Gait Pattern In Patients Research Articles

Validation of foot pitch angle estimation using inertial measurement unit against marker-based optical 3D motion capture system.

Gait analysis is relevant to a broad range of clinical applications in areas of orthopedics, neurosurgery, rehabilitation and the sports medicine. There are various methods available for capturing and analyzing the gait cycle. Most of gait analysis methods are computationally expensive and difficult to implement outside the laboratory environment. Inertial measurement units, IMUs are considered a promising alternative for the future of gait analysis. This study reports the results of a systematic validation procedure to validate the foot pitch angle measurement captured by an IMU against Vicon Optical Motion Capture System, considered the standard method of gait analysis. It represents the first phase of a research project which aims to objectively evaluate the ankle function and gait patterns of patients with dorsiflexion weakness (commonly called a "drop foot") due to a L5 lumbar radiculopathy pre- and post-lumbar decompression surgery. The foot pitch angle of 381 gait cycles from 19 subjects walking trails on a flat surface have been recorded throughout the course of this study. Comparison of results indicates a mean correlation of 99.542% with a standard deviation of 0.834%. The maximum root mean square error of the foot pitch angle measured by the IMU compared with the Vicon Optical Motion Capture System was 3.738° and the maximum error in the same walking trail between two measurements was 9.927°. These results indicate the level of correlation between the two systems.

The Relationship Between Fear-Avoidance and Objective Biomechanical Measures of Function in Patients With Adult Degenerative Scoliosis.

A prospective cohort study. The current study utilized quantitative gait analysis to examine the relationship of fear-avoidance beliefs to gait patterns in patients with adult degenerative scoliosis (ADS). Among patients with chronic spine pain, fear-avoidance beliefs are predictive of behavioral deficiencies, poor work, and surgery outcomes. The impact of such beliefs on patients with major spinal deformity has yet to be investigated. Patients with ADS have previously been shown to have an altered gait pattern. Utilizing quantified gait analysis, this study aims to examine correlations between fear-avoidance and various aspects of gait in patients with ADS. Twenty-five ADS patients completed the Tampa Scale for Kinesiophobia (TSK) questionnaire and the Fear Avoidance Beliefs Questionnaire (FABQ). Each patient performed a series of overground gait trials at a self-selected comfortable speed. Pearson product correlation analysis was used to determine the relationship between the self-reported fear of movement measures and the objective gait analysis biomechanical data. TSK score correlated strongly with gait speed, stride, step, double support times, and step length, and correlated moderately with cadence, and stride length. The FABQ physical portion strongly correlated with stride length and step length. The FABQ physical portion was moderately correlated with gait speed and single support time. The FABQ work portion was correlated with stride length and step length. This study demonstrates a strong correlation between biomechanical gait parameters, as measured with gait analysis, and fear-avoidance of movement, as measured with the TSK and FABQ. Further, it demonstrates that quantified gait analysis can be a useful tool to evaluate patients with spine deformity and to assess the outcomes of treatments in this group of patients. This study extends previous research on the role of fear-avoidance to include patients with spinal deformity. 3.

Gait pattern in patients with peripheral artery disease

BackgroundThe aim of the present paper is to assess the gait pattern of patients with Peripheral Artery Disease (PAD). A more specific aim is to compare the gait pattern of PAD patients before and after the appearance of intermittent claudication symptoms.MethodsThe study involved 34 PAD patients with a claudication distance ≥200 m and 20 participants without PAD, who formed the control group. The gait pattern of PAD patients was assessed twice: before the appearance of intermittent claudication symptoms (pain-free conditions) and after the appearance of intermittent claudication symptoms (pain conditions).ResultsCompared to the control group, PAD patients presented a statistically significant decrease in step length both during pain-free conditions (52.6 ± 12.5 vs. 72.8 ± 18.5 cm, p = 0.008) and in pain conditions (53.3 ± 13.3 vs. 72.8 ± 18.5 cm, p = 0.006). As for the remaining spatiotemporal parameters, there were no differences observed between the patient group and the controls. Intermittent claudication symptom induced by the walking test on the treadmill did not bring about any new abnormalities in the gait pattern or intensify the existing abnormalities of the gait.ConclusionsPAD patients have a tendency to shorten their step length regardless of the presence of intermittent claudication.

