Gait Parameters Research Articles

The effects of cognitive-motor interference on walking performance in adolescents with low balance

BackgroundChildren with reduced motor competence (MC) have reported differences in their walking performance when compared to their typically developed peers, albeit, with inconsistent results.Research questions:What is the effect of reduced balance on walking performance in adolescent boys and girls under cognitive-motor interference conditions? MethodsThis cross-sectional study assessed motor competence, in adolescents aged 13–14 years, using the Movement Assessment Battery for Children 2nd edition and walking performance from gait parameters derived from an inertial measurement unit placed over the estimated centre of mass. Each participant performed two 10 m straight-line walks at their self-selected speed. These consisted of a walk with no distractions and a cognitive-motor interference walk (reciting the alternate letters of the alphabet out loud). A two-way mixed ANOVA was used to assess for significant interactions. Results365 adolescents, (low balance = 58, typical balance = 307) participated in this study (boys = 204, girls = 161). Significant interactions were reported between MC groups and walking condition for walking speed in boys (F(1,195) = 5.23, p= 0.02, ηp2 = 0.03) and girls (F(1,154) = 4.05, p= 0.046, ηp2 = 0.03). Both sexes with low balance reduced their walking speed to a greater extent than their typically developed peers under cognitive-motor interference conditions compared to the single-task walk. In addition, boys with low balance reported increased stride length variability (F(1,198)= 4.40, p= 0.037, ηp2= 0.02) compared to typically developed peers. SignificanceAdolescents with low balance report altered walking. Our data could support a better understanding of the relationship between balance and gait and may help the development of interventions to support those with difficulties.

Two-step deep-learning identification of heel keypoints from video-recorded gait.

Accurate and fast extraction of step parameters from video recordings of gait allows for richer information to be obtained from clinical tests such as Timed Up and Go. Current deep-learning methods are promising, but lack in accuracy for many clinical use cases. Extracting step parameters will often depend on extracted landmarks (keypoints) on the feet. We hypothesize that such keypoints can be determined with an accuracy relevant for clinical practice from video recordings by combining an existing general-purpose pose estimation method (OpenPose) with custom convolutional neural networks (convnets) specifically trained to identify keypoints on the heel. The combined method finds keypoints on the posterior and lateral aspects of the heel of the foot in side-view and frontal-view images from which step length and step width can be determined for calibrated cameras. Six different candidate convnets were evaluated, combining three different standard architectures as networks for feature extraction (backbone), and with two different networks for predicting keypoints on the heel (head networks). Using transfer learning, the backbone networks were pre-trained on the ImageNet dataset, and the combined networks (backbone + head) were fine-tuned on data from 184 trials of older, unimpaired adults. The data was recorded at three different locations and consisted of 193 k side-view images and 110 k frontal-view images. We evaluated the six different models using the absolute distance on the floor between predicted keypoints and manually labelled keypoints. For the best-performing convnet, the median error was 0.55 cm and the 75% quartile was below 1.26 cm using data from the side-view camera. The predictions are overall accurate, but show some outliers. The results indicate potential for future clinical use by automating a key step in marker-less gait parameter extraction.

Effects of Clinic-Based and Telerehabilitation-Based Motor Control Exercises in Individuals with Chronic Low Back Pain - A Randomized Controlled Trial with 3-Month Follow-Up.

This study evaluated the effectiveness of clinic-based and telerehabilitation-based motor control exercises in individuals with chronic low back pain three months post-treatment. Forty-two participants were randomized to either clinic-based or telerehabilitation-based groups, performing exercises three times weekly for eight weeks. Assessments were conducted pre-intervention, post-intervention and one and three months after the intervention. The primary outcome was pain intensity (Visual Analog Scale) for low back pain. Both exercise approaches were found to be similarly effective in improving pain disability, quality of life (except for emotional response, energy level, sleep, and social isolation), and pain catastrophizing at all follow-up time points. The Visual Analog Scale showed a significant reduction in pain from baseline at all time points in both groups (P<0.001), with effect sizes ranging from moderate to strong. Nottingham Health Profile showed significant improvements in physical activity, pain, and total score, with effect sizes ranging from moderate to strong. No significant changes in spatiotemporal gait parameters were observed in either group. According to the post-intervention intention-to-treat analysis, lumbar flexion range of motion showed significant improvements in both groups with small effect sizes. Telerehabilitation-based motor control exercises proved as effective as clinic-based methods in treating chronic low back pain, offering a viable alternative tailored to individual needs and circumstances.

