Preditores espaço-temporais do andar para testes de capacidade funcional em pacientes com doença de Parkinson

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Stretching Exercise Program Improves Gait in the Elderly

Background: Ageing is characterized by a number of physical changes that contribute to a decline in the ability to perform daily tasks. Stretching has been proposed to reduce hip flexion contracture and increase hip and pelvis range of motion, thus improving gait performance. Objective: The purpose of this study was to determine whether a supervised stretching program designed to improve the range of motion of the lower limbs alters gait kinematics in older adults. Methods: Twenty healthy older adult women (65.9 +/- 4.2 years old and BMI 24.9 +/- 3.5) were divided into 2 groups. The experimental group undertook 12 sessions of stretching exercises, whereas the control group did not engage in any physical activity. Gait performance was assessed at the beginning of the experiment and after the 4-week intervention period. Results: Those in the experimental group showed increased step length, higher velocity and reduced double support time after training. In addition, participants involved in the stretching program showed greater anterior and lateral pelvis tilt and also greater rotation (p < 0.05). Conclusions: Based on our results, we can suggest that a supervised stretching program is effective to alter a number of gait variables. Moreover, after the stretching protocol, aged participants displayed gait parameters which were similar to those reported in young healthy adults. Therefore, stretching can be used as an effective means to improve range of motion and reverse some age-related changes that influence gait performance. Copyright (C) 2009 S. Karger AG, Basel

Gait training with partial body weight support during overground walking for individuals with chronic stroke: a pilot study

Background: It is not yet established if the use of body weight support (BWS) systems for gait training is effective per se or if it is the combination of BWS and treadmill that improves the locomotion of individuals with gait impairment. This study investigated the effects of gait training on ground level with partial BWS in individuals with stroke during overground walking with no BWS.Methods: Twelve individuals with chronic stroke (53.17 +/- 7.52 years old) participated of a gait training program with BWS during overground walking, and were evaluated before and after the gait training period. In both evaluations, individuals were videotaped walking at a self-selected comfortable speed with no BWS. Measurements were obtained for mean walking speed, step length, stride length and speed, toe-clearance, durations of total double stance and single-limb support, and minimum and maximum foot, shank, thigh, and trunk segmental angles.Results: After gait training, individuals walked faster, with symmetrical steps, longer and faster strides, and increased toe-clearance. Also, they displayed increased rotation of foot, shank, thigh, and trunk segmental angles on both sides of the body. However, the duration of single-limb support remained asymmetrical between each side of the body after gait training.Conclusions: Gait training individuals with chronic stroke with BWS during overground walking improved walking in terms of temporal-spatial parameters and segmental angles. This training strategy might be adopted as a safe, specific and promising strategy for gait rehabilitation after stroke.

Effects of fatigue induced by prolonged gait when walking on the elderly

Purpose. Fatigue has been pointed as a fall risk in the elderly; however, the effects of prolonged gait on neuromuscular recruitment and on its pattern remain unknown. The aim of this study was to evaluate the effects of prolonged gait on neuromuscular recruitment levels and spatial-temporal gait variables. Methods. Eight healthy older women (age: 72.63 ± 6.55 years) walked at their preferred walking speed for twenty minutes on a treadmill. The Root Mean Square (RMS) from the vastus-lateralis, femoral biceps, tibialis anterior and lateral gastrocnemius muscles were determined at the first and last minute of the test during the moments of Heel Strike (HS), Terminal Stance and Terminal Swing (TS). In addition, coactivation in the knee and ankle as well as the stride cadence and length were measured in the test. The two RMS data (taken at the first and last minute) were compared by means of a Student's t-test. Results. Twenty minutes of walking induced fatigue in the subjects, as observed through an increase in RMS, notably during the HS and TS. Coactivation was also influenced by the prolonged gait test. The only gait phase where a risk of falling was enhanced was the HS. Nonetheless, subjects developed strategies to maintain a safe motor pattern, which was evidenced by an increase in stride length and a decrease in stride cadence. Conclusion. Tests lasting just twenty minutes on a treadmill were enough to induce fatigue in older adults. However, the level of fatigue was not enough to present a danger or fall risk to elderly individuals.

Variabilidade de parâmetros eletromiográficos e cinemáticos em diferentes condições de marcha em idosos

The main goal of this study was to investigate the influence of fear of fall and dual task on electromyographic and kinematic variability parameters on the gait of older females. Seventeen college students (21,47 ± 2,06 years old) and eighteen older female adults, both groups were physically fit and performed the gait test on three different conditions: walking at self-select speed, fear of fall and dual task. Electromyographic activity was measured on muscles of dominant leg and stride time was recorded. ANOVA two-way (p<0.05) was used. Electromyographic and kinematic gait variability were higher in older adult groups. However, for the comparison between gait conditions was only found significant difference for electromyographic variability. In line with this, the higher EMG and kinematic variability in older adults suggest that aging contributes for a higher motor challenge while walking, which may be predispose these individuals a higher risk of fall.

