Difference between adult and infant gait compensation.

We highly doubt the infants compensated to the point of “recovering symmetrical gait”. It just isn’t possible seeing as there was frank asymmetry in leg length. However, it is quite possible they accomodated quicker with a more reasonable compensation, that MAY have appeared to have less limp. We did not do the study, but over a beer we might guess that the investigators might agree that our verbiage is closer to accurate. None the less, cool stuff to cogitate. We are very appreciative of this study, there is something to take from this study.

“The stability of a system affects how it will handle a perturbation: The system may compensate for the perturbation or not. This study examined how 14-month-old infants-notoriously unstable walkers-and adults cope with a perturbation to walking. We attached a platform to one of participants’ shoes, forcing them to walk with one elongated leg. At first, the platform shoe caused both age groups to slow down and limp, and caused infants to misstep and fall. But after a few trials, infants altered their gait to compensate for the platform shoe whereas adults did not; infants recovered symmetrical gait whereas adults continued to limp. Apparently, adult walking was stable enough to cope with the perturbation, but infants risked falling if they did not compensate. Compensation depends on the interplay of multiple factors: The availability of a compensatory response, the cost of compensation, and the stability of the system being perturbed.”- From the Cole et all study (reference below)

– thoughts by Shawn Allen

references:

Infant Behav Dev. 2014 Aug;37(3):305-14. doi: 10.1016/j.infbeh.2014.04.006. Epub 2014 May 20.Coping with asymmetry: how infants and adults walk with one elongated leg.Cole WG1, Gill SV2, Vereijken B3, Adolph KE4.

http://www.ncbi.nlm.nih.gov/pubmed/24857934

Reteaching sensory-motor patterns

Trying to reteach your client’s CNS new sensory-motor patterns so they can move better ? We like to say that the first few weeks are like paying down a mortgage, you do not own them, you are cerebrally renting those changes and barely paying down the principle. It takes focused work and time to truly own the changes so that they translate into better movement.
“Depending on the complexity of the activity, [experiments have required] four and a half months, 144 days or even three months for a new brain map, equal in complexity to an old one, to be created in the motor cortex.” -Swart
New connections and pathways are fragile and only through repetition and practice and focused attention can those connections be established enough to become habitual or default behaviors.

Neuroscience for Leadership: Harnessing the Brain Gain Advantage (The Neuroscience of Business). Tara Swart

Podcast #23. Neurology of walking babies, dialogues on step width for runners and so much more !

Syndication link:

http://thegaitguys.libsyn.com/podcast-23-walking-babies-step-width-cross-over-running

iTunes link:

https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138

Podcast #23. Neurology of walking babies, dialogues on step width for runners and so much more !

1- Newborn babies walk the walk | Body & Brain
http://www.sciencenews.org/view/generic/id/348262/description/Newborn_babies_walk_the_walk

2- 3D printing with stem cells could lead to printable organs – CNET Mobile
http://m.cnet.com/news/3d-printing-with-stem-cells-could-lead-to-printable-organs/57567789

3- our payloadz e-file download site.  http://store.payloadz.com/results/results.aspx?m=80204

4- www.onlineCE.com  

Great TeleSeminar Wed Feb 20th, 2013 8:00 PM Eastern Time Chiropractic TeleSeminar Biomechanics 302 Location: 1 hr by telephone Instructor: Waerlop/Allen, DC Price: 19.00

5- J Biomech. 2004 Jun;37(6):935-8.Owings TM, Grabiner MD.  Step width variability … .

Brach JS.    J Neuroeng Rehabil. 2005 Jul 26;2:21.  Step width variability … .

Sports Biomech. 2012 Nov;11(4):464-72.  IT Band strain and step width … .

6. Rethinking Ice Baths And Ibuprofen pulse.me/s/isg3t Inflammation IS part of the healing process!

7. Bringing the Foot Back To Life: Restoring the Extensor Hallucis Brevis Muscle.

http://youtu.be/1iZg_e4veWk

Podcast #23. Neurology of walking babies, dialogues on step width for runners and so much more !

