Assessment Of Gait Parameters Research Articles

Different types of mastoid vibrations affect the amount and structure of minimum toe clearance variability differently

BackgroundThe majority of research primarily examines the role of the vestibular system in regulating balance by assessing gait parameters in the transverse plane while neglecting those in the sagittal plane. The present study aimed to examine the impact of various forms of mastoid vibration (MV) on minimum toe clearance (MTC) and its pattern of variability. This study proposed two hypotheses: 1) the application of MV reduced the MTC, and 2) the application of different forms of MV influenced the amount and structure of MTC variability. MethodsA total of twenty young adults participated in this study. A high-resolution motion capture system with eight cameras captured the minimum toe clearance. Three locomotor tasks were randomly assigned to these young participants: 1) walking normally on the treadmill, 2) walking with unilateral MV, and 3) walking with bilateral MV. The dependent variables were the mean of MTC, the amount, and the structure of MTC variability. The amount of MTC variability was calculated by the coefficient of variation represented, and the structure of MTC variability was measured using a sample entropy measure for a total of 200 MTCs. ResultsApplying unilateral and bilateral MV decreased the MTC significantly (-1.6 %, p = 0.038; −4.3 %, p < 0.001) compared to normal walking. Also, applying unilateral MV increased the amount (11.8 %, p = 0.001) and structure of MTC variability (14.3 %, p < 0.001) compared to normal walking. However, applying bilateral MV decreased the amount (-8.8 %, p = 0.001) and structure of MTC variability (-9.0 %, p < 0.001) compared to regular walking. ConclusionAlthough the statistical differences in MTC and MTC variability were observed in the present study, the mean differences among the different MV conditions were relatively small, thereby requiring meticulous deliberation when extrapolating the results when implementing this MTC in the pathological cohort.

Walking representation and simulation based on multi-source image fusion and multi-agent reinforcement learning for gait rehabilitation

In the formulation of strategies for walking rehabilitation, achieving precise identification of the current state and making rational predictions about the future state are crucial but often unrealized. To tackle this challenge, our study introduces a unified framework that integrates a novel 3D walking motion capture method using multi-source image fusion and a walking rehabilitation simulation approach based on multi-agent reinforcement learning. We found that, (i) the proposal achieved an accurate 3D walking motion capture and outperforms other advanced methods. Experimental evidence indicates that, compared to similar visual skeleton tracking methods, the proposed approach yields results with higher Pearson correlation (r=0.93), intra-class correlation coefficient (ICC(2,1)=0.91), and narrower confidence intervals ([0.90,0.95] for r, [0.88,0.94] for ICC(2,1)) when compared to standard results. The outcomes of the proposed approach also exhibit commendable correlation and concurrence with those obtained through the IMU-based skeleton tracking method in the assessment of gait parameters ([0.85,0.89] for r, [0.75,0.81] for ICC(2,1)); (ii) multi-agent reinforcement learning has the potential to be used to solve the simulation task of gait rehabilitation. In mimicry experiment, our proposed simulation method for gait rehabilitation not only enables the intelligent agent to converge from the initial state to the target state, but also observes evolutionary patterns similar to those observed in clinical practice through motor state resolution. This study offers valuable contributions to walking rehabilitation, enabling precise assessment and simulation-based interventions, with potential implications for clinical practice and patient outcomes.

Gait Parameters Change can be an Early Marker of Cognitive Impairment.

