gait

Due to the increase in the older population and their high prevalence of falls and loss of balance, the use of medical insoles and shoes is one of the common and low-cost methods to improve balance in these people. This study uses a combined approach of shoes and soles (including shoes with lateral heel flares, arch support, and toe grip bar) on the static and dynamic balance parameters of older people with balance problems.

This is a quasi-experimental before-and-after study conducted on 15 eligible seniors with a history of falling in the past 6 months (Mean±SD age, 70±3.94 years). This study used a semi-rigid EVA (ethylene vinyl acetate) sole. Walking and standing stability tests were performed on the subjects in two conditions: one with standard shoes and the other with lateral heel flare and insole with arch support and toe grip bar. The gait analysis system was used to record the temporal and spatial parameters of walking and to measure balance.

Compared to standard shoes, shoes with a lateral heel flare, arch support, and toe grip bar significantly decreased the walking speed (P=0.003), cadence (P=0.004), and stride time (P=0.008). The finding of the movement of the center of pressure in the medial-lateral direction in the standing position increased significantly (P=0.001) when using modified shoes. The progressive force of the movement increased, and the opposing force of the movement decreased.

Using shoes with heel flares, arch support, and a toe grip bar will increase balance. It also improved the parameters of step time and gait speed to facilitate movements in older people.

Kyphosis is associated with relatively altered vertebral body shape, reduced bone density and fitness, and decreased muscle strength; accordingly, this study investigates the effects of two types of thoracolumbosacral braces on gait kinetics and muscle activities during walking before and after puberty in kyphosis child.

A total of 40 (20 boys and 20 girls) with kyphosis volunteered to participate in this study. The participants were divided into four equal groups (boys before and after puberty and girls before and after puberty). Kinetic and electromyography data were recorded during walking. 

Significant decreases and medium to large bracing effects for peak vertical and lateral ground reaction forces during heel contact were observed. Meanwhile, there were significant increases and medium to large-sized bracing effects for gas-med and biceps femoris activities during the loading phase of walking.

Lower vertical ground reaction force at brace conditions demonstrates the improvement of gait efficiency before and after puberty.

We aimed to determine the differences in physical fitness between older adults with and without indicators of possible sarcopenia and the associations between possible sarcopenia and fear of falling.

Individuals aged >75 years living in Harbin City, China in 2023 were recruited through a local community center. The presence of possible sarcopenia was defined using the Asian Working Group for Sarcopenia 2 criteria via grip strength measurement, with cut-off points of >28 kg for men and >18 kg for women. Physical fitness, gait ability tests, and a fear of falling questionnaire were administered. An independent t-test was used to compare differences in physical fitness and gait between individuals with and without possible sarcopenia. Multivariate logistic regression was used to investigate the association between possible sarcopenia and fear of falling.

The possible sarcopenia group had lower extremity strength, flexibility, and aerobic endurance than the group without possible sarcopenia (P<0.001). Regarding dynamic balance, the time taken was longer in the possible sarcopenia group (P<0.001). There was also a difference in gait ability and fear of falling between the two groups (P<0.001). Compared to individuals without possible sarcopenia, those with possible sarcopenia had significantly increased odds ratios for fear of falling (odds ratio, 9.66; 95% confidence interval, 4.06–22.98).
Falling

Possible sarcopenia based on the grip strength criterion was associated with decreased physical fitness and gait performance in Chinese community-dwelling older adults.

To comprehend the kinematic effects of hallux valgus (HV) deformity on young and older people, we assessed the angular acceleration of the joints in the lower limbs of these women. 

Forty-eight women in two groups, young adults (20-30 years old) and older adults (50-60 years old), participated in this study (12 healthy and 12 with HV). We used an inertial measurement unit (IMU)-based motion capture system to measure the kinematics of motion. Biomechanical variables were assessed at an ideal speed during gait (stance and swing phases). All modules were calibrated in advance and then attached to the right thigh, shank, and foot. 

