Introduction to gait analysis

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Questions and Answers

What is primarily assessed to determine the effectiveness and efficiency of walking during gait analysis?

The muscular strength of the lower limbs

The temporal and spatial descriptors of gait (correct)

The psychological state of the individual

The history of the individual's previous injuries

Which phase of the gait cycle occurs between the heel strike of one foot and the subsequent heel strike of the same foot?

Stance phase

Stride phase (correct)

Step phase

Swing phase

What describes the distance between the heels during walking as a critical spatial descriptor?

Step length

Cadence

Stride length

Step width (correct)

During the gait cycle, the primary muscles active during the stance phase are responsible for what main function?

Absorbing shock and providing stability Signup and view all the answers

Which descriptor measures the number of steps taken per minute, reflecting the rhythm of gait?

Cadence Signup and view all the answers

In gait analysis, how does aging typically affect walking speed and cadence?

Speed decreases, cadence increases Signup and view all the answers

Which plane of motion is primarily assessed to observe the lateral movement of the center of mass during gait?

Coronal plane Signup and view all the answers

What is the significance of identifying typical gait dysfunctions in relation to specific mechanisms during gait analysis?

Assists in therapeutic intervention planning Signup and view all the answers

What is the primary function completed during the terminal swing phase of the gait cycle?

Preparation of the limb for stance Signup and view all the answers

What is the vertical displacement of the center of mass during normal gait?

5 cm Signup and view all the answers

Which arc of motion is associated with the ankle during the sagittal plane kinematics of gait?

~ 30 degrees Signup and view all the answers

What is the total arc of motion for hip abduction and adduction during frontal plane kinematics?

~ 10 degrees Signup and view all the answers

During which phase of the gait cycle does the pelvis, femur, and tibia typically engage in internal rotation?

Swing phase Signup and view all the answers

What is the expected total arc of motion for knee abduction and adduction during the frontal plane mechanics?

~ 5 degrees Signup and view all the answers

What is the typical duration of muscle activity during walking phases?

10-40% of gait cycle Signup and view all the answers

What does the Gait Rite System primarily measure?

Limb kinematics on a mat with sensors Signup and view all the answers

What type of motion is not significantly present at the ankle joint during horizontal plane kinematics?

Translational movement Signup and view all the answers

How is electromyography utilized in gait analysis?

To assess muscle activation patterns Signup and view all the answers

What percentage of the gait cycle is allocated to the swing phase?

40% Signup and view all the answers

During which phase does the foot first make contact with the ground?

Initial Contact Signup and view all the answers

Which of the following statements about muscle activation during the pre-swing phase is correct?

Muscles are activated for advancement of the limb. Signup and view all the answers

In which phase does the center of mass first begin to progress over the stationary foot?

Mid-Stance Signup and view all the answers

What is primarily preserved during the loading response phase?

Weight bearing stability Signup and view all the answers

Which phase of gait features the final double limb stance interval?

Pre-Swing Signup and view all the answers

Which aspect of joint kinematics is most prominent during the terminal stance phase?

Heel rise Signup and view all the answers

During mid-swing, what significant change occurs in limb positioning?

Tibia is positioned vertically. Signup and view all the answers

Study Notes

Foot Clearance

Occurs during the Initial Swing Phase of Gait
Time period: 60-73% of gait cycle
Purpose: To lift the foot off the ground to avoid dragging
Swing Phase: The portion of the gait cycle where the foot is not in contact with the ground
Initial Swing Phase: The first portion of swing phase

Terminal Swing

Time period: 87-100% of gait cycle
Begins with the tibia in a vertical position
Ends with Initial Contact (IC)
Limb advancement is complete
Shin/shank moves forward (anteriorly) of the thigh

Displacement of Center of Mass (CoM)

Normal values:
- Vertical: 5 cm
- Medial-Lateral: 4 cm
Peaks in CoM displacement occur at:
- 30% of gait cycle
- 80% of gait cycle
These peaks happen during mid-stance for the left and right legs respectively
The Center of Mass is the balance point of an object

