Effects of cane use on the kinematic and kinetic of lower-extremity joints in inexperienced users

The cane is commonly prescribed for the elderly to maintain balance and enhance independent mobility. However, improper use of cane can increase the risk of falling. Understanding the characteristics of cane gait is critical for better establishing proper cane usage norms. The paper aimed to investigate effects of cane use on kinematics and kinetics of lower extremities in the elderly and the young to guide the development of adaptive cane gait. Twenty participants (10 elder and 10 young) were recruited and walked at a self-comfortable speed or with a cane in a two-point gait. The spatiotemporal gait parameters, hip/knee/ankle joint angles and ground reaction force (GRF) were statistically analyzed using MANOVAs to assess the effects of age and cane. Using the cane significantly decreased step length, cadence and speed and increased step time in both age groups. Age and cane had significant effects on ankle plantarflexion angle in initial swing phase (APA-ISw). In cane gait, the peaks of vertical GRF(V-GRF) and anterior-posterior GRF (AP-GRF) in bilateral lower extremities significantly decreased, and the troughs of right V-GRF significantly increased for both groups. These results suggest that using a cane does interfere with the natural gait of the user and insufficient ankle plantarflexion in initial swing phase (ISw) and reduced AP-GRF may be two key risk factors contributing to cane gait instability. Therefore, the users should consider actively increasing ankle plantarflexion in ISw to avoid deteriorating gait performance due to over-reliance on the cane.