Understanding Gait: Phases, Terminology, and Abnormalities

Gait

A person's manner of walking, measured through kinematic (movement), kinetic (forces), and observational analysis.

Heel Strike

Initial contact.

Foot Flat

Loading response.

Midstance

Body progresses over foot.

Heel Off

Terminal stance.

Toe Off

Pre swing.

Acceleration

Initial swing.

Mid Swing

Tibia vertical; limb swings forward.

Deceleration

Terminal swing.

Stride

One full gait cycle (heel to heel of same foot).

Step

Heel to heel of opposite foot.

Cadence

Steps per minute.

Step Length

Distance between heel strikes of opposite feet.

Stride Length

Distance between heel strikes of the same foot.

Walking Velocity

Speed of walking.

Initial Contact Phase

Heel touches the ground.

Loading Response Phase

Weight transferred onto limb.

Midstance Phase

Body progresses over foot.

Terminal Stance Phase

Heel rises; weight moves forward.

Preswing Phase

Toe-off; weight transferred to other foot.

Initial Swing Phase

Thigh advances; foot lifts off.

Midswing Phase

Tibia vertical; limb swings forward.

Terminal Swing Phase

Knee extends in preparation for contact.

Pelvic Tilt

Weak gluteus medius leads to pelvic drop on the opposite (swing) side — called uncompensated Trendelenburg, normally ~5°.

Lateral Pelvic Displacement

In compensated Trendelenburg, the person leans toward the weak side; normal shift is about 2.5 cm.

Pelvic Rotation

Occurs in the transverse plane, with ~4° forward rotation during swing and 4° backward during stance.

Foot Angle

Measured using the second toe and ankle center; normal is 5°-18° toe-out.

Base of Support

Normal step width is 5-10 cm.

Antalgic Gait

Shortened stance phase on painful side; limp to avoid weight bearing.

Trendelenburg Gait

Pelvic drop on swing side; may lean trunk toward stance side (compensated).

Hemiplegic Gait

Leg is stiff; circumduction or hip hiking during swing; arm often held flexed.

Ataxic Gait

Wide base, unsteady, irregular steps, poor coordination.

Shuffling Gait

Small steps, reduced arm swing, stooped posture, difficulty initiating steps.

Flaccidity

A state of reduced muscle tone.

Spastic synergy patterns

Patterns of movement that occur due to spasticity, where muscles work together in a fixed pattern.

Isolated movements

Movements that occur independently of other muscle groups.

Hamstrings

The muscle group that decelerates the leg during terminal swing.

Tibialis anterior

The muscle that causes foot drop during gait due to weakness.

Mid-stance

The phase that involves the body weight shifting over a single limb.

Gluteus medius

The muscle that prevents hip drop on the opposite side during gait.

Soleus

The muscle that eccentrically controls forward tibial movement during midstance.

Initial swing

The phase that begins the swing phase of gait.

Stance phase

The phase during which the joint moves from flexion to extension.

Brunnstrom Stage 1 gait pattern

Characterized by no voluntary movement.

Gastrocnemius

The muscle group that controls knee extension during terminal stance.

Heel strike

The moment when the foot contacts the ground to prevent foot slap.

Toe-off

An event that occurs in the pre-swing phase.

Pelvis tilt

The movement of the pelvis laterally towards the swing leg during normal gait.

Trendelenburg sign

A sign due to weakness in the gluteus medius muscle.

Brunnstrom recovery stages

Focus on motor function and synergy patterns.

Dorsiflexion

The movement that occurs most at the ankle during gait.

Steppage gait

Typically due to dorsiflexor paralysis.

Terminal stance

Involves heel rise and forward propulsion.

Initial contact

The position of the foot, which is neutral.

Quadriceps

The muscle group responsible for knee extension control during loading response.

Brunnstrom Stage 6

Characterized by isolated, coordinated movements.

Gait movement plane

Primarily described by the sagittal plane.

Pelvic stability

Maintained during single-leg stance by the gluteus minimus.

Deep peroneal nerve injury

Causes foot drop.

Ankle position during mid-swing

Should be neutral.

Extensor synergy gait deviation

Characterized by knee hyperextension.

Brunnstrom Stage 5

Indicates complex movements possible.