Gait Changes Research Articles

Sagittal Knee Gait Changes After Medial Unicompartmental and Total Knee Arthroplasty: An Exploratory Analysis of 32 Patients

Sagittal Knee Gait Changes After Medial Unicompartmental and Total Knee Arthroplasty: An Exploratory Analysis of 32 Patients

Gait performance changes after ten cervical retractions

Background and Study Aim. Students are prone to spine overloading, as they often spend prolonged periods in unfavorable postures. They tend to struggle with balancing study time and leisure physical activity. The head and neck regions are particularly rich in proprioceptors. Prolonged forward head posture (protraction) can lead to balance disturbances. This, in turn, affects gait and overall body posture. The aim of this study was to examine the effects of a series of corrective active head exercises on gait, a fundamental form of movement, in a group of healthy university students. Material and Methods. Gait patterns were assessed in 10 healthy male full-time students with an average age of 22.8 years (SD = 1.1). The assessment was based on the regional distribution of plantar pressure across two measurement sessions. One session was conducted before, and one after performing 10 active head retractions. Gait changes were analyzed in ten foot regions for 200 steps of each participant. Results. After 10 cervical retractions, a decrease in pressure, ground reaction force, contact time, and area values was observed in the 1st metatarsal head (1MTH). Conversely, an increase in these quantities was found in the toes. Additionally, there was a tendency toward a decrease in the contact area of the heel and 3rd metatarsal head (3MTH), along with increased contact time in the midfoot. Performing 10 neck retractions altered gait by inducing heel supination. It also increased hallux involvement in propulsion and widened the base of toe support. Conclusions. Even a few movements that correct head protraction have an immediate effect on whole-body movement. This effect suggests potential benefits of incorporating neck retractions into physical education programs for students. Even when time-consuming forms of regular exercise are not feasible, performing just a few neck-correcting movements can positively impact overall body movement.

High-Intensity Gait Training Intervention for Children With Cerebral Palsy: A Case Series.

The purpose of this pilot case series was to describe participation in high-intensity gait training (HIGT) and changes in (1) gait speed/endurance, (2) aerobic capacity, and (3) walking ability in children diagnosed with cerebral palsy (CP). Three children with CP participated in HIGT for 5weeks in lieu of their routine physical therapy. Outcome measures were collected at baseline and post-intervention. Post-intervention, all had at or above the minimal clinically important difference for 10-m walk test speed and 6-minute walk test distance. Two participants performed above the minimal clinically important difference in 7.5-m shuttle run test level and Gross Motor Function Measure-88 Dimension E score. This case series demonstrates short-term improvements in the walking outcome measures with participation in HIGT. Further research is needed with a larger and more diverse randomized controlled trial to determine parameters and long-term effects of HIGT in this population.

Effects of a vibrotactile biofeedback protocol on gait performance among older adults

Abstract Purpose Gait functions decline with aging, characterized by shorter strides, reduced hip range of motion and increased cadence and variability. Wearable biofeedback devices have been shown to improve gait, such as lengthening strides in older adults. While these devices attempted to improve the entire gait by suggesting changes in one gait parameter, it was not known if this approach could change gait patterns differently among elderly people. This study explored how a smart insole providing biofeedback on swing time only could produce different gait patterns. Methods Thirteen older adults walked on a flat walkway with and without biofeedback from a smart insole to increase the swing time. Gait analyses were recorded immediately after each condition using the GaitRite and Xsens systems. The sample was then divided into Group A (n = 7) who increased their stride length and Group B (n = 6) who did not to analyze within-group gait changes. Results Baseline analysis confirmed no significant gait differences between the two groups. Upon using the biofeedback devices, all participants increased over 5% their swing time and Group A significantly increased their hip extension (18.01%), hip flexion (5.1%) and stride length (5.5%). Conversely, the device caused Group B to significantly reduce their stride length (3.6%), velocity (13%), and increased gait variability (stance time COV 112%). Conclusions Biofeedback suggesting instant modifications in one gait parameter could produce two distinct walking patterns in participants with similar walking characteristics. Caution in biofeedback device design and gait analysis should be taken as gait outcomes could vary among users.