Joint Kinematics: Gait Analysis

Gait analysis uses a 3-dimensional approach:
- Sagittal Plane
- Frontal Plane
- Horizontal Plane
It considers the movement of all joints:
- Head
- Arm
- Trunk
- Pelvis
- Hip
- Knee
- Foot
It looks at the movement from two perspectives:
- Bottom-Up
- Top-Down

Sagittal Plane Kinematics

Sagittal plane: divides the body into left and right halves

Segment	Motion	Total Arc of Motion
Pelvis	Anterior and posterior tilt	2-4 degrees
Hip	Flexion and extension	~40 degrees
Knee	Flexion and extension	~60 degrees
Ankle	Dorsiflexion and plantarflexion	~30 degrees

Frontal Plane Kinematics

Frontal plane: Divides the body into anterior and posterior halves

Segment	Motion	Total Arc of Motion
Pelvis	Up and down obliquity (abduction/adduction)	6-8 degrees
Hip	Abduction and adduction	~10 degrees
Knee	Abduction (valgus) and adduction (varus)	~5 degrees
Ankle	Inversion and eversion	~8 degrees

Horizontal Plane Kinematics

Horizontal plane: Divides the body into top and bottom halves

Segment	Motion	Total Arc of Motion
Pelvis	Anterior/Posterior rotation (forward/backward)	~6-8 degrees
Hip	Internal and external rotation	~15 degrees
Knee	Internal and external rotation	~10 degrees
Ankle	Negligible	n/a

Summary of Horizontal Plane Kinematics

Focuses on the direction of motion, not absolute joint position
During the First Half of Stance:
- Pelvis, femur, and tibia rotate internally (IR)
- Subtalar joint everts
- Mid-tarsal joint increases pliability
During the Second Half of Stance:
- Pelvis, femur, and tibia rotates externally (ER)
- Subtalar joint inverts
- Mid-tarsal joint increases stability
During Swing:
- Pelvis, femur, and tibia rotate internally (IR)
- Subtalar joint everts
- Mid-tarsal joint increases pliability

Muscle Activity During Walking

Most muscles contract in short bursts:
- Duration: 100-400 ms
- Percentage of gait cycle: 10-40%
Understanding muscle function is important for:
- Understanding gait deviations
- Treatment planning

Types of Quantitative Gait Analysis

Quantitative gait analysis focuses on measuring different factors during gait
Types of quantitative analysis:
- Gait Rite System
- Plantar Pressure
- 3D Coordinate System
- Marker Placement
- Electromyography

Gait Rite System

A 14-foot long assessment mat with over 16,000 sensors
Measures forces and pressures applied to the mat during walking

Plantar Pressure

Uses Tekscan or Novel Pedar Systems
Measures pressure distribution across the plantar surface of the foot
Helps assess foot biomechanics during walking

3D Coordinate System

Uses optical-based systems with markers placed on limbs and joints
Multiple force plates are utilized
Captures 3-dimensional movement data
Helps analyze joint angles and movements

Pediatric Gait Analysis

Specialized gait analysis for children, including:
- Children's Hospital Zurich, Switzerland
- Royal Children's Hospital, Melbourne, Australia
- Children's Memorial Hospital, Chicago, IL
Adjusts techniques and equipment to meet the specific needs of children

Electromyography

Examines muscle activity
Uses surface electrodes or fine-wire electrodes
- Surface electrodes: Placed on the skin
- Fine-wire electrodes: Inserted into the muscle with a small gauge needle
Detects electrical activity in the muscles
Provides information on muscle activation patterns during gait

Gait Assessment

Range from simple observations to complex lab settings
Qualitative or quantitative depending on equipment availability
Goal is to identify:
- Effectiveness and efficiency of walking
- Potential impairments impacting ambulation
- Safety and balance of the individual
- Information for guiding interventions
Understanding normal gait characteristics helps identify typical gait dysfunctions

