Gait Parameters In Healthy Adults Research Articles

Evaluation of the Validity and Reliability of Connected Insoles to Measure Gait Parameters in Healthy Adults.

The continuous, accurate and reliable estimation of gait parameters as a measure of mobility is essential to assess the loss of functional capacity related to the progression of disease. Connected insoles are suitable wearable devices which allow precise, continuous, remote and passive gait assessment. The data of 25 healthy volunteers aged 20 to 77 years were analysed in the study to validate gait parameters (stride length, velocity, stance, swing, step and single support durations and cadence) measured by FeetMe® insoles against the GAITRite® mat reference. The mean values and the values of variability were calculated per subject for GAITRite® and insoles. A t-test and Levene’s test were used to compare the gait parameters for means and variances, respectively, obtained for both devices. Additionally, measures of bias, standard deviation of differences, Pearson’s correlation and intraclass correlation were analysed to explore overall agreement between the two devices. No significant differences in mean and variance between the two devices were detected. Pearson’s correlation coefficients of averaged gait estimates were higher than 0.98 and 0.8, respectively, for unipedal and bipedal gait parameters, supporting a high level of agreement between the two devices. The connected insoles are therefore a device equivalent to GAITRite® to estimate the mean and variability of gait parameters.

Spatio-temporal gait parameters obtained from foot-worn inertial sensors are reliable in healthy adults in single- and dual-task conditions

Inertial measurement units (IMUs) are increasingly popular and may be usable in clinical routine to assess gait. However, assessing their intra-session reliability is crucial and has not been tested with foot-worn sensors in healthy participants. The aim of this study was to assess the intra-session reliability of foot-worn IMUs for measuring gait parameters in healthy adults. Twenty healthy participants were enrolled in the study and performed the 10-m walk test in single- and dual-task ('carrying a full cup of water') conditions, three trials per condition. IMUs were used to assess spatiotemporal gait parameters, gait symmetry parameters (symmetry index (SI) and symmetry ratio (SR)), and dual task effects parameters. The relative and the absolute reliability were calculated for each gait parameter. Results showed that spatiotemporal gait parameters measured with foot-worn inertial sensors were reliable; symmetry gait parameters relative reliability was low, and SR showed better absolute reliability than SI; dual task effects were poorly reliable, and taking the mean of the second and the third trials was the most reliable. Foot-worn IMUs are reliable to assess spatiotemporal and symmetry ratio gait parameters but symmetry index and DTE gait parameters reliabilities were low and need to be interpreted with cautious by clinicians and researchers.

Validity of Hololens Augmented Reality Head Mounted Display for Measuring Gait Parameters in Healthy Adults and Children with Cerebral Palsy.

Serious games are a promising approach to improve gait rehabilitation for people with gait disorders. Combined with wearable augmented reality headset, serious games for gait rehabilitation in a clinical setting can be envisaged, allowing to evolve in a real environment and provide fun and feedback to enhance patient’s motivation. This requires a method to obtain accurate information on the spatiotemporal gait parameters of the playing patient. To this end, we propose a new algorithm called HoloStep that computes spatiotemporal gait parameters using only the head pose provided by an augmented reality headset (Hololens). It is based on the detection of peaks associated to initial contact event, and uses a combination of locking distance, locking time, peak amplitude detection with custom thresholds for children with CP. The performance of HoloStep was compared during a walking session at comfortable speed to Zeni’s reference algorithm, which is based on kinematics and a full 3D motion capture system. Our study included 62 children with cerebral palsy (CP), classified according to Gross Motor Function Classification System (GMFCS) between levels I and III, and 13 healthy participants (HP). Metrics such as sensitivity, specificity, accuracy and precision for step detection with HoloStep were above 96%. The Intra-Class Coefficient between steps length calculated with HoloStep and the reference was 0.92 (GMFCS I), 0.86 (GMFCS II/III) and 0.78 (HP). HoloStep demonstrated good performance when applied to a wide range of gait patterns, including children with CP using walking aids. Findings provide important insights for future gait intervention using augmented reality games for children with CP.

Agreement between the GAITRite® System and the Wearable Sensor BTS G-Walk®for measurement of gait parameters in healthy adults and Parkinson's disease patients.

