Gait Cycle
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Transcript of Gait Cycle
The Gait Cycle
Patient Centred Practice 1 2010
Objectives
Develop an understanding of the components of normal gait
Discuss the measurement of gait and its application in practice
Activity – thinking about the differences in gait in different people
Walking
Walking or ambulation is the moving from one place to another
Gait is the manner or style of walking
a method of locomotion involving 2 legs,alternately, to provide both supportand propulsion, at least one foot being in contact with the ground at all times.
(Whittle 1991)
Gait
Human locomotion involves smooth advancement of the body through space with the least mechanical and physiological energy expenditure
Gait Cycle:
the time interval between 2 successive occurrencesof one of the repetitive events of walking.
The cycle comprises of:
2 components, stance and swing phases60% stance and 40% swing
Initial contact to terminal swing
Components of successful gait
Production of a basic locomotor rhythm. Support and propulsion of the body in the
intended direction. Dynamic balance control of the moving body. Ability to adapt the movement to changing
environmental goals and demands.
Common Characteristics of Gait
Step and stride length – dependent on age, size, build, usually symmetrical
Stride width or walking base – within pelvic circumference
Cadence and velocity – dependent upon age, size, body build
Rotation – occurs at approx T8 level, passive arm swing greater with speed
Vertical displacement – in time with steps, symmetrical
Gait Cycle
From: Whittle M W, 1991, Gait analysis, an introduction.
Initial contact
Also known as heel strike Onset of stance phase in gait Ankle in some dorsiflexion Knee in slight flexion (7 degrees) Knee medially rotates slightly Hip in 30 degrees flexion
Loading response
Ankle becomes less dorsiflexed Knee flexes slightly further to 20 degrees Abductor muscles of the hip are active to
stabilise pelvis and trunk Weight is transferred onto single limb
Mid stance
Begins as the opposite foot is lifted Ankle dorsiflexes to advance body over the
stationary foot Knee extends almost fully Hip extends
Terminal stance Begins as heel starts to rise Continues until the opposite limb makes
ground contact The body’s centre of mass advances forward Point of maximum hip extension Knee joint begins to flex
Pre swing
Final part of the stance phase Second period of double support Begins with ground contact by the opposite
limb Ankle plantarflexes to 20 degrees Knee flexes rapidly to 40 degrees Hip flexion increases
Initial swing
Commences at toe off Finishes as the advancing limb is level with
the stance limb Ankle dorsiflexes to allow foot clearance Knee flexes rapidly reaching a maximum of
60 degrees Hip flexion allows the limb to progress
forwards
Mid swing
Begins when the swing limb is opposite the stance limb
Finishes when swing limb is forward of stance limb
Ankle stays dorsiflexed Hip stays in flexion to ensure foot clearance Knee flexion reduces to 30 degrees
Terminal swing
Advancement of the thigh is stopped Knee continues to extend reaching maximal
extension of 0-5 degrees Ankle reduces the amount of dorsiflexion Prepares the limb for initial ground contact The gait cycle is completed
Ranges of Movement needed for Normal Gait
Hip Flexion Hip Extension Knee Flexion Knee Extension Ankle Plantarflexion Ankle Dorsiflexion
Line of walking or progression – path followed when walking, usually a straight line.
Step length - distances between successive points of alternate feet, e.g. Right heel to left heel. Mean step length in young adults 76.3cm.
Stride length - linear distances between successive points of the same foot e.g. Right heel to next placing of right heel.
Stride or step width - lateral distance between each foot (usually from midpoint of each heel)
Cadence number of steps/given time. Innormal young adults this is 112.5 steps/per minute.Arm swing occurs at 70 steps/min
Velocity distance covered over a given time.changes in velocity result fromalterations in stride length notcadence. Normal young adults 1.46m/second or 5.26 km/h
Step length x Cadence = Velocity
Foot angle angle of deviation of foot measured from a
straight line level with the centre of the heel, usually 7 - 15º. Can be called angle of toe out.
Measuring Gait
Gait is often measured in terms of the following parameters:
Speed over given distance e.g. 6m walk test Cadence – steps per minute Stride or step width Step length and equality between left and
right
Activity
Think about the gait of An elderly person A toddler
How will they differ? Base of support/step width Stride length Cadence Velocity
Elderly person’s gait
Toddler’s gait
ReferencesBronstein A M, Brandt T, Wollacott M, 1996, Clinical disorders of posture, balance
and gait, Arnold, London.
Carr J H, Shepherd R B, 2003, Stroke Rehabilitation – guidelines for exercise training to optimise motor skill, Butterworth Heinemann, London.
Edwards S, 2003, Treatment of Gait in Neurology, Nottingham, lecture notes.
Polak F, 2002, Gait Analysis, in Pitt-Brooke et al (Eds), (2002), Rehabilitation of Movement, chapter 8, p285 – 318, London, WB Saunders.
Shumway-Cook A, Woollacott M, (2007), Motor control: Translating research into clinical practice, Third edition, Lippincott Williams and Wilkins, Philadelphia, chapter 12 ‘Control of normal mobility’ p299 – 329.
Whittle M W, 1991, Gait analysis : An introduction, Butterworth Heinemann, London.