Gait Tasks Research Articles

Gait Indicators Contribute to Screening Cognitive Impairment: A Single- and Dual-Task Gait Study.

Screening cognitive impairment is complex and not an appliance for early screening. Gait performance is strongly associated with cognitive impairment. We aimed to explore gait indicators that could potentially screen cognitive dysfunction. A total of 235 subjects were recruited from June 2021 to June 2022. Four gait tasks, including the walking test, the timed "Up & Go" test (TUG), foot pressure balance (FPB), and one-legged standing with eyes closed test (OLS-EC), were performed. Moreover, in the walking test, participants were instructed to walk at their usual pace for the single-gait test. For the dual-task tests, participants walked at their usual pace while counting backward from 100 by 1s. The data were analyzed by the independent sample t-test, univariate and multivariate logistic regression, a linear trend, stratified and interaction analysis, the receiver operating characteristic (ROC) curve, and Pearson's correlations. Among the 235 participants, 81 (34.5%) were men and 154 (65.5%) were women. The mean age of participants was 72 ± 7.836 years. The control, MCI, mild AD, and severe AD groups had means of 71, 63, 71, and 30, respectively. After adjusting for age, sex, education, and body mass index (BMI), the dual-task toe-off-ground angle (TOA) (odds ratio (OR) = 0.911, 95% confidence interval (CI): 0.847, 0.979), single-task TOA (OR = 0.904, 95% CI: 0.841-0.971), and the timed "Up & Go" time (TUGT) (OR = 1.515, 95% CI: 1.243-1.846) were significantly associated with an increased risk of cognitive impairment. In addition, the trend test and stratified analysis results had no significant differences (all p > 0.05). The area under the roc curve (AUC) values of TOA in the dual-task and TUGT were 0.812 and 0.847, respectively. Additionally, TOA < 36.75° in the dual-task, TOA < 38.90° in the single-task, and TUGT > 9.83 seconds (s) are likely to indicate cognitive impairment. The cognitive assessment scale scores were significantly correlated with TOA (all r > 0.3, p < 0.001) and TUGT (all r > 0.2), respectively. TOA and TUGT scores are, in some circumstances, associated with cognitive impairment; therefore, they can be used as simple initial screenings to identify patients at risk.

Inertial-based gait metrics during turning improve the detection of early-stage Parkinson's disease patients.

Patients with early-stage Parkinson's disease (PD) exhibit various but subtle motor symptoms, especially postural instability and gait disorders (PIGD). Patients show deteriorated gait performance at turns as the complex gait task requires more limb coordination and postural stability control, which may help to discriminate signs of early PIGD. In this study, we firstly proposed an IMU-based gait assessment model for quantifying comprehensive gait variables in both straight walking and turning tasks from five domains: respectively gait spatiotemporal parameters, joint kinematic parameters, variability, asymmetry, and stability. Twenty-one patients with idiopathic Parkinson's disease at the early stage and nineteen age-matched healthy elderly adults were enrolled in the study. Each participant wore a full-body motion analysis system with 11 inertial sensors and walked along a path consisting of straight walking and 180-degree turns at a self-comfortable speed. A total of one hundred and thirty-nine gait parameters were derived for each gait task. We explored the factor effect of group and gait tasks on gait parameters using a two-way mixed analysis of variance. The discriminating ability of gait parameters between PD and the control group was evaluated using receiver operating characteristic analysis. Sensitive gait features were optimally screened (AUC>0.7) and categorized into 22 groups to classify PD and healthy controls based on a machine learning method. Results demonstrated that PD patients exhibited more gait abnormalities at turns, especially on the RoM and stability of the neck, shoulder, pelvic, and hip joints compared to the healthy control group. These gait metrics have good discriminating abilities to identify early-stage PD (AUC>0.65). Moreover, the inclusion of gait features at turns can significantly improve the classification accuracy compared to that only used parameters during straight walking. We show that quantitative gait metrics during turning have great potential to be used for enhancing early-stage PD detection.