From lab to field: validity and reliability of inertial measurement unit-derived gait parameters during a standardised run

ABSTRACT The aim was to assess concurrent validity and test–retest reliability of spatiotemporal gait parameters from a thoracic-placed inertial measurement unit (IMU) in lab- (Phase One) and field-based (Phase Two) conditions. Spatiotemporal gait parameters were compared (target speeds 3, 5 and 7.5 m·s−1) between a 100 Hz IMU and an optical measurement system (OptoJump Next, 1000 hz) in 14 trained individuals (Phase One). Additionally, 29 English Premier League football players performed weekly 3 × 60 m runs (5 m·s−1; observations = 1227; Phase Two). Mixed effects modelling assessed the effect of speed on agreement between systems (Phase One) and test–retest reliability (Phase Two). IMU step time showed strong agreement (<0.3%) regardless of individual or running speed. Direction of mean biases up to 40 ms for contact and flight time depended on the running speed and individual. Step time, length and frequency were most reliable (coefficient of variation = 1.3-1.4%) but confounded by running speed. Step time, length and frequency derived from a thoracic-placed IMU can be used confidently. Contact time could be used if bias is corrected for each individual. To optimise test–retest reliability, a minimum running distance of 40 m is needed to ensure 10 constant-speed steps is gathered.

Gait Characteristics and Deviation Factors of Backward Walking in Patients With Chronic Ankle Instability.

Despite growing applications of backward walking (BW) in assessing and rehabilitating neuromuscular conditions, its effects on gait in chronic ankle instability (CAI) remain unclear. Moreover, linking patient-reported and clinically generated measures is imperative for understanding CAI. Patients with CAI will exhibit worse and compensatory spatio-temporal and kinetic gait parameters during BW, and patient-reported outcomes (PROs) will be correlated significantly with gait parameters. Case-control study. Level 4. A total of 46 volunteers participated (23 per group). Patients filled out scales for pain, functions, and fear-avoidance beliefs before testing. All participants walked 6 times each in both forward and backward conditions, and gait was recorded using the Win-Track system. A 2-way mixed analysis of variance was performed to compare gait parameters. The relationship between PRO and gait outcomes was assessed through the Pearson product correlation coefficient. The CAI group demonstrated prolonged support and swing phases, increased walk-off angle, and plantar pressure area, but decreased step length and plantar pressure versus controls (P < 0.05). The CAI group had a smaller right walk-off angle during BW than FW; the control group showed the opposite (P < 0.05). The left single stance duration was greater in the CAI group, while the right was not (P < 0.05). PRO correlated significantly with gait parameters, particularly spatial parameters (P < 0.05). The CAI group exhibited worse gait parameters during BW. The CAI group exhibited a characteristic compensatory gait pattern. Linking the self-reported scores provides a better representation of gait changes in CAI. These results suggest that BW may be an effective strategy for identifying and evaluating CAI. It may be feasible to apply BW to the rehabilitation of CAI.

Horseshoe effects on equine gait-A systematic scoping review.

