Effects of noxious stimulation to the back or calf muscles on gait stability

Abstract

a b s t r a c tGait stability is the ability to deal with small perturbations that naturally occur during walking. Changes in motor control caused by pain could affect this ability. This study investigated whether nociceptive stimulation (hypertonic saline injection) in a low back (LBP) or calf (CalfP) muscle affects gait stability. Sixteen participants walked on a treadmill at 0.94 ms À 1 and 1.67 ms À 1 , while thorax kinematics were recorded using 3D-motion capture. From 110 strides, stability (local divergence exponent, LDE), stride-tostride variability and root mean squares (RMS) of thorax linear velocities were calculated along the three movement axes. At 0.94 ms À 1 , independent of movement axes, gait stability was lower (higher LDE) and stride-to-stride variability was higher, during LBP and CalfP than no pain. This was more pronounced during CalfP, likely explained by the biomechanical function of calf muscles in gait, as supported by greater mediolateral RMS and stance time asymmetry than in LBP and no pain. At 1.67 ms À 1 , independent of movement axes, gait stability was greater and stride-to-stride variability was smaller with LBP than no pain and CalfP, whereas CalfP was not different from no pain. Opposite effects of LBP on gait stability between speeds suggests a more protective strategy at the faster speed. Although mediolateral RMS was greater and participants had more asymmetric stance times with CalfP than LBP and no pain, limited effect of CalfP at the faster speed could relate to greater kinematic constraints and smaller effects of calf muscle activity on propulsion at this speed. In conclusion, pain effects on gait stability depend on pain location and walking speed.

Changes in Trunk Variability and Stability of Gait in Patients with Chronic Low Back Pain: Impact of Laboratory Versus Daily-living Environments

“…These factors appear to cause disturbed control and recovery from perturbations and reduced stability 49,50 . Some studies have reported higher trunk variability and/or lower stability of gait in LBP as in our results, but opposite results showing decreased variability and/or increased stability of trunk movements due to increased trunk stiffness have also been reported in LBP 2,3,51,52 . Importantly, tight control of gait was mostly reported in studies employing a treadmill.…”

Changes in Trunk Variability and Stability of Gait in Patients with Chronic Low Back Pain: Impact of Laboratory versus Daily-Living Environments

“… 62 , 63 Some studies have described higher trunk variability and/or lower stability of gait in CLBP patients (as observed herein), but opposite results have also been reported in CLBP, describing decreased variability and/or increased stability of trunk movements due to increased trunk stiffness. 4 , 64 Importantly, the studies that reported tight control of gait used a treadmill. Treadmill walking tends toward less variability and more stability compared to walking on solid ground or in daily-living environments.…”

Effects of Chemotherapy-Induced-Peripheral-Neuropathy on Spatiotemporal Gait Parameters and Fall Risk in Cancer Patients After the Completion of Chemotherapy Drug Treatment

“…The presence of pain alone is associated with a decrease in walking velocity; a recent study that evaluated Gait parameters in individuals with foot pain related to gout found that those individuals with gout-related foot pain walked significantly slower (Stewart, 2016). A study by van den Hoorn, Hug, Hodges, Bruijn, and van Dieën (2015) investigated if nociceptive stimulation and induced pain affect gait stability. Previous research suggests that musculoskeletal pain is associated with fall risk and has a negative impact on stability (Asai, Misu, Sawa, Doi, & Yamada, 2015;de Zwart et al, 2015;Kitayuguchi, Kamada, Okada, Kamioka, & Mutoh, 2015;Ross, Mavor, Brown, & Graham, 2015).…”