Gait Parameters In People Research Articles

Comparison of Gait in Women with Degenerative Changes of the Hip Joint and Healthy Women Using the MoKA System-A Pilot Study.

Osteoarthritis (OA) is a global problem. There are few reports in the literature regarding the temporal and spatial parameters of gait in people with OA. The aim of this study was to determine spatiotemporal parameters for the pelvis and lower limbs during walking in women with OA and to compare these parameters with healthy people. For this purpose, a 6 min walking test (6MWT) was carried out. OA subjects had worse outcomes compared to the control group (p < 0.05). Data were collected using IMU sensors integrated into the MoKA system and mounted on indicator points on the body. Limited mobility of the pelvis in the frontal plane was observed in the study group, which influenced walking strategy. For the comparison with the control group at each minute, p < 0.05. IMU sensors attached to the body and integrated in one application provide extensive research and diagnostic capabilities.

Do proprioceptive training strategies with dual-task exercises positively influence gait parameters in chronic stroke? A systematic review.

This study aims to assess the impact of proprioceptive training strategies with dual-task exercises on gait in people with chronic stroke. Systematic review. Chronic stroke. Searches were conducted in accordance with PRISMA guidelines and PICOS criteria. PubMed, Web of Science, and Scopus databases were systematically searched from November 2020 to February 2022, for eligible clinical trials. Two independent reviewers thoroughly screened potential articles for relevance and assessed the methodology quality. In accordance with the GRADE, PICOS criteria, and Cochrane risk of bias tools, the authors included articles concerning the effectiveness of dual-task in proprioceptive training on gait parameters in people with chronic stroke. Of 3075 identified studies, 11 articles met the inclusion criteria: 7 were randomized clinical trials, 1 was not randomized, and 3 were observational studies. The overall quality of evidence, assessed using the GRADE framework, was high, indicating a high level of confidence in the systematic review's findings. The papers involved 393 stroke patients; 241 underwent dual-task in proprioceptive training, with 152 participants in other stroke rehabilitation; within the dual-task group, 71 engaged in cognitive tasks, and 170 participated in motor tasks. dual-task in proprioceptive training improved gait speed, cadence, stride time, stride length, and step length. The best effects were observed with training 3 times a week for 4 weeks, with each session lasting 30 minutes, on speed, cadence, stride length, and step length. Current evidence suggests that proprioceptive training strategies with dual-task exercises improved walking abilities in people with chronic stroke. Specifically, it enhanced gait speed, a key indicator of clinical severity.

Dual-Task vs. Single-Task Gait Training to Improve Spatiotemporal Gait Parameters in People with Parkinson's Disease: A Systematic Review and Meta-Analysis.

People with Parkinson's disease (pwPD) present alterations of spatiotemporal gait parameters that impact walking ability. While preliminary studies suggested that dual-task gait training improves spatiotemporal gait parameters, it remains unclear whether dual-task gait training specifically improves dual-task gait performance compared to single-task gait training. The aim of this review is to assess the effect of dual-task training relative to single-task gait training on specific gait parameters during dual-task tests in pwPD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), searching three electronic databases. Two reviewers independently selected RCTs, extracted data, and applied the Cochrane risk-of-bias tool for randomized trials (Version 2) and the GRADE framework for assessing the certainty of evidence. The primary outcomes were dual-task gait speed, stride length, and cadence. Secondary outcomes included dual-task costs on gait speed, balance confidence, and quality of life. We included 14 RCTs (548 patients). Meta-analyses showed effects favoring dual-task training over single-task training in improving dual-task gait speed (standardized mean difference [SMD] = 0.48, 95% confidence interval [CI] = 0.20-0.77; 11 studies; low certainty evidence), stride length (mean difference [MD] = 0.09 m, 95% CI = 0.04-0.14; 4 studies; very low certainty evidence), and cadence (MD = 5.45 steps/min, 95% CI = 3.59-7.31; 5 studies; very low certainty evidence). We also found a significant effect of dual-task training over single-task training on dual-task cost and quality of life, but not on balance confidence. Our findings support the use of dual-task training relative to single-task training to improve dual-task spatiotemporal gait parameters in pwPD. Further studies are encouraged to better define the features of dual-task training and the clinical characteristics of pwPD to identify better responders.

