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1.
The present article investigates gait stability of healthy older persons during weight transfer. Ten healthy older persons and ten younger persons walked 10 min each on a treadmill at 3 different gait speeds. The intra-stride change in gait stability was defined by the local divergence exponent λ(t) estimated by a newly developed method. The intra-stride changes in λ(t) during weight transfer were identified by separating each stride into a single and double support phase. The intra-stride changes in λ(t) were also compared to changes in the variation of the gait kinematics, i.e., SD(t). The healthy older persons walked at the same preferred walking speed as the younger persons. However, they exhibited significantly larger λ(t) (p<0.001) during weight transfer in the double support phase. Local divergence was closely related to intra-stride changes in SD(t) of the feet in the anterior-posterior direction. Furthermore, a high correlation was found between local divergence and the variation in step length and step width for both older (R>0.67, p<0.05) and younger persons (R>0.67, p<0.05). The present results indicate that the gait kinematics of older adults are more dynamical unstable during the weight transfer compared to younger persons. Furthermore, a close relationship exists between intra-stride changes in dynamical stability and variation in step length and step width. Further work will validate the results of the present study using real-life perturbations of the gait kinematics of both younger and older adults.  相似文献   

2.
When walking at a given speed, humans often appear to prefer gait patterns that minimize metabolic rate, thereby maximizing metabolic economy. However, recent experiments have demonstrated that humans do not maximize economy when walking downhill. The purpose of this study was to investigate whether this non-metabolically optimal behavior is the result of a trade-off between metabolic economy and gait stability. We hypothesized that humans have the ability to modulate their gait strategy to increase either metabolic economy or stability, but that increase in one measure will be accompanied by decrease in the other. Subjects walked downhill using gait strategies ranging from risky to conservative, which were either prescribed by verbal instructions or induced by the threat of perturbations. We quantified spatiotemporal gait characteristics, metabolic rate and several indicators of stability previously associated with fall risk: stride period variability; step width variability; Lyapunov exponents; Floquet multipliers; and stride period fractal index. When subjects walked using conservative gait strategies, stride periods and lengths decreased, metabolic rate increased, and anteroposterior maximum Lyapunov exponents increased, which has previously been interpreted as an indicator of decreased stability. These results do not provide clear support for the proposed trade-off between economy and stability, particularly when stability is approximated using complex metrics. However, several gait pattern changes previously linked to increased fall risk were observed when our healthy subjects walked with a conservative strategy, suggesting that these changes may be a response to, rather than a cause of, increased fall risk.  相似文献   

3.
Human walking requires active neuromuscular control to ensure stability in the lateral direction, which inflicts a certain metabolic load. The magnitude of this metabolic load has previously been investigated by means of passive external lateral stabilization via spring-like cords. In the present study, we applied this method to test two hypotheses: (1) the effect of external stabilization on energy cost depends on the stiffness of the stabilizing springs, and (2) the energy cost for balance control, and consequently the effect of external stabilization on energy cost, depends on walking speed. Fourteen healthy young adults walked on a motor driven treadmill without stabilization and with stabilization with four different spring stiffnesses (between 760 and 1820 N m−1) at three walking speeds (70%, 100%, and 130% of preferred speed). Energy cost was calculated from breath-by-breath oxygen consumption. Gait parameters (mean and variability of step width and stride length, and variability of trunk accelerations) were calculated from kinematic data. On average external stabilization led to a decrease in energy cost of 6% (p<0.005) as well as a decrease in step width (24%; p<0.001), step width variability (41%; p<0.001) and variability of medio-lateral trunk acceleration (12.5%; p<0.005). Increasing stabilizer stiffness increased the effects on both energy cost and medio-lateral gait parameters up to a stiffness of 1260 N m−1. Contrary to expectations, the effect of stabilization was independent of walking speed (p=0.111). These results show that active lateral stabilization during walking involves an energetic cost, which is independent of walking speed.  相似文献   

