1992; 72:45-53. PHYS THER.

David A Winter
Multifactorial Motor Control Task
Foot Trajectory in Human Gait: A Precise and
http://ptjournal.apta.org/content/72/1/45 online at:
The online version of this article, along with updated information and services, can be found
Collections
Kinesiology/Biomechanics
in the following collection(s):
This article, along with others on similar topics, appears
e-Letters
"Responses" in the online version of this article.
"Submit a response" in the right-hand menu under
or click on here To submit an e-Letter on this article, click
E-mail alerts to receive free e-mail alerts here Sign up
by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from
Research Report
Foot Trajectory in Human Gait: A Precise and
Multifactorial Motor Control Task
The trajecto y of the heel and toe during the swing phase of human gait were an-
alyzed on young adults. The magnitude and variability of minimum toe clear-
ance and heel-contact velocity were documented on 10 repeat walking trials on
11 subjects. The energetics that controlled step length resulted from a separate
study of 5 5 walking trials conducted on subjects walking at slow, natural, and
fast cadeitces. A sensitivity analysis of the toe clearance and heel-contact velocity
measures revealed the individual changes at each joint in the link-segment chain
that could be responsible for changes in those measures. Toe clearance was very
small (1.29 cm) and had low variability (about 4 mm). Heel-contact velocity was
negligible vertically and small (0.87 mls) horizontally. Six joints in the link-
segment chain could, with ve y small changes (+0.86"-k3.3") independently ac-
count for toe clearance variability. Only one muscle group in the chain (swing-
phase hamstring muscles) could be responsible for altering the heel-contact
velocity prior to heel contact. Four mechanical power phases in gait (ankle push-
08 hip ptrll-08 knee extensor eccentric power at push-08 and knee flexor eccen-
tric power prior to heel contact) could alter step length and cadence. These anuly-
ses demonstrate that the safe trajectoy of the foot during swing is a precise end-
point control task that is under the multisegment motor control of both the stance
and swiqg limbs. /Winter DA. Foot trajecto y in human gait: a precise and multi-
factorial motor control task. Pbys Ther. 1992; 72:45-561
Key Words: Kinesiologylbiomechaniu; gait analysis; Lower-limb trajectoy,
measurements; Slipping; Tripping.
Walking is primarily a lower-extremity
control a'ctivity, and researchers have
recognized this by focusing their re-
search on the kinematics and kinetics
of the lower limb. The upper body
(head, arms, and trunk [HAT]) has
received limited attention, and that
has dealt mainly with kinematic de-
scriptions.1 Some recent focus has
been placed on the HAT'S large iner-
tial load, as it affects balance,2 and on
the HAT'S large gravitational load, as it
affects collapse.3 The role of the lower
extremity in controlling both balance
and collapse was identified as unique
stance-phase tasks. The detailed role
of the lower extremity in achieving
forward progression has been limited,
however, to kinematic descriptions
and a number of kinetic analyses. For-
ward progression is essentially a
lower-extremity task and begins late
in stance during push-ofF and contin-
ues throughout swing. The detailed
DAWinter, PhD, PEng, is Professor, Department of Kinesiology, University of Waterloo, Waterloo,
Ontario, Canada N2L 3G1.
?his research was funded, in part, by Grant MT4343 from the Medical Research Council of Canada.
Thb article was submitted November 26, 1990, and was accepted July 24, 1991.
energetics that decide the magnitude
of step length and the precise trajec-
tory of the foot during swing have not
been analyzed and were the subject
of this research.
Review of Literature
To date, there has been considerable
effort focused on the kinematics of
the lower limb during normal walk-
ing. Joint angle data have most com-
monly been reported.5-12 Absolute
segment kinematics (linear and angu-
lar displacements, velocities, and ac-
celerations) are not commonly report-
ed.12 Other than the occasional "stick-
diagram" plot and a few individual
Physical Therapyflolume 72, Number l/Janualy 1992
by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from
trajectory plots,l3 there has not been a
comprehensive study that has exam-
ined [he trajectory of the foot (heel
and toe), especially critical variables
such as toe clearance and heel-contact
velocity.
