Effects of Early Gait Training on Inpatient Frailty After Transcatheter Aortic Valve Implantation.

INTRODUCTION: This study aimed to clarify the relationship between the number of days of early gait training and frailty in in-hospital patients undergoing transcatheter aortic valve implantation (TAVI) for aortic stenosis, focusing on the Clinical Frailty Scale (CFS) and clinical laboratory data. METHODS AND RESULTS: Sixty-nine patients admitted to the Ichinomiya West Hospital from November 1, 2019 to November 30, 2023 were included in the study. Of the 69 patients, those who started gait training on postoperative day 0 or 1 were defined as the early gait training group and those who started gait training later than postoperative day 1 were defined as the delayed gait training group. There was a significant difference in the number of days to gait training initiation, which was 3.9 days in the delayed gait training group and 0.9 days in the early gait training group. The early gait training group started early mobilization and had a significantly shorter postoperative hospital stay than the delayed gait training group. Clinical laboratory data showed that walking speed was significantly faster and grip strength was significantly higher in the early group. The number of days to gait training initiation was an independent predictor of changes in CFS scores. CONCLUSION: Early gait training in patients after TAVI may predict early improvements in physical function and movement, shorter hospital stay, and frailty at discharge.

Approaching Process in Walking through an Aperture for Individuals with Stroke.

Muroi et al. show that individuals with stroke have improved collision avoidance behavior when passing through an aperture while entering from the paretic-side of the body. However, the underlying mechanism remains unknown. We reanalyzed Muroi et al.'s data to reveal how individuals with stroke walk through an aperture by examining changes in walking velocity and behavioral complexity (i.e., sample entropy, an index of (ir)regularity of time series, regarded lower entropy as more regular and less complex) by focusing on the approaching process. The results showed that individuals with stroke reduced their walking velocity and behavioral complexity before passing through the narrow aperture when approaching from the paretic side. We interpreted that the improved obstacle avoidance when penetrating from the paretic side may be due to careful body rotation and adjusting the walking velocity in advance.

Gait velocity control using projection mapping for children with spastic diplegia cerebral palsy.

BACKGROUND: Gait characteristics in children with cerebral palsy vary according to their individual walking speed. As such, establishing methods to maintain a consistent gait velocity are necessary to evaluate specific intervention effects in this clinical population. Our study aim was to validate the accuracy of projection mapping for guiding gait velocity to a control gait velocity. METHODS: This was a cross-sectional study of 13 children with cerebral palsy (mean age [standard deviation] of 12.42 [2.31] years). The target velocity was calculated from the average speed obtained across three trials of self-selected walking speed. A virtual reality system with four projectors was used to project an image onto the floor to guide children to match two gait conditions: 100% and 125% velocity of the average speed. Participants completed three gait trials at each velocity under image guidance. Gait velocity was quantified using a 3-dimensional motion capture system. Bland-Altman plots were used to analyze systematic errors and the limits of agreement calculated. FINDINGS: The results indicated the limits of agreement were acceptable for 0.10 m/s for 100% velocity and 0.12 m/s for 125% velocity. Therefore, projection mapping was effective in guiding children to adjust their gait to the intended velocity. INTERPRETATION: Projection mapping is a novel method for guiding children with cerebral palsy to walk at a controlled target velocity that may improve the reliability of gait analysis.

Load-power relationship in older adults: The influence of maximal mean and peak power values and their associations with lower and upper-limb functional capacity.