4.
The purpose of the study was to compare the effects of a feedback-controlled treadmill (FeedbackTM) to a traditional fixed-speed treadmill (FixedTM) on spatiotemporal gait means, variability, and dynamics. The study also examined inter-session reliability when using the FeedbackTM. Ten young adults walked on the FeedbackTM for a 5-minute familiarization followed by a 16-minute experimental trial. They returned within one week and completed a 5-minute familiarization followed by a 16-minute experimental trial each for FeedbackTM and FixedTM conditions. Mean walking speed and step time, length, width, and speed means and coefficient of variation were calculated from all experimental conditions. Step time, length, width, and speed gait dynamics were analyzed using detrended fluctuation analysis. Mean differences between experimental trials were determined using ANOVAs and reliability between FeedbackTM sessions was determined by intraclass correlation coefficient. No difference was found in mean walking speed nor spatiotemporal variables, with the exception of step width, between the experimental trials. All mean spatiotemporal variables demonstrated good to excellent reliability between sessions, while coefficient of variation was not reliable. Gait dynamics of step time, length, width, and speed were significantly more persistent during the FeedbackTM condition compared to FixedTM, especially step speed. However, gait dynamics demonstrated fair to poor reliability between FeedbackTM sessions. When walking on the FeedbackTM, users maintain a consistent set point, yet the gait dynamics around the mean are different when compared to walking on a FixedTM. In addition, spatiotemporal gait dynamics and variability may not be consistent across separate days when using the FeedbackTM.  相似文献   

5.
The purpose of the current study was to investigate whether adaptations of stride length, stride frequency, and walking speed, independently influence local dynamic stability and the size of the medio-lateral and backward margins of stability during walking. Nine healthy subjects walked 25 trials on a treadmill at different combinations of stride frequency, stride length, and consequently at different walking speeds. Visual feedback about the required and the actual combination of stride frequency and stride length was given during the trials. Generalized Estimating Equations were used to investigate the independent contribution of stride length, stride frequency, and walking speed on the measures of gait stability. Increasing stride frequency was found to enhance medio-lateral margins of stability. Backward margins of stability became larger as stride length decreased or walking speed increased. For local dynamic stability no significant effects of stride frequency, stride length or walking speed were found. We conclude that adaptations in stride frequency, stride length and/or walking speed can result in an increase of the medio-lateral and backward margins of stability, while these adaptations do not seem to affect local dynamic stability. Gait training focusing on the observed stepping strategies to enhance margins of stability might be a useful contribution to programs aimed at fall prevention.  相似文献   

6.
Around 60% of persons with multiple sclerosis (MS) experience falls, however the dynamic balance differences between those who fall and those who don’t are not well understood. The purpose of this study is to identify distinct biomechanical features of dynamic balance during gait that are different between fallers with MS, non-fallers with MS, and healthy controls. 27 recurrent fallers with MS, 28 persons with MS with no falls history, and 27 healthy controls walked on a treadmill at their preferred speed for 3 min. The variability of trunk accelerations and the average and variability of minimum toe clearance, spatiotemporal parameters, and margin of stability were compared between groups. Fallers with MS exhibited a slower cautious gait compared to non-fallers and healthy controls, but had decreased anterior-posterior margin of stability and minimum toe clearance. Fallers walked with less locally stable and predictable trunk accelerations, and increased variability of step length, stride time, and both anterior-posterior and mediolateral margin of stability compared to non-fallers and healthy controls. The present work provides evidence that within a group of persons with MS, there are gait differences that are influenced by falls history. These differences indicate that in persons with MS who fall, the center of mass is poorly controlled through base of support placement and the foot is closer to the ground during swing phase relative to the non-fallers. These identified biomechanical differences could be used to evaluate dynamic balance in persons with MS and to help improve fall prevention strategies.  相似文献   

7.
Crouch gait, one of the most prevalent movement abnormalities among children with cerebral palsy, is frequently treated with surgical lengthening of the hamstrings. To assist in surgical planning many clinical centers use musculoskeletal modeling to help determine if a patient’s hamstrings are shorter or lengthen more slowly than during unimpaired gait. However, some subjects with crouch gait walk slowly, and gait speed may affect peak hamstring lengths and lengthening velocities. The purpose of this study was to evaluate the effects of walking speed on hamstrings lengths and velocities in a group of unimpaired subjects over a large range of speeds and to determine if evaluating subjects with crouch gait using speed matched controls alters subjects’ characterization as having “short” or “slow” hamstrings. We examined 39 unimpaired subjects who walked at five different speeds. These subjects served as speed-matched controls for comparison to 74 subjects with cerebral palsy who walked in crouch gait. Our analysis revealed that peak hamstrings length and peak lengthening velocity in unimpaired subjects increased significantly with increasing walking speed. Fewer subjects with cerebral palsy were categorized as having hamstrings that were “short” (31/74) or “slow” (38/74) using a speed-matched control protocol compared to a non-speed-matched protocol (35/74 “short”, 47/74 “slow”). Evaluation of patients with cerebral palsy using speed-matched controls alters and may improve selection of patients for hamstrings lengthening procedures.  相似文献   

