Presented by Ika Guslanda Bustam, S.Fis., M.

Sc
Department of Physical Therapy
STIKes Muhammadiyah Palembang
 Types of analysis
 Kinematic  a description of movement of the body a whole and or body segments in
relation to each other during gait.
 Kinetic  determine the force involved in gait
 Gait
Cycle

Swing Support
Phase Phase

Early Late Loading Mid- Drive off

Swing Swing Phase Stance Phase
Swing Early Late
Phase Swing Swing

Start Knee
Toe-off Toe-off
Exten

Foot Start Knee Foot

Strike Exten Strike
Stance Loading Mid-
Drive-Off
Phase Phase Stance

Foot Foot Foot Heel

Strike Strike Flat Raise

Foot Heel
Toe-off Toe-off
Flat Raise
 The moment when the foot touches
the floor
 Objective
 Positioning the leg
 Start  heel rocking
 Start  double support
 First Weight Acceptance

 Critical Event
 Hip  25 extensor
 Knee  0 quadriceps
 Ankle  0 pretibialis
 Double stance: From initial contact till
initial swing of the other leg
 Objective
 Shock absorption
 Weight-bearing stability
 Double stance phase
 Preservation of progression

 Critical Event
Hip and knee stability, drop foot
 Hip  25 extensor & abductors
 Knee  15 quadriceps
 Ankle plantar 10 pretibialis
 Mid-stance: start as the other foot is lifted
and continues until body weight is align
over the forefoot
 Objective
 Progression over the stationary foot
 Limb and trunk stability

 Critical Event
Controlled tibial advancement
 Hip  0 abductors
 Knee  0 quadriceps
 Ankle dorsiflex 5 calf
 From heel rise till the other foot strikes the
floor
 Objective
 Progression of the body beyond the
supporting foot
 Propulsion or push of

 Critical Event
Foot rocking and heel rise knee control
 Hip  20
 Knee  0
 Ankle  10
 Pre-swing: Second double limb support
from initial contact of the other leg
 Objective
 Prepare the limb for swing
 Double limb support

 Critical Event
Knee flexion till 40 and plantar flexion
 Hip  0 abductor longus
 Knee  40
 Ankle  20 Post-tibialis
 One-third of the swing: from toe-off till the
swinging foot is opposite the stance foot.
 Objective
 Foot clearance from of the floor
 Advancement of the limb from it is trailing
position
 Critical Event
Hip flexion till 15 and knee till 60
 Hip  15 Flexors
 Knee  60 Flexors
 Ankle  10 Pre-tibialis
 From swinging limb opposite the stance
limb till the tibia is vertical.
 Objective
 Foot clearance from of the floor
 Limb advancement

 Critical Event
Hip flexion till 25 and ankle in 0
 Hip  25 Hamstrings
 Knee  25 Biceps femoris
 Ankle  0 Pre-tibialis
 From vertical tibia till initial contact.
 Objective
 Deceleration of the tibia
 Complete limb advancement
 Prepare the limb for stance

 Critical Event
Knee extension 0
 Hip  25 Hamstrings
 Knee  0 Quadriceps
 Ankle  0 Pre-tibialis
 General Gait Characteristic
 Use or without shoes, aids for assessment
 Rhythm, step length, arm swing
 Speed, endurance, safety
 Variation  stairs, slope, stone, beach
 Which gait phase in stance
 Weight bearing ration
 In general gait deviations fall under four headings:
 Those caused by weakness
 Those caused by abnormal joint position or range of motion
 Those caused by muscle contracture
 Those caused by pain
 Pain
 Posture
 Flexibility and the amount of available joint motion
 Endurance - economy of mobility
 Base of Support
 Limb coordination
 Leg-length
 Gender
 Pregnancy
 Obesity
 Age
 Lateral and vertical displacement of the COG
 Properly functioning reflexes
 Vertical Ground Reaction Forces
 Medial-Lateral Shear Forces
 Anterior-Posterior Shear Forces
 Hip
 Inadequate power
 Inadequate or inappropriate range of motion
 Malrotation
 Knee
 The common problem at the knee during the stance
period is excessive flexion. During the swing period, the
most common error is due to inadequate motion
 Foot and ankle
 There are three broad types of errors of the foot and ankle in the stance and swing
periods:
 Malrotation
 Varus or valgus deformity
 Abnormal muscle moments
 Tendency to classify gait according to disease or injury state
 Hemiplegic gait
 Parkinson gait
 Spastic gait
 Quadra- or paraplegic gait
 Trendelenburg gait
 Amputee gait, etc.
 Normal Gait

Spastic gait

Cerebellar ataxic gait

Parkinson Gait

Frontal Gait
 The antalgic gait pattern can result from numerous causes
including joint inflammation or an injury to the muscles tendons
and ligaments of the lower extremity
 The antalgic gait is characterized by a decrease in the stance
period on the involved side in an attempt to eliminate the
weight from the involved leg and use of the injured body part as
much as possible
 The parkinsonian gait is characterized by a flexed and stooped
posture with flexion of the neck, elbows, metacarpophalangeal
joints, trunk, hips, and knees
 The patient has difficulty initiating movements and walks with
short steps with the feet barely clearing the ground. This results
in a shuffling type of gait with rapid steps
 The normal stabilizing affect of these muscles is lost and the patient
demonstrates an excessive lateral list in which the trunk is thrust
laterally in an attempt to keep the center of gravity over the stance
leg
 Normal gait  Gluteus mdius and minimus contract as soon as the
contralateral foot leaves the floor to prevent the pelvis tipping
 Trendelenburg gait  pelvis drops to side of raised foot
 CAUSES
 Superior gluteal nerve injury
 Dislocation of the hip
 Adequate pelvic stability
 L5 Radiculopathy
 weakness of the hip abductors (gluteus medius and minimus)
 Poliomyelitis
 The ataxic gait is seen
in two principal
disorders: cerebellar
disease (cerebellar
ataxic gait) and
posterior column
disease (sensory ataxic
gait)
 Good posture is a subjective term reflecting what the
clinician believes to be correct based on ideal models.
 Generally speaking muscles can be subdivided into:
 Postural muscles
 Phasic muscles
 The ability to main correct posture is related to a number of
factors, which includes but is not limited to:
 Energy cost
 Strength and flexibility
 Structural deformities
 Disease
 Pain