Normal gait pattern

Question 1

Initial contact normal motion

Answer 1

1. Heel strikes ground
2. 20° of hip flexion and slight external
   rotation
3. Knee fully extended
4. Ankle 90° from tibia

Question 2

Initial contact Muscle actions

Answer 2

Gluteus Maximus & Hamstrings: slow the leg
down, reduce flexion. Also, gluteus maximus
trying to pull trunk backwards to slow it down
Dorsiflexors: eccentric working

Question 3

Loading response normal motion

Answer 3

1. Hip external rotation moving toward
   internal rotation
2. Slight knee flexion (20°) moving back
   toward extension
3. Foot moves into pronation and
   plantarflexion moving into dorsiflexion

Question 4

Loading response muscle actions

Answer 4

Gluteus Max & Hamstrings: slows down
leg/flexion moment and pulling trunk in extension
Quadriceps: absorbs shock of body; is most active
during this phase
Triceps surae: in eccentric phase (elongating
phase); tibia moving over foot

Question 5

Midstance normal motion

Answer 5

1. Trunk has moved over foot
2. Slight drop in contralateral pelvis
3. Maximum extension of hip
4. Knee reaches full extension
5. Ankle rolls into dorsiflexion; tibia rolls
   forward onto foot
6. Foot pronation

Question 6

Midstance muscles actions

Answer 6

Iliopsoas: eccentrically working; controlling hip
extension
Gluteus Medius: holds pelvis upright so it doesn’t
drop under the weight of the trunk
Quadriceps: beginning to decrease with
extension
Gastrocnemius: eccentrically working

Question 7

Terminal stance normal motion

Answer 7

1. Hip in full extension, external rotation
2. Knee moving toward full extension at
   toe off
3. Pronation moving toward supination;
   external rotation of tibia on femur;
   maximum dorsal flexion (15°) moving
   toward maximum (20°) plantarflexion

Question 8

Terminal stance muscle action

Answer 8

Eccentric iliopsoas activity
Ankle planter flexion (concentric contraction)

Question 9

Pre-swing normal motion

Answer 9

1. Slight posterior pelvic rotation
2. Hip back at 0° flexion
3. Knee moving toward 40° of flexion
4. Ankle 20° plantar flexion, pushing off
5. MTP 60° extension

Question 10

Pre-swing muscle actions

Answer 10

Increasing concentric hip flexors (iliopsoas/rectus
femoris)
Concentric plantar flexion
Minimal eccentric quadriceps, gluteus medius

Question 11

Initial swing normal motion

Answer 11

1. Slight posterior rotation 5°
2. 15° hip flexion, increasing
3. 60° knee flexion, decreasing
4. 10° plantar flexion, decreasing
5. Goal is to clear foot and advance limb

Question 12

Initial swing muscle actions

Answer 12

Ankle dorsal flexion L5, deep peroneal
Hip flexors L2-L3, femoral nerve

Question 13

Mid swing and terminal swing normal motion

Answer 13

1. Hip flexion to about 30°
2. 25° knee flexion moving to 0°
3. Foot remains in neutral dorsal flexion

Question 14

Mid swing and terminal swing muscle actions

Answer 14

Concentric quadriceps extending knee
Eccentric hamstrings and gluteus maximus are
slowing limb (hip flexion moment)
Isometric dorsal flexion