Gait Parameters In Subjects Research Articles

A Quantitative Gait Assessment Approach Using a Wearable Device and Its Validation for Different Neurological Disorder Conditions

Improving independent mobility in people with various gait abnormalities is a major goal of rehabilitation therapy. While quantitative gait assessment is crucial to provide meaningful feedback on each treatment, many gait wearables have been validated with the standard method. However, none of the studies focused on validation of gait characterization in different classes of the pathological population compared with the control population. Hence, a novel wearable device called Gait Watch, worn on both the lower limbs, to estimate spatiotemporal and kinematic parameters of heterogeneous gait-impaired groups has been evaluated and its outcomes have been statistically analyzed. This article presents a statistical validation of gait dynamics of the control group and patients diagnosed with cerebral vascular accident, traumatic brain injury, peripheral nervous system, psychiatric issues, and seizures. Using the preliminary analysis results, a set of descriptive variables that allow for disease differentiation was selected to provide appropriate treatment to patients with various ailments and enhance their gait quality. The extraction of clinically significant gait parameters of interest using proposed Gait Watch would ascertain various neurological conditions as well as accurately quantify the extent of the difference in various gait parameters in subjects with different gait conditions when compared with the control group.

Immediate effects of trunk rotator stretching exercise on gait parameters in subjects with Parkinson’s disease: a randomized clinical trial

Immediate effects of trunk rotator stretching exercise on gait parameters in subjects with Parkinson’s disease: a randomized clinical trial

What Are the Criteria for an Acute Form of Anterior Cruciate Ligament Tear for the Severity of the Process by Gait Analysis Data?

There is still controversy over the criteria for acute ACL tear. In this paper, knee joint function and walking were considered possible ones. The study included 21 subjects with acute ACL tear and 20 healthy volunteers as a control group. Biomechanical gait analysis was performed using the inertial sensor system including EMG recording. All subjects (but for controls) were divided into two groups: Group 1-"up to 4 weeks" and Group 2-"from 4 weeks to 3 months". Temporal gait parameters in subjects from Group 1 demonstrate the asymmetry of 4% and more in terms of the gait cycle with a decrease in the affected limb, and are within normal range in Group 2. The amplitudes at the hip and knee joints in the affected limb are reduced which is especially pronounced in Group 1 (2-4 and 6-10 degrees, respectively). The affected knee joint shows a decrease in the range of motion by up to 5 degrees in the first half of the stance phase and flexion by less than 40 degrees in the swing phase. The tibialis anterior and quadriceps femoris muscle function is decreased in the affected limb only in Group 1 (72% and 78% from normal, respectively). The severity of the condition after an ACL tear is largely determined by functional changes. The time factor is of secondary importance.

Differences in the Impact of Plantar Fasciopathy on the Spatio-Temporal Gait Parameters between Participants with Bilateral Plantar Fasciopathy and Healthy Subjects: A Cross-Sectional Study

The aim of the present study was to determine the level of association of the spatio-temporal gait parameters in subjects with and without plantar fasciopathy. The second objective was to analyze whether differences in spatio-temporal parameters between both groups exist. Seventy-four subjects divided in two groups participated in the study, one presenting subjects with plantar fasciopathy for more than three months (n = 31), and the other group comprising subjects without plantar fasciopathy (n = 43). The spatio-temporal parameters were measured using Optogait. Decreased step length (p < 0.001), increased contact phase (p < 0.001), increased double support (p < 0.001), increased load response (p < 0.001), increased pre-swing (p < 0.001), increased gait cycle (p = 0.002), decreased stride (p < 0.001), decreased speed (p < 0.001), decreased cadence (p < 0.001), decreased phase flatfoot (p = 0.001), and increased propulsion (p < 0.001) in subjects with PF showed statistically significant differences when compared with the control group.. Furthermore, the level of association between the spatio-temporal parameters was different when comparing the groups. These findings may help when assessing potential plantar fascia injuries, and they may serve as a tool that helps with clinical decision-making, or as a clinical measurement in a treatment and follow-up program.

