, 2002 ), which impairs gait ( Ko, Hausdorff, & Ferrucci, 2010 ). Differences in gait patterns between older and young adults have been revealed in previous studies ( Cofré, Lythgo, Morgan, & Galea, 2011 ; Watelain, Barbier, Allard, Thevenon, & Angué, 2000 ). Najafi, Helbostad, Moe-Nilssen, Zijlstra
Mustafa M.O. Elhadi, Christina Z. Ma, Duo W.C. Wong, Anson H.P. Wan, and Winson C.C. Lee
Kimmery Migel and Erik Wikstrom
to contribute to aberrant gait biomechanics observed in those with CAI. More specifically, those with CAI demonstrate excessive inversion at heel strike and throughout stance as well as excessive inversion and plantar flexion in the swing phase of gait. 2 These impairments increase the risk of
Lei Zhou, Marie-Anne Gougeon, and Julie Nantel
Parkinson’s disease (PD) is a neurodegenerative disease that touches approximately 1–2% of the population over the age of 65 and 3% to 5% when reaching 85 years old or older ( Forsaa, Larsen, Wentzel-Larsen, Herlofson, & Alves, 2008 ). Postural balance and gait deficits are common motor deficits
Silvia Cabral, Renan A. Resende, Adam C. Clansey, Kevin J. Deluzio, W. Scott Selbie, and António P. Veloso
High levels of gait asymmetry are associated with many pathologies. Our long-term goal is to improve gait symmetry through real-time biofeedback of a symmetry index. Symmetry is often reported as a single metric or a collective signature of multiple discrete measures. While this is useful for assessment, incorporating multiple feedback metrics presents too much information for most subjects to use as visual feedback for gait retraining. The aim of this article was to develop a global gait asymmetry (GGA) score that could be used as a biofeedback metric for gait retraining and to test the effectiveness of the GGA for classifying artificially-induced asymmetry. Eighteen participants (11 males; age 26.9 y [SD = 7.7]; height 1.8 m [SD = 0.1]; body mass 72.7 kg [SD = 8.9]) walked on a treadmill in 3 symmetry conditions, induced by wearing custom-made sandals: a symmetric condition (identical sandals) and 2 asymmetric conditions (different sandals). The GGA score was calculated, based on several joint angles, and compared between conditions. Significant differences were found among all conditions (P < .001), meaning that the GGA score is sensitive to different levels of asymmetry, and may be useful for rehabilitation and assessment.
Christopher Dalton and Julie Nantel
The aim of this study was to investigate the impact of an 8-week Nordic walking (NW) intervention on older adult gait patterns and postural alignment. Twelve healthy older adults aged 60–80 years (8 female, 4 male) participated, all performing two 6-min walk tests (one with poles [WP], one without poles [NP]) and six 5-m walk trials (3 WP, 3 NP) at pre- and posttesting. Gait and postural variables were compared between poling conditions (i.e., WP to NP) as well as before and following the intervention. Following training, pole use resulted in various gait changes including: longer stride, faster gait, and increased power generation at the hip (H3) and power absorption at the knee (K1 and K4). We conclude that an initial 8-week training period is necessary for novice NW to perfect technique and to restore gait to a more natural, normal pattern following training.
Michael D. Lewek, Claire E. Bradley, Clinton J. Wutzke, and Steven M. Zinder
Falls are common after stroke and often attributed to poor balance. Falls often occur during walking, suggesting that walking patterns may induce a loss of balance. Gait after stroke is frequently spatiotemporally asymmetric, which may decrease balance. The purpose of this study is to determine the relationship between spatiotemporal gait asymmetry and balance control. Thirty-nine individuals with chronic stroke walked at comfortable and fast speeds to calculate asymmetry ratios for step length, stance time, and swing time. Balance measures included the Berg Balance Scale, step width during gait, and the weight distribution between legs during standing. Correlational analyses determined the relationships between balance and gait asymmetry. At comfortable and fast gait speeds, step width was correlated with stance time and swing time asymmetries (r = 0.39−0.54). Berg scores were correlated with step length and swing time asymmetries (r = –0.36 to –0.63). During fast walking, the weight distribution between limbs was correlated with stance time asymmetry (r = –0.41). Spatiotemporal gait asymmetry was more closely related to balance measures involving dynamic tasks than static tasks, suggesting that gait asymmetry may be related to the high number of falls poststroke. Further study to determine if rehabilitation that improves gait asymmetry has a similar influence on balance is warranted.
