The document provides details on human gait including its definition, characteristics, phases, parameters, classifications and various pathological gait patterns. Some key points include: - Gait is defined as the systematic, rhythmic movements of the lower limbs, trunk and head resulting in forward propulsion while maintaining balance. - The gait cycle consists of stance and swing phases, with double limb support during stance phase when both feet contact the ground. - Gait can be classified anatomically based on the affected body region, pathologically based on the type of pathology, or functionally based on parameters like stride length, cadence, velocity etc. - Various pathological gait patterns are described like antalgic,

1. - Dr. Gajanan Pandit

2. - Gait is defined as the systematic,rhythmic ,co-ordinated,semi-rotatory
movements of the lower limb,trunk,arm and head resulting in an interplay
between loss and recovery of balance with constant change in the centre of
gravity causing forward propulsion of an organism in space.
- Differs from spot march ---- rhythm present but no forward propulsion.
- Human gait is Biped Gait.Each leg performs function alternatively.Hence,
called Alternate Bipedalism.
- It is a Heel-Toe Gait.Heel touches the ground first followed by toes and heel
leaving the ground first followed by the toes.

3. - STEP LENGTH :-
-Distance between right and left heel when step is taken.
-Corresponds to length of foot + 25 cms.
-In average adults,it is between 45-50 cms (15 inches).
- STRIDE LENGTH :-
-Distance covered by the same heel after a stride is taken (27-32
inches).
-Varies according to the length of lower limb and height of the
person.

4. - CADENCE :-
-Number of steps taken per minute (90-120 /min).
- During normal walking, a linear distance of 5-10 cm is maintained
between midpoints of the feet.It is called ‘ Width of Base Support ‘.
- During normal walking, there is slight out-toeing i.e foot is placed at an
angle to the vertical (angle between the line of progression and
longitudinal axis of the foot).It is about 8-15 degrees. ‘Angle of Toe
Out’.
- Slow run v/s Fast Walk :-
-In slow run,there is always a stage when both feet are off the ground.
-In fast walk,there is always a stage when both feet are on the ground.

5. CENTRE OF GRAVITY :-
- Imaginary point at which all the weight of the body is concentrated
at a given instant.
- Lies 2 inches in front of the 2nd Sacral Vertebra.
- Follows a smooth sinusoidal curve and oscillates no more than 2
inches up and down and from side to side.

6. - Human gait is Biphasic Gait.
- Two phases :-
(1) Stance Phase – starts with foot contact and ends with foot lift off.Accounts for
60% of the cycle.
(2) Swing Phase - starts with foot lift off and ends with foot contact.Accounts for
40% of the cycle.
Double limb support – that portion of the gait cycle when both feet are in contact with
ground.Centre of gravity is at its lowest point.Kinetic energy is the maximum.

7. - HIP JOINT :-
- flexion
- adduction
- external rotation
- KNEE JOINT :-
- initial flexion – to clear off the ground
- followed by gradual extension
- ANKLE JOINT :-
- initial plantar flexion – resulting in push-off
- then dorsiflexion – to clear off the ground

8. PATHOLOGICAL CLASSIFICATION
Pathology Predominantly
Symmetrical
Predominantly
Assymetrical
Upper motor neuron
(UMN)
Diplegia
Quadriplegia
Hemiplegia
Brain Stem Ataxic
Lower motor neuron
(LMN)
Spina Bifida Femoral nerve palsy
Sensory Neuropathy
Basal Ganglia Athetoid
Cortical Apraxia
Orthopedic Anteversion
Tibial torsion
Congenital Dislocation
(CDH)
Amputee Trans-tibial
Trans-femoral

9. ANATOMICAL CLASSIFICATION
Region Sagittal Frontal Transverse
Foot Toe flexion Pes planus/supinatus In/out-toeing
Ankle Equinus, Drop foot
Excessive
dorsiflexion
Clonus
Varus/Valgus
Tibia Tibial Torsion
Knee Stiff knee
Recurvatum
Abnormal loading
Varus/Valgus
Femur Femoral Anteversion
Hip Forward trunk flexion Tendelenberg sign
Pelvis Anterior/posterior tilt Rotation
Spine Lordosis/kyphosis Duchenne sign Scoliosis
Arms Abnormal swing Lateral thrust

