Gait normal and abnormal

Heel strike

Initial contact

Foot Flat

Loading response

Mid stance

Mid stance

Heel off

Terminal stance

Toe off

Pre-swing

Acceleraton

Initial swing

Mid swing

Mid swing

Deceleration

Terminal swing

ROM at hip needed for normal gait

Stance phase: 0-30 flexion and 0-20 extension

Swing phase: 20-30 flexion

ROM at knee needed for normal gait

Stance phase: 0-40 flexion

Swing phase 0-60 flexion

ROM at ankle needed for normal gait

Stance phase: 0-10 DF, 0-20 PF

Swing phase: neutral DF, 0-10 PF

Pretibial muscles

Tibialis anterior, extensor digitorum longus, extensor hallucis longus

Prior to and during initial contact: eccentric contraction: lowers foot to the ground

Prior to and during swing: Concentric contraction: dorsiflexion clear toes off ground

Calf muscles

Gastrocnemius, soleus. flexor digitorum longus, flexor hallucis longus, tibialis posterior

Mid stance: eccentric contraction: control of tibia over the foot

Terminal stance: ankle plantarflexion

Quadriceps

Initial contact: quad femoris contracts eccentrically: Control rapid knee flexion and to prevent buckling

Pre swing phase: Eccentric contraction of rectus femoris to control rate of knee flexion

Hamstrings

Before initial contact: eccentric contraction to protect knee from hyperextension

Swing face: concentric contraction of knee flexion

Hip Abductors

Stance phase: eccentric contraction: stabilize pelvis

Hip Adductors

Early and late stance: concentric contraction: stabilize pelvis in frontal plane

What will a contracture cause?

Contracture will cause a decrease in the range of motion of the opposite motion

What will a weakness cause in walking?

Weakness will cause a decrease in the active range of motion of the same motion

Gluteus Maximus

Initial stance phase: eccentric contraction: decelerate forward momentum

Erector Spinae

Initial contact to pre swing: maintan trunk posture

Peroneus Longus and Brevis

Stance phase: concentric contraction: maintain medial and lateral stability of the foot

Foot intrinsic

Stance phase: concentric contraction: support plantar fascia

What causes a lateral trunk lean in stance phase?

Weak hip abductors

What causes forward lean during stance phase?

Quadriceps

What causes hands-to-knee gait, also known as polio gait?

Quad weakness, hands to push knee into extension

What happens with excessive plantarflexion in gait?

Causes loss of progression: leads to shortened stride length and reduced velocity

Low heel contact at initial contact and forefoot contact

3 substitutions: Premature heel off, knee hyperextension, forward trunk lean

When in midstance think high heels: increased PF, genu recurvatum, and anterior pelvic tilt causing lordosis