Age-related changes in gait, balance, and strength parameters: A cross-sectional study.

Longevity is increasing worldwide due to improvements in healthcare and living standards. Aging is often associated with disability and multiple health concerns. To address these challenges, effective interventions are essential. This study investigated potential age-related declines in gait, balance, and strength. We also sought to assess any relationships between these three parameters and explore potential differences between women and men. Healthy individuals over 50 years of age were recruited for this cross-sectional study. Upper extremity (grip) strength and lower extremity (knee) strength of the dominant side were measured. Static balance was performed on the force plate in different situations each for 30 seconds: bilateral stance with eyes open, bilateral stance with eyes closed, as well as dominant leg and non-dominant leg unilateral stance with eyes open. Gait was measured during level walking using an optical motion capture system. Additionally, the dynamic stability margin (DSM) was calculated for the level walking trials. The study results indicated that gait parameters were not significantly affected by age (p≥0.12), while knee and grip strength, along with several balance parameters, showed a significant decline with age. All individuals were able to maintain their bipedal balance, but their center of pressure movement increased significantly by age (p≤0.028). Z-scores were calculated to compare significant age parameters. Unipedal stance time was found to be the most affected by age compared to other contributing factors (p≤0.001). The duration of unipedal balance showed the most significant change per decade (non-dominant: -0.62 SDs; dominant: -0.53 SDs), while strength measures exhibited the lowest amount of change per decade (grip strength: -0.34 SDs; knee strength: -0.26 SDs). Sex differences were observed exclusively in strength parameters, with no discernible impact on the decline in balance parameters. These findings suggest that the duration of unipedal stance can serve as a reliable and gender-independent measure of neuromuscular aging for both elderly male and female subjects.

The dual timescales of gait adaptation: Initial stability adjustments followed by subsequent energetic cost adjustments.

Gait adaptation during bipedal walking allows people to adjust their walking patterns to maintain balance, avoid obstacles, and avoid injury. Adaptation involves complex processes that function to maintain stability and reduce energy expenditure. However, the processes that influence walking patterns during different points in the adaptation period remain to be investigated. We recruited seventeen young adults ages 19-35 to assess split-belt adaptation. We also assessed individual aerobic capacity to understand how aerobic capacity influences adaptation. We analyzed step lengths, step length asymmetry (SLA), mediolateral margins of stability, positive, negative, and net mechanical work rates, as well as metabolic rate during adaptation. We used dual-rate exponential mixed-effects regressions to estimate the adaptation of each measure over two timescales. Our results indicate that mediolateral stability adapts over a single timescale in under 1 minute, while mechanical work rates, metabolic rate, step lengths, and step length asymmetry adapt over two distinct timescales, ranging from 3.5 to 11.2 minutes. We then regressed mediolateral margins of stability, net mechanical work rate, and metabolic rate on step length asymmetry during early and late adaptation phases to determine if stability drives early adaptation and energetic cost drives late adaptation. Stability predicted SLA during the initial rapid onset of adaptation, and mechanical work rate predicted SLA during the latter part of adaptation. These findings suggest that stability optimization may contribute to early gait changes and that mechanical work contributes to later changes during adaptation. A final sub-analysis assessed the effect of aerobic capacity on step length asymmetry adaptation. Aerobic capacity levels below 36 and above 43 ml/kg/min resulted in greater adaptation, underscoring the metabolic influences on gait adaptation. This study illuminates the complex interplay between biomechanical and metabolic factors in gait adaptation, shedding light on fundamental mechanisms underlying human locomotion.

Evaluation of gabapentin administration on neurologic examination in 2 different age groups of healthy cats.

