Joint Range of Motion During Gait: Difference between revisions
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The video below shares a 90-second description of the basics of the gait 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> | The video below shares a 90-second description of the basics of the gait 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> | ||
== Range of Motion Involved in Gait Phases == | == Range of Motion Involved in Gait Phases == | ||
Initial contact (Heel Strike): | Initial contact (Heel Strike): 0% of gait cycle | ||
Involves: | 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<ref name=":2">Shultz SJ et al. Examination of musculoskeletal injuries. 2nd ed, North Carolina: Human Kinetics, 2005. p55-60.</ref><ref name=":1" />. | *Function: establish contact with surface and initiate weight acceptance | ||
*20-30° flexion of the hip: full extension in the knee: ankle moves from dorsiflexion to a neutral (supinated 5°) position then into plantar flexion<ref name=":2">Shultz SJ et al. Examination of musculoskeletal injuries. 2nd ed, North Carolina: Human Kinetics, 2005. p55-60.</ref><ref name=":1" />. | |||
*After this, knee flexion (5°) begins and increases, just as the plantar flexion of the heel increased<ref name=":1" />. | *After this, knee flexion (5°) begins and increases, just as the plantar flexion of the heel increased<ref name=":1" />. | ||
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Loading Response (Foot Flat): | |||
Loading Response (Foot Flat): 8-10% of gait cycle | |||
Involves: | Involves: | ||
*Function: weight acceptance and shock absorption | |||
*Body absorbs the impact of the foot by rolling in pronation<ref name=":2" />. | *Body absorbs the impact of the foot by rolling in pronation<ref name=":2" />. | ||
*Hip moves slowly into extension, caused by a contraction of the adductor magnus and gluteus maximus muscles. | *Hip moves slowly into extension from 20°-15°, caused by a contraction of the adductor magnus and gluteus maximus muscles. | ||
*Knee flexes to 15° to 20° of flexion<ref name=":1" />. | *Knee flexes to 15° to 20° of flexion<ref name=":1" />. | ||
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Involves: | Involves: | ||
*Hip moves from | *Function: single limb support and stability | ||
*Hip moves from flexion to extension 0° by contraction of the gluteus medius muscle<ref name=":1" />. | |||
*Knee reaches maximal flexion and then begins to extend. | *Knee reaches maximal flexion and then begins to extend. | ||
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Heel Off: | |||
Heel Off: 30-40% of gait cycle | |||
Involves: | Involves: | ||
* Function: single limb support, stability, and propulsion | |||
* Begins when the heel leaves the floor. | * Begins when the heel leaves the floor. | ||
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*Knee becomes flexed (0-5°)<ref name=":1" />. | *Knee becomes flexed (0-5°)<ref name=":1" />. | ||
*Ankle supinates and plantar flexes<ref name=":1" />. | *Ankle supinates and plantar flexes<ref name=":1" />; 0° of plantarflexion or dorsiflexion. | ||
Toe Off/Pre-swing: | Toe Off/Pre-swing: 60% of gait cycle | ||
Involves: | Involves: | ||
*Function: final burst of propulsion to propel the body forward | |||
*Hip becomes less extended. | *Hip becomes less extended. | ||
*Knee is flexed 35-40° | *Knee is flexed 35-40° | ||
| Line 92: | Line 100: | ||
Early Swing: | |||
Early Swing: 60-75% of gait cycle | |||
Involves: | Involves: | ||
*Function: propel the lower extremity forward and shorten the stance limb | |||
*Hip extends to 10° and then flexes (due to contraction of the iliopsoas muscle)<ref name=":1" /> 20° with lateral rotation<ref name=":2" /><ref name=":1" />. | *Hip extends to 10° and then flexes (due to contraction of the iliopsoas muscle)<ref name=":1" /> 20° with lateral rotation<ref name=":2" /><ref name=":1" />. | ||
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Mid Swing: | |||
Mid Swing: 75-85% of gait cycle | |||
Involves: | Involves: | ||
*Function: clear lower extremity from the ground in order to advance into initial contact | |||
*Hip flexes to 30° (by contraction of the adductors) and the ankle becomes dorsiflexed due to a contraction of the tibialis anterior muscle<ref name=":1" />. | *Hip flexes to 30° (by contraction of the adductors) and the ankle becomes dorsiflexed due to a contraction of the tibialis anterior muscle<ref name=":1" />. | ||
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Late Swing: | |||
Late Swing: 85-100% of gait cycle | |||
Involves: | Involves: | ||
*Function: decelerate lower extremity to establish contact with the ground | |||
*Hip flexion of 25-30° | *Hip flexion of 25-30° | ||
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Introduction[edit | edit source]
Merriam-Webster dictionary defines gait as “a manner of walking or moving on foot[1].” It involves the interaction between the nervous, musculoskeletal, and cardiorespiratory systems and is heavily impacted by human age, personality, mood, and sociocultural factors[2]. Normal gait function is determined by the optimal operation of the following: “locomotor function (for initiating and sustaining rhythmic gait), balance, postural reflexes, sensory function and sensorimotor integration, motor control, the musculoskeletal apparatus and cardiopulmonary functions.[2]”
Phases of Gait[edit | edit source]
There are 8 phases of gait which are listed as follows[3][4]:
- Initial Contact
- Loading Response
- Midstance
- Terminal Stance
- Pre swing
- Initial Swing
- Mid Swing
- Late Swing [5]
The video below shares a 90-second description of the basics of the gait cycle:
Range of Motion Involved in Gait Phases[edit | edit source]
Initial contact (Heel Strike): 0% of gait cycle
Involves:
- Function: establish contact with surface and initiate weight acceptance
- 20-30° flexion of the hip: full extension in the knee: ankle moves from dorsiflexion to a neutral (supinated 5°) position then into plantar flexion[7][3].
