Gait Parameters In Patients Research Articles

Addition of proprioceptive neuromuscular facilitation to cardiorespiratory training in patients poststroke: study protocol for a randomized controlled trial

BackgroundIndividuals affected by stroke present with changes in cardiovascular and respiratory functions. Cardiorespiratory training (CRT) is one of the classic intervention guidelines for cardiorespiratory fitness. CRT in association with the proprioceptive neuromuscular facilitation (PNF) technique for respiratory muscles could improve the quality of life, cardiorespiratory function and gait parameters of patients after stroke.ObjectiveTo assess the effects of respiratory and trunk patterns of CRT associated with PNF on the quality of life, gait, oxygen consumption, respiratory muscle strength and thoracic volumes.Methods/designA blind, randomized clinical trial with allocation confidentiality will be performed. Forty patients will be randomized into four groups: CRT-lower limb (LL) plus PNF; CRT-LL and respiration; CRT-upper limb (UL) plus PNF; or CRT-UL and respiration. Individuals will be evaluated at three different times (pretreatment, after 20 days of treatment and 1 month after the end of treatment). The treatment protocol consists of respiratory exercises, 30 min of CRT (cycle ergometer) and then repetition of the respiratory exercises, performed three times a week over a period of 20 days. Primary outcome measures are quality of life, gait, balance, peak oxygen uptake and rib cage compartment volumes. As secondary outcomes, respiratory function and maximal inspiratory and expiratory pressures will be measured. DiscussionThe association of PNF with CRT may be a viable and accessible alternative to increase cardiorespiratory function in patients with stroke.Trial registrationClinicalTrials.gov, NCT03171012. Registered on 6 June 2017.

Kinematic parameters of gait in patients with supra- or subtentorial focus location during the early rehabilitation period after ischemic stroke

To study kinematic gait parameters during early rehabilitation period in patients with supra- or subtentorial ischemic stroke (IS). We examined 24 patients (11 women, 13 men, age 61.3±8.2) 4-6 weeks after stroke onset. 15 patients had supratentorial IS (middle cerebral artery location), 9 patients had subtentorial IS (brainstem and cerebellum). NIHSS score was 6.4±0.6/6.1±0.8, modified Ashwort scale score - 0.5±0.6/0.4±0.7, hand paresis - 3.4±0.9/3.7±0.7, leg paresis - 4.1±0.7/4.0±0.8 points. Kinematic gait parameters were recorded on video analysis system Physiomed Smart (Physiomed, Germany, Davis protocol). Gait kinematic parameters in paretic and in unaffected leg were changed in both groups. Patients with supratentorial lesion had on paretic side exaggerated pelvic obliquity, an excessive internal rotation and amplitude of movements in the paretic hip joint, and an insufficient plantar extension on both sides. Patients with subtentorial stroke had exaggerated pelvic tilt forward, excessive flexion and insufficient extension of the hip joint, insufficient extension of the knee joint, excessive plantar flexion, and insufficient plantar extension on both sides. Patients with supra- or subtentorial IS with muscle weakness less than 3-4 points and slightly changed or normal muscle tone differed in kinematic parameters in pelvic motions and in joints of paretic and unaffected lower extremity. These results highlight the importance of differentiating rehabilitation techniques according to supra- or subtentorial focus location and cerebellar involvement.

Immediate Effects of Posteroanterior Cervical Mobilization on Pressure Pain Threshold and Gait Parameters in Patients with Chronic Neck Pain: A Pilot Study

Background: Mobilization and cranio-cervical flexion exercise has been reported in reducing pain from cervical part and improving its motor function; also, has been represented that alleviate of neck pain and recover of neck muscles improve the normal gait performance. However, few studies have identified the effects of mobilization and exercise on pain and gait parameters with preceding issues. Objective: To examine the effects or changes of pressure pain threshold (PPT) and gait parameters in patients with chronic neck pain. Design: Cross-Sectional Clinical Trials Methods: Twenty patients with the history of neck pain (>3 months) performed the cervical mobilization and cranio-cervical flexion exercise. Gait parameters were assessed with wireless device and collected data were transmitted to the personal computer via Bluetooth. The PPT was measured posteroanterior direction at the prone position and the mean of subsequent three PPT meas­urements was used for the final analysis. Results: Both cervical central posteroanterior mobilization (CCPAM) (p<.000) and sling-based cranio-cervical flexion exercise (SBCCFE) (p<.000) group showed a significant increase in the PPT and the gait parameters, cadence (p<.023), was significantly increased in the CCPAM group, however slightly increased in the SBCCFE group. The comparison between the CCPAM and the SBCCFE groups after treatment did not show significant differences for the score on the PPT and gait parameters. Conclusions: This study suggests that CCPAM and SBCCFE increase PPT, cadence, and gait speed.