The impact of strabismus surgery on gait pattern in patients with congenital or starting within one year of age strabismus

Strabismus is a common visual disorder that negatively affects walking and balance. Therapeutic interventions for strabismus include strabismus surgery. Few studies investigated the relationship between strabismus surgery and postural control while, to the best of our knowledge, none has been conducted to assess the influence of strabismus surgery on gait. Therefore, the aim of this study was to evaluate the locomotion characteristics over patients with congenital or starting within one year of age strabismus, one month and three months after strabismus surgery. We enrolled 17 patients with a number of motor and sensorial features. Patients underwent an orthoptic and ophthalmological evaluation as well as a biomechanical evaluation before (T0) and after strabismus surgery (T1 at 1 month, and T2 at 3 months). We observed, mostly in T2 evaluation, significant improvements in the spatio-temporal parameters, such as cadence, velocity, swing, stance and double support phases, step and stride length. The kinematic results revealed a significant increase in hip ROM, strongly related to the improvement of gait speed. No significant differences has been observed in knee and ankle joint ROM. The kinetic results revealed a significant increase in the maximum moment at the knee and ankle joints associated with an increase in the maximum ankle power. Our findings suggest that the safety and balance control associated with gait improve in patients with strabismus following surgery.

Evaluating the immediate effects of wearing foot orthotics in children with Joint Hypermobility Syndrome (JHS) by analysis of temperospatial parameters of gait and dynamic balance: A preliminary study

Joint Hypermobility Syndrome (JHS) in children, presents with increased joint range of motion and can lead to altered gait strategies and reduced dynamic balance. Despite limited evidence foot orthoses are sometimes prescribed to patients with JHS with the aim to improve the stability of their gait pattern and theoretically reduce associated symptoms of fatigue and joint pain. The purpose of this study was therefore to analyse the immediate effects of ‘off the shelf’ orthoses on temporospatial parameters of gait and dynamic balance in this cohort. MethodsA total of 21 patients were recruited for the study (13 female) with a median age of 10 years (IRQ = 4.12). Each patient had their gait analysed using the GAITRite walkway in their own footwear and immediately after being prescribed the orthoses. Gait was tested at both the patients’ preferred speed and when asked to walk slower to challenge their dynamic balance. ResultsGait appeared more synchronised, with a reduction in step length and width variability, when participants were provided with orthotics. The variation was greatest when participants were asked to walk slower. Double stance was significantly less at slower speeds when orthotics were added (1.61%, 95% CI = 0.34, 2.89, p = 0.015) ConclusionResults of this study indicate that orthotics have a definite immediate influence on gait patterns in patients with JHS. Future studies should investigate the long-term effects of orthotics in this population and include outcome measures for symptoms such as pain.

Effect of Extracorporeal Shockwave Therapy on Passive Ankle Stiffness in Patients With Plantar Fasciopathy

Plantar fasciopathy (PF) is the most common cause of heel pain. Extracorporeal shockwave therapy (ESWT) improves the gait pattern in patients with PF. However, the effects of ESWT on the biomechanics of the ankle in these patients remains unclear. Sixteen participants were included in the present study. Of the 16 participants, 8 patients with PF were assigned to receive extracorporeal shockwave therapy, and 8 healthy participants served as an external control group. ESWT was applied to the PF group for 1500 pulses at an energy flux of 0.26 mJ/mm2 every 3 weeks for 3 sessions. The biomechanics of the ankle joints were then assessed using an isokinetic dynamometer, and a health-related quality of life questionnaire was administered at baseline and at the final follow-up session 12 weeks after the initial treatment. Passive stiffness was calculated and compared between the foot affected with PF, the opposite foot, and both feet of those in the healthy control group. The Kruskal-Wallis 1-way analysis of variance with repeated measures was performed, and statistical significance was considered present at the 5% (p ≤ .05) level. Ankle dorsiflexion in the affected limb increased from 14° ± 3° to 17° ± 2° after ESWT (p < .05). No statistically significant differences were noted in the strength of dorsiflexion or plantarflexion at baseline and after ESWT. However, a statistically significant increase in the ratio of strength in ankle dorsiflexion versus plantarflexion was found after ESWT (p < .05). No differences in the passive stiffness of the ankle joint were demonstrated. Patients reported an improved physical function score after ESWT (p < .05). An increased dorsiflexion/plantarflexion torque ratio and maximal dorsiflexion associated with decreased pain might contribute to the improved physical function after ESWT for PF.

