Muscle Activity During Gait: Difference between revisions

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'''Original Editor '''- [[User:User Name|User Name]]
'''Original Editor '''- [[User:Wanda van Niekerk|Wanda van Niekerk]] based on the course by [https://members.physio-pedia.com/instructor/alexandra-kopelovich/ Alexandra Kopelovich]<br> '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}  &nbsp;   
 
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== Gait Kinetics and Joint Moment ==
== Gait Kinetics and Joint Moment ==
Gait kinetics investigates the forces and moments involved during the gait cycle. This includes the study of ground reaction forces (GRF), joint torque, plantar pressure distribution and muscle activity.<ref>Liu X, Zhao C, Zheng B, Guo Q, Duan X, Wulamu A, Zhang D. Wearable devices for gait analysis in intelligent healthcare. Frontiers in Computer Science. 2021 May 13;3:661676.</ref> The body should be in equilibrium during gait, therefore the external ground reaction forces (GRF) (external moment) should be balanced by the internal muscle forces (internal moment).<ref name=":0">Hazari A, Maiya AG, Nagda TV. Kinematics and Kinetics of Gait. InConceptual Biomechanics and Kinesiology 2021 (pp. 181-196). Springer, Singapore.</ref> Different muscles perform different actions at every phase to create an internal moment against the external joint moment. Ground reaction force vectors create the direction of moment and the muscle will act in the opposite direction. If the ground reaction force falls anterior to the axis of the joint, the proximal segment of the joint will move anteriorly and if the ground reaction force falls posterior to the axis of the joint, the proximal segment of the joint with move posteriorly. Muscles can contract concentrically or eccentrically to overcome the external moment. During a concentric muscle contraction, the muscle shortens and there is movement at the joint, whereas during an eccentric contraction the muscle lengthens while producing force.   
[[Gait]] kinetics investigates the forces and moments of the gait cycle. This includes the study of ground reaction forces (GRF), joint torque, plantar pressure distribution and [[muscle]] activity.<ref>Liu X, Zhao C, Zheng B, Guo Q, Duan X, Wulamu A, Zhang D. Wearable devices for gait analysis in intelligent healthcare. Frontiers in Computer Science. 2021 May 13;3:661676.</ref> The body should be in equilibrium during gait, therefore, the external ground reaction forces (GRF) (external moment) should be balanced by the internal muscle forces (internal moment).<ref name=":0">Hazari A, Maiya AG, Nagda TV. Kinematics and Kinetics of Gait. InConceptual Biomechanics and Kinesiology 2021 (pp. 181-196). Springer, Singapore.</ref> Different muscles perform different actions at every phase to create an internal moment against the external joint moment. Ground reaction force vectors create the direction of moment and the muscle will act in the opposite direction. If the ground reaction force falls anterior to the axis of the joint, the proximal segment of the joint will move anteriorly; if the ground reaction force falls posterior to the axis of the joint, the proximal segment of the joint with move posteriorly. Muscles can contract concentrically or eccentrically to overcome the external moment. During a concentric muscle contraction, the muscle shortens and there is movement at the joint, whereas during an eccentric contraction the muscle lengthens while producing force.   


Read more:   
Read more:   
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=== Stance Phase ===
=== Stance Phase ===
'''Initial Contact (or Heel Strike) - 0%'''   
'''Initial Contact (or Heel Strike)'''   


The moment the foot touches the ground and begins the first phase of double support. Its function is to establish contact with the ground surface and initiate weight acceptance.<ref name=":1">Magee DJ, Manske RC. Orthopedic physical assessment-E-Book. Elsevier Health Sciences; 2020 Dec 11.</ref>   
The moment the foot touches the ground and begins the first phase of double support. Its function is to establish contact with the ground surface and initiate weight acceptance.<ref name=":1">Magee DJ, Manske RC. Orthopedic physical assessment-E-Book. Elsevier Health Sciences; 2020 Dec 11.</ref>
 
'''''Sagittal Plane:'''''  
{| class="wikitable"
{| class="wikitable"
|+Kinematics and Kinetics at Initial Contact<ref name=":2">Webster JB, Darter BJ. Principles of normal and pathologic gait. InAtlas of Orthoses and Assistive Devices 2019 Jan 1 (pp. 49-62). Elsevier.</ref>
|+Kinematics and Kinetics at Initial Contact<ref name=":2">Webster JB, Darter BJ. Principles of normal and pathologic gait. InAtlas of Orthoses and Assistive Devices 2019 Jan 1 (pp. 49-62). Elsevier.</ref>
Line 25: Line 25:
! colspan="2" |Kinetics
! colspan="2" |Kinetics
|-
|-
|Ankle
|
|
|External forces
|
|Internal forces/ Muscle Action
|'''External Forces'''
|'''Internal Forces/ Muscle Action'''
|-
|-
|
|[[Ankle and Foot|Ankle]]
|Ankle moves from 0° neutral at initial contact to 5° of plantarflexion at foot flat
|Ankle moves from 0° neutral at initial contact to 5° of plantarflexion at foot flat
|GRF posterior to axis of ankle joint
|GRF posterior to axis of rotation of the ankle joint


