Gait Definitions

Introduction[edit | edit source]

Walking is an integral part of our daily locomotion and an important indicator of health. It is the most common type of physical activity for adults in their leisure time.[1]

"Human gait depends on a complex interplay of major parts of the nervous, musculoskeletal and cardiorespiratory systems."[2]

  • An individual's gait pattern is influenced by age, personality, mood and sociocultural factors.[2]
  • The preferred walking speed in older adults is a sensitive marker of general health and survival.[2]
  • Safe walking requires intact cognition and executive control. It is a complex biomechanical process of dynamic balance which requires a person to maintain their centre of gravity within their base of support throughout movement.[3]
  • Gait disorders lead to a loss of personal freedom, falls and injuries and result in a marked reduction in the quality of life.[2]

Thus, it is valuable to be able to measure and analyse human gait. In order to do so, a number of relevant terms and parameters have been defined.

Gait Definitions[edit | edit source]

  • Gait
    • Upright locomotion in a particular manner of moving on foot which may be a walk, jog or run.[4]
  • Walking
    • A particular form of gait and the most common of human locomotor patterns.[4]
  • Ambulation
    • Refers to a type of locomotion in a broad sense. It is more often used in the clinical sense of describing whether or not someone can walk freely or with the assistance of some device.[4]

Gait Development[edit | edit source]

  • Children take approximately 11 to 15 months to learn and develop gait[5]
  • Refinement and normalisation of a gait pattern takes another 4 to 5 years
  • Children around the ages of 6 to 7 years will have a normalised, adult-like gait pattern[6]
  • Gait changes throughout the lifespan[7]
    • Gait remains the same during mid ages, but as one gets progressively older, gait may deteriorate. Reasons for this may include[8]:
      • Neuromuscular conditions
      • Muscular atrophy[7]
      • Central neurological disorders[9]

Normal Gait or Ideal Gait?[edit | edit source]

An "ideal" gait needs to be both safe and energy efficient.[4] For example[4]:

  • The "ideal" gait of an individual with an orthopaedic injury and / or neurological condition may be considerably different from a clinician's picture of "ideal."
    • As long as the individual is ambulating as safely as possible and in the most efficient manner possible, their "dysfunctional" gait pattern is actually their "ideal" gait pattern.
  • An assistive device or brace should not always be looked upon as a "crutch."
    • If the device or brace improves an individual's safety, confidence, and/or unloads the injured structure, then it is a positive addition to the gait pattern.

Major Tasks of Gait[edit | edit source]

The five main functions of walking gait are[10]:

  1. To maintain support of the head, arms and trunk
  2. To maintain upright posture and balance of the body
  3. To control foot trajectory to achieve safe ground clearance and a gentle heel or toe landing
  4. To generate mechanical energy to maintain the present forward velocity or to increase the forward velocity
  5. To absorb mechanical energy for shock absorption and stability or to decrease the forward velocity of the body

Important Terminology of Gait[edit | edit source]

Gait cycle[edit | edit source]

  • The gait cycle is the time from when the heel of one foot touches the ground to the time the same heel touches the ground again or a repetitive pattern involving steps and strides.[11] The gait cycle is divided into two phases which are further divided into sub-phases[12]:
  1. Stance Phase (60% of the gait cycle) - during which some part of the foot is in contact with the ground[10]:
    • Initial contact (heel strike)
    • Foot flat (loading response)
    • Mid-stance (single-leg stance)
    • Heel off (terminal stance)
    • Toe off (preswing)
  2. Swing Phase (40% of the gait cycle) - during which the foot is not in contact with the ground[10]:
    • Initial/ early swing (acceleration)
    • Mid-swing
    • Late swing (deceleration)

Read more: Gait Cycle

Centre of Mass (COM)[edit | edit source]

  • The point where the mass of the body is centred[13]
  • Usually 5 cm anterior to S2 in adults
  • Also referred to as Centre of gravity
  • Centre of mass is not a fixed point and changes in different positions such as sitting, standing and kneeling[13]
  • Displacement of centre of mass
    • It is difficult to follow and evaluate the movement around S2. Another way to assess the displacement of the centre of mass of a body is to observe the head for a vertical representation of the movement of the COM[14]
      • The lowest point will be at double leg stance
      • Highest point will be at mid-stance/mid-swing
      • Vertical change of COM will be about 5 cm
      • Difficult to measure, so instead look for excessive amounts of vertical displacement[4]
      • An individual's head will rise during midstance (single-leg stance) and will descend during weight-loading and weight-unloading periods[10]
    • The centre of mass also shifts from side to side during ambulation[15]
      • Maximal shift to the right will occur during right mid-stance
      • Maximal shift to the left will occur during left mid-stance
      • Side to side shift of the COM will be about 4 cm
      • Difficult to measure, so instead observe to see if the individual ambulates with a wide or narrow base of support[4]