Effects of Strengthening and Stretching Exercises on the Temporospatial Gait Parameters in Patients With Plantar Fasciitis: A Randomized Controlled Trial.

Objective To investigate the effects of physical therapy interventions using strengthening and stretching exercise programs on pain and temporospatial gait parameters in patients with plantar fasciitis (PF).MethodsEighty-four patients with PF participated in the study and were randomly assigned to the strengthening or stretching exercise groups. All patients received 8 physical therapy interventions two times per week in the first 4 weeks and performed daily strengthening or stretching exercises three times per day. After 4 weeks, they continued the assigned exercise programs every day for 8 weeks. Pain visual analogue scale (VAS) scores at the worst and in the morning and temporospatial gait parameters were evaluated at the baseline, intermediate of the intervention, end of the intervention, and the first and second month follow-up.ResultsThere were significant effects of the time on the worst pain, morning pain, cadence, stride time, stride length, total double support, and gait speed, but there was no effect on step width. In addition, the main effect of the group and the interaction effects of the time and the group were not found in any parameters. For intra-group comparisons, there were significant differences in worst pain, morning pain, cadence, and stride time among the assessment times in both groups. For inter-group comparisons, there were no significant differences in all parameters.ConclusionBoth strengthening and stretching exercise programs significantly reduced pain and improved gait in patients with PF.

Concurrent validity and inter trial reliability of a single inertial measurement unit for spatial-temporal gait parameter analysis in patients with recent total hip or total knee arthroplasty

BackgroundOsteoarthritis (OA) is one of the main causes of disability and its frequent hip and knee joint localization requires surgical joint replacement treatment. Patients after total hip (THA) or knee (TKA) arthroplasty often show gait abnormalities, whose comprehension is crucial in order to plan an appropriate rehabilitative treatment. Wearable sensor devices can be a valid tool for gait assessment in clinical practice, being relatively inexpensive and easy to use. Research questionDoes the use of crutches influence the ability of a single inertial measurement unit (IMU), placed on the lower trunk, to correctly record the spatial-temporal gait parameters in patients after recent THA or TKA? Methods20 patients walking with crutches after recent THA or TKA and 10 healthy subjects were recruited. Each participant was recorded simultaneously with an IMU and with an optoelectronic motion capture system during 5 consecutive walking tests. ResultsIntraclass correlation index of spatial-temporal parameters recorded with the IMU showed moderate to excellent reliability results both for healthy subjects (ICC range 0.626–0.897) and for patients (ICC range 0.596–0.951). In terms of concurrent validity, Pearson’s r coefficient of healthy subjects, showed strong to very strong levels of correlations for some spatial-temporal parameters (speed, mean cadence, left and right stride length and stride duration) (r range 0.646–0.977) and very week to moderately week levels of correlation for gait cycle phases (swing, stance, single support and double support) (r range 0.390–0.633). Patients’ data analysis showed similar results for general spatial-temporal parameters (r range 0.704–0.986) and slightly lower values for gait cycle phases (r range 0.077–0.464). SignificanceWe can consider the single IMU as a reliable tool for the detection of some spatial-temporal gait parameters. Crutches seem to interfere with the detection of the gait cycle phases.

Effect of cycling and functional electrical stimulation with linear and interval patterns of timing on gait parameters in patients after stroke: a randomized clinical trial

