Increase In Cadence Research Articles

Freely Chosen Cadence During Cycling Attenuates Intracortical Inhibition and Increases Intracortical Facilitation Compared to a Similar Fixed Cadence

In contrast to other rhythmic tasks such as running, the preferred movement rate in cycling does not minimize energy consumption. It is possible that neurophysiological mechanisms contribute to the choice of cadence, however this phenomenon is not well understood. Eleven participants cycled at a fixed workload of 125 W and different cadences including a freely chosen cadence (FCC, ∼72), and fixed cadences of 70, 80, 90 and 100 revolutions per minute (rpm) during which transcranial magnetic stimulation (TMS) was used to measure short interval intracortical inhibition (SICI) and intracortical facilitation (ICF). There was a significant increase in SICI at 70 (P = 0.004), 80 (P = 0.008) and 100 rpm (P = 0.041) compared to FCC. ICF was significantly reduced at 70 rpm compared to FCC (P = 0.04). Inhibition-excitation ratio (SICI divided by ICF) declined (P = 0.014) with an increase in cadence. The results demonstrate that SICI is attenuated during FCC compared to fixed cadences. The outcomes suggest that the attenuation of intracortical inhibition and augmentation of ICF may be a contributing factor for FCC.

Balance Training in Older Adults Using Exergames: Game Speed and Cognitive Elements Affect How Seniors Play.

Falls in older adults are a serious threat to their health and independence, and a prominent reason for institutionalization. Incorrect weight shifts and poor executive functioning have been identified as important causes for falling. Exergames are increasingly used to train both balance and executive functions in older adults, but it is unknown how game characteristics affect the movements of older adults during exergaming. The aim of this study was to investigate how two key game elements, game speed, and the presence of obstacles, influence movement characteristics in older adults playing a balance training exergame. Fifteen older adults (74 ± 4.4 years) played a step-based balance training exergame, designed specifically for seniors to elicit weight shifts and arm stretches. The task consisted of moving sideways to catch falling grapes and avoid obstacles (falling branches), and of raising the arms to catch stationary chickens that appeared above the avatar. No steps in anterior-posterior direction were required in the game. Participants played the game for eight 2 min trials in total, at two speed settings and with or without obstacles, in a counterbalanced order across participants. A 3D motion capture system was used to capture position data of 22 markers fixed to upper and lower body. Calculated variables included step size, step frequency, single leg support, arm lift frequency, and horizontal trunk displacement. Increased game speed resulted in a decrease in mean single support time, step size, and arm lift frequency, and an increase in cadence, game score, and number of error messages. The presence of obstacles resulted in a decrease in single support ratio, step size, cadence, frequency of arm lifts, and game score. In addition, step size increased from the first to the second trial repetition. These results show that both game speed and the presence of obstacles influence players' movement characteristics, but only some of these effects are considered beneficial for balance training whereas others are detrimental. These findings underscore that an informed approach is necessary when designing exergames so that game settings contribute to rather than hinder eliciting the required movements for effective balance training.

Biomechanics of handcycling propulsion in a 30-min continuous load test at lactate threshold: Kinetics, kinematics, and muscular activity in able-bodied participants.

