Name: substantiating appropriate motion capture techniques for the assessment of nordic walking gait and posture in older adults
Uploaded: 2016-05-12T15:00:00
Description: Watch this Scientific Journal Video about Substantiating Appropriate Motion Capture Techniques for the Assessment of Nordic Walking Gait and Posture in Older Adults at JoVE.com

On behalf of my co-author and myself, I would like to acknowledge Nordixx Canada for helping to fund this research, our participants for their time and patience, and our fellow colleagues, Jos&#233;e, Ria, Lei, and Nadia, for their help with various aspects of this study.

This study was performed in accordance with the guidelines of the Research Ethics Board of the University of Ottawa.
1. Screening Procedure
<ol>
	<li>Provide side show presentations to local area walking groups and post recruitment posters at community centers and public facilities in order to recruit a group of active, community-dwelling older adults.</li>
	<li>Upon initial visit, first greet the participants, introduce them to the laboratory, and provide them time to change into appropriate attire (i.e.</e...

<ol>
	<li>Parkatti, T., Wacker, P., Perttunen, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improvements+in+Functional+Capacity+from+Nordic+Walking:+A+Aandomized+Controlled+Trial+Among+Older+Adults.">Improvements in Functional Capacity from Nordic Walking: A Aandomized Controlled Trial Among Older Adults.</a> J Aging Phys Act. 20 (1), 93-105 (2012).</li><li>Schwameder, H., Roithner, R., Muller, E., Niessen, W., Raschner, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Knee+joint+forces+during+downhill+walking+with+hiking+poles.">Knee joint forces during downhill walking with hiking poles.</a> J Sports Sci. 17 (12), 969-978 (1999).</li><li>Willson, J., Torry, M. R., Decker, M. J., Kernozek, T., Steadman, J. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+walking+poles+on+lower+extremity+gait+mechanics.">Effects of walking poles on lower extremity gait mechanics.</a> Med Sci Sports Exerc. 33 (1), 142-147 (2001).</li><li>Koizumi, T., Tsujiuchi, N., Takeda, M., Fujikura, R., Kojima, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Load+dynamics+of+joints+in+Nordic+walking.">Load dynamics of joints in Nordic walking.</a> Procedia Engineering. 13, 544-551 (2011).</li><li>Hansen, L., Henriksen, M., Larsen, P., Alkjaer, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nordic+Walking+does+not+reduce+the+loading+of+the+knee+joint.">Nordic Walking does not reduce the loading of the knee joint.</a> Scand J Med Sci Spor. 18 (4), 436-441 (2008).</li><li>Stief, F., Kleindienst, F. I., Wiemeyer, J., Wedel, F., Campe, S., Krabbe, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inverse+dynamic+analysis+of+the+lower+extremities+during+Nordic+walking,+walking,+and+running.">Inverse dynamic analysis of the lower extremities during Nordic walking, walking, and running.</a> J Appl Biomech. 24 (4), 351-359 (2008).</li><li>Hagen, M., Hennig, E. M., Stieldorf, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lower+and+upper+extremity+loading+in+nordic+walking+in+comparison+with+walking+and+running.">Lower and upper extremity loading in nordic walking in comparison with walking and running.</a> J Appl Biomech. 27 (1), 22-31 (2011).</li><li>Shim, J., Kwon, H., Kim, H., Kim, B., Jung, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+the+effects+of+walking+with+and+without+Nordic+pole+on+upper+extremity+and+lower+extremity+muscle+activation.">Comparison of the effects of walking with and without Nordic pole on upper extremity and lower extremity muscle activation.</a> J Phys Ther Sci. 25 (12), 1553-1556 (2013).</li><li>Jensen, S. B., Henriksen, M., Aaboe, J., Hansen, L., Simonsen, E. B., Alkjaer, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Is+it+possible+to+reduce+the+knee+joint+compression+force+during+level+walking+with+hiking+poles.">Is it possible to reduce the knee joint compression force during level walking with hiking poles.</a> Scand J Med Sci Spor. 21 (6), 195-200 (2011).</li><li>Ashburn, A., Hyndman, D., Pickering, R., Yardley, L., Harris, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Predicting+people+with+stroke+at+risk+of+falls.">Predicting people with stroke at risk of falls.</a> Age Ageing. 37 (3), 270-276 (2008).</li><li>Nasreddine, Z. S., Phillips, N. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+Montreal+Cognitive+Assessment,+MoCA:+a+brief+screening+tool+for+mild+cognitive+impairment.">The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.</a> J Am Geriatr Soc. 53 (4), 695-699 (2005).</li><li>Teaching the Technique. Nordixx Inc Available from: <a target="_blank" href="https://www.nordixx.com/pages/teaching-the-technique/">https://www.nordixx.com/pages/teaching-the-technique/</a> (2015)</li><li>Rikli, R. E., Jones, C. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+reliability+and+validity+of+a+6-minute+walk+test+as+a+measure+of+physical+endurance+in+older+adults.">The reliability and validity of a 6-minute walk test as a measure of physical endurance in older adults.</a> J Aging Phys Activ. 6 (4), 363-375 (1998).</li><li>Winter, D. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biomechanics+and+motor+control+of+human+gait:+normal,+elderly+and+pathological.">Biomechanics and motor control of human gait: normal, elderly and pathological.</a> ISBN. , (1991).</li><li>Winter, D. A., Patla, A. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Signal+processing+and+linear+systems+for+the+movement+sciences.">Signal processing and linear systems for the movement sciences.</a> Waterloo Biomechanics. , (1997).</li><li>Ali, N., Rouhi, G., Robertson, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gender,+vertical+height+and+horizontal+distance+effects+on+single-leg+landing+kinematics:+implications+for+risk+of+non-contact+acl+injury.">Gender, vertical height and horizontal distance effects on single-leg landing kinematics: implications for risk of non-contact acl injury.</a> J Hum Kinet. 37 (1), 27-38 (2013).</li></ol>

