An Evaluation of Symmetries in Ground Reaction Forces during Self-Paced Single- and Dual-Task Treadmill Walking in the Able-Bodied Men

Rawan Al-Juaid,Mohammad Al-Amri

doi:10.3390/sym12122101

Abstract

Gait is a complex autonomous activity that has long been viewed as a symmetrical locomotion, even when it adapts to secondary concurrent attention-demanding tasks. This study aimed to evaluate the symmetry of the three ground reaction forces (GRFs) in able-bodied individuals during self-paced treadmill walking with and without concurrent cognitive demands. Twenty-five male participants (age: 34.00 ± 4.44 years) completed two gait assessment sessions, each of whom were familiarized with the walking trials during their first session. Both sessions involved six-minute self-paced treadmill walking under three conditions: single-task walking and walking while concurrently responding to auditory 1-back and 2-back memory tasks. The symmetry of the GRFs was estimated using a nonlinear approach. Changes in the symmetry and walking speed across conditions in both sessions were assessed using inferential statistics. Results demonstrated that the three GRFs deviated from perfect symmetry by ≥10%. Engaging working memory during walking significantly reduced the symmetry of the vertical GRF (p = 0.003), and its detrimental effects on walking speed were significantly reduced in the second session with respect to the first session (p < 0.05). The findings indicate imperfect gait symmetry in able-bodied individuals, suggesting that common perceptions of gait symmetry should be reconsidered to reflect its objective importance in clinical settings.

Highlights

Gait symmetry describes the agreement between the movement of the right and left lower extremities in pattern and proportion [1]
The paired t-tests revealed insignificant differences between the mean symmetry scores for the vertical, anterior–posterior, or medial–lateral ground reaction forces (GRFs) recorded in both sessions across walking conditions (t-test, p > 0.05)
The results suggest that concurrent cognitive tasks during walking induced significant impacts on the vertical GRF

Summary

Introduction

Gait symmetry describes the agreement between the movement of the right and left lower extremities in pattern and proportion [1]. Gait symmetry assessment is often used in clinical practice to plan and measure the effectiveness of rehabilitation programs. Despite its importance, it is routinely assessed by clinicians using observational techniques, including naked eye assessment and video recordings [5]. Visual gait assessments can detect obvious deviations from normal patterns but not necessarily determine the primary deficits [5,6]. These types of assessment are neither sensitive nor reliable enough to assess gait symmetry, especially for people with symmetrical-looking gait performance

Objectives

Methods

Results

Conclusion