Single Support Time Research Articles

The Association Between Lower Limb Joint Position Sense and Different Aspects of Gait Pattern in Individuals With Bilateral Knee Osteoarthritis

Knee osteoarthritis (KOA) can have more pronounced effects on joint position sense (JPS) accuracy and gait characteristics. The aim of this study is to investigate the association between lower limb JPS and different aspects of gait pattern including gait asymmetry and variability and spatiotemporal coordination in individuals with bilateral KOA. In this cross-sectional study, lower limb JPS of 43 individuals with bilateral KOA (mild and moderate) were measured. Participants’ gait patterns during treadmill walking with self-selected comfortable speed were assessed. The correlations between JPS errors and gait parameters of limb with moderate KOA were analyzed. Positive relationships were found between stance time symmetry index and JPS errors of hip abduction (r = .46, P = .003), ankle plantar flexion (r = .33, P = .03), and ankle dorsiflexion (r = .33, P = .03). Positive relationship was found between single limb support time symmetry index and hip abduction JPS error (r = .41, P = .008). Significant negative associations were found between coefficient of variation of step length and JPS errors of knee extension (r = .47, P = .002) and ankle plantar flexion (r = .33, P = .003). Results did not show any significant relationship between lower limb JPS errors and walk ratio. It is likely that lower limb JPS deficits are partially responsible for some changes in gait patterns observed in individuals with bilateral KOA.

Portable Gait Analysis of Patients With Rotating Hinge Knee Megaprosthesis Compared With Total Knee Arthroplasty.

The gait analysis of patients after surgery for tumors around the knee joint relies on the use of a three-dimensional motion capture system. However, obtaining long-term, free-standing, real-world gait data with three-dimensional gait analysis is challenging. In this study, we utilized a portable gait analyzer to collect gait data from patients who underwent rotating hinge knee megaprosthesis (RHK) and total knee arthroplasty (TKA), this study aims to compare via gait analysis patients who underwent megaprosthesis with patients with TKA. A retrospective study was conducted on eight patients with knee bone tumors (RHK group) and ten patients with knee osteoarthritis who underwent standard TKA (TKA group) from January 2018 to January 2022. Gait analysis, was conducted using the Intelligent Device for Energy Expenditure and Activity (IDEEA), and the results were compared with those of a healthy control group. The lower limb alignment of the RHK and TKA groups was evaluated, and the KSS scores of the two groups were collected and compared. Energy consumption during a 20-m walk was measured and compared among the RHK, TKA, and healthy control groups using one-way ANOVA. Paired t-tests were used to compare the operated and nonoperated limbs within groups. All patients exhibited slower walking speeds and cadence than the healthy control participants (p < 0.01), While no significant differences were found between the RHK and TKA groups. The single support time (521.15 ± 94.56 ms) of the RHK-operated limb was significantly shorter than that of the nonoperated limb (576.53 ± 77.40 ms, p = 0.004). The pulling acceleration of the RHK group (0.71 ± 0.27 G) was lower than that of the TKA group (1.04 ± 0.31 G, p = 0.029). The push-off angle in the RHK group (24.91° ± 10.91°) was significantly greater than that in the TKA group (10.64° ± 5.41°, p = 0.007). The RHK group showed significant differences between the operated and nonoperated limbs in terms of swing power, ground impact, footfall, and push-off. The RHK (0.03 ± 0.01 kcal/min/kg) and TKA (0.029 ± 0.01 kcal/min/kg) groups had significantly greater energy expenditures than did the healthy control group (0.02 ± 0.00 kcal/min/kg, p < 0.05). The comparison of HKA angles and KSS scores between the TKA and RHK groups showed statistically significant differences. A portable gait analyzer appears to be suitable for evaluating the effects of RHK. RHK patients demonstrate more pronounced gait abnormalities than TKA patients, reflected in greater energy expenditure, implying reduced walking efficiency. This suggests the need for increased energy expenditure in RHK patients to compensate for abnormal knee joint conditions during walking and maintain body balance.

