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1
LEMOYNE, ROBERT, CRISTIAN COROIAN, TIMOTHY MASTROIANNI, and WARREN GRUNDFEST. "WIRELESS ACCELEROMETER ASSESSMENT OF GAIT FOR QUANTIFIED DISPARITY OF HEMIPARETIC LOCOMOTION." Journal of Mechanics in Medicine and Biology 09, no. 03 (September 2009): 329–43. http://dx.doi.org/10.1142/s0219519409003024.
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Assessment of locomotion quality subsequent to neurological trauma, such as stroke or traumatic brain injury is imperative for the correct allocation of therapy dosage and strategy. In light of the limited amount of medical professionals in contrast with the rising number of people with neurological disorders; a new paradigm for addressing therapeutic strategies for neurological trauma is advocated. An important aspect for therapy of neuro-motor disorders is the characterization of gait. There are devices presently used for evaluating gait, such as EMG, optical sensors, electrogoniometers, metabolic energy expenditure devices, foot stride analyzers, and ground reaction force sensors. These devices have inherent issues, such as spatial constraints, line of sight requirements, and specialization requirements. A solution for improved autonomy of gait assessment is demonstrated by the use of fully wireless 3D MEMS accelerometers, which are light weight and minimally intrusive. To minimize specialization issues, the accelerometers may be positioned at a standard anatomical anchor. The role of traumatic brain injury with respect to gait dysfunction is addressed. Enclosed is the initial test and evaluation of a wireless 3D MEMS accelerometer for gait analysis. The gait analysis is conducted in outdoor conditions, while walking on a sidewalk.
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Guzian, M. C., L. Bensoussan, J. M. Viton, V. Mihle De Bovis, J. Ramon, J. P. Azulay, and A. Delarque. "Orthopaedic Shoes Improve Gait in a Charcot-Marie-Tooth Patient: A Combined Clinical and Quantified Case Study." Prosthetics and Orthotics International 30, no. 1 (April 2006): 87–96. http://dx.doi.org/10.1080/03093640600585116.
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The aim of this study was to assess the extent to which orthopaedic shoes improved gait in a patient with Charcot-Marie-Tooth (CMT) disease and to show how the latest gait analysis tools available can help to assess and quantify the efficacy of this treatment. The case of a 55-year-old woman with CMT disease is described. She complained mainly of pain and frequent falling. The physical examination and the clinical gait analysis showed the presence of bilateral foot drop, high-stepping and varus. Treatment based on physical therapy and orthopaedic shoes was prescribed. In order to assess the clinical efficacy of the treatment, a complete physical examination was carried out after the patient had been wearing the orthopaedic shoes for one month. The quantified assessment was performed with a Gaitrite® system, which can be used to record the spatio-temporal parameters of gait. It was concluded that orthopaedic shoes provide specialists in physical and rehabilitation medicine with an excellent means of treating gait disabilities in patients with CMT disease. With the made-to-measure orthopaedic shoes used, the falling and pain disappeared; the patient's walking speed increased and the foot support base decreased in size. Both the clinical and quantified data confirmed the subjective improvement perceived by the patient. The latest tools available for performing quantified gait analysis in clinical practice provide useful means of objectively assessing the success of treatment.
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Yang, Cheng, Ukadike C. Ugbolue, Andrew Kerr, Vladimir Stankovic, Lina Stankovic, Bruce Carse, Konstantinos T. Kaliarntas, and Philip J. Rowe. "Autonomous Gait Event Detection with Portable Single-Camera Gait Kinematics Analysis System." Journal of Sensors 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/5036857.
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Laboratory-based nonwearable motion analysis systems have significantly advanced with robust objective measurement of the limb motion, resulting in quantified, standardized, and reliable outcome measures compared with traditional, semisubjective, observational gait analysis. However, the requirement for large laboratory space and operational expertise makes these systems impractical for gait analysis at local clinics and homes. In this paper, we focus on autonomous gait event detection with our bespoke, relatively inexpensive, and portable, single-camera gait kinematics analysis system. Our proposed system includes video acquisition with camera calibration, Kalman filter + Structural-Similarity-based marker tracking, autonomous knee angle calculation, video-frame-identification-based autonomous gait event detection, and result visualization. The only operational effort required is the marker-template selection for tracking initialization, aided by an easy-to-use graphic user interface. The knee angle validation on 10 stroke patients and 5 healthy volunteers against a gold standard optical motion analysis system indicates very good agreement. The autonomous gait event detection shows high detection rates for all gait events. Experimental results demonstrate that the proposed system can automatically measure the knee angle and detect gait events with good accuracy and thus offer an alternative, cost-effective, and convenient solution for clinical gait kinematics analysis.
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Haji Ghassemi, Nooshin, Julius Hannink, Nils Roth, Heiko Gaßner, Franz Marxreiter, Jochen Klucken, and Björn M. Eskofier. "Turning Analysis during Standardized Test Using On-Shoe Wearable Sensors in Parkinson’s Disease." Sensors 19, no. 14 (July 13, 2019): 3103. http://dx.doi.org/10.3390/s19143103.
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Mobile gait analysis systems using wearable sensors have the potential to analyze and monitor pathological gait in a finer scale than ever before. A closer look at gait in Parkinson’s disease (PD) reveals that turning has its own characteristics and requires its own analysis. The goal of this paper is to present a system with on-shoe wearable sensors in order to analyze the abnormalities of turning in a standardized gait test for PD. We investigated turning abnormalities in a large cohort of 108 PD patients and 42 age-matched controls. We quantified turning through several spatio-temporal parameters. Analysis of turn-derived parameters revealed differences of turn-related gait impairment in relation to different disease stages and motor impairment. Our findings confirm and extend the results from previous studies and show the applicability of our system in turning analysis. Our system can provide insight into the turning in PD and be used as a complement for physicians’ gait assessment and to monitor patients in their daily environment.
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Monoli, Cecilia, Manuela Galli, and Jeffrey A. Tuhtan. "Improving the reliability of underwater gait analysis using wearable pressure and inertial sensors." PLOS ONE 19, no. 3 (March 21, 2024): e0300100. http://dx.doi.org/10.1371/journal.pone.0300100.
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This work addresses the lack of reliable wearable methods to assess walking gaits in underwater environments by evaluating the lateral hydrodynamic pressure exerted on lower limbs. Sixteen healthy adults were outfitted with waterproof wearable inertial and pressure sensors. Gait analysis was conducted on land in a motion analysis laboratory using an optoelectronic system as reference, and subsequently underwater in a rehabilitation swimming pool. Differences between the normalized land and underwater gaits were evaluated using temporal gait parameters, knee joint angles and the total water pressure on the lower limbs. The proposed method was validated against the optoelectronic system on land; gait events were identified with low bias (0.01s) using Bland-Altman plots for the stride time, and an acceptable error was observed when estimating the knee angle (10.96° RMSE, Bland-Altman bias -2.94°). The kinematic differences between the land and underwater environments were quantified, where it was observed that the temporal parameters increased by more than a factor of two underwater (p<0.001). The subdivision of swing and stance phases remained consistent between land and water trials. A higher variability of the knee angle was observed in water (CV = 60.75%) as compared to land (CV = 31.02%). The intra-subject variability of the hydrodynamic pressure on the foot (CV z foot = 39.65%) was found to be substantially lower than that of the knee angle (CVz = 67.69%). The major finding of this work is that the hydrodynamic pressure on the lower limbs may offer a new and more reliable parameter for underwater motion analysis as it provided a reduced intra-subject variability as compared to conventional gait parameters applied in land-based studies.
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Firmani, Flavio, and Edward J. Park. "A framework for the analysis and synthesis of 3D dynamic human gait." Robotica 30, no. 1 (May 17, 2011): 145–57. http://dx.doi.org/10.1017/s0263574711000440.
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SUMMARYA comprehensive framework for the analysis and synthesis of 3D human gait is presented. The framework consists of a realistic morphological representation of the human body involving 40 degrees of freedom and 17 body segments. Through the analysis of human gait, the joint reaction forces/moments can be estimated and parameters associated with postural stability can be quantified. The synthesis of 3D human gait is a complicated problem due to the synchronisation of a large number of joint variables. Herein, the framework is employed to reconstruct a dynamically balanced gait cycle and develop sets of reference trajectories that can be used for either the assessment of human mobility or the control of mechanical ambulatory systems. The gait cycle is divided into eight postural configurations based on particular gait events. Gait kinematic data is used to provide natural human movements. The balance stability analysis is performed with various ground reference points. The proposed reconstruction of the gait cycle requires two optimisation steps that minimise the error distance between evaluated and desired gait and balance constraints. The first step (quasi-static motion) is used to approximate the postural configurations to a region close to the second optimisation step target while preserving the natural movements of human gait. The second step (dynamic motion) considers a normal speed gait cycle and is solved using the spacetime constraint method and a global optimisation algorithm. An experimental validation of the generated reference trajectories is carried out by comparing the paths followed by 19 optical markers of a motion tracking system with the paths of the corresponding node points on the model.
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Taishaku, Atsuhito, Shigeki Yamada, Chifumi Iseki, Yukihiko Aoyagi, Shigeo Ueda, Toshiyuki Kondo, Yoshiyuki Kobayashi, et al. "Development of a Gait Analysis Application for Assessing Upper and Lower Limb Movements to Detect Pathological Gait." Sensors 24, no. 19 (September 30, 2024): 6329. http://dx.doi.org/10.3390/s24196329.