10. FUNCTIONAL CLASSIFICATION
Velocity Stride
Length
Cadence Stance
Duration
Step
Length
(wrt.
contralat.)
Step Time
(wrt.
contralat.)
Step
Width
Antalgic Low Short Fast Short Long Short Wide
Unstable Low Short Low Long
Compensa
ted
Normal Short Fast Short
Uncompen
sated
Low Short Normal
Apropulsiv
e
Reduced

11. 1)Observational data :-
-videotape in frontal & lateral view.
-view in slow motion.
2) Gait parameters :-
-Cadence – 90-120 steps/min
-Step length – 0.7-0.9 m
-Walking velocity – 60-90 m/min
-Single limb support- 0.5-2 sec
3) Kinematic data :-
-Linear & angular displacement of body segments in space is an important
aspect.
-joint motion recorded with electrogoniometers..
-most accurate – photographic (cine) methods.

12. 4) Force plate data :-
-represents ground reaction force of walking generated by a force plate,set
in the floor of gait walkway.
-information regarding resultant reaction force with vertical and horizontal
components, sheer force and torque vectors can be obtained.
5) Kinesiological data :-
-broad term that combines motion,forces and muscle functions.
6) Energetics :-
-deals with oxygen consumption during a specific task or activity.

13. - 2 broad patterns :-
(1) LIMPING –
denotes painful condition on the affected side.Patient
avoids weight bearing on affected side (decrease in stance phase).
(2) Lurching –
denotes variable failure of abduction mechanism.

14. (1) ANTALGIC GAIT :-
- Any gait which relieves pain is known as antalgic gait.Patient
does not bear weight on the affected side.Therefore, body lurches to
the opposite side.
- decrease stance phase
- decrease step length
- decrease stride length

15. (2) TRENDELENBURG GAIT :-
-Abductor lever mechanism :-
-Ask patient to stand on one leg  opposite side ASIS tends to dip down .
-This is prevented by contraction of the abductors (gluteus medius &
minimus) on the same side.
-So ASIS level is maintained.
Here body weight acts as load, hip joint as the fulcrum & abductors as the power.
Defect in fulcrum
i.e. fracture neck femur 
dislocation of hip 
Defect in power Opposite ASIS dips down
i.e. Poliomyelitis  i.e TRENDELENBURG SIGN POSITIVE
Gluteii paralysis 

16. TRENDELENBURG TEST +VE TRENDELENBURG TEST -VE

17. (3) WADDLING GAIT :-
When Trendelenburg sign is present bilaterally, it will result in
swaying of the patient side to side on a wide base.This is called waddling
gait (duck gait).

18. (4) HIGH STEPPAGE/FOOT DROP/EQUINUS GAIT :-
During heel strike attempt,toes drop to the ground first due to the foot drop.
Hence, to clear the ground,patient will flex hip and knee excessively, raises the
foot and slaps it on the floor forcibly.
Common in foot drop due to muscle paralysis (common peroneal nerve
palsy).

19. (5) STAMPING GAIT :-
In posterior column affection of the spinal cord,there is loss of joint,
position & vibration sense.One is not able to percieve the distance of
floor from the feet resulting in a hard thump.
e.g tabes dorsalis,syringomyelia,diabetes mellitus,leprosy,etc.

20. (6) SCISSOR GAIT :-
Here one lower limb passes in front of the other lower limb due to
marked adductor spasm as seen in cases of cerebral palsy.

21. (7) IN TOEING AND OUT TOEING :-
When there is increased anteversion of femoral neck,there is internal rotation
of the hip joint to contain femoral head in the acetabular cavity  results in
internal rotation of the entire lower limb noted by inward pointing of the toes.
This may persist or compensatory external torsion of tibia may occur.Hence,
the toes point forward.In such a case, look at the patella.Due to femoral torsion,
both patella point inwards rather than forwards  KISSING PATELLA.
Normal range of out toeing is from 8 – 15 degrees….Usually associated with
lateral tibial torsion…..results in CHARLIE CHAPLIN GAIT.

22. (8) SHORT LIMB GAIT :-
< 1.5 cm ----- compensated by pelvic tilt while walking.
upto 5 cm ---- compensated by equinus.
> 5 cm --------- patient’s body dips down on that side.

