Gait & posture
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The purpose of this study was to explore how origin-insertion length and lengthening velocity of hamstring and psoas muscle change as a result of crouch gait. The second purpose was to study the effect of changes in walking speed, in crouch, on muscle lengths and velocities. Eight healthy female subjects walked on a treadmill both normally and in crouch. ⋯ Decreasing walking speed clearly reduced muscle lengths and lengthening velocities. Therefore, patients with short or spastic muscles are more likely to respond by walking slower than by walking in crouch. Also, differences in walking speed should be avoided as a confounding factor when comparing patient groups with controls.
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Historical Article
The history of gait analysis before the advent of modern computers.
Aristotle (384-322 BCE) can be attributed with the earliest recorded comments regarding the manner in which humans walk. It was not until the renaissance that further progress was made through the experiments and theorising of Giovanni Borelli (1608-1679). Although several scientists wrote about walking through the enlightenment period it was the brothers Willhelm (1804-1891) and Eduard (1806-1871) Weber, working in Leipzig who made the next major contribution based on very simple measurements. ⋯ The team headed by Verne Inman (1905-1980) and Howard Eberhart (1906-1993) made major advances in America shortly after the Second War. David Sutherland (1923-2006) and Jacquelin Perry pioneered clinical applications in America and Jurg Baumann (1926-2000) in Europe. It was not until the advent of modern computers that clinical gait analysis became widely available.
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Increased stride-to-stride variability during walking characterizes gait instability and predicts falling in older adults. Walking while performing cognitive tasks (dual task walking) is also associated with increased risk of falling. The purpose of the study was to examine whether gait velocity and stride-to-stride variability in gait velocity differ in older adults compared with middle-aged and younger adults during normal and dual task walking conditions. ⋯ Variability in stride velocity was increased in older subjects compared with middle-aged and younger subjects (p<0.05). Additionally, in older subjects, impaired walking performance was associated with impaired cognitive performance in dual task walking. The gait changes observed in dual task walking characterize decreased gait stability and indicate that cognitively demanding tasks during walking have a destabilizing effect on gait and may place older people at a greater risk of falling.
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Changes in coordination of postural control during dynamic stance in chronic low back pain patients.
The human postural system operates on the basis of integrated information from three independent sources: vestibular, visual and somatosensory. It is conceivable that a derangement of any of these systems will influence the overall output of the postural system. The peripheral proprioceptive system or the central processing of proprioceptive information may be altered in chronic low back pain (CLBP). ⋯ Control experiments ruled out that increased sway was due to pain interference. In CLBP patients, postural stability under challenging conditions is maintained by an increased sway in AP direction. This change in postural strategy may underlie a dysfunction of the peripheral proprioceptive system or the central integration of proprioceptive information.
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Current follow-up and outcome studies of Legg Calvé Perthes disease (LCPD) are based on subjective measures of function, clinical parameters and radiological changes [Herring JA, Kim HT, Browne RH. Legg-Calvé-Perthes disease. Part II: prospective multicenter study of the effect of treatment on outcome. J Bone Joint Surg 2004;86A:2121-34; Aksoy MC, Cankus MC, Alanay A, Yazici M, Caglar O, Alpaslan AM. Radiological outcome of proximal femoral varus osteotomy for the treatment of lateral pillar group-C. J Pediatr Orthop 2005;14 B:88-91; Kitakoji T, Hattori T, Kitoh H, Katho M, Ishiguro N. Which is a better method for Perthes' disease: femoral varus or Salter osteotomy? Clin Orthop 2005;430:163-170; Joseph B, Rao N, Mulpuri K, Varghese G, Nair S. How does femoral varus osteotomy alter the natural evolution of Perthes' disease. J Pediatr Orthop 2005;14B:10-5; Ishida A, Kuwajima SS, Laredo FJ, Milani C. Salter innominate osteotomy in the treatment of severe Legg-Calvé-Perthes disease: clinical and radiographic results in 32 patients (37 hips) at skeletal maturity. J Pediatr Orthop 2004;24:257-64.]. The objective of this study was to evaluate the frontal plane kinematics and the effect on hip joint loading on the affected side in children with a radiographic diagnosis of LCPD. ⋯ Subjects with LCPD demonstrated two distinct frontal plane gait patterns, both deviating from normal. Type 1 (n=3) was characterized by a pelvic drop of the swinging limb, a trunk lean in relation to the pelvis towards the stance limb and hip adduction during stance phase and corresponded well to the description of Trendelenburg gait caused by abductor insufficiency. Type 2 (n=12) is characterized by a trunk lean toward the affected stance limb with the pelvis stable or elevated on the swinging limb during single stance phase. The abductor moment of the involved side during single stance was significantly reduced in type 2 compared to the controls (p=0.004) indicating a hip-unloading mechanism. These results may influence the physiotherapy regimen, which may require to work towards a hip-unloading gait pattern.