Nevous System
3.10 The Gait as a Global Functional Motion Pattern The Gait as a Global Functional Motion Pattern
The gai perhap the mo mpreve exampe fo an activty tha afect the enre body We can ee here how the entire locomotor ytem act accong to a certain patter n (motio n paten). · Amyofa cal tuctue and a ll jon ac a propel ng ogan a well a hock aborber.
he phyiologica proce e of twing ogehe r and wt ing apa t hat occu i n he leg and unk fol low a pecial paten Wih the foward mpule dung walking, thi lead o the conveion of chemica en ergy, created by mucle activity to kinetic enegy ha pope the body foward. We can compae th motion pattern o a png tha unwind when the leg wng and wind back up when the wegh once aga n an d on the heel The impule in the gai tart when the heel touche the floor, the wegh hifed foward, and he eg mucle conduc the movement through he pelvi toward the pinal co- umn
The fact tha amot all oin pemt hreedimen ional movemen, togehe wth the altenang oder of lo rdoe and kyphoe from the ole of the foo up to the oo of he noe and the arrange ment of m u- cle ino lemnisipermi harmoniou and economical locomoion T utrate ow functon epenT utrate ow functon epen on tructure
on tructure
Note: n an ineeting arce, Gracoveky n ) e forth he hypothei that he aneropoerior curve of the pnal col umn are n o onl y an adaptaion o grav ity, bu a o erve the functi on o f maki ng oco motion more economca ypholordoe ac ke an anteropoeror leaf pring that preed togeher when the foot e down and reche ou when he eg wing.
Howard Dananbeg, pouologi and dector of the Walkng Clinic in New Hamphire Unied Stae, decrbe impreivey in an artice tled "Lowe Back an a a Gatreated Repetitive Motion njury in ) how an exenion defici in the metata opha ang eal ( M) oint of the lage o e can be the arng pon for lumbar pain.
A tretch defcit of he arge toe peven the foot from oll i ng o com pletely du r ng wal ki ng. The ogan m compenae for t hi by ncrea ing the do ra ex- tenion of the foot, flexing the knee and fexing he hip. The eult i an mbaance beween hp bende and hip echer, which horen he engh of the tride. The il opoa and quadrau l umborum mucle n tun bala nce thi ou wih an inc eaed pelvi oa tion Thi exampe how how a foo eion i compen- ated wth a cean muce chain, which can lead o a pedctabe dyfuncon
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Ga AnalyssGa Analyss
Here, we reproduce a decription of he gait cycle a mot exper vew it he gai cycle F a-f)F a-f) can be dvided no eveal age We mi ou accoun to dec bing tw o tag e
Swng age Sance tage
Both age occur imulaneouy with one leg beng the tance eg and the ohe the wing eg The body weight balanced on the ance eg, a a reut of whch he oher leg can be popeled forward FF
a-c) a-c)
Due to he fowad winging of one leg, the pelvi i roated t o the tance le g. hi ead to a coun terrota- i on o the de of he wing le g at the TL We can e- cognze hi fom he am movement which ae op- poie o the leg movemen
During he wing age the hp i ben and the foo extended doraly, while the knee i bent in the ft hal f and etched i n the econd hal f, befo re he heel ouche the gound.
n th e tance t age F -f),F -f), he h p i treched
The knee i intiay lighly ben befoe beng reched completely he ance tage begin at tha moment when the heel fir touche the goun d. Af er ward, the foo i oled of fom he heel up o he arge toe F -)F -)
At hi point, the lower ank e oint take o n a pe cial ole A dy functio n here w il change h e entie gait cy - cle The oppong movement a the pelvic grdle and the houder girdle reul in minma movement of the head and the abiliy to keep the viion tragh ahead
Duri ng waking, the p i na coumn make a naki ng o "coloc movement, a a reul of whch the LSC i bought convex to the wing ide wh e he TSC brought convex o the ance de
The pelv make a glo bal roaon oward he tance ide and a light til to the wng de. D ui ng the g at cycle, change ao occur in he pelv itelf between the acu m and i li um. n hi contex t, he pubic ym phy i play the ole o f a ha lfmobe oa tion al pivot n he ymphy itef, oation ake place n acco- dance with th e liac rotaon.