Nordic walking and arm swing asymmetry in people with Parkinson’s disease: protocol for a randomised clinical trial

People with Parkinson’s disease (PD) face disruptions in arm swing (AS) motion during walking, including a reduction in amplitude and an increase in asymmetry. Both conditions are detrimental to gait...

Effects of a dual-task activity on gait parameters of people with and without intellectual disabilities.

The main objective of this study was to evaluate gait parameters in people with intellectual disability (ID) and without intellectual disability (WID) in two different walking conditions [single task vs. dual task (DT)]. A secondary aim was to evaluate the dual-task cost (DTC) that the DT causes in each group. A total of 119 participants joined in this study: 56 ID (30 men) and 63 WID (30 men). The OptoGait system was used to assess gait. In addition, Witty photocells were added to assess gait under the DT condition. Single support time was lower for participants with ID (P<0.01), while double support time was higher (P<0.05). All coefficients of variation for gait parameters were higher in participants with ID. Additionally, changes in gait were observed in both groups during the DT condition compared with the single-task condition. These changes were larger for participants with ID in step length, double support time and gait speed (P<0.001), resulting in a higher DTC in these variables in the ID group (P<0.01). Both groups reduced gait performance in the DT condition. However, greater gait variability occurred in the ID group. In addition, DTC was higher for the ID group in all variables analysed. Therefore, people with ID show worse gait performance during a DT than people WID.

Psychometric properties of portable devices used in kinematic gait assessment after stroke: a systematic review protocol

Background Portable devices comprising inertial sensors are an alternative for kinematic gait assessment in people after stroke. Nevertheless, there is limited knowledge regarding the psychometric properties of these devices, specifically their reliability and measurement error, in the context of post-stroke gait assessment. Our objective is to investigate the psychometric properties of these devices in evaluating kinematic gait parameters in people after stroke. We will also analyze the reliability and measurement error of these devices and identify portable devices that can assess changes in lower limb angular movements during gait in this population. Methods We will search for studies in English, without publication date restriction, that have evaluated psychometric properties of portable devices utilizing inertial sensors to assess kinematic gait parameters in people after stroke. Searches will be performed in the following electronic databases: Cochrane Central Registry of Controlled Trials (CENTRAL), Medline/PubMed, EMBASE Ovid, CINAHL EBSCO, PsycINFO Ovid, IEEE Xplore Digital Library (IEEE), and Physiotherapy Evidence Database (PEDro). Gray literature will also be searched, including published and unpublished studies (dissertations and theses). The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) risk of bias tool will be used to assess the quality of studies that analyzed reliability and measurement error of devices. Expected results This will be the first review to analyze reliability and measurement error of portable devices utilizing inertial sensors to evaluate kinematic gait parameters in people after stroke, using the COSMIN tool. Then, we hope to elucidate this topic and help the decision-making of clinicians regarding the use of these devices. Finally, we also hope to list the portable devices that assessed changes in angular lower limb movements during gait in this population. Registration The protocol was registered in Open Science Framework on May 11th 2023 (https://doi.org/10.17605/OSF.IO/7M6DA).

The effects of social isolation on gait parameters of older people with Parkinson’s disease

BACKGROUND: The COVID-19 disease acquired pandemic proportions in 2020. To deal with the scenario, social isolation (SI) was adopted, which configures a lack of contact with people and places. The impediments of this measure, however, can bring risks to older people with Parkinson's disease (PD), such as impairments in gait parameters. AIM: To verify the effects of SI on gait parameters in people with Parkinson's disease. METHOD: Thirty-three people with PD were recruited. Gait assessment was conducted in two periods: February 2020 and March 2022 (before and after the SI, respectively). For that, participants were invited to walk on a 5.74m mat with pressure sensors under two conditions: preferred walking speed and fast walking speed. Three trials were performed for each condition. The gait parameters analyzed were Stride Length, Stride Time, Double Support Time, Stride Velocity, Stride Width, and Cadence. Statistical Analysis was performed by paired t-tests for the comparison of gait parameters between moments (pre and post-SI). RESULTS: In the preferred walking speed condition, the participants reduced their Stride Length (t15 = 3.88, p = 0.001) and Stride Velocity (t15 = 3.63, p = 0.002) in the post-SI period. In the fast-walking speed condition, the participants also reduced their Stride Length (t15 = 3.73, p = 0.002) and Stride Velocity (t15 = 2.86, p = 0.012) in the post-SI period. INTERPRETATION: The SI period reduced the stride length and velocity of people with PD. A possible explanation is the lack of physical activity resulting from this public safety measure.