External plantar flexor moment created
External plantar flexor moment created


|Internal dorsiflexor moment
|Internal dorsiflexor moment
Eccentric contraction of dorsiflexors (tibialis anterior, extensor digitorum longus, extensor hallucis longus)
Eccentric contraction of dorsiflexors ([[Tibialis Anterior|tibialis anterior]], [[Extensor Digitorum Longus|extensor digitorum longus]], [[Extensor Hallucis Longus|extensor hallucis longus]])
|-
|-
|Knee
|[[Knee]]
|Knee moves from 0° extension at initial contact to 15° flexion at foot flat
|Knee moves from 0° extension at initial contact to 15° flexion at foot flat
|GRF anterior to axis of knee joint
|GRF anterior to axis of rotation of the knee joint


External extensor moment created
External extensor moment created


|Internal flexor moment
|Internal flexor moment
Concentric contraction of knee flexors (hamstrings)
Concentric contraction of knee flexors ([[hamstrings]])


Eccentric contraction of knee extensors (quadriceps)  
Eccentric contraction of knee extensors ([[Quadriceps Muscle|quadriceps]])  


range of motion change in knee 0° - 15°, results in the shifting of GRF from anterior to posterior - this will result in external flexor torque and knee extensors will work eccentrically to control the knee  
The range of motion change in the knee joint (0° - 15°), results in the shifting of GRF from anterior to posterior - this will result in external flexor torque, and the knee extensors will work eccentrically to control the knee  
|-
|-
|Hip
|[[Hip]]
|Hip moves from 20° flexion at initial contact to to 15° of flexion at foot flat
|Hip moves from 20° flexion at initial contact to 15° of flexion at foot flat
|GRF anterior to axis rotation of hip joint
|GRF anterior to axis of rotation of the hip joint


External flexor moment created
External flexor moment created


|Internal extensor moment
|Internal extensor moment
Concentric contraction of hip extensors (gluteus maximus)
Concentric contraction of hip extensors ([[Gluteus Maximus|gluteus maximus]])
|}
|}
'''Foot Flat (Loading Response) - 0-10%'''
'''''Frontal Plane:'''''
{| class="wikitable"
|+Muscle Activity and Motion in the Frontal Plane from Initial Contact to Foot Flat<ref name=":4">Levangie, Pamela K., and Cynthia C Norkin. Joint Structure and Function: A Comprehensive Analysis. 4th ed. Philadelphia, PA: F.A. Davis Co, 2005.</ref>
!Joint
!Motion
!Muscle Activity
|-
|Pelvis
|Forward rotation on right side of pelvis at initial contact
Left side of pelvis begins to move forward


Begins with initial contact and continues until the contralateral foot leaves the ground. The foot continues to accept weight and absorb shock by rolling into pronation.<ref name=":1" />  
<nowiki>*</nowiki>Reference limb is the right lower extremity
|
|-
|Hip
|Medial rotation of the femur on pelvis
|
|-
|Knee
|Valgus thrust
Medial rotation of tibia
|[[Gracilis]], [[Vastus medialis obliquus|vastus medialis]], [[semitendinosus]]
[[Biceps Femoris|Long head of biceps femoris]] to control medial rotation of tibia
|-
|Ankle
|Valgus thrust with increasing pronation
Subtalar joint pronation - maximum at end of loading response
 
Transverse tarsal pronation
|Eccentric contraction of [[Tibialis Posterior|tibialis posterior]] to control valgus thrust on foot
|}
'''Foot Flat (Loading Response)'''
 
Begins with initial contact and continues until the contralateral foot leaves the ground. The foot continues to accept weight and absorb shock by rolling into pronation.<ref name=":1" />
 
'''''Sagittal Plane:'''''
{| class="wikitable"
{| class="wikitable"
|+
|+
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|
|
|
|
|External forces
|'''External Forces'''
|Internal forces/Muscle Action
|'''Internal Forces/Muscle Action'''
|-
|-
|Ankle
|Ankle
Line 84: Line 117:
Concentric contraction of dorsiflexors
Concentric contraction of dorsiflexors


Eccentric contraction of plantar flexors (gastrocnemius, soleus)
Eccentric contraction of plantarflexors ([[gastrocnemius]], [[soleus]])


Range of motion change in ankle 5° plantarflexion to 5° dorsiflexion, results in the shifting of GRF from posterior to anterior thus posterior musculature (plantarflexors) are used eccentrically to control dorsiflexion
The range of motion change in the ankle from 5° plantarflexion to 5° dorsiflexion results in the shifting of GRF from posterior to anterior, thus the posterior musculature (plantarflexors) is used eccentrically to control dorsiflexion.