Gait impairment leads to increased dependence, morbidity, institutionalization, and mortality in older people. We intended to assess gait parameters with the continuum of cognitive impairment and observe variation with the severity of cognitive impairment. This cross-sectional, observational study was conducted at the memory clinic of a tertiary care center. One hundred and twelve subjects were recruited, and cognition was assessed by the Clinical Dementia Rating scale. Usual gait was assessed by a 6-m walk test, and the dynamic gait was assessed using Biodex Gait Trainer™. Apart from crude analysis, adjusted linear regression was used to find the association of spatiotemporal gait parameters with cognitive decline. Subjects were divided into subjective cognitive decline (SCD; n = 38), mild cognitive impairment (MCI; n = 40), and major neurocognitive disorder (MNCD; n = 34) groups. History of falls (23.7% vs. 30.0% vs. 67.7%, P < 0.001) and impaired activities of daily living (ADLs) (5.3% vs. 15.0% vs. 100%, P < 0.001) were significantly higher with cognitive decline. Age- and gender-adjusted regression analysis revealed that usual gait speed (0.8 vs. 0.6 vs. 0.5, P < 0.001) (m/s), total time (3.9 vs. 2.9 vs. 2.6, P = 0.022) (min), total distance (65.6 vs. 55.8 vs. 46.6, P = 0.025) (m), step cycle time (0.6 vs. 0.8 vs. 0.8, P = 0.020) (cycles/s), and step lengths were significant. Gait speed and other parameters worsened with increasing cognitive impairment. Changes in gait parameters might be a useful marker of declining cognition, though a long-term follow-up study is required to establish this association. Early intervention could be beneficial in preserving autonomy in patients with cognitive impairment.

Objective Assessment of Equine Locomotor Symmetry Using an Inertial Sensor System and Artificial Intelligence: A Comparative Study.

In horses, quantitative assessment of gait parameters, as with the use of inertial measurement units (IMUs) systems, might help in the decision-making process. However, it requires financial investment, is time-consuming, and lacks accuracy if displaced. An innovative artificial intelligence marker-less motion tracking system (AI-MTS) may overcome these limitations in the field. Our aim was to compare the level of agreement and accuracy between both systems and visual clinical assessment. Twenty horses underwent locomotion analysis by visual assessment, IMUs, and AI-MTS systems, under the following conditions: straight hard (SH), straight soft (SS), left and right circle hard (LCH, RCH), and soft (LCS, RCS). A greater number of horses were considered sound by clinical examination, compared to those identified as symmetric by the two gait analysis systems. More limbs were considered asymmetric by the AI-MTS compared to IMUs, suggesting its greater sensitivity. The greatest agreement between the two systems was found for the difference between two minima in vertical head position in SH, while the lowest for the difference between two minima in vertical pelvis position in SS, reflecting the difficulties in assessing asymmetry of the hindlimbs. It is unknown what degree of asymmetry is clinically relevant, suggesting that more consistent use in training horses may help determine the thresholds for asymmetry. Some degree of asymmetry may be clinically relevant, suggesting its regular use in training horses.

Gait Analysis in Patients with Symptomatic Pes Planovalgus Following Subtalar Arthroereisis with the Talus Screw.

Pes planovalgus is one of the most common pediatric skeletal deformities. There have been no studies to analyze in detail the spatiotemporal variables of gait following arthroereisis. The purpose of our study was to assess gait parameters in patients with symptomatic flexible flatfoot following treatment with the talus screw. This was a prospective study assessing the 22 patients treated surgically due to symptomatic flexible flatfoot with the talus screw. Patients underwent gait assessment with a G-Sensor. We analyzed the following gait parameters: gait cycle duration, step length, support phase duration, swing phase duration, double support duration, single support duration, cadence, velocity, step length. The post-operative gait parameter assessment for the operated and non-operated foot showed a significant difference only in terms of step length. Cadence increased from the pre-operative mean of 82.29 steps/min to a post-operative mean of 102.94 steps/min. Gait velocity increased significantly from 0.81m/s before to 0.96m/s after surgery. Arthroereisis with the talus screw helps improve gait parameters following surgery. Post-operatively, we observed increased gait velocity and cadence and decreased gait cycle duration in the operated limb. Short-term biomechanical outcomes of pes planovalgus treatment with the talus screw are good.