Several energy-related motor patterns
have been identified as influencing
the magnitude of step length.14 Be-
cause the swing limb constitutes the
major energy demand in walking,l5J6
we must look at the mechanical
energy-generating and energy-
absorbing phases that accelerate and
decelerate the lower limb immedi-
ately prior to and during swing. En-
ergy generation during push-off by
the plantar flexors is the largest single
work phase in the gait cycle4 and is
responsible for the upward and for-
ward acceleration of the lower limb.
Simultaneous with this plantar-flexor
contraction (during 40%-60% of the
walking stride), the knee is flexing
under the control of the eccentrically
acting quadriceps femoris muscle.
During late stance (50% of stride), the
hip flexors commence a concentric
contraction, initiating a "pull-off'
power phase that continues past toe-
off (TO) into mid-swing (80% of
stride). Finally, the major deceleration
of the leg and foot is achieved by the
hamstring muscles, which contract
eccentrically to reduce the foot veloc-
ity to near-zero prior to heel contact
(HC). What is not known is how these
energy-generating and energy-
absorbing phases vary as stride length
(and cadence) varies in normal level
gait.
Methodology
Biomechanical Model
The precision of any task must be
considered relative to the number of
segments involved, their size and
mass, and the number of degrees of
freedom. The link chain for the con-
trol of the foot during swing begins
with the stance foot and proceeds up
to the hip, across the pelvis, and
down to the distal end of the swing
foot/phalangeal segment. This chain
can be considered to consist of seven
segments (or nine if a phalangeal seg-
Figure 1. Stick diagram of link-
chain system of seven segments of the
support limb, pelvis, and swing limb in-
volved in the control of the toe and heel
trajectories. The 12 major degrees offiee-
dom at the six joints that injluence those
trajectories are indicated.
rnent is considered), with 12 major
angular degrees of freedom at the
ankle, knee, and hip that can influ-
ence the displacement of the heel or
toe during the swing phase of gait.
Figure 1 represents this anatomical
model with those important degrees
of freedom indicated. For a typical
adult male subject (mass=70 kg,
height= 1.8 m), the length of this
chain exceeds 2 m. If we consider the
large number of muscles crossing
those joints, the end-point control of
the heel and toe trajectories is a chal-
lenging task.
Procedure and Subjects
The experimental evidence presented
in this report was taken from gait lab-
oratory data collected from young
adults. Some analyses were based on
individual walking trials, and other
analyses were based on repeat trials
conducted over a period of 1 hour.
Details of the kinematic and kinetic
systems have been reported previous-
lpJ2J4J6 and have recently been sum-
marized in a recent report on walking
pattern changes in the elderly.17 For
the foot-trajectory component of this
study, a group of young adults (six
men, five women), who ranged in age
from 21 to 28 years (X=24.9), were
analyzed. Their average height was
1.73 m, and their average weight was
69.2 kg. Each subject walked at his or
her natural cadence on a level walk-
way a minimum of 10 times; repeat
trials were conducted over a period
of 1 hour (one trial every 5 or 6 min-
utes). For the analysis of the energetic
factors that affect step length, data
were taken from analyses performed
over the past 10 years using 55 young
subjects averaging 22.6 years of age.
Their average height was 1.75 m, and
their average weight was 71.2 kg. The
data-collection protocol of this analy-
sis was identical to that of the foot-
trajectory analysis, except each subject
underwent only one walking trial at
his or her natural cadence, at a fast
cadence (defined as the subject's nat-
ural cadence+20 steps/min), or at a
slow cadence (defined as the subject's
natural cadence-20 stepdmin). A to-
tal of 19 subjects were analyzed at
slow and natural cadences, and 17
subjects were analyzed at fast ca-
dences. Each subject provided in-
formed consent before participation
in the study.
