Influence of wedges on lower limbs' kinematics and net joint moments during healthy elderly gait using principal component analysis.

The elderly are susceptible to many disorders that alter the gait pattern and could lead to falls and reduction of mobility. One of the most applied therapeutical approaches to correct altered gait patterns is the insertion of insoles. Principal Component Analysis (PCA) is a powerful method used to reduce redundant information and it allows the comparison of the complete waveform. The purpose of this study was to verify the influence of wedges on lower limbs' net joint moment and range of motion (ROM) during the gait of healthy elderly participants using PCA. In addition, discrete values of lower limbs' peak net moment and ROM were also evaluated. 20 subjects walked with no wedges (control condition) and wearing six different wedges. The variables analyzed were the Principal Components from joint net moments and ROM in the sagittal plane in the ankle and knee and joint net moments in frontal plane in the knee. The discrete variables were peak joint net moments and ROM in sagittal plane in knee and ankle. The results showed the influence of the wedges to be clearer by analyzing through PCA methods than to use discrete parameters of gait curves, where the differences between conditions could be hidden.

[1]  B. Van Gheluwe,et al.  Changes in plantar foot pressure with in-shoe varus or valgus wedging. , 2004, Journal of the American Podiatric Medical Association.

[2]  I. Jolliffe.  Principal Component Analysis , 2002 .

[3]  T. Schmalz,et al.  The influence of sole wedges on frontal plane knee kinetics, in isolation and in combination with representative rigid and semi-rigid ankle-foot-orthoses. , 2006, Clinical biomechanics.

[4]  K. Deluzio,et al.  Gait assessment in unicompartmental knee arthroplasty patients: Principal component modelling of gait waveforms and clinical status , 1999 .

[5]  B. Fregly,et al.  A solidification procedure to facilitate kinematic analyses based on video system data. , 1995, Journal of biomechanics.

[6]  Annegret Mündermann,et al.  Predicting changes in knee adduction moment due to load-altering interventions from pressure distribution at the foot in healthy subjects. , 2008, Journal of biomechanics.

[7]  R. Kirkwood,et al.  Application of principal component analysis on gait kinematics in elderly women with knee osteoarthritis. , 2011, Revista brasileira de fisioterapia (Sao Carlos (Sao Paulo, Brazil)).

[8]  R. Sampaio,et al.  Aplicação da análise de componentes principais na cinemática da marcha de idosas com osteoartrite de joelho , 2011 .

[9]  Lianne Jones,et al.  Reduction, classification and ranking of motion analysis data: an application to osteoarthritic and normal knee function data , 2008, Computer methods in biomechanics and biomedical engineering.

[10]  D. Kerrigan,et al.  The influence of arch supports on knee torques relevant to knee osteoarthritis. , 2008, Medicine and science in sports and exercise.

[11]  S. Olney,et al.  Multivariate examination of data from gait analysis of persons with stroke. , 1998, Physical therapy.

[12]  Brian Johnson.  Deriving trends in life expectancy by the National Statistics Socio‐economic Classification using the ONS Longitudinal Study , 2011, Health statistics quarterly.

[13]  A. Comrey,et al.  Further Construct Validation of a Measure of Self-Actualization , 1973 .

[14]  P. Allard,et al.  Main functional roles of knee flexors/extensors in able-bodied gait using principal component analysis (I). , 2002, The Knee.

[15]  Richard A. Brand,et al.  The biomechanics and motor control of human gait: Normal, elderly, and pathological , 1992 .

[16]  I. Sacco,et al.  Inexpensive footwear decreases joint loading in elderly women with knee osteoarthritis. , 2011, Gait & posture.

[17]  J. L. Astephen,et al.  Biomechanical features of gait waveform data associated with knee osteoarthritis: an application of principal component analysis. , 2007, Gait & posture.

[18]  Michelle M Lusardi,et al.  Spatial and Temporal Parameters of Self-Selected and Fast Walking Speeds in Healthy Community-Living Adults Aged 72–98 Years , 2010, Journal of geriatric physical therapy.

[19]  Andreas Daffertshofer,et al.  PCA in studying coordination and variability: a tutorial. , 2004, Clinical biomechanics.

[20]  B. Nigg,et al.  Asymmetries in ground reaction force patterns in normal human gait. , 1989, Medicine and science in sports and exercise.

[21]  Debra E Hurwitz,et al.  Normalization of joint moments during gait: a comparison of two techniques. , 2003, Journal of biomechanics.

[22]  R. Kirkwood,et al.  Step length appears to be a strong discriminant gait parameter for elderly females highly concerned about falls: a cross-sectional observational study. , 2011, Physiotherapy.

[23]  Y Toyama,et al.  The lateral wedged insole with subtalar strapping significantly reduces dynamic knee load in the medial compartment gait analysis on patients with medial knee osteoarthritis. , 2007, Osteoarthritis and cartilage.

[24]  Karl M Newell,et al.  Compressing movement information via principal components analysis (PCA): contrasting outcomes from the time and frequency domains. , 2013, Human movement science.

[25]  K. Deluzio,et al.  Principal component models of knee kinematics and kinetics: Normal vs. pathological gait patterns , 1997 .

[26]  Tzyy-Yuang Shiang,et al.  Effects of insoles and additional shock absorption foam on the cushioning properties of sport shoes. , 2007, Journal of applied biomechanics.

[27]  Christopher L. Vaughan,et al.  Dynamics of human gait , 1992 .

[28]  J. Hamill,et al.  Lateral wedges decrease biomechanical risk factors for knee osteoarthritis in obese women. , 2011, Journal of biomechanics.

[29]  J. Nadal,et al.  Application of principal component analysis in vertical ground reaction force to discriminate normal and abnormal gait. , 2009, Gait & posture.

[30]  G. Morrell,et al.  Intramuscular Adipose Tissue, Sarcopenia, and Mobility Function in Older Individuals , 2012, Journal of aging research.

[31]  Ricardo Machado Leite de Barros,et al.  A method to synchronise video cameras using the audio band. , 2006, Journal of biomechanics.

[32]  Michael Roan,et al.  An application of principal component analysis for lower body kinematics between loaded and unloaded walking. , 2009, Journal of biomechanics.

[33]  K. Deluzio,et al.  Knee biomechanics of moderate OA patients measured during gait at a self-selected and fast walking speed. , 2007, Journal of biomechanics.

[34]  T Chau,et al.  A review of analytical techniques for gait data. Part 1: Fuzzy, statistical and fractal methods. , 2001, Gait & posture.

[35]  Joseph Hamill,et al.  Influence of a custom foot orthotic intervention on lower extremity dynamics in healthy runners. , 2006, Clinical biomechanics.

[36]  Urs Granacher,et al.  A Qualitative Review of Balance and Strength Performance in Healthy Older Adults: Impact for Testing and Training , 2012, Journal of aging research.

[37]  Ian T. Jolliffe,et al.  Principal Component Analysis , 2002, International Encyclopedia of Statistical Science.

[38]  W. Kakihana,et al.  Effects of laterally wedged insoles on knee and subtalar joint moments. , 2005, Archives of physical medicine and rehabilitation.

[39]  D. Kerrigan,et al.  Effectiveness of a lateral-wedge insole on knee varus torque in patients with knee osteoarthritis. , 2002, Archives of physical medicine and rehabilitation.