G AI T

N O R M AL
Part A (Patton) Part B
l Introduction l Mechanics (Patton)
l Gait measurement l “Determinants” of gait
techniques l Kinematics
l Force l Kinetic Patterns
l Motions l Ground reaction forces
l EMG l COP
l GRFV method
l Other
l Inverse Dynamics method
l Terminology l Calculating joint power
l RLA vs “traditional” l Muscle Torques (Humphrey)
l Phases of gait
l Specialized Gait (Humphrey)
l Observational Gait l Pediatric
Analysis l Geriatric
l Running

(Patton) slide#1
 Review of Mechanics Terminology
Mechanics:
Interaction of forces, motions, deformations, and flow.
Kinematics:
Movements (position, velocity, acceleration, joint angles, etc.)
Kinetics:
Forces during movements (joint torque, GRF, etc.)
Forward Dynamics:
How forces cause movements. We use dynamics to estimate the
movements that result from forces and moments.
(a=F/m).
Inverse Dynamics:
How movements require forces. We use inverse dynamics to
estimate the forces that cause the motions we measure.
(F=ma).

Most labs use measured forces and measured motions combined to

get a best estimate of joint torque and muscle actions.

(Patton) slide#2
 Mechanics & mechanical
Patterns:
“streamlined research” gives
patterns & deviations

5.1 Center of mass motion

Determinants of Gait
5.2 Kinematics:
Sagittal, Frontal, Transverse, & Other
5.3 Kinetics
GRF’s, COP, “GRF vector method” for
estimating joint moments, inverse
dynamics, sagittal muscle torques
(Patton) slide#3
 0% 10% 20%
Gait Phase Diagram:
30% 40% 50% 60% 70% 80% 90% 100%

PHASES:
Gait cycle is 1 Stride (100%)

Stance (60 to 62%) Swing (38 to 40%)

SUB-
PHASES:
Double Single Support Phase Double Deceleration
Traditional Acceleration
Support Support phase phase
terminology:
Phase Phase

RLA Loading Mid- Terminal Preswing Initial Midswing Terminal

Response stance stance Swing Phase swing
terminology: Phase
Phase Phase Phase

EVENTS:
Traditional Heel Foot Flat Midstance Contra- Toe Midswing Heel
(weight is over lateral (Swing leg is
terminology: strike off under the body) strike
stance leg) Foot strike

RLA Initial Contra- Heel Contra-

Foot Maximum knee Tibia is Initial
terminology: con- lateral off lateral
off Flexion vertical contact
tact Foot off Foot strike

(Jim Patton)
kinesiology gait section, part1 (Patton) 5
kinesiology gait section, part1 (Patton) 6
 Center of Mass (CM) motion:
Bipedal tradeoff: mobility vs efficiency

l ADVANTAGES OF BIPEDAL GAIT:

l Bipedal gait frees our hands, elevates our head,
and allows us to move on challenging terrain.

l DISADVANTAGE:
l Very hard for our CM to move in a straight line,
which would be the most efficient. (like a wheel.)
l Instead, there is an arc-shaped pattern with
lateral sway.
l Maintaining a smoother trajectory of the CM plays
a large role in determining HOW we walk

(Patton) slide#7
 Smoothing out CM Excursion

1) Pelvic Rotation
2) Pelvic List (Lateral Tilt) (Pelvic Drop)
3) Stance Knee Flexion
4&5) Knee, Ankle & Foot Interactions
6) Lateral Displacement from Hip
Adductors & Genu Valgum
See Saunders (1953), Inman et. al, (1981). Modified slightly from original.