This study aims to investigate the biomechanics of handcycling during a continuous load trial (CLT) to assess the mechanisms underlying fatigue in upper body exercise. Twelve able-bodied triathletes performed a 30-min CLT at a power output corresponding to lactate threshold in a racing recumbent handcycle mounted on a stationary ergometer. During the CLT, ratings of perceived exertion (RPE), tangential crank kinetics, 3D joint kinematics, and muscular activity of ten muscles of the upper extremity and trunk were examined using motion capturing and surface electromyography. During the CLT, spontaneously chosen cadence and RPE increased, whereas crank torque decreased. Rotational work was higher during the pull phase. Peripheral RPE was higher compared to central RPE. Joint range of motion decreased for elbow-flexion and radial-duction. Integrated EMG (iEMG) increased in the forearm flexors, forearm extensors, and M. deltoideus (Pars spinalis). An earlier onset of activation was found for M. deltoideus (Pars clavicularis), M. pectoralis major, M. rectus abdominis, M. biceps brachii, and the forearm flexors. Fatigue-related alterations seem to apply analogously in handcycling and cycling. The most distal muscles are responsible for force transmission on the cranks and might thus suffer most from neuromuscular fatigue. The findings indicate that peripheral fatigue (at similar lactate values) is higher in handcycling compared to leg cycling, at least for inexperienced participants. An increase in cadence might delay peripheral fatigue by a reduced vascular occlusion. We assume that the gap between peripheral and central fatigue can be reduced by sport-specific endurance training.

Adaptive Control of Dynamic Balance across the Adult Lifespan.

The ability to adapt dynamic balance to perturbations during gait deteriorates with age. To prevent age-related decline in adaptive control of dynamic balance, we must first understand how adaptive control of dynamic balance changes across the adult lifespan. We examined how adaptive control of the margin of stability (MoS) changes across the lifespan during perturbed and unperturbed walking on the split-belt treadmill. Seventy-five healthy adults (age range, 18-80 yr) walked on an instrumented split-belt treadmill with and without split-belts. Linear regression analyses were performed for the mediolateral (ML) and anteroposterior (AP) MoS, step length, single support time, step width, double support time, and cadence during unperturbed and perturbed walking (split-belt perturbation), with age as predictor. Age did not significantly affect dynamic balance during unperturbed walking. However, during perturbed walking, the ML MoS of the leg on the slow belt increased across the lifespan due to a decrease in bilateral single support time. The AP MoS did not change with aging despite a decrease in step length. Double support time decreased and cadence increased across the lifespan when adapting to split-belt walking. Age did not affect step width. Aging affects the adaptive control of dynamic balance during perturbed but not unperturbed treadmill walking with controlled walking speed. The ML MoS increased across the lifespan, whereas bilateral single support times decreased. The lack of aging effects on unperturbed walking suggests that participants' balance should be challenged to assess aging effects during gait. The decrease in double support time and increase in cadence suggests that older adults use the increased cadence as a balance control strategy during challenging locomotor tasks.

Effects of Low-Dye Taping Applied to Chronic Stroke Patients on Gat Speed

Background/Objectives: This study examines the effects of the normal biomechanical maintenance of the feet through Low-Dye taping on the gait treatment in chronic stroke patients and presents the basis of clinical intervention.Method/Statistical Analysis: In this study, 5 cm-wide elastic tapings was applied to improve gait ability in 20 chronic stroke patients. Low-Dye taping was applied for foot alignment. Gait was measured by BTS G-walk (G-walk, BTS, Italy). In this study, taping was applied after the initial assessment, and post measurement was performed after 30 min of taping to examine the immediate effects of taping on the gait parameters. The main outcome of this study is gait speed, and the secondary outcomes are cadence and stride length.Findings: The research group showed significant increases in gait speed and cadence except for the stride length at 30 min after applying the taping.Improvements/Applications: After applying the Low-Dye taping to chronic stroke patients, their gait speed and cadence showed significant differences due to the effects of ankle joint alignment and medial longitudinal arch lift and support. Therefore, Low-Dye taping was effective in improving the gait ability of chronic stroke patients.

