Altered Gait Parameters Research Articles

Alterations In Gait Parameters During A Timed Ruck March Using A Single Inertial Measurement Unit

Alterations In Gait Parameters During A Timed Ruck March Using A Single Inertial Measurement Unit

Cognitive Load and Dual-Task Performance in Individuals with and without Forward Head Posture.

Background: Recent studies have found forward head posture (FHP) is associated with altered physiology. There is a lack of research into whether FHP is associated with altered gait parameters when cognitively challenged. Our hypothesis is that individuals with FHP and those without will demonstrate different responses when undergoing dual-task assessment. Methods: Forty-five asymptomatic participants with FHP, defined as a craniovertebral angle (CVA) < 50°, were matched to forty-five participants with normal head posture (NHP) with a CVA > 55°. Participants walked along a 10 m platform under a control condition (no cognitive load) while an optical motion-capture system assessed gait kinematics. Secondly, participants were assessed under a dual-task cognitive load condition to identify the impact on gait kinematics. Results: Under the single-task condition, there were no significant differences for any gait parameter. In the dual-task condition, 12/13 gait parameters were significantly altered for the FHP vs. NHP group (p < 0.01). A calculation of the dual-task cost (DTC) percentage showed significant increases in all gait parameters in participants with FHP (p < 0.02). Correlations between the CVA and gait parameters were not significant for the single-task condition, but all gait parameters were correlated to CVA for the dual-task condition (p < 0.01). The correlation between CVA and DTC for all gait variables was significant (p < 0.04). Conclusions: This study demonstrates that FHP significantly increases the cognitive cost during walking, highlighting the importance of proper postural alignment for maintaining cognitive function under a dual-task condition.

1103 Gait Analysis Using Wearables and AI in Predicting Peripheral Arterial Disease: A Systematic Review

Abstract Introduction Peripheral arterial disease (PAD) affects over 230 million people globally. The trajectory of this disease process can culminate in major amputation. These patients demonstrate statistically significant changes in gait including changes in stride length, plantarflexion and other spatiotemporal parameters. Aim To determine if alterations in gait parameters can be detected and measured accurately by wearables and AI in PAD patients and if these measurements are predictive of PAD progression. Method A systematic review was performed in line with PRISMA guidelines. MEDLINE, Embase, Web of Science and Scopus were used for database searches. A combination of medical subject headings (MeSH) regarding ‘PAD’, ‘gait’, ‘kinetics’, ‘biomechanics’, ‘ambulation’, ‘artificial intelligence’, ‘sensors’ and ‘smartphone data’ were employed in the primary search string. Screening, full text reviews and data extraction was conducted by 2 reviewers using Covidence. Bias was assessed using the Newcastle-Ottawa scale. Results 4719 studies were identified. 3873 were screened after de-duplication. 5 studies were included in the final review. The main methods of gait measurements included smartphones (iPhone and Samsung Galaxy), wearable sensors and motion sensor technology. Gait initiation parameters were sensitive in detecting gait impairment. iPhone pedometer demonstrated accuracy measuring steps comparable to reference Actigraph but was inaccurate measuring distance. Machine learning models including Random Forest algorithms and extreme gradient boosting, detected PAD patients with 89% and 92% accuracy respectively. Conclusions Wearables and AI algorithms can detect gait changes and differentiate PAD from non-PAD gait. All studies showed detective capability, however none demonstrated predictability of PAD. Limitations include accuracy and validation of measurement methods.

Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study

Purpose of the Study: This research investigates postoperative gait alterations in individuals aged 50 and above who underwent total knee arthroplasty (TKA) at least one year ago. The study aims to fill existing gaps in literature by comprehensively assessing various gait parameters and understanding the persistent changes in mobility following TKA. Materials and Methods: Conducted as an observational study, 30 TKA subjects were assessed using Kinovea software for gait parameters, including cadence, speed, step length, step width, stride length, and knee flexion angle. Statistical analysis with MS Excel compared obtained values with established norms. Results: Significant gait parameter alterations were observed in post-TKA subjects. These changes include decreased cadence, walking speed, step length, and stride length, along with variations in knee flexion angle. Approximately 36.67% of participants exhibited alterations in these parameters, highlighting the need for further understanding of mobility challenges post-TKA. Conclusion: This study contributes vital insights into the persistent impact of TKA on gait parameters, emphasizing the complexity of postoperative mobility changes. The observed alterations highlight the importance of tailored rehabilitation programs to enhance functional independence and address long-term gait concerns in this patient population.