8.
This study tested whether the lower economy of walking in healthy elderly subjects is due to greater gait instability. We compared the energy cost of walking and gait instability (assessed by stride to stride changes in the stride time) in octogenarians (G80, n = 10), 65-yr-olds (G65, n = 10), and young controls (G25, n = 10) walking on a treadmill at six different speeds. The energy cost of walking was higher for G80 than for G25 across the different walking speeds (P < 0.05). Stride time variability at preferred walking speed was significantly greater in G80 (2.31 +/- 0.68%) and G65 (1.93 +/- 0.39%) compared with G25 (1.40 +/- 0.30%; P < 0.05). There was no significant correlation between gait instability and energy cost of walking at preferred walking speed. These findings demonstrated greater energy expenditure in healthy elderly subjects while walking and increased gait instability. However, no relationship was noted between these two variables. The increase in energy cost is probably multifactorial, and our results suggest that gait instability is probably not the main contributing factor in this population. We thus concluded that other mechanisms, such as the energy expenditure associated with walking movements and related to mechanical work, or neuromuscular factors, are more likely involved in the higher cost of walking in elderly people.  相似文献   

9.
Falls pose a tremendous risk to those over 65 and most falls occur during locomotion. Older adults commonly walk slower, which many believe helps improve walking stability. While increased gait variability predicts future fall risk, increased variability is also caused by walking slower. Thus, we need to better understand how differences in age and walking speed independently affect dynamic stability during walking. We investigated if older adults improved their dynamic stability by walking slower, and how leg strength and flexibility (passive range of motion (ROM)) affected this relationship. Eighteen active healthy older and 17 healthy younger adults walked on a treadmill for 5min each at each of 5 speeds (80-120% of preferred). Local divergence exponents and maximum Floquet multipliers (FM) were calculated to quantify each subject's inherent local dynamic stability. The older subjects walked with the same preferred walking speeds as the younger subjects (p=0.860). However, these older adults still exhibited greater local divergence exponents (p<0.0001) and higher maximum FM (p<0.007) than the younger adults at all walking speeds. These older adults remained more locally unstable (p<0.04) even after adjusting for declines in both strength and ROM. In both age groups, local divergence exponents decreased at slower speeds and increased at faster speeds (p<0.0001). Maximum FM showed similar changes with speed (p<0.02). Both younger and older adults exhibited decreased instability by walking slower, in spite of increased variability. These increases in dynamic instability might be more sensitive indicators of future fall risk than changes in gait variability.  相似文献   

10.
This study compares the performance of algorithms for body-worn sensors used with a spatiotemporal gait analysis platform to the GAITRite electronic walkway. The mean error in detection time (true error) for heel strike and toe-off was 33.9 ± 10.4 ms and 3.8 ± 28.7 ms, respectively. The ICC for temporal parameters step, stride, swing and stance time was found to be greater than 0.84, indicating good agreement. Similarly, for spatial gait parameters--stride length and velocity--the ICC was found to be greater than 0.88. Results show good to excellent concurrent validity in spatiotemporal gait parameters, at three different walking speeds (best agreement observed at normal walking speed). The reported algorithms for body-worn sensors are comparable to the GAITRite electronic walkway for measurement of spatiotemporal gait parameters in healthy subjects.  相似文献   

