Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Change in Gait Speed on Vertical Force of the Cane and Distribution of Affected Foot in the Persons with Chronic Stroke

보행속도의 변화가 만성 뇌졸중 환자 지팡이의 수직력과 마비측 발의 체중지지에 미치는 영향

  • Jung, Kyoung-Sim (Department of Physical Therapy, The Graduate School, Sahmyook University) ;
  • Seo, Hyun-Du (Department of Physical Therapy, The Graduate School, Sahmyook University) ;
  • Lee, Kwan-Woo (Department of Physical Therapy, The Graduate School, Sahmyook University) ;
  • Chung, Yi-Jung (Department of Physical Therapy, College of Health and Welfare, Sahmyook University)
  • 정경심 (삼육대학교 대학원 물리치료학과) ;
  • 서현두 (삼육대학교 대학원 물리치료학과) ;
  • 이관우 (삼육대학교 대학원 물리치료학과) ;
  • 정이정 (삼육대학교 보건복지대학 물리치료학과)
  • Received : 2012.03.21
  • Accepted : 2012.04.13
  • Published : 2012.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose : The purpose of this study was to analyze weight bearing of cane and affected foot at different speeds during walking. Methods : Thirteen subjects (6 males, 7 females) with stroke enrolled in the study. A foot sensor and an instrumented cane were integrated to analyze the vertical peak force on the affected foot and the cane. Results : The applied vertical peak force on the cane were $12.02{\pm}4.80%$ (slow speed), $7.97{\pm}3.95%$ (comfortable speed), and $6.86{\pm}3.30%$ (fast speed) body weight, respectively. The results indicated significantly lower vertical peak force on the affected foot in the low speed walking condition when compared to the fast walking (p<.05) and the comfortable walking (p<.05) conditions. The correlations between TUG and vertical peak force on the cane and affected foot were .71, and -.70 (p<.01). There was a higher correlation between the vertical peak force on the cane and affected foot were -.87(p<.01). Conclusion : In conclusion, slower walking speed applied greater vertical peak force on the cane. On the contray, slower walking speed applied less vertical peak force on the affected foot. Further studies, duration of force should be measured at different speeds during walking in lower and higher functioning hemiparetic subjects, as its use may mask underlying gait impairment.