The results showed that in the young group, angular acceleration was significantly different during gait in all planes of the ankle joint, the sagittal plane of the knee joint, and the horizontal and frontal planes of the hip joint. In the older group, it was significantly different in the sagittal plane of the ankle and knee and the sagittal and frontal planes of the hip joint.

It appears that the angular acceleration of the lower limb joints was affected by HV, especially in the young group. Additionally, the angular acceleration of the knee joint was less affected in both groups.

Although gait rehabilitation based on sensorimotor synchronization (auditory and visual) is stimulating for patients with neurological disorders and older people, there is little evidence in patients with multiple sclerosis (MS). Therefore, this study investigates the effect of synchronization with rhythmic visual stimulus on gait spatiotemporal parameters, bilateral symmetry, and locomotor rehabilitation index in women with MS.

Spatiotemporal parameters, bilateral symmetry and the locomotor rehabilitation index were obtained before and after 6 weeks (three times per week, 30 min each session) of locomotor training. We compared these findings between two groups of 10 patients, each with an expanded disability status scale (EDSS) of 3-6, who performed the gait training with or without rhythmic visual stimulus.

Time×group interaction effect indicated greater significant improvements in the group with rhythmic visual stimulus in self-selected walking speed (SSWS) (P=0.041), stride frequency (P=0.009), stance time (P=0.021), and locomotor rehabilitation index (P=0.036). Stride length, double stance, and swing time were improved in the group with rhythmic visual stimulus, but this change was not significant. Also, bilateral symmetry did not change significantly in the experimental group. Therefore, rhythmic visual stimulation can help improve functional mobility and locomotor rehabilitation index in patients with MS, especially due to the improvements in the temporal parameters of gait.

Therefore, synchronizing gait with a rhythmic visual stimulus can be an effective therapeutic strategy to improve gait and main temporal parameters in patients with MS.

This research aims to investigate the effect of instrument-assisted soft tissue mobilization (IASTM) and Faradic electrotherapy (FES) on lower limb coupling during gait in a patient with excessive ankle stiffness.

The study was conducted on a single patient who was diagnosed with ankle stiffness, decreased muscle strength due to 3.5 years of immobilization of the ankle joint, and was experiencing difficulty in walking. The patient underwent a 12-week treatment program that included IASTM and FES. The lower limb kinematics were measured using a motion analysis system before and after the intervention and couplings were calculated for 3-dimensional ankle movement. 

The results of the study changed ankle-knee, ankle-hip sagittal and transverse, and knee-hip frontal and transverse plane coupling during different subphases of gait after the intervention. The observed coordination pattern in the subjects under investigation approached a level of similarity to that of healthy individuals in loading response (LR) and midstance (MS) for the ankle-knee sagittal plane.

The results of this study suggest that IASTM and FES can be used as effective interventions to lower limb coordination during gait in patients with post-operation complications. Further research on more patients is required.

Walking is a complex activity that involves multiple parts of the body, including the lower limb, upper limb, trunk, head, and neck. Contrary to popular belief, walking is not solely related to the forward movement of the legs. Biomechanical analysis, especially in terms of mechanical power, is an essential aspect of gait studying. The study aims to explore how altering arm swing speed affects the 3D maximum mechanical power of the lower limb while walking.

In this study, 30 healthy women walked on a force plate path in front of cameras in three states of normal upper limb swing, fast upper limb swing, and slow upper limb swing. The calculation of muscle power in each lower limb joint and plane is based on the product of the joint moment and its angular velocity. The average mechanical power of the joints was compared using the repeated measurement test (P≤0.05).

The results showed that changing the swing speed of the arm has a significant effect on all absorption and production parameters related to the mechanical power of the lower limb joints.

In conclusion, any change in arm movement during walking can affect movement, balance, and gait biomechanics.

Knee osteoarthritis (KOA) is a prevalent orthopedic condition that significantly affects patients’ well-being. This study investigates the spatial and temporal gait characteristics of patients with early-stage KOA during stair ascent and descent compared to healthy individuals.

