scholarly journals How does external lateral stabilization constrain normal gait, apart from improving medio-lateral gait stability?

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Mohammadreza Mahaki ◽  
Trienke IJmker ◽  
Han Houdijk ◽  
Sjoerd Matthijs Bruijn
Keyword(s):  
Energy Cost ◽  
Step Length ◽  
Step Width ◽  
Arm Swing ◽  
Gait Stability ◽  
Normal Gait ◽  
Consumption Data ◽  
Gait Features ◽  
Pelvis Rotation ◽  
Anterior Posterior

Background: The effect of external lateral stabilization on medio-lateral gait stability has been investigated previously. However, existing lateral stabilization devices not only constrain lateral motions but also transverse and frontal pelvis rotations. This study aimed to investigate the effect of external lateral stabilization with and without constrained transverse pelvis rotation on mechanical and metabolic gait features. Methods: We undertook two experiments with 11 and 10 young adult subjects, respectively. Kinematic, kinetic and breath-by-breath oxygen consumption data were recorded during three walking conditions (normal walking (Normal), lateral stabilization with (Free) and without transverse pelvis rotation (Restricted)) and at three speeds (0.83, 1.25 and 1.66 m s −1 ) for each condition. In the second experiment, we reduced the weight of the frame, and allowed for longer habituation time to the stabilized conditions. Results: External lateral stabilization significantly reduced the amplitudes of the transverse and frontal pelvis rotations, in addition to medio-lateral, anterior–posterior, and vertical pelvis displacements, transverse thorax rotation, arm swing, step length and step width. The amplitudes of free vertical moment, anterior–posterior drift over a trial, and energy cost were not significantly influenced by external lateral stabilization. The removal of pelvic rotation restrictions by our experimental set-ups resulted in normal frontal pelvis rotation in Experiment 1 and significantly higher transverse pelvis rotation in Experiment 2, although transverse pelvis rotation still remained significantly less than in the Normal condition. Step length increased with the increased transverse pelvis rotation. Conclusion: Existing lateral stabilization set-ups not only constrain medio-lateral motions (i.e. medio-lateral pelvis displacement) but also constrain other movements such as transverse and frontal pelvis rotations, which leads to several other gait changes such as reduced transverse thorax rotation, and arm swing. Our new set-ups allowed for normal frontal pelvis rotation and more transverse pelvis rotation (yet less than normal). However, this did not result in more normal thorax rotation and arm swing. Hence, to provide medio-lateral support without constraining other gait variables, more elaborate set-ups are needed.

scholarly journals How does external lateral stabilization constrain normal gait, apart from improving medio-lateral gait stability?

2020 ◽  
Author(s):  
Mohammadreza Mahaki ◽  
Trienke IJmker ◽  
Han Houdijk ◽  
Sjoerd Matthijs Bruijn
Keyword(s):  
Step Length ◽  
Step Width ◽  
Arm Swing ◽  
Gait Stability ◽  
Normal Gait ◽  
Consumption Data ◽  
Gait Features ◽  
Pelvis Rotation ◽  
Set Up ◽  
Anterior Posterior

AbstractBackgroundThe effect of external lateral stabilization on medio-lateral gait stability has been investigated previously. However, existing lateral stabilization devices not only constrains lateral motions, but also transverse and frontal pelvis rotations. This study aimed to investigate the effect of external lateral stabilization with and without constrained transverse pelvis rotation on mechanical and metabolic gait features.MethodsWe undertook 2 experiments with eleven and ten young adult subjects, respectively. Experiment 2 supplemented experiment 1, as it considered several potential confounding factors in the design and set-up of experiment 1. Kinematic, kinetic, and breath-by-breath oxygen consumption data were recorded during 3 walking conditions (normal walking (Normal), lateral stabilization with (Free) and without transverse pelvis rotation (Restricted)) and at 3 speeds (0.83, 1.25, and 1.66 m/s) for each condition.ResultsExternal lateral stabilization significantly reduced the amplitudes of the transverse and frontal pelvis rotations, medio-lateral pelvis displacement, transverse thorax rotation, arm swing, and step width. The amplitudes of free vertical moment, anterior-posterior and vertical pelvis displacements, step length, and energy cost were not significantly influenced by external lateral stabilization. The removal of transverse pelvis rotation restriction by our experimental set-up resulted in significantly higher transverse pelvis rotation, although it remained significantly less than Normal condition. In concert, concomitant gait features such as transverse thorax rotation and arm swing were not significantly influenced by our new set-up.ConclusionExisting lateral stabilization set-ups not only constrain medio-lateral motions (i.e. medio-lateral pelvis displacement), but also constrains other movements such as transverse and frontal pelvis rotations, which leads to several other gait changes such as reduced transverse thorax rotation, and arm swing. Our new setup allowed for more transverse pelvis rotation, however, this did not result in more normal pelvis rotation, arm swing, etc. Hence, to provide medio-lateral support without constraining other gait variables, more elaborate set-ups are needed. Unless such a set-up is realized the observed side effects need to be taken into account when interpreting the effects of lateral stabilization as reported in previous studies.

