The Gait Cycle: Difference between revisions

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== The Gait Cycle  ==
== The Gait Cycle  ==
[[File:Walk.jpg|right|frameless]]
[[File:Walk.jpg|right|frameless]]
The sequences for walking that occur may be summarised as follows:<ref name="Vaughan">Vaughan CL. [https://www.ncbi.nlm.nih.gov/pubmed/12600342 Theories of bipedal walking: an odyssey]. J Biomech 2001;36(2003):513-523.Available from<nowiki/>http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.468.2414&rep=rep1&type=pdf</ref>
The action of walking may be summarised by the following sequence:<ref name="Vaughan">Vaughan CL. [https://www.ncbi.nlm.nih.gov/pubmed/12600342 Theories of bipedal walking: an odyssey]. J Biomech 2001;36(2003):513-523.Available from<nowiki/>http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.468.2414&rep=rep1&type=pdf</ref>
# Registration and activation of the gait command within the central nervous system.
# Registration and activation of the gait command within the central nervous system.
# Transmission of the gait systems to the peripheral nervous system.
# Transmission of gait signals to the peripheral nervous system.
#
# Contraction of [[Muscle|muscles]].
# Contraction of [[Muscle|muscles]].
# Generation of several forces.
# Generation of forces across joints
# Regulation of joint forces and moments across [[Joint Classification|synovial joints]] and skeletal segments.
# Regulation of joint forces and moments by skeletal segments.
# Generation of ground reaction forces.
# Generation of ground reaction forces.
The normal forward step consists of two phases: stance phase; swing phase,  
 
* The Stance phase occupies 60% of the gait cycle, during which one leg and foot are bearing most or all of the bodyweight
 
* The Swing phase occupies only 40% of it <ref name="Loudon">Loudon J, et al. The clinical orthopedic assessment guide. 2nd ed. Kansas: Human Kinetics, 2008. p.395-408.</ref>, during which the foot is not touching the walking surface and the bodyweight is borne by the other leg and foot.  
Normal gait consists of two phases: stance phase; swing phase. 
* In a complete two-step cycle both feet are in contact with the floor at the same time for about 25 per cent of the time. This part of the cycle is called the double-support phase.Gait cycle phases: the stance phase and the swing phase and involves a combination of open and close chain activities.<ref name="Shultz">Shultz SJ et al. Examination of musculoskeletal injuries. 2nd ed, North Carolina: Human Kinetics, 2005. p55-60.</ref>   
 
The 90 second video below gives the basics of this cycle{{#ev:youtube|DP5-um6SvQI|400}}<ref>Nicole Comninellis The Gait Cycle Animation Available from https://www.youtube.com/watch?time_continue=35&v=DP5-um6SvQI</ref>[[Image:Figure2.jpg|576x576px|right|frameless]]'''Phases of the Gait Cycle (8 phase model):'''<ref name="Loudon" /><ref name="Demos">Demos, Gait analysis, (http://www.ncbi.nlm.nih.gov/books/NBK27235/), 2004.</ref>
'''Stance Phase'''  
#Initial Contact  
 
#Loading Response  
The stance phase occupies 60% of the total gait cycle, during which some part of the foot is in contact with the ground. It is further divided into 5 events: 
#Midstance
 
#Terminal Stance  
# Initial Contact/Heel Strike 
#Pre swing
#Loading Response/Foot Flat
#Initial Swing  
#Mid-Stance
#Mid Swing  
#Terminal Stance/Heel Off
#Late Swing.<ref name="Berger">Berger W, et al. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1193250/ Corrective reactions to stumbling in man: neuronal co-ordination of bilateral leg activity during gait]. J Physiol 1984;357: 109-125.</ref><br>  
#Pre-Swing/Toe Off
 
 
'''Swing Phase''' 
 
The swing phase occupies 40% of the total gait cycle <ref name="Loudon">Loudon J, et al. The clinical orthopedic assessment guide. 2nd ed. Kansas: Human Kinetics, 2008. p.395-408.</ref>, during which the foot is not in contact with the ground and the bodyweight is borne by the other leg and foot. It is further divided into 3 events: 
 
#Initial Swing
#Mid-Swing
#Late Swing<ref name="Berger" />
 
In a complete two-step cycle both feet are in contact with the floor at the same time for about 25 per cent of the time. This part of the cycle is called the double-support phase. Gait cycle phases: the stance phase and the swing phase and involves a combination of open and close chain activities.<ref name="Shultz">Shultz SJ et al. Examination of musculoskeletal injuries. 2nd ed, North Carolina: Human Kinetics, 2005. p55-60.</ref><nowiki>  </nowiki>
The 90 second video below gives the basics of this cycle{{#ev:youtube|DP5-um6SvQI|400}}<ref>Nicole Comninellis The Gait Cycle Animation Available from https://www.youtube.com/watch?time_continue=35&v=DP5-um6SvQI</ref>
 
'''Phases of the Gait Cycle (8 phase model):'''<ref name="Loudon" /><ref name="Demos">Demos, Gait analysis, (http://www.ncbi.nlm.nih.gov/books/NBK27235/), 2004.</ref>
[[File:Gait cycle.jpg|alt=|center|frameless|800x800px|Gait Cycle]]
#Initial Contact/Heel Strike
#Loading Response/Foot Flat
#Mid-Stance
#Terminal Stance/Heel Off
#Pre-Swing/Toe Off
#Initial Swing
#Mid-Swing
#Late Swing<ref name="Berger">Berger W, et al. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1193250/ Corrective reactions to stumbling in man: neuronal co-ordination of bilateral leg activity during gait]. J Physiol 1984;357: 109-125.</ref><br>
'''Heel Strike (or initial contact) -''' Short period, begins the moment the foot touches the ground and is the first phase of double support.<ref name="Shultz" />  
'''Heel Strike (or initial contact) -''' Short period, begins the moment the foot touches the ground and is the first phase of double support.<ref name="Shultz" />  


Revision as of 22:47, 11 May 2022

Original Editor - Karsten De Koster Top Contributors - Daphne Xuan and Tarina van der Stockt

The Gait Cycle[edit | edit source]

Walk.jpg

The action of walking may be summarised by the following sequence:[1]

  1. Registration and activation of the gait command within the central nervous system.
  2. Transmission of gait signals to the peripheral nervous system.
  4. Contraction of muscles.
  5. Generation of forces across joints
  6. Regulation of joint forces and moments by skeletal segments.
  7. Generation of ground reaction forces.


