Selected Walking Speed Research Articles

Functional Classification Spaces according to walking speed in self-sufficient Chilean older adults: A complement to the Periodic Physical Examination.

Walking speed is related to functionality in daily activities. Preventive Medicine Examination of the Chilean older adults is a vital prevention program for Chilean community- dwelling older adults. However, this evaluation does not include speed in its battery of tests. To evaluate the functional classification spaces for threshold, reference, and categorization val-ues of self- selected and maximum walking speed applied to self- sufficient older adults. Seventy- two self- sufficient older adults participated in this observational, exploratory, and cross- sectional study. Each participant was asked to walk naturally and then at full speed for three minutes. Through a dispersion graph between self- selected walking speed (axis "x") and maximum walking speed (axis "y"), functional classification spaces were constructed according to documented values for i) thresholds of basic functionality, ii) referential for the instrumental spectrum and iii) functional categorization for "household walker" (< 0.4 meters per second, m/s), "limited community ambulator" (0.40 to 0.80 m/s), "community ambulator" (0.81 to 1.3 m/s), and "cross street safely" (> 1.3 m/s). The relative frequency (%) of older adults who meet each established quadrant was determined. The threshold was reached by 100% of the participants (basic daily activities). About 80% of the older adults have a functional classification space below the reference limit (instrumental and advanced daily activities). It was also found that 81% of women and 69% of men are "efficient in the community", and 31% of men and 14% of women reach the minimum value for "effec-tive street crossing" (advanced daily activities). The exploration of functional classification spaces according to self- selected walking speed and maximum walking speed applied to a group of self- sufficient older adults reveals that this pop-ulation is at risk of deteriorating instrumental and advanced activities of daily living.

Users’ adaptations to the proportional speed control of a motorised walker

Purpose Speed control is commonly used to regulate the forces applied by motorised walkers (MW) and there are often situations where the speed targeted deviates from the preferred walking speed of its users, such as when encouraging higher walking speeds and due to safety consideration. This study investigates the effects of different MW’s target speeds on the selected walking speeds, force applied, perceived exertion, and gait of MW users during steady-state walking. Materials and methods The spatiotemporal gait parameters and perceived exertion of twenty young healthy participants were measured as they walked at a comfortable, self-selected speed using a MW as it was controlled to target forward speeds of 0.6, 0.8, 1.0, 1.2, and 1.4 m s −1 as well as when no assistive force was applied by the MW. Results On average, users would walk slower when their “No Assist” walking speed is higher than the MW’s speed target and vice versa. Additionally, the force applied to the MW is proportional to the difference in speed, either faster or slower, when compared to "No Assist". Conclusion The user’s exertion and the energy used by the MW are both minimised when target speed is close to the preferred walking speed of the user. Additionally, these findings suggest that the speed target can be used to change the walking speed of users but only to a certain extend and at the cost of higher perceived exertion. Implications for rehabilitation The larger the difference between the target speed of the MW and the preferred walking speed of the user, the more likely the user is to push or pull on the MW. Users would push or pull on the MW with a force proportional to the difference from their preferred walking speed even when matching the MW’s target speed. Users can be encouraged to walk at higher than preferred speeds, even though this would come at the cost of higher perceived exertion.

Are there common walking gait characteristics in patients diagnosed with late-onset Pompe disease?

Late-onset Pompe disease (LOPD) is a rare disease, defined as a progressive accumulation of lysosomal glycogen resulting in muscle weakness and respiratory problems. Anecdotally, individuals often have difficulties walking, yet, there is no three-dimensional data supporting these claims. We aimed to assess walking patterns in individuals with LOPD and compare with healthy individuals. Kinematic, kinetic and spatiotemporal data were compared during walking at a self-selected speed between individuals with LOPD (n=12) and healthy controls (n=12). Gait profile scores and movement analysis profiles were also determined to indicate gait quality. In comparison with healthy individuals, the LOPD group demonstrated greater thoracic sway (96%), hip adduction angles (56%) and pelvic range of motion (77%) and reduced hip extensor moments (36%). Greater group variance for the LOPD group were also observed. Individuals with LOPD had a slower (15%) walking speed and reduced cadence (7%). Gait profile scores were 37% greater in the LOPD group compared to the healthy group. Proximal muscular weakness associated with LOPD disease is likely to have resulted in a myopathic gait pattern, slower selected walking speeds and deviations in gait patterns. Although individuals with LOPD presented with some common characteristics, greater variability in gait patterns is likely to be a result of wide variability in phenotype spectrum observed with LOPD. This is the first study to examine walking in individuals with LOPD using instrumented gait analysis and provides an understanding of LOPD on walking function which can help orientate physiotherapy treatment for individuals with LOPD.

