title: Effects of balance ability and handgrip height on kinematics of the gait, torso, and pelvis in elderly women using a four-wheeled walker.
abstract: OBJECTIVE
  Numerous elderly individuals use the four-wheeled walker (FWW) as a gait-assistive device. The walker's handgrip height is important for correct use. However, few clinical studies have investigated the biomechanical effects of the FWW's handgrip height on balance. Therefore, the present study assessed kinematic features of the gait, torso and pelvis during use of the FWW at two levels of handgrip height (48% vs 55% of the subject's height) while assessing balance in older adults.
  
  
  METHODS
  A total of 20 older adults were allocated into two groups according to the Berg Balance Scale (BBS): good balance (GB; BBS≥46) versus poor balance (PB; BBS<45). Participants walked with the FWW at 48% or 55% handgrip height for 10 m.
  
  
  RESULTS
  Our study showed that the double-support period and stance phase significantly increased at 55% handgrip height, but the swing phase significantly decreased in the GB group. In the PB group, velocity and stride length significantly increased at 55% handgrip height. Tilt angle of the torso in the GB group was significantly lower at 55% than at 48% handgrip height, but no differences were observed in the PB group. In the pelvis, initial contact and toe-off angles of tilt were lower in the GB group at 55% handgrip height, but no differences were observed in the PB group.
  
  
  CONCLUSIONS
  These results showed that kinematic features of the gait, torso, and pelvis in older adults using the FWW might be dependent on the handgrip height of the FWW and the patient's balance. Additionally, greater than 48% of the body height might be appropriate for older adults with poor balance.
authors.affiliation: Korea Orthopedics & Rehabilitation Engineering Center, Incheon, Korea.
authors.forename: Hyuk-Jae
authors.initials: HJ
authors.lastname: Choi
authors.forename: Chang-Yong
authors.initials: CY
authors.lastname: Ko
authors.forename: Sungjae
authors.initials: S
authors.lastname: Kang
authors.forename: Jeicheong
authors.initials: J
authors.lastname: Ryu
authors.forename: Museong
authors.initials: M
authors.lastname: Mun
authors.forename: Hye-Seon
authors.initials: HS
authors.lastname: Jeon
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D001827:Body Height; D004867:Equipment Design; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D010388:Pelvis / Q000502:physiology*; D004856:Postural Balance; D060726:Torso / Q000502:physiology*; D014853:Walkers
keywords: Berg Balance Scale; balance ability; four-wheeled walker; gait features; torso and pelvic kinematics