The importance of maintaining consistency in terms of pole use is critical within this protocol. Particularly, appropriate steps for proper poling technique as well as proper pole set up are important to maintain consistency across different studies. Therefore the guidelines and instructions of a specific Nordic walking organization should be adhered to for protocols such as this. Additionally and particularly when using accelerometry, use of a full body set of tri-axial monitors is important to obtain a complete underst...

Nordic walking (NW) is regarded as a simple and safe form of fitness walking using specially designed poles1. It is suggested that poles provide added stability, improve posture, and reduce joint stress of the lower extremities. However, limited or contradictory evidence exists regarding joint loading and postural alignment. On one hand, Schwameder et al.2, Willson et al.3, and Koizumi et al.4 report improvements in kinematic measures and/or reductions in ground reaction, compression, and shear forces with their pole walking studies. On the other hand, declining kinematic measures and increased joint loading in terms of braking/propulsive forces and moments of force have been reported by Hansen et al.5, Stief et al.6, and Hagen et al.7 while pole walking. Additionally, claims of improved postural alignment appear to have gone entirely unsupported by scientific research to this point.
Similar to the contradictory results found with gait patterns, different methods and equipment have been employed in this line of research as well. Several studies have used 3-dimensional motion capture systems4,6 and digital video cameras2,5, all with force plates incorporated into the system, in order to adequately assess gait. While additionally, other studies have employed other means of assessing Nordic poling gait including use of electrogoniometry7, electromyography (EMG)8, and strain gauges mounted to poles2,9. With the technique utilized in this protocol, it presents the specific advantage of being able to demonstrate a more appropriate representation (i.e. repeated gait cycles) of an individual&#39;s Nordic poling gait over alternative techniques that have focused more on short durations and single gait cycles. Also, this method uses accelerometry, a valid tool, which to this point has been sparsely used in Nordic walking research. Depending on the aim of individual research projects, the application of this protocol may be appropriate for situations as outlined in this protocol, particularly for short and long duration gait. It is important to note that both motion capture and accelerometry are suitable for obtaining a variety of gait characteristics including: spatial-temporal (e.g. stride length, gait speed, etc.), kinematic (e.g. range of motion), and kinetic (e.g. forces, power outputs, etc.) parameters.
And despite the use of these various pieces of equipment, only short duration gait events (i.e. single gait cycle) have been assessed, leaving questions in regards to best assessing longer duration gait (i.e. repeated gait cycles). Therefore, the rationale for the development and use of this technique is based upon the importance of fashioning a complete picture of Nordic poling gait.
The purpose of this study was two-fold. First, the primary goal is to determine and substantiate the use of both accelerometry systems and 3-dimensional motion capture systems in the assessment of gait and posture over both short and long durations. Secondarily, the goal is to determine the overall effect of Nordic walking poles on gait patterns including spatial-temporal and kinetic measures as well as postural alignment of older adults. To date, minimal research has focused on older adult NW and of that which has been published, function (i.e. strength, balance, flexibility) has represented the primary outcome variables. Therefore, knowledge pertaining the role of walking poles on measureable gait variables is needed and can provide insight into how poles can play into our gait patterns as we age.