scholarly journals Novel methodology for assessing total recovery time in response to unexpected perturbations while walking

2019 ◽  
Author(s):  
Uri Rosenblum ◽  
Lotem Kribus-Shmiel ◽  
Gabi Zeilig ◽  
Yotam Bahat ◽  
Shani Kimel-Naor ◽  
...  
Keyword(s):  
Recovery Time ◽  
Center Of Mass ◽  
Principal Component ◽  
Random Order ◽  
Step Length ◽  
Step Width ◽  
Total Recovery ◽  
Age Related ◽  
Different Types ◽  
Anterior Posterior

AbstractWalking stability is achieved by adjusting the medio-lateral and anterior-posterior dimensions of the base of support (step length and step width, respectively) to contain an extrapolated center of mass. We aimed to calculate total recovery time after different types of perturbations during walking, and use it to compare young and older adults following different types of perturbations. Walking trials were performed in 12 young (age 26.92 ± 3.40 years) and 12 older (age 66.83 ± 1.60 years) adults. Perturbations were introduced at different phases of the gait cycle, on both legs and in anterior-posterior or medio-lateral directions, in random order. A novel algorithm was developed to determine total recovery time values for regaining stable step length and step width parameters following the different perturbations and compared between the two participant groups under low and high cognitive load conditions, using principal component analysis (PCA). We analyzed 829 perturbations each for step length and step width. The algorithm successfully estimated total recovery time in 91.07% of the runs. PCA and statistical comparisons showed significant differences in step length and step width recovery times between anterior-posterior and medio-lateral perturbations, but no age-related differences. Initial analyses demonstrated the feasibility of comparisons based on total recovery time calculated using our algorithm.

scholarly journals Recovery of dynamic stability during slips unaffected by arm swing in people with Parkinson’s Disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249303
Author(s):  
Tarique Siragy ◽  
Allen Hill ◽  
Julie Nantel
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Calculated Data ◽  
Step Length ◽  
Step Width ◽  
Arm Swing ◽  
Margin Of Stability ◽  
Recovery Response ◽  
Arm Elevation ◽  
Arm Motion

The arm elevation strategy assists in recovering stability during slips in healthy young and elderly individuals. However, in people with Parkinson’s Disease, one of the main motor symptoms affecting the upper limbs is reduced arm swing which intensifies throughout the course of the disease before becoming absent. This holds direct implications for these individuals when encountering slips as the arm elevation strategy is an integral component in the interlimb slip response to restore stability. Arm swing’s effect in recovering from slips in people with Parkinson’s Disease though remains unexamined. Twenty people with Parkinson’s Disease (63.78 ± 8.97 years) walked with restricted and unrestricted arm swing conditions on a dual-belt treadmill where slips were induced on the least and most affected sides. Data were collected on the CAREN Extended System (Motek Medical, Amsterdam, NL). The Margin of Stability, linear and angular trunk velocities, as well as step length, time, and width were calculated. Data were examined during the slipped step and recovery step. The restricted arm swing condition, compared to unrestricted, caused a faster step time during the slipped step. Compared to the most affected leg, the least affected had a wider step width during the slipped step. During the recovery step, the least affected leg had a larger anteroposterior Margin of Stability and longer step time than the most affected. No differences between our arm swing conditions suggests that the normal arm swing in our participants was not more effective at restoring stability after an induced slip compared to when their arm motion was restricted. This may be due to the arm elevation strategy being ineffective in counteracting the slip’s backward destabilization in these individuals. Differences between the legs revealed that our participants were asymmetrically impaired in their slip recovery response.

scholarly journals Turning Characteristics of the More-Affected Side in Parkinson’s Disease Patients with Freezing of Gait

Sensors ◽  
2020 ◽  
Vol 20 (11) ◽  
pp. 3098
Author(s):  
Hwayoung Park ◽  
Changhong Youm ◽  
Myeounggon Lee ◽  
Byungjoo Noh ◽  
Sang-Myung Cheon
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Center Of Mass ◽  
Freezing Of Gait ◽  
Step Length ◽  
Control Group ◽  
Maximum Speed ◽  
Step Width ◽  
Affected Side ◽  
Anterior Posterior

