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Biomec hanic s

Gait
Introduction
Ambulation or locomotion. Consists of 1 stride 2 phases ,
and 8 events. Is a translatory progression of the body as a whole
produced by a coordination rotary movements of body
segments.
Movements of body segments
The translatory progression is rhythmic and characterized
by alternating propulsive and retropulsive motions of the lower
extremities.
During gait the lower extremities support, balance, carry, and
transfer the head, arms, and trunk (HAT) which constitute 75%
of the body weight, the head and arm 25% and the trunk 50%.
Tasks accomplished with each gait cycle .
• Acceptance and balance of HAT.
• Transfer HAT from one extremity to another.
• Lift 1 extremity of the ground and place in front of
the other in alternating pattern.
Neuromuscular component of gait
1. Activation of gait neuromuscular in central nervous
system.
2. Transmission of neural commands to the peripheral
system.
3. Muscular contraction and producing movement.
4. Generation of forces and moment at the joints.
5. Regeneration of the joint forces and moments.
6. Linear and angular displacement of the bodies
segments.
7. Generation of ground reaction forces.

Gait Cycle
During bi-pedal locomotion, there are 2 distance phases:
Stance phase ( 60-62% ): contact phase
Biomec hanic s

Begins with 1 extremity contacts the ground ( Heel


strike), and ends
as the feet is leaving the ground (Toe off) and consists
of 5 events:
Traditional RLA
Heel strike Initial contact
Foot flat Loading response
Mid stance Mid-stance
Heel off Terminal stance
Toe off Pre swing

Swing phase (38- 40%): no contact phase


Begins with as soon as the toe of one extremity leaves
the ground and ceases just prior to heel strike or contact of
the same extremity when the feet swings toward the next
stance phase, and consists of 3 events:
Traditional RLA
Acceleration Initial swing
Mid-swing Mid swing
Deceleration Terminal swing
Biomec hanic s

Stance phase
Heel strike or Initial contact
- The moment when the red foot just touches the floor.
- Normally the heel is the first part of the foot to touch the
ground.
- Beginning of the 1st double support.
- Mean while, the blue leg is at the end terminal stance.
Foot flat or loading response
- 0 to 12 percent of the gait cycle.
- The double stance period beginning with the foot contacting
the floor until the other foot is lifted for swing.
- Body weight is transferred on to the red leg.
- Meanwhile the blue leg is the pre-swings phase.
Mid-stance or mid stance
- Single limb support during which one limb must support the
entire body weight and provide tranquil stability while
progression must be continued.
Heel off or terminal stance
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- Begins when the red heel rises and continues until the heel of
the blue foot hits the ground.
- Body weight progresses beyond the red foot as increased hip
extension puts the leg in a more trailing position.
Toe off or pre swing
- The 2nd double support stance interval in the gait cycle.
- It begins with the initial contact of the blue foot and ends with
red toe off.
- Ground contact by the blue leg causes the red leg to increase
ankle planter flexion, knee flexion, and decrease hip extensor.

Swing phase
Acceleration or Initial swings
- Begins when the foot is lifted from the floor and ends when
the swinging foot is opposite the stance foot.
- The red leg is advanced by increased hip and knee flexion.
- The ankle only partially planter flexion to natural to ensure
ground clearance.
- It is during this phase that a foot drop gait is most
appearant.
- The blue leg is in mid stance.
Mid swing or mid- swing
- Continues from the end point of the initial swing and
continues until the swinging limb is in front of the body and
the tibia is vertical.
- Advancement of the red leg is accomplished by further hip
flexion.
- The ankle is allowed to extend in response to gravity while
the ankle continues dorsiflexion to neutral.
- The blue leg is in late mid- stance.
Deceleration or terminal swing
- Begins when the tibia of red is vertical and ends when the
foot touches the floor
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- Limb advancement is completed by knee extension


- The hip maintains its flexion and the ankle remains
dorsiflexed to neutral.
Determinants of Gait
- Adjustments made by the body to minimize center of gravity
movement
- To achieve smooth sinusoidal (rhythmic) curve
Five determinants (adjustments)
1- Lateral pelvic tilt in the frontal plane
• minimize the elevation of the COG
2- Knee flexion
• minimize the elevation of the COG
3- Knee, ankle and foot interactions
(synchronization)
• minimize abrupt rise of COG
4- Pelvic rotation in the transverse plane
• minimize the depression of the COG
5- Physiologic valgus of the knee
• minimize width base of support