Psychometric properties of portable devices used in kinematic gait assessment after stroke: a systematic review protocol

Background: Kinematic gait assessment is essential to the gait rehabilitation program after stroke. Portable devices composed of inertial sensors are an alternative for this evaluation. However, knowledge regarding the psychometric properties of these devices is needed to understand their accuracy, especially in evaluation of individuals with movement disorders (e.g., people post stroke). This systematic review aims to analyze the psychometric properties of portable devices that use inertial sensors to assess kinematic gait parameters in people post stroke. We will also investigate which portable device assesses alterations in lower limb angular movements during gait. Methods: We will search for studies in English without publication date restriction, that evaluated psychometric properties of portable devices that use inertial sensors to assess kinematic gait parameters in people after stroke. Searches will be performed in the following electronic databases: Cochrane Central Registry of Controlled Trials (CENTRAL), Medline/PubMed, EMBASE Ovid, CINAHL EBSCO, PsycINFO Ovid, IEEE Xplore Digital Library (IEEE), and Physiotherapy Evidence Database (PEDro). Gray literature will also be searched, including published and unpublished studies (dissertations and theses). The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) risk of bias tool will be used to assess the quality of studies that analyzed reliability and measurement error of devices. Expected results: This will be the first review assessing the risk of bias in studies that analyzed psychometric properties of portable devices that use inertial sensors to assess kinematic gait parameters in people post stroke. Then, we hope to elucidate this topic and help the decision-making of clinicians regarding the feasibility of these devices. Finally, we also hope to provide an overview of the characteristics of portable devices that assessed changes in angular lower limb movements during gait in this population. Registration: The protocol was registered in Open Science Framework on May 11th 2023 (https://doi.org/10.17605/OSF.IO/7M6DA).

Effect of freezing of gait and dopaminergic medication in the biomechanics of lower limbs in the gait of patients with Parkinson’s disease compared to neurologically healthy

IntroductionThis study aims to evaluate the effects of medication, and the freezing of gait (FoG) on the kinematic and kinetic parameters of gait in people with Parkinson’s disease (pwPD) compared to neurologically healthy. MethodsTwenty-two people with a clinical diagnosis of idiopathic PD in ON and OFF medication (11 FoG), and 18 healthy participants (control) were selected from two open data sets. All participants walked on the floor on a 10-meter-long walkway. The joint kinematic and ground reaction forces (GRF) variables of gait and the clinical characteristics were compared: (1) PD with FoG (pwFoG) and PD without FoG (pwoFoG) in the ON condition and control; (2) PD with FoG and PD without FoG in the OFF condition and control; (3) Group (PD with FoG and PD without FoG) and Medication. Results(1) FoG mainly affects distal joints, such as the ankle and knee; (2) PD ON showed changes in the range of motion of both distal and proximal joints, which may explain the increase in step length and gait speed expected with the use of L-Dopa; and (3) the medication showed improvements in the kinematic and kinetic parameters of the gait of people with pwFoG and pwoFoG equally; (4) pwPD showed a smaller second peak of the vertical component of the GRF than the control. ConclusionThe presence of FoG mainly affects distal joints, such as the ankle and knee. PD presents a lower application of GRF during the impulse period than healthy people, causing lower gait performances.

The spatiotemporal gait parameters among people with visual impairment: A literature review study.