Impacts of audiovisual simultaneity perception on single-task and dual-task gaits in middle-aged and older adults

BackgroundWhile dual-task walking requires the ability to integrate sensory information from multiple ongoing sources, it remains unknown whether dual-task walking is more affected than single-task walking by the multisensory integration ability. Research questionHow does the audiovisual temporal integration ability affect single-task and dual-task gaits in the aging population? MethodsOne hundred and thirty healthy middle-aged and older adults (age = 64.7 ± 6.4 years) completed an audiovisual simultaneity judgment (AVSJ) task and underwent single-task, motor dual-task, and cognitive dual-task gait assessments. In the AVSJ task, participants judged whether a flash and an auditory stimulus presented at different stimulus onset asynchronies were simultaneous. The accuracy and precision of the AVSJ performance were assessed using the point of subjective simultaneity (PSS) and the temporal binding window (δ), respectively. A lower absolute PSS and δ indicated better performance. Participants held a cup of water and performed serial-7 subtraction for motor and cognitive dual-task gait assessments, respectively. The spatiotemporal gait parameters and their variability were calculated. The influences of PSS and δ on the gait parameters of the three gaits were examined with multiple hierarchical regressions. ResultsOnly the cognitive dual-task gait was significantly affected by PSS and δ. Greater PSS predicted a longer single support time (β = 0.195, p = 0.024) and its variability (β = 0.224, p = 0.011). Greater δ predicted greater step time variability (β = 0.198, p = 0.022). SignificanceDeclined perception of audiovisual simultaneity particularly degrades temporal control of cognitive dual-task walking, highlighting the importance of assessing and training this ability after midlife.

Machine Learning Model for Mild Cognitive Impairment Stage Based on Gait and MRI Images.

In patients with mild cognitive impairment (MCI), a lower level of cognitive function is associated with a higher likelihood of progression to dementia. In addition, gait disturbances and structural changes on brain MRI scans reflect cognitive levels. Therefore, we aimed to classify MCI based on cognitive level using gait parameters and brain MRI data. Eighty patients diagnosed with MCI from three dementia centres in Gangwon-do, Korea, were recruited for this study. We defined MCI as a Clinical Dementia Rating global score of ≥0.5, with a memory domain score of ≥0.5. Patients were classified as early-stage or late-stage MCI based on their mini-mental status examination (MMSE) z-scores. We trained a machine learning model using gait and MRI data parameters. The convolutional neural network (CNN) resulted in the best classifier performance in separating late-stage MCI from early-stage MCI; its performance was maximised when feature patterns that included multimodal features (GAIT + white matter dataset) were used. The single support time was the strongest predictor. Machine learning that incorporated gait and white matter parameters achieved the highest accuracy in distinguishing between late-stage MCI and early-stage MCI.

Ubiquitous Gait Analysis through Footstep-Induced Floor Vibrations.

Quantitative analysis of human gait is critical for the early discovery, progressive tracking, and rehabilitation of neurological and musculoskeletal disorders, such as Parkinson's disease, stroke, and cerebral palsy. Gait analysis typically involves estimating gait characteristics, such as spatiotemporal gait parameters and gait health indicators (e.g., step time, length, symmetry, and balance). Traditional methods of gait analysis involve the use of cameras, wearables, and force plates but are limited in operational requirements when applied in daily life, such as direct line-of-sight, carrying devices, and dense deployment. This paper introduces a novel approach for gait analysis by passively sensing floor vibrations generated by human footsteps using vibration sensors mounted on the floor surface. Our approach is low-cost, non-intrusive, and perceived as privacy-friendly, making it suitable for continuous gait health monitoring in daily life. Our algorithm estimates various gait parameters that are used as standard metrics in medical practices, including temporal parameters (step time, stride time, stance time, swing time, double-support time, and single-support time), spatial parameters (step length, width, angle, and stride length), and extracts gait health indicators (cadence/walking speed, left-right symmetry, gait balance, and initial contact types). The main challenge we addressed in this paper is the effect of different floor types on the resultant vibrations. We develop floor-adaptive algorithms to extract features that are generalizable to various practical settings, including homes, hospitals, and eldercare facilities. We evaluate our approach through real-world walking experiments with 20 adults with 12,231 labeled gait cycles across concrete and wooden floors. Our results show 90.5% (RMSE 0.08s), 71.3% (RMSE 0.38m), and 92.3% (RMSPE 7.7%) accuracy in estimating temporal, spatial parameters, and gait health indicators, respectively.