Comparing Gait Variability Between Deaf and Normal-Hearing Children After Proprioception Training

Objective: Gait variability is an important feature in clinical treatment of people with walking problems. Since the gait variability has not been yet evaluated among deaf people, the purpose of this study was to evaluate the gait variability in deaf children and compare it with normal-hearing peers. Methods: The study population consists of deaf and normal-hearing children living in Hamedan, Iran. Of these, 10 deaf (aged 8-14 years) and 10 with normal hearing matched for age and anthropometric characteristics volunteered to participate in the study. The 3D Vicon motion analysis system was used to measure the kinematic gait parameters in subjects. Paired sample t-test was used for within-group comparison and independent sample t-test for between-group comparison. Statistical analysis was performed in SPSS software by considering a significance level of P<0.05. Results: The gait variability after proprioception training decreased in deaf children, but this change was not statistically significant (P>0.05). There was no significant difference between the two groups before and after the training (P>0.05). Conclusion: It is suggested that balance exercise with an emphasis on proprioception training be included in the physical education program of deaf children.

Effect of Neuromuscular Electrical Stimulation Verses Electrical Stimulation On Gait Parameters in Subjects Having Plantar Fascitis

Objective: 1. To investigate the effect of neuromuscular electrical stimulation verses electrical stimulation on gait parameters in subjects having plantar fasciitis 2. To investigate the ratio of the effect in both males and females. 3. To compare the effect of neuromuscular electrical stimulation verses electrical stimulation on gait parameters in subjects having plantar fascitis Method: Total 30 subjects were selected according to inclusion and exclusion criteria aged between 40 to 60 years. The outcome measures were foot and ankle ability measures scale, gait parameters - stride length, step length and cadence. The subjects were divided into two groups,group A was treated with Electrical Stimulation and group B with Neuromuscular Electrical Stimulation. Result: The result was extremely significant within the group on foot and ankle ability measured scale and gait parameters post 4 weeks for Group A. The neuromuscular electrical stimulation on gait parameter in individual having plantar fasciitis there result was extremely significant (p=?0.0001) post 4 weeks for Group B. Between the group comparison: Post test there was significant difference between outcome variables in FAAM (p=?0.001) and gait parameters. Following are the p values which lead to analysis of improvement in stride length (0.0021), step length (0.0378) and cadence (p=?0.001). The result from the statistical analysis of present study support the null hypothesis is rejected which stated that there will be beneficial effect to the subject treated with neuromuscular stimulation than electrical stimulation Conclusion: Based on the statistical results and interpretation it was concluded that Neuromuscular electrical stimulation showed reduction in pain and improvement in gait parameters in individual having plantar fasciitis. Both the groups showed significant results but, post intervention Neuromuscular electrical stimulation group showed extremely significant effect than the electrical stimulation group

Gait evaluation using inertial measurement units in subjects with Parkinson’s disease

We investigated whether a wearable system based on a commercial Inertial Measurement Unit (IMU) can reliably provide the main spatiotemporal gait parameters in subjects with Parkinson’s disease (PD), compared to a gold-standard optoelectronic motion capture system.The gait of 22 subjects with PD (Age: 69.4 (6.1) years; UPDRS-III: 28.0 (9.2)) was recorded simultaneously with an optoelectronic system and a commercial IMU-based wearable system. Eight spatiotemporal parameters describing the step cycle (cadence, velocity, stride length, stride duration, step length, stance, swing and double support duration) were compared between the two systems. The IMU and the optical system reported comparable gait parameters, with the exception of walking velocity (optical system, 0.72 (0.27) m∙s−1 vs. IMU: 0.86 (0.26) m∙s−1, p < 0.05). Although most parameters detected by the two systems were not statistically different, some of them like stride length, double support and step duration showed notable root mean square and mean absolute errors. In conclusion, the algorithm embedded in the current release of the commercial IMU requires further improvements to be properly used with subjects with PD. Overall, the IMU system was sufficiently accurate in the assessment of fundamental gait spatiotemporal parameters. The fast and simplified data recording process allowed by wearables makes this technology appealing and represents a possible solution for the quantification of gait in the clinical context, especially when using a traditional 3D optoelectronic gait analysis is not possible, and when subjects are not fully cooperative.