(Patton) slide#8
 PELVIC ROTATION

n Pelvis moves
forward with swing
limb
n Trails behind with
the following limb
n Flattens the Arc of
CM motion by
increasing the
effective leg-length
at these times

(Patton) slide#9
 PELVIC LIST
n Pelvis dips down
on swing side
during swing
n Lowers CM and
flattens arc

Recently
Recently
disputed
disputedto
tobe
be
not
nottrue
true

(Patton) slide#10
 STANCE KNEE FLEXION

n Shortens the leg

during stance
n Flexion at the
beginning and
end of stance
smoothes the
abrupt changes
in CM
n Flattens the arc

Recently disputed to be not true:

Gard, S. A. (1996). "The influence of stance-phase knee flexion on the vertical displacement
of the trunk during normal walking." Journal of Biomechanics 29(10): 1387-91.
(Patton) slide#11
 KNEE, ANKLE & FOOT INTERACTIONS
n Heel-strike: Knee is
extended and ankle is
dorsiflexed to lengthen the
leg
n Loading response (HS
to FF): knee flexes, ankle
plantarflexes, and foot
pronates
n Midstance to terminal
stance (FF to HO): Knee
extends, ankle dorsiflexes Heel Loading Terminal Preswing
n Preswing (HO to TO): Strike Response Stance
ankle plantarflexes to Recently disputed to be not true:
lengthen the leg Kerrigan DC, Della Croce U, Marciello M, Riley PO. A refined
view of the determinants of gait: significance of heel rise.
Arch Phys Med Rehabil 2000;81:1077-80.
(Patton) slide#12
 GENU VALGUM & HIP ADDUCTION

n Valgus at the knee

permits a narrower
walking base, and
thus a smaller
lateral shift
n Tibia about vertical
n Femur articulates
adducts to shift CM
in the frontal plane,
toward the line of
progression

(Patton) slide#13
 l Averages 1 inch anterior to S2 on the
midline
l about 55% of body height up from the
floor.
l During gait, the CM still waves up and
down and side to side in a sinusoidal
trajectory that has about a 2 inch
amplitude

(Patton) slide#14
Gait is Variable

539 strides of a “normal” subject

kinesiology gait section, part1 (Patton) 15

 l Sagittal, lower extremity kinematics
dominate gait
l Gross motions and muscle groups
l Sometimes the only thing measured
l VARIABILITY MUST BE CONSIDERED
l People are variable
l Measurement techniques are variable

(Patton) slide#16
 40
Sagittal: Hip
30
Avg+std
20 avg
Avg-std
degrees

10

0
0 20 40 60 80 100
-10

-20 % gait cycle

(Patton) slide#17
 70
Sagittal: Knee
60

50 Avg+std
avg
40
Avg-std
degrees

30

20

10

0
0 20 40 60 80 100
-10 % gait cycle
(Patton) slide#18
 15
Sagittal: Ankle
10

0
degrees

0 20 40 60 80 100
-5
Avg+std
-10
avg
-15 Avg-std

-20
% gait cycle
(Patton)
-25 slide#19
 Loading Response Phase
(Heel Strike to Foot Flat)
(see also pg. 30 of Observational Gait Analysis)
l HIP: 25° flexion
l KNEE: 0° ® 15° flexion (Lowers CM)
l ANKLE: 0° ® 10° plantar flexion

“1st
“1strocker:”
rocker:”
Calcaneus
Calcaneus

(Patton) slide#20
 Midstance Phase
(Foot Flat to “midstance event”)
l HIP: 25° flexion ® 0°
l KNEE: 15° flexion ® 0° flexion
l ANKLE: 10° plantar flexion ® 5° dorsi
flexion

“2nd
“2ndrocker:”
rocker:”
ankle
ankle

(Patton) slide#21
 Terminal Stance Phase
(“midstance event” to Heel Off)
l HIP: 0° flexion ® 20° extension
l KNEE: 0°
l ANKLE: 5° dorsi flexion ® 10° dorsi
flexion

Continue
Continue“2nd
“2ndrocker:”
rocker:”ankle
ankle
At
Atend
endof
ofterminal
terminalstance,
stance,
Begin
Begin “3rd rocker:”MTP
“3rd rocker:” MTP

