Differences In Gait Patterns Research Articles

Gait pattern differences in unilaterally affected children with cerebral palsy and children with acquired brain insult

Gait pattern differences in unilaterally affected children with cerebral palsy and children with acquired brain insult

Effects of Immersive Virtual Reality with Treadmill in Subjects with Rett Syndrome: A Pilot Study.

Rett syndrome is a rare neurodevelopmental disorder that can severely affect motor functioning, particularly walking. Previous training programs proposed treadmills as tools to increase walking endurance of patients with Rett syndrome, but these trainings did not include virtual reality (VR). The aim of this study was to assess the feasibility of a short treadmill training coupled to VR in girls with Rett syndrome. Nine patients with Rett syndrome underwent a 3-day treadmill walking program performed in semi-immersive VR. During the training, the happiness index and performance metrics were collected. At the end of the training parents filled out the Suitability Evaluation Questionnaire (SEQ) and, when feasible, patients underwent a gait assessment. All the subjects recruited performed the three GRAIL sessions and parents showed a good satisfaction and considered the integration of treadmill and VR a good possibility for future rehabilitative programs. Participants showed greater satisfaction in environments requiring walking and their attention increased during training sessions, hypothesizing the feasibility of longer trainings with treadmill and VR. Data collected from gait analysis provided insights, although preliminary, concerning differences in gait pattern amongst the recruited subjects. Despite the small sample size and limited training duration, the paper suggests that a walking training with a treadmill combined with VR can represent a new strategy for Rett rehabilitation.

Functional impairments in NBIA patients: Preliminary results.

Neurodegeneration with brain iron accumulation (NBIA) is a heterogeneous group (genetically and phenotypically) of genetically determined disorders. Up to date there is no cure for this disease, so the applied treatments focus on symptoms control and palliative care. The main problems are delayed motor development, gait deterioration, postural instability, cognitive dysfunctions, abnormal muscle tone and many others. As gait and balance deficits are predominant features of NBIA patients this study aimed at the use of the objective, instrumented functional tests as well as functional assessment scales to assess their functional impairments. Twenty three NBIA patients recruited for the study underwent objective, instrumented gait analysis, balance assessment, pedobarography and functional evaluation with Gross Motor Function Measure (GMFM-88). The results showed high variability and heterogeneity of NBIA functional status (GMFM from 27.5 to 100.0), but also showed some differences in gait pattern between their types (p < 0.05 at the pelvis, hip and knee). We think that these results could help design objective assessment protocols in future clinical studies.

Gait Characteristics and Development in Pediatric Populations With Visual Disorders: Where Do We Stand and Where Are We Going?

Introduction: Vision plays an important role in walking development. Understanding gait characteristics and development in infants and children with visual disorders is crucial to identify early walking impairment and promoting optimal motor performance. We aimed to identify typical gait patterns and differences between infants and children with visual disorders and their sighted peers, and how these change over time, identifying key research gaps in this area. Methods: A search of three databases identified 1,531 papers, of which eight met inclusion criteria. Results: Children who are blind showed differences in gait compared to peers with low vision or full sight. Differences were identified across age groups with slower walking, postural, head, and trunk position alterations and uncoordinated and reduced upper limb swing motions observed in children with blindness. Discussion: We identified three macro areas of interest related to gait characteristics in children with visual disorders: (1) and (2) compensation mechanisms of limbs, and (3) probing the environment. In general, children who are blind also showed the use of a wider base of support, more external rotation of the feet, and fewer steps taken per minute. There are no studies reporting gait characteristics in the early stages of walking development, scarcity of longitudinal investigations, and studies using different variables to measure gait. The lack of such evidence prevented the establishment of gait development trajectories over time in pediatric populations with visual disorders. Implications for Practitioners: This review is the first to summarize existing knowledge of gait characteristics in children with visual disorders, advancing our understanding regarding the key differences in gait patterns that are observed in this population. Information gathered in this work can help inform future studies and practitioners in this field, enhancing decision-making processes to support walking development and promoting increasing knowledge of gait progresses in infants and children with visual disorders.

