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Updated: Aug 13 2021

Gait Cycle

Images
https://upload.orthobullets.com/topic/7001/images/gait cycle.jpg
https://upload.orthobullets.com/topic/7001/images/fibular notch.jpg
https://upload.orthobullets.com/topic/7001/images/key image.jpg
https://upload.orthobullets.com/topic/7001/images/subtalar joint.jpg
  • Overview
    • One gait cycle is measured from heel-strike to heel-strike
      • consists of
        • stance phase
          • period of time that the foot is on the ground
          • ~60% of one gait cycle is spent in stance
          • during stance, the leg accepts body weight and provides single limb support
        • swing phase
          • period of time that the foot is off the ground moving forward
          • ~40% of one gait cycle is spent in swing
          • the limb advances
    • Stride
      • is the distance between consecutive inital contacts of the same foot with the ground
    • Step
      • is the distance between initial contacts of the alternating feet
  • Stance Phase
    • Initial contact (heel strike)
      • definition
        • occurs when foot contacts the ground
      • muscular contractions
        • hip extensors contract to stabilize the hip
        • quadriceps contract eccentrically
        • tibialis anterior contracts eccentrically
    • Loading response (initial double limb support)
      • marks the beginning of the initial double limb stance
      • definition
        • occurs after initial contact until elevation of opposite limb
        • bodyweight is transferred on to the supporting limb
      • muscular contractions
        • ankle dorsiflexors (tibialis anterior) contract eccentrically to control plantar flexion moment
        • quads contract to stabilize knee and counteract the flexion moment (about the knee)
    • Mid-stance (single limb support)
      • initial period of single leg support
      • definition
        • from elevation of opposite limb until both ankles are aligned in coronal plane
      • muscular contractions
        • gluteus medius and calf muscles undergo eccentric contraction
    • Terminal stance (single limb support)
      • definition
        • begins when the supporting heel rises from the ground and continues until the opposite heel touches the ground
      • muscular contractions
        • toe flexors and tibialis posterior contract and are the most active during this phase
    • Pre-swing (second double limb support)
      • is the start of the second double limb stance in the gait cycle
      • definition
        • from initial contact of opposite limb to just prior to elevation of ipsilateral limb
      • muscular contractions
        • hip flexors contract to propel advancing limb
  • Swing Phase
    • Initial swing (toe off)
      • start of single limb support for opposite limb
      • definition
        • from elevation of limb to point of maximal knee flexion
      • muscular contractions
        • hip flexors concentrically contract to advance the swinging leg
    • Mid-swing (foot clearance)
      • definition
        • following knee flexion to point where tibia is vertical
      • muscular contractions
        • ankle dorsiflexors contract to ensure foot clearance
    • Terminal swing (tibia vertical)
      • definition
        • from point where tibia is vertical to just prior to initial contact
      • muscular contractions
        • hamstring muscles decelerate forward motion of thigh
  • Variables Affected During Gait Cycle
    • Pelvic rotation
      • pelvis rotates 4 degrees medially (anteriorly) on swing side
        • lengthens the limb as it prepares to accept weight
    • Pelvic tilt
      • pelvis drops 4 degrees on swing side
        • lowers COG at midstance
    • Knee flexion in stance
      • early knee flexion (15 degrees) at heel strike
        • lowers COG, decreasing energy expenditure
        • also absorbs shock of heel strike
    • Foot mechanisms
      • ankle plantar flexion at heel strike and first part of stance
    • Knee mechanisms
      • at midstance, the knee extends as the ankle plantar flexes and foot supinates
      • restores leg to original length
      • reduces fall of pelvis at opposite heel strike
    • Lateral displacement of pelvis
      • pelvis shifts over stance limb
        • COG must lie over base of support (stance limb)
    • Center of gravity (COG)
      • in standing position is 5cm anterior to S2 vertebral body
      • vertical displacement
        • during gait cycle COG displaces vertically in a rhythmic pattern
          • the highest point is during midstance phase
          • lowest point occurs at the time of double limb support
      • horizontal displacement
        • COG displaces 5cm horizontally during adult male step
  • Muscle Activity
    • Figure showing muscle activity through different phases of gait cycle
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