Effect of Trunk Solution® on hemodynamics in the supplementary motor area during walking.

[Purpose] Humans keep their trunks vertical while walking. This defining characteristic is known as upright bipedalism. Research on the neural control of locomotion indicates that not only subcortical structures, but also the cerebral cortex, especially the supplementary motor area (SMA), is involved in locomotion. A previous study suggested that SMA may contribute to truncal upright posture-control during walking. Trunk Solution® (TS) is a trunk orthosis designed to support the trunk in decreasing the low back load. We hypothesized that the trunk orthosis might reduce the burden of truncal control on the SMA. The objective of this study was, therefore, to determine the effect of trunk orthosis on the SMA during walking. [Participants and Methods] Thirteen healthy participants were enrolled in the study. We measured the hemodynamics of the SMA during walking with functional near-infrared spectroscopy (fNIRS). The participants performed two gait tasks on a treadmill: (A) independent gait (usual gait) and (B) supported gait while wearing the TS. [Results] During (A) independent gait, the hemodynamics of the SMA exhibited no significant changes. During (B) gait with truncal support, the SMA hemodynamics decreased significantly. [Conclusion] TS may reduce the burden of truncal control on the SMA during walking.

Kinetic coupling in distal foot joints during walking

BackgroundKinematic coupling between the first metatarsophalangeal (MTP) and midtarsal joints is evident during gait and other movement tasks, however kinetic foot coupling during walking has not been examined. Furthermore, contributing factors to foot coupling are still unclear. Therefore, the purpose of this study was to investigate kinematic and kinetic coupling within the foot by restricting MTP motion during overground walking. We hypothesized that when the MTP joint was prevented from fully extending, the midtarsal joint would achieve less peak motion and generate less positive work compared to walking with normal MTP motion.MethodsTwenty-six individuals participated in this randomized cross-over study. Using motion capture to track motion, participants walked at 1.3 m/s while wearing a brace that restricted MTP motion in a neutral (BR_NT) or extended (BR_EX) position. Additionally, participants walked while wearing the brace in a freely moveable setting (BR_UN) and with no brace (CON). A pressure/shear sensing device was used to capture forces under each foot segment. During stance, peak joint motion and work were calculated for the MTP and midtarsal joints using inverse dynamics. A series of ANOVAs and Holm post hoc tests were performed for all metrics (alpha = 0.05).ResultsThe brace successfully decreased peak MTP motion by 19% compared to BR_UN and CON. This was coupled with 9.8% less midtarsal motion. Kinetically, the work absorbed by the MTP joint (26–51%) and generated by the midtarsal joint (30–38%) were both less in BR_EX and BR_NT compared to BR_UN.ConclusionImplications and sources of coupling between the MTP and midtarsal joints are discussed within the context of center of pressure shifts and changes to segmental foot forces. Our results suggest that interventions aimed at modulating MTP negative work (such as footwear or assistive device design) should not ignore the midtarsal joint.

An observational study to assess validity and reliability of smartphone sensor-based gait and balance assessments in multiple sclerosis: Floodlight GaitLab protocol.

Gait and balance impairments are often present in people with multiple sclerosis (PwMS) and have a significant impact on quality of life and independence. Gold-standard quantitative tools for assessing gait and balance such as motion capture systems and force plates usually require complex technical setups. Wearable sensors, including those integrated into smartphones, offer a more frequent, convenient, and minimally burdensome assessment of functional disability in a home environment. We developed a novel smartphone sensor-based application (Floodlight) that is being used in multiple research and clinical contexts, but a complete validation of this technology is still lacking. This protocol describes an observational study designed to evaluate the analytical and clinical validity of Floodlight gait and balance tests. Approximately 100 PwMS and 35 healthy controls will perform multiple gait and balance tasks in both laboratory-based and real-world environments in order to explore the following properties: (a) concurrent validity of the Floodlight gait and balance tests against gold-standard assessments; (b) reliability of Floodlight digital measures derived under different controlled gait and balance conditions, and different on-body sensor locations; (c) ecological validity of the tests; and (d) construct validity compared with clinician- and patient-reported assessments. The Floodlight GaitLab study (ISRCTN15993728) represents a critical step in the technical validation of Floodlight technology to measure gait and balance in PwMS, and will also allow the development of new test designs and algorithms.

