Gait analysis is the study of human locomotion, specifically walking and running. A single gait cycle, known as a stride, involves a stance phase where one foot is in contact with the ground and a swing phase where the foot is not in contact. Gait involves complex movements of the pelvis, hips, knees, and ankles in three planes. Kinetics examines the internal and external forces that produce motion during gait, including the center of gravity and ground reaction forces. Gait deviations can occur due to musculoskeletal or neurological impairments.

1. GAIT ANALYSIS
Sujan Sukamani

2. GAIT ANALYSIS
 Study of human
locomotion
 Walking and running
 Walking is a series of gait
cycles
 A single gait cycle is
known as a STRIDE

3. THE MAIN TASKS OF THE GAIT CYCLE
 (1) Weight acceptance
 most demanding task in the gait cycle
 involves the transfer of body weight onto a limb that has just
finished swinging forward and has an unstable alignment.
 Shock absorption and the maintenance of a forward body
progression

4.  (2) single limb support
 One limb must support the entire body weight
 Same limb must provide truncal stability while bodily
progression is continued.
 (3) limb advancement
 Requires foot clearance from the floor
 The limb swings through three positions as it travels to its
destination in front of the body.

5. NORMAL WALKING REQUIREMENTS
 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

6. WALKING REQUIREMENTS CONT’D
 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, sensorimotor input)

7. GAIT CYCLE OR STRIDE
 A single gait cycle or stride is defined:
 Period when 1 foot contacts the ground to when that same foot
contacts the ground again
 Each stride has 2 phases:
Stance Phase (60%)
Foot in contact with the ground
Swing Phase (40%)
Foot NOT in contact with the ground

9. A SINGLE GAIT CYCLE OR STRIDE

10. GAIT FLOW CHART

12. LINEAR MEASUREMENTS- ( CADENCE OR
TEMPORAL PARAMETERS )
 Step length : Distance between two feet during double
limb suport.
 Stride length: Distance one limb travels during stance
and swing phases.
 Step time: Time required to complete one step length.
 Cadence: Number of steps per minute
 Walking velocity : Distance travelled per time(m/s)

13. GAIT PARAMETERS
 Cadence
 Cadence is defined as the number of separate steps
taken in a certain time
 Normal cadence is between 90 and 120 steps per
minute
 The cadence of women is usually 6-9 steps per minute slower
than that of men
 Cadence is also affected by age, with cadence decreasing
from the age of 4 to the age of 7, and then again in advancing
years

14. GAIT PARAMETERS
 Stride length
 Step length is measured as the distance
between the same point of one foot on
successive footprints (ipsilateral to the
contralateral foot fall).
 Stride length, on the other hand, is the distance
between successive points of foot-to-floor
contact of the same foot
 A stride is one full lower extremity cycle
 Two step lengths added together make the stride length

15. STANCE PHASE OF GAIT
• When the foot is contact
with the ground only
• Propulsion phase
• Stance phase has 5
parts:
– Initial Contact (Heel Strike)
(1)
– Loading Response (Foot
Flat) (2)
– Midstance (2)
– Terminal Stance (3)
– Toe Off (Pre-Swing) (4) (Missing Loading Response in
picture)

16. MOTIONS DURING STANCE PHASE
 Shoulder flexes
 Pelvis rotates right (transverse plane)
 Spine rotates left
 Hip extends, IRs
 Knee flexes, extends
 Ankle plantarflexes, dorsiflexes, plantarflexes
 Foot pronates, supinates
 Toes flex, extend, flex

17. INITIAL CONTACT
• Phase 1
• The moment when the
red foot just touches the
floor.
• The heel (calcaneous)
is the first bone of the
foot to touch the
ground.
• Meanwhile, the blue leg
is at the end of terminal
stance.

18. STATIC POSITIONS AT INITIAL CONTACT
 FREEZE FRAME POSITIONS
 Shoulder is extended
 Pelvis is rotated left
 Hip is flexed and externally
rotated
 Knee is fully extended
 Ankle is dorsiflexed
 Foot is supinated
 Toes are slightly extended

19. LOADING RESPONSE
• Phase 2
• The double stance period
beginning
• Body weight is transferred
onto the red leg.
• Phase 2 is important for
shock absorption, weight-
bearing, and forward
progression.
• The blue leg is in the pre-
swing phase.

