Putting the best foot forward: Relationships between indicators of step quality and cadence in three gait vulnerable populations

Article type: Research Article

Authors: Mate, K.K.V.^{a; b; *} | Abou-Sharkh, A.^{a; b} | Morais, J.A.^c | Mayo, N.E.^{a; b}

Affiliations: [a] School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada | [b] Center for Outcomes Research and Evaluation, McGill University Health Centre – Research Institute, Montreal, QC, CanadaCanada | [c] Division of Geriatrics, McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada

Correspondence: [*] Address for correspondence: Kedar K.V. Mate, Center for Outcome Research and Evaluation (CORE), McGill University Health Centre-Research Institute, 2C.23, 5252 de Maisonneuve, Montreal, QC, H4A 3S5, Canada. Tel.: +1 514 934 1934/Ext. 36922; E-mail: [email protected].

Abstract: BACKGROUND:Aging and neurological conditions like Multiple Sclerosis (MS) and Parkinson’s disease (PD) make people vulnerable for gait impairments, limit function, and restrict sustained walking needed for health promotion. Walking to meet physical activity guidelines requires adequate cadence which is difficult to achieve for gait vulnerable populations. OBJECTIVE:The objective of this study is to estimate, for seniors and people with MS or PD, the extent to which cadence is associated with heel-to-toe stepping pattern (good steps), angular velocity of ankle at heel-strike and its variability. METHODS:A cross-sectional regression analysis was performed on data collected during walking tests using the Heel2Toe sensor. RESULTS:Health condition (MS = 57, PD = 27, seniors = 56) had an association with cadence, independent of age and sex. Only angular velocity showed a significant relationship with cadence such that every – 50° difference in angular velocity (more negative is better) was associated with a difference of ≈3.5 steps per minute. CONCLUSION:Adequate angular velocity occurs with an optimal heel-to-toe movement. This heel-to-toe gait can easily be targeted during therapy but technology would be an asset to sustain the relearned movement during everyday activities, Technology that provides real-time feedback for steps with adequate angular velocity at heel strike could be a valuable therapeutic adjunct.

Keywords: Cadence, angular velocity, coefficient of variation, Multiple Sclerosis, Parkinson’s disease, seniors

DOI: 10.3233/NRE-182595

Journal: NeuroRehabilitation, vol. 44, no. 2, pp. 295-301, 2019