Effects of a dual-task activity on gait parameters of people with and without intellectual disabilities.

The main objective of this study was to evaluate gait parameters in people with intellectual disability (ID) and without intellectual disability (WID) in two different walking conditions [single task vs. dual task (DT)]. A secondary aim was to evaluate the dual-task cost (DTC) that the DT causes in each group. A total of 119 participants joined in this study: 56 ID (30 men) and 63 WID (30 men). The OptoGait system was used to assess gait. In addition, Witty photocells were added to assess gait under the DT condition. Single support time was lower for participants with ID (P<0.01), while double support time was higher (P<0.05). All coefficients of variation for gait parameters were higher in participants with ID. Additionally, changes in gait were observed in both groups during the DT condition compared with the single-task condition. These changes were larger for participants with ID in step length, double support time and gait speed (P<0.001), resulting in a higher DTC in these variables in the ID group (P<0.01). Both groups reduced gait performance in the DT condition. However, greater gait variability occurred in the ID group. In addition, DTC was higher for the ID group in all variables analysed. Therefore, people with ID show worse gait performance during a DT than people WID.

Inertial Sensor Gait Analysis of Trendelenburg Gait in Patients Who Have Hip Osteoarthritis

BackgroundGait abnormalities such as Trendelenburg gait (TG) in patients who have hip osteoarthritis (OA) have traditionally been evaluated using clinicians’ visual assessment. Recent advances in portable inertial gait sensors offer more sensitive, quantitative methods for gait assessment in clinical settings. This study sought to compare sensor-derived metrics in a cohort of hip OA patients when stratified by clinical TG severity. MethodsThere were 42 patients who had hip OA and were grouped by TG severity (mild, moderate, and severe) through visual assessment by a single arthroplasty surgeon who had > 30 years of experience. After informed consent, wireless inertial sensors placed at the midpoint of the intercristal line collected gait parameters including pelvic shift, support time, toe-off symmetry, impact, and cadence. Clinical data on hip strength, range of motion, and Kellgren-Lawrence grade were collected. ResultsWorsening TG severity had a higher mean Kellgren-Lawrence grade (2.5 versus 3.2 versus 3.4; P = .014) and reduced passive hip abduction (P = .004). Severe TG group demonstrated predominantly contralateral pelvic shift (n = 9 of 10, 90.0%), while ipsilateral shift was more frequently detected in moderate (n = 10 of 18, 55.6%) and mild groups (n = 9 of 14, 64.3%; P = .021). Contralateral single support time bias was greatest in severe TG (35.7% versus 50.0 versus 90.0%; P = .027). Asymmetric toe-off, impact, and support times were observed in all groups. ConclusionsTraditional understanding of TG is that truncal shift occurs to the ipsilateral side. Using sensor-based measurements, the present study demonstrates a shift of the weight-bearing axis toward the contralateral side with increasing TG severity, which has not been previously described. Inertial sensors are feasible, quantitative gait measuring tools, and may reveal subtle patterns not readily discernible by traditional methods.

Factors influencing gait performance in older adults in a dual-task paradigm.