Ground Reaction Force[edit | edit source]

  • Forces applied by the ground to the foot, when the foot is in contact with the ground[16]
  • Generates external torque
    • External torque
      • Torque that acts upon the body
      • When external torque passes at a distance from the axis, there is rotation of the superimposed body segment around that joint axis[17]
      • The magnitude increases as the distance increases between the ground reaction force and the joint axis
    • Internal torque
      • Muscle contractions to counterbalance external torque
    • Ground reaction force anterior to the joint axis
      • Causes anterior motion of the proximal segment
      • Flexion moment
    • Ground reaction force posterior to the joint axis
      • Causes posterior motion of the proximal segment
      • Extension moment
  • Read more: Ground Reaction Forces
  • Please view this video which provides a detailed overview of ground reaction forces during gait.


Centre of Pressure[edit | edit source]

  • Single point on the foot at which the surface pressure is acting[19]
  • This is the starting point of ground reaction forces
  • Barefoot pattern is different to a shoe wearing pattern
  • Pattern[19]:
    • Posterior-lateral edge of the heel (beginning of the stance phase)
    • Moves in a linear pattern through the mid-foot area (lateral to the midline)
    • Moves medially across the ball of the foot with a large concentration along the metatarsal break
    • Centre of pressure (CoP) moves to the second and first toes during late stance

Gait Observation[edit | edit source]

  • Observe an individual's footwear before formally assessing their gait[4]

Gait analysis[edit | edit source]

An analysis of each component of the two phases of ambulation is an essential part of the diagnosis of various  neurological disorders. It is also an essential part of the assessment of patient progress during rehabilitation and recovery from the effects of neurologic disease, musculoskeletal injury or disease process, or amputation of a lower limb. Clinicians and researchers use various qualitative and quantitative parameters to analyse gait. A systematic review[20] in 2017 found that the most relevant parameters for gait analysis in a healthy adult population were walking velocity, cadence, and step/stride length. The authors defined relevant parameters as those that help clinicians identify gait abnormalities applicable in a rehabilitation setting. These variables can be divided into two general categories[21]:

  • Temporal variables
  • Distance variables

Temporal Variables[edit | edit source]

  • Stride time
    • The time between the consecutive initial contacts of the same foot[21]
  • Step time
    • The time between one foot's initial contact and the contralateral foot's initial contact[11][21]

Distance Variables[edit | edit source]

  • Stride length
    • The distance between the consecutive initial contacts of the same foot. Average stride length is 1.44 metres[21][22]
  • Step length
    • The distance between the initial contact of one foot and the initial contact of the contralateral foot. Normal step length is on average about 70 cm.[21][23][22]
  • Step width
    • The mediolateral space between the two feet (the difference between right and left heels during gait).[11][21] Average normal step width is between 8-10 cm.[23][24] Step width will decrease with increasing speed (walk, jog, run, sprint)

Other Variables[edit | edit source]

  • Cadence
    • The number of steps taken per minute (steps/minute). Healthy adults average about 90-120 steps per minute for a comfortable walking speed.[23][25]
  • Gait speed/velocity
    • Velocity is determined by one's cadence and step length, measured in units of distance over time (metres/second). Clinically, it is often calculated by measuring the time it takes to walk a specified distance, usually 6 metres or less. Healthy adults will self-select a comfortable walking speed of about 1.34 m/s on average.[23] Slower speeds correlate with an increased risk of mortality in geriatric patients.[26] Normal walking speed primarily involves the lower extremities, with the arms and trunk providing stability and balance. With faster speeds, the body depends on the upper extremities and trunk for propulsion, balance, and stability with the lower limb joints producing greater ranges of motion.[27]

References[edit | edit source]