11.
Gait analysis in orthopaedic and neurological examinations is important; however, few studies assess gait variability at different walking speeds in patients with varying degrees of hip osteoarthritis. We aimed to clarify (1) how different controlled speeds and (2) various severities of hip osteoarthritis influence gait variability. Gait variability was described by the standard deviation (SD) of the spatial–temporal and mean standard deviation (MeanSD) of angular parameters. The spatial positions of the anatomical points for calculating gait parameters were determined in 20 healthy elderly controls and 20 patients with moderate and 20 patients with severe hip osteoarthritis with a zebris CMS-HS ultrasound-based motion analysis system at three walking speeds. The SD of the spatial–temporal and MeanSD of angular parameters of gait, which together describe gait variability, significantly depended on speed and osteoarthritis severity. The lowest variability in the gait was found near the self-selected walking speeds. Hip joint degeneration significantly worsened variability on the affected side, with non-affected joints and the pelvis compensating by increasing flexibility and adapting to step-by-step motions. Particular attention must be paid to improving gait stability and the reliability of limb movements in the presence of and increasing severity of osteoarthritis.  相似文献   

12.
The purpose of this study was to determine whether general fatigue induced by incremental maximal exercise test (IMET) affects gait stability and variability in healthy subjects. Twenty-two young healthy male subjects walked in a treadmill at preferred walking speed for 4 min prior (PreT) the test, which was followed by three series of 4 min of walking with 4 min of rest among them. Gait variability was assessed using walk ratio (WR), calculated as step length normalized by step frequency, root mean square (RMSratio) of trunk acceleration, standard deviation of medial-lateral trunk acceleration between strides (VARML), coefficient of variation of step frequency (SFCV), length (SLCV) and width (SWCV). Gait stability was assessed using margin of stability (MoS) and local dynamic stability (λs). VARML, SFCV, SLCV and SWCV increased after the test indicating an increase in gait variability. MoS decreased and λs increased after the test, indicating a decrease in gait stability. All variables showed a trend to return to PreT values, but the 20-min post-test interval appears not to be enough for a complete recovery. The results showed that general fatigue induced by IMET alters negatively the gait, and an interval of at least 20 min should be considered for injury prevention in tasks with similar demands.  相似文献   

13.
In this study, we examined Spatial–temporal gait stride parameters, lower extremity joint angles, ground reaction forces (GRF) components, and electromyographic activation patterns of 10 healthy elderly individuals (70 ± 6 years) walking in water and on land and compared them to a reference group of 10 younger adults (29 ± 6 years). They all walked at self-selected comfortable speeds both on land and while immersed in water at the Xiphoid process level. Concerning the elderly individuals, the main significant differences observed were that they presented shorter stride length, slower speed, lower GRF values, higher horizontal impulses, smaller knee range of motion, lower ankle dorsiflexion, and more knee flexion at the stride’s initial contact in water than on land. Concerning the comparison between elderly individuals and adults, elderly individuals walked significantly slower on land than adults but both groups presented the same speed walking in water. In water, elderly individuals presented significantly shorter stride length, lower stride duration, and higher stance period duration than younger adults. That is, elderly individuals’ adaptations to walking in water differ from those in the younger age group. This fact should be considered when prescribing rehabilitation or fitness programs for these populations.  相似文献   

14.

Background

Gait performance is widely evaluated to assess health status in older adult populations. While several investigators have presented normative values for spatiotemporal gait parameters drawn from older adult populations, the literature has been void of large-scale cohort studies, which are needed in order to provide quantitative, normative gait data in persons with Parkinson’s disease. The aim of this investigation was to provide reference values for clinically important gait characteristics in a large sample of ambulatory persons with Parkinson’s disease to aid both clinicians and researchers in their evaluations and treatments of gait impairment.

Methodology/Principal Findings

Gait performance was collected in 310 individuals with idiopathic Parkinson’s disease as they walked across a pressure sensitive walkway. Fourteen quantitative gait parameters were measured and evaluated with respect to Hoehn and Yahr disease staging and gender. Disease duration and age were controlled for in all analyses. Individuals with the greatest Parkinson’s disability walked significantly slower with shorter steps and stride lengths than the mild and moderately affected groups. Further, the most affected patients spent more time with both feet on the ground, and walked with a wider base of support than the moderately disabled patients. No differences were detected between the mild and moderate disability groups on any of the gait parameters evaluated.