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Pathological gait in patients with Hakim’s disease (HD, synonymous with idiopathic normal-pressure hydrocephalus; iNPH), Parkinson’s disease (PD), and cervical myelopathy (CM) has been subjectively evaluated in this study. We quantified the characteristics of upper and lower limb movements in patients with pathological gait. We analyzed 1491 measurements of 1 m diameter circular walking from 122, 12, and 93 patients with HD, PD, and CM, respectively, and 200 healthy volunteers using the Three-Dimensional Pose Tracker for Gait Test. Upper and lower limb movements of 2D coordinates projected onto body axis sections were derived from estimated 3D relative coordinates. The hip and knee joint angle ranges on the sagittal plane were significantly smaller in the following order: healthy > CM > PD > HD, whereas the shoulder and elbow joint angle ranges were significantly smaller, as follows: healthy > CM > HD > PD. The outward shift of the leg on the axial plane was significantly greater, as follows: healthy < CM < PD < HD, whereas the outward shift of the upper limb followed the order of healthy > CM > HD > PD. The strongest correlation between the upper and lower limb movements was identified in the angle ranges of the hip and elbow joints on the sagittal plane. The lower and upper limb movements during circular walking were correlated. Patients with HD and PD exhibited reduced back-and-forth swings of the upper and lower limbs.
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Vilas-Boas, Maria do Carmo, Pedro Filipe Pereira Fonseca, Inês Martins Sousa, Márcio Neves Cardoso, João Paulo Silva Cunha, and Teresa Coelho. "Gait Characterization and Analysis of Hereditary Amyloidosis Associated with Transthyretin Patients: A Case Series." Journal of Clinical Medicine 11, no. 14 (July 7, 2022): 3967. http://dx.doi.org/10.3390/jcm11143967.
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Hereditary amyloidosis associated with transthyretin (ATTRv), is a rare autosomal dominant disease characterized by length-dependent symmetric polyneuropathy that has gait impairment as one of its consequences. The gait pattern of V30M ATTRv amyloidosis patients has been described as similar to that of diabetic neuropathy, associated with steppage, but has never been quantitatively characterized. In this study we aim to characterize the gait pattern of patients with V30M ATTRv amyloidosis, thus providing information for a better understanding and potential for supporting diagnosis and disease progression evaluation. We present a case series in which we conducted two gait analyses, 18 months apart, of five V30M ATTRv amyloidosis patients using a 12-camera, marker based, optical system as well as six force platforms. Linear kinematics, ground reaction forces, and angular kinematics results are analyzed for all patients. All patients, except one, showed a delayed toe-off in the second assessment, as well as excessive pelvic rotation, hip extension and external transverse rotation and knee flexion (in stance and swing phases), along with reduced vertical and mediolateral ground reaction forces. The described gait anomalies are not clinically quantified; thus, gait analysis may contribute to the assessment of possible disease progression along with the clinical evaluation.
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Aghababa, Mohammad Pourmahmood, and Jan Andrysek. "Exploration and demonstration of explainable machine learning models in prosthetic rehabilitation-based gait analysis." PLOS ONE 19, no. 4 (April 2, 2024): e0300447. http://dx.doi.org/10.1371/journal.pone.0300447.
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Quantitative gait analysis is important for understanding the non-typical walking patterns associated with mobility impairments. Conventional linear statistical methods and machine learning (ML) models are commonly used to assess gait performance and related changes in the gait parameters. Nonetheless, explainable machine learning provides an alternative technique for distinguishing the significant and influential gait changes stemming from a given intervention. The goal of this work was to demonstrate the use of explainable ML models in gait analysis for prosthetic rehabilitation in both population- and sample-based interpretability analyses. Models were developed to classify amputee gait with two types of prosthetic knee joints. Sagittal plane gait patterns of 21 individuals with unilateral transfemoral amputations were video-recorded and 19 spatiotemporal and kinematic gait parameters were extracted and included in the models. Four ML models—logistic regression, support vector machine, random forest, and LightGBM—were assessed and tested for accuracy and precision. The Shapley Additive exPlanations (SHAP) framework was applied to examine global and local interpretability. Random Forest yielded the highest classification accuracy (98.3%). The SHAP framework quantified the level of influence of each gait parameter in the models where knee flexion-related parameters were found the most influential factors in yielding the outcomes of the models. The sample-based explainable ML provided additional insights over the population-based analyses, including an understanding of the effect of the knee type on the walking style of a specific sample, and whether or not it agreed with global interpretations. It was concluded that explainable ML models can be powerful tools for the assessment of gait-related clinical interventions, revealing important parameters that may be overlooked using conventional statistical methods.
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Wu, Jiaen, Kiran Kuruvithadam, Alessandro Schaer, Richie Stoneham, George Chatzipirpiridis, Chris Awai Easthope, Gill Barry, et al. "An Intelligent In-Shoe System for Gait Monitoring and Analysis with Optimized Sampling and Real-Time Visualization Capabilities." Sensors 21, no. 8 (April 19, 2021): 2869. http://dx.doi.org/10.3390/s21082869.
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The deterioration of gait can be used as a biomarker for ageing and neurological diseases. Continuous gait monitoring and analysis are essential for early deficit detection and personalized rehabilitation. The use of mobile and wearable inertial sensor systems for gait monitoring and analysis have been well explored with promising results in the literature. However, most of these studies focus on technologies for the assessment of gait characteristics, few of them have considered the data acquisition bandwidth of the sensing system. Inadequate sampling frequency will sacrifice signal fidelity, thus leading to an inaccurate estimation especially for spatial gait parameters. In this work, we developed an inertial sensor based in-shoe gait analysis system for real-time gait monitoring and investigated the optimal sampling frequency to capture all the information on walking patterns. An exploratory validation study was performed using an optical motion capture system on four healthy adult subjects, where each person underwent five walking sessions, giving a total of 20 sessions. Percentage mean absolute errors (MAE%) obtained in stride time, stride length, stride velocity, and cadence while walking were 1.19%, 1.68%, 2.08%, and 1.23%, respectively. In addition, an eigenanalysis based graphical descriptor from raw gait cycle signals was proposed as a new gait metric that can be quantified by principal component analysis to differentiate gait patterns, which has great potential to be used as a powerful analytical tool for gait disorder diagnostics.
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Moon, Byung Young, Kwon Son, and Jung Hong Park. "Study of Rehabilitation of Injured Knee Joint Applying Chaotic Theory in Human Body Motion." Key Engineering Materials 342-343 (July 2007): 581–84. http://dx.doi.org/10.4028/www.scientific.net/kem.342-343.581.
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Gait analysis is essential to identify accurate cause and knee condition from patients who display abnormal walking. Traditional linear tools can, however, mask the true structure of motor variability, since biomechanical data from a few strides during the gait have limitation to understanding the system. Therefore, it is necessary to propose a more precise dynamic method. The chaos analysis, a nonlinear technique, focuses on understanding how variations in the gait pattern change over time. Healthy eight subjects walked on a treadmill for 100 seconds at 60 Hz. Three dimensional walking kinematic data were obtained using two cameras and KWON3D motion analyzer. The largest Lyapunov exponent from the measured knee angular displacement time series was calculated to quantify local stability. This study quantified the variability present in time series generated from gait parameter via chaos analysis. Gait pattern is found to be chaotic. The proposed Lyapunov exponent can be used in rehabilitation and diagnosis of recoverable patients.
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Pfau, Thilo. "Sensor-based equine gait analysis: more than meets the eye?" UK-Vet Equine 3, no. 3 (May 2, 2019): 102–12. http://dx.doi.org/10.12968/ukve.2019.3.3.102.
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Quantitative gait analysis in the lame horse has gained in popularity, likely related to the potential to remove bias from the clinical decision-making process. Its implementation into clinical practice is, however, not without challenges. This review visits some of the challenges related to the use of thresholds and guideline values in the context of clinical decision making, as well as when applied to scientific studies based on relevant published studies: issues such as ‘normal day-to-day variation’, conformational asymmetry and the often limited number of parameters that are being quantified. Emphasis is put on outlining the basic underlying principles relating to head nod and hip hike, which are explained in the context of Newtonian mechanics associating reduced vertical acceleration of the upper body to reduced force production with the limb that is in contact with the ground during that time period. Further to quantifying what can be seen ‘by eye’, the review also visits phenomena such as asymmetries in weight bearing or pushoff and compensatory mechanisms, with emphasis on measurement of withers movement and thoughts about multilimb lameness. The review concludes with thoughts about additional parameters such as limb movement and movement of the thoraco-lumbo-sacral area, which may provide additional insights into lameness and poor performance but are at current less frequently included into clinical gait analysis in the horse.
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Kneis, Sarah, Elisa Straub, Isabelle Daniela Walz, Philipp von Olshausen, Anja Wehrle, Albert Gollhofer, and Hartmut Bertz. "Gait Analysis of Patients After Allogeneic Hematopoietic Cell Transplantation Reveals Impairments of Functional Performance." Integrative Cancer Therapies 19 (January 2020): 153473542091578. http://dx.doi.org/10.1177/1534735420915782.
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Background: After allogeneic hematopoietic cell transplantation (alloHCT), patients often report functional impairments like reduced gait speed and muscle weakness. These impairments can increase the risk of adverse health events similar to elderly populations. However, they have not been quantified in patients after alloHCT (PATs). Methods: We compared fear of falling (Falls Efficacy Scale–International) and temporal gait parameters recorded on a 10-m walkway at preferred and maximum gait speed and under dual-task walking of 16 PATs (aged 31-73 years) with 15 age-matched control participants (CONs) and 17 seniors (SENs, aged >73 years). Results: Groups’ gait parameters especially differed during the maximum speed condition: PATs walked slower and required more steps/10 m than CONs. PATs exhibited greater stride, stance, and swing times than CONs. PATs’ swing time was even longer than SENs’. The PATs’ ability to accelerate their gait speed from preferred to fast was smaller compared with CONs’. PATs reported a greater fear of falling than CONs and SENs. Conclusion: Gait analysis of alloHCT patients has revealed impairments of functional performance. Patients presented a diminished ability to accelerate gait and extending steps possibly related to a notable strength deficit that impairs power-generation abilities from lower extremities. Furthermore, patients reported a greater fear of falling than control participants and even seniors. Slowing locomotion could be a risk-preventive safety strategy. Since functional disadvantages may put alloHCT patients at a higher risk of frailty, reinforcing appropriate physical exercises already during and after alloHCT could prevent adverse health events and reduce the risk of premature functional aging.