Identifying the relative loads (%1RM) that maximize power output (Pmax-load) in resistance exercises can help design interventions to optimize muscle power in older adults. Moreover, examining the maximal mean power (MPmax) and peak power (PPmax) values (Watts) would allow an understanding of their differences and associations with functionality markers in older adults. Therefore, this research aimed to 1) analyze the load-mean and peak power relationships in the leg press and chest press in older adults, 2) examine the differences between mean Pmax-load (MPmax-load) and peak Pmax-load (PPmax-load) within resistance exercises, 3) identify the differences between resistance exercises in MPmax-load and PPmax-load, and 4) explore the associations between MPmax and PPmax in the leg press and chest press with functional capacity indicators. Thirty-two older adults (79.3 ± 7.3 years) performed the following tests: medicine ball throw (MBT), five-repetition sit-to-stand (STS), 10-m walking (10 W), and a progressive loading test in the leg press and chest press. Quadratic regressions analyzed 1) the load-mean and peak power relationships and identified the MPmax-load, MPmax, PPmax-load, and PPmax in both exercises, 2) the associations between MPmax and PPmax in the chest press with MBT, and 3) the associations between MPmax and PPmax in the leg press with STSpower and 10Wvelocity. In the leg press, the MPmax-load was ∼66% 1RM, and the PPmax-load was ∼62% 1RM, both for women and men (p > 0.05). In the chest press, the MPmax-load was ∼62% 1RM, and the PPmax-load was ∼56% 1RM, both for women and men (p > 0.05). There were differences between MPmax-load and PPmax-load within exercises (p < 0.01) and differences between exercises in MPmax-load and PPmax-load (p < 0.01). The MPmax and PPmax in the chest press explained ∼48% and ∼52% of the MBT-1 kg and MBT-3 kg variance, respectively. In the leg press, the MPmax and PPmax explained ∼59% of STSpower variance; however, both variables could not explain the 10Wvelocity performance (r 2 ∼ 0.02). This study shows that the Pmax-load is similar between sexes, is resistance exercise-specific, and varies within exercises depending on the mechanical power variable used in older adults. Furthermore, this research demonstrates the influence of the MBT as an upper-limb power marker in older adults.

Minimal clinically important difference in walking velocity, gait profile score and two minute walk test for individuals with lower limb amputation.

BACKGROUND: Individuals with lower limb amputation are routinely assessed with a variety outcome measures, however there is a lack of published data to indicate minimal clinically important differences (MCID) for many of these outcome measures. Three such important gait-specific outcome measures include walking velocity, gait profile score (GPS) and the two minute walk test (2MWT). RESEARCH QUESTION: Determine the MCIDs for walking velocity, GPS and 2MWT for individuals with lower limb amputation. METHODS: Walking velocity and GPS (n = 60), and 2MWT (n = 119) data for individuals with unilateral transfemoral or knee disarticulation were identified retrospectively from a database held at the study centre. An anchor-based method was used with Medicare functional classification level (MFCL) acting as the impairment-related criterion, and a least-squares linear regression approach was used to calculate the gradient required for a change between MFCL levels. RESULTS: An increase of 0.21 m/s (95 % CI: 0.13,0.29) for walking velocity, a reduction of 1.7° (95 % CI: -2.449,-1.097) for GPS and an increase of 37.2 m (95 % CI: 28.8,45.5) for 2MWT were found to correspond to an increase in MFCL of one level. Walking velocity, GPS and 2MWT correlated with MFCL with R2 values of 0.333, 0.322 and 0.398 respectively (p < 0.00001). The authors propose that 0.21 m/s for walking velocity, 1.7° for GPS and 37.2 m for 2MWT be used as MCID values for individuals with lower limb amputation. SIGNIFICANCE: The results of this study can be used to help both researchers and clinicians to objectively evaluate if interventions for individuals with lower limb amputation are effective.

Matching walking speed of controls affects identification of gait deviations in patients with a total knee replacement.

BACKGROUND: The assessment of functional recovery of patients after a total knee replacement includes the quantification of gait deviations. Comparisons to comfortable gait of healthy controls may incorrectly suggest biomechanical gait deviations, since the usually lower walking speed of patients already causes biomechanical differences. Moreover, taking peak values as parameter might not be sensitive to actual differences. Therefore, this study investigates the effect of matching walking speed and full-waveform versus discrete analyses. METHODS: Gait biomechanics of 25 knee replacement patients were compared to 22 controls in two ways: uncorrected and corrected for walking speed employing principal component analyses, to reconstruct control gait biomechanics at walking speeds matched to the patients. Ankle, knee and hip kinematics and kinetics were compared over the full gait cycle using statistical parametric mapping against using peak values. FINDINGS: All joint kinematics and kinetics gait data were impacted by applying walking speed correction, especially the kinetics of the knee. The lower control walking speeds used for reference generally reduced the magnitude of differences between patient and control gait, however some were enlarged. Full-waveform analysis identified greater deviating gait cycle regions beyond the peaks, but did not make peak value analyses redundant. INTERPRETATION: Matching walking speed of controls affects identification of gait deviations in patients with a total knee replacement, reducing deviations confounded by walking speed and revealing hidden gait deviations related to possible compensations. Full-waveform analysis should be used along peak values for a comprehensive quantification of differences in gait biomechanics.

The influence of trunk muscle strength on walking velocity in elderly people with sarcopenia.