  1. Schuna Jr JM, Tudor-Locke C. Step by step: accumulated knowledge and future directions of step-defined ambulatory activity. Research in Exercise Epidemiology. 2012 Sep 30;14(2):107-16.
  2. 2.0 2.1 2.2 2.3 Pirker W, Katzenschlager R. Gait disorders in adults and the elderly. Wiener Klinische Wochenschrift. 2017 Feb;129(3):81-95.
  3. Beauchet O, Allali G, Sekhon H, Verghese J, Guilain S, Steinmetz JP, Kressig RW, Barden JM, Szturm T, Launay CP, Grenier S. Guidelines for assessment of gait and reference values for spatiotemporal gait parameters in older adults: the biomathics and Canadian gait consortiums initiative. Frontiers in human neuroscience. 2017 Aug 3;11:353.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 Kopelovich, A. Gait Definitions and Gait Cycle. Course, Plus. 2022
  5. Bonnefoy A, Armand S. Normal gait. Orthopedic management of children with cerebral palsy: A comprehensive approach. 2015:567.
  6. Ganley KJ, Powers CM. Gait kinematics and kinetics of 7-year-old children: a comparison to adults using age-specific anthropometric data. Gait & posture. 2005 Feb 1;21(2):141-5.
  7. 7.0 7.1 Iosa M, Fusco A, Morone G, Paolucci S. Development and decline of upright gait stability. Frontiers in aging neuroscience. 2014 Feb 5;6:14.
  8. Mulas I, Putzu V, Asoni G, Viale D, Mameli I, Pau M. Clinical assessment of gait and functional mobility in Italian healthy and cognitively impaired older persons using wearable inertial sensors. Aging clinical and experimental research. 2021 Jul;33(7):1853-64.
  9. Mikolajczyk T, Ciobanu I, Badea DI, Iliescu A, Pizzamiglio S, Schauer T, Seel T, Seiciu PL, Turner DL, Berteanu M. Advanced technology for gait rehabilitation: An overview. Advances in Mechanical Engineering. 2018 Jul;10(7):1687814018783627.
  10. 10.0 10.1 10.2 10.3 Magee DJ, Manske RC. Orthopedic physical assessment-E-Book. Elsevier Health Sciences; 2020 Dec 11.
  11. 11.0 11.1 11.2 Loudon J, et al. The clinical orthopedic assessment guide. 2nd ed. Kansas: Human Kinetics, 2008. p.395-408.
  12. Shah K, Solan M, Dawe E. The gait cycle and its variations with disease and injury. Orthopaedics and Trauma. 2020 Jun 1;34(3):153-60.
  13. 13.0 13.1 Watson F, Fino PC, Thornton M, Heracleous C, Loureiro R, Leong JJ. Use of the margin of stability to quantify stability in pathologic gait–a qualitative systematic review. BMC musculoskeletal disorders. 2021 Dec;22(1):1-29.
  14. Petrovic M, Maganaris CN, Bowling FL, Boulton AJ, Reeves ND. Vertical displacement of the centre of mass during walking in people with diabetes and diabetic neuropathy does not explain their higher metabolic cost of walking. Journal of biomechanics. 2019 Jan 23;83:85-90.
  15. Malloggi C, Rota V, Catino L, Malfitano C, Scarano S, Soranna D, Zambon A, Tesio L. Three-dimensional path of the body centre of mass during walking in children: an index of neural maturation. International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation. 2019 Jun;42(2):112.
  16. Elhafez SM, Ashour AA, Elhafez NM, Elhafez GM, Abdelmohsen AM. Percentage contribution of lower limb moments to vertical ground reaction force in normal gait. Journal of Chiropractic Medicine. 2019 Jun 1;18(2):90-6.
  17. Camomilla V, Cereatti A, Cutti AG, Fantozzi S, Stagni R, Vannozzi G. Methodological factors affecting joint moments estimation in clinical gait analysis: a systematic review. Biomedical engineering online. 2017 Dec;16(1):1-27.
  18. Alexandra Kopelovich. Ground Reaction Force During the Gait Cycle. Available from:[last accessed 24/08/2022]
  19. 19.0 19.1 van Mierlo M, Vlutters M, van Asseldonk EH, van der Kooij H. Centre of pressure modulations in double support effectively counteract anteroposterior perturbations during gait. Journal of biomechanics. 2021 Sep 20;126:110637.
  20. Roberts M, Mongeon D, Prince F. Biomechanical parameters for gait analysis: a systematic review of healthy human gait. Phys. Ther. Rehabil. 2017 Aug 16;4(6).
  21. 21.0 21.1 21.2 21.3 21.4 21.5 Hazari A, Maiya AG, Nagda TV. Kinematics and Kinetics of Gait. InConceptual Biomechanics and Kinesiology 2021 (pp. 181-196). Springer, Singapore.
  22. 22.0 22.1 Bilney B, Morris M, Webster K. Concurrent related validity of the GAITRite® walkway system for quantification of the spatial and temporal parameters of gait. Gait & posture. 2003 Feb 1;17(1):68-74.
  23. 23.0 23.1 23.2 23.3 Webster JB, Darter BJ. Principles of normal and pathologic gait. InAtlas of Orthoses and Assistive Devices 2019 Jan 1 (pp. 49-62). Elsevier.
  24. Owings TM, Grabiner MD. Variability of step kinematics in young and older adults. Gait & posture. 2004 Aug 1;20(1):26-9.
  25. Marchetti GF, Whitney SL, Blatt PJ, Morris LO, Vance JM. Temporal and spatial characteristics of gait during performance of the Dynamic Gait Index in people with and people without balance or vestibular disorders. Physical therapy. 2008 May 1;88(5):640-51.
  26. Medical dictionary Gait speed Available from: (last accessed 28.6.2020)
  27. Shultz SJ et al. Examination of musculoskeletal injuries. 2nd ed, North Carolina: Human Kinetics, 2005. p55-60.