Comparing and approximating the data of kinect and 3D motion capture analysis for gait

Background: Gait can be analyzed by 3D motion capture systems (3Dmc) in laboratories. However, they are usually expensive and require special settings not available in most regular hospitals. Therefore, the assessment of abnormal gait pattern in patients with stroke or movement disorders was limited to the visual assessment by skilled neurologists in clinical practice. Recently, Microsoft Kinect has been proposed as a tool for motion analysis, however its usefulness in gait analysis has not been established.

Identification of specific gait patterns in patients with cerebellar ataxia, spastic paraplegia, and Parkinson’s disease: A non-hierarchical cluster analysis

BackgroundPatients with degenerative neurological diseases such as cerebellar ataxia, spastic paraplegia, and Parkinson’s disease often display progressive gait function decline that inexorably impacts their autonomy and quality of life. Therefore, considering the related social and economic costs, one of the most important areas of intervention in neurorehabilitation should be the treatment of gait abnormalities. This study aims to determine whether an entire dataset of gait parameters recorded in patients with degenerative neurological diseases can be clustered into homogeneous groups distinct from each other and from healthy subjects. Patients affected by three different types of primary degenerative neurological diseases were studied. These diseases were: i) cerebellar ataxia (28 patients), ii) hereditary spastic paraplegia (31 patients), and iii) Parkinson’s disease (70 patients). Sixty-five gender-age-matched healthy subjects were enrolled as a control group. An optoelectronic motion analysis system was used to measure time-distance parameters and lower limb joint kinematics during gait in both patients and healthy controls. When clustering single parameters, step width and ankle joint range of motion (RoM) in the sagittal plane differentiated cerebellar ataxia group from the other groups. When clustering sets of two, three, or four parameters, several pairs, triples, and quadruples of clusters differentiated the cerebellar ataxia group from the other groups. Interestingly, the ankle joint RoM parameter was present in 100% of the clusters and the step width in approximately 50% of clusters. In addition, in almost all clusters, patients with cerebellar ataxia showed the lowest ankle joint RoM and the largest step width values compared to healthy controls, patients with hereditary spastic paraplegia, and Parkinson’s disease subjects. This study identified several clusters reflecting specific gait patterns in patients with degenerative neurological diseases. In particular, the specific gait pattern formed by the increased step width, reduced ankle joint RoM, and increased gait variability, can differentiate patients with cerebellar ataxia from healthy subjects and patients with spastic paraplegia or Parkinson’s disease. These abnormal parameters may be adopted as sensitive tools for evaluating the effect of pharmacological and rehabilitative treatments.

What is the price for the Duchenne gait pattern in patients with cerebral palsy?

Duchenne gait is characterized by trunk lean towards the affected stance limb with the pelvis stable or elevated on the swinging limb side during single limb stance phase. We assessed the relationship between hip abduction moments and trunk kinetics in patients with cerebral palsy showing excessive lateral trunk motion. Data of 18 subjects with bilateral spastic cerebral palsy (CP) and 20 aged matched typically developing subjects (TD) were collected retrospectively. Criteria for patient selection were barefoot walking without aid presenting with excessive lateral trunk motion. Subjects had been monitored by conventional 3D gait analysis of the lower extremity including four markers for monitoring trunk motion. Post-hoc, a generic musculoskeletal full body model (OpenSim 3.3) assuming a rigid trunk articulated to the pelvis by a single ball joint was applied for analyzing joint kinematics and kinetics of the lower limb joints including this spine joint. Joint angle ranges of motion, maximum joint moments and powers in the frontal plane as well as mechanical work were calculated and averaged within groups showing prominent differences between groups in all parameters. To the best of our knowledge, this is the first work explicitly looking into the kinetics of Duchenne gait in patients with CP, clinically known as compensation for unloading hip abductor muscles. The results show that excessive lateral trunk motion may indeed be an extremely effective compensation mechanism to unload the hip abductors in single limb stance but for the price of a drastic increase in demand on trunk muscle effort and work.

