Gait & posture
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Low back pain (LBP) is a problem that can contribute to functional limitations and disability. Understanding kinematics during walking can provide a basis for examination and treatment in people with LBP. Prior research related to kinematics during walking is conflicting. ⋯ There were predictable differences in kinematics among some movement-based LBP subgroups that approached statistical significance (P=.09-.11). Walking was provocative of LBP in few subjects, and differences between people with and without LBP and among LBP subgroups were minimal. Limitations include that attempts to standardize gait speed may have minimized observed effects, and there was limited power to detect movement-based LBP subgroup differences.
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Randomized Controlled Trial Comparative Study
Active assistive forced exercise provides long-term improvement to gait velocity and stride length in patients bilaterally affected by Parkinson's disease.
Forced exercise training presents a valid method of improving symptoms of Parkinson's disease such as rigor, dyskinesia and gait dysfunctions. Brain imaging data suggest that use of active assistive forced exercise could improve Parkinsonian symptoms more effectively than passive assistive forced exercise. However, the long-term effects of active versus passive assistive forced exercise on the symptoms of Parkinson's disease are unknown. ⋯ Participation in both passive and active assistive forced exercise increased gait velocity (0.5 km/h), swing phase (2%), monopedal stance phase (2%), elongated stride length (11 cm) and decreased double stance phase (4%). However, with participation in active assistive forced exercise, postural and kinetic tremor were also reduced and gait velocity and stride length were increased long-term. Given these findings, we conclude that future treatment for patients bilaterally affected by Parkinson's disease should carefully consider the type of assistive forced exercise intervention to be used.
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For maintaining heading direction while walking we heavily rely on vision. Therefore, walking in the absence of vision or with visual attention directed elsewhere potentially leads to dangerous situations. Here we investigated whether tactile information from the feet can be used as a (partial) substitute for vision in maintaining a stable heading direction. ⋯ The drawback, however, was that the tactile pavement used in this study decreased gait stability. In sum, tactile pavement can be used as a partial substitute for vision in maintaining heading direction, but it can also decrease gait stability. Future work should focus on designing tactile pavement that does provided directional clues, but is less destabilizing.
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Three-dimensional gait analysis (3DGA) can provide detailed data on gait impairment in chronic low back pain (CLBP) patients. However, data about reliability and measurement error of 3DGA in this population is lacking. The aim of this study is to investigate test-retest reliability and minimal detectable change of 3DGA in a sample of CLBP patients. ⋯ The results of this study show high test-retest reliability for lower limb and trunk joint angles, and time-distance parameters during gait in CLBP individuals, together with a low measurement error. These results also support the use of this method in clinical assessments of CLBP patients' gait patterns.
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This study tested the hypothesis that the presence of isolated ankle (A-OA; N=30), knee (K-OA; N=20), or hip (H-OA; N=30) osteoarthritis (OA) compared to asymptomatic controls (N=15) would lead to mechanical changes in the affected joint but also in all other lower limb joints and gait overall. Stride length, stance and swing times, as well as joint angles and moments at the hip, knee, and ankle were derived from 3-D kinematic and kinetic data collected from seven self-selected speed walking trial. Values were compared across groups using a 1×4 ANCOVA, covarying for walking speed. ⋯ Finally, OA in any joint led to lower peak vertical forces as well as extension and plantar flexion moments compared to controls. The presence of end-stage OA at various lower extremity joints results in compensatory gait mechanics that cause movement alterations throughout the lower extremity. This work reinforces our understanding of the complex interaction of joints of the lower limb and the importance of focusing on the mechanics of the entire lower limb when considering gait disability and potential interventions in patients with isolated OA.