The Gait Cycle

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.
  3. Contraction of muscles.
  4. Generation of forces across joints
  5. Regulation of joint forces and moments by skeletal segments.
  6. Generation of ground reaction forces.


Normal gait consists of two phases: stance phase; swing phase. These phases are further divided into a total of 8 events.[2] The gait cycle involves a combination of open and closed chain activities.[3]

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 five 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 [4], 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[5]


In a complete two-step cycle both feet are in contact with the ground at the same time for about 25 per cent of the time. This part of the cycle is called the double-support phase. The rest of the time is spent in single support, when only one foot is in contact with the ground.

The 90-second video below gives the basics of this cycle:

[6]

Breakdown of Gait Cycle Events[edit | edit source]

Initial Contact (or Heel Strike) - 0%

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

Joint and muscle actions:

  • 30° flexion of the hip, full extension in the knee, ankle moves from dorsiflexion to a neutral (supinated 5°) position then into plantar flexion.[3][4]
  • After this, knee flexion (5°) begins and increases, just as plantarflexion of the ankle increases.[4]
  • Plantar flexion is allowed by eccentric contraction of the tibialis anterior and dorsiflexors
  • Knee flexion is allowed by a concentric contraction of the knee flexors and eccentric contraction of the knee extensors
  • Flexion of the hip is caused by the contraction of the rectus femoris.[4]


Loading Response (or Foot Flat) - 0-10%

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

Joint and muscle actions:

  • 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. [4]
  • Ankle plantarflexion increases to 10-15°.[3][4]


Midstance - 10-30%

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.[3]

Joint and muscle actions:

  • Hip moves from 10° of flexion to extension by contraction of the hip extensors.[4]
  • Knee reaches maximal flexion and then begins to extend.
  • Ankle becomes supinated[3] and dorsiflexed (5°), which is caused by some contraction of the triceps surae muscles.[3]


Terminal Stance (or Heel Off) - 30-50%

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.

Joint and muscle actions:

  • Bodyweight is divided over the metatarsal heads.[3]
  • 10-13° of hip hyperextension, which then goes into flexion.
  • Knee becomes flexed (0-5°)[4]
  • Ankle supinates and plantar flexes.[4]


Pre-Swing (or Toe Off) - 50-60%

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.[4]

Joint and muscle actions:

  • Hip becomes less extended.
  • Knee is flexes to 35-40°
  • Plantarflexion of the ankle increases to 20°.[3][4]


Early Swing - 60-75%

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.

Joint and muscle actions:

  • Hip extends to 10° and then flexes due to contraction of the iliopsoas muscle[4] 20° with lateral rotation.[3][4]
  • Knee flexes to 40-60°
  • Ankle goes from 20° of plantar flexion to dorsiflexion, to end in a neutral position.[3]


Mid-Swing - 75-85%

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.

Joint and muscle actions:

  • Hip flexes to 30° (by contraction of the adductors) and the ankle becomes dorsiflexed due to a contraction of the tibialis anterior muscle.[4]
  • Knee flexes 60° but then extends approximately 30° due to the contraction of the sartorius muscle[3][4](caused by the quadriceps muscles).[3][4]
  • Ankle remains neutral.


Late Swing/Deceleration - 85-100%

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

Joint and muscle actions:

  • Hip remains flexed to 25-30°.
  • Locked extension of the knee.
  • Ankle remains neutral.[3]

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. Webster JB, Darter BJ. Principles of Normal and Pathologic Gait. Atlas of Orthoses and Assistive Devices [Internet]. 2019 [cited 2022 May 11];49-62.e1. Available from: https://www.sciencedirect.com/science/article/pii/B9780323483230000044
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 Shultz SJ et al. Examination of musculoskeletal injuries. 2nd ed, North Carolina: Human Kinetics, 2005. p55-60.
  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 4.15 Loudon J, et al. The clinical orthopedic assessment guide. 2nd ed. Kansas: Human Kinetics, 2008. p.395-408.
  5. 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.
  6. Nicole Comninellis The Gait Cycle Animation Available from https://www.youtube.com/watch?time_continue=35&v=DP5-um6SvQI