The validity of activity trackers is affected by walking speed: the criterion validity of Garmin Vivosmart® HR and StepWatch™ 3 for measuring steps at various walking speeds under controlled conditions

IntroductionThe use of activity trackers has increased both among private consumers and in healthcare. It is therefore relevant to consider whether a consumer-graded activity tracker is comparable to or may substitute a research-graded activity tracker, which could further increase the use of activity trackers in healthcare and rehabilitation. Such use will require knowledge of their accuracy as the clinical implications may be significant. Studies have indicated that activity trackers are not sufficiently accurate, especially at lower walking speeds. The present study seeks to inform decision makers and healthcare personnel considering implementing physical activity trackers in clinical practice. This study investigates the criterion validity of the consumer-graded Garmin Vivosmart® HR and the research-graded StepWatch™ 3 compared with manual step count (gold standard) at different walking speeds under controlled conditions.MethodsThirty participants, wearing Garmin Vivosmart® HR at the wrist and StepWatch™ 3 at the ankle, completed six trials on a treadmill at different walking speeds: 1.6 km/h, 2.4 km/h, 3.2 km/h, 4.0 km/h, 4.8 km/h, and 5.6 km/h. The participants were video recorded, and steps were registered by manual step count. Medians and inter-quartile ranges (IQR) were calculated for steps and differences in steps between manually counted steps and the two devices. In order to assess the clinical relevance of the tested devices, the mean absolute percentage error (MAPE) was determined at each speed. A MAPE ≤3% was considered to be clinically irrelevant. Furthermore, differences between manually counted steps and steps recorded by the two devices were presented in Bland–Altman style plots.ResultsThe median of differences in steps between Garmin Vivosmart® HR and manual step count ranged from −49.5 (IQR = 101) at 1.6 km/h to −1 (IQR = 4) at 4.0 km/h. The median of differences in steps between StepWatch™ 3 and manual step count were 4 (IQR = 14) at 1.6 km/h and 0 (IQR = 1) at all other walking speeds. The results of the MAPE showed that differences in steps counted by Garmin Vivosmart® HR were clinically irrelevant at walking speeds 3.2–4.8 km/h (MAPE: 0.61–1.27%) as the values were below 3%. Differences in steps counted by StepWatch™ 3 were clinically irrelevant at walking speeds 2.4–5.6 km/h (MAPE: 0.08–0.35%).ConclusionGarmin Vivosmart® HR tended to undercount steps compared with the manual step count, and StepWatch™ 3 slightly overcounted steps compared with the manual step count. Both the consumer-graded activity tracker (Garmin Vivosmart® HR) and the research-graded (StepWatch™ 3) are valid in detecting steps at selected walking speeds in healthy adults under controlled conditions. However, both activity trackers miscount steps at slow walking speeds, and the consumer graded activity tracker also miscounts steps at fast walking speeds.

Words matter: instructions dictate “self-selected” walking speed in young adults

BackgroundVariability in gait speed is influenced by age and health status. However, no study has investigated the effects of different instructions on gait speed. Research questionThis study investigated how walking prompts contributed to variability in gait speed. MethodsParticipants walked on a pressurized walkway. Gait speed variability was assessed using multilevel modeling. Results61% of the variance in gait speed was due to instruction, while 14% was due to individual differences. SignificanceReference values for gait speed across a number of prompts will be highly useful for assessing gait performance in young adults. Further, the instruction given produces a large amount of variability in selected walking speed. This finding urges researchers to maintain consistency when delivering walking instructions.

