Immediate effects of contralateral and ipsilateral cane use on normal adult gait

Objective: To determine the effects of ipsilateral and contralateral cane use on gait kinematics and peak vertical force in young healthy adults.

Design: Prospective observational study.

Setting: Veterans Affairs Healthcare Center.

Participants: Fifteen healthy adults of aged 26 to 52 years (mean age 31 years) with no gait impairment and minimal experience using single-point canes.

Methods: The Pedar-X Mobile System plantar pressure measurement system was used to collect kinematic data from subjects walking in 3 different conditions (relative to a randomly “assigned” limb): contralateral cane (C), ipsilateral cane (I), and no cane (N).

Main outcome measures: Peak vertical force, cadence, percentage swing phase and double limb support, and regional plantar pressure ratios.

Results: Peak vertical force (normalized for body weight) was reduced during both cane use conditions on the randomly assigned limb when compared to walking unaided (P<.001). The peak vertical force was 7% to 11% lower for the assigned limb than the opposite limb when a cane was used on either side (P<.016). Mean cadence was higher when participants ambulated without a cane (113 steps/min) than with a cane used on either the contralateral (98 steps/min) or ipsilateral (98 steps/min) side (P<.0001). Mean cadence did not significantly differ between the cane use conditions (P=.93). Regional plantar pressure ratios did not significantly change on either limb in any of the tested conditions. Double limb support slightly increased with cane use (P<.016).

Conclusion: Both ipsilateral and contralateral cane use reduced cadence and mean peak vertical plantar force on the limb advanced with the cane in healthy young adults. Double limb support increased with cane use likely due to the reduced cadence and initial unfamiliarity with using an assistive device. A clinical implication of these findings is that prescription of canes for either ipsilateral or contralateral use effectively offloads a designated lower limb.

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