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Phases of Gait
Descriptions of the different phases of gait & what happens at each joint
37
Health Care
Graduate
08/08/2013

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Term
Initial Contact
Definition
*Point when foot first makes
contact with ground
*"Heel strike"
*Involved in weight acceptance
Term
Loading Response
Definition
*From initial contact until the
point when the opposite leg is
lifted for swing
*"Flat foot"
*Involved in weight acceptance
and deceleration of the limb
Term
Mid-Stance
Definition
*From the point when the
opposite limb is lifted for swing
until the body weight is aligned
over the forefoot
*Involved in stabiliztion
Term
Terminal Stance
Definition
*From heel rise until the other
limb makes initial contact with
the ground
*Body weight moves ahead of
forefoot
*Involved in stabilization
Term
Pre-Swing
Definition
*From initial contact of the
opposite limb until toe off
*"Toe-off"
*Involed in limb advancement
(acceleration of limb)
Term
Initial Swing
Definition
*From the point when foot is
lifted off the ground until the
swing leg is aligned with the
stance leg
*Foot clearance
*Acceleration of the limb
Term
Mid-Swing
Definition
*Continues until hip and knee
flexion are about equal and the
swing limb had advanced past the
stance limb
*Foot clearance
*Acceleration
Term
Terminal Swing
Definition
*From end of mid-swing to the
point when the foot makes
contact with the floor
*Preparing for landing
*Deceleration of the limb
Term
Initial Contact: Ankle in Sagittal Plane
Definition
Term
Initial Contact: Ankle in Frontal Plane
Definition
*GRF promotes pronation at heel
strike, as concentric, regular action
*Pronation controlled by
supinators (Tibialis anterior and
tibialis posterior) with eccentric,
regular action
*Occurs until early mid-stance
*Pronation occuring at subtalar
joint and forefoot
*Terrain will affect the amount of
pronation/supination occuring
Term
Initial Contact: Knee in Sagittal Plane
Definition
*Knee is mostly extended
(2 degree hyperextension to 5
degree flexion)
*GRF is anterior to knee and
creates extension moment
*Some quad and hamstring
cocontraction for stability
Term
Initial Contact: Knee in Frontal Plane
Definition
*Adduction moment of tibia
relative to femur
*Greatest during loading response,
but present throughout stance
phase
*Medial rotation (~8 degrees)
occurs as a result of tibia rotation
in the first part of stance (drives
foot into pronation)
Term
Initial Contact: Hip in Sagittal Plane
Definition
*30 degrees of flexion
*GRF creates hip flexion moment
*Gluteus and hamstring muscles
control the hip flexion moment,
with eccentric, regular action
Term
Initial Contact: Hip in Frontal Plane
Definition
*First half of stance involves hip
adduction which has to be
controlled by hip abductors with
eccentric, reversed action
Term
Initial Contact-Mid-Stance: Hip in Transverse Plane
Definition
*Pelvic and trunk roation in opposite directions to allow for more efficent movement and minimize lateral shifting
Term
Loading Response: Ankle in Sagittal Plane
Definition
Two Phases:
1) *0-10 degree PF
*Controlled by tibialis anterior
with eccentric, regular action
2) *10-0 degree DF
*Caused by concentric, reversed
action of the tibialis anterior and
the momentum of COG moving
forward
Term
Loading Response: Knee in Sagittal Plane
Definition
*Knee flexes about 15 degrees
*GRF now behind knee resulting
in a flexion moment
*Quads have to control the
moment with eccentric, reversed
action
*Shock absorbtion
Term
Loading Response: Hip in Sagittal Plane
Definition
*Hip moves into more extended
position
*Increased gluteal activity
(concentric, regular action) but
decreased hamstring
*By end of loading, GRF is
posterior to hip and little or no
extensor muscle activity is
needed
Term
Mid-Stance: Ankle in Sagittal Plane
Definition
*5-10 degrees DF
*Caused by forward momentum
of COG and anterior location
of GRF
*DF moment is controlled by
soleus and gastrocnemius (PF)
with eccentric, reversed action
Term
Mid-Stance: Ankle in Frontal Plane
Definition
*From early midstance to terminal
stance, subtalar joint moves from
pronation to supination to lock
midtarsal joint, allowing for more
