Abstract
Slopes are present in everyday environments and require specific postural strategies for successful navigation; different arm strategies may be used to manage external perturbations while walking. It has yet to be determined what impact arm swing has on postural strategies and gait stability during sloped walking. We investigated the potentially interacting effects of surface slope and arm motion on gait stability and postural strategies in healthy young adults. We tested 15 healthy adults, using the CAREN-Extended system to simulate a rolling-hills environment which imparted both incline (uphill) and decline (downhill) slopes (± 3°). This protocol was completed under three imposed arm swing conditions: held, normal, active. Spatiotemporal gait parameters, mediolateral margin of stability, and postural kinematics in anteroposterior (AP), mediolateral (ML), and vertical (VT) directions were assessed. Main effects of conditions and interactions were evaluated by 2-way repeated measures analysis of variance. Our results showed no interactions between arm swing and slope; however, we found main effects of arm swing and main effects of slope. As expected, uphill and downhill sections of the rolling-hills yielded opposite stepping and postural strategies compared to level walking, and active and held arm swings led to opposite postural strategies compared to normal arm swing. Arm swing effects were consistent across slope conditions. Walking with arms held decreased gait speed, indicating a level of caution, but maintained stability comparable to that of walking with normal arm swing. Active arm swing increased both step width variability and ML-MoS during downhill sections. Alternately, ML-MoS was larger with increased step width and double support time during uphill sections compared to level, which demonstrates that distinct base of support strategies are used to manage arm swing compared to slope. The variability of the rolling-hills also required proactive base of support changes despite the mild slopes to maintain balance.
Highlights
Everyday walking environments are complex as they vary in levelness and regularity (Allet et al, 2008)
Step length increased with increasing arm swing (p ≤ 0.01) and, during uphill sections only, step length coefficients of variation (CoV) was greater when walking with arms held compared to with normal arm swing (p = 0.027)
mediolateral margin of stability (ML-MoS) and step width CoV both increased within downhill sections of the rollinghills terrain with the use of active arm swing compared to normal
Summary
Everyday walking environments are complex as they vary in levelness and regularity (Allet et al, 2008). Responses to challenging terrain by the postural control system can be seen in adjustment of spatiotemporal gait characteristics. Compensatory changes such as increased double-support time. Arm Swing on Mild Slopes or step width are a means of coping with uphill or downhill slopes, respectively (Kawamura and Tokuhiro, 1991; Sun et al, 1996; Gottschall and Nichols, 2011). The effectiveness of such changes may be determined by quantifying stability. Taking wider steps has been linked to increased mediolateral margin of stability (ML-MoS) (McAndrew Young and Dingwell, 2012), indicating enhanced stability. Vieira et al (2017) found downhill walking decreased ML-MoS and uphill walking increased ML-MoS compared to level walking, but not all concomitant gait strategies were explored
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