Interpretable machine learning comprehensive human gait deterioration analysis.

Gait analysis, an expanding research area, employs non-invasive sensors and machine learning techniques for a range of applications. In this study, we investigate the impact of cognitive decline conditions on gait performance, drawing connections between gait deterioration in Parkinson's Disease (PD) and healthy individuals dual tasking. We employ Explainable Artificial Intelligence (XAI) specifically Layer-Wise Relevance Propagation (LRP), in conjunction with Convolutional Neural Networks (CNN) to interpret the intricate patterns in gait dynamics influenced by cognitive loads. We achieved classification accuracies of 98% F1 scores for PD dataset and 95.5% F1 scores for the combined PD dataset. Furthermore, we explore the significance of cognitive load in healthy gait analysis, resulting in robust classification accuracies of 90% ± 10% F1 scores for subject cognitive load verification. Our findings reveal significant alterations in gait parameters under cognitive decline conditions, highlighting the distinctive patterns associated with PD-related gait impairment and those induced by multitasking in healthy subjects. Through advanced XAI techniques (LRP), we decipher the underlying features contributing to gait changes, providing insights into specific aspects affected by cognitive decline. Our study establishes a novel perspective on gait analysis, demonstrating the applicability of XAI in elucidating the shared characteristics of gait disturbances in PD and dual-task scenarios in healthy individuals. The interpretability offered by XAI enhances our ability to discern subtle variations in gait patterns, contributing to a more nuanced comprehension of the factors influencing gait dynamics in PD and dual-task conditions, emphasizing the role of XAI in unraveling the intricacies of gait control.

Altered gait parameters in distracted walking: a bio-evolutionary and prognostic health perspective on passive listening and active responding during cell phone use.

The underpinnings of bipedal gait are reviewed from an evolutionary biology and prognostic health perspective to better understand issues and concerns related to cell phone use during ambulation and under conditions of distraction and interference. We also consider gait-related health issues associated with the fear of or risk of falling and include prognostic dimensions associated with cognitive decline, dementia, and mortality. Data were acquired on 21 healthy young adults without hearing loss, vestibular, balance, otological or neurological dysfunction using a computerized walkway (GAITRite® Walkway System) combined with specialized software algorithms to extract gait parameters. Four experimental conditions and seven temporo-spatial gait parameters were studied: gait velocity, cadence, stride length, ambulatory time, single-support time, double-support time, and step count. Significant main effects were observed for ambulation time, velocity, stride velocity, and double-support time. The greatest impact of distraction and interference occurred during the texting condition, although other significant effects occurred when participants were verbally responding to queries and passively listening to a story. These experimental observations show that relatively simple distraction and interference tasks implemented through the auditory sensory modality can induce significant perturbations in gait while individuals were ambulating and using a cell phone. Herein, emphasis is placed on the use of quantifiable gait parameters in medical, psychological, and audiological examinations to serve as a foundation for identifying and potentially averting gait-related disturbances.

Gait and strength assessment following surgical repair by intramedullary nailing of isolated tibial shaft fracture.

