The biomechanics of pathological gait - from muscle to movement

Clinicians face the daily challenge of assessing and treating patients with gait problems. Musculoskeletal models appear to show potential for assisting with the understanding of complex pathological movements, however they are also complex and reliant on multiple assumptions in order to maintain stability. This paper breaks down the process by which muscles produce movement into a series of steps. The contributions and limitations of modelling each separate step are then considered. The calf muscles serve as an illustration throughout the paper, as these muscles are frequently implicated in the development of pathological gait patterns. An argument is put forward for the development of a range of tools for use in clinical practice, leading to an enhanced appreciation of the importance of joint moments. Improved clinical understanding of the link between muscles and movement will allow clinicians to develop better treatment plans for their patients.