GAIT PARAMETERS IN OLDER BREAST CANCER SURVIVORS WITH PERSISTENT CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY

Abstract Chemotherapy-induced peripheral neuropathy (CIPN) results from chemotherapy for breast cancer treatment. CIPN symptoms persist causing significant loss of functional abilities and increased risk of falls. This study aimed to assess the spatiotemporal gait parameters in breast cancer survivors with CIPIN using an IMU system. We hypothesized that spatiotemporal gait parameters will differ between patients with persistent CIPN as compared to normative values. Thirty-two women who completed taxane-based chemotherapy for breast cancer and who have symptomatic neuropathy &amp;gt;6 months following completion of chemotherapy. Gait was assessed using seven Inertial Measurement Unit (IMU) sensors positioned at the sacrum, upper and lower leg, and foot. Participants completed a 2-minute walk at a comfortable walking pace. The outcome variables assessed included gait speed, single limb support, stride length, gait cycle time, stance percent, swing percent, double support percent, and cadence. Mean age 65(10) years, gait speed was 0.95(0.2) meters/second, single limb support 37.9(2.2) % of gait cycle, stride length 1.1(0.2) meters, gait cycle time 1.2(0.1) seconds, stance percent 62.1(2.2)% GC, swing percent 37.9(2.2)% GC, double support percent 23.9(4.3)% GC, and cadence 104.6(12.3) steps/min. Gait parameters assessed in this study showed an excellent test-retest reliability (r &amp;gt;0.86; ICC &amp;gt; 0.90). This is the first study to assess gait parameters in older breast cancer survivors with CIPN. Breast cancer survivors with CIPN showed reductions in all gait parameters. Reduced gait speed and stride length are critical indicators of fall risk for women with CIPN. Our study confirmed differences in spatiotemporal parameters between patients with persistent CIPN.

Associations between gait velocity parameters and brain amyloid‐β levels in cognitive normal older adults: a cross‐sectional analysis from the AGUEDA trial

AbstractBackgroundAmyloid beta (Aβ) is a protein associated with dementia‐related pathologies such Alzheimer’s Disease (AD). The accumulation of Aβ in the brain leads to neurodegeneration, cognitive decline, and motor impairment. Those factors might appear years before the onset of apparent symptoms. There is evidence for an association between gait performance and Aβ levels. Previous studies showed that gait variability has been associated with amyloid in older adults with mild dementia. Moreover, reduced gait velocity, has been associated with greater brain Aβ accumulation in adults with spontaneous memory complaints. However, the nature of this relationship needs further investigation. Thus, the aim of this study was to examine the associations between gait velocity and gait velocity variability, and brain amyloid burden in cognitively normal older adults. Our hypothesis was that gait parameters might differently predict amyloid‐β levels.MethodEighty‐six cognitively normal older adults participated in this study. The Optogait system (Microgate,Italy) was used to assess gait parameters. Participants walked back and forth across a 5‐m long track made up of two bars set 1‐meter apart at their maximum walking pace for 5 minutes. The mean and coefficient of variation (CV) of gait velocity (m/s) were calculated as gait parameters. All participants underwent T1‐weighted MRI scans and [18F] Florbetaben amyloid‐PET (positron emission tomography) scans. PET images were quantified using the Centiloid (CL) method with a 12 CL cutoff for amyloid positivity. The associations between gait parameters and amyloid burden were assessed by individual linear regressions unadjusted and adjusted by age, sex, and education as covariates.ResultTable 1 shows descriptive characteristics of the participants (22% Aβ+; 19 participants). Results showed a positive trend for an association between gait variability and amyloid burden (unadjusted: β = 0.21, p = 0.05; adjusted: β = 0.20, p = 0.08). There was no association between gait velocity and amyloid burden (unadjusted: β = ‐0.08, p = 0.42; adjusted: β = ‐0.08, p = 0.54).ConclusionGreater gait velocity variability, but not gait velocity, was marginally associated with higher amyloid burden. This result suggests that gait velocity variability might be an important marker of amyloid burden in cognitively normal older adults.