Gabapentin is often administered PO for preappointment or in-hospital anxiolysis in cats. A previous study reported mild changes on the neurologic examination after administration. Investigate the effects of gabapentin on anxiety, sedation, compliance, and neurologic examination in 2 age groups of cats. Thirty-one young cats and 12 geriatric cats perceived by their owners to be healthy and neurologically normal. Prospective double-blinded clinical crossover study. Assessment of baseline sedation and anxiety was performed before initial neurologic examinations and after gabapentin administration (100 mg/cat). Assessments were repeated 90 to 120 minutes after administration. Ease of handling pregabapentin and postgabapentin was assessed in the younger cats. All examinations were performed by a board-certified veterinary neurologist and scoring of examinations was performed by a different, masked board-certified neurologist. Sixteen cats (50%) in the younger cohort and 6 cats (50%) in the geriatric cohort exhibited an increase in their overall neurologic examination score postgabapentin administration, mainly through new or progressive postural reaction deficits and gait changes. Anxiety and sedation scores were significantly changed in the geriatric population (P < .01, P = .004, respectively); however, only sedation scores were significantly increased in the younger cats after gabapentin administration (P = .004). All study participants showed mild neurologic changes after gabapentin administration, most markedly noted in the geriatric population. Dose reduction of gabapentin for preappointment anxiolysis and neurologic examination in geriatric patients should be considered.

Foot-Floor Contact Sequences: A Metric for Gait Assessment in Parkinson's Disease after Deep Brain Stimulation.

Digital gait monitoring is increasingly used to assess locomotion and fall risk. The aim of this work is to analyze the changes in the foot-floor contact sequences of Parkinson's Disease (PD) patients in the year following the implantation of Deep Brain Stimulation (DBS). During their best-ON condition, 30 PD patients underwent gait analysis at baseline (T0), at 3 months after subthalamic nucleus DBS neurosurgery (T1), and at 12 months (T2) after subthalamic nucleus DBS neurosurgery. Thirty age-matched controls underwent gait analysis once. Each subject was equipped with bilateral foot-switches and a 5 min walk was recorded, including both straight-line and turnings. The walking speed, turning time, stride time variability, percentage of atypical gait cycles, stance, swing, and double support duration were estimated. Overall, the gait performance of PD patients improved after DBS, as also confirmed by the decrease in their UPDRS-III scores from 19.4 ± 1.8 to 10.2 ± 1.0 (T0 vs. T2) (p < 0.001). In straight-line walking, the percentages of atypical cycles of PD on the more affected side were 11.1 ± 1.5% (at T0), 3.1 ± 1.5% (at T1), and 5.1 ± 2.4% (at T2), while in controls it was 3.1 ± 1.3% (p < 0.0005). In turnings, this percentage was 13.7 ± 1.1% (at T0), 7.8 ± 1.1% (at T1), and 10.9 ± 1.8% (at T2), while in controls it was 8.1 ± 1.0% (p < 0.001). Therefore, in straight-line walking, the atypical cycles decreased by 72% at T1, and by 54% at T2 (with respect to baseline), while, in turnings, atypical cycles decreased by 43% at T1, and by 20% at T2. The percentage of atypical gait cycles proved an informative digital biomarker for quantifying PD gait changes after DBS, both in straight-line paths and turnings.

Impact of community-based precision functional training on older adults’ walking and cognitive abilities in rural Taiwan: a pre–posttest study

BackgroundFunctional training is essential for maintaining the independence of older adults, especially in rural areas with limited resources. In this study, we assess the short-term and long-term impacts of the Precision Functional Training (PFT) program on mobility outcomes, specifically walking performance, and cognitive ability in community-dwelling older adults. The unique feature of this training program was its countywide, community-based, and tailored approach, designed to strengthen the functional abilities of older adults living in rural areas.Methods158 older adults aged 65 years and above were assessed in this one-group pre–posttest study conducted in 11 community care stations in Chiayi County, Taiwan. Participants had two follow-ups, with data collection on mobility and cognition. The 12-week PFT program, led by certified trainers, integrated aerobic, strength, and cognitive elements. Primary outcomes, including changes in gait, falls, and cognition, were analyzed using linear mixed effects and logit models.ResultsStrengthening mobility is critical to slowing functional decline in older adults. The PFT program led to significant improvements in cognitive function and several gait parameters compared with the baseline. Participants with limited mobility showed enhanced activities of daily living 1-month post-training, but these gains did not persist at the 1-year mark. No significant differences were observed in fall occurrence and knee extension strength.ConclusionsThe training did not have a long-term effect; thus, more frequent practice may be necessary. Risk assessment and community-based interventions, particularly for older adults with a higher risk of falls, are recommended. Future prospective randomized controlled trials are needed to evaluate the PFT program’s effectiveness in preserving mobility.