BackgroundNowadays, the most widely used types of wearable sensors in gait analysis are inertial sensors. The aim of the study was to assess the agreement between two different systems for measuring gait parameters (inertial sensor vs. electronic walkway) on healthy control subjects (HC) and patients with Parkinson’s disease (PD).MethodsForty healthy volunteers (26 men, 14 women, mean age 58.7 ± 7.7 years) participated in the study and 24 PD patients (19 men, five women, mean age 62.7 ± 9.8 years). Each participant walked across an electronic walkway, GAITRite, with embedded pressure sensors at their preferred walking speed. Concurrently a G-Walk sensor was attached with a semi-elastic belt to the L5 spinal segment of the subject. Walking speed, cadence, stride duration, stride length, stance, swing, single support and double support phase values were compared between both systems.ResultsThe Passing-Bablock regression slope line manifested the values closest to 1.00 for cadence and stride duration (0.99 ≤ 1.00) in both groups. The slope of other parameters varied between 0.26 (double support duration in PD) and 1.74 (duration of single support for HC). The mean square error confirmed the best fit of the regression line for speed, stride duration and stride length. The y-intercepts showed higher systematic error in PD than HC for speed, stance, swing, and single support phases.ConclusionsThe final results of this study indicate that the G-Walk system can be used for evaluating the gait characteristics of the healthy subjects as well as the PD patients. However, the duration of the gait cycle phases should be used with caution due to the presence of a systematic error.

Immediate effect of individual bars of insoles and their combination on gait parameters in asymptomatic healthy adults

Objective: The way how individual bars of sensorimotor insoles influence the gait kinematics is not fully understood yet. Therefore, this study aimed to explore the effect of three sensorimotor orthotic conditions (the medial calcaneal and retrocapital lateral bars and their combination) on the gait parameters in healthy adults during the stance phase of gait cycle.Materials and methods: Twenty-six young adults performed 20 gait cycles in each condition using their self-selected cadence and provided standardised shoes with the base-sole and the three types of orthotics. A three-dimensional motion analysis system (8 cameras; 200 Hz) was used and a six-degrees of freedom model was applied. The cadence, the stride length, the first peaks of foot external rotation, eversion and dorsal flexion as well as the first peak of hip adduction were analysed.Results: Significant differences (p < 0.05) were found for all parameters between the orthotic conditions, except the cadence. Significant difference in the first peak of hip adduction (p = 0.008) was found between the dominant and non-dominant leg. There were no significant interactions between the factors of condition and leg dominance (p > 0.05).Conclusions: There seems to be overall tendencies in immediate changes in ankle joint kinematics caused by all three sensorimotor orthotic conditions and besides the mechanical principles, also ‘proprioceptive mechanism’ seems to play a role. However, maximum observed average angular change was 2° and some variability in reactions to each orthotic condition exists among the individuals. Therefore, clinical relevance of such changes remains unclear and careful analysis of expected outcomes should be the common part of every orthotic intervention.

A-26 Performance on Design Fluency and Visuoperception Measures is Related to Single and Dual Task Treadmill Gait Parameters in Healthy Adults

Abstract Objective Research suggests a link between gait and cognition. Executive functions have been related to gait speed, however the relation between design fluency and visuoperception and other spatiotemporal gait characteristics that are related to falling is unclear. The objective of the study was to determine whether performance on design fluency and visuoperception tasks is related to spatiotemporal gait parameters during single and dual task treadmill walking in a sample of healthy adults. Method Nineteen healthy adults averaging 40 years of age completed cognitive measures of design fluency, visual attention, and visuoperception. They underwent gait analysis while walking on an instrumented treadmill in single task and dual task conditions. Results Performance on Spatial Span significantly correlated with single task stride length, r = 0.47, p = 0.043. Performance on Block Design significantly correlated with dual task stride length, r = 0.46, p = 0.049. Performance on Design Fluency significantly correlated with single task stride length variability, r = -0.50, p = 0.030, dual task stride length variability, r = -0.62, p = 0.005, and dual task step width variability, r = -0.56, p = 0.012. Performance on Picture Completion also correlated with dual task step width variability, r = -0.54, p = 0.017. Conclusions Design fluency and visuoperception appear related to spatiotemporal gait parameters in healthy adults. Worse cognitive performance was related to greater variability in dual task stride length and step width, gait characteristics associated with falling in aging and neurological populations.

Agreement Between the Spatiotemporal Gait Parameters of Healthy Adults From the OptoGait System and a Traditional Three-Dimensional Motion Capture System.

While previous research has assessed the validity of the OptoGait system to the GAITRite walkway and an instrumented treadmill, no research to date has assessed this system against a traditional three-dimensional motion analysis system. Additionally, previous research has shown that the OptoGait system shows systematic bias when compared to other systems due to the configuration of the system's hardware. This study examined the agreement between the spatiotemporal gait parameters calculated from the OptoGait system and a three-dimensional motion capture (14 camera Vicon motion capture system and 2 AMTI force plates) in healthy adults. Additionally, a range of filter settings for the OptoGait were examined to determine if it was possible to eliminate any systematic bias between the OptoGait and the three-dimensional motion analysis system. Agreement between the systems was examined using 95% limits of agreement by Bland and Altman and the intraclass correlation coefficient. A repeated measure ANOVA was used to detect any systematic differences between the systems. Findings confirm the validity of the OptoGait system for the evaluation of spatiotemporal gait parameters in healthy adults. Furthermore, recommendations on filter settings which eliminate the systematic bias between the OptoGait and the three-dimensional motion analysis system are provided.