20. STATIC POSITIONS AT LOADING
RESPONSE
 Shoulder is slightly extended
 Pelvis is rotated left
 hip is flexed and slightly externally rotated
 knee is slightly flexed
 ankle is plantarflexing to neutral
 foot is neutral
 Toes are neutral

21. MIDSTANCE
• Phase 3
• single limb support interval.
• Begins with the lifting of the
blue foot and continues until
body weight is aligned over
the red (supporting) foot.
• The red leg advances over
the red foot The blue leg is in
its mid-swing phase.

22. STATIC POSITIONS AT MIDSTANCE
 Shoulder is in neutral
 Pelvis is in neutral rotation
 Hip is in neutral
 Knee is fully extended
 Ankle is relatively neutral
 Foot is pronated
 Toes are neutral

23. TERMINAL STANCE
 Phase 4
 Begins when the red
heel rises and
continues until the
heel of the blue foot
hits the ground.
 Body weight
progresses beyond
the red foot

24. STATIC POSITIONS AT TERMINAL STANCE
 Shoulder is slightly flexed
 Pelvis is rotated left
 Hip is extended and internally rotated
 Knee is fully extended
 Ankle is dorsiflexed
 Foot is slightly supinated
 Toes are neutral

25. TOE-OFF
• Phase 5
• The second double
stance interval in the
gait cycle.
• Begins with the initial
contact of the blue foot
and ends with red toe-
off.
• Transfer of body weight
from ipsilateral to
opposite limb takes
place.

26. STATIC POSITIONS AT TOE-OFF
 Shoulder is flexed
 Pelvis is rotated right
 Hip is fully extended and internally rotated
 Knee is fully extended
 Ankle is plantarflexed
 Foot is fully supinated
 Toes are fully extended

27. STANCE PHASE CHARACTERISTICS
 During a single stride, there are 2 periods of double
limb support (both feet on ground):
 Loading response (right) & Toe Off (left)
 Loading response (left) & Toe Off (right)

28. SWING PHASE
 When foot is NOT contacting the ground, it is
swinging!
 Limb advancement phase
 3 parts of swing phase:
 Initial swing
 Midswing
 Terminal swing

29. MOTIONS DURING SWING PHASE
 Shoulder extends
 Spine rotates right
 Pelvis rotates left (passive)
 Hip flexes, ERs
 Knee flexes, then extends
 Ankle dorsiflexes
 Foot supination (inversion)
 Toes extend

30. INITIAL SWING
• Phase 6
• Begins when the red
foot is lifted from the
floor and ends when the
red swinging foot is
opposite the blue
stance foot.
• It is during this phase
that a footdrop gait is
most apparent.
• The blue leg is in mid-
stance.

31. STATIC POSITIONS AT INITIAL SWING
 Shoulder is flexed
 Spine is rotated left
 Pelvis is rotated right
 hip is slightly extended and internally rotated
 Knee is slightly flexed
 Ankle is fully plantarflexed
 Foot is supinated
 Toes are slightly flexed

32. MIDSWING
• Phase 7
• Starts at the end of the
initial swing and
continues until the red
swinging limb is in front
of the body
• Advancement of the red
leg
• The blue leg is in late
mid-stance.

33. STATIC POSITIONS AT MIDSWING
 Shoulder is neutral
 Spine is neutral
 Pelvis is neutral
 Hip is neutral
 Knee is flexed 60-90°
 Ankle is plantarflexed to neutral
 Foot is neutral
 Toes are slightly extended

34. TERMINAL SWING
 Phase 8
 Begins at the end of
midswing and ends
when the foot touches
the floor.
 Limb advancement is
completed at the end
of this phase.

