Effects of Physical Rehabilitation on Spatiotemporal Gait Parameters and Ground Reaction Forces of Patients with Intermittent Claudication

Chronic ischemia of the lower extremities often presents as intermittent claudication characterized by lower limb pain which subsides after a short break. This study aimed to provide an assessment of the spatiotemporal parameters of gait and ground reaction forces in patients with PAD participating in three forms of supervised physical training. A total of 80 subjects completed a three-month supervised physical rehabilitation program with three sessions per week. The subjects were assigned to one of three programs: group 1—standard walking training on a treadmill (TT); group 2—Nordic walking (NW) training; group 3—strength and endurance training comprised of NW with isokinetic resistance training (NW + ISO). Gait biomechanics tests (kinematic and kinetic parameters of gait) and a six-minute walk test were carried out before and after three months of physical training. Nordic walking training led to the greatest improvements in the gait pattern of patients with PAD and a significant increase in the absolute claudication distance and total gait distance. Combined training (NW + ISO) by strengthening the muscles of the lower extremities increased the amplitude of the general center of gravity oscillation to the greatest extent. Treadmill training had little effect on the gait pattern. Nordic walking training should be included in the rehabilitation of patients with PAD as a form of gait training, which can be conducted under supervised or unsupervised conditions.

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Bilateral Changes in Ground Reaction Forces in Patients with Unilateral Anterior Cruciate Ligament Deficiency During Stair Locomotion

Journal of Mechanics ◽

10.1017/jmech.2011.46 ◽

2011 ◽

Vol 27 (3) ◽

pp. 437-445 ◽

Cited By ~ 1

Author(s):

H.-C. Lin ◽

H.-C. Hsu ◽

T.-W. Lu

Keyword(s):

Cruciate Ligament ◽

Ground Level ◽

Rehabilitation Program ◽

Lower Limbs ◽

Control Group ◽

Ground Reaction Forces ◽

Acl Deficiency ◽

Stair Ascent ◽

Reaction Forces ◽

Stair Locomotion

ABSTRACTStair locomotion is an important but challenging functional activity for people with lower limb pathology. This study aimed to investigate the bilateral changes in force-bearing on lower limbs during stair locomotion in patients with unilateral ACL deficiency. The ground reaction forces (GRF) were collected from three force platforms: One at ground level in front of a 5-step stair and two on the first two steps respectively. Parameters in vertical and anterior-posterior GRF were extracted and compared between the ACL-deficient (ACLD) and control groups. The ACLD group showed significantly slower stepping cadences in both stair ascent and stepping down to the ground (p < 0.05). The vertical GRF in the ACLD group demonstrated smaller peak forces but larger minimum forces between the two peaks than those in the control group during both stair ascent and descent. Significantly reduced anterior propulsive forces and push-off rates in the late stance were also found in both limbs of the ACLD group (p < 0.05). The slower cadences and reduced force-bearing on the affected limb suggested a protective strategy was adopted. However, the anterior loading parameters in the early stance on the unaffected limb demonstrated different adaptations with significantly larger magnitudes during stair ascent but reduced magnitudes during stair descent (p < 0.05). Similar results were also found in the weight- transferring strategies between legs in consecutive steps with a significantly larger percentage of lift-up forces but a smaller percentage of impact forces on the leading unaffected limb. The results of this study indicated a cautious force-bearing strategy and bilateral adaptation were apparent in the patients with unilateral ACL deficiency. This information may provide a safety guideline for the patients and be helpful for a better use of the stair tasks as part of a rehabilitation program.

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A cost-effective instrumented walkway for measuring ground reaction forces in rats to assess gait pattern

Measurement ◽

10.1016/j.measurement.2017.02.044 ◽

2017 ◽

Vol 103 ◽

pp. 241-249 ◽

Cited By ~ 1

Author(s):

Nuno Silva ◽

Joaquim J. Sousa ◽

Emanuel Peres ◽

Antonio Sousa ◽

Antonio M. Ruiz-Armenteros ◽

...

