The effect of regular walking with poles on the gait of elderly

1

Keywords:

• Gait quality
• elderly
• inertial sensors

1. Introduction

Aging is often associated with loss of independency resulting from the deterioration of the gait quality. In Europe, due to the high proportion of the elderly people (age > 65 years) in the population, several researchers have investigated age-related changes in gait parameters. The findings of their research show that elderly exhibited an alteration of several gait parameters compared to young healthy adults. In fact, it is widely reported that elderly people exhibited a reduction of preferred walking speed, step and stride length, duration of the swing phase with an increase of the duration of double support, step width and cadence (Senden et al. 2009). Recent epidemiological research has shown the interest of physical activity to counter the effect of senescence and maintains health. Recently, the use of poles has become popular among older people practicing sports walking. Usually, this kind of devices is used in rehabilitation programs in the case of different pathologies such as Parkinson’s disease, depression or stress fractures (Knobloch et al. 2007; Suija et al. 2009). Some research has suggested that the use of poles could preserve and ameliorate different parameters characterizing a large number of gait aspects. The aim of the current study was to assess the impact of regular walking with poles on the gait of elderly.

2. Methods

2.1. Experimental protocol

Thirty-one subjects participated in this study. They filled and signed a consent form that indicates the goals and procedures of the experiment. The participant formed two groups: the sedentary elderly group (11 subjects: 65 ± 5.1 years, 1.61 ± 0.06 m and 73 ± 12 kg) and the Nordic walking group practicing sports walking with poles (20 subjects: 61.7 ± 4.7 years, 1.65 ± 0.05 m and 67 ± 14 kg). Measurements were made along 12 m corridor allowing a steady state walking. Participants were asked to walk at self-selected speed and repeat the test six times in order to obtain the most representative gait patterns.

To avoid initiation of walking as well as slowing down at the end, the two first and last steps were excluded from treatment.

During this test, two inertial sensors located at the distal part of each shank were used. The inertial sensors were attached with double-sided tape and belt. Shank acceleration and angular velocity were recorded at 200 Hz. The local ethics committee approved the experiment.

2.2. Theoretical background

Based on the gathered signals a wide range of parameters describing multiple aspects of gait were assessed (Ben Mansour et al. 2015). In the current study, only parameters describing spatiotemporal, variability and regularity aspects will be presented. In fact, based on the mediolateral component of the angular velocity gathered at the right and left shank level, initial and terminal foot contact were detected. The definition of these gait events is a crucial step for the assessment of the spatiotemporal gait parameters (velocity, stride length, stance, swing and double support duration duration). Variability and regularity were derived from the computed spatiotemporal parameters. The regularity describes the similarity of the pattern of the same limb during multiple and successive steps.

Student’s T test for independent samples was applied with Statistica (Statsoft, Tulsa, OK, USA) to detect the differences between groups. The level of significance was set at 0.05.

3. Results and discussion

The purpose of the current study was to assess the impact of the Nordic poles on the gait of the elderly. The computed parameters highlight a significant difference between the two-group walking with and without poles. In fact, Statistical results showed that the Nordic Elderly group using poles walk significantly faster than the sedentary elderly (p > 0.05). This increase in speed is the consequence of an increase in the stride length and a decrease in the double support duration (cf. Table 1). Moreover, some derived parameters describing variability and regularity aspects were able to discriminate the groups. Concerning the variability aspect, two computed parameters (variability of stance duration and stride duration) discriminate the two groups. The highest values were computed for sedentary elderly group which walk without poles. Compared to the Nordic walking group, the sedentary elderly group also showed a significantly decline in four parameters describing the regularity aspect. The latest results demonstrate that the use of poles enhance the similarity of the pattern of the same side during successive steps (Figure 1).

Figure 1. Sensors location.

Table 1. Averages and standard deviation for computed parameters. Significant differences are highlighted in grey.

	Parameters	Sedentary Elderly	Nordic Elderly
Spatiotemporal	Velocity (m.s^-1)	1.48 ± 0.23*	1.79 ± 0.21*
	Stride length (m)	1.45 ± 0.13*	1.65 ± 0.14*
	Stance duration (s)	0.67 ± 0.07	0.65 ± 0.06
	Swing duration (s)	0.43 ± 0.03	0.42 ± 0.04
	Double support (s)	0.14 ± 0.03*	0.12 ± 0.01*
Variability	Stance duration	0.032 ± 0.009*	0.029 ± 0.008*
	Swing duration	0.016 ± 0.005	0.015 ± 0.005
	Double support	0.019 ± 0.004	0.017 ± 0.006
	Step duration	0.023 ± 0.006	0.022 ± 0.008
	Stride duration	0.039 ± 0.01*	0.035 ± 0.006*
	Stride length	0.01 ± 0.005	0.008 ± 0.004
Regularity	Stance duration	0.89 ± 0.001*	0.96 ± 0.01*
	Swing duration	0.96 ± 0.01	0.97 ± 0.02
	Double support	0.96 ± 0.02	0.96 ± 0.02
	Step duration	0.89 ± 0.02*	0.98 ± 0.01*
	Stride duration	0.87 ± 0.03*	0.96 ± 0.02*
	Stride length	0.89 ± 0.01*	0.98 ± 0.03*

4. Conclusions

In conclusion, the findings of this study highlight the benefits of regular practice of walking. Nevertherless, the contribution of poles is still not enough demonstrated. In order to consolidate the assumption that the use of poles improve the gait, this study will be extended and a comparison between gait with and without poles will be made.

Acknowledgements

The authors would like to thank all the volunteers who participated to the experiment.