Gait Analysis Study Research Articles

Gait assessment in a female rat Sprague Dawley model of disc-associated low back pain

ABSTRACT Purpose Gait disturbances are common in human low back pain (LBP) patients, suggesting potential applicability to rodent LBP models. This study aims to assess the influence of disc-associated LBP on gait in female Sprague Dawley rats and explore the utility of the open-source Gait Analysis Instrumentation and Technology Optimized for Rodents (GAITOR) suite as a potential alternative tool for spontaneous pain assessment in a previously established LBP model. Materials and Methods Disc degeneration was surgically induced using a one-level disc scrape injury method, and microcomputed tomography was used to assess disc volume loss. After disc injury, axial hypersensitivity was evaluated using the grip strength assay, and an open field test was used to detect spontaneous pain-like behavior. Results Results demonstrated that injured animals exhibit a significant loss in disc volume and reduced grip strength. Open field test did not detect significant differences in distance traveled between sham and injured animals. Concurrently, animals with injured discs did not display significant gait abnormalities in stance time imbalance, temporal symmetry, spatial symmetry, step width, stride length, and duty factor compared to sham. However, comparisons with reference values of normal gait reported in prior literature reveal that injured animals exhibit mild deviations in forelimb and hindlimb stance time imbalance, forelimb temporal symmetry, and hindlimb spatial symmetry at some time points. Conclusions This study concludes that the disc injury may have very mild effects on gait in female rats within 9 weeks post-injury and recommends future in depth dynamic gait analysis and longer studies beyond 9 weeks to potentially detect gait.

Click method preserves but EDC method compromises the therapeutic activities of the peptide-activated hydrogels for critical ischemic vessel regeneration

Peptide-functionalized hydrogel is one of commonly used biomaterials to introduce hydrogel-induced vessel regeneration. Despite many reports about the discoveries of high-active peptides (or ligands) for regeneration, the study on the conjugating methods for the hydrogel functionalization with peptides is limited. Here, we compared the vasculogenic efficacy of the peptide-functionalized hydrogels prepared by two commonly used conjugating methods, 1-ethyl-3-(3-dimethylamino propyl) carbodiimide (EDC) and Click methods, through cell models, organ-on-chips models, animal models, and RNA sequencing analysis. Two vascular-related cell types, the human umbilical vein endothelial cells (HUVECs) and the adipose-derived stem cells (ADSCs), have been cultured on the hydrogel surfaces prepared by EDC/Click methods. It showed that the hydrogels prepared by Click method supported the higher vasculogenic activities while the ones made by EDC method compromised the peptide activities on hydrogels. The vasculogenesis assays further revealed that hydrogels prepared by Click method promoted a better vascular network formation. In a critical ischemic hindlimb model, only the peptide-functionalized hydrogels prepared by Click method successfully salvaged the ischemic limb, significantly improved blood perfusion, and enhanced the functional recoveries (through gait analysis and animal behavior studies). RNA sequencing studies revealed that the hydrogels prepared by Click method significantly promoted the PI3K-AKT pathway activation compared to the hydrogels prepared by EDC method. All the results suggested that EDC method compromised the functions of the peptides, while Click method preserved the vascular regenerating capacities of the peptides on the hydrogels, illustrating the importance of the conjugating method during the preparation of the peptide-functionalized hydrogels.

Optimizing Rare Disease Gait Classification through Data Balancing and Generative AI: Insights from Hereditary Cerebellar Ataxia.

The interpretability of gait analysis studies in people with rare diseases, such as those with primary hereditary cerebellar ataxia (pwCA), is frequently limited by the small sample sizes and unbalanced datasets. The purpose of this study was to assess the effectiveness of data balancing and generative artificial intelligence (AI) algorithms in generating synthetic data reflecting the actual gait abnormalities of pwCA. Gait data of 30 pwCA (age: 51.6 ± 12.2 years; 13 females, 17 males) and 100 healthy subjects (age: 57.1 ± 10.4; 60 females, 40 males) were collected at the lumbar level with an inertial measurement unit. Subsampling, oversampling, synthetic minority oversampling, generative adversarial networks, and conditional tabular generative adversarial networks (ctGAN) were applied to generate datasets to be input to a random forest classifier. Consistency and explainability metrics were also calculated to assess the coherence of the generated dataset with known gait abnormalities of pwCA. ctGAN significantly improved the classification performance compared with the original dataset and traditional data augmentation methods. ctGAN are effective methods for balancing tabular datasets from populations with rare diseases, owing to their ability to improve diagnostic models with consistent explainability.