Data Analysis
The trajectories of the heel and toe
markers were plotted over the stride
period, which was normalized to
loo%, with HC at 0% and 100%.
These heel and toe profiles were then
averaged over the 10 repeat walking
trials to assess intrasubject variability.
Each intrasubject average was then
ensemble-averaged to produce an
intersubject average. Based on the
variability measurements recorded at
minimum toe clearance, each critical
degree of freedom in the link chain
was varied independently to demon-
strate the sensitivity of the toe trajec-
tory to small angular variations at
each joint in the chain. In this way,
the fine control necessary at each of
the joints was documented. In a simi-
lar manner, the velocities of the heel
in the vertical and horizontal direc-
tions were calculated in order to as-
sess the rapid reduction in velocity of
the heel during the latter half of
swing and after HC. A similar sensitiv-
ity analysis on the angular velocities
Physical Therapyflolume 72, Number ldanuary 1992 by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from
STRIDE ( Oh)
Figure 2. Ensemble-averaged displacement and velocities of the toe over one stride
of 22 subjects walking at their natural cadence. Heel contact was at 0% and 100% of
stride, and toe-off (TO) was at 60% of stride. Minimum toe vertical displacement for
each subject was set at zero at the minimum reached as the toe pressed downu~ard into
the Joor immediately before TO. (CV=coeficient of variation.)
of all segments in the link chain were
examined at HC to determine their
individual contributions to the slow-
ing down of the heel at this poten-
tially dangerous impact time. Finally,
the joint mechanical power patterns
immediately prior to and during
swing were assessed* to determine
how they changed as cadence and
step length increased.
Resutts
Figure ;! plots the average vertical
trajectory and both horizontal and
vertical velocities of the toe for 11
subjects over the stride period. The
toe trajectory showed the toe to reach
its lowest point at about 56% of stride
as the toe pushed downward during
the final phase of push-off. This mini-
mum on each trial was considered to
be zero toe clearance for the purpose
of plotting this displacement profile.
Me r TO, the toe reached a height of
a few centimeters. During mid-swing,
the toe dropped to its minimum
clearance; for these subjects, this
mean clearance averaged 1.29 cm.
During the latter half of swing, the toe
Figure 3. Position of body at the
instant of minimum toe clearance for
one representative walking trial showing
the high forward toe velocity (4.6 m/s)
and center of gravity of the head, arms,
and trunk located ahead of the stance
foot. (R represents the ground-reaction-
force vector, and mg represents the body's
center-ofgravity vector.)
rose to its maximum of about 15 cm
just prior to HC. The mean intra-
subject variability for this minimum
toe clearance was 0.45 cm. Figure 2
shows that this minimum clearance
was achieved when the forward veloc-
ity of the toe was at its maximum (ie,
about 4.6 m/s). Figure 3 demonstrates
the position of the stance and swing
limbs and the upper body at this po-
tentially dangerous tripping time dur-
ing one representative walking trial.
The forward velocity of the body was
1.4 m/s at this time, and the center of
gravity of the HAT was just folward of
the stance foot. The combination of
this center-of-gravity location and the
body's forward momentum means
that, if a trip occurs, there is no possi-
bility that the support limb can re-
cover to return the body's center of
gravity within the safe borders of the
foot. The only possible safe recovery
is by a safe placement of the swing
limb itself. It is noted that the coeffi-
cients of variation (CVs) of these in-
tersubject ensemble averages (Fig. 2)
are quite low and indicate consider-
Physical Therapy/Volume 72, Number 1January 1992 by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from
Table 1. Joint Angle Changes Potentially Responsible for Toe Clearance Variability
JointlSegment Controlling Joint 0' A B ~
Swing ankle
Swing knee
Swing hip
Pelvis
Stance knee
Stance ankle
Ankle dorsiflexors/plantar flexors
Knee flexors
Hip flexors
Stance hip abductors/adductors
Knee flexors
Ankle dorsiflexorslplantar flexors
3.2" plantar flexion
49" flexion
23" flexion
Horizontal
9.4" flexion
4.6" dorsiflexion
aO=joint angle at minimum toe clearance
bAO=joint angle change.
able consistency in this small group
of young adults.