(Patton) slide#22
 Preswing Phase
(Heel Off to Toe Off)
l HIP: 20° extension ® 0°
l KNEE: 0° ® 40° flexion
l ANKLE: 10° dorsi flexion ® 20° plantar
flexion

“3rd
“3rdrocker:”
rocker:”
MTP
MTP

(Patton) slide#23
 Swing Phase (Toe Off to Heel Strike)

l HIP: 0° ® 30° flexion

l KNEE: 40° flexion ® 60° flexion ® 0°
l ANKLE: 20° plantar flexion ® 0°

Note:
Note:
RLA
RLA divides
divides swingswing into
into 33
sections,
sections, where
where wewe will
will not
not
cover
cover itit in
in this
this amount
amount of of detail.
detail.

(Patton) slide#24
 Other motions

Pelvic tilt
n 5° forward in early stance, then tilts 5° backward
in late stance, then tilts
a nd5°vvforward
aari
r a
i abble
l e again by late
swing M 55°° and
RROOM

Arms
n Swing opposite to the legs (out of phase).
Smoothes the CM trajectory.

MTP
n 0° ® 30° ® 60° dorsiflexion

(Patton) slide#25
 Hip & Pelvis

Pelvic Obliquity (Pelvic List)

Near midstance, the CM is high.
The swing side of the pelvis drops
down during swing to lower the CM.

Hip AB-Adduction
Hip adducts in early stance about 5°,
abducts in late stance about 5°, and
returns to neutral in swing.

(Patton) slide#26
 Subtalar
In early stance, eversion
(pronation) unlocks the
midtarsal joint, allowing shock
absorption. Initial Loading Terminal
Contact Response Stance

In late stance, inversion

(supination) locks the midtarsal
joint, allowing a rigid forefoot
lever for heel off.

(Not quite frontal)

(Patton) slide#27
 Hip, trunk & lower limb

Pelvic Rotation
n the swing leg side of the pelvis rotates 10° with the
swing leg.
Trunk Rotation
n Lower trunk (below T7/T8 ) rotates with the pelvis.
n Upper Trunk rotates opposite to this (180° out of
phase)
Femoral/Tibial Rotation
n internal rotation until foot flat, then externally
rotates until toe off, then internally rotates through
swing.
(Patton) slide#28
 Talo-crural & Talo-calcaneal joints act as a
torque converter
Pronation at heel-strike is
converted to internal tibial
(and subsequently
femoral) rotation.

External rotation of the

femur between midstance
event and toe-off is
converted into supination
of the foot.

(Patton) slide#29
 Ground Reaction Forces (GRF)
l The equal-and-opposite
force the floor exerts on
the body during stance
l Best measured with a
force plate
l Forces are typically
resolved into:
n Vertical Compression (z)
n Anterior-Posterior Shear (y)
n Medial-Lateral Shear (x)

(Patton) slide#30
 Vertical GRF
140

120
% body weight

100 l “M” shaped curve

l There can be a
80 spike at heel
contact
60 l Hump during
loading response
Avg+std l Valley at
40
avg midstance
20 l Hump in preswing
Avg-std
0
0 20 40 60 80 100

(Patton)
% gait cycle slide#31
 Anterior-Posterior Shear Force
30
25 Avg+std
20 avg
% body weight

l Friction is
15 Avg-std required to walk
normally
10 l Often an anterior
5 spike at heel
contact
0 l Braking hump in
-5 0 20 40 60 loading
80 response
100
l Acceleration
-10 hump in
-15 preswing
response
-20

(Patton)
% gait cycle slide#32
 Medial-Lateral Shear Force
3
Avg+std
2.5
avg
% body weight

2
Avg-std
1.5
1 l Highly
variable
0.5 l CM is
usually
0 medial to
the
80 foot, so
-0.5 0 20 40 60 100
odds are it
is a lateral
-1 force
-1.5

(Patton)
% gait cycle slide#33
 Kinetics: Center Of Pressure (COP)
l Represents the centroid of
foot forces on the floor
l This is an idealization,
because pressures are
distributed all over
l It is important, because we
want to know where the
GRF is applied to the body
l When measured by a force COP
plate, it is more correctly
called the point of
application of the GRF GRF
(Patton) slide#34
 l Plotting the COP as it
moves under the
foot:
n Normal Path: Center of the
calcaneus or slightly lateral,
curving laterally and then
medial (pronation) and ending
between the 1st and second
toes
n Variable: Normal individuals
can have many COP
trajectories, just by changing
their gait style.