Human Gait Recognition using Machine Learning Teachnolgies for Inclusive Innovation

Gait recognition, or the ability to identify people based on how they walk, is used in a variety of contexts, including human computer interaction, security checks, and health monitoring. Due to Out of touch and uncooperative individuals, gait-based human recognition is an emerging behavioural biometric feature for intelligent surveillance monitoring. In video surveillance, gait recognition can be used to detect objects at a distance and assist in low-resolution object identification. Recent years have seen an explosion in the study of gait analysis for a wide range of uses, such as animation, video surveillance, health monitoring, and authentication. A sophisticated new technology called gait recognition can identify persons Shoot from a distance and perform well on movies with no resolution. This document provides various walkthroughs written in the form of examples and free samples. Four main processes make up the survey of gait detection algorithms covered in this study: feature extraction, classification, preprocessing, and data collection. The descriptions of the pathology database, Vision base, and wearable sensor are compiled. In recent years, deep architectures have made great progress in improving human recognition performance. This article provides an up-to-date overview of deep architectures for gait recognition, highlighting the use of convolutional neural networks along with other architectures. Furthermore, the overall problems of gait recognition are examined together with potential directions for future research.

Walking and Running of Children with Decreased Femoral Torsion.

Understanding the implications of decreased femoral torsion on gait and running in children and adolescents might help orthopedic surgeons optimize treatment decisions. To date, there is limited evidence regarding the kinematic gait deviations between children with decreased femoral torsion and typically developing children, as well as the implications of the same on the adaptation of walking to running. A three-dimensional gait analysis study was undertaken to compare gait deviations during running and walking among patients with decreased femoral torsion (n = 15) and typically developing children (n = 11). Linear mixed models were utilized to establish comparisons within and between the two groups and investigate the relationship between clinical examination, spatial parameters, and the difference in hip rotation between running and walking. Patients exhibited increased external hip rotation during walking in comparison to controls, accompanied by higher peaks for the same as well as for knee valgus and external foot progression angle. A similar kinematic gait pattern was observed during running, with significant differences noted in peak knee valgus. In terms of variations from running to walking, patients internally rotated their initially externally rotated hip by 4°, whereas controls maintained the same internal hip rotation. Patients and controls displayed comparable kinematic gait deviations during running compared to walking. The passive hip range of motion, torsions, and velocity did not notably influence the variation in mean hip rotation from running to walking. This study underlines the potential of 3D gait kinematics to elucidate the functional implications of decreased FT and, hence, may contribute to clinical decision making.

Does Fibula Free Flap Harvesting Affect Donor Site of Patients in Facial Reconstructions: A Gait Analysis Study

