Backward vs. Forward Gait Symmetry Analysis Based on Plantar Pressure Mapping

Anna Daniluk,Bartłomiej Zagrodny,Michał Ludwicki,Anna Hadamus

doi:10.3390/sym14020203

Anna Daniluk, Bartłomiej Zagrodny + Show 2 more

Open Access

https://doi.org/10.3390/sym14020203

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Abstract

Symmetry is one of the factors analysed in normal and pathological gaits. Backward gait is an area of interest to scientists, in terms of its physiology and therapeutic possibilities. This study aimed to analyse the symmetry of the pressure parameters of backward gait in comparison to forward gait using different symmetry indices. Eighty-one healthy people aged between 19 and 84 years took part in the study. Foot pressure distribution was analysed during forward and backward gaits at self-selected speeds. Mean and maximum pressure values were calculated after dividing the foot into four or ten areas. Delta, Ratio Index, Robinson Index, Gait Asymmetry, and Symmetry Angle were calculated for each area, separately for both forward and backward gaits. Higher ratios of asymmetry were found during backward than during forward gait. Larger ratios of asymmetry were found within toes II–V, forefoot, metatarsals I, II, and III, medial and lateral heel areas. No significant correlation between symmetry indices and age or BMI was found. Results suggested that the lower symmetry of backward gait is caused by a higher number of corrective movements that allow for the maintenance of body balance and global symmetry of gait. This can be realised by increased cortical control of the backward gait, which was a new movement task for all participants.

Highlights

Gait is a basic means of human locomotion and one of the most common human activities
Because the backward gait is for most people a new movement task, it is not automated [32] and requires more control from frontoparietal cortical regions to gait with dual-task [8,15,30], greater activity of the muscles [11], and is not repeatable [19,28]
The present study showed lower symmetry ratios of backward compared to forward gaits, which can be caused by the higher number of corrective movements that allow for the maintenance of body balance and global symmetry of gait

Summary

Introduction

Gait is a basic means of human locomotion and one of the most common human activities. It has a complicated, three-dimensional, and cyclic nature. The problem is more complicated, and in many cases a pathological gait can be more symmetrical than the normal one. From a mathematical point of view, we can call the normal gait quasi-repeatable (quasi-periodical) and quasi-symmetrical, whereas some short-time alterations are natural. Those “imperfections” are the results of interactions between many body segments, muscle groups, and their activation, and activity of a central nervous system. It must be underlined that the level of asymmetry imposed in the literature does not exist, the exceeding of which a gait can be termed as pathological [7]

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