(Patton) slide#35
kinesiology gait section, part1 (Patton) 36
kinesiology gait section, part1 (Patton) 37
 (see website for these)

(Patton) slide#38
 TThhis is Exter
is is Externnaal torque
The “GRF Vector Method” ((to l torque
torrqquuee ddeem a
manndd))
vvss
Estimating external joint torques IInnternal torq
((m u
ternal torquuee
musscclele totorrqquuee))
Midstance
LR MSt event TSt PSw

flex flex zero exten exten

flex
zero exten flex flex

plantar dorsi dorsi dorsi dorsi

NOTE: This method is dynamically inaccurate & can give WRONG results.

(Patton) slide#39
 GRF Vector Method:
Why this is NOT correct

l Dynamics are neglected

l The faster the gait, the more error
l Accuracy is fair for distal joints (ankle
and sometimes knee)
l Neck example: if we use this to
estimate the neck moment, we end up
with an outrageous value.
l GRF Vector Method says all moments
during swing are zero, which is not true
l (see Winter, 1990)
l What is the correct way?
INVERSE DYNAMICS

(Patton) slide#40
 Muscle torques:
What are the muscles doing in gait?

l An external (GRF) force :

l can cause motion OR,
l can be countered by gravity OR,
l it can be resisted by muscle OR,
l any combination of the above
l Inverse dynamics:
l tell us the net effect of the muscles
l Example:
“The muscles crossing the ankle are generating a
NET torque of 70 Newton*meters at heel rise”

(Patton) slide#41
 Cause & Effect
motor- muscle torques accelerations
neurons tensions

converging
converging
& mixing
mixing
MOTION

Dynamic
Dynamic
equations
equations

Why can’t we get the actual muscle tensions?

It is difficult to estimate the actual muscle forces from torques, because many
muscles can make the same torque (due to “converging” of muscles to torques)
(Patton) slide#42
 gives
givesthe
theparts
parts

Torques caused by motions

(IQ)

Kinematics Inverse
(positions, velocities, and Torques caused by gravity
Dynamics (ML)
accelerations)

GRF & COP LEFTOVERS: Net torques

caused by muscles and other
passive structures such as
ligaments, skin, etc. (RJT)

IDA : &&
IQ = SML + RJT
GRFVM : SML = -RJT
kinesiology gait section, part1 (Patton) 43
(Patton) slide#43
 Disadvantages of Inverse
Dynamics
l No information on co-contraction
l No information on elastic storage
l No information on passive structures
(ligament, skin, clothing)
l No information on what role bi-articular
muscles are playing

(Patton) slide#44
 SAGITTAL muscle torques:
ANKLE the fo
the following
are alllowingsslides
tora re alllmusclelides
3 Plantarflexion (+) q
torquuees ob muscl
e
using s obttaain e
inedd
dynaum singin v e r
nverssee
dynamics. iC
these ics. Coom pa
thesetorque mparree
those torques to
2 thoseestima s to
from testimatted
from the GRF ed
methohe GRF
moment Obsermethoddin
Observationa in
Anvaaltyisonal lGGaaiti
Nm/KG 1 Analysis
`
`
is
t

0
Dorsiflexion (-)
-1
(Patton) slide#45
 SAGITTAL muscle torques:
KNEE

2
Extension (+)

moment 1
Nm/KG
0

Flexion (-)
-1
(Patton) slide#46
 SAGITTAL muscle torques:
HIP

2
Extension (+)

moment 1
Nm/KG
0

Flexion (-)
-1
(Patton) slide#47
 Simply multiply torque times velocity
l UNITS (for angular power):
(Newton*meters/sec) = watts
l Positive: prime mover is concentric
l Negative: prime mover is eccentric
l Does not show co-contraction
l 3D is problematic