BackroundVascularized fibula free flap remains gold standard for reconstruction of bony defects of the maxilla or mandible. Research and publications in recent years essentially focused on the evolution and improvement of the recipient reconstructed area but very few concerning the donor site morbidity. PurposeThe aim of this study was to analyze walking ability of patients following vascularized fibula free flap (VFFF) operation and to determine if there are long term walking disabilities. Study designThe retrospective cohort study involved healthy controls and patients who had undergone VFFF between 2012 and 2019 at the oral and maxillo-facial department of the University Hospital in Lausanne, Switzerland. Patients with cardiovascular, pulmonary, neuromuscular or musculoskeletal pathologies that could impair walking were excluded from the study. Predictor/exposure/independent variablesPrimary predictor is the reconstruction status, vascularized fibula free flap (VFFF) vs healthy patients (controls) Main outcome variablesMain outcomes were gait parameters. Objective evaluation of walking abilities was assessed using the Gait up ® system (Gait Up SA, EPFL Innov’Park-C, Lausanne Switzerland), which are wearable motion sensors that provides 3D analytics of the gait. CovariatesCovariates implied patient characteristics such as age, sex, time after surgery and subjective evaluation of the gait obtained with two orthopedic validated questionnaires. ResultsThis study implied 10 healthy controls and 11 patients who had undergone VFFF. Results showed statistically significant differences in the speed [m/s] (1.3 vs 1.1 for a p-value of 0.001) , the stride length [m] (1.4 vs 1.2 for a p-value of 0.003), the flat foot phase [%] (55.0 vs 63.3 for a p-value of 0.006) and the pushing phase [%] (34.1 vs 25.1 for a p-value of 0.008). Conclusion and RelevanceReconstruction using vascularized autograft in maxillofacial surgery is substantial and well described. Our attention focusing on donor site morbidity has demonstrated subjective and objective long-term alterations. These results will have to be confirmed with gait analysis in a prospective project including pre-operative and post-operative analysis of the gait of the patient acting himself as his own control, with a larger scale of patients.

Kinematic effects of unilateral TKA on the contralateral knee in Chinese patients with advanced osteoarthritis: a prospective gait analysis study.

Patients with knee osteoarthritis (OA) who receive unilateral total knee arthroplasty (TKA) often report reduced pain and enhanced function in the untreated knee, yet the kinematic mechanisms are not fully understood. Our study aimed to clarify these effects through a gait analysis of the untreated knee following unilateral TKA. This study enrolled 118 end-stage OA patients with varus deformity scheduled for TKA, categorized into the contralateral osteoarthritis group (Contra-OA), consisting of patients with end-stage OA in both knees requiring surgical treatment, and the contralateral TKA group (Contra-TKA), which included patients who had undergone TKA on one knee and had end-stage OA in the untreated knee awaiting surgery. Kinematic data of the knee joint during treadmill walking were collected using the Opti_Knee gait analysis system, and a comparative analysis was conducted. The Contra-TKA group exhibited improvements in step length, anterior-posterior translation, range of motion, vertical translation, and internal-external rotation compared to the Contra-OA group (p-values ranging from 0.0013 to 0.0463). Notable differences in flexion-extension angles and abduction/adduction rotation were also observed (p = 0.0013 and 0.0166, respectively). At the initial contact (IC), obvious differences in internal-external rotation, anterior/posterior translation, and vertical translation were noted. At the opposite toe-off (OT), significant differences in internal-external rotation. At the tibia vertical (TV) moment, significant differences were observed in all three translation indicators of joint translation. At other pivotal gait cycle points, vertical and anterior/posterior translations in Contra-TKA group continued to exhibit more meaningful decrease. Collectively, these findings underscore the protective kinematic effects of TKA on the untreated contralateral knee, indicating an improved biomechanical adaptation following TKA surgery. In summary, the study's findings indicate that unilateral TKA imparts kinetic effects on the untreated contralateral knee, as evidenced by significant improvements in key gait parameters. These enhancements, observed at both initial contacts and throughout the gait cycle, suggest a positive biomechanical support post-TKA, might contribute to better gait efficiency and reduced load on the contralateral untreated knee.

Gait variability and biomechanical distinctions in knee osteoarthritis: Insights from a 3D analysis in an adult elderly cohort

