Older Adult's walk

An older adult in a nursing home has trouble walking and has already fallen. The aim of this consultation is to optimze the rehabilitation program to better maintain autonomy, to be able to inform loved ones of the patient’s walking status and to be able to follow walking progress in the weeks that follow.

PATIENT
Gender
Female
Age
-
Profession
Retiree
Size
-
Height
-
Consultation

Older adult's walk

Biomechanical parameters

Walking speed and cadence

Stride length

Propulsion ratio

Pronation / supination angles

Information collected during the walking examination?

The practitioner uses DigitsolePro® for the dynamic analysis (walking or running depending on the patient).

He collects data on the patient’s walking or running activity using the web interface available online at https://app.digitsolepro.com.

The results are then presented to the patient, medical staff and loved ones, allowing the patient to integrate them into the treatment process and facilitating acceptance.

Different parameters will be used to complete the clinical examination:

Certain parameters will help to determine the quality of the resident’s walk (angle of striking, propulsion ratio, height of toes from the ground) and others to quantify the walk.

The speed and cadence of the walk: This is the average speed at which the patient walks during their analysis. If the walking speed decreases by 0.1km/h, the risk of falling increases.

The cadence determines the number of steps per minute, the norm being between 102 and 124 steps/minute for an adult.

In this case, very poor speed is also associated with a very poor cadence. Strength training will be proposed, and we will ask the patient to squat while holding a bar.

The aim is to see how this speed varies during the following weeks and months. But it does not demonstrate the quality of the walk.

After a little over a month of rehabilitation:

After two months of rehabilitation:

We see that the speed and cadence develop positively, in the context of the different parameters that demonstrate walking quality.

The length of the stride: measure the distance between two heel contacts on the same side.

Shows very reduced distance, so work on elongating the length of the step must be done. In the physical therapy room, we place hoops between parallel bars in order to progressively elongate the stride. We monitor the evolution of this parameter over the following weeks:

After a little over a month of rehabilitation:

After two months of rehabilitation:

The development is positive - there is an elongation of the stride length.

The propulsion ratio: this provides indications as to which muscles are the most utilized during propulsion, between hip flexors and plantar flexors.

There is a greater use of the hip flexors. To increase the action of the plantar flexors, we have to put the patient on her toes.

After a little over a month of rehabilitation versus two months of rehabilitation:

Positive development, ratios showing hip flexors decreasing.

Walking pronation/supination angles:

Significant pronation is measured. So that she has better stability, we will advise the patient to change shoes (she uses slippers for walking) so that the deformation is controlled better.

The striking angle and the height of the toes from the ground: two important parameters that allow us to determine the quality of the walk:

We note that the height of the step is good (if less than 2mm the risk of falling increases).

However, the striking angle is too weak, and work will be done on the mobility of the ankle and on toe extensions.

After a little over a month of rehabilitation:

After two months of rehabilitation:

The patient has gained several degrees in the striking angle; work to be continued.

Conclusion:

Following the first summary done with DigitsolePro, we were able to determine which parameters were the weakest.

Over the course of the weeks, we were able to track the changes in these parameters, also allowing the patient and her loved ones to visualize the progress that was being made and feel motivated.

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