Automated Mechanical Peripheral Stimulation Improves Gait Parameters in Subjects With Parkinson Disease and Freezing of Gait: A Randomized Clinical Trial.

This study aimed to assess spatiotemporal gait parameters and range of motion of lower limbs in subjects with Parkinson disease (PD) and freezing of gait, treated with automated mechanical peripheral stimulation (AMPS) or AMPS SHAM (placebo). This randomized clinical trial included 30 subjects allocated into two groups: AMPS (15 subjects with PD) and AMPS SHAM (15 subjects with PD). Fourteen age-matched healthy subjects were also included as a reference group. Both PD groups received the treatment twice a week during 4 weeks. Automated mechanical peripheral stimulation was applied using a commercial medical device (Gondola) and consisted of mechanical pressure in four areas of feet. For AMPS SHAM group, a subliminal stimulus was delivered. Gait analysis were measured before, after the first, after the fourth, and after the eighth sessions. We did not find significant differences between AMPS and AMPS SHAM groups either for spatiotemporal gait parameters or for range of motion of lower limbs. However, within-group analysis showed that AMPS group significantly improved spatiotemporal gait parameters and hip rotation range of motion throughout the treatment period. The AMPS SHAM group did not show any improvement. Automated mechanical peripheral stimulation therapy induces improvements in spatiotemporal parameters and hip rotation range of motion of subjects with PD and freezing of gait. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Understand the impact of reduced plantar sensitivity on gait in individuals with Parkinson disease; (2) Identify the improvements on spatiotemporal gait parameters in subjects with Parkinson disease and freezing of gait after automated mechanical peripheral stimulation therapy; and (3) Recommend the use of new strategies of plantar stimulus for gait disorders of subjects with Parkinson disease. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Wearable tubing assistive walking device immediately enhances gait parameters in subjects with stroke: A randomized controlled study.

Stroke patients develop compensatory movements due to limitations of ankle dorsiflexion and knee flexion. To solve the limitations, there are many adjustable walking assistive devices such as robotic devices, ankle-foot orthoses, and functional electric stimulation in rehabilitation session. However, these assistive devices have some disadvantages, including expense and discomforts. Therefore, the development of a new assistive device for stroke patients is needed to assist ankle dorsiflexion and knee flexion. This study investigated the effects of a wearable tubing assistive walking device (WTAWD) on gait parameters (gait speed, cadence, and step length and stride length on affected and less affected sides) in patients with stroke. Gait parameters were measured using the GAITRite system. One-way repeated measures analysis of variance was used to determine gait differences under three conditions (WTAWD, barefoot, and conventional elastic band orthosis). Gait speed, cadence, and step length and stride length on both affected and less affected sides were significantly greater with WTAWD, compared to barefoot and conventional elastic band orthosis conditions. WTAWD could be effective for patients with stroke.

GS7-2 Investigation of Gait Parameters of Subjects with Idiopathic Scoliosis(GS7: Rehabilitation Biomechanics I)

GS7-2 Investigation of Gait Parameters of Subjects with Idiopathic Scoliosis(GS7: Rehabilitation Biomechanics I)

Reliability of spatial–temporal gait parameters during dual-task interference in people with multiple sclerosis. A cross-sectional study

PurposeTo evaluate the reliability and minimum detectable change (MDC) of spatial–temporal gait parameters in subjects with multiple sclerosis (MS) during dual tasking. MethodThis cross-sectional study involved 25 healthy subjects (mean age 49.9±15.8 years) and 25 people with MS (mean age 49.2±11.5 years). Gait under motor-cognitive and motor–motor dual tasking conditions was evaluated in two sessions separated by a one-day interval using the GAITRite® Walkway System. Test–retest reliability was assessed using intraclass correlation coefficients (ICCs), standard errors of measurement (SEM), and coefficients of variation (CV). MDC scores were computed for the velocity, cadence, step and stride length, step and stride time, double support time, the % of gait cycle for single support and stance phase, and base of support. ResultsAll of the gait parameters reported good to excellent ICCs under both conditions, with healthy subject values of >0.69 and MS subject values of >0.84. SEM values were always below 18% for both groups of subjects. The gait patterns of the people with MS were slightly more variable than those of the normal controls (CVs: 5.88–41.53% vs 2.84–30.48%). ConclusionsThe assessment of quantitative gait parameters in healthy subjects and people with MS is highly reliable under both of the investigated dual tasking conditions.

