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Kinematics Of Human Gait

OBJECTIVE OF THIS PRESENTATION

To describe the normal joint kinematics of human gait Gait cycle/gait terminology Average ROM in sagital/frontal & transverse

plan Normal joint motion in sagital/frontal &

transverse plan Average peak ROM comparison between

running and walking Stair ascent gait

What is gait? A translatory progression of the body as

whole, produced by coordinated, rotatory movement of different body segments. Which Includes :—

—Head —Upper Extremity —Trunk —Pelvis —Lower Extremity

What is Kinematic ?

Kinematic is science of motion, in human movement sciences. Kinematics includes the set of

concepts that allow us to describe the motion or displacement of a body segment without regard to the forces that causes that movement.

What is kinematics ? What we assess is kinematics i.e. what

the terminology and what involves kinematics. One of the major purposes of any

rehabilitative process is to help patients achieve the highest level of functional independence as possible within the limit of their disability.

The human locomotion or gait is one of the basic components of independent functioning.

Gait analysis In order to set realistic treatment goals

and to develops treatment plan. 1) An accurate description of gait pattern

and gait variables. 2) Identification and description of common

gait deviations. 3) Analyses of deviatons and identification

of possible cause. 4) Assessement of energy expenditure and

endurance. 5) Determination of the functional

ambulation capability of the patients

Gait Terminology. To assess gait we should be well familiar

with terminology used to describe gait. Gait cycle—

Gait cycle commences when the heel of one leg come in contact with supporting surface and ends when heel of same leg come in contact with supporting surface again.

A gait cycle consists of two major phases called —stance phase —swing phase and a periods of two double support.

Gait Terminology. Time and distance are two basic

parameters of motion we measures these variables to the description of gait. —Temporal variables. —Distance variables.

Temporal variable includes :— Stance time

i.e. time elapsed during stance phase of one extremity in a gait cycle.

Single limb support time— Amount of time elapsed during the period

when only one limb is an supporting surface.

Gait Terminology. Double-support time : —Amount to time

spent with both feet on ground. This is increased in elderly and patients with

balance disorders. This decreased when walking speed increase.

Stride length—It is linear displacement or distance between two successive events that is accomplished by the same extremity during gait cycles. i.e. linear distance between point of one feet

strike to next feet strike of same extremity. A stride includes two steps whereas the stride

length is not always twice the length of one step.

Gait Terminology.

Gait Terminology. Step length—

linear distance between two successive points of contact of opposite extremity.

Step duration— Amount of time spent during single step.

Cadence—it is number of steps taken by a person per unit of time. Cadence=No of steps/time. 110 steps/min is typical for adult men. 116 steps/min is typical for adult female.

Gait Terminology. Walking velocity :—

It is ratio of linear forward motion of body usually measured in meter/second.

Walking speed = distance walked/time (sec.) Women tends to walk with shorter and faster

steps than do men at the same velocity. Power generation—

It is accomplished when muscles shortens i.e. concentric contraction and the positive work added to the energy of body.

Power absorption— It is accomplished when muscle lengthens i.e

eccentric contraction they do negative work and reduce the energy.

Normal Kinematic of gait includes The events occuring during different phases

of gait cycle. Joint motion i.e.

Joint angle in sagital plane. Joint angle in frontal plane. Joint angle in transverse plane.

Gait cycle phases :—events There are two types of terminology used

i.e. —Traditional —Rancho los Amigos.

A gait cycle has —A stance phase it makes about 60% of total

gait. —Swing phase it makes about 40% of gait cycle.

Gait cycle phases Events of stance phase :— 1) Heel contact or Heel strike.

—When leading limb heel strike the ground. 2) Foot flat —

when whole foot makes contact with ground, it occurs after heel strike at about 7% of gait cycle.

3) Midstance — Occurs when total body weight is on supporting limb

at about 30% of gait cycle. 4) Heel off—

Point at which heel of the reference limb leaves the ground at about 40% gait cycle.

5) Toe off— When the toe of foot leaves the ground at about 60%

of the gait cycle.

Gait cycle phases

Subphases of stance phase :— 1) Heel strike phase—Occurs from

heel strike to foot flat. 2) Mid stance phase—From foot flat to

heel off at 40% of Gait cycle. 3) Push off phase—Begins at heel off

40% to toe off i.e. 60%.

Gait cycle phases Event of swing phase : — 1) Acceleration or early swing—

Occurs when toe leaves the ground and continues until mid swing.

2) Mid swing — Occurs approximately when extremity passes

beneath the body it begins at end of acceleration and ends at starts of decceleration.