The objective of the study was to evaluate the long-term strength and gait outcomes after intramedullary nailing of isolated tibial diaphyseal fractures. This retrospective cohort study was conducted at an academic Level I trauma center. Fifteen participants with isolated tibial diaphyseal fractures (OTA/AO 42) at least 2 years postoperative from intramedullary nailing (IMN) provided informed consent. The average age was 40 ± 14 (range, 24-69); there were nine men and six women. Knee flexion-extension strength data were collected. Temporal-spatial, kinematic, and kinetic gait parameters were measured and compared to historic control data. Participants completed the SF-36 and shortened musculoskeletal function assessment questionnaires. The mean length of follow-up between surgery and gait analysis was 6 ± 2 years. The fractured limb demonstrated deficits in quadriceps strength between 9.8% and 23.4% compared to the unaffected limb. Temporal-spatial parameters revealed slower walking speed, shorter stride length, decreased cadence, and shorter single-limb support time in the fractured limb. Altered kinematic and kinetic findings included a knee extension shift during stance, with an increased knee flexor moment demand and decreased total knee power during loading and midstance. These findings represent deficits in concentric and eccentric knee extensor activity. Additionally, the fractured limb demonstrated decreased ankle dorsiflexion during stance and diminished ankle push-off power. Long-term outcomes after IMN of tibial diaphyseal fractures demonstrate decreased quadriceps strength and altered gait parameters that may have implications to the high incidence of knee and ankle pain in the fractured limb.

Childhood obesity and its impact on the characteristics of gait stance phases: a cross-sectional study.

This study aimed to investigate the variations in foot type, laxity, dynamic characteristics of gait, and the characteristics of the stance phase of gait, in relation to body mass index (BMI) and groups of children of different ages. Additionally, it aimed to explore the correlations between BMI and these variables across children groups of different ages. A cross-sectional study was conducted involving 196 infants aged between 5 and 10years old. The variables assessed included BMI, foot type, laxity, dynamic variables, and characteristics of the stance phase of gait. Significant variations were observed in foot type, laxity, certain dynamic variables, and characteristics of the stance phase of gait between normoweight (NW) and overweight/obese (OW/OB) groups among children aged between 5 and 10years old (p ranged between 0.019 and 0.050). Moreover, BMI was also positively associated with the initial forefoot contact, heel off, total duration of the step, and forefoot contact phase of children 7 to 10years of age (p ranged between < 0.010 and 0.040). Conclusion:Children who are OW/OB had alterations at different stages of gait. Being OW/OB is related to alterations of the phases of gait mainly from 7 to 10years of age, and spending more time in each of the phases of walking. This could indicate that children who are OW/OB, in addition to walking slower, overload the musculoskeletal system, subjecting their joints and muscles to greater stress. What is Known: • Children who are overweight (OW) and obese (OB) can experience changes in their musculoskeletal systems, posture, and gait due to increased body mass index. • OW and OB children experience additional stress on their musculoskeletal systems, impacting posture, biomechanics, mobility, physical activity, and daily tasks. Excessive plantar loading is linked to foot pain in adults. What is New: • Body mass index was positively associated with initial forefoot contact, heel off, total duration of the step, and forefoot contact phase in children aged 7 to 10years old. OW/OB children aged 5-6 exhibited less ankle dorsiflexion and smaller relaxed calcaneal stance position (RCSP) as compared to normal-weight children. • Obese children aged 5-6 showed less pronation excursion, suggesting altered frontal plane movement due to RCSP differences. Children aged 7-8 who are OW/OB spent more time in certain gait phases, particularly in the forefoot contact phase. Being OW/OB is linked to altered gait parameters such as initial forefoot, heel off, total step duration, and forefoot contact phase. Being OW/OB was associated with a longer forefoot contact phase, particularly in the right foot.

Physiological measures and anatomical correlates of subthalamic deep brain stimulation effect on gait in Parkinson's disease

We examined whether conflicting visual and non-visual information leads to gait abnormalities and how the subthalamic deep brain stimulation (STN DBS) influences gait dysfunction in Parkinson's disease (PD). We used a motion capture system to measure the kinematics of the lower limbs during treadmill walking in immersive virtual reality. The visual information provided in the virtual reality paradigm was modulated to create a mismatch between the optic-flow velocity of the visual scene and the walking speed on the treadmill. In each mismatched condition, we calculated the step duration, step length, step phase, step height, and asymmetries. The key finding of our study was that mismatch between treadmill walking speed and the optic-flow velocity did not consistently alter gait parameters in PD. We also found that STN DBS improved the PD gait pattern by changing the stride length and step height. The effects on phase and left/right asymmetry were not statistically significant. The DBS parameters and location also determined its effects on gait. Statistical effects on stride length and step height were noted when the DBS volume of activated tissue (VTA) was in the dorsal aspect of the subthalamus. The statistically significant effects of STN DBS was present when VTA significantly overlapped with MR tractogrphically measured motor and pre-motor hyperdirect pathways. In summary, our results provide novel insight into ways for controlling walking behavior in PD using STN DBS.