The aim of this study was to determine the effect of cognitive interference through a dual-task (DT) paradigm on gait parameters by sex or other predictive variables, such as physical fitness, health status, and cognition. A total of 125 older adults joined in this study (age, 72.42 ± 5.56years old; 28 men and 97 women). The DT paradigm was evaluated through Comfortable Linear Gait (CLG) and Complex Gait Test (CGT). The gait parameters between single task (ST) vs. DT condition in men showed a significant reduction in speed (p < 0.001), cadence (p < 0.001), and step length (p = 0.049) and increased time to execute the CGT (p < 0.001), while women showed a decreased speed (p = 0.014), cadence (p < 0.001), and double support coefficient variation (CV) (p = 0.024) and increased single support time (p < 0.001) and CV step length (p < 0.05). In addition, women increased CGT time (p < 0.001). Furthermore, correlations between DT cost (DTC) cadence vs. Physical Activity for Elderly questionnaire (PASE) (r = - 0.399; p = 0.008), DTC single support vs. 30s Sit to Stand Test (r = - 0.356; 0.016), DTC single support vs. Rey Auditory Verbal Learning Test-Learning curve (r = - 0.335; p = 0.023), DTC double support vs. 30s Sit to Stand Test (r = - 0.590; p < 0.001), DTC CV step length vs. 30s Sit to Stand (r = - 0.545; p = 0.003), and DTC CGT vs. 30s Sit to Stand Test (r = - 0.377; p = 0.048) were found. The results of our study indicate that the gait parameters within the DT condition decreased speed and cadence, while increasing CV step length and CGT time, causing slower gait with shortened steps in men and women.

Usefulness of one-arm motorized gait device for chronic hemiplegic stroke survivors.

After stroke, gait training is a key component of rehabilitation, and most individuals use a variety of walking aids depending on their physical condition and environment. This study aimed to investigate the potential effect of a one-arm motorized gait device for gait assist of chronic hemiplegic stroke survivors through comparison with traditional gait devices (parallel bar and hemi-walker). This study was conducted on 14 chronic hemiplegic stroke survivors. The participants were asked to walk under three conditions using different gait devices, and their gait parameters during walking were collected and analyzed. The first condition involved walking on parallel bars; second condition, walking using hemi-walkers; and third condition, walking using one-arm motorized gait devices. With the use of a gait analysis system, the spatio-temporal gait parameters in each condition were collected, such as gait velocity, cadence, step length, stride length, single support time, and double support time. In the results by repeated-measures ANOVA or the Friedman test, a significant difference was found in the gait parameters among all three conditions (p< 0.05). The post-hoc test showed a significant change in the spatio-temporal gait parameters (especially, velocity, cadence and affected side single and double support time) when one-arm motorized gait device were used compared with parallel bars and hemi-walkers (p< 0.05). The results of this study suggest that one-arm motorized gait devices developed for hemiplegic stroke survivors may be more effective potentially than parallel bars and hemi-walkers in gait assistance of chronic hemiplegic stroke survivors.

Gait and sEMG characteristics of lower limbs in children with unilateral spastic cerebral palsy during walking

BackgroundChildren with unilateral spastic cerebral palsy (USCP) have muscle hypertonia, balance, and coordination defects that affect gross motor skills, especially walking. Understanding the gait characteristics and lower limb muscle activation patterns of USCP children can provide an objective and quantitative basis for patient assessment and treatment plan formulation. ObjectiveThis study compared the gait and lower limb muscle activation characteristics of children with USCP and with typical development (TD) during walking. MethodsWe recorded gait and sEMG data of 20 children with USCP, and 20 with typical development. sEMG signals were acquired from the bilateral tibialis anterior (TA) and lateral gastrocnemius muscles (LG) during walking. The root mean square (RMS) value, integrated electromyographic (iEMG) value and co-contraction ratio (CR) were used to evaluate muscle activity. Student's t Test and non-parametric rank sum Test were used to compare the differences between the data groups (significance level of 0.05). ResultsThe stance time, step length, speed, single leg support time ratio, ground impact, pre-swing angle, and muscle strength of the affected side were significantly decreased compared to those of the unaffected side in children with USCP (P < 0.05), while the swing phase, muscle tonus of LG were significantly prolonged (P < 0.05). Compared with TD children, children with USCP exhibited reduced bilateral walking ability, particularly noticeable in their smaller pre-swing angle(P < 0.05), diminished muscle strength of the TA and LG, as well as LG spasms(P < 0.05). SignificanceChildren with USCP have decreased ambulatory gait stability. Step length, pull acceleration, pre-swing angle, and CR can be used as sensitive indicators for gait assessment. Strengthening the TA muscle and reducing ankle spasm may help improve gait and postural stability in children with USCP.