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Galli, Manuela, Veronica Cimolin, Giorgio Cesare Santambrogio, Marcello Crivellini, and Giorgio Albertini. "Gait Analysis before and after Gastrocnemius Fascia Lengthening for Spastic Equinus Foot Deformity in a 10-Year-Old Diplegic Child." Case Reports in Medicine 2010 (2010): 1–9. http://dx.doi.org/10.1155/2010/417806.
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Purpose. This case study quantified kinematic and kinetic effects of gastrocnemius lengthening on gait in a Cerebral Palsy child with equinus foot.Methods. A 10-year-old diplegic child with Cerebral Palsy was evaluated with Gait Analysis (GA) before and after gastrocnemius fascia lengthening, investigating the lower limb joints kinematics and kinetics.Results. Kinematics improved at the level of distal joints, which are directly associated to gastrocnemius, and also at the proximal joint (like hip); improvements were found in ankle kinetics, too.Conclusions. This case study highlighted that GA was effective not only to quantify the results of the treatment but also to help preoperative decision making in dealing with CP child.
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Gaßner, Heiko, Philipp Sanders, Alisa Dietrich, Franz Marxreiter, Bjoern M. Eskofier, Jürgen Winkler, and Jochen Klucken. "Clinical Relevance of Standardized Mobile Gait Tests. Reliability Analysis Between Gait Recordings at Hospital and Home in Parkinson’s Disease: A Pilot Study." Journal of Parkinson's Disease 10, no. 4 (October 27, 2020): 1763–73. http://dx.doi.org/10.3233/jpd-202129.
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Background: Gait impairments in Parkinson’s disease (PD) are quantified using inertial sensors under standardized test settings in the hospital. Recent studies focused on the assessment of free-living gait in PD. However, the clinical relevance of standardized gait tests recorded at the patient’s home is unclear. Objective: To evaluate the reliability of supervised, standardized sensor-based gait outcomes at home compared to the hospital. Methods: Patients with PD (n = 20) were rated by a trained investigator using the Unified Parkinson Disease Rating Scale (UPDRS-III). Gait tests included a standardized 4×10 m walk test and the Timed Up and Go Test (TUG). Tests were performed in the hospital (HOSPITAL) and at patients’ home (HOME), and controlled for investigator, time of the day, and medication. Statistics included reliability analysis using Intra-Class correlations and Bland-Altman plots. Results: UPDRS-III and TUG were comparable between HOSPITAL and HOME. PD patients’ gait at HOME was slower (gait velocity Δ= –0.07±0.11 m/s, –6.1%), strides were shorter (stride length Δ= –9.2±9.4 cm; –7.3%), and shuffling of gait was more present (maximum toe-clearance Δ= –0.7±2.5 cm; –8.8%). Particularly, narrow walkways (<85 cm) resulted in a significant reduction of gait velocity at home. Reliability analysis (HOSPITAL vs. HOME) revealed excellent ICC coefficients for UPDRS-III (0.950, p < 0.000) and gait parameters (e.g., stride length: 0.898, p < 0.000; gait velocity: 0.914, p < 0.000; stance time: 0.922, p < 0.000; stride time: 0.907, p < 0.000). Conclusion: This pilot study underlined the clinical relevance of gait parameters by showing excellent reliability for supervised, standardized gait tests at HOSPITAL and HOME, even though gait parameters were different between test conditions.
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Lv, Xinyu, Na Ta, Tao Chen, Jing Zhao, and Haicheng Wei. "Analysis of Gait Characteristics of Patients with Knee Arthritis Based on Human Posture Estimation." BioMed Research International 2022 (April 14, 2022): 1–8. http://dx.doi.org/10.1155/2022/7020804.
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A gait feature analysis method based on AlphaPose human pose estimation fused with sample entropy is proposed to address complicated, high-cost, and time-consuming postoperative rehabilitation of patients with joint diseases. First, TensorRT was used to optimize the inference of AlphaPose, which consists of the target detection algorithm YOLOv3 and the pose estimation algorithm. It can speed up latency and throughput by about 2.5 times while maintaining the algorithm’s accuracy. Second, the optimized human posture estimation algorithm AlphaPose_trt was used to process gait videos of healthy people and patients with knee arthritis. The joint point motion trajectories of the two groups were extracted, and the sample entropy algorithm quantified the joint trajectory signals for feature analysis. The experimental results showed significant differences in the entropy of the heel and ankle joint motion signals between healthy people and arthritic patients ( p < 0.01 ), which can be used to identify patients with knee arthritis. This technique can assist doctors in determining needed postoperative joint surgery rehabilitation.
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Sun, Zheng, Yi-ren Lin, Meng-jiang Lu, Kai-yu Huang, Ke Sun, and Jian-bin Zhang. "Acupuncture for gait disturbance of patients with subacute and chronic stroke: a systematic review and meta-analysis protocol." BMJ Open 13, no. 6 (June 2023): e071590. http://dx.doi.org/10.1136/bmjopen-2023-071590.
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IntroductionHemiparetic gait is one of the most common sequelae of a stroke. Acupuncture has shown potential in correcting hemiplegic gait patterns and improving motor function recovery after stroke. However, controversial findings and a lack of supportive evidence on the effectiveness of acupuncture for post-stroke hemiplegia. The intelligent gait analysis system provides a new perspective for the study of hemiparetic gait. This systematic review aims to collect relevant studies and critically evaluate the efficacy and safety of acupuncture in alleviating gait disturbance of post-stroke hemiplegia based on quantified gait parameters.Methods and analysisA comprehensive search of PubMed, Embase, Cochrane stroke group trials register, Cochrane Central Register of Controlled Trials, CINAHL, AMED, three Chinese databases (Chinese Biomedical Literatures database (CBM), National Knowledge Infrastructure (CNKI), and Wan fang Digital Periodicals), four trails registries (The WHO International Clinical Trials Registry Platform, The Chinese Clinical Trial Registry, The US National Institutes of Health Ongoing Trials Register, and The Australian New Zealand Clinical Trials Registry) will be conducted to identify randomised controlled trials of acupuncture for gait disturbance in post-stroke patients. No restrictions on language or publication status. The primary outcomes are gait temporospatial parameters (eg, step length, stride length, step width, step frequency (cadence), walking speed, etc), and gait kinematic parameters (eg, hip peak flex/extend angle, knee peak flex/extend angle, ankle peak dorsi/plantar-flexion angle, etc). We will assess bias using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. A meta-analysis will be conducted to synthesise the evidence for each outcome measure. The χ2test and I2statistic will be used for assessing heterogeneity between studies.Ethics and disseminationNo ethical approval is needed because no primary data is collected. Scientific conferences or peer-reviewed journals will publish the findings.PROSPERO registration numberCRD42022384348.
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Ashhar, Karalikkadan, Mohammad Khyam, Cheong Soh, and Keng Kong. "A Doppler-Tolerant Ultrasonic Multiple Access Localization System for Human Gait Analysis." Sensors 18, no. 8 (July 27, 2018): 2447. http://dx.doi.org/10.3390/s18082447.
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Ranging based on ultrasonic sensors can be used for tracking wearable mobile nodes accurately for a long duration and can be a cost-effective method for human movement analysis in rehabilitation clinics. In this paper, we present a Doppler-tolerant ultrasonic multiple access localization system to analyze gait parameters in human subjects. We employ multiple access methods using linear chirp wave-forms and narrow-band piezoelectric transducers. A Doppler shift compensation Technique is also incorporated without compromising on the tracking accuracy. The system developed was used for tracking the trajectory of both lower limbs of five healthy adults during a treadmill walk. An optical motion capture system was used as the reference to compare the performance. The average Root Mean Square Error values between the 3D coordinates estimated from the proposed system and the reference system while tracking both lower limbs during treadmill walk experiment by 5 subjects were found to be 16.75, 14.68 and 20.20 mm respectively along X, Y and Z-directions. Errors in the estimation of spatial and temporal parameters from the proposed system were also quantified. These promising results show that narrowband ultrasonic sensors can be utilized to accurately track more than one mobile node for human gait analysis.
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Pieruccini-Faria, Frederico, and Manuel Montero-Odasso. "Obstacle Negotiation, Gait Variability, and Risk of Falling: Results From the “Gait and Brain Study”." Journals of Gerontology: Series A 74, no. 9 (October 31, 2018): 1422–28. http://dx.doi.org/10.1093/gerona/gly254.
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Abstract Background Gait variability is an early fall predictor. However, it is unknown how gait variability of older adults at high risk of falls is affected by an obstacle negotiation task. We aimed to compare gait performance between older adults with significant history of falls (i.e. fallers) and nonfallers while approaching an obstacle crossing. Methods A total of 137 older adults without dementia were enrolled (72.7 ± 5.1 years of age; 60.5% women) from the “Gait and Brain Study.” Fallers were defined as having at least one injurious fall or at least two noninjurious falls in the previous 12 months. Participants performed gait assessments under unobstructed and obstructed conditions. During the obstructed condition, participants walked and stepped over an ad hoc obstacle set at 15% of participants’ height, transversally placed on a 6-meter electronic walkway. Gait speed and step-to-step variabilities were quantified from the last six steps prior to obstacle crossing. Analysis of variance models adjusted for age, sex, fear of falling, comorbidities, and unobstructed gait were used to compare gait performance of fallers and nonfallers during an obstacle approaching. Results In the study, 27 older adults were identified as fallers and 110 as nonfallers. Fallers had higher step time variability and step length variability when approaching an obstacle compared with nonfallers, although groups had comparable gait performance during unobstructed walking. Conclusion Gait variability of older individuals at high risk of falling is more disturbed, compared with low-risk individuals, while approaching an obstacle crossing. High gait variability prior to crossing an obstacle may be a risk factor for falls.
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Acuña, Samuel A., Mitchell E. Tyler, and Darryl G. Thelen. "Individuals with Chronic Mild-to-Moderate Traumatic Brain Injury Exhibit Decreased Neuromuscular Complexity During Gait." Neurorehabilitation and Neural Repair 36, no. 4-5 (March 23, 2022): 317–27. http://dx.doi.org/10.1177/15459683221081064.