The sensitivity analysis of the kinemat-
ics from one of the subjects examined
all joints in the link segment that had
a potential for influencing the toe tra-
jectoly at the time of minimum toe
clearance: swing ankle, swing knee,
swing hip, stance hip abductor (pelvic
list), stance knee, and stance ankle.
The sensitivity analysis calculated the
angular changes that, at each joint by
itself, would cause the '0.45-cm toe
clearance variability. These results are
reported in Table 1, and one typical
calculation is presented in Figure 4.
According to this interpretation of the
results, if all the remaining joints re-
mained unchanged, a change of
k0.86 degree at this time in stance
hip abduction alone could be respon-
sible for all of the variability seen in
toe clearance.
Figure 5 plots the average vertical
trajectory and both horizontal and
vertical velocities of the heel for these
same subjects over the stride period.
The heel began rising in mid-stance at
heel-off and reached a maximum of
about 25 cm just after TO, then de-
creased rapidly, reaching about 1 cm
above the ground at 90% of the stride
period. During the last 10% of the
stride prior to HC, the trajectoly was
almost horizontal; the horizontal ve-
locity also decreased drastically from
4 m/s, reaching about 0.87 m/s at HC.
This forward velocity decreased to
zero at about 4% of the stride, indicat-
ing a small skidding of the heel of the HAT, during one representative walk-
shoe immediately after HC. Figure 6 ing trial.
demonstrates the position of the body
at HC, especially the heel velocity vec- A hr t her sensitivity analysis of the
tors relative to the forward velocity of kinematics of the link chain at this
time of HC was completed to assess
What angular change at the knee alone would
result In a k0.45-cm vertical change at the toe?
With the foot position unchanged, there would be
a k0.45cm vertlcal change at the ankle.
The leg would have to change * A 8 to achieve
Vertical distance from knee to ankle =.425 sin 64"
=0.382 m
: . .425 sln (64 +do) = .382 2 .0045
sin (64 *A0) = .9094 :. A0 1.4'
sln (64 +.dB) = .I3882 : . A0 = 1.4"
: . a &I .4" change in knee angle by itself would cause
the k0.45cm change in toe clearance.
k0.45 cm
----f
Figure 4. &ample of sensitivity calculation to determine the angular change
(k AO) necessary at the knee alone to cause the k0.45-cm displacement variability seen
at the toe at the instant of minimum toe clearance.
Physical Therapyllrolume 72, Number ldanuary 1992
by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from
I . . . . . . . . . I . . . . . . . . . I . . . . . . . . . . . . .
0 20 40 60 80 100
STRIDE (%)
Figure 6. Position of body at heel
contact for one representative walking
trial showing the low heel velocities rela-
tive to the forward velocity of the body's
center of mas (R represents the ground-
reaction-force vector, and mg represents
the body's center-ofgravity vector.)
length of 1.51 m (walking veloci-
ty= 1.33 m/s). The 19 slow walkers
had a cadence of 86.8 steps/min and a
step length of 1.38 m (walking veloci-
ty=1.00 m/s), and the 17 fast walkers
had a cadence of 123.1 steps/min and
a step length of 1.64 m (walking ve-
locity= 1.68 m/s) .