Changes in postural sway and gait characteristics as a consequence of anterior load carriage

BackgroundAnterior load carriage represents a common daily and occupational activity. Carrying loads in front of the body could potentially increase instability during standing and walking. Research questionThis study examined the effects of anterior load carriage on postural sway and gait parameters in healthy adults. MethodsTwenty-nine participants (19 males, 10 females, age = 33.8 ± 12.7 years, height = 1.73 ± 0.07 m, mass = 75.1 ± 13.7 kg) were assessed in four conditions; (1) carrying no load (CON), (2) carrying a load with no added weight (i.e. empty box), (3) carrying a load with 5% body mass, and (4) carrying a load with 10% body mass. Anteroposterior and mediolateral centre of pressure (COP) displacement (cm) and the mean COP velocity (cm s-1) were used to characterise postural sway. Coefficient of variation of the stride length, stride time and double support time were calculated from 1 min of treadmill walking at a preferred pace for gait assessment. ResultsThe addition of the 10% load elicited an increase in anteroposterior COP displacement when compared to CON (d = 1.59), 0% (d = 1.50), and 5% (d = 0.75) (P < 0.001). The addition of the 10% load increased stride time (d = 1.71) and stride length (d = 1.20) variability when compared to CON (P < 0.001). SignificanceIn summary, the increase in postural sway and gait variability with added weight is dependent on the magnitude of the load, where the greater the load, the greater the effect on static and dynamic stability. Anterior load carriage potentially increases the risk of fall-related injuries.

Intra-rater repeatability of gait parameters in healthy adults during self-paced treadmill-based virtual reality walking

Self-paced treadmill walking is becoming increasingly popular for the gait assessment and re-education, in both research and clinical settings. Its day-to-day repeatability is yet to be established. This study scrutinised the test-retest repeatability of key gait parameters, obtained from the Gait Real-time Analysis Interactive Lab (GRAIL) system. Twenty-three male able-bodied adults (age: 34.56 ± 5.12 years) completed two separate gait assessments on the GRAIL system, separated by 5 ± 3 days. Key gait kinematic, kinetic, and spatial-temporal parameters were analysed. The Intraclass-Correlation Coefficients (ICC), Standard Error Measurement (SEM), Minimum Detectable Change (MDC), and the 95% limits of agreements were calculated to evaluate the repeatability of these gait parameters. Day-to-day agreements were excellent (ICCs > 0.87) for spatial-temporal parameters with low MDC and SEM values, <0.153 and <0.055, respectively. The repeatability was higher for joint kinetic than kinematic parameters, as reflected in small values of SEM (<0.13 Nm/kg and <3.4°) and MDC (<0.335 Nm/kg and <9.44°). The obtained values of all parameters fell within the 95% limits of agreement. Our findings demonstrate the repeatability of the GRAIL system available in our laboratory. The SEM and MDC values can be used to assist researchers and clinicians to distinguish ‘real’ changes in gait performance over time.

Comparison of accelerometer-based and treadmill-based analysis systems for measuring gait parameters in healthy adults.

[Purpose] This study aimed to determine the correlation between accelerometer-based and treadmill-based analysis systems for measuring gait parameters during comfortable walking in healthy young adults. [Subjects and Methods] Twenty-three healthy adults participated in this study. Gait parameters were measured with simultaneous use of accelerometer-based and treadmill-based gait analysis systems, while participants walked for 30 s. [Results] There was a highly-significant correlation between the two systems with respect to cadence and velocity. The cadence, speed, and stride measured with the accelerometer system were significantly and highly correlated with the cadence, velocity, and number of steps measured with the treadmill-based system. The gait cycle duration measured with the accelerometer system was significantly and highly correlated with the step time and stride time measured with the treadmill-based gait system. [Conclusion] Gait analysis using an accelerometer system is a valid method for assessment of the effectiveness of therapeutic interventions in a clinical setting.

Comparison between a center of mass and a foot pressure sensor system for measuring gait parameters in healthy adults.

[Purpose] The purpose of this study was to determine the relationship between an accelerometer system and a foot pressure sensor system for measuring gait characteristics during walking in healthy adults. [Subjects and Methods] Thirty-five healthy participants with no neurological, musculoskeletal, or cardiopulmonary disorders volunteered for this study. Gait characteristics were measured while participants walked freely along a 10-m walkway using two different measurement systems simultaneously. The first analysis system was based on center of mass using a wireless tri-axial accelerometer and the second system was a foot pressure sensor system. [Results] There was a significant and high correlation between the two systems with respect to gait velocity and cadence. The stride length as a percentage of the stride height measured with the center of mass system was significantly and highly correlated with stride length and stride velocity that was measured with the foot pressure system. Furthermore, stride length from the center of mass system was significantly and highly correlated with stride length and stride velocity from the foot pressure system. [Conclusion] A gait analysis based on a center of mass system is a valid method to assess the effectiveness of therapeutic interventions in a clinical setting.