Predicting peak kinematic and kinetic parameters from gait speed
Introduction
A reference set of ‘normal’ gait parameter values provides an invaluable tool within the realm of clinical gait analysis as a basis of comparison when deciding on treatment for abnormal and/or pathological gait. It is becoming more common to make allowances for the effect of gait speed on these gait parameters when making these comparisons, since patients tend to walk slower than their healthy counterparts [1], [2], [3], [4]. To do this, one must know or be able to predict each reference value at a wide range of walking velocities. As it is generally accepted that gait parameters follow a consistent pattern of change in response to varying gait speed, [5] we believe it possible to model the pattern for each parameter and predict its value at any given walking velocity. Much has been done in an attempt to characterize the effect of gait speed on temporal and kinematic gait parameters. This work has shown that although the temporal parameters exhibit characteristic and predictable relationships with gait speed [6], [7], [8], [9], [10], there are varying conclusions as to the existence of the relationships between certain kinematic gait parameters and gait speed [5], [10], [11], [12]. Studies of the dependency of kinetic gait parameters on gait speed are relatively limited, generally focusing only on one or two specific kinetic parameters [13], [14].
The overall goal of this study was to assess the predictability of the relationships between gait speed and 27 common peak sagittal plane kinematic and kinetic parameters to provide a set of reference values. Specifically, we aimed to validate any existing relationships known for many of the kinematic and a few of the kinetic peak sagittal plane parameters. For those where no previous known relationship with gait speed is documented, we aimed to derive these relationships. Finally, we attempted to present all the results together in a clear, concise manner to provide a quick reference for comparison with and interpretation of pathological gait.
Section snippets
Methods
Sixty four healthy adults between the age of 19 and 40 years (mean age 28.1 (5.9) years, mean weight 65.7 (15.7) kg and mean height 1.69 (0.10) m) with no known neurologic, orthopedic or cardiopulmonary problems volunteered for this study. Subjects were recruited by flyers and notices throughout the Partners HealthCare System. The study was approved by the Spaulding Rehabilitation Hospital Internal Review Board and informed consents were obtained from all subjects. The subjects were asked to
Results
Each peak of the plots of motion, moments and powers at the ankle, knee and hip were evaluated for a total of 27 common peak sagittal plane parameters. Of these 27 parameters, ten were motion measures, eight were moment measures and the remaining nine were power measures. The equations and their R2 values resulting from the regression analysis with absolute gait speed for each of these kinematic and kinetic parameters are presented in Table 1, Table 2, respectively. The results for the
Discussion
In general, we found the peak sagittal plane kinematic parameters to have poor predictive relationships with gait speed. Winter et al. also reported little variation in joint kinematics at increasing cadences, except for minor increases in peak knee flexion during loading response [5]. We also observed an increase in peak knee flexion during loading response with increased speed consistent with that reported by others [10], [12], [21]. Moreover, we found a moderately predictive quadratic
Acknowledgements
We appreciate Mark E. Karvosky and Ugo Della Croce for their technical assistance and Richard Goldstein for his statistical assistance. We acknowledge the following suppliers, as noted in text: (a) Oxford Metrics LTD, 14 Minns Estate, West Way, Oxford, OX2 0JB, UK; (b) Advanced Medical Technology Inc. (AMTI), 176 Waltham Street, Watertown, MA 02472; and (c) Stata Corporation, 702 University Drive East, College Station, TX 77840. This study was supported in part by Public Health Service grant
References (24)
- et al.
Walking speed as a basis for normal and abnormal gait measurements
J. Biomech.
(1977) Normal gait characteristics under temporal and distance constraints
J. Biomed. Eng.
(1989)- et al.
A biomechanical investigation of the human hip
J. Biomech.
(1978) - et al.
Influence of walking speed on gait parameters
J. Biomed. Eng.
(1985) - et al.
Reduced hip extension during walking: healthy elderly and fallers versus young adults
Arch. Phys. Med. Rehabil.
(2001) - et al.
Biomechanical gait alterations independent of speed in the healthy elderly: evidence for specific limiting impairments
Arch. Phys. Med. Rehabil.
(1998) - et al.
Reliability of gait measurements in people with osteoarthritis of the knee
Phys. Ther.
(1997) - et al.
The relationship of stride characteristics to pain before and after total knee arthroplasty
Clin Orthop
(1989) - et al.
Self-selected walking speed in patients with hemiparesis after stroke
Scand. J. Rehabil. Med.
(1997) - Mueller MJ, Minor SD, Sahrmann SA, Schaaf JA, Strube MJ. Differences in the gait characteristics of patients with...