Das
Maximum PF into DF (concentric ant tib)
Peak knee flexion occurs, uniquely timed for optimal clearance of the foot
Hip: flexes- assists foot clearance
Initial swing
Ankle: neutral dorsiflexion
Knee: minimal flexion
Hip: about 30 deg flexion
Gluteus maximus and hamstrings control hip
hamstrings prevent knee hyperextension (eccentric)
Anterior tib and quads initiate the loading response (eccentric)
Ankle: PF
knee: flexing to about 45 deg at toe-off
Hip: begins to flex, concentric hip flexors, primarily the iliopsoas; rectus femoris muscle is active to augment hip flexion at faster walking speeds
Pre-swing
Ankle: DF - concentric ant tib
Knee: extending by INERTIAL forces without muscle activity
Hip: concentric flexion
Mid swing
Forward progression of the tibia is slowed/stopped and further increase in dorsiflexion is limited
ankle DF decreases by concentric contraction of the gastrocnemius and soleus
knee moves from relative extension to increasing flexion during terminal stance
hip continues to extend
Terminal stance
Ankle dorsiflexion controlled by eccentric contraction of the soleus muscle
knee extends
vastus medialis, intermedius, and lateralis stabilize the knee until the ground reaction force passes anterior to the knee joint
hip continues to extend
Midstance
Ankle: begins to PF eccentric ant tib positions ankle in neutral
Knee: extension from eccentric hamstrings decelerate the forward swing of the thigh; quads become active to assist with control of the knee
Hip: minimal movement noted
Terminal swing
Initial contact of one foot to initial contact of the same foot
Stride
Toeing in/out
Step angle
Hip controlled through concentric glut max, glut min and hamstring coming into extension
Knee flexes 15 deg to absorb shock
eccentric quad to control knee flexion
Forefoot lowers to the ground through eccentric anterior tib
Loading response
Initial contact on one foot to initial contact of the other foot
Step length
Distance between feet in the frontal place
Base of support
1. Head to toe or toe to head
2. look at all body segments
3. be systematic
4. be consistent
5. only report what is observed! (Make no assumptions)
Observational gait analysis rules
Hip drop in midstance
Trendelenburg
Distance between midline and step in frontal plane
Step width
Audible slap at initial contact
Foot slap
Lateral deviation of swing
Circumduction
Hip, knee, ankle flex, hip adduction
Crouched gait
Elevation of pelvis during swing
Hip hiking
Lack of DF during swing
Drop foot
Usually from spasticit5y, bilateral hip adduction
Scissoring gait
Uncoordinated, not-smooth
Ataxic gait
Avoiding weight bearing on one limb
Antalgic gait