The Effect of Load Carrying on Gait Kinetic and Kinematic Variables in Soldiers with Patellofemoral Pain Syndrome

Individuals suffering from patello-femoral pain syndrome (PFPS) exhibit altered gait parameters compared with healthy individuals. As soldiers carry heavy equipment, the extra load might further alter gait pattern. The aim of this study was to investigate the effect of load carrying on kinetic and kinematic variables in soldiers with PFPS compared with controls. The sample comprised 23 active-duty infantry soldiers (10 with bilateral/13 without bilateral PFPS, mean age: 20.4 (±0.5) years, height 179 (±5.8) cm, weight 76 (±6.9) kg). The participants walked barefoot on a 10 m walkway with and without loading equipment. The equipment added 50% to each participant’s body mass. Gait kinematic and kinetic variables were assessed by the VICON three-dimensional motion analysis system and two force plates. Weight carrying increased joint maximal angles, mean peak moments and double support and decreased single support and walk speed in both groups, without differences between groups (p &gt; 0.05). The only difference between groups was in the hip adduction angle without a load (p &lt; 0.05); no difference was observed while carrying the load. Kinematic and kinetic differences in gait were detected between weight and non-weight conditions, yet there was no effect of PFPS. Further studies with subjects performing different tasks are essential to examining the effect of PFPS and load among soldiers.

Abnormal vibration perception threshold alters the gait features in type 2 diabetes mellitus patients.

It is generally believed that gait characteristics of diabetic neuropathic patients differ from those of non-diabetic ones. However, it is still unclear how the abnormal foot sensation influences the gait during walking in type 2 diabetes mellitus (T2DM). For the purpose of gaining a better insight into the alterations of detailed gait parameters and figuring out important aspects in the gait indexes by peripheral neuropathy in elder T2DM patients, we compared the gait features in participants with normal glucose tolerance (NGT) controls and diabetic individuals complicated by peripheral neuropathy or not. Gait parameters were observed during the 10-m walk on flat land among different conditions of diabetes in 1,741 participants from three clinical centers. Subjects were divided into four groups: persons with NGT were taken as the control group; patients with T2DM included three subgroups: DM control (no chronic complications), DM-DPN (DM complicated by only peripheral neuropathy), and DM-DPN+LEAD (DM complicated by both neuropathy and artery disease). The clinical characteristics and gait parameters were assessed and compared among these four groups. Analyses of variance were employed to verify possible differences of gait parameters between groups and conditions. Stepwise multivariate regression analysis was performed to reveal possible predictors of gait deficits. Receiver operating characteristic (ROC) curve analysis was employed to find any discriminatory power of diabetic peripheral neuropathy (DPN) for the step time. In participants burdened with DPN, whether complicated by lower extremity arterial disease (LEAD) or not, step time increased sharply (p < 0.05). Stepwise multivariate regression models showed that independent variables of gait abnormality were sex, age, leg length, vibration perception threshold (VPT), and ankle-brachial index (ABI) (p < 0.01). Meanwhile, VPT was a significant independent predictor of step time, spatiotemporal variability (SDA), and temporal variability (SDB) (p < 0.05). ROC curve analysis was explored to find the discriminatory power of DPN for the occurrence of increased step time. The area under the curve (AUC) value was 0.608 (95% CI: 0.562-0.654, p < 0.01), and the cutoff point was 538.41 ms accompanied by a higher VPT. A significant positive association was observed between increased step time and the highest VPT group [odds ratio (OR) = 1.83, 95% CI: 1.32-2.55, p< 0.01]. In female patients, this OR value elevated to 2.16 (95% CI: 1.25-3.73, p< 0.01). In addition to sex, age, and leg length, VPT was a distinct factor that associated with altered gait parameters. DPN is associated with increased step time, and the step time increases with worsening VPT in type 2 diabetes.

