Single Support Duration Research Articles

変形性股関節症患者の歩行について

The purpose of this study was to identify temporal gait parameters in coxarthrosis.In this report, gait analysis was performed on 20 patients (all females; mean age 61.2 years) who had total hip arthroplasty from May to September 2004.All patients were tested during "free" walking along an 5-m walkway in which a ground reaction force plate (gait scan 8000; Nitta, Inc.) was installed. Normal average values reported by Murray et al.2 ) were used. As an index of pain, the Japanese Orthopaedic Association (JOA) pain score was used.Single support duration was compared with the involved and normal legs. Single support duration of the involved leg decreased in 19 patients. Moreover, compared with normal values, in the normal leg, those of most patients remained unchanged. In the involved leg, single support duration of all patients decreased from the normal value. Single support duration of the involved leg decreased as JOA pain score decreased. Double support duration of both legs increased as JOA pain score decreased. The results of gait analysis can be used as an objective index of hip pain.

The effects of blurring vision on medio-lateral balance during stepping up or down to a new level in the elderly

Visual impairment is an important risk factor for falls, but relatively little is known about how it affects stair negotiation. The present study determined how medio-lateral (ML) dynamics of stepping and single limb support stability when stepping up or down to a new level were affected by blurring the vision of healthy elderly subjects. Twelve elderly subjects (72.3 +/- 4.2 years) were analysed performing single steps up and single steps down to a new level (7.2, 14.4 and 21.6 cm). Stepping dynamics were assessed by determining the ML ground reaction force (GRF) impulse, lateral position of the centre of mass (CM) relative to the supporting foot (average horizontal ML distance between CM and CP during single support) and movement time. Stability was determined as the rms fluctuation in ML position of the centre of pressure (CP) during single support. Differences between optimal and blurred visual conditions were analysed using a random effects model. Duration of double and single support, and the ML GRF impulse were significantly greater when vision was blurred, while the average CM-CP ML distance and ML stability was reduced. ML stability decreased with increasing step height and was further decreased when stepping down than when stepping up. These findings indicate that ML balance during stepping up and down was significantly affected by blurring vision. In particular, single limb support stability was considerably reduced, especially so during stepping down. The findings highlight the importance of accurate visual feedback in the precise control of stepping dynamics when stepping up or down to a new level, and suggest that correcting common visual problems, such as uncorrected refractive errors and cataract may be an important intervention strategy in improving how the elderly negotiate stairs.

The validity of the GaitRite and the Functional Ambulation Performance scoring system in the analysis of Parkinson gait1

The purpose of this study was (1) to determine the validity of the GaitRite System in detecting footfall patterns and selected gait characteristics of person with early stage Parkinson's disease (PD) and (2) to investigate whether the Functional Ambulation Performance (FAP) scoring system is a valid tool to distinguish between selected gait characteristics of patients with early stage Parkinson's disease and similar age of non-impaired individuals. The FAP score is a quantitative means of assessing gait based on specific spatial and temporal gait parameters. 11 volunteers with idiopathic Parkinson's disease, (mean age = 74.3), and 11 age matched volunteers, (mean age = 70.3), with no history of neurological disorder participated in the study. The non-impaired control group were not matched in age and sex but of similar age and males and females were represented in the control group. Temporal and spatial parameters of gait were analyzed for both preferred- speed and fast-speed walking using the computerized GaitRite system. The system integrates specific components of locomotion to provide a single, numerical representation of gait, the Functional Ambulation Performance Score (FAP) score. The most powerful and discriminating variable between Parkinson's and non-impaired groups for both walking speeds was the mean normalized velocity (MNV). Which is velocity divided by leg length. The MNV was 0.83 for PD at preferred walking speed and 1.14 at fast speed, the non-impaired group preferred-speed group walking was 1.33, while fast-speed walking MNV was 1.70. Note the fast walking of PD was slower than the preferred velocity of the non-impaired group. For preferred-speed walking, all gait variables analyzed in the study were different between the two groups beyond the p < 0.05 level of confidence with the single exception of right stance percentage. For fast-speed walking, three of the entered variables did not discriminate between the two groups: the fast walking FAP score, left fast-walking cadence, and right fast-walking single support percentage. Our results indicate that persons with Parkinson's disease (PD) attain a significantly lower FAP score when ambulating at their preferred rate and demonstrate shorter step length and a longer step time than the age matched non-impaired group during both preferred and fast velocities of walking. Stance duration and double support duration were increased for the Parkinson's population, whereas single support duration, mean cadence, and heel-to-heel base of support were markedly reduced for both walking speeds. The FAP score was significantly different from the non-impaired control group for preferred-speed walking. These results indicate that the GaitRite system can be useful in detecting footfall patterns and selected time and distance measurements of persons with early stage Parkinson's disease and the FAP score discriminates between the PD population and the non-impaired controls when walking at preferred rate but not at fast walking.

Temporal gait analysis of hip osteoarthritic patients operated with cementless hip replacement

Objective. This study attempts to identify temporal gait parameters, which characterize the pre- and postoperative course of hip monoarthritic patients who undergo cementless hip replacement. Background and methods. Twenty-five female hip monoarthritic subjects (mean age 51, SD 5.0) were studied preoperatively; 20 out of them were studied at 1 and 8–10 years after the operation with a 22-m conductive walkway system using telemetry. A gender-matched control group was also studied (mean age 60, SD 2.0). The assessed parameters are the gait cycle duration, the single and double support, the single step duration and the gait speed. Results. The results indicate that improvement in patients' conditions following the operation occurs rapidly during the first postoperative year. Yet the hip has not reached optimal performance 1 year postoperatively; 8–10 years later it seems to have reached its optimal performance and remains in good condition. However, it still is below that of the controls. Conclusions. Single support duration and speed are crucial in characterizing the functional restitution of patients after hip replacement. Relevance An orthopaedic surgeon who attempts to quantify the postoperative course of hip monoarthritic patients after cementless hip replacement can focus at those temporal factors, which are typical of the functional restitution after the operation, without losing any valuable information given by other values.

