Introduction: Stair gait is an activity performed daily. Inherently falls during stair gait continue to be a concern especially for older adults 65 years +. Recently falls have become the most common cause of injury-related deaths in individuals over the age of 75 y.o. Stair descent falls account for 75% of stair falls and also present a greater injury severity. Poor shoes or insoles and lighting condition can contribute to an increased risk of falls during stair locomotion. Stability can be measured using the COM-BOS ‘stability margin’ relationship. Center of pressure (COP), another stability measure,can be calculated from a multi-axis force-plate system. As well, plantar pressure is an important indicator of gait pattern efficiency. Aim: To identify aspects of stair gait that increase the risk of falls. By measuring the COM-BOS ‘stability margin’, the COP and plantar pressure patterns of individuals during stair gait, while modifying insoles and lighting. Methods: Young and older adults will ascend and descend a 4 level staircase, with two imbedded AMTI-force platforms in varying lighting condition (low, normal). Participants will be fitted with standardized footwear with Medi-logic insoles placed under varying hardnesses of insoles. An Optotrak motion capture system will record 12 IRED markers placed on the individual to determine the COM trajectory and BOS of location. Hypothesis: Partipants should demonstrate a greater lateral displacement in the single support phase during dim lighting as opposed to normal lighting. The stability of older adults will be compromised with alteration to the insoles (soft and hard).

Listed In: Biomechanics, Gait, Other

Conflicting evidence exists regarding the presence of aberrant gait biomechanics more than one-year following anterior cruciate ligament reconstruction (ACLR). Overground walking may not elucidate differences in those further removed from surgery due to the unexacting nature of the task. Quadriceps dysfunction is common post-ACLR and contributes to aberrant gait biomechanics, thus downhill walking may exacerbate differences as this task places greater demands on the quadriceps. Purpose: To compare gait biomechanics between individuals with ACLR and healthy controls during level and downhill walking conditions. Methods: 24 individuals more than 1-year removed from ACLR and 24 healthy controls completed both level and downhill (10 degree grade) gait biomechanics assessments on an instrumented split-belt treadmill at their preferred walking speed. Peak variables were evaluated over the first 50% of stance including the vertical ground reaction force, internal knee extension and abduction moments and knee flexion angle. Moments were normalized to %body weight*height (%BW*Ht) and vGRF was normalized to %body weight. Dependent variables were compared across groups and conditions via two-way repeated measures ANCOVAs controlling for gait speed. Results: There were no significant condition*group interaction effects nor group main effects for any outcomes. However, there were significant condition increases in knee extension moment (P=0.020) and knee flexion angle (P=0.018) from level to downhill. Conclusions: Downhill walking necessitates larger knee extension moments and knee flexion angle compared to level gait. Our results suggest that changes in gait biomechanics between level and downhill conditions do not differ between individuals with ACLR >1 year post-reconstruction and controls.
Listed In: Biomechanics, Gait, Orthopedic Research

Obesity and female sex are considered independent risk factors for the development of knee osteoarthritis (KOA) which may be due to aberrant gait biomechanics. Few data exist on the interaction of obesity and female sex despite their independent influence on KOA risk. The purpose of this study was to examine the influence of sex and BMI on knee joint sagittal and frontal plane gait mechanics. Dependent variables included the knee flexion moment (KFM) and first peak knee adduction moment (KAM1). Gait biomechanics were assessed in 42 obese and 39 normal weight participants that were matched on age and sex. Kinematic and kinetic data were sampled using a 9-camera Qualisys system and 2 AMTI force-plates. Participants completed walking trials in laboratory standard neutral-cushion footwear at self-selected speed and the external KFM and KAM1 during the first 50% of stance was extracted and normalized to a product of bodyweight (N) and height (m). A 2 (BMI) by 2 (Sex) analysis of co-variance (α=0.05) was used to examine dependent variables with gait speed as a covariate. The BMI by sex interaction was not significant for KFM (p=0.073) or KAM1 (p=0.703). A main effect was observed for sex and females exhibited smaller KFM (p=0.05) and greater KAM1 (p=0.004) compared to males. No differences were found in normalized knee moments between BMI groups. Regardless of BMI, females exhibited aberrant gait mechanics that are indicative of KOA progression. Further studies are needed examining the influence of altered gait in young, healthy females on knee cartilage morphology.
Listed In: Biomechanics, Gait