<table>
	<tbody>
		<tr>
			<td>Nordic walking poles</td>
			<td>Nordixx Canada</td>
			<td>Nordixx Global Traveler or Walker</td>
			<td>Alternative poles may be used</td>
		</tr>
		<tr>
			<td>APDM accelerometry system</td>
			<td>APDM</td>
			<td>Opal system</td>
			<td>Alternative systems may be used</td>
		</tr>
		<tr>
			<td>Vicon motion capture system</td>
			<td>Vicon</td>
			<td></td>
			<td>Alternative systems may be used</td>
		</tr>
		<tr>
			<td>Kistler force platforms</td>
			<td>Kistler</td>
			<td></td>
			<td>Alternative platforms may be used</td>
		</tr>
		<tr>
			<td>Vicon Nexus &#38; Polygon</td>
			<td>Vicon</td>
			<td></td>
			<td>Used in data analysis</td>
		</tr>
		<tr>
			<td>14mm reflective markers</td>
			<td>Vicon</td>
			<td></td>
			<td>Number or markers depends on model</td>
		</tr>
		<tr>
			<td>Tape measure</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Weight scale</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Caliper</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

substantiating appropriate motion capture techniques for the assessment of nordic walking gait and posture in older adults

Nordic walking (NW) has become a safe and simple form of exercise in recent years, and in studying this gait pattern, various data collection techniques have been employed, each with positives and negatives. The aim was to determine the effect of NW on older adult gait and posture and to determine optimal use of different data collection systems in both short and long duration analysis. Gait and posture during NW and normal walking were assessed in 17 healthy older adults (age: 69 &#177; 7.3). Participants performed two trials of 6 Minute Walk Tests (6MWT) (1 with poles (WP) and 1 without poles (NP)) and 6 trials of a 5m walk (3 WP and 3 NP). Motion was recorded using two systems, a 6-sensor accelerometry system and an 8-camera 3-dimensional motion capture system, in order to quantify spatial-temporal, kinematic, and kinetic parameters.
With both systems, participants demonstrated increased stride length and double support and decreased gait speed and cadence WP compared to NP (p &#60;0.05). Also, with motion capture, larger single support time was found WP (p &#60;0.05). With 3-D capture, smaller hip power generation and moments of force were found at heel contact and pre-swing as well as smaller knee power absorption at heel contact, pre-swing, and terminal swing WP compared to NP, when assessed over one cycle (p &#60;0.05). Also, WP yielded smaller moments of force at heel contact and terminal swing along with larger moments at mid-stance of a gait cycle (p &#60;0.05). No changes were found for posture.
NW seems appropriate for promoting a normal gait pattern in older adults. Three-dimensional motion capture should primarily be used during short duration gait analysis (i.e. single gait cycle), while accelerometry systems should be primarily employed in instances requiring longer duration analysis such as during the 6MWT.

Spatial-Temporal Gait Parameters
When walking with Nordic walking poles and assessed using motion capture and force plates, stride length (p &#60;0.01), double support time (p &#60;0.001), and single support time (p &#60;0.001) are all significantly longer compared to walking without poles. In addition, gait speed (p &#60;0.05) is significantly slower and cadence (p &#60;0.001) is significantly smaller with poles compared to wit...

Watch this Scientific Journal Video about Substantiating Appropriate Motion Capture Techniques for the Assessment of Nordic Walking Gait and Posture in Older Adults at JoVE.com

Substantiating Appropriate Motion Capture Techniques for the Assessment of Nordic Walking Gait and Posture in Older Adults

The aim was to substantiate optimal use of data collection techniques for Nordic walking gait and posture analysis. Three-dimensional motion capture should be used during short duration analysis (i.e. single gait cycle), while accelerometry should be employed for longer duration analysis (i.e. repeated cycles) like a 6 Minute Walk Test.

Nordic walking (NW) has become a safe and simple form of exercise in recent years, and in studying this gait pattern, various data collection techniques ...

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