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  • FW: Reply Summary: Controlling walking velocity?

    > We would like to thank all of the people that replied to our
    > query on controlling walking velocity during gait trials. Even
    > though there is not a definitive answer to the way you should
    > control for velocity, it must be accounted for in the design of
    > the study, especially, if you are going to compare between
    > groups or are repeating measurements. Since Paul and I have two
    > different research questions we will control for velocity
    > differently. Thanks again to all of those that replied, and
    > here is a copy of the messages we received.
    >
    > Sincerely,
    > Jody B. Brucker
    > Paul D. Stoneman
    > BYU Physical Education Doctoral Candidates
    >
    >
    > ------------------
    > COPY OF MESSAGES
    > ------------------
    >
    > Why not have subjects walk at a self selected speed AND at a
    > constrained
    > velocity. Ultimately, it depends on your focused research
    > question but this
    > will cover both statistical deign control and allow for
    > research protocol
    > design control and offers the best option for detecting
    > differences in the
    > end.
    > Michael R. Torry, PhD
    > ---------------------
    >
    > In our lab we have also found that velocity contaminates our
    > interpretation
    > of treatment effects on gait. Furthermore, we have found that
    > subjects use
    > complex combinations of velocity, cadence and stride length to
    > achieve a
    > variety of objectives that they may have (speed, pain, habit,
    > personal
    > style, efficiency, etc). Indeed any of those 3 variables can be
    > changed or
    > controlled by some combination of changes in the other 2
    > variables.
    >
    > One question that you always have to be concerned about is that
    > if you
    > control any of these variables, is there gait any longer
    > representative of
    > anything that you can use to make your judgements about their
    > gait. We have
    > come to the conclusion that the best way to control these
    > variables (if you
    > are going to do so) is with a treadmill to control velocity,
    > and with a
    > metronome to control cadence. This is relatively easy for
    > subjects to do and
    > seems to least interfere with the quality of their gait. The
    > downside is
    > that when you control velocity and cadence, you can be sure
    > that you are
    > also controlling stride length - it may be indirect, but there
    > will be very
    > little variation in stride length possible if the subjects
    > conform to the
    > prescribed velocity and cadence. Under these conditions you
    > will have to
    > rely on kinematic and kinetic variables other than velocity,
    > cadence and
    > stride length for your analysis, as well as qualitative
    > information about
    > subject pain, etc under the conditions set.
    >
    > I would be interested in hearing what you decide to do and how
    > you make your
    > decision.
    >
    > Peter V. Loubert PhD, PT, ATC
    > -----------------------------
    >
    > We test in at a fixed velocity and at the subject's average
    > velocity. Then
    > you can see how much difference there really is. We are
    > assessing plantar
    > pressure data with an EMED Pedar system.
    >
    > Elizabeth J. Higbie, PhD, PT, ATC
    > ---------------------------------
    >
    > On chatting to a colleague who is a Physio she mentioned that
    > in
    > clinical settings physio's calculate the cost of gate to allow
    > quantitative measures of improvement to be recorded.
    >
    > Steve Myers
    > -----------
    > Jody
    > do both.
    > if you can.
    > at least do a pilot study first with both methods.
    > the key is to not end up down the road a year with mush for
    > data.
    >
    > this problem vexes me when i read running fatigue studies.
    > are kinematics changing because person is running slower or
    > because
    > they are fatigued or both.
    >
    > Rodger Kram
    > -----------
    >
    > Hi Jody,
    > I don't have a reference at my fingertips, but I believe time
    > normalization
    > has been used for gait in both kinematic and kinetic analysis.
    > Check authors
    > like Winter, Patla,or Perry and some of the other gait
    > literature.
    >
    > Shaw
    > -----
    >
    > Dear Jody,
    > In 1997 we did some work related to this. We were
    > interested in the
    > effect of different levels of gait control on planter pressure
    > measurement
    > (but also force). I attach a PDF file of our paper. I also
    > looked at the
    > issue of using walking velocity as a covariate in gait analysis
    > - this was
    > quite successful. It was only produced as an abstract and I
    > don't have the
    > copy to hand but here is the reference;
    >
    > Shaw J.E., Harrison A.J., Entwistle H., Boulton A.J.M., (1996)
    > Complex Gait
    > Analysis in Diabetic Neuropathy. British Diabetic Association
    > medical and
    > scientific conference Sept. 1995.
    >
    > I think you have a fair degree of choice here - based on our
    > experience
    > either way will work quite well. It is probably just a matter
    > of choosing
    > the approach that is most appropriate to your situation. eg. we
    > found full
    > gat control to be impracticable with subject who had gait
    > difficulty eg.
    > diabetics older patients etc. but it was ideal with normal
    > subjects and
    > those with minor gait problems.
    >
    > Good Luck
    > Dr Drew Harrison
    >
    > (the PDF is not included with this Reply Summary, jbb)
    > ----------------------------
    >
    > Dear Jody,
    > You hit at an important point. Speed influences practically all
    > gait
    > quantities. In order to compare patients before and after
    > treatment,
    > my opinion is that you should investigate
    > 1) whether 'normal' or maximal speed has increased. This alone
    > is
    > already a very important finding.
