The major determinants in normal and pathological gait

Abstract

Human locomotion is such a complex process consisting of multiple simultaneous individual three dimensional motions that its analysis is diffi cult without a unifying principle. Such a unifying principle is the concept that locomotion is essentially the travel of the centre of gravity through space along a pathway that requires the least energy expenditure. This allows qualitative analysis of gait in terms of the essential determinants of gait. The six major determinants are pelvic rotation, pelvic tilt, knee and hip fl exion, knee and ankle interaction, and lateral pelvic displacement. Changes in these determinants may help understand and assess pathological gaits. Pathological gaits may represent a try to preserve energy consumption by exaggerating motion at unaffected levels. Compensation is reasonably effective, with loss of the knee determinant being the most costly. Loss of two determinants may make effective compensation impossible with the energy cost of locomotion increasing by threefold.