Tuesday, 29 October 2013

NORMAL GAIT & BIOMECHANICS

NORMAL GAIT

       It is the series of rhythmical, alternating movements of limb and trunk, which results in the forward progression of the center of gravity.

       The gait cycle is the period of time between any two identical events in the walking cycle  e.g.: Time from heel strike to the next ipsilateral heel strike.  The gait cycle is divided into two periods

       Stance Phase
o   It is the phase of gait cycle in which the foot is in contact with the ground and is bearing the body weight.
o   It is 60% of the total gait cycle.
       Swing Phase
o   it is the phase of gait cycle in which the foot is not in contact with the ground and is not bearing the body weight.
o   It is 40% of the total gait cycle.

       Step length
o   It is the linear distance in the plane of progression between corresponding successive contact points of opposite feet.
       Stride length
o   It is the linear distance between the corresponding successive points of heel contact of the same foot.
       Single support
o   It refers to the period when only one foot is in contact with floor.
       Double support (20% of gait cycle)
o   It occurs when both feet are in contact with floor.
o   The absence of period of double support distinguishes running from walking.
       Cadence
o   It is the number of steps taken per minute. It may vary from 70 in slow walking to 130 in fast walking,
o   Adult male covers 2.50 miles or 4 km in one hour.

 Sub divisions of stance phase

       Heel contact
o   The instant when the heel of the reference limb touches the floor.
       Ball contact
o   When the bases of the metatarsals of the reference limb’s foot touches the floor
       Foot flat
o   The initial contact of the forefoot with the floor.
       Mid stance
o   When the greater trochanter is in vertical alignment with the vertical bisector of foot.
       Heel off
o   When the heel of the reference foot leaves the floor.
       Toe off
o   When the toe of the reference foot leaves the floor.
OR
It can be divided into

       Weight acceptance phase
o   begins at heel contact and ends with foot flat position.
       Mid stance
o   Begins with foot flat and ends with heel off.
       Push off
o   Extends from heel off to toe off.

       Sub divisions of swing phase:
It can be divided in to:
       Acceleration:
It is characterized by the rapid acceleration of the lower end of the limb shortly after the toe off.
       Mid swing:
It is the interval when the swinging limb over takes and moves ahead of the limb in stance face (contra lateral limb).
       Deceleration:
It is the interval when the swinging limb approaches the end of interval and slows down for heel contact.

 Path of center of gravity:
         The laws of mechanics make it clear that the least amount of energy is required when a body moves along straight lines, with center of gravity neither deviating neither up and down or side ways. Which is not possible in human beings?  So the body’s center of gravity deviates from straight line but for the sake of energy conservation, deviation should be kept to an optimal level. This is done by the muscles and ligaments of the body.

 Vertical displacement:
          In the normal walking pattern the center of gravity goes trough a rhythmical ups and downs as it moves forward but it is extremely smooth with no abrupt change in direction. The highest point is in the mid stance and the lowest point is in double support. The average amount of vertical displacement is 5cm or 2 inches.

Lateral displacement:
          As weight is transfers from one limb to the other one the pelvis also shifts to the weight bearing side and with it COG also shifts. The total amount of sideway movement of pelvis is 5cm or 2 inches. The limit is achieved in the mid stance and the path followed by the COG is extremely smooth.

Gait characteristics that influence the path of COG:
The characteristics that influence the path of COG are:
       Flexion on knee during stance
Just after the heel contact, flexion of knee begins and continues until it reaches 20*. This characteristic of normal gait helps to smoothen the path of COG and limits it’s up and down osilation to an optimal level
       Pelvic depth
In normal walking the pelvis drops on the swing side, i.e: stance hip adducts slightly. The amount of displacement of the pelvis from the horizontal is controlled with in 5* by the abductors of the hip of the contralateral side. In standing this dip found is the positive trendelenberg sign, in walking it is normal and serves to reduce the upward displacement of COG.
       Pelvic rotation
In addition to the dipping the pelvic rotates forward in the horizontal plane. This rotation is 4* on each side of the COG. This helps to reduce the vertical displacement of COG.
       Width of the walking base
In figure WB is the width of the walking base that falls within the range of 5-10cm or 2-4 inches. As the pelvic shifts towards the supporting side to maintain the stability so the normal narrow walking base minimizes the lateral shifting of the COG.

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