Keyword(s):

Cost Effective ◽

Gait Pattern ◽

Ground Reaction Forces ◽

Reaction Forces

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Gait analysis by measuring ground reaction forces in children: changes to an adaptive gait pattern between the ages of one and five years

Developmental Medicine & Child Neurology ◽

10.1111/j.1469-8749.1997.tb07416.x ◽

2008 ◽

Vol 39 (4) ◽

pp. 228-233 ◽

Cited By ~ 25

Author(s):

Sabine Preis ◽

Anja Klemms ◽

Kristiina Müller

Keyword(s):

Gait Analysis ◽

Gait Pattern ◽

Ground Reaction Forces ◽

Reaction Forces ◽

Adaptive Gait

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Influence of the Physical Training on Muscle Function and Walking Distance in Symptomatic Peripheral Arterial Disease in Elderly

BioMed Research International ◽

10.1155/2018/1937527 ◽

2018 ◽

Vol 2018 ◽

pp. 1-16 ◽

Cited By ~ 6

Author(s):

Katarzyna Kropielnicka ◽

Wioletta Dziubek ◽

Katarzyna Bulińska ◽

Małgorzata Stefańska ◽

Joanna Wojcieszczyk-Latos ◽

...

Keyword(s):

Intermittent Claudication ◽

Physical Training ◽

Lower Limb ◽

Training Group ◽

Walking Distance ◽

Nordic Walking ◽

Group Iii ◽

Exercise Rehabilitation ◽

Force Velocity ◽

Group Ii

Introduction. A typical symptom of chronic lower-limb ischaemia is lower-limb pain, which occurs during walking forcing the patient to stop, intermittent claudication (IC). Exercise rehabilitation is the basic form of treatment for these patients. Aim. The aim of this study was to compare the effectiveness of three types of physical training programmes conducted over a 12-week period in patients with chronic lower-limb arterial insufficiency. Materials and Methods. Ninety-five people qualified for the 3-month supervised motor rehabilitation programme, conducted three times a week. The respondents were assigned to three types of rehabilitation programmes using a pseudo-randomization method: Group I (TW), subjects undertaking treadmill walking training; Group II (NW), subjects undertaking Nordic walking training; Group III (RES+NW), subjects undertaking resistance and Nordic walking training. Treadmill test, 6 Minute Walk Test (6MWT), and isokinetic test were repeated after 3 months of rehabilitation, which 80 people completed. Results. Combined training (RES+NW) is more effective than Nordic walking alone and supervised treadmill training alone for improving ankle force-velocity parameters (p<0.05) in patients with intermittent claudication. Each of the proposed exercise rehabilitation programmes increased walking distance of patients with intermittent claudication (p<0.05), especially in 6MWT (p=0.001). Significant relationships of force-velocity parameters are observed in the maximum distance obtained in 6MWT, both in Group III (RES + NW) and in Group II (NW) at the level of moderate and strong correlation strength, which indicates that if the lower limbs are stronger the walking distance achieved in 6MWT is longer. Conclusions. Given both the force-velocity parameters and the covered distance, the training RES + NW gives the most beneficial changes compared to training TW alone and NW alone. All types of training increased walking distance, which is an important aspect of the everyday functioning of people with IC.

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PCA-Based SVM for Automatic Recognition of Gait Patterns

Journal of Applied Biomechanics ◽

10.1123/jab.24.1.83 ◽

2008 ◽

Vol 24 (1) ◽

pp. 83-87 ◽

Cited By ~ 18

Author(s):

Jianning Wu ◽

Jue Wang

Keyword(s):

Gait Pattern ◽

Technical Note ◽

Ground Reaction Forces ◽

Test Results ◽

Linear Kernel ◽

Gait Patterns ◽

Gait Classification ◽

Gait Features ◽

Reaction Forces ◽

Improved Performance

In this technical note, we investigate a combination PCA with SVM to classify gait pattern based on kinetic data. The gait data of 30 young and 30 elderly participants were recorded using a strain gauge force platform during normal walking. The gait features were first extracted from the recorded vertical directional foot– ground reaction forces curve using PCA, and then these extracted features were adopted to develop the SVM gait classifier. The test results indicated that the performance of PCA-based SVM was on average 90% to recognize young– elderly gait patterns, resulting in a markedly improved performance over an artificial neural network–based classifier. The classification ability of the SVM with polynomial and radial basis function kernels was superior to that of the SVM with linear kernel. These results suggest that the proposed technique could provide an effective tool for gait classification in future clinical applications.