Gait variability, fractal dynamics, and statistical regularity of treadmill and overground walking recorded with a smartphone

BackgroundThe nonlinear variability present during steady-state gait may provide a signature of health and showcase one’s walking adaptability. Although treadmills can capture vast amounts of walking data required for estimating variability within a small space, gait patterns may be misrepresented compared to an overground setting. Smartphones may provide a low-cost and user-friendly estimate of gait patterns among a variety of walking settings. However, no study has investigated differences in gait patterns derived from a smartphone between treadmill walking (TW) and overground walking (OW). Research questionThis study implemented a smartphone accelerometer to compare differences in temporal gait variability and gait dynamics between TW and OW. MethodsSixteen healthy adults (8F; 24.7 ± 3.8 years) visited the laboratory on three separate days and completed three 8-minute OW and three TW trials, at their preferred speed, during each visit. The inter-stride interval was calculated as the time difference between right heel contact events located within the vertical accelerometery signals recorded from a smartphone while placed in participants front right pant pocket during walking trials. The inter-stride interval series was used to calculate stride time standard deviation (SD) and coefficient of variation (COV), statistical persistence (fractal scaling index), and statistical regularity (sample entropy). Two-way analysis of variance compared walking condition and laboratory visits for each measure. ResultsCompared to TW, OW displayed significantly (p < 0.01) greater stride time SD (0.014 s, 0.020 s), COV (1.26 %, 1.82 %), fractal scaling index (0.70, 0.79) and sample entropy (1.43, 1.63). No differences were found between visits for all measures. SignificanceSmartphone-based assessment of gait provides the ability to distinguish between OW and TW conditions, similar to previously established methodologies. Furthermore, smartphones may be a low-cost and user-friendly tool to estimate gait patterns outside the laboratory to improve ecological validity, with implications for free-living monitoring of gait among various populations.

Gait Characterization in Duchenne Muscular Dystrophy (DMD) Using a Single-Sensor Accelerometer: Classical Machine Learning and Deep Learning Approaches.

Differences in gait patterns of children with Duchenne muscular dystrophy (DMD) and typically developing (TD) peers are visible to the eye, but quantifications of those differences outside of the gait laboratory have been elusive. In this work, we measured vertical, mediolateral, and anteroposterior acceleration using a waist-worn iPhone accelerometer during ambulation across a typical range of velocities. Fifteen TD and fifteen DMD children from 3 to 16 years of age underwent eight walking/running activities, including five 25 m walk/run speed-calibration tests at a slow walk to running speeds (SC-L1 to SC-L5), a 6-min walk test (6MWT), a 100 m fast walk/jog/run (100MRW), and a free walk (FW). For clinical anchoring purposes, participants completed a Northstar Ambulatory Assessment (NSAA). We extracted temporospatial gait clinical features (CFs) and applied multiple machine learning (ML) approaches to differentiate between DMD and TD children using extracted temporospatial gait CFs and raw data. Extracted temporospatial gait CFs showed reduced step length and a greater mediolateral component of total power (TP) consistent with shorter strides and Trendelenberg-like gait commonly observed in DMD. ML approaches using temporospatial gait CFs and raw data varied in effectiveness at differentiating between DMD and TD controls at different speeds, with an accuracy of up to 100%. We demonstrate that by using ML with accelerometer data from a consumer-grade smartphone, we can capture DMD-associated gait characteristics in toddlers to teens.

Comparison of ground reaction forces as running speed increases between male and female runners.