Validity of Spatio-Temporal Gait Parameters in Healthy Young Adults Using a Motion-Sensor-Based Gait Analysis System (ORPHE ANALYTICS) during Walking and Running.

Motion sensors are widely used for gait analysis. The validity of commercial gait analysis systems is of great interest because calculating position/angle-level gait parameters potentially produces an error in the integration process of the motion sensor data; moreover, the validity of ORPHE ANALYTICS, a motion-sensor-based gait analysis system, has not yet been examined. We examined the validity of the gait parameters calculated using ORPHE ANALYTICS relative to those calculated using conventional optical motion capture. Nine young adults performed gait tasks on a treadmill at speeds of 2−12 km/h. The three-dimensional position data and acceleration and angular velocity data of the feet were collected. The gait parameters were calculated from motion sensor data using ORPHE ANALYTICS, and optical motion capture data. Intraclass correlation coefficients [ICC(2,1)] were calculated for relative validities. Eight items, namely, stride duration, stride length, stride frequency, stride speed, vertical height, stance phase duration, swing phase duration, and sagittal angleIC exhibited excellent relative validities [ICC(2,1) > 0.9]. In contrast, sagittal angleTO and frontal angleIC demonstrated good [ICC(2,1) = 0.892−0.833] and moderate relative validity [ICC(2,1) = 0.566−0.627], respectively. ORPHE ANALYTICS was found to exhibit excellent relative validities for most gait parameters. These results suggest its feasibility for gait analysis outside the laboratory setting.

RGB-Depth Camera-Based Assessment of Motor Capacity: Normative Data for Six Standardized Motor Tasks.

Instrumental motion analysis constitutes a promising development in the assessment of motor function in clinical populations affected by movement disorders. To foster implementation and facilitate interpretation of respective outcomes, we aimed to establish normative data of healthy subjects for a markerless RGB-Depth camera-based motion analysis system and to illustrate their use. We recorded 133 healthy adults (56% female) aged 20 to 60 years with an RGB-Depth camera-based motion analysis system. Forty-three spatiotemporal parameters were extracted from six short, standardized motor tasks-including three gait tasks, stepping in place, standing-up and sitting down, and a postural control task. Associations with confounding factors, height, weight, age, and sex were modelled using a predictive linear regression approach. A z-score normalization approach was provided to improve usability of the data. We reported descriptive statistics for each spatiotemporal parameter (mean, standard deviation, coefficient of variation, quartiles). Robust confounding associations emerged for step length and step width in comfortable speed gait only. Accessible normative data usage was lastly exemplified with recordings from one randomly selected individual with multiple sclerosis. We provided normative data for an RGB depth camera-based motion analysis system covering broad aspects of motor capacity.

Automatic ML-based vestibular gait classification: examining the effects of IMU placement and gait task selection

BackgroundVestibular deficits can impair an individual’s ability to maintain postural and/or gaze stability. Characterizing gait abnormalities among individuals affected by vestibular deficits could help identify patients at high risk of falling and inform rehabilitation programs. Commonly used gait assessment tools rely on simple measures such as timing and visual observations of path deviations by clinicians. These simple measures may not capture subtle changes in gait kinematics. Therefore, we investigated the use of wearable inertial measurement units (IMUs) and machine learning (ML) approaches to automatically discriminate between gait patterns of individuals with vestibular deficits and age-matched controls. The goal of this study was to examine the effects of IMU placement and gait task selection on the performance of automatic vestibular gait classifiers.MethodsThirty study participants (15 with vestibular deficits and 15 age-matched controls) participated in a single-session gait study during which they performed seven gait tasks while donning a full-body set of IMUs. Classification performance was reported in terms of area under the receiver operating characteristic curve (AUROC) scores for Random Forest models trained on data from each IMU placement for each gait task.ResultsSeveral models were able to classify vestibular gait better than random (AUROC > 0.5), but their performance varied according to IMU placement and gait task selection. Results indicated that a single IMU placed on the left arm when walking with eyes closed resulted in the highest AUROC score for a single IMU (AUROC = 0.88 [0.84, 0.89]). Feature permutation results indicated that participants with vestibular deficits reduced their arm swing compared to age-matched controls while they walked with eyes closed.ConclusionsThese findings highlighted differences in upper extremity kinematics during walking with eyes closed that were characteristic of vestibular deficits and showed evidence of the discriminative ability of IMU-based automated screening for vestibular deficits. Further research should explore the mechanisms driving arm swing differences in the vestibular population.

