Unidad 1 - Gait PDF

ELECTIVA II
Dra. Ing. Cecilia Villa Parra
17/4/2020 1
Content
REFERENCES
17/4/2020 2
Basic biomechanics of the gait
Gait
- Locomotion
- Translatory
progression of the
human body
produced by
coordinated and
rotatory movements
of the body segments
- Achieved through the

movement of trunk
and limbs
- Bipedal
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Gait
Biphasic forward propulsion of center of gravity of the human

body, in which there are alternate sinuous movements of
different segments of the body with least expenditure of energy

Parameters of Interest for the Human Gait
• Stride duration
• Step duration
• Stride length
• Step length
• Speed
• Gait cycle duration
• Cadence
• Stance % gait cycle







Step length
Distance between corresponding successive
points of heel contact of the opposite feet



Step length
Distance between successive points of heel
contact of the same foot





Stride lenght
Step length Step length

Step width
Step width
Foot angle
Foot angle
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A.C. Villa-Parrahttp://www.optogait.com/What-is-OptoGait/The-two-dimensional-system
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Stride lenght
Step length Step length
Step width
Foot angle
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http://www.optogait.com/What-is-OptoGait/The-two-dimensional-system


GAIT CYCLE
https://neupsykey.com/gait-disorders-3/

GAIT CYCLE

GAIT CYCLE

GAIT CYCLE Stance phase of the gait cycle


GAIT CYCLE
Gait trajectories during Human Gait
https://www.biorxiv.org/content/10.1101/597294v2.full

Stance phase
0% 60%
https://medical-dictionary.thefreedictionary.com/gait+cycle
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Gait autonomy: the máximum time a person

can walk, taking ubti acciunt the number and
duration of the stops
https://medical-dictionary.thefreedictionary.com/gait+cycle
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Running Gait
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Running Gait
Initial contact Mid-stance Mid-float

body’s center of mass is at
body’s center of mass is directly over
the highest vertical position
the foot and at its lowest vertical
position of the gait cycle
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Running Gait
Horizontal
Foot inclination distance from Leg inclination angle
angle allows for the foot to This angle can play a
the determination body’s center role in the amount of
of mass loading that occurs to
of foot-strike A greater value
pattern the tibia during
increases the braking running.
impulse and resulting
knee extensor moment
during the loading
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response 35
Running Gait
Knee flexion angle Peak knee Peak ankle dorsiflexion

at initial contact flexion angle at angle at mid stance
20° are generally mid stance may provide insights
recommended 45° are generally into calf muscle load
recommended and Achilles tendon
strain
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Running Gait
Center of mass (COM) vertical excursion

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Running Gait
Trunk side bend Lateral pelvic drop Knee center Mediolateral

position distance from the
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foot to center
38
of mass
These measures are useful in characterizing the amount of foot
Running Gait pronation that is occurring during running, which may
influence recommendations regarding shoes and shoe inserts
Recognition and analysis of the human gait
- Image processing
- Floor sensors
- Sensors placed on
the body
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https://www2.vetmed.ucdavis.edu/vorl/facilities/locomotion_gait_analysis.cfm
Gait Analysis Systems and Laboratories
https://www.researchgate.net/figure/The-setup-of-a-typical-contemporary-gait-
analysis-laboratory-1-video-cameras-with_fig25_301935875