Association of walking cadence with knee adduction angular impulse while controlling for speed in patients with knee osteoarthritis

Purpose: Walking cadence and speed are correlated and may affect knee loading in different ways. Previous research suggests higher walking cadence at baseline is associated with less structural progression of knee osteoarthritis (OA), presumably due to lower cumulative knee loading. The knee adduction angular impulse during walking is a surrogate measure of medial compartment load throughout stance and is associated with greater knee OA progression and knee pain. Thus, we aimed to test the hypothesis that higher walking cadence is associated with lower knee adduction angular impulse, while controlling for walking speed, in patients with medial knee OA. Methods: We analyzed existing data from 691 patients with medial compartment knee OA and varus alignment who participated in studies investigating rehabilitative and surgical interventions. The mean age and body mass index were 47±9 years and 30±5 kg/m2, respectively. All patients had undergone a baseline 3D quantitative gait analysis at preferred walking speed and cadence. Analyses included spatiotemporal characteristics and external knee joint moments. We used multivariate linear regression to test the association of cadence with knee adduction angular impulse while controlling for walking speed. We repeated the regression analyses while sequentially replacing the dependent variable knee adduction angular impulse with the first peak knee adduction moment, second peak knee adduction moment, peak knee flexion moment and peak vertical ground reaction force. We also repeated these analyses separately for females (n=163) and males (n=528). Lastly, we split the cohort into higher (n=462) and lower (n=229) cadence groups based on a cut-point of 100 steps/min - the minimum recommended walking cadence for adults - and plotted their adjusted means using analysis of covariance controlling for walking speed. Results: Mean ± SD for cadence, speed and knee adduction angular impulse were 1.10±0.19 m/s, 103±10 steps/min, 1.59±0.56 %BW.Ht.s; respectively. While controlling for walking speed, cadence was negatively associated with knee adduction angular impulse (unstandardized B [95% CI], p-value = -0.020 [-0.027 to -0.015], p<0.001), suggesting every 1 step/min increase in cadence was associated with a 0.02 %BW.Ht.s decrease in knee adduction angular impulse. For example, an increase in cadence of 20 steps/min (e.g. from 100 to 120 steps/min) was associated with a decrease in knee adduction angular impulse of 0.4 %BW.Ht.s (e.g. from 1.6 to 1.2 %BW.Ht.s), and when described in terms of the percent changes from the present sample means, this translated to a 20% increase in cadence associated with a 25% decrease in knee adduction angular impulse. The association was slightly higher in females (-0.028 [-0.039 to -0.016], p<0.001) than males (-0.017 [-0.024 to -0.009], p<0.001). While controlling for walking speed, cadence was also negatively associated with other surrogate measures of knee loading (Table 1). Adjusted means for higher and lower cadence groups are shown in Figure 1, illustrating that patients with medial knee OA walking with higher cadence (109±6 steps/min) have lower knee adduction angular impulse than patients walking at the same speed but with lower cadence 92±7 steps/min) (adjusted knee adduction angular impulse mean difference [95% confidence interval]: -0.27 %BW.Ht.s [-0.37 to -0.16]). Conclusions: In patients with medial knee OA, when controlling for walking speed, higher walking cadence is associated with lower knee adduction angular impulse. Although lower in size, the negative association of cadence remained with other surrogate measures of knee loading while controlling for walking speed. Future prospective studies should investigate the hypothesis that gait retraining to increase cadence at a given walking speed has beneficial biomechanical and clinical effects in patients with knee OA.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

An Omnidirectional Assistive Platform Integrated With Functional Electrical Stimulation for Gait Rehabilitation: A Case Study.

This paper presents a novel omnidirectional platform for gait rehabilitation of people with hemiparesis after stroke. The mobile platform, henceforth the "walker", allows unobstructed pelvic motion during walking, helps the user maintain balance and prevents falls. The system aids mobility actively by combining three types of therapeutic intervention: forward propulsion of the pelvis, controlled body weight support, and functional electrical stimulation (FES) for compensation of deficits in angular motion of the joints. FES is controlled using gait data extracted from a set of inertial measurement units (IMUs) worn by the user. The resulting closed-loop FES system synchronizes stimulation with the gait cycle phases and automatically adapts to the variations in muscle activation caused by changes in residual muscle activity and spasticity. A pilot study was conducted to determine the potential outcomes of the different interventions. One chronic stroke survivor underwent five sessions of gait training, each one involving a total of 30 minutes using the walker and FES system. The patient initially exhibited severe anomalies in joint angle trajectories on both the paretic and the non-paretic side. With training, the patient showed progressive increase in cadence and self-selected gait speed, along with consistent decrease in double-support time. FES helped correct the paretic foot angle during swing phase, and likely was a factor in observed improvements in temporal gait symmetry. Although the experiments showed favorable changes in the paretic trajectories, they also highlighted the need for intervention on the non-paretic side.