[Purpose] Sarcopenia increases the risk of falls and fractures. However, its relationship with walking, which is the generation mechanism of falls, has not been clarified. The purpose of this study was to clarify the trunk muscle strength and the characteristics of walking, in elderly people with sarcopenia. [Participants and Methods] The participants were 40 elderly people aged 65 years and over. The participants were able to walk without assistance and were attending outpatient rehabilitation or community day-care centers. The assessment and measurement items included: the presence or absence of sarcopenia (using the diagnostic criteria of the Asian Working Group for Sarcopenia), lower limb and trunk muscle strength, and characteristics of walking. The participants were divided into two groups depending on the presence or absence of sarcopenia, and a comparison was made between the two groups. [Results] The participants in the sarcopenia group had significantly lower trunk extension muscle strength as compared to the participants in the non-sarcopenia group. In addition, the hip joint maximum flexion moment, ankle joint maximum plantar flexion moment, and walking velocity of participants in the sarcopenia group were significantly lower than those in the non-sarcopenia group. [Conclusion] This study revealed that weakness of the trunk muscle strength causes a decrease in walking velocity in elderly people with sarcopenia.

Grazing Seasons and Stocking Rates Affects the Relationship between Herbage Traits of Alpine Meadow and Grazing Behaviors of Tibetan Sheep in the Qinghai-Tibetan Plateau.

Under the combined effect of stocking rate and grazing season, it is very significant to ascertain whether there is a quantitative relationship between plant community characteristics, chemical composition of forage, and grazing behaviors of Tibetan sheep to better utilize native pasture in the northeast region of the Qinghai-Tibetan Plateau (QTP). The two consecutive year observation experiments on Tibetan sheep's grazing behavior were conducted to evaluate the above-stated relationships between stocking rates of 8 sheep/ha and 16 sheep/ha stocking rates in the both the warm and cold seasons. The results demonstrated that at 8 sheep/ha or in the warm season, due to better forage quality, Tibetan sheep had higher herbage mass, forage crude protein (CP) concentration, CP intake, dry matter intake (DMI), and interval between feed boluses and total number of steps, as well as lower fiber concentration than that at 16 sheep/ha or in the cold season. Diurnal intake rate and walking velocity while intaking increased as both average daylight ambient temperature and relative humidity rose. Using the CP concentration, acid detergent fiber (ADF) concentration, neutral detergent fiber (NDF) concentration, and forage metabolic energy (ME) to predict grazing behavior yielded the best fit equation for Tibetan sheep. For local herdsmen to sustainably use the alpine meadow, 8 sheep/ha in the warm season should be considered as the better grazing condition for preventing grassland degradation.

Comparison of measurement protocols to estimate preferred walking speed between sites.

BACKGROUND: Walking speed influences a variety of typical outcome measures in gait analysis. Many researchers use a participant's preferred walking speed (PWS) during gait analysis with a goal of trying to capture how a participant would typically walk. However, the best practices for estimating PWS and the impact of laboratory size and walk distance are still unclear. RESEARCH QUESTION: Is measured PWS consistent across different distances and between two laboratory sites? METHODS: Participants walked overground at a "comfortable speed" for six different conditions with either dynamic (4, 6, 10, and 400 m) or static (4 and 10 m) starts and stops at two different data collection sites. Repeated measures ANOVA with Bonferroni corrections were used to test for differences between conditions and sites. RESULTS: Participants walked significantly faster in the 4, 6, and 10 m dynamic conditions than in the 400 m condition. On average, participants walked slower in the static trials than the dynamic trials of the same distance. There was a significant interaction of lab and condition and so results were examined within each lab. Across both labs, we found that the 4 and 10 m dynamic conditions were not different than the 6 m dynamic condition at both sites, while other tests did not provide consistent results at both sites. SIGNIFICANCE: We recommend researchers use a 6 m distance with acceleration and deceleration zones to reliably test for PWS across different laboratories. Given some of the differences found between conditions that varied by site, we also emphasize the need to report the test environment and methods used to estimate PWS in all future studies so that the methods can be replicated between studies.

Reactive gait and postural adjustments following the first exposures to (un)expected stepdown.

