Analysis of Lateral Straddling Motion of the Bathtub by the Differences in the First Leg of Patients after THA / The Japanese Journal of Rehabilitation Medicine

Objective：The movement of an elderly person involving stepping over a bathtub makes them prone to falls and requires caution. Gait analysis suggested that the risk of falling increases with time spent in supporting both legs. A similar relationship was expected for side-straddling motion. This study aims to analyze differences in the side-straddling movements between THA patients who did not fully recover their functional balance, mobility, or walking ability from the viewpoint of the ratio of time spent supporting both legs.Methods：Eleven patients with hip osteoarthritis underwent initial unilateral THA via a posterior approach. Using a portable three-dimensional motion analyzer, we calculated the percentages of time spent supporting both legs while entering the bathtub, and exiting the bathtub with a handrail and examined the factors associated with percent of the time spent supporting both legs.Results：The percentage of time spent supporting both legs when exiting the bathtub was significantly lesser when exiting using the nonoperative than the operated side. A negative correlation was found between the percentages of time spent supporting both legs. while exiting the bathtub, and the percentage of handrail load values.Conclusion：The risk of falling may be reduced by using the nonoperative leg as the leading leg when exiting a bathtub. Use of handrails contributes to a reduction in fall risk.

The effect of age on the center of plantar pressure / 中华物理医学与康复杂志

Objective To study the effect of age on the trajectory of the center of plantar pressure.Methods Twenty-five healthy young people constituted a youth group,while another 25 elderly counterparts formed an aged group.Descriptors of everyone's gait were collected using an AL-600 gait and balance training and evaluation apparatus.The length of the total trajectory of the center of plantar pressure (COPD) was recorded along with the average left and right deviation of the center of plantar pressure (COPD-X) and its average anterior-posterior deviation (COPD-Y) in the heel strike (LR),single plantar stance (SPS) and push-off (PS) phases of striding.Results The average COPD of the aged group was significantly longer than that of the youths.For both groups,the average COPD-X and COPD-Y deviations in SPS were significantly less than those in the LR and PS phases,with no significant difference between them.Compared with the youth group,the average COPD-X in the LR and PS phases and the average COPD-Y in the PS were significantly greater among the aged,but there was no significant difference between the two groups in the average COPD-X in SPS or in the average COPD-Y in the LR and SPS phases.Conclusions The average COPD,COPD-X and COPD-Y increase with age,indicating the higher risk of falling.The changes in each sub-phase of gait are different,but those in the LR and PS phases more reliably reflect stability.

Effects of backpack loads and positions on the variability of gait spatiotemporal parameters in young adults

Abstract Introduction: People carry backpacks of different weight in different positions every day. The effects of backpack wearing under different loads and positions were assessed according to the gait's spatiotemporal parameters and their variability in young adults. Methods Twenty-one subjects performed trials of 4 min in the conditions: control condition with no backpack; bilateral back load consisting of 10% body weight (BW); bilateral back load of 20% BW (B20); unilateral load of 10% BW; unilateral load with 20% BW (U20); bilateral frontal load with 10% BW; bilateral frontal load with 20% BW. Results Step length (SL) and step frequency (SF) show that frontal conditions differed from others as seen in B20. Gait cycle phases showed an increase in the B20 condition for double stance phase and stance phase, swing phase presented reduction in the B20 condition. There were significant main effects in position for SL, SF, and walk ratio, in load only for stride width. The highest variability of spatiotemporal parameters occurred in the U20 condition. All load conditions with 20% BW showed a greater variability when compared to the 10% BW counterpart. Conclusion We concluded that young adults can cope with up to a 15% BW load under a bilateral back position, but in the frontal position not even a 10% BW load was proven to be a safe limit. 20% BW loads should be avoided in any position. These recommendations may assure increased gait stability, decreased trunk forward lean and decreased muscle activation and fatigue reducing back pain occurrence.

