Biomechanical analysis of two-point alternate crutch gait – comparison with standard gait

Lechosław B. Dworak, Michał Murawa, Jacek Mączyński

Lechosław B. Dworak, Michał Murawa, Jacek Mączyński – Biomechanical analysis of two-point alternate crutch gait – comparison with standard gait. Fizjoterapia Polska 2006; 6(4); 310-316

Abstract
Background. This paper presents the results of a biomechanical investigation of two-point alternate crutch gait by comparing selected parameters of the crutch-assisted gait and standard gait as well as seeking to determine the efficacy of unloading in crutch-assisted gait. Material and methods. 7 healthy physiotherapists participated in the experiment. Some dynamic parameters of simulated two-point alternate crutch-assisted gait and standard gait were measured using force plates (Kistler) and video-recording. Maximum and average values of ground reaction forces (GRF) as well as indices of asymmetry were calculated for both gaits. Results. Maximum values of the vertical component of the GRF (Rz-p i Rz-I) were 13 and 15%, respectively, lower during crutch gait compared to standard gait. The difference increased to around 20% for the mean values of the <Rz> index. The mean values of the remaining horizontal components of the GRF (<Ry>i <Rx>) were 32% (<Ryh-l>) and as much as 60% (<Rx-p>) lower during crutch gait. The mean values of all GRF components during crutch-assisted gait were around 25% of the corresponding values observed during standard gait. The vast majority of the asymmetry indices assumed higher values for the crutch gait. Conclusions. The analysis shows that during two-point alternative crutch gait a patient gets a great unloading of the lower limbs (1/5 of the BM). Simultaneously upper limbs get considerable overloading.

Key words:
locomotion, crutches, unloading, ground reaction forces, asymmetry

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The influence of external loading on weight compensatory changes and pelvic behaviour during walking in scoliotic children

Olga Nowotny-Czupryna, Krzysztof Czupryna, Anna Brzęk, Małgorzata Domagalska, Andrzej Szopa

Olga Nowotny-Czupryna, Krzysztof Czupryna, Anna Brzęk, Małgorzata Domagalska, Andrzej Szopa – The influence of external loading on weight compensatory changes and pelvic behaviour during walking in scoliotic children. Fizjoterapia Polska 2008; 8(4); 436-444

Abstract
Background. Compensatory changes in the spatial arrangement of body segments are a characteristic sign of the development of scoliosis. Additional external loads may lead to intensification of existing signs in both static and dynamic conditions. The manner of carrying heavy objects on a daily basis is a key factor here. The aim of this paper was to assess some changes in static and dynamic parameters associated with carrying the school pack in children with scoliosis.Material and methods. Thirty-six children aged 8-15 years with low-grade scoliosis were examined. Foot pressure in static conditions was recorded using a force platform without additional loading, and with a 4 kg external load carried in a symmetric or asymmetric manner. Three-dimensional gait analysis was also performed using a Zebris® system. Parameters were registered during walking without and with the external load.Results. Signs of asymmetric foot pressures were observed that intensified during external loading of spine (both symmetric and asymmetric). These changes were not clearly related to body posture parameters. There were also signs of gait asymmetry that intensified during walking with asymmetrical external loading. The most marked changes were observed with respect to pelvis-related gait determinants. The magnitude of changes was related to the manner of carrying the school pack rather than to body posture parameters. Conclusions. External loads intensify the asymmetry of foot pressure distribution as a result of spontaneous and unpredictable compensatory dislocations. The manner of carrying the school pack is not irrelevant in children with scoliosis.
Key words:
scolioses, foot pressure, gait, locomotion, external loading, gait determinants
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