Angle Gait Research Articles

Dynamic and static footprints: comparative calculations for angle and base of gait

Information derived from footprint data serves as a useful, reliable and objective component to the assessment of patients with musculoskeletal pathology. Common spatial parameters extrapolated from such data include the angle and base of gait. Previous research has described a reliable method for analysing dynamic footprint data. While this data remains fundamental, few studies, if any have documented the comparisons of dynamic and static footprints. The purpose of this study was to ascertain the differences between the angle and base of gait from dynamic and static footprint data. Twenty-five subjects provided three dynamic (mid-gait analysis) and three static footprints. Intra-rater reliability of the measurement technique for both the angle and base of gait was found to be excellent ( p > 0.001) for each of the two conditions (dynamic and static). Comparisons between the dynamic and static condition revealed no significant differences ( p < 0.0001) for the angle of gait, whilst significant differences were noted between the static and dynamic condition for the base of gait. Further analysis using linear regression identified that the angle of gait for the left and right foot predicted a 67 and 60% of that of a dynamic situation; a slightly lower prediction of 54% was noted for base of gait. These results suggest that static footprints do demonstrate some prediction of dynamic function when assessing the angle and base of gait in normal subjects.

Angle of gait: a comparative reliability study using footprints and the EMED-SF ®

Background: Gait analysis using footprint impressions is a simple and inexpensive method of obtaining valuable information relating to foot dynamics. Objectives: To assess the reliability and comparability of two different measurement techniques to quantify angle of gait (AOG). Method: Part 1. Two observers measured angle of gait (AOG), in six asymptomatic adult subjects, three times at weekly intervals. Part 2. A comparison of AOG from powdered footprints, and foot progression angle (FPA), the equivalent to AOG, derived from the EMED-SF ® force platform were simultaneously compared using 11 asymptomatic adult subjects. Results: A Pearson’s product moment correlation of 0.94 for rater 1 and 0.93 for rater 2 was observed between trials 1 and 2. Between trials 2 and 3, a Pearson’s product moment correlation of 0.95 was observed for rater 1 and rater 2. The mean difference was 0.26 (CI: −0.06, 0.57), indicating no significant difference ( t = −1.63, P = 0.108). A Pearson’s product moment correlation of 0.98 for AOG from powdered footprints and FPA from EMED-SF ® was observed with a mean difference of 0.03 (CI: −0.54, 0.59), indicating no significant difference ( t = 0.09, P = 0.93). Assessment of agreement using the Bland and Altman statistical model reflected moderate differences between raters and techniques of measuring AOG. Conclusions: Calculation of AOG from powdered footprints is a reliable and repeatable method, also demonstrating comparability to the FPA derived from the EMED-SF ® platform.

Femoral Varus Derotation Osteotomy in Management of Perthes’ Disease

This is a prospective study done on 27 hips in 25 patients presented with Perthes’ disease between December 1999 and August 2002. Fourteen hips were treated operatively by mean of upper femoral osteotomy (group A), and the other remaining 13 hips were treated conservatively by mean of Scottish Rite abduction brace (group B). All hips were classified preoperatively as Catterall group III and IV, furthermore, two or more “head at risk signs” were seen in all hips with particular emphasis placed on lateral uncovering of the femoral head. Of the 25 patients, 20 (80%) were boys and 5 (20%) were girls, the left side was affected in 18 hips (66.7%), while the right side was involved in 9 hips (33.3%), two patients had bilateral involvement and were encountered in group A. The average time between onset of symptoms and time of treatment for group A and groups B was 9 months and 8.5 months respectively, while the mean duration of follow up was 2.2 years and 1.8 years respectively. It was concluded that group A showed better results than B regarding hip pain (100% vs 15.4%), hip motion (85.7% vs 7.6%), gait (28.5% vs 7.6%), limb-length discrepancies (93.6% vs 30.7%) and centre-edge angle (100% vs 15.4%). Femoral varus derotation osteotomy was found to be the treatment of choice for containment of Perthes’ disease with Catterall group III and IV. Both age and sex at the time of the treatment, influences the final outcome, however, longer period of follow-up may allow better final evaluation.

