title: Effects of walking with a shopping trolley on spinal posture and loading in subjects with neurogenic claudication.
abstract: OBJECTIVE
  To explore possible mechanisms underpinning symptom relief and improved walking tolerance in patients with neurogenic claudication (NC) when pushing a shopping trolley by evaluating the effects of a shopping trolley on spinal posture and loading patterns.
  
  
  METHODS
  An exploratory study of kinematic and kinetic changes in walking with and without pushing a shopping trolley in persons with NC symptoms and a comparison with asymptomatic control subjects.
  
  
  METHODS
  A primary care-based musculoskeletal service.
  
  
  METHODS
  Participants (n=8) with NC symptoms who have anecdotally reported symptomatic improvement when walking with a shopping trolley and a control group of asymptomatic persons (n=8).
  
  
  METHODS
  Shopping trolley.
  
  
  METHODS
  Changes in lumbar spinal sagittal posture and ground reaction force.
  
  
  RESULTS
  Subjects with NC and asymptomatic controls walked with significantly more flexed spinal posture (increase in flexion, 3.40°; z=3.516; P<.001) and reduced mean ground reaction forces (-6.9% of body weight; z=-3.46; P=.001) when walking with a shopping trolley. However, at the midstance point of the gait cycle, controls showed minimal reliance on the trolley, whereas, people with NC showed continued offloading.
  
  
  CONCLUSIONS
  Both posture and loading are affected by pushing a shopping trolley; however, patients with NC were found to offload the spine throughout the stance phase of gait, whereas asymptomatic controls did not.
authors.affiliation: Leeds Institute of Molecular Medicine, University of Leeds, UK.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Comer
authors.forename: Derrick
authors.initials: D
authors.lastname: White
authors.forename: Philip G
authors.initials: PG
authors.lastname: Conaghan
authors.forename: Howard A
authors.initials: HA
authors.lastname: Bird
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Redmond
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000534:rehabilitation*; D007698:Kinesis; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011187:Posture; D012656:Self-Help Devices; D013131:Spine; D016138:Walking