Maximus Gage
Gait is the action of walking, or locomotion, in humans. It is a complex, whole-body movement that requires the coordinated action of many joints and muscles of the musculoskeletal system. Gait analysis is a method used to evaluate an individual's walking pattern, including step length, walking speed, rhythm, and symmetry of movements. It is a crucial tool for diagnosing and treating various conditions, including arthritis, stroke, cerebral palsy, and Parkinson's disease. To memorize the muscles involved in gait, one can create flashcards that match muscles with their descriptions and functions. For example, the biceps brachii muscle is responsible for extending the forearm at the elbow, while the gluteus maximus compresses the contents of the abdominal cavity. Understanding the role of each muscle in gait can help identify abnormalities and develop targeted interventions to improve mobility and quality of life.
| Characteristics | Values |
|---|---|
| Definition | Gait is the action of walking (locomotion) |
| Body Systems Involved | Nervous, musculoskeletal, cardiovascular, and respiratory systems |
| Factors Influencing Gait | Age, personality, mood, and sociocultural factors |
| Gait Disorders | Loss of personal freedom, injuries, falls, and reduced quality of life |
| Gait Analysis | Observational or instrumented techniques to assess gait abnormalities |
| Muscle Contraction Types | Concentric, eccentric, and isometric |
| Hip Flexion | Created by hip flexor muscles, predominantly iliopsoas, with hamstring muscles |
| Hip Extension | Controlled by hip extensor muscles, including gluteus maximus and hamstrings |
| Hip Abduction | Stabilization by gluteus medius and gluteus minimus muscles |
| Hip Adduction | Controlled by hip adductor muscles for balance |
| Knee Extension | Controlled by knee extensors and plantar flexors |
| Toe Walking | Loss of plantar flexion-knee extension couple, seen in CP patients |
| Parkinsonian Gait | Reduced arm swing, stooped posture, shuffling steps, and freezing |
| Equinus Gait | Accomplished by flexing the hip joint, seen in spastic cerebral palsy |
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What You'll Learn
Muscle contraction types
Muscle contraction is fundamental to our ability to perform different movements. There are three primary types of muscle contractions: isotonic, isometric, and isokinetic. Mammals have three types of muscles: skeletal, cardiac, and smooth.
Isotonic Contractions
Isotonic contractions involve a change in muscle length without altering the resistance. This type of contraction can be further divided into two subtypes: concentric and eccentric. During a concentric contraction, the muscle shortens under load, while in an eccentric contraction, the muscle lengthens under load. For example, when lifting a heavy weight, a concentric contraction of the biceps would cause the arm to bend at the elbow, lifting the weight towards the shoulder. On the other hand, when lowering the weight, an eccentric contraction occurs as the biceps lengthen under load.
Isometric Contractions
Isometric contractions are characterized by a change in muscle tension without a change in muscle length. This type of contraction occurs when pushing against an immovable object or attempting to lift a weight that is too heavy.
Isokinetic Contractions
Isokinetic contractions are similar to isotonic contractions in that the muscle changes length during the contraction. However, the key difference is that isokinetic contractions produce movements of a constant speed. Examples of isokinetic contractions in daily activities and sports are rare, with the breaststroke in swimming being one of the best examples.
Skeletal Muscles
Skeletal muscles are attached to bones and provide the body with structure and strength. They also play a role in maintaining posture, storing amino acids, and regulating core body temperature through shivering.
Cardiac Muscles
Cardiac muscles form the walls of the heart, enabling blood to be pumped throughout the vasculature. There are two types of cardiac muscle cells: autorhythmic and contractile. Autorhythmic cardiac cells do not contract but set the pace of contraction for other cardiac muscle cells. Contractile cardiac cells, or cardiomyocytes, make up the majority of the heart muscle and are responsible for contraction.