Background and Aim: Type 2 Diabetes (T2DM) in midlife represents a potent risk factor for the development of dementia in later life. Early indicators to highlight particular individuals with T2DM who are at risk of cognitive decline are lacking. Subtle abnormalities in gait (and particularly dual-task gait with a cognitive task) have emerged as a potential predictor of cognitive decline in older adults, but have not been investigated in patients with T2DM. The ENBIND Study (Exploring Novel Biomarkers of Brain health IN Diabetes) aims to assess patients with T2DM in midlife without cognitive impairment and follow participants over the course of several years to establish early predictors of cognitive decline in this poorly characterised yet high-risk group. Methods: Patients with midlife T2DM (40-65 yrs) were recruited at the time of their diabetic clinic appointment. Patients were excluded if they had a diagnosis of peripheral neuropathy, peripheral vascular disease, musculoskeletal disease, previous stroke, any form of diagnosed cognitive impairment or diabetic retinopathy/nephropathy. Patients underwent medical/diabetes assessment and examination by a physician. Cognition was screened using the Montreal Cognitive Assessment (MoCA) and assessed using a computerised cognitive battery designed for prodromal Alzheimer's Disease (CANTAB®). Gait was then assessed using both a raw clinical measure (stopwatch) and Shimmer® Inertial Measurement Units (IMUs) across four tasks: (i) 30 metre walk at a normal pace (turn at 15m), (ii) 30 metre fast walk (turn at 15m) (iii) dual cognitive-gait task (reciting alternate letters of the alphabet) and (iv) a long walk at a self-selected pace. Between group differences were assessed using t-tests and appropriate non-parametric equivalents Results: 20 participants with T2DM (52.05 yrs ± 2.13) and 10 matched healthy volunteers (mean age 52.2 yrs ± 2.74) were recruited. T2DM was associated with a significantly lower score on the MoCA (29.2 vs 27.6; p=0.0452). Participants with T2DM had slower but non-significant self-selected (0.87 ms-1 vs 0.8ms-1) and fast gait speed (0.66 ms-1 vs 0.59 ms-1). On the dual-cognitive task, participants with T2DM made more errors (1.1 vs 0.6), and had higher dual-task cost (9.17% vs 2.7%, p=0.014). Dual-task cost (the percentage decrement in walking speed due to introduction of the cognitive task) was significantly correlated with total MoCA score (R2 = 0.17, p =0.031). Discussion: Otherwise healthy participants with midlife T2DM display significantly poorer scores on MoCA. Performance on the dual-cognitive gait task was significantly correlated with MoCA score. Our study adds evidence to the presence of cognitive decrements in midlife T2DM, in-keeping with its role as a potent risk factor for the later development of dementia. We provide early data to support the utility of simple clinical gait analysis, particularly where a dual-cognitive paradigm is employed. Expansion of the sample size of patients in this study as well as longitudinal follow up should afford more detailed insight into using gait as a potential marker for cognition in this high risk cohort
Listed In: Biomechanical Engineering, Biomechanics, Gait, Neuroscience

Tai Chi (TC) has the rehabilitative potential to prevent falls in the elderly, however it is unclear how TC training improves postural control capacity. Fifteen male participants with more than 4 years of TC experience were asked to perform two TC movements, the “Repulse Monkey (RM)” and “Wave-hands in clouds (WHIC).” Three-dimensional (3-D) temporospatial, kinematic and kinetic data was collected using VICON motion analysis system with 10 infrared cameras and 4 force plates. Stride width, step length, step width, single- and double-support times, center of mass (COM) displacement, peak joint angles, range of motion, peak joint moments, time to peak moment, and ground reaction force (GRF) were analyzed. The differences in the measurements of the two TC movements were compared with walking using two-way ANOVA analysis. Compared with walking kinematics, both TC movements spent less time in single-support; RM and WHIC had larger mediolateral and vertical displacement of the COM. Compared with walking kinetics, both TC movements generated significantly smaller peak ground reaction forces in all directions, except the anterior; larger hip extension, adduction and internal rotational moments, knee adduction/abduction and internal rotation moments and eversion/inversion and external/internal moments of ankle–foot; and longer peak moment generation time for hip extension, adduction and internal rotation, knee extension and ankle dorsiflexion and inversion. The slow, gentle stepping-action and loading patterns that are consistent with the mechanical behavior of biological tissues. These two TC movements would be suitable training to help strengthen the lower extremities and prevent falls in the elderly.
Listed In: Biomechanics, Gait, Sports Science