Introduction: The biomechanics associated with human running are affected by gender and speed. Knowledge regarding ground reaction force (GRF) at various running speeds is pivotal for the prevention of injuries related to running. This study aimed to investigate the gait pattern differences between males and females while running at different speeds, and to verify the relationship between GRFs and running speed among both males and females. Methods: GRF data were collected from forty-eight participants (thirty male runners and eighteen female runners) while running on an overground runway at seven discrete speeds: 10, 11, 12, 13, 14, 15 and 16km/h. Results: The ANOVA results showed that running speed had a significant effect (p < 0.05) on GRFs, propulsive and vertical forces increased with increasing speed. An independent t-test also showed significant differences (p < 0.05) in vertical and anterior-posterior GRFs at all running speeds, specifically, female runners demonstrated higher propulsive and vertical forces than males during the late stance phase of running. Pearson correlation and stepwise multiple linear regression showed significant correlations between running speed and the GRF variables. Discussion: These findings suggest that female runners require more effort to keep the same speed as male runners. This study may provide valuable insights into the underlying biomechanical factors of the movement patterns at GRFs during running.

USING INERTIAL MEASUREMENT UNITS (IMUS) TO DETECT MOBILITY DECLINES IN MIDDLE-AGED INDIVIDUALS

Abstract Valid and reliable assessments of mobility are routinely used in clinics to track patient progress, assess the need for assistive devices, and predict risk of falling. These tests require patients to perform tasks that span varying degrees of difficulty so that therapists can observe changes in mobility and balance that can occur as a function of age and neurological disease. Evidence suggests that subtle gait changes which begin in middle-age can predict the future onset of mobility difficulties. However, standard clinical tests which rely on visual observation are designed to capture easily observable balance and gait problems in patients, rather than small changes that begin in middle-age. In this study we examined mobility changes that occur as a function of age using a common clinical test, the Functional Gait Assessment (FGA). Both middle aged (n=8) and young adult (n=12) participants completed the FGA while wearing small sensors, called inertial measurement units (IMUs). IMUs were placed on each ankle and the trunk to capture subtle differences in gait patterns. Participants also completed a health history questionnaire. Preliminary data suggest gait variability was increased in middle-aged adults (especially towards the end of the gait cycle), in the more difficult tasks. Subtle changes in gait velocity and leg acceleration during the swing phase of gait also appears to emerge by middle-age. Using IMUs to capture changes in gait patterns of middle-aged participants may help to identify those who are at future risk of having mobility difficulties and significant health risk.

Clinical gait analysis in older children with autism spectrum disorder

Individuals with autism spectrum disorder (ASD) often exhibit motor deficits that increase their risk of falls. There is a lack of understanding regarding gait biomechanics demonstrated by older children with ASD. The purpose of the study was to determine differences in gait patterns between older children with ASD and typically developing children. Eleven children with ASD and 11 age- and gender-matched typically developing children were recruited for the study. Participants walked on a force-instrumented treadmill at a constant speed (1.1 ​m/s ​- ​1.2 ​m/s) for five minutes (min). Participants performed maximal voluntary contractions to assess their knee muscular strength. Differences between individuals with ASD and matched control participants were examined through paired t-tests with a significance level of p ​≤ ​0.05. Individuals with ASD demonstrated a smaller knee extensor torque compared to controls (p ​= ​0.002). Participants with ASD exhibited a shorter stride length (p ​= ​0.04), a greater cadence (p ​= ​0.03), and a higher variation in stride width (p ​= ​0.04) compared to control participants. The individuals with ASD experienced a greater braking ground reaction force (p ​= ​0.03) during loading response. The results indicate older children with ASD develop a unique gait pattern signified by a reduced stride length, increased cadence, and an increase of variation in stride width. This unique gait pattern may represent a movement strategy used by the individuals with ASD to compensate for the weakness associated with their knee extensor muscles. Individuals with ASD who demonstrate these unique gait deviations may face reduced postural stability and an increased risk of fall-related injuries.

Implementation of relative phase analysis to evaluate continuous interlimb coordination and stability in individuals with lower limb loss: Design and protocol for a retrospective analysis

IntroductionThe number of people with lower limb loss continues to grow, though most research to date has been non-committal and lacks the appropriate clinical guidance required for proper prosthetic prescription....

