Gait Assessment Research Articles

Abstract 28: Bihemispheric transcranial direct current stimulation did not add benefit to stance-phase gait training using virtual reality setting for chronic motor deficits after stroke

Introduction: Chronic gait deficits after stroke are prevalent. Current therapy fails to restore normal gait for many stroke survivors. Transcranial Direct Current Stimulation (tDCS), a form of non-invasive brain stimulation, is a promising adjunct intervention that may enhance motor-learning induced neuroplasticity. tDCS is readily deployable into the clinic owing to its safety, ease of set-up, and feasibility to be paired with gait therapies. Our objective was to test whether bihemispheric tDCS would improve response to stance-phase focused gait therapy in a double-blind randomized control trial. Methods: 44 subjects (65.2±9.8 y/o; 27.3% female; 4.5±4.2 years post-stroke) were randomized to active or sham tDCS+gait training. Ten treatment sessions consisted of 30 min of virtual-reality obstacle clearance training on a treadmill followed by 30 min of overground stance phase training. 2mA tDCS with anode over ipsilesional primary motor cortex (M1) and cathode over contralesional M1 was applied during the first 15 min of training. Individuals were assigned custom home exercises. Primary outcome was fastest gait speed with 10-meter walk test(10MWT) and secondary outcomes were preferred gait speed during 2-min walk test(2MWT), Fugl-Meyer(FM), Timed Up and Go(TUG), Functional Gait Assessment (FGA), and Gait Assessment and Intervention Tool(GAIT). Outcomes were collected at baseline, mid-treatment, post-treatment, and 6-week follow up. Statistical analyses included longitudinal linear mixed-effects models and analysis of treatment group by time interaction effects. Results: At baseline(mean(SD)): 10MWT=0.71(0.40) m/s, 2MWT=0.55(0.28) m/s, FM=25.0(3.7), TUG =33.2(30.6) s; FGA=12.7(4.1) points, GAIT=16.9(7.3) points. None of the longitudinal linear mixed-effects models detected a significant group by time interaction. However, there were significant improvements from baseline for all measures as follows (median(95%CI)): 10MWT(m/s) of 0.12(0.08, 0.16) post-treatment, and 0.11(0.07, 0.16) at follow-up; 2MWT(m/s) of 0.05(0.03, 0.07) and 0.05(0.02, 0.09); FM (points) of 2.5(2, 3) and 3(2.5,3.5); TUG(s) of 3.9(2.5, 5.6) and 3.3(2, 5.2); FGA(points) 3(2.5,3.5) and 3(2,3.5); GAIT(points) of 2.5(2, 3.5) and 3(2,4). Conclusions: Bihemispheric tDCS did not enhance improvements that were achieved by a 10-session gait training intervention targeting stance phase.

Navigating the Ice: Establishing Pre-Concussion Baselines in Ice-Hockey Players for Gait Assessment Utilizing Inertial Measurement Units

