INTRODUCTION TO BIOMECHANICS OF GAIT, RUNNING AND REHABILITATION ENT 214 Biomechanics INTRODUCTION TO BIOMECHANICS OF GAIT, RUNNING AND REHABILITATION Written by Ed Ayyappa, MS, CPO Picture retrieved from http://www.sportsci.com/apasgait/gait_cycle.htm

BERJALAN Dua kaki melangkah, gilir-bergilir, ulang-berulang melangkah dalam tijak dan ayun. Gerakan berkala sebelah kaki mulanya tijak: tumit menjejak, kaki pun rata tijak tengah: tumit lepas, jari pun lepas masuk ke ayun: pertama pecut, kedua ayun tengah, ketiga awapecut menjejak tumit ke bumi semula. Gerakan berkala sebelah kaki sebelah lagi bergerak simetri tijak dan ayun bergilir harmoni bertindih pada fasa tijak dua kaki di bumi serentak. Berjalanlah engkau... jaga ayun dengan tijak kaki jangan berayun serentak sebegitu masuk fasa terbang bukan berjalan, berlari sudah. irwan abu bakar Kuala Lumpur, 12 Julai 2006

Introduction of Gait Nearly a century ago, A.A. Marks, an American prosthetist, offered a precise qualitative description of normal human locomotion when he illustrated and analyzed the walking process in eight organized phases and discussed the implications of prosthetic design on the function of amputee gait

Gait The terminology of human walking began with descriptive phrases obtained as a result of observational and kinematic analysis of normal subjects. This approach yielded terms such as "push off" and "heel strike" (as differentiated from "foot flat"). Confused ???

Gait Cycle The gait cycle is the period of time between any two identical events in the walking cycle. Any event could be selected as the onset of the gait cycle because the various events follow each other continuously and smoothly. Initial contact, however, generally has been selected as the starting and completing event.

Term Used in Gait Step length Stride length Cadence - in steps/min Retrieved picture from http://moon.ouhsc.edu/dthompso/namics/labs/strdanal.htm Term Used in Gait Step length Stride length Cadence - in steps/min

Stride analysis Step length is the distance between the point of initial contact of one foot and the point of initial contact of the opposite foot. In normal gait, right and left step lengths are similar. Stride length is the distance between successive points of initial contact of the same foot. Right and left stride lengths are normally equal.

Stride analysis Cadence or walking rate is calculated in steps per minute. Velocity, the product of cadence and step length, is expressed in units of distance per time. "Free speed" refers to the individual's comfortable walking speed.

Stride analysis Foot angle or toe out describes an angle between the line of progression and a line drawn between the midpoints of the calcaneus and the second metatarsal head.

Functional Tasks of Gait weight acceptance Two phases of the stance period, initial contact and loading response single-limb support midstance and terminal stance limb advancement preswing, initial swing, midswing and terminal swing.

Gait Cycle The gait cycle can be described as Stance Phase Swing Phase initial contact (IC) preswing (PSw) loading response (LR) initial swing (ISw) midstance (MSt) midswing (MSw) terminal stance (TSt) terminal swing (TSw)

Loading Response

Stance Phase Initial Contact - beginning of the stance phase Loading Response - the foot comes in full contact with the floor, and body weight is fully transferred onto the stance limb Midstance - begins when the contralateral foot leaves the ground and continues as the body weight travels along the length of the foot until it is aligned over the forefoot Terminal Stance - begins with heel rise and ends when the contralateral foot contacts the ground

Swing Phase Preswing - terminal double-limb support period Initial Swing - begins the moment the foot leaves the ground and continues until maximum knee flexion occurs, when the swinging extremity is directly under the body and directly opposite the stance limb Midswing - maximum knee flexion and ends when the tibia is in a vertical position Terminal Swing - tibia passes beyond perpendicular, and the knee fully extends in preparation for heel contact.

Running Gait The running gait is a unique set of actions and reactions that your foot performs while in motion to support, cushion, and balance your body. A runner's gait can be characterized as having three distinct phases:

Running

Pronation Pronation is simply a normal foot in motion, from foot-strike on the outside of the heel through the inward roll of the foot. Pronation occurs as the foot rolls from the outer edge to the inner edge

Over Pronation Over-pronators generally land in a pronated position and continue to roll significantly inward as they go from heel strike to toe off. They exhibit excessive inward motion

Under pronation Under-pronators generally land in a significantly supinated position and experience very little pronation, meaning from impact to toe-off their foot rolls inward less than the norm. They do not have enough inward motion and therefore can benefit from neutral cushioned-based shoes, which allow and promote the foot to follow the natural pronation movement.

Picture retrieved from http://www.nbwebexpress.com/achieve_more/running_gait.asp

Difference Walking & Running Duration of each aspect of stance decreases as walking velocity increases. The transition from walking to running is marked by elimination of double support period(s).

ABR stands for Advanced BioMechanical Rehabilitation. WHAT IS ABR? ABR stands for Advanced BioMechanical Rehabilitation. ABR is a unique biomechanically based rehabilitation approach for children and young adults with brain injury that brings predictable recovery of musculoskeletal structure and motor functions. ABR is the method of structural correction of musculoskeletal deformities. It is a hands-on method performed by the parents who learn the ABR technique and receive individual prescription of applications from the ABR professional staff. ABR is a method that re-builds even the most severely distorted musculoskeletal structure ABR redefines "rehabilitation" – ABR improves musculoskeletal structure so significantly that normal motor functions recover spontaneously, making special training and management for "motor disabled" unnecessary. © 2002—2005 Advanced Biomechanical Solutions Ltd.

ABR CONCEPT ABR emphasises 3 essential concepts in describing the functional role of smooth muscles or internal myofascia with respect to the body's biomechanical structure: Hydraulic (or hydraulic/pneumatic) skeleton A normal "hydraulic skeleton" provides normal alignment of the bony skeleton and normality of skeletal muscles - allowing normal motor function. Am abnormal, weakened "hydraulic skeleton" results in the collapse of the musculoskeletal system and impossibility of motor function. Visceral skeleton (visceral core) Hydraulic/pneumatic capacity

What are the smooth muscles? The smooth muscles are the ones that make up the internal organs, such as the liver, lungs, kidneys, intestines, etc. Why address the smooth muscles? Strengthening of the smooth muscles induces gradual growth of internal pneumatic capacity, which in a cascade effect restores: volume, shape and strength of the neck and trunk, normal alignment of the joints of the limbs, eliminating spasticity and contractures, normal volume and then strength of weakened skeletal muscles, normal alignment of the shoulder girdle and arms as well as pelvis and legs - allowing normal "insertion" of arms and legs and thus making proper movements possible.

WHO ARE ABR PATIENTS? Down's Syndrome Rett Syndrome Spinal Injuries Premature babies Hyperactivity Developmental disorders