Article

Intermittent claudication has been associated with impaired gait and balance. The
study aim was to compare gait adaptations over time between claudicants
classified with good versus poor balance. Kinematic data were collected from 24
claudicants during continuous walking. Balance was assessed using; Timed Up and
Go test (TUG), and Sensory Organisation (SOT) and Motor Control (MCT) Tests using
NeuroCom Equitest(R). 'Good balance' (GB) was operationally defined as those
claudicants achieving normal scores on at least 2 of 3 tests whereas 'poor
balance' (PB) claudicants achieved normal scores on 0 or 1 test. Temporal-spatial
and sagittal plane joint kinematics were analysed at three time intervals; 'no
pain' (prior to onset), 'initial pain' and 'maximal pain' (unable to continue
walking). A two-way mixed design ANOVA was performed. Claudicants demonstrated a
significant decrease in walking speed, step frequency and increased time in
double support (p<0.05). Inter-group analysis showed no differences between GB
and PB on any temporal-spatial or kinematic parameters (p>0.05). There was no
significant time and group interaction for any temporal-spatial or kinematic
variable except hip flexion.
GB claudicants demonstrated increased hip flexion as
pain progressed but this adaptive strategy was not seen in PB claudicants.
Claudicants make adaptations to walking by slowing (down) when in pain.
Differences between GB and PB were not seen in temporal-spatial or ankle, knee
and pelvic kinematic gait parameters. However adaptation to pain in GB
claudicants involved a hip strategy, not seen in PB claudicants.
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