Introduction Ice hockey can lead to high-energy collisions and traumas and is a sport with high risk of concussion (Ornon et al., 2020). Concussions represent 2–14% of all hockey injuries (Izraelski, 2014). Sports-related concussions (SRC) sustained in professional ice hockey are a common in-competition injury leading to highly individual return to sport that can be associated with symptoms lasting days to months (Höllerer et al., 2023). Following SRC there is an increased risk of subsequent concussion and musculoskeletal injury upon return to play, however, assessments that can detect subclinical changes in function following a concussion are lacking (Dunne et al., 2023). A COSMIN systematic review suggests gait-based assessments using inertial measurement units to capture pre-concussion baseline scores (Dunne et al., 2023). This study measured pre-season pre-concussion gait data in Swiss National League Ice hockey players. Baseline scores will be compared with measures from players sustaining in-season SRC. Methods Temporal and spatial gait parameters were measured with the Physilog (https://www.physilog.com/ , Lausanne, Switzerland) movement sensors. The sensors were fixed to the shoes for flat overground gait analysis. Over a 20-30 m walkway, participants performed a single-task (ST) walking condition (preferred gait speed) and a dual-task (DT) walking condition, i.e., preferred gait speed whilst counting backwards. Application of the dual-task paradigm aimed at quantifying the automaticity of movement (Soulard et al., 2021). The focus of this study was on gait speed, cadence (+ cv%), and stride length (+ cv%) (Dunne et al., 2023). Results Thirteen male National League players from SC Rapperswil-Jona Lakers, 21.9 ± 3.1 years, 182.5 ± 5.9 cm height, 83.3 ± 7.6 kg body weight performed a pre-season gait analysis. The players sustained 1.5 ± 1.4 [range 0 – 3] concussions in the past. ST/DT walking revealed a walking speed of 1.3 ± 0.14/1.12 ± 0.14 m/s; step length 0.72 ± 0.09/0.67 ± 0.07 m; step length coefficient of variation (cv, %) 5.4 ± 1.9/5.6 ± 1.4 %; cadence 106.7 ± 5.1/100.5 ± 5.7 steps/min; cadence cv 2.8 ± 1/2.9 ± 0.9 %. Discussion/Conclusion Our results will shed light on the reliability and validity of using inertial measurements in the context of concussion management. Practitioners can use this resource at their disposal to help make informed decisions regarding concussion management. References Dunne, L. A. M., et al. (2023). Validity and reliability of methods to assess movement deficiencies following concussion: A COSMIN systematic review. Sports Medicine - Open, 9, 76. https://doi.org/10.1186/s40798-023-00625-0 Höllerer, D., et al. (2023). Injury incidence, outcomes, and return to competition times after sports-related concussions during one professional ice hockey season: A prospective cohort study. Healthcare, 11, 3153. https://doi.org/10.3390/healthcare11243153 Izraelski, J. (2014). Concussions in the NHL: A narrative review of the literature. Journal of the Canadian Chiropractic Association, 58(4), 346–352. Ornon, G., et al. (2020). Epidemiology of injuries in professional ice hockey: A prospective study over seven years. Journal of Experimental Orthopaedics, 7, 87. https://doi.org/10.1186/s40634-020-00300-3 Soulard, J., et al. (2021). Spatio-temporal gait parameters obtained from foot-worn inertial sensors are reliable in healthy adults in single- and dual-task conditions. Scientific Reports, 11, 10229. https://doi.org/10.1038/s41598-021-88794-4

Construct validity, responsiveness, and interpretability of the Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI)

Objective We investigated the construct validity, responsiveness, and interpretability of the Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI) to determine its usefulness in measuring the functional level of gait. Patients and Methods This was a prospective observational study following the checklist of the Consensus-Based Standards for Selecting Health Measurement Instruments. The SCI-FAI consists of three items: Gait Parameter, Assistive Devices, and Temporal. We recruited 55 patients diagnosed with a spinal cord injury (SCI) in the subacute or chronic phase from Ibaraki Prefectural University of Health Sciences Hospital. Construct validity was clarified by hypothesis testing and the rate of hypothesis verification. We divided responsiveness into subacute and chronic groups and determined the correlation between the changes in the two timepoints of the SCI-FAI and 6-minute walk test. Interpretability involved the calculation of cutoff values for indoor and outdoor walking. Results Construct validity was confirmed for 12 of the 15 hypotheses, indicating high construct validity. In the subacute group, Gait Parameter and Assistive Devices showed moderate responsiveness. Interpretability showed that the Gait Parameter was perfect in 19 of the 20 subjects who did not need a walking aid when walking. The cutoff value for Gait Parameter for indoor walking was 17.5 points (AUC 0.91) and that for Assistive Devices was 9.5 points (AUC 0.88). The cutoff values for outdoor walking were Gait Parameter 18.5 points (AUC 0.96) and Assistive Devices 10.5 points (AUC 0.94). Conclusion Our results demonstrated that the SCI-FAI has adequate construct validity, moderate responsiveness in SCI patients in the subacute phase, and interpretability in the gait assessment of individuals with SCIs. Gait Parameter is likely to show a ceiling effect for people with SCIs who can walk without using an upper-limb walking aid.

