Objective: To investigate the effect of body weight support on the gait of hemiparetic subjects walking on a treadmill. Design: Survey. Patients: Eleven nonambulatory hemiparetic subjects. Methods: Subjects walked on the treadmill with full weight bearing and with 15%, 30%, 45%, and 60% body weight support at constant walking velocity. Cycle parameters, symmetry ratios, and the kinematic EMG of several lower limb muscles of the affected leg were recorded. Video-analysis served for assessment of posture and hip and knee angle displacement. Results: With body weight support the relative double support time decreased, the relative single stance period of the affected limb increased, and the functional activity of the vastus and soleus diminished. The activity of the gluteus tended to increase. Patients walked more upright and with less hip and knee flexion. The extensor spasticity did not change and the qualitative activation pattern of all recorded muscles remained unchanged. Conclusion: Body weight support did not facilitate a less physiological gait. By reducing double support duration, body weight support resulted in a greater stimulus for balance training. The facilitation of gluteus medius is favorable with respect to training pelvic alignment. The reduction of the activity of other antigravity muscles suggests a limit of 30% BWS not be exceeded.

This study further supports the beneficial effects of botulinum toxin in the treatment of lower limb extensor spasticity. A correlation was observed between the clinical reduction of muscle tone, functional gait parameters, and a more normal EMG pattern with a predominant reduction of the premature activity of the plantar flexors. The qualitative type of EMG pattern corresponding to an increased stretch-reflex excitability (type I) was a positive predictor for the outcome.

Normal gait is characterised by a high level of inter-leg symmetry of gait parameters. Therefore, efforts in rehabilitation of amputees are directed at the construction of a prosthesis which provides normal leg function and allows a more symmetrical gait. Analysis of the gait of trans-tibial amputees was performed when they were ambulating at their own freely selected speed and at a faster speed. The effect of speed on selected gait parameters in each leg was evaluated and the influence on symmetry established by comparing the inter-leg changes for each of the selected parameters. The faster gait trail affected significantly all temporal and distance parameters in both legs but not the level of symmetry between legs. At the faster speed, the hip angles at heel-strike and during swing and the knee angle during load response, in the normal leg, and the knee angle during swing in the amputated leg, all increased significantly. Speed of gait significantly affected symmetry between knee angles as reflected by the increased differences measured during load response (from 2.62 ±5.2 to 7.06 ±4.2 degrees) and during toe-off (from 1.80 ±7.4 to 9.50 ±9.1 degrees). Timing and sequence of selected gait events, as related to stride time, were not significantly affected by speed of gait. These results might contribute to a better understanding of gait characteristics in trans-tibial amputees and provide design guidance for prosthetic components.

Ground reaction force is one of the most relevant parameters in the assessment of human gait. It is, however, difficult to measure without encumbering natural locomotion. A description of a system for measuring the vertical component of the ground reaction force and its distribution under the foot is given. The calibration procedure for the measuring shoes is described. The results of measurements are compared with those obtained from a force plate. Illustrative examples of the changes in pathological gait patterns of a hemiplegic patient during therapy by functional electrical stimulation are also given.

Gait analysis of trans-tibial amputees brings to light asymmetries of different gait parameters between the amputated and sound legs. The present study investigated the activity of the vastus medialis and biceps femoris muscles during ambulation of trans-tibial amputees. Peak activities of the vastus medialis were reached similarly in both legs (6.06+/-4.9% and 8.84+/-3.6% of gait cycle, in the sound and amputated leg, respectively). Biceps femoris peak activities were reached at 92.43+/-6.6% of gait cycle in the sound leg, and significantly later (at 9.81+/-4.8% of gait cycle) in the amputated leg (p < 0.05). Integrated EMG activity ratios, between swing and stance periods, were similar for the vastus medialis (0.33 in the sound and 0.35 in the amputated leg). However, these ratios differed significantly for the biceps femoris since the amputated leg presented a substantial (p < 0.05) smaller ratio (0.22) compared with the sound leg (0.83). The use of prosthesis in trans-tibial amputees requires further activity of the biceps femoris during stance period to improve support of the amputated leg knee joint.