Estimation of Spatio-Temporal Parameters of Gait and Posture of Visually Impaired People Using Wearable Sensors

In rehabilitating orientation and mobility (O&amp;M) for visually impaired people (VIP), the measurement of spatio-temporal gait and postural parameters is of specific interest for rehabilitators to assess performance and improvements in independent mobility. In the current practice of rehabilitation worldwide, this assessment is carried out in people with estimates made visually. The objective of this research was to propose a simple architecture based on the use of wearable inertial sensors for quantitative estimation of distance traveled, step detection, gait velocity, step length and postural stability. These parameters were calculated using absolute orientation angles. Two different sensing architectures were tested for gait according to a selected biomechanical model. The validation tests included five different walking tasks. There were nine visually impaired volunteers in real-time acquisitions, where the volunteers walked indoor and outdoor distances at different gait velocities in their residences. The ground truth gait characteristics of the volunteers in five walking tasks and an assessment of the natural posture during the walking tasks are also presented in this article. One of the proposed methods was selected for presenting the lowest absolute error of the calculated parameters in all of the traveling experimentations: 45 walking tasks between 7 and 45 m representing a total of 1039 m walked and 2068 steps; the step length measurement was 4.6 ± 6.7 cm with a mean of 56 cm (11.59 Std) and 1.5 ± 1.6 relative error in step count, which compromised the distance traveled and gait velocity measurements, presenting an absolute error of 1.78 ± 1.80 m and 7.1 ± 7.2 cm/s, respectively. The results suggest that the proposed method and its architecture could be used as a tool for assistive technology designed for O&amp;M training to assess gait parameters and/or navigation, and that a sensor placed in the dorsal area is sufficient to detect noticeable postural changes that compromise heading, inclinations and balancing in walking tasks.

Comparing Microsoft Kinect and Observational Gait Analysis in Assessing Gait Parameters of Apparently Healthy Adults

Objectives: Although the Microsoft Kinect has compelling potential for gait analysis in medicine, data available to compare it with observational gait analysis (OGA) is scarce. This study compared the Microsoft Kinect and the OGA in assessing the gait parameters of apparently healthy adults. Methods: Ninety-seven apparently healthy young male adults participated in this comparative study. First, the participant’s age, height, weight, and body mass index were obtained. Afterward, gait parameters involving the number of steps, cadence, stride length, and step length were assessed concurrently following OGA standard procedures and the Microsoft Kinect during a 6-m walk down the hallway. The obtained data were analyzed using descriptive and inferential statistics. The significance level was set at P&lt;0.05. Results: The Mean±SD walk time, steps, cadence, velocity, and stride length were 8.07±1.39 s, 14.0±2.96 counts, 72.9±11.9 steps/min, 0.8±0.13 m/s, and 0.77±0.13m, respectively. Step length was significantly higher (P&lt;0.05) with Microsoft Kinect than OGA, whereas stride length and walk speed values were significantly (P&lt;0.05) lower with Microsoft Kinect. A moderate but significant (P=0.001) positive correlation existed between Microsoft Kinect and OGA regarding walk speed. In contrast, regarding the step length, a weak but significant (P&lt;0.05) positive correlation was found between Microsoft Kinect and OGA. Discussion: Step length values of Microsoft Kinect were significantly higher than OGA values, whereas stride length and walk speed values of Microsoft Kinect were significantly lower than OGA values. Walk speed and step length measured by Microsoft Kinect and OGA were positively correlated.