Figure 5. Ensemble-averaged displacement and velocities of the heel of the same
I 1 subjects as represented in Fig. 2 over one stride, from heel contact (HC) to HC. Hori-
zontal heel velocity reached a peak in mid-swing and decreased to virtually zero in the
vertical direction and to a low value horizontally at HC. (CV=coeficient of variation;
TO =toe-($)
the angu~lar velocity changes that, by
themselves, would be necessary to
reduce the forward heel velocity by
0.87 m/s, thus reducing it to exactly
zero at HC. The potential angular ve-
locities to which heel velocity is sensi-
tive are swing foot, swing leg, swing
thigh, pelvic horizontal velocity (con-
trolled bly hip rotators), stance thigh,
stance leg, and stance foot. The neces-
sary angular velocity changes are sum-
marized in Table 2 with an indication
of what :muscle group would be re-
sponsible in each case (remembering
that during stance the muscles at ei-
ther the proximal or distal end of
each segment can control). One typi-
cal calculation of the velocity sensitiv-
ity is presented in Figure 7.
The variability of the heel trajectories,
as demonstrated by the CVs in the
ensemble averages presented in
Figure 5, is quite low. Again, this low
variability is indicative of consistency
in this small group of young adults.
Figures 8 through 10 present mechan-
ical power profiles drawn from the
database from subjects walking at
three different cadences and at differ-
ent step lengths. The 19 natural-
cadence walkers had a mean cadence
of 105.3 steps/min and a mean step
Toe clearance has been considered to
be a major responsibility of the swing
leg dorsiflexors, and, as expected, it
is quite sensitive to small angular
changes (22.07")f the swing ankle.
The sensitivity analysis results
(Tab. I), however, show that the end-
point toe trajectory is also very sensi-
tive to small angular changes at five
other joints in the total link-segment
chain. Toe clearance is sensitive to
even smaller angular changes at the
knee ( 2 1.35-d during stance hip
abduction and adduction (20.869.
Clinically, it is important to observe
each walking patient and note any
clearance problems and at which joint
compensations are taking place. Thus,
it is not surprising that certain pa-
tients, such as those with below-knee
Physical TherapyNolume 72, Number loanuary 1992
49 / 59
by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from
-
Table 2. Angular Velocity Changes and Muscle Groups with Potential to Reduce Heel Velocity to Zero at Heel Contact
Angle from
Segment Horizontal Ama Muscle Group
Swing foot 69.6" 12.3 Plantar flexors
Swing leg 108.4" 2.15 Knee flexorsa
Swing thigh 109.6" 2.9 Hip extensorsa
Pelvis Horizontal 2.96 Stance hip external rotatorsa
Stance thigh 71.3" 2.9 Hip extensorslknee flexors
Stance leg 56.2" 2.47 Knee extensorslankle plantar flexors
Stance foot 1 19.6" 5.5 Plantar flexors (less activity)
"Aw=angular velocity change (in radians per second)
b~ndicates only muscle groups capable of decelerating heel at heel contact.
amputations, adapt to achieve a safe
foot clearance with increased knee
flexion and "hip hiking" (increased
stance hip abduction). Circumduction
is also a common adaptation, but, be-
cause of the low sensitivity of the
swing hip abductors, an appreciable
angular change is required to make a
significant change in toe clearance.
The trajectory velocity of the heel im-
mediately prior to HC is virtually zero
vertically and low in the horizontal
direction; such findings raise the ques-
tion as to why many researchers refer
to this initial contact as "heel-strike."
With the exception of the swing foot,
the angular velocity changes necessary
to reduce the heel forward velocity to
zero were well within the range of
I
\Y
What angular velocity change (Aw)
of the leg would result in a AV
sufficient to reduce the
kA*
heel horizontal velocity to zero?
0 ' \
.425 Aw sin 72O=AV=0.87 m1-S
Am= '87 =2.15 radiansls
.425 sin 72"
Figure 7. Example of calculation to determine the sensitivity of the heel contact
(HC) velocity to the velocity of the individual segment. (Aw=angular velocity change
that, by itself; could reduce the horizontal velocity of the heel at HCfiom its average
value 10.87 m/s] to zero; AV=change in velocity.)
biomechanically determined angular
velocities during natural walking.lH
Functionally, however, some of the
potential controls implied by the re-
sults of Table 2 must be discarded.