This study evaluated the reactive biomechanical strategies associated with both upper- and lower-body (lead and trail limbs) following the first exposures to (un)expected stepdown at comfortable (1.22 ±â€¯0.08 m/s) and fast (1.71 ±â€¯0.11 m/s) walking velocities. Eleven healthy adults completed 34 trails per walking velocity over an 8-m, custom-built track with two forceplates embedded in its center. For the expected stepdown, the track was lowered by 0-, -10- and -20-cm from the site of the second forceplate, whereas the unexpected stepdown was created by camouflaging the second forceplate (-10-cm). Two-way repeated-measurement ANOVAs detected no velocity-related effects of stepdown on kinematic and kinetic parameters during lead limb stance-phase, and on the trail limb stepping kinematics. However, analyses of significant interactions revealed greater peak flexion angles across the trunk and the trail limb joints (hip, knee and ankle) in unexpected versus expected stepdown conditions at a faster walking velocity. The -10-cm unexpected stepdown (main effect) had a greater influence on locomotor behavior compared to expected conditions due mainly to the absence of predictive adjustments, reflected by a significant decrease in peak knee flexion, contact time and vertical impulse during stance-phase. Walking faster (main effect) was associated with an increase in hip peak flexion and net anteroposterior impulse, and a decrease in contact time and vertical impulse during stepdown. The trail limb, in response, swung forward faster, generating a larger and faster recovery step. However, such reactive stepping following unexpected stepdown was yet a sparse compensation for an unstable body configuration, assessed by significantly smaller step width and anteroposterior margin-of-stability at foot-contact in the first-recovery-step compared with expected conditions. These findings depict the impact of the expectedness of stepdown onset on modulation of global dynamic postural control for a successful accommodation of (un)expected surface elevation changes in young, healthy adults.

Gait Mechanics Differences Between Healthy Controls and Patients With Peripheral Artery Disease After Adjusting for Gait Velocity Stride Length and Step Width.

Patients with peripheral artery disease (PAD) experience significant leg dysfunction. The effects of PAD on gait include shortened steps, slower walking velocity, and altered gait kinematics and kinetics, which may confound joint torques and power measurements. Spatiotemporal parameters, joint torques and powers were calculated and compared between 20 patients with PAD and 20 healthy controls using independent t-tests. Separate ANCOVA models were used to evaluate group differences after independently adjusting for gait velocity, stride length and step width. Compared to healthy controls, patients with PAD exhibited reduced peak extensor and flexor torques at the knee, and hip. After adjusting for all covariates combined, differences between groups remained for ankle power generation in late stance, and knee flexor torque. Reduced walking velocity observed in subjects affected by PAD was closely connected with reductions in joint torques and powers during gait. Gait differences remained, at the knee and ankle, after adjusting for the combined effect of spatiotemporal parameters. Improving muscle function through exercise or with the use of assistive devices needs to be a key tool in the development of interventions that aim to enhance the ability of PAD patients to restore spatiotemporal gait parameters.

Rhythmic arm swing integrated into treadmill training in patients with chronic stroke: A single-subject experimental study.

Normal walking includes coordinated and controlled movement of the legs and arms. However, patients following stroke often present with inappropriate motor control which limits coordinated movement patterns of the affected limbs. This study aimed to compare the effects of rhythmic arm swing and arm fixation during treadmill walking in patients with poststroke hemiparesis. We used an alternating study design with multiple baselines across subjects. Three patients with chronic stroke participated in this study. During treadmill walking, rhythmic arm swing and arm fixation conditions were alternately applied. Outcome measures included the 10-meter walk test (10MWT) and energy expenditure index (EEI). In the intervention phase, all subjects showed significantly greater improvements in the 10MWT and EEI scores for rhythmic arm swing condition compared to those for arm fixation condition (p < 0.05). 10MWT improvement rates: Subject 1-34.81% vs. 15.75%; Subject 2-40.00% vs. 17.95%; and Subject 3-38.08% vs. 21.85%; and EEI improvements: Subject 1-23.19% vs. 14.08%; Subject 2-26.15% vs. 20.43%; and Subject 3-22.99% vs. 14.49%. These findings suggest that rhythmic arm swing is clinically feasible as a more favorable option to enhance the effects of treadmill walking training. However, larger studies with a different study design are needed to be able to make any judgment about the usefulness of the treatment.

A comparison of the initial orthotic effects of functional electrical stimulation and ankle-foot orthoses on the speed and oxygen cost of gait in multiple sclerosis.

