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Morris A, Masegian C, Zhang A, Carrillo M, Székely B, Murray NG, Jiang F. The effect of age and proprioceptive illusion susceptibility on gait. Physiol Behav 2024; 287:114717. [PMID: 39424022 PMCID: PMC11568900 DOI: 10.1016/j.physbeh.2024.114717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Revised: 10/14/2024] [Accepted: 10/14/2024] [Indexed: 10/21/2024]
Abstract
OBJECTIVE Age-related gait decline has been associated with impaired proprioception, one's internal awareness of spatial location and movement. Although impaired proprioception has further been linked to greater susceptibility to proprioceptive illusions, it is unclear the impact such susceptibility has on gait and its interaction with age. The purpose of this study was to address these uncertainties. METHODS We measured proprioceptive illusions induced by muscle spindle manipulation and gait in young and older adults. We also compared illusory measures with traditionally used joint position matching to examine if illusory susceptibility can reveal proprioceptive impairments. RESULTS We found no effect of age on proprioceptive illusion susceptibility or joint position matching error. Compared to non-perceivers, illusion perceivers across both age groups showed greater joint matching error, suggesting reduced proprioceptive acuity. Consistent with previous studies, older adults had reduced cadence, gait velocity, and step length compared to young adults in both single- and dual-task walking. Interestingly, illusion perceivers, regardless of age, showed reduced cadence and step width compared to non-perceivers. CONCLUSIONS Our results suggest that gait impairments observed in those who perceive these proprioceptive illusions are age-independent, potentially rooted in deteriorated proprioception. SIGNIFICANCE This is the first study to examine these relations.
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Affiliation(s)
- Amy Morris
- Department of Psychology, University of Nevada, Reno, 1664 N Virginia St, Reno, NV, 89557, USA.
| | - Corinne Masegian
- Department of Psychology, University of Nevada, Reno, 1664 N Virginia St, Reno, NV, 89557, USA
| | - Angela Zhang
- Department of Psychology, University of Nevada, Reno, 1664 N Virginia St, Reno, NV, 89557, USA
| | - Madelyn Carrillo
- Department of Psychology, University of Nevada, Reno, 1664 N Virginia St, Reno, NV, 89557, USA
| | - Brian Székely
- Department of Psychology, University of Nevada, Reno, 1664 N Virginia St, Reno, NV, 89557, USA
| | - Nicholas G Murray
- Department of Kinesiology, University of Nevada, Reno, 1664 N Virginia St, Reno, NV, 89557, USA
| | - Fang Jiang
- Department of Psychology, University of Nevada, Reno, 1664 N Virginia St, Reno, NV, 89557, USA
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Hemmati F, Karimi MT. The effect of rocker sole shoes on ground reaction force in the elderly. Proc Inst Mech Eng H 2022; 236:988-993. [DOI: 10.1177/09544119221098529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aging is associated with decreases in gait performance and mobility. Toe-only rocker sole is prescribed as a common shoe modification in restricted foot and ankle joints mobility. Therefore, this study aimed to determine the effect of toe-only rocker sole shoes on the ground reaction force (GRF) in the elderly. Twenty-one older adults walked on a walkway equipped with one force plate under six different conditions including barefoot (BF), normal shoe (NS), and four types of toe-only rocker sole shoes (RS) with various degrees of rocker angle (RS10, RS20, RS30, and RS40). The peaks of the GRFs in three planes were obtained. Different rocker angles could affect GRF parameters. The first peak of GRF (FZ1) significantly increased with both RS30 and RS40 compared to BF, NS, RS10, and RS20. FZ1 significantly decreased with RS30 compared to RS40. The braking force (FX1) was significantly lower with NS compared to RS30 and RS40. FX1 was significantly higher with RS40 compared to the other shoe conditions. The propulsive force (FX2) significantly decreased during walking with BF compared to NS, RS20, RS30, and RS40. A higher FX2 was observed in RS40 than the other shoe conditions except RS30. Also, FX2 was significantly lower with RS10 compared to RS30. Increasing rocker angle may result in an increase in the peak magnitude of FZ1, FX1, FX2 in the elderly without any improvement in walking speed.
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Affiliation(s)
- Fatemeh Hemmati
- Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Taghi Karimi
- Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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3
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Non-age-related gait kinematics and kinetics in the elderly. BMC Musculoskelet Disord 2022; 23:623. [PMID: 35768797 PMCID: PMC9241214 DOI: 10.1186/s12891-022-05577-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The change of gait kinematics and kinetics along aging were reported to indicate age-related gait patterns. However, few studies focus on non-age-related gait analysis. This study aims to explore the non-age-related gait kinematics and kinetics by comparing gait analysis outcomes among the healthy elderly and young subjects. METHODS Gait analysis at self-paced was conducted on 12 healthy young subjects and 8 healthy elderly subjects. Kinematic and kinetic features of ankle, knee and hip joints were analyzed and compared in two groups. The degree of variation between the young and elderly in each kinematic or kinetic feature was calculated from pattern distance and percentage of significant difference. The k-means clustering and Elbow Method were applied to select and validate non-age-related features. The average waveforms with standard deviation were plotted for the comparison of the results. RESULTS A total of five kinematic and five kinetic features were analyzed on ankle, knee and hip joints in healthy young and elderly groups. The degrees of variation in ankle moment, knee angle, hip flexion angle, and hip adduction moment were 0.1074, 0.1593, 0.1407, and 0.1593, respectively. The turning point was where the k value equals two. The clustering centers were 0.1417 and 0.3691, and the two critical values closest to the cutoff were 0.1593 and 0.3037. The average waveforms of the kinematic or kinetic features mentioned above were highly overlapped with a minor standard deviation between the healthy young and elderly but showed larger variations between the healthy and abnormal. CONCLUSIONS The cluster with a minor degree of variation in kinematic and kinetic features between the young and elderly were identified as non-age-related, including ankle moment, knee angle, hip flexion angle, and hip adduction moment. Non-age-related gait kinematics and kinetics are essential indicators for gait with normal function, which is essential in the evaluation of mobility and functional ability of the elderly, and data fusion of the assistant device.
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Hellec J, Chorin F, Castagnetti A, Guérin O, Colson SS. Smart Eyeglasses: A Valid and Reliable Device to Assess Spatiotemporal Parameters during Gait. SENSORS (BASEL, SWITZERLAND) 2022; 22:1196. [PMID: 35161941 PMCID: PMC8846265 DOI: 10.3390/s22031196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 12/14/2022]
Abstract
The study aims to determine the validity and reproducibility of step duration and step length parameters measured during walking in healthy participants using an accelerometer embedded in smart eyeglasses. Twenty young volunteers participated in two identical sessions comprising a 30 s gait assessment performed at three different treadmill speeds under two conditions (i.e., with and without a cervical collar). Spatiotemporal parameters (i.e., step duration and step length normalized by the lower limb length) were obtained with both the accelerometer embedded in smart eyeglasses and an optoelectronic system. The relative intra- and inter-session reliability of step duration and step length computed from the vertical acceleration data were excellent for all experimental conditions. An excellent absolute reliability was observed for the eyeglasses for all conditions and concurrent validity between systems was observed. An accelerometer incorporated in smart eyeglasses is accurate to measure step duration and step length during gait.
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Affiliation(s)
- Justine Hellec
- Université Côte d’Azur, LAMHESS, EUR HEALTHY, 06205 Nice, France; (F.C.); (S.S.C.)
- Ellcie Healthy, 06600 Antibes, France
| | - Frédéric Chorin
- Université Côte d’Azur, LAMHESS, EUR HEALTHY, 06205 Nice, France; (F.C.); (S.S.C.)
- Université Côte d’Azur, CHU, Cimiez, Plateforme Fragilité, 06000 Nice, France
| | | | | | - Serge S. Colson
- Université Côte d’Azur, LAMHESS, EUR HEALTHY, 06205 Nice, France; (F.C.); (S.S.C.)
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Dunsky A, Zeev A, Netz Y. Predictors of Future Walking Speed: A 12-Month Monitoring Program. Int J Aging Hum Dev 2021; 95:205-221. [PMID: 34866427 DOI: 10.1177/00914150211066566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of the current study was to identify significant predictors of walking speed (WS) among community-dwelling older adults, as it is one of the most representative measures of functioning in their daily lives. Seventy-seven (24 adult men, 26 adult women, and 27 older-adult women) community-dwelling older adults (73.7 ± 4.9 years) performed two assessments, over a 12-month period. Several physical, cognitive, and psychological tests were performed, as well as assessing the preferred WS. Multiple linear regression, stratified by gender, was used to identify significant predictors of future WS. For the adult men, walking and functional performances at the first assessment predicted 71.9%; for adult women, reaction time, walking, and balance performance predicted 64.4%; and, for the older-adult women, fast walking and reaction time predicted 48.2% of the variance of future WS. Clinicians should consider including different exercises for each group of older adults to evaluate and preserve functional abilities.
