The Physics of Gait Associated with Neurology

Fall prevention week is a time to remind health care professionals, patients, and caregivers of the important ways that falls can be avoided.

In my experience while working with the elder population I have witness the consequences of a fall. Even if a patient is healthy, a fall can be detrimental to their overall health, because in many instances a fall can lead to extreme health decline or even death. Therefore, it is important that fall prevention week is taken seriously by the community.

First of all, It is important to identify the characteristics of walking gaits and learn about the physics involved when walking in order to understand the differences in walking patterns between normal individual and individuals suffering with disease.  According to (Dann, n.d.), walking involves pushing the ground with a backward force which will cause a forward reaction force.  This follows Newton's third law which states that when two objects interact, they each exert a force on each other, therefore as the foot exerts a force that pushes on the ground backwards while walking, the ground exerts a force in the form of friction which pushes you forward (Dann, n.d.). A research study by (Lockhart, et al., 2009) demonstrated that individuals suffering from cognitive impairments have lower gait parameters including: slower heel contact velocity with the ground, shorter step lengths, and slower walking velocities, all of which is correlated with a higher required coefficient of friction (RCOF).  The data in this study supported the statistical significant lower gait parameters, while also showing that the demand for friction was higher.  Without an understanding of the physics of walking, quantitative analysis of walking parameters would not be possible.

Some neurological disorders and mental health conditions associated with abnormal gait parameters include Depression, Dementia, Parkinson's disease, cerebral dysfunction or degeneration, Alzheimer's, multiples Sclerosis, and stroke (Salzman, 2010).
While I was shadowing medical doctors and a Physician Assistant (PA) in Neurology, I was able to observed the integration of neurological tests within their diagnostic and treatment practices. Healthcare providers frequently use clinical tests including assessments in their practice to evaluate gait and balance in patients (Salzman, 2010). Other tests, involve measuring the walking gait of individuals suffering with symptoms that are related to cognitive impairments: by analyzing these walking patterns, health care providers can make more specific diagnoses, and apply the most appropriate treatment. Measuring walking gaits are also used to constantly determine the progression of disease; since many neurological disorders including Parkinson's disease and Alzheimer's disease progress at different rates in each patient, it is crucial that individuals undergo these neurological tests on a regular basis in case new symptoms arise or treatments including medications need to be changed.

According to (Salzman, 2010), patients, caregivers and health care professionals can utilize techniques that can reduce fall risks. Health care professionals should use assessments and clinical tests more frequently on patients, especially if they have noticed a change in their health, or if there has been a change in their medication in addition to other treatment plans (Salzman, 2010). Healthcare professionals and caregiver should also be aware of changes in health, medications, treatments, and make sure that patients use any specialize equipment properly and at all times including, walkers, eye glasses, hearing aids, etc. Care givers, or any individuals who spends a lot of time with patients should make notes about their activities of daily living so that they can be able to detect any changes (Salzman, 2010). Caregivers should also make sure that the areas in an individuals living space is clear, and clean to avoid falls or further injury after falling. (Salzman, 2010) emphasize the importance of physical exercise in a patients daily activities, and suggests that they should engage in physical exercise on a regular basis independently, in a group, or with a physical therapist.

Citations:

Dann, D.  (Director). (n.d.). Physics of Walking [Motion picture]. U.S. https://www.youtube.com/watch?v=Ws_sKgGNSFE (no author).  (n.d).  Encephalography lab.  Retrieved September 22, 2016, from https://web.csulb.edu/~cwallis/482/eeg/eeg.html

Salzman, B. (2010). Gait and Balance Disorders in Older Adults. Am Fam Physician. 82(1):61-68 Retrieved September 22, 2016, from http://www.aafp.org/afp/2010/0701/p61.html