Forward and Backward Walking: Multifactorial Characterization of Gait Parameters

Although extensive literature exists on forward and backward walking, a comprehensive assessment of gait parameters on a wide and homogenous population is missing. Thus, the purpose of this study is to analyse the differences between the two gait typologies on a relatively large sample. Twenty-four healthy young adults participated in this study. By means of a marker-based optoelectronic system and force platforms, differences between forward and backward walking were outlined in terms of kinematics and kinetics. Statistically, significant differences were observed in most of the spatial–temporal parameters, evidencing some adaptation mechanisms in backward walking. Differently from the ankle joint, the hip and knee range of motion was significantly reduced when switching from forward to backward walking. In terms of kinetics, hip and ankle moment patterns for forward and backward walking were approximately mirrored images of each other. Moreover, joint powers appeared drastically reduced during reversed gait. Specifically, valuable differences in terms of produced and absorbed joint powers between forward and backward walking were pointed out. The outcomes of this study could represent a useful reference data for future investigation evaluating the efficacy of backward walking as a rehabilitation tool for pathological subjects.

Kinect-Based Assessment of Lower Limbs during Gait in Post-Stroke Hemiplegic Patients: A Narrative Review.

The aim of this review was to present an overview of the state of the art in the use of the Microsoft Kinect camera to assess gait in post-stroke individuals through an analysis of the available literature. In recent years, several studies have explored the potentiality, accuracy, and effectiveness of this 3D optical sensor as an easy-to-use and non-invasive clinical measurement tool for the assessment of gait parameters in several pathologies. Focusing on stroke individuals, some of the available studies aimed to directly assess and characterize their gait patterns. In contrast, other studies focused on the validation of Kinect-based measurements with respect to a gold-standard reference (i.e., optoelectronic systems). However, the nonhomogeneous characteristics of the participants, of the measures, of the methodologies, and of the purposes of the studies make it difficult to adequately compare the results. This leads to uncertainties about the strengths and weaknesses of this technology in this pathological state. The final purpose of this narrative review was to describe and summarize the main features of the available works on gait in the post-stroke population, highlighting similarities and differences in the methodological approach and primary findings, thus facilitating comparisons of the studies as much as possible.

Usefulness of gait parameters obtained from inertial sensors attached to the lower trunk and foot for assessment of gait performance in the early postoperative period after total knee arthroplasty

BackgroundThis study was performed to (i) compare gait parameters obtained from inertial sensors attached to the lower trunk and foot between patients in the early postoperative period after total knee arthroplasty (TKA) and healthy age- and sex-matched controls and (ii) elucidate the association between the gait parameters and patient-reported outcome measures (PROMs). MethodThe gait performance of 19 patients who had undergone TKA was assessed using inertial sensors and PROMs obtained from the Knee Injury and Osteoarthritis Outcome Score (KOOS) 1 week before hospital discharge. The patients walked along a 15-m walkway and we calculated the following gait parameters: walking speed, coefficient of variation (CV) of stride time, unbiased autocorrelation coefficient (AC), harmonic ratio (HR), and symmetry index (SI). The same gait parameter data from 19 age- and sex-matched healthy adults (controls) were obtained from our past study. ResultsThe TKA group demonstrated slower walking speed, larger CV of stride time, lower HR in all three directions, lower AC in the vertical direction, and higher SI in the vertical direction than the healthy control group (all p < 0.05). Correlation analysis revealed that the SI in the anteroposterior direction was significantly correlated with the KOOS symptoms subscore and ADL subscore (p < 0.05). ConclusionsPatients in the early postoperative period after TKA exhibited worse gait performance as assessed by inertial sensors compared with healthy controls. Gait symmetry was correlated with PROMs. These results indicate the usefulness of assessing gait parameters after TKA.

Computation of Gait Parameters in Post Stroke and Parkinson's Disease: A Comparative Study Using RGB-D Sensors and Optoelectronic Systems.

