“those with chronic neck pain demonstrated a narrower step width, a shorter step length and slower gait speed during walking with the head movements and at maximum speed” –  Uthaikhup et al. study:

Head movement and Gait Parameters:

By now you should have a good grasp of the global impact of gait and how it presents and translates in everything we do. It is how we move through this world, and everything we do, and everything that has happened to us, impacts our gait. And, our gait impacts things in turn, from our mental state to how we think and act.  

By now, if you have been with us here on The Gait Guys long enough, you know that with the tremendous proprioceptive impact of the system from the cervical spine, that neck pain can influence sensorimotor function and thus motor function. However, little is known about the effects of head movement and walking speed on gait characteristics in patients with neck pain.

From the Uthaikhup et al. study:

Patient sample:  20 women aged between 18 and 59 years with chronic neck pain (>3 months) and 20 healthy controls of similar age, weight and height

Indexes used: Neck Disability Index and Visual Analogue Pain Scale.

“The experiment consisted of two walking sessions. The first session included walking with head straight, head up-down, and head turns from side to side. The second session included walking at comfortable and maximum speeds. Each trial was performed twice. Gait parameters measured using GAITRite walkway system were step length, stride length, step time, stride time, step width, cadence and gait speed.”

According to this study, the clients with chronic neck pain showed several changes in how they implemented their gait. They displayed step width narrowing, a reduction in step length and speed of gait, and even an overall reduction in gait speed when neck movements were induced or encouraged or when there was pain..

As Uthaikhup et al. summarized, “The results suggest that patients with chronic neck pain have gait disturbances. This supports the notion that assessment of gait should be addressed in patients with persistent neck pain.”

You have to know your gait norms to understand abnormals. We have written about other parameters that affect gait speed, step length and width here on the blog. Here is one more parameter for you to store in your noggin. It is all connected. So, when you goto your gait analysis guru, ask them if they are going to clinically assess your painful neck as part of the gait analysis (be prepared for the “deer in the headlights” look).

Dr. Shawn Allen, one of the gait guys

Reference:

Man Ther. 2014 Apr;19(2):137-41. doi: 10.1016/j.math.2013.09.004. Epub 2013 Sep 27.The effects of head movement and walking speed on gait parameters in patients with chronic neck pain. Uthaikhup S, Sunkarat S, Khamsaen K, Meeyan K, Treleaven J.

Podcast 97: Decomposition of human movement.

Topics: Decomposition of movement, sacrificing speed and efficiency for movement, gait efficiency, arm swing, more on injuries and unshod running and more !

A. Link to our server: http://traffic.libsyn.com/thegaitguys/pod_97final.mp3

Podcast Direct Download:  http://thegaitguys.libsyn.com/podcast-97

Other Gait Guys stuff

B. iTunes link:
https://itunes.apple.com/us/podcast/the-gait-guys-podcast/id559864138
C. Gait Guys online /download store (National Shoe Fit Certification & more !)
http://store.payloadz.com/results/results.aspx?m=80204
D. other web based Gait Guys lectures:
Monthly lectures at : www.onlinece.com type in Dr. Waerlop or Dr. Allen, ”Biomechanics”

-Our Book: Pedographs and Gait Analysis and Clinical Case Studies
Electronic copies available here:

-Amazon/Kindle:
http://www.amazon.com/Pedographs-Gait-Analysis-Clinical-Studies-ebook/dp/B00AC18M3E

-Barnes and Noble / Nook Reader:
http://www.barnesandnoble.com/w/pedographs-and-gait-analysis-ivo-waerlop-and-shawn-allen/1112754833?ean=9781466953895

https://itunes.apple.com/us/book/pedographs-and-gait-analysis/id554516085?mt=11

-Hardcopy available from our publisher:
http://bookstore.trafford.com/Products/SKU-000155825/Pedographs-and-Gait-Analysis.aspx

Show notes:

-Brain Friendly Interface Could Change the Way People with Spinal Cord Injuries Lead Their Lives
http://neurosciencenews.com/extracellular-matrix-brain-interface-2395/

-Barefoot vs Shoe debate
http://www.theglobeandmail.com/life/health-and-fitness/fitness/barefoot-vs-shod-running-its-a-dead-heat/article26180292/

-Sacrificing speed and efficiency for stability as we age (1) . Not a bad plan. Kind of like what we spoke about here below in this video: returning to a more primitive state as the system starts to break down.