Gait is an individual's walking pattern, and it is a significant part of daily living activities. Quantitative gait assessments, like spatiotemporal parameters (STPs), are related to the functional conditions to provide useful information. This study reviewed the comprehensive differences in spatiotemporal gait variability measures between visually impaired people and the sighted. The search strategy was performed in three databases (PubMed/MEDLINE, Web of Science, and Scopus) from the start date to October 2022, and the utilized keywords for this search are related to gait and blindness. This review considered only those studies that evaluated gait parameters in people with visual impairment and blind people without any limitations in age and gender. In this review, studies without a control group (sighted people) were excluded. The Newcastle-Ottawa Scale (NOS) was applied for critical appraisal. Six full manuscripts were included. The sample size ranged from 19 to 91. The mean modified NOS critical appraisal scores for cross-sectional studies were 6.0. In these studies, among nine STPs: stride length, walking speed, stance and swing phase, step width, cadence, step length, double support, and single support, at least five and at most seven factors were examined. The gait pattern of blind and low-vision people is characterized by a slower walking speed, shorter stride length, increased step width, decreased cadence, prolonged duration of double support, and reduced single support compared to the controls.

Limited evidence of altered gait parameters in people with chronic nonspecific low back pain

BackgroundDifferences in gait parameters have been shown between people with and without low back pain (LBP). However, previous studies did not well control factors such as sex, age, height and walking speed known to influence gait parameters. Research questionIs gait altered in people with LBP when sex, age, height and walking speed are controlled? MethodsA series of gait parameters were measured in 16 participants with LBP and 16 age, sex and height matched healthy controls while walking on an instrumented treadmill. LBP group walked at a comfortable speed whilst control group walked at their own comfortable speed and at the comfortable speed of their matched participants with LBP. Pain and disability were measured for the LBP group. The between-group differences in mean, standard deviation (SD) and coefficient of variation (CV) of gait parameters were tested using paired samples t-test, Wilcoxon signed-rank test or two-factor repeated measures analyses of variance. ResultsThe median (interquartile range) of pain intensity was 2 (1, 3.5). From 102 tests of between-group difference in mean, SD and CV of 17 gait parameters at both comfortable speed and matched speed walking, only the mean of stride length (p = 0.037) during matched speed walking and SD of single support phase (p = 0.040) during comfortable speed walking showed significant between-group differences. There was no significant between-group difference in the rest means (comfortable walking: p ≥ 0.116; matched speed walking: p ≥ 0.069), SDs (comfortable walking: p ≥ 0.066; matched speed walking: p ≥ 0.098) and CVs of gait parameters (comfortable walking: p ≥ 0.110; matched speed walking: p ≥ 0.121). SignificanceThe lack of significant between-group difference in gait parameters may suggest that the gait of people with low level of LBP were not altered when sex, age and height were controlled.

Decomposing the Effects of Familiarity with Music Cues on Stride Length and Variability in Persons with Parkinson's Disease: On the Role of Covariates.

This study aimed to determine the role of cognitive and affective responses to music cues in modulating the effects of familiarity with music on stride length and stride-to-stride variability in people with Parkinson’s disease (PD). Using multilevel modeling, people with PD’s spatiotemporal gait parameters and self-reported ratings of familiarity, enjoyment, cognitive and physical demand, beats salience of music cues after each walking trial, as well as music reward, were analyzed. Our findings indicate that (1) condition-varying perceived enjoyment and beat salience are positively associated with increased stride length; (2) participants with a greater music reward for mood regulation and emotion evocation show greater stride length changes compared with those with less music reward; (3) condition-varying perceived enjoyment is positively associated with decreases in stride-to-stride variability; and (4) participants with lower cognitive demand of walking with music cues and higher beat salience show lower stride-to-stride variability compared with those with higher cognitive demand and lower beat salience. These results provide behavioral evidence of independent and interactive influences of cognitive and affective responses to music cues on spatiotemporal gait parameters in people with PD.

Does visual cueing improve gait initiation in people with Parkinson's disease?

