Gait Parameters In Patients Research Articles

A Prospective Study on Gait Impairment in Patients With Symptomatic Lumbar Canal Stenosis and Impact of Surgical Intervention on Gait Function.

Prospective observational cohort study. To analyze the effect of decompression surgery on gait characteristics in patients with stenosis. Also, to test the hypothesis that patient-reported functional outcomes and gait parameters (spatiotemporal, kinetic, and kinematic measures) will improve postoperatively and achieve normal values when compared with matched healthy controls. Lumbar spinal stenosis is one of the leading causes of disability among elderly population. Gait impairment is one of the primary symptoms of degenerative conditions involving lumbar spine. Research suggests that decompressive surgery can positively influence gait parameters in patients with spinal stenosis. Studies have shown improvements in walking speed, stride length, and balance post-surgery. Thirty-two patients with single-level lumbar stenosis and 32 healthy volunteers were prospectively recruited. All patients underwent gait analysis preoperatively and 6 months postoperatively as per standard protocol. Spatiotemporal, kinematic, and kinetic parameters were analyzed. Stepwise linear regression models were used to detect significant relationships between changes in functional score (Visual Analogue Scale/Oswestry Disability Index) and gait parameters. Significant improvement was noted in functional scores(P<0.05) 6 months post-surgery. Spatiotemporal (swing phase, mean velocity, cadence, stride length, step length, and step width) and kinetic parameters (hip, knee, and ankle power) were significantly better after surgery, reaching normal levels. Kinematic parameters significantly improved after surgery but did not reach normal levels when compared with controls. A significant correlation was found between changes in functional scores with changes in certain kinematic parameters (knee-power, ankle plantarflexion, swing time, peak ankle dorsiflexion in swing, peak-hip, and knee flexor moment). Decompression surgery in lumbar stenosis produces improvement in gait parameters, pain scores, and functional outcomes that significantly improve gait posture and speed.

Effect of cognitive training on selected gait parameters in patients with stroke

Background. Not only may early cognitive rehabilitation help stroke patients with their cognitive impairment, but it can also help patients restore their capabilities to do everyday activities. There isn’t much data on how cognitive training affects spatiotemporal gait variables in stroke survivors. Objective. To examine the impact of cognitive training on selected gait parameters in stroke patients. Subjects and Methods. Forty male and female patients with mild ischemic chronic stroke, ranging in age from 45 to 60 years, were recruited and distributed into two equal groups at random (G1 and G2). The Montreal Cognitive Assessment Scale (MOCA) and the Rehacom system were utilized to evaluate the patient’s cognitive function. The Biodex gait trainer device was utilized to measure several gait variables for all patients. Rehacom cognitive training and a selected physiotherapy program were administered to the study group (G1). The similar selected physiotherapy program utilized for the G1 was applied to the control group (G2). For eight weeks, the treatment was administrated three sessions each week, day after day. All variables were evaluated before- and after-intervention. Results. The step length and walking speed, as well as the MOCA scale score of G1, were significantly higher after treatment than those of G2 (p = 0.001). The correlation between step length and median reaction time (MRT) was moderate negative significant correlation (r = – 0.698, p = 0.001). Conclusion. Cognitive training has a beneficial impact on improving the selected spatiotemporal gait parameters in stroke patients.

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.

Effect of extracorporeal shockwave on gait parameters in patients with plantar fascitis: a randomized controlled trial