BackgroundThis study employs 3D gait analysis to investigate normal gait patterns in individuals afflicted with knee Osteoarthritis (OA). Focusing on the adult osteoarthritic population, the research aims to establish reference values for joint angles, temporospatial parameters, Gait Profile Score (GPS), and Movement Analysis Profile (MAP) collected concurrently along a standardized walking path. Furthermore, the study delves into potential variations linked to gender and OA severity, comparing gait parameters between male and female participants and among individuals with grade 3 and grade 4 OA. MethodThe study involved 34 adults with a mean age of 68.6 ± 5.75 years, all experiencing OA knees and awaiting Total Knee Arthroplasty (TKA). Utilizing Qualisys Motion capture system, 3D gait analysis was conducted. Data were processed through Visual 3D C-Motion Software. ResultsGait analysis revealed noteworthy differences between genders for various parameters, including stance time, GPS, MAP of the hip, and joint angle for the sagittal plane (ankle), coronal plane (knee), and transverse plane (hip and knee). Moreover, significant differences were observed between grade 3 and grade 4 OA knees in MAP and for the transverse plane joint angle (ankle). ConclusionThis gait analysis study sheds light on distinctive gait patterns in the adult osteoarthritic population. The identified variations in temporospatial parameters, joint angles, GPS, and MAP provide valuable reference values for individuals suffering from knee OA. The observed differences between genders and across different OA severity grades emphasize the need for personalized approaches in managing knee OA and planning interventions like TKA.

Stretching and Eccentric Exercises Normalize Gait Parameters in Gastrocnemius Tightness Subjects

Background: Isolated gastrocnemius tightness (IGT) is a prevalent condition linked to various foot pathologies. In a previous quantitative gait analysis study, we identified an increase in knee flexion during the midstance phase in IGT patients compared with controls. Although stretching and eccentric exercises (the Stanish protocol) are commonly used for IGT management, their impact on gait parameters remains poorly understood. This study aimed to assess the influence of a Stanish protocol on gait parameters in bilateral IGT subjects. Methods: We enrolled 10 asymptomatic bilateral IGT subjects and 10 controls. Quantitative gait analysis and dynamic baropodometry were carried out on each subject. A Stanish protocol was applied for 4 weeks (five sessions/week) by the IGT group, followed by a similar gait analysis. The ankle and knee range of motion and foot pressure distribution were assessed during the midstance phase of the gait. Results: An increase in knee flexion was initially present in the IGT group compared with controls (8.9 +/− 4.6 vs. 3.4 +/− 2.3 degrees, p < 0.001). There was no difference in the ankle range of motion and foot pressures between the groups at that time. Significant reductions in knee flexion during gait were observed in the IGT subjects after the Stanish protocol (8.9 +/− 4.6 to 3.7 +/− 2.3 degrees, p < 0.001) with a normalization of this parameter (3.4 +/− 2.3 in controls vs. 3.7 +/− 2.3 degrees in IGT, p = 0.72). There was no change in ankle range of motion and foot pressure after the Stanish protocol. Conclusions: Our findings support the effectiveness of the Stanish protocol in reducing knee flexion and normalizing gait in IGT subjects. This protocol not only offers a noninvasive approach for IGT-related issues management but could also enable prophylactic care in asymptomatic cases.

The Effects of Different Degrees of Leg Length Discrepancy on Vertical Ground Reaction Force in Children and Adults: Treatment Implications.

Previous studies on the degree of leg length discrepancy that causes limb biomechanical problems did not differentiate between adults and children. We conducted this study to determine the effects of simulated leg length discrepancy on vertical ground reaction force in children and adults to enable decision-making for intervention in patients with leg length discrepancy for different age groups or heights. This cross-sectional study involved male volunteers of children 150cm and adults with 170cm in height. Vertical ground reaction force was measured using a gait analysis study. The first measurement was taken without any leg length discrepancy as a baseline. Subsequently, different amounts of leg length discrepancy were simulated on the left leg with shoe lifts of 2, 3, and 4cm. The measurements were repeated on each volunteer with similar shoe lifts on the right leg. Therefore, 14 volunteers provided simulations of 28 leg length discrepancies for each group. The first and second peaks of vertical ground reaction force were separately analysed. The vertical GRF of a simulated leg length discrepancy was compared with the baseline. Repeated measurement of analysis of variance (ANOVA) within each group was done. In both groups, the second peak of vertical ground reaction force in the longer leg reduced gradually as the shoe lift increased sequentially from 2 to 3cm and then to 4cm. A discrepancy of 3cm and above was statistically significant to cause a reduction in the vertical GRF on the longer limb in both height groups. The degree of leg length discrepancy that caused significant changes in second peak ground reaction force in children with 150 and adults with 170cm height population was similar at 3cm. Therefore, the cut-off point for intervention for both groups are similar with additional consideration of future growth in children.