Footprints, Trackways, and Hip Heights of Bipedal Dinosaurs—Testing Hip Height Predictions with Computer Models

Three-dimensional, dynamic, computer models of the pelvis and hind limbs of theropods and ornithopods are used to produce synthetic trackways using a range of gait angles and degrees of limb joint flexion. The hip heights of the modeled stances are compared with the predictions of hip heights computed with various formulae that incorporate parameters measured from footprints and trackways. The tested formulae include: 4*footprint-length and other morphometric methods where the coefficients vary according to the size and taxonomic group of the inferred trackmaker, allometric methods with size and taxon specific coefficients and exponents, and pace-length divided by 0.6. The best fit (least difference) between model and predicted hip heights is achieved with the simple 4*footprint-length formula. The pace-length formula also works well, but only for a very narrow gait range. With one exception, a small theropod, the variable morphometric and allometric formulae consistently overestimate the hip heights in all case. For large theropods and ornithopods the overestimates can be up to 84% in extreme cases. There was also a trend for the magnitudes of overestimation to increase with increasing size of the trackmaker. The overestimates of hip height using these methods results in underestimation of the computed velocities attributed to the dinosaurs that made the trackways.

The dose–response effects of repeated subacute sarin exposure on guinea pigs

The present study assessed the effects of repeated subacute exposure to the organophosphorous nerve agent, sarin. Guinea pigs were injected five times per week (Monday–Friday) for 2 weeks with fractions of the established LD 50 dose of sarin (42 μg/kg sc). The animals were assessed for the development of cortical EEG seizures. Changes in body weight, red blood cell (RBC) acetylcholinesterase (AChE) levels and neurobehavioral reactions to a functional observational battery were monitored over the 2 weeks of sarin exposure and for an extended postinjection period. There were dose-related changes in body weight and RBC AChE levels. No guinea pigs receiving 0.3, 0.4 or 0.5×LD 50 of sarin showed signs of cortical EEG seizures despite decreases in RBC AChE levels to as low as 10% of baseline. Seizures were evident in animals receiving 0.6×LD 50 of sarin as early as the second day, and subsequent injections led to incapacitation and death. Animals receiving 0.5×LD 50 sarin showed obvious signs of cholinergic toxicity, which included a significant increase in their angle of gait. Overall, 2/13 animals receiving 0.5×LD 50 sarin died before all 10 injections were given. By the 10th day of injections, the animals receiving saline were significantly easier to remove from their cages and handle as compared to the first day of injections. They were also significantly less responsive to an approaching pencil and touch on the rump in comparison to the first day of testing. In contrast, the animals receiving 0.4×LD 50 sarin failed to show any significant reductions in their responses to an approaching pencil and a touch on the rump as compared to the first day. The 0.5×LD 50 sarin animals failed to show any significant changes to the approach response and touch response and did not adjust to handling or cage removal from the first day of injections to the last day of handling. In summary, the guinea pigs receiving the 0.4×LD 50 and 0.5×LD 50 doses of sarin failed to habituate to some aspects of the functional observational battery testing.

Validating the process of taking lateral foot x-rays.

This study validates the concept that a standard (static) weightbearing lateral x-ray, taken with an orthoposer device, in the patient's angle and base of gait is clinically similar to findings seen during ambulatory (dynamic) gait. Sixty female subjects requiring diagnostic x-rays underwent videofluoroscopy of their walking gait. Using a single-frame, shuttle-advance video recorder, the appropriate fluoroscopic video frame was identified. The calcaneal pitch angle was measured using a digitized program. A high repeatability of the measuring process and high correlation between x-ray and fluoroscopic results suggest the value of taking weightbearing angle and base of gait lateral x-rays.

Is in-toeing gait a developmental stage?

Very little literature has examined the symmetry of left and right foot progression angles. The lack of standardization between gait angle measurement techniques also make reliable comparison of different gait angle studies difficult. This study examined foot progression angles in random samples of children (aged 3, 6 and 9 years) and adults, to establish if in-toeing is a developmental stage in children. The incidence of in-toeing in this study indicates that an adducted gait is still fairly prevalent in 6- year-olds, but somewhere between the ages of 6 and 9 years in-toeing seems to resolve. It is likely that some degree of in-toeing can be considered as a developmental stage in young children under the age of 9. From age 9 onwards it reduces, showing less prevalence in older children and adults.