BackgroundPlantar fasciitis (PF) is the most common cause of heel pain affecting both young active patients and older sedentary individuals. It most often arises as a result of degenerative changes in the proximal plantar fascia.AimThe purpose of this study was to investigate the effect of extracorporeal shockwave on gait parameters in patients with plantar fasciitis.DesignA randomized controlled clinical trial.SettingThe outpatient physiotherapy clinic of the teaching hospital Shibin El Kom.MethodsParticipants were randomly divided into two equal groups. Group (A) (study group): received extracorporeal shockwave therapy one session per week and traditional treatment (ultrasound, stretching exercises, and strengthening exercises) three sessions per week for 4 weeks. Group (B)(the control group): received traditional treatment (ultrasound, stretching exercises, and strengthening exercises) 3 sessions per week for 4 weeks. The pre- and post-treatment development of the patients was evaluated by visual analog scale (VAS) to measure pain, foot function index (FFI) to measure foot function, and Kinovea software to analyze gait parameters (stride length, stride time, walking speed, and cadence).ResultsBoth groups showed improvement in all study variables, but the study group showed more improvement. There was a statistically significant decrease in VAS (p = 0.001), a significant decrease in FFI (p = 0.001), a significant increase in stride length (p = 0.001), a significant decrease in stride time (p = 0.001), a significant increase in walking speed (p = 0.001), and a significant increase in cadence (p = 0.01) post-treatment compared to group (B).ConclusionExtracorporeal shockwave treatment is regarded as a useful treatment for improving gait parameters in patients with plantar fasciitis.Clinical rehabilitation impactExtracorporeal shockwave therapy improved gait parameters in patients with plantar fasciitis as it increases stride length, walking speed, cadence, and decreases stride time. So, it is recommended to be included in the rehabilitation program for patients with plantar fasciitis and gait disabilities.

Gait, Quality of Life, and Knee Function in Advanced Knee Osteoarthritis: A Single-Center, Prospective, Observational Study.

Background/Objectives: Treatment of advanced knee osteoarthritis with total knee arthroplasty typically results in an improvement in function, gait, and quality of life, which tend to be affected by the condition. It is, however, necessary to determine the baseline factors that could influence the patients' postoperative outcome. Methods: This is a single-center prospective observational study of patients with advanced knee osteoarthritis (Kellgren-Lawrence grade 3 or 4) treated with total knee arthroplasty. Gait parameters were recorded at baseline and at various postoperative time points using a wireless device. Progression of function was assessed using the Knee Society Score questionnaire and quality of life by means of the EQ-5D and Knee Injury and Osteoarthritis Outcome Score questionnaires. Progression of gait and quality of life was analyzed in all patients, distinguishing between those where baseline velocity was < 1 m/s and those where it was ≥1 m/s. The potential correlation between baseline and postoperative parameters was also evaluated. Results: All 119 patients showed a significant improvement in their gait, function, and quality of life parameters at one year from the procedure (p < 0.05). No statistically significant differences were found in any of the postoperative subscales, regardless of baseline velocity (< o ≥ 1 m/s) or between any of the baseline or postoperative parameters (r < 0.29). Conclusions: Baseline gait parameters in patients with advanced knee osteoarthritis do not appear to bear a statistically significant relationship with function or quality of life outcomes following total knee arthroplasty. Such parameters exhibit a significant improvement one year after surgery.

Posture, balance and gait in axial spondyloarthritis: a case-control study.

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that primarily involves the axial skeleton but may also present with peripheral joint involvement and extra-articular involvement. The present study aims to quantitatively analyze posture, balance, and gait parameters in patients with axSpA and and assess associated factors. This cross-sectional case-control study included 51 axSpA patients (30 males, 21 females; mean age 40.94 ± 10.48 years) and 51 age- and sex-matched healthy controls. In patients with axSpA, the Ankylosing Spondylitis Disease Activity Score CRP, the Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index(BASMI), the Maastrich Ankylosing Spondylitis Enthesitis Score(MASES), and the Ankylosing Spondylitis Quality of Life(ASQoL) scale were used. For postural analysis, DIERS formetric (Diers GmbH, Schlangenbad, Germany) videoraster- stereography device was utilized. HUR SmartBalance BTG4 (HUR-labs Oy, Kokkola, Finland) balance platform was used for postural balance and limit of stability (LOS) measurement. Participants were evaluated using Berg Balance Scale (BBS), Functional Reach Test (FRT) and Timed Up and Go Test (TUG). The Zebris FDM type 3 (Zebris Medical GmbH, Germany) walking platform was used to measure the spatiotemporal parameters of the participants. Comparison of postural parameters showed that sagittal imbalance and cervical depth distance were increased in the axSpA group than in the healthy participants (p < 0.004). Comparison of functional balance parameters showed that BBS and FRT scores were significantly lower (p < 0.001) in the axSpA group than in the control group, while TUG scores were significantly higher (p < 0.001). The LOS values, which evaluate dynamic balance were significantly lower, indicating impairment, in the axSpA group. In the measurement of postural sway, which indicates static balance, all 23 subparameters were found to be similar. When analyzing the spatiotemporal gait parameters, in the axSpA group compared with those in the control group; Foot angles (p= 0.028) and stride width (p = 0.004) were increased, whereas step lengths (p = 0.004) and stride lengths (P = 0.004) were decreased. In the axSpA group the gait speed was decreased (p = 0.004). When axSpA was analyzed separately as radiographic and nonradiographic axSpA, similar findings were observed in posture, balance, and gait parameters. No significant difference was observed. We found that the clinical assessments most closely associated with posture, balance, and gait analyses were BBS, FRT, TUG, and BASFI.