Locomotor and gait changes in the LPS model of neuroinflammation are correlated with inflammatory cytokines in blood and brain.

Lipopolysaccharide (LPS) challenge in mice has been used to identify the mechanisms and therapeutics for neuroinflammation. In this study, we aimed to comprehensively evaluate the behavioral changes including locomotion, exploration, and memory, correlating them with a panel of thirteen inflammatory cytokines in both blood and brain.We found that acute LPS administration (0.83 mg/Kg i.p.) reduced body weight, food intake, and glucose levels compared to the saline-injected mice, concomitant with decreased activity in home cage monitoring. Locomotion was significantly reduced in Open Field, Introduced Object, and Y-Maze tests. Decreased exploratory behavior in the Y-Maze and Introduced Object tests was noticed, by measuring the number of arms explored and object interaction time, respectively. Additionally, in rotarod, LPS administration led to a significant decrease in the distance achieved, while in the MouseWalker, LPS led to a reduction in average velocity.LPS induced a decrease in microglia ramification index in the motor cortex and the striatum, while surprisingly a reduction in microglia number was observed in the motor cortex.The concentrations of thirteen cytokines in the blood were significantly altered, while only CXCL1, CCL22, CCL17, G-CSF, and IL-12p40 were changed in the brain. Correlations between cytokine levels in blood and brain were found, most notably for CCL17 and CCL22. TGFβ was the only one with negative correlations to other cytokines. Correlations between cytokines and behavior changes were also disclosed, especially for CCL17, CCL22, G-CSF, and IL-6 and negatively for TGFβ and IL-10.In summary, our study employing acute LPS challenge in mice has revealed a comprehensive profile of behavioral alterations alongside significant changes in inflammatory cytokine levels, both in peripheral blood and brain tissue. These findings contribute to a deeper understanding of the interplay between inflammation and behavior, with possible implications for identifying prognostics and therapeutic targets for neuroinflammatory conditions.

Quantifying Asymmetric Gait Pattern Changes Using a Hidden Markov Model Similarity Measure (HMM-SM) on Inertial Sensor Signals.

Wearable gait analysis systems using inertial sensors offer the potential for easy-to-use gait assessment in lab and free-living environments. This can enable objective long-term monitoring and decision making for individuals with gait disabilities. This study explores a novel approach that applies a hidden Markov model-based similarity measure (HMM-SM) to assess changes in gait patterns based on the gyroscope and accelerometer signals from just one or two inertial sensors. Eleven able-bodied individuals were equipped with a system which perturbed gait patterns by manipulating stance-time symmetry. Inertial sensor data were collected from various locations on the lower body to train hidden Markov models. The HMM-SM was evaluated to determine whether it corresponded to changes in gait as individuals deviated from their baseline, and whether it could provide a reliable measure of gait similarity. The HMM-SM showed consistent changes in accordance with stance-time symmetry in the following sensor configurations: pelvis, combined upper leg signals, and combined lower leg signals. Additionally, the HMM-SM demonstrated good reliability for the combined upper leg signals (ICC = 0.803) and lower leg signals (ICC = 0.795). These findings provide preliminary evidence that the HMM-SM could be useful in assessing changes in overall gait patterns. This could enable the development of compact, wearable systems for unsupervised gait assessment, without the requirement to pre-identify and measure a set of gait parameters.