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Background Synergy analysis provides a means of quantifying the complexity of neuromuscular control during gait. Prior studies have shown evidence of reduced neuromuscular complexity during gait in individuals with neurological disorders associated with stroke, cerebral palsy, and Parkinson’s disease. Objective The purpose of this study was to investigate neuromuscular complexity during gait in individuals who experienced a prior traumatic brain injury (TBI) that resulted in chronic balance deficits. Methods We measured and analyzed lower extremity electromyographic data during treadmill and overground walking for 44 individuals with residual balance deficits from a mild-to-moderate TBI at least 1 year prior. We also tested 20 unimpaired controls as a comparison. Muscle synergies were calculated for each limb using non-negative matrix factorization of the activation patterns for 6 leg muscles. We quantified neuromuscular complexity using Walk-DMC, a normalized metric of the total variance accounted for by a single synergy, in which a Walk-DMC score of 100 represents normal variance accounted for. We compared group average synergy structures and inter-limb similarity using cosine similarity. We also quantified each individual’s gait and balance using the Sensory Organization Test, the Dynamic Gait Index, and the Six-Minute Walk Test. Results Neuromuscular complexity was diminished for individuals with a prior TBI. Walk-DMC averaged 92.8 ± 12.3 for the TBI group during overground walking, which was significantly less than seen in controls (100.0 ± 10.0). Individuals with a prior TBI exhibited 13% slower overground walking speeds than controls and reduced performance on the Dynamic Gait Index (18.5 ± 4.7 out of 24). However, Walk-DMC measures were insufficient to stratify variations in assessments of gait and balance performance. Group average synergy structures were similar between groups, although there were considerable between-group differences in the inter-limb similarity of the synergy activation vectors. Conclusions Individuals with gait and balance deficits due to a prior TBI exhibit evidence of decreased neuromuscular complexity during gait. Our results suggest that individuals with TBI exhibit similar muscle synergy weightings as controls, but altered control of the temporal activation of these muscle weightings.
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Wesson, Troy, Jeffrey Haddad, Satyajit Ambike, Abigail Foley, Radha Patel, Sarah Burgin, and Alexander L. Francis. "Does hearing impairment affect gait under realistic conditions?" Journal of the Acoustical Society of America 155, no. 3_Supplement (March 1, 2024): A36. http://dx.doi.org/10.1121/10.0026709.
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Hearing loss is associated with increased risk of falling, but little is known about how hearing impairment might affect mobility. Here, we report preliminary results from an ongoing experimental study investigating dynamic properties of gait while walking with and without impaired hearing. Young- and middle-aged adult participants with self-reported normal hearing completed four walking tasks, 2 indoors, 2 outdoors, each conducted with and without a simulated hearing loss. In the impaired condition, participants wore an insert earplug in one ear combined with binaural, circumaural noise-damping headphones. We quantified gait parameters using data from inertial measurement units (IMUs) affixed to participants’ ankles and waist, allowing participants to walk farther than in typical gait assessments. Parameters included standard gait metrics, such as limb acceleration as well as a novel spatiotemporal index quantifying variability in step patterns. Data have been collected from 13 of 30 projected participants. Analysis will focus on how temporal-spatial gait parameters and variability differ between indoor and outdoor walking with and without hearing impairment. We expect gait parameters to reflect a more variable and potentially less mobile walking strategy in the outdoor condition and with impaired hearing due to increased cognitive load and/or reduced spatial awareness in those conditions.
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Senden, Rachel, Rik Marcellis, Kenneth Meijer, Paul Willems, Ton Lenssen, Heleen Staal, Yvonne Janssen, Vincent Groen, Roland Jeroen Vermeulen, and Marianne Witlox. "Comparison of sagittal plane gait characteristics between the overground and treadmill approach for gait analysis in typically developing children." PeerJ 10 (July 22, 2022): e13752. http://dx.doi.org/10.7717/peerj.13752.
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Background Instrumented treadmills have become more mainstream in clinical assessment of gait disorders in children, and are increasingly being applied as an alternative to overground gait analysis. Both approaches differ in multiple elements of set-up (e.g., overground versus treadmill, Pug-in Gait versus Human Body Model-II), workflow (e.g., limited amount of steps versus many successive steps) and post-processing of data (e.g., different filter techniques). These individual elements have shown to affect gait. Since the approaches are used in parallel in clinical practice, insight into the compound effect of the multiple different elements on gait is essential. This study investigates whether the outcomes of two approaches for 3D gait analysis are interchangeable in typically developing children. Methods Spatiotemporal parameters, sagittal joint angles and moments, and ground reaction forces were measured in typically developing children aged 3–17 years using the overground (overground walking, conventional lab environment, Plug-In Gait) and treadmill (treadmill walking in virtual environment, Human Body Model-II) approach. Spatiotemporal and coefficient of variation parameters, and peak values in kinematics and kinetics of both approaches were compared using repeated measures tests. Kinematic and kinetic waveforms from both approaches were compared using statistical parametric mapping (SPM). Differences were quantified by mean differences and root mean square differences. Results Children walked slower, with lower stride and stance time and shorter and wider steps with the treadmill approach than with the overground approach. Mean differences ranged from 0.02 s for stride time to 3.3 cm for step width. The patterns of sagittal kinematic and kinetic waveforms were equivalent for both approaches, but significant differences were found in amplitude. Overall, the peak joint angles were larger during the treadmill approach, showing mean differences ranging from 0.84° (pelvic tilt) to 6.42° (peak knee flexion during swing). Mean difference in peak moments ranged from 0.02 Nm/kg (peak knee extension moment) to 0.32 Nm/kg (peak hip extension moment), showing overall decreased joint moments with the treadmill approach. Normalised ground reaction forces showed mean differences ranging from 0.001 to 0.024. Conclusion The overground and treadmill approach to 3D gait analysis yield different sagittal gait characteristics. The systematic differences can be due to important changes in the neuromechanics of gait and to methodological choices used in both approaches, such as the biomechanical model or the walkway versus treadmill. The overview of small differences presented in this study is essential to correctly interpret the results and needs to be taken into account when data is interchanged between approaches. Together with the research/clinical question and the context of the child, the insight gained can be used to determine the best approach.
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Buckalew, Daniel P., David A. Barlow, James W. Fischer, and James G. Richards. "Biomechanical Profile of Elite Women Marathoners." International Journal of Sport Biomechanics 1, no. 4 (November 1985): 330–47. http://dx.doi.org/10.1123/ijsb.1.4.330.
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Extensive study has been done on male subjects dealing with gait analysis, but similar investigations of women runners are limited. The purpose of this study was to quantify the essential characteristics and alterations in gait mechanics of women marathoners. Forty elite women marathoners were filmed at four camera locations during the first U.S. Olympic Women's Marathon Trial. Data were quantified with a microcomputer and digitizing system. Quantification of 11 kinematic and temporal variables of gait were obtained. Five variables were examined bilaterally to determine degree of symmetry. Results showed remarkably consistent characteristics of gait across the four camera locations. However, substantial changes did occur between the third and fourth camera locations in stride length and horizontal velocity. All subjects displayed little asymmetry throughout the race. Minimal differences between the top and bottom 10 finishers were noted. There are differences between the gait patterns of men and women distance runners. Stride length, support/nonsupport time ratio, and percent overstride appear to be important factors for success of women distance runners. Most alterations in gait mechanics appear to occur between the 20- and 24-mile marks of the marathon.
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Hwang, Miriam, Ann Flanagan, Adam Graf, Karen M. Kruger, Nancy Scullion, Samantha Tayne, and Haluk Altiok. "Gait Characteristics in Youth With Transverse Myelitis." Topics in Spinal Cord Injury Rehabilitation 27, no. 3 (August 13, 2021): 38–48. http://dx.doi.org/10.46292/sci20-00048.
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Background: Transverse myelitis (TM) in childhood is a rare disorder characterized by the presence of spinal cord inflammation. Gait difficulty in children with TM is common; however, there is a paucity of literature regarding quantitative assessment of gait in children and adolescents with TM. Objectives: To characterize gait patterns in a cohort of ambulatory children with TM and age-matched, typically developing peers in order to better understand the functional mobility of patients diagnosed with childhood TM. Methods: This was a retrospective study of 26 ambulatory pediatric patients with a confirmed diagnosis of TM who had undergone three-dimensional, instrumented gait analysis (3D-IGA) at 3 years of age or older. A group of 38 typically developing children served as a control group. Results: Gait in children with TM was characterized by moderate kinematic deviations as measured by the Gait Deviation Index (GDI) and a crouched gait pattern (p < .001), increased anterior pelvic tilt (p < .001), decreased motion at the knees (p < .001), and a wider base of support (foot progression angle, p < .001). The TM group had a slower walking speed (p < .001), shorter strides (p < .001), and an increased stance phase compared to controls. Conclusion: Our study results showed moderate kinematic deviations quantified by the GDI. Overall, the gait pattern in the TM population tested had greater hip and knee flexion with wider foot progression angle. Identification of gait characteristics in children with TM is the first step in predicting changes in gait pattern as they mature over time, which may ultimately allow for targeted intervention to maintain their ambulatory function.
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Zahedi, M. S., W. D. Spence, S. E. Solomonidis, and J. P. Paul. "Repeatability of kinetic and kinematic measurements in gait studies of the lower limb amputee." Prosthetics and Orthotics International 11, no. 2 (August 1987): 55–64. http://dx.doi.org/10.3109/03093648709078179.