A Study on the Effectiveness of VR Rehabilitation Training Content for Older Individuals with Total Knee Replacement: Pilot Study.

There is a paucity of research applying fully immersive virtual reality (VR) training to older adults with degenerative joint disease. This study investigated the effects of a training program utilizing fully immersive VR games on proprioception and gait ability in older patients with degenerative arthritis who had undergone total knee arthroplasty. This randomized controlled trial enrolled patients aged ≥65 years who were diagnosed with knee joint arthritis and had undergone knee arthroplasty followed by physical therapy. Participants were randomly assigned to an experimental group (receiving training using fully immersive VR games along with regular physical therapy) and a control group (receiving only regular physical therapy). The intervention was conducted five times a week for four weeks. Knee joint proprioception was measured using Biodex before and after the intervention. Spatial-temporal gait variables were collected using OptoGait for gait assessment. There was a significant decrease in the absolute error values of proprioception after the intervention in the experimental group, compared to before (p < 0.05), indicating improvement in proprioception. Gait speed, step count, and stride length improved significantly (p < 0.05, p < 0.01), demonstrating an enhancement in gait ability. The experimental group showed significantly greater improvements in gait speed, step count, and stride length than the control group (p < 0.01). Training using a fully immersive VR exercise program may have potential benefits for improving proprioception and gait parameters in patients who have undergone total knee arthroplasty. Fully immersive VR game-based training can be utilized as an effective rehabilitation intervention for patients undergoing knee arthroplasty in the future.

Impact of step width on trunk motion and gait adaptation in elderly women with knee osteoarthritis.

Step width during walking can provide important information about aging and pathology. Although knee osteoarthritis (OA) is a common disease in elderly women, little is known about how different step widths influence gait parameters in patients with knee OA. To address this, we investigated the differences between narrower and wider step width on the center of mass (CoM) and gait biomechanics of elderly women with knee OA. Gait and CoM data were measured using a three-dimensional motion capture system and anthropometric data were acquired via standing full-limb radiography. Thirty elderly women with knee OA were divided into two groups depending on the average step width value (0.16 m). Specifically, the narrower step width group included those with a below average step width (n= 15) and the wider step width group included those with an above average step width (n= 15). The differences between the two groups were analyzed using an independentt-test. Walking speed, step length, knee and ankle sagittal excursion, and medial-lateral CoM range were significantly greater in the narrower group. In contrast, the medial-lateral CoM velocity, medial-lateral ground reaction force (GRF), and foot progression angle were significantly higher in wider group. The external knee adduction moment, vertical GRF, and vertical CoM did not differ between the groups. Our data indicate that step width in women with knee OA is associated with trunk motion and gait patterns. People with a narrower step might improve their gait function by increasing trunk frontal control to maintain gait stability. In contrast, in those with a wider step, greater toe out angle and shorter step length might be a compensatory adaptation to reduce knee loading.

Stroke walking and balance characteristics via principal component analysis

Balance impairment is associated gait dysfunction with several quantitative spatiotemporal gait parameters in patients with stroke. However, the link between balance impairments and joint kinematics during walking remains unclear. Clinical assessments and gait measurements using motion analysis system was conducted in 44 stroke patients. This study utilised principal component analysis to identify key joint kinematics characteristics of patients with stroke during walking using average joint angles of pelvis and bilateral lower limbs in every gait-cycle percentile related to balance impairments. Reconstructed kinematics showed the differences in joint kinematics in both paretic and nonparetic lower limbs that can be distinguished by balance impairment, particularly in the sagittal planes during swing phase. The impaired balance group exhibited greater joint variability in both the paretic and nonparetic limbs in the sagittal plane during entire gait phase and during terminal swing phase respectively compared with those with high balance scores. This study provides a more comprehensive understanding of stroke hemiparesis gait patterns and suggests considering both nonparetic and paretic limb function, as well as bilateral coordination in clinical practice. Principal component analysis can be a useful assessment tool to distinguish differences in balance impairment and dynamic symmetry during gait in patients with stroke.