|-
|-
|Knee
|Knee
|Knee moves from 15° flexion at foot flat to 5° flexion at midstance
|Knee moves from 15° flexion at foot flat to 5° flexion at midstance
|GRF posterior to axis of rotation of knee joint
|GRF posterior to axis of rotation of the knee joint


External flexor moment created
External flexor moment created
Line 100: Line 133:
|Hip
|Hip
|Hip moves from 15° flexion at foot flat to 0° at midstance
|Hip moves from 15° flexion at foot flat to 0° at midstance
|GRF anterior to axis of rotation of hip joint
|GRF anterior to axis of rotation of the hip joint
External flexor moment created
External flexor moment created


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|}
|}


'''Midstance - 10-30%'''
'''''Frontal Plane:'''''
{| class="wikitable"
|+Muscle Activity and Motion in the Frontal Plane from Foot flat to Midstance<ref name=":4" />
!Joint
!Motion
!Muscle Activity
|-
|Pelvis
|Right side rotates backward to reach neutral at midstance
Lateral tilt towards swinging extremity
 
<nowiki>*</nowiki>Reference limb is right lower extremity
|Hip abductors active to prevent excessive lateral tilt (gluteus medius and tensor fascia latae)
|-
|Hip
|Medial rotation of the femur on the pelvis continues to a neutral position at midstance.
Adduction moment continues throughout single limb support
|Minimal or no activity
|-
|Knee
|Reduction in valgus thrust and tibia begins to rotate laterally
|Minimal or no activity
|-
|Ankle
|Foot begins to move into supination direction from pronation at end of loading response
Foot neutral position at midstance
|Tibialis posterior helps to produce supination
|}
'''Midstance'''
 
Begins when the contralateral foot leaves the ground and continues until the ipsilateral heel lifts off the ground. The body is supported by a single leg and begins to move from force absorption at impact to force propulsion forward.<ref name=":1" />


Begins when the contralateral foot leaves the ground and continues until ipsilateral heel lifts off the ground. The body is supported by a single leg and begins to move from force absorption at impact to force propulsion forward.<ref name=":1" />
'''''Sagittal Plane:'''''
{| class="wikitable"
{| class="wikitable"
|+Kinematics and Kinetics at Midstance<ref name=":2" />
|+Kinematics and Kinetics at Midstance<ref name=":2" />
Line 118: Line 181:
|
|
|
|
|External forces
|'''External Forces'''
|Internal forces/Muscle Actions
|'''Internal forces/Muscle Actions'''
|-
|-
|Ankle
|Ankle
|Ankle moves from 5° dorsiflexion at midstance to 0° of dorsiflexion at heel off
|Ankle moves from 5° dorsiflexion at midstance to 0° of dorsiflexion at heel off
|GRF anterior to axis of rotation of ankle
|GRF anterior to axis of rotation of the ankle
External dorsiflexor moment
External dorsiflexor moment
 
|Internal plantarflexor moment
Ankle moves from 5° dorsiflexion at midstance to 0° of dorsiflexion at heel off
|Internal plantar flexor moment
Concentric contraction of plantarflexors
Concentric contraction of plantarflexors
|-
|-
|Knee
|Knee
|Knee moves from 5° flexion at midstance to 0° flexion at heel off
|Knee moves from 5° flexion at midstance to 0° flexion at heel off
|GRF anterior to axis of rotation of knee joint
|GRF anterior to axis of rotation of the knee joint
External extensor moment
External extensor moment
Knee moves from 5° flexion at midstance to 0° flexion at heel off
|Internal flexor moment
|Internal flexor moment
Eccentric contraction of knee flexors
Eccentric contraction of knee flexors
|-
|-
|Hip
|Hip
|Hip moves from 0° flexion at midstance to 10° - 20° of extension at foot flat
|Hip moves from 0° flexion at midstance to 10° - 20° of extension at heel off
|GRF posterior to axis of rotation
|GRF posterior to axis of rotation of the hip joint
External extensor moment
External extensor moment


|Internal flexor moment
|Internal flexor moment
Eccentric contraction of hip flexors
 
Eccentric contraction of hip flexors ([[iliopsoas]])
|}
'''''Frontal Plane:'''''
{| class="wikitable"
|+Muscle Activity and Motion in the Frontal Plane from Midstance to Heel Off<ref name=":4" />
!Joint
!Motion
!Muscle Activity
|-
|Pelvis
|Right side moves posteriorly from neutral
<nowiki>*</nowiki>Reference limb is the right lower extremity
|Minimal or no muscle activity
|-
|Hip
|Lateral rotation of femur and adduction
|Inconsistent hip adductor activity
|-
|Knee
|Lateral rotation of tibia
|No activity
|-
|Ankle
|Increased supination of subtalar joint
|Concentric plantarflexor activity
|}
|}
'''Heel Off (or Terminal Stance) - 30-50%'''
'''Heel Off (or Terminal Stance)'''