The accurate and reliable assessment of gait parameters is assuming an important role, especially in the perspective of designing new therapeutic and rehabilitation strategies for the remote follow-up of people affected by disabling neurological diseases, including Parkinson’s disease and post-stroke injuries, in particular considering how gait represents a fundamental motor activity for the autonomy, domestic or otherwise, and the health of neurological patients. To this end, the study presents an easy-to-use and non-invasive solution, based on a single RGB-D sensor, to estimate specific features of gait patterns on a reduced walking path compatible with the available spaces in domestic settings. Traditional spatio-temporal parameters and features linked to dynamic instability during walking are estimated on a cohort of ten parkinsonian and eleven post-stroke subjects using a custom-written software that works on the result of a body-tracking algorithm. Then, they are compared with the “gold standard” 3D instrumented gait analysis system. The statistical analysis confirms no statistical difference between the two systems. Data also indicate that the RGB-D system is able to estimate features of gait patterns in pathological individuals and differences between them in line with other studies. Although they are preliminary, the results suggest that this solution could be clinically helpful in evolutionary disease monitoring, especially in domestic and unsupervised environments where traditional gait analysis is not usable.

The reliability of gait parameters captured via instrumented walkways: a systematic review and meta-analysis.

Electronic pressure-sensitive walkways are commonly available solutions to quantitatively assess gait parameters for clinical and research purposes. Many studies have evaluated their measurement properties in different conditions with variable findings. In order to be informed about the current evidence of their reliability for optimal clinical and scientific decision making, this systematic review provided a quantitative synthesis of the test-retest reliability and minimal detectable change of the captured gait parameters across different test conditions (single and cognitive dual-task conditions) and population groups. A literature search was conducted in PubMed, Embase, and Scopus until November 2021 to identify articles that examined the test-retest reliability properties of the gait parameters captured by pressure-sensitive walkways (gait speed, cadence, stride length and time, double support time, base of support) in adult healthy individuals or patients. The methodological quality was rated using the Consensus-Based Standards for the Selection of Health Measurement Instruments Checklist. Data were meta-analyzed on intraclass correlation coefficient to examine the test-retest relative reliability. Quantitative synthesis was performed for absolute reliability, examined by the weighted average of minimal detectable change values. A total of 44 studies were included in this systematic review. The methodological quality was adequate in half of the included studies. The main finding was that pressure-sensitive walkways are reliable tools for objective assessment of spatial and temporal gait parameters both in single-and cognitive dual-task conditions. Despite few exceptions, the review identified intraclass correlation coefficient higher than 0.75 and minimal detectable change lower than 30%, demonstrating satisfactory relative and absolute reliability in all examined populations (healthy adults, elderly, patients with cognitive impairment, spinocerebellar ataxia type 14, Huntington's disease, multiple sclerosis, Parkinson's disease, rheumatoid arthritis, spinal cord injury, stroke or vestibular dysfunction). Current evidence suggested that, despite different populations and testing protocols used in the included studies, the test-retest reliability of the examined gait parameters was acceptable under single and cognitive dual-task conditions. Further high-quality studies with powered sample sizes are needed to examine the reliability findings of the currently understudied and unexplored pathologies and test conditions.

A Sensorized Overground Body Weight Support System for Assessing Gait Parameters During Walking Rehabilitation.

Although the needs of individuals undertaking gait rehabilitation sessions may appear similar, they present facets that may assist therapists to come up with more targeted treatment. However, acquiring such aspects is a major problem for rehabilitation personnel due to time constraints and/or complexity. In this paper, we propose an alternative method for estimating gait parameters for individuals requiring Body Weight Support (BWS) during gait training. Results show that the proposed device is able to acquire step length and the amount of body weight unloaded with relatively high accuracy. This reduces the need to set up external sensors to measure patients. Moreover, it can provide gait parameters for patients evaluation which can be used for more personalized treatment.Clinical relevance - Tracking patient progress during therapy is an important part of personalized therapy. The proposed device is a simple, low-cost method of collecting gait parameters from patients, without the use of expensive motion tracking and force sensors.

Long-term living in unfavorable socioeconomic conditions impairs late-life gait performance.