3) Decceleration or late swing phase — it occurs after mid swing when limb is

deccelerating to prepare heel strike

Jim Patton

Determinants of Gait

1) Pelvic rotation2) Pelvic list (lateral tilt) (pelvic dips)3) Stance knee flexion4&5) knee, ankle & foot interactions

Determinant 1 Pelvic

Rotation Pelvis moves

forward with swing limb- increasing limb length forward

Determinant 2

Pelvis dips down on swing side

Lowers CM

Pelvic Tilt

Determinant 3

Shortens the leg length during stance

Flexion at beginning and end smoothes the abrupt change in CM

Stance Knee Flexion

Determinant 4/5

Heel strike Knee is

extended & ankle is dorsiflexed to lengthen the leg

Knee ankle foot interaction

Determinant 4/5

Heel strike to foot flat

Knee flexes, ankle planterflex, foot pronates.


Determinant 4/5

Foot flat to heel off

Knee extends, Ankle dorsiflexes


Determinant 4/5

Heel off to toe off Ankle

planterflexes to lengthen the leg


Joint Motion —

It could be discussed under following headings. Joint angle in sagital plane. Joint angle in frontal plane. Joint angle in transverse plane.

Sagital plane kinematics.Heel strike to foot Flat

Hip: 30 Degree Flexion

Knee: 0 – 15 degree

flexion

Ankle: 0-15 degree

planter flexionPhysical Rehabilitation,3rd edition/Susan B sullivan

Sagital plane kinematics.Foot Flat to midstance

HIP: 30 degree to 5 degree

flexion (neutral) KNEE:

15 to 5 degree flexion ANKLE:

15 degree planter flexion to 10 degree dorsiflexion

Physical Rehabilitation,3rd edition/Susan B sullivan

Sagital plane kinematics.Midstance to heel off

HIP: 5 degree flexion to 10

degree extension KNEE:

Extends from 5 degree flexion to 0 degree

ANKLE: 10 degree dorsiflexion to

15 degree dorsiflexion


Sagital plane kinematicsHeel off to Toe off

HIP: 10 degree extension to

5 degree flexion KNEE:

0 degree to 40 degree flexion

ANKLE: 15 degree dorsiflexion to

20 degree planter flexion


Sagital plane kinematics Swing Phase Toe off to Heel strike

HIP: 5 degree to 30

degree flexion KNEE:

40 degree to 60 degree flexion

ANKLE: 20 degree planter

flexion to 0Physical Rehabilitation,3rd edition/Susan B sullivan

Sagittal plane

Motion Curve

Swing phaseStance phaseExte

nsi

on

Flexio

n

10 9050 7030

LoadingResponse

Mid stance

Terminal stance Pre swing

Initial

swingMid swing Terminal

swing

Single supportDouble

support

Double

support

Acceleration DecelerationTraditional

Terninology

RLA

Terninology

Phase

sEvem

ts

Traditional

RLA Initial

contact

Heel strike

Contra

foot off

Foot flat

Contra

foot strike

Contra foot strike

Foot off

Toe offMidstance

Max

knee flex

Tibia is

vertical

Initial contact

Mid swing Heel strike

Heel

off

Gait cycle One stride(100 %)

(60-62%) (38-40 %)

LoadingResponse

Mid stance


Initial


swing


support

Double

support


Terninology

RLA

Terninology

Phase

sEvem

ts

Traditional

RLA Initial

contact

Heel strike

Contra

foot off

Foot flat

Contra

foot strike

Contra foot strike

Foot off

Toe offMidstance

Max

knee flex

Tibia is

vertical

Initial contact


Heel

off


Swing phaseStance phase

Exte

nsi

on

Flexio

n

10 9050 7030(60-62%) (38-40 %)

LoadingResponse

Mid stance


Initial


swing


support

Double

support


Terninology

RLA

Terninology

Phase

sEvem

ts

Traditional

RLA Initial

contact

Heel strike

Contra

foot off

Foot flat

Contra

foot strike

Contra foot strike

Foot off

Toe offMidstance

Max

knee flex

Tibia is

vertical

Initial contact


Heel

off


Swing phaseStance phase

Pla

nte

rflesi

on

Dors

ilexio

n

10 9050 7030

(60-62%) (38-40 %)

Sagital plane kinematicsOther motion

ARMS: Swings opposite to the legs

MTP : 0 to 60 degree dorsiflexion

(variable)

Frontal plane kinematicsHip& Pelvis motion Pelvic Obliquity(List)

Near midstance the CM is high the swing side of the pelvis list down to lower the CM

Hip Abd-Add Adducts in early stance

about 5°,Abducts in late stance about 5°,returns to neutral in swing

Frontal plane kinematicsSubtalar motion

In early stance,eversion allowing shock absorption.

