Title

Effect of Specific Gait Modifications on Medial Knee Loading, Metabolic Cost and Perception of Task Difficulty

Author(s)

Lydia K. Caldwell, University of Dayton
Lloyd L. Laubach, University of DaytonFollow
Joaquin Alberto Barrios, University of DaytonFollow

Document Type

Article

Publication Date

7-2013

Publication Source

Clinical Biomechanics

Abstract

Background: The metabolic cost and cognitive demand of altering natural gait have not been well studied. The purpose of this investigation was to assess three modified patterns – toe out, ipsilateral trunk lean and a medial weight shift at the foot – on the basis of 1) medial knee joint load reduction, 2) metabolic cost of performance and 3) subject perception of task difficulty.

Methods: 12 healthy individuals underwent 3 dimensional motion analysis and metabolic testing to assess the gait mechanics and energy expenditure of natural gait and the three experimental gait patterns, performed to a self-selected moderate degree. Walking speed was controlled. Perceived workload was assessed using the NASA Task Load Index.

Findings: Trunk lean significantly reduced first peak knee adduction moment (↓32%, P < 0.001) as well as KAM impulse (↓35%, P < 0.001), but was costly in terms of energy expenditure (↑11%, P < 0.001) and perceived workload (↑1178%, P < 0.001). A moderate toe-out pattern significantly reduced the second peak knee adduction moment (↓32%, P < 0.001) and KAM impulse (↓14%, P = 0.026), but had no effect on the first peak. Conversely, toe-out was least demanding in terms of additional energy expenditure (↑2%, P = 0.001) and perceived workload (↑314%, P = 0.001). Medial shift did not reduce knee adduction moment.

Interpretation: The prioritization of joint load reduction versus additional metabolic and cognitive demands could play a substantial role in the clinical decision making process of selecting a modified gait pattern.

Inclusive pages

649–654

ISBN/ISSN

0268-0033

Comments

Permission documentation on file.

Copyright

Copyright © 2013, Elsevier

Publisher

Elsevier

Volume

28

Issue

6

Peer Reviewed

yes

eCommons Citation

Caldwell, Lydia K.; Laubach, Lloyd L.; and Barrios, Joaquin Alberto, "Effect of Specific Gait Modifications on Medial Knee Loading, Metabolic Cost and Perception of Task Difficulty" (2013). Physical Therapy Faculty Publications. 70.
https://ecommons.udayton.edu/dpt_fac_pub/70