Biomechanics of gait (1)

By:H.a.maaz
OPT
Why ……….
Nothing optimizes a level of independence and
our perception of a good quality of life more
than the ability to travel independently under
own power from one place to another. We
celebrate the development of this ability in
children and try to sustain it throughout the
lifespan”
(Patla, 1995).
Gait
- It is a form of bipedal locomotion on which there is
alternating action between both lower extremities.
- one leg in touch with the ground for supporting
and propulsion. The other leg for creating a new
step.
- Gait is the result of a series of rhythmic alternating
movement of arms, legs and trunk that creates
forward movement of the body.
Neuromuscular Components of Gait

 1.Activation of the gait neuromuscular system in the

central nervous system.
 2.Transmission of neural commands to the peripheral
nervous system.
 3.Muscular contraction and producing movement.
 4.Generation of forces and moments at the joints
 5.Regulation of the joint forces and moments.
 6.Linear and angular displacement of the body's
segments
 7.Generation of ground reaction forces
Prerequisites of gait

1- Equilibrium & Stability in stance:

The ability to assume an upright posture and maintain balance
2- Clearance of swing limb
3- Pre-position of the foot in terminal swing
4- Adequate step length
5- Energy conservation
6- the ability to initiate and maintain rhythmic stepping
7- Musculoskeletal Integrity
•normal bone, joint, and muscle function
8- Neurological Control,
 •visual, vestibular, auditory, sensorimotor input
Phases of the Gait Cycle
Stance Phase (60 %) Swing Phase (40 %)

ISw TSw
DS SS DS
Stance Swing
Gait Cycle
 I- Stance phase

Stance phase begins at the instance that one

extremity contacts the ground and continues as long
as some portion of the foot in contact with the ground
and ends when the reference foot lifts off the ground.

The supporting phase or weight bearing phase.

Represents 60% of the gait cycle.
Stance phase (60-62%): Contact phase
Traditional RLA
1) Heel strike 1) Initial contact
2) Foot flat 2) •Loading response
3) Midstance 3) •Midstance
4) Heel off 4) •Terminal stance
5) Toe off 5) •Preswing
Stance phase
1- Initial contact (heel Strike)

Initial Contact (0-2%)

The instant at which the
foot (heel) just touches
the floor.
Beginning of Loading.
Stance phase
2- loading response (Foot Flat)

- (2- 10 %) GC.
-The foot fully contacts the ground.
-Maximum Impact loading occurs.
Weight has been shifted to the
support leg.
-Continues until the other foot is lifted
for swing.
3- Mid-Stance

- 10- 30%
- the body weight is directly over
the supporting lower extremity.
All weight supported by single
leg
 4- terminal stance (Heel-Off)
- 30-50 % GC.
- The heel of the reference extremity leaves
the ground.
- Un-loading of limb and preparation for
swing.
-Weight Shift to opposite side begins.
- From the end of mid stance to just prior to
the initial contact of the contralateral
extremity.
5- Preswing (Toe-Off)

-(50- 60%) GC
- only the toes of the reference
extremity is in contact with the
ground.
-Propulsion.
 I- Swing phase

Swing phase begins at the instance that one

extremity leaves the ground and finishes just prior
to initial contact of the same extremity.
The non weight bearing phase.
Represents 40% of the gait cycle.
Swing phase (38-40%): No contact phase

Traditional RLA
1) Acceleration 1) Initial swing
2) Mid-swing 2) Mid-swing
3) Deceleration 3) Terminal swing
1- initial swing
-60- 73% GC
-Begins once the toes of the
reference extremity leaves the
ground and continues until the
point at which the swinging limb
is directly under the body or
maximum knee flexion.
2- Mid-swing
-73- 87 % GC
-The reference extremity directly
under the body.
-Begins from maximum knee
flexion until the tibia is in
vertical position.
3- Terminal Swing
-87- 100 % GC.
-From point at which the tibia
is in the vertical position to a
point just prior to initial
contact.
-The knee is extendind in
preparation for initial
contact.
Double support
 Intervals of the Stance Phase

Initial double stance. 10 % (ipsilateral initial contact and

loading response and contralateral preswing).
Single limb support. 40 % (ipsilateral midstance and
terminal stance and contralateral swing phase).
Terminal double stance. 10% (ipsilateral preswing and
contralateral initial contact and loading response.
 Running

Running:
 By definition: walking without double support
Ratio stance/swing reverses
Double support disappears. ‘Double floats'’
develops
 Gait Events
 Stance phase: Swing Events
Support Events Initial swing
Initial contact. (acceleration ) 13 %
(Heel Strike) 2% Mid swing . 14 %
Loading response Terminal swing. 13 %
(Foot Flat). 8 %
Midstance 20 %
Terminal stance.
(Heel off) 20 %
Pre swing (Toe) Off.
10 %
 Gait cycle timing
Time Frame:  With increasing walking
A. Stance vs. Swing:
speeds:
 Both stance and swing
Stance phase = times are shortened.
60% of gait  Stance phase:
decreases
cycle  Swing phase:
Swing phase = increases
 Double support:
40% decreases
B. Single vs. Double support:  Running:
Single support=  By definition: walking
without double support
40% of gait cycle  Ratio stance/swing
Double support= reverses
 Double support
20% disappears. ‘Double
floats'’ develops
Kinematic analysis

1- distance (spatial) and time

(temporal variables)

2- measurement of joint angles

3- determinants of gait
1- distance (spatial) and time (temporal
variables)

