Analysis of Plantar Foot Pressure during the Non-crutch, Two-point, and Four-point Crutch Gait performed by Healthy Volunteers

Abstract

Abstract.[Purpose] The measurement of foot pressure (FP) is widely used for the evaluation of gait. The fluctuating changes of FP parameters according to various types of crutch gait, however, are not fully understood. This study examined the changes of FP during normal, two-point, and four-point crutch gait of healthy volunteers.[Subjects] The subjects were thirty-three adults who were 26.5 ± 1.4 years old, weighed 64.2 ± 10.3 kg, and were 168.8 ± 8.7 cm in height.[Methods] FP parameters were collected by a force plate with 2,304 resistive sensors. Regional plantar FP, trajectories of center of pressure (COP) in the anterior-posterior (AP) and the medio-lateral (ML) directions, contact time of foot on the ground, and the relative durations of sub-stages of the stance phase were measured during gait with or without a crutch.[Results] The regional plantar FP significantly decreased during two-point and four-point crutch gait compared with that during normal gait in the AP direction and overall. Analyzed by its trajectory, displacement of COP in the AP direction was significantly smaller during four-point gait than during normal gait. Contact time during two-point and four-point gait was significantly longer than during normal gait. Also, the relative duration of heel contact stage during four-point gait was significantly smaller than during normal gait. The relative durations of the midstance stage during two-point and fourpoint gait, however, were longer than that of normal gait. [Conclusion] These results suggest that types of gait with or without a crutch affect the fluctuation of FP and that may lead to a change of body position and gait pattern. The present data therefore may be useful for understanding the variations of crutch gait.

Analysis of Crutch Position in the Horizontal Plane to Estimate the Stability of the Axillary Pad in the Axilla during Single-crutch Walking

“…Many diverse studies of crutch walking have been performed by researchers. For example, the study of appropriate crutch length 6 , 11 , 12 ) , the study of energy cost 13 ) , the study of crutch palsy or fracture 14 , 15 ) , and the kinematic or kinetic study of the upper and lower extremities 16 , 17 , 18 , 19 , 20 , 21 , 22 ) . However, we were not able to find a study on the stability of the axillary pad in the axilla.…”

Posture Analysis of Various Types of Crutch Gait of Healthy Volunteers

“…Each subject was provided with a crutch of length and handle position that were suitable for the subject's height. The humeral crosspieces of the crutches were located 5 cm below the upper extremity axillary boundary, the handles were located within reach of the hand when the elbow joint was bent to 20°-30°, and the length of each crutch was adjusted so that the end of the crutch could be comfortably placed 15 cm ahead on the ground lateral to the top of the fifth metatarsal bone 11,22) . The subjects were given instruction about how to use the crutches and types of crutch gait before they were measured.…”

“…Four-point gait is the slowest and the most stable gait type, and two-point gait, which is similar to normal gait pattern, is the second slowest gait type 5,7) . Changes to the body posture, foot pressure, and joint posture occur according to the crutch gait pattern [11][12][13] . Crutches cause the subject to tilt forward, which changes the body posture and joint positions of the hand, elbow, shoulder, and trunk in the stance phase [12][13][14] .…”

Effects of orthosis on balance and gait in healthy adults

“…Gait is defined as a sequential and repetitive movement in which one leg moves the body ahead while the other leg maintains a stable condition in the stance phase. Furthermore, gait motion is a complex movement enabled by the coordination of the skeletal muscles with many joints in the arms and legs 1 ) .…”