Using In-Shoe Inertial Measurement Unit Sensors to Understand Daily-Life Gait Characteristics in Patients With Distal Radius Fractures During 6 Months of Recovery: Cross-Sectional Study.

A distal radius fracture (DRF) is a common initial fragility fracture among women in their early postmenopausal period, which is associated with an increased risk of subsequent fractures. Gait assessments are valuable for evaluating fracture risk; inertial measurement units (IMUs) have been widely used to assess gait under free-living conditions. However, little is known about long-term changes in patients with DRF, especially concerning daily-life gait. We hypothesized that, in the long term, the daily-life gait parameters in patients with DRF could enable us to reveal future risk factors for falls and fractures. This study assessed the spatiotemporal characteristics of patients with DRF at 4 weeks and 6 months of recovery. We recruited 16 women in their postmenopausal period with DRF as their first fragility fracture (mean age 62.3, SD 7.0 years) and 28 matched healthy controls (mean age 65.6, SD 8.0 years). Daily-life gait assessments and physical assessments, such as hand grip strength (HGS), were performed using an in-shoe IMU sensor. Participants' results were compared with those of the control group, and their recovery was assessed for 6 months after the fracture. In the fracture group, at 4 weeks after DRF, lower foot height in the swing phase (P=.049) and higher variability of stride length (P=.03) were observed, which improved gradually. However, the dorsiflexion angle in the fracture group tended to be lower consistently during 6 months (at 4 weeks: P=.06; during 6 months: P=.07). As for the physical assessments, the fracture group showed lower HGS at all time points (at 4 weeks: P<.001; during 6 months: P=.04), despite significant improvement at 6 months (P<.001). With an in-shoe IMU sensor, we discovered the recovery of spatiotemporal gait characteristics 6 months after DRF surgery without the participants' awareness. The consistently unchanged dorsiflexion angle in the swing phase and lower HGS could be associated with fracture risk, implying the high clinical importance of appropriate interventions for patients with DRF to prevent future fractures. These results could be applied to a screening tool for evaluating the risk of falls and fractures, which may contribute to constructing a new health care system using wearable devices in the near future.

Gait Analysis in Patients with Symptomatic Pes Planovalgus Following Subtalar Arthroereisis with the Talus Screw.

Pes planovalgus is one of the most common pediatric skeletal deformities. There have been no studies to analyze in detail the spatiotemporal variables of gait following arthroereisis. The purpose of our study was to assess gait parameters in patients with symptomatic flexible flatfoot following treatment with the talus screw. This was a prospective study assessing the 22 patients treated surgically due to symptomatic flexible flatfoot with the talus screw. Patients underwent gait assessment with a G-Sensor. We analyzed the following gait parameters: gait cycle duration, step length, support phase duration, swing phase duration, double support duration, single support duration, cadence, velocity, step length. The post-operative gait parameter assessment for the operated and non-operated foot showed a significant difference only in terms of step length. Cadence increased from the pre-operative mean of 82.29 steps/min to a post-operative mean of 102.94 steps/min. Gait velocity increased significantly from 0.81m/s before to 0.96m/s after surgery. Arthroereisis with the talus screw helps improve gait parameters following surgery. Post-operatively, we observed increased gait velocity and cadence and decreased gait cycle duration in the operated limb. Short-term biomechanical outcomes of pes planovalgus treatment with the talus screw are good.