Conclusions/Significance

Reference values for 14 gait parameters in a large cohort of ambulatory patients with Parkinson’s disease are provided and these may be highly useful for assessing and interpreting an individual’s gait dysfunction. It is important for clinicians and researchers to appreciate the lack of change in quantitative parameters as PD patients move from mild to moderate gait impairment.  相似文献   

15.
BackgroundThe aim of this study was to determine whether changes in synergies relate to changes in gait while walking on a treadmill at multiple speeds and slopes. The hypothesis was that significant changes in movement pattern would not be accompanied by significant changes in synergies, suggesting that synergies are not dependent on the mechanical constraints but are instead neurological in origin.MethodsSixteen typically developing children walked on a treadmill for nine combinations (stages) of different speeds and slopes while simultaneously collecting kinematics, kinetics, and surface electromyography (EMG) data. The kinematics for each stride were summarized using a modified version of the Gait Deviation Index that only includes the sagittal plane. The kinetics for each stride were summarized using a modified version of the Gait Deviation Index – Kinetic which includes sagittal plane moments and powers. Within each synergy group, the correlations of the synergies were calculated between the treadmill stages.ResultsWhile kinematics and kinetics were significantly altered at the highest slope compared to level ground when walking on a treadmill, synergies were similar across stages.ConclusionsThe high correlations between synergies across stages indicate that neuromuscular control strategies do not change as children walk at different speeds and slopes on a treadmill. However, the multiple significant differences in kinematics and kinetics between stages indicate real differences in movement pattern. This supports the theory that synergies are neurological in origin and not simply a response to the biomechanical task constraints.  相似文献   

16.
The purpose of this study was to determine the subjective and quantitative donor-site morbidity after removal of a free vascularized fibula flap for autoreconstruction. Ten patients and six age-matched, healthy control subjects were included in this study. The postoperative periods ranged from 6 to 87 months. Subjective donor-site morbidity was assessed with a patient questionnaire and the Enneking system. For quantification of donor-site morbidity, gait was evaluated during normal walking, walking under visual and cognitive constraints, and walking at a velocity higher than the preferred one. In general, the patient perception of donor-site morbidity was low. Complaints were frequently mentioned, however, including pain (60 percent), dysesthesia (50 percent), a feeling of ankle instability (30 percent), and inability to run (20 percent). Gait analyses revealed that patients walked at a lower preferred velocity, compared with control subjects. Furthermore, they demonstrated significant increases in the coefficients of variation of stride time during walking under visual and cognitive loads and during walking at a velocity higher than the preferred one, compared with normal walking. These increases were not observed for control subjects. These findings suggest that the reautomatization of gait is affected among patients. This study demonstrates that fibula harvesting is associated with low subjective morbidity but frequent complaints. Walking during complex tasks and at high velocities reveals that restoration of gait is not complete after partial fibulectomy.  相似文献   

17.
Investigating inter-joint coordination at different walking speeds in young and elderly adults could provide insights to age-related changes in neuromuscular control of gait. We examined effects of walking speed and age on the pattern and variability of inter-joint coordination. Gait analyses of 10 young and 10 elderly adults were performed with different self-selected speeds, including a preferred, faster, and slower speed. Continuous relative phase (CRP), derived from phase planes of two adjacent joints, was used to assess the inter-joint coordination. CRP patterns were examined with cross-correlation measures and root-mean-square (RMS) differences when comparing ensemble mean curves of the faster or slower speed to preferred speed walking. Variability of coordination for each participant was assessed with the average value of all standard deviations calculated for each data point over a gait cycle from all CRP curves, namely the deviation phase (DP). For hip-knee CRP pattern, RMS differences were significantly greater between the slower and preferred walking speeds than between the faster and preferred walking speeds in young adults, but this was not found in elderly adults. Significant group differences in RMS differences and cross-correlation measures were detected in hip-knee CRP patterns between the slower and preferred walking speeds. No significant walking speed or age effects were detected for the knee-ankle CRP. Significant walking speed effects were also detected in hip-knee DP values. However, no significant group differences were detected for all three speeds. These findings suggested that young and elder adults compromise changes of walking speed with different neuromuscular control strategies.  相似文献   