Begins when the heel leaves the floor and continues until the contralateral foot contacts the ground. In addition to single limb support and stability, this event serves to propel the body forward. Bodyweight is divided over the metatarsal heads.<ref name=":1" />
Begins when the heel leaves the floor and continues until the contralateral foot contacts the ground. In addition to single limb support and stability, this event serves to propel the body forward. Bodyweight is divided over the metatarsal heads.<ref name=":1" />
'''''Sagittal Plane:'''''
{| class="wikitable"
{| class="wikitable"
|+Kinematics and Kinetics at Heel Off<ref name=":2" />
|+Kinematics and Kinetics at Heel Off<ref name=":2" />
Line 158: Line 244:
|
|
|
|
|External forces
|'''External Forces'''
|Internal forces/Muscle action
|'''Internal Forces/Muscle Actions'''
|-
|-
|Ankle
|Ankle
|Ankle moves from 0° at heel off to 20° plantarflexion at toe off
|Ankle moves from 0° at heel off to 20° plantarflexion at toe off
|GRF anterior to axis of rotation of ankle
|GRF anterior to the axis of rotation of the ankle
External dorsiflexor moment
External dorsiflexor moment


Line 171: Line 257:
|Knee
|Knee
|Knee moves from 0° at heel off to 30° flexion at toe off
|Knee moves from 0° at heel off to 30° flexion at toe off
|GRF anterior to axis of rotation of knee
|GRF anterior to the axis of rotation of the knee
External extensor moment
External extensor moment


Line 179: Line 265:
|Hip
|Hip
|Hip moves from 10° extension at heel off to 20° extension at toe off
|Hip moves from 10° extension at heel off to 20° extension at toe off
|GRF posterior to axis of rotation of hip
|GRF posterior to the axis of rotation of the hip joint
External extensor moment
External extensor moment


Line 185: Line 271:
Eccentric contraction of hip flexors
Eccentric contraction of hip flexors
|}
|}
'''Toe Off (or Preswing) - 50-60%'''
'''''Frontal Plane:'''''
{| class="wikitable"
|+Muscle Activity and Motion in the Frontal Plane from Heel Off to Toe Off(End of Preswing)<ref name=":4" />
!Joint
!Motion
!Muscle Activity
|-
|Pelvis
|Left side moving forward until left heel contact (right toe off)
Lateral tilting to swing side ceases as contralateral limb begins stance phase and start of double support period
 
<nowiki>*</nowiki>Reference limb is the right lower extremity
|Eccentric control by adductors
|-
|Hip
|Abduction as weight is shifted onto opposite extremity.
Lateral rotation of femur
|
|-
|Knee
|Lateral rotation tibia ( inconsistent motion)
|
|-
|Ankle
|Weight is shifted to toes.
Supination of subtalar joint
|Plantarflexors
|}
'''Toe Off (or Preswing)'''  


Begins when the contralateral foot contacts the ground and continues until the ipsilateral foot leaves the ground. Provides the final burst of propulsion as the toes leave the ground.<ref name=":1" />
Begins when the contralateral foot contacts the ground and continues until the ipsilateral foot leaves the ground. Provides the final burst of propulsion as the toes leave the ground.<ref name=":1" />
'''''Sagittal Plane:'''''
{| class="wikitable"
{| class="wikitable"
|+Kinematics and Kinetics at Toe Off<ref name=":2" />
|+Kinematics and Kinetics at Toe Off<ref name=":2" />
Line 196: Line 312:
|
|
|
|
|External Forces
|'''External Forces'''
|Internal Forces/Muscle Action
|'''Internal Forces/Muscle Actions'''
|-
|-
|Ankle
|Ankle
|Ankle moves from 20° plantarflexion at toe off to 10° plantar flexion at early swing
|Ankle moves from 20° plantarflexion at toe off to 10° plantar flexion at early swing
|GRF anterior to axis of rotation of ankle
|GRF anterior to the axis of rotation of the ankle joint
External dorsiflexor moment
External dorsiflexor moment


Line 211: Line 327:
|Knee
|Knee
|Knee moves from 30° flexion at toe off to 60° flexion at early swing
|Knee moves from 30° flexion at toe off to 60° flexion at early swing
|GRF posterior to axis of rotation of knee
|GRF posterior to the axis of rotation of the knee joint
External flexor moment
External flexor moment


Line 221: Line 337:
|Hip
|Hip
|Hip moves from 10° - 20° extension at toe off to 20° flexion at early swing
|Hip moves from 10° - 20° extension at toe off to 20° flexion at early swing
|GRF posterior to axis of rotation of hip
|GRF posterior to the axis of rotation of the hip joint
External extensor moment
External extensor moment


Line 231: Line 347:
Ground reaction forces are not applicable to the swing phase as there is no contact with the ground. However, the muscles still contract concentrically or eccentrically as needed.<ref name=":0" />
Ground reaction forces are not applicable to the swing phase as there is no contact with the ground. However, the muscles still contract concentrically or eccentrically as needed.<ref name=":0" />


