Effect of Sacroiliac Joint Manipulation on Selected Gait Parameters in Healthy Subjects

Background. The sacroiliac joints have complicated biomechanics. While the movements in the joints are small, they exert a significant effect on gait. This study aimed to assess how sacroiliac joint manipulation influences selected gait parameters. Material and method. The study enrolled 57 healthy subjects. The experimental group consisted of 26 participants diagnosed with dysfunction of one sacroiliac joint. The control group was composed of 31 persons. All subjects from the experimental group underwent sacroiliac joint manipulation. Results. The experimental group showed significant lengthening of the step on both sides and the stride length in this group increased as well. Moreover, the duration of the stride increased (p=0.000826). The maximum midfoot pressure was higher and maximum heel pressure decreased. The differences were statistically significant. Conclusions. 1. Subclinical dysfunctions of the sacroiliac joints may cause functional gait disturbance. 2. Manipulation of the iliosacral joint exerts a significant effect on gait parameters, which may lead to improved gait economy and effec­tiveness. 3. Following manipulation of one iliosacral joint, altered gait parameters are noted on both the manipulated side and the contralateral side, which may translate into improved quality of locomotion.

Energy costs and performance of transfemoral amputees and non-amputees during walking and running: A pilot study

Background:Limited information is available concerning the effects of prosthetic foot components on energy costs and ambulatory performance for transfemoral amputees.Objectives:Compare energy costs (VO2; gait economy) and ambulatory performance (self-selected walking speeds, self-selected running speeds, peak running speeds) differences during walking and running for transfemoral amputees and matched, non-amputee runners.Study design:Repeated measures.Methods:Transfemoral amputees were accommodated and tested with three prosthetic feet: conventional foot, solid-ankle cushioned heel (SACH); energy storing and return foot, Renegade; and running-specific energy storing and return foot, Nitro.Results:During walking, VO2was similar between transfemoral amputees but was increased compared to controls. Self-selected walking speeds were slower for SACH compared to Renegade and Nitro. For transfemoral amputees, gait economy was decreased and self-selected walking speeds were slower compared to controls. During fixed running speeds, transfemoral amputees ran using Nitro, and VO2was greater compared to controls. Transfemoral amputees ran at self-selected running speeds using Renegade and Nitro. Self-selected running speeds were slower for Renegade compared to Nitro. For transfemoral amputees, gait economy was decreased and self-selected running speeds were slower compared to controls. VO2peak was similar between transfemoral amputees and controls, but controls achieved greater peak running speeds and % grade.Conclusion:Energy costs were greater and ambulatory performance was lower for transfemoral amputees compared to matched, non-amputee controls for all prosthetic foot conditions.Clinical relevanceBoth types of energy storing and return feet may improve walking performance for transfemoral amputees by providing faster self-selected walking speeds. For transfemoral amputees interested in performing vigorous running (exercise and running competition), clinicians should recommend a running-specific energy storing and return foot.

Changes in Gait Economy Between Full-Contact Custom-made Foot Orthoses and Prefabricated Inserts in Patients with Musculoskeletal Pain

Background: Specific kinematic and kinetic outcomes have been used to detect biomechanical change while wearing foot orthoses; however, few studies demonstrate consistent effects. We sought to observe changes in walking economy in patients with musculoskeletal pain across 10 weeks while wearing custom-made foot orthoses and prefabricated shoe inserts. Methods: In this crossover randomized controlled trial, 40 participants wore custom-made orthoses and prefabricated inserts for 4 weeks each, consecutively. The path length ratio was used to quantify walking economy by comparing the undulating path of a point in the pelvis with its direct path averaged across multiple strides. Results: For the prefab-custom group (n = 27), significant decreases in path length ratio (improved economy of gait) were noted at the initial introduction of prefabricated inserts (P = .02) and custom orthoses (P = .02) but maintained a trend toward improved economy only while wearing custom orthoses (P = .08). For the custom-prefab group (n = 13), there was worsening of the path length ratio that was significant after removing the custom-made orthoses for 4 weeks (P = .01). Conclusion: For patients with lower-extremity musculoskeletal pain, immediate improvements in economy of gait can be expected with both interventions. It seems, however, that only the custom-made orthoses maintain economy of gait for 4 weeks. Patients who begin wearing custom-made orthoses and then wear prefabricated insoles can expect a decrease in economy of gait. (J Am Podiatr Med Assoc 98(6): 429–435, 2008)