Objective Patients in the chronic phase after a stroke are an underrepresented group in the literature. Therefore, the aim of this study was to compare the effects of cycling and functional electrical stimulation with linear versus interval patterns of timing on gait parameters in patients after stroke. Design A double blinded, parallel, randomized clinical trial. Setting Neuroscience Institute. Participants Patients with lower limb disability due to stroke (N = 30) with a stroke onset >6 months and <18 months. Interventions Twenty-eight minutes of leg cycling with functional electrical stimulation with linear or interval patterns of timing applied to the peroneal and biceps femoris muscles, 3 times/week for 4 weeks. Main measures Timed 10-Meter Walk Test and Functional Ambulation Classification were the primary outcome measures. The Modified Modified Ashworth scale, active range of motion, Timed Up and Go Test, and Single Leg Stance Test were the secondary outcome measures. Evaluation was performed at baseline, after 4, and after 8 weeks. Results Thirty participants completed the 4-week intervention (interval group, n = 16; linear group, n = 14). The Functional Ambulation Classification, Timed 10-Meter Walk Test, and the Timed Up and Go Test improved significantly in both groups. The Modified Modified Ashworth scale scores for quadriceps and plantar flexion statistically decreased after 4-weeks in the interval group. Significant group-by-time interaction was shown for Timed Up and Go Test (p = 0.003, np2=0.228), knee flexion active range of motion (p < 0.001, np2=0.256) and dorsiflexion active range of motion (p < 0.001, np2=0.359). Modified Modified Ashworth scale and active range of motion in both the ankle and knee improved significantly in the interval group. Conclusions The functional electrical stimulation with cycling protocols improved the Functional Ambulation Classification, Timed 10-Meter Walk Test, active range of motion, Timed Up and Go Test, and Modified Modified Ashworth scale. An interval protocol of timing was more effective than the linear protocol in terms of spasticity and active range of motion. Implications for rehabilitation Cycling + functional electrical stimulation training with an interval pattern of timing seems superior to cycling + functional electrical stimulation training with a linear pattern. Interval protocol has positive effects on spasticity and range of motion after 12 sessions in patients post stroke. Cycling + functional electrical stimulation improves functional mobility and speed in stroke survivors and the effects of this intervention lasted in follow-up assessment after one month.

Efficacy Of Dual-Task Training With Two Different Priorities Instructional Sets On Gait Parameters In Patients With Chronic Stroke.

PurposeBalance is controlled through a complex process involving sensory, visual, vestibular and cerebral functioning which get affected by various neurological disorders such as in stroke. Various types of exercises are designed to address the imbalance that is developed due to these neurological disorders. This study aimed to compare the efficacy of dual-task training using two different priority instructional sets in improving gait parameters in patients with chronic stroke.MethodsThis study was a randomized, pretest-posttest experimental group design that compared between two different priority instructional sets (fixed versus variable) of the dual-task training. A convenience sample of thirty patients with chronic stroke due to ruptured middle cerebral artery (mean age±SD = 55.76±5.23; range 48–65 years) was recruited and equally allocated into two groups. Group 1 received dual-task training with fixed priority instructional sets and group 2 received dual-task training with variable priority instructional sets. Both groups were trained for a period of 45 mins each session, 3-sessions per week for 4 weeks. The timed 10-m walk test and foot prints on walkway paper were used to assess the gait parameters (walking speed, stride length and step length) before and after the training session.ResultsWithin-group analysis revealed a significant improvement (p<0.05) on gait parameters for both the groups. Furthermore, Cohen’s d calculation for the treatment effect size revealed highly larger effect size on gait parameters in group 2 (Cohen’s d>2 SD) than group 1 (Cohen’s d<2 SD) for the all variables.ConclusionThe dual-task training with variable priority instructional sets (group 2) was more effective than dual-task training with fixed priority instructional sets (group 1) in improving gait parameters such as gait speed, stride length, and step length in patients with chronic stroke. Physiotherapists should spread awareness and use this specific set of exercises (variable priority instructional sets) while performing a dual-task balance training program among patients with chronic stroke.

Numerical calculus solution of gait recognition algorithm based on compressed sensing

X-ray stereo imaging analysis technology requires multiple X-ray fluoroscopy of the object of study, and ionizing radiation has potential health hazards. At the same time, pre-implantation of markers and collection of large amounts of data is unrealistic in large-scale studies. Based on this, a three-dimensional numerical calculus model of human knee joint is proposed and introduced into gait recognition to achieve dimension reduction and feature extraction of gait sequence. It firstly quantifies the changes of gait parameters of patients after total knee arthroplasty by adopting three-dimensional gait analysis technique, and constructs a three-dimensional numerical calculus model of the knee joint in this paper. Then the three-dimensional numerical calculus model of knee joint is applied to gait feature extraction. To solve the model, an adaptive selection algorithm based on gait feature dimension is proposed to realize the autonomous selection of gait feature vector dimension. The results show that the low-dimensional observation measurement contains important information for accurately reconstructing the original gait image, which can be used to characterize the image. The training and recognition experiments of gait samples using SVM multi-classifier also verify the validity of the gait features extracted according to the algorithm. The research results show that the proposed method has certain feasibility and there is room for improvement.