'''Early Swing - 60-75%'''
'''Early Swing'''  


Begins when the foot leaves the ground until it is aligned with the contralateral ankle. This event functions to advance the limb and shorten the limb for foot clearance.<ref name=":1" />
Begins when the foot leaves the ground until it is aligned with the contralateral ankle. This event functions to advance the limb and shorten the limb for foot clearance.<ref name=":1" />
'''''Sagittal Plane:'''''
{| class="wikitable"
{| class="wikitable"
|+Muscle Actions at Early Swing<ref name=":3">Richie DH. Human Walking: The Gait Cycle. In Pathomechanics of Common Foot Disorders. Springer; 2021.</ref>
|+Muscle Actions at Early Swing<ref name=":3">Richie DH. Human Walking: The Gait Cycle. In Pathomechanics of Common Foot Disorders. Springer; 2021.</ref>
!
!
!Kinematics/Joint motion
!Kinematics/Joint Motion
!Muscle Action
!Muscle Action
|-
|-
Line 245: Line 363:
|-
|-
|Knee
|Knee
|Knee moves from 30° flexion at toe off to 60° flexion at early swing
|Knee moves from 30° flexion at toe off to 60° flexion at early swing
|Eccentric contraction of knee extensors and concentric contraction of knee flexors  
|Eccentric contraction of knee extensors and concentric contraction of knee flexors  
|-
|-
Line 252: Line 370:
|Concentric contraction of hip flexors
|Concentric contraction of hip flexors
|}
|}
'''Mid-Swing - 75-85%'''
'''''Frontal Plane:'''''
{| class="wikitable"
|+Muscle Activity and Motion in the Frontal Plane from Initial Swing through Midswing<ref name=":4" />
!Joint
!Motion
!Muscle Activity
|-
|Pelvis
|Lateral pelvic tilt to the right
Right side moving forward
 
<nowiki>*</nowiki>Reference limb is the right lower extremity
|Left gluteus medius
|-
|Hip
|Rotation from lateral to medial rotation
|
|-
|Knee
|From lateral to medial rotation
|
|-
|Ankle
|Subtalar joint (no weight) returns to slight supination
|
|}
'''Mid-Swing'''


Begins from the ankle and foot alignment and continues until the swing leg tibia is vertical. As in early swing, it functions to advance the limb and shorten the limb for foot clearance.<ref name=":1" />
Begins from the ankle and foot alignment and continues until the tibia of the swing leg is vertical. As in early swing, it functions to advance the limb and shorten the limb for foot clearance.<ref name=":1" />
 
'''''Sagittal Plane:'''''
{| class="wikitable"
{| class="wikitable"
|+Muscle Action at Mid-Swing<ref name=":3" />
|+Muscle Action at Mid-Swing<ref name=":3" />
!
!
!Kinematics/Joint motion
!Kinematics/Joint Motion
!Muscle Action
!Muscle Action
|-
|-
|Ankle
|Ankle
|Ankle moves from 10° of plantarflexion at early swing to 0° of plantarflexion at mid swing
|Ankle moves from 10° of plantarflexion at early swing to 0° of plantarflexion at mid-swing
|Concentric contraction of dorsiflexors
|Concentric contraction of dorsiflexors
|-
|-
|Knee
|Knee
|Knee moves from 60° flexion at early swing to 30° flexion at mid swing
|Knee moves from 60° flexion at early swing to 30° flexion at mid-swing
|Eccentric contraction of knee flexors
|Eccentric contraction of knee flexors
|-
|-
|Hip
|Hip
|Hip moves from 20° flexion at early swing to 30° flexion at mid swing
|Hip moves from 20° flexion at early swing to 30° flexion at mid-swing
|Concentric contraction of hip flexors
|Concentric contraction of hip flexors
|}
|}
'''Late Swing/Deceleration - 85-100%'''
'''''Frontal Plane:'''''
{| class="wikitable"
|+Muscle Activity and Motion in the Frontal Plane from Mid -Swing through Late Swing (Deceleration)<ref name=":4" />
!Joint
!Motion
!Muscle Activity
|-
|Pelvis
|Right side moving anteriorly
<nowiki>*</nowiki>Reference limb is right lower extremity
| rowspan="2" |Right gluteus medius
|-
|Hip
|Lateral tilting to the left medial rotation
|-
|Knee
|Medial rotation
|
|}
'''Late Swing/Deceleration'''