To provide an overview of available research about effects of horseshoes on equine kinetics and kinematics. The terms, "horse/equine," "hoof," "shoes/horseshoes," "kinetics," and "kinematics" were searched in PubMed, Web of Science, Center for Agriculture and Bioscience International, and United States Department of Agriculture National Agricultural Library for manuscripts from first availability to 2024. Independent reviewers used preferred reporting items for systematic reviews and meta-analyses guidelines to map and extract evidence-based data from sources. Metrics included participant demographics, research methods, major findings, and study limitations. Knowledge gaps were also identified. A total of 46 studies were included. Most utilized non-lame horses to compare original shoe designs or modifications to unshod or a standard open-heel shoe. Horse demographics and gait, study design and outcome measures varied widely. Prevalent data collection equipment included force platforms and pressure plates, wearable force measuring technology, and videography. Many studies reported shoeing effects on limb forces and motion, but there was little consensus among unrelated studies. Common limitations included insufficient data resolution, no randomization, small sample size, single breed, and outcome measures specific or unique to the study. Knowledge gaps included data collection from all limbs and the impact of conformation and limb and hoof morphology and health condition on outcomes. Information from manuscripts that met inclusion criteria confirmed distinct, variable effects of shoe characteristics on equine gait parameters. Details from published work can serve as resource for clinical decisions and to guide standardization among investigations on shoe configuration effects on equine motion.

422 The use of 3D kinematics for improved gait assessment in broilers

Abstract Genetic selection for high growth rates in broiler chickens has resulted in larger broilers and changes in broiler gait. Traditionally, broiler gait is assessed using visual observation which is subjective and labor intensive. In contrast, newer technologies are available which can be adapted to objectively score changes in broiler gait, thereby, increasing the validity and reliability of gait scoring with less labor required. The objective of this study was to compare the use of 3D kinematics versus visual scoring to assess broiler gait. Second, to determine how strain and age affect 3D kinematic gait metrics in broilers. Four strains of broiler chickens were used; two heritage strains: 1957 (H57; n = 52) and 1977 (H77; n = 51); and two commercially available strains: Cobb (n = 50) and Ross (n = 53). All broilers were weighed weekly throughout the study. Kinematic markers were placed along the spine and bony landmarks of each leg. Commercial strains had kinematic recordings and body weights (BW) recorded every week for 4 wk while Heritage strains had measurements recorded every week for 6 wk. Visual gait scoring was completed using a 5-point scale each week by two trained observers. Data were analyzed using the correlation procedure in SAS to determine the relationship between visual gait score and kinematic metrics as well as the GLIMMIX procedure to determine the effects of strain, age, and strain x age on all gait parameters. There was a weak positive correlation (r &amp;lt; 0.2) between visual gait score and all kinematic metrics. Cobb were the heaviest strain (1,292.6 ± 14.71 g P &amp;lt; 0.001) while H57 broilers were the lightest (326.4 ± 9.99 g P &amp;lt; 0.001). Each week, the BW of all strains increased significantly. Total Stride Time differed significantly by strain (P &amp;lt; 0.001; Cobb: 26.3 ± 0.47 cs, Ross: 23.1 ± 0.39 cs, H77: 23.7 ± 0.28 cs, H57: 21.5 ± 0.26 cs) and Age (P &amp;lt; 0.01; Commercial: wk 3: 21.8 ± 0.54 cs, wk 6: 28.1 ± 0.68 cs and Heritage: wk 3: 19.7 ± 0.42 cs, wk 8: 25.4 ± 0.52 cs). Total stride length (SL) also significantly differed by strain. Cobb had the longest SL of the two commercial strains (P &amp;lt; 0.001; 88.6 ± 1.94 mm) while H77 had the longest stride of the heritage strains (97.9 ± 1.51 mm). Total SL also increased with age resulting in longer stride times. Heavier birds, such as Cobb, had longer stride Times and SL compared with lighter birds such as the H57 strain. In conclusion, visual gait score and kinematic metrics were not found to be measuring the same things. However, kinematics can be a used as an informative and objective tool for assessing gait metrics associated with broiler lameness such as changes in stride length and stride time.

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

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

Biomechanical Gait Analysis Using a Smartphone-Based Motion Capture System (OpenCap) in Patients with Neurological Disorders.

