One of the first things a physical therapist observes when a patient walks into the clinic is his/her gait. Gait, sometimes called ambulation, is the way a person walks. Gait analysis is a detailed inspection of how a person walks. Most people walk in order to cover short distances - around the home, office or neighborhood. In order to do this, certain conditions are necessary: adequate energy, joint range of motion and muscle strength. Therefore a person's physical condition will determine whether his gait is normal or impaired.
Gait analysis will reveal a lot of information. How a foot loads can affect the rest of the body, and hence it is very important in physical therapy.
The gait cycle refers to the period from when the foot first contacts the ground to the end when it contacts the ground again. During a normal gait cycle, the legs go through two phases - the swing phase and the stance phase. Under normal circumstances, these movements are carried out in a precise manner without much thought.
The swing phase
This accounts for approximately 40% of the gait cycle and corresponds with single leg support by the opposite leg. It begins when the big toe leaves the floor, with knee bent. This is known as initial swing. Mid-swing follows when the knee straightens, lowering the rest of the foot to the ground, and ends when the heel strikes the ground. This is known as terminal swing.
The stance phase
This consists of five stages.
- Under normal conditions, the heel strikes the ground first. This is known as initial contact. However, in pathological cases, the entire foot or the toes contact the ground initially.
- Loading response begins with initial contact.
- Mid-stance. This is when the body's weight is directly over the foot. This begins with toe off on the other foot.
- Terminal stance. This begins when the body's weight is over the supporting foot and ends when the other foot contacts the ground.
- Pre-swing. At this stage both feet are on the ground. Pre-swing begins when the other foot contacts the ground and ends at toe off.
In normal gait patterns, there is coordination and harmony between both legs. Weight is loaded on to one leg and unloaded off the other. Shock absorption is carried out by the knees and ankles. If there are problems within the joints or muscles are weak, then shock absorption is compromised and gait abnormality may be the result. Decreased energy can slow the amount of time it normally takes to cover a certain distance.
Gait analysis may include a foot scan, where the biomechanics of the feet are examined through measurements of pressure distribution using a computerized system. Orthotics may be required following analysis to help restore a natural gait.
As your physical therapist, we are qualified to consult and treat you if you have any problems with your gait. Please contact us.
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