A Step in the Right Direction: Body Location Determines Activity Tracking Device Accuracy in Total Knee and Hip Arthroplasty Patients.

Step counts measured by activity monitoring devices (AMDs) and smartphones (SPs) can objectively measure a patient's activity levels after total hip and knee arthroplasty (total joint arthroplasty [TJA]). This study investigated the use and optimal body location of AMDs and SPs to measure step counts in the postoperative period. This was a two-armed, prospective, observational study of TJA inpatients (n = 24) and 2-week status after TJA (n = 25) completing a 100-ft walk. Observer-counted steps were compared with those measured by AMDs (wrist and ankle) and SPs (hip and neck). Acceptable error was defined as <30%. Error rates were treated as both dichotomous and continuous variables. AMD and SP step counts had overall unacceptable error in TJA inpatients. AMDs on the contralateral ankle and SPs on the contralateral hip had error rates less than 30% at 2 weeks postoperatively. Two-week postoperative patients required lower levels of assist (11/25 walker; 4/25 no assist), and significant improvements in stride length (total hip arthroplasty 1.27 versus 1.83 ft/step; total knee arthroplasty 1.42 versus 1.83 ft/step) and cadence (total hip arthroplasty 74.6 versus 166.0 steps/min; total knee arthroplasty 73.5 versus 144.4 steps/min) were seen between inpatient and postoperative patients. Regression analysis found that increases in postoperative day and cadence led to a decrease in device error. In inpatients with TJA, AMDs and SPs have unacceptable variability and limited utility for step counting when using a walker. As gait normalizes and the level of ambulatory assist decreases, AMDs on the contralateral ankle and SPs on the contralateral hip demonstrated low error rates. These devices offer a novel method for measurement of objective outcomes and potential for remote monitoring of patient progress after TJA. Level II, prospective, three-armed study, prognostic study.

Design, Control, and Pilot Study of a Lightweight and Modular Robotic Exoskeleton for Walking Assistance After Spinal Cord Injury

Abstract Walking rehabilitation using exoskeletons is of high importance to maximize independence and improve the general well-being of spinal cord injured subjects. We present the design and control of a lightweight and modular robotic exoskeleton to assist walking in spinal cord injured subjects who can control hip flexion, but lack control of knee and ankle muscles. The developed prototype consists of two robotic orthoses, which are powered by a motor-harmonic drive actuation system that controls knee flexion–extension. This actuation module is assembled on standard passive orthoses. Regarding the control, the stance-to-swing transition is detected using two inertial measurement units mounted on the tibial supports, and then the corresponding motor performs a predefined flexion–extension cycle that is personalized to the specific patient’s motor function. The system is portable by means of a backpack that contains an embedded computer board, the motor drivers, and the battery. A preliminary biomechanical evaluation of the gait-assistive device used by a female patient with incomplete spinal cord injury at T11 is presented. Results show an increase of gait speed (+24.11%), stride length (+7.41%), and cadence (+15.56%) when wearing the robotic orthoses compared with the case with passive orthoses. Conversely, a decrease of lateral displacement of the center of mass (−19.31%) and step width (−13.37% right step, −8.81% left step) are also observed, indicating gain of balance. The biomechanical assessment also reports an overall increase of gait symmetry when wearing the developed assistive device.