This study evaluates the utility of OpenCap (v0.3), a smartphone-based motion capture system, for performing gait analysis in patients with neurological disorders. We compared kinematic and kinetic gait parameters between 10 healthy controls and 10 patients with neurological conditions, including stroke, Parkinson's disease, and cerebral palsy. OpenCap captured 3D movement dynamics using two smartphones, with data processed through musculoskeletal modeling. The key findings indicate that the patient group exhibited significantly slower gait speeds (0.67 m/s vs. 1.10 m/s, p = 0.002), shorter stride lengths (0.81 m vs. 1.29 m, p = 0.001), and greater step length asymmetry (107.43% vs. 91.23%, p = 0.023) compared to the controls. Joint kinematic analysis revealed increased variability in pelvic tilt, hip flexion, knee extension, and ankle dorsiflexion throughout the gait cycle in patients, indicating impaired motor control and compensatory strategies. These results indicate that OpenCap can effectively identify significant gait differences, which may serve as valuable biomarkers for neurological disorders, thereby enhancing its utility in clinical settings where traditional motion capture systems are impractical. OpenCap has the potential to improve access to biomechanical assessments, thereby enabling better monitoring of gait abnormalities and informing therapeutic interventions for individuals with neurological disorders.

Characterization of spatiotemporal and kinetic gait variables in dogs with hindlimb ataxia and bilateral hindlimb lameness

BackgroundDiscriminating the underlying cause of gait abnormalities can be challenging in a clinical setting, especially in the presence of bilateral disease. Pressure-sensitive walkways (PSWs) have been utilized to characterize the gait of dogs with various neurologic or orthopaedic conditions. The potential use of the PSW includes the discrimination of conditions that can be similar in clinical presentation, such as bilateral hindlimb lameness and hindlimb ataxia. The primary aim of this study was to describe the spatial, temporal, and kinetic gait parameters of dogs with hindlimb ataxia or bilateral hindlimb lameness and compare them to those of normal dogs. Forty-six dogs were prospectively recruited. The normal group included 20 dogs with normal neurologic and orthopaedic exams. The orthopaedic group included 15 dogs with bilateral hindlimb orthopaedic diseases with weight-bearing hindlimb lameness and normal neurologic exams. The neurologic group included 11 dogs with ambulatory paraparesis and normal orthopaedic exams. Each dog was walked across the PSW, and at least 3 valid trials were collected. The stride time, stance time, swing time, stride length, gait velocity, peak vertical force (PVF), vertical impulse (VI), and limb symmetry were recorded. The mean values of all parameters from the valid trials were calculated and used for data analysis. The outcomes were compared among all groups.ResultsCompared with the normal group, the orthopaedic group had a significantly greater percent body weight distribution (%BWD) and vertical impulse distribution (VID) in the forelimbs. When comparing the spatiotemporal parameters, the neurologic group showed an increase in forelimb stance time compared to that of the normal group. Compared with that in the normal group, the stride velocity in the forelimbs in the orthopaedic group was greater. There were no significant differences in the kinetic parameters between the neurologic group and the normal group, nor in stride time or stride length among the groups.ConclusionThe gait parameters obtained by PSW demonstrated that the orthopaedic and neurologic groups may have different compensatory mechanisms for their gait deficiencies. These parameters can potentially be used to construct a predictive model to evaluate PSW as a diagnostic tool in future studies.

Effects of Treadmill Inclination and Load Position on Gait Parameters while Carrying a Backpack Asymmetrically

Effects of Treadmill Inclination and Load Position on Gait Parameters while Carrying a Backpack Asymmetrically

Immediate effects of insoles applied to the sound side lower extremity of patients with chronic hemiplegia during walking.

Asymmetric gait patterns are mostly observed in hemiplegic stroke patients. These abnormal gait patterns resulting in abnormal speed, and decreased ability in daily of activity living. This study aimed to determine the immediate changes in gait parameters and plantar pressure during elevation by wearing an insole on the sound side lower extremity of patients with hemiplegia. Thirty-six participants were recruited, comprising those with a post-stroke follow-up of ≥3 months and a functional ambulation category score of ≥2. The participants were asked to walk with and without a 1 cm insole in the shoe of their sound side, and the order of wearing or not wearing the insole was randomized. Gait parameters, bilateral gait parameters, and dynamic plantar pressure were measured using the GAITRite Walkway System. Paired t-test was used to examine immediate changes in gait parameters and plantar pressure with and without insoles during walking in the same group. Overall, gait velocity and step length significantly decreased (p < 0.05), whereas step time significantly increased (p < 0.05). The swing phase of the affected sidelower extremities significantly increased (p < 0.05), and the stance phase significantly decreased (p < 0.05). Double-support unloading phase (pre-swing phase) significantly increased (p < 0.05). The changes in plantar pressure were significantly increased in some lateral zones and significantly decreased in the medial zone of the mid-hindfoot, both in terms of pressure per time and peak pressure (p < 0.05). Although this study did not show immediate positive effects on gait parameters and gait cycle, it is expected that sensory input from the sole of the foot through changes in plantar pressure may help improve gait asymmetry and regulate postural symmetry.

