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UNDERSTANDING
NORMAL
GAIT
Gait Cycle - Definitions:
►Normal Gait =
 Series of rhythmical , alternating movements of
the trunk & limbs which result ...
Gait Cycle - Definitions:
► Gait Cycle =
 Single sequence of functions by one limb
 Begins when reference foot contacts ...
Gait Cycle - Definitions:
► Step Length =
 Distance between corresponding successive points
of heel contact of the opposi...
Gait Cycle - Definitions:
► Stride Length =
 Distance between successive points of heel contact of
the same foot
 Double...
Gait Cycle - Definitions:
► Walking Base =
 Side-to-side distance between the line of the two feet
 Also known as ‘strid...
Gait Cycle - Definitions:
►Cadence =
 Number of steps per unit time
 Normal: 100 – 115 steps/min
 Cultural/social varia...
Gait Cycle - Definitions:
► Velocity =
 Distance covered by the body in unit time
 Usually measured in m/s
 Instantaneo...
Normal Development
 Walking begins at about 12 - 15 months of age.
 Children have shorter legs, so cadence is increased ...
Gait Cycle - Components:
► Phases:
(1)Stance Phase: (2) Swing Phase:
reference limb reference limb
in contact not in conta...
Gait Cycle - Components:
► Support:
(1) Single Support: only one foot in contact with the floor
(2) Double Support: both f...
Gait Cycle - Subdivisions:
A. Stance phase:
1. Heel contact: ‘Initial contact’
2. Foot-flat: ‘Loading response’, initial c...
Gait Cycle - Subdivisions:
B. Swing phase:
1. Acceleration: ‘Initial swing’
2. Midswing: swinging limb overtakes the limb ...
Gait Cycle
► Time Frame:
A. Stance vs. Swing:
►Stance phase = 60% of gait cycle
►Swing phase = 40%
B. Single vs. Double support:
►Sin...
► With increasing walking speeds:
►Stance phase: decreases
►Swing phase: increases
►Double support: decreases
► Running:
►...
Path of Center of Gravity
►Center of Gravity (CG):
 midway between the hips
 Few cm in front of S2
►Least energy consump...
Path of Center of Gravity
A. Vertical displacement:
► Rhythmic up & down movement
► Highest point: midstance
► Lowest poin...
Path of Center of Gravity
B. Lateral displacement:
► Rhythmic side-to-side movement
► Lateral limit: midstance
► Average d...
Path of Center of Gravity
C. Overall displacement:
► Sum of vertical & horizontal
displacement
► Figure ‘8’ movement of CG...
Determinants of Gait :
►Six optimizations used to minimize excursion
of CG in vertical & horizontal planes
►Reduce signifi...
Determinants of Gait :
 (1) Pelvic rotation:
 Forward rotation of the pelvis in the horizontal plane approx. 8o
on the s...
Determinants of Gait :
 (2) Pelvic tilt:
 5o dip of the swinging side (i.e. hip adduction)
 In standing, this dip is a ...
Determinants of Gait :
 (3) Knee flexion in stance phase:
 Approx. 20o dip
 Shortens the leg in the middle of stance ph...
Determinants of Gait :
 (4) Ankle mechanism:
 Lengthens the leg at heel contact
 Smoothens the curve of CG
 Reduces th...
Determinants of Gait :
 (5) Foot mechanism:
 Lengthens the leg at toe-off as ankle moves from
dorsiflexion to plantarfle...
Determinants of Gait :
 (6) Lateral displacement of body:
 The normally narrow width of the walking base minimizes
the l...
“ Don’t walk behind me, I may not lead.
Don’t walk ahead of me, I may not follow.
Walk next to me and be my friend.”
Alber...
THANK YOU
Gait (PMR)
Gait (PMR)
Gait (PMR)
Gait (PMR)
Gait (PMR)
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Gait (PMR)

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Gait (PMR)