Anticipatory postural adjustments (APAs) prior to gait initiation are impaired in people with Parkinson's disease (PD), particularly in those who report Freezing of Gait (FOG). External cues can improve gait parameters in people with PD, but the effects of visual cues on gait initiation are poorly known. The study aimed to (i) assess differences, during gait initiation, between people with PD with (FOG+) and without FOG (FOG-) and healthy controls (HC), (ii) explore the effect of disease severity on gait initiation and (iii) investigate the acute effect of visual cueing on gait initiation and straight-ahead gait. Twenty FOG- and twenty FOG+, and eighteen HC participated in this study. Participants were asked to perform self-initiated gait with and without visual cues presented as transverse taped lines on the floor. Gait initiation and gait were characterized with wireless inertial measurement units. Results showed that FOG+ had smaller APAs than HC and FOG-; although no differences were detected between FOG+ and FOG- when taking into account disease severity. Significant correlations between MDS-UPDRS III scores and gait initiation/straight-ahead gait variables confirmed that differences between FOG+ and FOG- were driven by disease severity. In gait initiation, visual cues elicited different behaviors in people with and without PD. Particularly, people with PD showed smaller and longer APAs, whereas HC showed longer first step durations, compared to baseline. However, the adopted visual cues improved gait speed and stride length in all individuals. These results suggest that people with PD, despite the presence of FOG, utilize different motor strategies, compared to HC, to adapt to the new biomechanical requirements of gait initiation dictated by the visual cues.

Is BDNF related to spatial-temporal gait parameters in people with multiple sclerosis? An observational study

BackgroundIt has been suggested that the protein Brain-derived Neurotrophic Factor (BDNF) plays a neuroprotective role in people with multiple sclerosis (pwMS). Also, BDNF seems to play a role in cognition performance. In the same line, gait in pwMS requires a higher cognitive resource, mainly during complex walking. Thus, maybe BDNF could be related to gait in pwMS. ObjectiveTo investigate the relationship between BDNF and gait spatial-temporal parameters during unobstructed and obstructed conditions and the Timed Up and Go (TUG) in pwMS and healthy controls (HC). MethodsThe study included 20 pwMS (11F/9M, 33.1±7.5 years, Expanded Disability Status Scale- EDSS 2.2±1.2) and 18 HC (13F/5M, 35.5±5.9 years). Both groups performed 20 gait attempts in two conditions: unobstructed walking (10 trials) and avoiding an obstacle. The obstacle was 15 cm in height and made of foam material. The BDNF serum concentration was collected with participants in fasting and completed before the clinical, gait, and mobility assessments. Clinical variables included the Symbol Digit Modality Test (SDMT), the Fatigue Severity Scale (FSS), and the International Physical Activity Questionnaire (IPAQ- short version). Associations between BDNF and spatial-temporal gait parameters, clinical variables, and TUG were determined by Pearson/Spearman correlations with Bonferroni's correction being applied (p<0.0013). Gait was compared by a two-way, repeated-measures ANOVA (group and condition) to characterize our cohort. ResultsReduced BDNF was observed for pwMS (41.66±4.45 ng/ml) in comparison with HC (61.67±7.07, p<0.001). However, although some correlations presented a moderate correlation between BDNF with gait variables, the correlations didn't reach a significant p-value after Bonferroni's correction. Lastly, pwMS presented shorter step length and slower step velocity for both gait conditions, with more evidence for obstacle conditions. Only pwMS changed gait behavior from unobstructed walking to obstacle avoidance conditions (i.e., reduced step length and velocity and increased step duration). ConclusionBDNF is not related to either clinical (i.e., EDSS, SDMT, FSS, or IPAQ) or gait parameters in pwMS and HC, even in a condition involving higher cognitive demand. These results may suggest that BDNF does not play a role in these parameters' performance.