Plantar Pressures and Ground Reaction Forces During Walking of Individuals With Unilateral Transfemoral Amputation

To describe and compare the plantar pressures, temporal foot roll-over, and ground reaction forces (GRFs) between both limbs of subjects with unilateral transfemoral amputation and with those of able-bodied participants during walking. We also verify the relevance of a force plate and a pressure plate to discriminate changes in gait parameters of subjects with limb loss. Cross-sectional study. Biomechanics laboratory. A total of 14 subjects with unilateral transfemoral amputation and 21 able-bodied participants. We used a force plate and a pressure plate to assess biomechanical gait parameters while the participants were walking at their self-selected gait speed. We measured plantar pressure peaks in 6 foot regions and the instant of their occurrence (temporal foot roll-over); and GRF peaks and impulses of anterior-posterior (braking and propulsive phases), medial-lateral, and vertical (load acceptance and thrust phases) components. The thrust, braking, and propulsive peaks, and the braking and propulsive impulses, were statistically significantly lower in the amputated limb than in the sound limb (P< .05) and in able-bodied participants (P< .05). In the amputated limb, we observed higher pressure peaks in the lateral rearfoot and medial and lateral midfoot, and lower values in the forefoot regions compared to those in the other groups (P< .05). The temporal foot roll-over showed statistically significant differences among the groups (P<.05). The plantar pressures, temporal foot roll-over, and GRFs in subjects with unilateral transfemoral amputation showed an asymmetric gait pattern, and different values were observed in both of their lower limbs as compared with those of able-bodied subjects during walking. The force plate and pressure plate were able to determine differences between participants in gait pattern, suggesting that both plantar pressure and GRF analyses are useful tools for gait assessment in individuals with unilateral transfemoral amputation. Because of the convenience of pressure plates, their use in the clinical context for prosthetic management appears relevant to guide the rehabilitation of subjects with lower limb amputation.

A portable gait assessment tool to record temporal gait parameters in SCI

Background The ability to objectively analyze gait in a clinical environment is challenging due to time, space and cost constraints. This study investigated the validity of a portable gait assessment tool in objectively assessing the temporal gait parameters in subjects with spinal cord injury. The portable gait assessment tool consisted of a pair of insoles instrumented with force sensing resistors that were strategically positioned over the sole of each foot. Aim To demonstrate the validity of the gait assessment tool by assessing the change in walking ability in incomplete spinal cord injured (ISCI) subjects, who participated in a robot-assisted gait training program. Methods Eighteen subjects with either an acute or chronic ISCI participated in this study (age range 26–63 years). Each subject participated in a robot assisted gait training programme for 6 weeks. Assessments were performed using the gait assessment tool before during and after the intervention. Results The gait assessment tool showed greater sensitivity to the change in the subject's gait, when compared to clinical assessments such as the walking index in spinal cord injury (WISCI II). Subjects with an acute ISCI showed a statistically significant ( p < 0.05) change in temporal gait parameters within the first 3 weeks of training. Discussion and conclusion This study for the first time has used the gait assessment tool in an ISCI population and has demonstrated that gait parameters can be measured and changes can be quantified within a clinical environment. The statistically significant changes during the first 3 weeks of training may indicate that an effective dose of robotic training can be administered within a relatively short period in ISCI subjects during the acute phase.

278 THE THREE-DIMENSIONAL ANALYSIS OF KINEMATIC GAIT PARAMETERS OF SUBJECTS WITH GONARTHROSIS BEFORE AND AFTER TOTAL KNEE REPLACEMENT

278 THE THREE-DIMENSIONAL ANALYSIS OF KINEMATIC GAIT PARAMETERS OF SUBJECTS WITH GONARTHROSIS BEFORE AND AFTER TOTAL KNEE REPLACEMENT

Effect of treadmill exercise training on spatial and temporal gait parameters in subjects with chronic stroke: A preliminary report

