Treadmill walking in incomplete spinal-cord-injured subjects: 1. Adaptation to changes in speed

Walking in spinal-cord-injured (SCI) subjects is usually achieved at a lower speed than in normal subjects.Study design/methods: Time and distance parameters, angular displacements of lower limbs and electromyographic (EMG) activity were measured for seven normal and seven SCI subjects at several walking speeds. Analyses of variance were used for comparing groups and speeds.Objectives: First, to measure the adaptability of SCI subjects' walking pattern to different speeds (0.1–1.0 m/s), and to compare it to that of normal subjects. Second, to characterize SCI subjects' walking pattern as compared to that of normal subjects at a matched treadmill speed (0.3 m/s).Setting: University-Based Human Gait Laboratory, Montreal, Canada.Results: SCI subjects' pattern adapted to a limited range of speeds. Longer cycle duration, flexed knee at foot contact, increased hip joint flexion at foot contact and during swing, and altered coordination of hip and knee joints were found for the SCI group. At all speeds, duration of muscle activity was longer in the SCI group and the increase in amplitude of soleus EMG activity at higher speeds was not specific to push-off. The importance of matching the walking speed of SCI and normal subjects in order to differentiate the features that are a consequence of SCI subjects' reduced walking speed rather than a direct consequence of the injury is demonstrated.Conclusions: All SCI subjects could adapt to a narrow range of speeds and only three could reach the maximal tested speed. This limited maximal speed seems to be a consequence of SCI subjects having reached their limit in increasing stride length and not being able to increase stride frequency further. This limitation in increasing stride frequency is likely because of the altered neural drive.Sponsorship: Neuroscience Network of the Canadian Centre of Excellence.

[1]  J. Halbertsma,et al.  Changes in leg movements and muscle activity with speed of locomotion and mode of progression in humans. , 1985, Acta physiologica Scandinavica.

[2]  T P Andriacchi,et al.  Walking speed as a basis for normal and abnormal gait measurements. , 1977, Journal of biomechanics.

[3]  R. Stein,et al.  H-Reflex Modulation During Walking in Spastic Paretic Subjects , 1991, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[4]  A. Tokuhiro,et al.  Electromyographic kinesiology of lower extremity muscles during slope walking. , 1985, Archives of physical medicine and rehabilitation.

[5]  D A Winter,et al.  Treadmill versus walkway locomotion in humans: an EMG study. , 1986, Ergonomics.

[6]  S. Grillner,et al.  The locomotion of the low spinal cat. I. Coordination within a hindlimb. , 1980, Acta physiologica Scandinavica.

[7]  S. Rossignol,et al.  Enhancement of locomotor recovery following spinal cord injury. , 1994, Current opinion in neurology.

[8]  E. Knutsson.  Analysis of gait and isokinetic movements for evaluation of antispastic drugs or physical therapies. , 1983, Advances in neurology.

[9]  Kathleen E. Norman,et al.  Review : Walking After Spinal Cord Injury: Control and Recovery , 1998 .

[10]  J Quintern,et al.  Electrophysiological studies of gait in spasticity and rigidity. Evidence that altered mechanical properties of muscle contribute to hypertonia. , 1981, Brain : a journal of neurology.

[11]  V. Edgerton,et al.  EMG amplitude relationships between the rat soleus and medial gastrocnemius during various motor tasks , 1989, Brain Research.

[12]  M P Murray,et al.  COMPARISON OF FREE AND FAST SPEED WALKING PATTERNS OF NORMAL MEN , 1966, American journal of physical medicine.

[13]  Alf Thorstensson.  Adaptation in Trunk and Leg Movements and Motor Patterns to Speed, Mode and Direction of Progression in Man , 1986 .

[14]  G. Street.  Biomechanics IX-B , 1985 .

[15]  V. Reggie Edgerton,et al.  Electromyographic activity of cat hindlimb flexors and extensors during locomotion at varying speeds and inclines , 1989, Brain Research.

[16]  D. Grieve,et al.  The relationships between length of stride, step frequency, time of swing and speed of walking for children and adults. , 1966, Ergonomics.

[17]  H Barbeau,et al.  Effects of conditioning cutaneomuscular stimulation on the soleus H-reflex in normal and spastic paretic subjects during walking and standing. , 1994, Journal of neurophysiology.

[18]  H. Barbeau,et al.  Postural adaptation to walking on inclined surfaces: I. Normal strategies. , 2002, Gait & posture.

[19]  P. J. Delwaide,et al.  Human Monosynaptic Reflexes and Presynaptic Inhibition , 1973 .

[20]  G. J. van Ingen Schenau,et al.  Some fundamental aspects of the biomechanics of overground versus treadmill locomotion , 1980 .