EFFECTS OF BACKWARD WALKING ON GAIT PARAMETERS IN PEOPLE WITH STROKE: A SYSTEMATIC REVIEW

According to the Centers for Disease Control, roughly 795,000 people in the United States experience a stroke each year. A common result of a stroke is the negative impact on the person’s gait, including an asymmetrical gait pattern, a slower cadence, and decreased stride and step lengths. A well-structured, comprehensive rehabilitation program is necessary to address the gait deficits and reduce the risk of falls in people following stroke. Backward walking training has been reported as an appropriate therapeutic intervention to address these deficits for people following a stroke. Due to the range of benefits reported, the purpose of this systematic review was to examine the effects of backward walking training on gait parameters in people following stroke. A search of Embase, CINAHL, and PubMed databases was performed using specific search terms related to backward walking, stroke, and gait parameters. Following a defined process of title screen, abstract screen, full text screen, and application of inclusion/exclusion criteria, six articles were included in the final systematic review. Study results indicate significant evidence within the experimental groups for improvement in gait speed, step length, stride length, endurance, and balance. The findings from this systematic review indicate that backward walking training is an effective therapeutic intervention to improve gait parameters in people following stroke.

Movement Quality Parameters during Gait Assessed by a Single Accelerometer in Subjects with Osteoarthritis and Following Total Joint Arthroplasty.

This study’s aim is threefold: (I) Evaluate movement quality parameters of gait in people with hip or knee osteoarthritis (OA) compared to asymptomatic controls from a single trunk-worn 3D accelerometer. (II) Evaluate the sensitivity of these parameters to capture changes at 6-weeks, 3-, 6-, and 12-months following total knee arthroplasty (TKA). (III) Investigate whether observed changes in movement quality from 6-weeks and 12-months post-TKA relates to changes in patient-reported outcome measures (PROMs). We invited 20 asymptomatic controls, 20 people with hip OA, 18 people pre- and post-TKA to our movement lap. They wore a single trunk-worn accelerometer and walked at a self-selected speed. Movement quality parameters (symmetry, complexity, smoothness, and dynamic stability) were calculated from the 3D acceleration signal. Between groups and between timepoints comparisons were made, and changes in movement quality were correlated with PROMs. We found significant differences in symmetry and stability in both OA groups. Post-TKA, most parameters reflected an initial decrease in movement quality at 6-weeks post-TKA, which mostly normalised 6-months post-TKA. Finally, improved movement quality relates to improvements in PROMs. Thus, a single accelerometer can characterise movement quality in both OA groups and post-TKA. The correlation shows the potential to monitor movement quality in a clinical setting to inform objective, data-driven personalised rehabilitation.

Longitudinal relationships between disability and gait characteristics in people with MS

Longitudinal data are vital in order to understand intra individual gait changes with the progression of multiple sclerosis (MS). Therefore, the primary aim of this study was to explore the relationship between changes in disability with changes in major spatio-temporal parameters of gait in people with MS (PwMS). PwMS (n = 83) completed two gait assessments performed at separate time points (M1, M2). For each individual, the absolute difference between the Expanded Disability Status Scale (EDSS) score, key spatio-temporal parameters of gait, Falls Efficacy Scale International (FES-I), and the 12-item Multiple Sclerosis Walking Scale (MSWS-12), were calculated. The mean time difference between M1 and M2 was 2.5 (SD = 1.7) years. At M2, PwMS presented with shorter strides, a wider base of support, increased perceived mobility difficulties and fear of falling compared with M1. According to the odds ratio (OR) analysis, the odds of experiencing an increase in the EDSS score was significantly higher once the MSWS-12 score increased at M2 compared with M1 (OR = 7.930, p = 0.004). This observation was highlighted specifically in people with mild-moderate MS (OR = 12.427, p < 0.001). The increase in the EDSS score was not associated with changes in key spatio-temporal parameters of gait. The present study provides a better understanding of gait and disease progression in PwMS, highlighting the significant role of the MSWS-12.

