ORTHOTICS-PROSTHETICS

Topic: GAIT ANALYSIS UERM

Lecturer: Dra. Dorothy Dychingbing - Agsaoay BSPT-2017
Date: November 5, 2015

PREREQUISITE OF NORMAL GAIT

1. Intact musculoskeletal and neurologic system
2. Locomotion MAIN TASK OF GAIT CYCLE
• Learned activity
• Important aspect of ADLs
• Symmetrical in movement

*Any problems in joints and bones will affect/ influence

the gait

PHASES OF GAIT
NON – CONTACT (Swing Phase)
 Foot left the ground and advancing forward until
the heel is about to touch the ground, no weight
on the foot from the body above
 Represents 40% of total gait

CONTACT (Stance Phase)

 Foot and heel make contact with the weight Stride – The sequence of events between successive heel
strikes of the same foot
bearing surface
 Represents 60% of total gait
 1/3 are occupied by double support ASSESSMENT OF GAIT
1. Anterior view
Double support – the period in which both feet are 2. Sagittal or lateral view
touching the ground 3. Posterior view
4. Top view
Single support – only the limb in stance phase is in
contact with the ground MUSCLES ACTIVE DURING GAIT
HEEL STRIKE
 Foot dorsiflexors, contracts eccentrically and
lowers the foot to the ground with quadriceps
eccentrically contracting to prevent knee buckling
while knee goes into 5° of flexion

DECELERATION OF THIGH
 Hamstring, contracts eccentrically

FOOT FLAT
 Abductors contract to move the body up and with
the center of mass moves forward, the plantar
flexors contract to push the body ahead

TOE OFF
 Quadriceps contracting concentrically to assist
plantar flexors to push the body ahead the
elongating limb

ACCELERATION OF THIGH
 Iliopsoas and rectus femoris contract to advance
limb forward during swing phase

Prelim Lecture 1 BATCH NOTES |Page 1 of 4

 UERM
TRANS & EDITED BY:  BSPT-2017

STANCE PHASE KNEE FLEXION

 A slight flexion of the knee lowers the COM during
stance.
 There is some degree of flexion during stance
phase

ANKLE ROCKERS
 The ankle is dorsiflexed at heel strike and plantar
flexes at toe off. Both these actions increase length
of leg.

PATHOLOGIC GAIT VARIANCE

Variance from the normal smooth locomotory function of

gait can be associated with deformity in:

1. Osseus - congenital, developmental, metabolic,

neoplastic
2. Neurological - sensory, motor, spastic, paralytic
3. Muscular, soft tissue - contractures, fibrosis, laxity,
metabolic and etc…
4. Functional - lack of coordination, neuromuscular

VIDEO – Normal Gait: Normal and Abnormal Gait Series

GAIT CYCLE
Heel strike of one leg to the next heel strike of the same leg
2 Phases:
 Stance phase
 Swing phase
2/3 stance phase on one LE = the opposite is in the swing
phase

DETERMINANTS OF GAIT
PELVIC LIST
 The pelvis lists downward (obliquity) to increase
the effective leg length at toe off and heel strike.

 As ipsilateral limb hits ground (stance phase) –

pelvis drops down a few degrees
 In opposite side (Swing phase) – elevate the pelvis
a few degrees
DOUBLE STANCE OR DOUBLE SUPPORT
PELVIC ROTATION  A period of time in normal gait where in both feet
 The pelvis rotates anteriorly at heel strike and are on the ground
posteriorly at toe off to increase the effective leg  This period is lost when there is an increase rate
length. of forward motion (i.e. Running)
 Rotates anteriorly when the foot is in stance phase
 Rotates posteriorly in swing phase
 Best observed in the top view
Prelim Lecture 1 BATCH NOTES |Page 2 of 4

TRANS & EDITED BY: 
NORMAL GAIT (STANCE PHASE)
HEEL STRIKE
 First part of stance phase
 Begins at the moment where the heel of swing leg
first makes contact to the ground
 Forefoot is not yet in contact in the ground
 Knee in full extension
 Prior to heel strike- hamstrings contracts:
serves to decelerate limb which just completed
the swing phase
 After Heel strike
o Quadriceps contracts to prevent buckling
of knee
FOOT FLAT
 Controlled relaxation of the foot and ankle
dorsiflexors to allow forefoot to come in contact
with the ground
MID STANCE
 As opposite extremity progresses throught the
swing phase, there is a period of time where the
body weight is centered momentarily on the
supporting foot.
HEEL OFF
 As body weight moves further forward over the
supporting foot, the Gastrocnemius-soleus
complex contracts > causing plantar flexion of the
foot and ankle to occur, giving rise to heel off
position in preparation for the final critical incident
of the stance phase known as toe off
NORMAL GAIT (SWING PHASE)
ACCELERATION OR INITIAL SWING (PRE-SWING)
 Prior to toe off- iliopsoas contracts to propel the
leg forward by flexing the hip
o This also results to knee flexion which
raises the leg, enabling the foot to clear
the ground
o Foot and ankle dorsiflexors contracts to
get further clearance from the ground
MID SWING
 Portion of the cycle in the which the swing leg
advances through and in front of the opposite leg
which is in concurrently in the mid stance leg
DECELERATION
 Contraction of Hamstrings and Gluteus Maximus -
to slow down the leg in swing phase prior to heel
strike
Prelim Lecture 1
UERM
BSPT-2017
OTHER COMPONENTS OF GAIT
PELVIC TILT
 During normal gait:
o The pelvic crest at the side of the swing
leg drops approximately 5° below the
horizontal at mid stance of the opposite
leg
PELVIC ROTATION
 During the swing phase, the pelvis on the
ipsilateral side rotates anteriorly approximately
4°
 On stance side, the pelvis rotates 4° posteriorly
LATERAL SHIFT
 During stance phase of normal gait, the pelvis and
trunk shifts approximately 1 inch towards the
stance phase leg
NOTE:
 PELVIC TILT, PELVIC ROTATION, and LATERAL
SHIFT in combination with knee flexion, knee,
foot and ankle motions serve to minimize the
shift in COG in the body in both horizontal and
vertical axis, which results in conservation of
energy during normal gait
 Any interference with normal motions during gait
such as imposed by a brace or arthritic joints will
result in increased energy expenditure
WIDTH OF BASE
 Normal: 2-4 inches wide
 Determined by the horizontal distance between
feet at time of double stance or double support
STRIDE LENGTH
 Defined as distance from the point of heel strike of
one foot to the point of the heel strike of the same
foot
STEP LENGTH
 Defined as distance from the point of heel strike of
one foot to the point of the heel strike of the other
foot
In normal gait
 Stride length - both legs are equal
 Step length - both left and right leg will be equal
Any abnormality in the various components of stance
phase or swing phase, or any other components of gait
suggests that there is pathology to be identified by the
examiner.
BATCH NOTES |Page 3 of 4
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TRANS & EDITED BY:  BSPT-2017

Prelim Lecture 1 BATCH NOTES |Page 4 of 4