Effectiveness of dynamic neuromuscular stabilization, neurodevelopmental techniques and proprioceptive neuromuscular facilitation on trunk and gait parameters in patients with subacute stroke: A three-arm parallel randomised clinical trial

Background Today, stroke is the principal cause of demise in both developed and developing countries. There are different techniques used to treat patients with sub-acute stroke. Trunk muscles play a key role, i.e. in keeping the spine and trunk in place. This stabilization requires moving the head and extremities freely and selectively. The aim of this study is to compare the effectiveness of dynamic neuromuscular stabilization (DNS), neurodevelopmental techniques (NDT) and proprioceptive neuromuscular facilitation (PNF) on trunk and gait parameters in the subacute phase of stroke. This study is intended to ascertain the efficacy of all three approaches individually and to compare the effectiveness of DNS, NDT and PNF on trunk and gait parameters. Furthermore, the findings of this study could be used to assist post-stroke survivors in their early recovery and improve their level of independence. Methods In this interventional study, participants will be divided into three groups, and in each group, 20 patients will be assigned randomly to each group using the sequentially numbered opaque sealed envelope method. Group A patients will be given DNS, Group B will be given NDT, and Group C will be given PNF. The patients will be given treatment for five days for four consecutive weeks. Outcome measures that will be used are trunk impairment scale (TIS), dynamic gait index (DGI) and gait parameters. Data will be collected before and after the 4-week treatment period. Conclusions After the study, a conclusion will be drawn regarding which treatment technique is most suitable among all the three strategies for treating stroke patients if the hypothesis of the study is found valid. Clinical Trials Registry – India (CTRI) reference no. CTRI/2022/06/043037; date of registration 22/05/2022.

Arm Swing while Walking and Running: A New Clinical Feature to Separate Parkinson's Disease from Functional Parkinsonism.

Functional parkinsonism is an important differential diagnosis of Parkinson's disease (PD). Based on anecdotal experience, we hypothesized that arm swing while walking and running could differentiate these two conditions, but this assumption has not been previously explored systematically. To examine differences in arm swing while walking and running between patients with PD and functional parkinsonism. We analyzed blinded video assessments of arm swing and other gait parameters in patients with asymmetrical PD (n = 81) and functional parkinsonism (n = 8) while walking and running. The groups were matched for age, sex and disease duration. In contrast to those with PD, patients with functional parkinsonism (i) were more likely to have a marked asymmetry in arm swing while walking (5/8 vs. 25/81; P = 0.06), (ii) were less likely to improve arm swing while running with full effort (3/8 vs. 72/81; P < 0.001) and (iii) demonstrated normal passive arm swing even when asymmetry of arm swing was marked during running/walking (6/6 vs. 9/33; P = 0.002). Assessment of arm swing while walking and running and passive arm swing could be important differentiating clinical features between functional parkinsonism and PD.

The effect of using walking poles on the spatiotemporal gait parameters in patients who underwent surgery for hip fractures

Purpose This study aimed to investigate the differences in spatiotemporal gait parameters in patients who underwent surgery for hip fractures when using walking poles and T-canes. Methods This cross-sectional study enrolled eight patients who underwent surgery for a unilateral hip fracture (mean age, 79.0 ± 7.9 years) and 34 healthy individuals who had no symptoms (mean age, 32.1 ± 6.2 years). The outcome measures were the walking speed, trunk acceleration, and lateral lean angles of the trunk, shoulder, and pelvis during walking. The results were compared among the three types of walking aids, namely, a T-cane, double T-canes, and walking poles. Results Acceleration indices step symmetry in the vertical and anteroposterior directions in walking with walking poles were significantly larger than that in walking with a T-cane. These results were common in patients with fractures and healthy individuals. Conclusions Walking with walking poles might be a more symmetrical gait style than walking with a T-cane in patients who underwent surgery for hip fractures.

The Effectiveness of a Single Dry Needling Session on Gait and Quality of Life in Multiple Sclerosis: A Double-Blind Randomized Sham-Controlled Pilot Trial.

Gait disorders are a major cause of disability and reduced health-related quality of life in people with multiple sclerosis (pwMS). Dry needling (DN) has demonstrated positive results to improve gait parameters in patients with stroke. The main aim of this study was to evaluate the effect of a single session of DN in the gait performance of pwMS. A double-blind parallel randomized sham-controlled pilot trial was conducted. Study participants received a single session of active DN or sham DN in the gastrocnemius medialis muscle. Pre-treatment and immediately post-treatment measurements were taken, as well as at one and four weeks after the intervention. Outcomes related to gait performance (Timed 25-Foot Walk), self-perceived walking capacity (Multiple Sclerosis Walking Scale), risk of falls (Timed Up and Go test), disability level (Expanded Disability Status Score) and quality of life (Multiple Sclerosis Quality of Life-54 questionnaire and Analogic Quality of Life scale) were evaluated. 18 patients who had multiple sclerosis participated in the study. The group who received active DN showed within-group significant statistical differences immediately after treatment for gait performance (p = 0.008) and risk of falls (p = 0.008), as well as for self-perceived walking capacity at one week (p = 0.017) and four weeks (p = 0.011) and quality of life at four weeks (p = 0.014). Regarding the comparison between groups, only significant results were obtained in the physical domain of the quality of life at four weeks (p = 0.014). DN seems to be a promising therapeutic tool for the treatment of gait disorders in pwMS. However, when results were compared with sham DN, no differences were found.