VIRTUAL REALITY REHABILITATION VERSUS TASK-ORIENTED TRAINING FOR IMPROVING DYNAMIC BALANCE AND GAIT AMONG PARKINSON’S DISEASE PATIENTS

Background: Gait and balance are significant complained in patients with Parkinson’s disease (PD) which decrease their movement capability and life quality. Two innovative therapeutic modalities reported to provide better functioning in PD are virtual reality (VR) and task-oriented training (TOT). Objective : To determine effect of virtual reality rehabilitation versus task-oriented training for improving dynamic balance and gait among parkinsons disease patients Material and methods : This was comparative randomized controlled trial . Allied hospital Civil hospital Faisalabad Moeen physiotherapy clinic were utilized as study setting .Diagnosed PD patients (Hoehn and Yahr stages 2–3) aged 50–70 years were included. Exclusion criteria was patients with severe dementia or other neurological abnormalities. Sample Size was 28. Group A undergo VR-based sessions vs Group B participants were given task-oriented training Berg Balance Scale (BBS) and Timed Up and Go Test and Functional Gait Assessment (FGA) used as assessment tools. Statistical analysis performed by SPSS version 21. Results : Demonstrated BBS Score was 48.9 ± 2.9 with p score 0.03 FGA Score 23.3 ± 2.1 with p score 0.04 and 12.0 ± 1.4 TUG score with p value 0.02 among group A and group B revealed BBS Score was 46.3 ± 3.0 FGA Score was 21.7 ± 2.4 12.9 ± 1.6 was TUG score. Group A revealed more significant results as compared to group B. Conclusion: Both intervention groups revealed significant improvement after treatment but virtual reality training group showed more improvement on balance and gait among parkinsonism patients as compared to task oriented group.

Evaluating the Reliability and Consistency of Treadmill Gait Analysis Using an RGB-D Camera: Effects of Assistance and No Assistance.

This study aimed to assess the intraday reliability of markerless gait analysis using an RGB-D camera versus a traditional three-dimensional motion analysis (3DMA) system with and without a simulated walking assistant. Gait assessments were conducted on 20 healthy adults walking on a treadmill with a focus on spatiotemporal parameters gathered using the RGB-D camera and 3DMA system. The intraday reliability of the RGB-D camera was evaluated using intraclass correlation coefficients (ICC 1, 1), while its consistency with the 3DMA system was determined using ICC (2, 1). The results demonstrated that the RGB-D camera provided high intraday reliability and showed strong consistency with 3DMA measurements regardless of the presence of an assistant. The Bland-Atman analysis indicated no significant systematic bias, with the minimum detectable change remaining within acceptable clinical ranges. These findings highlight the potential of the RGB-D camera for reliable markerless gait analysis in clinical environments in which walking assistance may be needed, thereby expanding its applicability in patients with various impairment degrees. Future research should validate these results in patient populations and explore their utility for measuring kinematic parameters.

Gait Analysis in Patients After Hemiepiphysiodesis Due to Valgus or Varus Knee Deformity.

Background: Developmental knee joint deformities are a common problem in pediatric orthopedics. Children with a valgus or varus deformity of the distal femur or the proximal tibia are commonly treated with hemiepiphysiodesis. Gait analysis in patients with lower limb deformities plays an important role in clinical practice. The purpose of our study was to assess gait parameters in patients who underwent hemiepiphysiodesis procedures of the distal femur or proximal tibia due to a knee deformity and to compare them with those in healthy controls. Methods: We prospectively evaluated 35 patients (14 females and 21 males) after hemiepiphysiodesis and compared the results with a healthy control group (26 participants). Gait was analyzed with a G-Sensor device (BTS Bioengineering Corp., Quincy, MA, USA). We assessed the following gait parameters: gait cycle duration, step length, support phase duration, swing phase duration, double support duration, single support duration, cadence, velocity, and step length. We assessed these gait parameters in a group of patients before and after treatment with hemiepiphysiodesis. We compared the patients' results before and after treatment to those of a healthy control group. The level of significance was set at p < 0.05. Results: The mean follow-up period was 13 months. There was no difference in the results of gait assessments in patients prior to and after treatment. The median step length was 47.09% in the treated limb after treatment and 54.01% in the intact limb (p = 0.018). There were no other differences in gait parameters in the treated limbs and the healthy, intact limbs in the patient group after treatment. There were no significant differences in the patients before and after treatment compared with those in the healthy control group in all gait parameters. Conclusions: Valgus or varus knee deformity correction with the use of hemiepiphysiodesis does not significantly improve preoperative gait parameters. The biomechanical outcomes of hemiepiphysiodesis in the treatment of valgus or varus knee deformity are good. We observed no differences in gait cycle duration, step length, support phase duration, swing phase duration, double support duration, single support duration, gait velocity, cadence, or step length between the experimental and healthy control groups.

