The document discusses gait disorders, their classifications, and analysis techniques, including video-assisted observational gait analysis (VAOGA). It outlines the types and causes of gait disorders, emphasizing the importance of proper assessment to improve mobility and prevent falls, particularly in the elderly. The document also details various gait patterns associated with different conditions, such as cerebral palsy and other pathological causes.

1. Gait Disorders &
Analysis
A Roadmap to
Decision Making
Prof. Anisuddin Bhatti
Dr. Ziauddin University Hospital, Clifton
Webinar 27th September, 2020

2. Agenda
Preamble
• Gait: Defination, requirments,
terminology, cycle, compnents etc
• VAOGA: Video Assisted OBSERVATIONAL
Gait Analysis..
• VGA_Laboratoy: Videographic Gait
Laboratory Analysis.
• Gait Types_Orthoapedic Concern
• How effective is VAOGA.
• Case Presentations.
• Discussion_ Penalist.
• Q&A

3. Gait
• Rhythmic, cyclic movement of
the limbs in relation to the
trunk resulting in forward
propulsion of the body.
Gait Disorder
• An altered gait pattern, in
Rhythm & cycle

4. GAIT DISORDER_MAJOR REASONS:
• Deformities
• Weakness / Loss of motor control
• Pain: Inflamatory / infective disorder
• Multifactorial [common & Complex
with advancing age]
Prevelence increases with ageing
population and increasing morbidity
index
Look when he bears weight on left leg

5. Altered Gait leads to:
• Loss of personal freedom
• Reduced quality of life.
• Tendency falls (in elderly
prxns), that may cause a
potentially severe injuries &
frxs

6. • Careful history taking &
examination focussed on:
oGait pattern
oPhysical examination
oNeurological assesment
oOrthopaedic evaluation
oGait Analysis [VAOGA]
• Objectives to
improve
oMobility
oIndependence,
oPrevent falls
oDetect underlying
causes
Assesment & Evaluation:
Two basic steps in the categorization of gait disorders and guideline for ancillary investigations and
therapeutic interventions includes:.

7. Gait Disorder Causes
Physiological
• Paediatric Gait <3 yrs
years
• Elderly Gait >70 yrs
Pathological
• Muskuloskeletal Causes:
oAnatlgic
oLLD
oContracture
• Neuro Vascular disorders
o Sensory Ataxia
o Cerebelar Ataxia
o Lower Motor neuron: Polio, neuropathies
o Upper Motor Neuron: Cerebral Palsy &
o Dystonia
o Myopathies Dysvascular

8. Gait Analysis
• Observational Gait Laboratory

9. Gait
Analysis
A systematic approach to:
• looking at trunk & each joint moving
in all three planes i,e. saggital,coronal
& transverse.
• Yield valuable information about
patient's condition & help in
establishing a treatment plan.

10. Benefits
of Gait
Analysis
• To diagnose mechanisms responsible
for gait disorders.
• To asses degree of disability.
• To evaluate the post treatment
improvement.
• Evaluate rate of deterioration in
progressive disorders.
• Quantification for clinical research.

11. Gait Requirents
Normal functioning of musculoskeletal
system of lower limbs & spine.
Good sensory feedback from
propioceptive sensation from feet and
the joints.
Visual, labrinthine sensory inputs & co
ordination. That, adds smoothness,
rhythm & elegance to the human gait.
MSK Functional
Elements

12. Gait Cycle
• Period of time from one
heel strike to next heel
strike of the same limb
• Normally 1-2 sec

13. Gait Cycle Components
Components:
•Stance phase :60%
•Swing phase :40%
K.PRAKASAM, THOUSEEF A MAJEED

14. Phases of
Gait Cycle
Stance &
Swing
STANCE PHASE
• Time during which
the limb is in
contact with the
ground and
supporting the
weight of the body.
• 60% of Gait Cycle
SWING PHASE
Time period during
which the limb is
off the ground and
advancing
forward,the body
weight supported
by contralateral
limb.
• 40% of Gait Cycle

15. Gait Cycle Terminology:
Conventional _ HLA terminology
STANCE PHASE
• Heel strike _ Initial Contact
• Flat foot _ Loading Response
• Midstance _ Midstance
• Heel off _ Terminal Stance
• Toe off _ Pre swing
SWING PHASE
• Acceleration _ Initial Swing
• Mid-Swing – Mid Swing
• Deceleration _ Terminal Swing