Most commonly:
30 to 60 fps
Faster motions:
100 to 120 fps

https://drexel.edu/now/archive/2015/January/Running-Clinic/
http://www.simi.com/fileadmin/user_upload/Dokumente/Downloads/Simi_
Clinical_and_Sports_Catalogue.pdf

https://www.mdpi.com/2076-3417/8/7/1167

Technologies for analysis of gait in clinical conditions
- Non-wearable sensors (NWS)
- Wearable sensors (WS)
- Hybrid systems NWS & WS
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- based on image processing (IP)
- based on floor sensors (FS)
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http://www.stanfordchildrens.org/en/service/motion-gait-analysis-laboratory/gait
https://www2.vetmed.ucdavis.edu/vorl/facilities/locomotion_gait_analysis.cfm https://www.researchgate.net/figure/Real-time-gait-analysis-the-subject-is-walking-on-a-treadmill-and-
the-gait-analysis_fig6_277034356
Placement of the tripod-mounted 2-D and 3-D analyses

video camera needs to be Real time gait analysis, overground and
perpendicular to the plane of interest treadmill easy, moderate, or racing speeds
Image Processing NWS

Movemente Analysis
Markers are used in conjunction with

automated multi-camera tracking systems
Typical marker diameters range from 3mm to 25 mm
Types
- Passive retroreflective markers (require a
source of illumination)
- Actively illuminated (optoelectric) marker
(actively illuminated (optoelectric) marker)


Milwaukee Foot Model
Upper extremity marker placement

Loftsrand crutch
For evaluate assisted gait of children with
orthopedic disabilities
Ziad O. Abu-Faraj. Et al. Human Gait and Clinical Movement Analysis. 2015. DOI:
17/4/2020 10.1002/047134608X.W6606.pub2 60
Markers are
mounted over
predetermined
anatomical
landmarks: bony
prominences,
joint axes, limb
axes
Diagram of the marker-

set (antero-lateral—left
and postero-lateral—
right views)
implemented for gait
analysis
Ferrari, A., Benedetti, M. G., Pavan, E., Frigo, C., Bettinelli, D., Rabuffetti, M., ... &
17/4/2020 Leardini, A. (2008). Quantitative comparison of five current protocols in gait 61
analysis. Gait & posture, 28(2), 207-216.
https://www.nature.com/articles/s41597-019-0124-4.pdf
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Image Processing NWS
• To create visual images based on surface temperatures
Infrared Thermography (IRT)

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https://www.zebris.de/fileadmin/Editoren/zeb
ris-PDF/zebris-Prospekte-
EN/Rehawalk_181110_en_web.pdf


- based on image processing (IP)
- based on floor sensors (FS)
17/4/2020 https://www.concordia.ca/research/perform/facilities/functional-assessment-lab.html 66
Floor Sensors NWS
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Pressure and Force Sensors
https://accesshealth.com.au/product/gaitrite-portable-gait-
analysis-system-poa/

- Wearable sensors (WS)
- Located on several parts of the body
- accelerometers, gyroscopic sensors,
- magnetometers, force sensors,
- extensometers, goniometers,
- active markers,
- electromyography
17/4/2020 http://podiatryclinicsyorkshire.co.uk/services/gait-analysis/ 69
http://www.mdpi.com/1424-8220/14/2/3362/htm
Ultrasonic Sensors WS
Electromyography (EMG)
The sEMG methodology

- noise control
- cross talk
- low signal reception
- muscle co-contraction
- electrode placement protocol.
70

Electromyography (EMG)
WS

Inertial Sensors “IMU device (Inertial WS

Measurement Unit)”
Combination of accelerometers, gyroscopes and
magnetometers
An accelerometer basically uses the fundamentals that

the acceleration of a body is proportional to the net force
acting on the body

- image processing
- floor sensors
- sensors placed on the body
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Pressure insoles
Prototipo de Plantilla Instrumentada para la

Adquisición de Presión Plantar y Parámetros de
Marcha Orientada a la Prevención de Úlceras en
el Pie Diabético. Juan Diego Arévalo Márquez, Christian Xavier
Sangurima Tenepaguay. UPS Cuenca, 2019
https://oapl.com.au/blog/rehagait-mobile-gait-
17/4/2020 analysis-technology-2 77
Pressure and Force Sensors WS
Capacitive, resistive piezoelectric and

piezoresistive sensors
The choice of sensor depends:

- Range of pressure
- Linearity
- Sensitivity

http://www.simi.com/fileadmin/user_upload/Dokumente/Downloads/Simi_Clini
cal_and_Sports_Catalogue.pdf
17/4/2020 79
Changes in gait
(a) neurological diseases:

multiple sclerosis, Parkinson’s
(b) systemic diseases:

cardiopathies
(c) alterations in deambulation:

due to stroke, joint alterations
(d) diseases caused by ageing

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https://sites.google.com/site/pathologicalgaitpatterns/pathological-gait-parkinsons-disease
https://sites.google.com/site/pathologicalgaitpatterns/pathological-gait-parkinson-s
Cerebral palsy conditions https://www.slideshare.net/FarvardinneuroCognit/gait-pattern-

classification-in-children-with-cp
Traditional analysis of gait in clinical

conditions
- Scales are semi-subjective

(concerning accuracy and precision)
- Specialists to observe the quality of a

patient’s gait by making him/her walk
- A survey in which the patient is asked

to give a subjective evaluation of the
quality of his/her gait
Semi-Subjective Analysis
Techniques
Timed 25-Foot Walk (T25-FW)
Clinical tests on multiple
sclerosis
Time to walk a distance of
7.5 m
Multiple Sclerosis Walking
Scale (MSWS-12)
Assesses 12 parameters
Can be adapted to other
neurological conditions

Semi-Subjective Analysis
Techniques
Tinetti Performance-Oriented
Mobility Assessment (POMA)
Timed Get up and Go (TUG)
Walk forward at least 3 m, turn
180° and then walk quickly
back to the chair
Objective: To valuate elderly
persons’ balance and gait
disorders in everyday situations

Gait and coordination training

Dual-task-training
The patient moves while

observing various tasks which
require a continual variation of
walking and balancing. Postural
control as well as coordination
skills are checked and trained
as a result.
The training to be individually

adapted to each patient
Physical and cognitive abilities

are simultaneously demanded
during dual-task-training.
https://www.zebris.de/fileadmin/Editoren/zeb
ris-PDF/zebris-Prospekte-
EN/Rehawalk_181110_en_web.pdf
17/4/2020 85
Gait and coordination training

The patient solves simple
Dual-task-training
perceptual and memory tasks as
well as arithmetic problems while
walking.
White Reaction time and attentiveness
Blue are improved
Yellow Say colors

Read words
Red
Green Blanco
Azul
Amarillo
Rojo
Verde
Work 4 Group 2 persons
1) Measure 4 gait parameters during walking in the following conditions:

• Normal speed gait
• Gait with dual-task-training
Describe the process.
2) Describe the suitable instrumentation and the protocol required to measure 4

running gait parameters
3) Carry out the Tinetti Performance-Oriented Mobility Assessment (POMA) with

- A young person
- An old person
- Compare both situations and analyze data
4) Based on the diagram of the marker-set which is employing for analysis in gait
laboratories, execute the protocol with one subject. Measure the time needed to
place all the markers and indicate which markers would be necessary to assess the
gait in the sagittal plane.
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ELECTIVA II

Dra. Ing. Cecilia Villa Parra

- Achieved through the

Biphasic forward propulsion of center of gravity of the human

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

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Step length Step length

Step length Step length

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Parameters of Interest for the Human Gait

Parameters of Interest for the Human Gait

Parameters of Interest for the Human Gait

Parameters of Interest for the Human Gait

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Parameters of Interest for the Human Gait

Gait trajectories during Human Gait

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Parameters of Interest for the Human Gait

Parameters of Interest for the Human Gait

Parameters of Interest for the Human Gait

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Gait autonomy: the máximum time a person

Parameters of Interest for the Human Gait

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Initial contact Mid-stance Mid-float

Knee ﬂexion angle Peak knee Peak ankle dorsiﬂexion

Center of mass (COM) vertical excursion

Trunk side bend Lateral pelvic drop Knee center Mediolateral

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