1. Zurales K, DeMott TK, Kim H, et al. Gait efficiency on an uneven surface is associated with falls and injury in older subjects with a spectrum of lower limb neuromuscular function: A

prospective study. Am J Phys Med Rehabil 2015 Jun 5. [Epub ahead of print]

https://www.youtube.com/watch?v=_fBjyutWQvU  video link to our video on this

-http://lermagazine.com/news/in-the-moment-gait/speed-trap-slowest-seniors-have-increased-mortality

-Shoe:  the UnderArmor Fat Tire GTX Trail shoe.

https://www.underarmour.com/…/mens-ua-fat-tire-g…/pid1262064

– assessing the different genders: http://www.ncbi.nlm.nih.gov/pubmed/12689785

Ferber R, Davis IM, Williams DS 3rd. Gender differences in lower extremity mechanics during running. Clin Biomech 2003;18(4):350-357.

-Arm Swing
http://thegaitguys.tumblr.com/post/128715659449/unique-adaptations-to-arm-swing-challenges-the

Does slowing gait increase gait stability ?

As this study suggests, it has been difficult to find studies that establish a clear connection between gait stability and gait speed. One can easily assume that slowing down increases stability, we do it on slippery surfaces, we do it when a joint is painful, even the elderly do it naturally everyday. Walking speed, step length, step frequency, step width, local dynamic stability , and margins of stability were measured in this study below. It was found that the subjects did not change walking speed in response to the balance perturbations rather they made shorter, faster, and wider steps with increasing perturbation intensity. They became locally less stable in response to the perturbations but increased their margins of stability in medio-lateral and backward direction. 

So what did they conclude ?  Here are their words,“In conclusion, not a lower walking speed, but a combination of decreased step length and increased step frequency and step width seems to be the strategy of choice to cope with medio-lateral balance perturbations, which increases Margins of Stability (MoS) and thus decreases the risk of falling.”

It is my assumption, and this just seems logical, that if the perturbations were to continue constantly, that one would slow the gait speed to reduce the need for these shorter, faster and wider steps. 

Dr. Shawn Allen

http://www.ncbi.nlm.nih.gov/pubmed/22464635

Gait Posture. 2012 Jun;36(2):260-4. doi: 10.1016/j.gaitpost.2012.03.005. Epub 2012 Mar 29.Speeding up or slowing down?: Gait adaptations to preserve gait stability in response to balance perturbations.Hak L1, Houdijk H, Steenbrink F, Mert A, van der Wurff P, Beek PJ, van Dieën JH.

Optimal walking speed

How fast you should move in order to improve your health?
In many studies, the more intense runners are healthier than those who walk or run more moderately. However, this is not the entire picture, there are studies that say moderation is wiser. Confusingly, and perhaps unfortunately there is literature that will support whatever makes you happy.
From the linked blog:
“This risk of death is lower even with a very minimal energy expenditure. The lowest-energy-expenditure group in each study is walking at about 3 mph for 20 to 40 minutes per day. In other words, a mile or two of walking. In exchange, their risk of death goes down by 10 percent.
"Walking a bit farther — say, 2 to 3 miles at 3 mph — gets you an additional death reduction of about 30 percent. But walking more than that, or more than an hour a day at this speed, is no better.”
“If we take this research at face value, we learn a few things. First, some exercise reduces your risk of death. Second, the optimal walking/jogging exercise is light to moderate jogging. The optimal speed is between 5 and 7 mph, and if you do 25 minutes about three times a week, you’re all set. Nothing in the data suggests that running more — farther, or faster — will do more to lower your risk of death.”

What do you think ? Agree /Disagree?

http://fivethirtyeight.com/features/whats-the-optimal-speed-for-exercise/

Podcast 68: Gait , Arm Swing, Neuro-developmental Windows

A. Link to our server:

Direct Download: http://traffic.libsyn.com/thegaitguys/pod_68ffinal.mp3

Permalink: http://thegaitguys.libsyn.com/podcast-68

B. iTunes link:

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

C. Gait Guys online /download store (National Shoe Fit Certification and more !) :

http://store.payloadz.com/results/results.aspx?m=80204

D. other web based Gait Guys lectures:

www.onlinece.com   type in Dr. Waerlop or Dr. Allen,  ”Biomechanics”

______________

Today’s Show notes:

1.Brain implant helps paralysed man move his hand
http://realitysandwich.com/220399/brain-implant-helps-paralysed-man-move-his-hand-wired-uk/?u=95820

2. Has Science Finally Confirmed the Existence of Acupuncture Points, Validating Chinese Medicine?

3.This Tiny, Whip-Tailed Robot Can Administer Meds Anywhere In the Body

4. It matters what you put on your kids feet
“Shoes affect the gait of children. With shoes, children walk faster by…
5. Normal gait development.
6. Myelination
7. Arm swing in kids.
8. Arm swing and gait speed.