Gait and Gait Analysis

Travelling short or medium distances for us is easilyand preswing consists of the last part of the double
accomplished by walking, which is convenient andsupport phase before the leg goes on into swing.
easy but needs our muscles and joints to be in goodThere are three swing phases, initial, mid and terminal,
condition and to be pain free. Having enough musclewhich allow the leg to be brought forward for the
power and sufficient joint range of movement in thenext heel strike and for the leg to clear the
legs is necessary for efficient walking. As walkingintervening ground.
progresses one leg gives the body support while theEnergy conservation and shock absorption are
other swings through to be placed forward and in itsimportant parts of efficient gait. The joint contact
turn to take weight. The swing and stance phasesforces can be increased if there are joint restrictions
are the easiest way of understanding where eitheror loss of muscle power, leading to structural
leg is at a particular point.pathologies in the abnormally loaded areas. Sixty
The process of going through all the stages andpercent of the bodyweight loads extremely quickly
getting back onto the same foot again is known asonto the leg in the early stance phase, taking only
the gait cycle. Both feet are down on the ground fortwenty milliseconds.
about 10% of the gait cycle, with a single down onThe leg joints absorb and control these forces as
the ground for about 40% percent overall. Thethey act as shock absorbers and dampers. When the
remainder is made up of the swing part of the cycleleg is placed initially on the ground the forward forces
as the legs are being brought through to be placedinvolved tend to make the knee bend so we resist
down on the ground again for the next step. Asthis by making the knee straighter even though this
walking gets faster the duration of these phases ofincreases the forces through the joints. Loading
the gait cycle reduces and when we start runningforces are minimised by eccentric muscle action by
then there is no double support phase when boththe hip adductors and quadriceps.
legs are on the ground at the same time.Walking always takes energy but these demands are
The stance and swing phases consist of a preciserelatively small for normal adults walking on the level
and repeatable series of movements during normalat their natural speed. We each tend to have a
locomotion, with five different stages of stancenaturally chosen walking speed which minimises the
phase. These are initial contact, loading response, midamount of energy we expend. All muscular or
stance, terminal stance and preswing, although initialneurological conditions slow walking speed down but
contact is often referred to as heel strike. Heel strikedo not necessarily increase the amount of energy
is a slight misnomer as some people do not heelused per time due to the slower cycle. Even though
strike or at least weight transfer to the heel later inthe energy cost per unit time may not change the
the phase. Heel strike allows shock reduction andactual cost of getting along a particular distance can
maintenance of stability and speed whilstincrease markedly, for instance more than 3 times
accomplishing weight transfer to a new leg.the normal in stroke.
The swing phase occurs as the other leg supportsUsing a wheelchair cuts energy requirements per
the weight of the body, taking the body centre ofdistance by 50% and allows speed to be maintained.
support to be placed over the foot in what isThe choice of using a wheelchair may be made by a
referred to as mid stance which initiates the phase ofpatient when the amount of energy to get across a
single leg support. The supporting foot lifts at thecertain distance exceeds a certain level, often when
heel as the cycle progresses into terminal stance, athe load exceeds 300% of what would be normally
phase which stops when heel strike is obtained onrequired.
the other foot. The swing phase is about to start