Kin191 A.Ch.9. Evaluation Of Gait

KIN 191A

Evaluation of Gait

INTRODUCTION

• OBSERVATION TECHNIQUES• GAIT CYCLE• QUALITATIVE OBSERVATION OF GAIT• WALKING vs. RUNNING GAIT• COMPENSATORY GAIT DEVIATIONS

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OBSERVATION TECHNIQUES

• Limb position• ROM• Speed of motion• Force production• Timing of each event in the gait cycle

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GAIT CYCLE

• STANCE PHASE– Initial contact: lateral surface of heel (strike)– Loading response– Midstance: entire foot on ground– Terminal stance– Preswing: just before toe off

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• SWING PHASE– Initial swing: immediately after toe-off– Midswing– Terminal swing: before heel strike

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Initial Contact

• Foot touches the supporting surface• Lateral aspect of the plantar surface of the

heel • Opposite limb is ending with toe-off• Subtalar joint 5° supinated and talocrural joint

is dorsiflexed• 20% of the total gait cycle

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Loading Response

• Loading response occurs immediately after initial contact

• Talocrural joint plantar flexed and subtalar joint pronated calcaneal eversion

• Tibial internal rotation subtalar pronation

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Midstance

• Begins as the body weight moves directly over the stationary support limb

• Talocrural joint continues to dorsiflex• Subtalar joint supinates calcaneal inversion• Tibial external rotation/knee & hip joints move into extension

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Midstance

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Terminal Stance

• Begins as the center of gravity passes over the foot and ends just before the contralateral limb makes initial contact with the ground

• Weight-bearing forces placed on the 1st MTP joint

• In preparation of the swing phase

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Terminal Stance

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Preswing

• Final period of the stance phase• Begins with the initial contact of the

contralateral limb and ends with the toe-off of the stance limb

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Preswing

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SWING PHASE

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Initial Swing

• Begins at the point when the toes leave the ground and

• Continues until the knee reaches its maximum range of flexion (≈60°)

• Pronation occurs at the subtalar joint at the beginning of the initial swing

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Midswing

• Knee extends from the point of maximum flexion

• Tibia reaches a vertical position • Talocrural joint into neutral position or into

slight dorsiflexion

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Midswing

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Terminal Swing

• Final period of the swing phase• Occurs from the end of the midswing to the

initial contact period of the stance phase• Supination occurs at the talocrural joint in

preparation for initial contact

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QUALITATIVE OBSERVATION OF GAIT

• Center of gravity: men is higher L1-L5, women S1-S2• Position of the trunk• Position of the head• Movement/Symmetrical of limbs• Heel strike (initial contact)• Movement of arms• Movement of pelvis• Cadence– Number of steps per unit of time

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WALKING vs. RUNNING GAIT

• Two distinct differences– A flight phase during which neither foot is in contact with

the supporting surface– No time are both feet in contact with the surface at the

same time

• Stance phase– Walking (62%)– Running (33% or depend on the speed)

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COMPENSATORY GAIT DEVIATIONS

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