This study investigated the turning characteristics of the more-affected limbs in Parkinson’s disease (PD) patients in comparison with that of a control group, and in PD patients with freezing of gait (FOG; freezers) in comparison with those without FOG (non-freezers) for 360° and 540° turning tasks at the maximum speed. A total of 12 freezers, 12 non-freezers, and 12 controls participated in this study. The PD patients showed significantly longer total durations, shorter inner and outer step lengths, and greater anterior–posterior (AP) root mean square (RMS) center of mass (COM) distances compared to those for the controls. The freezers showed significantly greater AP and medial-lateral (ML) RMS COM distances compared to those of non-freezers. The turning task toward the inner step of the more-affected side (IMA) in PD patients showed significantly greater step width, total steps, and AP and ML RMS COM distances than that toward the outer step of the more-affected side (OMA). The corresponding results for freezers revealed significantly higher total steps and shorter inner step length during the 540° turn toward the IMA than that toward the OMA. Therefore, PD patients and freezers exhibited greater turning difficulty in performing challenging turning tasks such as turning with an increased angle and speed and toward the more-affected side.

scholarly journals The use of Bally-Valens-Rehab shoes to improve gait in patients following stroke

1999 ◽  
Vol 55 (2) ◽  
pp. 18-22
Author(s):  
Jan Kool ◽  
P. Oesch ◽  
U. Sloksnath ◽  
O. Knusel
Keyword(s):  
Lateral Force ◽  
Step Length ◽  
Order Effects ◽  
Ground Reaction Forces ◽  
Randomised Study ◽  
Normal Gait ◽  
Reaction Forces ◽  
Opposite Order ◽  
One Year ◽  
Anterior Posterior

A randomised study was conducted to determine the influence which the Bally-Valens-Rehab shoes may have on gait in patients following stroke. The 11 subjects were all independent ambulators who were more than one year post stroke. Measurements were performed twice in opposite order to balance order effects. The reliability of the measurements was good (r>0.97). With the Bally-Valens-Rehab shoes, velocity improved by 8,6% from an average of 0.59 to an average of 0,64 m/s (p=0.021). Step-length gained 6,2% (42,1 cm to 44,5 cm, p=0.026) and endurance improved from 119 to 126 m/3 minutes (p=0.016). Meanwhile, ground reaction forces revealed a decrease in lateral force indicating a narrower, more normal gait (p=0.059). The anterior-posterior force increased significantly (p=0.021) showing that the shoes enhance heel-rise. The measurements confirmed the subjective findings and showed that use of the Bally-Valens-Rehab shoes in stroke patients may improve gait and enhance rehabilitation.

scholarly journals Regional Associations of Cortical Thickness With Gait Variability: The Tasmanian Study of Cognition and Gait

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 232-233
Author(s):  
Oshadi Jayakody ◽  
Monique Breslin ◽  
Richard Beare ◽  
Velandai Srikanth ◽  
Helena Blumen ◽  
...  
Keyword(s):  
Cortical Thickness ◽  
Step Length ◽  
Gait Variability ◽  
Thickness Ratio ◽  
Sensory Function ◽  
Time Variability ◽  
Step Width ◽  
Time Step ◽  
Cortical Regions ◽  
Regional Associations

Abstract Gait variability is a marker of cognitive decline. However, there is limited understanding of the cortical regions associated with gait variability. We examined associations between regional cortical thickness and gait variability in a population-based sample of older people without dementia. Participants (n=350, mean age 71.9±7.1) were randomly selected from the electoral roll. Variability in step time, step length, step width and double support time (DST) were calculated as the standard deviation of each measure, obtained from the GAITRite walkway. MRI scans were processed through FreeSurfer to obtain cortical thickness of 68 regions. Bayesian regression was used to determine regional associations of mean cortical thickness and thickness ratio (regional thickness/overall mean thickness) with gait variability. Smaller overall cortical thickness was only associated with greater step width and step time variability. Smaller mean thickness in widespread regions important for sensory, cognitive and motor functions were associated with greater step width and step time variability. In contrast, smaller thickness in a few frontal and temporal regions were associated with DST variability and the right cuneus was associated with step length variability. Smaller thickness ratio in frontal and temporal regions important for motor planning, execution and sensory function and, greater thickness ratio in the anterior cingulate was associated with greater variability in all measures. Examining individual cortical regions is important in understanding the relationship between gray matter and gait variability. Cortical thickness ratio highlights that smaller regional thickness relative to global thickness may be important for the consistency of gait.