The use of Akatinol Memantine in the treatment of gait disturbances in Parkinson's disease

To assess the efficacy of memantine hydrochloride in the treatment of GD in PD patients. Patients of the main group (n=30) received memantine hydrochloride (akatinol memantine) in a dose of 20 mg/day for 3 months in addition to antiparkinsonian therapy. Patients of the comparison group (n=25) received only antiparkinsonian drugs. Cognitive rating scales and computerized gait assessment protocol were performed in both groups twice in 3 months interval in order to examine cognitive deficit and gait parameters. The increase in MMSE scores, improvement in gait cycle phases ratio and increase of cadence according to computerized gait analysis were observed in the main group compared to the comparison group. The improvement in gait achieved during the study confirms that the treatment of cortical gait disturbances in patients with PD using memantine hydrochloride is a promising area of therapy.

Immediate Effects of Frequency-dependent Electrotherapy on the Gait and Ankle Range of Motion of Chronic Stroke Patients

Transcutaneous electrical nerve stimulation and interferential current therapy were applied to the plantar flexor of the stroke patients, and the immediately effects on gait and ankle ROM were investigated. TENS group (n=15) and ICT group (n=15) were applied to the paretic side plantar flexor, respectively. After 60 minutes of application, evaluation of the gait and passive ankle dorsiflexion range of motion (ROM) using smartphone. After 60 minutes of application, immediate post evaluation was carried out. Two electrotherapy methods showed a significant increase in gait speed, cadence, and ankle ROM. Two electrotherapy methods were intervention methods that could increase the gait and ankle ROM of stroke patients. More subjects will be needed to pinpoint differences between the two electrotherapy methods.

Multidimensional evaluation of changes in limb function following botulinum toxin injection in persons with stroke.

There are limited evidence of instrumented measures of gait and balance to determine the functional effects of botulinum toxin injections (BoNT-A) in spasticity after stroke. To evaluate the functional changes in gait and balance following upper limb and lower limb BoNT-A in persons with stroke. A pre-post prospective study of 35 stroke patients with upper and/or lower limb spasticity after focal treatment with BoNT-A. Assessments were at baseline (T0), 6-weeks (T1) and 12-weeks (T2), using validated subjective and objective physical activity measures. After BoNT-A injections, significant improvements in most measures of impairments, activity and participation domains were found at T1 (p < 0.05, effect sizes (r) = 0.5-0.9). There was a significant increase in low intensity physical activity (at T1) and sedentary time reductions at both follow-up periods. Instrumented gait/balance measures showed a significant increase in cadence and turn velocity, but no changes in sway measures were found using posturography. Improvements in most outcome measures were maintained at 12-weeks. BONT-A improved scores in most clinical measures but only in some of the objective gait/balance and physical activity measures. Further robust studies should utilize a larger sample size to better determine the benefits of BoNT-A for stroke-related spasticity.

47. The effect of surgical decompression on spine and lower extremity range of motion during gait in patients with cervical spondylotic myelopathy