stable foot complex for push-off
*Excessive supination controlled
by everters (peroneus longus,
peroneus brevis, extensor
digitorum longus) by eccentric,
regular action
Term
Mid-Stance: Knee in Sagittal Plane
Definition
*Knee extends to near full
extension
*First done by quadriceps,
overcome knee flexion moment
with concentric, reversed action
*Later, momentum of body moves
femur forward over tibia with less
quadriceps required
*GRF moves more anterior
requiring less quadriceps
Term
Mid-Stance: Knee in Frontal Plane
Definition
*Lateral rotation occurs as a result
of tibial lateral rotation in the
later part of stance (when foot
moving into supination)
Term
Mid-Stance: Hip in Sagittal Plane
Definition
*Hip continues to move
passively into extension
*GRF moving posterior to hip joint
so little or no hip extension
muscle activity needed
Term
Terminal Stance: Ankle in Sagittal Plane
Definition
*Need less gastroc-soleus for
support due to double stance
and unloading
*Gastroc-soleus torque used
to assist with accelerating the
limb forward and flexing the
knee rapidly in preparation for
swing
*Roll off- PF momentum
*Push off- PF concentric, regular
action
Term
Terminal Stance: Ankle in Frontal Plane
Definition
*Need adequate MTP extension
(75 degrees) to "roll-over" foot
in terminal stance and pre-swing
*Toe flexors and intrinsics work
here to maintain stability
Term
Terminal Stance: Knee in Sagittal Plane
Definition
*Knee completes maximum
extension
*Toward end of terminal stance,
slight flexion occurs in preparation
for swing
*Extension keeps COG from
going too low
Term
Terminal Stance: Hip in Sagittal Plane
Definition
*Hip moves into hyperextension
*GRF posterior to hip joint
*Amount of hyperextension
controlled by flexor component
of tensor fascia lata with eccentric,
regular action
Term
Terminal Stance: Hip in Frontal Plane
Definition
*Hip abducts near end of stance
as weight is shifted to opposite
limb, requiring control by hip
adductors with eccentric, reversed
action
Term
Pre-Swing: Ankle in Sagittal Plane
Definition
*Need less gastroc-soleus for
support due to double stance
and unloading
*Gastroc-soleus torque used
to assist with accelerating the
limb forward and flexing the
knee rapidly in preparation for
swing
*Roll off- PF momentum
*Push off- PF concentric, regular
action
Term
Pre-Swing: Knee in Sagittal Plane
Definition
*40 degrees of knee flexion
occurs passively
*PF of ankle by gastroc-soleus
indirectly causes passive knee
flexion
Term
Pre-Swing: Hip in Sagittal Plane
Definition
*Hip flexes to neutral
*Caused in part by advancing
forward, flexing the knee,
which also flexes the thigh
*Also from adductor longus and
rectus femoris activity if more
force is needed (concentric,
regular action)
Term
Initial-Terminal Swing: Ankle in Sagittal Plane
Definition
*Ankle DF as concentric, regular
action
*Toe extension as concentric,
regular action
*Need both to occur for
clearance
Term
Initial Swing: Knee in Sagittal Plane
Definition
*60 degrees of knee flexion for
foot clearance
*Caused by momentum of thigh
and by contraction of hamstrings,
with concentric, regular action
Term
Initial & Mid-Swing: Hip in Sagittal Plane
Definition
*Hip continues to flex
*Caused primarily by forward
momentum of thigh
*May also have contributions
from hip flexor muscles to
accelerate into flexion
Term
Mid-Swing: Knee in Sagittal Plane
Definition
*Knee begins to passively extend
*Gravity acting on the tibia and
the forward momentum of the
thigh provide the forces for
extending the knee (mainly
momentum)
Term
Terminal Swing: Knee in Sagittal Plane
Definition
*Active extension occurs
*Quads needed to get knee into
enough extension for contact
and to assist in making the knee
stable on contact (concentric,
regular action)
*Hamstrings are active to
decelerate the knee and help
make the knee stable for contact
(eccentric, regular action)
*quads and hamstrings are
working together to cocontract
Term
Terminal Swing: Hip in Sagittal Plane
Definition
*Deceleration of hip flexion by
hamstrings with eccentric,
regular action
*In late terminal swing, hamstring
activity decreases and gluteal and
adductor magnus activity
increases with eccentric, regular
action
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