 Step Length =
 Linear Distance between two successive points of foot
contact of the opposite extremities.
 Rt step length = Lt step length (in normal gait)
 Average for woman 64 cm, for men73 cm, overall average
70.5 cm
 Stride Length =
 Linear distance between two successive points of foot
contact of the same extremity.
 Double the step length (in normal gait).
 The men average is 146 cm and women 128 cm, overall
average 141 cm.
 Walking Base: width of base of support
 Linear distance between the midpoint of the heel of one
foot to the same point on the other foot.
 Side-to-side distance between the line of the two feet
 2.5- 12.5 cm. increases in elderly and in small children.
Degree of toe out:
-Represents the angle of foot placement.
-Angle between the foot’s line of progression and a line
intersecting the center the center of heel and the second toe.
-The angle about 7 degrees. Decreases as the speed of
walking increases in normal men.
Time variables
Cadence =
 Number of steps minute
 Normal: 100 – 115 steps/min. women 117, men 110,
overall 113 step/min.
 Short step length will result in increased cadence at
constant distance.
 When the cadence of walking reaches 180
steps/min, running, the period of double limb
stance dissappears and running starts.
 Walking velocity
Velocity =
 Distance covered by the body in unit time
 Usually measured in m/s
 Average= 82 m/min (~ 5 km/h), men 86 m/min,
women 77m/ min.
 Slow, free (average), fast.
 A fast speed is associated with increased cadence
and stride length, and decreased angle of toe out.
 Time variables
Step time.
Stride time.
Stance time.
Swing time.
Single limb time.
Double limb time.
Cadence
velocity
Angular displacement in sagittal
plane
- Measurement of joint angles.

- Draw graphical presentation.

- Determination of values and function

of arcs (peaks) of displacement.
 Hip joint

- In stance: continuous
progressive hip extension. Starts
with hip flexion and ends with
maximum hyperextension.
-In swing: continuous hip
flexion. Reaches its maximum
value in mid swing.
 Hip joint

I.C L.R M.S T.S P.S I.S M.S T.S

30 25 0 20 0 20 30 30
Flex. Flex. Hyper ext. Flex. Flex. Flex.
 Knee joint

- In stance: extension, flexion,

extension, flexion.
-In swing: flexion, extension
 knee joint

I.C L.R M.S T.S P.S I.S M.S T.S

5 15-20 5 0 35-40 60 60-65 0
Flex. Flex. Flex. Flex. Flex. Flex.
30 Flex.
 Ankle joint

- In stance: dorsi flexion, planter

flexion, dorsi flexion, planter
flexion.
-In swing: dorsiflexion
 Ankle joint

I.C L.R M.S T.S P.S I.S M.S T.S

0 15 5-10 10 20-30 10 0 0
planter Dorsi Dorsi planter planter dorsi dorsi
I.C L.R M T.S P.S I.S M.S T.S
.S
30 25 0 20 0 20 30 30
Flex Flex Hyper Flex Flex Flex
ext.

I.C L.R M. T.S P.S I.S M.S T.

S S

5 15- 5 0 35-40 60 60-65 0

Flex 20 Fle Flex. Fl Flex.
. Flex x. ex. 30 Flex
I.C L.R M.S T.S P.S I.S
M. T.S
S
0 15 5-10 10 20- 10 0 0
plant Dor Dorsi 30 plant dor dors
plan
 Shoulder and elbow

Shoulder and elbow move in the same direction.

One arc of flexion and one arc of extesion.
Maximum shoulder flexion 24° at the end of terminal
stance (elbow 44° preswing). Maximum shoulder
extension 8° at the ipsilateral initial contact (elbow 20°
flex midswing)..
Axial displacement: head, trunk. pelvic

Lateral displacement:
follows a single sinusoidal path.
Average magnitude is 5 cm (2.5 right- 2.5 left).
Motion is toward the side of supporting limb.
Maximum ipsilateral displacement is at the onset of
terminal stance. And contralateral on midswing.
Axial displacement: head, trunk. pelvic

 vertical displacement:
- double sinusoidal path. Average displacement 5 cm. two
cycle downward and upward.
-Peak downward in (double limb support) loading response
and preswing.
-Peak upward: (single limb support) midstance and
midswing.
-At peak upward displacement of COG still lie slightly below
its level at standing.
 Path of Center of Gravity
A. Vertical displacement:
 Rhythmic up & down movement
 Highest point: midstance-mdswing
 Lowest point: double support LR-
PS
 Average displacement: 5cm
 Path: extremely smooth sinusoidal
curve
 Progressional displacement

Overall displacement:
 Sum of vertical & Horizontal
plane
horizontal displacement
 Figure ‘8’ movement of CG
as seen from AP view Vertical
plane
Displacement
3- determinants of gait
- Adjustments made by the body that
help to
- - minimize the displacement of the
COG in vertical and lateral direction
to only 5 cm.
- - produce a smooth sinusoidal curve
of the COG.
- - Decrease the energy expenditure.
 First determinant: Pelvic Rotation
-average magnitude
8 degrees

-function:
-minimize downward
displacement of COG.
2nd determinant: Lateral pelvic Tilt

- average
magnitude
4 degrees.
 3 rd determinant: Knee Flexion During
Stance

-Knee flexion in LR 15- 20

-Minimize vertical rise of COG.
-Shock absorption.
 4th and 5th knee, Ankle and foot
interactions.

Knee extension with ankle Knee flexion and ankle Knee and ankle foot
dorsiflexion Lengthens Leg in planter flexion in loading interaction prevent
terminal stance and initial response shorten the limb, sudden change in
contact to minimize depression minimize rise of COG. vertical displacement of
of COG. COG.
6th determinants: physiological valgus of
the knee

 (6) Lateral displacement of body:

 The normally narrow width of the walking base
minimizes the lateral displacement of CG
 Reduced muscular energy consumption due to reduced
lateral acceleration & deceleration
Thank you…………….