289 - Walking in Wet Pads: A clinical investigation of changes in gait associated with walking in soaked continence containment products in older women

289 - Walking in Wet Pads: A clinical investigation of changes in gait associated with walking in soaked continence containment products in older women

Craniectomy and Cranioplasty Effects on Balance and Gait in Rehabilitation: A Retrospective Study

ObjectiveTo analyze changes in balance and gait in patients undergoing rehabilitation postcraniectomy and postcranioplasty, including comparison of outcomes across time periods, rate of change, and among diagnoses. DesignRetrospective cohort study. SettingInpatient rehabilitation. ParticipantsFifty-three patients (mean age 52.3±16.9y; 62% male) with stroke, traumatic, or nontraumatic brain injury postcraniectomy or postcranioplasty. InterventionsNot applicable. Main Outcome MeasuresBerg Balance Scale (BBS), Functional Gait Assessment (FGA), 6-minute walk test (6MWT), and 10-meter walk test (10MWT) were collected at baseline, first discharge, readmission, and final discharge. ResultsAcross the full rehabilitation course, all 4 outcomes improved: BBS, 17.9 points (95% confidence interval [CI], 12.7-23.2); FGA, 7.8 points (95% CI, 0.6-15.0); 6MWT, 141.0 m (95% CI, 89.0-192.0); and 10MWT, 0.381 m/s (95% CI, 0.188-0.575). All outcomes improved at postcraniectomy admission: BBS, 13.0 points (95% CI, 8.4-17.5); FGA, 4.0 points (95% CI. −1.65 to 9.65); 6MWT, 100.0 m (95% CI, 58.2-142.0); and 10MW, 0.160 m/s (95% CI, 0.004-0.316). During leave of absence from rehabilitation, BBS decreased 6.3 points (95% CI, −11.8 to −0.8); FGA decreased 6.6 points (95% CI, −13.8 to 0.6); 6MWT decreased 19.2 m (95% CI, −73.5 to 35.2); and 10MWT increased 0.089 m/s (95% CI, −0.097 to 0.276). All outcomes improved at postcranioplasty admission: BBS, 11.3 points (95% CI, 6.6-16.0); FGA, 10.4 points (95% CI, 4.8-16.1); 6MWT, 59.4 m (95% CI, 14.1-105.0); and 10MWT, 0.132 m/s (95% CI, −0.039 to 0.303). Diagnosis was not associated with changes in outcomes. ConclusionsGait and balance outcomes improved during postcraniectomy and postcranioplasty rehabilitation admissions but not immediately post cranioplasty.

Early gait analysis after total knee arthroplasty based on artificial intelligence dynamic image recognition

To explore early postoperative gait characteristics and clinical outcomes after total knee arthroplasty (TKA). From February 2023 to July 2023, 26 patients with unilateral knee osteoarthritis (KOA) were treated with TKA, including 4 males and 22 females, aged from 57 to 85 years old with an average of (67.58±6.49) years old;body mass index (BMI) ranged from 18.83 to 38.28 kg·m-2 with an average of (26.43±4.15) kg·m-2;14 patients on the left side, 12 patients on the right side;according to Kellgren-Lawrence(K-L) classification, 6 patients with grade Ⅲ and 20 patients with grade IV;the courses of disease ranged from 1 to 14 years with an average of (5.54±3.29) years. Images and videos of standing up and walking, walking side shot, squatting and supine kneeling were taken with smart phones before operation and 6 weeks after operation. The human posture estimation framework OpenPose were used to analyze stride frequency, step length, step length, step speed, active knee knee bending angle, stride length, double support phase time, as well as maximum hip flexion angle and maximum knee bending angle on squatting position. Western Ontario and McMaster Universities (WOMAC) arthritis index and Knee Society Score (KSS) were used to evaluate clinical efficacy of knee joint. All patients were followed up for 5 to 7 weeks with an average of (6.00±0.57) weeks. The total score of WOMAC decreased from (64.85±11.54) before operation to (45.81±7.91) at 6 weeks after operation (P<0.001). The total KSS was increased from (101.19±9.58) before operation to (125.50±10.32) at 6 weeks after operation (P<0.001). The gait speed, stride frequency and stride length of the affected side before operation were (0.32±0.10) m·s-1, (96.35±24.18) steps·min-1, (0.72±0.14) m, respectively;and increased to (0.48±0.11) m·s-1, (104.20±22.53) steps·min-1, (0.79±0.10) m at 6 weeks after operation (P<0.05). The lower limb support time and active knee bending angle decreased from (0.31±0.38) s and (125.21±11.64) ° before operation to (0.11±0.04) s and (120.01±13.35) ° at 6 weeks after operation (P<0.05). Eleven patients could able to complete squat before operation, 13 patients could able to complete at 6 weeks after operation, and 9 patients could able to complete both before operation and 6 weeks after operation. In 9 patients, the maximum bending angle of crouching position was increased from 76.29° to 124.11° before operation to 91.35° to 134.12° at 6 weeks after operation, and the maximum bending angle of hip was increased from 103.70° to 147.25° before operation to 118.61° to 149.48° at 6 weeks after operation. Gait analysis technology based on artificial intelligence image recognition is a safe and effective method to quantitatively identify the changes of patients' gait. Knee pain of KOA was relieved and the function was improved, the supporting ability of the affected limb was improved after TKA, and the patient's stride frequency, stride length and stride speed were improved, and the overall movement rhythm of both lower limbs are more coordinated.