Playing Music May Improve the Gait Pattern in Patients with Bilateral Caloric Areflexia Wearing a Cochlear Implant: Results from a Pilot Study.

Auditory information through an active cochlear implant (CI) influences gait parameters in adults with bilateral caloric areflexia and profound sensorineural hearing loss. Patients with bilateral caloric areflexia suffer from imbalance, resulting in an increased risk of falling. In case of simultaneous deafness, the lack of auditory feedback results in less awareness of the auditory scene. This combination might produce significant challenges while walking and navigating. Auditory cues can be restored to some extent with a CI. Electrical stimulation through a CI can also produce a vestibulocollic reflex through current spread, which can be measured as cervical vestibular-evoked myogenic potentials. Adults (seven males, one female, mean age 61 ± 14 years), wearing a CI to treat profound sensorineural hearing loss and presenting with bilateral caloric areflexia walked barefoot, over ground, at self-selected speed in three different conditions: with CI turned on, while listening to music and with CI turned off. Spatiotemporal and kinematic parameters of gait were calculated using the conventional gait model. Removing auditory feedback by turning off the CI decreased stride time (mean difference 0.03 ± 0.15 s) and slightly increased stride length (mean difference 0.5 ± 1.2 cm) compared to the control condition with the CI on. Walking while playing music positively affected gait compared to walking with the CI on but without auditory feedback. By increasing the motion of the pelvis (mean difference 1.3° ± 0.4°), the knee (mean difference 3.9° ± 0.8°) and the ankle (mean difference 2.2° ± 0.2°), stride length increased (7.8 ± 1.2 cm), while stride time decreased (0.059 ± 0.016 s). Although a practice effect cannot be completely ruled out, this pilot study suggests that playing music while wearing an active CI may improve gait in patients with bilateral otovestibular loss. It remains unclear if the musical cues boost balance control or the CI might produce current spread and electrical stimulation to the vestibular afferents, thereby boosting its detection threshold, through stochastic resonance, and improving gait.

Arthrose, lésion méniscale dégénérative et ostéonécrose primitive du genou : une analyse simple de la marche améliore-t-elle la démarche diagnostique ?

IntroductionThe purpose of the current study was to compare the gait patterns in patients with three differing knee pathologies – knee osteoarthritis (OA), degenerative meniscal lesion (DML) and spontaneous osteonecrosis of the knee (SONK) and a group of healthy controls. HypothesisA simple gait test will detect differences between different knee pathologies. Material and methodsForty-seven patients with bilateral knee OA, 47 patients with DML, 28 patients with SONK and 27 healthy controls were included in this analysis. Patients underwent a spatiotemporal gait assessment and were asked to complete the Western Ontario and McMaster university (WOMAC) Index and the Short-Form (SF)-36 Health Survey. Anova tests, followed by Bonferroni multiple comparison tests and the Chi2 tests were performed for continuous and categorical variables, respectively. ResultsSignificant differences were found for all gait measures and clinical questionnaires between healthy controls and all knee conditions. Patients with SONK differed from patients with bilateral knee OA and DML in all gait measures and clinical questionnaires, except for WOMAC subscales. There were no significant differences between patients with bilateral knee OA and patients with DML. Symmetry was also examined and revealed asymmetry in some gait parameters in patients with SONK and DML. DiscussionBased on the differences in gait parameters that were found in the current study, adding an objective functional spatiotemporal gait test may assist in the diagnostic process of knee pathologies. Type of studyCase Control Study Level III.

Whole-Day Gait Monitoring in Patients with Alzheimer's Disease: A Relationship between Attention and Gait Cycle.

Background: Gait impairment in patients with Alzheimer’s disease (AD) and its relationship with cognitive function has been described, but reports of gait analysis in AD in daily living are limited.Objective: To investigate whether gait pattern of patients with AD in daily living is associated with cognitive function.Methods: Gait was recorded in 24 patients with AD and 9 healthy controls (HC) for 24 hours by using a portable gait rhythmogram. Mean gait cycle and gait acceleration were compared between the AD and HC groups. For the AD group, these gait metrics were assessed for correlations with cognitive function, as determined by the Mini Mental State Examination and Wechsler Memory Scale-Revised (WMS-R).Results: Although both gait parameters were not different between the patients with AD and HC, gait cycle in patients with AD was positively correlated with attention/concentration scores on the WMS-R (r = 0.578), and not with memory function. Patients with AD with attention scores as high as HC displayed a longer gait cycle than both HC (p = 0.048) and patients with AD with lower attention scores (p = 0.011). The patients with AD with lower attention scores showed a similar gait cycle with HC (p = 0.994).Conclusion: Patients with AD with impaired attentional function walk with faster gait cycle comparable to HC in daily living walking, which was unexpected based on previous gait analysis in clinical settings. This result probably reflects diminished consciousness to either the environment or instability of gait in the patients with AD with impaired attention.