A total of 12 individuals diagnosed with KOA and 12 healthy controls participated in the study. The diagnosis of KOA was based on the clinical criteria provided by the American College of Rheumatology, and disease severity was evaluated using the Kellgren-Lawrence grading scale. A thorough inclusion and exclusion protocol ensured that the participants met specific criteria. Spatial-temporal variables were measured using a 3D motion capture system during stair negotiation. A repeated-measure multivariate analysis of covariance was used for the statistical analyses (P<0.05).

Significant differences in spatial and temporal gait variables were observed between individuals with KOA and the healthy control group during stair descending and ascending. The KOA group exhibited shorter step length (P=0.019), wider step width (P=0.029), shorter step time in both directions (P=0.022 for descending, P=0.031 for ascending), increased time in double support phase in both directions (P=0.009 for descending, P=0.004 for ascending), prolonged total stance time in both directions (P=0.003 for descending, P=0.009 for ascending), and lower gait velocity in both directions (P<0.001). During stair ascent, the overall gait velocity decreased (P<0.001), step width increased (P=0.039), and more time was allocated to single support (P=0.009), double support (P=0.038), and total stance (P<0.001). These findings highlight the significant differences in gait variables observed in individuals with knee osteoarthritis during stair walking compared to the control group.

These findings provide valuable insights into how KOA impacts gait adaptations during stair climbing. The results support the need for targeted treatment and rehabilitation programs to improve the quality of life for patients. These findings provide valuable insights for healthcare professionals, enabling better diagnosis, treatment, and rehabilitation for KOA patients. They also aid in developing assistive devices and assessing disease progression for improved patient care.

The knee joint must adapt to the changes in walking speed to stabilize the stance phase and provide fluency in the swing phase. This study aimed to report a comparison of the gait patterns of transfemoral amputees using a novel mechanical prosthetic knee that can adapt automatically to different walking speeds with 3R60 and 3R15 knee prostheses. In this experimental study, biomechanical data were collected from six unilateral trans-femoral amputees walking with three knee prostheses. Gait data were gathered at slow, normal, and fast walking speeds across a 7-meter walkway using the Vicon motion system. The results revealed a significant difference in knee angular velocity during the swing phase between prosthetic knees across three walking speeds (P-value=0.002). Prosthetic knee flexion decreased significantly by increasing walking speed for the novel mechanical auto-adaptive prosthetic knee (P-value<0.001). A lower value of hip power during early swing was considered when amputees walked with novel knee prosthesis (P-value<0.00). The intact leg ankle plantar flexion angle or vaulting did not significantly change while walking speed increased in the novel knee prostheses compared to walking with the 3R60 and 3R15 knee prostheses (P-value=0.002 and P-value<0.06, respectively).  Based on the results, a novel mechanical auto-adaptive knee prosthesis has advantages compared to the other conventional designs for unilateral trans-femoral amputees walking at different speeds.

There is little evidence regarding the relationship between gait performance and psychological factors in people with chronic neck pain. This study evaluates gait performance in patients with neck pain and explores the relationship between gait performance and kinesiophobia, pain catastrophizing, pain intensity, and disability.

A cross-sectional study was conducted on 34 patients with chronic neck pain and 29 age- and sex-matched controls were recruited for this study. The participants performed timed up-and-go (TUG), and 10-m walk tests (TMW) with and without head-turning tests. The associations between clinical gait tests, kinesiophobia (Tampa scale of kinesiophobia (TSK), pain catastrophizing scale, pain intensity (visual analog scale), and disability (neck disability index) were assessed.

People with neck pain had significant differences in the TUG, and TMW with and without head-turning tests compared to controls (P<0.01). Kinesiophobia and pain catastrophism were significantly correlated with TMW tests (r range=0.45 to 0.71, and 0.40 to 0.47, respectively). Pain intensity and disability were not correlated with gait tests.

The gait performance, as represented by TUG and TMWs test scores, altered in patients with chronic neck pain in comparison controls. Fear of motion and pain catastrophizing thoughts correlated with clinical gait test scores.

