The Effect of Spring Loaded Single-Hip Support Cane Mechanisms on Upper and Affected Lower Limb Ground Reaction Forces, Muscle Activity, and Self-perceived Ease of Use

Abstract

The primary purpose of this study was to determine the effect of commercial spring loaded single-tip canes on ground reaction forces, impulse, and EMG activation in the upper limb during ambulation. Ground reaction forces and impulse were also assessed for a simulated injured lower limb. A secondary purpose was to assess both traditional and spring loaded cane designs for subject-perceived ease of use. Healthy participants (n=21) were fitted with three types of canes (traditional, Miracle Cane®, and Stander Cane®) and a T-Scope knee brace to simulate an injury. Each participant walked over two force plates, where EMG, force, impulse, and Ease of Use data were collected. Intra-class correlation (ICC) values were calculated for all dependent variables to examine the consistency across replications of the protocol. The result values ranged from 0.558 to 0.999, indicating strong correlations between trials for all measured variables. A one-way ANOVA was performed to analyze differences in walking speed between cane types and no significant differences were found. Multiple two-way mixed factorial ANOVAs were performed to answer research questions regarding differences in muscle activation, ground reaction forces, and impulses between the three types of canes. Statistically significant differences were found in EMG activation between cane types, (F(2, 280) = 732.48, p < .05, partial η2 = 0.11), in which the Miracle Cane® produced less EMG output than all other canes. There was a statistically significant interaction between the type of cane and type of limb on vertical, (F(2,78) = 35.16, p< .05, partial η2 = .47), medial, (F(2,78) = 4.07, p< .05, partial η2 = .09) lateral ground reaction forces, (F(2,78) = 5.29, p< .05, partial η2 = .12) and vertical impulse, (F(2,78) = 9.93, p< .05, partial η2 = .2). There was also statistically significant difference in anterior force production between cane types, (F(1.645, 64.164) = 7.74, p < .05, partial η2 = 0.16). Means, standard deviations, and participant testimonials were analyzed for the Ease of Use Questionnaire. The results from the qualitative and quantitative data indicate that individuals preferred the spring loaded canes over the traditional cane; however, participants preferred the Stander Cane® over the Miracle Cane®. The findings of this research may have implications for the design of standard single-tip support canes and suggest avenues for future research.