A rapid plantar flexion of the foot
(12.3 radians/s) immediately prior to
HC is not a valid solution, because this
movement would result in a rapid
foot-slap rather than a controlled low-
ering of the foot after HC. The analysis
also suggests the stance thigh's forward
velocity could be decelerated by in-
creased knee flexor activity at the same
time as the stance leg was decelerated
by increased knee extensor activity.
Obviously, this is not an anatomically
possible combination. Similarly, the
tabulated results suggest that the
stance ankle plantar flexors would
have to increase their activity to decel-
erate the forward-rotating leg at the
same time as they decreased activity to
decrease foot plantar flexion. Again,
this is not a compatible solution. An-
other possibility is hip extensor con-
trol of the stance thigh, but such con-
trol is not likely, because the stance
hip extensors are not reported to be
active at this time.l9,20
Thus, the knee flexors, hip extensors,
and stance hip external rotators are
the only muscle groups that have the
potential for decelerating the heel
immediately prior to HC (Tab. 2). The
most compatible combination of
those three muscle groups are the
knee flexors and the hip extensors,
60 / 50 Physical Therapyllrolume 72, Number loanuary 1992
by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from
STRIDE ( Oh)
Flgure 8. Mechanical power generation and absorption proJles at the ankle for
three walking-speed cadences: natural, slow, and fast. The push-offpower (A2 burst) by
the plantar flexors drastically increased )om slow to fast walking cadences and repre-
sents over 75% of all energy generated in the stride period. The A1 power phase was the
absorption! of e ne w as the plantar flexors lengthen as the leg rotates forward over the
foot. FO =:toe-off)
which means that the biarticulate
hamstring muscles would be pre-
dicted to decelerate both the swing
thigh and leg and therefore are the
major decelerators of the foot. Elec-
tromyographic profiles show the ham-
string muscles to be active in late
swing.19J" Mechanical power analyses
have also shown this to be true in
both walking4 and running,21 during
which the eccentric work done at the
knee during the latter half of swing
was dominant. In running,21 a small,
short-duration burst of positive power
immediately followed this K4 negative
work and was due to a concentric
contraction as these same hamstring
muscles momentarily accelerated the
leg backward. This finding does not
mean that the foot was traveling back-
ward at this time. Rather, the body
had a forward velocity of about 3 m/s,
and, to reduce the foot velocity to
near-zero, the foot would need a mo-
mentary backward velocity of about
3 m/s relative to the center of mass of
the body. The central nervous system
obviously recognizes the energetics of
this fine control. The third possible
muscle group noted in Table 2 that
could control the swing limb's for-
ward velocity are the stance hip exter-
nal rotators. Because the angular rota-
tion and velocity of the pelvis in the
transverse plane were quite small,
these rotators would have only mini-
mal potential for control.
The clinical significance of this HC
velocity analysis relates to the poten-
tial for a patient to slip at this critical
phase of the gait cycle. Heel contact
usually involves weight bearing on a
small surface area of the heel, and, if
the ground contact area is wet or slip-
pery, there is an increased probability
of slipping. In a study on fit and non-
disabled elderly subjects, we have
documented that their HC velocity
was 1.15 m/s, which is significantly
higher (P<.01) than for the younger
adults in this study. Thus, these el-
derly individuals are at a greater risk
for slipping, even though their walk-
ing velocity was significantly lower
than that of the younger adults in this
study (1.29 versus 1.43 m/s, respec-
tively). To date, we have not docu-
mented the HC velocity for patients
who are prone to fall; such studies
are currently ongoing.
