Author
Nick DiPaolo, Scarlett Elliott, Chris Smith, Kayla Stoeffler, Trine University
Findings
- The fixed and ROM status of the TayCo Brace did not appear to affect overall stability during the gait cycle.
- Subjects reported experiencing the most instability wearing the CAM boot.
- CAM boot showed decreases in overall cadence, walking speed, and stride length, contributing to an increased sense of instability.
- Wearing ROM and fixed TayCo Braces did not produce an increase in step width variation, indicating higher levels of stability.
- The ROM TayCo showed the least amount of variance of the three tested devices compared to the control.
- Data showed similarities between the step width and walking speed of the ROM TayCo and the control shoe, supporting the claim that the ROM TayCo provides the most stability for geriatrics.
Results
- Cadence values for the ROM TayCo brace (109 ± 58.3 steps/min), fixed TayCo brace (112 ± 81.4 steps/min), and CAM boot (87.0 ± 9.95 steps/min) were shown to decrease compared to the control shoe (136 ± 133 steps/min), indicating a relationship between the overall cadence and reduction in ankle mobility.
- The ROM showed the least amount of variance in walking speed when compared to the control (ROM: 1.03 ± 0.21 m/s; Control: 1.03 ± 0.30 m/s). The CAM boot, alternatively, showed a significant decrease in walking speed
- (0.78 ± 0.30 m/s).
- The presence of the fixed and ROM TayCo braces did not appear to impact step width variation. The CAM boot showed a marginal difference in step width value (0.20 ± 0.042 m) compared to the control shoe value (0.16 ± 0.043 m).
- Data showed an inverse relationship between ankle mobility and stride time, with a decrease in ankle mobility resulting in an increase in stride time. The stride times were as follows: Control shoe: 1.15 ± 0.37 s; ROM brace: 1.23 ± 0.21 s; Fixed brace: 1.30 ± 0.23 s; CAM boot: 1.36 ± 0.15 s.
- Data showed no significant changes in stride length between the control shoe and TayCo braces. The CAM boot had a small decrease in stride length (1.03 ± 0.34 m) compared to the control shoe (1.17 ± 0.40 m).
Study
Elderly gait stability is largely influenced by variations in sagittal alignment, gait width, gait phase, and vertical displacement. High levels of variation within the gait are indicative of instability and an increased fall risk. Spinal sagittal alignment impacts the postural balance and deteriorates directly with age [1]. Studies show a correlation between the ratio of the thoracic and lumbar angles to fall risk caused by overcompensation of related muscles and decline in spinal functions [2]. Changes in gait parameters influence the margins of stability experienced by elderly during the gait cycle. Controlled ankle movement (CAM) boots alter normal gait patterns, causing the elderly to experience increased step width to compensate for instability [3]. Studies have shown that elderly patients experience longer single and double support phases compared to the swing phase, resulting in increased instability [6]. Functional leg length discrepancy (FLLD) is defined as a condition of asymmetrical leg length due to pelvic tilt, not necessarily a result or compensation of a true bone length difference. FLLD causes a shift in weight towards the shorter limb, resulting in a decrease in stability during the gait cycle [9]. In this study, a spatiotemporal gait analysis of elderly subjects wearing CAM boots and ankle-foot orthotics (AFO) was performed to investigate how balance and gait variability are affected by each device to minimize the fall risk of elderly patients.