23. (9) GLUTEUS MAXIMUS GAIT :-
Due to gluteus maximus paralysis,it is not possible to extend the
supported hip in the swing phase.This is overcome by backwaed
lurch of the trunk.Therefore, while walking, forward & backward
movements of the trunk occur.Hence, also called as ROCKING
HORSE GAIT.

24. (10) HAND TO KNEE/QUADRICEPS GAIT :-
Normally ,to transmit weight of lower limb during midstance, the knee is
locked by quadriceps contraction.If it is weak,locking is hampered & buckling
at knees will occur.Therefore, to stabilise the knee for weight bearing,patient
places his hand in front of the knee and lower thigh region.
e.g poliomyelitis

25. (11) CALCANEUS GAIT :-
Just before the swing phase,there is push off at the ankle joint by
plantar flexion.This is absent in paralysis or rupture of tendo-achilles.Weight
is largely borne by the heel & there is widening & thickening of heel.Foot is
flat on the ground.
Occurs with weakness of triceps surae or contracture of dorsiflexors of
ankle.

26. (12) SHUFFLING/FESTINANT GAIT :-
Here, the patient takes short steps, has a stooping posture
(flexed neck, trunk, hip, knee) and is propelled forward quickly as if
trying to catch up with the centre of gravity which is placed anteriorly.
(13) ATAXIC/CEREBELLAR GAIT :-
Here, there is loss of sense of balance.patient sways in different
directions during ambulation.

27. (14) HEMIPLEGIC GAIT :-
There is rigidity in lower limb muscles due to UMN lesion.
Therefore, extension at knee & plantar flexion at ankle prevail.
Hence, there is circumduction of limb at hip while swinging the limb
to achieve forward propulsion.

28. (15) STIFF HIP GAIT :-
In normal gait, 20 degree flexion occurs at the hip.In stiff hip, patient
does not flex hip.To compensate, patient raises the pelvis & semi-circumducts
the limb to propel it forward.
(16) STIFF KNEE GAIT :-
Due to loss of flexion at knee,patient raises pelvis to clear off the
ground and swing sideways with circumduction to propel it forward.Looks
like that of a German Soldier marching.
(17) FLAT FOOT :-
There is affection of arches of the foot.Foot is flat on the ground.There
is loss of spring in the gait.

29. (1) BROAD BASED GAIT :-
- Rare
- Earlier seen in seamen due to habit of standing in boat with a broad
base to balance self (centre of gravity falls between two feet).
(2) HELICOPOD GAIT :-
- Legs & feet thrown in half circles as in hemiplegia.
(3) LATHYRIATIC GAIT :-
-Combination of spasticity, hyperabduction & dragging of lower limb elements.
(4) DRUNKERS/REELING GAIT :-
- Irregular walk on a wide base,sideways swing without stability,tendency to
fall with every step.
- seen in drunken state or cerebellar inco-ordination.
(5) KNOCK KNEE GAIT :-
- Knees point & oppose each other while ankle & feet are kept apart.
(6) GENU RECURVATUM GAIT :-
- Hyperextension at knee.Seen in paralysis of hamstring (e.g polio).
(7) CHARCOT GAIT :-
- In hereditary ataxia.

30. (1) ATHLETE’S GAIT :-
At end of game,the players have a crouching attitude.This keeps
the centre of gravity as low as possible Prevents fatigue.
(2) MOURNER’S GAIT :-
In a mourning ceremony,people of various height are present.
But crowd moves together at the same pace.This can be done by
altering the cadence.However,this alteration cannot be sustained
for a long time.Hence a tall person will alter his step length.he takes
a step forward & then brings it back a bit.In such a case,there is
more expenditure of energy.

31. (3) CRUTCH GAIT :-
- Consider crutches & legs as four points…Either crutches move together
or legs move together.
2 Point gait – double amputee with crutches.
crutches are put forward & then body swung
forwards (swing to or swing through).
3 Point gait – when weight is allowed on one leg,
crutches are put forward & limb follows with
the other limb off the ground.
4 Point gait – when limbs are allowed to bear weight
but are not strong enough to do so unaided.Crutches & legs alternately
put forwards singly to achieve 4 point gait.