16. Functional divisions of the gait cycle according to Perry and Barnfield (2010).
Gait Cycle _ Gait Flow Chart

17. Stance Phase
Time during which the limb is in contact with
the ground and supporting the weight of the
body.
Components:
Conventional _ HLA terminology
• Heel strike _ Initial Contact
• Flat foot _ Loading Response
• Midstance _ Midstance
• Heel off _ Terminal Stance
• Toe off _ Pre Swing

18. Stance Phase
Heel Strike_ Initial Contact
• Beginning of Stance phase when
heel strike the ground
• Begins with
initial contact &
ends with flat foot
Flat foot_ Loading response
• occurs immediately following
heel strike
• Point at which
the foot fully contacts
the floor
Occupies 10-15% of
gait cycle

19. Stance Phase
Midstance
• The Point at which body
passes directly over the
support of extremity
• Occupies 15-20%.
Heel off_ Terminal Stance
• The Point following midstance,
the heel of the refrence extremity
leaves the ground
• Occupies 20 -25%.
Toe off_ Preswing
• The Point Following heel off when
only te toe of the refernce
extremity is in contact with the
ground
• Occupies 5-10%.

20. Stance Phase: Hip Muscles Activities

21. Stance Phase Knee Muscle Activities

22. Stance Phase Ankle & Foot Muscles Activity

23. Swing Phase
Time period during which the
limb is off the ground and
advancing forward,the body
weight supported by
contralateral limb.
Components:
• Acceleration_ Initial
Swing
• Mid-Swing
• Deceleration_
Terminal Swing

24. Swing Phase
Acceleration_ Initial Swing
• Begins once the toe leaves the ground
& continues until mid Swing or the
point at which the swinging extremilty
is directly under the body.
• Occupies 5-10%
Midswing
• Occurs approximately when the reference
extremity passes directly under the body
• It extends from end of acceleration to
beginning of deceleration
• Occupies 20-30%
Deceleration_ Terminal Swing
Occurs after Midswing
When reference extremity is
decelerating in prepration for
heel strike
Occupis 5-10%

25. Swing Phase Hip Muscle Activity

26. Swing Phase Knee Muscle Activity

27. Swing Phase Ankle & Foot Muscle Activity

28. Methods of Gait Analysis
• Observational _ Naked Eye
Examination
• Video Assisted Observational
Gait Analysis. (VAOGA)
• Videographic Gait Analysis _ Gait
Laboratory (VGA)
• Multichannel Functional
Electrical Stimulation
method (MFES)
VAOGA
Gait Laboratory

29. Methods of Gait Analysis
Gait Laboratory (VGA):
oForce Plate study – ground
reaction force check
oElectroMyography
oPedography
oElectroGoniometric study
oEnergy expenditure
o3-D Videography
Gait Lab test being performed on patients during
CP workshop
on 19 March 2011

30. Gait Laboratory to determine:
Movement Pattern & Force used
KINEMATIC Gait Analysis KINETIC Gait Analysis
• Determine the force that are
involved in the gait
• Describe the movement pattern
without regard for the force
involved in producing the
movement
oQualitative
oQuantitative
PEDOGRAM: Cavo Varus, Plano ValgusEMG: Indicating spastic, normal & Weak Muscles

31. Video Assisted Observational Gait Analysis
VAOGA
• Require Little or no
supportive electronic
gadgets, Except a Camera
• Inexpensive
• Yields general Description
of gait variables

32. GAIT PATTERNS

33. GAIT IN CHILDREN (<2years)
• Gait of small children differs from that of adult
• The walking base is wider.
• The stride length & speed are lower & the cycle time shorter
(higher cadence).
• Small children have no heel strike, initial contact being made by flat
foot.
• There is very little stance phase and knee flexion.
• The whole leg is externally rotated during the swing phase.
• There is an absence of reciprocal arm swinging.
• The pattern will change to adult pattern by age of 2 to 4yrs.

34. GAIT IN ELDERLY _ Senile Gait
• The age related changes in gait takes place in
decade 60- 70yrs.
• There is a decreased stride length, increased
cycle time (decreased cadence).
• Relative increase in duration of stance phase of
gait cycle.
• The speed almost always reduced in elderly
people.
• Reduction in total range of hip flexion &
extension,
• Reduction in swing phase and knee flexion

35. Senile Gait
• Changes in gait & difficulty with balance
occurs with aging.
• Elderly man develops forward of upper
portion of trunk with flexion of arms &
knees.
• Decreasing arm swing & shortening of
step length.