Whole-Head Functional Near-Infrared Spectroscopy as an Ecological Monitoring Tool for Assessing Cortical Activity in Parkinson's Disease Patients at Different Stages.

Functional near-infrared spectroscopy (fNIRS) is increasingly employed as an ecological neuroimaging technique in assessing age-related chronic neurological disorders, such as Parkinson's disease (PD), mainly providing a cross-sectional characterization of clinical phenotypes in ecological settings. Current fNIRS studies in PD have investigated the effects of motor and non-motor impairment on cortical activity during gait and postural stability tasks, but no study has employed fNIRS as an ecological neuroimaging tool to assess PD at different stages. Therefore, in this work, we sought to investigate the cortical activity of PD patients during a motor grasping task and its relationship with both the staging of the pathology and its clinical variables. This study considered 39 PD patients (age 69.0 ± 7.64, 38 right-handed), subdivided into two groups at different stages by the Hoehn and Yahr (HY) scale: early PD (ePD; N = 13, HY = [1; 1.5]) and moderate PD (mPD; N = 26, HY = [2; 2.5; 3]). We employed a whole-head fNIRS system with 102 measurement channels to monitor brain activity. Group-level activation maps and region of interest (ROI) analysis were computed for ePD, mPD, and ePD vs. mPD contrasts. A ROI-based correlation analysis was also performed with respect to contrasted subject-level fNIRS data, focusing on age, a Cognitive Reserve Index questionnaire (CRIQ), disease duration, the Unified Parkinson's Disease Rating Scale (UPDRS), and performances in the Stroop Color and Word (SCW) test. We observed group differences in age, disease duration, and the UPDRS, while no significant differences were found for CRIQ or SCW scores. Group-level activation maps revealed that the ePD group presented higher activation in motor and occipital areas than the mPD group, while the inverse trend was found in frontal areas. Significant correlations with CRIQ, disease duration, the UPDRS, and the SCW were mostly found in non-motor areas. The results are in line with current fNIRS and functional and anatomical MRI scientific literature suggesting that non-motor areas-primarily the prefrontal cortex area-provide a compensation mechanism for PD motor impairment. fNIRS may serve as a viable support for the longitudinal assessment of therapeutic and rehabilitation procedures, and define new prodromal, low-cost, and ecological biomarkers of disease progression.

Turning and multitask gait unmask gait disturbance in mild-to-moderate multiple sclerosis: Underlying specific cortical thinning and connecting fibers damage.