e u ue he wing a ge of he rgh le g a an ex- ample. h cyce begin in he momen when the left heel ouche he ground and the igh lage oe loe contact wih the ground. Thi oent the ef i lum do raly and the righ one ventray he acrum i n the neutral potion between the two um. A oon a the igh foot eave he gound, weght i placed on he ef e g. Thi caue a l igamen tou an d
40 3 PysiooyPysiooy
a
cc e ed
L igol x Right igol xiFig 34a-
Biochnics pvc ovts urig ch stg o t gt cyca
bTh Gt Glbl ntnl tn Pttn
41cc
Fig 3.Sac
Weiht shifs duri the staes of te at cyclescuar locng of th ft losacal jont (lSJ that contrbuts to stabng th body.
To shft th wght to th lft g, th LSC aks a ftwad sdbnd, whch shfts ssu to th short shan of th lft SJ. Concrntly, th ls ts to th rght (accordng to Schowt by 5°) Th owr ol of th r ght SJ s coro sd by th w ght of th rght g and th rsultng scl tnson Ths causs a ft dagona axs Th SC s n a n utal os ton wth a lftward sdbnd and rghtward otaton (SR accordng to ry tt. Th sacr blow t as a lftwad otaton aond a lft dago nal ax s (a cco rd- ng to Mtchl . Th ls otat tog th wth th snal coln, whch guarants constant tnson n th gants
Dng th swng stag of th ght and th ro- lng stag of th ft lg th u s otat n th oo- st drcton Th rght l rotats bacward, th
lft on fowad. Ths ont s ntatd by s cls and cotd by th ont of th o- nt (th aw of cono y s obsd
Noe Th sacru os n conuncton wth th us as th sa otaton and sdbnd bt o slowly. s a rslt, t acqus th fncton of a babang that antans th forc ns btwn th snal con and th tw o ls
Msce Activity drng WalkngMsce Activity drng Walkng
o obos rasons, w canno t dscrb uscl act- ty n dtal hr rst, statnts n th ltatu r- gadng th act ty of nd da u scls ay wdly Scond usc chans a n ou onon or - ortant than solatd scs urthro anayss s dcut bcaus so onts ha to b stablzd
2 3PhysioogyPhysioogy
d
ee
Fig. 3.Sd-
Weigt shifts drig he stages of the gait cycle in sal lans and ons a ac hdnsionally hlss, w dscrib h func ons o ndidua uscs n h scond half o his boo on iggr ons.
classic xa or uscl aciiy s h n jon a h bg n nn g o h sanc sa g Th isc h uscs and h uadrics usc sab h n n h sa ga lan h u scs of h s ansr inus r n agus o h n. h i obia l rac is nsd bcaus h nsor fascia laa TL assss n rning ad ducion o h h.
Swg Stage Swg Stage
h ons of h swing sag, whn h larg o las h gound h iliosoas and cus oris uscs bnd h h whi h ischocrura usc grou bnds h n Th ibias anrio ls h
foo ogh wih h o x nsors. h co nclu son of h swing sag, h uadrics xnds h n Shoy bo and durng h on whn h h ouchs h grou nd, h n sablirs ar aci ad s abo h swng lg sag hfor con sss of an aciaon o h g flxor s.
Stae Stage Stae Stage
hs sag bgns whn h hl ouchs h gound h h is flxd, h n is srchd, and h foo and os a xndd dorsally Th sanc g has wo fun cion s o fulfi
Mainanng h sabiy o lg and is abduc os
g
h Gt Gb untn Mtn Pttn
43Fig 35g-i
Wegt ift drig the tageof
the gait yle Th stabilty of th lis s guaratd by th glta scs, th T, ad th otiba tact. Th agus of th k s guaratd by th s asi scls ad by th cha o th scs guts ax usas- tus latasata rtiaclu Th as o th foot s liitd by th roal uscs Ths cha s cotd towards th had a th glutal scls to th atissius dorsi o th oost sid.Th u body is rolld forward by a strtch th hi, , a d foot. Th ai scls sosib for this acto a th glutus axus quadcs, tcs sua, ad tbialis ostior th o us- cls, ad th to fxos
tstig sight s th fact that th uscls that ar actatd i o ot stag a os- to d otia y by th c di g stag that s thy ar brought ito a strtchd osto. Th oosit rotato o lis ad shoud gds as w as th
oosit ot o th as ad gs ilstrat this clarl y.
