ANALISIS POLA JALAN

Angela B.M.Tulaar
Kedokteran Fisik & Rehabilitasi
FKUI - RSCM
 Gait Cycle
STANCE PHASE SWING PHASE
60 % 40%
Initial contact (heelstrike) Initial swing
Loading response (foot flat) (acceleration)
Mid-stance Mid-swing
Terminal stance (push off) Terminal swing
Pre-swing (toe off) (deceleration)
 Inmans Six Determinants of Gait
1. Pelvic rotation in the horizontal plane : swinging
hip moves forward faster than stance hip.
2. Pelvic tilt in the frontal plane : pelvis on side of
swinging leg is lowered.
3. Early knee flexion (15 degrees) during the first
part of stance.
4. Weight transfer from the heel to flat foot
associated with controlled plantar flexion
during first part of stance.
5. Late knee flexion (30-40 degrees) during the last
part of the stance phase.
6. Lateral displacement of the pelvis toward the
stance limb.To reduce displacement of CM.
 LOCOMOTION

KINETICS KINEMATICS

forces acting on bodies: location of joint in

Externally generated space
(pull of gravity)
Internally generated
(muscular contraction)
magnitude & direction
ANALISIS POLA JALAN
Gait Analysis of the ABOVE-KNEE AMPUTEE

ABDUCTED GAIT
Width of walking base greater than normal range ;
exaggerated lateral displacement of pelvis ;
lateral bending of trunk ;
during period of double support .
Causes : 1. Pain or discomfort of the crotch area
2. Contracted abductors of the stump
3. Prosthesis too long
4. Shank aligned in valgus position
5. Mechanical hip joint set socket & stump abduction
6. Amputee feels insecure
Gait Analysis of the ABOVE-KNEE AMPUTEE

CIRCUMDUCTION
The prosthesis follows a laterally curved line as it
swings through
Observed throughout swing phase
Causes :
1. Little or no knee flexion
2. Manual knee lock, excessive friction, tight
extension aid
3. Inadequate suspension, prosthesis slips off stump
4. Too small a socket
5. Foot set in plantar flexion
Gait Analysis of the ABOVE-KNEE AMPUTEE
SWING PHASE WHIPS
Medial whip : at toe-off the heel moves medially
Lateral whip : at toe-off the heel moves laterally
Causes :
1. Stump with weak, loose musculature in which
tissues rotate freely around femur
2. Socket too tight or insufficiently contoured
3. Toe break not set at right angle to the line of
progression
4. Improper alignment of knee belt
Gait Analysis of the ABOVE-KNEE AMPUTEE

ROTATION OF THE FOOT ON HEEL STRIKE

As the heel contacts the ground, the foot rotates laterally

sometimes with a vibratory motion
Causes :
1. Too hard a plantar flexion bumper or heel cushion
2. Correction after a lateral whip
3. With a new suction socket wearer, the foot
rotation may be due to poor control of the socket by
the stump
Gait Analysis of the ABOVE-KNEE AMPUTEE

FOOT SLAP

The foot plantar flexes too rapidly and strikes the floor
with a slap ; just after heel strike
Causes :
plantar flexion bumper is too soft, and does not offer
enough resistance to motion of the foot as weight is
transferred to the prosthesis
 Gait Analysis of the ABOVE-KNEE AMPUTEE

LUMBAR LORDOSIS
Exaggerated normal convexity of lumbar area when
prosthesis is in stance phase
Causes :
1. Flexion contracture of the hip
2. Insufficient initial flexion of socket
3. Insufficient support from brim of anterior socket wall
4. Weak extensors of the hip
5. Weak abdominal muscles
6. Painful ischial bearing
 Gait Analysis of the ABOVE-KNEE AMPUTEE
VAULTING
The amputee bobs up and down excessively as he walks ;
he raises his entire body by excessive plantar flexion of
the sound foot during swing phase of prosthesis
Causes :
1. Insufficient friction on the prosthetic knee
2. Excessive length of prosthesis factors :
- little or no knee flexion
- manual knee lock or excessive friction
- inadequate suspension prosthesis slips off
- too small a socket
- foot set in plantar flexion
TERIMA KASIH