Cognitive impairment mediates the white matter injury load and gait disorders in subcortical ischemic vascular disease.

Gait disorders are common in patients with subcortical ischemic vascular disease (SIVD). We aim to explore the impact of white matter (WM) damage on gait disorders in SIVD. 21 SIVD patients and 20 normal controls (NC) were included in the study. Montreal Cognitive Assessment (MoCA) was used to evaluate general cognition, while Speed-Accuracy Trade-Off (SAT) was used to assess executive function. Gait velocity, cadence, and stride length were measured. Diffusion Tensor Imaging (DTI) data were analyzed using Tract-Based Spatial Statistics (TBSS) and Peak Width of Skeletonized Mean Diffusivity (PSMD). The relationships among WM damage, gait disorders, and cognitive function were examined through mediation analysis. SIVD scored lower than NC in MoCA and SAT tests (P < 0.001). Gait velocity and stride length were decreased in SIVD. SIVD had lower PSMD (P < 0.001). PSMD correlated with gait parameters, which were totally mediated by MoCA and partially mediated by SAT. The fractional anisotropy (FA) and mean diffusivity (MD) of the genu of the corpus callosum (GCC) and body of CC (BCC) were correlated with gait parameters. The FA of the bilateral anterior corona radiata (ACR) was positively correlated with gait parameters, while the MD of the bilateral superior corona radiata (SCR), bilateral superior longitudinal fasciculus (SLF), and left external capsule (EC) were negatively correlated with them (P < 0.05). Gait impairments in SIVD were associated with cognitive deficits. Cognitive impairment mediated the WM damage and gait disorders. The microstructural alterations of CC, SLF, EC, and CR may be related to changes in gait.

Gait Characteristics and Deviation Factors of Backward Walking in Patients With Chronic Ankle Instability.

Despite growing applications of backward walking (BW) in assessing and rehabilitating neuromuscular conditions, its effects on gait in chronic ankle instability (CAI) remain unclear. Moreover, linking patient-reported and clinically generated measures is imperative for understanding CAI. Patients with CAI will exhibit worse and compensatory spatio-temporal and kinetic gait parameters during BW, and patient-reported outcomes (PROs) will be correlated significantly with gait parameters. Case-control study. Level 4. A total of 46 volunteers participated (23 per group). Patients filled out scales for pain, functions, and fear-avoidance beliefs before testing. All participants walked 6 times each in both forward and backward conditions, and gait was recorded using the Win-Track system. A 2-way mixed analysis of variance was performed to compare gait parameters. The relationship between PRO and gait outcomes was assessed through the Pearson product correlation coefficient. The CAI group demonstrated prolonged support and swing phases, increased walk-off angle, and plantar pressure area, but decreased step length and plantar pressure versus controls (P < 0.05). The CAI group had a smaller right walk-off angle during BW than FW; the control group showed the opposite (P < 0.05). The left single stance duration was greater in the CAI group, while the right was not (P < 0.05). PRO correlated significantly with gait parameters, particularly spatial parameters (P < 0.05). The CAI group exhibited worse gait parameters during BW. The CAI group exhibited a characteristic compensatory gait pattern. Linking the self-reported scores provides a better representation of gait changes in CAI. These results suggest that BW may be an effective strategy for identifying and evaluating CAI. It may be feasible to apply BW to the rehabilitation of CAI.