Gait Variability is Related to Pain Interference in Children with Hypermobility Spectrum Disorder and Hypermobile Ehlers-Danlos Syndrome

<h3>Research Objectives</h3> To examine the relationship between variability of gait spatiotemporal parameters and pain interference in children with hypermobile spectrum disorder/hypermobile Ehlers-Danlos syndrome (HSD/hEDS). <h3>Design</h3> Cross-sectional, prospective study. <h3>Setting</h3> Movement Analysis for Biomedical Innovation and Technology (Mobility) Lab at the University of Wisconsin-Milwaukee, Milwaukee, WI. <h3>Participants</h3> Thirteen children with HSD/hEDS; 3 males, 10 females; 14.2 ± 2.9 years of age, body mass index: 22.0 ± 6.4 kg/m2. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Coefficient of variation (CV) was used to represent the variability of gait (CV = standard deviation (SD)/mean*100). The CV of step time, step length, gait speed, and cadence from five gait cycles were calculated. CV value greater than 3 SD from the mean was excluded from the analysis. The Brief Pain Inventory interference items related to daily activities (i.e., general activity, mobility, and going to school) were analyzed using a 0-10 scale where 0 is no interference and 10 is complete interference. Associations between gait variability and pain interference scores were analyzed using Pearson's correlation (r). <h3>Results</h3> The participants had CV of step time (n=12, 5.2 ± 9.5 CV%), step length (n=13, 5.5 ± 4.2 CV%), gait speed (n=13, 4.8 ± 2.5 CV%), and cadence (n=12, 5.7 ± 10.2 CV%). Brief Pain Inventory scores comprised general activity (2.5 ± 1.9), mobility (3.4 ± 2.0), and school (2.1 ± 2.8). Greater step length variability was moderately to strongly associated with greater pain interference with general activity (r=0.65, p=0.016), mobility (r=0.61, p=0.026), and going to school (r=0.78, p=0.003). <h3>Conclusions</h3> Increased gait variability was significantly correlated to pain interference during functional activities in children with HSD/hEDS. The variability may be due to altered muscle activation, disrupted proprioceptive feedback, and the instinct to protect from injury and provocative pain. Alterations in gait parameters and increased pain interference may reduce the quality of life. Future studies are needed to examine the mechanisms contributing to gait variability to guide patient-specific interventions for children with HSD/hEDS. <h3>Author(s) Disclosures</h3> The authors have no conflicts of interest to disclose.

Limited evidence of altered gait parameters in people with chronic nonspecific low back pain

BackgroundDifferences in gait parameters have been shown between people with and without low back pain (LBP). However, previous studies did not well control factors such as sex, age, height and walking speed known to influence gait parameters. Research questionIs gait altered in people with LBP when sex, age, height and walking speed are controlled? MethodsA series of gait parameters were measured in 16 participants with LBP and 16 age, sex and height matched healthy controls while walking on an instrumented treadmill. LBP group walked at a comfortable speed whilst control group walked at their own comfortable speed and at the comfortable speed of their matched participants with LBP. Pain and disability were measured for the LBP group. The between-group differences in mean, standard deviation (SD) and coefficient of variation (CV) of gait parameters were tested using paired samples t-test, Wilcoxon signed-rank test or two-factor repeated measures analyses of variance. ResultsThe median (interquartile range) of pain intensity was 2 (1, 3.5). From 102 tests of between-group difference in mean, SD and CV of 17 gait parameters at both comfortable speed and matched speed walking, only the mean of stride length (p = 0.037) during matched speed walking and SD of single support phase (p = 0.040) during comfortable speed walking showed significant between-group differences. There was no significant between-group difference in the rest means (comfortable walking: p ≥ 0.116; matched speed walking: p ≥ 0.069), SDs (comfortable walking: p ≥ 0.066; matched speed walking: p ≥ 0.098) and CVs of gait parameters (comfortable walking: p ≥ 0.110; matched speed walking: p ≥ 0.121). SignificanceThe lack of significant between-group difference in gait parameters may suggest that the gait of people with low level of LBP were not altered when sex, age and height were controlled.

