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KKU_Biomech_M5_L1

   Gait analysis



                                                       Lesson (1)
Dr / Shimaa Essa
Lecturer of physical therapy , faculty of community,
King Khalid university
Upon successful completion of this lesson you
  would be able to:

1.   Define gait cycle
2.   Distinguish between the phases of gait cycle
3.   Identify Spatial and temporal parameters of gait cycle
4.   Measure spatial and temporal components of gait cycle
     practically
Gait analysis is used for clinical and
laboratory identification of deviations of
normal gait. In order to conduct a gait
analysis you should firstly learn about the
normal gait cycle and its spatial and
temporal components.
Gait Cycle
Normal Gait definition:

Is series of rhythmical , alternating movements
   of the trunk & limbs which result in the
   forward progression of the center of gravity
   and the body.
Gait Cycle




Gait Cycle =
   – Single sequence of functions by one limb
   – Begins when reference foot contacts the ground
   – Ends with subsequent floor contact of the same foot
Prerequisites for normal gait

 1- Maintenance of upright position of the HAT against
    gravity (H= head, A= arms, T= trunk).

 2- Maintenance of body stability & balance.

 3- Good foot control, to ensure safe foot clearance and
    gentle heel contact during gait.
Gait cycle
                                       (one stride)




                      Stance phase                Swing phase


                   Initial contact                     Initial swing
                                                       (Acceleration)
Loading response
    (foot flat)
                                                        midswing
                                                         (Toe off)

   Mid stance
                                                      Terminal swing
                                                      (Deacceleration)
Terminal stance
    (heel off)

   Pre-swing
     (Toe off)
Stance intervals

 1- Initial double stance…… timing 10%

 2- Single limb support…… timing 40%

 3- Terminal double stance……… timing 10%
Phases:
  (1) Stance Phase: 60%   (2) Swing Phase: 40%
   reference limb            reference limb
     in contact                not in contact
      with the floor             with the floor
Support:
   (1) Single Support: only one foot in contact with the floor
   (2) Double Support: both feet in contact with floor
- Subdivisions:




A. Stance phase:
   1. Heel contact: ‘Initial contact’
   2. Foot-flat: ‘Loading response’, initial contact of forefoot w. ground
   3. Midstance: greater trochanter in alignment w. vertical bisector of foot
   4. Heel-off: ‘Terminal stance’
   5. Toe-off: ‘Pre-swing’
- 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
Gait analysis

                                         Gait analysis



                          Kinematic analysis           Kinetic analysis



  1) Distance (spatial) & time (temporal) variables.



  2) Measurement of joint angles of lower and upper extremities.



  3) Descriptive components of gait (determinants of gait).
1) Distance (spatial) & time (temporal)
variables

    A) Distance variables
     1- Step length.
     2- Stride length.
     3- Width of walking base
     4- Foot angle (degree of toe out or angle of gait).
1) Distance (spatial) & time (temporal)
variables




 1) Step Length =
    – Distance between corresponding successive points of heel
      contact of the opposite feet.
    – Rt step length = Lt step length (in normal gait).
1) Distance (spatial) & time (temporal)
variables




  2) Stride Length =
     – Distance between successive points of heel contact
       of the same foot
     – Double the step length (in normal gait)
1) Distance (spatial) & time (temporal)
variables




  3) Walking Base =
     – Side-to-side distance between the line of the two
       feet
     – Also known as ‘stride width’
1) Distance (spatial) & time (temporal)
variables




   4) Degree of toe out=
     it represents the angle of foot placement and may be found by
     measuring the angle formed by each foot's line of progression
     and a line intersecting the center of the heel and the second toe.
     The angle for men is about 7°. The degree of toe out decreases as
     the speed of walking increases in normal men.
1) Distance (spatial) & time (temporal)
variables

    B- Time variables
    1)   Step time
    2)   Stride time
    3)   Stance time
    4)   Single limb time
    5)   Double limb time
    6)   Swing time
    7)   Cadence
    8)   speed
1) Distance (spatial) & time (temporal)
variables

   Step time:
   It is referred to the amount of time spent during
     single step. It is the time between heel strike of
     one leg and heel strike of the contra-lateral leg.

