Dr.

Muhammad Ali-ur-Rasheed
Lecturer , Department of
Physiotherapy.
Sargodha Medical College.
GAIT

Walk and gait ??

Define Gait??
Walking pattern
Complex system
The ability to initiate or terminate
Gait Cycle - Definitions
► Normal Gait =
Series of rhythmical , alternating movements of the
trunk & limbs which result in the forward
progression of the center of gravity
Series of ‘controlled falls’
Pre requisite
There are (4) major criteria essential to walking.

Equilibrium:
The ability to assume an upright posture and maintain balance.

Locomotion:
The ability to initiate and maintain rhythmic stepping

Musculoskeletal Integrity:
Normal bone, joint, and muscle function

Neurological Control:
Must receive and send messages telling the body how and when
to move. (visual, vestibular, auditory, sensori-motor input)
Phases of Gait
Step and stride length and stride
width
 Gait Cycle - Subdivisions:

A. Stance phase:
1. Heel contact: ‘Initial contact’
2. Foot-flat: ‘Loading response’,
3. Midstance:
4. Heel-off: ‘Terminal stance’
5. Toe-off: ‘Pre-swing’
Gait Cycle - Subdivisions:

B. Swing phase:
1. Acceleration: ‘Initial swing’
2. Midswing: swinging limb overtakes the limb in stance
3. Deceleration: ‘Terminal swing’
► Time Frame:
A. Stance vs. Swing:
► Stance phase = 60% of
gait cycle
► Swing phase = 40%
B. Single vs. Double support:
► Single support= 40% of
gait cycle
► Double support= 20%
► With increasing walking speeds:
► Stance phase: decreases
► Swing phase: increases
► Double support: decreases

► Running:
► By definition: walking without double support
► Ratio stance/swing reverses
► Double support disappears. ‘Double swing’ develops
Saggital kinematics
Initial contact
(Heel strike)

Hip 25-30 flexion

Knee 0-5
Ankle 0 (90)

Muscle work
Stabilizers
 Loading Response Phase
(Heel Strike to Foot Flat)
KNEE: 0° → 15° flexion
ANKLE: 0° → 10° plantar flexion
1st rocker : Calcaneus

Muscle work
Quards ---Eccentric
DF….Eccentric
T.Antand Post….Eccentric
Hip extensors
Mid stance
(Foot Flat to mid stance)
HIP: 25° → 0°
KNEE: 15° →0°
ANKLE: 10PF→5°dorsiflexion
2nd rocker ankle

Muscle work
Hip extensors
Soleus and gastro…eccentric
Terminal Stance
Mid stance to Heel off
HIP: 0 - 20° Ext.
KNEE: 0°
ANKLE: 5° → 10°DF
At end of terminal stance, Begin
3rd rocker MTP

Muscle work
Planter flexors
No quards and hamstring
Pre swing
(Heel Off to Toe Off)

HIP: 20° Ext → 0°F

KNEE: 0° → 40°F
ANKLE: 10° dorsi flexion → 20°
plantar flexion

Muscle work
Planter flexors
Push off
Passive knee flexion
Initial swing
Toe Off to early
HIP: 15 °F
KNEE: 60°F
ANKLE: 10° plantar flexion

Muscle work

Hip flexors
Knee flexors
DF
Mid swing

HIP: 25 °F
KNEE: 25°F
ANKLE: 0°

Muscle work
Hip flexors
Quards
Terminal Swing
Mid-swing-deceleration

HIP: 25 °F
KNEE: 0°-5
ANKLE: 0°

Muscle
Hip extensors
Hamstring
Temporal and Distance Factors
Velocity– 1.46 m/second (3.26 miles/hour)
Step length – 76.3 cm (30.05 inches)
Cadence – 1.9 steps /second
Stride length –
Walking speed – men-110 steps/minute ,
women-115 steps/minute
Gait Parameters
Males Females

Step Length (cm) 79 66

Stride Length (cm) 158 132

Cadence (steps/min) 117 (60-132) 117 (60 132

Velocity (m/sec) 1.54 1.31

Walking Base (cm) 8.1 7.1

Foot angle 7 6
Control Mechanisms of Gait
Spinal cord
1. Pattern generation
2. Reflex action
3. Execute other rhythmic movements concurrently
Brainstem and cerebellum
4. Improve coordination of activation patterns
5. Weight support
6. Active propulsion
Control Mechanisms of Gait
Basal ganglion
1. Dynamic stability
2. Initiates movement
3. Terminates movements
Cortex
4. Adoptable motor control system to meet goals
in different types of environments
Essential Requirements for Successful
Locomotion
Progression
Coordinated and rhythmic pattern of muscle activation in legs
and trunk
Requires the ability to initiate and terminate locomotion
Guide locomotion towards end points that are no t necessarily
visible
Stability
Appropriate posture for locomotion
Dynamic stability
Adaptation
Adaptations to avoid obstacles, navigate uneven terrain, and
change speed and direction as needed
Any Question ???
Thanx