Multiple sclerosis (MS) causes gait and cognitive impairments that are partially normalized by compensatory mechanisms. We aimed to identify the gait tasks that unmask gait disturbance and the underlying neural correlates in MS. We included 25 patients with MS (Expanded Disability Status Scale score: median 2.0, interquartile range 1.0-2.5) and 19 healthy controls. Fast-paced gait examinations with inertial measurement units were conducted, including straight or circular walking with or without cognitive/motor tasks, and the timed up and go test (TUG). Receiver operating characteristic curve analysis was performed to distinguish both groups by the gait parameters. The correlation between gait parameters and cortical thickness or fractional anisotropy values was examined by using three-dimensional T1-weighted imaging and diffusion tensor imaging, respectively (corrected p < .05). Total TUG duration (>6.0s, sensitivity 88.0%, specificity 84.2%) and stride velocity during cognitive dual-task circular walking (<1.12 m/s, 84.0%, 84.2%) had the highest discriminative power of the two groups. Deterioration of these gait parameters was correlated with thinner cortical thickness in regional areas, including the left precuneus and left temporoparietal junction, overlapped with parts of the default mode network, ventral attention network, and frontoparietal network. Total TUG duration was negatively correlated with fractional anisotropy values in the deep cerebral white matter areas. Turning and multitask gait may be optimal to unveil partially compensated gait disturbance in patients with mild-to-moderate MS through dynamic balance control and multitask processing, based on the structural damage in functional networks.

Neural signature of mobility-related everyday function in older adults at-risk of cognitive impairment

Assessment of everyday activities is central to the diagnosis of dementia. Yet, little is known about brain processes associated with everyday functional limitations, particularly during early stages of cognitive decline. Twenty-six older adults (mean = 74.9 y) were stratified by risk using the Montreal Cognitive Assessment battery (MoCA, range: 0– 30) to classify individuals as higher (22–26) and lower risk (27+) of cognitive impairment. We investigated everyday function using a gait task designed to destabilize posture and applied Mobile Brain/Body Imaging. We predicted that participants would increase step width to gain stability, yet the underlying neural signatures would be different for lower versus higher risk individuals. Step width and fronto-parietal activation increased during visually perturbed input. Frontomedial theta increased in higher risk individuals during perturbed and unperturbed inputs. Left sensorimotor beta decreased in lower risk individuals during visually perturbed input. Modulations in theta and beta power were associated with MoCA scores. Our findings suggest that older adults at-risk of cognitive impairment can be characterized by a unique neural signature of everyday function.

Lower-limbs’ muscle coordination mechanism of healthy preschoolers while walking across obstacles

Research backgroundThe obstacle-crossing task is a complex gait task, it requires an advance predict of the obstacle for posture adjustment and accurate control of bilateral legs to ensure crossing the obstacles successfully. By monitoring the activated intensity and duration of muscles in this process, preschoolers' motor ability could be assessed objectively and quantitatively, as well as disclose their potential pathogenesis quality eventually. Scientific questionwhat are the patterns and characteristics of lower limb muscles when they are facing the obstacle-crossing walking (OW) tasks, and how they coordinate their individual muscle or muscle groups of lower-limbs muscles while walking across obstacles? Thereby, the purpose of this study was first to portray the patterns and characteristics of lower limb muscles of healthy preschoolers while OW motion and second to assess the muscles’ coordination mechanism. Method35 healthy preschoolers and 35 healthy adults’ lower limbs' surface electromyography (sEMG) were collected while left and right OW and four muscle groups (Tibialis Anterior, Lateral Gastrocnemius, Rectus Femoris, and Biceps Femoris) were recorded. sEMG variables such as Muscle Activation Time, Total Duration of Activity Time, Average Muscle Activation Rate, and Average Rate of Change were calculated. The paired sample-t-test was used to explore the differences of sEMG variables between preschoolers and adults when obstacle-crossing. ResultsPreschoolers would adjust the gait by changing the activation time and activation rate to fulfill the obstacle crossing tasks, but they also showed variations by contrasting to adults. Further, synergy between muscles in leg and thigh were also found. ConclusionAlthough preschoolers performed well enough to finish the OW tasks, ability gaps were still apparent when compared to adults. Hence, with the help of a deeply recognizable muscle coordination mechanism in OW, motor dysfunction in the lower limbs of preschool children can be effectively identified.

Humans trade off whole-body energy cost to avoid overburdening muscles while walking.