Syndication link:

http://thegaitguys.libsyn.com/podcast-23-walking-babies-step-width-cross-over-running

iTunes link:

https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138

Podcast #23. Neurology of walking babies, dialogues on step width for runners and so much more !

1- Newborn babies walk the walk | Body & Brain
http://www.sciencenews.org/view/generic/id/348262/description/Newborn_babies_walk_the_walk

2- 3D printing with stem cells could lead to printable organs – CNET Mobile
http://m.cnet.com/news/3d-printing-with-stem-cells-could-lead-to-printable-organs/57567789

3- our payloadz e-file download site.  http://store.payloadz.com/results/results.aspx?m=80204

4- www.onlineCE.com  

Great TeleSeminar Wed Feb 20th, 2013 8:00 PM Eastern Time Chiropractic TeleSeminar Biomechanics 302 Location: 1 hr by telephone Instructor: Waerlop/Allen, DC Price: 19.00

5- J Biomech. 2004 Jun;37(6):935-8.Owings TM, Grabiner MD.  Step width variability … .

Brach JS.    J Neuroeng Rehabil. 2005 Jul 26;2:21.  Step width variability … .

Sports Biomech. 2012 Nov;11(4):464-72.  IT Band strain and step width … .

6. Rethinking Ice Baths And Ibuprofen pulse.me/s/isg3t Inflammation IS part of the healing process!

7. Bringing the Foot Back To Life: Restoring the Extensor Hallucis Brevis Muscle.

http://youtu.be/1iZg_e4veWk

Gait Problem ? But where is the problem ? A case of failed single leg stance in a runner during the “3 Second Gait Challenge”.

Remember, what you see is not the problem most of the time.
You have heard it from us over and over again. What you are seeing in someone’s gait or running, the thing that does not look right, is their strategy to cope with the body parts that are dysfunctional. You are quite often not seeing what is wrong.
For example, here during our “3 Second Gait Challenge” this gentleman shows a solid left stance phase of gait. At times it is so solid and calm that it looks like we still-framed the video. The right side is another matter. During right stance there is excessive “checking” of the frontal plane (side to side) at the ankle. You also clearly see him using the right arm as a ballast moving it out to the right during right stance phase to help offset and dampen the frontal plane challenges.
Now going back to our initial thesis (“Remember, what you see is not the problem most of the time.”) surely you will agree that what you are seeing that right arm doing is probably not the problem here. Correct ? 
Now, this is a patient of ours, so we know what is wrong with him.  But from an outsider looking in, the problem in this case is more likely in the right lower limb, but you cannot see what is wrong with it. So remember, what you see is frequently not the problem, rather it is a compensation strategy. This gentleman’s problem is coming from his right lower abdominal functional impairment (specificially the lower transverse abdominus and internal abdominal oblique functional weaknesses, we know because we  clinically muscle assessed him for strength, skill, and motor patterns in our office.) These muscles were clearly neurologically inhibited and weak and the motor pattern he has laid down is many years in the making, driving a deeply seated compensation pattern.  Basically, he cannot stabilize his torso on the pelvis-hip during single leg stance. This lets the pelvis drift to the right. In this case it was not gluteus medius weakness allowing for the drift, which is more common. The torso is weak on the right side making it difficult to stabilize right lateral torso movement so he cheats by moving his torso to the left (which you can see) but does so ineffectively and thus needs to use the right arm to “check” the poor strategy.  His Rolling patterns were clearly disfuctional however even after correcting them he still had the gait neurologic pattern as his default,  hence gait retraining is necessary in this and all cases. We do many other functional assessments, methods we have developed and they all clearly directed and confirmed the diagnosis.  Just remember, if you fix a person’s movement patterns but then do not fix the repetitive gait pattern they have been using then their gait is cycling the problems right back into the person and you are wasting your, and their, time. 

Additionally, It would be easy to say that this gentleman has a proprioceptive deficit and that he needs to do some balance work on a Bosu ball or  tilt board.  But that is “so last year” thinking. If someone is having troubles standing and balancing on a stable concrete floor why in the world would you make his stance surface training even more unstable ?  This again is just not wise thinking. You don’t first learn to drive on the freeway, you start in a parking lot or back street where you can learn skills at a slow speed first. Conquer stability on a stable surface, then progress them to a more unstable surface.

