Walking is the most important part of our life. It is the most convenient way to travel short distances. Have you ever seen a person who has a different walking pattern other than you? “Gait” in medical language defines the body locomotion and the way you walk. Every person has a unique gait pattern.
What is Gait?
Gait is the series of rhythmical, alternating movements of the trunk and limbs which result in the forwarding progression of the center of gravity.
What is the Gait Cycle?
The period of time from one heel strike to the next heel strike of the same limb.
The gait cycle is divided into two parts-
- Stance phase– It is defined as the interval in which the foot is on the ground. It covers 60% of the gait cycle.
It is divided into four phases:
- Loading response (foot flat)
- Mid stance
- Terminal stance (heel off)
- Pre-swing (Toe off)
- Swing phase – It is defined as the interval in which the foot is not in contact with the ground. It covers 40% of the gait cycle. This phase is divided into three-phase-
- Initial swing (Acceleration)
- Mid swing (Toe off)
- Terminal swing ( Deacceleration)
when a person is unable to walk in a usual way. Many functions of the body such as strength, coordination, and sensation of the body that work together to allow the person to walk in a normal way. When one or more of these interacting systems is not working properly that could result in an abnormal gait. This may be due to any injury, underlying condition, or problems with the legs and feet.
Abnormal gait is categorized in many the types based on their symptoms and the appearance of individual walk-
It is common in patients with “Cerebral palsy” or “Multiple sclerosis”. It is a way of walking in which one leg is stiff and the patient drags his leg while walking in a semicircular motion on the side most affected by long-term muscle contraction. It is also known as Ataxic gait.
In this type of walking, as the name suggests legs are in scissor form when you walk. In this legs are flexed at the hip and knees bent, with the knees and thigh hitting or crossing in a scissor-like movement typical in people with spastic cerebral palsy. A physical therapist can provide leg braces and in-shoe-splint as well as exercise therapy for this patient. It is also known as Diplegic gait.
A “high-stepping” type of gait in which the leg is lifted high, the foot drops, and the toes points downward and scrape the ground. If it is unilateral, causes include peroneal nerve palsy and L5 radiculopathy. If it is bilateral, causes include Amyotrophic lateral sclerosis, Charcot-Marie-Tooth disease, and other peripheral neuropathies including uncontrolled diabetes.
The physical therapists recommended rest since fatigue can increase the risk of tripping and falling. It is also known as Neuropathic gait.
This type of gait is seen in Parkinsonism
patient. This patient has rigidity and bradykinesia. The patient will be stooped with the head or neck forward, with flexion of the knee. The whole upper extremity is seen in flexion except the fingers which are extended. The patient walks with slow little steps known as Marche a petit pas. The patient has difficulty in initiating steps. The patient may show an involuntary inclination to take accelerating steps known as festination.
This gait is also known as the Trendelenburg sign and Myopathic gait. Hip girdle muscles are responsible to maintain the hip level when walking. If you have one side weakness in hip muscles, this will lead to a drop on the contralateral side of the pelvis while walking. With bilateral weakness, the patient will have dropping of the pelvis on both sides during walking leading to waddling. It is also seen in patients with Myopathies such as muscular dystrophy.
The patient will display irregular, jerky, involuntary movement in all extremities. Walking may accentuate their baseline movement disorder. It is seen in Basal ganglia disorders like Sydenham’s chorea, Huntington’s disease, and other forms of chorea, athetosis, or dystonia.
It is seen in stroke patients, that the leg on the affected side is extended and internally rotated and swung in a wide arc rather than lifted to walk.