Clinical assessments and gait analysis for patients with Trimalleolar fractures in the early postoperative period

BackgroundTrimalleolar fracture is a common ankle fracture with serious complications and costly healthcare problem. Most studies used clinical assessments to evaluate the functional status of the patients. Although clinical assessments are valid, they are static and subjective. Dynamic, objective and precise evaluations such as gait analysis are needed. Ankle biomechanics studies on gait in patients with trimalleolar fractures are still rare. This study aimed to investigate the clinical outcomes and gait biomechanics in patients with trimalleolar fractures in the early postoperative period and compared to healthy controls.MethodsThis was a cross-sectional study. 12 patients with trimalleolar fractures were recruited, and 12 healthy people served as controls. All patients underwent clinical assessments: Olerud and Molander ankle score (OMAS), ankle swelling and passive range of motion (ROM) of ankle, and completed gait biomechanical analysis when weight-bearing was allowed: temporal-spatial parameters, plantar pressure distributions, and surface electromyography (sEMG). The control group only performed gait test.ResultsPatients had poor outcomes of clinical assessments in the short-term. During gait analysis, patients presented compromised gait patterns: shorter step length, larger step width, slower walking speed and shorter single support compared to healthy controls (P < 0.001), and patients showed asymmetrical gait. Symmetry index of step width and walking speed were mainly correlated with the difference of ankle inversion ROM between two sides (R = -0.750, P = 0.005; R = -0.700, P = 0.011). During walking, patients showed abnormal dynamic plantar pressure features (mainly in the hindfoot and forefoot regions), and the IEMG (integrated electromyography) of tibial anterior muscle (TA) and peroneal longus muscle (PL) were larger than healthy controls (P = 0.002, 0.050).ConclusionsPatients with trimalleolar fractures showed physical impairments of the ankle, and presented altered gait parameters compared to healthy subjects in the short-term. The ankle stability of patients declined, and deficits in TA and PL muscle ability might contribute to it. Restoring complete muscle functions and improving passive ankle ROM are significant to promote the recovery of a normal gait pattern.

Association between quadriceps function, joint kinetics, and spatiotemporal gait parameters in young adults with and without obesity

BackgroundIndividuals with obesity have impaired gait and muscle function that may contribute to reduced mobility and increased fall risk. Research questions(1) what is the difference in spatiotemporal gait parameters and joint kinetics between individuals with and without obesity; (2) what is the association between spatiotemporal gait parameters, joint kinetics, and quadriceps function? MethodsForty-eight young adults with obesity (BMI = 33.0 ± 4.1 kg/m2) and 48 without obesity (BMI = 21.6 ± 1.7 kg/m2) completed assessments of quadriceps function (peak torque and early/late rate of torque development (RTD)) and walking biomechanics at self-selected speed. Spatiotemporal gait parameters (stance time, double support time, double support to stance ratio, step width, step length, cadence, and gait stability ratio (GSR)) and joint kinetics (total support moment, and relative contribution from extensor moments) were compared using one-way MANOVAs. Partial correlation examined the association between the total support moment and quadriceps function, and spatiotemporal gait parameters controlling for sex and speed. ResultsIndividuals with obesity walked with longer stance (p = 0.01), longer double-limb support (p < 0.001), wider steps (p < 0.001), lower cadence (p = 0.03), and a greater absolute (p < 0.001) but lesser normalized total support moment (p = 0.03) compared with adults without obesity. In those with obesity, greater PT was associated with less double limb support (p = 0.011) and smaller double support to stance ratio (p = 0.006); greater early RTD was associated with less double limb support (r = −0.455, p = 0.0021), less stance time (r = −0.384, p = 0.008), and a smaller double support to stance ratio (r = −0.371, p = 0.011). In those without obesity, a larger total support moment was associated with longer step length (r = 0.512, p < 0.001), lesser cadence (r = −0.497, p < 0.001), and smaller GSR (−0.460, p = 0.001). SignificanceIndividuals with obesity walk with altered spatiotemporal gait parameters and joint kinetics that may compromise stability. Extended periods of support may be a strategy used by individuals with obesity to increase stability during gait and accomodate insufficient quadriceps function.