BACKGROUND CONTEXT Cervical spondylotic myelopathy (CSM) is a neurologic condition resulting from spinal cord compression due to degenerative narrowing of the spinal canal. It is the most common cause of spinal cord dysfunction in patients older than 50. Symptoms of CSM may include numbness or weakness in the extremities, loss of fine motor dexterity, and difficulty with balance and gait. The natural history is typically one of progressive decline in neurologic function, so surgery to decompress the spinal cord is generally indicated to prevent progression in symptomatic patients. Despite the prevalence of this condition, relatively little quantitative kinematic information is available on the effect of surgical intervention on the gait of patients with CSM. PURPOSE To evaluate for changes in the spine and lower extremity range of motion (RoM) during gait in patients with CSM before and after surgical intervention. STUDY DESIGN/SETTING Non-randomized, prospective, concurrent cohort study. PATIENT SAMPLE Thirty-eight patients with symptomatic CSM. OUTCOME MEASURES Lower extremity and spine range of motion (RoM), spatiotemporal parameters, and pain level. METHODS Clinical gait analysis was performed one week before surgery (Pre) and three months after surgery (Post). Fifty reflective markers (9.5 mm diameter) attached to the patients; bodies were utilized to collect full body three-dimensional kinematics using 10 cameras (VICON) at a sampling rate of 100 Hz. Each patient performed a series of over-ground gait trials at a comfortable, self-selected speed. Neck and mid-back visual analog scale (VAS), Oswestry Disability Index (ODI), and Neck Disability Index (NDI) scores were also collected at both time points. Repeated measurements ANOVA was used to analyze data. RESULTS When comparing preoperative to postoperative gait parameters, significant increases in walking cadence (98.28 vs 103.37 steps/minutes, p=0.004), stride length (1.02 vs 1.07 m, p=0.018), and walking speed (0.86 vs 0.94 m/s, p=0.001) were observed. The amount of time spent in double support decreased after surgery (0.37 vs 0.32 s, p=0.032). The only significant difference in spine and lower extremity joint RoM measures was a decline in coronal RoM of both the knees and ankles postoperatively. VAS neck and mid-back as well as ODI improved significantly postoperatively, while the reduction in NDI did not attain statistical significance. CONCLUSIONS Despite conventional teaching that the goal of surgical intervention for CSM is to halt symptomatic progression, the data presented here demonstrate that significant improvements in gait are frequently observed after surgical management of CSM. Postoperative patients walk more quickly as a result of increased stride length and cadence. Furthermore, they lift their knees and dorsiflex/plantarflex their ankles less, consistent with a more efficient gait pattern. While surgeons should remain conservative with respect to how they counsel patients and set expectations preoperatively, cautious optimism regarding improvements in gait may be warranted in the setting of surgery for CSM. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Impact of Graded Passive Cycling on Hemodynamics, Brain, and Heart Perfusion in Healthy Adults.

Purpose: Passive in-bed cycling (PC) can provide the benefits of early mobilization to critically ill patients who are unable to exercise actively. However, the effect of PC on global hemodynamics and perfusion of ischemia-prone organs, such as the brain and the heart, is unknown. Therefore, prior to studying the effects of PC in hemodynamically fragile critically ill patients, we characterized hemodynamic, brain blood flow, and cardiac function responses to a graded increase in PC cadence in a cohort of healthy subjects.Methods: We measured global hemodynamic indices, middle cerebral artery velocity (MCAv), and cardiac function in response to a graded increase in PC cadence. Using 5 min stages, we increased cadence from 5 to 55 RPM in increments of 10 RPM, preceded and followed by 5 min baseline and recovery periods at 0 RPM. The mean values obtained during the last 2 min of each stage were compared within and between subjects for all metrics using repeated measures ANOVA.Results: 11 healthy subjects (6 females) completed the protocol. Between subjects, there was no change in MCAv, cardiac function or hemodynamics with the graded increase in cadence with one exception. There was a 7% increase in mean arterial pressure (MAP) from baseline to 55RPM, that persisted through the recovery period. Across subjects, responses were heterogeneous, with some experiencing reduction in cardiac index, cerebral blood flow (CBF) and cardiac function, especially at higher cadence.Conclusions: In healthy adults, increasing PC cadence increased MAP in all subjects, while cardiac index, CBF, and cardiac function responses varied between subjects. Application of PC to critically ill patients must therefore consider individual variation in responses and tailor the PC to the patient. It is essential to further characterize these responses to PC in the critically ill prior to wide-scale clinical implementation.

