Physiotherapy and Gait Analysis

Travelling short or medium distances for us is easilyphase, which is preswing, is preparatory for the
accomplished by walking, which is convenient andswing phase, starting with the last part of both leg
easy but needs our muscles and joints to be in goodsupport and ending when the heel comes up on one
condition and to be pain free. Having enough muscleside. The swing phases (initial, mid and terminal)
power and sufficient joint range of movement in themanage clearance of the foot above the ground and
legs is necessary for efficient walking. As walkingthe bringing forward of the trailing limb to move to
progresses one leg gives the body support while thethe front.
other swings through to be placed forward and in itsEfficient gait includes aspects of shock absorption
turn to take weight. The swing and stance phasesand energy conservation and alterations of joint
are the easiest way of understanding where eithermovement or absence of muscle power may
leg is at a particular point.increase the joint contact forces which can lead to
Achieving all the phases of gait so that you get backpathological changes in the structures abnormally
onto the same foot you started on is referred to asloaded. Almost 60% of the body weight is
the gait cycle. The duration of both feet remaining ontransferred to the early stance leg in very short
the ground at the same time is about 10 percent andperiod, under 20 milliseconds.
one leg is standing on the ground for about 40The leg joints absorb and control these forces as
percent of the time. The rest consists of the swingthey act as shock absorbers and dampers. When the
part of the cycle as the non-weightbearing leg isleg is placed initially on the ground the forward forces
taken through to a position where it can again bearinvolved tend to make the knee bend so we resist
weight. As our walking speeds increase the durationthis by making the knee straighter even though this
of the gait cycle phases  reduces until there is noincreases the forces through the joints. Loading
double support phase where both feet are weightforces are minimised by eccentric muscle action by
bearing at the same time, a condition known asthe hip adductors and quadriceps.
running.Locomotion demands that we expend energy but for
The leg joints follow a specific and repeatable seriesmost of us the level is low if we are healthy, going
of actions during the swing and stance phases withat our normal speed and walking on level ground. We
stance made up of five sections in the order of initialminimise the amount of energy we use in walking by
contact, loading response, mid stance, terminal stancechoosing a preferred speed which is most efficient.
and preswing. Heel strike is the common name givenMusculoskeletal or neurological conditions always slow
to initial contact but some people do not heel strikedown the walking speed but do not have to increase
at all or transfer weight to the heel later in the phase.the energy load per unit time because patients usually
Heel strike allows the leg which is about to weightslow their cycle down. However, the energy needed
bear to take the weight but not compromise speed,to cover an identified distance can increase greatly
stability or shock protection.with more than three times the normal expenditure in
While the one leg is supporting the weight of thethe case of stroke.
body the other leg is in swing phase. The first part ofWheelchair use allows locomotion speed to be
the single leg support phase is called mid stance and itmaintained and can cut energy expenditure per unit
is during this phase that the bodyweight moves theof distance by fifty percent. Patients tend to choose
centre of gravity and support over the foot. Thea wheelchair to get about when the amount of
cycle continues into terminal stance where theenergy necessary exceeds a particular level,
supporting foot rises at the heel and then stopsespecially when it goes beyond three times the
when the opposite foot makes contact. The lastnormal amount of energy required.