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Research Papers

Analysis of Spatial and Temporal Step Parameters During Crutch-Assisted Gait as a Dual-Task: A Pilot Study

[+] Author and Article Information
Carmen Ridao-Fernández

Department of Physiotherapy,
Research Group “Area of Physiotherapy CTS-305,”
University of Seville,
Seville 41009, Spain
e-mail: mcrf.2817@gmail.com

Joaquín Ojeda

Department of Mechanical
Engineering and Manufacture,
Research Group “Mechanical Engineering,”
University of Seville,
Seville 41092, Spain
e-mail: joaquinojeda@us.es

Gema Chamorro-Moriana

Department of Physiotherapy,
Research Group “Area of Physiotherapy CTS-305,”
University of Seville,
Seville 41009, Spain
e-mail: gchamorro@us.es

1Corresponding author.

Manuscript received November 12, 2017; final manuscript received April 10, 2018; published online June 21, 2018. Assoc. Editor: Tammy L. Haut Donahue.

J Biomech Eng 140(10), 101006 (Jun 21, 2018) (11 pages) Paper No: BIO-17-1522; doi: 10.1115/1.4040020 History: Received November 12, 2017; Revised April 10, 2018

The main objective was to analyze the changes in the spatial and temporal step parameters during a dual-task: walking with a forearm crutch to partially unload the body weight of the subject. The secondary objective was to determine the influence of the use of the crutch with the dominant or nondominant hand in the essential gait parameters. Seven healthy subjects performed gait without crutches (GWC) and unilateral assisted gait (UAG) with the crutch carried out by dominant hand (dominant crutch (DC)) and nondominant hand (nondominant crutch (NDC)). Gait was recorded using a Vicon System; the GCH System 2.0 and the GCH Control Software 1.0 controlled the loads. The variables were step length, step period, velocity, step width, and step angle. The Wilcoxon signed-rank test compared GWC and UAG while also analyzing the parameters measured for both legs with DC and NDC in general and in each subject. Wilcoxon test only found significant differences in 1 of the 15 general comparisons between both legs. In the analysis by subject, step length, step period, and velocity showed significant differences between GWC and UAG. These parameters obtained less differences in DC. The effect of a forearm crutch on UAG caused a reduction in step length and velocity, and an increase in step period. However, it did not entail changes in step angle and step width. UAG was more effective when the DC carried the crutch. The unloading of 10% body weight produced an assisted gait which closely matched GWC.

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Figures

Grahic Jump Location
Fig. 1

Assisted gait was contralateral with simultaneous support for heel and crutch at two points

Grahic Jump Location
Fig. 2

GCH 2.0 load measurement system for assisted gait with forearm crutches

Grahic Jump Location
Fig. 3

Representation of the parameters: step length, step angle and step width: Stride length was defined as the distance between one heel strike and the next strike with the same heel. The heel strike event was determined analyzing the vertical component of the foot velocity and the trajectory of the marker placed on the heel following the foot velocity algorithm (FVA) proposed by O'Connor [37]. This procedure employed the markers HEE and TOE placed on the calcaneus and over the second metatarsal head, respectively. Stride period was defined as the time to carry out one stride. Stride velocity was defined as the ration between the stride length and the stride period. Step length was defined as the length between the heel strike of one foot and the next heel strike carried out by the other foot. Step period was defined as the time to carry out one step. Step angle was defined by the anterior-posterior axis of the foot local frame and the line of progression. Anterior-posterior axis was determined by markers HEE and TOE. The step width was defined as the mediolateral distance between the feet and measured on the heel markers.

Grahic Jump Location
Fig. 4

Descriptive analysis representation

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