Impact of deep brain stimulation on gait in Parkinson disease: A kinematic study

BackgroundThe effect of Deep Brain Stimulation (DBS) on gait in Parkinson’s Disease (PD) is poorly understood. Kinematic studies utilizing quantitative gait outcomes such as speed, cadence, and stride length have shown mixed results and were done mostly before and after acute DBS discontinuation. ObjectiveTo examine longitudinal changes in kinematic gait outcomes before and after DBS surgery. MethodWe retrospectively assessed changes in quantitative gait outcomes via motion capture in 22 PD patients before and after subthalamic (STN) or globus pallidus internus (GPi) DBS, in on medication state. Associations between gait outcomes and clinical variables were also assessed. ResultGait speed reduced from 110.7 ± 21.3 cm/s before surgery to 93.6 ± 24.9 after surgery (7.7 ± 2.9 months post-surgery, duration between assessments was 15.0 ± 3.8 months). Cadence, step length, stride length, and single support time reduced, while total support time, and initial double support time increased. Despite this, there was overall improvement in the Movement Disorder Society-Unified Parkinson Disease Rating Scale-Part III score “on medication/on stimulation” score (from 19.8 ± 10.7–13.9 ± 8.6). Change of gait speed was not related to changes in levodopa dosage, disease duration, unilateral vs bilateral stimulation, or target nucleus. ConclusionQuantitative gait outcomes in on medication state worsened after chronic DBS therapy despite improvement in other clinical outcomes. Whether these changes reflect the effects of DBS as opposed to ongoing disease progression is unknown.

Altered gait parameters in distracted walking: a bio-evolutionary and prognostic health perspective on passive listening and active responding during cell phone use.

The underpinnings of bipedal gait are reviewed from an evolutionary biology and prognostic health perspective to better understand issues and concerns related to cell phone use during ambulation and under conditions of distraction and interference. We also consider gait-related health issues associated with the fear of or risk of falling and include prognostic dimensions associated with cognitive decline, dementia, and mortality. Data were acquired on 21 healthy young adults without hearing loss, vestibular, balance, otological or neurological dysfunction using a computerized walkway (GAITRite® Walkway System) combined with specialized software algorithms to extract gait parameters. Four experimental conditions and seven temporo-spatial gait parameters were studied: gait velocity, cadence, stride length, ambulatory time, single-support time, double-support time, and step count. Significant main effects were observed for ambulation time, velocity, stride velocity, and double-support time. The greatest impact of distraction and interference occurred during the texting condition, although other significant effects occurred when participants were verbally responding to queries and passively listening to a story. These experimental observations show that relatively simple distraction and interference tasks implemented through the auditory sensory modality can induce significant perturbations in gait while individuals were ambulating and using a cell phone. Herein, emphasis is placed on the use of quantifiable gait parameters in medical, psychological, and audiological examinations to serve as a foundation for identifying and potentially averting gait-related disturbances.

Talar Neck Malunions: Evaluation of Kinematics, Pedobarographic Changes and Patient Reported Outcome Measures

