Comparative biomechanical gait analysis of patients with central cord syndrome walking with one crutch and two crutches

Background

Ambulatory people with central cord syndrome often require assistive devices. The selection of a suitable assistive device should be based on an objective assessment. Our objective in this study was to determine whether there was any difference in using two crutches over one crutch, considering that these patients have bilateral upper-limb involvement.

Methods

Kinematic gait analysis was conducted in 12 patients with central cord syndrome of more than one year of evolution and functional capacity for walking with one crutch or without crutches. Patients were asked to walk with one crutch and with two crutches at a freely chosen walking speed through a 10-m walkway. Three-dimensional kinematic equipment based on active markers was used to analyze temporospatial and articular parameters (maximum, minimum, and range of motion, ROM, throughout the cycle)

Findings

During two-crutch versus one-crutch walking, speed was lower (P = 0041), stride time and step time were longer (P = 0.004 and P = 0.005) and there were fewer strides/minute and steps/minute (P = 0.005 and P = 0.006). The duration of the single support stance was longer during two-crutch walking (P = 0.008). With respect to the articular parameters, both ankle ROMs (dorsi-plantar flexion P = 0.003 and pronation–supination P = 0.004) were greater with one-crutch walking than with two-crutch walking.

Interpretation

In patients with central cord syndrome capable of walking with one crutch or without crutches, walking with two crutches decreases speed, increases stride time and step time and improves stability by increasing single support, and diminishes ankle plantar flexion during swing phase.