웨어러블 센서를 이용한 뇌졸중 환자의 게이트 특징벡터 추출

Stroke is a health problem experienced by many elderly people around the world. Stroke has a devastating effect on quality of life, causing death or disability. Hemiplegia is clearly an early sign of a stroke and can be detected through patterns of body balance and gait. The goal of this study was to determine various feature vectors of foot pressure and gait parameters of patients with stroke through the use of a wearable sensor and to compare the gait parameters with those of healthy elderly people. To monitor the participants at all times, we used a simple measuring device rather than a medical device. We measured gait data of 220 healthy people older than 65 years of age and of 63 elderly patients who had experienced stroke less than 6 months earlier. The center of pressure and the acceleration during standing and gait-related tasks were recorded by a wearable insole sensor worn by the participants. Both the average acceleration and the maximum acceleration were significantly higher in the healthy participants (p < .01) than in the patients with stroke. Thus gait parameters are helpful for determining whether they are patients with stroke or normal elderly people.

Correlation of walking gait characteristics and fear of falling in patients with acute ischemic stroke and hemiplegia

Objective To explore the correlation between walking gait characteristics and fall fear in hemiplegic patients with acute ischemic stroke. Methods 189 patients with hemiplegia after acute ischemic stroke treated in the First Affiliated Hospital of Zhengzhou University from March 2016 to March 2018 were selected as the research subjects. The patients were investigated by General Data Questionnaire, Single Item Fall Fear Assessment and Modified Fall Efficacy Scale (MFES) . The gait parameters of patients were measured by gait analyzer to detect and analyze the correlation between gait characteristics and fall fear in hemiplegic patients with acute ischemic stroke. Results Among 189 patients with hemiplegia after acute ischemic stroke, 123 (65.08%) were fearful of falling and 66 (34.92%) were not fearful of falling. The average score of items in Single Item Fall Fear Assessment in the patients with fear of falling were (7.64±1.63) and those without fear of falling were (9.01±1.33) , the difference between the two groups was statistically significant (P<0.05) . The step speed, step frequency, step length and standing phase in the fear of falling group were lower than those in the non-fear of falling group, and the step time and swing phase were higher than those in the non-fear of falling group with statistical difference (P<0.05) . Pearson correlation analysis showed that the step speed, step frequency, step length and standing phase were positively correlated with the MFES score (P<0.05) , and the step time and swing phase were negatively correlated with the MFES score (P<0.05) . Conclusions Most of the hemiplegic patients with acute stroke have the fear of falling, and those who are afraid of falling are more likely to have abnormal gait, which indicates that those who are afraid of falling are more likely to fall, and need the attention of family members and medical staff. Key words: Stroke; Acute disease; Ischemic; Hemiplegia; Gait; Fear of falling; Correlation

A single session of anodal transcranial direct current stimulation applied over the affected primary motor cortex does not alter gait parameters in chronic stroke survivors

The excitability of some neural circuits involved in walking and affected in individuals with chronic stroke can be modulated during and/or immediately after anodal transcranial direct current stimulation (a-tDCS). This study was designed to investigate the effects of a-tDCS during and immediately after application on leg muscle activity during gait, and on spatiotemporal and kinematic gait parameters in patients with chronic stroke. This study was randomized, sham-controlled and double-blinded with a cross-over design and included 24 individuals with chronic stroke. Each participant underwent one 30-minute session each of effective a-tDCS at 2mA and sham tDCS. In both sessions, the anode was placed over the leg motor cortex of the affected hemisphere and the cathode over the contralateral orbit. Six gait trials were performed before, during and immediately after each effective/sham tDCS session. Electromyographic activity of leg muscles, as well as spatiotemporal (e.g. gait speed) and kinematic (e.g. peak knee flexion and ankle dorsiflexion in the swing phase of gait) gait parameters were recorded. Genotyping for the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism was undertaken since this gene may influence motor skill learning and the effects of tDCS. No significant effects of a-tDCS on gait parameters were found either for the total group or for the Val66Met (N=10) and Val66Val (N=14) subgroups. A single session of a-tDCS delivered to the leg motor cortex did not immediately improve gait parameters in individuals with chronic stroke, regardless of their BDNF genotype.

