Biomechanical Gait Parameters Research Articles

Analysis of Biomechanical Gait Parameters in Patients after Total Hip Replacement in the Early Recovery Period

INTRODUCTION. The widespread use of total hip arthroplasty (THA) places high demands on the restoration of a normal gait pattern and is one of the key goals of rehabilitation. AIM. Determination of key parameters of walking in patients after THA to assess the effectiveness of restoration of the physiological gait pattern. MATERIALS AND METHODS. In a control prospective study, the main group consisted of 23 patients (11 men, 12 women, aged from 41 to 75 years, mean age 63.9 ± 9.4 years), who in the first 8 weeks after planned THA, moved with the help of assistive devices. supports (two crutches or walkers) who underwent stage II of medical rehabilitation; control group — 27 healthy people (12 men and 15 women, aged from 42 to 73 years, average age 60.9 ± 9.9 years). Spatiotemporal and kinematic gait parameters were recorded before and after the rehabilitation course using a gait simulator with biofeedback equipped with three sensors. For each leg, spatiotemporal and kinematic biomechanical parameters were separately recorded. RESULTS. All spatiotemporal gait parameters on both limbs and pelvic mobility in the sagittal plane in patients in the early recovery period after THA before the start of the rehabilitation course are significantly different from healthy people. After a course of rehabilitation, the studied gait parameters approach physiological values. The main asymmetry is observed in the single support phase from 16 % at the beginning of the course, to 10 % at the end; sagittal pelvic mobility are 2 times higher than the physiological normal meaning at the beginning of the course, without significant changes in dynamics. DISCUSSION. Disturbances in the gait pattern are observed in the majority of patients undergoing THA. Step symmetry is one of the significant parameters of walking, according to which the primary global assessment of its quality is carried out. Asymmetry of the single support phase of the limbs is a natural development of compensatory motor reactions after endoprosthetics. CONCLUSION. The gait parameters “step frequency” and “step cycle” quickly change after a course of rehabilitation and can be used to assess the locomotor activity of patients during short courses of medical rehabilitation in the early recovery period. Indicators of stance and swing phases, their symmetry changes much more slowly, can serve as criteria for assessing the effectiveness of measures taken at the stages of rehabilitation in the dynamics of gait restoration.

Characteristics of gait function in hemiparetic patients with subacute period of ischemic stroke: a single-center retrospective study

BACKGROUND: Gait disorders are common among 80% of stroke patients. Its consequences include increased risk of falls and functional limitations, which can significantly reduce the quality of life. AIM: To investigate the functional profile of hemiparesis resulting from subacute ischemic stroke. MATERIALS AND METHODS: This observational, retrospective, one-stage, single-center study analyzed primary biomechanical gait parameters in 31 patients and 34 healthy controls. Spatial, temporal, kinematic, and electromyographic characteristics were recorded. A statistical assessment and inter-group and intra-group comparison of the collected data were performed to identify the pathognomonic features of hemiplegic gait in patients with subacute stroke. RESULTS: Changes in gait biomechanics typical for hemiparetic patients who have suffered from ischemic stroke were described: slight asymmetry of step cycle, normal duration of support period on the paretic side, significant increase in duration of support period on the healthy side, and shortening of single support period on the paretic side. Additionally, the asymmetry of the walking function was characterized by changes in reciprocity, that is, a harmonious sequence of step cycles. The function of the hip and knee joints was reduced and altered, and the amplitude of the ankle joint was increased. Decrease and change in the bioelectric activity profile of muscles were detected. Moreover, the quadriceps femoris function was least affected. CONCLUSION: The main changes in walking function are characterized by an asymmetry of spatiotemporal parameters, a decrease in movement amplitudes of the hip and knee joints on the paretic side, an increase in ankle joint amplitude, a decrease in the bioelectric activity of muscles, and a shift in the phases of their activity. The results contribute to a better understanding of the mechanisms behind hemiplegic gait and provide a valuable tool for developing more personalized and targeted rehabilitation plans for patients suffering from hemiparesis as a result of subacute ischemic stroke.