P 106 - Intra- and inter-operator reliability of a novel hand protocol during grip movement in healthy subjects

Variability in gait speed is influenced by age and health status. However, no study has investigated the effects of different instructions on gait speed.This study investigated how walking prompts contributed to variability in gait speed.Participants walked on a pressurized walkway. Gait speed variability was assessed using multilevel modeling.61% of the variance in gait speed was due to instruction, while 14% was due to individual differences.Reference values for gait speed across a number of prompts will be highly useful for assessing gait performance in young adults. Further, the instruction given produces a large amount of variability in selected walking speed. This finding urges researchers to maintain consistency when delivering walking instructions.

Measuring gait kinematics and self selected walking speed in healthy adults using inertial measurement units

Measuring gait kinematics and self selected walking speed in healthy adults using inertial measurement units

Assessment of upper-body dynamic stability during walking in patients with subacute stroke

The analysis of upper-body acceleration is a promising and simple technique to quantitatively assess dynamic gait stability. However, this method has rarely been used for people with stroke, probably because of some technical issues still not addressed. We evaluated the root-mean-square (RMS) and harmonic ratio of trunk accelerations for a group of 15 inpatients with subacute stroke who were able to walk (61.4 +/- 14.9 yr) and compared them with those of an age-matched group of nondisabled subjects (65.1 +/- 8.8 yr) and those of a highly functional group of young nondisabled subjects (29.0 +/- 5.0 yr). Small (<2%) but significant (p < 0.03) differences were found in RMS values obtained by applying the two most common computational approaches: (1) averaging among individual-stride RMS values and (2) computing the RMS value over the entire walking trial without stride partitioning. We found that the intersubject dependency of acceleration RMS values by selected walking speed was specific for each group and for each of the three body axes. The analysis of ratios between these three accelerations provided informative outcomes correlated with clinical scores and not affected by walking speed. Our findings are an important step toward transferring accelerometry from human movement analysis laboratories to clinical settings.

Assessment of spatio-temporal gait parameters using inertial measurement units in neurological populations

Laboratory based gait analysis techniques are expensive, time consuming and require technical expertise. Inertial measurement units can directly measure temporal parameters and in combination with gait models may provide a solution to obtain spatial gait measurements within daily clinical assessments. However it is not known if a model and standard correction factor determined by Zijlstra and Hof [8] to estimate step and stride length parameters in typically developed adults (TDA) can be accurately used in neurologically impaired gaits. This research estimated the stride length over two 10 m walks at self selected walking speed in people with neurological conditions, using a previously established model and correction factor for TDA. The relation of the correction factor to walking speed was explored. We recruited TDA ( n = 10) and participants with Parkinson's disease (PD; n = 24), muscular dystrophy (MD; n = 13), motor neuron disease (MND; n = 7) and stroke survivors ( n = 18) for the study who twice walked 10 m at a self-selected pace. Stride length correction factors, for TDA (1.25 ± 0.01), PD (1.25 ± 0.03), and MD (1.21 ± 0.08) ( p = 0.833 and p = 0.242) were the same as previously reported in TDA (Zijlstra and Hof [8]). Correction factors for stroke (1.17 ± 0.42) and MND (1.10 ± 0.08) were different ( p < 0.01 and p = 0.028 respectively). However there was a high level of variability for correction factors within groups, which did not relate to walking speed. Our findings support that correction factors should be determined for each individual to estimate average step/stride length in patients suffering from a neurological condition.

Estimation of effects of walking speed to vertical ground reaction force

The measurement of ground reaction force (GRF) is important in biomechanical analysis for clinical gait assessment and gait research. The GRF measured by the force plate, along with the gravity, are the only significant external forces acting on the body during gait. The purpose of this study is to show the effects of walking speed on vertical ground reaction force (VGRF) F z using Kistler quartz force platform embedded on the floor. Since considerable differences in the gait of normal subjects arises due to ‘constrained’ walking, so subject are made to walk with their self selected walking speed in the walkway. Vertical component of the GRF was analysed from the recorded data using Bioware software. It was clearly observed that with increasing walking speed VGRF increased at F z 1 and F z 3 whereas decreased at F z 2 .