Begins when the swing leg tibia is vertical and ends with initial contact. Limb advancement slows in preparation.<ref name=":1" />
Begins when the swing leg tibia is vertical and ends with initial contact. Limb advancement slows in preparation.<ref name=":1" />
Line 279: Line 444:
|+Muscle Action at Late Swing<ref name=":3" />
|+Muscle Action at Late Swing<ref name=":3" />
!
!
!Kinematics/Joint motion
!Kinematics/Joint Motion
!Muscle Action
!Muscle Action
|-
|-
Line 287: Line 452:
|-
|-
|Knee
|Knee
|Knee moves from 3o° flexion at mid swing to o° flexion at late swing
|Knee moves from 3o° flexion at mid-swing to o° flexion at late swing
|Eccentric contraction of knee flexors, then concentric contraction of knee flexors
|Eccentric contraction of knee flexors, then concentric contraction of knee flexors
|-
|-
|Hip
|Hip
|Hip moves from 20°-30° flexion at mid swing to 30° flexion at late swing
|Hip moves from 20°-30° flexion at mid-swing to 30° flexion at late swing
|Concentric contraction of hip flexors
|Concentric contraction of hip flexors
|}
|}

Latest revision as of 10:16, 8 May 2024

Original Editor - Wanda van Niekerk based on the course by Alexandra Kopelovich
Top Contributors - Wanda van Niekerk, Jess Bell and Lucinda hampton  

Gait Kinetics and Joint Moment[edit | edit source]

Gait kinetics investigates the forces and moments of the gait cycle. This includes the study of ground reaction forces (GRF), joint torque, plantar pressure distribution and muscle activity.[1] The body should be in equilibrium during gait, therefore, the external ground reaction forces (GRF) (external moment) should be balanced by the internal muscle forces (internal moment).[2] Different muscles perform different actions at every phase to create an internal moment against the external joint moment. Ground reaction force vectors create the direction of moment and the muscle will act in the opposite direction. If the ground reaction force falls anterior to the axis of the joint, the proximal segment of the joint will move anteriorly; if the ground reaction force falls posterior to the axis of the joint, the proximal segment of the joint with move posteriorly. Muscles can contract concentrically or eccentrically to overcome the external moment. During a concentric muscle contraction, the muscle shortens and there is movement at the joint, whereas during an eccentric contraction the muscle lengthens while producing force.

Read more:

Breakdown of Kinematics and Kinetics During the Gait Cycle[edit | edit source]

Stance Phase[edit | edit source]

Initial Contact (or Heel Strike)

The moment the foot touches the ground and begins the first phase of double support. Its function is to establish contact with the ground surface and initiate weight acceptance.[3]

Sagittal Plane:

Kinematics and Kinetics at Initial Contact[4]
Joint Kinematics Kinetics
External Forces Internal Forces/ Muscle Action
Ankle Ankle moves from 0° neutral at initial contact to 5° of plantarflexion at foot flat GRF posterior to axis of rotation of the ankle joint

External plantar flexor moment created

Internal dorsiflexor moment

Eccentric contraction of dorsiflexors (tibialis anterior, extensor digitorum longus, extensor hallucis longus)

Knee Knee moves from 0° extension at initial contact to 15° flexion at foot flat GRF anterior to axis of rotation of the knee joint

External extensor moment created

Internal flexor moment

Concentric contraction of knee flexors (hamstrings)

Eccentric contraction of knee extensors (quadriceps)

The range of motion change in the knee joint (0° - 15°), results in the shifting of GRF from anterior to posterior - this will result in external flexor torque, and the knee extensors will work eccentrically to control the knee

Hip Hip moves from 20° flexion at initial contact to 15° of flexion at foot flat GRF anterior to axis of rotation of the hip joint

External flexor moment created

Internal extensor moment

Concentric contraction of hip extensors (gluteus maximus)

Frontal Plane:

Muscle Activity and Motion in the Frontal Plane from Initial Contact to Foot Flat[5]
Joint Motion Muscle Activity
Pelvis Forward rotation on right side of pelvis at initial contact

Left side of pelvis begins to move forward

*Reference limb is the right lower extremity

Hip Medial rotation of the femur on pelvis
Knee Valgus thrust

Medial rotation of tibia

Gracilis, vastus medialis, semitendinosus

Long head of biceps femoris to control medial rotation of tibia

Ankle Valgus thrust with increasing pronation

Subtalar joint pronation - maximum at end of loading response

Transverse tarsal pronation

Eccentric contraction of tibialis posterior to control valgus thrust on foot

Foot Flat (Loading Response)

Begins with initial contact and continues until the contralateral foot leaves the ground. The foot continues to accept weight and absorb shock by rolling into pronation.[3]

Sagittal Plane:

Kinematics and Kinetics at Foot Flat[4]
Joint Kinematics Kinetics
External Forces Internal Forces/Muscle Action
Ankle Ankle moves from 5° of plantarflexion during foot flat to 5° of dorsiflexion at midstance GRF posterior to axis of rotation of ankle joint

External plantar flexor moment created

Internal dorsiflexor moment

Concentric contraction of dorsiflexors

Eccentric contraction of plantarflexors (gastrocnemius, soleus)

The range of motion change in the ankle from 5° plantarflexion to 5° dorsiflexion results in the shifting of GRF from posterior to anterior, thus the posterior musculature (plantarflexors) is used eccentrically to control dorsiflexion.