The Role of Biomarkers in Predicting Outcomes of Anterior Cruciate Ligament Reconstruction: A Systematic Review.

Anterior cruciate ligament (ACL) injury is frequently associated with injuries to other parts of the knee, including the menisci and articular cartilage. After ACL injury and reconstruction, there may be progressive chondral degradation. Biomarkers in blood, urine, and synovial fluid can be measured after ACL injury and reconstruction and have been proposed as a means of measuring the associated cellular changes occurring in the knee. To systematically review the literature regarding biomarkers in urine, serum, or synovial fluid that have been associated with an outcome measure after ACL reconstruction. Systematic review; Level of evidence, 3. This review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The MEDLINE, Embase, CINAHL, and Web of Science databases were searched to identify studies published before September 2023 that reported on patients undergoing ACL reconstruction where a biomarker was measured and related to an outcome variable. Of 9360 results, 16 studies comprising 492 patients were included. Findings were reported as descriptive summaries synthesizing the available literature. A total of 45 unique biomarkers or biomarker ratios were investigated (12 serum, 3 urine, and 38 synovial fluid; 8 biomarkers were measured from >1 source). Nineteen different outcome measures were identified, including the International Knee Documentation Committee Subjective Knee Form, Knee injury and Osteoarthritis Outcome Score, numeric pain scores, radiological outcomes (magnetic resonance imaging and radiography), rates of arthrofibrosis and cyclops lesions, and gait biomechanics. Across the included studies, 17 biomarkers were found to have a statistically significant association (P < .05) with an outcome variable. Serum interleukin 6 (s-IL-6), serum and synovial fluid matrix metalloproteinase-3 (s-MMP-3 and sf-MMP-3), urinary and synovial fluid C-terminal telopeptide of type 2 collagen (u-CTX-II and sf-CTX-II), and serum collagen type 2 cleavage product (s-C2C) showed promise in predicting outcomes after ACL reconstruction, specifically regarding patient-reported outcome measures (s-IL-6 and u-CTX-II), gait biomechanical parameters (s-IL-6, sf-MMP-3, s-MMP-3, and s-C2C), pain (s-IL-6 and u-CTX-II), and radiological osteoarthritis (ratio of u-CTX-II to serum procollagen 2 C-propeptide). The results highlight several biomarkers that have been associated with clinically important postoperative outcome measures and may warrant further research to understand if they can provide meaningful information in the clinical environment.

Inter-session and inter-rater variability in biomechanical gait parameters for a single subject: Preliminary results of a multicenter study

Inter-session and inter-rater variability in biomechanical gait parameters for a single subject: Preliminary results of a multicenter study

Extraction and Validation of Biomechanical Gait Parameters with Contactless FMCW Radar.

A 77 GHz frequency-modulated continuous wave (FMCW) radar was utilized to extract biomechanical parameters for gait analysis in indoor scenarios. By preprocessing the collected raw radar data and eliminating environmental noise, a range-velocity-time (RVT) data cube encompassing the subjects' information was derived. The strongest signals from the torso in the velocity and range dimensions and the enveloped signal from the toe in the velocity dimension were individually separated for the gait parameters extraction. Then, six gait parameters, including step time, stride time, step length, stride length, torso velocity, and toe velocity, were measured. In addition, the Qualisys system was concurrently utilized to measure the gait parameters of the subjects as the ground truth. The reliability of the parameters extracted by the radar was validated through the application of the Wilcoxon test, the intraclass correlation coefficient (ICC) value, and Bland-Altman plots. The average errors of the gait parameters in the time, range, and velocity dimensions were less than 0.004 s, 0.002 m, and 0.045 m/s, respectively. This non-contact radar modality promises to be employable for gait monitoring and analysis of the elderly at home.

Might patients with cerebellar ataxia benefit from the Computer Assisted Rehabilitation ENvironment (CAREN)? A pilot study focusing on gait and balance.