Center of Pressure Trajectory and Spatiotemporal Gait Parameters When Walking with Limited Knee Flexion

2021 ◽  
Vol 65 (1) ◽  
pp. 1490-1493
Author(s):  
Seobin Choi ◽  
Jieon Lee ◽  
Gwanseob Shin
Keyword(s):  
Knee Flexion ◽  
Stance Phase ◽  
Center Of Pressure ◽  
Dynamic Balance ◽  
Left Knee ◽  
Step Width ◽  
Normal Walking ◽  
Gait Stability ◽  
Gait Parameters ◽  
Stiff Knee

Stiff-knee, which indicates reduced range of knee flexion, may decrease gait stability. Although it is closely related to an increase in fall risk, the effect of limited knee flexion on the balance capacity during walking has not been well studied. This study aimed at examining how walking with limited knee flexion would influence the center of pressure (COP) trajectory and spatiotemporal gait parameters. Sixteen healthy young participants conducted four different walking conditions: normal walking and walking with limited knee flexion of their left knee up to 40 and 20 degrees, respectively. Results show that the participants walked significantly (p<0.05) slower with shorter stride length, wider step width, less cadence, and decreased stance phase when walking with limited knee flexion, compared to normal walking. The increase in the asymmetry and variability of the COP was also observed. It indicates that limited knee flexion during walking might affect the dynamic balance.

scholarly journals Effect of wearing diapers on toddler’s gait

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tomoya Ueda ◽  
Haruna Asano ◽  
Kyoko Tsuge ◽  
Kanako Seo ◽  
Motoki Sudo ◽  
...  
Keyword(s):  
Motor Development ◽  
Joint Angle ◽  
Step Length ◽  
Step Width ◽  
Lower Stress ◽  
Gait Patterns ◽  
Bulk Stress ◽  
Joint Dynamics ◽  
Spatiotemporal Parameters ◽  
High Bulk

AbstractGait maturation in infants develops gradually through several phases. However, external factors such as childrearing practices, especially the wearing of diapers, may affect an infant’s motor development. This study investigated the influence of different bulk stresses on the gait of toddlers wearing a disposable diaper. Twenty-six healthy toddlers (age: 19.2 ± 0.9 months) participated in this study. We measured the joint kinematics (pelvis angle and hip-joint angle) and spatiotemporal parameters (step length and step width) of the toddlers’ gait under four dress conditions (wearing Type A_WET, Type A_DRY, and Type B_WET diapers and naked). Type B_WET had a higher bulk stress than Type A_WET, and Type A_DRY had lower stress than Type A _ WET. Our results indicate that the walk of toddlers when wearing a diaper differs from that when naked. This difference is due to the effect of the bulk of the diaper on the lower limb. A high bulk stress has a greater influence than that of a low bulk stress on joint dynamics and step width. Therefore, our findings suggest that wearing diapers with high bulk stress may inhibit the natural gait patterns of toddlers.

scholarly journals Disentangling the energetic costs of step time asymmetry and step length asymmetry in human walking

2021 ◽  
Author(s):  
Jan Stenum ◽  
Julia T. Choi
Keyword(s):  
Energy Cost ◽  
Metabolic Cost ◽  
Step Length ◽  
Human Walking ◽  
Metabolic Power ◽  
Healthy Human ◽  
Time Asymmetry ◽  
Double Support ◽  
Post Stroke ◽  
The Cost

The metabolic cost of walking in healthy individuals increases with spatiotemporal gait asymmetries. Pathological gait, such as post-stroke, often has asymmetry in step lengths and step times which may contribute to an increased energy cost. But paradoxically, enforcing step length symmetry does not reduce metabolic cost of post-stroke walking. The isolated and interacting costs of asymmetry in step times and step lengths remain unclear, because previous studies did not simultaneously enforce spatial and temporal gait asymmetries. Here, we delineate isolated costs of asymmetry in step times and step lengths in healthy human walking. We first show that the cost of step length asymmetry is predicted by the cost of taking two non-preferred step lengths (one short and one long), but that step time asymmetry adds an extra cost beyond the cost of non-preferred step times. The metabolic power of step time asymmetry is about 2.5 times greater than the cost of step length asymmetry. Furthermore, the costs are not additive when walking with asymmetric step times and step lengths: metabolic power of concurrent asymmetry in step lengths and step times is driven by the cost of step time asymmetry alone. The metabolic power of asymmetry is explained by positive mechanical power produced during single support phases to compensate for a net loss of center of mass power incurred during double support phases. These data may explain why metabolic cost remains invariant to step length asymmetry in post-stroke walking and suggests how effects of asymmetry on energy cost can be attenuated.

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