Knee Knee moves from 15° flexion at foot flat to 5° flexion at midstance GRF posterior to axis of rotation of the knee joint

External flexor moment created

Internal extensor moment

Concentric contraction of knee extensors

Hip Hip moves from 15° flexion at foot flat to 0° at midstance GRF anterior to axis of rotation of the hip joint

External flexor moment created

Internal extensor moment

Concentric contraction of hip extensors

Frontal Plane:

Muscle Activity and Motion in the Frontal Plane from Foot flat to Midstance[5]
Joint Motion Muscle Activity
Pelvis Right side rotates backward to reach neutral at midstance

Lateral tilt towards swinging extremity

*Reference limb is right lower extremity

Hip abductors active to prevent excessive lateral tilt (gluteus medius and tensor fascia latae)
Hip Medial rotation of the femur on the pelvis continues to a neutral position at midstance.

Adduction moment continues throughout single limb support

Minimal or no activity
Knee Reduction in valgus thrust and tibia begins to rotate laterally Minimal or no activity
Ankle Foot begins to move into supination direction from pronation at end of loading response

Foot neutral position at midstance

Tibialis posterior helps to produce supination

Midstance

Begins when the contralateral foot leaves the ground and continues until the ipsilateral heel lifts off the ground. The body is supported by a single leg and begins to move from force absorption at impact to force propulsion forward.[3]

Sagittal Plane:

Kinematics and Kinetics at Midstance[4]
Joint Kinematics Kinetics
External Forces Internal forces/Muscle Actions
Ankle Ankle moves from 5° dorsiflexion at midstance to 0° of dorsiflexion at heel off GRF anterior to axis of rotation of the ankle

External dorsiflexor moment

Internal plantarflexor moment

Concentric contraction of plantarflexors

Knee Knee moves from 5° flexion at midstance to 0° flexion at heel off GRF anterior to axis of rotation of the knee joint

External extensor moment

Internal flexor moment

Eccentric contraction of knee flexors

Hip Hip moves from 0° flexion at midstance to 10° - 20° of extension at heel off GRF posterior to axis of rotation of the hip joint

External extensor moment

Internal flexor moment

Eccentric contraction of hip flexors (iliopsoas)

Frontal Plane:

Muscle Activity and Motion in the Frontal Plane from Midstance to Heel Off[5]
Joint Motion Muscle Activity
Pelvis Right side moves posteriorly from neutral

*Reference limb is the right lower extremity

Minimal or no muscle activity
Hip Lateral rotation of femur and adduction Inconsistent hip adductor activity
Knee Lateral rotation of tibia No activity
Ankle Increased supination of subtalar joint Concentric plantarflexor activity

Heel Off (or Terminal Stance)

Begins when the heel leaves the floor and continues until the contralateral foot contacts the ground. In addition to single limb support and stability, this event serves to propel the body forward. Bodyweight is divided over the metatarsal heads.[3]

Sagittal Plane:

Kinematics and Kinetics at Heel Off[4]
Joint Kinematics Kinetics
External Forces Internal Forces/Muscle Actions
Ankle Ankle moves from 0° at heel off to 20° plantarflexion at toe off GRF anterior to the axis of rotation of the ankle

External dorsiflexor moment

Internal plantarflexor moment

Concentric contraction of plantarflexors

Knee Knee moves from 0° at heel off to 30° flexion at toe off GRF anterior to the axis of rotation of the knee

External extensor moment

Internal flexor moment

Concentric contraction of knee flexors

Hip Hip moves from 10° extension at heel off to 20° extension at toe off GRF posterior to the axis of rotation of the hip joint

External extensor moment

Internal flexor moment

Eccentric contraction of hip flexors

Frontal Plane:

Muscle Activity and Motion in the Frontal Plane from Heel Off to Toe Off(End of Preswing)[5]
Joint Motion Muscle Activity
Pelvis Left side moving forward until left heel contact (right toe off)

Lateral tilting to swing side ceases as contralateral limb begins stance phase and start of double support period

*Reference limb is the right lower extremity

Eccentric control by adductors
Hip Abduction as weight is shifted onto opposite extremity.

Lateral rotation of femur

Knee Lateral rotation tibia ( inconsistent motion)
Ankle Weight is shifted to toes.