The effects of task-repetitive locomotor training on stroke patients' spatial and temporal gait parameters during unassisted walking are not well understood. This study determined the effects of treadmill aerobic exercise (T-EX) on spatial and temporal gait parameters that underlie changes in overground walking function. Thirty-nine subjects with hemiparetic stroke underwent T-EX three times weekly for 6 months. We measured the subjects pre- and posttraining on 30-foot timed walks and 6-minute distance walks with usual assistive devices and on an 8 m instrumented walkway without assistive devices. T-EX improved 30-foot walks by 17% and 6-minute walks by 23%. Unassisted walking velocity increased 22%, stride length increased 13%, and cadence increased 7%. Paretic and nonparetic step lengths increased significantly, and respective step times decreased significantly. Interlimb symmetry did not change. This study presents preliminary evidence that changes in spatial and temporal gait parameters contribute to the increased velocity of subjects with stroke after T-EX.

O007 Increases in ankle plantarflexor volume after strength training in children with cerebral palsy

The ability to objectively analyze gait in a clinical environment is challenging due to time, space and cost constraints. This study investigated the validity of a portable gait assessment tool in objectively assessing the temporal gait parameters in subjects with spinal cord injury. The portable gait assessment tool consisted of a pair of insoles instrumented with force sensing resistors that were strategically positioned over the sole of each foot.To demonstrate the validity of the gait assessment tool by assessing the change in walking ability in incomplete spinal cord injured (ISCI) subjects, who participated in a robot-assisted gait training program.Eighteen subjects with either an acute or chronic ISCI participated in this study (age range 26–63 years). Each subject participated in a robot assisted gait training programme for 6 weeks. Assessments were performed using the gait assessment tool before during and after the intervention.The gait assessment tool showed greater sensitivity to the change in the subject's gait, when compared to clinical assessments such as the walking index in spinal cord injury (WISCI II). Subjects with an acute ISCI showed a statistically significant (p < 0.05) change in temporal gait parameters within the first 3 weeks of training.This study for the first time has used the gait assessment tool in an ISCI population and has demonstrated that gait parameters can be measured and changes can be quantified within a clinical environment. The statistically significant changes during the first 3 weeks of training may indicate that an effective dose of robotic training can be administered within a relatively short period in ISCI subjects during the acute phase.

Inter-trial and test–retest reliability of kinematic and kinetic gait parameters among subjects with adolescent idiopathic scoliosis

Gait analysis is actually used in subjects with scoliosis to determine the change in lower limb parameters after surgery, but the reliability of these parameters still remained unknown. The purpose of this study was to assess the repeatability of traditional gait parameters in subjects with adolescent idiopathic scoliosis (AIS) and to estimate the associated standard error of measurement (SEM). A test-retest design was used to assess the reliability of gait parameters at self-selected and fast speeds. A convenience sample of 20 girls aged from 12 to 17 years, with an idiopathic scoliosis (King classification: types I, II or III; Cobb angle 17-50 degrees) participated in the study. Five good trials were recorded on two occasions. The time-distance, kinematic, and kinetic gait parameters were recorded using foot-switches in combination with a three-dimensional motion analysis system (Optotrak) and Advanced Mechanical Technologies Inc., (AMTI) Watertown, MA, USA; force plates. The coefficients of dependability and SEM derived from the generalizability theory were used to assess the reliability. Inter-trial reliability was good for time-distance, kinematic, and kinetic (absolute and normalized) gait parameters except for the medio-lateral ground reaction force (GRF) component and the ankle dorsiflexor moment (phi = 0.60-0.77). Test-retest reliability was higher for the kinetic than for the kinematic parameters. These coefficients ranged from 0.42 to 0.58 for the time-distance parameters; from 0.55 to 0.88 for the angular displacements and from 0.25 to 0.99 for the kinetic parameters. The SEMs were lower than 3.3 degrees for the angular displacements and lower than 8 Nm (0.15 Nm/kg) and 36 W (0.54 W/Kg) for the joint moments and powers regardless of the speed. Several gait parameters are reliable among subjects with AIS and can be used to assess the evolution of the spinal modifications and the impact of treatment on their lower limb gait pattern.