Metabolic cost minimization is thought to underscore the neural control of locomotion. Yet, avoiding high muscle activation, a cause of fatigue, often outperforms energy minimization in computational predictions of human gait. Discerning the relative importance of these criteria in human walking has proved elusive, in part, because they have not been empirically decoupled. Here, we explicitly decouple whole-body metabolic cost and 'fatigue-like' muscle activation costs (estimated from electromyography) by pitting them against one another using two distinct gait tasks. When experiencing these competing costs, participants (n = 10) chose the task that avoided overburdening muscles (fatigue avoidance) at the expense of higher metabolic power (p < 0.05). Muscle volume-normalized activation more closely models energy use and was also minimized by the participants' decision (p < 0.05), demonstrating that muscle activation was, at best, an inaccurate signal for metabolic energy. Energy minimization was only observed when there was no adverse effect on muscle activation costs. By decoupling whole-body metabolic and muscle activation costs, we provide among the first empirical evidence of humans embracing non-energetic optimality in favour of a clearly defined neuromuscular objective. This finding indicates that local muscle fatigue and effort may well be key factors dictating human walking behaviour and its evolution.

Acute unilateral vestibular neuritis contributes to alterations in vestibular function modulating circumvention around obstacles: A pilot study suggesting a role for vestibular signals in the spatial perception of orientation during circumvention.

Walking among crowds avoiding colliding with people is described by patients with vestibular disorders as vertigo-inducing. Accurate body motion while circumventing an impeding obstacle in the gait pathway is dependent on an integration of multimodal sensory cues. However, a direct role of vestibular signals in spatial perception of distance or orientation during obstacle circumvention has not been investigated to date. We examined trunk yaw motion during circumvention in patients with acute unilateral vestibular loss (aUVL) and compared their results with age-matched healthy controls (HCs). Subjects performed five gait tasks with eyes open two times: walk 6 m in total, but after 3 m, circumvent to the left or right, as closely as possible, a cylindrical obstacle representing a person, and then veer back to the original path; walk 6 m, but after left and right circumvention at 3 m, veer, respectively, to the right, and left 45 deg; and walk 6 m without circumvention. Trunk yaw angular velocities (YAVs) were measured using a gyroscope system. Yaw angular velocity peak amplitudes approaching to, and departing from, the circumvented object were always greater for patients with aUVL compared to HCs, regardless of whether passing was to the aUVLs' deficit or normal side. The departing peak YAV was always greater, circa 52 and 87%, than the approaching YAV for HCs when going straight and veering 45 deg (p ≤ 0.0006), respectively. For patients with aUVL, departing velocities were marginally greater (12%) than approaching YAVs when going straight (p < 0.05) and were only 40% greater when veering 45 deg (p = 0.05). The differences in departing YAVs resulted in significantly lower trajectory-end yaw angles for veering trials to the deficit side in patients with aUVL (34 vs. 43 degs in HCs). The results demonstrate the effects of vestibular loss on yaw velocity control during the three phases of circumvention. First, approaching an obstacle, a greater YAV is found in patients with aUVL. Second, the departing YAV is found to be less than in HCs with respect to the approaching velocity, resulting in larger deficit side passing yaw angles. Third, patients with UVLs show yaw errors returning to the desired trajectory. These results could provide a basis for rehabilitation protocols helping to avoid collisions while walking in crowded spaces.

Relationship Between Dual-Task Walking and Level of Conflict Between Gait and Concurrent Tasks in Adolescents

This study aimed to determine the role of resource conflict in dual-task (DT) effects on gait and concurrent tasks in children and adolescents. Gait was evaluated with and without concurrent tasks (visual-manual, visual-vocal and auditory-vocal). The roles of condition (single vs dual) and type of concurrent task in DT effect were tested by Repeated Measured of ANOVA. Relative changes from single to DT conditions were compared using One-Way ANOVA. There were significant reductions in gait speed, cadence, and stride length, and increases in double support time, step time and variability in step time, and no change in variability in stride length, step width, and concurrent task performance from single to DT conditions. DT effects on gait parameters and concurrent tasks were comparable across DT conditions.

Volitional Head Movement Deficits and Alterations in Gait Speed Following Mild Traumatic Brain Injury.