Normal gait consists of two phases: stance phase; swing phase.

Stance Phase

The stance phase occupies 60% of the total gait cycle, during which some part of the foot is in contact with the ground. It is further divided into 5 events:

  1. Initial Contact/Heel Strike
  2. Loading Response/Foot Flat
  3. Mid-Stance
  4. Terminal Stance/Heel Off
  5. Pre-Swing/Toe Off


Swing Phase

The swing phase occupies 40% of the total gait cycle [2], during which the foot is not in contact with the ground and the bodyweight is borne by the other leg and foot. It is further divided into 3 events:

  1. Initial Swing
  2. Mid-Swing
  3. Late Swing[3]

In a complete two-step cycle both feet are in contact with the floor at the same time for about 25 per cent of the time. This part of the cycle is called the double-support phase. Gait cycle phases: the stance phase and the swing phase and involves a combination of open and close chain activities.[4]

The 90 second video below gives the basics of this cycle

[5]

Phases of the Gait Cycle (8 phase model):[2][6]

  1. Initial Contact/Heel Strike
  2. Loading Response/Foot Flat
  3. Mid-Stance
  4. Terminal Stance/Heel Off
  5. Pre-Swing/Toe Off
  6. Initial Swing
  7. Mid-Swing
  8. Late Swing[3]

Heel Strike (or initial contact) - Short period, begins the moment the foot touches the ground and is the first phase of double support.[4]

Involves:

  • 30° flexion of the hip: full extension in the knee: ankle moves from dorsiflexion to a neutral (supinated 5°) position then into plantar flexion.[4][2]
  • After this, knee flexion (5°) begins and increases, just as the plantar flexion of the heel increased.[2]
  • Plantar flexion is allowed by eccentric contraction of the tibialis anterior
  • Extension of the knee is caused by a contraction of the quadriceps
  • Flexion is caused by a contraction of the hamstrings,
  • Flexion of the hip is caused by the contraction of the rectus femoris.[2]

Foot Flat (or loading response phase)

  • Body absorbs the impact of the foot by rolling in pronation.[4]
  • Hip moves slowly into extension, caused by a contraction of the adductor magnus and gluteus maximus muscles.
  • Knee flexes to 15° to 20° of flexion. [2]
  • Ankle plantarflexion increases to 10-15°.[4][2]

Midstance

  • Hip moves from 10° of flexion to extension by contraction of the gluteus medius muscle.[2]
  • Knee reaches maximal flexion and then begins to extend.
  • Ankle becomes supinated[4] and dorsiflexed (5°), which is caused by some contraction of the triceps surae muscles.[4]
  • During this phase, the body is supported by one single leg.
  • At this moment the body begins to move from force absorption at impact to force propulsion forward.[4]

Heel Off

  • Begins when the heel leaves the floor.
  • Bodyweight is divided over the metatarsal heads.[4]
  • 10-13° of hip hyperextension, which then goes into flexion.
  • Knee becomes flexed (0-5°)[2]
  • Ankle supinates and plantar flexes.[2]

Toe Off/pre-swing

  • Hip becomes less extended.
  • Knee is flexed 35-40°
  • Plantar flexion of the ankle increases to 20°.[4][2]
  • The toes leave the ground.[2]

Early Swing

  • Hip extends to 10° and then flexes due to contraction of the iliopsoas muscle[2] 20° with lateral rotation.[4][2]
  • Knee flexes to 40-60°
  • Ankle goes from 20° of plantar flexion to dorsiflexion, to end in a neutral position.[4]

Mid Swing

  • Hip flexes to 30° (by contraction of the adductors) and the ankle becomes dorsiflexed due to a contraction of the tibialis anterior muscle.[2]
  • Knee flexes 60° but then extends approximately 30° due to the contraction of the sartorius muscle.[4][2](caused by the quadriceps muscles).[4][2]

Late Swing/declaration

  • Hip flexion of 25-30°
  • Locked extension of the knee
  • Neutral position of the ankle.[4]

References[edit | edit source]

  1. ↑ Vaughan CL. Theories of bipedal walking: an odyssey. J Biomech 2001;36(2003):513-523.Available fromhttp://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.468.2414&rep=rep1&type=pdf
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 Loudon J, et al. The clinical orthopedic assessment guide. 2nd ed. Kansas: Human Kinetics, 2008. p.395-408.
  3. ↑ 3.0 3.1 Berger W, et al. Corrective reactions to stumbling in man: neuronal co-ordination of bilateral leg activity during gait. J Physiol 1984;357: 109-125.
  4. ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 4.12 4.13 4.14 Shultz SJ et al. Examination of musculoskeletal injuries. 2nd ed, North Carolina: Human Kinetics, 2005. p55-60.
  5. ↑ Nicole Comninellis The Gait Cycle Animation Available from https://www.youtube.com/watch?time_continue=35&v=DP5-um6SvQI
  6. ↑ Demos, Gait analysis, (http://www.ncbi.nlm.nih.gov/books/NBK27235/), 2004.


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