No difference in gait kinematics or kinetics between limbs in bilateral total hip replacement patients at long-term follow-up

BackgroundPrevious studies report that gait parameters of patients following total hip replacement improve from pre-operative levels, although in most cases do not reach those of normal subjects. However, studies are generally of unilateral total hip replacement patients at short-term follow-up. There have been no reports of 3D gait kinematics and kinetics in patients with bilateral total hip replacements at long-term follow-up. The aim of this study was to compare temporospatial parameters and 3D lower limb gait kinematics and kinetics at long-term follow-up between limbs and against controls for patients who have undergone staged bilateral total hip replacement. Methods3D gait analysis was performed on 13 patients who had undergone bilateral total hip replacement, at an average follow-up of 10.1 (first hip) and 9.3 years (second hip), and a normal elderly control group comprising 10 subjects. FindingsKnee flexion/extension range of motion was marginally greater in Hip 2 (p = 0.049) compared to Hip 1 by 3.2°. There were no other significant differences in temporospatial parameters or a range of lower limb kinematics or kinetics between the first and second operated hip. Multiple gait parameters were significantly worse for both hips compared to age-matched normal individuals. InterpretationAlthough symmetrical biomechanical recovery was achieved, significant gait deficiencies remain in both hips compared to normal controls. These deficits may provide targets for enhanced rehabilitation programs.

Functional electrical stimulation compared with ankle-foot orthosis in subacute post stroke patients with foot drop: A pilot study

ABSTRACT Background: The conventional treatment for foot drop includes an ankle-foot orthosis (AFO) or functional electrical stimulation (FES). Goal: To compare gait parameters in patients following a subacute post stroke with foot drop treated with AFO or FES. Method: Twenty one subacute patients with stroke with foot drop were fitted with FES (N = 10) or AFO (N = 11). Evaluations were performed at baseline, following 4 weeks and 12 weeks. Spatiotemporal gait parameters and symmetry, dynamic electromyography, 10-m walk test, 6-min walk test, timed up and go, functional ambulation classification, and perception of improvement in walking were measured. The gait analysis measures were collected without the assistive devices while the functional measures were collected with them. Results: Both groups showed improvement in all of the outcome measures, with no between-groups differences. The swing duration’s and step length’s symmetry indicated better gait symmetry in the FES group after 12 weeks (p = 0.037, effect size = −0.538 and p = 0.028 effect size = −0.568, respectively). The FES group perceived significant improvement in gait after 4 weeks, while subjects in the AFO group reported to perceive improvement only after 12 weeks. Conclusions: Our findings suggest that FES is at least as effective as traditional AFO and may be more so.

Assessing Gait in Parkinson's Disease Using Wearable Motion Sensors: A Systematic Review.

: Parkinson’s disease (PD) is a progressive neurodegenerative disorder. Gait impairments are common among people with PD. Wearable sensor systems can be used for gait analysis by providing spatio-temporal parameters useful to investigate the progression of gait problems in Parkinson disease. However, various methods and tools with very high variability have been developed. The aim of this study is to review published articles of the last 10 years (from 2008 to 2018) concerning the application of wearable sensors to assess spatio-temporal parameters of gait in patients with PD. We focus on inertial sensors used for gait analysis in the clinical environment (i.e., we do not cover the use of inertial sensors to monitor walking or general activities at home, in unsupervised environments). Materials and Methods: Relevant articles were searched in the Medline database using Pubmed. Results and Discussion: Two hundred ninety-four articles were initially identified while searching the scientific literature regarding this topic. Thirty-six articles were selected and included in this review. Conclusion: Wearable motion sensors are useful, non-invasive, low-cost, and objective tools that are being extensively used to perform gait analysis on PD patients. Being able to diagnose and monitor the progression of PD patients makes wearable sensors very useful to evaluate clinical efficacy before and after therapeutic interventions. However, there is no uniformity in the use of wearable sensors in terms of: number of sensors, positioning, chosen parameters, and other characteristics. Future research should focus on standardizing the measurement setup and selecting which spatio-temporal parameters are the most informative to analyze gait in PD. These parameters should be provided as standard assessments in all studies to increase replicability and comparability of results.