Predictive validity of obstacle-crossing test variations in identifying fallers after inpatient rehabilitation for stroke

ABSTRACT Background The ability to step over an obstacle is often evaluated as part of fall-risk and balance assessments. Although different obstacle-crossing tests exist, their comparative predictive validity in stroke is unknown. Objectives To examine the predictive validity of different obstacle depths and different obstacle-crossing tests, including a novel, custom-height test and an existing “one-size-fits-all” obstacle test, for predicting post-stroke fallers. Methods 46 independently ambulatory adults with stroke completed a custom-height obstacle-crossing test with 3 depths (0.5-inch, 1.5-inch, 3.0-inch) and the Functional Gait Assessment (FGA) 1–3 days before hospital discharge. Falls were tracked prospectively for 3 months using fall calendars and fortnightly phone calls. Results 35% of participants fell at least once in 3 months. Test accuracy was not significantly different between obstacle depth conditions. However, the 0.5-inch obstacle depth condition demonstrated the highest sensitivity and specificity, and participants who failed were 9 times more likely to fall in the first 3 months after discharge than those who passed (95% CI 1.9, 42.1; p = 0.005). Performance on the obstacle item of the FGA at hospital discharge was not significantly associated with fall status at 3 months post-discharge and had a 50% floor effect. Conclusions The ability to step over a custom-height obstacle may be a good indicator of post-stroke fall status 3 months after hospital discharge. Subtle increases in obstacle depth did not significantly alter accuracy. The “one-size-fits-all” obstacle test from the FGA had poor predictive validity at discharge from inpatient rehabilitation for stroke.

Clinical Whole-Body Gait Characterization Using a Single RGB-D Sensor.

Instrumented gait analysis is widely used in clinical settings for the early detection of neurological disorders, monitoring disease progression, and evaluating fall risk. However, the gold-standard marker-based 3D motion analysis is limited by high time and personnel demands. Advances in computer vision now enable markerless whole-body tracking with high accuracy. Here, we present vGait, a comprehensive 3D gait assessment method using a single RGB-D sensor and state-of-the-art pose-tracking algorithms. vGait was validated in healthy participants during frontal- and sagittal-perspective walking. Performance was comparable across perspectives, with vGait achieving high accuracy in detecting initial and final foot contacts (F1 scores > 95%) and reliably quantifying spatiotemporal gait parameters (e.g., stride time, stride length) and whole-body coordination metrics (e.g., arm swing and knee angle ROM) at different levels of granularity (mean, step-to-step variability, side asymmetry). The flexibility, accuracy, and minimal resource requirements of vGait make it a valuable tool for clinical and non-clinical applications, including outpatient clinics, medical practices, nursing homes, and community settings. By enabling efficient and scalable gait assessment, vGait has the potential to enhance diagnostic and therapeutic workflows and improve access to clinical mobility monitoring.

Three-Dimensional Gait Analysis of School-Age Children With Angelman Syndrome: A Case-Control Study.

Gait disturbance is a common motor symptom in Angelman syndrome (AS), but its characteristics have been poorly studied quantitatively. This study aimed to analyze gait characteristics in school-age children with AS using three-dimensional gait analysis (3DGA). Patients with clinically and genetically confirmed AS and healthy children aged 6-15 years were included. For gait assessments, 3DGA was performed using an eight-camera motion analysis system and eight force plates. Gait metrics, including gait speed, step length, step width, gait variability, gait deviation index, and kinematic and kinetic data of lower extremity joints were compared between the groups. Eight children with AS and 24 healthy controls were evaluated. Seven children with AS had flat feet. While step length and gait speed were similar between groups, children with AS showed greater variability in these parameters and larger step widths. Their average gait deviation index was 74.5, indicating significant gait disturbance, and characteristic features included anterior pelvic tilt, insufficient hip extension, excessive knee flexion during early stance, and reduced ankle joint power. School-age children with AS exhibit unstable, prancing gait characterized by knee flexion in the early stance phase, quantifiable using 3DGA. These findings provide foundation for evaluating therapeutic interventions.