Four of the power bursts (ie, A2, K3,
K4, and H3) shown in Figures 8
through 10 demonstrated drastic
changes during push-off and swing
that could influence step length. The
ankle push-off burst (A2 in Fig. 8)
showed a dramatic increase as the
subjects accelerated their lower limb
prior to TO to achieve a longer step
length. Almost simultaneous to this
push-off impulse was an increasing
absorption of energy at the knee
(K3 in Fig. 9) by the eccentrically act-
Physical TherapyNolume 72, Number :I./January 1992
by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from
I I . l . . ~ . . . t . . . . . . . . . . l . . . . . . . , . ~
0 20 40 60 80 100
STRIDE (%)
Figure 9. Mechanical power absorption and generation at the knee for the same
three cadence groups as represented in Fig. 8. The IU burst was the power associated
with the eccentrically contracting quadriceps femoris muscle necessary to control knee
jlexion caused by the 'piston-like" push-off by the ankle in late stance. The K4 burst was
due to the eccentrically contracting hamtn'ng muscles decelerating the swinging leg
prior to heel contact. Both and K4 increased as cadence and stride length increased.
The KI bum was the absorption by the knee extensors as they lengthen when the knee
jlexes. The k2 burst was the generation by the same knee extensors as the knee extends
during mid-stance. (TO=toe-off)
ing quadriceps femoris muscle. This the hip flexors contracted concentri-
absorption represents a necessary loss cally to commence a pull-off of the
of energy to prevent t oo rapid a knee lower limb (H3 in Fig. lo), which con-
flexion prior to TO (60% of stride) tinued past TO until midswing. This
resulting from the forceful upward impulse of pull-off energy also in-
acceleration of the leg caused by A2. At creased dramatically with increased
mid-double support (50% of stride), cadence and step length. In mid-swing,
the swinging lower limb (mainly leg
and foot) reached its maximum en-
ergy, which must be removed prior to
HC. The K4 burst (Fig. 9) showed the
knee flexors (hamstring muscles) to
be eccentrically acting, mainly to re-
move the kinetic energy from the
swinging leg and foot. Thus, increased
step length (and cadence) is normally
achieved with an increase in both posi-
tive work by the ankle plantar flexors
and hip flexors and a matched in-
crease in the negative work by the
knee extensors during late stance and
the knee flexors during late swing.
The influence of these energy bursts
on the gait patterns of fit and nondis-
abled elderly subjects has also been
demonstrated recently.17 These elderly
subjects were seen to have the same
natural cadence as the younger adults
in this study, but a significantly
(Pc.01) shorter stride length. Two
motor pattern changes responsible for
this reduction were a significantly re-
duced push-off power (A2 burst) and a
significant increase in quadriceps fem-
oris muscle absorption (K3 burst).
Conclusions
The trajectory of the f oot during gait
is a precise end-point control task. It
is under the multisegment motor con-
trol of both stance and swing limbs.
Toe clearance of slightly more than
1 cm was found to be sensitive to fine
control by at least six muscle groups
in the link-segment chain. Heel-
contact velocity was virtually zero in
the vertical direction, with a low hori-
zontal velocity. The dominant muscle
group responsible for reducing that
velocity was the hamstrings. The mag-
nitude of step length was found to be
under the control of four concentric
and eccentric motor patterns during
late stance and swing. Step length and
walking velocity were increased by
increased plantar-flexor power during
push-off and by increased hip-flexor
power during "pull-off." Step length
can be reduced by increased eccen-
tric quadriceps femoris muscle activity
during late stance and by increased
eccentric hamstring muscle activity
during late swing. In spite of the con-
sistency in the foot trajectory profiles
for this small group of young adults,
62 / 52 Physical TherapyFolume 72, Number ldanuary 1992
by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from
References
STRIDE (%)
Figure 10. Mechanical power generation and absorption at the hip for the same
three caa'ence groups as represented in Fig. 8. The H3 burst represents the 'pull-of'
power generation by the hipJexors. This positive work began in late stance (50%), con-
tinued into mid-swing (go%), and increased drastically as cadence increased. The HI
power ph'ase resulted )om the hip extensors shortening immediately after heel contact.
The H2 power burst resulted from the hipJexors; lengthening during mid-stance to de-
celerate rhe backward-rotating thigh. (TO=toe-of)
more research may be necessary to Acknowledgment
quantify any differences in larger
groups of young adults and in other I acknowledge the technical assistance
age groups. of Mr Paul Guy.