The Effect of Prosthesis Alignment on the Symmetry of Gait in Subjects with Unilateral Transtibial Amputation

A high degree of gait symmetry is characteristic of healthy gait. The aim of this study is to examine the symmetry of various gait parameters in subjects with unilateral trans-tibial amputation over a range of acceptable anteroposterior translational and tilt alignments, and further to examine if a consistent alignment of highest symmetry can be found. Acceptable alignments were determined by bench, static and dynamic testing on level and non-level surfaces. A total of 15 kinetic and kinematic parameters were then measured in the seven subjects participating in this study. Results indicate that some parameters show consistently higher symmetries, particularly the vertical ground reaction force parameters and the stance duration, step length and time to full knee flexion during the swing phase. Symmetries in other parameters such as knee flexion at loading response, acceleration impulse, and peak anteroposterior propulsive force seem to have little relevance in determining whether the gait pattern for that prosthetic alignment is acceptable or not. While analysis of the symmetry of more relevant gait parameters may assist the prosthetist in consistently and objectively identifying a most symmetrical alignment within the acceptable range, further clinical study is required before any conclusions can be drawn regarding evaluation of symmetry as a tool in defining any optimum alignment.

Gait Analysis in a Challenging Environment Differentiates Between Fallers and Nonfallers Among Older Patients With Peripheral Neuropathy

Richardson JK, Thies SB, DeMott TK, Ashton-Miller JA. Gait analysis in a challenging environmental differentiates between fallers and nonfallers among older patients with peripheral neuropathy. Objective To identify differences in gait based on fall history among a group of older subjects with peripheral neuropathy (PN) in 2 environments: standard (SE) (smooth surface, normal lighting) and challenging (CE) (irregular surface, low lighting). Design Observational, case-control study of PN subjects with and without a history of falling in the previous year. Setting A biomechanical laboratory. Participants Forty-two subjects (mean age, 64.7±9.8y; 20 [47.6%] women), including 22 (52.4%) with a history of at least 1 fall in the previous year. Intervention Subjects walked in the SE and CE while kinematic data were obtained. Main Outcome Measures Step width variability, step time variability, step width-to-step length ratio, step length, and step time and speed (with step length and speed normalized for height) in the SE and CE. Results In the SE, gait parameters of subjects with and without a history of falls did not differ significantly. However, in the CE, subjects with a history of falls had increased step time variability ( P=.001). Moreover, significant interactions between environment and fall status were identified: in the CE, subjects with a history of falls had greater increases in step time variability ( P=.010) and step width-to-step length ratio ( P=.009) and greater decreases in step length ( P=.007) and speed ( P=.045) than did subjects with no fall history. Conclusions Analysis of gait in the CE and adjustment to the CE from the SE effectively identified gait characteristics associated with falls in an older PN population, whereas analysis of gait in the SE did not. PN-associated gait dysfunction is more sensitively detected on an irregular rather than on a flat surface.

Relationship of spasticity to knee angular velocity and motion during gait in cerebral palsy

This study investigated the effects of spasticity in the hamstrings and quadriceps muscles on gait parameters including temporal spatial measures, knee position, excursion and angular velocity in 25 children with spastic diplegic cerebral palsy (CP) as compared to 17 age-matched peers. While subjects were instructed to relax, an isokinetic device alternately flexed and extended the left knee at one of the three constant velocities 30 degrees/s, 60 degrees/s and 120 degrees/s, while surface electromyography (EMG) electrodes over the biceps femoris and the rectus femoris recorded muscle activity. Patients then participated in 3D gait analysis at a self-selected speed. Results showed that, those with CP who exhibited heightened stretch responses (spasticity) in both muscles, had significantly slower knee angular velocities during the swing phase of gait as compared to those with and without CP who did not exhibit stretch responses at the joint and the tested speeds. The measured amount (torque) of the resistance to passive flexion or extension was not related to gait parameters in subjects with CP; however, the rate of change in resistance torque per unit angle change (stiffness) at the fastest test speed of 120 degrees/s showed weak to moderate relationships with knee angular velocity and motion during gait. For the subset of seven patients with CP who subsequently underwent a selective dorsal rhizotomy, knee angular extension and flexion velocity increased post-operatively, suggesting some degree of causality between spasticity and movement speed.