7. HEMIPLEGIA (PARALYSIS OF ONE SIDE OF THE BODY)

~ DUE TO PARALYSIS OF ONE SIDE OF THE BODY , THE PATIENT CIRCUMDUCTS THE LEG DURING SWING .
~ THIS GAIT PATTERN IS CALLED A CIRCUMDUCTORY / HEMIPLEGIC GAIT.

8. PARALYSIS OF BOTH LOWER LIMB ( PARAPLEGIA)

~OVERLOAD ON TRUNK & LL MUSCLES
~HENCE, ENERGY COST IS HIGHER THAN NORMAL
RX – LONG LEG BRACES & CRUTCHES
- FUNCTIONAL NEUROMUSCULAR STIMULATION (FNS)

9.PARKINSON`S DISEASE
~ IT IS CHARACTERISED BY BRADYKINESIA, TREMOR & RIGIDITY.DUE TO THESE CLINICAL FEATURES, THE PATIENT HAS A
FESTINANT GAIT (FREEZING OR SHUFFLING GAIT)
FEATURES: SHORT STEP & STRIDE
: INCREASED CADENCE
; HEEL STRIKE & TOE OFF ARE LACKED
: NO ARM SWING ( NO RECIPROCAL MOVEMENT )
10. PARALYSIS OF PLANTAR FLEXOR ( CALCANEAL GAIT)
( GASTROSOLEUS, PLANTARIS, TIBIALIS POSTERIOR, FDL ,FHL..)
1.DECREASED STEP LENGTH ON LENGTH ON AFFECTED SIDE ( LESS PUSH OFF)

2. INCREASED DF & KNEE FLEXION DURING STANCE

↓
SO,KNEE EXTENSORS NEED TO BE STRONG
↓
IF NO, THEN TIBIA & KNEE CANNOT BE STABILISED
↓
SHORT SINGLE LIMB SUPPORT

11. BELOW THE KNEE AMPUTATION

~ COMPENSATED BY HIP EXTENSORS & KNEE EXTENSORS ( GLUTEUS MAXIMUS ,SEMITENDINOUS,QUADRICEPS)

12.ARTHROGENIC GAIT (STIFF HIP & KNEE)

~SEEN AFTER POST IMMOBLISATION IN A POP CAST OFTEN A TREATMENT .

13.STAMPING GAIT ( SENSORY ATAXIC GAIT )

~ SEEN IN TABES DORSALIS

14. PAIN ( ANTALGIC GAIT)

~ OVERUSE INJURIES CAUSE PAIN.
~ HENCE O2 COMSUMPTION INCREASE → ENERGY COST INCREASES
EG : OVERUSE INJURIES LIKE – PLANTAR FASCITIS , PATELLOFEMORAL PAIN SYNDROME ( INHIBIT ACTIVITY OF QUADRICEPS
DUE TO PAIN ),OA, IT BAND SYNDROME , POPLITEAL TENDONITIS
15. ADAPTATION / COMPENSATION
~ OCCURS DUE TO STRCTURAL & FUNCTIONAL IMPAIREMENT
~ HUMAN BODY HAS GREAT ABILITY TO COMPENSATE FOR FUNCTIONAL DYSFUNCTIONS.
~ IN SLIGHT GAIT DEVIATIONS →UNCONSCIOUS ADAPTATION / COMPENSATION
STAIR GAIT
~ A LOCOMOTOR ACTIVITY WHERE THERE IS ASCENDING & DESCENDING OF STAIRS .

~ VERY IMP IN ADL ACTIVITIES .

EG: SHOPPING ,PUBLIC TRANSPORTATION , MULTITASKING HOME OR BUILDING
~ HAS STANCE & SWING PHASE SIMILAR TO LEVEL GROUND GAIT BUT INCREASED STRESS THAN LEVEL GROUND GAIT.

~ MORE MUSCLE STRENGTH & ROM NEEDED.