A new method proposed for realizing human gait pattern recognition: Inspirations for the application of sports and clinical gait analysis

BackgroundFinding the best subset of gait features among biomechanical variables is considered very important because of its ability to identify relevant sports and clinical gait pattern differences to be explored under specific study conditions. This study proposes a new method of metaheuristic optimization-based selection of optimal gait features, and then investigates how much contribution the selected gait features can achieve in gait pattern recognition. MethodsFirstly, 800 group gait datasets performed feature extraction to initially eliminate redundant variables. Then, the metaheuristic optimization algorithm model was performed to select the optimal gait feature, and four classification algorithm models were used to recognize the selected gait feature. Meanwhile, the accuracy results were compared with two widely used feature selection methods and previous studies to verify the validity of the new method. Finally, the final selected features were used to reconstruct the data waveform to interpret the biomechanical meaning of the gait feature. ResultsThe new method finalized 10 optimal gait features (6 ankle-related and 4-related knee features) based on the extracted 36 gait features (85 % variable explanation) by feature extraction. The accuracy in gait pattern recognition among the optimal gait features selected by the new method (99.81 % ± 0.53 %) was significantly higher than that of the feature-based sorting of effect size (94.69 % ± 2.68 %), the sequential forward selection (95.59 % ± 2.38 %), and the results of previous study. The interval between reconstructed waveform-high and reconstructed waveform-low curves based on the selected feature was larger during the whole stance phase. SignificanceThe selected gait feature based on the proposed new method (metaheuristic optimization-based selection) has a great contribution to gait pattern recognition. Sports and clinical gait pattern recognition can benefit from population-based metaheuristic optimization techniques. The metaheuristic optimization algorithms are expected to provide a practical and elegant solution for sports and clinical biomechanical feature selection with better economy and accuracy.

Visual and vestibular integration in Parkinson's disease while walking

Postural control requires effective sensory integration. People with Parkinson's disease (PD) are reported to have impaired visual and vestibular perception. While self-motion perception is a key aspect of locomotion, visual-vestibular integration has not been directly characterized in people with PD during gait. We compared the ability of people with PD and healthy older adults (OA) to integrate multi-sensory information during straight-line walking in response to visual and vestibular perturbations, using continuous translations of the visual surround and galvanic vestibular stimulation within a virtual reality environment. We measured their endpoint deviations from midline and changes in gait parameters. We found that people with PD deviated more than OA when walking in a dark environment but did not show differences in deviations when walking in a virtual room with visual information. With visual and vestibular perturbations, people with PD did not differ from OA in endpoint deviations nor variabilities. However, people with PD did not adopt a more cautious gait when GVS was applied in a virtual room, unlike OA. Overall, we showed that people with mild PD did not perform worse than OA but did show differences in gait patterns, suggesting that visual-vestibular integration is relatively preserved during gait in PD.

Exploring variations in gait patterns and joint motion characteristics in school-aged children across different walking speeds: a comprehensive motion analysis study.

This study aimed to investigate differences in gait patterns among individuals with different walking speeds and identify the range of motion (ROM) and angular velocity for various joints during gait. Forty-five schoolchildren were randomly selected for this study. To capture their walking patterns, two FDR-AX700 4K HDR camcorders were positioned to observe the predetermined walkway. Each participant completed a 5-meter walk at various speeds, including slow, normal, and fast, while maintaining a straight stride. There were significantly higher ROM and angular velocity (p<0.05) at the hip, knee, and ankle joints across most stages of walking at a faster speed compared to slow and normal speeds. At the same time, the angular velocity was significantly higher at the hip joint during hip extension terminal stance at normal speed compared to slow and fast speeds (p<0.05, ƞ2 =0.74). Similarly, the ROM of knee flexion swing, ankle plantar flexion loading response, and ankle dorsiflexion midswing angular velocity were significantly higher during normal walking speed (p<0.05). Conversely, slow-speed walking showed significantly higher ROM at knee extension terminal swing (ƞ2=0.52) and ankle dorsiflexion terminal stance (ƞ2=0.78) (p<0.05). The results indicate that individuals with different walking speeds exhibit significant differences in gait patterns. Slower walking speeds resulted in lower gait velocity and different joint motions compared to faster walking speeds.