Post-activation potentiation (PAP) is a novel warm-up method shown to improve sports performance. This study aimed to investigate the acute impact of this method on semi-dynamic balance while walking on the balance beam among female gymnasts aged 9–12 in Kerman city. Twenty healthy gymnasts volunteered to participate (height: 138.1 ± 5.04 cm; mass: 40.7 ± 3.12 kg) and were randomly divided into two equal sub-groups. The two groups attended the laboratory on two separate days, 48 hours apart. On the first day, the first sub-group performed a general warm-up (GWU), while the second sub-group performed a PAP warm-up. On the second day, the first sub-group switched to a PAP warm-up, and the second sub-group switched to a GWU. After the warm-up, the subjects took a two-minute rest, and then they walked on the balance beam while their movements were recorded using six motion analyzer cameras that captured the kinematic data of the shoulder, thigh, knee, and ankle joints. The data were processed using a low-pass Butterworth filter and analyzed using one-way ANOVA and paired t tests. The results showed significant differences in shoulder, hip, knee, and ankle joint positions in proximal-distal movements following GWU and PAP warm-ups (P ≤ 0.001). In addition, PAP caused a significant decrease in shoulder, hip, knee, and ankle joint positions in medial-lateral movements compared to GWU (P ≤ 0.001, P ≤ 0.001, P ≤ 0.038, P ≤ 0.001, respectively). PAP warm-up positively affects semi-dynamic balance factors in gymnasts. Given the importance of balance in gymnastics, PAP warm-up is recommended to improve sports performance.

Given the high prevalence of age-related diseases and physiological changes in addition to the susceptibility of the elderly to falls, this issue has become a major public health problem. This study assesses the risk of falls and related factors among the elderly living in rural areas.

This cross-sectional study was conducted on 302 elderly people in rural areas of Yazd Province, Iran, using the multi-stage sampling method. They completed a multi-section questionnaire, including demographic questions and the Tinetti gait and balance scale for assessing gait and balance in the elderly. The data were entered into the SPSS software, version 20 and analyzed by the chi-square test and ordinal logistic regression model. The statistical significance level of P<0.05 was considered in all tests.

The results showed that 38.1% of the participants presented a high fall risk, 20.5% demonstrated medium risk and 41.4% showed a low fall risk. Gender, age and visual status had a significant relationship with the risk of falls in the elderly (P<0.05). The probability of falls in women was 2.6 times higher compared to men. Moreover, the likelihood of falls in people with visual impairment was 1.7 times higher compared to subjects with no visual impairment and the probability of falls increased by 15% as they aged.

Visual impairment, gender, and age factors are diagnosed as related risk factors for falls in rural elderly people. It is recommended to consider these factors for the greater effectiveness of interventions to reduce falls in the elderly.

 Although immobilizing the upper limb is known to aid rehabilitation and improve symptoms for specific conditions, there is evidence suggesting that casting or splinting the upper limb can substantially alter walking biomechanics, including kinetics, kinematics, and spatiotemporal aspects.

 This study aimed to explore how unilateral casting of either the dominant or non-dominant upper limb affects the maximum three-dimensional mechanical power of the ankle joint during walking.

 In this quasi-experimental study, 30 healthy women (average age ± standard deviation: 29.5 ± 3.45 years) participated. They walked under three conditions: Without immobilization, with immobilization of the dominant upper limb, and with immobilization of the non-dominant upper limb, along a path equipped with force plates and cameras. The instantaneous muscle power at the ankle joint in each plane was measured. A repeated measures analysis of variance (ANOVA) was conducted to identify significant differences among the three conditions.

 Significant changes were observed in all parameters of maximum power generation and absorption at the ankle joint across all planes when walking with the dominant and non-dominant upper limbs splinted (P ≤ 0.05).

 Considering that muscle power is a crucial biomechanical parameter during walking, the observed alterations in this parameter due to upper limb splinting highlight the need for awareness to prevent potential walking difficulties when using upper limb braces.