Self selected walking speed in overweight adults: Is this intensity enough to promote health benefits?

Introduction and objective Walking is the most often indicated physical activity modality to increase population physical activity levels aiming to improve health-related conditions. However, we do not know how overweight adults self-selected the intensity of their walking speed. The objective was to evaluate the self-selected walking speed in overweight adults. Methods We evaluated 50 men (41.7 ± 5.4 years), who performed walking without professional guidance. The exercise intensity was monitored by heart rate, and also by the perceived exertion. We performed anthropometric measurements of body weight, height, waist circumference and hip. The sample was divided into two groups by body mass index (BMI) categories: G1 (BMI < 25 kg m −2) = «Normal Weight» and G2 (BMI ≥25 kg m −2) = «Overweight». Was used t test for independent samples, with p < 0.05. Results The t test showed significant difference between groups for the following variables: body weight, waist hip ratio (WRH) and waist circumference (p≤0,001). It was verified, by the heart rate analyses, an elevated percentage of participants who did their self-selected walking intensity choices at higher levelsthan the «moderate» classification, in both groups. Conclusion It can be concluded that the self-selected walking intensity was adequate for the largest part of the participants in attending American College of Sports Medicine recommendations, mainly in normal weight group. However large part of the evaluated sample in overweight group is exercising at inadequate intensity, considering their age and weight conditions. Particularly for this group, professional exercise guidance has to be recommended for safety reasons.

Two-level control strategy of an eight link biped walking model

This paper presents an adaptive two-level control strategy for a biped walking model and demonstrates its performance in a wide range of walking modes with considerably diverse model and control parameter settings. Proposed control strategy inherits a push off that resembles considerably to forceful extension of the trailing leg during push off in human locomotion and represents a very important source of forward propulsion. Extensive simulations have shown that adjustments in the push off related parameter on higher between-step control level after each step enable evolution of various walking modes of the biped walker at selected walking speeds and distinctive gait patterns. It also allows us to investigate the changes in gait kinematics and kinetics of the biped walking model due to changes in gait velocity, torso inclination and propulsion distribution profiles.

Subjective perceptions of load carriage on the head and back in Xhosa women

The purpose of this study was to compare the subjective perceptual responses to both head-loading and back-loading in a group of Xhosa women. Thirty two women were divided into three groups based on their experience of head-loading and walked on a treadmill on two occasions, head-loading and back-loading, at a self selected walking speed for 4 min with a variety of loads until pain or discomfort caused the test to be terminated or a load of 70% body mass was successfully carried. After each workload there was a 1 min rest period during which the women indicated feelings of pain or discomfort in particular areas of the body via visual analogue scales. At the end of each test the women were asked to complete further questionnaires relating to pain and discomfort and on completion of the second test were also asked to compare the two loading conditions. Finally the women were interviewed to establish their history of load carriage and associated pain and discomfort. The data indicate that whilst back-loading was generally associated with more areas of discomfort than head-loading, the pain and discomfort in the neck associated with head-loading was the predominant factor in the termination of tests and that this was independent of head-loading experience. This early termination meant that, on average, the women could carry greater loads on their backs than on their heads. The study suggests that further work needs to be carried out to establish viable alternatives to head-loading for rural dwellers in Africa.

Effects of Clinically Prescribed Ankle Foot Orthoses on Ankle-Foot Roll-Over Shapes: A Case Series