Introduction: Ataxia is a neurological symptom that causes decreased balance, loss of coordination, and gait alterations. Innovative rehabilitation devices like virtual reality (VR) systems can provide task-oriented, repetitive and intensive training with multisensorial feedback, thus promoting neuroplastic processes. Among these VR technologies, the Computer Assisted Rehabilitation ENvironment (CAREN) associates a split belt treadmill on a 6-degrees of freedom platform with a 180° VR screen and a Vicon motion capture system to monitor patients' movements during training sessions. Methods: Eight patients affected by cerebellar ataxia were enrolled and received 20 sessions of CAREN training in addition to standard rehabilitation treatment. Each patient was evaluated at the beginning and at the end of the study with 3D gait analysis and clinical scales to assess balance, gait function and risk of falls. Results: We found improvements in kinematic, kinetic, and electromyographic parameters (as per pre-post- CAREN training), as well as in clinical outcomes, such as balance and risk of falls in ataxic patients. In addition, we found that trunk rotation improved, after CAREN intervention, approximating to the normative values. Discussion: Our results suggested that CAREN might be useful to improve specific biomechanical parameters of gait in ataxic patients.

Effect of manual manipulation on mechanical gait parameters.

A variety of manual manipulation techniques are utilized in clinical practice to alleviate pain and improve musculoskeletal function. Many manual practitioners analyze gait patterns and asymmetries in their assessment of the patient, and an increasing number of gait motion capture studies are taking place with recent improvements in motion capture technology. This study is the first systematic review of whether these manual modalities have been shown to produce an objectively measurable change in gait mechanics. This study was designed to perform a systematic review of the literature to assess the impact of manual medicine modalities on biomechanical parameters of gait. A master search term composed of keywords and Medical Subject Headings (MeSH) search terms from an initial scan of relevant articles was utilized to search six databases. We screened the titles and abstracts of the resulting papers for relevance and then assessed their quality with the Cochrane Risk of Bias Tool. Clinical trials that featured both a manual manipulation intervention and multiple mechanical gait parameters were included. Case reports and other studies that only measured gait speed or other subjective measures of mobility were excluded. We included 20 studies in our final analysis. They utilize manipulation techniques primarily from osteopathic, chiropractic, massage, and physiotherapy backgrounds. The conditions studied primarily included problems with the back, knee, and ankle, as well as healthy patients and Parkinson's patients. Control groups were highly variable, if not absent. Most studies measured their gait parameters utilizing either multicamera motion capture systems or force platforms. Twelve of 20 papers included in the final analysis demonstrated a significant effect of manipulation on gait variables, many of which included either step length, walking speed, or sagittal range of motion (ROM) in joints of the lower extremity. However, the results and study design are too heterogeneous to draw robust conclusions from these studies as a whole. While there are initial indications that certain modalities may yield a change in certain gait parameters, the quality of evidence is low and there is insufficient evidence to conclude that manual therapies induce changes in biomechanical gait parameters. Studies are heterogeneous with respect to the populations studied and the interventions performed. Comparators were variable or absent across the studies, as were the outcome variables measured. More could be learned in the future with consistent methodology around blinding and sham treatment, and if the gait parameters measured were standardized and of a more robust clinical significance.

Gait Characteristics over the Six-minute Walk Test in Older Women of a Specific Portuguese Community: A Cross-Sectional Study.

There is limited research on the changes that can occur in the gait biomechanical parameters of older adults over long-distance walking. Thus, this study aimed to evaluate the gait characteristics of older women of a specific Portuguese community over the six-minute walk test (6MWT) along with gait spatial and temporal parameters and angular kinematics of the lower limb joints. Twenty-six older women voluntarily participated. Each woman performed the 6MWT, and during this, their spatial and temporal parameters were collected through plantar pressure data (100Hz) and angular kinematics through an inertial sensor system (100Hz). The 6MWT was divided into four intervals, and the Friedman test was used to compare them. The median age of the women was calculated, and the Mann-Whitney test was used to compare women above and below the median age value. An increase in gait speed, stance phase, and double stance phase along the intervals was observed, as well as larger angular displacements of the hip, knee, and ankle (p<0.05). Women below or above the median age value also yielded these behaviours. Gait speed, cadence, stride length, and step length were higher in women below the median age value, while stride and step duration were lower (p<0.05). Older women yielded changes in gait spatial and temporal parameters along the 6MWT, as well as larger angular displacements of the lower limb joints. Older women (compared to younger ones) yielded lower gait speed, cadence, stride length, and step length, higher stance and double stance phases, and shorter angular displacements of the lower limb joints.