18.
Spatiotemporal characteristics of gait such as step time and length are often associated with overall physical function in clinical populations, but can be difficult, time consuming and obtrusive to measure. This study assessed the concurrent validity of overground walking spatiotemporal data recorded using a criterion reference – a marker-based three-dimensional motion analysis (3DMA) system – and a low-cost, markerless alternative, the automated skeleton tracking output from the Microsoft Kinect™ (Kinect). Twenty-one healthy adults performed normal walking trials while being monitored using both systems. The outcome measures of gait speed, step length and time, stride length and time and peak foot swing velocity were derived using supervised automated analysis. To assess the agreement between the Kinect and 3DMA devices, Bland–Altman 95% bias and limits of agreement, percentage error, relative agreement (Pearson's correlation coefficients: r) overall agreement (concordance correlation coefficients: rc) and landmark location linearity as a function of distance from the sensor were determined. Gait speed, step length and stride length from the two devices possessed excellent agreement (r and rc values >0.90). Foot swing velocity possessed excellent relative (r=0.93) but only modest overall (rc=0.54) agreement. Step time (r=0.82 and rc=0.23) and stride time (r=0.69 and rc=0.14) possessed excellent and modest relative agreement respectively but poor overall agreement. Landmark location linearity was excellent (R2=0.991). This widely available, low-cost and portable system could provide clinicians with significant advantages for assessing some spatiotemporal gait parameters. However, caution must be taken when choosing outcome variables as some commonly reported variables cannot be accurately measured.  相似文献   

19.

Objective

The control of gait requires executive and attentional functions. As preterm children show executive and attentional deficits compared to full-term children, performing concurrent tasks that impose additional cognitive load may lead to poorer walking performance in preterm compared to full-term children. Knowledge regarding gait in preterm children after early childhood is scarce. We examined straight walking and if it is more affected in very preterm than in full-term children in dual-task paradigms.

Study design

Twenty preterm children with very low birth-weight (≤ 1500 g), 24 preterm children with birth-weight > 1500 g, and 44 full-term children, born between 2001 and 2006, were investigated. Gait was assessed using an electronic walkway system (GAITRite) while walking without a concurrent task (single-task) and while performing one concurrent (dual-task) or two concurrent (triple-task) tasks. Spatio-temporal gait parameters (gait velocity, cadence, stride length, single support time, double support time), normalized gait parameters (normalized velocity, normalized cadence, normalized stride length) and gait variability parameters (stride velocity variability, stride length variability) were analyzed.

Results

In dual- and triple-task conditions children showed decreased gait velocity, cadence, stride length, as well as increased single support time, double support time and gait variability compared to single-task walking. Further, results showed systematic decreases in stride velocity variability from preterm children with very low birth weight (≤ 1500 g) to preterm children with birth weight > 1500 g to full-term children. There were no significant interactions between walking conditions and prematurity status.

Conclusions

Dual and triple tasking affects gait of preterm and full-term children, confirming previous results that walking requires executive and attentional functions. Birth-weight dependent systematic changes in stride velocity variability indicate poorer walking performance in preterm children who were less mature at birth.  相似文献   

20.
The Laetoli footprints and early hominin locomotor kinematics   总被引:1,自引:0,他引:1  
A critical question in human evolution is whether the earliest bipeds walked with a bent-hip, bent-knee gait or on more extended hindlimbs. The differences between these gaits are not trivial, because the adoption of either has important implications for the evolution of bipedalism. In this study, we re-examined the Laetoli footprints to determine whether they can provide information on the locomotor posture of early hominins. Previous researchers have suggested that the stride lengths of Laetoli hominins fall within the range of modern human stride lengths and therefore, Laetoli hominins walked with modern-human-like kinematics. Using a dynamic-similarity analysis, we compared Laetoli hominin stride lengths with those of both modern humans and chimpanzees. Our results indicate that Laetoli hominins could have used either a bent-hip, bent-knee gait, similar to a chimpanzee, or an extended-hindlimb gait, similar to a human. In fact, our data suggest that the Laetoli hominins could have walked near their preferred speeds using either limb posture. This result contrasts with most previous studies, which suggest relatively slow walking speeds for these early bipeds. Despite the many attempts to discern limb-joint kinematics from Laetoli stride lengths, our study concludes that stride lengths alone do not resolve the debate over early hominin locomotor postures.  相似文献   

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