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During the last few years considerable attention has been given to the use of gait analysis as a tool for clinical use. The instrumentation for measurement of the kinetics and kinematics of human locomotion was originally designed for research use. Extension of its use into the clinical field calls for simplified methodology and clearly defined protocols with precise identification of the relevant parameters for the analysis. Force platforms, TV-computer and pylon transducer systems were used for collection of kinetic and kinematic data of five normal subjects, 10 below-knee, 10 above-knee and one hip disarticulation amputee. The repeatability tests showed significant differences in the measured parameters. These variations are attributed to the methodology of the analysis and the step to step variation of the subjects' gait. Differences in the degree of step to step variation between various amputee and normal subjects are quantified. In this presentation the capability of present day systems to perform repeatable gait measurements is discussed. A computational method for determination of representative measurements for the purposes of biomechanical evaluation and comparison as well as quantification of the degree of repeatability is described.
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Devillers, Nicolas, Emmanuel Janvier, Farhoud Delijani, Steve Méthot, Kristopher J. Dick, Qiang Zhang, and Laurie Connor. "Effect of Slat and Gap Width of Slatted Concrete Flooring on Sow Gait Using Kinematics Analysis." Animals 9, no. 5 (April 30, 2019): 206. http://dx.doi.org/10.3390/ani9050206.
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The housing of gestating sows in groups requires sound information about the adapted design of the pen floor. Slatted concrete floors are commonly used for effective drainage of manure but can cause feet injuries and lameness. In the present study, kinematics were used to characterize the gait of 12 gilts and 12 lame sows walking in a corridor on slatted concrete floors with different combinations of slat (85, 105 or 125 mm) and gap (19, 22 or 25 mm) widths. The nine experimental floors were tested with slats in the perpendicular and parallel orientation to the direction of animal walk, according to a duplicated lattice design. Gait parameters were quantified using spatial, temporal and angular kinematics for front and rear limbs. Some parameters were significantly affected by the treatments (p < 0.05), but the effects differed between gilts and lame sows and between slat orientations. Gap width had a significant effect on parameters such as back angle, stride length, foot height, and carpal and tarsal joint angle amplitudes. Slat width significantly affected parameters such as foot height, and carpal and tarsal joint angle amplitudes. Comparisons of the different combinations of slat and gap widths revealed that slats with a width of 105–125 mm and gap width of 19–22 mm had the least effect on the gait characteristics of the gilts and sows.
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Takahashi, Kota Z., John R. Horne, and Steven J. Stanhope. "Comparison of mechanical energy profiles of passive and active below-knee prostheses: A case study." Prosthetics and Orthotics International 39, no. 2 (January 13, 2014): 150–56. http://dx.doi.org/10.1177/0309364613513298.
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Background: With the recent technological advancements of prosthetic lower limbs, there is currently a great desire to objectively evaluate existing prostheses. Using a novel biomechanical analysis, the purpose of this case study was to compare the mechanical energy profiles of anatomical and two disparate prostheses: a passive prosthesis and an active prosthesis. Case description and methods: An individual with a transtibial amputation who customarily wears a passive prosthesis (Elation, Össur) and an active prosthesis (BiOM, iWalk, Inc.) and 11 healthy subjects participated in an instrumented gait analysis. The total mechanical power and work of below-knee structures during stance were quantified using a unified deformable segment power analysis. Findings and outcomes: Active prosthesis generated greater peak power and total positive work than passive prosthesis and healthy anatomical limbs. Conclusion: The case study will enhance future efforts to objectively evaluate prosthetic functions during gait in individuals with transtibial amputations. Clinical relevance A prosthetic limb should closely replicate the mechanical energy profiles of anatomical limbs. The unified deformable (UD) analysis may be valuable to facilitate future clinical prescription and guide fine adjustments of prosthetic componentry to optimize gait outcomes.
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Tian, Qu, Susan Resnick, Eleanor Simonsick, and Luigi Ferrucci. "INCREASED TEMPORAL GAIT VARIABILITY OVER TIME IS RELATED TO FUTURE DEMENTIA." Innovation in Aging 7, Supplement_1 (December 1, 2023): 168. http://dx.doi.org/10.1093/geroni/igad104.0549.
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Abstract Age-related brain changes affect the timing and coordination of gait. High gait variability may stem from impaired brain motor control and has been associated with compromised cognition and cognitive impairment. Whether increased gait variability over time is associated with future MCI or dementia is unknown. In the Baltimore Longitudinal Study of Aging, we used age-, sex-, and race-adjusted linear mixed-effects models to examine whether changes in gait variability were associated with future MCI or dementia in participants aged 65+. Gait characteristics were quantified by 3D motion analysis. Independent of baseline gait speed and compared to cognitively normal participants (n=387), those who developed dementia (n=24) had greater rates of increase in gait cycle time variability, stance time variability, and swing time variability (but not mean performance) before the symptom onset (all p<0.05). Further adjustment for concurrent assessment of visuospatial ability or manual dexterity attenuated these associations. Adjustments for verbal memory, psychomotor speed, attention, or executive function did not attenuate these associations. Rates of changes in these gait variability measures were not statistically different between cognitively normal participants (n=387) and those who developed MCI (n=41). Baseline gait variability measures were not different across groups. These findings suggest that longitudinal trajectories of gait variability, not one-time assessment, provide the additional predictive value of future dementia over and beyond gait speed. Mechanisms may include compromised visuospatial ability or manual dexterity. Future neuroimaging studies are warranted to understand neural substrates connecting increased gait variability and dementia risk.
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Bermejo-García, Javier, Daniel Rodríguez Jorge, Francisco Romero-Sánchez, Ashwin Jayakumar, and Francisco J. Alonso-Sánchez. "Actuation Strategies for a Wearable Cable-Driven Exosuit Based on Synergies in Younger and Older Adults." Sensors 23, no. 1 (December 27, 2022): 261. http://dx.doi.org/10.3390/s23010261.
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Older adults (aged 55 years and above) have greater difficulty carrying out activities of daily living than younger adults (aged 25–55 years). Although age-related changes in human gait kinetics are well documented in qualitative terms in the scientific literature, these differences may be quantified and analyzed using the analysis of motor control strategies through kinetic synergies. The gaits of two groups of people (older and younger adults), each with ten members, were analyzed on a treadmill at a constant controlled speed and their gait kinetics were recorded. The decomposition of the kinetics into synergies was applied to the joint torques at the hip, knee, and ankle joints. Principal components determined the similarity of the kinetic torques in the three joints analyzed and the effect of the walking speed on the coordination pattern. A total of three principal components were required to describe enough information with minimal loss. The results suggest that the older group showed a change in coordination strategy compared to that of the younger group. The main changes were related to the ankle and hip torques, both showing significant differences (p-value <0.05) between the two groups. The findings suggest that the differences between the gait patterns of the two groups were closely related to a reduction in ankle torque and an increase in hip torque. This change in gait pattern may affect the rehabilitation strategy used when designing general-purpose rehabilitation devices or rehabilitation/training programs for the elderly.
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Cimolin, Veronica, Manuela Galli, Marcello Crivellini, and Giorgio Albertini. "Quantitative Effects on Proximal Joints of Botulinum Toxin Treatment for Gastrocnemius Spasticity: A 4-Year-Old Case Study." Case Reports in Medicine 2009 (2009): 1–4. http://dx.doi.org/10.1155/2009/985717.
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Botulinum toxin A (BTA) is a recognized treatment for the early management of spasticity in children with Cerebral Palsy. This study quantified with Gait Analysis (GA) the gait pattern of a 4-year-old diplegic child with calf contracture before, 5 days, and 3 months after BTA injections into gastrocnemius. Kinematic and kinetic data of main lower limb joints were investigated. After only 5 days, ankle dorsi-plantarflexion and knee flex-extension improved, but hip joint worsened, increasing its excessive flexion, to compensate the improvement in knee position of the treated limb and to obtain better stability. A worsening of hip power happened. After 3 months, all joints generally improved their position during gait cycle. Hip and knee joints increased their range of movement and improvements occurred at ankle kinematics and kinetisc, too; a better ankle position and an increase of its capacity of propulsion during terminal stance were evident.
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Shull, Pete B., Wisit Jirattigalachote, Michael A. Hunt, Mark R. Cutkosky, and Scott L. Delp. "Quantified self and human movement: A review on the clinical impact of wearable sensing and feedback for gait analysis and intervention." Gait & Posture 40, no. 1 (May 2014): 11–19. http://dx.doi.org/10.1016/j.gaitpost.2014.03.189.
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Koller, Willi, Arnold Baca, and Hans Kainz. "The gait pattern and not the femoral morphology is the main contributor to asymmetric hip joint loading." PLOS ONE 18, no. 9 (September 26, 2023): e0291789. http://dx.doi.org/10.1371/journal.pone.0291789.
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Gait asymmetry and skeletal deformities are common in many children with cerebral palsy (CP). Changes of the hip joint loading, i.e. hip joint contact force (HJCF), can lead to pathological femoral growth. A child’s gait pattern and femoral morphology affect HJCFs. The twofold aim of this study was to (1) evaluate if the asymmetry in HJCFs is higher in children with CP compared to typically developing (TD) children and (2) identify if the bony morphology or the subject-specific gait pattern is the main contributor to asymmetric HJCFs. Magnetic resonance images (MRI) and three-dimensional gait analysis data of twelve children with CP and fifteen TD children were used to create subject-specific musculoskeletal models and calculate HJCF using OpenSim. Root-mean-square-differences between left and right HJCF magnitude and orientation were computed and compared between participant groups (CP versus TD). Additionally, the influence on HJCF asymmetries solely due to the femoral morphology and solely due to the gait pattern was quantified. Our findings demonstrate that the gait pattern is the main contributor to asymmetric HJCFs in CP and TD children. Children with CP have higher HJCF asymmetries which is probably the result of larger asymmetries in their gait pattern compared to TD children. The gained insights from our study highlight that clinical interventions should focus on normalizing the gait pattern and therefore the hip joint loading to avoid the development of femoral deformities.
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McCabe, Jessica P., Svetlana Pundik, and Janis J. Daly. "Targeting CNS Neural Mechanisms of Gait in Stroke Neurorehabilitation." Brain Sciences 12, no. 8 (August 9, 2022): 1055. http://dx.doi.org/10.3390/brainsci12081055.