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Affiliation(s)
- Ayelet Dunsky
- 172890The Academic College at Wingate, Netanya, Israel
| | - Aviva Zeev
- 172890The Academic College at Wingate, Netanya, Israel
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Nam DC, Hwang SC, Lee EC, Song MG, Yoo JI. Femoral neck stress fractures after trampoline exercise: A case report. World J Clin Cases 2021; 9:4783-4788. [PMID: 34222448 PMCID: PMC8223852 DOI: 10.12998/wjcc.v9.i18.4783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/17/2021] [Accepted: 04/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Femoral neck stress fractures (FNSFs) are commonly found in long-distance running athletes. For FNSFs, early diagnosis and proper treatment are important. The objective of this study was to report FNSFs that occurred after excessive exercise using trampoline in middle-aged women. CASE SUMMARY The patient was a 43-year-old woman who exercised jumping on a trampoline for 6 wk for 1-3 h a day to diet. Exercise includes repeated flexion-extension of the hip joint. The patient was admitted to the hospital due to sudden bilateral groin pain that occurred suddenly during a trampoline exercise. Hip magnetic resonance imaging (MRI) revealed bilateral FNSFs. After 2 wk of follow-up with conservative treatment, the pain slightly decreased. However, it did not disappear completely. It was determined that it was difficult to control symptoms only by conservation treatment. Thus, closed reduction and internal fixation using a cannulated screw were performed for the more painful left hip joint. After operation, the pain was improved. Walking using crutches was possible. Follow-up MRI showed that the right femoral head signal was decreased compared to the left femoral head signal. Therefore, nonsteroidal anti-inflammatory drug and conservative treatment were provided. CONCLUSION In middle-aged people, excessive trampoline exercise can repeat hip flexion and extension for a short period of time, leading to FNSFs.
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Affiliation(s)
- Dae Cheol Nam
- Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine, Jinju 52727, South Korea
| | - Sun Chul Hwang
- Department of Orthopaedic Surgery and Institute of Health Sciences, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju 52727, South Korea
| | - Eun Chang Lee
- Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine, Jinju 52727, South Korea
| | - Myung-Geun Song
- Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine, Jinju 52727, South Korea
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine, Jinju 52727, South Korea
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Fantozzi S, Cortesi M, Giovanardi A, Borra D, Di Michele R, Gatta G. Effect of walking speed during gait in water of healthy elderly. Gait Posture 2020; 82:6-13. [PMID: 32836027 DOI: 10.1016/j.gaitpost.2020.08.112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Walking in water (WW) is frequently used as an aquatic exercise in rehabilitation programs for the elderly. Understanding gait characteristics of WW is of primary importance to effectively design specific water-based rehabilitation programs. Moreover, as walking speed in water is reduced with a possible effect on gait parameters, the age- and environment-related changes during WW have to be investigated considering the effects of instantaneous walking speed. RESEARCH QUESTION how do gait kinematic characteristics differ in healthy elderly between WW and on land walking condition (LW)? Do elderly show different walking patterns compared to young adults? Can these kinematic changes be accounted only by the different environment/age or are they also related to walking speed? METHODS Nine healthy elderly participants (73.5 ± 5.8 years) were acquired during walking in WW and LW at two different speeds. Kinematic parameters were assessed with waterproofed inertial magnetic sensors using a validated protocol. The influence of environment, age and walking speed on gait parameters was investigated with linear mixed models. RESULTS Shorter stride distances and longer stride durations were observed in WW compared to LW. In the sagittal plane, hip and knee joint showed larger flexion in WW (>10deg over the whole stride and ∼28deg at foot strike, respectively). Furthermore, lower walking speeds and stride distances were observed in elderly compared to young adults. In the sagittal plane, a slightly more flexed hip joint and a less plantarflexed ankle joint (∼9 deg) were observed in the elderly. SIGNIFICANCE The results showed the importance of assessing the walking speed during WW, as gait parameters can vary not only for the effect environment but also due to different walking speeds.
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Affiliation(s)
- Silvia Fantozzi
- Department of Electrical, Electronic, and Information Engineering «Guglielmo Marconi», University of Bologna, Viale Risorgimento 2, Bologna, Italy; Interdepartmental Centre for Industrial Research in Health Sciences and Technologies, University of Bologna, Tolara di Sopra 41/E, Ozzano Emilia (BO), Italy.
| | - Matteo Cortesi
- Department for Life Quality Studies, University of Bologna, Corso D'Augusto 237, 47921 Rimini, Italy.
| | - Andrea Giovanardi
- School of Pharmacy, Biotechnology and Sport Science, University of Bologna, Viale Berti Pichat 10, Bologna, Italy.
| | - Davide Borra
- Department of Electrical, Electronic, and Information Engineering «Guglielmo Marconi», University of Bologna, Viale Risorgimento 2, Bologna, Italy.
| | - Rocco Di Michele
- Department of Biomedical and Neuromotor Sciences, University of Bologna, via del Pilastro 8, Bologna, Italy.
| | - Giorgio Gatta
- Department for Life Quality Studies, University of Bologna, Corso D'Augusto 237, 47921 Rimini, Italy.
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Umehara T, Tsunematsu M, Sugihara K, Yata K, Kakehashi M. Interactive effect of cognitive function and intervention on the walking independence of stroke patients: a retrospective cohort study. J Exerc Rehabil 2020; 16:242-248. [PMID: 32724781 PMCID: PMC7365727 DOI: 10.12965/jer.2040306.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/16/2020] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to investigate the interactive effect of cognitive function and intervention on walking independence of stroke patients. Stroke patients (n=405) who admitted to convalescent rehabilitation ward, were classified as being walking independent or dependent. To examine the interaction between cognitive function and intervention, high cognitive function (functional independence measure score ≥20) and physical therapy and occupational therapy intervention delivered in 1 day (lasting >2 hr) were defined as cognition-intervention interaction and included as independent variables. The incidence of walking independence was calculated using Kaplan–Meier curves. Intergroup differences were estimated using log-rank test. Cox proportional hazards analysis was used to extract the predictors of walking independence. Survival analyses using Kaplan–Meier log-rank test showed that the probability of incidence of walking independence was significantly higher in the presence of a cognition-intervention interaction. The results of Cox proportional hazards analysis showed that age, left versus right cerebral damage, and cognition-intervention interaction significantly influenced walking independence at discharge from the hospital. The hazard ratios were 0.971 per year of age, 0.544 for left versus right cerebral damage, and 1.794 for cognition-intervention interaction. Walking independence was more likely to be achieved by stroke patients with high cognitive function who received therapy. In other words, the conditions that increase the likelihood of an effect of therapy intervention on walking independence were identified in this study.
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Affiliation(s)
- Takuya Umehara
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Hiroshima, Japan
| | - Miwako Tsunematsu
- Department of Health Informatics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Katsunori Sugihara
- Department of Rehabilitation, Hiroshima City Rehabilitation Hospital, Hiroshima, Japan
| | - Kaori Yata
- Department of Rehabilitation Technology, Hiroshima City Rehabilitation Hospital, Hiroshima, Japan
| | - Masayuki Kakehashi
- Department of Health Informatics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Chan K, Lee JW, Unger J, Yoo J, Masani K, Musselman KE. Reactive stepping after a forward fall in people living with incomplete spinal cord injury or disease. Spinal Cord 2019; 58:185-193. [PMID: 31358908 DOI: 10.1038/s41393-019-0332-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/11/2019] [Accepted: 07/12/2019] [Indexed: 12/11/2022]
Abstract
STUDY DESIGN Cross sectional. OBJECTIVES To compare the reactive stepping ability of individuals living with incomplete spinal cord injury or disease (SCI/D) to that of sex- and age-matched able-bodied adults. SETTING A tertiary SCI/D rehabilitation center in Canada. METHODS Thirty-three individuals (20 with incomplete SCI/D) participated. Participants assumed a forward lean position in standing whilst 8-12% of their body weight was supported by a horizontal cable at waist height affixed to a rigid structure. The cable was released unexpectedly, simulating a forward fall and eliciting one or more reactive steps. Behavioral responses (i.e., single step versus non-single step) were compared using a Chi-square test. The following temporal parameters of reactive stepping were compared using t-tests: the onset of muscle activation in 12 lower extremity muscles (six per limb) and step-off, step contact and swing time of the stepping leg. RESULTS Behavioral responses were significantly different between groups (χ2 = 13.9 and p < 0.01) with participants with incomplete SCI/D showing more non-single step responses (i.e., multi-steps and falls). The onsets of muscle activation were more variable in participants with incomplete SCI/D, but only the stepping tibialis anterior showed a significantly slower onset in this group compared with able-bodied adults (t = -2.11 and p = 0.049). Movement timing of the stepping leg (i.e., step-off, step contact, and swing time) was not significantly different between groups. CONCLUSIONS Reactive stepping ability of individuals with incomplete SCI/D is impaired; however, this impairment is not explained by temporal parameters. The findings suggest that reactive stepping should be targeted in the rehabilitation of ambulatory individuals with SCI/D.
