Gait & posture
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The purpose of this study was to assess the use of a multivariate statistical method to rank clinical and gait variables, thus describing a ranking of patient dysfunction prior to and following total knee replacement (TKR) surgery. Twenty end-stage knee osteoarthritis (KOA) subjects scheduled for TKR and 20 healthy controls performed level walking and stair ascent twice: pre- (P1) and 6 months post-surgery (P2). Clinical and gait measures were entered into a principle component analysis (PCA) to determine orthogonal principle components (PCs). ⋯ For P2, the "stair ascent dysfunction" dimension best discriminated between 6 months post-TKR patients and controls. The results of this study suggest that a multivariate statistical method provides a clinically relevant ranking of patient dysfunction prior to and following TKR. This ranking of dysfunction could serve to identify rehabilitation priorities.
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Randomized Controlled Trial Comparative Study
Rapid gait termination: effects of age, walking surfaces and footwear characteristics.
The aim of this study was to systematically investigate the influence of various walking surfaces and footwear characteristics on the ability to terminate gait rapidly in 10 young and 26 older people. Subjects walked at a self-selected speed in eight randomized shoe conditions (standard versus elevated heel, soft sole, hard sole, high-collar, flared sole, bevelled heel and tread sole) on three surfaces: control, irregular and wet. In response to an audible cue, subjects were required to stop as quickly as possible in three out of eight walking trials in each condition. ⋯ Subjects required more time to terminate gait in the soft sole shoes compared to the standard shoes. In contrast, the high-collar shoes reduced total stopping time on the wet surface. These findings suggest that older adults have more difficulty terminating gait rapidly than their younger counterparts and that footwear is likely to influence whole-body stability during challenging postural tasks on wet surfaces.
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Prolonged standing has been associated with the onset of low back pain symptoms in working populations. So far, it is unknown how individuals with chronic low back pain (CLBP) behave during prolonged unconstrained standing (PS). The aim of the present study was to analyze the control of posture by subjects with CLBP during PS in comparison to matched healthy adults. ⋯ The present study provides additional evidence that individuals with CLBP might have altered sensory-motor function. Their inability to generate responses similar to those of healthy subjects during prolonged standing may contribute to CLBP persistence or an increase risk of recurrent back pain episodes. Moreover, quantification of postural changes during prolonged standing could be useful to identify CLBP subjects prone to postural control deficits.
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The objective of this study was to investigate the association between step variability, muscle strength and functional walking performance in children post-traumatic brain injury (TBI) and typically developed (TD) children. A convenience sample of 16 children post-TBI and 16 TD age and sex matched controls participated in this cross sectional study. The main outcome measures included step length and step time variability, measured with an electronic walkway, strength of four lower-extremity muscle groups, tested bilaterally with a hand held dynamometer, walking performance as assessed by the 2-min walk test, energy expenditure index (EEI) and rating of perceived exertion (OMNI scale). ⋯ TD children had significantly higher mean strength values than children post-TBI in the knee extensor and hip abductor muscle groups (p<0.05). The 2-min walk test correlated inversely with the step time and length variability only among children post-TBI while muscle strength values correlated positively with the 2-min walk test only in TD children. This study found that step time and length variability and lower-extremity muscle strength correlated differently to distance covered during the 2-min walk test among children post-TBI and among TD children.
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This study developed an objective graphical classification method of spastic diplegic cerebral palsy (CP) gait patterns based on principal component analysis (PCA). Gait analyses of 20 healthy and 20 spastic diplegic CP children were examined to define gait characteristics. PCA was used to reduce the dimensionality of 27 parameters (26 selected kinematics variables and age of the children) for the 40 subjects in order to identify the dominant variability in the data. ⋯ Results indicated that only the healthy children formed a distinct cluster; however it was possible to recognise gait patterns in overlapping clusters in children with spastic diplegia. This study demonstrates that it is possible to quantitatively classify gait types in CP using PCA. Graphical classification of gait types could assist in clinical evaluation of the children and serve as a validation of clinical reports as well as aid treatment planning.