Kinetic and temporospatial parameters in male and female cats walking over a pressure sensing walkway

Background: Several factors may influence kinetic data measurements, including body conformation and body mass. In addition, gender differences in gait pattern have been observed in healthy humans. Therefore, the aim of this study was to compare the kinetic and temporospatial parameters in clinically healthy male and female cats using a pressure-sensitive walkway. Eighteen crossbreed adult cats were divided into two groups: G1 had ten male cats (nine neutered) aged from 1 to 4 years and body mass 3.1-6.8 kg; G2 had eight spayed female cats, aged from 1 to 6 years and body mass 3.3-4.75 kg. The data from the first five valid trials were collected for each cat. A trial was considered valid if the cat maintained a velocity between 0.54-0.74 m/s and acceleration from -0.20 to 0.20 m/s2. The peak vertical force (PVF), vertical impulse (VI), gait cycle time, stance time, swing time, stride length, and percentage body weight distribution among the four limbs were determined. In addition, the lengths of each forelimb and each hind limb were measured using a tape with the animal standing.Results: No significant differences were observed in each group in either the forelimbs or the hind limbs or between the left and right sides for any of the variables. For both groups, the PVF (%BW), the VI, and the percentage body weight distribution were higher at the forelimbs than the hind limbs. The stride length was larger for males; however, the other kinetic and temporospatial variables did not show any statistically significant differences between the groups. The lengths of the forelimbs and hind limbs were larger in the male cats. There was a significant moderate positive correlation between the stride length and the length of the limbs.Conclusions: In conclusion, the only difference observed between male and female cats was the stride length, and this was due to the greater body size of male cats. This difference did not affect other temporospatial or kinetics variables. © 2013 Verdugo et al.; licensee BioMed Central Ltd.

Efeito de dica auditiva na marcha livre e adaptativa em pacientes com doença de Parkinson

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Sugestões para professores de orientação e mobilidade a partir de um estudo da marcha de alunos com deficiência visual

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Revisão sistemática do efeito do envelhecimento no andar livre e adaptativo

Aging seems to impair the walking. However, it is not clear the effects of aging on walking. The aim of this study was to determine changes in kinematic, kinetic and electromyographic parameters of the free and adaptive gait, in preferred velocity, caused by aging. The initial search strategy was performed to identify all articles that examined the free and adaptive gait. The electronic databases analyzed were: MEDLINE, PubMed, EMBASE, CINAHL, Sports Discus, DARE, PsychInfo, ERIC, AusportMed, AMI, Cochrane and PEDro. Twenty-three articles were reviewed in full. Elderly are slower, with shorter step length and longer double support duration than young adults during free and adaptive gait. Even, they showed higher muscular demands, with redistribution of joint power and torque and decreased force in the propulsion and absorption phases. It was concluded that elderly present altered kinematic, kinetic and electromyographic parameters of free and adaptive gait compared to young adults.

Visual cues and gait improvement in Parkinson's disease: which piece of information is really important?

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Positive effects of auditory cue in locomotor pattern of people with Parkinson's disease (off and on medication)

Gait disorders are identified in people with Parkinson’s disease. The aim of this study was to investigate the effect of auditory cues and medication on kinematic, kinetic and EMG parameters, during different gait phases of people with PD and healthy elderly. Thirty subjects distributed in two groups (Group 1, PD patients off and on medication; Group 2, healthy elderly) participated in this study and were instructed to walk in two experimental conditions: non-cued and cued. Therefore, kinematic, kinetic and electromyography analyses were utilized to investigate the locomotor pattern. Changes in locomotor pattern (greater muscular activity) with auditory cue were observed for PD patients. Regarding the medication, locomotor parameter improvement was observed after levodopa intake in association with the auditory cue. These results confirm the hypothesis about the external cues therapy that could be used as a complement to drug therapy to achieve improvement in the locomotor pattern of PD patients.

Gait analysis in giant anteater (myrmecophaga tridactyla) with the use of a pressure-sensitive walkway

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Excess body weight and gait influence energy cost of walking in older adults

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Gait analysis in dogs with pelvic fractures treated conservatively using a pressure-sensing walkway

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Recovery of gait after quadriceps muscle fatigue

The aim of this study was to investigate the effect of recovery time after quadriceps muscle fatigue on gait in young adults. Forty young adults (20-40 years old) performed three 8-m gait trials at preferred velocity before and after muscle fatigue, and after 5, 10 and 20min of passive rest. In addition, at each time point, two maximal isometric voluntary contractions were preformed. Muscle fatigue was induced by repeated sit-to-stand transfers until task failure. Spatio-temporal, kinetic and muscle activity parameters, measured in the central stride of each trial, were analyzed. Data were compared between before and after the muscle fatigue protocol and after the recovery periods by one-way repeated measures ANOVA. The voluntary force was decreased after the fatigue protocol (p<0.001) and after 5, 10 and 20min of recovery compared to before the fatigue protocol. Step width (p<0.001) and RMS of biceps femoris (p<0.05) were increased immediately after the fatigue protocol and remained increased after the recovery periods. In addition, stride duration was decreased immediately after the fatigue protocol compared to before and to after 10 and 20min of rest (p<0.001). The anterior-posterior propulsive impulse was also decreased after the fatigue protocol (p<0.001) and remained low after 5, 10 and 20min of rest. We conclude that 20min is not enough to see full recovery of gait after exhaustive quadriceps muscle fatigue.