ABSTRACT The purpose of this case series was to explore the effects of clinically prescribed ankle-foot orthoses (AFOs) (i.e., the orthosis an individual is provided by their health care team for everyday use) on the ankle-foot roll-over shapes (ROS) of persons with various pathologies. We hypothesized that persons for whom AFOs had been prescribed would have an abnormal ROS and that AFOs would make the ROS similar to that of able-bodied persons. Gait data were recorded from eight adults with unilateral involvement: five subjects (one with a common peroneal nerve injury, one with a subchondral talar cyst, one with an incomplete spinal cord injury, one with hemiplegia due to stroke, and one with postpolio) wore posterior leaf spring AFOs (PLS-AFOs); two subjects (with hemiplegia due to stroke) wore articulated AFOs with a plantar flexion stop and free dorsiflexion; and one subject (with hemiplegia due to stroke) wore a solid AFO. Participants walked with and without their AFO at their freely selected walking speed. “Normal” reference data were recorded from 10 able-bodied subjects of similar age walking at similar speeds. As hypothesized, ROS—as characterized by arc length and arc radius—was abnormal for all subjects when walking without an AFO. However, the prescribed AFOs were only able to partially restore ROS. Arc lengths were closer to normal with the AFO when compared to without, but changes in arc radius were less consistent, with only three subjects having radii that were closer to normal when the AFO was worn. Overall, there were smaller changes in ROS arc length and radius when PLS-AFOs were worn compared with articulated AFOs, consistent with the fact that PLS-AFOs are typically prescribed for those with less severe pathologies. ROS arc length and radius increased in all subjects with stroke when AFOs were worn. The results of this case series suggest that although clinically prescribed AFOs tend to improve ROS compared with walking without an AFO, they do not completely normalize it. Further research is required to assess the relationship between gait dysfunction, AFO design, and ROS.

White Paper: “Walking Speed: the Sixth Vital Sign”

White Paper: “Walking Speed: the Sixth Vital Sign”

Differences in Gait Characteristics Between Persons With Bilateral Transtibial Amputations, Due to Peripheral Vascular Disease and Trauma, and Able-Bodied Ambulators

Su P-F, Gard SA, Lipschutz RD, Kuiken TA. Differences in gait characteristics between persons with bilateral transtibial amputations, due to peripheral vascular disease and trauma, and able-bodied ambulators. Objectives To examine differences in gait characteristics between persons with bilateral transtibial amputations because of trauma and peripheral vascular disease (PVD); and to compare that with data from able-bodied controls that were previously collected and maintained in a laboratory database. Design Observational study of persons with bilateral transtibial amputations. Setting A motion analysis laboratory. Participants Nineteen bilateral transtibial amputees. Intervention No experimental intervention was performed. To standardize the effect of prosthetic foot type, subjects were fitted with Seattle Lightfoot II feet 2 weeks before quantitative gait analyses. Main Outcome Measures Temporospatial, kinematic, and kinetic gait data were recorded and analyzed. Results Results showed that the freely selected walking speeds of subjects with PVD and trauma were 0.69m/s and 1.11m/s, respectively, while that of able-bodied control subjects was 1.20m/s. When data were compared on the basis of freely selected walking speed, numerous differences were found in temporospatial, kinematic, and kinetic parameters between the PVD and trauma groups. However, when data from similar speeds were compared, the temporospatial, kinematic, and kinetic gait data demonstrated no statistically significant differences between the 2 amputee groups. Although not statistically significant, the PVD group displayed increased knee ( P=.09) and hip ( P=.06) flexion during the swing phase, whereas the trauma group displayed increased pelvic obliquity ( P=.06). These actions were believed to represent different strategies to increase swing phase foot clearance. Also, the PVD group exhibited slightly greater hip power ( P=.05) before toe-off. Conclusions Many of the differences observed in the quantitative gait data between the trauma and PVD groups appeared to be directly associated with their freely selected walking speed; the trauma group walked at significantly faster freely selected speeds than the PVD group. When their walking speeds were matched, both amputee groups displayed similar gait characteristics, with the exception that they might use slightly different strategies to increase foot clearance.