Unconstrained head motion is necessary to scan for visual cues during navigation, for minimizing threats, and to allow regulation of balance. Following mild traumatic brain injury (mTBI) people may experience alterations in head movement kinematics, which may be pronounced during gait tasks. Gait speed may also be impacted by the need to turn the head while walking in these individuals. The aim of this study was to examine head kinematics during dynamic gait tasks and the interaction between kinematics and gait speed in people with persistent symptoms after mTBI. A clinical assessment laboratory. A cross-sectional, matched-cohort study. Forty-five individuals with a history of mTBI and 46 age-matched control individuals. All participants were tested at a single time point and completed the Functional Gait Assessment (FGA) while wearing a suite of body-mounted inertial measurement units (IMUs). Data collected from the IMUs were gait speed, and peak head rotation speed and amplitude in the yaw and pitch planes during the FGA-1, -3, and -4 tasks. Participants with mTBI demonstrated significantly slower head rotations in the yaw ( P = .0008) and pitch ( P = .002) planes. They also demonstrated significantly reduced amplitude of yaw plane head rotations ( P < .0001), but not pitch plane head rotations ( P = .84). Participants with mTBI had significantly slower gait speed during normal gait (FGA-1) ( P < .001) and experienced a significantly greater percent decrease in gait speed than healthy controls when walking with yaw plane head rotations (FGA-3) ( P = .02), but not pitch plane head rotations (FGA-4) ( P = .11). Participants with mTBI demonstrated smaller amplitudes and slower speeds of yaw plane head rotations and slower speeds of pitch plane head rotations during gait. Additionally, people with mTBI walked slower during normal gait and demonstrated a greater reduction in gait speed while walking with yaw plane head rotations compared with healthy controls.

Portable RGB-D Camera-Based System for Assessing Gait Impairment Progression in ATTRv Amyloidosis

Hereditary Amyloidosis associated with variant Transthyretin (ATTRv Amyloidosis) is a progressive and highly disabling neurological disorder that affects gait. Quantitative motion analysis is useful for assessing motor function, including gait, in diseases affecting movement. A single markerless RGB-D camera enables 3D full-body motion capture in a less expensive and intrusive, and more portable way than multi-camera marker-based systems. In this study, we examine whether a gait analysis system based on an RGB-D camera can be used to detect significant changes in the gait of ATTRv amyloidosis patients over time, when compared with a 12-camera system. We acquired 3D data provided by both systems from six ATTRv amyloidosis patients, while performing a simple gait task, once (T0) and 18 months later (T1). A direct comparison of systems has already been conducted. In this work, however, for each patient, we investigated if the RGB-D camera system detects statistically significant differences between the two different acquisitions in a similar way to the reference system, and whether it is reliable to use during patients’ follow-up. The obtained results show that the differences detected between T0 and T1 for both systems follow the same tendency for 65% of the spatiotemporal gait parameters, and for 38% of the kinematic parameters (38%). The most reliable parameters were: stride duration/length, gait speed (and its variability), and arm/foot swing velocity, all with an almost perfect strength of agreement.

Motor-cognitive interference in balance and gait tasks of increasing complexity: a fNIRS and IMUs study