Smooth Muscles
Smooth muscles are found throughout the body, including in blood vessels, the gastrointestinal tract, bronchioles, uterus, and bladder. They can be further categorized into two types: single-unit and multi-unit. Single-unit smooth muscles are found in the gut and blood vessels, linked together by gap junctions, allowing for contraction as a functional unit. Multi-unit smooth muscles, on the other hand, are found in the muscles of the eye and at the base of hair follicles.
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Gait cycle phases
Gait, or the action of walking, is a complex, whole-body movement that requires the coordinated action of many joints and muscles of our musculoskeletal system. It typically includes the movements of the lower limbs, upper limbs, pelvis and spine, and depends on the proper functioning of other body systems such as the nervous, cardiovascular and respiratory systems.
The gait cycle consists of two phases: the stance phase and the swing phase. The stance phase makes up 60% of the gait cycle, during which some part of the foot is in contact with the ground and bears body weight. It can be further divided into the heel strike, support, and toe-off sub-phases. The heel strike stage involves three muscle sets, each acting at a different joint: the gluteus maximus, which acts on the hip to decelerate the forward motion of the lower limb; the quadriceps femoris, which keeps the leg extended at the knee and the thigh flexed at the hip; and the anterior compartment of the leg, which maintains the ankle dorsiflexion, positioning the heel for the strike.
The swing phase makes up the remaining 40% of the gait cycle, during which the foot is not in contact with the ground and the body weight is borne by the other leg and foot. It can be further divided into the leg lift, initial swing, mid-swing, and terminal swing sub-phases. The iliopsoas and rectus femoris muscles are crucial in the initial swing sub-phase, as they initiate the swing and keep the thigh flexed at the hip, resisting gravity as it tries to pull the lower extremity down. The mid-swing phase is when the non-weight-bearing leg passes directly beneath the body and past the weight-bearing leg, while the trunk is moved forward so that the weight of the body is directly over the weight-bearing leg. In the terminal swing sub-phase, the leg decelerates in preparation for the next heel strike, with the hamstrings and quadriceps working to extend the knee and position the foot for landing.
In a complete two-step cycle, both feet are in contact with the ground at the same time for about 20-25% of the total gait cycle, with 10% at the beginning of the stance phase and 10% at the end. These periods are termed 'double-support periods'. The rest of the time is spent in single support, when only one foot is in contact with the ground.
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Muscle functions
Gait is defined as the walking pattern in humans, including walking, jogging, and running. The gait cycle involves the study of ground reaction forces (GRF), joint torque, plantar pressure distribution, and muscle activity. The body should be in equilibrium during gait, with external ground reaction forces balanced by internal muscle forces.
During gait, muscles contract concentrically or eccentrically to overcome the external moment. In a concentric contraction, the muscle shortens, creating movement at the joint, while in an eccentric contraction, the muscle lengthens while producing force. For example, when the foot first touches the ground, the body enters the first phase of double support, where the foot establishes contact with the ground and begins to accept weight. The foot continues to absorb the shock by rolling into pronation until the contralateral foot leaves the ground. At this point, the body is supported by a single leg and begins to move from force absorption to force propulsion forward.
The abductor muscles are responsible for stabilising the pelvis, allowing the opposite leg to lift during the swing phase. Weak abductor muscles will cause the hip to drop towards the side of the swinging leg, resulting in a Trendelenburg gait. Conversely, weak hip extensors will cause a person to take smaller steps to reduce the hip flexion required for initial contact, leading to reduced force contraction from the extensors. Similarly, weak hip flexors result in a reduced step length due to the muscle's inability to create sufficient forward motion.
Gait disorders can lead to a significant reduction in an individual's quality of life, as seen in patients with cerebral palsy (CP). These disorders can manifest as functional deformities that later become structural, greatly increasing energy consumption and limiting function.
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Joint moments
Gait kinetics is the study of the forces and moments of the gait cycle, including ground reaction forces (GRF), joint torque, plantar pressure distribution, and muscle activity. The body should be in equilibrium during gait, with external ground reaction forces (the external moment) balanced by internal muscle forces (the internal moment).