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Affiliation(s)
- Katherine Chan
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Jae Woung Lee
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Janelle Unger
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Jaeeun Yoo
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Kei Masani
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Kristin E Musselman
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. .,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. .,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
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Grimmer M, Riener R, Walsh CJ, Seyfarth A. Mobility related physical and functional losses due to aging and disease - a motivation for lower limb exoskeletons. J Neuroeng Rehabil 2019; 16:2. [PMID: 30606194 PMCID: PMC6318939 DOI: 10.1186/s12984-018-0458-8] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 10/18/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Physical and functional losses due to aging and diseases decrease human mobility, independence, and quality of life. This study is aimed at summarizing and quantifying these losses in order to motivate solutions to overcome them with a special focus on the possibilities by using lower limb exoskeletons. METHODS A narrative literature review was performed to determine a broad range of mobility-related physical and functional measures that are affected by aging and selected cardiovascular, respiratory, musculoskeletal, and neurological diseases. RESULTS The study identified that decreases in limb maximum muscle force and power (33% and 49%, respectively, 25-75 yrs) and in maximum oxygen consumption (40%, 20-80 yrs) occur for older adults compared to young adults. Reaction times more than double (18-90 yrs) and losses in the visual, vestibular, and somatosensory systems were reported. Additionally, we found decreases in steps per day (75%, 60-85 yrs), maximum walking speed (24% 25-75 yrs), and maximum six-minute and self-selected walking speed (38% and 21%, respectively, 20-85 yrs), while we found increases in the number of falls relative to the number of steps per day (800%), injuries due to falls (472%, 30-90 yrs) and deaths caused by fall (4000%, 65-90 yrs). Measures were identified to be worse for individuals with impaired mobility. Additional detrimental effects identified for them were the loss of upright standing and locomotion, freezing in movement, joint stress, pain, and changes in gait patterns. DISCUSSION This review shows that aging and chronic conditions result in wide-ranging losses in physical and sensory capabilities. While the impact of these losses are relatively modest for level walking, they become limiting during more demanding tasks such as walking on inclined ground, climbing stairs, or walking over longer periods, and especially when coupled with a debilitating disease. As the physical and functional parameters are closely related, we believe that lost functional capabilities can be indirectly improved by training of the physical capabilities. However, assistive devices can supplement the lost functional capabilities directly by compensating for losses with propulsion, weight support, and balance support. CONCLUSIONS Exoskeletons are a new generation of assistive devices that have the potential to provide both, training capabilities and functional compensation, to enhance human mobility.
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Affiliation(s)
- Martin Grimmer
- Lauflabor Locomotion Lab, Technische Universität Darmstadt, Magdalenenstr. 27, Darmstadt, 64289 Germany
| | - Robert Riener
- Sensory-Motor Systems (SMS) Lab, Institute of Robotics and Intelligent Systems (IRIS), Department of Health Sciences and Technology, ETH Zurich, Tannenstr. 1, Zurich, 8092 Switzerland
| | - Conor James Walsh
- Harvard Biodesign Lab, John A. Paulson School of Engineering and Applied Sciences, Wyss Institute for Biologically Inspired Engineering, Harvard University, 60 Oxford Street, Cambridge, 02138 MA United States
| | - André Seyfarth
- Lauflabor Locomotion Lab, Technische Universität Darmstadt, Magdalenenstr. 27, Darmstadt, 64289 Germany
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Yamaguchi T, Okamoto R, Hokkirigawa K, Masani K. Decrease in required coefficient of friction due to smaller lean angle during turning in older adults. J Biomech 2018; 74:163-170. [PMID: 29752052 DOI: 10.1016/j.jbiomech.2018.04.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 04/19/2018] [Accepted: 04/22/2018] [Indexed: 11/16/2022]
Abstract
We investigated age-related differences in the required coefficient of friction (RCOF) during 90° turning, the difference of RCOF during step and spin turn, and how affects observed differences. Sixteen healthy young and healthy older adults (eight men and eight women in each group) participated. Participants performed 90° step and spin turns to the right at a self-selected normal speed. Older adults turned with lower RCOF than the young adults during both step and spin turns. This was associated with reduced mediolateral (ML) RCOF component (RCOFML) for the older adults. Reduced RCOFML in older adults was associated with reductions in the ML component of the lean angle of the body during turning. This age-related gait changes during turning can be compensatory mechanisms that allowed older adults to turn while reducing the risk of slipping. Spin turns exhibited lower RCOF, resulting from significantly lower RCOFML, than step turns in young and older adults; thus, spin turning is a safer turning strategy for preventing lateral slips. This may suggest that, in older adults, slip prevention may take precedence over balance recovery after slips sustained during turning. These results illustrate a turning gait mechanism that helps prevent slips and falls, and how age affects this mechanism.
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Affiliation(s)
- Takeshi Yamaguchi
- Graduate School of Engineering, Tohoku University, 6-6-01 Aramaki-Aza-Aoba, Aoba-ku, Sendai, Miyagi 980-8579, Japan; Graduate School of Biomedical Engineering, Tohoku University, 6-6-01 Aramaki-Aza-Aoba, Aoba-ku, Sendai, Miyagi 980-8579, Japan.
| | - Ryosuke Okamoto
- Graduate School of Engineering, Tohoku University, 6-6-01 Aramaki-Aza-Aoba, Aoba-ku, Sendai, Miyagi 980-8579, Japan
| | - Kazuo Hokkirigawa
- Graduate School of Engineering, Tohoku University, 6-6-01 Aramaki-Aza-Aoba, Aoba-ku, Sendai, Miyagi 980-8579, Japan
| | - Kei Masani
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada; Lyndhurst Centre, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada
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12
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Floreani M, Rejc E, Taboga P, Ganzini A, Pišot R, Šimunič B, Biolo G, Reggiani C, Passaro A, Narici M, Rittweger J, di Prampero PE, Lazzer S. Effects of 14 days of bed rest and following physical training on metabolic cost, mechanical work, and efficiency during walking in older and young healthy males. PLoS One 2018. [PMID: 29529070 PMCID: PMC5847238 DOI: 10.1371/journal.pone.0194291] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In this study, we investigated: i) the effects of bed rest and a subsequent physical training program on metabolic cost (Cw), mechanical work and efficiency during walking in older and young men; ii) the mechanisms underlying the higher Cw observed in older than young men.Twenty-three healthy male subjects (N = 16 older adults, age 59.6±3.4 years; N = 7 young, age: 23.1±2.9 years) participated in this study. The subjects underwent 14 days of bed rest followed by two weeks of physical training (6 sessions). Cw, mechanical work, efficiency, and co-contraction time of proximal muscles (vastus lateralis and biceps femoris) and distal muscles (gastrocnemius medialis and tibialis anterior) were measured during walking at 0.83, 1.11, 1.39, 1.67 m·s-1 before bed rest (pre-BR), after bed rest (post-BR) and after physical training (post-PT).No effects of bed rest and physical training were observed on the analysed parameters in either group. Older men showed higher Cw and lower efficiency at each speed (average +25.1 and -20.5%, P<0.001, respectively) compared to young. Co-contraction time of proximal and distal muscles were higher in older than in young men across the different walking speeds (average +30.0 and +110.3%, P<0.05, respectively).The lack of bed rest and physical training effects on the parameters analyzed in this study may be explained by the healthy status of both young and older men, which could have mitigated the effects of these interventions on walking motor function. On the other hand, the fact that older adults showed greater Cw, overall higher co-contraction time of antagonist lower limb muscles, and lower efficiency compared to the young cohort throughout a wide range of walking speed may suggest that older adults sacrificed economy of walking to improve stability.
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Affiliation(s)
- Mirco Floreani
- Department of Medical Area, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
| | - Enrico Rejc
- Department of Medical Area, University of Udine, Udine, Italy
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United States of America
| | - Paolo Taboga
- Department of Medical Area, University of Udine, Udine, Italy
- Department of Kinesiology and Health Science, California State University, Sacramento, CA, United States of America
| | - Alessandro Ganzini
- Department of Medical Area, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
| | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Bostjan Šimunič
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Gianni Biolo
- Department of Medical, Surgical and Health Sciences, Division of Internal Medicine, University of Trieste, Trieste, Italy
| | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Angelina Passaro
- Department of Medical Sciences, Section of Internal and Cardiorespiratory Medicine, University of Ferrara, Ferrara, Italy
| | - Marco Narici
- MRC/ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Derby Royal Hospital, Derby, United Kingdom
| | - Joern Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - Pietro Enrico di Prampero
- Department of Medical Area, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
| | - Stefano Lazzer
- Department of Medical Area, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
- * E-mail:
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Effects of Slipper Features and Properties on Walking and Sit-to-Stand Tasks of Older Women. J Aging Phys Act 2017; 25:587-595. [DOI: 10.1123/japa.2016-0298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Indoor slippers with a strap across the dorsal forefoot are popular with older women. However, their influence on the foot motion has not been reported. This study evaluated the range of movement in the knee and ankle joints during walking and changes in trunk displacement during sit-to-stand when 10 healthy older women wore two types of slippers and were barefoot. Compared to barefeet, walking in slippers results in significant increases in the knee flexion angle in the swing phase. However, there is nonsignificant differences in the ankle angle in any phase across all conditions. During the sit-stand transition when slippers are worn, there is a significant reduction in the peak trunk tilt angle and range, as well as the duration of the weight shift when motion is initiated. The findings therefore provide a better understanding of slipper features and designs associated with changes in foot kinematics in older women.
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Boyer KA, Johnson RT, Banks JJ, Jewell C, Hafer JF. Systematic review and meta-analysis of gait mechanics in young and older adults. Exp Gerontol 2017; 95:63-70. [DOI: 10.1016/j.exger.2017.05.005] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 04/05/2017] [Accepted: 05/04/2017] [Indexed: 11/16/2022]
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Yamaguchi T, Suzuki A, Hokkirigawa K. Required coefficient of friction in the anteroposterior and mediolateral direction during turning at different walking speeds. PLoS One 2017. [PMID: 28640853 PMCID: PMC5480978 DOI: 10.1371/journal.pone.0179817] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
This study investigated the required coefficient of friction (RCOF) and the tangent of center of mass (COM)–center of pressure (COP) angle in the mediolateral (ML) and anteroposterior (AP) directions during turning at different walking speeds. Sixteen healthy young adults (8 males and 8 females) participated in this study. The participants were instructed to conduct trials of straight walking and 90° step and spin turns to the right at each of three self-selected speeds (slow, normal, and fast). The ML and AP directions during turning gait were defined using the orientation of the pelvis to construct a body-fixed reference frame. The RCOF values and COM–COP angle tangent in the ML direction during turning at weight acceptance phase were higher than those during straight walking, and those values increased with increasing walking speed. The ML component of the RCOF and COM–COP tangent values during weight acceptance for step turns were higher than those for spin turns. The mean centripetal force during turning tended to increase with an increase in walking speed and had a strong positive correlation with the RCOF values in the ML direction (R = 0.97 during the weight acceptance phase; R = 0.95 during the push-off phase). Therefore, turning, particularly step turn, is likely to cause lateral slip at weight acceptance because of the increased centripetal force compared with straight walking. Future work should test at-risk population and compare with the present results.