Lateral pelvic tilt in the frontal plane


COG reaches the lowest and highest points of the sinusoidal
curve during the double support and mid stance, respectively
- Figure 14-22 Sinusoidal curve
- It’s leteral telting of pelvis (pelvis drop) on the side of the
unsupported extremity (swing leg)
• Produces adduction of the stance hip
 Done by opposing hip abductors
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 i.e. pelvic drop during right extremity swing is


controlled by left hip abductors
- Keeps the peak of the rise lower than if the pelvis did not
drop.
- Figure 14-23
Knee flexion
• Knee flexion of the swinging leg at midstance, when the
COG is at its highest point, represents another adjustment.
• Helps to keep the COG from rising as much as it would
have to if the body had to pass over a completely extended
knee.
Knee, Ankle, and Foot Interactions
• The synchronization of the knee, ankle, and foot
movements provide smooth transfer of COG from lower to
higher location
• Prevent abrupt changes while the vertical
displacement of the COG from a downward to an
upward direction
• Moving COG upwardly from heel strike to foot flat is
accomplished with knee flexion, ankle plantarflexion, and
foot pronation.
• The relative shortening of the extremity achieved with
the combined movements of these body part provides
the smooth rise COG after heel strike
• Without these motions occurring together, the COG
would rise abruptly after heel strike as the tibia rides
over the talus.
• Figure 14-31
• The interaction between the 3 body parts plays an
important role when the body's COG falls after mid stance.
• Meanwhile the combination of ankle plantar-flexion, foot
supination, and knee extension at heel off slow the descent
of the body’s COG by a relative lengthening of the stance
extremity.
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• Figure 14-33
Forward and Backward Rotation of the Pelvis
• A small (~ 8°) back- & fore-ward hip rotations occur during
lower extremity advancement
• As the pelvis begins to move forward at preswing and
continues as the swinging extremity advances forward
during initial swing until reaching midstance (max.
elevation of COG) is reached, the pelvis rotate forwardly
to reach natural position.
• Forward pelvis rotation continues beyond neutral on the
swing side through terminal swing to initial contact.
• Figure 14-24
• Meanwhile, an apparent lengthening of the lower
extremities is occurring for both extremities (stance and
swing) as the COG descends to its lowest level in the period
of double support.
• The swinging extremity is lengthened in terminal
swing by the forwardly rotating pelvis
• The weight-bearing extremity is lengthened in
preswing by the posterior position of the pelvis.
• This relative lengthening helps to prevent an excessive
drop of the COG and maintains the COG at a higher level
than would be possible if no pelvic rotation occurred.
Physiologic Valgus at the Knee
• The physiologic valgus at the knee reduces the width of the
base of support
• Narrower base of support result in little lateral motion of
the body to shift the COG from one lower extremity to
another over the base of support.
• Figure 14-25
KINEMATICS AND KINETICS OF THE TRUNK AND
UPPER EXTREMITIES
(Trunk)
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• The trunk remains essentially in the erect position during


normal walking with slight rotation primarily in a direction
opposite to the direction of pelvic rotation.
• As the pelvis rotates forward with the swinging lower
extremity, the thorax on the opposite side rotates
forward as well.
• Helps preventing excess body motion and to
counterbalance rotation of the pelvis.
• Figure 14-37
• The erector spinae exhibit two periods of activity at heel strike
and at toe off.
• Prevent the trunk from falling forward.
• The quadratus lumborum and the rectus abdominis are also
active
• Precise function is not clear.
(Upper Extremities)
• The arm swing opposite to the lower limps and similar to the
trunk movements
• The right arm swings forward with the forward swing of
the left lower extremity, while the left arm swings
backward.
• counterbalance to the forward swinging of the leg
and helps to decelerate rotation of the body caused
by the rotating pelvis.
• Figure 14-38
• The normal shoulder motion [~30° (24° ext. & 6° of flex.)] is
the result of the combined effects of gravity and muscle
activity.
• During the forward portion of arm swinging, the medial
rotators are active (subscapularis, teres major, and latissimus
dorsi).
• In backward swing the middle and posterior deltoid are active
throughout, while the latissimus dorsi and teres major are
active only during the first portion of backward swing.
Biomec hanic s

• The supraspinatus, trapezius, and posterior & middle deltoid


are active in both backward and forward swing.
• The normal shoulder motion [~30° (24° ext. & 6° of flex.)] is
the result of the combined effects of gravity and muscle
activity.
• Little or no activity is reported in the shoulder flexors.
• The role of the middle deltoid is unclear, although it has
been suggested that it functions to keep the arm
abducted so that it may clear the side of the body.
• Activity in all muscles increases as the speed of gait
increases.
Muscle Activities
(Stance Phase)
• Heel strike to Foot flat
• Figure 14-31
• Table 14-3
• Foot flat to Midstance
• Figure 14-32
• Table 14-4
• Midstance to heel off
• Figure 14-33
• Table 14-5
• Heel off to Toe off
• Figure 14-34
• Table 14-6

(Swing Phase)
• Acceleration to mid swing
• Figure 14-35
• Table 14-7
• Mid swing to deceleration
Biomec hanic s

• Figure 14-36
• Table 14-8

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