Walking
Paul Grimshaw, Michael Cole, Adrian Burden, Neil Fowler in Instant Notes in Sport and Exercise Biomechanics, 2019
In the analysis of any skill, it is important to understand the role of the various joint movements and body segments involved. Walking is no exception. The joint and segmental interactions involved in walking are so complex that it takes most humans a year to be able to “toddle” and a further three to four years to walk perfectly. Gait is defined according to the sequence of swing and support phases of the legs when the foot is either in the air (swing) or in contact with the floor (support or stance). Walking gait is characterised by periods of double support, where both feet are in contact with the ground, separated by periods of single support when one foot is on the ground while the other leg is swung forwards to make the next step. There is no time at which both feet break contact with the ground at the same time; in other words, there is no flight phase.
The locomotor system
Peter Kopelman, Dame Jane Dacre in Handbook of Clinical Skills, 2019
Gait Observe the patient from the front and sides while they are standing in their underwear (Figs 5.2 and 5.3), looking for any kind of asymmetry and deformity such as one leg being shorter or longer (Fig. 5.4) than the other, or abnormality of the spinal curvature (kyphosis, scoliosis or a loss of lumbar lordosis). Observe the patient walking to make sure that the gait is normal, that they are swinging the arms and moving the legs symmetrically. Look out for an antalgic gait, and make sure that both the person’s knees are straight. An antalgic gait is an abnormality of gait rhythm in which the patient avoids bearing weight on the painful leg and spends most of the gait cycle on the unaffected limb. This may suggest a problem of the hip, knee, hindfoot, midfoot or forefoot.
Falls and Gait Impairment
K. Rao Poduri in Geriatric Rehabilitation, 2017
Gait disorders may be classified as neurological, nonneurological, or multifactorial in origin. Neurologic causes of abnormal gait include conditions resulting in the upper and lower motor neuron syndromes, sensory and proprioceptive impairments, neurodegenerative conditions, and cognitive dysfunction. Impaired peripheral sensory function may manifest with gait impairment. A deafferentation patterned gait results from impaired proprioception, most commonly from dysfunction of the posterior column of the spinal cord or severe sensory peripheral neuropathy. Deafferentation presents as a wide-based, steppage gait (exaggerated hip flexion, knee extension, and foot lifting). They will often display a worsening of their gait stability in darkened environments and may report frequently bumping into objects. They will typically have a positive Romberg sign on physical examination. As a common cause of this pattern in older adults is cervical myelopathy, spinal cord imaging should be considered in evaluation of this gait pattern to rule out cord compression. Additionally, such patients should also have a serum vitamin B12 level and syphilis serology included in their evaluation. Patients with vestibular disorders often display a weaving gait and may lurch toward the side of the affected ear. Patients with visual impairment may demonstrate an uncertain, hesitant, and uncoordinated gait, particularly in low lighting conditions.
Reliability and applicability of a low-cost, camera-based gait evaluation method for clinical use
Published in Expert Review of Medical Devices, 2023
Savvas Spanos, Asimakis Kanellopoulos, Kyriakos Petropoulakos, Zacharias Dimitriadis, Ioannis Siasios, Ioannis Poulis
Gait is a daily living activity, which could be unfavorably altered by a plethora of pathological conditions. Gait assessment is essential in rehabilitation since it constitutes a contributing parameter in patients’ functional status [1,2]. Therefore there is the need for valid, reliable and easy to use in routine clinical practice, gait assessment tools. Observational gait assessment tools require less time, little equipment, are cheap and more accessible, therefore are easy to use in routine clinical practice [3]. Although according to Guzik et al. [4], some observational scales showed strong correlation to 3D methods (gold standard) and seem to be effective tools that enable the assessment of gait, their assessment remains qualitative and as a result, they present luck of quantitative data. More than that, according to other studies, are difficult to use by less experienced clinicians [5] and are relatively subjective in nature, leading to low accuracy [6] as well as poor validity, reliability, sensitivity and specificity [7].
Immediate kinematic and muscle activity changes after a single robotic exoskeleton walking session post-stroke
Published in Topics in Stroke Rehabilitation, 2020
Chad Swank, Sattam Almutairi, Sharon Wang-Price, Fan Gao
Gait is considered a motor skill that is developed and refined over time. Comprised of volitional, emotional, and automatic processes, gait is a complex motor skill involving several regions of the brain and spinal cord.21 The interconnected neural structures drive the biomechanical motor behavior (e.g. gait) toward efficient coordinated and rhythmic movement.22 Descending neural pathways are disrupted post-stroke resulting gait deviations (e.g. temporospatial, kinematic, and muscle activity asymmetries)22 due to the initial pathology. Secondary gait deviations occur due to compensatory neural adaptations attempting to counteract primary deviations23 reinforcing the asymmetrical gait pattern.24 Rehabilitation efforts to recover gait post-stroke target automaticity bypassing attention-demanding executive control processes.25 Our findings suggest that walking in EKSO may promote improved symmetry during gait. Whether or not this improved symmetry is a result of tapping into the automaticity processes of gait is unknown. Nevertheless, EKSO uses a symmetrical rhythmic movement pattern. The lingering effects of which appear to impact gait characteristics even immediately afterward.
Age-Related Changes in Smoothness of Gait of Healthy Children and Early Adolescents
Published in Journal of Motor Behavior, 2020
Bruno Leban, Veronica Cimolin, Micaela Porta, Federico Arippa, Giuseppina Pilloni, Manuela Galli, Massimiliano Pau
In most cases, gait is represented and characterized through its main spatio-temporal parameters (speed, stride/step length, cadence, step width, duration of stance/swing/double support phases) that are widely studied in clinical gait analysis. They provide important information about organization and control of individuals’ gait strategy and are effective indicators of the quality of mobility (Gouelle & Mégrot, 2016). However, in some cases, they are ineffective in detecting alterations associated with the presence of conditions known to have a direct influence on motor milestone developments. For example, children affected by developmental coordination disorder, autism or attention-deficit hyperactivity disorders, exhibit spatio-temporal parameters of gait hardly discernible from those of typically developing children (Calhoun, Longworth & Chester, 2011; Manicolo, Grob & Hagmann-von Arx, 2017; Wilmut, Du & Barnett, 2016).Thus, it appears important to have available other metrics able to reveal subtle changes in locomotor patterns, possibly more informative regarding overall body dynamics in gait compared with spatio-temporal parameters, and obtainable using reasonably simple instrumentation and data processing procedures.
Related Knowledge Centers
- Bipedalism
- Central Nervous System
- Central Pattern Generator
- Enzyme Inhibitor
- Vestibular System
- Visual System
- Limb
- Bipedal Gait Cycle
- Hand Walking
- Acetylcholine