Gait & posture
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Gait variability has been correlated with fall risk in the elderly. Older adults typically display greater variability than young adults, but the cause of this increase is unclear. Slower walking leads to greater variability in young adults, but slow speeds are also typical in older adults. ⋯ Step length (p=0.005), stride time (p=0.018), and trunk pitch (p=0.022) exhibited similar trends. This greater variability was explained by decreased leg strength and passive ranges of motion. Thus, the greater variability observed in the gait of older adults may result more from loss of strength and flexibility than from their slower speeds.
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The activity of descending stairs increases loading at the joints of the lower extremities as compared to walking, which may cause discomfort and or difficulties in completing the task. This study compared and contrasted the kinematics and kinetics of both forwards and backwards stair descent to those of level walking. We compared the support moments and moment powers of the lower limb joints while descending stairs forwards at a self-selected pace, backwards at a self-selected pace and forwards at the same pace as backwards. ⋯ The hip moments during stair descent were relatively small and highly variable. We observed significantly larger distances between the centres of pressure and the stair edges for backwards stair descent versus forwards stair descent. These results demonstrate that stair descent, even at a slower pace, requires greater power from the knee extensors than level walking but that backwards stair descent significantly reduced the peak knee power during midstance and provided a potentially safer means of descending stairs than forwards stair descent.
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This study investigated the reliability and validity of the Visual Gait Assessment Scale when used by experienced and inexperienced observers. Four experienced and six inexperienced observers viewed videotaped footage of four children with hemiplegic cerebral palsy on two separate occasions. Validity of the Scale was obtained by comparison with three-dimensional gait analysis (3DGA). ⋯ The experienced observers had slightly higher agreement with 3DGA than the inexperienced observers. The inexperienced observers showed a learning effect and had higher inter-observer agreement and higher agreement with 3DGA in the second assessment of the videotapes. This scale can be used by inexperienced observers but is limited to observations in the sagittal plane and by poor reliability at the knee and hip for experienced and inexperienced observers.
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In walking faster than 3 km/h, transverse pelvic rotation lengthens the step ("pelvic step"). It is often assumed that the thorax then starts to counter rotate to limit total body angular momentum around the vertical. But the relative timing of pelvis and thorax rotation during gait is insufficiently understood. ⋯ Moreover, pelvic and thoracic contributions to total body angular momentum were low (less than 10%), while contributions of the legs and arms were much larger (approximately 90%), suggesting that pelvis-thorax coordination is relatively unimportant to the organisation of total body angular momentum. Taken together, these results may imply that our understanding of the pelvic step need to be changed. Moreover, the alterations in pelvis-thorax relative phase that were reported for different locomotor pathologies may depend on different mechanisms.
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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.