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Affiliation(s)
- Takeshi Yamaguchi
- Graduate School of Engineering, Tohoku University, Sendai, Miyagi, Japan
- Graduate School of Bioengineering, Tohoku University, Sendai, Miyagi, Japan
- * E-mail:
| | - Akito Suzuki
- Graduate School of Engineering, Tohoku University, Sendai, Miyagi, Japan
| | - Kazuo Hokkirigawa
- Graduate School of Engineering, Tohoku University, Sendai, Miyagi, Japan
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Moinard C, Tliba L, Diaz J, Le Plénier S, Nay L, Neveux N, Cynober L, Raynaud-Simon A. Citrulline stimulates locomotor activity in aged rats: Implication of the dopaminergic pathway. Nutrition 2017; 38:9-12. [DOI: 10.1016/j.nut.2017.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/21/2016] [Accepted: 01/01/2017] [Indexed: 12/20/2022]
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AKHTARUZZAMAN MD, SHAFIE AMIRAKRAMIN, KHAN MDRAISUDDIN. GAIT ANALYSIS: SYSTEMS, TECHNOLOGIES, AND IMPORTANCE. J MECH MED BIOL 2016. [DOI: 10.1142/s0219519416300039] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Human gait is the identity of a person's style and quality of life. Reliable cognition of gait properties over time, continuous monitoring, accuracy of evaluation, and proper analysis of human gait characteristics have demonstrated their importance not only in clinical and medical studies, but also in the field of sports, rehabilitation, training, and robotics research. Focusing on walking gait, this study presents an overview on gait mechanisms, common technologies used in gait analysis, and importance of this particular field of research. Firstly, available technologies that involved in gait analysis are briefly introduced in this paper by concentrating on the usability and limitations of the systems. Secondly, key gait parameters and motion characteristics are elucidated from four angles of views; one: gait phases and gait properties; two: center of mass and center of pressure (CoM-CoP) tracking profile; three: Ground Reaction Force (GRF) and impact, and four: muscle activation. Thirdly, the study focuses on the clinical observations of gait patterns in diagnosing gait abnormalities of impaired patients. The presentation also shows the importance of gait analysis in sports to improve performance as well as to avoid risk of injuries of sports personnel. Significance of gait analysis in robotic research is also illustrated in this part where the study focuses on robot assisted systems and its possible applicability in clinical rehabilitation and sports training.
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Affiliation(s)
- MD. AKHTARUZZAMAN
- Department of Mechatronics Engineering, Kulliyyah of Engineering, International Islamic University Malaysia, 53100 Kuala Lumpur, Malaysia
| | - AMIR AKRAMIN SHAFIE
- Department of Mechatronics Engineering, Kulliyyah of Engineering, International Islamic University Malaysia, 53100 Kuala Lumpur, Malaysia
| | - MD. RAISUDDIN KHAN
- Department of Mechatronics Engineering, Kulliyyah of Engineering, International Islamic University Malaysia, 53100 Kuala Lumpur, Malaysia
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Afiah IN, Nakashima H, Loh PY, Muraki S. An exploratory investigation of changes in gait parameters with age in elderly Japanese women. SPRINGERPLUS 2016; 5:1069. [PMID: 27462517 PMCID: PMC4943906 DOI: 10.1186/s40064-016-2739-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 07/01/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The aim of the present study was to identify gait parameters in elderly Japanese women. 30 elderly women (65-74.9 years old) and 19 very elderly women (≥75 years old) participated in this study. A 3-dimensional (3D) motion analysis system was used to collect kinematic data, and a total of 70 gait parameters were analysed. Gait parameters included basic gait parameters, gait cycle parameters, and joints angle parameters, as well as angular velocity parameters, such as peak velocity and timing at the hip, knee, and ankle joints. RESULTS Our results indicated that basic gait parameters, such as the gait cycle, peak joint angle timing, and angular velocity parameters, significantly differ between elderly and very elderly women. Delayed peak joint angle timing and angular velocity parameters occurred during critical phases throughout the gait cycle: pre-swing, initial swing, and terminal swing phases. CONCLUSIONS Several gait parameters exhibited significant differences between elderly and very elderly women. The timing of the peak joint angle and angular velocity parameters are primary characteristics defining gait changes in the elderly.
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Affiliation(s)
- Irma Nur Afiah
- />Department of Human Science, Graduate School of Design, Kyushu University, Fukuoka, Japan
| | - Hiroki Nakashima
- />Department of Human Science, Graduate School of Design, Kyushu University, Fukuoka, Japan
| | - Ping Yeap Loh
- />Department of Human Science, Graduate School of Design, Kyushu University, Fukuoka, Japan
- />Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Satoshi Muraki
- />Department of Human Science, Faculty of Design, Kyushu University, Fukuoka, Japan
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Aboutorabi A, Arazpour M, Bahramizadeh M, Hutchins SW, Fadayevatan R. The effect of aging on gait parameters in able-bodied older subjects: a literature review. Aging Clin Exp Res 2016. [PMID: 26210370 DOI: 10.1007/s40520-015-0420-6] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Gait disorders are common in the elderly populations, and their prevalence increases with age. Abnormal gait has been associated with greater risk for adverse outcomes in older adults, such as immobility and falls, which in turn lead to loss of functional independence and death. AIM The purpose of this review was to evaluate all of the original papers that measured gait parameters in the healthy elderly subjects. METHOD The search strategy was based on Population Intervention Comparison Outcome method. A search was performed in Pub Med, Science Direct, Google scholar, ISI web of knowledge databases by using the selected keywords. Forty-two articles were selected for final evaluation. The procedure using the PRISMA method was followed. RESULTS Stride lengths of older subjects ranged between 135 and 153 cm, and they preferred to walk with a 41 % increase in step width compared to young subjects. Cadence was reported to be between 103 and 112 steps/min in older adults. They consumed an average of 20-30 % more metabolic energy than younger subjects. All except one study demonstrated that older people have significantly reduced gait symmetry. CONCLUSION The progression toward shorter steps and slower walking and increased step width and prolonged double support in older adult, may therefore emerge as a compensatory strategy aimed at increasing stability, avoiding falls, or reducing the energetic cost of mobility.
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Affiliation(s)
- Atefeh Aboutorabi
- Orthotics and Prosthetics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran
| | - Mokhtar Arazpour
- Orthotics and Prosthetics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran.
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Mahmood Bahramizadeh
- Orthotics and Prosthetics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran
| | - Stephen William Hutchins
- Institute for Health and Social Care Research (IHSCR), Faculty of Health & Social Care, University of Salford, Manchester, Salford, UK
| | - Reza Fadayevatan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran
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Contribution of Step Length to Increase Walking and Turning Speed as a Marker of Parkinson's Disease Progression. PLoS One 2016; 11:e0152469. [PMID: 27111531 PMCID: PMC4844147 DOI: 10.1371/journal.pone.0152469] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 03/15/2016] [Indexed: 12/21/2022] Open
Abstract
When increasing ambulation speed in Parkinson’s disease, step cadence increases more than stride length, indicating movement scaling difficulties that affect step generation in particular. We investigated whether step length variation when increasing ambulation speed was related to disease progression. Patients with Parkinson’s disease (N = 39) and controls (N = 152) performed two timed ambulation tasks: at a 'free' (self-selected) pace and then at 'maximal' speed. The total number of steps (including during turns) and time to complete the task were clinically measured. The relative contribution of step length and cadence to increased ambulation speed was determined using two methods: the ratios of change in step length or in cadence to the change in ambulation speed, and the step length index. While the relative contribution of step length and cadence to increased ambulation speed was independent of age in both control and patient groups, in Parkinson’s disease there was a negative correlation between time from diagnosis and the ratio of change in step length to change in ambulation speed (R = 0.54; p = 0.0004) and the step length index (R = 0.56, p = 0.0002). In parallel, there was a positive correlation between time since diagnosis and the ratio of change in cadence to change in ambulation speed (R = 0.57; p = 0.0002). The relative contribution of step length and cadence to increased ambulation speed is age invariant but a marker of Parkinson's disease advancement, and can be easily determined in the clinical setting.
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21
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Anantrasirichai N, Burn J, Bull D. Terrain Classification From Body-Mounted Cameras During Human Locomotion. IEEE TRANSACTIONS ON CYBERNETICS 2015; 45:2249-2260. [PMID: 25420277 DOI: 10.1109/tcyb.2014.2368353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper presents a novel algorithm for terrain type classification based on monocular video captured from the viewpoint of human locomotion. A texture-based algorithm is developed to classify the path ahead into multiple groups that can be used to support terrain classification. Gait is taken into account in two ways. Firstly, for key frame selection, when regions with homogeneous texture characteristics are updated, the frequency variations of the textured surface are analyzed and used to adaptively define filter coefficients. Secondly, it is incorporated in the parameter estimation process where probabilities of path consistency are employed to improve terrain-type estimation. When tested with multiple classes that directly affect mobility-a hard surface, a soft surface, and an unwalkable area-our proposed method outperforms existing methods by up to 16%, and also provides improved robustness.