Effectiveness of Task-Oriented Training in Improving Gait in a Child with Ataxic Cerebral Palsy: A Case Report

This case report examines the impact of task-oriented training on gait improvement in a child with Ataxic Cerebral Palsy (CP), a rare subtype characterized by balance and coordination difficulties. The goal was to determine the effectiveness of this intervention in enhancing gait stability, motor coordination, and overall mobility. A 6-year-old boy with Ataxic CP underwent task-oriented training for five days per week over a four-week period. Each session lasted one hour and included lower limb strengthening, coordination exercises, stretching, and walking practice. The Holden Gait Scale (HG) and Gross Motor Function Measure (GMFM) were used to evaluate changes in the child's gait and motor function pre- and post-intervention. After one week of therapy, the child demonstrated reduced tremors and attempted to climb stairs independently. By the end of the four-week period, the child was able to walk approximately 200 meters indoors without displaying a high-guard posture, although supervision was still required when navigating stairs. Improvements in gait stability and balance were observed, though the scissor gait persisted. Task-oriented training proved to be an effective approach in improving gait stability and motor coordination in a child with Ataxic CP. However, challenges such as upper limb high guarding and scissor gait remained, indicating the need for further personalized rehabilitation strategies. Future research should focus on integrated interventions to address these residual issues and enhance the long-term outcomes for children with Ataxic CP.

422 The use of 3D kinematics for improved gait assessment in broilers

Abstract Genetic selection for high growth rates in broiler chickens has resulted in larger broilers and changes in broiler gait. Traditionally, broiler gait is assessed using visual observation which is subjective and labor intensive. In contrast, newer technologies are available which can be adapted to objectively score changes in broiler gait, thereby, increasing the validity and reliability of gait scoring with less labor required. The objective of this study was to compare the use of 3D kinematics versus visual scoring to assess broiler gait. Second, to determine how strain and age affect 3D kinematic gait metrics in broilers. Four strains of broiler chickens were used; two heritage strains: 1957 (H57; n = 52) and 1977 (H77; n = 51); and two commercially available strains: Cobb (n = 50) and Ross (n = 53). All broilers were weighed weekly throughout the study. Kinematic markers were placed along the spine and bony landmarks of each leg. Commercial strains had kinematic recordings and body weights (BW) recorded every week for 4 wk while Heritage strains had measurements recorded every week for 6 wk. Visual gait scoring was completed using a 5-point scale each week by two trained observers. Data were analyzed using the correlation procedure in SAS to determine the relationship between visual gait score and kinematic metrics as well as the GLIMMIX procedure to determine the effects of strain, age, and strain x age on all gait parameters. There was a weak positive correlation (r &amp;lt; 0.2) between visual gait score and all kinematic metrics. Cobb were the heaviest strain (1,292.6 ± 14.71 g P &amp;lt; 0.001) while H57 broilers were the lightest (326.4 ± 9.99 g P &amp;lt; 0.001). Each week, the BW of all strains increased significantly. Total Stride Time differed significantly by strain (P &amp;lt; 0.001; Cobb: 26.3 ± 0.47 cs, Ross: 23.1 ± 0.39 cs, H77: 23.7 ± 0.28 cs, H57: 21.5 ± 0.26 cs) and Age (P &amp;lt; 0.01; Commercial: wk 3: 21.8 ± 0.54 cs, wk 6: 28.1 ± 0.68 cs and Heritage: wk 3: 19.7 ± 0.42 cs, wk 8: 25.4 ± 0.52 cs). Total stride length (SL) also significantly differed by strain. Cobb had the longest SL of the two commercial strains (P &amp;lt; 0.001; 88.6 ± 1.94 mm) while H77 had the longest stride of the heritage strains (97.9 ± 1.51 mm). Total SL also increased with age resulting in longer stride times. Heavier birds, such as Cobb, had longer stride Times and SL compared with lighter birds such as the H57 strain. In conclusion, visual gait score and kinematic metrics were not found to be measuring the same things. However, kinematics can be a used as an informative and objective tool for assessing gait metrics associated with broiler lameness such as changes in stride length and stride time.