Comparison of Two Therapeutic Approaches of Cerebellar Transcranial Direct Current Stimulation in a Sardinian Family Affected by Spinocerebellar Ataxia 38: a Clinical and Computerized 3D Gait Analysis Study.

Spinocerebellar ataxia 38 (SCA 38) is a very rare autosomal dominant inherited disorder caused by a mutation in ELOV5 gene, specifically expressed in cerebellar Purkinje cells, encoding an enzyme involved in the synthesis of fatty acids. Seven symptomatic SCA 38 patients of a Sardinian family were administered 15 sessions of cerebellar anodal transcranial direct current stimulation (tDCS) in a cross-over study, employing deltoid cerebellar-only (C-tDCS) and cerebello-spinal (CS-tDCS) cathodal montage. Clinical evaluation was performed at baseline (T0), after 15 sessions of tDCS (T1) and after 1 month of follow-up (T2). Modified International Cooperative Ataxia Rating Scale (MICARS) and the Robertson dysarthria profile were used to rate ataxic and dysarthric symptoms, respectively. Alertness and split attention tests from Zimmermann test battery for attentional performance were employed to rate attentive functions. Moreover, 3D computerized gait analysis was employed to obtain a quantitative measure of efficacy of tDCS on motor symptoms. While clinical data showed that both CS and C-tDCS improved motor, dysarthric, and cognitive scores, the quantitative analysis of gait revealed significant improvement in spatio-temporal parameters only for C-tDCS treatment. Present findings, yet preliminary and limited by the small size of the tested sample, confirm the therapeutic potential of cerebellar tDCS in improving motor and cognitive symptoms in spinocerebellar ataxias and underline the need to obtain quantitative and objective measures to monitor the efficacy of a therapeutic treatment and to design tailored rehabilitative interventions. ClinicalTrials.gov identifier: NCT05951010.

Sports medicine methodologies applied in occupational medicine: analyzing the workstations of video terminal operators

BACKGROUND: Three-dimensional movement reconstruction systems, based on the use of infrared cameras capable of recognizing and capturing 3-D movement, are the standard in the biomechanical study of sporting actions. In this study, the knowledge and expertise inherent in sports medicine and engineering applied to sport were used for occupational risk assessment. In Italy, in 2020, muscularticular problems accounted for 69% of the problems reported to INAIL: these pathologies are correlated with bad posture. Using a methodology peculiar to sports medicine applied in the study of postural adjustment and gait analysis, therefore, the different working postures assumed at the video terminal typically employed by the staff of the leading international “E-commerce company” were subjected to analysis.METHODS: Four subjects (2 males and 2 females; age: 33.0± 12.9 years; stature 175.6± 0.07 cm; body weight 70.8± 8.87 kg) were evaluated in the laboratory of the Institute of Sports Medicine and Science of CONI by a three-dimensional optoelectronic system (SMART-DX 7000, BTS Bioengineering, Milan, Italy).RESULTS: The video terminal stations were characterized by three work surfaces of different heights: 73 cm for “sitting” positions, 100cm and 110cm for “standing” positions. The postures for the “sitting” position: 1) standard: correct posture as per D.Lgs.81/08; 2) leaning: with head bent forward towards the monitor; 3) slouching: “tired at the end of the day” and for the “standing” positions: 4) standard: correct posture; 5) leaning: with head bent forward towards the monitor. The angles (at knee, elbows, ankles, back created between C7-sacro-knee, head, visual, head-shoulder) and distances (forehead-monitor; acromion-monitor) were measured.CONCLUSIONS: Analysis of the data collected compared the different postures with the standard sitting position, the normative term of reference. The best “standing” posture is the one that also includes a rest under one of the feet, which brings the angles studied closer to those of the standard position. The standing position alone, however, exposes the back to “overload” and, therefore, the use of a bar stool of between about 72 to 85 cm high is suggested. This paper demonstrates how the methodology of movement analysis typical of sports medicine integrates with the ergonomic assessment needs of occupational medicine, needs that are and will become increasingly important in the management of workers who are called upon to extend their careers well beyond the age of 60.