Association of oral frailty and gait characteristics in patients with cerebral small vessel disease

BackgroundThe objectives of this study were twofold: (1) to compare gait characteristics between cerebral small vessel disease (CSVD) patients with low-risk oral frailty (OF) and high-risk OF, particularly during dual-task walking (DTW); (2) to investigate the association of OF, the gait characteristics of DTW, and falls among older adults patients with CSVD.MethodsA total of 126 hospitalized patients diagnosed with CSVD were recruited and classified into a low-risk group (n = 90) and a high-risk group (n = 36) based on OF status in our study. Comprehensive data pertaining to basic parameters (cadence, as well as stride time, velocity and length), variability, asymmetry, and coordination were gathered during both single-task walking (STW) and DTW. Additionally, the number of falls was calculated. Subsequently, t-test or chi-squared test was used for comparison between the two groups. Furthermore, linear regression analysis was employed to elucidate the association of the OF index-8 score and gait parameters during cognitive DTW. Also, logistic regression models were utilized to assess the independent association of OF risk and falls.ResultsDuring cognitive DTW, the high-risk group demonstrated inferior performance in terms of basic parameters (p < 0.01), coefficient of variation (CV) of velocity and stride length (p < 0.05), as well as phase coordination index (PCI) when compared with the low-risk group (p < 0.05). Notably, differences in basic gait parameters were observed in cognitive DTW and STW conditions between the two groups (p < 0.01). However, only the high-risk group evinced significant variations in CV and PCI during cognitive DTW, as opposed to those during STW (p < 0.05). Furthermore, our findings also revealed the association of OF, the gait characteristics of cognitive DTW, (p < 0.01) and falls (p < 0.05).ConclusionCSVD patients with a high risk of OF need to pay more attention to their gait variability or coordination. Also, they are recommended to undergo training involving dual-task activities while walking in daily life, thereby reducing the deterioration and mitigating the risk of falls. Besides, this study has confirmed an association of OF and DTW gait as well as falls in patients with CSVD.

Longitudinal Changes of Clinical, Imaging, and Fluid Biomarkers in Preataxic and Early Ataxic Spinocerebellar Ataxia Type 2 and 7 Carriers.

Brain MRI abnormalities and increases in neurofilament light chain (NfL) have mostly been observed in cross-sectional studies before ataxia onset in polyglutamine spinocerebellar ataxias. Our study aimed to identify longitudinal changes in biological, clinical, and/or imaging biomarkers in spinocerebellar ataxia (SCA) 2 and SCA7 carriers over 1 year. We studied SCA2 and SCA7 carriers and controls (expansion-negative relatives) at the Paris Brain Institute. Inclusion criteria included Scale for the Assessment and Rating of Ataxia (SARA) scores between 0 and 15. Assessments at baseline, 6 months, and 12 months comprised neurologic, quality of life, orofacial motor, neuropsychological, and ophthalmologic examinations, along with gait and oculomotor recordings, brain MRI, CSF, and blood sampling. The primary outcome was the longitudinal change in these assessments over 1 year. We included 15 SCA2 carriers, 15 SCA7 carriers, and 10 controls between May 2020 and April 2021. At baseline, the ages were similar (41 [37, 46] for SCA2, 38 [28.5, 39.8] for SCA7, and 39.5 [31, 54.5] for controls, p = 0.78), as well the sex (p = 0.61); SARA scores were low but different (4 [1.25, 6.5] in SCA2, 2 [0, 11.5] in SCA7, and 0 in controls, p < 0.01). Pons and medulla volumes were smaller in SCAs (p < 0.05) and cerebellum volume only in SCA2 (p = 0.01). Plasma NfL levels were higher in SCA participants (SCA2: 14.2 pg/mL [11.52, 15.89], SCA7: 15.53 [13.27, 23.23]) than in controls (4.88 [3.56, 6.17], p < 0.001). After 1-year follow-up, in SCA2, there was significant pons (-144 ± 60 mm3) and cerebellum (-1,508 ± 580 mm3) volume loss and a worsening of gait assessment; in SCA7, SARA score significantly increased (+1.3 ± 0.4) and outer retinal nuclear layer thickness decreased (-15.4 ± 1.6 μm); for both SCA groups, the orofacial motor assessment significantly worsened. For preataxic and early ataxic carriers, the strongest longitudinal deterioration on outcome measures was orofacial motility in SCA2 and retinal thickness in SCA7. Despite the limitation of the small sample size, we detected annual changes in preataxic and early ataxic SCA individuals across brain MRI imaging, clinical scores, gait parameters, and retinal thickness. These parameters could serve as potential end points for future therapeutic trials in the preataxic phase. ClinicalTrials.gov NCT04288128.