~ TRUNK ROM DURING LEVEL GROUND GAIT IS SIMILAR TO STAIR DESCEND & DIFFERENT THAN STAIRS ASCEND .

PHASES
1.STANCE (64%)
A . WEIGHT ACCEPTANCE (WA)
B. PULL UP (PU)
C. FORWARD CONTINUANCE (FCN)

WA-CONTRIBUTES (14%)
- SIMILAR TO HEEL STRIKE

PU- 14- 32%

- THIS IS SINGLE LIMB SUPPORT (INSATBILITY)
- HERE HIP, KNEE & ANKLE IS FLEXED
- PU EVENT PULLS THE BODY WEIGHT UP TO THE NEXT STAIR LEVEL.
- POWER GENERATION BY KNEE EXTENSION

FCN – 32-64%
- SIMILAR TO MIDSTANCE TOE OFF ( PUSH OFF)
- POWER GENERATION BY ANKLE PF.
2.SWING (36%)

A. FOOT CLEARANCE (FC)

B.FOOT PLACEMENT (FP)

FC – 64-82%

- LEG CLEARS FROM THE STAIRS.

FP – 82- 100%

- CLEARED SWING LEG LANDS ON THE NEXT STEP

FEATURES OF STAIR CLIMBING - # MAGNITUDE OF MOMENT IS LARGE

# GREATER MUSCLE STRENGTH REQUIRED

# MORE CONCENTRIC MUSCLE WORK

#IN STAIR ASCENT - POWER GENERATION ; IN STAIR DESCENT –POWER ABSORPTION

#MORE HIP & KNEE FLEXION ROM

#COP ANTERIOR TO FOOT AT WEIGHT ACCEPTANCE.

#COP PATTERN ANTERIOR TO POSTERIOR

# TRUNK FLEXION ROM MORE IN STAIR ASCENT THAN DESCENT & NORMAL GAIT.
RUNNING GAIT
~LOCOMOTOR ACTIVITY SIMILAR TO WALKING.
~ A PATIENT MAY WALK BUT MAY NOT BE ABLE TO RUN

RUNNING REQUIRES:

1.GREATER BALANCE
BECAUSE - A) BOS DECREASING IN RUNNING
- IN NORMAL GAIT – 2 -4 INCH BOS
- IN RUNNING GAIT – DECREASES

B) ABSCENCE OF DOUBLE SUPPORT

C) PRESENCE OF FLOATING PERIOD

- BOTH FEET IN AIR
- SPEED PROPORTIONAL TO FLOATING PERIOD

2. GREATER MUSCLE STRENGTH

- TO RAISE HAT HIGHER THAN NORMAL
- TO SUPPORT HAT
3. GREATER ROM
-20 DEGREE KNEE FLEXION IN HEEL STRIKE INSTEAD OF KNEE EXTENSION
- HENCE , IMPACT FORCES DECREASES AT KNEE JOINT.
- BUT FORCES INCREASE ON THE PATELLOFEMORAL JOINT (RUNNER`S JOINT)

PHASES
2 PHASES – STANCE (30%)
- SWING (70%)

BIOMECHANICAL PERSPECTIVE
~ IN SWING PHASE – LL MEDIALLY ROTATE
~ IN HEEL STRIKE – MEDIAL ROTATION CONTINUES
- FOOT PRONATES
~ AFTER MID STANCE(SWING LEG CROSSES THE LEG IN STANCE) - LATERAL ROTATION OF LEG
- FOOT SUPINATOR
REFERENCES

1. JOINT STRUCTURE & FUNCTION 5 TH EDITION – PAMELA .K. LEVANGIE –CHAPTER 14

2. ESSENTIALS OF ORTHOPAEDICS & APPLIED PHYSIOTHERAPY 3 RD EDITION – JAYEN JOSHI – CHAPTER 31

3. IMAGES – GOOGLE
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