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Abstract
BACKGROUND Functional fitness is the ability of an older adult to perform activities of daily living. Stair-climb power is a well-documented marker of functional fitness among older adults. Gait velocity and parameters of gait are related to functional fitness but have been understudied to date. PURPOSE The purpose of this observational study was to determine differences in parameters of gait between high- and low-functioning older adults. METHODS Twenty high-functioning older adults, mean age (SD)=71.6 (5.6), volunteered for the cross-sectional observational study. Functional fitness was determined by a stair-climb performance test. Parameters of gait included velocity, step length, swing and stance phase, double support time, ground reaction forces, impulse, and propulsion during habitual walking. Analysis of variance was performed to determine differences in the dependent variables between groups. RESULTS Individuals with high levels of functional fitness walked 13.1% faster than the lower-functioning group (P=.01). No significant differences (P>.05) were detected for any other measure; however, all gait parameters were more favorable in the higher-functioning group. CONCLUSION Functional fitness is imperative for older adults as declines could hinder mobility. Thus, earlier detection of declines in gait parameters may reduce the risk of falling. The results suggest that gait velocity was slower among older adults with lower levels of functional fitness.
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Affiliation(s)
- Sally Paulson
- 1Department of Exercise Science, Shippensburg University, Shippensburg, Pennsylvania. 2Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
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Roche N, Bonnyaud C, Geiger M, Bussel B, Bensmail D. Relationship between hip flexion and ankle dorsiflexion during swing phase in chronic stroke patients. Clin Biomech (Bristol, Avon) 2015; 30:219-25. [PMID: 25708311 DOI: 10.1016/j.clinbiomech.2015.02.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 01/30/2015] [Accepted: 02/01/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND During the clinical examination of stroke patients, it is common to observe that involuntary hip flexion occurs during voluntary ankle dorsiflexion (synkinesia). This suggests that there is a relationship between these two joints. We hypothesized that there may be a relationship between hip and ankle flexion during swing phase of the gait cycle. The objective of this study was to determine if there is a biomechanical relationship between peak hip flexion and peak ankle dorsiflexion during the swing phase of the gait cycle following stroke. METHOD The paretic lower limbs of 60 patients with stroke were evaluated using clinical tests and 3D-gait analysis. The clinical assessment included muscle strength, spasticity and passive range of ankle motion. The gait analysis focused on sagittal frontal and transverse kinematic gait parameters during swing. FINDINGS A stepwise-linear-regression indicated that peak hip flexion and gait speed were the only 2 parameters which accounted for peak ankle dorsiflexion. There was also a significant negative correlation between peak hip flexion and peak ankle dorsiflexion during swing, and a significant positive correlation between hip flexor and ankle dorsiflexor muscle strength. INTERPRETATION These results suggest that the biomechanical behaviour of hip and ankle joints during the swing phase of the gait cycle is linked in patients with stroke. They also suggest that two strategies exist: if sufficient ankle dorsiflexion is present, less hip flexion is required (distal-strategy) whereas if dorsiflexion is reduced, it is compensated for by an increase in peak hip flexion (proximal-strategy).
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Affiliation(s)
- N Roche
- U1179, CIC-IT 805, Université de Versailles Saint Quentin en Yvelines, France.
| | - C Bonnyaud
- U1179, CIC-IT 805, Université de Versailles Saint Quentin en Yvelines, France; Service de Médecine Physique et Réadaptation, Hôpital R. Poincaré, AP-HP, Garches, France
| | - M Geiger
- U1179, CIC-IT 805, Université de Versailles Saint Quentin en Yvelines, France
| | - B Bussel
- U1179, CIC-IT 805, Université de Versailles Saint Quentin en Yvelines, France; Service de Médecine Physique et Réadaptation, Hôpital R. Poincaré, AP-HP, Garches, France
| | - D Bensmail
- U1179, CIC-IT 805, Université de Versailles Saint Quentin en Yvelines, France; Service de Médecine Physique et Réadaptation, Hôpital R. Poincaré, AP-HP, Garches, France
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Salbach NM, O'Brien KK, Brooks D, Irvin E, Martino R, Takhar P, Chan S, Howe JA. Reference values for standardized tests of walking speed and distance: a systematic review. Gait Posture 2015; 41:341-60. [PMID: 25542397 DOI: 10.1016/j.gaitpost.2014.10.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 09/13/2014] [Accepted: 10/04/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To provide an overview of the reference values and methodology used to obtain them for time- and distance-limited walk tests. METHODS We performed a systematic review and searched PubMed, MEDLINE (Ovid), EMBASE, CINAHL, Scopus, PEDro, and The Cochrane Library from 1946 to May 2013. Full-text peer-reviewed articles written in English, French or Spanish were considered eligible. Two authors independently screened titles and abstracts. One author determined eligibility of full-text articles, appraised methodological quality, and extracted data. A second author independently verified the accuracy of extracted data. RESULTS Of the 41 eligible studies reviewed, 25 failed to describe the method used to select participants and 10 had an inadequate sample size. Twenty-five studies provided reference values for one time-limited walk test (6-min walk test (6 MWT)) and 18 studies provided reference values for 15 distance-limited walk tests. Across studies, walk test distances ranged from 3m to 40m. Descriptive values and reference equations for the 6 MWT were reported in 15 and 20 studies, respectively. Across 43 regression equations (median R(2)=0.46), age (98%) and sex (91%) were most frequently included. The equation yielding the maximum R(2) value (0.78) included age, height, weight and percentage of predicted maximum heart rate. Among six unique regression equations for distance-limited walk tests (median R(2)=0.17), sex (83%), age (67%) and weight (67%) were most frequently included. The equation yielding the maximum R(2) value (0.25) included age and sex. CONCLUSIONS Reference values reported for these tests provide a basis for classifying walking capacity as within normal limits, determining the magnitude of deficit, educating clients, setting rehabilitation goals, and planning studies.
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Affiliation(s)
- Nancy M Salbach
- Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, ON M5G 1V7, Canada; Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, Toronto, ON M5G 2A2, Canada.
| | - Kelly K O'Brien
- Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, ON M5G 1V7, Canada.
| | - Dina Brooks
- Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, ON M5G 1V7, Canada; Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, Toronto, ON M5G 2A2, Canada.
| | - Emma Irvin
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON M5G 2E9, Canada.
| | - Rosemary Martino
- Department of Speech-Language Pathology, University of Toronto, 160-500 University Avenue, Toronto, ON M5G 1V7, Canada.
| | - Pam Takhar
- Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, ON M5G 1V7, Canada.
| | - Sylvia Chan
- Physiotherapy, Allied Health Program, Toronto Western Hospital - University Health Network, 3 East Wing, Room 400, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada.
| | - Jo-Anne Howe
- Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, ON M5G 1V7, Canada; Toronto Rehabilitation Institute - University Health Network, 550 University Avenue, Toronto, ON M5G 2A2, Canada.
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Tsushima A, Ochi A, Takaishi T. Immediate effects of varying cadence in bicycle ergometry on characteristics of gait and lower extremity motor activity in frail older adults. Aging Clin Exp Res 2015; 27:43-51. [PMID: 24866498 DOI: 10.1007/s40520-014-0245-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 05/15/2014] [Indexed: 10/25/2022]
Abstract
AIM This study examined the immediate effects of a 5-min pedaling period with varying cadence (VC) on various dimensions of gait function in frail older adults. METHODS Twenty frail older adults (mean age 77.2 years) were randomly assigned to one of two groups: the VC group or the constant cadence (CC) group. Each group performed bicycle ergometry for 5 min at 20 W. The CC group pedaled continuously at a CC of 50 rpm, while the VC group pedaled continuously at cadences of 45, 55, 65, 55, and 45 rpm, in this order, changing cadence every 60 s. Immediately before and after bicycle ergometry, the following measurements were carried out: gait performance, muscle activity (electromyographic analysis), and knee motion analysis. RESULTS CC did not significantly affect any of the measured parameters. In contrast, the VC group showed improvement in all three parameters: an increase in normal gait speed and cadence (p < 0.01), a reduction in the activation period (p < 0.04) and CI-THIGH (antagonistic coactivation time between knee flexor and extensor muscles, p < 0.05), and an increase in maximum knee extension angular velocity (p < 0.01). CONCLUSION A short period of VC bicycle ergometry with low work intensity was effective in immediately improving gait function in frail older adults.