KINEMATIC TRAJECTORIES WHILE WALKING WITHIN THE LOKOMAT ROBOTIC GAIT-ORTHOSIS

Purpose/Hypothesis: To compare the kinematic patterns of subjects walking in the Lokomat robotic gait-orthosis with those demonstrated during treadmill walking, and to quantify the amount of relative movement inside the device. The field of neurorehabilitation has been adopting robotic devices to help deliver mass-practice therapy to individuals with various types of neurological disorders (Hidler et al, 2005 for review). The Lokomat (Hocoma AG, Volketswil Switzerland) is the most widely adopted robotic system used for gait training. Previous studies have quantified changes in muscle activation pattern when subjects walk in the Lokomat to those on a treadmill (Hidler and Wall, 2005). No studies to date have tracked the kinematic patterns of the legs inside the Lokomat. Number of Subjects: 6 healthy subjects (4 male, 2 female) participated in the study. Materials/Methods: A Codamotion (Charnwood Dynamics, UK) motion analysis system was used to track the kinematic patterns of the subject's pelvis and legs, and the robotic limbs of the Lokomat. Marker clusters were placed on each limb segment and tracked at 100 Hz. Subjects walked on the treadmill with and without the Lokomat at four randomly selected walking speeds (2.0, 2.4, 2.8, 3.2 km/hr). For all trials, subject and Lokomat marker positions and ground reaction forces were recorded for 30-second step sequences. A number of kinematic metrics were compared between the two modalities using a one sample t-test (alpha = 0.05), including ankle, knee, and hip range of motion, maximum and minimum joint flexion and extension angles, and the point in the gait cycle each occurred. The relative knee and hip movement between the subject's and Lokomat's joint centers in both the frontal and sagittal planes were quantified. Results: While some subjects experienced slight differences in kinematic patterns, there were no significant differences in any of the metrics computed for all subjects across walking modalities. Despite there being no differences in sagittal joint angular patterns, the side to side motion of the hip in the medial-lateral plane was significantly less in the Lokomat than on the treadmill, sometimes restricted by as much as 75%. The relative movement of subjects' legs inside the Lokomat was substantial, where the variability in the knee joint center in the sagittal plane was approximately 1 cm while deviations exceeded 2 cm for the hip joint. Conclusions: With proper setup, the Lokomat gait patterns mimic those utilized during treadmill ambulation. Differences in the amount of medial-lateral hip motion can be attributed to the reduced degrees of freedom the Lokomat places on the subject. Clinical Relevance: The finding that there is significant movement of the subject's legs inside the Lokomat is important clinically, as a variable step pattern has been shown to be a more effective gait training strategy than one which forces the same kinematic pattern across successive steps (Cai et al., 2005).

Effects of Lesion Laterality on Cardiovascular Responses of Post Stroke Hemiparetic Patients to A Single Bout of Exercise

The aim of this study was to determine how hemiparetic stroke patients with dominant or non-dominant side brain lesion respond to a single bout of exercise. Participants were 14 dominant (DSH) and 17 non-dominant side hemiparetic (NDSH) stroke patients recruited from among those receiving physiotherapy on an outpatient basis at the University College Hospital in Ibadan, Nigeria. Twenty age-matched individuals with no known neurological impairments served as the control group (CG). Pre-exercise systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR) and rate pressure product (RPP) were assessed. Participants performed a 6-minute level ground walk test at their own selected walking speed, after which their immediate post-walk cardiovascular parameters were determined. One-way ANOVA revealed no significant difference in the baseline cardiovascular parameters across the three groups; the NDSH group recorded significantly higher HR than their DSH counterparts. Post walk mean values showed significant difference in all but one (HR; p = 0.10) of the cardiovascular parameters of the three groups. Post hocanalyses showed no significant difference in the post walk SBP and DBP of the DSH and NDSH groups, but the NDSH group had significantly higher RPP than the DSH group. The within- group comparison showed that the exercise caused significant increase in HR (NDSH, CG), SBP (DSH, NDSH), DBP and RPP (all groups) of the participants. The results suggest that laterality had no significant effect on cardiovascular response of hemiparetic stroke patients to the exercise. However, when compared with non-stroke apparently healthy individuals, both groups of hemiparetic stroke subjects recorded significantly higher SBP, DBP and RPP responses to the 6-minute walk test.

Self Selected Walking Speed as an Outcome Measure for Burn Patients

Self Selected Walking Speed as an Outcome Measure for Burn Patients

The development of the kinematics of gait in 7 to 12 year old normal children at self selected walking speeds: Characterisation by normalised speed

The development of the kinematics of gait in 7 to 12 year old normal children at self selected walking speeds: Characterisation by normalised speed