35. STATIC POSITIONS AT TERMINAL SWING
 Shoulder is extended
 Spine is rotated right
 Pelvis is rotated left
 Hip is flexed and externally rotated
 Knee is fully extended
 Ankle is fully dorsiflexed
 Foot is neutral
 Toes are slightly extended

36. KINEMATICS
 It denotes movements observed and measured
at the pelvis, hip, knee, and ankle during stance
and swing phases
 It can be observed in 3 planes
sagittal
coronal
transverse

37. SAGITTAL PLANE
The pelvis tilts approximately 15 degree

38. SAGITTAL PLANE
HIP
 Stance –flexed at
initial contact then
extends fully
 Swing – hip flexes
rapidly to pull the
stance limb off the
ground

39. SAGITTAL PLANE
KNEE
 Stance- At initial contact knee
flexes 15 deg. It then extends
 Swing – At heel rise knee begins
to flex again reaching maximum
flexion in early swing .In
remainder of swing knee extends
passively

40. SAGITTAL PLANE
ANKLE
 Stance – neutral at initial
contact,then plantar flexes 5-10
deg as forefoot comes to rest on
the ground.- FIRST ROCKER
 Ankle dorsiflexes throughout mid
stance as tibia moves forward over
plantigrade foot – SECOND
ROCKER

41. SAGITTAL PLANE
 ANKLE(CONTD)-during terminal
stance and pre swing ankle
plantar flexes and heel rises to
prepare for push off- THIRD
ROCKER
 Swing – dorsiflexion to neutral position
seen

42. CORONAL PLANE
 PELVIS-each hemipelvis rises
slightly during swing phase
 - stance phase hemipelvis drops
slightly
 - accentuated pelvic drop in
swing seen in trendelenburg gait

43. CORONAL PLANE (CONTD)
 HIP- Stance phase – slight
adduction occurs
 - Swing – abduction seen

44. TRANSVERSE PLANE
 Measure rotation
 Pelvis and hips rotate minimally
 Tibia has a fixed external rotation

45. Determinants of Gait
1. Pelvic Rotation – transverse plane
2. Lateral Pelvic Tilt – frontal plane
3. Knee Flexion – during stance
4. Knee / ankle / foot
5. lateral displacement of pelvis
DETERMINANTS OF GAIT

46. KINETICS OF GAIT
• It is the study of forces that produces a change in
motion.
• It is concerned with internal forces developed
within body by muscular action as well as forces
acting in body.
External forces includes:
• Centre of gravity
• Ground reaction forces

47. CENTRE OF GRAVITY:
• It is imaginary point at which all weight of body is
concentrated at a given instant.
• The body of gravity lies two inches in front of
SECOND SACRAL VERTEBRA.
• It follows up & down movements as well as side to
side.
• Due to complex interaction of muscular activity &
joint motion in lower extremity it follows a SMOOTH
SINUSOIDAL CURVE.

48. GROUND REACTION FORCES:
• It is a line represents the direction & magnitude of
force encountered by the body at heel strike.
• The length of vector is proportionate to the
magnitude of force.
• The ground reaction force horizontal & vertical can
be measured by force platforms (force plates).

49. GAIT DEVIATIONS
 Due to pain
 weak muscle
 abnormal muscle activity
 joint abnormalities
 Contractures around joints
 limb length discrepancies

50. GAIT DEVIATIONS
1) antalgic gait - dec stance phase
avoiding wt. Bearing on involved limb
2) Short limb gait – dipping of shoulder
and pelvis on affected side & inc flexion
of hip , knee and ankle of opposite limb.
3) Trendelenburg gait –patient lurches on
affected side & pelvis drops on opp side

51. GAIT DEVIATIONS
4)Waddling gait – patient lurches on both sides during
walking
5)High stepping gait – patient flexes foot and knee
excessively to clear the ground

52. GAIT DEVIATIONS
6)Scissoring gait – one leg crosses directly over
the other with each step
7)Calcaneus gait –walks on broadened heel with
tendency to external rotation and genu
recurvatum. No calcaneal pick up and push off

53. GAIT DEVIATIONS
8)Stiff hip gait – no movements at affected hip ,
excess movements in spine & unaffected hip
9)Stiff knee gait – no flexion at knee, so pelvis raised
during swing

54. GAIT DEVIATIONS
10)Gluteus maximus gait – patient lurches backwards
due to weak gluteus maximus
11)Gluteus medius gait – like trendelenburg gait

55. GAIT DEVIATIONS
12)Quadriceps gait / hand to knee gait – patient
stabilizes hips & knee for weight bearing by leaning
on affected side & pressing over lower thigh by his
hand