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Affiliation(s)
- Akira Tsushima
- Graduate School of Natural Sciences, Nagoya City University, 1 Yamanohata Mizuho-cho, Mizuho-ku, Nagoya-shi, Aichi, 467-8501, Japan,
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Demura T, Demura SI, Uchiyama M, Sugiura H. Examination of factors affecting gait properties in healthy older adults: focusing on knee extension strength, visual acuity, and knee joint pain. J Geriatr Phys Ther 2014; 37:52-7. [PMID: 23835771 DOI: 10.1519/jpt.0b013e318295daba] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Gait properties change with age because of a decrease in lower limb strength and visual acuity or knee joint disorders. Gait changes commonly result from these combined factors. This study aimed to examine the effects of knee extension strength, visual acuity, and knee joint pain on gait properties of for 181 healthy female older adults (age: 76.1 (5.7) years). METHODS Walking speed, cadence, stance time, swing time, double support time, step length, step width, walking angle, and toe angle were selected as gait parameters. Knee extension strength was measured by isometric dynamometry; and decreased visual acuity and knee joint pain were evaluated by subjective judgment whether or not such factors created a hindrance during walking. RESULTS Among older adults without vision problems and knee joint pain that affected walking, those with superior knee extension strength had significantly greater walking speed and step length than those with inferior knee extension strength (P < .05). Persons with visual acuity problems had higher cadence and shorter stance time. In addition, persons with pain in both knees showed slower walking speed and longer stance time and double support time. CONCLUSION A decrease of knee extension strength and visual acuity and knee joint pain are factors affecting gait in the female older adults. Decreased knee extension strength and knee joint pain mainly affect respective distance and time parameters of the gait.
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Affiliation(s)
- Tomohiro Demura
- 1Child Education, Jin-ai Women's College, Fukui, Fukui, Japan. 2Graduate School of Natural Science & Technology, Kanazawa University, Kanazawa, Ishikawa, Japan. 3Akita Prefectural University, Shimoshinjo-Nakano, Akita, Japan
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Sakurai R, Fujiwara Y, Yasunaga M, Takeuchi R, Murayama Y, Ohba H, Sakuma N, Suzuki H, Oda K, Sakata M, Toyohara J, Ishiwata K, Shinkai S, Ishii K. Regional Cerebral Glucose Metabolism and Gait Speed in Healthy Community-Dwelling Older Women. J Gerontol A Biol Sci Med Sci 2014; 69:1519-27. [DOI: 10.1093/gerona/glu093] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Han SY, Ge SR, Liu HT. The Relation of Three-dimensional Knee Kinematics between Walking and Squatting for Healthy Young and Elderly Adults. J Phys Ther Sci 2014; 26:465-7. [PMID: 24707109 PMCID: PMC3976028 DOI: 10.1589/jpts.26.465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 10/16/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to study the correlation of knee range of motion
between walking and squatting for young and elderly populations. [Subjects] Sixteen young
and eight elderly healthy subjects were recruited for this study. [Methods]
Three-dimensional joint motions of each subject were captured while they performed walking
and squatting exercises. [Results] Significant differences in the non-sagittal plane knee
motions (peak adduction, and peak external and internal rotation) were revealed between
the young and the elderly during squatting. Correlations of three-dimensional knee range
of motion between walking and squatting were positive and high in all three planes for the
young subjects (R2=0.70, 0.52, and 0.45, respectively), but not for the elderly
subjects (R2=0.23, 0.0004, and 0.05, respectively). [Conclusion] We suggest
that changes in secondary knee kinematics and poor correlations between walking and
squatting for the elderly may result from degeneration of the sensory and neuromuscular
systems. It could be injurious for the elderly to perform high flexion activities.
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Affiliation(s)
- Shu-Yang Han
- College of Mechanical and Electrical Engineering, China University of Mining and Technology, China ; Julius Wolff Institute, Charité Universitätsmedizin Berlin, Germany
| | - Shi-Rong Ge
- College of Mechanical and Electrical Engineering, China University of Mining and Technology, China
| | - Hong-Tao Liu
- College of Material Science and Engineering, China University of Mining and Technology, China
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Lee IH, Park SY. A comparison of gait characteristics in the elderly people, people with knee pain, and people who are walker dependent people. J Phys Ther Sci 2013; 25:973-6. [PMID: 24259896 PMCID: PMC3820225 DOI: 10.1589/jpts.25.973] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 03/29/2013] [Indexed: 11/25/2022] Open
Abstract
[Purpose] The purpose of this study was to compare the gait parameters of age-matched
people with a normal gait (≥ 65 years), age-matched people with knee pain, and age-matched
people with walker dependent gait at a self-selected gait speed. [Methods] Subjects walked
on even ground in bare feet and were allowed a natural arm swing on a 6-m walkway.
Walker-dependent participants walked on a walkway without a walker. [Results] The
kinematic and spatiotemporal gait characteristics were used to investigate the difference
among the each group. Hip flexion, knee flexion, and stride width parameters were not
different. The gait speed, stride length and time, hip and knee extension, and ankle
flexion and extension parameters were significantly different. [Conclusion] A comparision
of kinematic and spatiotemporal gait characteristics during gait may provide an insight
into the gait pattern of normal elderly people, those with knee pain, and the
walker-dependent elderly.
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Affiliation(s)
- In-Hee Lee
- Department of Physical Medicine and Rehabilitation, Keimyung University
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Kikkawa K, Okada H, Oishi R. Age-associated changes of walking parameters in Japanese adult women. Rejuvenation Res 2013; 17:229-34. [PMID: 24079572 DOI: 10.1089/rej.2013.1507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this paper is to clarify the age-associated changes in walking movements. A two-dimensional movement analysis was conducted on a sample of 177 healthy women aged 19-82 years, with performance descriptors, kinematics, and kinetics as the parameters. An analysis of co-variance, with the gait velocity as co-variate and the categorized age group as a fixed factor, was adopted to examine the differences in each parameter among eight age groups. We conclude that age-associated changes in walking movement occur due to the essential effect of aging in walking, rather than due to differences in the physique or decrease of the gait velocity.
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Affiliation(s)
- Kazutoshi Kikkawa
- 1 Faculty of Informatics and Engineering, The University of Electro-Communications Tokyo , Japan
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Kikkawa K. Age-associated changes of walking parameters in Japanese adult women. Rejuvenation Res 2013:130930081148002. [PMID: 24079612 DOI: 10.1089/rej.2013.1506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract The purpose of this paper is to clarify the age-associated changes in walking movements. A two-dimensional movement analysis was conducted on a sample of 177 healthy women aged 19 to 82 years, with performance-descriptors, kinematics and kinetics as the parameters. An analysis of covariance, with the gait velocity as covariate and the categorized age group as a fixed factor, was adopted to examine the differences in each parameter among eight age groups. We conclude that age-associated changes in walking movement occur due to the essential ageing effect in the walking, rather than due to differences in the physique or decrease of the gait velocity.
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Affiliation(s)
- Kazutoshi Kikkawa
- University of Electro-Communications, Health and Physical Education, 1-5-1 Chofugaoka, Tokyo 1828585Japan, Chofu, Tokyo, Japan, 182-8585, 81-42-443-5583, 81-42-4435590, University of Electro-Communications, Health and Physical Education, 1-5-1 Chofugaoka, Chofu, Tokyo, Chofu, Tokyo, Japan, 182-8585, 81-42-4435583, 81-42-4435590 ;
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da Silva-Hamu TCD, Formiga CKMR, Gervásio FM, Ribeiro DM, Christofoletti G, de França Barros J. The impact of obesity in the kinematic parameters of gait in young women. Int J Gen Med 2013; 6:507-13. [PMID: 23837005 PMCID: PMC3699163 DOI: 10.2147/ijgm.s44768] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background The prevalence of obesity is increasing in the population, particularly in women. Obesity has an impact on the musculoskeletal system, leading to knee and ankle overexertion, difficulty with balance, and functional disability. The aim of this study was to identify changes in kinematic parameters of gait in obese young women. Methods A case-control study with 24 obese women (mean age 35.20 ± 9.9 years and mean body mass index of 31.85 ± 2.94 kg/m2) and 24 eutrophic women (mean age of 36.33 ± 11.14 and mean body mass index of 21.82 ± 1.58 kg/m2). The gait of women was evaluated by the system Vicon Motus® 9.2. The linear parameters of speed, cadence, right and left step, and stride lengths were studied, as well as the angular parameters of knee and ankle. Results There was a decrease in linear gait parameters (P < 0.001), speed, cadence, right and left step, and stride lengths. In regard to the angular parameters of the knee and ankle, there were also differences between the analyses (P < 0.001). At the knee joint, obese women have delayed onset of the second wave of flexion, exacerbating such movement in order to compensate. In regard to the ankle, both groups showed curves of normal plantar flexion and dorsiflexion, but there was a delay in the path graph in the ankle of obese women indicating a reduced range of motion and possible over-exertion of the pretibial muscles and soleus muscles simultaneously. Conclusion The results of this study revealed that obesity is a factor that negatively influences the kinematic parameters of gait of young women.
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Hallal CZ, Marques NR, Castro A, Spinoso DH, Rossi DM, Navega MT, Silva JAMG, Gonçalves M. Variabilidade de parâmetros eletromiográficos e cinemáticos em diferentes condições de marcha em idosos. MOTRIZ: REVISTA DE EDUCACAO FISICA 2013. [DOI: 10.1590/s1980-65742013000100014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi investigar a influência do medo de cair e da dupla tarefa sobre a variabilidade de parâmetros eletromiográficos e cinemáticos da marcha de idosas. Dezessete universitárias (21,47 ± 2,06 anos) e dezoito idosas (65,33 ± 3,14 anos), fisicamente ativas, realizaram teste de marcha em três condições: velocidade de preferência; medo de cair; e dupla tarefa. A atividade eletromiográfica dos músculos do membro inferior dominante e o comprimento e tempo de passada foram registrados. Utilizou-se o teste ANOVA Two-Way (p<0,05). A variabilidade eletromiográfica e cinemática foram maior para o grupo de idosas na comparação entre grupos. Para a comparação entre as condições de marcha analisadas, houve diferença significativa apenas para variabilidade eletromiográfica. Assim, o aumento da variabilidade dos parâmetros EMG e cinemáticos do grupo de idosos em relação ao grupo de jovens sugere que o fator envelhecimento contribui para uma maior dificuldade no controle da marcha, o que possivelmente predispõe estes indivíduos à ocorrência de quedas.