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Characteristic Ground-Reaction Forces in Baseball Pitching

The American Journal of Sports Medicine ◽

10.1177/03635465980260014101 ◽

1998 ◽

Vol 26 (1) ◽

pp. 66-71 ◽

Cited By ~ 11

Author(s):

Bruce A. MacWilliams ◽

Tony Choi ◽

Mark K. Perezous ◽

Edmund Y. S. Chao ◽

Edward G. McFarland

Keyword(s):

Body Weight ◽

Lower Extremities ◽

School Level ◽

Clinical Impression ◽

Ground Reaction Forces ◽

High School Level ◽

Overhand Throwing ◽

Reaction Forces ◽

Force Data ◽

Throwing Motion

Overhand throwing requires contributions from and interaction between all limb segments. Most previous investigations have concentrated on the throwing arm itself, yet poor mechanics at the arm may originate in the lower extremities. Multicomponent ground-reaction forces of both the push-off and landing limbs were measured in six collegiate and one high school level baseball pitchers. Full body kinematics were simultaneously recorded to correlate phases in the pitching cycle with the force data. Pitchers were found to generate shear forces of 0.35 body weight in the direction of the pitch with the push-off leg and to resist forces of 0.72 body weight with the landing leg. Wrist velocity was found to correlate highly with increased leg drive. This study validates the clinical impression that the lower extremity is an important contributor to the throwing motion. Based on this study, strengthening of the lower extremities could be inferred to be important both to enhance performance and to avoid injury.

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The Effects of a Multimodal Rehabilitation Program on Symptoms and Ground-Reaction Forces in Runners With Patellofemoral Pain Syndrome

Journal of Sport Rehabilitation ◽

10.1123/jsr.2014-0245 ◽

2016 ◽

Vol 25 (1) ◽

pp. 23-30 ◽

Cited By ~ 15

Author(s):

Jean-Francois Esculier ◽

Laurent J. Bouyer ◽

Jean-Sébastien Roy

Keyword(s):

Motor Control ◽

Outcome Measures ◽

Lower Limb ◽

Pain Syndrome ◽

Patellofemoral Pain ◽

Rehabilitation Program ◽

Isometric Strength ◽

Ground Reaction Forces ◽

Vertical Loading ◽

Reaction Forces

Context:Patellofemoral pain (PFP) is one of the most frequent running-related injuries. However, few interventions taking into consideration the specificity of running have been shown to be effective in runners with PFP.Objective:To evaluate the effects of a multimodal rehabilitation program including lower-limb-strengthening/motor-control exercises, advice on running biomechanics, and symptoms management on symptoms, strength, and ground-reaction forces in runners with PFP.Design:Pre- to post- quasi-experimental.Setting:Gait-analysis laboratory and private physical therapy clinic.Participants:21 runners with PFP (34.1 ± 6.0 y old, symptoms duration 38.1 ± 45.5 mo).Intervention:An 8-wk multimodal rehabilitation program including lower-limb- and core-strengthening and motor-control exercises, as well as advice on running gait and symptoms management.Main Outcome Measures:The Activities of Daily Living Scale of the Knee Outcome Survey (KOS-ADLS) questionnaire and visual analog scales for usual pain (VAS-U), worst pain (VAS-W), and pain during running (VAS-R) were used to assess changes in symptoms and function. Vertical ground-reaction forces (VGRF) during running and lower-limb isometric strength were also measured.Results:Statistically and clinically significant improvements (P < .001) were reported on KOS-ADLS (+17.8 pts), VAS-U (−19.2 pts), VAS-W (−28.7 pts), and VAS-R (−32.2 pts) after the intervention. No significant changes in isometric strength were observed. The instantaneous vertical loading rate was decreased after the intervention (P = .002), and this reduction was correlated with changes in KOS-ADLS scores (P = .028).Conclusion:This multimodal intervention was successful in reducing pain and improving function of runners with PFP. However, no significant changes in lower-limb strength were observed. It appears that changes in VGRF combined with appropriate training advice could explain the clinical outcomes.

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