The Impact of Upper Limb Functioning on Gait Patterns in Individuals with Post-Stroke Hemiplegia

Hemiplegia resulting from a stroke leads to a distinct gait pattern and dysfunction in the upper limb. The objective of this study was to determine a correlation between the functionality of the upper limb and selected spatiotemporal parameters of gait in patients with hemiplegia following a stroke. The study comprised a sample of 80 outpatients (45 males and 35 females) with post-stroke hemiplegia, with an average age of 60.78 years, selected using a convenient sampling method. To assess the functionality of the affected upper limb, the study employed the QuickDASH questionnaire, which is a shortened version of the Disabilities of the Arm, Shoulder, and Hand questionnaire. Concurrently, the participants were recorded on video while performing the 4-meter walk test (4mWT). The recorded videos were meticulously analyzed using Kinovea software (version 0.8.15) to calculate gait parameters such as comfortable and maximum speeds, stride length and time on the paretic and affected side, number of steps taken to cover the 4m, and cadence. Pearson Correlation analysis was conducted to explore potential associations between these gait parameters and the QuickDASH score, with a significance level of p &lt; 0.05.&#x0D; The findings revealed significant correlations between upper limb functionality and selected gait parameters. Reduced upper limb functionality correlated with decreased comfortable speed (p &lt; 0.05), maximum speed (p &lt; 0.05), and cadence (p &lt; 0.05) during the 4mWT. In contrast, impaired upper limb function linked to prolonged time to complete the 4m distance (p &lt; 0.05), increased steps taken by both affected (p &lt; 0.05) and unaffected (p &lt; 0.05) sides, and extended stride time on both sides (p &lt; 0.05). However, no substantial correlation emerged between upper limb functionality and stride length on either side (p &gt; 0.05).&#x0D; In conclusion, this study emphasizes the correlation between upper limb functionality and specific gait parameters in post-stroke hemiplegic patients. The correlation between upper limb functionality and selected spatiotemporal parameters of gait underscores the necessity for integrated rehabilitation strategies targeting both upper limb and gait training. These findings contribute to a deeper comprehension of the connection between upper limb disability and gait parameters, emphasizing the significance of personalized treatments in order to maximize the restoration of functionality in individuals who have suffered a stroke.

Shoulder brace has no detrimental effect on basic spatio-temporal gait parameters and functional mobility after arthroscopic rotator cuff repair

BackgroundThe risk of falls in patients undergoing orthopedic procedures is significant in terms of health and socioeconomic effects. Research questionIs there an influence of the shoulder abduction brace (SAB) on gait parameters in patients undergoing arthroscopic rotator cuff repair (ARCR)? MethodsThirty-five patients undergoing ARCR, who used a 15° SAB in the postoperative period, were included in a prospective study. Participants underwent gait analysis preoperatively (T0), 24 h after surgery (T1), 1 week (T2), and 4 weeks after surgery (1 week after SAB removal) (T3) by using a wearable inertial sensor (BTS G-Walk sensor). Gait Parameters (cadence, speed, right (R) and left (L) step length, gait and propulsion-R and L symmetry indices) and functional mobility (agility and balance) were assessed using the 10-meter test (10MWT) and the Timed Up and Go (TUG) test, respectively. ResultsThere were 22 men and 13 women with a median age of 56 (IQR 48.0–61.0) years. The right upper limb was involved in 83% of cases. Regarding the 10MWT, speed was significantly higher at T0 than at T1 (p < 0.01) and significantly lower at T1 than at T3 (p < 0.05). Cadence was significantly lower at T1 than at T3 (p < 0.05). Propulsion-R was significantly higher at T3 than at T1 (p < 0.01), whereas propulsion-L was significantly lower at T1 than at T0 (p < 0.05) and significantly higher at T2 and T3 than T1 (p < 0.01 for all). No significant differences were found for R and L step lengths as well as for symmetry index (p > 0.05). Regarding TUG test, the final turning phase was significantly higher at T2 than at T3 (p < 0.01). SignificanceThe results demonstrated that the use of the SAB affected gait speed and propulsion only 24 h after ARCR, but no effects were reported at long-term observations.