Evaluation of biomechanical gait parameters of patients with Cerebral Palsy at three different levels of gait assistance using the CPWalker

BackgroundCerebral Palsy (CP) is the most common cause of permanent serious physical disability in childhood. Although many platforms have been developed, so far there are still not precise guidelines for the rehabilitation of the population with CP. The CPWalker is a robotic platform for the rehabilitation of children with CP, through which they can start experiencing autonomous locomotion in the rehabilitation environment. It allows the possibility of free movement and includes physical and cognitive interfaces into the therapy. The main objective of this work is to evaluate the effects of the CPWalker-based rehabilitation intervention in children with CP by comparing different gait parameters before, during and after the use of the platform.FindingsThe evaluation was divided in three stages where the gait parameters and symmetry indexes of eight subjects with CP were evaluated. In the first stage patients walked only with the help they receive normally in daily life. During the second stage they walked with the CPWalker and finally, in the third stage, they repeated their gait without the platform. In all stages they wore an inertial G-Sensor Ⓡ while walking through the hospital facilities. The results showed statistical significant differences in several spatio-temporal parameters, pelvic angles and general gait cycle parameters, with and without the use of the robotic device. For the eight patients: cadence, speed and stride length presented similar values when comparing before and after the therapy. However, they decreased during the intervention (both means and standard deviations). No significant differences were found in the symmetry indexes with the use of the platform. In spite of this, a reduction in the pelvic angles ranges and propulsion was observed.ConclusionsThe effect of using the device was analyzed for spatio-temporal parameters, pelvic girdle angles and general gait cycle parameters. Among the eighteen initial parameters, seven presented a statistical significant difference when comparing stage 2 of the intervention with stages 1 and 3. Those changes showed the potential of the CPWalker to improve muscular strength and gait patterns of the patients with CP in the long term and to provide useful information for the design of the future generations of rehabilitation robotic devices.

The Diagnostic Scope of Sensor-Based Gait Analysis in Atypical Parkinsonism: Further Observations.

Background: Differentiating idiopathic Parkinson's disease (IPD) from atypical Parkinsonian disorders (APD) is challenging, especially in early disease stages. Postural instability and gait difficulty (PIGD) are substantial motor impairments of IPD and APD. Clinical evidence implies that patients with APD have larger PIGD impairment than IPD patients. Sensor-based gait analysis as instrumented bedside test revealed more gait deficits in APD compared to IPD. However, the diagnostic value of instrumented bedside tests compared to clinical assessments in differentiating APD from IPD patients have not been evaluated so far.Objective: The objectives were (a) to evaluate whether sensor-based gait parameters provide additional information to validated clinical scores in differentiating APD from matched IPD patients, and (b) to investigate if objective, instrumented gait assessments have comparable discriminative power to clinical scores.Methods: In a previous study we have recorded instrumented gait parameters in patients with APD (Multiple System Atrophy and Progressive Supranuclear Palsy). Here, we compared gait parameters to those of retrospectively pairwise disease duration-, age-, and gender-matched IPD patients in order to address this new research questions. To this aim, the PIGD score was calculated as sum of the MDS-UPDRS-3-items “gait,” “postural stability,” “arising from chair,” and “posture.” Gait characteristics were evaluated in standardized gait tests using an instrumented, sensor-based gait analysis system. Machine learning algorithms were used to extract spatio-temporal gait parameters. Receiver Operating Characteristic analysis was performed in order to detect the discriminative power of the instrumented vs. the clinical bedside tests in differentiating IPD from APD.Results: Sensor-based stride length, gait velocity, toe off angle, and parameters representing gait variability significantly differed between IPD and APD groups. ROC analysis revealed a high Area Under the Curve (AUC) for PIGD score (0.919), and UPDRS-3 (0.848). Particularly, the objective parameters stance time variability (0.841), swing time variability (0.834), stride time variability (0.821), and stride length variability (0.804) reached high AUC's as well.Conclusions: PIGD symptoms showed high discriminative power in differentiating IPD from APD supporting gait disorders as substantial diagnostic target. Sensor-based gait variability parameters provide metric, objective added value, and serve as complementary outcomes supporting clinical diagnostics and long-term home-monitoring concepts.

Assessment of Spatiotemporal Gait Parameters in Patients with Lumbar Disc Herniation and Patients with Chronic Mechanical Low Back Pain.