Spatial and Temporal Gait Characteristics in Patients Admitted to a Neuro-Rehabilitation Department with Age-Related White Matter Changes: A Gait Analysis and Clinical Study.

Patients with age-related white matter changes (ARWMC) frequently present a gait disorder, depression and cognitive impairment. Our aims are to define which alterations in the gait parameters are associated with motor or neuro-psychological impairment and to assess the role of motor, mood or cognitive dysfunction in explaining the variance of the gait parameters. Patients with gait disorders admitted to a Neuro-rehabilitation Department, affected by vascular leukoencephalopathy who had ARWMC confirmed by a brain MRI, were consecutively enrolled, classified by a neuroradiological scale (Fazekas 1987) and compared to healthy controls. We excluded subjects unable to walk independently, subjects with hydrocephalus or severe aphasia, with orthopaedic and other neurological pathologies conditioning the walking pattern. Patients and controls were assessed by clinical and functional scales (Mini Mental State Examination, Geriatric Depression Scale, Nevitt Motor Performance Scale, Berg Balance Scale, Functional Independence Measure), and computerised gait analysis was performed to assess the spatial and temporal gait parameters in a cross-sectional study. We recruited 76 patients (48 males, aged 78.3 ± 6.2 years) and 14 controls (6 males, aged 75.8 ± 5 years). In the multiple regression analysis, the gait parameter with overall best model summary values, associated with the ARWMC severity, was the stride length even after correction for age, sex, weight and height (R2 = 0.327). The motor performances justified at least in part of the gait disorder (R2 change = 0.220), but the mood state accounted independently for gait alterations (R2 change = 0.039). The increase in ARWMC severity, the reduction of motor performance and a depressed mood state were associated with a reduction of stride length (R = 0.766, R2 = 0.587), reduction of gait speed (R2 = 0.573) and an increase in double support time (R2 = 0.421). The gait disorders in patients with ARWMC are related to motor impairment, but the presence of depression is an independent factor for determining gait alterations and functional status. These data pave the way for longitudinal studies, including gait parameters, to quantitatively assess gait changes after treatment or to monitor the natural progression of the gait disorders.

Non-human primate models and systems for gait and neurophysiological analysis.

Brain-computer interfaces (BCIs) have garnered extensive interest and become a groundbreaking technology to restore movement, tactile sense, and communication in patients. Prior to their use in human subjects, clinical BCIs require rigorous validation and verification (V&V). Non-human primates (NHPs) are often considered the ultimate and widely used animal model for neuroscience studies, including BCIs V&V, due to their proximity to humans. This literature review summarizes 94 NHP gait analysis studies until 1 June, 2022, including seven BCI-oriented studies. Due to technological limitations, most of these studies used wired neural recordings to access electrophysiological data. However, wireless neural recording systems for NHPs enabled neuroscience research in humans, and many on NHP locomotion, while posing numerous technical challenges, such as signal quality, data throughout, working distance, size, and power constraint, that have yet to be overcome. Besides neurological data, motion capture (MoCap) systems are usually required in BCI and gait studies to capture locomotion kinematics. However, current studies have exclusively relied on image processing-based MoCap systems, which have insufficient accuracy (error: ≥4° and 9 mm). While the role of the motor cortex during locomotion is still unclear and worth further exploration, future BCI and gait studies require simultaneous, high-speed, accurate neurophysiological, and movement measures. Therefore, the infrared MoCap system which has high accuracy and speed, together with a high spatiotemporal resolution neural recording system, may expand the scope and improve the quality of the motor and neurophysiological analysis in NHPs.

