Mosiolek A1, Hadamus A1, Selegrat M1,2, Wójtowicz S1, Grabowicz M1, Bugalska A1, Wroński Z1, Wiśniewska K3, Białoszewski D1
1Medical University of Warsaw, Department of Rehabilitation of the Division of Physiotherapy of the 2nd Faculty of Medicine, Warsaw, Poland, 2Warsaw University of Technology, Institute of Electronic Systems, Warsaw, Poland, 3Medical University of Warsaw, Student Sience Club of Physiotherapy, Department of Rehabilitation of Physiotherapy Division, 2nd Faculty of Medicine, Warsaw, Poland
Background: Backward gait is involved in some everyday activities. It is also used as an element of rehabilitation programmes. In the literature there is continuing discussion about muscle activation patterns during this activity and the rationale for using backward gait in rehabilitation.
Purpose: The purpose of the study was to investigate differences in the duration of activity of lower limb muscles during forward and backward walking.
Methods: A group of 90 healthy people aged 19-85 years (average age: 53 years) were enrolled. Each person walked forward (FW) and backward (BW) over a 10-meter walkway 3 times at their natural walking pace. Measurements were obtained during the third attempt. Activity was recorded for the following muscles: gluteus maximus (GMax), Gluteus medius (GMed), semitendinosus (St), rectus femoris (RF), gastrocnemius medialis (GM) and tibialis anterior (TA). A Delsys Trigno Lab wireless system was used to collect the EMG signal. Electrodes were placed in accordance with the SENIAM guidelines. Accelerometers used to determine the gait phases were located on the front and back of the footwear. The data were analyzed in Matlab (version R2016b). First, segmentation was performed for individual cycles on the basis of accelerometer data. EMG data was high-pass filtered at 20, 25 or 30 Hz and subsequently low-pass filtered at 450 Hz. The fixed signal component was removed. The signals were smoothed with an RMS envelope with a 50 ms window. Muscle activity was calculated based on an envelope with a 20% or 50% decision threshold according to quality of the EMG signal. Statistical analysis was performed in Statistica 13.0 and utilised descriptive statistics and Wilcoxon's test. The level of statistical significance was set at p 0.05.
Results: During BW in the stance phase, GMed, St and GM were active for a longer time than in FW (p 0,005). The biggest differences were visible in GMed (22% of the cycle in FW and 32% in BW) and GM (21% and 30%, respectively). There were no differences in the duration of activity in the stance phase for RF. A shorter activity time was noted for TA in the stance phase in BW in comparison with FW (p 0.05). In the swing phase, there was a clearly longer activation time of GMax, GMed, St and RF in BW. (p 0.001). BW did not increase the duration of activity of TA and GM during the swing phase.
Conclusion(s): Our analysis showed statistically longer duration of activity of GMed, GM and St during BW in comparison with FW. A longer duration of activity of these muscles may indicate a greater need for stabilization of the pelvis, thigh and ankle during BW as an unusual activity.
Implications: Backward gait can be used as an additional exercise for orthopedic or neurological patients to strengthen the pelvic stabilizers.
Keywords: EMG, backward gait, physiotherapy
Funding acknowledgements: The study was financed from the NCR&D fund as part of the VB-Clinic project Strategmed programme.
Purpose: The purpose of the study was to investigate differences in the duration of activity of lower limb muscles during forward and backward walking.
Methods: A group of 90 healthy people aged 19-85 years (average age: 53 years) were enrolled. Each person walked forward (FW) and backward (BW) over a 10-meter walkway 3 times at their natural walking pace. Measurements were obtained during the third attempt. Activity was recorded for the following muscles: gluteus maximus (GMax), Gluteus medius (GMed), semitendinosus (St), rectus femoris (RF), gastrocnemius medialis (GM) and tibialis anterior (TA). A Delsys Trigno Lab wireless system was used to collect the EMG signal. Electrodes were placed in accordance with the SENIAM guidelines. Accelerometers used to determine the gait phases were located on the front and back of the footwear. The data were analyzed in Matlab (version R2016b). First, segmentation was performed for individual cycles on the basis of accelerometer data. EMG data was high-pass filtered at 20, 25 or 30 Hz and subsequently low-pass filtered at 450 Hz. The fixed signal component was removed. The signals were smoothed with an RMS envelope with a 50 ms window. Muscle activity was calculated based on an envelope with a 20% or 50% decision threshold according to quality of the EMG signal. Statistical analysis was performed in Statistica 13.0 and utilised descriptive statistics and Wilcoxon's test. The level of statistical significance was set at p 0.05.
Results: During BW in the stance phase, GMed, St and GM were active for a longer time than in FW (p 0,005). The biggest differences were visible in GMed (22% of the cycle in FW and 32% in BW) and GM (21% and 30%, respectively). There were no differences in the duration of activity in the stance phase for RF. A shorter activity time was noted for TA in the stance phase in BW in comparison with FW (p 0.05). In the swing phase, there was a clearly longer activation time of GMax, GMed, St and RF in BW. (p 0.001). BW did not increase the duration of activity of TA and GM during the swing phase.
Conclusion(s): Our analysis showed statistically longer duration of activity of GMed, GM and St during BW in comparison with FW. A longer duration of activity of these muscles may indicate a greater need for stabilization of the pelvis, thigh and ankle during BW as an unusual activity.
Implications: Backward gait can be used as an additional exercise for orthopedic or neurological patients to strengthen the pelvic stabilizers.
Keywords: EMG, backward gait, physiotherapy
Funding acknowledgements: The study was financed from the NCR&D fund as part of the VB-Clinic project Strategmed programme.
Topic: Musculoskeletal: lower limb; Musculoskeletal: lower limb; Orthopaedics
Ethics approval required: Yes
Institution: Medical University of Warsaw
Ethics committee: Bioethical Committee
Ethics number: KB/227/2015
All authors, affiliations and abstracts have been published as submitted.