Different muscles perform different actions at every phase to create an internal moment against the external joint moment. Ground reaction force vectors create the direction of the moment, and the muscle will act in the opposite direction. If the ground reaction force falls in front of the axis of the joint, the proximal segment of the joint will move forward; if it falls behind the axis of the joint, the proximal segment will move backward.
Muscles contract concentrically or eccentrically to overcome the external moment. During a concentric contraction, the muscle shortens and produces movement at the joint; during an eccentric contraction, the muscle lengthens while producing force.
The swing phase of gait does not involve ground reaction forces, as there is no contact with the ground. However, muscles still contract concentrically or eccentrically as needed to advance the limb and shorten it for foot clearance.
Several studies have examined joint moments during gait, particularly in the lower limbs. These studies have found that different reference frames for the expression of the net moment vector can significantly impact joint moment profiles. For example, one study found that the non-orthogonal JCS (joint coordinate system) was the most logical representation of the joint moment from a biomechanical perspective.
Additionally, large knee adduction moments during gait have been implicated as a factor in the progression and severity of tibiofemoral osteoarthritis. These moments increase the load on the medial compartment of the knee joint, and muscle and ligament forces play a role in this mechanism, although they are challenging to measure directly.
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Gait disorders
Gait refers to the movement pattern in humans when walking or running. It is a complex process that requires the coordination of the nervous, musculoskeletal, and cardiorespiratory systems. Gait disorders, therefore, arise when there is a problem with any of these systems. They are characterised by deviations from normal walking or gait and can be either episodic or chronic. Episodic gait disorders include freezing gait, festinating gait, and disequilibrium, which occur suddenly and can cause unexpected falls. Chronic gait disorders, on the other hand, are adaptations to the chronicity of the underlying neurological dysfunction.
There are several types of gait disorders, including hemiplegic, spastic diplegic, neuropathic, myopathic, Parkinsonian, choreiform, ataxic (cerebellar), and sensory gaits. Hemiplegic gait, for example, affects one side of the body, with the arm staying at the side and the leg being dragged in a semi-circle to move forward. This is often the result of a stroke. Diplegic gait affects both sides of the body, with bent hips and knees and turned-in ankles, resulting in a swinging motion. This can be caused by cerebral palsy, stroke, or head trauma. Neuropathic gait, sometimes called foot drop, causes one foot to flop down when the leg is lifted, requiring the knee to be lifted higher to prevent toe dragging.
The treatment for gait disorders aims to minimise their effects and improve mobility. This can include medication, surgery, physical therapy, exercise, mobility aids, special footwear, or orthotics. In some cases, gait disorders can be improved by addressing the underlying metabolic disorder or managing contributing factors. However, for chronic and progressive neurological conditions, gait disturbances may worsen over time, and complications can further impact prognosis.
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Frequently asked questions
Gait is the walking pattern in humans. It is described as a particular manner of moving on foot, which can be a walk, jog or run.
Gait is a multi-joint, multi-organ activity that involves the contraction and joint mobility of many muscles in the musculoskeletal system. These include the iliopsoas, hamstring, gluteus maximus, gluteus medius, gluteus minimus, quadriceps, triceps, biceps femoris, semimembranosus, and semitendinosus.
Gait analysis is a systematic method used to evaluate an individual's walking pattern. It involves observing and measuring step length, walking speed, rhythm, and the symmetry of movements. It is used to identify deviations or abnormalities that can indicate underlying health conditions.
Abnormal gaits include limping, toe walking, and asymmetrical steps. Limping is due to pain or weakness, often from trauma or injury, and is characterised by a shorter stance phase on the affected side. Toe walking is walking on the toes or ball of the foot without the heel touching the ground. Asymmetrical steps can result from a leg length discrepancy, muscle weakness, or joint stiffness.