Therapeutic Potential of Agmatine in Essential Tremor Through Regulation of Lingo-1 and Inflammatory Pathways.

Essential tremor (ET) is a prevalent movement disorder, yet current therapeutic options remain limited. Emerging evidence implicates leucine-rich repeat and immunoglobulin-like domain-containing protein (Lingo-1) and neuroinflammation in the pathophysiology of ET. This study aimed to investigate whether agmatine, a biogenic amine neuromodulator attenuates tremors and modulates the expression of Lingo-1 and proinflammatory markers in a rodent model of ET. Tremor was induced in male Swiss Webster mice through intraperitoneal injections of harmaline (10mg/kg) on Days 1, 3, and 5 of the study. During the same period, agmatine (40mg/kg) was administered for 5 consecutive days. Behavioral assessments of tremor severity, gait, balance, muscular strength, locomotion, anxiety-like behavior, and memory were conducted. Moreover, Lingo-1 and interleukin (IL)-6 gene expression was examined in the cerebellum using real-time polymerase chain reaction (RT-PCR). Our findings demonstrated that agmatine administration significantly reduced tremors, ameliorated anxiety-like behaviors, and attenuated harmaline-induced locomotor deficits. At the molecular level, agmatine treatment significantly suppressed the overexpression of Lingo-1 elicited by harmaline. Moreover, IL-6 expression was attenuated to an extent comparable to control levels. Collectively, this study provides the first evidence that agmatine dampens tremor severity, improves behavioral outcomes, and modulates key pathways implicated in ET pathogenesis in a rodent model. The ability of agmatine to normalize Lingo-1 and IL-6 expression suggests regulation of these pathways could underlie its neuroprotective action. These results suggest promise for agmatine as a prospective therapeutic agent in ET.

An exploration of visual gait assessment of horses by physiotherapists

An exploration of visual gait assessment of horses by physiotherapists

Racial and Gender Differences in Factors Associated with Research Engagement and Research Mistrust in a Gait Analysis Study

ABSTRACT Introduction There is a history of research mistrust and lack of engagement in clinical research among Black people due to centuries of racism and medical neglect. However, it is critical that Black people are included in research, especially in gait analysis research, because we know there are racial differences in gait. Thus, the purpose of this study is to determine if Black research participants have the same attitudes toward research engagement and research mistrust as their White counterparts while participating in gait analysis research. Methods A cross-sectional study was conducted. This work focuses on one portion of a larger study in which individuals were asked to complete two surveys related to research participation and mistrust and complete a gait assessment. Data were collected from 106 participants, 44 of whom identified as Black or African American. Wilcoxon rank sum and Kruskal–Wallis tests were used to determine if significant differences existed in responses by racial and racial–gender groups. Results Wilcoxon rank sum tests found that factors associated with research engagement and feelings of research mistrust differed significantly between Black and White research participants. Additionally, Kruskal–Wallis tests and Dunn tests found significant differences among the racial–gender groups, especially when comparing White men and Black women. Conclusion The findings show that in a gait analysis study, Black people have higher feelings of mistrust in medical research than White people and will likely be less willing to participate. These results could improve our understanding of why Black people are less likely to participate in research than White people, even in a gait analysis study. This work can provide insights into how to modify recruitment practices to increase participation of underrepresented groups in exercise science and biomechanics, such as racial concordance and promoting transparency.