36. PATHOLOGIC GAIT
Neuro-Vascular
• CP, SMN, Polio
• Dysvascular
Musculoskeletal:
 Inflamatory Joint disease
 B & J Infection
 Tendinopathy
 Trauma
 Congenital / developmental
disorders
Types:
Limping & Lurching

37. PATHOLOGIC GAIT
LIMPING:
• Patient avoids weight
bearing on affected
side as far as
possible. i,e.
diminished stance
phase.
• It denotes a painful
condition of affected
side.

38. PATHOLOGIC GAIT
LURCHINNG:
• Patient prolongs stance phase to
improve the stability.
• It denotes variable failure of
abduction mechanism.
Causes:
• Muscle weakness
• Structural deformities of bone &
joint
• Neurological disorders
• Miscellaneou

39. Pathologic
Gaits
Limping &
Lurching
LIMPING:
• Antalgic gait
LURCHING:
• Waddling gait
• Trendelenberg gait
• Spastic Gait
LURCHING_PARALYTIC:
• High stepping gait
• Quadricep gait
• Gluteal medius gait
• Gluteal maximus gait
LURCHING_
STRUCTURAL
ABNORMALITIES
• Short limb gait
• In toeing gait
• Out toeing gait
• Knock knee gait
• Genu recurvatum
gait
• Stiff hip gait
• Festinant gait

40. ANTALGIC GAIT_ Limp
• Gait pattern in which stance
phase on affected side is
shortened due to pain in the
weight bearing limb.
• There is corresponding increase
in stance phase on unaffected
side
• Common causes:
Osteoarthritis [Coxalgia], LCPD,
SCFE,Fractures, tendinitis

41. Antalgic
Gait

42. Trendelenburg Gait
Abduction Lurch
Waddling Gait
Backward Lurch

43. TRENDELENBERG GAIT: PathoMechanics
• Cause: Distruption of the osseo-muscular
mechanism between pelvis and femur
1. Power: Weak abductors
2. Fulcrum: acetabulo femoral articulation
defect
3. Lever Arm: defective lever system
• Here the abductor action in pulling the pelvis
downwards in stance phase becomes
ineffective and the pelvis drops on the opposite
side causing instability.
• To prevent this body lurches on the same side.

44. TRENDELENBERG GAIT _ WADDLING : Causes
• Usually unilateral
• If bilateral = Waddling gait
Causes:
1. Weak abductors :poliomyelitis . muscular
dystrophies, motor neuron disease
2. Defective fulcrum: Congenital dislocaion of
hip(CDH), pathological dislocation of hip
3. Defective lever: Fracture neck of femur,
Perthes disease, Coxa vara.

45. Trendelenburg &
Waddling Gait
Case Reports

46. Case 1:TRENDELENBERG GAIT
• 6m-old H/O fall
• Antalgic Limp left hip
• Positive Trendelenburg
• Positive Thomas Test 150
• LLD 1.5cm True.
Apparent
• Bryant’s.. Shortening
above trochanter.

47. Xray in his record @ 2/12 months

48. Pathophysiology of
Trendelenburg Test
•Short Lever Arm
•Poor Fulcrum
@ 18 m post trauma
i.e 12/12m post fixation.
Implant removed.
NON-Union Fremoral Neck
Fracture

49. Case 2: Pathophysio_ Trendlenburg
6 Yrs Old Girl
• Limp 2 year
• Shortening of Rt. Leg_ 6
months… 2 inches
• Squat & sit cross legs easily.
• Spine normal.
• N-V Intact
• Scar mark at the lat. aspect
of upper thigh.
• Mild wasting.
ROM
• Ext Rotation 900
• Int Rotation 1100
• Abduction 900
• Adduction 45o
• Telescope +ve
• Trendelenburg +ve

50. Case 2: Pathophysio_ Trendlenburg
6 Yrs Old Girl
• Limp 2 year
• Rt. Leg Shortening 4cm
• Telescope +ve
• Trendelenburg +ve
• Hyper lordosis
Standing on both leg Indicate ShorteningHunka V

51. Case 3 & 4: Perthese:
1. Healed 5 yr FU.
2. Active 1 year FU: Trendelenburg +ve
7 year aged 6 year aged

52. Case 4 yeas Old. Developmenta Dysplastic Hip

53. Case:6 Pathophysiology of TRENDELENBURG TEST:
• Primary Acetabular Dysplasia
• Cause of failure:
oSubluxation of the hip joint
o Fulcrum for the action of the
pelvi-femoral muscle is lost.