Do they Feel Better When they Walk Better? 3D Gait Analysis Study in Total Knee Arthroplasty for Indian Osteoarthritic Knees

Background: Osteoarthritis (OA) is a leading cause of disability in the elderly population. Gait analysis is a widely used tool to measure functional outcomes after total knee arthroplasty (TKA). This study aimed to assess the gait pattern and influence of TKA in patients with osteoarthritic knees. Materials and Methods: Preoperative and postoperative gait analysis was carried out on patients with grade 4 OA knee undergoing TKA. Sequential 33 adults (45 knees) with a mean age of 68.4 ± 5.8 years were studied. Gait analysis was carried out in Jupiter gait lab with 9 Qualisys Oqus cameras system and Qualisys track manager. Kinematic data were processed using Visual 3D C-Motion Software during a minimum of 6 walks across the walkway. Results: A significant difference in temporospatial parameters (gait speed, Cadence, step time, step length, stride width, stride length), joint kinematics in the sagittal plane (pelvis, hip, knee, ankle), coronal plane (pelvis, hip, knee, ankle), transverse plane (hip, knee) and motion analysis profile of knee (flexion/extension), ankle (dorsiflexion/plantarflexion), and hip (adduction/abduction). A significant difference was observed in the oxford knee score (OKS), Short Form 12, and knee society score. Conclusion: 3D gait analysis is a good tool to document and compare gait changes in patients undergoing TKA. Recent advances in surgical techniques and improvements in prosthesis design are important factors for better functional outcomes. Our results may be used by clinicians, physiotherapists, or researchers as a reference for integrated aspects for the development of TKA implant designs and improving functional outcomes.

Development of a clinically useful multi-segment kinetic foot model

BackgroundTraditionally, gait analysis studies record the foot as a single rigid segment, leaving movements and loads within the foot undetected. In addition, very few data of multi-segment foot kinetics have been represented in the literature due to measurement and equipment limitations. As a result, this study aims to develop a novel multi-segment kinetic foot model that is clinically feasible and enables both kinematic and kinetic analysis of large patient groups.ResultsOutcome measurements include rotation angles of intersegmental dorsi/plantar flexion, inversion/eversion, and internal/external rotation, joint moments, joint powers and the medial longitudinal arch (MLA) height/length ratio. Repeatability of joint motions was calculated using coefficients of multiple correlation. Most joint motions measured by this foot model showed strong within-subject reliability (R > 0.7) in healthy adults. Outcome measures were in agreement with other multi-segment foot models found in the biomechanics literature.ConclusionsThis novel multi-segment foot model is able to quantify intersegmental foot kinematics and kinetics and can be a useful tool for research and assessments on clinical populations.

Measurement of temporal and spatial parameters of ice hockey skating using a wearable system

Ice hockey is a dynamic and competitive sport that requires a high level of neuromuscular and cardiovascular function. An objective assessment of skating helps coaches monitor athletes' performance during training sessions and matches. This study aimed to estimate the temporal and spatial parameters of skating by proposing an optimized configuration of wearable inertial measurement units (IMUs) and validating the system compared to in-lab reference systems. Ten participants were recruited to skate on a 14 m synthetic ice surface built in a motion-capture lab. Eight original event detection methods and three more adopted from gait analysis studies were implemented to detect blades-off and skate-strikes. These temporal events were detected with high accuracy and precision using skate-mounted IMUs. Also, four novel stride length estimation methods were developed to correct the estimated skaters' position using IMUs' readouts. The stride time, contact time, stride length, and stride velocity were obtained with relative errors of 3 ± 3%, 4 ± 3%, 2 ± 6%, and 2 ± 8%, respectively. This study showed that the wearable IMUs placed on skates and pelvis enables the estimation of temporal and spatial parameters of skating with high accuracy and precision, which could help coaches monitor skaters' performance in training.

Surgical Management of Severe Equinus Deformity in Ambulatory Children With Cerebral Palsy.