Comparison of methods for assessing the quality of rehabilitation measures by indicators of statodynamic functions and emg studies in dogs

The work is devoted to the qualitative and quantitative assessment of physical rehabilitation in dogs. The relevance of the study is due to the need for a reliable comprehensive assessment of rehabilitation measures to expand the use of rehabilitation in treatment protocols for dogs. The animals in the experimental group had a history of neuropathies of various etiologies and underwent a course of physical rehabilitation with an assessment of the functions of the neuromuscular apparatus. Quantitative assessment was carried out using an instrumental electrophysiological research method - stimulation electroneuromyography (ENMG). Qualitative assessment of the indicators of statodynamic functions was assessed by the following indicators: the presence and degree of lameness, goniometric indicators of joints, assessment of gait and static postures, quality of the support function of the limbs, quality of reflex reactions. The study showed a reliable change in electrophysiological indicators in neuropathies of various etiologies and, at the same time, in the functions of the neuromuscular apparatus in dogs. At the same time, an improvement in the indicators of statodynamic functions was noted. Such results indicate the presence of a direct correlation between the improvement of statodynamic clinical parameters and the improvement of electrophysiological parameters recorded during the ENMG study. At the same time, the quantitative digital assessment using electroneuromyography is more reliable than the qualitative assessment of statodynamic function parameters, which largely depends on the subjective view of the assessor.

Comparison of Complications Between Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Microdiscectomy for The Treatment of Lumbar Disc Herniation

Background: Lumbar disc herniation (LDH), a common spinal condition causing lower back pain, requires surgical intervention, with common procedures being percutaneous endoscopic lumbar discectomy (PELD) and open lumbar microdiscectomy (OLM). Objective: The study was aimed to compare the complications and outcomes of Percutaneous Endoscopic Lumbar Discectomy (PELD) and Open Lumbar Microdiscectomy (OLM) in treating lumbar disc herniation (LDH) at the L4/L5 level. Methods: A cross-sectional comparative analysis was conducted from January 1, 2022, to June 30, 2023, at the Department of Neurosurgery, National Institute of Neurosciences&amp; Hospital. Seventy patients with LDH were divided into two groups: Group-I (PELD, n=33) and Group-II (OLM, n=37). Baseline characteristics, motor examinations, reflexes, sensory integrity, gait assessments, and MRI findings were recorded. Primary outcomes included per-operative and post-operative complications such as dural tears, nerve root injuries, wound infections, disk space infections, cerebrospinal fluid (CSF) leaks, foot drop, and recurrence rates. Visual Analogue Scale (VAS) scores for lower back and leg pain, and Oswestry Disability Index (ODI) scores, were evaluated pre-operatively and at the 90th postoperative day follow-up. Statistical analysis was performed using the chi-square test in SPSS version 26. Results: Partial nerve root injury occurred in 3.03% of Group-I and 6.06% of Group-II. Post-operative wound infection was noted in 3.03% of Group-I, while no infections were reported in Group-II. CSF leak was observed in 2.7% of Group-II but none in Group-I. Recurrence of LDH occurred in 2.7% of Group-II and none in Group-I. Conclusion: PELD and OLM are both effective for treating LDH, with PELD showing fewer complications. J Rang Med Col. September 2024; Vol. 9, No. 2: 8-14

Analyzing the relationship between specific brain structural changes and the diffusion tensor image analysis along the perivascular space index in idiopathic normal pressure hydrocephalus.

Diffusion Tensor Image Analysis Along the Perivascular Space (DTI-ALPS) evaluates the glymphatic system in patients with idiopathic normal-pressure hydrocephalus (iNPH). However, white matter compression due to ventricular enlargement may affect the ALPS index. This study aimed to investigate the relationship among the ALPS index, white matter changes, and clinical symptoms in patients with iNPH. We calculated the ALPS index in 30 patients with iNPH, aged 70 and above, using DTI data and correlated it with various clinical and imaging indices, including the Evans index, callosal angle, cognitive tests, gait assessment (timed up-and-go [TUG] test), cerebrospinal fluid (CSF) medullary pressure, and various DTI indices (axial diffusivity [AD], radial diffusivity [RD], mean diffusivity [MD], fractional anisotropy [FA]). Significant negative correlations were observed between the ALPS index and the rate of change in step count in the TUG test after the tap test (r = -0.5014, p = 0.0048), as well as CSF medullary pressure (r = -0.4651, p = 0.0096). Positive correlations were identified between the ALPS index and both AD (r = 0.4984, p = 0.0051) and MD (r = 0.3631, p = 0.0486). A lower ALPS index was associated with gait improvement following the tap test as well as higher CSF medullary pressure. The ALPS index may detect subtle periventricular compression-induced changes in iNPH. Consequently, it could potentially serve as a predictor for tap test effectiveness in patients with iNPH, offering a new perspective on its application in iNPH diagnosis and treatment.

