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GAIT 2 - Clinical Gait Analysis - Handout

This document discusses clinical gait analysis. It describes how joint motion during walking can be measured using eyeballing, video analysis with markers, or wearable sensors. Traditional motion capture uses expensive research-grade equipment while markerless systems and wearable sensors do not require subject preparation. Gait kinetics, or the forces involved in walking, can be measured through footprints, pressure maps, or force plates. Key gait events like initial contact, toe off, and heel rise can be identified on vertical ground reaction force curves. Understanding normal gait kinematics and kinetics data is important for clinical gait analysis.

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276 views

GAIT 2 - Clinical Gait Analysis - Handout

This document discusses clinical gait analysis. It describes how joint motion during walking can be measured using eyeballing, video analysis with markers, or wearable sensors. Traditional motion capture uses expensive research-grade equipment while markerless systems and wearable sensors do not require subject preparation. Gait kinetics, or the forces involved in walking, can be measured through footprints, pressure maps, or force plates. Key gait events like initial contact, toe off, and heel rise can be identified on vertical ground reaction force curves. Understanding normal gait kinematics and kinetics data is important for clinical gait analysis.

Uploaded by

j
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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400906 Introduction to Physiotherapy Practice

Clinical Gait Analysis

Professor Roy Cheung PT PhD


Professor of Physiotherapy, School of Health Sciences
Gait kinematics

Joint motion during walking


How do we measure gait kinematics?

Eyeball

Video analysis
Markerless
system
Wearable
sensors
Traditional
mocap
Traditional motion capturing

Research grade equipment – costly and difficult


Skin artefacts
Wearable sensors

It breaks the wall of laboratories


Data Drifting

Frequent re-calibration required


Markerless system

No subject preparation is needed


Video-based analysis

Beware of projection error


2D Joint range measurement

Perpendicular to axis
Projection error

Visual illusion
Eyeball

Shortcomings are obvious


“Simplified” version

Sagittal plane Frontal plane

Gait cycle 0%: heelstrike; Gait cycle ~60%: toe-off


Hip: Flexion-extension

• Hip flexion accompanies with body progression • Max hip flexion at ipsilateral heel strike
• It governs step length • Max hip extension at contralateral heel
• Hip extension allows the ‘hind limb’ to support strike
the body
Knee: Flexion-extension

• Two knee flexion waves • Full knee extension at mid stance can be
• Small flexion wave missed in patients with weak quadriceps
– Occurs at early stance
– Shock absorption by eccentric contraction of • Large flexion wave
quadriceps
– Foot clearance in the swing phase
Ankle: Dorsiflexion-plantarflexion

(Dorsiflexion)

• Heel strike to early stance • Early to mid stance


– Slight dorsiflexion or in neutral – Ankle passively pushed to dorsiflexion
– Eccentric control of dorsiflexors
Ankle: Dorsiflexion-plantarflexion

• Propulsion • Rapid ankle dorsiflexion


– Rapid contraction of plantarflexion – Foot clearance
– Plantarflexors turn silent after contralateral heelstrike
– Plantarflexion movement continues due to inertia
Hip: Abduction-adduction
Hip Adduction

• Pelvis in neutral at heel strike


• Hip abductor of stance leg fires to work against pelvic drop
• Max abduction at ipsilateral toe off
• Max adduction at contralateral toe off
• No abduction in swing i.e. no circumduction gait
Knee & ankle frontal plane movements

Limited by strong ligament and joint morphology


Gait kinetics

Force related to walking


How do we measure gait kinetics?

Footprint
Pressure
map
Force
plate
Footprint

Integrity of foot arch


Arch indices

Details will be covered in future MSK units


Pressure map device

More information than footprint


Dynamic measurement

Not only confine to gait analysis


Force plate

3-dimensional force vector(s)


Gait kinetics

Force (ground reaction force) during walking


Vertical ground reaction force

Key:
IC=initial contact;
OT=opposite toe off;
HR= heel rise;
OI=opposite initial contact;
TO=toe off;
FA=feet adjacent;
TV=tibia vertical

• A double hump and overlapped curve


• F1: results from the loading of the body
• F2: a reduction in downward force with the upward acceleration of the
center of mass (COM)
• F3: a second peak due to a downward acceleration of the COM and
the force generated during push off
COM trajectory during walking
Antero-posterior ground reaction force

• F4: braking force


• F5: propulsive force
Medio-lateral ground reaction force

• ML force should be very small (look at • Weight shift to medial border


the scale!) • A hump due to contralateral toe-off
• We land on lateral border of foot and weight shifting
• A second peak of medial force due to
• Induce a lateral ‘braking’ force propulsion
Learning Summary

1. Understand ‘norm’ kinematics and


kinetics data

2. Appreciate the equipment required


for different gait measurements

3. Understand the strength and


limitations of the methods

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