   Stride time:
   It is referred to the amount of time it takes to
     complete one stride. Stride duration and gait cycle
     duration are the same.
1) Distance (spatial) & time (temporal)
variables
  Stance time:
   It is the amount of time that passes during the
     stance phase of one extremity in a gait cycle. It
     includes single support and double support.

  Swing time:
   It is the amount of time that passes during the
     swing phase of one extremity in a gait cycle. If the
     stride time of the gait cycle is one second, the
     stance time is 0.6 second and swing time is 0.4
     second.
1) Distance (spatial) & time (temporal)
variables
 Single limb time:
   It is the amount of time that passes during the
    period when only one extremity is on the
    supporting surface in a gait cycle.

 Double limb time:
  It is the amount of time that a person spends with
    both feet on the ground during one gait cycle. The
    percentage of time spent in double support
    decreases as the speed of walking increases.
1) Distance (spatial) & time (temporal)
variables
Cadence =
  – Number of steps per unit time
  – Normal: 100 – 115 steps/min
  – Cultural/social variations

Speed (Velocity)=
     Distance covered by the body in unit time
     Usually measured in m/s
     Instantaneous velocity varies during the gait cycle
     Average velocity (m/min) = step length (m) x cadence
      (steps/min). Average walking speed= 80m/minute.
Summary of
 Gait analysis
o Normal Gait Is series of rhythmical , alternating movements
  of the trunk & limbs which result in the forward progression
  of the center of gravity and the body.
o Gait Cycle =
   – Single sequence of functions by one limb
   – Begins when reference foot contacts the ground
   – Ends with subsequent floor contact of the same foot

o Gait cycle is divided into two phases, Stance phase &
Swing phase

   o Gait analysis is divided into Kinematic & Kinetic analysis

     o Kinematic gait analysis is concerned by the description
     of gait components. That include temporal and spatial
     variables of gait cycle.
Gait analysis