54. Waddling Gait
• 5 years aged Male
• Abnormal gait since he started
Walking@ age 18 months
• Waddling Gait
• Hyper lordosis
• Telescope Negative
• Prominent trochanter _ Bilateral
• ROM Hip _Bilateral
o Flexion 150 degrees
o Extension 15 degrees
o Int.Rotation 100 degrees
o Ext.Rotation 80 degrees
o Abd.35 degrees
o Add. 30 degrees

55. 5 years aged Male, Abnormal gait since he started, Walking@ age 18 months
Waddling Gait, Hyper lordosis, Telescope Negative

56. 5 years aged Male, Wadling gait since he started, Walking@ age 18 months
Waddling Gait, Hyper lordosis, Telescope Negative

57. ABDUCTION LURCH_ Gluteus medius Gait
• Gluteus Medius is principal abductor of hip
joint along with obturator internus &
piriformis.
• Weakeness of Gluteus Medius forces
patient to lurch towards involved side to
place centre of gravity over hip.
27Yrs aged
Gluteus Medius 3/5 power

58. BACKWARD LURCH_ Gluteus Maximus Gait
• Weakness in gluteus maximus muscle,
• while the body propels forward during
midstance phase,
• trunk is lurched posterior to effect
posterior pelvic and shifting the centre
of gravity towards stance hip.
• Cause: Poliomyelities & above knee
amputation with prosthesis.

59. Spastic Gait Patterns
Cerebral Palsy

60. SPASTIC GAIT PATTERNS _ Cerebral palsy
• Circumduction Gait
• Scissoring Gait
• Ataxic
• Ethetoid
• Drunkers gait
• Chorioform Gait
• Hemiplegic Gait
o4 pattern
• Diplegic Gait
o4 pattern

61. Spastic Gait Patterns
• Different Gait patterns observed in CP depends on the involvement of
spasticity or contracture of different muscles:
• Variations relates to topographical type of CP
• Best seen in contrast between unilateral spastic CP and bilateral
spastic CP.

62. HEMIPLEGIC GAIT_ Circumduction gait
• The shoulder is adducted & the
elbow & wrist are flexed.
• To avoid the foot from scrapping
the ground, the hip and the lower
limb rotates outward.
• The pateint swings the paraplegic
gait outwards & aheads in a
circumduction to avoid foot
scraping ground.
• It is seen in cerebrovascular
disease.
Hemiplegia_ Typical Posture

63. Spastic Hemiplegia Gaits
• In spastic hemiplegia, there is more involvement
distally and therefore true equinus is the basis of
common patterns.
• Winters et al. described four gait patterns in
hemiplegics based on sagittal kinematics.
• Type 1 – Drop foot type
• Type 2 – True equinus with or without
recurvatum knee
• Type 3 – Stiff knee gait
• Type 4 – JUMP / Scissor

64. Type II
True Equinus
hemiplegic gait.
(a): Right-sided
hemiplegia with ankle
equinus in stance [AP view].
(b): Right-sided
hemiplegia with ankle
equinus in stance [Lat view]
Equinus With
Recurvatu

65. Spastic Hemiplegia Gaits
• Type 3 – Stiff knee gait: Rectus Femoris over active
in Swing phase
• Type 4 – JUMP [Common in diplegics]
In sagittal plane, the ankle is in equinus, knee in
flexion, hip in flexion and anterior pelvic tilt is
present.
In coronal plane, there is hip adduction and
internal rotation.

66. Spastic_ Diplegia
• Involvement on both sides
• Spasticity in lower extremities worse than upper
extremities.
• Walks with an abnormally narrow base, dragging both
legs and scraping the toes.
• Cause: CP_ Bilateral periventricular lesions
• Characteristic extreme tightness of hip adductors which
can cause legs to cross the midline referred to as a
scissors gait.
• The hip adductor release surgery to minimize scissoring.
Dipegia_ Typical Posture

67. Spastic Diplegia Gaits Patterns:
• There are four common patterns of gait in spastic
Diplegia as described by Rodda et al.
• Type 1 – True equinus
• Type 2 – Jump gait
• Type 3 – Apparent equinus
• Type 4 – Crouch gait

