Walking Gait Before and After Chiropractic Care Following Fifth Metatarsal Fractures: A Single Case Kinetic and Kinematic Study.

OBJECTIVES: The purpose of this report is to describe the kinetic and kinematic analysis of walking gait following healed left proximal fifth metatarsal fractures.

CLINICAL FEATURES: A 62-year-old female presented at a chiropractic clinic with concerns that recent metatarsal fractures had not fully resolved and reported abnormal gait due to pain and several weeks use of a "walking boot." The patient's walking gait was evaluated with a force-sensor treadmill and an inertial measurement unit motion capture system. Recordings were made before, at midpoint, and post-chiropractic care (11 visits total). Data were analyzed for spatio-temporal gait parameters, vertical ground reaction forces, and ranges of motion of the hip, knee, and ankle.

INTERVENTION AND OUTCOME: Pre-care, the patient's self-rated disability in walking was 50 out of 80 on a Lower Extremity Functional Scale, which improved to 80 out of 80, post-care. Her self-selected preferred walking speed increased, as did step length, cadence, and single support time. Increased symmetry was seen in timing of peak ground reaction forces, stance phase percentages of loading and pre-swing, and ranges of motion for hip and knee flexion and extension.

CONCLUSIONS: The patient recovered completely, and the post-injury kinematic and kinetic data allowed for quantification of gait patterns and changes in the clinical environment.