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Affiliation(s)
| | | | - Alex Castro
- UNESP - Univ Estadual Paulista, Campus de Rio Claro, Brasil
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Beijersbergen C, Granacher U, Vandervoort A, DeVita P, Hortobágyi T. The biomechanical mechanism of how strength and power training improves walking speed in old adults remains unknown. Ageing Res Rev 2013; 12:618-27. [PMID: 23501431 DOI: 10.1016/j.arr.2013.03.001] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 03/04/2013] [Accepted: 03/07/2013] [Indexed: 10/27/2022]
Abstract
Maintaining and increasing walking speed in old age is clinically important because this activity of daily living predicts functional and clinical state. We reviewed evidence for the biomechanical mechanisms of how strength and power training increase gait speed in old adults. A systematic search yielded only four studies that reported changes in selected gait biomechanical variables after an intervention. A secondary analysis of 20 studies revealed an association of r(2)=0.21 between the 22% and 12% increase, respectively, in quadriceps strength and gait velocity in 815 individuals age 72. In 6 studies, there was a correlation of r(2)=0.16 between the 19% and 9% gains in plantarflexion strength and gait speed in 240 old volunteers age 75. In 8 studies, there was zero association between the 35% and 13% gains in leg mechanical power and gait speed in 150 old adults age 73. To increase the efficacy of intervention studies designed to improve gait speed and other critical mobility functions in old adults, there is a need for a paradigm shift from conventional (clinical) outcome assessments to more sophisticated biomechanical analyses that examine joint kinematics, kinetics, energetics, muscle-tendon function, and musculoskeletal modeling before and after interventions.
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Demura T, Demura S. Combined effects of knee extension strength, visual acuity, and knee-joint pain on older women’s gait. Health (London) 2013. [DOI: 10.4236/health.2013.53060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Effects of reduction mammaplasty on the static balance and biomechanics of gait. EUROPEAN JOURNAL OF PLASTIC SURGERY 2012. [DOI: 10.1007/s00238-012-0771-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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John CT, Seth A, Schwartz MH, Delp SL. Contributions of muscles to mediolateral ground reaction force over a range of walking speeds. J Biomech 2012; 45:2438-43. [PMID: 22884038 DOI: 10.1016/j.jbiomech.2012.06.037] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 06/21/2012] [Accepted: 06/24/2012] [Indexed: 11/30/2022]
Abstract
Impaired control of mediolateral body motion during walking is an important health concern. Developing treatments to improve mediolateral control is challenging, partly because the mechanisms by which muscles modulate mediolateral ground reaction force (and thereby modulate mediolateral acceleration of the body mass center) during unimpaired walking are poorly understood. To investigate this, we examined mediolateral ground reaction forces in eight unimpaired subjects walking at four speeds and determined the contributions of muscles, gravity, and velocity-related forces to the mediolateral ground reaction force by analyzing muscle-driven simulations of these subjects. During early stance (0-6% gait cycle), peak ground reaction force on the leading foot was directed laterally and increased significantly (p<0.05) with walking speed. During early single support (14-30% gait cycle), peak ground reaction force on the stance foot was directed medially and increased significantly (p<0.01) with speed. Muscles accounted for more than 92% of the mediolateral ground reaction force over all walking speeds, whereas gravity and velocity-related forces made relatively small contributions. Muscles coordinate mediolateral acceleration via an interplay between the medial ground reaction force contributed by the abductors and the lateral ground reaction forces contributed by the knee extensors, plantarflexors, and adductors. Our findings show how muscles that contribute to forward progression and body-weight support also modulate mediolateral acceleration of the body mass center while weight is transferred from one leg to another during double support.
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Affiliation(s)
- Chand T John
- Department of Computer Science, Stanford University, Stanford, CA 94305-5450, USA
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Demura T, Demura SI, Yamaji S, Yamada T, Kitabayashi T. Gait characteristics when walking with rounded soft sole shoes. Foot (Edinb) 2012; 22:18-23. [PMID: 22079403 DOI: 10.1016/j.foot.2011.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Revised: 09/06/2011] [Accepted: 09/07/2011] [Indexed: 02/04/2023]
Abstract
This study aimed to examine the effect of shoes with a rounded soft sole (Stretch Walker: SW) on gait. Fifteen healthy male (mean age: 23.2) walked under three conditions (SW, Flat-bottomed Shoe: FS, Barefoot: BF). Including walking speed, stance time, step length were selected as temporal-spatial parameters. The angle of hip, knee, and ankle joints during particular phases were selected as kinematic parameters. Walking speed, stance time, step length and flexion angle of the ankle joint at initial contact were greater when wearing either shoe than walking BF; cadence was faster walking BF than wearing either shoe; double support time increased (FS>SW>BF); step width was greater (FS>SW>BF); walking angle was greater wearing the SW than wearing the FS and walking BF; and range of motion and maximum flexion angle of the hip and knee joints were greater wearing the FS than walking BF. In conclusion, wearing the SW with a heel-to-toe rocker and soft sole changes the double support time, step width, and walking angle and increases step length and walking speed compared to walking BF. The difference of the range of motion in hip and knee joints was larger between walking BF and wearing the FS than between walking BF and wearing the SW.
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Affiliation(s)
- Tomohiro Demura
- Graduate School of Natural Science & Technology, Kakuma, Kanazawa University, Kanazawa, Ishikawa 920-1192, Japan.
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Effectiveness of a targeted exercise intervention in reversing older people's mild balance dysfunction: a randomized controlled trial. Phys Ther 2012; 92:24-37. [PMID: 21979272 DOI: 10.2522/ptj.20100289] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Previous research has mainly targeted older people with high risk of falling. The effectiveness of exercise interventions in older people with mild levels of balance dysfunction remains unexplored. OBJECTIVE This study evaluated the effectiveness of a home balance and strength exercise intervention in older people systematically screened as having mild balance dysfunction. DESIGN This was a community-based, randomized controlled trial with assessors blinded to group allocation. PARTICIPANTS Study participants were older people who reported concerns about their balance but remained community ambulant (n=225). After a comprehensive balance assessment, those classified as having mild balance dysfunction (n=165) were randomized into the trial. INTERVENTION Participants in the intervention group (n=83) received a 6-month physical therapist-prescribed balance and strength home exercise program, based on the Otago Exercise Program and the Visual Health Information Balance and Vestibular Exercise Kit. Participants in the control group (n=82) continued with their usual activities. OUTCOME MEASURES Laboratory and clinical measures of balance, mobility, and strength were assessed at baseline and at a 6-month reassessment. RESULTS After 6 months, the intervention group (n=59) significantly improved relative to the control group (n=62) for: the Functional Reach Test (mean difference=2.95 cm, 95% confidence interval [CI]=1.75 to 4.15), the Step Test (2.10 steps/15 seconds, 95% CI=1.17 to 3.02), hip abductor strength (0.02, 95% CI=0.01 to 0.03), and gait step width (2.17 cm, 95% CI=1.23 to 3.11). There were nonsignificant trends for improvement on most other measures. Fourteen participants in the intervention group (23.7%) achieved balance performance within the normative range following the exercise program, compared with 3 participants (4.8%) in the control group. LIMITATIONS Loss to follow-up (26.6%) was slightly higher than in some similar studies but was unlikely to have biased the results. CONCLUSIONS A physical therapist-prescribed home exercise program targeting balance and strength was effective in improving a number of balance and related outcomes in older people with mild balance impairment.
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Dynamics of the ankle joint analyzed through moment–angle loops during human walking: Gender and age effects. Hum Mov Sci 2011; 30:1185-98. [DOI: 10.1016/j.humov.2011.02.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 10/27/2010] [Accepted: 02/16/2011] [Indexed: 11/15/2022]
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Demura T, Demura SI. Influence of Restricted Vision and Knee Joint Range of Motion on Gait Properties During Level Walking and Stair Ascent and Descent. J Mot Behav 2011; 43:445-50. [DOI: 10.1080/00222895.2011.626470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Soma M, Nakae H, Abiko T, Shimamura R, Uematsu H, Kawama K. Influence of a Dual Task while Stepping Over an Obstacle in the Fall-experienced Elderly People. J Phys Ther Sci 2011. [DOI: 10.1589/jpts.23.369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Masayuki Soma
- Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University
| | - Hideyuki Nakae
- Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University
| | - Teppei Abiko
- Division of Physical Therapy, Tokyo Metropolitan Rehabilitation Hospital
| | - Ryouta Shimamura
- Division of Physical Therapy, Tokyo Metropolitan Rehabilitation Hospital
| | - Hisashi Uematsu
- Division of Physical Therapy, Tokyo Metropolitan Rehabilitation Hospital
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Abstract
BACKGROUND Walking speed norms and several risk thresholds for poor health outcomes have been published for community-dwelling older adults. It is unclear whether these values apply to hospitalized older adults. OBJECTIVE The purpose of this study was to determine the in-hospital walking speed threshold that best differentiates walking-independent from walking-dependent older adults. DESIGN This was a cross-sectional study. METHODS This study recruited a convenience sample of 174 ambulatory adults aged 65 years and older who had been admitted to a medical-surgical unit of a university hospital. The participants' mean (SD) age was 75 (7) years. Fifty-nine percent were women, 66% were white, and more than 40% were hospitalized for cardiovascular problems. Usual-pace walking speed was assessed over 2.4 m. Walking independence was assessed through self-report. Several methods were used to determine the threshold speed that best differentiated walking-independent patients from walking-dependent patients. Approaches included a receiver operating characteristic (ROC) curve, sensitivity and specificity, and frequency distributions. RESULTS The participants' mean (SD) walking speed was 0.43 (0.23) m/s, and 62% reported walking independence. Nearly 75% of the patients walked more slowly than the lowest community-based risk threshold, yet 90% were discharged home. Overall, cut-point analyses suggested that 0.30 to 0.35 m/s may be a meaningful threshold for maintaining in-hospital walking independence. For simplicity of clinical application, 0.35 m/s was chosen as the optimal cut point for the sample. This threshold yielded a balance between sensitivity and specificity (71% for both). Limitations The limitations of this study were the small size of the convenience sample and the single health outcome measure. CONCLUSIONS Walking speeds of older adults who are acutely ill are substantially slower than established community-based norms and risk thresholds. The threshold identified, which was approximately 50% lower than the lowest published community-based risk threshold, may serve as an initial risk threshold or target value for maintaining in-hospital walking independence.