Gait Biomechanical Parameters Related to Falls in the Elderly: A Systematic Review

According to the World Health Organization, one-third of elderly people aged 65 or over fall annually, and this number increases after 70. Several gait biomechanical parameters were associated with a history of falls. This study aimed to conduct a systematic review to identify and describe the gait biomechanical parameters related to falls in the elderly. MEDLINE Complete, Cochrane, Web of Science, and CINAHL Complete were searched for articles on 22 November 2023, using the following search sentence: (gait) AND (fall*) AND ((elder*) OR (old*) OR (senior*)) AND ((kinematic*) OR (kinetic*) OR (biomechanic*) OR (electromyogram*) OR (emg) OR (motion analysis*) OR (plantar pressure)). This search identified 13,988 studies. From these, 96 were selected. Gait speed, stride/step length, and double support phase are gait biomechanical parameters that differentiate fallers from non-fallers. Fallers also tended to exhibit higher variability in gait biomechanical parameters, namely the minimum foot/toe clearance variability. Although the studies were scarce, differences between fallers and non-fallers were found regarding lower limb muscular activity and joint biomechanics. Due to the scarce literature and contradictory results among studies, it is complex to draw clear conclusions for parameters related to postural stability. Minimum foot/toe clearance, step width, and knee kinematics did not differentiate fallers from non-fallers.

Proprioceptive and Strength Exercise Guidelines to Prevent Falls in the Elderly Related to Biomechanical Movement Characteristics.

Falls are a major concern in the elderly and walking is an important daily activity in which falls occur, with tripping and slipping being the most frequent causes. Gait biomechanical parameters have been related to the occurrence of falls in the elderly. Moreover, there is evidence that falls can be prevented through exercise programs, which have been shown to be also effective in improving gait biomechanical parameters. However, a question remains: "What types of exercises must be included in exercise programs to prevent falls?". The purpose of this manuscript was to present guidelines for a fall prevention exercise program for the elderly, which was created with the aim of improving the gait biomechanical parameters related to falls. The critical review performed during the preparation of this manuscript collected important evidence and knowledge in order to create a structural basis for the development of a fall prevention exercise program. This type of program should last 6 or more weeks and be prescribed based on four movement pillars (locomotion, level changes, pulling and pushing, and rotations); however, the locomotion pillar must be the focus of the program. Proprioceptive and functional strength exercises should be included in this program. Based on the theoretical rationale, a proposal for a fall prevention exercise program is presented.

The nature of gait biomechanics changes with walking speed increase in patients with anterior cruciate ligament injury.

This study on gait biomechanics is based on a functional test (FT) performed at free and fast walking speeds. We investigated the pattern of changes in gait biomechanical parameters and the knee function in patients after anterior cruciate ligament (ACL) injury or its reconstruction. The study included 51 patients (33 males, 18 females) with a confirmed recent or old history of ACL tear, before or after reconstruction (26 patients). Mocap data was obtained using an inertial system. All patients were divided into three groups: 41 patients with physiological response (compensation), 6 patients with signs of decompensation, and 4 non-assessable patients. Increase in gait speed was associated with decrease in the walking cycle duration, stance and double support phases. In the compensation group, the physiological response of the knee was manifested in increased amplitudes. In the decompensation group, the amplitudes remained unchanged or decreased. In the compensation group, there were increases in the symmetrical muscle activity. The decompensation group was characterized by electromyography asymmetry. The observed universal physiological mechanism limiting the load on the damaged joint can be used for accurate assessment of the knee functional state in various periods of rehabilitation.

