Gait Examination and Evaluation

Describe components of motion and muscle

function to analyze movement and muscle
activity specific to various activities and during
normal gait.
Observe and analyze functional human
movement in both simple (unidimensional and
uniarticular) and complex (multiplanar and
multiarticular) models.
Appropriately to break down a gait cycle into
parts and then analyze the most important
events that occur during each part.
Understand the phases, tasks, and subtasks of
gait including:
Critical events
Range of motion required at the hip, knee and
ankle
Muscle contractions required
Understand and measure the various
determinants of gait
Basic sequence of limb motions that serve to progress the
body along a desired path while maintaining weigh
bearing stability, conserving energy, and absorbing the
shock of floor impact.
Cycle
The time from heel strike to the next ipsilateral hip
strike

Phases
Divided into Stance and Swing

Tasks
Weight acceptance
Single limb support
Swing phase
From the point
of initial contact
of one lower
extremity to a
point at which
the same
extremity
contacts the
ground again
Stance Phase Swing Phase
60% 40%
WB or CKC NWB or OKC
Traditional/NYU Ranchos Los Amigos Contralateral Leg

Heel Strike Initial Contact (IC) Heel Off

Foot Flat Loading Response (LR) Toe Off

Midstance Midstance (MSt) Swing Phase

Heel Off Terminal Stance (TSt) Heel Strike

Toe Off Preswing (PSw) Foot Flat

Acceleration Initial Swing (Isw) Midstance

Midswing Midswing (MSw) Midstance

Deceleration Terminal Swing (TSw) Midstance

Accomplishments
Forward progression
Stability
Shock absorption

Periods/ Subtasks
Initial Contact (IC): foot contacts ground
Loading response (LR): weight transfer, double limb
support
Accomplishments
Stability
Forward Progression

Subtasks/ Periods
Midstance (MSt): progression over single limb
Terminal Stance (TSt): body moves ahead
Accomplishments
Foot clearance
Limb advancement
Subtasks/ Periods
Pre-Swing (PSw): rapid unloading and weight
transfer: double limb support
Initial Swing(Isw): thigh advances; foot leaves floor
Mid Swing(MSw): knee extends and foot clears
ground
Terminal Swing (TSw): knee extends and limb
prepares contact with ground)
Spatial
Stride Length: Linear distance between 2 successive steps of
the same lower extremity; 144 cm
Step Length: Linear distance between 2 steps of opposite
feet; 72 cm
Width of Base of Support : Linear distance between feet; 7-9 cm.
Line of progression: Line drawn between successive heel
contacts of the same foot
Toe Out (In) Angle: Angle of foot placement; Measured from line
of progression through second toe. Varies between 5-18 degrees
– normal 7 degrees
Temporal
Cadence (# steps/min): 119 steps/min
Stride Time
Step Time: 1.87 steps/sec or 110 steps/min
Spatio-Temporal
Walking Speed (m/sec or mph): 1.37 m/sec; 3mph
Kinetic Energy
Body slows down when supporting limb is in front of the COM
Body speeds up when the supporting limb is behind the COM
Lowest velocity at mid stance
Highest velocity at double limb support

Potential Energy
Function of the mass of the body, the gravitational field
acting on the body, and the height of the body’s COM
Maximal potential energy occurs when the COM reaches it’s
highest points – midstance
Minimum potential energy occurs at double limb support,
when body COM is at its lowest points
Heel rise: lowers the movement of COG by 5-
6mm; balance - anterior directed force
Pelvic rotation: pd of double limb support;
minimizes the drop of COG; 8 degrees (4 deg
forward & 4 deg backward)
Pelvic tilt/list/drop/obliquity: pd of single limb
support minimizes the rise of COG thus
depressing the COG; Normal Trendelenburg; 8
degrees (4 deg upward & 4 deg downward)
Lateral displacement of pelvis & physiologic
valgus of the knee
Controls mediolateral displacement
Knee, ankle and foot motions
Control movement of the COG
Knee flexion during midstance
Depress the COG
Balance: 5deg flexion
Rancho Los AmigosMedical Center (2001).
Observational Gait Analysis Handbook. Downey,
CA: Los Amigos Research Education Center.
Neumann, DA. Kinesiology of the
Musculoskeletal System: Foundations for
Rehabilitation. (2nd edition) St Louis: Mosby
Inc; 2010. (Abbreviated Neumann in readings)
Revised for instruction and adapted from: Prof.
Rolando T. Lazaro, PhD, PT, DPT, MS, GCS,
Visiting Professor at UP-CAMP