68. Rodda et al. JBJS. 2004

70. Type 1 – Diplegia True equinus
• Hip extension
• Knee extension
• Ankle equinus
Pic Courtesy: Sharaf Ibrahim, Malaysia
Thanks Drs. Sadam & Shahzaib
@ ZHC Clifton, for help
True Equine Diplegia

71. Type 2 – Diplegia Jump gait
Jump Gait with
•Bilateral hip
Flexion
•Knee flexion
•Ankle Equinus.

72. Apparent Equinus
[Dynamic Equinus]
• Hip flexion
• Knee flexion
• Ankle neutral..
plantigrade
Pic Courtesy: Prof. Sharaf Ibrahim, Malaysia

73. SCISSORING_ Scissor Gait
• Here one leg crosses directly over the other with each
step due to adductor tightness.
• This gait is characteristic of gait of a spastic child with
marked b/l adductor spasm at hip & equinus in the
ankle.
• The child needs support to walk & leg goes into
marked adduction in swing phase so that the foot with
equinus goes across to opposite side.
• Such repeated crossing of leg while walking gives
scissoring appearance called as scissor gait.

74. Type 4 – Diplegia Crouch gait
•Bilateral hip
Flexion
•Knee flexion
•Ankle
dorsiflexion.
Crouch _ Decompensated JumpCrouch gait _ Gait

75. Usual “Staging” in CP_Diplegia Surgery
A. True Equinus
B. Crouch after TAL
C. Crouch corrected after
Hamstring F
Lengthening
D.Final erect Posture
after hip Flexion
contracture Corrected
Better option: Combine
surgery at three levels to
get directly from A to D. Orthopaedic Management of Cerebral Palsy. Eugene E Bleck. 1979. WB Saunders.

76. CEREBELLAR ATAXIC GAIT
Drunkers or Drunkard or Reeling Gait
• Clumsy, staggering movements with a wide-based gait.
• While standing still, the patient's body may swagger back and
forth and from side to side, known as titubation
• Patient tends to walk irregularly on wide base, not be able to
walk from heel to toe or in a straight line, swinging sideways
without stability and balance.
• The gait of acute alcohol intoxication
• With unilateral lesion of cerebellum, balance is lost towards the
side of the lesion.
• Cause: Cerebellar lesion & lesion connecting pathway to &
from the cerebellum _ midline cerebellar disease at the vermis.

77. Cerebelar_ Ataxia
• Lack of Balance
• Uncoordinated Movement
• Dysmetria [Fig.A]
• Wide base _Sway as he walks.
[Fig B]
• Pes Valgus (flexible) common

78. CHOREIFORM_ Hyperkinetic GAIT:
• The patient will be having chorea
[Irregular, Jerky, Involuntary
movements] more in upper limbs &
has a unstable gait.
• Walking may accentuate their
baseline movement disorder.
• Seen in patients having
extrapyramidal symptoms
• Cause: Basal ganglia disorders including
Sydenham's chorea, Huntington's Disease and
other forms of chorea, athetosis or dystonia.

79. STEPPAGE / Equine
HIGH STEPPING GAIT
• On attempt of heel strike, the toe drops to the ground first.
• To avoid this the patient flexes the hip and knee extensively to
raise the foot, and slaps it on the floor forcibly.
Cause:
• Foot drop
• Due to paralysis of Tib. Ant. & other extensor of ankle & toes.
• lesions of the lower motor neuron:
o multiple neuritis,
o anterior motor horn cells,
o cauda equina.

80. STAMPING / Stomping
SENSORY ATAXIC GAIT
• Occurs in sensory ataxia in which there is loss
of sensation in lower extremity.
• Due to absence of deep position sense,the
patient constantly observes placing of his feet.
• Hip is hyperflexed & externally rotated &
forefoot is dorsiflexed to strike ground with a
Stamp.

81. STAMPING / Stomping
SENSORY ATAXIC GAIT
Causes:
• Peripheral neuritis
• Brain stem lesion in children,
• Tabes dorsalis in adults.

82. Quadriceps gait
• Normally the knee is locked by
the quadriceps contraction while
transmitting weight to the lower
limb during midstance.
• Hence patient with weak
quadriceps stabilizes his knee by
leaning forward on the affected
side & pressing over lower thigh by
his Ispilateral hand or fingers.