BackgroundLow socioeconomic status has been associated with individual health-related problems; however, no study has specifically investigated the impact of socioeconomic disparities on gait performance using an index that considers the population aggregation, as the Human Development Index (HDI). Thus, the aim of the present study was to assess gait parameters of older people living in cities with differences in socioeconomic conditions, identified by HDI. MethodsCross-sectional design study conducted with a sample of 233 older people from two Brazilians regions: Coari, state of Amazonas, Brazil (n= 124, low-HDI-Bra) and Ribeirão Preto, state of São Paulo, Brazil (n= 109, very high-HDI-Bra). The gait performance was assessed by an electronic walkway, and the interest variables were gait speed, cadence, stride time, step length and stride width. ResultsLow-HDI-Bra group presented worse gait performance as identified by slower gait speed (p = < .001), slower cadence (p = < .001), higher stride time (p = < .001), shorter step length (p = < .001), compared with the very high-HDI-Bra group. There was a positive association between HDI, and gait spend, cadence and step length, and there was a negative association between HDI and stride time and stride width. ConclusionsLong-term exposure to socioeconomic inequalities found in low HDI cities may impair gait performance in late life. Such information may be relevant to create public politics that use the gait parameter based on the region where the people live.

Domain-specific self-perceptions of aging are associated with different gait patterns in older adults: a cross-sectional latent profile analysis

BackgroundPrevious studies have pointed to the impact of self-perceptions of aging (SPA) on self-reported physical function in later life. However, less is known about associations of SPA with objectively measured physical function, especially gait. Research that examined other psychological variables and objectively measured gait has focused on single gait parameters such as gait speed, which seems to fall short for the complexity of this movement. Some approaches have proposed ways to identify gait patterns in specific patient groups, but not in community samples. Our goal was (a) to identify gait patterns based on a combination of important gait parameters in a community sample, and (b) to investigate differential associations of gain- and loss-related SPA with these gait patterns.MethodsThe study used an electronic walkway to assess gait parameters of 150 community dwelling adults aged 71–93 years (61.0% women) at their usual and maximum gait speed. SPA were assessed with a questionnaire. We used latent profile analysis (LPA) to identify groups exhibiting distinct gait patterns and binary logistic regression to investigate associations of SPA with these groups, controlling for personality traits, number of illnesses, age, gender, and education. To compare overall function between groups, a t-test for scores in the Short Physical Performance Battery was used.ResultsLPA revealed two distinct groups in both gait speed conditions. The fit group exhibited a stable, well-coordinated and faster gait pattern, while the functionally limited group’s gait pattern was less stable, less coordinated and slower. The odds of belonging to the functionally limited group were increased by loss-related SPA at usual gait speed, while the odds of belonging to the fit group were increased by gain-related SPA at individual maximum speed.ConclusionsThe findings (a) suggest LPA as a useful approach to investigate complex gait patterns considering several gait parameters simultaneously, and (b) provide first evidence for differential associations of gain- and loss-related SPA with gait patterns at usual and maximum gait speed. Intervention studies addressing gait in older adults should additionally address gain-related views on aging.

Assessment of Gait after Treatment of Tibial Nonunion with the Ilizarov Method.

Background: Tibial nonunion is a common bone union disorder leading to abnormal gait, and thus reducing quality of life in the social dimension. Research question: The aim of our work was to comprehensively assess gait parameters of patients who had undergone Ilizarov treatment for tibial nonunion compared to a control group of healthy individuals. Methods: This study evaluated patients treated for aseptic tibial nonunion with the Ilizarov method. 24 patients with a mean age of 55.0 years were included in the study. The control group consisted of 32 healthy volunteers with no significant medical history who were selected to match the gender and age of patients in the study group so that the groups were homogeneous. A Zebris Medical GmbH pedobarographic platform was used to assess the gait parameters. Results: For all gait parameters examined, force forefoot max, force backfoot max, step length, stance phase, swing phase and step time, we observed statistically significant differences between the group that had undergone treatment and the control group. In the group of patients, statistically significant differences between the operated lower limb and the non-operated limb were only observed for the force forefoot max and step time parameters (p = 0.029 and p = 0.045, respectively). Patients presented a longer loading of the operated limb (0.720 s) than the non-operated limb (0.635 s). For the stride time, step cadence and gait velocity parameters, healthy subjects achieved much better results during locomotion, and these differences were statistically significant at p < 0.001. Significance: Treatment of tibial nonunion with the Ilizarov method did not restore normal gait parameters in our group of patients. In fact, the gait parameters of patients were significantly worse than the healthy individuals in the control group. Furthermore, gait parameters following treatment were not symmetrical, and the dynamics of the musculoskeletal system remained impaired.