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The central nervous system (CNS) control of human gait is complex, including descending cortical control, affective ascending neural pathways, interhemispheric communication, whole brain networks of functional connectivity, and neural interactions between the brain and spinal cord. Many important studies were conducted in the past, which administered gait training using externally targeted methods such as treadmill, weight support, over-ground gait coordination training, functional electrical stimulation, bracing, and walking aids. Though the phenomenon of CNS activity-dependent plasticity has served as a basis for more recently developed gait training methods, neurorehabilitation gait training has yet to be precisely focused and quantified according to the CNS source of gait control. Therefore, we offer the following hypotheses to the field: Hypothesis 1. Gait neurorehabilitation after stroke will move forward in important ways if research studies include brain structural and functional characteristics as measures of response to treatment. Hypothesis 2. Individuals with persistent gait dyscoordination after stroke will achieve greater recovery in response to interventions that incorporate the current and emerging knowledge of CNS function by directly engaging CNS plasticity and pairing it with peripherally directed, plasticity-based motor learning interventions. These hypotheses are justified by the increase in the study of neural control of motor function, with emerging research beginning to elucidate neural factors that drive recovery. Some are developing new measures of brain function. A number of groups have developed and are sharing sophisticated, curated databases containing brain images and brain signal data, as well as other types of measures and signal processing methods for data analysis. It will be to the great advantage of stroke survivors if the results of the current state-of-the-art and emerging neural function research can be applied to the development of new gait training interventions.
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Lee, Dongchul, and Paul Sung. "Gait Asymmetry Comparison between Subjects with and without Nonspecific Chronic Low Back Pain." Symmetry 13, no. 11 (November 9, 2021): 2129. http://dx.doi.org/10.3390/sym13112129.
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Individuals with chronic low back pain (LBP) report impaired somatosensory function and balance. However, there is a lack of investigation on limb motion similarities between subjects with and without LBP during gait. The aim of this study was to compare gait parameters as well as combined limb motions using the kinematic similarity index (KSI) between subjects with and without LBP. Twenty-two subjects with LBP and 19 age- and body mass index-matched control subjects participated in this study. The combined limb motions in the gait cycle of subjects with LBP were compared with those of a prototype derived from healthy subjects. The calculations resulted in response vectors that were analyzed in comparison to control-derived prototype response vectors for the normalized index at 5% increments in the gait cycle. The results of our study indicated that the KSI of the control group demonstrated higher similarities in the swing (t = 4.23, p = 0.001) and stance (t = 6.26, p = 0.001) phases compared to the LBP group. The index for the whole gait cycle was significantly different between the groups (t = 6.52, p = 0.001), especially in the midstance and swing phases. The LBP group could have adjusted the gait patterns during these specific phases. The KSI is useful for clinical outcome measures to differentiate kinematic changes and to demonstrate quantified similarities in the gait cycle between subjects with and without LBP. It is warranted to validate the KSI for the analysis of physiological gait asymmetry using a larger sample in future studies.
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Ragothaman, Anjanibhargavi, Oscar Miranda-Dominguez, Barbara H. Brumbach, Andrew Giritharan, Damien A. Fair, John G. Nutt, Martina Mancini, and Fay B. Horak. "Relationship Between Brain Volumes and Objective Balance and Gait Measures in Parkinson’s Disease." Journal of Parkinson's Disease 12, no. 1 (January 21, 2022): 283–94. http://dx.doi.org/10.3233/jpd-202403.
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Background: Instrumented measures of balance and gait measure more specific balance and gait impairments than clinical rating scales. No prior studies have used objective balance/gait measures to examine associations with ventricular and brain volumes in people with Parkinson’s disease (PD). Objective: To test the hypothesis that larger ventricular and smaller cortical and subcortical volumes are associated with impaired balance and gait in people with PD. Methods: Regional volumes from structural brain images were included from 96 PD and 50 control subjects. Wearable inertial sensors quantified gait, anticipatory postural adjustments prior to step initiation (APAs), postural responses to a manual push, and standing postural sway on a foam surface. Multiple linear regression models assessed the relationship between brain volumes and balance/gait and their interactions in PD and controls, controlling for sex, age and corrected for multiple comparisons. Results: Smaller brainstem and subcortical gray matter volumes were associated with larger sway area in people with PD, but not healthy controls. In contrast, larger ventricle volume was associated with smaller APAs in healthy controls, but not in people with PD. A sub-analysis in PD showed significant interactions between freezers and non-freezers, in several subcortical areas with stride time variability, gait speed and step initiation. Conclusion: Our models indicate that smaller subcortical and brainstem volumes may be indicators of standing balance dysfunction in people with PD whereas enlarged ventricles may be related to step initiation difficulties in healthy aging. Also, multiple subcortical region atrophy may be associated with freezing of gait in PD.
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Jiménez-Grande, David, S. Farokh Atashzar, Eduardo Martinez-Valdes, and Deborah Falla. "Muscle network topology analysis for the classification of chronic neck pain based on EMG biomarkers extracted during walking." PLOS ONE 16, no. 6 (June 21, 2021): e0252657. http://dx.doi.org/10.1371/journal.pone.0252657.
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Neuromuscular impairments are frequently observed in patients with chronic neck pain (CNP). This study uniquely investigates whether changes in neck muscle synergies detected during gait are sensitive enough to differentiate between people with and without CNP. Surface electromyography (EMG) was recorded from the sternocleidomastoid, splenius capitis, and upper trapezius muscles bilaterally from 20 asymptomatic individuals and 20 people with CNP as they performed rectilinear and curvilinear gait. Intermuscular coherence was computed to generate the functional inter-muscle connectivity network, the topology of which is quantified based on a set of graph measures. Besides the functional network, spectrotemporal analysis of each EMG was used to form the feature set. With the use of Neighbourhood Component Analysis (NCA), we identified the most significant features and muscles for the classification/differentiation task conducted using K-Nearest Neighbourhood (K-NN), Support Vector Machine (SVM), and Linear Discriminant Analysis (LDA) algorithms. The NCA algorithm selected features from muscle network topology as one of the most relevant feature sets, which further emphasize the presence of major differences in muscle network topology between people with and without CNP. Curvilinear gait achieved the best classification performance through NCA-SVM based on only 16 features (accuracy: 85.00%, specificity: 81.81%, and sensitivity: 88.88%). Intermuscular muscle networks can be considered as a new sensitive tool for the classification of people with CNP. These findings further our understanding of how fundamental muscle networks are altered in people with CNP.
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GU, YAODONG, JIANSHE LI, XUEJUN REN, MARK LAKE, and ZHIYONG LI. "A PILOT STUDY IN DIFFERENT UNSTABLE DESIGNS ON THE BIOMECHANICAL EFFECT OF GAIT CHARACTERISTICS." Journal of Mechanics in Medicine and Biology 12, no. 05 (December 2012): 1250031. http://dx.doi.org/10.1142/s0219519412500315.
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The purpose of this study was to compare kinematics and kinetics during walking for healthy subjects using unstable shoes with different designs. Ten subjects participated in this study, and foot biomechanical data during walking were quantified using motion analysis system and a force plate. Data were collected for unstable shoes condition after accommodation period of one week. With soft material added in the heel region, the peak impact force was effectively reduced when compared among similar shapes. In addition, the soft material added in the rocker bottom showed more to be in dorsiflexed position during the initial stance. The shoe with three rocker curves design reduced the contact area in the heel strike, which may result in increasing human body forward speed. Further studies shall be carried out after adapting to long periods of wearing unstable shoes.
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Hughes, Liam David, Martin Bencsik, Maria Bisele, and Cleveland Thomas Barnett. "Using Lower Limb Wearable Sensors to Identify Gait Modalities: A Machine-Learning-Based Approach." Sensors 23, no. 22 (November 17, 2023): 9241. http://dx.doi.org/10.3390/s23229241.
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Real-world gait analysis can aid in clinical assessments and influence related interventions, free from the restrictions of a laboratory setting. Using individual accelerometers, we aimed to use a simple machine learning method to quantify the performance of the discrimination between three self-selected cyclical locomotion types using accelerometers placed at frequently referenced attachment locations. Thirty-five participants walked along a 10 m walkway at three different speeds. Triaxial accelerometers were attached to the sacrum, thighs and shanks. Slabs of magnitude, three-second-long accelerometer data were transformed into two-dimensional Fourier spectra. Principal component analysis was undertaken for data reduction and feature selection, followed by discriminant function analysis for classification. Accuracy was quantified by calculating scalar accounting for the distances between the three centroids and the scatter of each category’s cloud. The algorithm could successfully discriminate between gait modalities with 91% accuracy at the sacrum, 90% at the shanks and 87% at the thighs. Modalities were discriminated with high accuracy in all three sensor locations, where the most accurate location was the sacrum. Future research will focus on optimising the data processing of information from sensor locations that are advantageous for practical reasons, e.g., shank for prosthetic and orthotic devices.
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Steele, Amy, Ramon Gonzalez, Juan C. Garbalosa, Keith Steigbigel, Tania Grgurich, Erika J. Parisi, Richard S. Feinn, Steven M. Tommasini, and Carolyn M. Macica. "Osteoarthritis, Osteophytes, and Enthesophytes Affect Biomechanical Function in Adults With X-linked Hypophosphatemia." Journal of Clinical Endocrinology & Metabolism 105, no. 4 (February 12, 2020): e1798-e1814. http://dx.doi.org/10.1210/clinem/dgaa064.
