[Walking with walking aids. III. Control and training of partial weightbearing by means of instrumented crutches (author's transl)].
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Biomedical subjects
Publications and source records attributed to N Rauschenbach.
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Partial weight bearing is frequently prescribed but cannot be controlled adequately. In a previous paper the change of forces at the hip joint as effected by a one sided cane was determined by instrumentation of the cane and a mechanical analysis of gait on a walkway. In the present study we looked at the conditions for control of partial weightbearing when two forearm crutches are used. Instrumented crutches and a forceplate were used. In walking with two forearm crutches the total of the ground reaction forces and the force pattern differ from those in free walking. The total of two crutch forces plus the force at the leg with partial weightbearing exceeds that caused by body weight alone. This is due to mass accelerations in a changed gait pattern. When the maximal leg force is reduced from 100% body weight to zero, the additional dynamic forces exceed those caused by body weight alone by 4%-19%. Only 2% of the additional dynamic forces act on the controlateral crutch while the rest is transmitted through the ipsilateral crutch. The crutch force pattern on the ipsilateral side depends more on individual gait characteristics than does that on the controlateral side. Load reduction is more pronounced in the late stages of the stand phase than in the early ones.
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The effect of one cane or forearm-crutch on some mechanical parameters at the contralateral hip were investigated. 5 healthy individuals were photographed on a walkway while using an instrumented cane/crutch. Geometric data from an original mathematical model were taken from these fotographs and an X-ray film of the pelvis and femur. The resultant force and pressure at the hip joint, shear force in the femoral neck and, in one case, the bending moment in the trochanteric region were computed and expressed as a function of the load applied to the walking-aid. All values decreased with an increase of this load. The reduction of force and pressure at the hip joint achieved by application of a load equal to 15% of bodyweight are superior to those resulting from common operative procedures done for the samp purpose. Differences between the effects of one sided cane and forearm-crutch are negligible.