Comparison of Hip and Low Back Loads between Normal Gait, Axillary Crutch Ambulation and Walking with a Hands-free Crutch in a Healthy Population

# Background Instead of using axillary crutches, using a hands-free crutch (HFC) has been associated with higher functional outcome scores. However, hip and back pain have been reported as side effects. # Purpose/Hypothesis The purpose of this study was to compare range of motion and joint reacti...

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Autores principales:	Karl Orishimo, Amir Shapira, Ian Kremenic, Malachy McHugh, Stephen Nicholas
Formato:	article
Lenguaje:	EN
Publicado:	North American Sports Medicine Institute 2021
Materias:	Sports medicine RC1200-1245
Acceso en línea:	https://doaj.org/article/7eeb6587fe2f4c019f24e9ea3b0227ec
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spelling	oai:doaj.org-article:7eeb6587fe2f4c019f24e9ea3b0227ec2021-12-02T00:38:45ZComparison of Hip and Low Back Loads between Normal Gait, Axillary Crutch Ambulation and Walking with a Hands-free Crutch in a Healthy Population2159-2896https://doaj.org/article/7eeb6587fe2f4c019f24e9ea3b0227ec2021-12-01T00:00:00Zhttps://ijspt.scholasticahq.com/article/29517-comparison-of-hip-and-low-back-loads-between-normal-gait-axillary-crutch-ambulation-and-walking-with-a-hands-free-crutch-in-a-healthy-population.pdfhttps://doaj.org/toc/2159-2896# Background Instead of using axillary crutches, using a hands-free crutch (HFC) has been associated with higher functional outcome scores. However, hip and back pain have been reported as side effects. # Purpose/Hypothesis The purpose of this study was to compare range of motion and joint reaction forces at the hip and low back between HFC walking, normal walking, and standard crutch walking. It was hypothesized that hip joint reaction forces and low back joint reaction forces would be higher with HFC walking compared with normal walking and axillary crutch walking. # Study Design Controlled Laboratory Study # Methods Using 3D motion analysis and force plates, kinematics and ground reaction forces were measured in 12 healthy subjects during gait, crutch ambulation and HFC walking. Gait speed, hip and trunk range of motion, and hip and low back reaction forces, were compared using repeated-measures ANOVA. # Results Gait speed during HFC ambulation was reduced 33% compared to crutch ambulation (P<0.001) and 44% compared to normal gait (p<0.001). Hip range of motion was reduced during both crutch conditions compared to gait (p<0.001). Trunk range of motion was greatest during HFC walking compared to both gait and crutch ambulation (p<0.001). Peak hip joint reaction force during HFC walking was 11% lower than during gait (p=0.026) and 30% lower than during crutch walking (p<0.001). Peak low back reaction force during HFC walking was 18% higher than during gait (p=0.032) but not different than during crutch walking. # Conclusion Hip joint reaction forces during HFC walking did not exceed those during gait or axillary crutch ambulation. However, a reduction in hip motion using the HFC was associated with increases in trunk motion and low-back loading. These could be a cause for reports of low-back pain accompanying HFC usage. # Level of Evidence Level 3Karl OrishimoAmir ShapiraIan KremenicMalachy McHughStephen NicholasNorth American Sports Medicine InstitutearticleSports medicineRC1200-1245ENInternational Journal of Sports Physical Therapy, Vol 16, Iss 6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sports medicine RC1200-1245
spellingShingle	Sports medicine RC1200-1245 Karl Orishimo Amir Shapira Ian Kremenic Malachy McHugh Stephen Nicholas Comparison of Hip and Low Back Loads between Normal Gait, Axillary Crutch Ambulation and Walking with a Hands-free Crutch in a Healthy Population
description	# Background Instead of using axillary crutches, using a hands-free crutch (HFC) has been associated with higher functional outcome scores. However, hip and back pain have been reported as side effects. # Purpose/Hypothesis The purpose of this study was to compare range of motion and joint reaction forces at the hip and low back between HFC walking, normal walking, and standard crutch walking. It was hypothesized that hip joint reaction forces and low back joint reaction forces would be higher with HFC walking compared with normal walking and axillary crutch walking. # Study Design Controlled Laboratory Study # Methods Using 3D motion analysis and force plates, kinematics and ground reaction forces were measured in 12 healthy subjects during gait, crutch ambulation and HFC walking. Gait speed, hip and trunk range of motion, and hip and low back reaction forces, were compared using repeated-measures ANOVA. # Results Gait speed during HFC ambulation was reduced 33% compared to crutch ambulation (P<0.001) and 44% compared to normal gait (p<0.001). Hip range of motion was reduced during both crutch conditions compared to gait (p<0.001). Trunk range of motion was greatest during HFC walking compared to both gait and crutch ambulation (p<0.001). Peak hip joint reaction force during HFC walking was 11% lower than during gait (p=0.026) and 30% lower than during crutch walking (p<0.001). Peak low back reaction force during HFC walking was 18% higher than during gait (p=0.032) but not different than during crutch walking. # Conclusion Hip joint reaction forces during HFC walking did not exceed those during gait or axillary crutch ambulation. However, a reduction in hip motion using the HFC was associated with increases in trunk motion and low-back loading. These could be a cause for reports of low-back pain accompanying HFC usage. # Level of Evidence Level 3
format	article
author	Karl Orishimo Amir Shapira Ian Kremenic Malachy McHugh Stephen Nicholas
author_facet	Karl Orishimo Amir Shapira Ian Kremenic Malachy McHugh Stephen Nicholas
author_sort	Karl Orishimo
title	Comparison of Hip and Low Back Loads between Normal Gait, Axillary Crutch Ambulation and Walking with a Hands-free Crutch in a Healthy Population
title_short	Comparison of Hip and Low Back Loads between Normal Gait, Axillary Crutch Ambulation and Walking with a Hands-free Crutch in a Healthy Population
title_full	Comparison of Hip and Low Back Loads between Normal Gait, Axillary Crutch Ambulation and Walking with a Hands-free Crutch in a Healthy Population
title_fullStr	Comparison of Hip and Low Back Loads between Normal Gait, Axillary Crutch Ambulation and Walking with a Hands-free Crutch in a Healthy Population
title_full_unstemmed	Comparison of Hip and Low Back Loads between Normal Gait, Axillary Crutch Ambulation and Walking with a Hands-free Crutch in a Healthy Population
title_sort	comparison of hip and low back loads between normal gait, axillary crutch ambulation and walking with a hands-free crutch in a healthy population
publisher	North American Sports Medicine Institute
publishDate	2021
url	https://doaj.org/article/7eeb6587fe2f4c019f24e9ea3b0227ec
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Comparison of Hip and Low Back Loads between Normal Gait, Axillary Crutch Ambulation and Walking with a Hands-free Crutch in a Healthy Population

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