What gait features influence the amount and intensity of physical activity in people with multiple sclerosis?

Although the mutual relationship between ambulation and physical activity (PA) in people with multiple sclerosis (pwMS) has been described in several studies, there is still a lack of detailed information about the way in which specific aspects of the gait cycle are associated with amount and intensity of PA. This study aimed to verify the existence of possible relationships among PA parameters and the spatio-temporal parameters of gait when both are instrumentally assessed.Thirty-one pwMS (17F, 14 M, mean age 52.5, mean Expanded Disability Status Scale (EDSS) score 3.1) were requested to wear a tri-axial accelerometer 24 hours/day for 7 consecutive days and underwent an instrumental gait analysis, performed using an inertial sensor located on the low back, immediately before the PA assessment period. Main spatio-temporal parameters of gait (i.e., gait speed, stride length, cadence and duration of stance, swing, and double support phase) were extracted by processing trunk accelerations. PA was quantified using average number of daily steps and percentage of time spent at different PA intensity, the latter calculated using cut-point sets previously validated for MS. The existence of possible relationships between PA and gait parameters was assessed using Spearman rank correlation coefficient rho.Gait speed and stride length were the parameters with the highest number of significant correlations with PA features. In particular, they were found moderately to largely correlated with number of daily steps (rho 0.62, P< .001), percentage of sedentary activity (rho = –0.44, P < .001) and percentage of moderate-to-vigorous activity (rho = 0.48, P < .001). Small to moderate significant correlations were observed between PA intensity and duration of stance, swing and double support phases.The data obtained suggest that the most relevant determinants associated with higher and more intense levels of PA in free-living conditions are gait speed and stride length. The simultaneous quantitative assessment of gait parameters and PA levels might represent a useful support for physical therapists in tailoring optimized rehabilitative and training interventions.

Agreement and consistency of five different clinical gait analysis systems in the assessment of spatiotemporal gait parameters

BackgroundMeasuring gait function has become an essential tool in the assessment of mobility in aging populations for both, clinicians and researchers. A variety of systems exist that assess gait parameters such as gait cycle time, gait speed or duration of relative gait phases. Due to different measurement principles such as inertial or pressure sensors, accurate detection of spatiotemporal events may vary between systems. Research questionTo compare the absolute agreement and consistency in spatiotemporal gait parameters among five different clinical gait analysis systems using different sensor technologies. MethodsWe compared two devices using inertial sensors (GaitUp & Mobility Lab), two devices using pressure sensor systems (GAITRite & Zebris) as well as one optical system (OptoGait). Twelve older adults walked at self-selected speed through a walkway integrating all of the above systems. Basic spatiotemporal parameters (gait cycle time, cadence, gait speed and stride length) as well as measures of relative phase (stance phase, swing phase, double stance phase, single limb support) were extracted from all systems. We used Intraclass Correlation Coefficients as measures of agreement and consistency. ResultsHigh agreement and consistency between all systems was found for basic spatiotemporal parameters, whereas parameters of relative phase showed poorer agreement and consistency. Overground measurement (GAITRite & OptoGait) showed generally higher agreement with each other as compared to inertial sensor-based systems. SignificanceOur results indicate that accurate detection of both, the heel-strike and toe-off event are crucial for reliable results. Systematic errors in the detection of one or both events may only have a small impact on basic spatiotemporal outcomes as errors remain consistent from step to step. Relative phase parameters on the other hand may be affected to a much larger extent as these differences lead to a systematic increase or reduction of relative phase durations.