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Responsiveness of 2 procedures for measurement of temporal and spatial gait parameters in older adults. PM R 2010; 2:537-43. [PMID: 20630440 DOI: 10.1016/j.pmrj.2010.02.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 01/29/2010] [Accepted: 02/17/2010] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the responsiveness of the GAITRite system and a stopwatch-footfall count technique for measurement of walking speed, cadence, and stride length during comfortable and fast-paced walking. DESIGN Criterion standard. SETTING Research laboratory in a physical therapy education program. PARTICIPANTS Twenty-four healthy volunteers (13 men, 11 women; mean age 74.5 years) without lower extremity injury or history of falls. INTERVENTIONS Participants walked across a GAITRite mat with embedded pressure sensors at their self-selected comfortable and fast walking speeds. Simultaneously, an examiner, using a stopwatch, recorded the elapsed time necessary to cross the mat and counted the number of complete footfalls. MAIN OUTCOME MEASURE(S) Walking speed, cadence, and stride length were compared between the GAITRite system and the stopwatch-footfall count technique for both comfortable and fast walking speeds. Responsiveness values for each procedure were described by the 95% minimal detectable change (MDC). RESULTS During comfortable self-paced walking, MDC values for the stopwatch-footfall count technique ranged from 10% to 65% greater than those obtained for the GAITRite system. During fast self-paced walking MDC values for the stopwatch-footfall count technique ranged from 26% to 65% larger than those measured by the GAITRite system for the temporal and spatial gait performance parameters. CONCLUSIONS When measured by the GAITRite system, the 95% MDC values for temporal and spatial gait parameters of older community-dwelling adults were more responsive to change than those obtained by the stopwatch-footfall technique. Clinicians should recognize that self-selected walking speed, cadence, and stride length when obtained by an instrumented walkway must be equal to or exceed 12.6 cm/s, 8.4 steps/min, or 7 cm, respectively, for the change to be considered real change and not from measurement error.
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Wert DM, Brach J, Perera S, VanSwearingen JM. Gait biomechanics, spatial and temporal characteristics, and the energy cost of walking in older adults with impaired mobility. Phys Ther 2010; 90:977-85. [PMID: 20488977 PMCID: PMC2897132 DOI: 10.2522/ptj.20090316] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2009] [Accepted: 04/01/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND Abnormalities of gait and changes in posture during walking are more common in older adults than in young adults and may contribute to an increase in the energy expended for walking. OBJECTIVE The objective of this study was to examine the contributions of abnormalities of gait biomechanics (hip extension, trunk flexion, and foot-floor angle at heel-strike) and gait characteristics (step width, stance time, and cadence) to the energy cost of walking in older adults with impaired mobility. DESIGN A cross-sectional design was used. METHODS Gait speed, step width, stance time, and cadence were derived during walking on an instrumented walkway. Trunk flexion, hip extension, and foot-floor angle at heel contact were assessed during overground walking. The energy cost of walking was determined from oxygen consumption data collected during treadmill walking. All measurements were collected at the participants' usual, self-selected walking speed. RESULTS Fifty community-dwelling older adults with slow and variable gait participated. Hip extension, trunk flexion, and step width were factors related to the energy cost of walking. Hip extension, step width, and cadence were the only gait measures beyond age and gait speed that provided additional contributions to the variance of the energy cost, with mean R(2) changes of .22, .12, and .07, respectively. Limitations Other factors not investigated in this study (interactions among variables, psychosocial factors, muscle strength [force-generating capacity], range of motion, body composition, and resting metabolic rate) may further explain the greater energy cost of walking in older adults with slow and variable gait. CONCLUSIONS Closer inspection of hip extension, step width, and cadence during physical therapy gait assessments may assist physical therapists in recognizing factors that contribute to the greater energy cost of walking in older adults.
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Affiliation(s)
- David M Wert
- Department of Physical Therapy, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA 15260, USA.
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Relationship between dynamic balance measures and functional performance in community-dwelling elderly people. Phys Ther 2010; 90:748-60. [PMID: 20223944 DOI: 10.2522/ptj.20090100] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Poor balance control, mobility restrictions, and fall injuries are serious problems for many older adults. OBJECTIVE The purpose of this study was to evaluate a new dynamic standing balance assessment test for identifying individuals at risk for falling in a group of community-dwelling older adults. DESIGN This was a cross-sectional observational study of 72 community-dwelling older adults who were receiving rehabilitation in a geriatric day hospital. METHOD A Dynamic Balance Assessment (DBA) test protocol was developed based on the concept of the Sensory Organization Test and the Clinical Test of Sensory Interaction and Balance. The DBA consists of 6 tasks performed on a normal floor surface and repeated on a sponge surface. A flexible pressure mat was used to record the foot's center of pressure (COP) on both surfaces, and loss of balance was recorded. Balance performance also was evaluated using the Berg Balance Scale, the Timed "Up & Go" Test, gait speed, and the Six-Minute Walk Test. Participants were classified as "fallers" or "nonfallers" based on a self-report. RESULTS No significant differences were noted between the faller group (n=47) and the nonfaller group (n=25) for demographic variables or medications. The DBA composite scores, which were derived from analysis of COP excursions of the 6 tasks performed on the sponge surface, were able to distinguish between fallers and nonfallers. Of the clinical tests, only the Timed "Up & Go" Test was able to differentiate between the faller and nonfaller groups. Limitations A prospective study is needed to confirm the current findings and to expand testing to a larger and more diverse sample. CONCLUSIONS The findings indicate that analysis of the extent and amount of COP displacements during selected tasks and under different surface conditions is an appropriate method to assess dynamic standing balance controls and can discriminate between fallers and nonfallers among community-dwelling elderly people.
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Shimada H, Kim H, Yoshida H, Suzukawa M, Makizako H, Yoshida Y, Saito K, Suzuki T. Relationship between Age-Associated Changes of Gait and Falls and Life-Space in Elderly People. J Phys Ther Sci 2010. [DOI: 10.1589/jpts.22.419] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hiroyuki Shimada
- Section for Health Promotion, Department of Health and Medical Care, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology
| | - Hunkyung Kim
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology
| | - Hideyo Yoshida
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology
| | - Megumi Suzukawa
- Graduate School of Human Health Sciences, Tokyo Metropolitan University
| | - Hyuma Makizako
- Section for Health Promotion, Department of Health and Medical Care, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology
| | - Yuko Yoshida
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology
| | - Kyoko Saito
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology
| | - Takao Suzuki
- National Institute for Longevity Sciences, National Center for Geriatrics and Gerontology
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Feasibility and Outcomes of a Home-Based Exercise Program on Improving Balance and Gait Stability in Women With Lower-Limb Osteoarthritis or Rheumatoid Arthritis: A Pilot Study. Arch Phys Med Rehabil 2010; 91:106-14. [DOI: 10.1016/j.apmr.2009.08.150] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 07/20/2009] [Accepted: 08/10/2009] [Indexed: 11/22/2022]
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Soma M, Masuda T, Shimamura R, Abiko T, Uematu H, Kawama K. Influence of a Dual-Task on Toe Clearance of the Young and Elderly While Stepping Over an Obstacle. J Phys Ther Sci 2010. [DOI: 10.1589/jpts.22.75] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Masayuki Soma
- Tohoku Fukushi University, Department of Rehabilitation Faculty of Health Sciences
| | - Tsukasa Masuda
- Tokyo Metropolitan Rehabilitation Hospital, Division of Physical Therapy
| | - Ryouta Shimamura
- Tokyo Metropolitan Rehabilitation Hospital, Division of Physical Therapy
| | - Teppei Abiko
- Tokyo Metropolitan Rehabilitation Hospital, Division of Physical Therapy
| | - Hisashi Uematu
- Tokyo Metropolitan Rehabilitation Hospital, Division of Physical Therapy
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Kinematics and kinetics of the lower extremities of young and elder women during stairs ascent while wearing low and high-heeled shoes. J Electromyogr Kinesiol 2009; 19:1071-8. [PMID: 19054686 DOI: 10.1016/j.jelekin.2008.09.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Revised: 08/17/2008] [Accepted: 09/14/2008] [Indexed: 11/20/2022] Open
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