Abstract
The detection of gait abnormalities is essential for professionals involved in the rehabilitation of walking disorders. Instrumented treadmills are spreading as an alternative to overground gait analysis. To date, the use of these instruments for recording kinematic gait parameters is still limited in clinical practice due to the lack of validation studies. This study aims to investigate the performance of a multi-sensor instrumented treadmill (i.e., WalkerViewTM, WV) for performing gait analysis. Seventeen participants performed a single gait test on the WV at three different speeds (i.e., 3 km/h, 5 km/h, and 6.6 km/h). In each trial, spatiotemporal and kinematic parameters were recorded simultaneously by the WV and by a motion capture system used as the reference. Intraclass correlation coefficient (ICC) of spatiotemporal parameters showed fair to excellent agreement at the three walking speeds for steps time, cadence, and step length (range 0.502–0.996); weaker levels of agreement were found for stance and swing time at all the tested walking speeds. Bland–Altman analysis of spatiotemporal parameters showed a mean of difference (MOD) maximum value of 0.04 s for swing/stance time and WV underestimation of 2.16 cm for step length. As for kinematic variables, ICC showed fair to excellent agreement (ICC > 0.5) for total range of motion (ROM) of hip at 3 km/h (range 0.579–0.735); weaker levels of ICC were found at 5 km/h and 6.6 km/h (range 0.219–0.447). ICC values of total knee ROM showed poor levels of agreement at all the tested walking speeds. Bland–Altman analysis of hip ROM revealed a higher MOD value at higher speeds up to 3.91°; the MOD values of the knee ROM were always higher than 7.67° with a 60° mean value of ROM. We demonstrated that the WV is a valid tool for analyzing the spatiotemporal parameters of walking and assessing the hip’s total ROM. Knee total ROM and all kinematic peak values should be carefully evaluated, having shown lower levels of agreement.
Highlights
Walking represents the primary locomotion modality of the human being
The results demonstrated a Pearson’s coefficient ranging from moderate to very strong levels when spatiotemporal parameters retrieved by the WV were compared against the reference values, as well as mean of difference (MOD) values of gait phases up to 0.04 s
The findings of the present study demonstrated that the WV could be used in clinical practice to achieve a rapid and accurate assessment of the mean step time, cadence, and step length, while for swing and stance phases the accuracy is low
Summary
Walking represents the primary locomotion modality of the human being Different pathologies, both musculoskeletal or neurological, may alter this function, causing a restriction of autonomy and participation in everyday life [1,2]. Being a rather complex function, walking disorders present multiple alterations of gait parameters (i.e., spatiotemporal, kinematic, and kinetic) [3]. Detecting these abnormalities is pivotal for professionals involved in the rehabilitation of walking disorders to set up an appropriate treatment plan and perform a successful rehabilitation program. The literature emphasizes the need to use valid outcome measures to assess walking and offers therapists the ability to monitor the progress of their work in correcting gait alterations [9]. The most common methods for analyzing gait in clinical practice are based on visual observation and questionnaires [9,11,12], which is already demonstrated to be inefficient and poorly reliable [13,14,15]
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