- After this, knee flexion (5°) begins and increases, just as the plantar flexion of the heel increased[3].
- 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[3].
Loading Response (Foot Flat): 8-10% of gait cycle
Involves:
- Function: weight acceptance and shock absorption
- Body absorbs the impact of the foot by rolling in pronation[7].
- Hip moves slowly into extension from 20°-15°, caused by a contraction of the adductor magnus and gluteus maximus muscles.
- Knee flexes to 15° to 20° of flexion[3].
Midstance:
Involves:
- Function: single limb support and stability
- Hip moves from flexion to extension 0° by contraction of the gluteus medius muscle[3].
- Knee reaches maximal flexion and then begins to extend.
- Ankle becomes supinated and dorsiflexed (5°), which is caused by some contraction of the triceps surae muscles[7].
- 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[7].
Heel Off: 30-40% of gait cycle
Involves:
- Function: single limb support, stability, and propulsion
- Begins when the heel leaves the floor.
- Bodyweight is divided over the metatarsal heads[7].
- 10-13° of hip hyperextension, which then goes into flexion.
- Knee becomes flexed (0-5°)[3].
- Ankle supinates and plantar flexes[3]; 0° of plantarflexion or dorsiflexion.
Toe Off/Pre-swing: 60% of gait cycle
Involves:
- Function: final burst of propulsion to propel the body forward
- Hip becomes less extended.
- Knee is flexed 35-40°
- Plantar flexion of the ankle increases to 20°[7][3].
- The toes leave the ground[3].
Early Swing: 60-75% of gait cycle
Involves:
- Function: propel the lower extremity forward and shorten the stance limb
- Hip extends to 10° and then flexes (due to contraction of the iliopsoas muscle)[3] 20° with lateral rotation[7][3].
- Knee flexes to 40-60°.
- Ankle goes from 20° of plantar flexion to dorsiflexion, to end in a neutral position[7].
Mid Swing: 75-85% of gait cycle
Involves:
- Function: clear lower extremity from the ground in order to advance into initial contact
- Hip flexes to 30° (by contraction of the adductors) and the ankle becomes dorsiflexed due to a contraction of the tibialis anterior muscle[3].
- Knee flexes 60° but then extends approximately 30° due to the contraction of the sartorius muscle[7][3] - caused by the quadriceps muscles[7][3].
Late Swing: 85-100% of gait cycle
Involves:
- Function: decelerate lower extremity to establish contact with the ground
- Hip flexion of 25-30°
- Locked extension of the knee
- Neutral position of the ankle[7].
The following video describes the range of motion requirements involved in the different gait phases:
Range of Motion during Gait [8]
Resources[edit | edit source]
- ↑ Merriam-Webster. Gait. Available from: https://www.merriam-webster.com/dictionary/gait (last accessed 23.6.2022)
- ↑ 2.0 2.1 Pirker W, Katzenschlager R. Gait disorders in adults and the elderly. Wiener Klinische Wochenschrift. 2017 Feb 1;129(3-4):81-95.Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5318488/ (last accessed 25.6.2022)
- ↑ 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 3.15 Loudon J, et al. The clinical orthopedic assessment guide. 2nd ed. Kansas: Human Kinetics, 2008. p.395-408.
- ↑ Demos, Gait analysis, (http://www.ncbi.nlm.nih.gov/books/NBK27235/), 2004.
- ↑ 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.
- ↑ Nicole Comninellis The Gait Cycle Animation Available from https://www.youtube.com/watch?time_continue=35&v=DP5-um6SvQI
- ↑ 7.00 7.01 7.02 7.03 7.04 7.05 7.06 7.07 7.08 7.09 7.10 7.11 Shultz SJ et al. Examination of musculoskeletal injuries. 2nd ed, North Carolina: Human Kinetics, 2005. p55-60.
- ↑ Alexandra Kopelovich. Gait Range of Motion Available from: https://www.youtube.com/watch?v=5Z6shSu96CM [last accessed 28.6.2022]