Hip (F/E) Knee (F/E) Ankle (D/P)

Joint Concentric (+)

Power
(Watts/Kg)
Eccentric (-
(-)

% Gait Cycle % Gait Cycle % Gait Cycle

(Patton) slide#48
 r e h e th i
Yo on ate lid
t
sp m s s
u’ s i r i e
Where to get more info

l Books:
n Gage, James R. Gait analysis in cerebral palsy. Clinics in
developmental medicine; no.121. London: Mac Keith, 1991.
n Inman, VT, Ralston, HJ, Todd, F. (1981) , Human Walking,
Baltimore: Williams and Wilkins
n Inman & Saunders, Human Walking (2nd Edition).
n Perry, Jacquelin. Gait analysis: normal and pathological
n
function. Thorofare, N.J: SLACK, 1992.
Vaughan, CL. Gait analysis laboratory an interactive book &
software package. [kit]. Champaign, Ill: Human Kinetics
Publishers, 1992.
n Vaughan C.L., B.L. Davis, and J.C. O'Connor, "Dynamics of
Human Gait", 1st edition, Human Kinetics Publishers, 1992
n Vaughan, Christopher L. Biomechanics of human gait: an
annotated bibliography. 2nd ed. Champaign, Ill.: Human
n
Kinetics Publishers, 1987.
Weber, Wilhelm Eduard. Mechanics of the human walking
apparatus. Berlin: Springer-Verlag, 1991.
n Whittle, Michael. Gait analysis: an introduction. Oxford:
Butterworth-Heinemann, 1991.
n Winter, David A. The biomechanics and motor control of
human gait: normal, elderly and pathological. 2nd ed.
Waterloo, Ont.: University of Waterloo Press, 1991.
n Winter, David A. A.B.C. (anatomy, biomechanics, control)
of balance during standing and walking. Waterloo, Ont.:
Waterloo Biomechanics, 1995.
n Gait: an anthology. [United States]: American Physical
Therapy Association, 1981.
Winters and Woo (eds), Multiple Muscle Systems, Springer
n
Verlag, 1990.
n Craik and Oatis (eds), Gait analysis: Theory and
application. Mosby-Yearbook, St. Luis, 1995.
re bl al
no e f on
t or
l Local Labs/Clinical Facilities:
n NU/Rehab. Institute (RIC): Dudley Childress, Scott Delp.
n Chicago Children’s Hospital Clinical Gait Lab
n U. Of Illinois at Chicago and Rush Presbyterian St. Luke’s
n VA/Hine’s Hospital
l Gait Journals:
n Gait & Posture
n Journal of Biomechanics
n Human Movement Science
l Key Journal Articles:
n Ounpuu, S., (1994) The biomechanics of walking and
running Clinics in Sports Medicine, 13(4) 843-863.
n Saunders, J. B., V. T. Inman, H. D. Eberhardt (1953) The
major determinants in normal and pathological gait. The
Journal of Bone and Joint Surgery. 35-A:543-558.
n Winter, D. A. (1984) Kinematic and Kinetic patterns in
Human Gait: Variability and Compensating Effects. Human
Movement Science. 3:51-76.
n Kirtley C, Whittle MW & Jefferson RJ (1985) Influence of
Walking Speed on Gait Parameters Journal of Biomedical
Engineering 7(4): 282-8.
l Web/Internet:
n Clinical Gait Analysis Web Page and Listserver:
http://www.curtin.edu.au/curtin/dept/physio/pt/staff/kirtley
/cga/
n Biomechanics Listserver:
http://www.kin.ucalgary.ca/isb/biomch-l.html
n http://www.linder.com/muybridge.html
n http://165.124.30.88/jim/kinesiology_gait

(Patton) slide#49