Using Theia Markerless Motion capture to measure the impact of adjusting deep brain stimulation parameters on gait in a Parkinson’s Disease case study

The way one swings their arms, turns their torso, and moves their feet, are gait parameters that are commonly disturbed in patients with Parkinson’s Disease (PD).1 Deep brain stimulation in the subthalamic nucleus (STN-DBS) has proven to be an effective long-term therapy for reducing cardinal motor symptoms and improving quality of life, compared to standard medical treatments like levodopa-based therapies.2-4 However, optimizing STN-DBS settings for individual needs can be a complex process, as standard clinical tools for PD progression, such as the Unified Parkinson's Disease Rating Scale, may be subjective and have limitations.5,6 This project aimed to explore markerless motion capture as a novel, objective measurement of gait progression in PD. The study used an n=1 case design to investigate how gait metrics change with adjustments to DBS settings. The participant, a PD patient with STN-DBS, underwent five randomized, double-blind trials in which their DBS frequency (Hz) and current strength (mA) were adjusted. The following combinations of left and right ventral electrode settings were used: Left: 179 Hz, 3.1 mA; Right: 179 Hz, 2.9mA (Baseline) Left: 149 Hz, 3.1 mA; Right: 149 Hz, 2.9mA (149 low) Left: 149 Hz, 3.4 mA; Right: 149 Hz, 3.2 mA (149 high) Left: 104 Hz, 3.1 mA; Right: 104 Hz, 2.9mA (104 low) Left: 104 Hz, 3.3 mA; Right: 104 Hz, 3.2 mA (104 high) During each 5-minute trial, the participant walked on a treadmill at a comfortable speed while being recorded using a Theia3D markerless motion capture system. The recordings were analyzed using Visual3D software, which quantified gait metrics including cadence, step length, stride length, posture, and arm swing. Notably, differences in the participant’s arm swing between the left and right sides were observed across the various DBS settings. This technology provided objective, measurable data on gait, offering a potential tool for future gait assessments in PD. Its applicability extends to long-term tracking of patient progress, with the potential for markerless motion capture to transform how clinicians evaluate the efficacy of DBS in patients with PD.

Comparison of spatiotemporal gait parameter measurements across various emulated foot strike patterns between the Tekscan® Strideway™ pressure sensitive walkway and gold-standard marker-based motion capture

