Exercise and The Spine
The Spine and Gait
The Spine and Gait
Gait
The term gait refers to the manner of moving on foot, by way of walking or running. Normal walking requires the integration of neurological, muscular and joint functions. Many of the precise movements that take place during gait represent unconscious reflexes controlled by the brain and spinal cord.
Phases of Gait
Walking consists of two phases for each lower extremity: the swing phase (when the foot is off the ground) and the stance phase (when the foot is on the ground and bearing weight). During the stance phase of gait, extremity joints and the spine are supported on a single fixed leg. This is when the biomechanics of the foot and ankle can influence spine health. The three components of the stance phase are heel strike, midstance and toe off. Each of these components can be evaluated.
What is a Gait Evaluation?
Gait represents a complex activity which is not simple to evaluate. Gait evaluation requires an experienced examiner and the use of advanced technology. It is used to diagnose conditions and to plan and direct treatment. It provides a method for evaluating and measuring the dynamic consequences of neurologic and orthopedic disorders. Gait analysis is used to help assess treatment outcome and to help determine the complex relationships between impairment, functional limitation and disability.
The Spine and Gait
The way you stand and walk affects your body in many ways. Function and balance of the spine and pelvis depend on coordinated support from the feet and legs, especially during gait. Physicians must consider the lower extremities when evaluating spinal disorders. Spine disorders with nerve damage may result in weakness of muscles involved in walking. A good example is foot drop. Rehabilitation of the spine may include lower extremity strengthening and gait training.
The Foot and Gait
The foot is an intricate structure containing 26 bones, 33 joints, 107 ligaments, 19 muscles, and numerous tendons. The 52 bones in your feet make up about one quarter of all the bones in your body. The average active person takes about 8,000 to 10,000 steps a day. This adds up to a few miles per day and about 115,000 miles during the average lifetime. While walking the pressure on your feet exceeds your body weight, and when you're running, it can be the equivalent of three or four times your weight.
Gait
The term gait refers to the manner of moving on foot, by way of walking or running. Normal walking requires the integration of neurological, muscular and joint functions. Many of the precise movements that take place during gait represent unconscious reflexes controlled by the brain and spinal cord.
Phases of Gait
Walking consists of two phases for each lower extremity: the swing phase (when the foot is off the ground) and the stance phase (when the foot is on the ground and bearing weight). During the stance phase of gait, extremity joints and the spine are supported on a single fixed leg. This is when the biomechanics of the foot and ankle can influence spine health. The three components of the stance phase are heel strike, midstance and toe off. Each of these components can be evaluated.
What is a Gait Evaluation?
Gait represents a complex activity which is not simple to evaluate. Gait evaluation requires an experienced examiner and the use of advanced technology. It is used to diagnose conditions and to plan and direct treatment. It provides a method for evaluating and measuring the dynamic consequences of neurologic and orthopedic disorders. Gait analysis is used to help assess treatment outcome and to help determine the complex relationships between impairment, functional limitation and disability.
The Spine and Gait
The way you stand and walk affects your body in many ways. Function and balance of the spine and pelvis depend on coordinated support from the feet and legs, especially during gait. Physicians must consider the lower extremities when evaluating spinal disorders. Spine disorders with nerve damage may result in weakness of muscles involved in walking. A good example is foot drop. Rehabilitation of the spine may include lower extremity strengthening and gait training.
The Foot and Gait
The foot is an intricate structure containing 26 bones, 33 joints, 107 ligaments, 19 muscles, and numerous tendons. The 52 bones in your feet make up about one quarter of all the bones in your body. The average active person takes about 8,000 to 10,000 steps a day. This adds up to a few miles per day and about 115,000 miles during the average lifetime. While walking the pressure on your feet exceeds your body weight, and when you're running, it can be the equivalent of three or four times your weight.
Conditions which can lead to Abnormal Gait
- Polyneuropathy
- Vestibular disturbances
- Vision impairment
- Arthritis
- Foot pain
- Pronation
- Bunions
- Medications
- Nerve damage
- Back pain
- Spinal stenosis
- Disc herniation and radiculopathy
Methods of Evaluating Gait
There are different methods of evaluating of gait. These methods include:
- History and physical examination
- Visual gait evaluation
- Plantar pressure assessment
- Force plate assessment
- Quantitative treadmill assessment
- Regional functional assessment
- Video capture and analysis
History and Physical Examination
The physical exam provides information about neurological integrity, muscle strength and joint range of motion. The information obtained from a physical exam is limited because it is usually limited to assessing the patient in a sedentary fashion with the patient sitting or lying down. The gait evaluation becomes a valuable extension of the physical examination.
Visual Gait Analysis
During a gait examination, the attending specialist will observe for movement fluency and symmetry during the various phases of gait. This includes the evaluation of posture, the assessment of arm swing asymmetry, head position, pelvic movement, stride length, and heel-toe strike dynamics. Visual gait assessment is also used to observe for foot pronation and supination.
Plantar Pressure Assessment
Plantar pressure assessment requires that the patient assume a normal stance on a device which performs a scan of the plantar surfaces of the feet. The image data is then transferred to a computer. Color is assigned to various weight bearing areas of the foot creating a color map of the pressure patterns and their relationship to foot anatomy and callus formation.