Myriam Verstappen and Peter Aerts
Spatio-temporal gait characteristics are determined for walking, running, and out of phase hopping magpies, at velocities ranging from 0.4 to 4 m/s. Below 1 m/s, magpies walk. At higher velocities they either run or hop, the latter being preferred. Stride length and frequency during walking and running relate to speed in an identical way. It is suggested that the control of walking and running, despite the abrupt drop in duty factor and step length at the transition from walking to either running or hopping, is represented by one single intrinsic pattern. Swing phase duration is independent of speed and similar of the three gaits, pointing to a passive, mechanical control. Stride frequencies during hopping barely change with velocity, while its stride length relates to velocity in a way highly comparable to that of walking and running. Hopping step length and duty factor are indifferent from those of running. These facts, combined with the similar spatio-temporal behavior of both legs in hopping suggest fairly comparable intra-limb coordination for running and hopping, and a simple phase-shift in inter-limb coordination to transform a run into a hop.
Tom Melai, Nicolaas C. Schaper, T. Herman IJzerman, Paul J.B. Willems, Ton L.H. de Lange, Kenneth Meijer, Aloysius G. Lieverse, and Hans H.C.M. Savelberg
Increased forefoot loading in diabetic polyneuropathy plays an important role in the development of plantar foot ulcers and can originate from alterations in muscle strength, joint moments and gait pattern. The current study evaluated whether strength training can improve lower extremity joint moments and spatiotemporal gait characteristics in patients with diabetic polyneuropathy. An intervention group receiving strength training during 24 weeks and a control group receiving no intervention. Measurements were performed in both groups at t = 0, t = 12, t = 24 and t = 52 weeks at an individually preferred and standardized imposed gait velocity. The strength training did not affect the maximal amplitude of hip, knee and ankle joint moments, but did result in an increase in stance phase duration, stride time and stride length of approximately 5%, during the imposed gait velocity. In addition, both groups increased their preferred gait velocity over one year. Future longitudinal studies should further explore the possible effects of strength training on spatiotemporal gait characteristics. The current study provides valuable information on changes in gait velocities and the progressive lower extremity problems in patients with polyneuropathy.
André G. P. Andrade, Janaine C. Polese, Leopoldo A. Paolucci, Hans-Joachim K. Menzel, and Luci F. Teixeira-Salmela
Lower extremity kinetic data during walking of 12 people with chronic poststroke were reanalyzed, using functional analysis of variance (FANOVA). To perform the FANOVA, the whole curve is represented by a mathematical function, which spans the whole gait cycle and avoids the need to identify isolated points, as required for traditional parametric analyses of variance (ANOVA). The power variables at the ankle, knee, and hip joints, in the sagittal plane, were compared between two conditions: With and without walking sticks at comfortable and fast speeds. For the ankle joint, FANOVA demonstrated increases in plantar flexion power generation during 60–80% of the gait cycle between fast and comfortable speeds with the use of walking sticks. For the knee joint, the use of walking sticks resulted in increases in the knee extension power generation during 10–30% of the gait cycle. During both speeds, the use of walking sticks resulted in increased power generation by the hip extensors and flexors during 10–30% and 40–70% of the gait cycle, respectively. These findings demonstrated the benefits of applying the FANOVA approach to improve the knowledge regarding the effects of walking sticks on gait biomechanics and encourage its use within other clinical contexts.
M. Monda, A. Goldberg, P. Smitham, M. Thornton, and I. McCarthy
To study mobility in older populations it can be advantageous to use portable gait analysis systems, such as inertial measurement units (IMUs), which can be used in the community. To define a normal range, 136 active subjects were recruited with an age range of 18 to 97. Four IMUs were attached to the subjects, one on each thigh and shank. Subjects were asked to walk 10 m at their own self-selected speed. The ranges of motion of thigh, shank, and knee in both swing and stance phase were calculated, in addition to stride duration. Thigh, shank, and knee range of movement in swing and stance were significantly different only in the > 80 age group. Regressions of angle against age showed a cubic relationship. Stride duration showed a weak linear relationship with age, increasing by approximately 0.1% per year.