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Abstract Context X-Linked hypophosphatemia (XLH) is a lifelong metabolic disease with musculoskeletal comorbidities that dominate the adult clinical presentation. Objective The adult XLH disorder has yet to be quantified on the basis of the physical and functional limitations that can affect activities of daily living. Our goal was to report the impact of the musculoskeletal manifestations on physical function. Design and setting Musculoskeletal function was evaluated by validated questionnaires and in an interdisciplinary clinical space where participants underwent full-body radiologic imaging, goniometric range of motion (ROM) measurements, general performance tests, and kinematic gait analysis. Patients Nine adults younger than 60 years with a diagnosis of XLH and self-reported musculoskeletal disability, but able to independently ambulate, were selected to participate. Passive ROM and gait analysis were also performed on age-approximated controls to account for differences between individual laboratory instrumentation. Results Enthesophytes, degenerative arthritis, and osteophytes were found to be consistently bilateral and diffusely present at the spine and synovial joints across participants, with predominance at weight-bearing joints. Passive ROM in adults with XLH was decreased at the cervical spine, hip, knee, and ankle compared to controls. Gait analysis relative to controls revealed increased step width, markedly increased lateral trunk sway, and physical restriction at the hip, knees, and ankle joints that translated into limitations through the gait cycle. Conclusions The functional impact of XLH musculoskeletal comorbidities supports the necessity for creating an interprofessional health-care team with the goal of establishing a longitudinal plan of care that considers the manifestations of XLH across the lifespan.
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Klenow, Tyler D., Jason T. Kahle, and M. Jason Highsmith. "The dead spot phenomenon in prosthetic gait: Quantified with an analysis of center of pressure progression and its velocity in the sagittal plane." Clinical Biomechanics 38 (October 2016): 56–62. http://dx.doi.org/10.1016/j.clinbiomech.2016.08.013.
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Peeters, Nicky, Eirini Papageorgiou, Britta Hanssen, Nathalie De Beukelaer, Lauraine Staut, Marc Degelaen, Christine Van den Broeck, et al. "The Short-Term Impact of Botulinum Neurotoxin-A on Muscle Morphology and Gait in Children with Spastic Cerebral Palsy." Toxins 14, no. 10 (September 29, 2022): 676. http://dx.doi.org/10.3390/toxins14100676.
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Children with spastic cerebral palsy (SCP) are often treated with intramuscular Botulinum Neurotoxin type-A (BoNT-A). Recent studies demonstrated BoNT-A-induced muscle atrophy and variable effects on gait pathology. This group-matched controlled study in children with SCP compared changes in muscle morphology 8–10 weeks post-BoNT-A treatment (n = 25, median age 6.4 years, GMFCS level I/II/III (14/9/2)) to morphological changes of an untreated control group (n = 20, median age 7.6 years, GMFCS level I/II/III (14/5/1)). Additionally, the effects on gait and spasticity were assessed in all treated children and a subgroup (n = 14), respectively. BoNT-A treatment was applied following an established integrated approach. Gastrocnemius and semitendinosus volume and echogenicity intensity were assessed by 3D-freehand ultrasound, spasticity was quantified through electromyography during passive muscle stretches at different velocities. Ankle and knee kinematics were evaluated by 3D-gait analysis. Medial gastrocnemius (p = 0.018, −5.2%) and semitendinosus muscle volume (p = 0.030, −16.2%) reduced post-BoNT-A, but not in the untreated control group, while echogenicity intensity did not change. Spasticity reduced and ankle gait kinematics significantly improved, combined with limited effects on knee kinematics. This study demonstrated that BoNT-A reduces spasticity and partly improves pathological gait but reduces muscle volume 8–10 weeks post-injections. Close post-BoNT-A follow-up and well-considered treatment selection is advised before BoNT-A application in SCP.
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Shen, Chwan-Li, C. Roger James, Ming-C. Chyu, Walter R. Bixby, Jean-Michel Brismée, Mimi A. Zumwalt, and Glen Poklikuha. "Effects of Tai Chi on Gait Kinematics, Physical Function, and Pain in Elderly with Knee Osteoarthritis — A Pilot Study." American Journal of Chinese Medicine 36, no. 02 (January 2008): 219–32. http://dx.doi.org/10.1142/s0192415x08005734.
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Our previous study has demonstrated that 6 weeks of Tai Chi exercise significantly improves knee pain and stiffness in elderly with knee osteoarthritis. This study also examine the effects of Tai Chi exercise on gait kinematics, physical function, pain, and pain self-efficacy in elderly with knee osteoarthritis. In this prospective, pretest-posttest clinical trial, 40 men and women (64.4 ± 8.3 years) diagnosed with knee osteoarthritis participated in 6 weeks of instructed Tai Chi training, 1 hour/session, 2 sessions/week. The following measures were taken at baseline and the conclusion of the intervention: (a) gait kinematics including stride length, stride frequency, and gait speed quantified using video analysis, (b) physical function, (c) knee pain, and (d) pain self-efficacy. Data were analyzed using repeated MANCOVA, MANOVA, ANOVA and Wilcoxon tests. After 6 weeks of Tai Chi exercise, stride length ( p = 0.023; 1.17 ± 0.17 vs. 1.20 ± 0.14 m ), stride frequency ( p = 0.014; 0.91 ± 0.08 vs. 0.93 ± 0.08 strides/s), and consequently gait speed (p < 0.025; 1.06 ± 0.19 vs. 1.12 ± 0.15 m/s ) increased in the participants. Physical function was significantly improved ( p < 0.001) and knee pain was significantly decreased ( p = 0.002), while no change was observed in pain self-efficacy. In conclusion, these findings support that Tai Chi is beneficial for gait kinematics in elderly with knee osteoarthritis, and a longer term application is needed to substantiate the effect of Tai Chi as an alternative exercise in management of knee osteoarthritis.
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Yazdani, Armin, Zehra Khoja, Aaron Johnstone, Laura Dale, Emmanouil Rampakakis, and Pia Wintermark. "Sildenafil Improves Brain Injury Recovery following Term Neonatal Hypoxia-Ischemia in Male Rat Pups." Developmental Neuroscience 38, no. 4 (2016): 251–63. http://dx.doi.org/10.1159/000448327.
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Term asphyxiated newborns remain at risk of developing brain injury despite available neuropreventive therapies such as hypothermia. Neurorestorative treatments may be an alternative. This study investigated the effect of sildenafil on brain injury induced by neonatal hypoxia-ischemia (HI) at term-equivalent age. Neonatal HI was induced in male Long-Evans rat pups at postnatal day 10 (P10) by left common carotid ligation followed by a 2-hour exposure to 8% oxygen; sham-operated rat pups served as the control. Both groups were randomized to oral sildenafil or vehicle twice daily for 7 consecutive days. Gait analysis was performed on P27. At P30, the rats were sacrificed, and their brains were extracted. The surfaces of both hemispheres were measured on hematoxylin and eosin-stained brain sections. Mature neurons and endothelial cells were quantified near the infarct boundary zone using immunohistochemistry. HI caused significant gait impairment and a reduction in the size of the left hemisphere. Treatment with sildenafil led to an improvement in the neurological deficits as measured by gait analysis, as well as an improvement in the size of the left hemisphere. Sildenafil, especially at higher doses, also caused a significant increase in the number of neurons near the infarct boundary zone. In conclusion, sildenafil administered after neonatal HI may improve brain injury recovery by promoting neuronal populations.
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Pacini Panebianco, Giulia, Davide Ferrazzoli, Giuseppe Frazzitta, Margherita Fonsato, Maria Cristina Bisi, Silvia Fantozzi, and Rita Stagni. "A Statistical Approach for the Assessment of Muscle Activation Patterns during Gait in Parkinson’s Disease." Electronics 9, no. 10 (October 5, 2020): 1641. http://dx.doi.org/10.3390/electronics9101641.
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Recently, the statistical analysis of muscle activation patterns highlighted that not only one, but several activation patterns can be identified in the gait of healthy adults, with different occurrence. Although its potential, the application of this approach in pathological populations is still limited and specific implementation issues need to be addressed. This study aims at applying a statistical approach to analyze muscle activation patterns of gait in Parkinson’s Disease, integrating gait symmetry and co-activation. Surface electromyographic signal of tibialis anterior and gastrocnemius medialis were recorded during a 6-min walking test in 20 patients. Symmetry between right and left stride time series was verified, different activation patterns identified, and their occurrence (number and timing) quantified, as well as the co-activation of antagonist muscles. Gastrocnemius medialis presented five activation patterns (mean occurrence ranging from 2% to 43%) showing, with respect to healthy adults, the presence of a first shorted and delayed activation (between flat foot contact and push off, and in the final swing) and highlighting a new second region of anticipated activation (during early/mid swing). Tibialis anterior presented five activation patterns (mean occurrence ranging from 3% to 40%) highlighting absent or delayed activity at the beginning of the gait cycle, and generally shorter and anticipated activations during the swing phase with respect to healthy adults. Three regions of co-contraction were identified: from heel strike to mid-stance, from the pre- to initial swing, and during late swing. This study provided a novel insight in the analysis of muscle activation patterns in Parkinson’s Disease patients with respect to the literature, where unique, at times conflicting, average patterns were reported. The proposed integrated methodology is meant to be generalized for the analysis of muscle activation patterns in pathologic subjects.
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Huang, Yuke. "Optimized Gait of Climbing Caterpillar Robots in Terms of Enhanced Obstacle-crossing Ability and Stability." Journal of Physics: Conference Series 2386, no. 1 (December 1, 2022): 012088. http://dx.doi.org/10.1088/1742-6596/2386/1/012088.
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Abstract Modular caterpillar robots moving via locomotion waves play increasingly important roles in completing engineering tasks. Obstacle-crossing ability and stability are their crucial properties. Although the stability examinations in previous studies are similar, there are few unified quantitative approaches to study the obstacle-crossing ability. This study aims to propose proper quantification of the robot’s maximum obstacle-crossing ability, which is meaningful in terms of universality and practicality. This study also aims to design the gait that could enhance the robot’s properties. The enhancement of obstacle-crossing ability is achieved via static optimization, where the quantified obstacle-crossing ability is maximized. The relationship between obstacle size and the optimal wave parameters is obtained. The optimization results of the waves with large numbers of links can be forecast via data analysis, which greatly reduces computational cost. The enhancement of stability is achieved via dynamic optimization, where the moment induced by gravity (i.e., climbing instability) is minimized at every time node. The dynamic gait and the pattern of the moment induced by gravity during each movement unit is obtained. Overall, climbing caterpillar robots moving in the designed gait can make the best use of the wave to surmount obstacles in stable locomotion.