Effects of Dynamic Suit Orthoses on the Spatio-Temporal Gait Parameters in Children with Cerebral Palsy: A Systematic Review.

Dynamic suit orthoses (DSO) are currently used as a complementary treatment method in children with Cerebral Palsy (cwCP). The aim of this review was to assess the effects of interventions with DSO on the altered spatio-temporal gait parameters (STGPs) in cwCP. An electronic search was conducted in the Web of Science, Scopus, PEDro, Cochrane Library, MEDLINE/PubMed, and CINAHL databases up to July 2021. We included a total of 12 studies, which showed great heterogeneity in terms of design type, sample size, and intervention performed (two employed a Therasuit, three employed the Adeli suit, three employed Theratogs, one employed elastomeric tissue dynamic orthosis, one employed a full-body suit, one employed external belt orthosis, and one employed dynamic orthosis composed of trousers and T-shirt). The Cochrane collaboration’s tool and the Checklist for Measuring Study Quality were used to assess the risk of bias and the methodological quality of the studies. It was variable according to the Checklist for Measuring Study Quality, and it oscillated between eight and 23. The studies of higher methodological quality showed significant post-intervention changes in walking speed (which is the most widely evaluated parameter), cadence, stride length, and step length symmetry. Although the evidence is limited, the intervention with DSO combined with a programme of training/physical therapy seems to have positive effects on the STGPs in cwCP, with the functional improvements that it entails. Despite the immediate effect after one session, a number of sessions between 18 and 60 is recommended to obtain optimum results. Future studies should measure all STGPs, and not only the main ones, such as gait speed, in order to draw more accurate conclusions on the functional improvement of gait after the use of this type of intervention.

Dual task gait deteriorates gait performance in cervical dystonia patients: a pilot study

Day-to-day walking-related activities frequently involve the simultaneous performance of two or more tasks (i.e., dual task). Dual task ability is influenced by higher order cognitive and cortical control mechanisms. Recently, it has been shown that the concomitant execution of an attention-demanding task affected postural control in subject with cervical dystonia (CD). However, no study has investigated whether dual tasking might deteriorate gait performance in CD patients. To investigate whether adding a concomitant motor and cognitive tasks could affect walking performance in CD subjects.17 CD patients and 19 healthy subjects (HS) participated in this pilot case–control study. Gait performance was evaluated during four walking tasks: usual, fast, cognitive dual task and obstacle negotiation. Spatiotemporal parameters, dual-task cost and coefficients of variability (CV%) were measured by GaitRite® and were used to detect differences between groups. Balance performance was also assessed with Mini-BEST and Four Step Square tests. In CD participants, correlation analysis was computed between gait parameters and clinical data. Significant differences in complex gait and balance performance were found between groups. CD patients showed lower speed, longer stance time and higher CV% and dual-task cost compared to HS. In CD, altered gait parameters correlated with balance performance and were not associated with clinical features of CD. Our findings suggest that complex walking performance is impaired in patients with CD and that balance and gait deficits might be related

Localized chondro-ossification underlies joint dysfunction and motor deficits in the Fkbp10 mouse model of osteogenesis imperfecta

Osteogenesis imperfecta (OI) is a genetic disorder that features wide-ranging defects in both skeletal and nonskeletal tissues. Previously, we and others reported that loss-of-function mutations in FK506 Binding Protein 10 (FKBP10) lead to skeletal deformities in conjunction with joint contractures. However, the pathogenic mechanisms underlying joint dysfunction in OI are poorly understood. In this study, we have generated a mouse model in which Fkbp10 is conditionally deleted in tendons and ligaments. Fkbp10 removal substantially reduced telopeptide lysyl hydroxylation of type I procollagen and collagen cross-linking in tendons. These biochemical alterations resulting from Fkbp10 ablation were associated with a site-specific induction of fibrosis, inflammation, and ectopic chondrogenesis followed by joint deformities in postnatal mice. We found that the ectopic chondrogenesis coincided with enhanced Gli1 expression, indicating dysregulated Hedgehog (Hh) signaling. Importantly, genetic inhibition of the Hh pathway attenuated ectopic chondrogenesis and joint deformities in Fkbp10 mutants. Furthermore, Hh inhibition restored alterations in gait parameters caused by Fkbp10 loss. Taken together, we identified a previously unappreciated role of Fkbp10 in tendons and ligaments and pathogenic mechanisms driving OI joint dysfunction.