Postural Assessment

A static postural assessment is often the first step of a gait assessment
It focuses on the position of the body while standing
Provides insight into alignment, muscle imbalances, and potential gait deviations

Gait Cycle/Stride: Spatial Descriptors

Step: Heel strike of one foot to heel strike of the other foot
Stride: From heel strike of one foot to heel strike of the same foot (synonymous with gait cycle)
Stride length: Distance from heel to same heel
Step length: Distance from one heel strike to the opposite foot
Step width: Distance between heels

Gait Cycle: Temporal Descriptors

Cadence: Number of steps per minute:
- Typical walking: 110-120 steps/min
- Running: 170-180 steps/min
Step time: Time taken for one right or left step
Stride time: Time taken for one complete gait cycle/stride

Spatial-Temporal Descriptor

Walking speed: Distance over time (m/s or mph)
- Average walking speed: 1.37 m/sec (3 mph)
Various measurement approaches can be used for assessing speed:
- 10m walk test
- 6-minute walk test
- Self-selected pace
- Fast pace
- Predetermined pace

Normal Value Considerations

Gait parameters vary based on age
With increasing age, gait speed decreases, but cadence increases
This age-related change can lead to intervention considerations for maintaining mobility and safety
The specific age where these changes become relevant varies based on individual factors

Stance and Swing in Walking

Each gait cycle consists of:
- Stance phase: ~60% of the cycle
- Swing phase: ~40% of the cycle

Rancho Los Amigos Terminology (Periods of Gait Cycle)

Stance Phase:
- Initial Contact (IC)
- Loading Response (LR)
- Midstance
- Terminal Stance
- Preswing
Swing Phase:
- Initial Swing
- Midswing
- Terminal Swing

Initial Contact (IC)

Time period: 0% gait cycle
Instant the foot makes contact with the ground
An immediate reaction to body weight transfer occurs
Marks the beginning of the stance phase
Leads to impact deceleration

Loading Response (LR)

Time period: 0-10% gait cycle
The initial double limb stance period
Continues from IC until the contralateral foot lifts for swing, creating double limb support
Functions include:
- Shock absorption
- Weight bearing stability
- Preservation of forward progression

Midstance

Time period: 10-30% of the gait cycle
First half of single limb support (SLS)
Begins when the contralateral limb leaves the ground
Ends when body weight is over the forefoot
Main functions include:
- Progression over the stationary foot
- Limb and trunk stability to maintain balance

Terminal Stance

Time period: 30-50% of the gait cycle
Completes SLS
Begins with heel rise
Ends when the contralateral limb has IC
Body weight shifts forward beyond the forefoot
Functions include:
- Progression of the body past the supporting foot
- Limb and trunk stability for efficient walking

Preswing

Time period: 50-60% of the gait cycle
The final phase of stance, representing the second double limb stance period
Begins with IC of the contralateral limb
Ends with ipsilateral toe off
Known as "weight release" or "weight transfer" as body weight is shifted to the other leg
Muscle activation prepares the limb for the swing phase
Functions include:
- Positioning the limb for swing
- Accelerating forward motion
- Generating momentum for the swing phase

Initial Swing

Time period: 60-73% of the gait cycle, approximately one-third of the swing period
Begins when the foot is lifted off the ground
Ends when the swing foot is opposite the stance foot
Functions include:
- Foot clearance to prevent dragging
- Advancing the limb from a trailing position to a forward position

### Midswing

Time period: 73-87% of the gait cycle, representing the middle one-third of swing
Begins when the swing foot is opposite the contralateral (opposite) foot
Ends when the swing limb is forward, and the tibia is in a vertical position
Functions:
- Limb advancement

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Description

This quiz covers essential concepts related to foot clearance and terminal swing phases during gait analysis. It emphasizes the importance of center of mass displacement and the three-dimensional approach to understanding joint kinematics. Test your knowledge on these critical aspects of human movement.