The influence of heel height on gait of young females during stair descent / 医用生物力学

Objective To investigate the effects of heel heights on gait of young women when going downstairs, and analyze the injury risk of women wearing high-heeled shoes during stair descent. Methods The gait from 17 young women wearing shoes with 4 different heel heights during their stair descent was measured by infrared high-speed motion capture system. The subjects’temporal parameters of gait and 3D joint angles of lower extremity were calculated and analyzed. Results Compared with flat shoes, the gait cycle increased when wearing 3 cm, 5 cm, 7 cm high-heeled shoes during stair descent, and the stance phase proportion and double-support stance phase proportion decreased, while the step width also decreased evidently. For 5 cm, 7 cm high-heeled shoes, the ankle range of motion (ROM) in the sagittal plane would reduce significantly, and for all the 3 cm, 5 cm, 7 cm high-heeled shoes, the ankle ROM in transverse plane would increase during stair descent. Wearing 3 cm, 5 cm high-heeled shoes could make the knee ROM in the sagittal plane significantly reduce, while wearing 3 cm, 5 cm, 7 cm high-heeled shoes, the knee ROM in the transverse plane would increase evidently. Wearing 5 cm, 7 cm high-heeled shoes, the maximum hip flexion angle was greater than that of wearing flat shoes, and the minimum hip flexion angle would be also greater when wearing 3 cm, 5 cm, 7 cm high-heeled shoes. Conclusions During stair descent, with the increase of heel heights, the gait cycle and swing phase proportion increase, while the stance phase proportion, double-support stance phase proportion and step width decrease, which will raise the risk of falling. Meanwhile, the knee and ankle ROMs in sagittal plane decrease gradually, while those in transverse plane come to increase. The research findings can help to further understand the influence of heel heights on gait characteristics and patterns during stair descent and provide reference for possible injury risk analysis.

The Effects of Physical Factors on Anteroposterior, Intersidal Weight-Bearing Pattern and Stance Phase in Normal Adults

OBJECTIVE: To determine if physical factors (age, sex, weight, foot length) affected anteroposterior and intersidal weight- bearing pattern on footplate in standing posture and duration of stance phase at walking. METHOD: Participants were 578 healthy adults (250 men, 328 women). All participants were tested by Gaitview? (Alfoots, Seoul, Korea) which measure anteroposterior, intersidal weight-bearing pattern on foot plate and duration of stance phase at walking. Measurements were analyzed to find any relations among physical factors (age, sex, weight, foot length), anteorposterior, intersidal weight-bearing pattern and stance phase. RESULTS: The age, weight, foot length had no specific relations to anteroposterior weight-bearing pattern (r0.4, p<0.01). CONCLUSION: There was a significant correlation between sex and anteroposteior weight-bearing pattern. And there was a positive relation between age and stance, midstance phase.

Evaluation of Kinematic Data and Energy Consumption of Domestic Swing and Stance Phase Control Knee Assembly

OBJECTIVE: This study aimed to evaluate the kinematic data and energy consumption of domestic swing and stance phase (SNS) control knee assembly in transfemoral amputees. METHOD: Five male transfemoral amputees took prosthetic training of more than one week and evaluated with random applying 3 types of knee assembly; mechanical type, pneumatic type, and domestic SNS type. Kinematic data was obtained by the VICON 370 system (Oxford Metrics Ltd., UK.). Energy consumption was measured using a KB1-C (Aerosport Inc, U.S.A). RESULTS: Domestic SNS type showed a significantly increased walking speed, cadence and step length compared with mechanical type and pneumatic type (p<0.05). Domestic SNS type showed a significantly increased maximal hip flexion and extension compared with mechanical type and pneumatic type (p<0.05). Domestic SNS type showed decreased peak knee flexion at swing phase and significantly increased peak knee extension at stance phase compard with mechanical type and pneumatic type (p<0.05). In energy consumption, the domestic SNS type tended to show a lower O2 cost and faster walking speed than the mechanical type and pneumatic type at free-walking. CONCLUSION: We concluded the domestic SNS type had more tendency toward a normal gait pattern and lower energy consumption compared with mechanical type and pneumatic type.