Category: Trauma; Hindfoot Introduction/Purpose: Malunion is a disabling complication of talar neck fractures and is prevalent in approximately 17% of cases. The impact of talar neck malunions (TNM) on foot biomechanics and functional outcomes is not well established. The available evidence is primarily derived from cadaveric studies which have demonstrated that TNMs result in reduced motion and significant alterations in contact characteristics of the subtalar joint. Owing to the paucity of literature on this subject, we conducted this study to evaluate the kinematic and pedobarographic changes and functional outcomes associated with TNMs. Methods: In this study, adult patients with talar neck malunions (TNM) without ankle arthrosis were prospectively enrolled over a 5-year period. The Rammelt and Zwipp classification was utilized to categorize the deformities. Demographic data and ankle and subtalar range of motion were assessed. Weight-bearing anteroposterior (AP), lateral, and long axial radiographs, as well as CT scans of both feet, were obtained. Dynamic pedobarography was performed to evaluate gait kinematics and plantar pressure distribution. Functional outcomes were evaluated using the Manchester Oxford Foot Questionnaire (MOxFQ), Visual Analog Score, and the EQ5D questionnaire. The t-test was utilized to compare the range of motion, pedobarographic and kinematic parameters between the normal and pathologic foot. Furthermore, correlation coefficients were calculated to determine the strength of the association between changes in talar neck geometry, plantar pressures, kinematics, and functional outcomes. Results: A total of 10 patients, 6 males, and 4 females, with a mean age of 32.4 years were enrolled. On the TNM side, significant increases were observed in step length and step time, while significant decreases were noted in the single limb support time and single limb support center of pressure line. Moreover, midfoot forces were significantly increased, whereas the forefoot and hindfoot forces were significantly decreased on the TNM side. A strong positive correlation was found between midfoot force and the talar torsion angle, and a moderate negative correlation was observed between hindfoot and midfoot forces and the inclination angle. A strong positive correlation was also noted between high midfoot pressures and VAS Scores, MOxFQ scores, and the EQ5D walking and usual activities domains. Conclusion: This study demonstrates that TNMs are associated with decreased single limb support time, increased step length and time, increased midfoot pressures, and decreased forefoot and hindfoot pressures. Additionally, an increase in talar neck torsion after TNM is linked with higher midfoot pressures, which can lead to higher levels of pain and poorer function. Our findings provide valuable insights into the altered foot biomechanics after TNMs, which can assist surgeons in offering optimal management strategies for these patients.

Can developmental trajectories in gait variability provide prognostic clues in motor adaptation among children with mild cerebral palsy? A retrospective observational cohort study.

To investigate whether multiple domains of gait variability change during motor maturation and if this change over time could differentiate children with a typical development (TDC) from those with cerebral palsy (CwCP). This cross-sectional retrospective study included 42 TDC and 129 CwCP, of which 99 and 30 exhibited GMFCS level I and II, respectively. Participants underwent barefoot 3D gait analysis. Age and parameters of gait variability (coefficient of variation of stride-time, stride length, single limb support time, walking speed, and cadence; as well as meanSD for hip flexion, knee flexion, and ankle dorsiflexion) were used to fit linear models, where the slope of the models could differ between groups to test the hypotheses. Motor-developmental trajectories of gait variability were able to distinguish between TDC and CwCP for all parameters, except the variability of joint angles. CwCP with GMFCS II also showed significantly higher levels of gait variability compared to those with GMFCS I, these levels were maintained across different ages. This study showed the potential of gait variability to identify and detect the motor characteristics of high functioning CwCP. In future, such trajectories could provide functional biomarkers for identifying children with mild movement related disorders and support the management of expectations.

Selective motor control may be associated with the single support time of gait and single limb standing time in cerebral palsy

Selective motor control may be associated with the single support time of gait and single limb standing time in cerebral palsy

Effects of muscular and mental fatigue on spatiotemporal gait parameters in dual task walking in young, non-frail and frail older adults.

Dual-task (DT) walking is of great interest in clinical evaluation to evaluate frailty or cognitive declines in older adults. Frail older adults are known to adopt different walking strategy to overcome fatigue. However, no studies evaluated the effect of muscular or mental fatigue on dual-task walking strategy and the difference between frail and non-frail older adults. Evaluate the effect of mental and muscular fatigue on spatio-temporal parameters in dual-task walking in young, non-frail and frail older adults. 59 participants divided into 20 young (Y) (24.9 ± 3years old), 20 non-frail (NF) (75.8 ± 4.9years old) and 19 frail older adults (F) (81 ± 4.7years old) performed single-task (ST) walking, single-task cognitive (serial subtraction of 3), and dual-task (subtraction + walking) for 1min at their fast pace. Gait speed, step length, step length variability, stance and swing phase time, single and double support time, cadence, gait speed variability were recorded in single- and dual-task walking. The dual-task effect (DTE) was calculated as ((DT-ST)/ST)×100). Generalized linear mixed models (GLMM) were used to compare the effects of mental and muscular fatigue on gait and cognitive variables between the groups. The DTE walking parameters were worse in F compared to NF or Y but no significant effect of fatigue were highlighted except for swing time and single support time DTEs. The results were mitigated but a clear difference in dual-task spatio-temporal parameters was found between F and NF which brings hope into the capacity of DT to better reveal frailty.

