Biomechanical Gait Parameters Research Articles

Treatment of acute Achilles tendon ruptures with Achillon device: Clinical outcomes and kinetic gait analysis

We reviewed the outcomes of the Achillon minimally invasive suture system and an early semi-functional rehabilitation program for the treatment of acute Achilles tendon ruptures. From December 2006 to April 2008, 18 consecutive patients with acute Achilles tendon ruptures were retrospectively reviewed with an average follow-up of 22 months. Clinical data were assessed with the patient satisfaction and the AOFAS hindfoot score. Biomechanical gait parameters were obtained using the NedAMH/IBV dynamometric platform. At last follow-up the AOFAS score was 98 (range, 89-100) and correlated well with kinetic gait analysis. All patients regained normal range of motion and were able to resume their previous activities after six months, with a high rate of satisfaction. Three patients had scar adhesions. There were no cases of recurrent rupture or nerve injury. The Achillon device allows semi-functional rehabilitation and provides satisfactory results with a low rate of complication.

Frühfunktionelle Vorteile von minimalinvasiv implantierten Hüfttotalendoprothesen – Ganganalytische Befunde zur Symmetrie und Belastung aus der Messung der Bodenreaktionskraft

The purpose of this clinical study is to evaluate the postoperative walking ability after total hip replacement (THR) in terms of different surgical approaches by means of an evaluation of gait velocity. 21 patients underwent a total hip replacement using an anterolateral minimally invasive modified Watson-Jones approach (MIS group). 20 other patients received a THR using a transgluteal approach (standard group). Differences in functional indices of ground reaction forces and symmetry indices were measured one day pre-operatively, and at 6 and 13 weeks postoperatively on the walkway. The intervention of gait velocity was done by means of a digital metronome. The given step frequences were 70, 90 and 110 steps/minute. The results were compared to an age-matched control group (n = 20). There are significantly reduced pain symptoms in both surgical groups at 6 weeks post-operatively. The MIS group has a higher functional ability, improved symmetry indices of stance time, loading rate and single limb stance compared to the control group at 6 weeks postoperatively. At 13 weeks postoperatively there are no differences between the two surgical groups, except for the parameter "loading rate". The patients in the MIS group had an increasing improvement already at 6 weeks after THR. From 6 to 13 weeks after surgery there were important changes in the control group. Obviously, the early postoperative advantages of the minimal invasive approach provide for an improved re-establishment of symmetry and load. In this clinical course study, the proof is validated because the trends in the biomechanical gait parameters are comparable by means of gait velocity standardisation.

Comparison of biomechanical gait parameters of young children with haemophilia and those of age‐matched peers

Quality of life for children with haemophilia has improved since the introduction of prophylaxis. The frequency of joint haemorrhages has reduced, but the consequences of reduced bleeding on the biomechanical parameters of walking are not well understood. This study explored the differences in sagittal plane biomechanics of walking between a control group (Group 1) of normal age-matched children and children with haemophilia (Group 2) with a target ankle joint. A motion capture system and two force platforms were used to collect sagittal plane kinematic, kinetic and temporal-spatial data during walking of 14 age-matched normal children and 14 children with haemophilia aged 7-13 years. Group differences in maximum and minimum flexion/extension angles and moments of the hip, knee and ankle joints, ground reaction forces and temporal-spatial gait cycle parameters were analysed using one-way anova. Significant changes (P < 0.05) in kinematic and kinetic parameters but not temporal-spatial parameters were found in children with haemophilia; greater flexion angles and external moments of force at the knee, greater ankle plantarflexion external moments and lower hip flexion external moments. These results suggest that early biomechanical changes are present in young haemophilic children with a history of a target ankle joint and imply that lower limb joint function is more impaired than current clinical evaluations indicate. Protocols and quantitative data on the biomechanical gait pattern of children with haemophilia reported in this study provide a baseline to evaluate lower limb joint function and clinical progression.

The influence of boot stiffness on gait kinematics and kinetics during stance phase

In the study, the influence of different boot prototype stiffness on gait kinematics and kinetics was investigated. The boot stiffness was determined by force-deformation measurement while pressing the foot model inserted into the boot by a custom-made robot. Gait analysis was carried out in nine neurologically intact subjects during walking while wearing two different boots with and without carrying a backpack, and differences were statistically tested using ANOVA. The results indicated distinctions in the boot shaft and vamp stiffness. The boot with a softer boot shaft enabled a wider range of motion in the ankle joint leading to more power generation in the ankle joint during the push-off, increased step length and gait velocity. The backpack mostly influenced the pelvis and trunk kinematics. The study has demonstrated the influence of boot shaft stiffness on biomechanical gait parameters and its importance for push-off that manufacturers should take into consideration when optimizing the footwear performance.