Keywords

References

  1. Ada L, Dorsch S, Canning CG. Strengthening interventions increase strength and improve activity after stroke: a systematic review. Aust J Physiother. 2006;52(4):241-8. https://doi.org/10.1016/S0004-9514(06)70003-4
  2. Aminzadeh F, Edwards N. Exploring seniors' views on the use of assistive devices in fall prevention. Public Health Nurs. 1998;15(4):297-304. https://doi.org/10.1111/j.1525-1446.1998.tb00353.x
  3. Bateni H, Maki BE. Assistive devices for balance and mobility: benefits, demands, and adverse consequences. Arch Phys Med Rehabil. 2005;86(1):134-45. https://doi.org/10.1016/j.apmr.2004.04.023
  4. Beaman CB, Peterson CL, Neptune RR et al. Differences in self-selected and fastest-comfortable walking in post-stroke hemiparetic persons. Gait Posture. 2010;31(3):311-6. https://doi.org/10.1016/j.gaitpost.2009.11.011
  5. Brandstatter ME, de Bruin H, Gowland C et al. Hemiplegic gait analysis of temporal variables. Arch Phys Med Rehabil. 1983;64(12):583-7.
  6. Bobath B. Adult Hemiplegia Evaluation and Treatment, 3rd ed. London. Heinnemann. 1990.
  7. Bohannon RW. Strength of lower limb related to gait velocity and cadence in stroke patients. Physiother Can. 1986;38(4):204-6. https://doi.org/10.3138/ptc.38.4.204
  8. Bohannon RW. Gait performance of hemiparetic stroke patients: selected variables. Arch Phys Med Rehabil. 1987;68(11):777-81.
  9. Bohannon RW, Andrews AW. Correlation of knee extensor muscle torque an spasticity with gait speed in patients with stroke. Arch Phys Med Rehabil. 1990;71(5):330-3.
  10. Buurke JH, Hermens HJ, Erren-Wolters CV et al. The effect of walking aids on muscle activation patterns during walking in stroke patients. Gait Posture. 2005;22(2):164-70. https://doi.org/10.1016/j.gaitpost.2004.09.003
  11. Chen CL, Chen HC, Wong MK et al. Temporal stride and force analysis of cane-assisted gait in people with hemiplegic stroke. Arch Phys Med Rehabil. 2001;82(1):43-8. https://doi.org/10.1053/apmr.2001.18060
  12. Chiu SL, Chou LS. Effect of walking speed on inter-joint coordination differs between young and elderly adults. J Biomech. 2012;45(2):275-80. https://doi.org/10.1016/j.jbiomech.2011.10.028
  13. Dean E, Ross J. Relationships among cane fitting, function, and falls. Phys Ther. 1993;73(8):494-500.
  14. Dickstein R, Abulaffio N, Pillar T. Vertical force loaded on walking canes in hemiparetic patients. Gait Posture. 1993;1(2):113-8. https://doi.org/10.1016/0966-6362(93)90022-S
  15. Ely DD, Smidt GL. Effect of cane on variables of gait for patients with hip disorders. Phys Ther. 1977;57(5):507-12.
  16. Hodt-Billington C, Helbostad JL, Moe-Nilssen R. Should trunk movement or footfall parameters quantify gait asymmetry in chronic stroke patients? Gait Posture. 2008;27(4):552-8. https://doi.org/10.1016/j.gaitpost.2007.07.015
  17. Horvah M, Tihanyi T, Tihanyi J. Kinematic and kinetic analyses of gait patterns in hemiplegic patients. Facta Univ. 2001;1(8):25-35.
  18. Hsu AL, Tang PF, Jan MH. Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil. 2003;84(8):1185-93. https://doi.org/10.1016/S0003-9993(03)00030-3
  19. Jonkers I, Delp S, Patten C. Capacity to increase walking speed is limited by impaired hip and ankle power generation in lower functioning persons post-stroke. Gait Posture. 2009;29(1):129-37 https://doi.org/10.1016/j.gaitpost.2008.07.010
  20. Kim CM, Eng JJ. Symmetry in vertical ground reaction force is accompanied by symmetry in temporal but not distance variables of gait in persons with stroke. Gait Posture. 2003;18(1):23-8. https://doi.org/10.1016/S0966-6362(02)00122-4
  21. Kodesh E, Kafri M, Dar G et al. Walking speed, unilateral leg loading, and step symmetry in young adults. Gait Posture. 2012;35(1):66-9. https://doi.org/10.1016/j.gaitpost.2011.08.008
  22. Krakauer JW. Motor learning: its relevance to stroke recovery and neurorehabilitation. Curr Opin Neurol. 2006;19(1):84-90. https://doi.org/10.1097/01.wco.0000200544.29915.cc
  23. Kuan TS, Tsou JY, Su FC. Hemiplegic gait of stroke patients: the effect of using a cane. Arch Phys Med Rehabil. 1999;80(7):777-84. https://doi.org/10.1016/S0003-9993(99)90227-7
  24. Laufer Y. Effects of one-point and four-point canes on balance and weight distribution in patients with hemiparesis. Clin Rehabil. 2002;16(2):141-8 https://doi.org/10.1191/0269215502cr481oa
  25. Laufer Y. The effect of walking aids on balance and weight-bearing patterns of patients with hemiparesis in various stance positions. Phys Ther. 2003;83(2):112-22.
  26. Mastos M, Miller K, Eliasson AC et al. Goaldirected training: linking theories of treatment to clinical practice for improved functional activities in daily life. Clin Rehabil. 2007;21(1):47-55. https://doi.org/10.1177/0269215506073494
  27. Murray MP, Seireg AH, Scholtz RC. A survey of the time, magnitude and orientation of forces applied to walking sticks by disabled men. Am J Phys Med. 1969;48(1):1-13.
  28. Nadeau S, Arsenault AB, Gravel D et al. Analysis of the clinical factors determining natural and maximal gait speeds in adults with a stroke. Am J Phys Med Rehabil. 1999a;78(2):123-30. https://doi.org/10.1097/00002060-199903000-00007
  29. Nadeau S, Gravel D, Arsenault AB et al. Plantarflexor weakness as a limiting factor of gait speed in stroke subjects and the compensating role of hip flexors. Clin Biomech (Bristol Avon). 1999b;14(2):125-35. https://doi.org/10.1016/S0268-0033(98)00062-X
  30. Olney SJ, Griffin MP, McBride ID. Temporal, kinematic, and kinetic variables related to gait speed in subjects with hemiplegia: a regression approach. Phys Ther. 1994;74(9):872-85.
  31. Podsiadlo D, Rechardson S. The timed up and go: Atest of basis fuctional mobility for frail elderly persons. J Am Geriatr Soc, 1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  32. Polese JC, Teixeira-Salmela LF, Nascimento LR et al. The effects of walking sticks on gait kinematics and kinetics with chronic stroke survivors. Clin Biomech (Bristol, Avon). 2012;27(2):131-7. https://doi.org/10.1016/j.clinbiomech.2011.08.003
  33. Schmid A, Duncan PW, Studenski S et al. Improvements in speed-based gait classifications are meaningful. Stroke. 2007;38(7):2096-100. https://doi.org/10.1161/STROKEAHA.106.475921
  34. Studenski S, Perera S, Wallace D et al. Physical performance measures in the clinical setting. J Am Geriatr Soc. 2003;51(3):314-22. https://doi.org/10.1046/j.1532-5415.2003.51104.x
  35. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in communitydwelling older adults using the timed up & go test. Phys Ther. 2000;80(9):896-903.
  36. Tinetti ME, Powell L. Fear of falling and low selfefficacy: a case of dependence in elderly persons. J Gerontol. 1993;48:35-8. https://doi.org/10.1093/geronj/48.Special_Issue.35

Cited by

  1. Effects of Gait Training Using a Robot for Balance in Total Hip Arthroplasty Patients after Bilateral Avascular Necrosis: A Case Study vol.33, pp.5, 2012, https://doi.org/10.18857/jkpt.2021.33.5.231