Clinical and biomechanical foundation of application of the exoskeleton Exoatlet at walking of patients with poststroke disturbances

Influence of training in the exoskeleton on the biomechanical and innervative structure of walking of patients with the ischemic stroke has been revealed for the first time in Russia. It has been established that the most expressed locomotor disturbances in patients with the ischemic stroke are seen in combination of recurvation (hyperextension) at a knee joint with equinus deformation of the foot, which is characterized by its stable plantar flexion or equinovarus deformation of the foot and ankle joint (invertion inside and plantar flexion of the foot). Biomechanical and innervative structure of walking in 5 patients with consequences of the ischemic stroke in 3‒4 months after the beginning of the disease has been considered. The main disorders of the biomechanical structure of walking in these patients have been determined, namely, decrease of walking velocity, cadence and double step length, expressed asymmetry of the temporal, kinematic and dynamic parameters, disappearance of the separate phases of the locomotor cycle, change of the pattern of movements, reduction of the support and push functions of the lower extremities, remarkable transformation of electromyography pattern of muscles. Method of application of the exoskeleton in this contingent of patients has been demonstrated in this article, which includes determination of duration of the session of training, duration of the course, distance, which patient could walk for the session. It has been revealed, that the following changes take place after 10‒days course of training in the exoskeleton: increase of walking velocity, cadence and step length, complete elimination of the temporal asymmetry, growth of the support and push functions of the lower extremities, enhancement of amplitude of angular displacements at the joints of the lower extremities, inconsiderable improvements of electromyography pattern of muscles.

Transition to forefoot strike reduces load rates more effectively than altered cadence

BackgroundExcessive vertical impacts at landing are associated with common running injuries. Two primary gait-retraining interventions aimed at reducing impact forces are transition to forefoot strike and increasing cadence. The objective of this study was to compare the short- and long-term effects of 2 gait-retraining interventions aimed at reducing landing impacts. MethodsA total of 39 healthy recreational runners using a rearfoot strike and a cadence of ≤170 steps/min were randomized into cadence (CAD) or forefoot strike (FFS) groups. All participants performed 4 weeks of strengthening followed by 8 sessions of gait-retraining using auditory feedback. Vertical average load rates (VALR) and vertical instantaneous load rates (VILR) were calculated from the vertical ground reaction force curve. Both cadence and foot strike angle were measured using 3D motion analysis and an instrumented treadmill at baseline and at 1 week, 1 month, and 6 months post retraining. ResultsANOVA revealed that the FFS group had significant reductions in VALR (49.7%) and VILR (41.7%), and changes were maintained long term. Foot strike angle in the FFS group changed from 14.2° dorsiflexion at baseline to 3.4° plantarflexion, with changes maintained long term. The CAD group exhibited significant reduction only in VALR (16%) and only at 6 months. Both groups had significant and similar increases in cadence at all follow-ups (CAD, +7.2% to 173 steps/min; and FFS, +6.1% to 172 steps/min). ConclusionForefoot strike gait-retraining resulted in significantly greater reductions in VALR and similar increases in cadence compared to cadence gait-retraining in the short and long term. Cadence gait-retraining resulted in small reductions in VALR at only the 6-month follow-up.

Gait festination in parkinsonism: introduction of two phenotypes

Gait festination is one of the most characteristic gait disturbances in patients with Parkinson’s disease or atypical parkinsonism. Although festination is common and disabling, it has received little attention in the literature, and different definitions exist. Here, we argue that there are actually two phenotypes of festination. The first phenotype entails a primary locomotion disturbance, due to the so-called sequence effect: a progressive shortening of step length, accompanied by a compensatory increase in cadence. This phenotype strongly relates to freezing of gait with alternating trembling of the leg. The second phenotype results from a postural control problem (forward leaning of the trunk) combined with a balance control deficit (inappropriately small balance-correcting steps). In this viewpoint, we elaborate on the possible pathophysiological substrate of these two phenotypes of festination and discuss their management in daily clinical practice.

