Questions
3–5 questions per university paper
Difficulty
Medium
Importance
High yield for clinical rotations and orthopedic viva
Overview
Posture and gait analysis is a cornerstone of biomechanical assessment, focusing on the alignment of body segments and the rhythmic cycle of human locomotion. Mastering this topic is essential for clinical diagnosis and rehabilitative planning, as it provides the foundation for identifying mechanical faults in movement patterns.
Normal Gait Cycle Phases
The gait cycle describes the sequence of events from heel strike of one foot to the subsequent heel strike of the same foot. It is divided into two primary phases: the stance phase, representing 60% of the cycle, and the swing phase, representing 40%.
- Stance Phase: Initial contact, loading response, mid-stance, terminal stance, and pre-swing.
- Swing Phase: Initial swing, mid-swing, and terminal swing.
- Double Support: Occurs twice during the cycle at the start and end of the stance phase.
- Single Support: The duration when only one limb is in contact with the ground.
- Stride length: Distance between two successive heel strikes of the same foot.
Postural Deviations
Postural analysis evaluates the alignment of the body against a plumb line in static positions. Abnormalities usually result from muscular imbalances, skeletal deformities, or chronic compensatory patterns.
- Kyphosis: Exaggerated posterior curvature of the thoracic spine.
- Lordosis: Excessive anterior curvature of the lumbar or cervical spine.
- Scoliosis: Lateral curvature of the spine often associated with vertebral rotation.
- Forward Head Posture: Protraction of the cervical spine with rounded shoulders.
- Genu Varum/Valgum: Bow-legged or knock-kneed alignments, respectively.
Gait Abnormalities
Pathological gait occurs when injury, pain, or neurological deficits disrupt the normal biomechanical flow of walking. These patterns are compensatory mechanisms to reduce pain or stabilize the body during movement.
- Antalgic Gait: Pain-avoidance strategy characterized by a shortened stance phase on the affected side.
- Trendelenburg Gait: Dropping of the pelvis on the unaffected side due to weak gluteus medius.
- Steppage Gait: High-stepping lift to compensate for foot drop caused by peroneal nerve palsy.
- Festinating Gait: Short, accelerating steps often seen in Parkinson's disease.
- Circumduction Gait: Swinging the leg in an arc to clear the ground, common with knee stiffness.
Exam Tip
Always draw a schematic representation of the gait cycle phases if a question asks for a definition, as it carries more marks and demonstrates clinical precision.
Common Mistakes
- Confusing the percentages of stance versus swing phase in the gait cycle.
- Misidentifying the cause of Trendelenburg gait as a hip adductor weakness rather than abductor insufficiency.
- Failing to distinguish between postural kyphosis and structural vertebral deformities.
More Revision Notes
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