Moving in real environments requires to consider not only ecological motor tasks (e.g., curvilinear walking), but also the cognitive load associated with the motor performance [1,2]. Wearable technology provides non-invasive monitoring solutions for both aspects, through inertial sensors and functional Near-Infrared Spectroscopy (fNIRS) technique. Specifically, fNIRS assesses cortical activity through the hemodynamic response of the brain [3] and can be performed while the participant freely moves in the environment [3,4]. In this context, the prefrontal cortex (PFC) is of particular interest: it regulates executive functions and has the potential to reveal crucial information related to cognitive processes and dynamic gait indices [1,3,4]. While it is well known that different motor tasks are characterized by different PFC activations, it is not clearly understood how PFC activation changes with increased complexity of balance locomotion tasks yet. Therefore, the study aims at filling this gap investigating motor-cognitive interference in balance and gait tasks of increasing difficulty. Twenty healthy young adults (11 females, 24.4±2.7 years) randomly performed four different motor tasks of 60 s each related to dynamic (linear walking, LW, and tandem walking, TW) and static (doubleleg stance, DLS, and single-leg stance, SLS) balance while wearing: i) a fNIRS brain cap (Brite 24, Artinis, The Netherlands) to measure the PFC changes in oxygenated hemoglobin (ΔO2Hb), and ii) 4 synchronized measurement units (IMUs, Opal, APDM, USA) at sternum, pelvis and both lateral malleoli to quantify gait and balance motor patterns. Repeated measures ANOVA (ΔO2Hb) and t-tests (IMUs) were computed to investigate differences among tasks. fNIRS (top panel) and IMUs (bottom panels) results are displayed in Fig. 1. As expected, more challenging motor tasks (TW and SLS) require greater PFC activation, suggesting the use of additional attentional resources during tasks of increased difficulty. In addition, motor performance suffers of tasks complexity, as clearly emerge from dynamic gait indices and postural parameters. This study lays foundation for better understanding the motor-cognitive interference in ecological gait and balance tasks.

Interventions for improving mobility after hip fracture surgery in adults.

Interventions for improving mobility after hip fracture surgery in adults.

Longitudinal Analysis Of Mobile Smartphone Application For The Assessment Of Facioscapulohumeral Muscular Dystrophy (FSHD) Gait

Facioscapulohumeral muscular dystrophy (FSHD) can be categorized as having a loss of muscular function in the torso, pelvic girdle, and legs. FSHD patient’s gait may decline over time, which could be used as a marker of disease progression. If so, this may be beneficial for potential clinical trials. PURPOSE: Evaluate gait velocity and cadence across three gait tasks using a novel smartphone application among individuals with FSHD over 6 months. METHODS: 2 (male = 1, female = 1; avg. age = 65 years) genetically confirmed FSHD1 patients completed three gait trials that required them to walk on a level surface at home 5 out of 7 days a week at two time points, 6 months apart. Patients used a custom smartphone application (FSHD Gait), installed on a smartphone (LG KG40) and secured on the lower back using a running belt, while walking. FSHD Gait application was used to take pictures of their shoes and walking environment. The first task (T1) involved walking 10 meters 12 times once each day. The second task (T2) was to walk 10 meters 6 times, with 6 trials being performed in the morning and 6 in the afternoon with a minimum of 4 hours between sessions. In the final week (T3), participants were instructed to walk for 6 minutes without any breaks. One-way ANOVAs compared the two time points while controlling for shoe type and walking surface. RESULTS: Over the course of 6 months, neither participant expressed a significant decline in gait velocity. There was no difference in gait velocity between time point one and two for T1 (PRE = 0.93 ± 0.24 m/s, POST = 0.85 ± .04 m/s; Cohen’s d = 0.27; p = 0.75), T2 (PRE = 0.93 ± 0.15 m/s, POST = 0.88 ± 0.07 m/s; Cohen’s d = 0.50, p = 0.54) or T3 (PRE = 0.94 ± 0.21 m/s, POST = 1.00 ± .09 m/s; Cohen’s d = 0.47; p = 0.63). Similarly, over the course of 6 months, neither participant expressed decline in cadence between time point one and two for T1 (PRE = 94.07 ± 4.78 steps/min, POST = 99.66 ± 6.44 steps/min; Cohen’s d = 3.36; p = 0.13), T2 (PRE = 103.71 ± 5.17 steps/min, POST = 0.85 ± 0.04 steps/min; Cohen’s d = 0.44; 0.64) or T3 (PRE = 98.74 ± .25 steps/min, POST = 86.88 ± 11.30 steps/min; Cohen’s d = 1.03; p = 0.35). CONCLUSION: FSHD Gait application can successfully collect and analyze gait for FSHD patient assessments over a 6-month period. While cadence nor velocity significantly changed, overall both metrics declined in both participants during T1 and T2.