  1. 1. UNDERSTANDING NORMAL GAIT
  2. 2. 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’
  3. 3. Gait Cycle - Definitions: ► Gait Cycle =  Single sequence of functions by one limb  Begins when reference foot contacts the ground  Ends with subsequent floor contact of the same foot
  4. 4. Gait Cycle - Definitions: ► Step Length =  Distance between corresponding successive points of heel contact of the opposite feet  Rt step length = Lt step length (in normal gait)
  5. 5. Gait Cycle - Definitions: ► Stride Length =  Distance between successive points of heel contact of the same foot  Double the step length (in normal gait)
  6. 6. Gait Cycle - Definitions: ► Walking Base =  Side-to-side distance between the line of the two feet  Also known as ‘stride width’
  7. 7. Gait Cycle - Definitions: ►Cadence =  Number of steps per unit time  Normal: 100 – 115 steps/min  Cultural/social variations
  8. 8. Gait Cycle - Definitions: ► Velocity =  Distance covered by the body in unit time  Usually measured in m/s  Instantaneous velocity varies during the gait cycle  Average velocity (m/min) = step length (m) x cadence (steps/min) ► Comfortable Walking Speed (CWS) =  Least energy consumption per unit distance  Average= 80 m/min (~ 5 km/h , ~ 3 mph)
  9. 9. Normal Development  Walking begins at about 12 - 15 months of age.  Children have shorter legs, so cadence is increased (170 st/min at age 1 yr to 140 st/min at 7y)  Stride length is roughly the same as height (stature), so a child 0.5 m tall will have an expected stride length of about 0.5 m  Velocity is roughly 1 stature/s, so a child 0.5 m tall will have an expected walking velocity of about 0.5 m/s  Walking pattern more flexed than adult, especially at hip and knee, becomes adult at 7 yrs, and gait parameters stabilise by 16 - 18 yrs (when long bones stop growing)  Elderly people gradually shorten stride length after about 65 yrs, but cadence remains relatively constant
  10. 10. Gait Cycle - Components: ► Phases: (1)Stance Phase: (2) Swing Phase: reference limb reference limb in contact not in contact with the floor with the floor
  11. 11. Gait Cycle - Components: ► Support: (1) Single Support: only one foot in contact with the floor (2) Double Support: both feet in contact with floor
  12. 12. 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’
  13. 13. Gait Cycle - Subdivisions: B. Swing phase: 1. Acceleration: ‘Initial swing’ 2. Midswing: swinging limb overtakes the limb in stance 3. Deceleration: ‘Terminal swing’
  14. 14. Gait Cycle
  15. 15. ► 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%
  16. 16. ► 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
  17. 17. Path of Center of Gravity ►Center of Gravity (CG):  midway between the hips  Few cm in front of S2 ►Least energy consumption if CG travels in straight line
  18. 18. Path of Center of Gravity A. Vertical displacement: ► Rhythmic up & down movement ► Highest point: midstance ► Lowest point: double support ► Average displacement: 5cm ► Path: extremely smooth sinusoidal curve
  19. 19. Path of Center of Gravity B. Lateral displacement: ► Rhythmic side-to-side movement ► Lateral limit: midstance ► Average displacement: 5cm ► Path: extremely smooth sinusoidal curve
  20. 20. Path of Center of Gravity C. Overall displacement: ► Sum of vertical & horizontal displacement ► Figure ‘8’ movement of CG as seen from AP view Horizontal plane Vertical plane
  21. 21. Determinants of Gait : ►Six optimizations used to minimize excursion of CG in vertical & horizontal planes ►Reduce significantly energy consumption of ambulation ►Classic papers: Sanders, Inman (1953)
  22. 22. Determinants of Gait :  (1) Pelvic rotation:  Forward rotation of the pelvis in the horizontal plane approx. 8o on the swing-phase side  Reduces the angle of hip flexion & extension  Enables a slightly longer step-length w/o further lowering of CG
  23. 23. Determinants of Gait :  (2) Pelvic tilt:  5o dip of the swinging side (i.e. hip adduction)  In standing, this dip is a positive Trendelenberg sign  Reduces the height of the apex of the curve of CG
  24. 24. Determinants of Gait :  (3) Knee flexion in stance phase:  Approx. 20o dip  Shortens the leg in the middle of stance phase  Reduces the height of the apex of the curve of CG
  25. 25. Determinants of Gait :  (4) Ankle mechanism:  Lengthens the leg at heel contact  Smoothens the curve of CG  Reduces the lowering of CG
  26. 26. Determinants of Gait :  (5) Foot mechanism:  Lengthens the leg at toe-off as ankle moves from dorsiflexion to plantarflexion  Smoothens the curve of CG  Reduces the lowering of CG
  27. 27. Determinants of Gait :  (6) Lateral displacement of body:  The normally narrow width of the walking base minimizes the lateral displacement of CG  Reduced muscular energy consumption due to reduced lateral acceleration & deceleration
  28. 28. “ Don’t walk behind me, I may not lead. Don’t walk ahead of me, I may not follow. Walk next to me and be my friend.” Albert Camus
  29. 29. THANK YOU

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