To assess spatiotemporal gait parameters in patients with lumbar disc herniation (LDH) and chronic mechanical low back pain (CMLBP), and compare with healthy control group. A total of 70 patients was enrolled in this prospective, controlled cross-sectional study, of which 25 with LDH, 25 with CMLBP and 20 healthy individuals as the control group. Participants completed 10 passes on the "WIN-TRACK" Gait Analysis Platform at their self-selected walking speed. The arithmetic mean of the five flawless walking data was used for analysis. Pain intensity is assessed by the Visual Analog Scale (VAS). The spatiotemporal gait parameters were significantly decreased in LDH and CMLBP groups than the healthy control group, particularly in LDH groups (p≥0.001). It was found that pain intensity is negatively correlated to step and stride length, cadence and velocity (p < 0.001). Results of linear regression analysis showed that 10% of the changes in gait cycle duration of the left extremity and 74% of the changes in the velocity were associated with pain intensity. Pain intensity can affect the spatiotemporal gait parameters in patients with Low Back Pain (LBP). Rehabilitation programs with gait optimization should be considered in the management of patients with LDH and CMLBP.

Reliability and Validity of a Smartphone-based Assessment of Gait Parameters in Patients with Chronic Stroke

Reliability and Validity of a Smartphone-based Assessment of Gait Parameters in Patients with Chronic Stroke

P124. Evaluation of gait parameters in functional gait disorders

Objective To identify thresholds for pathognomonic gait parameters in functional gait disorders. Background Characteristics of functional gait disorders are e.g. transient fluctuations in stance and gait, excessive slowness or hesitation that is not compatible with neurological disease, uneconomic postures with wastage of muscular energy, the ‘walking on ice’ gait pattern with typical small cautious steps with fixed ankle joints and sudden buckling of the knees that generally do not lead to falls ( Lempert et al., 1991 ). Early diagnosis is important: Over half of the patients with psychogenic disorder of stance and gait remain unchanged after five and a half years. If the disorder is present no longer than four months complete remission can often be achieved ( Brandt et al., 1994 ). Methods We used a pressure-sensitive GAITRite© carpet to assess gait analysis during eight gait conditions (three different walking speeds, two sensory and three cognitive tasks). Each of the 23 gait parameters was edited with custom software. A binary logistic regression, ROC (receiver operating characteristic) analysis and an inversed regression were performed to identify thresholds for pathological deviations from normal range. Results In the preferred speed condition, patients with functional gait disorder differed from healthy subjects in all gait parameters, particularly in velocity, spatial, and variability measures. In the cognitive dual task condition (i.e. dual task words), however, the gait parameters almost normalized, especially the variability parameters assimilate healthy subjects. Conclusion Characteristics of gait parameters of patients with functional gait disorder were similar to postural performance in patients with phobic postural vertigo (PPV; Wuehr et al., 2017 ): The dual-task effect in patients with functional gait disorder revealed that cognitive distraction led to a normalization in walking. This is typical for functional disorders and can also be observed in patients with PPV.

Análise dos parâmetros espaço-temporais da marcha em indivíduos com disfunção neurológica tratados com prática mental

A habilidade da marcha após uma patologia neurológica muitas vezes é prejudicada e limitada a curtas distâncias, sendo o tempo de caminhada, o comprimento do passo e a cadência inferiores às pessoas sem patologias ou deficiências conhecidas. Atualmente a prática mental vem sendo combinada ao contexto clínico, na reabilitação de pacientes com sequelas neurológicas, principalmente pós-Acidente Vascular Cerebral. Objetivo: Analisar os efeitos da prática mental, associada ou não a outras estratégias de intervenção, nos parâmetros espaço-temporais da marcha de pessoas com doenças neurológicas. Métodos: Trata-se de uma revisão sistemática da literatura sobre os parâmetros espaciais da marcha em pacientes com disfunção neurológica tratados com prática mental. As bases de dados pesquisadas foram Pubmed/Medline LILACS, Scopus, Web of Science e Cochrane. Resultados: A maioria dos estudos apresentou o Acidente Vascular cerebral como disfunção neurológica, seguidos de Doença de Parkinson, Lesão medular e Esclerose múltipla. Os estudos selecionados apresentaram protocolos de prática mental associado à fisioterapia combinado ou não com outras estratégias de tratamento no grupo experimental dentre elas estimulação magnética transcraniana e estimulação auditiva rítmica. Dentre os parâmetros espaço-temporais da marcha a velocidade foi o parâmetro mais avaliado e o comprimento da passada o menos avaliado. Conclusão: A prática mental apresentou efeitos positivos nos parâmetros tempo, velocidade e cadência da marcha de pacientes com AVC. Poucos estudos limitam a interpretação dos resultados para doença de Parkinson, Esclerose múltipla e Lesão medular.