Comparing stepping-in-place and gait ability in adults with and without hemiplegia

Garcia RK, Nelson AJ, Ling W, Van Olden C. Comparing stepping-in-place and gait ability in adults with and without hemiplegia. Arch Phys Med Rehabil 2001;82:36-42. Objective: To determine and compare select temporal-distance measures of stepping-in-place with gait ability in 2 age-matched groups. Design: Repeated measures, matched research design. Setting: Gait laboratory and hospital outpatient unit. Participants: Convenience sample recruited from within the community and the outpatient unit of a local rehabilitation hospital included 30 healthy adults (age range, 58.1 ± 10.8yr) and 30 age-matched adults with hemiplegia (age range, 58.6 ± 10.3yr), secondary to a cerebrovascular accident. Interventions: Subjects were videotaped in the sagittal plane performing stepping-in-place and while walking. Select temporal-distance measures obtained by manual calculations from the video recordings were determined for 3 20-second trials of each activity. Main Outcome Measures: Single limb support duration (SLSD) of the lower extremities (LEs) and step frequency during stepping-in-place and during gait. Results: A significant difference was found between the step frequency of each activity for the adults with hemiplegia (p <.05), but not for the healthy adults. A significant difference was also found between SLSD of the same LE across activities for each group (p <.05). SLSD of each LE during each individual activity, stepping-in-place, or gait, was not significantly different for the healthy adults, indicating LE symmetry; but it was significantly different for the adults with hemiplegia (p <.05), indicating LE asymmetry. Conclusions: Stepping-in-place incorporates reciprocal, rhythmic LE movement patterns similar to gait. And, although SLSD of the LEs was different between the activities in both groups, each group showed similar LE movement patterns during each individual activity. In addition, step frequency was consistent between the activities for the healthy adults. These results seem to indicate that the reciprocal, rhythmic LE movement patterns, which are invoked during gait, may also be invoked during stepping-in-place. However, further research is needed to enhance the data related to stepping-in-place and gait ability in clinical populations. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Measurement of the temporal parameters of gait from slow motion video

Objective. This study attempts to identify temporal gait parameters, which characterize the pre- and postoperative course of hip monoarthritic patients who undergo cementless hip replacement.Background and methods. Twenty-five female hip monoarthritic subjects (mean age 51, SD 5.0) were studied preoperatively; 20 out of them were studied at 1 and 8–10 years after the operation with a 22-m conductive walkway system using telemetry. A gender-matched control group was also studied (mean age 60, SD 2.0). The assessed parameters are the gait cycle duration, the single and double support, the single step duration and the gait speed.Results. The results indicate that improvement in patients' conditions following the operation occurs rapidly during the first postoperative year. Yet the hip has not reached optimal performance 1 year postoperatively; 8–10 years later it seems to have reached its optimal performance and remains in good condition. However, it still is below that of the controls.Conclusions. Single support duration and speed are crucial in characterizing the functional restitution of patients after hip replacement.RelevanceAn orthopaedic surgeon who attempts to quantify the postoperative course of hip monoarthritic patients after cementless hip replacement can focus at those temporal factors, which are typical of the functional restitution after the operation, without losing any valuable information given by other values.

Rehabilitation After High Tibial Osteotomy and Unicompartmental Arthroplasty

Ten patients with medial gonarthrosis treated by unicompartmental arthroplasty were matched with ten patients who had high tibial osteotomy; their courses of rehabilitation were evaluated. All patients regained motion without problems, with no difference between the groups. Muscle torque was measured by a Cybex II dynamometer. The results six months postoperatively were better in the patients treated by unicompartmental arthroplasty than they were 12 months postoperatively in the patients treated by high tibial osteotomy. In the prosthesis group there was an increase in the maximal gait velocity and the duration of single support. In the osteotomy group there was no significant change. This difference in the results of rehabilitation constitutes an argument for arthroplasty in aged patients.

Evaluation of Out-patient Physiotherapy and a Home Exercise Program in the Management of Gait Asymmetry in Residual Stroke

This article investigates the relative effectiveness in the ways in which physiotherapy exercises are administered to patients with residual stroke. The exercises were designed to improve walking by increasing the ability of the affected limb to bear weight during the single support phase of the gait cycle and, therefore, to increase the duration of this phase, thereby making the gait pattern more symmetrical. Twenty patients were divided into four equal groups, one of which acted as a control, receiving no treatment. The other three groups received exercises for two 1-h sessions per week supervised by a physiotherapist in an outpatient facility (group A), by a spouse or companion at home (group B), or by a combination of these (group C). Treatment was given for 6 months with assessments at monthly intervals during and for 3 months posttreatment. Results from this study indicate that on any given visit there were no differences between any of the four groups with respect to increasing the duration of single support on the affected side nor gait symmetry nor walking speed. When each group was compared to pretest data, only walking speed was found to increase significantly, but even this improvement, seen only in the treatment groups, was inconsistent and not maintained. The possible reasons for these results and their implications for rehabilitation are discussed.