Contributors of stiff knee gait pattern for able bodies: Hip and knee velocity reduction and tiptoe gait

Akalan, N.E.; Kuchimov, Shavkat; Apti, Adnan; Temelli, Yener; Nene, A.V.

doi:10.1016/j.gaitpost.2015.09.019

Cited by 12 publications

(4 citation statements)

References 17 publications

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“…Using the HWA for gait training, we have previously reported improved lower limb kinematic parameters during walking, as well as early improvement of walking ability after surgical operation in a patient who underwent total hip arthroplasty (THA). 19 As SKG is affected by hip and knee flexion velocity at the early swing phase 20 , 21 ( Figure 1B ), we hypothesized that effective walking exercises with improved knee biomechanics may be possible with hip assistance using HWA gait training.…”

Section: Introductionmentioning

confidence: 99%

Gait Training Using a Hip-Wearable Robotic Exoskeleton After Total Knee Arthroplasty: A Case Report

Koseki

Mutsuzaki

Yoshikawa

et al. 2020

Geriatr Orthop Surg Rehabil

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The Honda Walking Assist® (HWA) is a light and easy wearable robot device for gait training, which assists patients’ hip flexion and extension movements to guide hip joint movements during gait. However, the safety and feasibility of gait training with HWA after total knee arthroplasty (TKA) remains unclear. Thus, we aimed to evaluate the safety and feasibility of this gait training intervention using HWA for a patient who underwent TKA. The patient was a 76-year-old female who underwent a left TKA. Gait training using HWA was conducted for 18 sessions in total, from 1 to 5 weeks after TKA. To verify the recovery process after TKA surgery, knee function parameters and walking ability were measured at pre-TKA and 1, 2, 4, and 8 weeks after TKA. The gait patterns at self-selected walking speed (SWS) without HWA at pre- and 5 weeks after TKA were measured by using 3-dimensional (3D) gait analysis. The patient completed a total of 18 gait training interventions with HWA without any adverse complications such as knee pain and skin injury. The postoperative knee extension range of motion (ROM), knee extension torque, SWS, and maximum walking speed were remarkably improved. Regarding gait kinematic parameters, though this patient had a characteristic gait pattern with decreased knee ROM (called stiff knee gait) preoperatively, the knee flexion angle at 5 weeks after TKA showed knee flexion movement at loading response phase (LR; called double knee action), increased knee ROM during gait, and increased knee flexion angle at swing phase. In this case, the gait training using HWA was safe and feasible, and could be effective for the early improvement of gait ability, hip function, and gait pattern after TKA.

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Section: Introductionmentioning

confidence: 99%

Gait Training Using a Hip-Wearable Robotic Exoskeleton After Total Knee Arthroplasty: A Case Report

Koseki

Mutsuzaki

Yoshikawa

et al. 2020

Geriatr Orthop Surg Rehabil

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“…Knee flexion angle during pre-swing has been attributed to the reaction forces passing behind the knee joint. In healthy subjects and children with cerebral palsy, relationships between knee flexion angle during Sw and knee flexion velocity at toe-off has been reported [22,27,28]. Similarly, in stroke patients, knee flexion angle during Sw was shown to be associated with knee flexion velocity at toe-off and ankle plantarflexor moment [21,29].…”

Section: Discussionmentioning

confidence: 92%

Effect of Leg Extension Angle on Knee Flexion Angle during Swing Phase in Post-Stroke Gait

et al. 2021

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Background and Objectives: Leg extension angle is important for increasing the propulsion force during gait and is a meaningful indicator for evaluating gait quality in stroke patients. Although leg extension angle during late stance might potentially also affect lower limb kinematics during the swing phase, the relationship between these two remains unclear. This study aimed to investigate the relationship between leg extension angle and knee flexion angle during pre-swing and swing phase in post-stroke gait. Materials and Methods: Twenty-nine stroke patients walked along a 16 m walkway at a self-selected speed. Tilt angles and acceleration of pelvis and paretic lower limb segments were measured using inertial measurement units. Leg extension angle, consisting of a line connecting the hip joint with the ankle joint, hip and knee angles, and increments of velocity during pre-swing and swing phase were calculated. Correlation analysis was conducted to examine the relationships between these parameters. Partial correlation analysis adjusted by the Fugl-Meyer assessment-lower limb (FMA-LL) was also performed. Results: On the paretic side, leg extension angle was positively correlated with knee flexion angle during the swing phase (r = 0.721, p < 0.001) and knee flexion angle and increments of velocity during the pre-swing phase (r = 0.740–0.846, p < 0.001). Partial correlation analysis adjusted by the FMA-LL showed significant correlation between leg extension angle and knee flexion angle during the swing phase (r = 0.602, p = 0.001) and knee flexion angle and increments of velocity during the pre-swing phase (r = 0.655–0.886, p < 0.001). Conclusions: Leg extension angle affected kinematics during the swing phase in post-stroke gait regardless of the severity of paralysis, and was similar during the pre-swing phase. These results would guide the development of effective gait training programs that enable a safe and efficient gait for stroke patients.

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“…When the swinging leg landed and the body transitioned to the double‐leg support period, the body had an obvious swing in the frontal plane and could not maintain an upright posture. Combined with video recording analysis, all three participants tended to walk on tiptoes, increasing the burden of supporting leg (Akalan et al ., 2016). We also found that their foot‐ground contact was insufficient and contact location points changed frequently.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical analysis of gait patterns in children with intellectual disabilities

Zhang

et al. 2021

J intellect Disabil Res

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Background Children with intellectual disabilities (ID) typically master walking skills much later than typically developing (TD) children and have poor postural control ability. This study aimed to explore the gait ability and characteristics of children with ID and whether there is any difference in walking ability between them and TD children. Method In this study, integrating kinematic–biomechanic–dynamic measurement methods and corresponding analysis methods (video analysis, three‐dimensional force analysis and electromyography test analysis) were used to characterise and compare the gait patterns between ID children and TD children. Results ID children's step length/leg length ratio was lower than TD children. The left‐leg single‐leg support time and step length of ID children were shorter than TD children. While walking, ID children touched the ground with the whole foot pad and could not powerfully thrust against the ground with their toes. Their left legs had obvious disadvantages compared with their right legs. ID children's lower limb muscle strength was lower than TD children, and their thigh muscles had an obvious compensation function. Conclusions Correcting ID children's gait should be an important teaching goal for physical education institutors and teachers. Muscle‐strength and flexibility training can help ID children reinforce core strength and better coordinate lower limbs.

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Contributors of stiff knee gait pattern for able bodies: Hip and knee velocity reduction and tiptoe gait

Cited by 12 publications

References 17 publications

Gait Training Using a Hip-Wearable Robotic Exoskeleton After Total Knee Arthroplasty: A Case Report

Gait Training Using a Hip-Wearable Robotic Exoskeleton After Total Knee Arthroplasty: A Case Report

Effect of Leg Extension Angle on Knee Flexion Angle during Swing Phase in Post-Stroke Gait

Biomechanical analysis of gait patterns in children with intellectual disabilities

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