A biomechanical analysis of turning during gait in individuals with different subtypes of Parkinson's disease

BackgroundTurning while walking is a complex component of locomotor capacity, which can be challenging in the daily lives of people with Parkinson's disease. The aim of the study was to compare biomechanical strategies during turning of gait in individuals with Parkinson's disease and its different clinical subtypes. MethodsA cross-sectional study, comprising of 43 individuals with idiopathic Parkinson's disease, divided in subgroups: akineto-rigid, dominant tremor and mixed. Motor impairment was assessed using the Unified Parkinson's Disease Rating Scale. The gait biomechanical parameters (number of steps, step length, cadence, amplitude, velocity and radius of the turn) were analyzed during turning in a kinematics laboratory. In the statistical analysis, a comparison was made between subgroups, and correlations between biomechanical parameters. FindingsThere was no statistically significant difference between the subgroups. In the correlation analysis, notable correlations were found between the anticipatory step length and the following variables: number of steps (r = −0.418), step length while turning (r = 0.805), step length after turning (r = 0.644), average velocity (r = 0.830), average velocity while turning (r = 0.755), and maximum velocity (rho = 0.835). InterpretationThe difficulties primarily occur during the anticipatory phase of the turn, which affects the entire task. The greater the length of the anticipatory step, the greater the length of the step taken to turn as well as the step taken after turning. And the greater the velocity, the greater the step length, and to fewer steps taken to perform the task.

Changes in body balance due to exposure to trauma – multi-center studies

Aim. The purpose of the study was to assess the impact of a traumatic event experienced by the subject on postural balance and biomechanical parameters of gait. Research methodology. The study involved 31 people (n = 100%), including 22 women (nk% = 70.97%), 9 men (nm% = 29.03), aged 29-60. People with diseases and dysfunctions affecting body balance and gait pattern were excluded from the study. Balance and gait tests were performed using pedobarography (pedobarograph mod. EPS R2, Biomech Studio v2 software). The balance test was performed while standing, for 20 seconds, with sampling every 1 ms (millisecond) – the number of samples during one test is 20,000. The balance and gait assessment tests were performed twice. Test I included testing in neutral conditions, Test II included testing in conditions in which the subject was exposed to a traumatic event he or she had experienced in the past (so-called exposure to “experienced trauma”). Results. The obtained results of studies on the impact of exposure to experienced trauma on body balance while standing showed significant differences in body fluctuations in the most important parameters of stabilometric assessment. The obtained results of research on the impact of exposure to trauma on the subject’s gait showed no significant differences between the test in neutral conditions and the test during exposure. Conclusions. (1) Exposure to the trauma experienced by the subject significantly affects the body’s balance in a standing position. (2) The research showed no influence of exposure to the experienced trauma on the subject’s gait in the area of the time of contact of the feet with the ground and on the values of maximum and average pressure; The area of the plane where the feet are placed on the ground changes significantly before and after exposure to the trauma experienced by the subject. (3) In research on the impact of trauma on body posture, detailed results of studies on the range of COP fluctuations in each plane should be taken into account – the study showed that the analysis of only average results may significantly indicate an incorrect result in the assessment of body balance.

Peripheral artery disease causes consistent gait irregularities regardless of the location of leg claudication pain

BackgroundThe most common symptom of peripheral artery disease (PAD) is intermittent claudication that involves the calf, thigh, and/or buttock muscles. How the specific location of this leg pain is related to altered gait, however, is unknown. ObjectivesWe hypothesized that because the location of claudication symptoms uniquely affects different leg muscle groups in people with PAD, this would produce distinctive walking patterns. MethodsA total of 105 participants with PAD and 35 age-matched older volunteers without PAD (CTRL) were recruited. Participants completed walking impairment questionnaires (WIQ), Gardner-Skinner progressive treadmill tests, the six-minute walk test, and we performed an advanced evaluation of the biomechanics of their overground walking. Participants with PAD were categorized into 4 groups according to their stated pain location(s): calf only (C, n = 43); thigh and calf (TC, n = 18); buttock and calf (BC, n = 15); or buttock, thigh, and calf (BTC, n = 29). Outcomes were compared between CTRL, C, TC, BC and BTC groups using a one-way ANOVA with post-hoc comparisons to identify and assess statistically significant differences. ResultsThere were no significant differences between CTRL, C, TC, BC and BTC groups in distances walked or walking speed when either pain-free or experiencing claudication pain. Each participant with PAD had significantly dysfunctional biomechanical gait parameters, even when pain-free, when compared to CTRL (pain-free) walking data. During pain-free walking, out of the 18 gait parameters evaluated, we only identified significant differences in hip power generation during push-off (in C and TC groups) and in knee power absorption during weight acceptance (in TC and BC groups). There were no between-group differences in gait parameters while people with PAD were walking with claudication pain. ConclusionsOur data demonstrate that PAD affects the ischemic lower extremities in a diffuse manner irrespective of the location of claudication symptoms. Database RegistrationClinicalTrials.gov NCT01970332.

