15- Normal and Abnormal Gait
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Transcript of 15- Normal and Abnormal Gait
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Normal GaitNormal GaitHeikki Uustal, MDHeikki Uustal, MD
Medical Director, Prosthetic/Orthotic TeamMedical Director, Prosthetic/Orthotic TeamJFKJFK--Johnson Rehab InstituteJohnson Rehab Institute
Edison, NJEdison, NJ
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Critical Gait ParametersCritical Gait Parameters
Average walking speed = 2Average walking speed = 2--3 mph (603 mph (60--80m/min)80m/min)Average cadence = 80Average cadence = 80--110 steps/min110 steps/minAverage step length = 60 cmAverage step length = 60 cmStance/swing = 60/40Stance/swing = 60/40Single/double limb support = 80/20Single/double limb support = 80/20Running has no double limb supportRunning has no double limb support
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Step or Stride?Step or Stride?
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Phases of the Gait CyclePhases of the Gait CycleStance Phase Stance Phase –– 60%60%Swing Phase Swing Phase –– 40%40%
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Single Limb Support Single Limb Support –– 80% 80% Double Limb Support Double Limb Support –– 20%20%
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Phases of the Gait CyclePhases of the Gait Cycle
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Comparison of Right Leg to Left Comparison of Right Leg to Left Leg PhasesLeg Phases
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Subdivisions of the Gait CycleSubdivisions of the Gait Cycle
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Rockers or Pivot Points in Rockers or Pivot Points in StanceStance
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Joint Positions and MovementsJoint Positions and MovementsToo Complex?Too Complex?
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Methods of Analyzing GaitMethods of Analyzing Gait
KinematicsKinematics is the method of is the method of observing or measuring the position observing or measuring the position of joints and segments through each of joints and segments through each phase of gait (visual gait analysis)phase of gait (visual gait analysis)KineticsKinetics is the method of measuring is the method of measuring the Ground Reaction Force at each the Ground Reaction Force at each joint and then calculating the muscle joint and then calculating the muscle activity or soft tissue resistance activity or soft tissue resistance present to stabilize the jointpresent to stabilize the joint
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Planes of Planes of ReferenceReference
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Kinetics of Stance PhaseKinetics of Stance Phase
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Gait Analysis Basic TrainingGait Analysis Basic Training
Assess only one joint at a timeAssess only one joint at a timeLook at early stance, late stance, Look at early stance, late stance, then swingthen swingSeparate kinetics from kinematicsSeparate kinetics from kinematicsKEEP IT SIMPLE!KEEP IT SIMPLE!
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KinematicsKinematics of the Ankle from of the Ankle from Initial Contact to MidstanceInitial Contact to Midstance
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KineticsKinetics of the Ankle from of the Ankle from Initial Contact to MidstanceInitial Contact to Midstance
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Muscle Activity of the Muscle Activity of the Dorsiflexors and PlantarflexorsDorsiflexors and Plantarflexors
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KinematicsKinematics of the Knee from of the Knee from Initial Contact to MidstanceInitial Contact to Midstance
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KineticsKinetics of the Knee from of the Knee from Initial Contact to MidstanceInitial Contact to Midstance
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Activity of the Quads in Early Activity of the Quads in Early StanceStance
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KinematicsKinematics of the Hip from of the Hip from Initial Contact to MidstanceInitial Contact to Midstance
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KineticsKinetics of the Hip from Initial of the Hip from Initial Contact to MidstanceContact to Midstance
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Muscle Activity of the Hip Muscle Activity of the Hip ExtensorsExtensors
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KinematicsKinematics of the Ankle from of the Ankle from Midstance to PreMidstance to Pre--swingswing
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KineticsKinetics of the Ankle from of the Ankle from Midstance to PreMidstance to Pre--swingswing
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Muscle Activity of the Muscle Activity of the Plantarflexors in Late StancePlantarflexors in Late Stance
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KinematicKinematics of the Knee from s of the Knee from Midstance to PreMidstance to Pre--swingswing
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KineticsKinetics of the Knee from of the Knee from Midstance to PreMidstance to Pre--swingswing
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KinematicsKinematics of the Hip from of the Hip from Midstance to PreMidstance to Pre--swingswing
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KineticsKinetics of the Hip from of the Hip from Midstance to PreMidstance to Pre--swingswing
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KinematicsKinematics of the Hip, Knee, of the Hip, Knee, and Ankle in Swing Phaseand Ankle in Swing Phase
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KineticsKinetics of the of the Hip in Hip in
Midstance Midstance Frontal PlaneFrontal Plane
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Muscle Activity of the Hip Muscle Activity of the Hip Abductors in StanceAbductors in Stance
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Hip Abductor ActivityHip Abductor Activity
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Activity of All Major MusclesActivity of All Major Muscles
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Activity of All Major MusclesActivity of All Major Muscles
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Determinants of GaitDeterminants of GaitStick Figure Model Stick Figure Model
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1.Pelvic Rotation1.Pelvic RotationLengthens Limb at IC and PSLengthens Limb at IC and PS
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2.Pelvic Tilt2.Pelvic TiltShortens Limb at MSShortens Limb at MS
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3.Knee Flexion in Stance3.Knee Flexion in StanceShortens Limb at MSShortens Limb at MS
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4&5.Foot and Ankle Motion4&5.Foot and Ankle MotionLengthens and Shortens LimbLengthens and Shortens Limb
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Effect of Ankle Motion on the Effect of Ankle Motion on the KneeKnee
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Smoothing the COG MotionSmoothing the COG Motion
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Muscles Muscles of the of the AnkleAnkle
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Vertical Displacement of the Hip Vertical Displacement of the Hip JointsJoints
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Sinusoidal Motion of the COGSinusoidal Motion of the COG
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6.Narrow Base of Support6.Narrow Base of Supportto Minimize Horizontal Motionto Minimize Horizontal Motion
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3D Displacement of COG3D Displacement of COG
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Effect of Increased Speed on Effect of Increased Speed on Gait ParametersGait Parameters
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Effect of Incline on EnergyEffect of Incline on Energy
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Effect of Ankle Effect of Ankle Immobilization Immobilization
on Gaiton Gait
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Effect of Knee ImmobilizationEffect of Knee Immobilization
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Up and Down StairsUp and Down Stairs
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Center of Center of Gravity Gravity
LineLine
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Base of SupportBase of Support
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Base of SupportBase of Support
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