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Objective To explore dynamic characteristics of the gait for the elderly with different fall risks before and after obstacle crossing. Methods Twenty-seven elderly people in community were graded as fall risk by using the time up and go test and five-time sit to stand test. The plantar pressure parameters of the elderly before and after obstacle crossing were measured and analyzed by foot pressure measurement system. Results There was no significant difference in the characteristic value of bimodal curve of overall plantar pressure between the high and low fall risk groups before and after obstacle crossing(P>0.05). The center of pressure (COP) trajectory in X direction of high fall risk group after obstacle crossing was significantly greater than that of low fall risk group (P0.05). Conclusions The support time of the elderly with high fall risk is longer than that of the elderly with low fall risk during obstacle crossing, the peak pressure of plantar metatarsal region of the crossing leg increases, and the plantar COP curve shows asymmetry, with an increase in transverse range of the coronal plane. In clinical evaluation, plantar pressure characteristics of people with fall risks during obstacle crossing should be focused on.
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Objective:To observe the effect of quadriceps femoris spasticity on the movement parameters in stroke patients during obstacle crossing. Methods:From October, 2017 to November, 2018, 20 stroke patients were divided into spasticity group (n = 11) and non-spasticity group (n = 9) based on the score of modified Ashworth Scale (MAS) of quadriceps femoris. A 10-camera 3D motion analysis system and two force plates were used to synchronously measure the movement parameters of the patients during obstacle crossing of 15 cm high, such as step length, step width, anterior-posterior velocity of the center of mass (COMAPV) and medio-lateral velocity of the center of mass, toe-obstacle distance of unaffected limb, toe-obstacle clearance of affected limb, heel-obstacle distance, double support phase, and the swing phases of affected and unaffected limb. Results:Compared with the non-spasticity group, the COMAPV decreased as both affected and unaffected limb above the obstacle in the spasticity group (F > 10.006, P < 0.01), as well as the toe-obstacle distance and step length before obstacle crossing (F > 13.456, P < 0.01); while, the double support phase and the step width after obstacle crossing increased (F > 4.533, P < 0.05). Conclusion:The quadriceps femoris spasticity may make the strategy of obstacle crossing more carefully for stroke patients, and less efficiently.
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Objective:To observe the gait characteristics related to the horizontal obstacle crossing, to optimize obstacle crossing strategy to reduce the risk of falling. Methods:A total of 15 healthy young men were recruited in September, 2019, to complete horizontal obstacle crossing tasks (0 cm, 45 cm, 55 cm and 65 cm wide), with dominant and non-dominant limbs first on a specific experimental path. Gait parameters were collected with infrared camera and biomechanics force plate. Results:As the width of the obstacle increasing, the speed, stride length, step length and toe clearance of trailing limb (TCt) increased; while the heel-to-obstacle distance (HOD) and toe-to-obstacle distance (TOD) decreased. As the non-dominant limb crossing first, the speed of following step was slower, and the TCt, step width, step length and HOD increased. Conclusion:The risk of falling increases with the width of the obstacle during horizontal obstacle crossing. It is recommended to use non-dominant limbs leading crossing, and increase stride length, step length and TCt to reduce the risk of falling.
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Objective:To explore the kinematics characteristics of obstacle crossing in old people with high or low falling risks in Community. Methods:From July to September, 2016, 27 old persons in community were divided into high falling risk group (H group, n = 15) and low fall risk group (L group, n = 12) according to the performance of Timed "Up and Go" Test and Five Times Sit to Stand Test. The kinematics characteristics were analyzed with Ariel Performance Analysis System as obstacle crossing. Results:The total time of crossing and the swing time of crossing legs were longer in H group than in L group (t > 2.073, P < 0.05), and the maximum height of standardized centre of mass was less in H group than in L group (t =-2.014, P < 0.05). As the crossing leg was just above the obstacle, the angle of knee of crossing leg was more in H group than in L group (t > 2.106, P < 0.05), the velocity of hip of crossing leg was less in H group than in L group (t = -2.119, P < 0.05), and the acceleration of ankle of swinging leg was less in H group than in L group (t = -3.038, P < 0.05). Conclusion:When the old people cross the obstacle, they trend to fall if they spend more time to overcome, lower in mass centre, in less speed of crossing hip and less acceleration of swinging ankle.
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Objective To study the factors leading to the increased risk of falls when the elderly cross obstacles with different load distributions in their hands, and to explore the gait strategies to prevent falls for elderly people with different load distributions during obstacle crossing. Methods Twelve young healthy (control group) and 12 elderly healthy participants performed walking tasks with or without obstacle crossing at their daily speed under different load distributions. Surface electromyography (sEMG) signals were collected from both sides of the lateral femoris, rectus femoris and medial femoris. Then the average sEMG was analyzed and compared. The numbers of contact incident during obstacle touching were also recorded. Results Age, weight carrying and obstacle all had significant influences on the activity level of lower limb muscles in elderly people. A total of 9 contact incidents occurred in 1 152 obstacle crossing tests. In addition, the contribution of right vastus medialis muscle was the greatest in the elderly and young adults when they completed the weight carrying and obstacle crossing tasks. Conclusions The elderly people had the lowest risk of falling down by taking advantage of the dominant side of the leg to take the lead in obstacle crossing under the uniform distributions of load. The research findings provide references for systematic assessment of fall risk in the elderly and have certain guiding significance for lower limb exercise or rehabilitation training in the elderly.
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Objective: To investigate obstacle crossing characteristics in the young and the elderly subjects. Methods: Twenty young and 20 elderly subjects were investigated for their obstacle crossing characteristics by using a 3D motion analysis system. Markers were placed on the bony prominences of the feet and obstacles. Obstacle crossing characteristics were determined with the obstacle crossing time, the vertical distance between toe and obstacle, and the maximum vertical toe clearance. The main effects and interaction effect of age (young and elderly) and limb [leading limb (LL) and trailing limb (TL)] were examined by two way analysis of variance. The obstacle crossing characteristics were also compared in each condition by using Independent sample t-test and Paired t-test. Results: There were main effects of the age and the limb on the obstacle crossing time. No interaction effect of the age and limb was found in any variables. In each condition of age and limb, there was a significant difference (p<0.05) in the obstacle crossing time between the limbs in both the young and the elderly. Furthermore, the vertical distance between toe and obstacle between the LL and TL was found to be significantly different (p<0.05) in the young, but not in the elderly (p>0.05). Conclusion: Age and limb were found to be the factors which related to the obstacle crossing time characteristic. The present findings suggested that the TL’s clearance is critical and should pay more consideration for the elderly.
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OBJECTIVE: To compare gait parameters of patients with idiopathic Parkinson's disease (IPD) during obstacle crossing with those of healthy control subjects. METHOD: Conventional physical examinations and three- dimensional gait analysis were performed on 16 patients of IPD with stage 2~3 of the Hoehn and Yahr disease rating scale, and 11 healthy control subjects during stepping over the obstacle. Temporospatial, kinematic and kinetic parameters of patients were compared with those of the control group. RESULTS: In patients with IPD, walking velocity was slower and stride length were shorter than control group. Decreased post-obstacle distance of the lead limb and increased pre-swing time of the lead and trail limbs were noted in IPD patients compared to control group. Many significant modifications of kinematic and kinetic parameters were detected in IPD patients compared to control group during obstacle crossing. CONCLUSION: Using three-dimensional gait analysis, we could identify specific modifications of gait parameters in IPD patients during obstacle crossing. These modifications may reduce or increase the risk of a falling in IPD patients.