BACKGROUND: Foot drop affects walking in people with multiple sclerosis (pwMS). This study compares the initial orthotic effects of two treatments for foot drop: ankle-foot orthoses (AFO) and functional electrical stimulation (FES), on the speed and oxygen cost of walking in MS. METHOD AND MATERIALS: Seventy-eight pwMS were randomised to receive AFO or FES (ODFS PACE (OML, Salisbury, UK)). Participants completed the 25-ft walk test (25ftWT) and 5-min self-selected walk test (5minSSWT), from which oxygen cost was determined, with and without their device. Between-, within- and sub-group analyses (based on baseline walking speed of <0.8 m/s (slow) or ≥0.8 m/s (fast)) were undertaken. RESULTS: No significant differences between baseline measures were observed. The AFO group walked significantly slower than the FES group (5minSSWT, p = 0.037, 0.11 m/s). The AFO group walked significantly slower with than without AFO (25ftWT, p = 0.037), particularly in the fast-walking group ( p = 0.011). The slow-walking FES group walked significantly faster with FES than without (25ftWT; p = 0.029, 5minSSWT; p = 0.037). There were no differences in the fast-walking FES group or in the oxygen cost for either device. CONCLUSION: AFO reduced walking speed, particularly in fast walkers. FES increased walking speed in slow, but not fast walkers.

The effects of ankle weight loading on the walking factors of adults without symptoms.

The purpose of this study was to evaluate the components of walking adults who have no symptoms by integrating the temporal and spatial walking variables obtained from the GAITRite system. The following describes previous debates on weight-loaded walking training. The conclusion was as follows. First, there was a significant difference in walking distance between the 0% group and 1% group and between the 1% group and 2% group (P<0.05). Sencond, there was a significant difference in walking velocity between the 0% group and 1% group and between the 0% group and 2% group (P<0.05). Third, there was a significant difference in walking cadence between the 0% group and 1% group, between the 1% group and 2% group, and between the 0% group and 2% group (P<0.05). These study results indicate that diverse amounts of weight loading can be effective for enhancing the walking factors of adults without symptoms.

Reducing gait speed affects axial coordination of walking turns.

Turning is a common feature of daily life and dynamic coordination of the axial body segments is a cornerstone for safe and efficient turning. Although slow walking speed is a common trait of old age and neurological disorders, little is known about the effect of walking speed on axial coordination during walking turns. The aim of this study was to investigate the influence of walking speed on axial coordination during walking turns in healthy elderly adults. Seventeen healthy elderly adults randomly performed 180° left and right turns while walking in their self-selected comfortable pace and in a slow pace speed. Turning velocity, spatiotemporal gait parameters (step length and step time), angular rotations and angular velocity of the head and pelvis, head-pelvis separation (i.e. the angular difference in degrees between the rotation of the head and pelvis) and head-pelvis velocity were analyzed using Wilcoxon signed-rank tests. During slow walking, turning velocity was 15% lower accompanied by shorter step length and longer step time compared to comfortable walking. Reducing walking speed also led to a decrease in the amplitude and velocity of the axial rotation of the head and pelvis as well as a reduced head-pelvis separation and angular velocity. This study demonstrates that axial coordination during turning is speed dependent as evidenced by a more 'en bloc' movement pattern (i.e. less separation between axial segments) at reduced speeds in healthy older adults. This emphasizes the need for matching speed when comparing groups with diverse walking speeds to differentiate changes due to speed from changes due to disease.

Effect of investigator observation on gait parameters in individuals with and without chronic low back pain.

Despite the ubiquity of gait assessment in clinic and research, it is unclear how observation impacts gait, particularly in persons with chronic pain and psychological stress. We compared temporal spatial gait patterns in people with and without chronic low back pain (CLBP) when they were aware and unaware of being observed. This was a repeated-measures, deception study in 55 healthy persons (32.0±12.4 yr, 24.2±2.7kg/m2) and persons with CLBP (51.9±17.9 yr, 27.8±4.4kg/m2). Participants performed one condition in which they were unaware of observation (UNW), and three conditions under investigator observation: (1) aware of observation (AWA), (2) investigators watching cadence, (3) investigators watching step length. Participants walked across an 8.4m gait mat, while temporal spatial parameters of gait were collected. The Medical Outcomes Short Form (SF-12), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), and Oswestry Disability Index (ODI) were completed. Significant condition by group interactions were found for velocity and step length (p<0.05). Main effects of study condition existed for all gait variables except for step width. Main effects of group (healthy, LBP) were significant for all variables except for step width (p<0.05). Regression analyses revealed that after accounting for age, sex, and SF-12 mental component score, BDI scores predict velocity changes during walking from the UNW to AWA conditions. These findings show that people change their gait patterns when being observed. Gait analyses may require additional trials before data can reliably be interpreted and used for clinical decision-making.