Enhancing Intelligent Shoes with Gait Analysis: A Review on the Spatiotemporal Estimation Techniques

The continuous, automated monitoring of sensor-based data for walking capacity and mobility has expanded gait analysis applications beyond controlled laboratory settings to real-world, everyday environments facilitated by the development of portable, cost-efficient wearable sensors. In particular, the integration of Inertial Measurement Units (IMUs) into smart shoes has proven effective for capturing detailed foot movements and spatiotemporal gait characteristics. While IMUs enable accurate foot trajectory estimation through the double integration of acceleration data, challenges such as drift errors necessitate robust correction techniques to ensure reliable performance. This review analyzes current literature on shoe-based systems utilizing IMUs to estimate spatiotemporal gait parameters and foot trajectory characteristics, including foot–ground clearance. We explore the challenges and advancements in achieving accurate 3D foot trajectory estimation using IMUs in smart shoes and the application of advanced techniques like zero-velocity updates and error correction methods. These developments present significant opportunities for achieving reliable and efficient real-time gait assessment in everyday environments.

Smartphone Accelerometer for Gait Assessment: Validity and Reliability in Healthy Adults

Smartphone-based accelerometers offer a cost-effective and portable alternative to traditional gait analysis systems, with high reliability in measuring key parameters such as walking speed, cadence, and distance. This study assessed their validity compared to the GAITRite system, a widely recognized gold-standard tool, using data from 30 healthy adults walking at 3 self-selected speeds: preferred, slow, and fast. The results demonstrated a high degree of agreement between the two systems, with intraclass correlation coefficients (ICCs) ranging from 0.778 to 0.999. Although the findings emphasize the potential of smartphone accelerometers for clinical and real-world applications, certain limitations were noted, including participant homogeneity and minor discrepancies at extreme walking speeds. To address these limitations, incorporating data from additional sensors, such as gyroscopes and magnetometers, may enhance the accuracy and reliability of spatial parameter estimation. Overall, the findings support the use of smartphone accelerometers as a promising tool for advancing gait monitoring technologies, particularly in the contexts of telerehabilitation and mobility assessments.

Window entrapment trauma in cats: clinical, neurological and clinicopathological findings and outcome (70 cases).

Window entrapment in cats can lead to reduced blood flow to the spinal cord, muscles and nerves, resulting in ischaemic neuromyelomyopathy. The severity and duration of entrapment greatly influence clinical and neurological outcomes, as well as prognosis. The aim of the present retrospective multicentric study (2005-2022) was to describe clinical, neurological and selected clinicopathological findings, as well as the outcome of cats trapped in bottom-hung windows, presented to both first-opinion and referral-only clinics. The study included cats with detailed clinical and neurological evaluations at admission, along with at least one of the following biochemical parameters: creatine kinase (CK), aspartate transaminase (AST), alanine aminotransferase (ALT) activities, urea and/or creatinine. Clinical and neurological parameters evaluated in the study included rectal temperature, femoral pulse, gait, urinary bladder function, tail function and survival to discharge. Odds ratios (ORs) were calculated for survival and each clinical, neurological and biochemical variable. Of the 70 cats that met the inclusion criteria, only seven (10%) died or were euthanased during hospitalisation. Nevertheless, with the available data, we found evidence of an association between clinical and neurological status and survival, with tail function being the strongest association. Cats lacking tail sensation, motor function and/or tonus were more likely to die than cats with normal tail function or only mild abnormalities (OR = 24). Similarly, cats with severe hypothermia or an absent femoral pulse were less likely to survive (OR = 12.75 and 7.5, respectively). In this sample (with a relatively low number of deaths), we did not find evidence of an association between CK, AST and ALT activity with survival. However, the only two cats with severe increases in creatinine died. Assessment of gait, urinary bladder function, femoral pulse, rectal temperature and particularly tail function is promising for predicting outcomes in cats with window entrapment trauma.

