Abstract
Kerrigan DC, Della Croce U, Marciello M, Riley PO. A refined view of the determinants
of gait: significance of heel rise. Arch Phys Med Rehabil 2000;81:1077-80. Objectives: Although the major determinants of gait described by Saunders and colleagues have
been accepted for more than 40 years, recent investigations raise the question of
whether the reduction in center of mass (COM) displacement compared with a compass
gait model indeed results from the factors originally described. We tested the hypothesis
that heel rise at the end of stance is a true determinant that can explain a considerable
portion of the reduction in COM vertical displacement during walking. Design: Stereophotogrammetric data during walking were collected. A modified compass gait
model incorporating the effect of heel rise, as compared with predictions based on
a standard compass model, were used to estimate the isolated effect of heel rise on
reducing the vertical displacement of COM. Setting: A gait laboratory. Participants: Thirty able-bodied subjects. Main Outcome Measure: The estimated reduction in COM displacement due to heel rise was compared with the
actual reduction in displacement. Results: The estimated effect of heel rise on reduction in COM displacement was 23.4 ± 7.6mm,
whereas the actual reduction in COM displacement was 21.2 ± 6.5mm (difference not
significant, paired p = .185). Conclusion: During normal walking, heel rise from foot flat has a considerable role in raising
the height of the COM when it is at its lowest, thus reducing its overall displacement.
Insofar as reduction of COM vertical displacement may have important energy implications,
appreciating the specific gait parameter of heel rise is key in rehabilitative approaches
to improve gait disability. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy
of Physical Medicine and Rehabilitation
Keywords
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Article info
Publication history
Accepted:
January 25,
2000
Received in revised form:
January 25,
2000
Received:
November 10,
1999
Footnotes
☆Supported in part by Public Health Service grant NIH HD01071-05 and by the Ellison Foundation.
☆☆No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
★Reprint requests to D. Casey Kerrigan, MD, MS, Harvard Medical School Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 125 Nashua Street, Boston, MA 02114.
★★Suppliers
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Copyright
© 2000 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