Tendo Achilles lengthening (TAL) for the management of equinus contractures in ambulatory children with cerebral palsy (CP) is generally not recommended due to concerns of over-lengthening, resulting in weakness and plantar flexor insufficiency. However, in some cases, surgical correction of severe equinus deformities can only be achieved by TAL. The goal of this study is to assess the outcomes following TAL in these cases. A retrospective cohort study of children with CP with severe equinus contractures (ankle dorsiflexion with the knee extended of -20 degrees or worse) who underwent TAL as part of a single event multilevel surgery, with preoperative and postoperative gait analysis studies. Continuous data were analyzed by paired t test, and categorical data by McNemar Test. There were 60 subjects: 42 unilateral, 18 bilateral CP; 41 GMFCS II, 17 GMFCS I; mean age at surgery was 10.6 years, mean follow-up was 1.3 years. Ankle dorsiflexion with the knee extended improved from -28 to 5 degrees (P<0.001). The ankle Gait Variable Score improved from 34.4 to 8.6 (P<0.001). The ankle moment in terminal stance improved from 0.43 to 0.97Nm/kg (P<0.001). Significant improvements (P<0.001) were seen in radiographic measures of foot alignment following surgery. There were few significant differences in the outcome parameters between subjects with unilateral versus bilateral CP (eg, only the bilateral group showed improved but persistent increased knee flexion in mid-stance). The outcomes following TAL for the management of severe equinus deformity in ambulatory children with CP were favorable 1 year after surgery, with significant improvements in all domains measured. This study does not advocate for the widespread use of TAL to correct equinus deformity in children with CP. However, it does show that good short-term outcomes following TAL are possible in properly selected subjects with severe contractures when the dosing of the surgery is optimal (correction of contracture to between 0 and 5 degrees of dorsiflexion with the knee extended) and the procedure is performed in the setting of single event multilevel surgery with subsequent proper orthotic management and rehabilitation.

Is simultaneous bilateral total hip arthroplasty deleterious in a biomechanical point of view? A comparative gait analysis study

PurposeUni- or bilateral hip osteoarthritis is a common disease generating pain, stiffness, and functional disabilities. Changes in the normal walking with higher energy expenditures are observed. Facing a cruel lack of biomechanical data, we decided to analyse the impact on the walking of single and simultaneous bilateral total hip arthroplasties (THA).MethodWe conducted a prospective monocentric study, comparing two matched groups of 15 patients able to walk with symptomatic isolated uni- (group 1) or bilateral HO (group 2) and treated respectively by unilateral THA (UTHA) or simultaneous bilateral THA (SBTHA). Surgery was performed by a single surgeon with a direct anterior approach and approved by local ethical committee. Walking was assessed by a « 3D Gait analysis motion» pre and at 6 months post operatively.ResultIn the UTHA group, recovery, i.e., efficiency of locomotor mechanism (p < 0.001) and pelvis sagittal balance (p = 0.031) improved, while external and total work (p = 0.010) decreased post operatively. In the SBTHA group, speed (p = 0.035), step length (p = 0.046), range of motion of knee sagittal stance (p = 0.009) and hip frontal (p = 0.031), and internal work are significatively higher (p < 0.001) post operatively.ConclusionsThis original study attests that THA has a positive impact on walking and energetics outcome in UTHA and SBTHA.

Ground-Reaction-Force-Based Gait Analysis and Its Application to Gait Disorder Assessment: New Indices for Quantifying Walking Behavior.

Gait assessment is an important tool for determining whether a person has a gait disorder. Existing gait analysis studies have a high error rate due to the heel-contact-event-based technique. Our goals were to overcome the shortcomings of existing gait analysis techniques and to develop more objective indices for assessing gait disorders. This paper proposes a method for assessing gait disorders via the observation of changes in the center of pressure (COP) in the medial–lateral direction, i.e., COPx, during the gait cycle. The data for the COPx were used to design a gait cycle estimation method applicable to patients with gait disorders. A polar gaitogram was drawn using the gait cycle and COPx data. The difference between the areas inside the two closed curves in the polar gaitogram, area ratio index (ARI), and the slope of the tangential line common to the two closed curves were proposed as gait analysis indices. An experimental study was conducted to verify that these two indices can be used to differentiate between stroke patients and healthy adults. The findings indicated the potential of using the proposed polar gaitogram and indices to develop and apply wearable devices to assess gait disorders.