PO374 Comparison of Effects of a Comprehensive Cardiac Rehabilitation Program on Aerobic Capacity in Patients With Low Versus Normal Ejection Fraction In India

This study aimed to clarify the influence of various speeding strategies (i.e. adjustments of cadence and stride length) on external joint moments. This study investigated the gait of 52 healthy subjects who performed self-selected normal and fast speed walking trials in a motion analysis laboratory. Subjects were classified into three separate groups based on how they increased their speed from normal to fast walking: (i) subjects who increased their cadence, (ii) subjects who increased their stride length and (iii) subjects who simultaneously increased both stride length and cadence. Joint moments were calculated using inverse dynamics and then compared between normal and fast speed trials within and between three groups using spatial parameter mapping.Individuals who increased cadence, but not stride length, to walk faster did not experience a significant increase in the lower limb joint moments. Conversely, subjects who increased their stride length or both stride length and cadence, experienced a significant increase in all joint moments. Additionally, our findings revealed that increasing the stride length had a higher impact on joint moments in the sagittal plane than those in the frontal plane. However, both sagittal and frontal plane moments were still more responsive to the gait speed change than transverse plane moments. This study suggests that the role of speed in altering the joint moment patterns depends on the individual's speed-regulating strategy, i.e. an increase in cadence or stride length. Since the confounding effect of walking speed is a major consideration in human gait research, future studies may investigate whether stride length is the confounding variable of interest.

Features of the space-time characteristics of the gait of children and adolescents involved in sports

The study of the spatial and temporal characteristics of the gait of children and adolescents is an important task. The purpose of this study was to determine the spatial and temporal characteristics of the gait of children and adolescents of different age categories who systematically engage in sports.Methods. On motion capture complex Vicon in the Center for Collective Use "Three-dimensional study of the biomechanics of motion" of the Astrakhan State University, 43 children were examined: 22 children in the control group and 21 children in the study group.Results. Quantitative indicators of the spatial and temporal characteristics of the gait of children engaged in sports dancing were obtained and a comparative analysis of this data with the control group was carried out. An increase of walking speed and cadence, a decrease in the time of single and double support in male athletes in the 7-12 year old group was revealed; increased of walking speed and cadence, a marked decrease in the time of single support, a decrease in the limp index in female athletes in the 7-12 year old group; an increase the cadence in female athletes in the group of 12-15 years.Conclusions. Doing sport every day helps with the spatio-temporal changes of the walk among children and teenagers. The imbalance of the motor function is examined among girls, that doing sports between the age of 7-12, so that’s why it needs a special attention from doctors, traumatologist and orthopedists.

Effect of foam roller, kinesiotaping and dynamic stretching on gait parameters with induced ankle muscle fatigue

Objective: The purpose of this study was to investigate the effects of foam roller (FR) stretching, kinesiotaping (KT), and dynamic stretching (DS) on gait parameters after inducing muscle fatigue in the ankle joint. Design: Cross-sectional study. Methods: The subjects were thirty healthy young adults between the ages of 20 and 31 years at Baekseok University who voluntarily participated in this study. The participants were randomly assigned to either the FR group, KT group, or the DS group after inducing muscle fatigue of the ankle joint. Fatigue induction of the ankle joint muscles was performed by alternating a heel up and down exercise with the standing posture on the ground. The speed was maintained at 40 beats/minute using a metronome. Subsequently, the respective intervention was applied to each group. Gait parameters were measured before and after ankle muscle fatigue induction, and after intervention using the GAITRite system. One-way ANOVA was used to compare gait parameters among groups, while repeated measures ANOVA was used to compare gait parameters within each intervention group. Results: The FR group increased significantly in velocity, step length, and stride length except for cadence after intervention compared to after ankle muscle fatigue induction (p<0.01). Furthermore, the KT group showed significant increases in velocity, cadence, step length, and stride length after intervention, especially in cadence group (p<0.05). All intervention groups showed significant increases in stride length after intervention, especially the DS group (p<0.05). Conclusions: Therefore, we suggest that KT, FR, and DS can be an effective intervention on gait parameters when the ankle joint is unstable and injured.