A - 2 Risk Factors for Reduced Mobility and Falls in Older Adults: the Role of Medication Use and Cognitive Impairment

Abstract Objective Sedative and anticholinergic (AC) medication use and cognitive impairment impose risk of gait imbalance and falls in older adults, but their combined effects on mobility have not been assessed. Method This cross-sectional study of 392 outpatients (age = 72 ± 7.7; 60.5%women; 93%White; education = 14 ± 3 years) characterized AC use (Anticholinergic Cognitive Burden Scale [ACB]) and number of sedative medications. Balance confidence (Activities-specific Balance Confidence Scale), walking decline compared to 5 years prior (0–3 scale), and recurrent falls (dichotomized by ≥2) were self-reported. Neuropsychological performance was averaged into a norm-adjusted composite (COG). T-tests and Pearson correlations assessed bivariate relationships across medication use, COG, and mobility. Multivariate models regressed falls, balance confidence, and gait changes (in separate models) on COG and medication use (ACs and sedatives examined separately), controlling for covariates. Results Most patients (70%–85%) used ≥1 sedative or AC medication. Few (12%) reported recurrent falls (range = 0–30), but balance confidence was reduced (M = 77.68 ± 21.31%) with mild walking declines reported (M = 1.34 ± 1.03). More sedative medication use and higher ACB scores were bivariately related to worse COG and mobility, and stronger COG was associated with better mobility (p’s ≤ 0.004). Worse COG (β = 0.196, p = 0.002) and more medication use, both sedatives (β = −0.246, p = 0.002) and ACB (β = −0.147, p = 0.047), independently predicted worse balance confidence. Higher ACB (β = 0.182, p = 0.022) and worse COG (β = −0.193, p = 0.007) uniquely predicted walking decline. Each sedative medication increased odds of falls by 27.4% (adjOR = 1.274, p = 0.034). Conclusion AC/sedative medication use and cognitive impairment pose complementary risks for compromised mobility. Clinicians should be alert to AC/sedative use and cognitive impairment in older patients at risk of falls.

Exploring the impacts of daytime sleepiness on gait, physical balance, and the occurrence of orofacial trauma: a narrative review

Daytime sleepiness (DS) often accompanies obstructive sleep apnea (OSA), exacerbating its effects. DS can impair cognitive function, attention, reaction time, and motor coordination, increasing the risk of accidents. This study aimed to explore the relationship between DS, changes in gait and balance, and the occurrence of orofacial fractures. A narrative review was conducted using PubMed, Scopus, and Web of Science publications. The analysis revealed the impact of DS and OSA on gait and balance control in older individuals, emphasizing the need for interventions to address these issues and identify associated pathologies. Continuous Positive Airway Pressure (CPAP) therapy was recognized as a potential treatment, although further research is needed to understand DS triggers and treatment options in older populations. The study underscores the importance of analyzing interactions between the central nervous system, medications, balance, and mobility to prevent falls and related injuries. While the literature highlights the vulnerability of elderly individuals and those with OSA to falls, no established link between DS, gait, balance, and orofacial trauma necessitating medical and dental intervention was found. Thus, further research is warranted to address this gap and promote better understanding and management of these conditions.