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Dmitry V.skvortsov
05-12-1997, 10:38 PM
Dear List Members,
I am clinical biomechanic from Russia. My research interest is in area
of clinical gait analysis. As a result of long time investigation I
would like to suggest you for discuss some conception. It is the
clinical conception of analysis of abnormal walking.

A few different approaches to clinical analysis of abnormal walking
are known now. They are suggested by (Gage 1991), (Perry 1992),
(Whittle 1991), (Sutherland 1988) and so on. Those approaches
generally are using definition a different gait abnormality by
identifying corresponding motion symptoms in details. However, the
common reaction of muscular-bone system would be take the addition
information for clinical understanding of the patient's problem. On
the other hand, often we need to differentiate specific gait
abnormality from nonspecific for clinical decision making.

The suggested conception is based on investigation of walking of 50
normal adult volunteers and 149 patients at different groups: 65 -
with unilateral calcaneal fracture (one year after), 49 - with
unilateral low back pain syndrome at different stage of disease, 28 -
cerebral palsied patients at teen age and 7 adult after cruse fracture
they are was investigated directly after beginning of loading of
affected leg. Investigation of walking was made on 3D motion analysis
system called "Biomechanica" (manufactured by MBN company) and
previous gait analysis systems.

As a result of investigation we found that general reaction of
muscular-bone system could divide to specific and nonspecific
symptoms. The specific symptoms are including the particular for
definite decease disturbances of gait parameters. The nonspecific
symptoms are involving a different modification of gait parameters.
They illustrate the slow walking. They are - low cadence and speed of
gait, wider walking base, bigger stance and double support time, low
swing and single support time, less maximums and higher minimum of
vertical component of, diminished maximums of horizontal component of
force reaction and so on. Those symptoms commonly do not contain
information which possible to use for identifying some definite gait
abnormality. In result of gait aberrance the muscular-bone system
could involve different elements of body to compensate the abnormal
walking. We suggest a formal dividing it on six levels of compensation
corresponding to the successive involving of different parts of the
muscular-bone system and assistive devices. The first level is level
of affected leg. It is for case when motion disturbance could be
compensate generally by correction of function only affected leg. In
this case the function of the other part of the body does not have
suffer. The mechanism of compensation can include different parts of
the affected leg: on the level of damage only, on the level above,
below of injury or both from it. If the affected leg can not
compensate a walking abnormality it is including the other level. It
is the level of the legs interaction. We found tow groups of
mechanisms of compensation. The first group was determined as general
common mechanisms. It is consists of the mechanism of redistribution
of the function, the copy function mechanism and providing optimum
mechanism. The second group are including well-known mechanisms of
compensation functional leg length discrepancy.
The mechanism of redistribution of the function is determine as: "the
normal leg execute mainly support function and affected leg mainly
swing function". Thus the normal leg had the support time larger than
affected. It was significant statistically (p