Knee osteoarthritis, degenerative meniscal lesion and osteonecrosis of the knee: Can a simple gait test direct us to a better clinical diagnosis

IntroductionThe purpose of the current study was to compare the gait patterns in patients with three differing knee pathologies – knee osteoarthritis (OA), degenerative meniscal lesion (DML) and spontaneous osteonecrosis of the knee (SONK) and a group of healthy controls. HypothesisA simple gait test will detect differences between different knee pathologies. Material and methodsForty-seven patients with bilateral knee OA, 47 patients with DML, 28 patients with SONK and 27 healthy controls were included in this analysis. Patients underwent a spatiotemporal gait assessment and were asked to complete the Western Ontario and McMaster University (WOMAC) Index and the Short-Form (SF)-36 Health Survey. ANOVA tests, followed by Bonferroni multiple comparison tests and the Chi2 tests were performed for continuous and categorical variables, respectively. ResultsSignificant differences were found for all gait measures and clinical questionnaires between healthy controls and all knee conditions. Patients with SONK differed from patients with bilateral knee OA and DML in all gait measures and clinical questionnaires, except for WOMAC subscales. There were no significant differences between patients with bilateral knee OA and patients with DML. Symmetry was also examined and revealed asymmetry in some gait parameters in patients with SONK and DML. DiscussionBased on the differences in gait parameters that were found in the current study, adding an objective functional spatiotemporal gait test may assist in the diagnostic process of knee pathologies. Type of studyCase Control study Level III.

The impact of symptomatic knee osteoarthritis on overall gait pattern deviations and its association with performance-based measures and patient-reported outcomes

BackgroundLimited knowledge exists regarding the impact of symptomatic knee osteoarthritis (OA) on the overall gait pattern; and whether gait deviations are associated with performance-based measures (PBMs) and patient-reported outcomes (PROs). This cross-sectional study evaluated overall gait patterns in patients with knee OA using the Gait Deviation Index for kinematics (GDI) and kinetics (GDI-kinetic), and explored associations between gait deviations, PBMs, and PROs. MethodsForty patients with knee OA and 25 age and gender-matched controls underwent three-dimensional gait analysis. Participants performed the Timed Up and Go (TUG), Five Times Sit-to-Stand (5STS), and Single Limb Mini Squat (SLMS) tests and completed a disease-specific PRO. Associations between gait deviations, PBMs, and PROs were assessed by Pearson's correlation and multiple linear regression. ResultsPatients with OA demonstrated significantly lower GDI and GDI-kinetic scores of the OA and contralateral limbs compared to controls; with GDI-kinetic scores on the contralateral limb more impacted than the OA limb. On the contralateral limb, GDI-kinetic score significantly correlated with TUG (r=−0.42) and 5STS (r=−0.33), while on the OA limb with TUG (r=−0.68), 5STS (r=−0.38), SLMS (r=−0.38), activities of daily living (r=0.35) and Knee-related Quality of Life (r=0.35). No significant associations existed between kinematic GDI scores, PBMs and PROs. ConclusionThe overall gait pattern, as represented by GDI and GDI-kinetic scores, in patients with symptomatic knee OA is affected both on the painful OA limb and the contralateral limb. The GDI and GDI-kinetic scores provide different information regarding function that is not revealed by PBMs or PROs.

