NORMAL GAIT

Basic terminologies
► Basic biomechanics
► COG
► BOS
► LOG

► Stability and mobility

► Tibial movement on ankle joint
► Tibial translation at Knee
► Eccentric work of muscles
COG
 Bipedal gait
► Advantage
►Freely move
►Challenging

► Disadvantages
►Hard for CM to move in straight line
►Arc shaped
 Gait Cycle - Definitions:
► Normal Gait =
 Series of rhythmical , alternating movements of
the trunk & limbs which result in the forward
progression of the center of gravity
 Series of ‘controlled falls’

► Physiological
definition
► Mechanical definition
 Pre requisite
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

► 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, sensori-motor input)
 Phases of step cycle
► Stance phase -60% (20% double support)
1. Initial contact
2. The loading response
3. Mid stance
4. Terminal stance
5. Pre swing
► Swing phase -40%
1. Initial swing
2. Mid swing
3. terminal swing
 Terminology
RLA (phases) Traditional (events)
Stance Stance
► Initial Contact Heel Strike
► Loading response HS → foot flat
► Midstance FF → midstance
► Terminal stance Midstance → heel off
► Pre-swing Heel off → toe off
Swing Swing
► Initial swing Toe off → early accel.
► Midswing Accel. → midswing
► Terminal swing Midswing → deceler.
Phases of Gait
 Gait Cycle - Subdivisions:

A. Stance phase:
1. Heel contact: ‘Initial contact’
2. Foot-flat: ‘Loading response’, initial contact of forefoot w. ground
3. Midstance: greater trochanter in alignment w. vertical bisector of foot
4. Heel-off: ‘Terminal stance’
5. Toe-off: ‘Pre-swing’
 Gait Cycle - Subdivisions:

B. Swing phase:
1. Acceleration: ‘Initial swing’
2. Midswing: swinging limb overtakes the limb in stance
3. Deceleration: ‘Terminal swing’
► Time Frame:
A. Stance vs. Swing:
►Stance phase = 60%
of gait cycle
►Swing phase = 40%
B. Single vs. Double support:
►Single support= 40%
of gait cycle
►Double support= 20%
► With increasing walking speeds:
► Stance phase: decreases
► Swing phase: increases
► Double support: decreases

► Running:
► By definition: walking without double support
► Ratio stance/swing reverses
► Double support disappears. ‘Double swing’ develops
► The stance period consists of the first
five phases: initial contact, loading
response, mid-stance and terminal stance.
Stance phase
Swing phase
 Kinematic Description of Gait
Movement of the joints and segments in
space –Pelvis, Hip, Knee, Ankle
► Sagittal Kinematics
► Frontal Kinematics
► Transverse kinematics
 Saggital kinematics
Initial contact
(Heel strike)

► Hip25-30 flexion
► Knee 0-5
► Ankle 0 (90)

► Muscle work
► Stabilizers
 Loading Response Phase
(Heel Strike to Foot Flat)

► KNEE: 0° → 15° flexion

► ANKLE: 0° → 10° plantar
flexion
► 1st rocker : Calcaneus

► Muscle work
► Quards ---Eccentric
► DF….Eccentric
► T.Antand Post….Eccentric
► Hip extensors
 Mid stance
(Foot Flat to mid stance)
► HIP: 25° → 0°
► KNEE: 15° →0°
► ANKLE:10 pf to 5 DF
► 2nd rocker ankle

► Muscle work
► Quads concentrically to initate the
extension
► Soleus and gastro…eccentric
 Terminal Stance
Mid stance to Heel off

► HIP: 0 - 20° Ext.

► KNEE: 0°
► ANKLE: 5° → 10
► At end of terminal stance,
Begin 3rd rocker MTP

► Muscle work
► Planter flexors
► No quards and hamstring
 Pre swing
(Heel Off to Toe Off)

► HIP: 20° Ext → 0°F

► KNEE: 0° → 40°F
► ANKLE: 10° dorsi flexion → 20°
plantar flexion

► Muscle work
► Planter flexors
► Push off
► Passive knee flexion
 Initial swing
Toe Off to early

► HIP: 15 °F
► KNEE: 60°F
► ANKLE: 10° plantar flexion

► Muscle work

► Hip flexors
► Knee flexors
► DF
 Mid swing

► HIP:25 °F
► KNEE: 25°F
► ANKLE: 0°

► Muscle work
► Hip flexors
► Quards
 Terminal Swing
Mid-swing-deceleration

► HIP:25 °F
► KNEE: 0°-5
► ANKLE: 0°

► Muscle
► Hipextensors
► Hamstring
 Swing phase
1. Initial quads and hip
flexors
2. Pendulum…momentum
3. Hamstring and hip
extensors
4. Quads
 Frontal Kinematics
Subtalar
► In early stance, eversion(pronation) unlocks
the midtarsaljoint, allowing shock
absorption.
► In late stance, inversion (supination) locks
the midtarsaljoint, allowing a rigid forefoot
lever for heel off.
 Transverse axis
Hip, trunk & lower limb
► Pelvic Rotation
The swing leg side of the pelvis rotates 10°
► Trunk Rotation
Lower trunk (below T7/T8 ) rotates with the
pelvis.
Upper Trunk rotates opposite to this (180°)
► Femoral/ Femoral/Tibial
Internal rotation until foot flat, then externally
rotates until toe off, then internally rotates
through swing.
 Gait

Initial HC HC
‘Heel transient’

Foot-Flat Mid-stance
 Gait

Initial HC HC
‘HeelHeel-off
transient’
Toe-off
 Gait analysis

1. Temporal / Spatial

2. Kinematics
•Qualitative Gait analysis
•Observational gait analysis OGA
•Biomechanical evaluation
•GHORT

3. Kinetics

4. Dynamic Electromyography
 Temporal and Distance Factors
► Velocity– 1.46 m/second (3.26 miles/hour)
► Step length – 76.3 cm (30.05 inches)
► Cadence – 1.9 steps /second
► Stride length –
► Walking speed – men-110 steps/minute ,
women-115 steps/minute
 Gait Parameters
Males Females

Step Length (cm) 79 66

Stride Length (cm) 158 132

Cadence (steps/min) 117 (60-132) 117 (60 132

Velocity (m/sec) 1.54 1.31

Walking Base (cm) 8.1 7.1

Foot angle 7 6
 GAIT
Muscle strength

► Planter flexors 5

► Quards 3plus
► Hip extensors 3plus
► Hip flexors 2 plus