Original Editor - Rishika Babburu
Introduction[edit | edit source]
A fundamental body movement is required to ascend and descend stairs. It is important for everyday activities such as shopping, taking public transportation, or going about a multistory building or apartment. The variation between the two modes of locomotion(level-ground locomotion and stair locomotion) may be significant for a patient population.
Biomechanics[edit | edit source]
Locomotion in the stair gait involves both swing and stance phases in which forward progression of the body is brought about by alternating movements of the lower extremities. The lower extremities must balance and carry along HAT(Head, arms and trunk), similar to level ground gait.The knee extensor moment in both stair ascent and descent was nearly three times greater than that of level ground walking. The ankle moments are almost similar in both gaits. The knee has generative role in stair ascent( absorptive in level walking). Powers are mostly generative in stair ascent and absorptive in descent for all joints.
The stair gait cycle is divided into:
A.Stance phase and
- Stance phase is subdivided into
- Weight Acceptance
- Pull up
- Forward Continuance
- Swing Phase is subdivided into
- Foot Clearance
- Foot Placement
Sagittal Plane Analysis of Stair Ascent[edit | edit source]
Stance Phase–Weight Acceptance (0%–14% of Stance Phase) Through Pull-Up (14%–32% of Stance Phase)
Knee Joint - Extension: 80°–35° of flexion - Vastus lateralis, Rectus femoris
Ankle Joint - Dorsiflexion: 20°–25° of dorsiflexion, Plantarflexion: 25°–15° of dorsiflexion - Tibialis anterior , Soleus, Gastrocnemius
Stance Phase–Pull-Up (End of Pull-Up) Through Forward Continuance (32%–64% of the Stance Phase of Gait Cycle)
Hip Joint - Extension: 30°–5° flexion,Flexion: 5° to 10°–20° of flexion - Gluteus maximus ,Gluteus medius,Semitendinosus.
Knee Joint - Extension: 35°–10° of flexion,Flexion: 5° to 10°–20° of flexion - Vastus lateralis, Rectus femoris.
Ankle Joint - Plantarflexion: 15° of dorsiflexion to 15°–10° of plantarflexion - Soleus,Gastrocnemius,Tibialis anterior
Swing Phase (64%–100% of Gait Cycle)—Foot Clearance Through Foot Placement
Hip Joint - Flexion: 10°–20° to 40°–60° of flexion, Extension: 40°–60° of flexion to 50° of flexion - Gluteus medius
Knee Joint - Flexion: 10° of flexion to 90°–100° of flexion, Extension: 90°–100° of flexion to 85° of flexion - Vastus lateralis, Semitendinosus, Rectus femoris
Ankle Joint - Dorsiflexion: 10° of plantarflexion to 20° of dorsiflexion - Tibialis anterior.
- Descending stairs involves energy absorption and is achieved through eccentric activity of the same muscles.
- The support moments during stair ascent, stair descent, and level-ground walking show near to same patterns but the magnitude of the moments is greater in stair gait.
- Hence, more muscle strength is required during stair gait.
According to a study, it is determined, the predictors of foot clearance and amount of overhang showing that physical activity was a common predictor for both younger and older age groups. In addition, for the older group, medications and fear of falling were found to predict stair performance for most goings, while sway during single-legged standing was the most common predictor for the younger group. Older participants adapted to smaller goings by using the handrails and reducing gait velocity. The predictors of performance suggest that motor and fall risk assessment is complex and multifactorial. The results shown were consistent with the recommendation that larger going and pausing before negotiating stairs may improve stair safety, especially for older users.
The below less than 3 minute video is titled: Biomechanical analysis of height and knee flexion in walking stairs
References[edit | edit source]
- Pamela K. Levangie, Cynthia C. Norkin,editors. Joint structure and function : a comprehensive analysis. 5th Edition. Philadelphia.F. A. Davis Company,2011. p 553,554,555
- Di Giulio I, Reeves ND, Roys M, Buckley JG, Jones DA, Gavin JP, Baltzopoulos V, Maganaris CN. Stair gait in older adults worsens with smaller step treads and when transitioning between level and stair walking. Frontiers in sports and active living. 2020:63.
- Biomechanical analysis of height and knee flexion in walking stairs. Available from : https://www.youtube.com/watch?v=FRdK2kO80A8