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Piccinato, Carlos Eli, Antônio Carlos de Sousa, William Alves do Prado, André Messias, Matheus Bredarioli, Marcelo Belini Dalio, and Edwaldo Edner Joviliano. "Assessment of gait dynamics in rats submitted to limb ischemia." Acta Cirurgica Brasileira 26, no. 6 (December 2011): 490–95. http://dx.doi.org/10.1590/s0102-86502011000600014.
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PURPOSE: To describe a method for the assessment of gait dynamics in rats submitted to limb ischemia. METHODS: Twenty-four male Wistar rats (150-160g) were used. Twelve animals were submitted to limb ischemia by ligation of the common left iliac artery (ischemic group: n = 12); and a sham-operated group was used as control (n=12). After a recovery period of 6 weeks, gait dynamics was assessed by counting the complete footprints and the number of hindlimb-floor contacts during a treadmill test for five minutes at a speed of 12 m.min-1 and angulation of 15°. The number of contacts of the left hindlimb was divided by the right hindlimb values (LRR) for group comparisons. Ischemic disability was quantified by comparing the area under curve (AUC) created by plotting each contact versus time for each hindlimb. The left hindlimb ischemic disability index (LHDI), which was compared between groups, was defined by the formula: LHDI = (1- AUC left / AUC right) x 100. RESULTS: Surgery was well tolerated by all animals. Rats did not suffer tissue loss or ulcerations. Complete footprint LRR was 0.3 ± 0.08 for the ischemic group and 1.3 ± 0.9 for controls (p=0.0043). Number of contacts LLR was 0.5 ± 0.2 for the ischemic group and 1.0 ± 0.1 for the control group (p=0.0051). LHDI was 56.83 ± 10.67 for the ischemic group and 2.50 ± 13.10 for the control group (P = 0.031). CONCLUSION: Assessment of gait dynamics in rats submitted to limb ischemia could be done by footprint analysis and hindlimb contact recording during a treadmill test.
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Cross, Alan R., Steven C. Budsberg, and Thomas J. Keefe. "Kinetic gait analysis assessment of meloxicam efficacy in a sodium urate-induced synovitis model in dogs." American Journal of Veterinary Research 58, no. 6 (June 1, 1997): 626–31. http://dx.doi.org/10.2460/ajvr.1997.58.06.626.
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Abstract Objective To examine the ability of meloxicam, a cyclooxygenase inhibitor, to mediate the effects of sodium urate-induced acute stifle synovitis in dogs. Animals 12 clinically normal adult hound-type dogs. Procedure A blinded, randomized, controlled single crossover design study was performed to determine the efficacy of meloxicam, using 2 dosage groups. In 2 experimental phases, dogs, according to group, received meloxicam (0.1 or 0.5 mg/kg of body weight) or matched volume of meloxicam vehicle, with a washout period of 21 to 28 days between phases. Blood samples for hematologic and biochemical analysis, as well as synovial fluid for cytologic analysis, were collected immediately before and approximately 24 hours after articular challenge of dogs under propofol anesthesia. Ground reaction forces (GRF) and subjective clinical scores were determined before and at 4, 8, 12, and 24 hours after articular challenge. Vertical force data included peak force, impulse, limb loading, and unloading rates. Craniocaudal data were divided into braking and propulsion phases and consisted of peak force and associated impulses. Results Except for propulsion impulse at 24 hours, all GRF variables were significantly greater at all postsynovitis induction times in the group receiving the high meloxicam dose. Significant differences in all GRF variables were seen at various times between the low-dose meloxicam group and the corresponding control group, and between the low- and high-dose meloxicam groups. Similar significance was seen in the subjective clinical evaluations. Strong correlations existed between the subjective and objective data. Conclusions Meloxicam was effective in attenuating the effects of sodium urate-induced acute synovitis in dogs. Kinetic gait data provided an objective measurement of lameness in an experimentally induced arthritis model and quantified lameness improvements in response to medication with a nonsteroidal anti-inflammatory drug. (Am J Vet Res 1997;58:626–631)
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Stein, Michael D., Suzanne J. Hand, Michael Archer, Stephen Wroe, and Laura A. B. Wilson. "Quantitatively assessing mekosuchine crocodile locomotion by geometric morphometric and finite element analysis of the forelimb." PeerJ 8 (June 15, 2020): e9349. http://dx.doi.org/10.7717/peerj.9349.
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Morphological shifts observed in the fossil record of a lineage potentially indicate concomitant shifts in ecology of that lineage. Mekosuchine crocodiles of Cenozoic Australia display departures from the typical eusuchian body-plan both in the cranium and postcranium. Previous qualitative studies have suggested that these crocodiles had a more terrestrial habitus than extant crocodylians, yet the capacity of mekosuchine locomotion remains to be tested. Limb bone shape, such as diaphyseal cross-section and curvature, has been related to habitual use and locomotory function across a wide variety of taxa. Available specimens of mekosuchine limbs, primarily humeri, are distinctly columnar compared with those of extant crocodylians. Here we apply a quantitative approach to biomechanics in mekosuchine taxa using both geomorphic morphometric and finite element methods to measure bone shape and estimate locomotory stresses in a comparative context. Our results show mekosuchines appear to diverge from extant semi-aquatic saltwater and freshwater crocodiles in cross-sectional geometry of the diaphysis and generate different structural stresses between models that simulate sprawling and high-walk gaits. The extant crocodylians display generally rounded cross-sectional diaphyseal outlines, which may provide preliminary indication of resistance to torsional loads that predominate during sprawling gait, whereas mekosuchine humeri appear to vary between a series of elliptical outlines. Mekosuchine structural stresses are comparatively lower than those of the extant crocodylians and reduce under high-walk gait in some instances. This appears to be a function of bending moments induced by differing configurations of diaphyseal curvature. Additionally, the neutral axis of structural stresses is differently oriented in mekosuchines. This suggests a shift in the focus of biomechanical optimisation, from torsional to axial loadings. Our results lend quantitative support to the terrestrial habitus hypothesis in so far as they suggest that mekosuchine humeri occupied a different morphospace than that associated with the semi-aquatic habit. The exact adaptational trajectory of mekosuchines, however, remains to be fully quantified. Novel forms appear to emerge among mekosuchines during the late Cenozoic. Their adaptational function is considered here; possible applications include navigation of uneven terrain and burrowing.
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Seuthe, Jana, Anna Heinzel, Femke Hulzinga, Pieter Ginis, Kirsten E. Zeuner, Günther Deuschl, Nicholas D’Cruz, Alice Nieuwboer, and Christian Schlenstedt. "Towards a better understanding of anticipatory postural adjustments in people with Parkinson’s disease." PLOS ONE 19, no. 3 (March 11, 2024): e0300465. http://dx.doi.org/10.1371/journal.pone.0300465.
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Introduction Previous studies have shown that anticipatory postural adjustments (APAs) are altered in people with Parkinson’s disease but its meaning for locomotion is less understood. This study aims to investigate the association between APAs and gait initiation, gait and freezing of gait and how a dynamic postural control challenging training may induce changes in these features. Methods Gait initiation was quantified using wearable sensors and subsequent straight walking was assessed via marker-based motion capture. Additionally, turning and FOG-related outcomes were measured with wearable sensors. Assessments were conducted one week before (Pre), one week after (Post) and 4 weeks after (Follow-up) completion of a training intervention (split-belt treadmill training or regular treadmill training), under single task and dual task (DT) conditions. Statistical analysis included a linear mixed model for training effects and correlation analysis between APAs and the other outcomes for Pre and Post-Pre delta. Results 52 participants with Parkinson’s disease (22 freezers) were assessed. We found that APA size in the medio-lateral direction during DT was positively associated with gait speed (p<0.001) and stride length (p<0.001) under DT conditions at Pre. The training effect was largest for first step range of motion and was similar for both training modes. For the associations between changes after the training (pooled sample) medio-lateral APA size showed a significant positive correlation with first step range of motion (p = 0.033) only in the DT condition and for the non-freezers only. Conclusions The findings of this work revealed new insights into how APAs were not associated with first step characteristics and freezing and only baseline APAs during DT were related with DT gait characteristics. Training-induced changes in the size of APAs were related to training benefits in the first step ROM only in non-freezers. Based on the presented results increasing APA size through interventions might not be the ideal target for overall improvement of locomotion.
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Kadanka, Zdenek, Zdenek Kadanka, Tomas Skutil, Eva Vlckova, and Josef Bednarik. "Walk and Run Test in Patients with Degenerative Compression of the Cervical Spinal Cord." Journal of Clinical Medicine 10, no. 5 (March 1, 2021): 927. http://dx.doi.org/10.3390/jcm10050927.
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Impaired gait is one of the cardinal symptoms of degenerative cervical myelopathy (DCM) and frequently its initial presentation. Quantitative gait analysis is therefore a promising objective tool in the disclosure of early cervical cord impairment in patients with degenerative cervical compression. The aim of this cross-sectional observational cohort study was to verify whether an objective and easily-used walk and run test is capable of detecting early gait impairment in a practical proportion of non-myelopathic degenerative cervical cord compression (NMDCC) patients and of revealing any correlation with severity of disability in DCM. The study group consisted of 45 DCM patients (median age 58 years), 126 NMDCC subjects (59 years), and 100 healthy controls (HC) (55.5 years), all of whom performed a standardized 10-m walk and run test. Walking/running time/velocity, number of steps and cadence of walking/running were recorded; analysis disclosed abnormalities in 66.7% of NMDCC subjects. The DCM group exhibited significantly more pronounced abnormalities in all walk/run parameters when compared with the NMDCC group. These were apparent in 84.4% of the DCM group and correlated closely with disability as quantified by the modified Japanese Orthopaedic Association scale. A standardized 10-m walk/run test has the capacity to disclose locomotion abnormalities in NMDCC subjects who lack other clear myelopathic signs and may provide a means of classifying DCM patients according to their degree of disability.