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Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder

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Minimum toe clearance adaptations to floor surface irregularity and gait speed.

Brian W Schulz¹

¹VA HSR&D/RR&D Center of Excellence in Maximizing Rehabilitation Outcomes, James A. Haley VA Hospital, 8900 Grand Oak Circle, Room 149, Tampa, FL 33637-1022, USA. Brian.Schulz@va.gov

Journal of Biomechanics

|March 1, 2011

Summary

Obstacles on walking surfaces reduce the frequency of minimum toe clearance events, a key factor in tripping. However, when trips do occur, obstacles significantly increase the toe clearance distance, potentially preventing falls.

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Area of Science:

Biomechanics
Gait Analysis
Human Movement Science

Background:

Trips often occur during the swing phase of gait at minimum toe clearance (MTC) events.
Minimum toe clearance (MTC) quantifies trip risk by measuring the minimum distance between the toe and the ground.

Purpose of the Study:

To investigate the effect of floor surfaces with and without obstacles on MTC during gait.
To analyze how obstacle visibility influences MTC and associated joint kinematics.

Main Methods:

14 unimpaired subjects walked at different speeds on surfaces with no, visible, and hidden obstacles.
Motion tracking of shoes and body segments using passive markers.
Calculation of MTC and joint kinematics.

Main Results:

Faster walking speeds increased MTC values but not the likelihood of MTC events.
Obstacle surfaces reduced MTC event frequency (80% vs. 98% for no obstacles).
Visible obstacles doubled MTC values (11.1 mm to 22.2 mm), and hidden obstacles further increased them (26.8 mm).

Conclusions:

Obstacles significantly alter gait to increase toe clearance, reducing trip frequency but increasing clearance distance when events occur.
Changes in joint kinematics, within 10% of range of motion, underlie these MTC modifications.
Obstacle visibility impacts the gait adjustments and MTC outcomes.