Sensor-based gait analyses of the six-minute walk test identify qualitative improvement in gait parameters of people with multiple sclerosis after rehabilitation

The aim of this work was to determine whether wearable inertial measurement units (IMUs) could detect gait improvements across different disability groups of people with Multiple Sclerosis (pwMS) by the six-minute walk test (6MWT) during a rehabilitation stay in a specialized rehabilitation center. Forty-six pwMS and 20 healthy controls (HC) were included in the study. They performed the 6MWT with two inertial measurement units (IMUs) placed on the feet. Thirty-two of the pwMS were retested at the end of the stay. PwMS were divided in a mild-disability and a moderate-disability group. The 6MWT was divided in six sections of 1 min each for technical analysis, and linear mixed models were used for statistical analyses. The comparison between the two disability groups and HC highlighted significant differences for each gait parameter (all p < 0.001). The crossing effect between the test–retest and the two disability groups showed greater improvement for the moderate-disability group. Finally, the gait parameter with the higher effect size, allowing the best differentiation between the disability groups, was the foot flat ratio (R2 = 0.53). Gait analyses from wearable sensors identified different evolutions of gait patterns during the 6MWT in pwMS with different physical disability. The measured effect of a short-time rehabilitation on gait with 6MWT was higher for pwMS with higher degree of disability. Using IMUs in a clinical setting allowed to identify significant changes in inter-stride gait patterns. Wearable sensors and key parameters have the potential as useful clinical tools for focusing on gait in pwMS.

Reliability of using foot-worn devices to measure gait parameters in people with Parkinson's disease.

Recent advances in technology have warranted the use of wearable sensors to monitor gait and posture. However, the psychometric properties of using wearable devices to measure gait-related outcomes have not been fully established in patients with Parkinson's disease (PD). This study aimed to investigate the test-retest reliability of body-worn sensors for gait evaluation in people with PD. Additionally, the influence of disease severity on the reliability was determined. Twenty individuals with PD were recruited. During the first evaluation, the participants wore inertial sensors on their shoes and walked along a walkway thrice at their comfortable walking speed. The participants were then required to return to the lab after 3-5 days to complete the second evaluation with the same study procedure. Test-retest reliability of gait-related outcomes were calculated. To determine whether the results would be affected by disease severity, reliability was re-calculated by subdividing the participants into early and mid-advanced stages of the disease. The results showed moderate to good reliability (ICC = 0.64-0.87) of the wearable sensors for gait assessment in the general population with PD. Subgroup analysis showed that the reliability was higher among patients at early stages (ICC = 0.71-0.97) compared to those at mid-advanced stages (ICC = 0.65-0.81) of PD. Wearable sensors could reliably measure gait parameters in people with PD, and the reliability was higher among individuals at early stages of the disease compared to those at mid-advanced stages. Absolute reliability values were calculated to act as references for future studies.

Effect of hippotherapy on walking performance and gait parameters in people with multiple sclerosis

BackgroundWalking dysfunction is one of the most common symptoms of multiple sclerosis (MS). ObjectiveTo evaluate the effects of an 8-week hippotherapy intervention on walking performance and spatiotemporal gait parameters in people with relapsing-remitting MS; and to examine whether the effects of hippotherapy on walking performance are mediated by changes in spatiotemporal gait parameters. MethodsParticipants were assigned into a hippotherapy intervention group (n = 17) or a control group (n = 16). The intervention included 16 sessions of 30-minutes of hippotherapy conducted twice a week. Participants underwent the 25-foot walk test (T25FW) and 6-minute walk test (6MWT), as primary outcomes, and spatiotemporal gait evaluation using GaitRite system, as secondary outcomes, before and after intervention. The data were examined using mixed model ANOVA with Bonferroni post hoc. Mediation analysis was conducted as per Baron and Kenny's criteria. ResultsCompared with control, the intervention group significantly increased 6MWT distance (+9.70%, p<0.001) and decreased T25FW time (-15.86%, p<0.001).Regarding spatiotemporal gait parameters, the intervention group exhibited significantly greater improvements in most variables (Δ% from 3.66 and 41.43%; all p<0.005) than control. Only balance time (p = 0.043), stance time (p = 0.031), and absolute (p = 0.004) and relative (p = 0.017) double support time were identified as significant mediators of the effects of hippotherapy on walking performance evaluated by T25FW. There was no significant mediator for 6MWT (all p>0.05). ConclusionHippotherapy improved walking performance and spatiotemporal gait parameters in people with relapsing-remitting MS, and changes in walking performance, evaluated by T25FW, were partially driven by reduction in stance time and double support time and increase in balance time. Hippotherapy may be a useful complimentary treatment approach for improving walking in people with MS.