Analyzing Sleep and Gait Dynamics through Digital Monitoring across Mild Cognitive Impairment (MCI) and non‐MCI Groups

AbstractBackgroundSleep apnea and insomnia are risk factors for dementia. Slower gait and increased gait variability are also associated with increased risk of MCI, linked to cognitive decline. Wearable digital sensors can serve as vital tools for measuring sleep and motor function. While poor quality of sleep has been correlated with decline in cognitive function, the relationship between sleep quality and gait parameters is less characterized. We hypothesized sleep apnea and lower sleep quality were associated with gait speed, gait variability, and functional mobility.MethodParticipants aged 50+ (n=55, female=31) used a finger‐worn sensor with embedded plethysmography [Sleepimage] for at least three consecutive nights over two weeks, quarterly for eight quarters. Five major sleep parameters were evaluated: Sleep Quality Index (SQI), sleep efficiency, Apnea Hypopnea Index (sAHI) at 3% oxygen desaturation threshold, sleep latency, and stable non‐REM sleep percentage. Gait assessments were completed on‐site with inertial sensors [APDM Opals] worn on the wrists, shanks, and waist. It included timed walks with and without cognitive tasks and a Timed Up and Go (TUG) test. Relevant parameters included comfortable gait velocity, dual‐task walking velocity, and lateral step variability. Pearson correlations were used to assess the relationship between sleep and gait parameters. Mean values were compared between participants with and without MCI (MCI=8, Non‐MCI=47) and between slow and fast walkers (above or below 1 meters/second, fast, n=29, slow, n=26) using independent t‐tests.ResultMean sAHI was significantly greater in slow (22.39) than fast walkers (14.57, t=2.309, p=0.026). sAHI demonstrated a significant negative correlation with gait velocity (r=‐0.288, p=0.047) and a positive correlation with time required to stand from sitting (r=0.367, p=0.01). Better SQI (r=‐0.316, p=0.029), longer sleep latency (r=0.296, p=0.041), and stable non‐REM sleep (r=‐0.316, p=0.029) was significantly associated with increased lateral step variability. Mean lateral step variability was higher in participants with MCI (16.89) than those without (0.68, t=2.485, p=0.036); mean TUG time was longer in participants with MCI (12.21 seconds) than those without (9.85, t=‐2.755, p=0.028).ConclusionThis preliminary analysis suggests associations between sleep disturbances and gait parameters associated with risk of cognitive decline. Constraints of sample size and participant diversity are acknowledged, informing the ongoing enrollment of the cohort.

Translated article] AVIP project (Prosthetic Virtual Friend): Study of clinical-functional outcomes and satisfaction with a mobile application in the perioperative management and follow-up of hip arthroplasty.

To analyse the clinical, quality of life, and healthcare quality outcomes obtained in a series of patients undergoing total hip arthroplasty (THA), who were empowered and monitored using the AVIP application. These results will be compared with a control group followed through a standard protocol. Randomised clinical trial with parallel groups involving patients with an indication for THA. Clinical variables were measured and compared using the WOMAC and mHHS, pain assessed by the VAS, quality of life with the SF-12 test. Walking capabilities were analysed using the Functional Gait Assessment Scale, along with satisfaction levels assessed through the SUCE questionnaire, and perceived anxiety levels related to the process. A total of 68 patients were evaluated, with 31 patients in the AVIP group and 33 in the Control group completing the follow-up. Both groups demonstrated improvement in clinical outcomes based on the WOMAC and mHHS hip tests, a reduction in perceived pain, and an enhancement in quality of life according to the SF-12 test. Patients in the AVIP study group exhibited non-inferiority in clinical outcomes and satisfaction compared to the control group, as well as lower anxiety levels and improved walking capabilities after the first month of follow-up. Notably, 82.25% of the follow-up visits for this group were conducted remotely. The implementation of a mHealth application like AVIP can be safely offered to selected patients undergoing hip arthroplasty, enabling effective monitoring and providing continuous information and training.