Spatiotemporal gait parameters are commonly used to quantify physical functioning including in populations with atypical foot strike patterns. The current gold standard measurement system for gait analysis is marker-based motion capture and floor-mounted force plates, but it can be expensive and cumbersome to set up. Pressure sensitive walkways are more affordable, quicker to set up, and more portable. Currently available walkways have not been compared to marker-based motion capture when measuring atypical foot strike patterns. The recently developed Tekscan® Strideway pressure sensitive walkway system has not been compared to any gold standard. This study compared measurements of step width, step length, and step time from the Strideway™ system against a gold standard marker-based motion capture (Vicon® Vantage™) and floor-mounted force plate (AMTI®) system. Ten typically ambulating adults, free of injury, emulated five different foot strike patterns recording two-hundred footsteps for each. Results indicate that the Strideway™ compares well to the gold standard especially under typical foot strike patterns. The errors were highest for step width and near-zero for step time. However, the user needs to be aware that errors can substantially increase with certain foot strike patterns such as when the heel does not make contact with the walkway. The results of this study will help inform users about potential limitations when using a pressure sensitive walkway like the Strideway™ for testing populations with typical and atypical strike patterns.

Vestibular perceptual learning improves self-motion perception, posture, and gait in older adults

Vestibular motion perception declines with age, increasing the risk of falling substantially. We performed a two-week perceptual learning intervention using a self-motion direction discrimination task (2800 training trials per person) on a 6 degrees of freedom motion platform in healthy older adults (n = 40, aged 70–88 yr). Linear inter-aural and angular roll tilt vestibular thresholds improved with training (95% credible interval for pre/post difference), suggesting altered sensitivity post-training. Moreover, improved perceptual abilities transfer to actual posture (reduced sway) and gait parameters. Passive self-motion discrimination training provides a new and promising way to counteract age-related sensory decline. It can reduce the risk of falling, and thereby maintain individual autonomy and quality of life.

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

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

Postural control depends on early visual experience.

The present study investigated the role of early visual experience in the development of postural control (balance) and locomotion (gait). In a cross-sectional design, balance and gait were assessed in 59 participants (ages 7-43 years) with a history of (a) transient congenital blindness, (b) transient late-onset blindness, (c) permanent congenitally blindness, or (d) permanent late-onset blindness, as well as in normally sighted controls. Cataract-reversal participants who experienced a transient phase of blindness and gained sight through cataract removal surgery showed worse balance performance compared with sighted controls even when tested with eyes closed. Individuals with reversed congenital cataracts performed worse than individuals with reversed developmental (late emerging) cataracts. Balance performance in congenitally cataract-reversal participants when tested with eyes closed was not significantly different from that in permanently blind participants. In contrast, their gait parameters did not differ significantly from those of sighted controls. The present findings highlight both the need for visual calibration of proprioceptive and vestibular systems and the crossmodal adaptability of locomotor functions.

An observational study of the impact of professional walking aid prescription on gait parameters for individuals with suspected balance impairments

BackgroundThe primary management strategy for gait impairment is the adoption of a walking aid. However, there are no established criteria upon which to base a decision regarding the need for a walking aid. It appears clinicians prescribe aids based on preference, clinical experience and intuition rather than standardised objective rationale. This may contribute to the inconsistent gait response to walking aids reported in the published literature. Understanding gait changes resulting from gait aid usage may have significant impact on clinical practice by improving confidence of prescribing clinicians and compliance of walking aid usage by patients, maximising the benefits of use, and reducing any risks associated with non-use or inappropriate use, of the walking aid. Research questionDo professionally prescribed walking aids improve gait parameters? MethodsThis is a secondary data analysis of a cross-sectional study where participants, identified by healthcare staff requiring a mobility assessment due to potential balance impairment of any cause, walked a 20-m straight walking course under three different walking conditions (no aid, walking stick and 4-wheeled walker). Fifty-eight participants were recruited. Commonly reported spatial and temporal gait parameters were assessed using a validated gait analysis device. Changes in gait parameters across the three conditions were compared, noting the individual's professionally prescribed aid and interpreting changes in parameters towards outcomes of the ‘no aid required group’. Results and significanceGait cycle, cadence, stance, swing and stride length during unaided walking were significantly changed when a walking stick was prescribed (p < 0.05). Stance, swing, double support, stride length, speed, max toe clearance and minimum toe clearance were significantly changed when a 4-wheel walker was prescribed (p < 0.05). Professional walking aid prescription improves some gait parameters. A greater number and magnitude of gait parameter improvements were seen in people requiring a 4-wheel walker than people requiring a walking stick.