83. WEKANESS HIP FLEXORS
• The patient will have difficulty in
initiating swing through.
• To compensate for this specific
muscular weakness patient externally
rotates leg & uses hip adductors for
swing through.
• This circumduction of hip exaggerates
energy expenditure & produces
extreme trunk & pelvis motion.

84. Festinant gait
• The steps are short so that feet barely clear floor.
• If patient is pushed backward or forward, compensatory
flexion or extension fails to occur & patients is forced to
make a series of propulsive or retropulsive steps with
forward locomotion.
• Steps become successively more rapid as if trying to
catch up with centre of gravity.
• Cause: Parkinson's disease.

85. CALCANEAL GAIT
• Gastro-Solius Weakness

86. Non-Paralytic Disorders

87. KNOCK KNEE
GAIT_ Genu
Valgus
• The patient flexes his hip slightly
the knee joint opposes each other,
the ankle & feet are kept apart
with tendency of toe in.

88. GENU
RECURVATUM
GAIT
• Seen in poliomyelitis
• In Paralysis of hamstring muscles
the knee goes in for hyper
extension while transmitting the
weight in mid stance phase.

89. Stiff hip gait
• When the hip is ankylosed, it is not possible to flex at the hip
joint during walking to clear the ground in the swing phase.
• Hence the person with stiff hip, lifts the pelvis on that side and
swings the leg with the pelvis in circumduction and moves it
forward.

90. HIP & KNEE CONTRACTUREs GAIT
• 4Years old
• Bilateral clubfeet + 200 Knee
contractures at birth
• Managed by Ponseti Casting & PCT
• No Hyper reflexia
• Knee FFC- POP angle 700-700
• Stahli Hip FFC 350 – 350
• Elbow FFC 200 - 200
Gif made by Dr. Sadm baloch & Dr. Shahzaib@ZHC Clifton

91. SHORT LIMB GAIT
• Shortening less than 1.5 cm compensated by pelvic tilt, and
shortening upto 5 cm compensated by equinus.
• Shortening more than 5 cm the patient dips his body on that side.
• A limb length discripancy of 1 to 1.5 inch is
compensated by tilt of the pelvis,which is
demonstrated by a low shoulder,low iliac crest &
low ASIS. •
• Another method to compensate shortening is to
put foot & ankle at the affected side into equinus
position & hip & knee of normal limb in flexion.

92. ALDERMAN’S GAIT:
• Patient walk with head and chest thrown
backward and protuberant abdomen and legs
thrown wide apart.
• Cause: Tuberculosis of spine Thoraco-lumber
Junction.
HYSTERICAL GAIT:
• Patient walks in a bizzare as if going to fall on
every step but seldom falls and walks cautiously.

93. Bibliographic Reference:
1. Orthopaedic Management of
Cerebral Palsy. Eugene E Bleck. 1979. WB Saunders.
2. Orthopaedic Management of Cerebral Palsy. 2nd Ed.
Helen W Horstmann & Eugene Bleck. 2007. Blackwell
Publication.
3. Cerebral Palsy. Freeman Miller. 2005. Springer
• 4. Multiple literature from google.com
• Videos prepared with Dr. Sadam Mazar Baloch & Dr.
Shahzaib Baloch Dr. Nida Hameed @ Dr. Ziuaddin
University, Karachi

96. Gait Laboratory _ Gait Analysis Types

97. Terminology used in Gait cycle
Base of
support
Step length
Stride length Gait cycle
Cadence
Walking
velocity
Double limb
support
Single limb
support
Ground
reaction force
vector

98. Base
support
• Distance between a person’s feet
while standing or during ambulation.
• Provides balance & stability to
maintain erect posture.
• Normally 2-4 inches from heel to
heel.

99. Step
Length
&
Stride
Length
Step Length
• Linear distance along the line of
progression of one foot travelled during
one gait cycle.
• Approximately 15 inches.
Stride length
• Linear distance in the plane of
progression between successive point of
foot to floor contact of the same foot.
• Normally 27 – 32 inches.

100. Cadence
• It is measured as the number of steps
/ sec or per minute.
• Approximately 70 steps per minute
Gait Cycle
• Period of time from one heel strike to
next heel strike of the same limb
Cadence
Gait Cycle

101. Double
Limb
Support
• During normal gait, for a moment , two
lower extremities are in simultaneous
contact with the ground.
• During this period, both legs support the
body weight.
• Happens between push off & toe off on
same side and heel strike & foot flat on
the contra lateral side.