[21]  H. Barbeau,et al.  A dynamic EMG profile index to quantify muscular activation disorder in spastic paretic gait. , 1989, Electroencephalography and clinical neurophysiology.

[22]  R. Kearney,et al.  Intrinsic and reflex stiffness in normal and spastic, spinal cord injured subjects , 2001, Experimental Brain Research.

[23]  S. Grillner.  Control of Locomotion in Bipeds, Tetrapods, and Fish , 1981 .

[24]  John H Warfel,et al.  The Extremities: Muscles and Motor Points , 1985 .

[25]  L W Lamoreux,et al.  Kinematic measurements in the study of human walking. , 1971, Bulletin of prosthetics research.

[26]  C Frigo,et al.  Speed-dependent variations of lower-limb joint angles during walking. A graphic computerized method showing individual patterns. , 1986, American journal of physical medicine.

[27]  R. Shiavi,et al.  Variability of electromyographic patterns for level-surface walking through a range of self-selected speeds. , 1981, Bulletin of prosthetics research.

[28]  P. Harris.  The International Standards Booklet for Neurological and Functional Classification of Spinal Cord Injury , 1994, Paraplegia.

[29]  W. J. Beek,et al.  Hemiplegic gait: a kinematic analysis using walking speed as a basis. , 1992, Journal of biomechanics.

[30]  J. C. Wall,et al.  The effects of uphill and downhill walking on pelvic oscillations in the transverse plane. , 1981, Ergonomics.

[31]  J. Desmedt,et al.  New Developments in Electromyography and Clinical Neurophysiology , 1973 .

[32]  Peggy Arnell,et al.  The Biomechanics and Motor Control of Human Gait , 1988 .

[33]  M. Ladouceur,et al.  Does Neurorehabilitation Play a Role in the Recovery of Walking in Neurological Populations? a , 1998, Annals of the New York Academy of Sciences.

[34]  W. Rymer,et al.  Spastic hypertonia: mechanisms and measurement. , 1989, Archives of physical medicine and rehabilitation.

[35]  S. Rossignol,et al.  Recovery of locomotion after chronic spinalization in the adult cat , 1987, Brain Research.

[36]  D. Winter.  Biomechanical motor patterns in normal walking. , 1983, Journal of motor behavior.

[37]  R. Waters,et al.  International Standards for Neurological and Functional Classification of Spinal Cord Injury , 1997, Spinal Cord.

[38]  H Barbeau,et al.  A treadmill apparatus and harness support for evaluation and rehabilitation of gait. , 1995, Archives of physical medicine and rehabilitation.

[39]  R. Shiavi,et al.  Electromyographic gait assessment, Part 1: Adult EMG profiles and walking speed. , 1987, Journal of rehabilitation research and development.

[40]  G. J. van Ingen Schenau,et al.  Some fundamental aspects of the biomechanics of overground versus treadmill locomotion. , 1980, Medicine and science in sports and exercise.

[41]  B. Brandell.  Functional roles of the calf and vastus muscles in locomotion. , 1977, American journal of physical medicine.

[42]  Murray Mp,et al.  Treadmill vs. floor walking: kinematics, electromyogram, and heart rate. , 1985, Journal of applied physiology.

[43]  P. Stein,et al.  Neurobiology of Vertebrate Locomotion , 1986, Wenner-Gren Center International Symposium Series.

[44]  R. Joffe.  Gait disturbances. , 1992, Australian family physician.

[45]  A. Patla,et al.  Visual control of locomotion: strategies for changing direction and for going over obstacles. , 1991, Journal of experimental psychology. Human perception and performance.

[46]  T. Brandt,et al.  Disorders of posture and gait. , 1990, Journal of vestibular research : equilibrium & orientation.

[47]  H Barbeau,et al.  The Effects of Body Weight Support on the Locomotor Pattern of Spastic Paretic Patients , 1989, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[48]  K. Hidaka,et al.  3.0‐ns surface discharge development , 1986 .

[49]  H. Barbeau,et al.  Adaptation of the walking pattern to uphill walking in normal and spinal-cord injured subjects , 1999, Experimental Brain Research.

[50]  Lamoreux Lw.  Kinematic measurements in the study of human walking. , 1971 .

[51]  V. Dietz,et al.  Normal and impaired regulation of muscle stiffness in gait: A new hypothesis about muscle hypertonia , 1983, Experimental Neurology.

[52]  S. Grillner,et al.  The adaptation to speed in human locomotion , 1979, Brain Research.

[53]  P. London.  Injury , 1969, Definitions.

[54]  Brandell Br.  Functional roles of the calf and vastus muscles in locomotion. , 1977 .