141 Locomotion pattern analysis using digital video labeling by machine learning

The assessment of lameness has long relied on the expertise of a human observer. Innovations in technology have provided new options to objectively detect lameness, but most systems involve equipment attached to the horse, potentially causing changes in their normal locomotion patterns. One such tool, the Lameness Locator, analyzes motion data recorded by accelerometers mounted to the horse with bandages, stickers or hats. Tactile sensors in horse skin across the body can detect pressures as small as 0.008g, which is comparable to the sensitivity of a human fingertip. Thus, the weight and instability of even very small accelerometers may cause variation in the way horses move when being tested for lameness. In this study, we used a software package to digitally label videos of individual horses with and without the Lameness Locator applied. Unlike current methods of detection, this software can be used in the natural environment without attaching equipment to the animal. Thus, we hypothesize that the digital video analysis approach will objectively identify shifts in locomotion patterns due to the pressure from the Lameness Locator device. All horses were video recorded at 120fps and a resolution of 1280 × 720p on a standard path while handled in halter at the walk, trot and canter for both the left and right-side views. The DeepLabCut software package was used to extract coordinates for 23 skeletal landmarks as they proceed across the frame. Quantitative gait parameters such as stride length, stance time, and vertical travel of the withers were derived from the landmark tracking data by a robust data processing pipeline. The pipeline comprises a series of operations, including outlier removal due to occlusion, trajectory smoothing, model-fitting-based phase identification, and gait parameters calculation. In this preliminary analysis we considered the stride length, stance time, and the range of travel for the poll, withers and croup at the trot; key metrics traditionally used to assess lameness. Comparing these gait variables within each horse, we found that the right-to-left normalized stride length, stance time, and normalized withers range were all significantly different for each horse between the unencumbered and Lameness Locator equipped trot passes ( P < 0.01, ANOVA JMPv15, SAS Institute). On-going work is expanding this study in a larger sampling of horses, but these preliminary findings suggest that asymmetrically applied equipment does alter gait parameters. We also demonstrate the utility and feasibility of the digital video analysis approach and enable applications in many different scenarios within the horse world.

Effect of Body Weight Support Treadmill Training on Gait Speed in Acute Stroke Rehabilitation -A Quasi Experimental Study

Background: Stroke is a global health problem. The most common manifestation of stroke are gaitabnormalities along with other neuromusculor impairments. Around 60% of stroke survivors will be limitedin community ambulation, walking after stroke is characterized by altered gait parameters and reduction inthe gait speed, it changes the quality and adaptability of walking pattern, for the optimal ambulation needto restore the gait speed along with other gait parameter, Through the elimination of deterrents like bodyweight and other neuromusculor impairments will effectively helps to restore the gait parameters along withits speed. So, use of body weight support treadmill in gait training is effective in restoration of gait speedin acute stroke rehabilitation, in addition it is feasible and safe. Objective: To evaluate the effect of bodyweight supported treadmill training by using 10 meter walk test on gait speed in acute stroke subjects.Methodology: A Quasi experimental study, A total of 25 stroke patients were screened and only 20 wererecruited who are willing to be in the study and they were randomly allocated into two groups. In GroupA (n=10) subjects were received body weight supported treadmill training along with routine individualphysiotherapy , where in Group B (n=10) subjects were received routine individual physiotherapy only,10 meter walk test measured as outcome. Analysis: Statistical analysis was performed using the JASPversion 0.12.2, Paired t test for within group and Unpaired t test for between groups comparison. Results:Statistically significant difference was found between pre and post measures of gait speed in the controland study groups with greater improvement in the study group. Conclusion: adding body weight supporttreadmill training in acute stroke rehabilitation is effective in improvement of gait speed in acute strokerehabilitation, in addition it is feasible and safe.