Gait pattern in patients with different multiple sclerosis phenotypes

BackgroundGait pattern is frequently impaired in multiple sclerosis (MS), however gait characteristics in patients with different MS phenotypes have not been fully elucidated. MethodsWe analyzed spatio-temporal gait pattern characteristics in patients with relapsing-remitting (RR, n=52) and primary-progressive (PP, n=18) MS in comparison with age-matched healthy controls (HC, n=40). All subjects performed a standardized simple walking task, a dual motor- motor task, a dual motor-mental task, and a triple combined motor-mental task at a GAITRite electronic walkway of 5.5m active area. We measured: cycle time (CT), stride length (SL), swing time (ST), double support time (DST), gait velocity (GV) and calculated symmetry index (SI) for CT, SL and ST. ResultsWith each task performed, CT and DST in the total MS group were significantly longer while SL was significantly shorter and GV significantly lower than in HC. ST was similar in the total MS patient group and HC. In both MS patients and HC, CT and DST increased and SL and GV decreased over repeated assessments. Dual and triple tasks while walking influenced walking performance in both MS patients and HC. Although patients with PPMS differed significantly from those with RRMS in the majority of gait parameters, the subgroup analysis in patients matched for age and disability (Expanded Disability Status Scale Score -EDSS, 3.0–5.0) showed similar gait performance in RRMS and PPMS patients having the same level of disability, except for CT and ST- symmetry parameters that were more impaired in the PPMS group. The EDSS score correlated significantly with CT, DST, SL and GV, but no significant correlation was found with ST except at the triple combined motor-mental task. ConclusionA disturbed gait pattern in MS patients with different MS phenotypes depends on disability and reflects a cognitive-motor interference.

Walking balance and compensatory gait mechanisms in surgically treated patients with adult spinal deformity

Background ContextGait patterns and their relationship to demographic and radiographic data in patients with adult spinal deformity (ASD) have not been fully documented. PurposeThis study aimed to assess gait pattern in patients with ASD and the effect of corrective spinal surgery on gait. Design/SettingThis is a prospective case series. Patient SampleThe gait patterns of 33 consecutive women with ASD (age 67.1 years; body mass index [BMI] 22.5±2.5 kg/m2, Cobb angle 46.8±18.2°, coronal vertical axis [CVA] 1.5±3.7 cm, C7 sagittal vertical axis [SVA] 9.1±6.4 cm, pelvic incidence minus lumbar lordosis [PI−LL] 38.2±22.1°, and lean volume of the lower leg, 5.5±0.6 kg) before and after corrective surgery were compared with those of 33 age- and gender-matched healthy volunteers. Outcome MeasuresScoliosis Research Society Patient Questionnaire (SRS22r), Oswestry Disability Index (ODI), and forceplate analysis. MethodsAll subjects underwent gait analysis on a custom-built forceplate using optical markers placed on all joints and spinal processes. Dual X-ray absorptiometry scores were used to calculate the lean composition of the lower legs. Subjects with ASD were followed for at least 2 years post operation. ResultsPreop mean values showed that patients with ASD had a significantly worse gait velocity (54±10 m/min vs. 70.7±12.9 m/min, p<.01) and stride (97.8±13.4 cm vs. 115.3±15.1 cm, p<.01), but no difference was observed in the stance-to-swing ratio. The right and left ground reaction force vectors were also discordant in the ASD group (vertical direction; r=0.84 vs. r=.97, p=.01). The hip range of motion (ROM) was also significantly decreased in ASD. Correlation coefficient showed moderate correlations between the preoperative gait velocity and the gravity line (GL), PI, ROM of the lower extremity joints, and lean volume, and between the stride and the lean volume, GL, and PI−LL. Gait pattern, stride, and velocity all improved significantly in the patients with ASD after surgery, but were still not as good as in healthy volunteers. The SRS22r satisfaction domain correlated moderately with postoperative gait velocity (r=0.34). ConclusionsThe patients with ASD had an asymmetric gait pattern and impaired gait ability compared with healthy volunteers. Gait ability correlated significantly with the GL, spinopelvic alignment, lower extremity joint ROM, and lean volume. The surgical correction of spinopelvic alignment and exercises to build muscle strength may improve the gait pattern and ability in patients with ASD.

Gait Patterns in Patients with Hereditary Spastic Paraparesis.

