People Preferentially Increase Hip Joint Power Generation to Walk Faster Following Traumatic Brain Injury

Abstract

Reduced gait speed following TBI appears to be attributable to biomechanical deficiencies such as reduced ankle power generation rather than reduced postural stability and increased caution.

Running abnormalities after traumatic brain injury

“…In contrast to TBI gait where cadence and step length were not significantly different to HCs at a matched speed [3], this cohort of people with TBI used a significantly higher cadence and shorter step length to attain a matched running speed. When asked to walk at faster gait speeds, people with TBI have demonstrated their ability to increase cadence and step length [34]. However, these results indicate the ability to further increase affected step length for running appears to be limited.…”

“…These variables were generated from a review of known gait abnormalities following TBI, the key gait variables for normal walking and running and specific variables which have been identified as problematic in other neurological populations [3,33]. Several additional kinetic variables were also prioritized, based on the recent findings of Williams et al [34] which showed people with TBI compensate for distal power generation deficits with increased hip power generation when walking at faster gait speeds. Only data for participants capable of performing the walking and running trials are reported here.…”

The influence of body weight support on ankle mechanics during treadmill walking

“…Because the plantarflexor's roles of body support and forward propulsion are not independent (McGowan et al, 2009), the provision of external BWS should also reduce forward propulsion and subsequently step length for a given walking speed. Available data, however, either indicate no change in step length with BWS (Burgess et al, 2010;van Hedel et al, 2006) or contradict this assertion (McGowan et al, 2008;Threlkeld et al, 2003), suggesting that gait compensations occur at other important joints, such as the hip flexors (Nadeau et al, 1999;Williams et al, 2010). Understanding the biomechanical changes (e.g., forward propulsion and step lengths) with BWS is important to properly retrain abberant movement patterns in individuals who exhibit distal muscle weakness.…”

Training Conditions Influence Walking Kinematics and Self-Selected Walking Speed in Patients with Neurological Impairments

“…Nine kinematic measures of pelvic, hip, knee, and ankle movements, together with foot progression, were collated. The mean performance of five trials for each patient's kinematic trace for each of the nine parameters was compared to the average values obtained from a sample of 10 (5 male) healthy controls (Williams et al, 2010), walking at a speed which was slow, yet adequate for community ambulation (Perry et al, 1995). The mean age of the healthy control sample was 27.3 years (range 18-35 years).…”

“…The 3DGA was performed at the Centre for Health, Exercise and Sports Medicine, School of Physiotherapy, The University of Melbourne, using a previously described approach (Williams et al, 2010). Four additional markers were placed on a small thermoplastic plate positioned over the sacrum and secured with a firm pelvic support strap (Barrere Pelvic Strap model 384).…”