Today we showed you a small diamond in our assessments. The “3 second gait challenge”.  This one is a keeper for us.  As we always say “Speed kills”. And in gait speed also is a disguise, it blends and blurs the deficits and challenges.  Slow your clients done to 3-4 seconds and watch what jumps out at you !  (did you read our blog post on Speed and Gait deficits ? Here is the link.) Speed is the devil when it comes to gait. At a normal walking pace and running pace these deficits were not perceptible, because speed in the sagittal plane (moving forward) reduced the lateral challenges. Speed blurs, speed blends and speed kills.

We continue to ask “Of all the functional movement courses being offered out there now, why do they not get into functional gait screening?”  We think we have the answer.  It is likely because this stuff is difficult, it is because it takes a deep knowledge base of whole body biomechanics/functional anatomy (from arm swing to big toe function) and it is because what you see in someone’s gait is very often not the problem.  A deep and broad understanding of human gait is not something you can pick up in a single weekend seminar nor can it be something done simply by a “check off” sheet.  This is complicated stuff, our 700+ blog posts with 230 in the draft folder plus 90 YouTube videos proves that there is great depth to gait and proves how complex it can be. But, if you have been with us for awhile and continue to work at this stuff you are likely getting better and better at this gait stuff. Do not give up. This is a worthwhile journey.

We are The Gait Guys. Shawn and Ivo.

Providing a stable surface for your knowledge base!

The Essex Swagger: Are Gait (Walking and Running) Styles Cultural and/or Geographical ?

Do Australians move like Americans ?  Does a woman in Israel move like a woman in Ireland ? Do Swedish men move differently than a rural farmer in Tibet ?

Sure there are many variables that come to mind that can drive differing answers; things like foot wear (winter boots, rugged rural shoes/boots to fashionable Manhattan), terrain, tight or loose clothing an so on.  But the main question we are asking here is this: are there cultural and geographical differences in the way we walk devoid of issues related to climate, terrain, and fashion?  In other words, because of our deeply rooted genetic codes that may have been slightly tweaked over the centuries, are there subtle differences in the way these different cultures walk and run ?

Recently we came across an internet article on a gait study “College walking study to capture the Essex swagger” being done at the Chelmsford University . Scientists at Anglia Ruskin University, in Bishops Hall Lane, are calling on people to help them capture “the Essex swagger”, which could help provide better treatment for UK patients.  The gait analysis lab, at the university’s postgraduate medical institute, is a replica of the one at the Hospital for Special Surgery in New York, the leading hospital for orthopaedics in the United State so one might assume this is no meager investigation.

He believes establishing a local database will allow more accurate testing and analysis of patients, ranging from burns victims to those who have just undergone hip or knee surgery.

Dr Rajshree Mootanah, director of the university’s medical engineering research group mentioned that “When we are working with patients it is important to have a reference database of ‘normal’ gait to compare them to. The only database we have is of the New York population and we believe there may be slight, but still significant, differences to the way our local population walks due to the different racial make-up of the two groups.” 

So the bigger question is in fact, are geographic and/or cultural differences present significant enough to warrant different baselines for gait studies ? This question had us looking deeper into the research.  Unfortunately there is not much in the literature on transcultural movement differences but what we did find was supportive of our hypothesis.  To keep this blog article within readable limits for now, we have included the two journal articles we wanted to mention to support the hypothesis.  In Ebersbach’s study (references below) the

“healthy subjects in Berlin showed faster gait velocity than their counterparts in Tyrol, Austria, and patients with Parkinson’s disease were slightly slower than their respective healthy peers in both environments”.

Surprisingly, his study found that patients with Parkinson’s disease from Berlin had significantly faster walking speeds than both patients and healthy control subjects from Tyrol. There was a high gait tempo in Parkinsonian patients from Berlin characterized by fast step-rates and short strides. Thus, it appeared that in Ebersbach’s study there were sociocultural differences in gait, even in disease processes such as Parkinson’s disease. This certainly opens ones eyes into the understanding of disease. After all, we thought that a disease was a disease, not matter what part of the world you are in. And this study shows that this may not be the case.

