[Purpose] To investigate the differences in foot kinetics during gait initiation between young and elderly participants using a modified multi-segment foot model. [Participants and Methods] Twelve young (23.3 ± 2.4 years) and 12 elderly participants (73.3 ± 3.9 years) were included in this study. Gait initiation was measured using a three-dimensional motion analysis system. We calculated the kinetic and kinematic values using our modified multi-segment foot model and compared those values with the values calculated using Bruening et al.’s multi-segment foot model. Modified gait initiation values were also compared between the elderly and young participants. [Results] Our modified multi-segment foot model, created using the Software for Interactive Musculoskeletal Modeling, showed similar values to those reported by Bruening et al. When we compared gait initiation between the elderly participants and their younger counterparts, the elderly exhibited lower torque and power values in the ankle, tarsometatarsal, and metatarsophalangeal joints. Additionally, the elderly exhibited a lower torque ratio in the distal joint than in the proximal joint (torque ratio: ankle joint >tarsometatarsal joint >metatarsophalangeal joint). [Conclusion] The elderly participants had less speed, stride, foot joint movement, moment, and power than the young participants. Moreover, the ratio of joint moment was smaller in the elderly participants. In elderly patients whose walking speed has decreased, consideration of the kinetics of the foot is important when deciding physiotherapy intervention.

The relationship of the Functional Reach Test (FRT) value with the Center of Pressure Excursion (COPE) and physical function remains unclear, and would be influenced by different population characteristics and movement patterns used in the FRT. Therefore, we explored the relationship between the FRT value and the COPE and physical function in healthy young and older individuals classified according to movement patterns. In 21 healthy young participants (42 sides) and 20 older participants (40 sides), three-dimensional motion analysis was performed during the FRT and physical function assessments. The participants were assigned to two clusters after performing a motion analysis during the FRT. Kinematic and kinetic parameters during the FRT and physical function assessment results were compared between the clusters for both groups. Correlation analysis was performed to investigate the relationships of the FRT value with COPE and physical function parameters in each cluster, in young and older individuals separately. The results showed that the hip strategies could be divided into two groups according to the degree of use (Small Hip Strategy, SHS Group; Large Hip Strategy, LHS Group). In the older SHS group, the FRT values were significantly correlated with the COPE (r = 0.75), toe grip strength (r = 0.62), and the five-times sit-to-stand test time (r = -0.52). In the older LHS group and in both groups of young individuals, there were no significant correlations of the FRT value with any parameters. The FRT value reflects the COPE and physical function only in older individuals using the SHS. This could explain previous discrepant results. As there is no simple relationship between the FRT value and physical function, it is important to include movement strategy assessment when using the FRT in clinical evaluations.

No abstract

We evaluated the reliability of the measurement function of the Honda Walking Assist Device and investigated the effect of the device on walking improvements, and foot and ankle function, in hemiplegic stroke patients. [Participants and Methods] We recruited 16 hemiplegic stroke patients who performed 10-meter walk tests, twice without assistance and once with device assistance. Based on the rate of change of velocity, we divided the participants into two groups and compared the walking parameters, the toe grip strength, the cross tests, and the maximum step width. Two examiners assessed the 10-meter walk test results, and the authors calculated the intraclass correlation coefficients for walking speed, stride length, cadence, flexion, extension, and scissor angles.[Results] The intraclass correlation coefficients were greater than 0.70 for all the walking parameters we measured. The device increased hip joint movement but did not alter the maximum walking speed of the stroke patients. The patients in the group with a greater change in velocity displayed lower toe grip strength and decreased maximum step width and used orthoses more commonly. [Conclusion] The walking measurement function of the device was reliable. The immediate effect of the device in stroke patients may be influenced by the level of paralysis and the presence of an orthosis.

No abstract