Kinematic Analysis Of Treadmill Walking Among Individuals With Cerebral Palsy

Purpose To analyze gait kinematics of treadmill walking in individuals with cerebral palsy (CP) as compared to overground walking, in order to understand the relationship between overground and treadmill walking and to validate the use of a treadmill for gait intervention in individuals with CP. Methods A repeated measures comparison study for two groups and two walking conditions. 20 children with ambulatory spastic diplegic CP (10 males/10 females; age range 6–16 yrs, mean 11 yrs) and 20 children without disability (age/gender matched) participated in this study. All participants were tested for walking at the same speed on both walkway (10 meter) and treadmill (Biodex Gait Trainer, Biodex Medical System, Shirley, NY). The biomechanical gait parameters, including temporal-spatial and lower limb joint kinematics, were examined by using a three dimensional (3-D) motion analysis system (Vicon 512, Oxford Metrics, Tustin, CA). The walking speed was determined based on the average of three self-selected (comfortable) overground walking trials and the same speed was applied to treadmill walking trials. Results Main results from 3-D gait analysis demonstrated statistically significant differences in cadence, stride length, and lower limb joint kinematics between treadmill and overground walking. For both test groups with CP and without disability, significantly greater cadence (p<0.01 and p<0.05 respectively) and shorter stride length (p<0.05 and p<0.01 respectively) were noted during treadmill walking. In the group with CP, significantly greater peak ankle dorsi-flexion (p<0.01) and peak knee flexion (p<0.05) were observed during TM walking while significantly decreased peak ankle plantar-flexion (p<0.01) and range of motion in pelvic rotation (p<0.05) were noted. Conclusions The results indicate that the different task and environmental constraints of the treadmill walking alter the gait patterns of children with CP. The differences between the two conditions should be considered for treadmill-based gait experiments and clinical intervention.

Effect of piroxicam on gait in patients with osteoarthritis of the knee.

To determine whether the use of a nonsteroidal antiinflammatory drug (NSAID) in patients with painful osteoarthritis (OA) of the knee would result in alterations in specific biomechanical parameters of gait. Eighteen patients with symptomatic knee OA and varus knee deformity underwent initial clinical evaluation for pain and activities of daily living, and assessment of parameters of gait utilizing a well-described computerized system. All patients were then treated with piroxicam at 20 mg once daily, and clinical and gait analyses were repeated after 4 weeks. Fifteen of the 18 patients studied had a significant increase in the knee adduction moment after treatment. In the group as a whole there was a significant increase in knee adduction moment (mean percent body weight times height [%BWTH] 4.11 pretreatment versus 4.57 after 4 weeks of treatment; P < 0.01) and maximum quadriceps moment (mean %BWTH 2.13 pretreatment, 2.62 posttreatment; P < 0.01), as well as changes in other gait parameters that might be expected to be altered as a result of relief of pain. Sixteen of 18 patients experienced symptomatic relief, with a significant reduction in pain in the group as a whole after 4 weeks (P < 0.001). NSAID treatment in patients with knee OA results in a reduction in symptomatic pain and an increase in loading of the knee. Whether the increased loading is due to the analgesic effects of the treatment is unknown, but if so, the development of agents capable of relieving pain while reducing loads at the knee may be desirable.

Motion of the normal and anterior cruciate ligament deficient canine knee during the walk and trot

Motion of the normal and anterior cruciate ligament deficient canine knee during the walk and trot

Effects of different loads and carrying systems on selected biomechanical parameters describing walking gait.

The effects of two different systems on selected biomechanical parameters of walking gait, while carrying loads of varying magnitude, were investigated. Ten healthy males who were not regularly engaged in carrying tasks walked a distance of 20 m for ten trials for each of the following five conditions: (i) normal walking without any external load; (ii) 20% and (iii) 40% body weight carried using a backpack system; and (iv) 20% and (v) 40% body weight carried using a doublepack system which distributed the load equally between the front and back of the subjects. The experimental set-up consisted of a Kistler force platform interfaced to a Tektronix 4051 Graphic Calculator, two super 8 mm movie cameras and a photoelectric timing system. Force data (417 Hz) were obtained for ten trials along with side- and rear-view film data (100 fps) for three of the trials for each of the subject conditions. In addition, selected aspects of foot-position data were acquired from a minimum of six footprints from one trial for each subject condition. Walking speed was controlled at 4·5 ± 0·3km/h. Parameters describing the temporal relationship of the gait pattern and values describing the spatial relationship of foot position were evaluated. Selected variables describing the components of the ground-reaction-force-time curves were also examined. Finally, selected kinematic and kinetic parameters were evaluated for four functional subphases of the support period. Comparisons using a one-way ANOVA with repeated measures were conducted to examine differences between parameters describing the load-carrying conditions and normal gait. Results from the analysis revealed that both the light and heavy loads substantially modified the normal walking gait pattern. Interactions between the load conditions and carrying systems were tested using separate two-way ANOVA with repeated measures. Significant ordinal interactions as well as significant main effects were found between the two carrying systems for some parameters, suggesting that the doublepack system was more effective than the conventional backpack system, especially for carrying the heavy load.