PATIENT-REPORTED OUTCOMES AND GAIT FOLLOWING PRIMARY AND REVISION TOTAL HIP ARTHROPLASTY

This study aimed to quantify self-reported outcomes and walking gait biomechanics in patients following primary and revision THA. The specific goals of this study were to investigate: (i) if primary and revision THA patients have comparable preoperative outcomes; and (2) if revision THA patients have worse postoperative outcomes than primary THA patients.Forty-three patients undergoing primary THA for osteoarthritis and 23 patients undergoing revision THA were recruited and followed longitudinally for their first 12 postoperative months. Reasons for revision were loosening (73%), dislocation (9%), and infection (18%). Patients completed the Hip dysfunction and Osteoarthritis Outcome Score (HOOS), and underwent gait analysis preoperatively, and at 3 and 12 months postoperatively. A 10 camera motion analysis system (V5 Vantage, Vicon, UK) recorded marker trajectories (100 Hz) during walking at self- selected speeds. A generic lower-body musculoskeletal model (Gait2392) was scaled using principal component analysis [1] and the inverse kinematics tool in Opensim 3.3 was used to compute joint angles for the lower limbs in the sagittal plane. Independent samples t-test were used to compare patient reported outcomes between the primary and revision groups at each timepoint. Statistical parametric mapping was used to compare gait patterns between the two groups at each timepoint.Preoperatively, patients undergoing primary THA reported significantly worse pain (p&lt;0.001), symptoms (p&lt;0.001), function (p&lt;0.001), and quality of life (p=0.004). No differences were observed at 3 and 12 months postoperatively between patients who had received a primary or revision THA. The only observed difference in gait pattern was that patients with a revision THA had reduced hip extension at 3 months, but no differences were observed preoperatively and 12 months.Despite the suggestions in the literature that revision THA is bound to have worse outcomes compared to primary THA, we found no differences in in patient-reported outcomes and gait patterns at 12 months postoperatively. This suggests that it may be possible, in some circumstances, for patients following revision THA to achieve similar outcomes to their peers undergoing primary THA.

Comparative Analysis of the Components of a Child's Gait Pattern with Flat Foot Disorder

Flat foot is a condition that generally occurs in children. Flat-foot is a condition where the entire foot is on the ground. The condition of a flat foot often does not show symptoms because in pre-school children, this condition remains a physiological condition. However, this condition will become pathological if it continues with age. The gait pattern is a structured movement carried out by a person to move and have a step distance, speed, and footprints. This study aimed to determine the gait pattern of normal-foot children and flat-foot children between the ages of 4-6 years at PAUD Sahabat Ananda Dau. The method used is a case-control two-group test on 23 children who have met the inclusion and exclusion criteria at PAUD Sahabat Ananda Dau in March 2022. Measurements of the wet footprint test, Clarke‘s angle, and gait parameters were out after obtaining approval from the respondents. \ It was found that respondents with flat-foot were 57%. Based on the T2 Sample Independent Test, the results obtained on stride was p=0.263, step right was p=0.235, step left was p=0.69, cadence p=0.7, and speed p=0.311(p&lt;0,05). It was discovered that there is no difference in gait pattern in normal foot and flat foot children aged 4-6 years at PAUD Sahabat Ananda Dau.&#x0D; Keywords: normal arch, flat foot, Gait pattern, Gait parameter, preschool children

