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"The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy."
Martin Luther King, Jr., 1929–1968. American pastor, activist, and leader in the African-American Civil Rights Movement
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LEARNING OUTCOMES
This chapter provides a descriptive analysis of upright stance control and gait. By completion of this chapter, the reader should be able to:
Indicate the typical alignment seen in upright stance posture and summarize the mechanisms that preserve upright postural control;
Use gait terminology fluently when describing or analyzing human gait;
Describe gait by using the kinematic spatial and temporal descriptors seen in walking;
Summarize the main functional tasks associated with gait;
Identify the phases of the gait cycle and the main functional tasks associated with each phase;
Summarize the basic angular joint displacements at the pelvis, hip, knee, and ankle that occur during the gait cycle and translate these into the functional minimal range of motion requirements for gait;
Explain the muscular activation patterns at the trunk, pelvis, and lower extremities that occur during the gait cycle;
Summarize the age-related differences seen in the gait characteristics of children, mature and older adults;
Illustrate common methods of gait analysis;
Explain gait efficiency and the factors that contribute to this efficiency;
Describe the functional consequence on locomotion of commonly encountered pathological conditions;
Contrast and compare walking to running.
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CLINICAL SCENARIO
Morgan is working with Cody, a distance runner who injured his right knee while downhill skiing during his vacation. The knee was placed in a brace, and Cody was limited to nonweight-bearing on the limb for three weeks. Now that he has progressed to full weight-bearing as tolerated, it is Morgan's responsibility to advance him from walking to running again. The first day Cody put weight on the right limb, he was unable to walk normally. Morgan expected this and is prepared to instruct Cody in the proper technique.
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This first chapter in Unit 4 describes and summarizes the two most common functional tasks we engage in throughout our day: controlling our posture and walking. It is amazing how smoothly these two daily tasks are performed and how efficiently our bodies orchestrate them without conscious effort. When is the last time you ever really paid any attention to what muscles you were using, for example, as you stood in line to buy your books or buy a ticket to a game or show? Do you realize that when you walk, more than 1,000 muscles synchronize to move more than 200 bones around 100 joints?1 Your study of kinesiology in the preceding chapters has prepared you well for delving into the next step of clinical kinesiology: analysis of human movements. It is easier and most logical to begin with a static activity such as posture ...