PRINCIPLE 1. Equitable Use
4.10 SUMMARY
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Section B
Disorders and Disabilities
5 Gait and Ergonomics:
Normal and Pathological
Siobhan Strike
CONTENTS
5.1 Nature of Walking Gait ... 138 5.2 Introduction to the Biomechanics of Gait ... 139 5.2.1 Progression ... 139 5.2.2 Stability ... 139 5.3 Pathological Gait ... 139 5.4 Mechanical Concepts Pertinent to Understanding Gait ... 141 5.4.1 Loading ... 141 5.4.2 Kinematic Chain ... 143 5.4.3 Effi ciency ... 144 5.5 Functional Restoration: Devices and Training ... 145 5.6 Gait and Symmetry ... 146 5.7 Gait Analysis—Variables and Their Selection ... 147 5.7.1 Outcome Variables ... 147 5.7.2 Temporospatial Variables ... 148 5.7.3 TS Variables and Functional Mobility ... 150 5.8 Process Variables ... 150 5.9 Phases of the Gait Cycle ... 152 5.9.1 Loading: 0%–10% Cycle ... 153 5.9.2 Effects of Joint Pathologies ... 154 5.9.3 Support/Progression: 10%–50% Cycle ... 156 5.9.4 Pathologies ... 158 5.9.5 Propulsion: 50%–60% Cycle ... 159 5.9.6 Pathologies ... 160 5.9.7 Swing: 60%–100% Cycle ... 161 5.9.8 Pathologies ... 161 5.9.9 Detailed Description of Gait for Transtibial Amputees ... 162 5.9.10 Outcome Measures ... 163 5.9.11 Loading ... 163 5.9.12 Support/Progression ... 165 5.9.13 Propulsion ... 166 5.9.14 Swing ... 166 5.9.15 Biomechanically Based Specifi c Needs of the TTA ... 167
5.10 Conclusion ... 169 References ... 169
This chapter reviews many of the publications related to gait and presents them in a way that is applicable to ergonomics for health professionals. This chapter initially introduces walking gait, the aim of walking, and overviews how this aim is achieved.
The factors that result in pathological gait are outlined, and the implications on the achievement of the aim of walking are highlighted. Selected mechanical issues pertinent to understanding gait, loading, the anatomical implications of the link-chain system, and effi ciency are detailed. The mechanics of gait, which gives an in-depth review of the outcome and process measures that cause and result in gait, are detailed. The effect pathologies have on these mechanics are illustrated. Finally, an analysis of how all these elements combine is given through a detailed description of transtibial amputee gait.