    > 2) whether the walking pattern, i.e. the time course of the
    > relevant
    > quantities, moments, forces, angles etc. etc. has significantly
    >
    > changed. To separate treatment effects from effects due to the
    > speed
    > increase, patients should be compared at equal speeds. A
    > proposed
    > protocol would thus include a) pre-op: at 'comfortable' or
    > 'maximal'
    > speed, b) post-op: again at the new 'comfortable' or 'maximal'
    >
    > speed PLUS recordings at the speeds of a)
    > 3) When patients are to be compared with a normal population,
    > care
    > should be taken that the normal values represent the whole
    > range of
    > speeds to be encountered in the patients.
    > 4) To compare speeds in subjects of various stature, speeds
    > should be
    > scaled. This gives me one more opportunity to advertize my
    > paper
    > in Gait and Posture 4:222-223 (1996).
    > It is a pity of much otherwise good research in this field,
    > that
    > these effects are insufficiently taken care of.
    >
    > Good luck with your work,
    > At Hof
    > --------
    >
    > I, too, am running test subjects through a gait lab and
    > understand there may
    > be effects of walking velocity on their GRFs. I would be
    > interested in the
    > responses you collect from your inquiry.
    >
    > Thanks.
    > Jacqueline Schmit
    > -----------------
    >
    > Jody,
    >
    > An interesting article by Grabiner in J Biomech (1995 Sep; 28
    > (9): 1115-7)
    > looked at targeting and ground reaction force variability and
    > concluded
    > that "targeting would not be expected to influence the
    > variability of
    > calculated kinetic variables that are subservient to GRF".
    > In my own work subjects walk across a force plate but I control
    > their
    > walking velocity via a metronome. Subjects choose a
    > self-selected pace and
    > begin a self-selected distance away from the force plate so
    > that they are
    > walking at a constant velocity upon heel-strike and the foot
    > strikes in
    > relatively the same place on the force plate. My particular
    > group of
    > subjects then under go arthroscopic ACL surgery and return 3
    > and 6 months
    > later for post-testing. I then use the same self-selected
    > velocity and
    > distance for each of the 2 post-tests as was used in the first
    > test sesion.
    > There have been few alterations in velocity and no deviations
    > in distance
    > thus far which may or may not play an important role in
    > subsequent data
    > analysis according to Grabiner.
    > This may not answer your question regarding inter-subject
    > variability and
    > what to control. I chose to be more concerned with
    > intra-subject
    > variability and collect from as many subjects as possible then
    > look to see
    > how to generalize the results. Essentially, I have a
    > single-subject design
    > and will look for possible group similarities afterwards. In
    > this fashion,
    > intra-subject variability was more my concern and collecting
    > numerous
    > trials more important than inter-subject variability and
    > controling for
    > cadence and stride length.
    > I hope this is useful.
    >
    > Reed
    > --------
    >
    > there is some work by Messier in the area of OA gait where they
    > controlled
    > the gait & looked at kinematics & ground reaction forces. This
    > is always a
    > debate. The other possibility if you have the time is to do a
    > few trials
    > each way & see what the changes are.
    >
    > Karen Perell
    > -------------
    >
    > If you use their preferred walking speed and possibly match
    > your control group
    > for height and leg length, then changes in the preferred
    > velocity (step length
    > and cadence) could be attributed to the treatment or recovery
    > in general. If
    > you are measuring your pre and post treatment on the same day,
    > this conclusion
    > is tighter. Try some searches on preferred rate with respect
    > to gait.
    >
    > Beth Boyd EdD, PT
    > -------------------
    >
    > Hi Jody,
    > Suggest you use 2 velocities: self paced and one standardized
    > velocity. You
    > can always normalize afterwards.
    >
    > Shaw Bronner
    > ---------------
    >
    > I have just about made up a simulation software for a biped
    > walking model
    > where I may compute the impulses in order to maintain symetry
    > and a desired
    > walking velocity in two dimensions.My model, while still
    > elementary,
    > produce an illimited number of steps, reaching a sort of stable
    > limit
    > cycles. I have made a few conferences so far with this model
    > but I am in
    > the process of writing one or two journal papers. If you can
    > supply me with
    > some recorded data on foot impulses and velocity, I might be
    > able to see if
    > there is some validation coming out for my model. Of course, I
    > would not
    > publish anything with your data unless authorised and I will
    > keep them
    > confidential.
    >
    > Yours very truly,
    > Paul Bourassa
    > ------------------
    >
    > I've been a subject in projects where the researchers have
    > tried to vary
    > velocity as a continuous variable- *extremely* difficult,
    > especially at
    > higher speeds. Has to do with the leg as a pendulum and all
    > that. My
    > inclination is to treat velocity as a categorical variable
    > (slow walk, fast
    > walk, trot, run, that sort of thing) and figure that the actual
    > velocity of
    > each individual is going to be fairly consistent from session
    > to session,
    > but that there's going to be outrageous inter-individual
    > variation. Might
    > be a good correlation with their inseam length. A literature
    > search on
    > Gregory Breit might help here.
    >
    > Clifford M. Les, DVM, PhD
    > ---------------------------
    >

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