Monday, April 30, 2018

Basics of Gait Training (Walking)

Phases of Walking:

Summary of Muscle Function in Level Walking

Muscle Group
Main Function
Abnormalities if Weak
Hip Flexors
Acceleration of Swing
Backward lurch and pelvic tilt to initiate swing as seen in hemiplegia
Hip Abductors
Stabilize pelvis in stance
Control drop of pelvis
Trendelenburg or contralateral hip drop
Hip Extensor
Stabilize pelvis, and stance
Backward lurch, or jacknife with quick step on contralateral side
Absorb shock at heel strike and support knee at stance
Lock knee during stance and tendency to hyperextend
Deceleration of swing phase
May overshoot at end of swing and "slam into extension"
Ankle DF & Toe Extensors
Control foot hitting the ground "slap" and lift the foot during swing
Steppage gait, toe-heel gait, vault up on opposite leg or circumduct around
Ankle PF & Toe Flexors
Push off at the end of stance phase
Absence of push off and small steps with poor balance and slow speed
  • Hip Flexors start the swing
  • Hip Extensors, especially hamstrings, decelerate the leg at the end of swing
  • Knee extensors contract eccentrically at heel-strike to prevent buckling of knee
  • Dorsiflexors act to hold toe off floor during swing, and to prevent foot slap at heel strike (act to slow plantar flexion), another eccentric contraction
  • Plantar flexors act during push off