Gait Analysis

• Study of human
locomotion
• Walking and running
• Walking is a series
of gait cycles
– A single gait cycle is
known as a STRIDE
 The Main Tasks of the Gait
Cycle
• (1) Weight acceptance
– most demanding task in the gait cycle
– involves the transfer of body weight onto a
limb that has just finished swinging forward
and has an unstable alignment.
– Shock absorption and the maintenance of a
forward body progression
• (2) single limb support
– One limb must support the entire body weight
– Same limb must provide truncal stability while
bodily progression is continued.
• (3) limb advancement
– Requires foot clearance from the floor
– The limb swings through three positions as it
travels to its destination in front of the body.
 Why Study Normal Gait?
• Loss of the ability to walk can result is significant
health problems
(co-morbidities)
• Pain, injury, paralysis or tissue damage can alter
normal gait and lead to:
– further musculoskeletal problems (compensations)
– Cardiovascular and pulmonary problems (inactivity due
to pain)
– Psychological problems (depression)
• Sports, Exercise/Fitness, and
Rehabilitation Professionals must have a
sound knowledge of normal gait so they
can accurately detect, interpret, and
ultimately correct deviations and/or gait
pathologies to restore “normal,” pain-free
function
• It is important to remember that each
person displays “normal” variations from
the normal pattern of walking
• ULTIMATE GOAL: KEEP YOURSELF
AND YOUR PATIENTS/CLIENTS
MOVING PAIN-FREE THROUGHOUT
YOUR/THEIR LIFESPANS!!!
Normal Walking Requirements
• 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
Walking Requirements Cont’d
– 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, sensorimotor input)
 Gait Cycle or Stride
• A single gait cycle or stride is defined:
– Period when 1 foot contacts the ground to when
that same foot contacts the ground again
– Each stride has 2 phases:
• Stance Phase
– Foot in contact with the ground
• Swing Phase
– Foot NOT in contact with the ground
A Single Gait Cycle or Stride
Gait Flow Chart
 Stance Phase of Gait
• When the foot is contact with
the ground only
• Propulsion phase
• Stance phase has 5 parts:
– Initial Contact (Heel Strike) (1)
– Loading Response (Foot Flat)
(2)
– Midstance (2)
– Terminal Stance (3)
– Toe Off (Pre-Swing) (4)
(Missing Loading Response in
picture)
 Motions during Stance Phase
• Shoulder flexes
• Pelvis rotates right (transverse plane)
• Spine rotates left
• Hip extends, IRs
• Knee flexes, extends
• Ankle plantarflexes, dorsiflexes, plantarflexes
• Foot pronates, supinates
• Toes flex, extend, flex
 Initial Contact
• Phase 1
• The moment when the red
foot just touches the floor.
• The heel (calcaneous) is
the first bone of the foot to
touch the ground.
• Meanwhile, the blue leg is
at the end of terminal
stance.
 Static Positions at Initial
Contact
• FREEZE FRAME
POSITIONS
• Shoulder is extended
• Pelvis is rotated left
• Hip is flexed and externally
rotated
• Knee is fully extended
• Ankle is dorsiflexed
• Foot is supinated
• Toes are slightly extended
 Loading Response
• Phase 2
• The double stance period
beginning
• Body weight is transfered
onto the red leg.
• Phase 2 is important for
shock absorption, weight-
bearing, and forward
progression.
• The blue leg is in the pre-
swing phase.
 Static Positions at Loading
Response
• Shoulder is slightly extended
• Pelvis is rotated left
• hip is flexed and slightly externally rotated
• knee is slightly flexed
• ankle is plantarflexing to neutral
• foot is neutral
• Toes are neutral
 Midstance
• Phase 3
• single limb support
interval.
• Begins with the lifting of the
blue foot and continues until
body weight is aligned over
the red (supporting) foot.
• The red leg advances over
the red foot The blue leg is
in its mid-swing phase.
 Static Positions at Midstance
• Shoulder is in neutral
• Pelvis is in neutral rotation
• Hip is in neutral
• Knee is fully extended
• Ankle is relatively neutral
• Foot is pronated
• Toes are neutral
 Terminal Stance