1 Thorstensson A, Nilsson J, Carlson H, Zom-
lefer MR. Trunk movements in human normal
walking. Acta Physiol Scand. 1984; 12 15-22,
2 Patla AE, Frank JS, Winter DA. Assessment of
balance control in the elderly: some issues.
Physiotherapy Canada. 1990;42:89-98.
3 Winter DA. Overall principle of lower limb
support during stance phase of gait. J Bio-
mech. 1980;13:923-927,
4 Winter Dk Energy generation and absorption
at the ankle and knee during fast, natural and
slow cadences. Clin Orthop. 1983;197:147-154.
5 Finley FR, Karpovich PV. Electrogoniometric
analysis of normal and pathological gaits. Re-
search QuarterLy. 1964;35:379-384.
6 Murray MP, Drought AB, Kory RC. Walking
patterns of normal men. J Bone Joint Surg
[Am]. 1964;46:335-360.
7 Murray MP. Gait as a total pattern of move-
ment. Am J Phys Med. 1967;46:290-333.
8 Murray MP. Walking patterns of normal
women. Arch Pbys Med Rehabil. 1967;51:637-650.
9 Johnston RC, Smidt GI. Measurement of hip-
joint motion during walking. J Bone Joint Surg
[Am]. 1969;51:1083-1094.
10 Lamoreux LW. Kinematic measurements in
the study of human walking. Bulletin of Pros-
thetics Research. Spring 1971:3-84.
11 Sutherland DH, Hagy JL. Measurement of
gait movements from motion picture film.
J Bone Joint Surg [Am]. 1972;54:787-797.
12 Winter DA, Quanbury AO, Hobson DA, et
al. Kinematics of normal locomotion: a statisti-
cal study based on TV data. J Biomech. 1974;
1 :479-486.
13 Murray MP, Clarkson BH. The vertical path-
ways of the foot during level walking, 11: clini-
cal examples of distorted pathways. Phys Ther.
1966;46:590-599,
14 Winter DA. Concerning scientific basis for
the diagnosis of pathological gait and for reha-
bilitation protocols. Physiotherap~j Canada.
1985;37:245-252.
15 Ralston HJ, Lukin L. Energy levels of hu-
man body segments during level walking. Er-
gonomics. 1969;12:39-46.
16 Winter DA, Quanbury AO, Reimer GD.
Analysis of instantaneous energy of normal
gait. J Biomech. 1976;9:253-257.
17 Winter DA, Patla AE, Frank JS, Walt SE. Bio
mechanical walking pattern changes in the fit
and healthy elderly. Pbjs Ther 1930,70:340-347.
18 Winter DA. Biomechanics and Motor Con-
trol of Hu mn Gait. Waterloo, Ontario, Can-
ada: University of Waterloo Press; 1987:25-26.
19 Winter DA, Yack HJ. EMG profiles during
normal human walking: stride-to-stride and
inter-subject variability. Electroencephalogr
Clin Neumpbysiol. 1987;67:402-411.
20 Shiavi R. Electromyographic patterns in
adult locomotion: a comprehensive review.
J Rehabil Res Deu. 1985;22:85-97.
21 Winter DA. Moments of force and mechan-
ical power in slow jogging. J Biomech.
1983;16:91-97.
Physical Therapyllrolume 72, Number loanuary 1992
by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from
1992; 72:45-53. PHYS THER.
David A Winter
Multifactorial Motor Control Task
Foot Trajectory in Human Gait: A Precise and
Cited by
http://ptjournal.apta.org/content/72/1/45#otherarticles
articles:
This article has been cited by 20 HighWire-hosted
Information
Subscription http://ptjournal.apta.org/subscriptions/
Permissions and Reprints http://ptjournal.apta.org/site/misc/terms.xhtml
Information for Authors http://ptjournal.apta.org/site/misc/ifora.xhtml
by guest on September 9, 2014 http://ptjournal.apta.org/ Downloaded from