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Quantification of changes in gait characteristics associated with intermittent claudication in patients with lumbar
Koutatsu Nagai1, Tomoki Aoyama, Minoru Yamada
1*Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University †Human Health Sciences ‡Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto §Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan.
Study Design:
Cross-sectional observational study.
Objective:
To quantify changes in gait characteristics associated with claudication after continuous walking, and to investigate the relationship between walking capacity and gait characteristics in patients with lumbar spinal stenosis (LSS).
Summary Of Background Data:
Walking difficulty due to pain or neurological symptoms accompanied by continuous walking may have negative effects on gait characteristics in patients with LSS. However, there are few detailed reports on the association of these changes with intermittent claudication and their relationship with walking capacity.
Methods:
For this study, 11 LSS patients with intermittent claudication were recruited. The subjects continued walking until they expressed a difficulty in continuing further. Postural sway, autocorrelation peak (AC), stride frequency (SF), and coefficient of variance (CV) were analyzed using accelerometers. To detect changes in gait parameters, we compared acceleration at the start and at the end of the walking task.
Results:
Walking difficulty during the test increased from 4 (interquartile range, 1-5) to 9 (interquartile range, 7-10). The postural sway significantly increased after the onset of maximum walking difficulty. AC, SF, or CV did not show significant change. Maximum walking distance significantly correlated with postural sway at the cervical sensor (r=-0.64), and CV (ρ=-0.66), an index of gait variability, at the beginning of the walking task.
Conclusions:
The change in gait parameters associated with claudication during continuous walking is detectable using accelerometers. Postural sway increases after the provocation of walking difficulty due to pain or neurological symptoms. In addition, walking capacity correlated with postural sway of the upper trunk and gait variability during walking initiation. This methodology warrants further studies to confirm its usefulness as an assessment tool for patients with LSS.