In late stance, inversion locks the midtarsal joint,allowing a rigid fore foot for heel off.

Heel off Midstance

Heel strike

Transverse plane kinematicsHip,Trunk & Lower limb

Pelvic rotation The swing leg side of the pelvis rotates

10°. Trunk rotation

Lower trunk rotates with the pelvis upper trunk rotates opposite.

Femoral/tibial rotation Internal rotation until foot flat External rotation until toe off Then internal rotation during swing.

Stair gait Kinematics

Phases of stair gait Stance phase – 64%

Weight acceptance – 15% Pull up – 15%-30% Forward continuance 30%-64%

Swing phase – 36% Foot clearance – 64%-80% Foot placement – 80%-100%

Sagittal analysis of stair ascent.Weight acceptance to pull up

JOINT Hip joint

MOTION Extends from 60° flexion to 30° flexion

MUSCLE G-MAX (Power generation) G-MED (Power generation) Hams (Power generation)

Source – Joint structure & function,a comprehensive analysis

/Levangie,C norkins,4th edition /chapter-14/page 552-558

Sagittal analysis of stair ascent.Weight accepatence to pull up

JOINT Knee joint

MOTION Extends 80° flexion – 35° flexion

MUSCLE VL (Power generation) RF (Power generation)Source – Joint structure & function,a comprehensive analysis


Sagittal analysis of stair ascent.Weight acceptance to pull up

JOINT Ankle joint

MOTION Dorsiflexion:- 20° to 25° dorsiflexion Planterflexion:- 25° dorsi to 15° dorsiflexion

MUSCLE Tibialis anterior (Power generation) Solius (Power generation) Gastrocnemius (Power generation)

Sagittal analysis of stair ascent.End of pull up forward continuation JOINT

Hip joint MOTION

Extends from 30° flexion to 5° flexion Flex from 5° flexion to 20° flexion

(Power Absorption)

MUSCLE G-MAX (Power generation) G-MED (Power generation) Hams (Power generation)

Sagittal analysis of stairascent.End of pull up forward continuation

JOINT Knee joint

MOTION Extends 35° flexion – 10° flexion (PG Flexion 10° flexion – 35° flexion (PA)

MUSCLE VL (Power generation) RF (Power generation)See – Joint structure & function,a comprehensive analysis


Sagital analysis of stair ascent.End of pull up forward continuation

JOINT Ankle joint

MOTION Planterflexion:- 15° dorsi to 10°

planterflexion MUSCLE

Tibialis anterior (Power absorption) Solius (Power generation) Gastrocnemius (Power generation)See – Joint structure & function,a comprehensive analysis


Stair ascent.(Sagital) Swing phaseFoot clearance to foot placement

JOINT Hip joint

MOTION Flexion 20° to 60° flexion then Extend 60° Flexion to 50° flexion

MUSCLE G medius (Power generation)Source– Joint structure & function,a comprehensive analysis



JOINT Knee joint

MOTION Flexion 10° flexion to 100° flexion (PG Extends 100° flexion – 85° flexion (PG)

MUSCLE VL (Power generation) Hams (Power generationSource – Joint structure & function,a comprehensive analysis



JOINT Ankle joint

MOTION Dorsiflexion 10° planterflexion to 20°

dorsi MUSCLE

Tibialis anterior (Power absorption)Source – Joint structure & function,a comprehensive analysis


Running gait KinematicsGait cycle phase

Toe off Heel strike

Stance phase Swing phase

Heel strike

Running gait KinematicsAverage peak ROM comparision running and walking

Runningwalking

Hip jointFlexion- 55-65 30Extension- 10-20 0-20

KneeFlexion 80-130 40-50Extension 0-5 0

AnkleDorsi flexion 10-30 10Planter flexion 20-30 20

Source – Joint structure & function,a comprehensive analysis


Where to get more……

Web/Internetwww.curtin,edu.au/curtin/depat/physiwww.kinesiology.newww.apta.orgwww.arialdynamics.comwww.medicalstudent.comwww.oandp.org/jpo/library

Books1- Physical Rehabilitation,3rd edition/SusanB sullivan2- Joint StructureFunction,4thedition/Levangie,C. Norkins3- Dynamics of human Gait,2nd edition , Christopher & Brian

JuornalsPhysical TherapyClinical AnatomyJuornal of orthopaedic surgeryJuornal of physical therapy science

……..?

Thank you !

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