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Gait analysis

  • 1. KKU_Biomech_M5_L1 Gait analysis Lesson (1) Dr / Shimaa Essa Lecturer of physical therapy , faculty of community, King Khalid university
  • 2. Upon successful completion of this lesson you would be able to: 1. Define gait cycle 2. Distinguish between the phases of gait cycle 3. Identify Spatial and temporal parameters of gait cycle 4. Measure spatial and temporal components of gait cycle practically
  • 3. Gait analysis is used for clinical and laboratory identification of deviations of normal gait. In order to conduct a gait analysis you should firstly learn about the normal gait cycle and its spatial and temporal components.
  • 4. Gait Cycle Normal Gait definition: Is series of rhythmical , alternating movements of the trunk & limbs which result in the forward progression of the center of gravity and the body.
  • 5. Gait Cycle Gait Cycle = – Single sequence of functions by one limb – Begins when reference foot contacts the ground – Ends with subsequent floor contact of the same foot
  • 6. Prerequisites for normal gait 1- Maintenance of upright position of the HAT against gravity (H= head, A= arms, T= trunk). 2- Maintenance of body stability & balance. 3- Good foot control, to ensure safe foot clearance and gentle heel contact during gait.
  • 7. Gait cycle (one stride) Stance phase Swing phase Initial contact Initial swing (Acceleration) Loading response (foot flat) midswing (Toe off) Mid stance Terminal swing (Deacceleration) Terminal stance (heel off) Pre-swing (Toe off)
  • 8. Stance intervals 1- Initial double stance…… timing 10% 2- Single limb support…… timing 40% 3- Terminal double stance……… timing 10%
  • 9. Phases: (1) Stance Phase: 60% (2) Swing Phase: 40% reference limb reference limb in contact not in contact with the floor with the floor
  • 10. Support: (1) Single Support: only one foot in contact with the floor (2) Double Support: both feet in contact with floor
  • 11. - Subdivisions: A. Stance phase: 1. Heel contact: ‘Initial contact’ 2. Foot-flat: ‘Loading response’, initial contact of forefoot w. ground 3. Midstance: greater trochanter in alignment w. vertical bisector of foot 4. Heel-off: ‘Terminal stance’ 5. Toe-off: ‘Pre-swing’
  • 12. - Subdivisions: B. Swing phase: 1. Acceleration: ‘Initial swing’ 2. Midswing: Swinging limb overtakes the limb in stance 3. Deceleration: ‘Terminal swing’
  • 13. 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%
  • 14. • 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
  • 15. Gait analysis Gait analysis Kinematic analysis Kinetic analysis 1) Distance (spatial) & time (temporal) variables. 2) Measurement of joint angles of lower and upper extremities. 3) Descriptive components of gait (determinants of gait).
  • 16. 1) Distance (spatial) & time (temporal) variables A) Distance variables 1- Step length. 2- Stride length. 3- Width of walking base 4- Foot angle (degree of toe out or angle of gait).
  • 17. 1) Distance (spatial) & time (temporal) variables 1) Step Length = – Distance between corresponding successive points of heel contact of the opposite feet. – Rt step length = Lt step length (in normal gait).
  • 18. 1) Distance (spatial) & time (temporal) variables 2) Stride Length = – Distance between successive points of heel contact of the same foot – Double the step length (in normal gait)
  • 19. 1) Distance (spatial) & time (temporal) variables 3) Walking Base = – Side-to-side distance between the line of the two feet – Also known as ‘stride width’
  • 20. 1) Distance (spatial) & time (temporal) variables 4) Degree of toe out= it represents the angle of foot placement and may be found by measuring the angle formed by each foot's line of progression and a line intersecting the center of the heel and the second toe. The angle for men is about 7°. The degree of toe out decreases as the speed of walking increases in normal men.
  • 21. 1) Distance (spatial) & time (temporal) variables B- Time variables 1) Step time 2) Stride time 3) Stance time 4) Single limb time 5) Double limb time 6) Swing time 7) Cadence 8) speed
  • 22. 1) Distance (spatial) & time (temporal) variables Step time: It is referred to the amount of time spent during single step. It is the time between heel strike of one leg and heel strike of the contra-lateral leg. Stride time: It is referred to the amount of time it takes to complete one stride. Stride duration and gait cycle duration are the same.
  • 23. 1) Distance (spatial) & time (temporal) variables Stance time: It is the amount of time that passes during the stance phase of one extremity in a gait cycle. It includes single support and double support. Swing time: It is the amount of time that passes during the swing phase of one extremity in a gait cycle. If the stride time of the gait cycle is one second, the stance time is 0.6 second and swing time is 0.4 second.
  • 24. 1) Distance (spatial) & time (temporal) variables Single limb time: It is the amount of time that passes during the period when only one extremity is on the supporting surface in a gait cycle. Double limb time: It is the amount of time that a person spends with both feet on the ground during one gait cycle. The percentage of time spent in double support decreases as the speed of walking increases.
  • 25. 1) Distance (spatial) & time (temporal) variables Cadence = – Number of steps per unit time – Normal: 100 – 115 steps/min – Cultural/social variations Speed (Velocity)=  Distance covered by the body in unit time  Usually measured in m/s  Instantaneous velocity varies during the gait cycle  Average velocity (m/min) = step length (m) x cadence (steps/min). Average walking speed= 80m/minute.
  • 26. Summary of Gait analysis
  • 27. o Normal Gait Is series of rhythmical , alternating movements of the trunk & limbs which result in the forward progression of the center of gravity and the body. o Gait Cycle = – Single sequence of functions by one limb – Begins when reference foot contacts the ground – Ends with subsequent floor contact of the same foot o Gait cycle is divided into two phases, Stance phase & Swing phase o Gait analysis is divided into Kinematic & Kinetic analysis o Kinematic gait analysis is concerned by the description of gait components. That include temporal and spatial variables of gait cycle.