NORMAL MECHANICS

OF GAIT

Merry Isaaq
 Gait
• It is a form of bipedal locomotion & is a result of series rhythmic alternating
movements of arms, legs and trunk that creates forward movement of the body

Gait cycle
Gait cycle: cycle from heel contact of one foot to the heel contact of the same foot.
• During one gait cycle each extremity passes through two phases, stance phase
and swing phase.
 1-stance phase
The stance phase begins when one extremity contacts the ground (heel strike) and
ends when the reference foot lifts off the ground.

So it is called the supporting phase or weight bearing phase

• it represents 60% of the gait cycle
 Five phases of stance
1- initial contact or heel strike:

it refers to the instant at which the foot just touches the floor.

2- loading response or foot flat:

this is the initial double stance period, the foot fully contacts the ground

3- midstance:
• it is the point at which bodyweight is directly over the supporting lower extremity.
• 4- terminal stance: is the point at which the heel of reference extremity leaves the ground.
• 5- preswing( toe off):
• it is the point at which only the toe of the ipsilateral extremity is in contact with the ground, this phase called
weight release or weight transfer.
 Swing phase
The swing phase begins as soon as the toe of one extremity leaves the ground and finishes just perior
heel strike or contact of the same extremity so it is called non weight bearing period. It represents 40%
of GC.

The 3 phases of swing phase are:

1- initial swing or acceleration: begins from the toe of the reference extremity leaves the ground to tha
maximum knee flexion

2- midswing: occurs when ipsilateral extremity passes directly under the body, it begins from max.
knee flexion until tibia is in vertical position
3- terminal swing or deceleration: it is the period from vertical tibial position to a point just prior to
initial contact, the knee is extending for preparation of heel strike
 . Spatiotemporal parameters

Spatial parameters(distance variables)

Step length: Linear distance between two successive points of foot contact of the opposite
extremities. Value for normal adults average 70.5 cm
Stride length: Linear distance between two successive points of foot contact of same
extremities. Normal value is 141cm. Stride include two steps “right,left step”
The width of base of support : measure linear distance between the mid point of heel of
one foot and same point on the other foot. Mean width of 8cm. This value change with
age Increase with elderly and small with children
Degree of toe out : it represent the angel of foot placement. The angel for men is 7 degree,
the degree of toe out decreases as speed of walking increase.
 Temporal parameters(time variables)

Step time : time spent during a single step between heel strike of one leg and heel strike
of contralateral leg.

Stride time : it is the amount of time it takes to complete one stride. Stride duration and
gait cycle duration are the same.

Stance time : it is the time that passes during the stance phase of one extremity in a gait
cycle. It includes single support and double support.
• Swing time : it is the time spent during the swing phase of one extremity.
Single limb time : it is when only one extremity is on supporting surface.
• Double limb time : it is the time spent with both feet on the ground during one
gait cycle. The percentage of time spent in double support decrease as speed of
walking increase.
• Cadence : number of steps taken per minute. Typical cadence average is about
113 steps/min
• Walking speed : it is measured in cm per minute. Speed of gait speed of gait is
referred to as slow , free and fast. Free speed refers to a person’s normal walking
speed while slow and fast speeds of gait refer to speeds slower or faster than the
free speed. overall average is 1.2 m/sec
 Shoulder and elbow ROM in the sagittal plane
In normal pattern of gait ,during each gait cycle There
are

1-One arch of flexion

2-one arch of extension

• Moving in the same direction as the shoulder, the
elbow also go through An equivalent arch of flexion
and extension during each stride
 Head, Trunk and Pelvic
Displacement During Gait Cycle

.
• Throughout the gait cycle, head, arms, trunk & COG deviates from the line of
progression in both vertical (up & down) and lateral (Rt & Lt) directions, occurring in
a sinusoidal curve pattern.

• Vertical displacement is about 2.5 cm (upward & downward).

 Peak downward displacement occurs at period of double limb support.
 Peak upward displacement occurs at period of single limb support.

• Lateral displacement is about 5 cm (right & left).

 It displaces to the right with the right single stance,
and to the left with left single stance.
6 Determinants of Gait
• They are adjustments made by the body to:
1. Minimize the movement of COG.
2. Decrease the energy expenditure during normal walking.
1st Pelvic
determinant rotation in • The pelvic forward rotation occurs at the side of the forward
transverse (swinging) limb.
plane
• Magnitude of rotation is about 8 degrees.
• Aim:
• Functional lengthening of the limb
• Prevents excessive COG drop
2nd Lateral
determinant pelvic • The pelvis tilts downward at the swing leg.
tilting in
frontal • This tilt is controlled eccentrically by the contralateral hip
plane abductors.
• Magnitude of 5 degrees drop.
• Aim: Minimize COG elevation.

3rd Knee • At initial contact, the knee is fully extended & at loading response,
determinant flexion in knee joints begins to be flexed.
stance
• Aim:
• Shock absorption.
• Minimize excessive COG rising.
• Dec. energy expenditure.
4th & 5th Knee, ankle, • During gait, knee movements occurs in conjunction of ankle movements
determinan foot during stance phase in a certain sequence:
ts interaction
• Knee flexion is always combined with ankle planter flexion.
• Knee extension is always combined with ankle dorsiflexion.
• Aim: Prevents excessive lengthening & excessive shortening
of the limbs.

