Normal Walking

Normal Walking
dr Fitri Anestherita, SpKFR
Departemen Rehabilitasi Medik

RSUPN Cipto Mangukusumo, Jakarta
How can humans walk?
Normal Gait Mechanism

-For Efficient and Stable walk-
Human body integrate the motions
of the various segments and control the activity of the
muscles so that the metabolic energy required for a given
distance walked is minimized
Requirements For Gait
• Control system
• Energy source
• Skeletal levers
• Motors (muscle)
Production of Movement
Prerequisites for gait (Gage 1991)
1. Stability in stance
2. Clearance in swing
3. Prepositionering of the foot
4. Sufficient step length
5. Efficiency of gait  energy conservation
(1) continuing ground reaction forces that support the body

(2) periodic movement of each foot from one position of support to the next in the direction of
progression.
Stability in stance
• Foot is stable on the ground
• Sufficient LE joint mobility
• Smooth transitions of foot rockers
• Stability of the trunk (arm movement)
• Perception of balance
Clearance in swing
• Sufficient flexion in ankle, knee and hip of the
swinging leg
• Correct position of the standing leg including the
pelvis: height of femoral head
• Sufficient stability (1.) is a prerequisite for clearance
in swing
Preparation of the foot in terminal swing
• Ankle dorsalflexion in terminal swing
• Neutral heel valgus/varus position
• Preparation of knee & hip stability
• Sufficient stability (1.) and footclearance(2) is a prerequisite for
preparation of the foot in terminal swing.
Sufficient step length
• Sufficient knee-extension in swing phase and contralateral
midstance/terminal stance
• Sufficient hip-flexion and contralateral hip extension
• Transversal rotation of the pelvis
• Sufficient stability (1.) ; foot clearance(2) and preparation of the foot
in terminal swing (3) are a prerequisite for step length
Sufficient step length
Efficiency of gait, conservation of energy
• "Walk like a pendulum“  The inverted pendulum analogy
• Alignment load-line over the joints
• Minimizing excursion of the centre-of-mass
• Smooth transitions, shock absorption
Energy consumption of walking
Displacement of COM during Gait
• COM tends to remain within the
pelvis  not remaining in an
absolutely fixed position
• A smooth sinusoidal curve
• The highest : midstance
• The lowest : double stance
Two major theories of human walking
The six determinants of gait theory
(Saunders, Inman, & Eberhart, 1953)
• Pelvic rotation
• Pelvic lateral tilting
• Knee flexion in stance phase
• Foot mechanism
• Ankle mechanism
• Lateral displacement of body
Pelvic Rotation
Pelvic Lateral Tilting
Knee Flexion in Stance Phase
Foot and Ankle mechanism
Lateral Displacement of Body
Wide base Narrow base

Reduced COM Displacement
Shock
• Pelvic absorption • Foot and
rotation • Pelvic list ankle
• Knee flexion mechanism
to increase Rocker
step length forward
The Inverted Pendulum Theory
(e.g., Cavagna & Margaria, 1966; Cavagna, Saibene, & Margaria, 1963)
• The stance leg is kept relatively straight during single support

• The swing leg also moves like a pendulum -> swinging freely about the hip
Walking can be performed with no muscle actuation, and therefore

no energy cost
If pendulums can swing freely, why does walking

cost any energy at all?
The Inverted Pendulum Theory
(e.g., Cavagna & Margaria, 1966; Cavagna, Saibene, & Margaria, 1963)
Rocker-based Inverted Pendulum Model
Dynamic Walking (McGeer 1990)
• An extension of the pendulum
theory  passive dynamics of
the limbs dominate the motion
• An energetic consequence due
to collision  step-to-step
transition
Multi-segmented Human Body
Ground Reaction Force During Gait
Ligaments in Lower Extrimities
Minimal Muscle Activation during Normal
Gait Cycle
Eccentric Muscle Contraction (Energy
absorption)
• 1976, Basmajian : EMG during
walking
Antigravity muscle are active during

double support
Turn off during single support and
swing phase like a pendulum

Normal Walking

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Normal Walking

dr Fitri Anestherita, SpKFR

Departemen Rehabilitasi Medik

Normal Gait Mechanism

(1) continuing ground reaction forces that support the body

Wide base Narrow base

• The stance leg is kept relatively straight during single support

Walking can be performed with no muscle actuation, and therefore

If pendulums can swing freely, why does walking

Antigravity muscle are active during

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