Distinctive parameters of gait in patients with multiple sclerosis, depending on the profile of its dysfunction

Distinctive parameters of gait in patients with multiple sclerosis, depending on the profile of its dysfunction

Effect of overground gait training with ‘Mobility Assisted Robotic System-MARS’ on gait parameters in patients with stroke: a pre-post study

ObjectiveTo observe the effect of overground gait training with ‘Mobility Assisted Robotic System-MARS’ on gait parameters in patients with stroke.Patients & methodsThis prospective pre-post study was conducted in a tertiary teaching research hospital with 29 adult stroke patients, with age up to 65 years. Patients fulfilling the inclusion criteria were divided in 2 groups based on the duration of stroke (≤ 6 months-sub-acute & > 6 months-chronic stroke) and provided overground gait training with MARS robot for 12 sessions (1 h/session) over a period of 2–3 weeks. Primary outcome measures were; 10-Meter walk test-10MWT, 6-min’ walk test-6MWT and Timed up & Go-TUG tests. Secondary outcome measures were Functional Ambulation Category-FAC, Modified Rankin Scale-MRS and Scandinavian Stroke Scale-SSS.ResultsNo adverse events were reported. Twenty-five patients who were able to perform 10-MWT at the beginning of study were included in the final analysis with 12 in sub-acute and 13 in chronic stroke group. All primary and secondary outcome measures showed significant improvement in gait parameters at the end of the training (p < 0.05) barring 10-Meter walk test in sub-acute stroke group (p = 0.255). Chronic stroke group showed significant minimum clinically important difference-MCID difference in endurance (6MWT) at the end of the training and both groups showed better ‘minimal detectable change-MDC’ in balance (TUG) at the end of the training.ConclusionsPatients in both the groups showed significant improvement in walking speed, endurance, balance and independence at the end of the training with overground gait training with MARS Robot.Clinical trial registryNational Clinical Trial Registry of India (CTRI/2021/08/035695,16/08/2021).

Added forearm weights for gait pattern normalization in patients with Parkinson’s disease

Patients with Parkinson’s Disease presented gait impairment. Applying additional weights to enhancing sensory input may improve gait impairment. We assumed that gait impairment could be improved when patients walked with additional forearm weights, and the gait improvement was associated with clinical characteristic of Parkinson’s Disease. Thirty patients with Parkinson’s Disease and 30 age-sex matched controls were recruited. Spatiotemporal and joint kinematics parameters were evaluated by a three-dimensional motion capture system in normal walking and walking with sandbags, respectively. The comparisons of spatiotemporal parameters were analyzed using t-test or nonparametric tests. The comparison of joint kinematic data was analyzed using statistical parametric mapping. The correlation between motor symptom and gait parameters changes was analyzed using Pearson’s correlation analysis. During normal walking, patients showed deteriorated gait compared with controls. After applying weights to forearms patients increased cadence (p = 0.004), speed (p < 0.001) and step length (p = 0.048), and decreased stride time (p = 0.003). The hip angles significantly increased during 5%–23% and 87%–100% of gait cycle, while knee angles during 9%–25% and 88%–98% of the gait cycle, and ankle angles in 92%-100% of gait cycle. The gait parameters of patients with forearm-loading showed no significant difference compared with healthy subjects walking normally. The change of gait parameters correlated positively with the axial and tremor severity while correlated negatively with the rigidity sub-score. Patients with tremor dominant subtype also showed greater improvement of speed and step time compared with patients with postural instability/gait difficulty subtype. Applying added weights bilaterally to the forearms of patients can normalize gait patterns. Notably, patients with higher scores on axial and tremor and lower rigidity scores gained more benefits.