Walking Pattern in COPD Patients.

PURPOSE: To compare the activity and walking pattern of individuals with chronic obstructive pulmonary disease (COPD) and control subjects during a 24-hour period. DESIGN: Cross-sectional study in home and community. METHODS: The average walking velocity, time spent in sitting, standing, and lying, and numbers of steps per 24 hours were measured in nine individuals with COPD and eight healthy control subjects. FINDINGS: The average walking velocity in individuals with COPD was equivalent to that of the control subjects. Individuals with COPD walked significantly less than the control subjects. The total time spent sitting, standing, and walking was similar in the two groups. CONCLUSIONS: The results suggested that the walking velocity selected by individuals with COPD serves to minimize energy cost per distance. CLINICAL RELEVANCE: The study findings emphasize the need to maintain walking velocity in any exercise prescription for individuals with COPD.

Effect of a combination of whole body vibration exercise and squat training on body balance, muscle power, and walking ability in the elderly.

A randomized controlled trial was conducted to clarify the beneficial effect of whole body vibration (WBV) exercise plus squat training on body balance, muscle power, and walking ability in the elderly with knee osteoarthritis and/or spondylosis. Of 35 ambulatory patients (14 men and 21 women) who were recruited at our outpatient clinic, 28 (80.0%, 12 men and 16 women) participated in the trial. The subjects (mean age 72.4 years) were randomly divided into two groups (n=14 in each group), ie, a WBV exercise alone group and a WBV exercise plus squat training group. A 4-minute WBV exercise (frequency 20 Hz) was performed 2 days per week in both groups; squat training (20 times per minute) was added during the 4-minute WBV training session in the WBV exercise plus squat training group. The duration of the trial was 6 months. The exercise and training program was safe and well tolerated. WBV exercise alone improved indices of body balance and walking velocity from baseline values. However, WBV exercise plus squat training was more effective for improving tandem gait step number and chair-rising time compared with WBV exercise alone. These results suggest the benefit and safety of WBV exercise plus squat training for improving physical function in terms of body balance and muscle power in the elderly.

Can we unmask features of spasticity during gait in children with cerebral palsy by increasing their walking velocity?

BACKGROUND AND AIM: Spasticity is a velocity dependent feature present in most patients with cerebral palsy (CP). It is commonly measured in a passive condition. The aim of this study was to highlight markers of spasticity of gastrocnemius and hamstring muscles during gait by comparing the effect of increased walking velocity of CP and typical developing (TD) children. METHODS: 53 children with spastic CP and 17 TD children were instructed to walk at self-selected speed, faster and as fast as possible without running. Kinematics, kinetics and electromyography (EMG) were collected and muscle length and muscle lengthening velocity (MLV) were calculated. To compare the data of both groups, a linear regression model was created which resulted in two non-dimensional gait velocities. A difference score (DS) was calculated between the high and low velocity values for both groups. RESULTS: 103 gait parameters were analyzed of which 16 had a statistically significant DS between TD and CP groups. The spastic gastrocnemius muscle presented at high velocity with a higher ankle angular velocity, plantar flexion moment, power absorption and increased EMG signal during loading response. The spastic hamstrings demonstrated at high velocity a delayed maximum knee extension moment at mid-stance and increasing hip extension moment and hip power generation. The hamstrings also presented with a lower MLV during swing phase. CONCLUSIONS: A limited number of gait parameters differ between CP and TD children when increasing walking velocity, giving indirect insight on the effect of spasticity on gait.

Effect of gait speed changes on foot loading characteristics in children.

Gait speed has been shown to influence foot loading patterns in adults but the mechanism has not been investigated in children. The present study investigated the effects of changes in gait speed on foot loading characteristics in 20 typically developing children who participated in plantar pressure measurements at normal, slow and fast walking speeds. In spite of shorter contact times in the fast walking speed condition, significantly increased foot loading was seen in the hindfoot, medial and central forefoot and toes while it slightly decreased in the lateral midfoot and forefoot. The results generally confirm the findings in adults that gait speed does not uniformly affect foot loading characteristics and that these effects should be kept in mind when comparing different subject groups or children at repeated measurement occasions.