Impaired heel to toe progression during gait is related to reduced ankle range of motion in people with Multiple Sclerosis

Psarakis, Michael; Greene, David; Moresi, Mark; Baker, Michael K.; Stubbs, Peter William; Brodie, Matthew A.; Lord, Stephen R.; Hoang, Phu

doi:10.1016/j.clinbiomech.2017.08.012

Cited by 7 publications

(12 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The primary outcome measure was the reliability of heel-to-toe progression during stance; the heel-contact phase, mid-stance phase and propulsive phase [ 2 ]. These variables were calculated from heel-on time, toe-on time, heel-off time and toe-off time.…”

Section: Methodsmentioning

confidence: 99%

“…The stance phase of normal gait is characterized by heel-contact, foot progression (where the tibia progresses over the foot) and push off [ 1 ]. Psarakis et al [ 2 ] described these phases as ‘heel-to-toe progression’ (heel-contact, mid-stance and propulsive phases) and developed a method, using a pressure sensitive walkway, to measure the time taken for each phase. It was suggested that heel-contact time (which begins when the heel touches the mat and ends when the toe touches the mat), and mid-stance time (which begins when the toes touches the mat and ends when the heel leaves the mat) could be used to functionally characterise ankle flexor weakness and/or ankle extensor contracture [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Psarakis et al [ 2 ] described these phases as ‘heel-to-toe progression’ (heel-contact, mid-stance and propulsive phases) and developed a method, using a pressure sensitive walkway, to measure the time taken for each phase. It was suggested that heel-contact time (which begins when the heel touches the mat and ends when the toe touches the mat), and mid-stance time (which begins when the toes touches the mat and ends when the heel leaves the mat) could be used to functionally characterise ankle flexor weakness and/or ankle extensor contracture [ 2 ]. That study [ 2 ] found that patients with multiple sclerosis with ankle extensor contracture and ankle flexor weakness had a reduced heel-contact time and increased mid-stance time on the more affected leg compared to the less affected leg and healthy controls.…”

Section: Introductionmentioning

confidence: 99%

“…The measurement of heel-to-toe progression has been investigated in patients with multiple sclerosis and healthy subjects, however the reliability and variability of the measurement was not reported [ 2 ]. To be a worthwhile measurement, that could be used clinically, the measure needs to be reliable.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Between session reliability of heel-to-toe progression measurements in the stance phase of gait

et al. 2018

Self Cite

View full text Add to dashboard Cite

The objective of the current study was to determine the test-retest reliability of heel-to-toe progression measures in the stance phase of gait using intraclass correlation coefficient (ICC) analysis. It has been proposed that heel-to-toe progression could be used as a functional measure of ankle muscle contracture/weakness in clinical populations. This was the first study to investigate the test-retest reliability of this measure. Eighteen healthy subjects walked over the GAITRite® mat three times at a comfortable speed on two sessions (≥ 48 hours apart). The reliability of the heel-to-toe progression measures; heel-contact time, mid-stance time and propulsive time were assessed. Also assessed were basic temporal-spatial parameters; velocity, cadence, stride length, step length, stride width, single and double leg support time. Reliability was determined using the ICC(3,1) model and, fixed and proportional biases, and measures of variability were assessed. Basic gait temporal-spatial parameters were not different between sessions (p > 0.05) and had excellent reliability (ICC(3,1) range: 0.871–0.953) indicating that subjects walked similarly between sessions. Measurement of heel-to-toe progression variables were not different between sessions (p > 0.05) and had excellent reliability (ICC(3,1) range: 0.845–0.926). However, these were less precise and more variable than the measurement of standard temporal-spatial gait variables. As the current study was performed on healthy populations, it represents the ‘best case’ scenario. The increased variability and reduced precision of heel-to-toe progression measurements should be considered if being used in clinical populations.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Between session reliability of heel-to-toe progression measurements in the stance phase of gait

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…2 A significant consequence of ankle contractures is the debilitating impact on gait and functional mobility such as impaired heel to toe progression during gait. 3 Similarly, ankle contractures may also contribute to the high frequency of falls in people with MS 4 due to reduced foot clearance during the swing phase of gait with consequent trips and slips, which account for 48% of falls in people with MS. 5 Therefore, interventions that can reduce ankle contracture should improve gait and functional mobility as well as reduce trips, slips and falls.…”

Section: Introductionmentioning

confidence: 99%

Safety, Feasibility, and Efficacy of an Eccentric Exercise Intervention in People with Multiple Sclerosis with Ankle Contractures

Psarakis¹,

Lord²,

Hoang³

2020

International Journal of MS Care

Self Cite

View full text Add to dashboard Cite

Background: The primary aim of this study was to investigate the safety and feasibility of an eccentric exercise program for people with multiple sclerosis (MS) who have ankle contractures, i.e. reduced ankle range of motion (ROM). Secondary aims were to explore the efficacy of eccentric exercise on ankle joint ROM and functional mobility. Methods: Five people with MS (3 females and 2 males, mean age 50.8 ± 9.4, duration of MS 7.6 ± years) completed two eccentric exercise training sessions (between 10 - 45 min) per week for 12 weeks (total = 24 sessions). The training involved walking backwards downhill on an inclined treadmill (gradient = 10 - 14°) at a self-selected pace. The intervention was assessed for its safety (adverse events) and feasibility (recruitment rates, adherence rates, enjoyment levels, difficulty and discomfort) along with clinical outcomes including passive/active ankle ROM and distance walked in 6 minutes. Results: There were no adverse events during or following the eccentric training. There was a 100% adherence rate. All participants enjoyed the training and experienced low levels of muscle soreness/discomfort. The training program improved passive and active ankle ROM in all participants, however, improvements did not translate to improvements in walking for all participants. Conclusions: Eccentric exercise (walking backwards and downhill) is a safe and feasible training modality for people with MS with ankle contractures. Clinical outcomes (greater passive and active ankle ROM) following training were evident. However, translation to clinically meaningful changes in walking function requires further examination.

show abstract

Brief report: Passive mechanical properties of gastrocnemius in multiple sclerosis and ankle contracture

Hoang

Psarakis

Kwah

et al. 2021

Clinical Biomechanics

View full text Add to dashboard Cite

Impaired heel to toe progression during gait is related to reduced ankle range of motion in people with Multiple Sclerosis

Cited by 7 publications

References 16 publications

Between session reliability of heel-to-toe progression measurements in the stance phase of gait

Between session reliability of heel-to-toe progression measurements in the stance phase of gait

Safety, Feasibility, and Efficacy of an Eccentric Exercise Intervention in People with Multiple Sclerosis with Ankle Contractures

Brief report: Passive mechanical properties of gastrocnemius in multiple sclerosis and ankle contracture

Contact Info

Product

Resources

About