Gender Differences in Gait Parameters of Healthy Adult Individuals

Background and Purpose: Anatomical and biomechanical differences between male and female are also known to cause differences in gait patterns. However, the results of the studies are contradictory. Furthermore, these studies focused only on some of the spatiotemporal parameters, and pelvic movements were not analyzed. The aim of the present study is to reveal the difference in gait parameters between male and female. Methods: 44 female and 39 males were included in the study. BTS G-Walk system was used to evaluate the gait. After the accelerometer was placed, the participants were asked to walk 8 m. Spatiotemporal parameters and pelvic kinematics were recorded. Results: Given the spatiotemporal parameters, it was found that male and female were similar in terms of speed, % stride length and step length (p&gt;0.05), while gait cycle duration, stride length, swing phase and single support phases were higher in male; and stance phase, first double support phases, cadence were found to be higher in female (p0.05), while pelvic tilt total range was higher in male and obliquity total range was higher in female (p

An exploratory study of clinical characteristics and gait features of adolescents with hypermobility disorders

BackgroundIn adolescents with non-pathological and pathological joint hypermobility, gait deviations have been associated with pain and fatigue. It remains unclear what distinguishes the non-pathological form of joint hypermobility (JH) from pathological forms (i.e. hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorders (HSD). Our objective was to identify discriminative clinical characteristics and biomechanical gait features between adolescents with hEDS/HSD, JH, and healthy controls (HC). MethodsThirty-two adolescents were classified into three subgroups (hEDS/HSD=12, JH=5, HC=15). Clinical characteristics (e.g. pain intensity and surface, fatigue, functional disability) were inventoried.The gait pattern was assessed using a three-dimensional, eight-camera VICON MX1.3 motion capture system, operating at a sample rate of 100 Hz (VICON, Oxford, UK). Spatiotemporal parameters, joint angles (sagittal plane), joint work, joint impulse, ground reaction force and gait variability expressed as percentage using Principal Component Analysis (PCA) were assessed and analysed using multivariate analysis. Multivariate analysis data is expressed in mean differences(MD), standard error(SE) and P-values. ResultsThe hEDS/HSD-group had significantly higher fatigue score (+51.5 points, p = <0.001) and functional disability (+1.6, p < .001) than the HC-group. Pain intensity was significantly higher in the hEDS/HSD-group than the other subgroups (JH; +37 mm p = .004, HC; +38 mm, p = .001). The hEDS/HSD-group showed significantly more gait variability (JH; +7.2(2.0)% p = .003, HC; + 7.8(1.4)%, p = <0.001) and lower joint work (JH; −0.07(0.03)J/kg, p = .007, HC; − 0.06(0.03)J/kg, p = .013) than the other subgroups. The JH-group showed significantly increased ankle dorsiflexion during terminal stance (+5.0(1.5)degree, p = .001) compared to hEDS/HSD-group and knee flexion during loading response compared to HC-group (+5.7(1.8) degree, p = .011). SignificanceA distinctive difference in gait pattern between adolescents with non-pathological and pathological joint hypermobility is found in gait variability, rather than in the biomechanical features of gait. This suggests that a specific gait variability metric is more appropriate than biomechanical individual joint patterns for assessing gait in adolescents with hEDS/HSD.

Effect of gait training using Welwalk on gait pattern in individuals with hemiparetic stroke: a cross-sectional study.

We aimed to explore the effect of gait training using Welwalk on gait patterns by comparing differences in gait patterns between robotic-assisted gait training using Welwalk and gait training using an orthosis in individuals with hemiparetic stroke. This study included 23 individuals with hemiparetic stroke who underwent gait training with Welwalk combined with overground gait training using an orthosis. Three-dimensional motion analysis on a treadmill was performed under two conditions for each participant: during gait training with Welwalk and with the ankle-foot orthosis. The spatiotemporal parameters and gait patterns were compared between the two conditions. The affected step length was significantly longer, the step width was significantly wider, and the affected single support phase ratio was significantly higher in the Welwalk condition than in the orthosis condition. The index values of abnormal gait patterns were significantly lower while using Welwalk than in the orthosis condition. The following four indices were lower in the Welwalk condition: contralateral vaulting, insufficient knee flexion, excessive hip external rotation during the paretic swing phase, and paretic forefoot contact. Gait training using Welwalk increased the affected step length, step width, and single support phase while suppressing abnormal gait patterns as compared to gait training using the ankle-foot orthosis. This study suggests that gait training using Welwalk may promote a more efficient gait pattern reacquisition that suppresses abnormal gait patterns. Prospectively registered in the Japan Registry of Clinical Trials (https://jrct.niph.go.jp; jRCTs042180152).