BackgroundSpastic gait is a key feature in patients with hereditary spastic paraparesis, but the gait characterization and the relationship between the gait impairment and clinical characteristics have not been investigated.ObjectivesTo describe the gait patterns in hereditary spastic paraparesis and to identify subgroups of patients according to specific kinematic features of walking.MethodsWe evaluated fifty patients by computerized gait analysis and compared them to healthy participants. We computed time-distance parameters of walking and the range of angular motion at hip, knee, and ankle joints, and at the trunk and pelvis. Lower limb joint moments and muscle co-activation values were also evaluated.ResultsWe identified three distinct subgroups of patients based on the range of motion values. Subgroup one was characterized by reduced hip, knee, and ankle joint range of motion. These patients were the most severely affected from a clinical standpoint, had the highest spasticity, and walked at the slowest speed. Subgroup three was characterized by an increased hip joint range of motion, but knee and ankle joint range of motion values close to control values. These patients were the most mildly affected and had the highest walking speed. Finally, subgroup two showed reduced knee and ankle joint range of motion, and hip range of motion values close to control values. Disease severity and gait speed in subgroup two were between those of subgroups one and three.ConclusionsWe identified three distinctive gait patterns in patients with hereditary spastic paraparesis that correlated robustly with clinical data. Distinguishing specific features in the gait patterns of these patients may help tailor pharmacological and rehabilitative treatments and may help evaluate therapeutic effects over time.

Recognizing Parkinsonian Gait Pattern by Exploiting Fine-Grained Movement Function Features

Parkinson's disease (PD) is one of the typical movement disorder diseases among elderly people, which has a serious impact on their daily lives. In this article, we propose a novel computation framework to recognize gait patterns in patients with PD. The key idea of our approach is to distinguish gait patterns in PD patients from healthy individuals by accurately extracting gait features that capture all three aspects of movement functions, that is, stability, symmetry, and harmony. The proposed framework contains three steps: gait phase discrimination, feature extraction and selection, and pattern classification. In the first step, we put forward a sliding window--based method to discriminate four gait phases from plantar pressure data. Based on the gait phases, we extract and select gait features that characterize stability, symmetry, and harmony of movement functions. Finally, we recognize PD gait patterns by applying a hybrid classification model. We evaluate the framework using an open dataset that contains real plantar pressure data of 93 PD patients and 72 healthy individuals. Experimental results demonstrate that our framework significantly outperforms the four baseline approaches.

Vitamin d is related to gait recovery after total hip arthroplasty: A prospective analysis

ObjectivesTo investigate the association between baseline serum levels of 25-hydroxyvitamin D (25(OH)D) and gait pattern in patients undergoing total hip arthroplasty (THA). MethodsProspective study of patients with hip osteoarthritis undergoing primary THA between January 2012 and December 2013. Blood samples were collected on the day of hospital admission. Gait analyses were performed before surgery and 3 months postoperatively. Internal moments were captured. ResultsMajor improvements were observed in gait data after THA. 25(OH)D levels correlated with change in peak extension (R=0.25, p=0.017) and peak power generation (R=0.25, p=0.04). Multiple linear regression analyses were performed. In model 1, 25(OH)D and change in gait speed explained the variability of peak extension (R2=0.1, p=0.004). In model 2, only 25(OH)D explained the variability of peak power generation (R2=0.05, p=0.044). Conclusions25(OH)D levels were correlated with change in peak extension and peak power generation. The effect of 25(OH)D on change in gait variables after THA is modest.

Effect of dual-task-induced uncertainty on gait biomechanics in patients with multiple sclerosis with 2–6.5 EDSS grade

The goal of this study was to assess the effect that uncertainty induced by dual task conditions has on reaction-response time parameters and gait patterns of patients with multiple sclerosis (MS) with a 2–6.5 EDSS grade. The study involved eleven patients – nine women and two men – diagnosed with multiple sclerosis (age, 48±10years; height, 1.65±0.1m; weight, 72±22kg) with capacity to walk five meters without any aid or assistance. We employed an intra-group repeated measures design. Each participant was asked to walk with and without task-related uncertainty. Reaction-response and gait cycle times, as well as center of mass (CM) dynamics were measured using three force plates synchronized with a video camera through an electronic device that also controlled the system of uncertainty. The results obtained reveal that uncertainty induced by dual tasking is related to a reduction in the mean stride length and mean displacement and horizontal velocity of the CM in patients with MS. The values obtained for CM parameters indicate that uncertainty affects balance, as compared to no-uncertainty situations. These results confirm the necessity of including controlled dual-task-induced uncertainty in physical training programs for MS patients.