The effect of minimalist footwear wearing on biomechanical parameters of gait

The effect of minimalist footwear wearing on biomechanical parameters of gait

Effects of Physical Activity Program on Body Composition, Physical Performance, and Neuromuscular Strategies during Walking in Older Adults with Sarcopenic Obesity: Randomized Controlled Trial.

The potential impact of a specific physical activity program on biomechanical gait parameters and neuromuscular strategies around the ankle joint in older adults with sarcopenic obesity (SO) remains largely unexplored. The objective of this study was to investigate the effectiveness of a 24-week posture, strengthening, and motricity (PSM) program on improving neuromuscular strategies and biomechanical gait parameters in older adults with SO. 40 participants were randomly assigned to either the trained group (TG) and the control group (CG). Only the TG received the PSM program. Standardized evaluations were performed before and after the intervention, including walking tests on an instrumented gait analysis treadmill to evaluate biomechanical gait parameters and EMG activity of ankle muscles. After the PSM program, TG exhibited an increase in comfortable walking speed (+80%, p < 0.001) and step length (+38%, p < 0.05). Moreover, TG demonstrated a reduction in CoP velocity (-26%, p < 0.01). These gait modifications were associated with decreased muscle activity during the different gait phases (p < 0.05). The PSM program effectively improved gait and neuromuscular capacities in older adults with SO. Notably, these results shed light on the remarkable trainability of neuromuscular capacities in older adults with SO, despite the adverse effects of aging and obesity.

Technology applications in bovine gait analysis: A scoping review.

Quantitative bovine gait analysis using technology has evolved significantly over the last two decades. However, subjective methods of gait assessment using visual locomotion scoring remain the primary on-farm and experimental approach. The objective of this review is to map research trends in quantitative bovine gait analysis and to explore the technologies that have been utilized to measure biomechanical parameters of gait. A scoping literature review was conducted according to PRISMA guidelines. A search algorithm based on PICO framework generated three components-bovine, gait, and technology-to address our objectives. Three online databases were searched for original work published from January 2000 to June 2020. A two-step screening process was then conducted, starting with the review of article titles and abstracts based on inclusion criteria. A remaining 125 articles then underwent a full-text assessment, resulting in 82 final articles. Thematic analysis of research aims resulted in four major themes among the studies: gait/claw biomechanics, lameness detection, intervention/comparison, and system development. Of the 4 themes, lameness detection (55% of studies) was the most common reason for technology use. Within the literature identified three main technologies were used: force and pressure platforms (FPP), vision-based systems (VB), and accelerometers. FPP were the first and most popular technologies to evaluate bovine gait and were used in 58.5% of studies. They include force platforms, pressure mapping systems, and weight distribution platforms. The second most applied technology was VB (34.1% of studies), which predominately consists of video analysis and image processing systems. Accelerometers, another technological method to measure gait characteristics, were used in 14.6% of studies. In sum, the strong demand for automatic lameness detection influenced the path of development for quantitative gait analysis technologies. Among emergent technologies, deep learning and wearable sensors (e.g., accelerometers) appear to be the most promising options. However, although progress has been made, more research is needed to develop more accurate, practical, and user-friendly technologies.