Wh th ght il iosoas i s suosd to u th rght hi orward, th lft lat iss us d osi ll s th ft a bacwad ad thrby stabs th sia co, whch gs th soas a stab bass
Cccad ad a rst th gait as a haro ios itlay of scl chas i th boo Les Pvts Ostpathques Th tr locootor syst bhas accordig to th sa attr that ats t slf wth ry ac Th lis ad sia col ak crtai ots arod th ots that had b dscbd by M ittl oh Th s two athors xtd ttljohs odl to th xtts ad d- scrb additio a o t oi ts i th stocostocla - cuar joit, i th joit ad th lowr a o t.
44 3yslgyyslgy
As already enoned above, he snal colun akes a scolioic oveen when the evis bends sideways duing he swng stage n ths ocess, he lubar verebrae rotate o he sde of he swing leg and the hoacic vetebae to the side of the sance leg, with L3 and T6 beng the resective aex of he tuns The CSC akes a tansaton to the swing leg side whie otating o he other side Fryette ; see Fyettes La ws 38 [i n 0707]
..This behavor can be illu- strated wih the hi dro test his tes iitates he gait cycle We descbe he behavo of he exteiies in the section on usc le chain s (see 78)
By recalng WG Suherland's canosacal odel we can deduce he oveents hat he she nobas ar synchondrosis SBS) and he en tire head ake duing every stride
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ConcusonConcuson
The gait s a hysioogica functon o the entie oco- oor syste n whi ch the org ani s acts lke a sri ng he oosie aangeent of lodoses and kyhosis fo the sol e of the oot o the head, and the elasticity of the ligaents, tendon s an d asciae ake t oss ble o relea se the en egy won durin g the stan ce sta ge for he swing stage hs ensues hat the law of econoy s obseved
Te at cce
Te at cce usustrates te tw mtn trates te tw mtn patternspatterns
Fexn and extensn aternate rtmca. Fexn and extensn aternate rtmca. Whie
the exensor chan is acve on one side, the fexo chan doinates on the othe side Sherington ; see th e law o f recr ocal nn eva on, 3 6 [ in 11 0707
])
.. This causes a toson aern o the snal colun (oosi te otatio n o f the elvic and sh ouder gidles Fro a caniosacral esective, this esults n tor sons of th e SBSNoraly unctioning strucures are he recondi- on or a haronious oveent ocess. Hyo, as well as h yeobity a fect the oon atern he resul i s wong ostual as we l as ooric behaviors
ExampA dysf uncti on o the first eatas al bone owards dorsa or of the talus towads anteio re- vens the oot fro o in g of, which over ie causes a ben ositon of the lower extreity The esuting shorenng of the soas canno bu aec he entie sinal coun
The oti on atten ha t he heast f ind s n a a- ent coresonds to he ada tive attern of t he ente ogani s to ts dysf unction his henoenon accods wth the law o econoy and anlessness as well as he aw of global iy
Not
Vleeng et al assue tha the eason f or ea-
ure exhauson duing sl ow walking, as f or exa e duing window shoing, is ound n the act that he sing rin cile can not be ale d here A s a re sult, he uscles, n articula those hat ae already ovebudened by a osure and ib ala nce, have to wok harde.
H Dananbeg akes soe interesng stateents abou the g ait cyc e in his arcle in ) Wak ing is a day activity. Considering ha a erson aks for an aveage of 80 nues every day, which translates nto aound 200 sdes this akes a toal of around 1 000 000 sdes er year Cean occua tions or sorts can doub e o even tre hs nuber. Even no ibalances can cause an sytos
n ano ther arcle (in ), Gracov esky osits tha t the eason o the secial bioechan ics o the CSC could be that it neualizes the rotaion of the shoulder gidle i n orde to antain a f orard vision.