Supination of subtalar joint

Plantarflexors

Toe Off (or Preswing)

Begins when the contralateral foot contacts the ground and continues until the ipsilateral foot leaves the ground. Provides the final burst of propulsion as the toes leave the ground.[3]

Sagittal Plane:

Kinematics and Kinetics at Toe Off[4]
Joint Kinematics Kinetics
External Forces Internal Forces/Muscle Actions
Ankle Ankle moves from 20° plantarflexion at toe off to 10° plantar flexion at early swing GRF anterior to the axis of rotation of the ankle joint

External dorsiflexor moment

Internal plantarflexor moment

Eccentric contraction of plantarflexors

Concentric contraction of dorsiflexors to propel the foot up

Knee Knee moves from 30° flexion at toe off to 60° flexion at early swing GRF posterior to the axis of rotation of the knee joint

External flexor moment

Internal extensor moment

Eccentric contraction of knee extensors

Concentric contraction of knee flexors

Hip Hip moves from 10° - 20° extension at toe off to 20° flexion at early swing GRF posterior to the axis of rotation of the hip joint

External extensor moment

Internal flexor moment

Concentric contraction of hip flexors

Swing Phase[edit | edit source]

Ground reaction forces are not applicable to the swing phase as there is no contact with the ground. However, the muscles still contract concentrically or eccentrically as needed.[2]

Early Swing

Begins when the foot leaves the ground until it is aligned with the contralateral ankle. This event functions to advance the limb and shorten the limb for foot clearance.[3]

Sagittal Plane:

Muscle Actions at Early Swing[6]
Kinematics/Joint Motion Muscle Action
Ankle Ankle moves from 20° of plantarflexion at toe off to 10° of plantarflexion at early swing Concentric contraction of dorsiflexors
Knee Knee moves from 30° flexion at toe off to 60° flexion at early swing Eccentric contraction of knee extensors and concentric contraction of knee flexors
Hip Hip moves into flexion Concentric contraction of hip flexors

Frontal Plane:

Muscle Activity and Motion in the Frontal Plane from Initial Swing through Midswing[5]
Joint Motion Muscle Activity
Pelvis Lateral pelvic tilt to the right

Right side moving forward

*Reference limb is the right lower extremity

Left gluteus medius
Hip Rotation from lateral to medial rotation
Knee From lateral to medial rotation
Ankle Subtalar joint (no weight) returns to slight supination

Mid-Swing

Begins from the ankle and foot alignment and continues until the tibia of the swing leg is vertical. As in early swing, it functions to advance the limb and shorten the limb for foot clearance.[3]

Sagittal Plane:

Muscle Action at Mid-Swing[6]
Kinematics/Joint Motion Muscle Action
Ankle Ankle moves from 10° of plantarflexion at early swing to 0° of plantarflexion at mid-swing Concentric contraction of dorsiflexors
Knee Knee moves from 60° flexion at early swing to 30° flexion at mid-swing Eccentric contraction of knee flexors
Hip Hip moves from 20° flexion at early swing to 30° flexion at mid-swing Concentric contraction of hip flexors

Frontal Plane:

Muscle Activity and Motion in the Frontal Plane from Mid -Swing through Late Swing (Deceleration)[5]
Joint Motion Muscle Activity
Pelvis Right side moving anteriorly

*Reference limb is right lower extremity

Right gluteus medius
Hip Lateral tilting to the left medial rotation
Knee Medial rotation

Late Swing/Deceleration

Begins when the swing leg tibia is vertical and ends with initial contact. Limb advancement slows in preparation.[3]

Muscle Action at Late Swing[6]
Kinematics/Joint Motion Muscle Action
Ankle Maintains a neutral position Concentric and isometric contraction of dorsiflexors
Knee Knee moves from 3o° flexion at mid-swing to o° flexion at late swing Eccentric contraction of knee flexors, then concentric contraction of knee flexors
Hip Hip moves from 20°-30° flexion at mid-swing to 30° flexion at late swing Concentric contraction of hip flexors

References[edit | edit source]

  1. Liu X, Zhao C, Zheng B, Guo Q, Duan X, Wulamu A, Zhang D. Wearable devices for gait analysis in intelligent healthcare. Frontiers in Computer Science. 2021 May 13;3:661676.
  2. 2.0 2.1 Hazari A, Maiya AG, Nagda TV. Kinematics and Kinetics of Gait. InConceptual Biomechanics and Kinesiology 2021 (pp. 181-196). Springer, Singapore.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Magee DJ, Manske RC. Orthopedic physical assessment-E-Book. Elsevier Health Sciences; 2020 Dec 11.
  4. 4.0 4.1 4.2 4.3 4.4 Webster JB, Darter BJ. Principles of normal and pathologic gait. InAtlas of Orthoses and Assistive Devices 2019 Jan 1 (pp. 49-62). Elsevier.
  5. 5.0 5.1 5.2 5.3 5.4 5.5 Levangie, Pamela K., and Cynthia C Norkin. Joint Structure and Function: A Comprehensive Analysis. 4th ed. Philadelphia, PA: F.A. Davis Co, 2005.
  6. 6.0 6.1 6.2 Richie DH. Human Walking: The Gait Cycle. In Pathomechanics of Common Foot Disorders. Springer; 2021.
  7. Alexandra Kopelovich. Ground Reaction Force During the Gait Cycle. Available from:https://www.youtube.com/watch?v=Y2RHvicAM2o[last accessed 15/09/2022]
  8. Alexandra Kopelovich. Gait Muscular Activity & Action. Available from: https://www.youtube.com/watch?v=WuG87mRiY-8[last accessed 15/09/2022]