Effects of handrail use on healthy treadmill walking

Date
2010
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Publisher
University of Delaware
Abstract
Upper extremity movements and forces have important implications for rehabilitation of pathological gait. Patients with pathological gait often rely on an outside source (such as a cane or handrail) to assist them. It is important to take into consideration if handrail usage significantly alters the kinetic and kinematic data during different walking conditions because the amount of force used on the handrail varies between subjects and may influence these parameters. This study combined treadmill gait analysis with upper extremity force measurement on healthy subjects to provide an understanding of the changes that occur in kinetics and kinematics with handrail use. Objective: The objective of this study was to evaluate the effect of handrail use on the kinetics and kinematics during treadmill walking in healthy subjects. We compared (1) magnitudes of handrail and ground reaction forces and (2) hip angles when no handrails were used and when five percent of body weight was applied to the handrail. Methods: Twenty five healthy young adults were recruited for this study. Kinematic and kinetic data were collected while all subjects walked on an instrumented split-belt treadmill at their self-selected speed. To determine the effect of handrail usage on walking kinetics, subjects walked under four handrail conditions (no hands on handrail (NHR), both hands on the handrail (BHR), left hand only on the handrail (LHR), and right hand only on the handrail (RHR)). The subjects walked under three additional conditions to quantify changes in kinematics when handrail force was controlled (no hands on handrail, 5% body weight (BW) on right handrail, and 5% body weight on left handrail). Ground reaction forces and handrail forces as well as hip angles, trunk list and trunk tilt were analyzed. Results: The first peak of the ground reaction force was reduced significantly when both handrails were used. This suggests the handrails were used for stability during heel strike. The left and right handrail forces when only one handrail was used showed no significant differences and the right handrail forces in the RHR and BHR conditions also remained the same. During handrail force control conditions, the trunk list, in the frontal plane, and trunk tilt, in the sagittal plane, were significantly different, but the hip angles were not. Conclusions: Handrail use needs to be considered because it has an effect on ground reaction forces, which may influence inverse dynamics calculations. Although there were no significant differences in hip angles when a handrail force of 5% BW (or less) is applied to the handrails, there were significant differences in trunk list and trunk tilt, which may be more pronounced with greater handrail forces applied. When a subject uses a handrail during a data collection, different handrail conditions and the amount of force applied to the handrails need to be taken into account.
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