Direct Ryanodine Receptor-2 Knockout in Primary Afferent Fibers Modestly Affects Neurological Recovery after Contusive Spinal Cord Injury.

Neuronal ryanodine receptors (RyR) release calcium from internal stores and play a key role in synaptic plasticity, learning, and memory. Dysregulation of RyR function contributes to neurodegeneration and negatively impacts neurological recovery after spinal cord injury (SCI). However, the individual role of RyR isoforms and the underlying mechanisms remain poorly understood. To determine whether RyR2 plays a direct role in axonal fate and functional recovery after SCI, we bred Advillin-Cre: tdTomato (Ai9) reporter mice with "floxed" RyR2 mice to directly knock out (KO) RyR2 function in dorsal root ganglion neurons and their spinal projections. Adult 6- to 8-week-old RyR2KO and littermate controls were subjected to a contusive SCI and their dorsal column axons were imaged in vivo using two-photon excitation microscopy. We found that direct RyR2KO in dorsal column primary afferents did not significantly alter secondary axonal degeneration after SCI. We next assessed behavioral recovery after SCI and found that direct RyR2KO in primary afferents worsened open-field locomotor scores (Basso Mouse Scale subscore) compared to littermate controls. However, both TreadScan™ gait analysis and overground kinematic gait analysis tests revealed subtle, but no fundamental, differences in gait patterns between the two groups after SCI. Subsequent removal of spared afferent fibers using a dorsal column crush revealed similar outcomes in both groups. Analysis of primary afferents at the lumbar (L3-L5) level similarly revealed no noticeable differences between groups. Together, our results support a modest contribution of dorsal column primary afferent RyR2 in neurological recovery after SCI.

Child And Adolescent Hamstrings:Quadriceps Strength Ratio Effects On Running Biomechanics

PURPOSE: There is limited research on strength and gait biomechanics implications in young runners. The purpose of this study was to assess the relationship of hamstrings-to-quadriceps strength (H:Q) ratio with mass-adjusted peak ground reaction force (GRF), and percentage of gait spent in stance phase (stance%) in children and adolescents. METHODS: Healthy runners age 9-21 years who received anthropomorphic measures, isometric muscle strength testing using hand-held dynamometry, and a running gait analysis on force plate treadmill were included. Linear regressions were used to assess the relationship between H:Q ratio with GRF and stance% by age and sex. Independent t-tests were used to compare strength measures by H:Q ratio symmetry (more symmetric: ≥0.6; less symmetric: <0.6). RESULTS: Data from 796 athletes was analyzed; most were 14-17 years old (48.2%) and females (71%). Those with less symmetric H:Q ratio had significantly weaker hamstrings (Mean Difference: 5.90 Nm [0.33], p = 0.04), however there were equivocal quadriceps measures regardless of H:Q symmetry (p = 0.16). H:Q ratio was inversely associated with mass-adjusted GRF, and directly associated with stance%. Interaction effects were seen between age, sex, and H:Q ratio (Table). CONCLUSIONS: In this young runner population, variance in the H:Q ratio was primarily attributable to relative hamstring weakness. H:Q ratio was inversely associated with mass-adjusted GRF and directly associated with stance%, both running biomechanics features which have been associated with injury risk. Unique gait pattern differences between sexes and developmental levels were identified.