PM&R
Volume 1, Issue 3 , Pages 208-213, March 2009

Immediate Effects of Contralateral and Ipsilateral Cane Use On Normal Adult Gait

Presented at the AAPM&R Annual Assembly in Boston, Massachusetts; September 2007.

  • Dixie R. Aragaki, MD

      Affiliations

    • David Geffen School of Medicine at UCLA, Los Angeles, CA and Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, Los Angeles, CA†
    • Corresponding Author InformationAddress correspondence to D.R.A.: Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Mailcode 117, Los Angeles, CA 90073-1003
    • ,
  • Mary C. Nasmyth, MD

      Affiliations

    • David Geffen School of Medicine at UCLA, Los Angeles, CA and Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, Los Angeles, CA‡
    • ,
  • Scott C. Schultz, MD

      Affiliations

    • David Geffen School of Medicine at UCLA, Los Angeles, CA and Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, Los Angeles, CA§
    • ,
  • Gretchen M. Nguyen, MD

      Affiliations

    • David Geffen School of Medicine at UCLA, Los Angeles, CA and Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, Los Angeles, CA
    • ,
  • Jennifer M. Yentes, MS

      Affiliations

    • Research Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA∥
    • ,
  • Kaly Kao, BS

      Affiliations

    • David Geffen School of Medicine at UCLA, Los Angeles, CA#
    • ,
  • Karen Perell, PhD

      Affiliations

    • California State University, Fullerton, CA⁎⁎
    • ,
  • Meika A. Fang, MD

      Affiliations

    • David Geffen School of Medicine at UCLA, Los Angeles, CA and Rheumatology Section, VA Greater Los Angeles Healthcare System, Los Angeles, CA††

Received 18 June 2008; accepted 14 October 2008. published online 29 December 2008.

Objective

To determine the effects of ipsilateral and contralateral cane use on gait kinematics and peak vertical force in young healthy adults.

Design

Prospective observational study.

Setting

Veterans Affairs Healthcare Center.

Participants

Fifteen healthy adults of aged 26 to 52 years (mean age 31 years) with no gait impairment and minimal experience using single-point canes.

Methods

The Pedar-X Mobile System plantar pressure measurement system was used to collect kinematic data from subjects walking in 3 different conditions (relative to a randomly “assigned” limb): contralateral cane (C), ipsilateral cane (I), and no cane (N).

Main Outcome Measures

Peak vertical force, cadence, percentage swing phase and double limb support, and regional plantar pressure ratios.

Results

Peak vertical force (normalized for body weight) was reduced during both cane use conditions on the randomly assigned limb when compared to walking unaided (P<.001). The peak vertical force was 7% to 11% lower for the assigned limb than the opposite limb when a cane was used on either side (P<.016). Mean cadence was higher when participants ambulated without a cane (113 steps/min) than with a cane used on either the contralateral (98 steps/min) or ipsilateral (98 steps/min) side (P<.0001). Mean cadence did not significantly differ between the cane use conditions (P=.93). Regional plantar pressure ratios did not significantly change on either limb in any of the tested conditions. Double limb support slightly increased with cane use (P<.016).

Conclusion

Both ipsilateral and contralateral cane use reduced cadence and mean peak vertical plantar force on the limb advanced with the cane in healthy young adults. Double limb support increased with cane use likely due to the reduced cadence and initial unfamiliarity with using an assistive device. A clinical implication of these findings is that prescription of canes for either ipsilateral or contralateral use effectively offloads a designated lower limb.

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  • † Disclosure: nothing to disclose
  • ‡ Disclosure: nothing to disclose
  • § Disclosure: nothing to disclose
  •  Disclosure: nothing to disclose
  • ∥ Disclosure: nothing to disclose
  • # Disclosure: nothing to disclose
  • ⁎⁎ Disclosure: nothing to disclose
  • †† Disclosure: nothing to disclose

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

 This work was supported by the Office of Research and Development, Rehabilitation Research and Development Service, Department of Veterans Affairs (Grant F3873R).

 Device status: The Pedar-X Mobile System (Novel Electronics, St. Paul, Minnesota) was used in this study. This medical device is classified as an intermittent pressure measurement system (Class 1) and is FDA exempt from premarket notification procedures per Title 21, Chapter I—Food and Drug Administration Department of Health and Human Services, Subchapter H—Medical Devices, Part 890, Subpart B—Physical Medicine Diagnostic Devices, Section 890.1600.

PII: S1934-1482(08)00012-9

doi:10.1016/j.pmrj.2008.10.002

PM&R
Volume 1, Issue 3 , Pages 208-213, March 2009

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