6th Physiological • The normal valgus angle between the femur and the tibia places
determinan knee valgus the feet and knees closer to each other.
t
• The anatomical distance between the 2 hip joints is 25 cm, while
the normal step width is reduced to 8 cm due to such valgus.

• Aim:
• Places the knee near to each other.
• Reduces the width of BOS.
• Reduces excessive lateral displacement of COG.
• Reduce energy expenditure.
• Increases speed of gait.
 Kinetics of Hip
• Kinetics Forces that produce Movement, produced by Muscles mainly and
assisted by Ligaments,tendons,jt capsules and bones..
• For Equilibrium ;
• IF=EF
• Muscle activity is counterbalanced by GRFV……
 Intial Loading Midstance Terminal Preswing
contact respose stance
Hip A A P P P
Knee A P A A P
Ankle P P A A A
 Intial Loading Midstance Terminal Preswing
contact respose stance
Joint angle 30 flexion 25 flexion 0 10-20 0
hyper
extension
GRFV A A P P P
Kinetic Result Flexion Flexion Extension Extension Extension
hip motion moment moment moment moment moment

joint Counter Extension Extension Flexion Flexion Flexion

balance
Muscle Extensor Extensor Flexor Flexor Flexor
action
Desired Flexion Extension Extension Extension Flexion
motion
Type of Eccentric Concentric Eccentric Eccentric Concentric
contraction contraction contraction contraction
 Intial swing Midswing Terminal swing

Joint angle 20 30 30

GRFV
Limb off the ground
Result motion

Counter balance

Muscle action Flexor Momenteum Extensor

Desired motion Flexor Flexion

Type of contaction Concentric Eccentric

 Intial Loading Midstance Terminal Preswing
contact respose stance

Joint angle 0 15-20 5 0 30-40

FLEXION flexion

Kinetic GRFV A P A A P

knee Result
motion
Extension
moment
Flexion
moment
Extension
moment
Extension
moment
Flexion
moment

Counter Flexion Extension Flextion Flexion Extension

balance

Muscle flexor extensor Extensor

action No muscle activity

Desired extension flexion flexion

motion

Type of Eccentric Eccentric eccentric

contraction flexor
 Intial swing Midswing Terminal swing

Joint angle 40-60 60-30 zero

GRFV
Limb off the ground
Result motion

Counter balance

Muscle action Flexion Extension

Desired motion Flexion Momentum Extension

Type of contraction Concentric Concentric quadri

Eccentric hamstring
 Intial Loading Midstance Terminal Preswing
contact respose stance
Joint angle 0 10-15 5 10 20-30
planter dorsiflexion dorsiflexion planter
flexion flexion
GRFV P P A A A
Result planter planter dorsiflexion dorsiflexion dorsiflexion
motion flexion flexion
Counter dorsiflexion dorsiflexion planter planter planter
Kinetic balance flexion flexion flexion

ankle Muscle
action
Dorsiflexor Dorsiflexor Planter
flexor
Planter
flexor
Planter
flexor

Desired Dorsi Planter Dorsi Dorsi Planter

motion flexion flexion flexion flexion flexion

Type of Concentric Eccentric Eccentric Eccentric Concentric

contraction
 Intial swing Mid swing Terminal swing
Joint angle 10 planter 0 0
GRFV
Foot off the ground
Result motion
Counter balance
Muscle action Dorsi flexion Dorsi flexion Dorsi flexion

Desired motion Dorsi flexion Dorsi flexion Dorsi flexion

Type of contraction Concentric Concentric Isometric

Objective method for gait analysis
The objective method for gait analysis is more efficient
and reliable. Objective methods includes:
1-3D motion capture system
2-Gait analysis with synchronized EMG
Electromyography
3-Biomechanical Gait Analysis using a force platform
 3 Dimensions capture system
3D motion capture system uses 10 infra-red cameras surrounding the patient, with
reflective markers attached to key body segments, thus capturing high resolution data
from all angles.
It is considered the gold standard in measuring human movement.
It allows assessment of multiplane motion and can accurately determine rotational
forces across joints.
3D motion capture systems have limited application in the clinical setting due to the
high-priced equipment and time-consuming set-up.
• Joint angles from treadmill gait represent a set of waveforms to determine a
characteristic pattern of motion that is representative of the movements for a given
subject.
3D motion capture system
Reflective Markers Attached To Key Body Segments
 Gait analysis with synchronized EMG
electromyography

• Electromyography (EMG) is the measurement of the

electrical activity of a muscle during its contraction (i.e.
Muscle activation) by measuring the motor unit action
potential (MUAP).
•
• The information provided by EMG is electrical but not
mechanical: it does not give information about the nature of
the contraction (concentric, eccentric, or isometric) or the
force produced by the muscle contraction.
Gait analysis with synchronized EMG
Biomechanical gait analysis using a force platform
Force-plated treadmill can be used to analyze ground
contact patterns at different paces and whether foot
contact occurs by heel, midfoot, or forefoot strike.
• It can accurately measure limb symmetry, spatial
and time parameters, foot angles, foot pressure
tracking, and impact forces.
Pressure Mapping & Force
Plates