A Study on the Effect of Degree of Freedom of Ankle Motion on Gait of Transfemoral Amputees with SNS Control Prosthesis / 대한정형외과연구학회지

Using three different types of the ankle joint, i.e., the fixed, single-axis, and multi axis type, the gait characteristics of transfemoral amputees were investigated to understand the biomechanics of ankle joint motion during gait of transfemoral amputees with a SNS (swing and stance phase) control prosthesis controlling the flexion-extension of knee in the stance phase unlike conventional swing control prostheses. The socket pressure was measured to explain the resulting gait characteristic of the transfemoral amputees for different ankle joint components. Based on the results from the gait characteristics, socket pressure, knee flexion-extension behavior, and ground reaction vector, the fixed type ankle joint could be considered as the most appropriate ankle joint for the transfemoral amputees using the SNS control prosthesis.

A Study on the Effect of Degree of Freedom of Ankle Motion on Gait of Transfemoral Amputees with SNS Control Prosthesis / 대한정형외과연구학회지

Using three different types of the ankle joint, i.e., the fixed, single-axis, and multi axis type, the gait characteristics of transfemoral amputees were investigated to understand the biomechanics of ankle joint motion during gait of transfemoral amputees with a SNS (swing and stance phase) control prosthesis controlling the flexion-extension of knee in the stance phase unlike conventional swing control prostheses. The socket pressure was measured to explain the resulting gait characteristic of the transfemoral amputees for different ankle joint components. Based on the results from the gait characteristics, socket pressure, knee flexion-extension behavior, and ground reaction vector, the fixed type ankle joint could be considered as the most appropriate ankle joint for the transfemoral amputees using the SNS control prosthesis.

The Location of the Center of Pressure in Foot during Stance Phase of Normal Gait by Plantar Pressure Measurement

The purpose of this study was to detect where the center of pressure in foot would be located at the end point of loading response and the terminal stance by the dynamic plantar pressure measurement. Seventeen adults who had the usual feet without a pathologic gait were evaulated simultaneously by the motion analysis using VICON 370, and the plantar pressure measurement using EMED-SF. Two devices were set in the 60 Hz frame. The foot was divided into 3 different zones; hindfoot, midfoot, and forefoot. The end point of loading response was located at the 1.92+/-1.46 frame distal to the hindfoot- midfoot borderline. The end point of terminal response was located at the 2.27+/-1.96 frame distal to the maximal pressure points of metatarsal head. Authors could differentiate each period of stance phase; the initial contact, loading response, mid-stance, terminal stance, and preswing, using the analysis of center of pressure by the dynamic plantar pressure measurement.

Analysis of the Stance Phase in a Hemiplegic Patient by the Measurement of Plantar Pressure

OBJECTS: The purpose of this study is to estimate the values of foot pressure of the stance phase during a gait cycle in hemiplegic gait. METHOD: Thirty patients who had a stroke and forty healthy adults were evaluated by the EMED-SF system to analyze the stance phase of hemiplegic gait. The stance phase was evaluated by 6 points according to the foot pressure and center of pressure proposed by Lee et al.2) RESULTS: 1) In hemiplegics, the stance time of involved limb decreased compared with that of the uninvolved limb and increased that of control groups (p<0.05). 2) In hemiplegics, the midstance time increased but the loading response and terminal stance decreased compared with the uninvolved limb and controls (p<0.05). 3) In hemiplegics, the midstance time decreased and the loading response and terminal phase increased according to the increased Brunnstrom stage (p<0.05). CONCLUSION: The results showed that an analysis of stance phase by the measurement of plantar pressure was a valuable parameter in the gait analysis of hemiplegic patients.