Gait Analysis

Here, we reproduce a description of the gait cycle as most experts view it. The gait cycle (Fig. 3.4a-f) can be divided into several stages. We limit our account to describing two stages:

Both stages occur simultaneously, with one leg being the stance leg and the other the swing leg. The body weight is balanced on the stance leg, as a result of which the other leg can be propelled forward (Fig. 3.5a-c).

Due to the forward swinging of one leg, the pelvis is rotated to the stance leg. This leads to a counter-rota-tion to the side of the swing leg at the TLJ. We can recognize this from the arm movements, which are opposite to the leg movements.

During the swing stage, the hip is bent and the foot extended dorsally, while the knee is bent in the first half and stretched in the second half, before the heel touches the ground.

In the stance stage (Fig. 3.5d-f), the hip is stretched. The knee is initially slightly bent, before being stretched completely. The stance stage begins at that moment when the heel first touches the ground. Afterwards, the foot is rolled off from the heel up to the large toe (Fig. 3.5g-i).

At this point, the lower ankle joint takes on a special role. A dysfunction here will change the entire gait cycle. The opposing movements at the pelvic girdle and the shoulder girdle result in minimal movement of the head and the ability to keep the vision straight ahead.

During walking, the spinal column makes a snaking or "scoliotic" movement, as a result of which the LSC is brought convex to the swing side, while the TSC is brought convex to the stance side.

The pelvis makes a global rotation toward the stance side and a slight tilt to the swing side. During the gait cycle, changes also occur in the pelvis itself between the sacrum and ilium. In this context, the pubic symphysis plays the role of a half-mobile rotational pivot. In the symphysis itself, rotations take place in accordance with the iliac rotations.

Let us use the swing stage of the right leg as an example. This cycle begins in the moment when the left heel touches the ground and the right large toe loses contact with the ground. This orients the left ilium dorsally and the right one ventrally. The sacrum is in the neutral position between the two iliums. As soon as the right foot leaves the ground, weight is placed on the left leg. This causes a ligamentous (and

Left diagonal axis

Right diagonal axis

Left diagonal axis

Right diagonal axis

Fig. 3.4a-f Biomechanics and pelvic movements during each stage of the gait cycle.

T

M

U

L

Fig. 3.5a-c Weight shifts during the stages of the gait cycle.

Fig. 3.5a-c Weight shifts during the stages of the gait cycle.

muscular) locking of the left iliosacral joint (ISJ) that contributes to stabilizing the body.

To shift the weight to the left leg, the LSC makes a leftward sidebend, which shifts pressure to the short shank of the left ISJ. Concurrently, the pelvis tips to the right (according to Schiowitz49 by 5°). The lower pole of the right ISJ is compromised by the weight of the right leg and the resulting muscle tension. This causes a left diagonal axis. The LSC is in a neutral position with a leftward sidebend and rightward rotation (NSR according to Fryette). The sacrum below it makes a leftward rotation around a left diagonal axis (according to Mitchell107). The iliums rotate together with the spinal column, which guarantees constant tension in the ligaments.

During the swing stage of the right and the propelling stage of the left leg, the iliums rotate in the opposite direction. The right ilium rotates backward, the left one forward. This movement is initiated by muscles and completed by the momentum of the movement (the law of economy is observed).

Note: The sacrum moves in conjunction with the iliums, makes the same rotation and sidebend, but more slowly. As a result, it acquires the function of a ball-bearing that maintains the force lines between the spinal column and the two iliums.

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