Gait analysis and knee kinematics before, and 6 and 18 months after corrective valgus osteotomy

BackgroundThe study objective was to assess clinical outcomes and gait biomechanics in patients after 6 and 18 months after varus deformity (VD) surgical correction at knee joint (KJ). MethodThe study included 20 patients with medial osteoarthritis (OA) of the knee of grade 2–3 and a VD of >4°. A total of 21 surgeries were performed on the patients. Full length weight bearing (FLWB) X-ray and KJ assessments were done using the KSS, KOOS and VAS scoring systems were obtained from all the patients. Biomechanical gait parameters were captured using an inertial sensor system at timepoints before, and 6 and 18 months after surgery. Temporal and kinematic parameters of walking were analyzed. ResultsThe radiological parameters showed a stable VD correction. According to the KOOS, KS and VAS scores, there was a moderate dynamic improvement in the operated knee function during the study. The biomechanical parameters remained virtually unchanged throughout the entire follow-up period. In the following year, there were some subjective improvements but without any significant changes in gait biomechanics or knee kinematics. ConclusionsThus, the main changes in the joint clinical condition and function occur in the first 6 months after surgery. According to the study data—assessments by VAS, KOOS, and KSS—there was a moderate clinical improvement during the long-term follow-up period, however, the biomechanical changes were minor.

Kinematic Comparison of Orthopedic Shoes and Ankle-Foot Orthoses in Children With Cerebral Palsy

Background. In patients with cerebral palsy (CP), secondary orthopedic deformities and violations of the walking pattern are often observed, so various methods of treatment are used for its correction, including orthosis. Abroad, orthoses (AFO) for ankle joints are most often used in clinical practice, whereas in Russia complex orthopedic shoes are used. At the same time, there are no comparative studies investigating the influence of these orthopedic products on the biomechanical parameters of gait.&#x0D; The aim of the study was to compare the kinematic parameters of walking in children with cerebral palsy, depending on the type of fixation of the foot and ankle joint.&#x0D; Methods. 25 biomechanical studies (9 barefoot tests; 7 tests in orthopedic shoes; 9 tests in AFO) were conducted in 9 patients with GMFCS 2 and GMFCS 3 levels of global motor function impairment.&#x0D; Results. The analysis showed that using AFO compared to walking barefoot, regardless of the GMFCS level, positively affects the space-time characteristics of walking, the kinematics of the ankle and knee joints, without significantly affecting the function of the hip joint. In this regard, an improvement in the integral indicator the gait index was noted. The use of orthopedic shoes in patients with GMFCS 2 and GMFCS 3 levels of global motor functions led to an improvement in the kinematics of the ankle and knee joints. At the same time, in patients in the GMFCS 2 group, the use of orthopedic shoes provided an improvement in more components of the gait index, whereas in the GMFCS 3 group, the number of such variables was significantly less. A comparative analysis of the results showed that the kinematic parameters of walking in orthopedic shoes are better in patients of the GMFCS 2 group, but in the GMFCS 3 group it is significantly better when using AFO.&#x0D; Conclusion. The choice of the type of foot fixation in patients with cerebral palsy, taking into account the level of global motor functions impairment, can significantly affect the correction of biomechanical parameters of walking.

Estimation of Gait Parameters From Trunk Movement Measured by Doppler Radar

This study proposes a novel method to estimate biomechanical gait parameters using the monostatic continuous wave Doppler radar data corresponding to trunk movement; the use of trunk movement leads to stable gait parameter estimations when compared to the conventional method which is based on leg movements because the received powers of the trunk echoes are larger and more stable than those of the legs. The proposed gait parameter estimation method employs trunk accelerations extracted from radar spectrograms. The accuracies of the gait parameters, such as the step length, swing time, and stance time, estimated using the proposed methods were evaluated by comparing them with the reference motion capture data. We experimentally demonstrated that the proposed trunk-based method estimated gait parameters with accuracy similar to that of the conventional leg-based method. Additionally, the proposed trunk-based method was able to estimate the swing and stance times, whereas the leg-based method failed to estimate them owing to instability of the ankle echoes. Furthermore, the combined method of the trunk and toe data achieved better accuracy in the estimation of swing and stance times. This study is the first to use data on trunk movements (not leg movements) for temporal gait parameter estimation using radar and demonstrated its practicality for realistic situations in clinical and daily gait assessment to grasp the health status of individuals such as risks of future falls and cognitive impairments.