In Al-Obaidi’s study the gait of healthy young adult Kuwaiti subjects from both genders were compared those in Sweden. The study indicated several significant differences between the subjects in their manner of walking regarding walking at “free, slow and fast” rates.

Both of these studies suggest that people move differently from each other around the world, and surprisingly, even differently from within the disease group of “movement impairment syndromes”. People in Australia move different from those in England, Canada, Germany, Sudan etc.  it suggests that our gait is as unique as our language and as subtle as an accent within a common tongue.  The studies also  suggest that if the gait world is to expand further in terms of research that multi cross-cultural data bases must be built.

Shawn and Ivo, The Gait Guys.

Two geeks looking for the missing links in how humans move.

_______

Mov Disord. 2000 Nov;15(6):1145-7. Sociocultural differences in gait. Ebersbach G, Sojer M, Müller J, Heijmenberg M, Poewe W. Source

Fachkrankenhaus für Bewegungsstörungen/Parkinson, Beelitz-Heilstätten, Germany.

Abstract

Transcultural differences in routine motor behavior and movement disorders have rarely been assessed. In the present study gait was studied in 47 healthy inhabitants of Tyrol living in rural or semi-urban (Innsbruck, Austria) settings and 43 healthy subjects residing in Berlin, Germany. In addition, gait was assessed in 23 patients in early stages of idiopathic Parkinson’s disease (11 in Berlin, 12 in Innsbruck). Healthy subjects in Berlin showed faster gait velocity than their counterparts in Tyrol, and patients with Parkinson’s disease were slightly slower than their respective healthy peers in both environments. Surprisingly, patients with Parkinson’s disease from Berlin had significantly faster walking speeds than both patients and healthy control subjects from Tyrol. High gait tempo in parkinsonian patients from Berlin was characterized by fast step-rates and short strides. Differences in normal gait in different sociocultural settings are thus reflected in parkinsonian slowing of gait.

________

J Rehabil Res Dev. 2003 Jul-Aug;40(4):361-6. Basic gait parameters: a comparison of reference data for normal subjects 20 to 29 years of age from Kuwait and Scandinavia. Al-Obaidi S, Wall JC, Al-Yaqoub A, Al-Ghanim M. Source

Department of Physical Therapy, Faculty of Allied Health Sciences, Kuwait University, Kuwait.

Abstract

This study obtained measurements of the spatiotemporal gait parameters of healthy young adult Kuwaiti subjects from both genders and compared the data to those collected in a similar study performed in Sweden. Thirty healthy subjects volunteered to participate in the study (which included being asked to walk at their “free,” “slow,” and “fast” self-selected speeds). We collected the spatiotemporal gait data using an automated system. Descriptive statistics were calculated for each variable measured at each walking condition. The data were then compared to those from the Swedish study. The results indicate several significant differences between Kuwaiti and Swedish subjects in their manner of walking. These results suggest a need to include data from subjects with diverse cultural backgrounds when a database on normal gait is developed or a need to limit the results of the database to a specified ethnic population.

More on Gait Forensics. Soon to be in airports ? not yet

Trust us, this will be something we will see in time.  This brief newsflash talked about foot plantar pressure representations, but as Ivo and I know…… there is so much more to the overall gait patterning. We know, we look at it everyday.

According to the brief article, “Researchers at the University of Liverpool analyzed more than 100,000 pressure points people’s feet create when they walk and came up with about 70 patterns said to be unique to any one individual, The Daily Telegraph reported.

The researchers said the findings could add another type of “biometric” identification in addition to retinal scanning and fingerprints at airports and in other security settings.”

Read more: http://www.upi.com/Science_News/2011/10/10/Study-How-you-walk-can-identify-you/UPI-96891318285793/#ixzz1axvvfVAO

Gait Forensics labs……. you might want to look at our body of work…… we kinda know what we are doing. 

Shawn and Ivo, quite possibly, future experts in Gait Forensics.

More on Gait Forensics. Soon to be in airports ? not yet