The measurement of gait parameters from footprints

Footprints are commonly utilized to quantify spatial parameters of gait to establish normative data for the purpose of research and to assist in the recognition of abnormal function. Investigation into the analysis of footprints revealed discrepancies in measurement technique and a lack of precise landmark definitions. The purpose of this paper is to outline the inception of reference points and measurement technique when using footprints as a tool for the calculation of base and angle gait and step and stride length. It is anticipated that researchers using footprints to measure spatial parameters of gait will gain step by step guidance from this report. Greater consistency of techniques would enable more valid comparison of results.

Relationship between selected static an dynamic lower extremity measures

Twenty-four non-symptomatic subjects were recruited for this study. They were evaluated for foot-type and selected static parameters to determine their influence on kinematic and kinetic variables measured during barefoot overground walking. Foot-type and lower extremity characteristics were examined through the measurement of arch index, range of motion measurements of the ankle, subtalar, first metatarsal and hip joints, and the measurement of the orientation of the calcaneus and tibia. Measurements collected during the support phase of the gait cycle included kinetic measures via a force platform, kinematic measures of the knee joint using a three-dimensional electrogoniometer and kinematic measures of the rearfoot angle using a high speed motion camera. Angle of gait and step parameters were also measured utilizing an inked paper track system. Using the static evaluation measures to predict dynamic gait resulted in significant canonical correlations between first ray mobility and rotational values at the knee, first ray mobility and anteroposterior ground reaction force variables, and static hip internal-external rotation with varus-vaigus motion at the knee. The results suggest that static lower extremity measures have limited value in predicting dynamic lower extremity function to any great degree.

Neonatal metatarsus adductus, joint mobility, axis and rotation of the lower extremity in preterm and term children 0-5 years of age.

A total of 484 premature children and a control group of 114 healthy term children underwent orthopaedic follow-up from birth to 5 years of age. At birth, metatarsus adductus was found to be more frequent in twins than in single infants (41% vs 16%; P less than 0.01), but occurred with equal frequency in single preterm and term infants (16% vs 12%). By 5 years of age, metatarsus adductus had resolved in all the term but only in 81% of the preterm children (P less than 0.05). In the preterm and term groups, knee axis (mean intermalleolar distance 22.0 mm vs 20.1 mm), tibial torsion (mean angle -1.2 degrees vs + 0.6 degrees) and angle of gait (mean angle + 1.5 degrees vs + 0.7 degrees) at 5 years were statistically insignificant. Hip function at 5 years was similar in normal preterm and term children but significantly decreased in preterm children with cerebral palsy, more so with regard to abduction (56 degrees vs 39 degrees, P less than 0.05) and extension (22 degrees vs 8 degrees, P less than 0.01). The difference between the sexes was insignificant in both the preterm and term groups.

NEONATAL METATARSUS ADDUCTUS, JOINT MOBILITY, AXIS AND ROTATION OF THE LOWER EXTREMITY IN TERM AND PRETERM BORN CHILDREN AT 5 YEARS OF AGE

To compare the development of attitude and joint mobility of the lower extremity in 111 normal term born(TB) with that of 128 preterm born(PTB) children, orthopedic examinations were carried out at birth and the age of 5 years. 21/128 (16%) PTB children had cerebral palsy(CP) requiring physiotherapy for 6 to 24 months (m= 12.5, 1SD=5.1). At birth, the incidence of metatarsus adductus(MA) was identical in single born TB and PTB infants(12% vs 16%), but higher in twins compared to single born infants(41%vs 16%, p<.05). At 5 years, MA had resolved in all TB but only in 83% of the PTB children. In the PTB group, incomplete resolution of neonatal MA occurred in 5/7(71%) children with CP compared with 2/18 (11%) without CP [p<.05]. Passive joint mobility did not differ between the groups except abduction (56 vs 45°) and extension(22 vs 9°) of the hip which were both smaller in the PTB group [p<.01]. When PTB children with CP were excluded from analysis, abduction and extension of the hip were identical in TB and PTB children. Median gait angle, tibia torsion and genu valgum were comparable in both groups.In conclusion, neonatal MA is more frequent in twins because of intrauterine space constraint. At 5 years, incomplete resolution of MA and impaired hip mobility are more likely to be the expression of neurological impairment than of prematurity.

The Effectiveness of Shoe Modifications for Intoeing

Shoe wedges have no immediate clinically significant effect on the angle of gait in children. The circular Torqheel was found to be more effetive, but still corrected only a quarter of the apparent rotatory deformity during gait.

A device to influence the angle of gait.

A device to influence the angle of gait.

The angle of gait in women

The angle of gait in women