The effect of cane use method on center of mass displacement during stair ascent

The aim of the study was to examine the effect of forward and lateral cane placement on displacement of whole body center of mass (COM) and spatial relationship between COM and the cane during stair ascent (SA) in healthy adults. The data were obtained using three-dimensional motion analysis while ascending stairs non-reciprocally with following methods: (1) dominant foot stepped up first, then the opposite foot without a cane (NC); (2) forward placement of a quadricane followed by the ipsilateral foot, then contralateral foot (FCI); (3) forward cane placement followed by the contralateral foot, then ipsilateral foot (FCC); (4) ipsilateral foot stepping up first, followed by the contralateral foot, then the cane (LCI); (5) contralateral foot stepping up, followed by the ipsilateral foot, then the cane (LCC). The results indicated that the cane placement had significant effect on the medial-lateral (ML) COM displacement and the kinematics of the trunk. Lateral cane placement requires greater trunk extension and side-flexion. The major differences between ipsilateral and contralateral cane use are the motions at frontal and transverse planes in which the COM displacement in ML direction is larger in ipsilateral cane use. The COM displacement in ML direction is larger in ipsilateral use of cane (LCI and FCI). The results of this study may help clinicians better understand the possible nature of balance control in patients who ascend stairs with a cane, and suggest that the method of cane placement should be taken into consideration by clinicians when teaching the cane user to ascend stairs.