• Phase 4
• Begins when the red
heel rises and
continues until the heel
of the blue foot hits the
ground.
• Body weight
progresses beyond the
red foot
 Static Positions at Terminal
Stance
• Shoulder is slightly flexed
• Pelvis is rotated left
• Hip is extended and internally rotated
• Knee is fully extended
• Ankle is dorsiflexed
• Foot is slightly supinated
• Toes are neutral
 Toe-Off
• Phase 5
• The second double stance
interval in the gait cycle.
• Begins with the initial
contact of the blue foot
and ends with red toe-off.
• Transfer of body weight
from ipsilateral to opposite
limb takes place.
 Static Positions at Toe-Off
• Shoulder is flexed
• Pelvis is rotated right
• Hip is fully extended and internally rotated
• Knee is fully extended
• Ankle is plantarflexed
• Foot is fully supinated
• Toes are fully extended
 Stance Phase Characteristics
• During a single stride, there are 2 periods
of double limb support (both feet on
ground):
– Loading response (right) & Toe Off (left)
– Loading response (left) & Toe Off (right)
Gait Progression
 Swing Phase
• When foot is NOT contacting the ground, it
is swinging!
• Limb advancement phase
• 3 parts of swing phase:
• Initial swing
• Midswing
• Terminal swing
 Motions during Swing Phase
• Shoulder extends
• Spine rotates right
• Pelvis rotates left (passive)
• Hip flexes, ERs
• Knee flexes, then extends
• Ankle dorsiflexes
• Foot supination (inversion)
• Toes extend
 Initial Swing
• Phase 6
• Begins when the red foot is
lifted from the floor and ends
when the red swinging foot is
opposite the blue stance
foot.
• It is during this phase that a
footdrop gait is most
apparent.
• The blue leg is in mid-
stance.
 Static Positions at Initial Swing

• Shoulder is flexed
• Spine is rotated left
• Pelvis is rotated right
• hip is slightly extended and internally rotated
• Knee is slightly flexed
• Ankle is fully plantarflexed
• Foot is supinated
• Toes are slightly flexed
 Midswing
• Phase 7
• Starts at the end of the
initial swing and continues
until the red swinging limb
is in front of the body
• Advancement of the red
leg
• The blue leg is in late mid-
stance.
 Static Positions at Midswing
• Shoulder is neutral
• Spine is neutral
• Pelvis is neutral
• Hip is neutral
• Knee is flexed 60-90°
• Ankle is plantarflexed to neutral
• Foot is neutral
• Toes are slightly extended
 Terminal Swing
• Phase 8
• Begins at the end of
midswing and ends
when the foot touches
the floor.
• Limb advancement is
completed at the end
of this phase.
Static Positions at Terminal Swing

• Shoulder is extended
• Spine is rotated right
• Pelvis is rotated left
• Hip is flexed and externally rotated
• Knee is fully extended
• Ankle is fully dorsiflexed
• Foot is neutral
• Toes are slightly extended
 Gait Pathologies
• Deviations from “normal” gait pattern
• Result from
– Pain
– Injury (ROM restrictions)
– Surgery (ROM restrictions)
– Weakness
– Balance deficits
• Consider all “normal” components of stance and swing
phase of a gait cycle or stride
• Compare right and left sides when observing a person’s
gait pattern
 Antalgic Gait

• Painful leg gait

• Decreased stance time on painful leg
• Increased swing time on painful leg
• Decreased swing time on non-painful leg
• Increased stance time on non-painful leg
 Trendelenburg Gait
• Gluteus medius weakness gait
• Lateral trunk lean towards side of
weakness
• Maintain body’s COG over weak side
during stance phase
 Flexed Knee Gait
• Flexed knees
• Flexed trunk posture
• No arm swing
• No initial contact
• No Toe-off
• No hip extension
• Short step
• Shortened stride
• COG stays within BOS
• Common in elderly with fear of falling
Flexed Gait Posture
Common Gait Posture in Elderly
People