Differences in gait parameters when crossing real versus projected everyday life obstacles in healthy children and adolescents

Practicing complex everyday life walking activities is challenging in paediatric neurorehabilitation, although it would prepare patients more comprehensively for the requirements of daily life. Floor projections allow simulation and training of such situations in therapy. Twenty healthy youths aged 6–18 years stepped over a tree trunk and balanced over kerbstones in a real and projected condition. Spatiotemporal and kinematic parameters of the two conditions were compared by equivalence analysis, using the medians of the differences between the two conditions with their bootstrapped 95% confidence intervals. Velocity, step and stride length, step width, and single support time were generally equivalent between the two conditions. Knee and hip joint angles and toe clearance decreased substantially during the execution phase of the projected tree trunk condition. The largest differences were found at the end of the execution phase in both tasks for the ankle joints. As spatiotemporal parameters were equivalent between the conditions, floor projections seem suitable to train precise foot placement. However, differences in knee and hip joint kinematics and toe clearance revealed that floor projections are not applicable for obstacles with a vertical extension. Therefore, exercises aiming at knee and hip flexion improvement should favourably be trained with real objects.

Understanding the Role of Children's Footwear on Children's Feet and Gait Development: A Systematic Scoping Review.

Children's footwear plays an important role in the healthy growth of foot and gait development during the growing stage. This review aims to synthesize findings of previous investigations and to explore the biomechanical influences of different types of children's footwear on foot health and gait development, thus guiding the healthy and safe growth of children's feet and gait. Online databases were searched for potential eligible articles, including Web of Science, Google Scholar, and PubMed. In total, nineteen articles were identified after searching based on the inclusion requirements. The following five aspects of biomechanical parameters were identified in the literature, including spatiotemporal, kinematics, kinetics, electromyography (EMG), and plantar pressure distribution. Children's footwear can affect their foot health and gait performance. In addition, children's shoes with different flexibility and sole hardness have different effects on children's feet and gait development. Compared to barefoot, the stride length, step length, stride time, and step time were increased, but cadence was decreased with wearing shoes. Furthermore, the support base and toe-off time increased. Double support time and stance time increased, but single support time decreased. The hip, knee, and ankle joints showed increased range of motion in children with the rear-foot strike with larger ground reaction force as well. Future studies may need to evaluate the influence of footwear types on gait performance of children in different age groups. Findings in this study may provide recommendations for suitable footwear types for different ages, achieving the aim of growth and development in a healthy and safe manner.

노인의 넘어짐 경험에 따른 보행능력과 균형능력 비교

This study was designed to investigate the effects of falling experience on gait ability and balance ability in the elderly women utilizing new instruments with high validity to measure gait ability and balance in the lower extremities. Forty six elderly women were volunteered to participate in the study as subjects. They were divided into two groups, i.e., falling experienced group(FG: n=24) and non-falling experienced group(NFG: n=22). The collected data were calculated with falling experience group and non-falling experience group utilizing independent t-test with repeated measures. Variables related to physique, gait ability(Temporal parameters and Spatial parameters) and balance ability were measured and compared between the two groups. There was no significant difference between the two groups in all variables of step time, gait cycle time, single support time, double support time, ambulation time, velocity, and mean normalized velocity. in the case of spatial parameters, step length(left, right), stride length(left), step/extremity ratio(left), and funcional ambulatory profiles of gait, were significantly lower in FG than NFG. In addition, FG showed signifiantly lower. in the case of level 2, there was a significant differencce in overall, Anterior･Posterior, Medial･Lateral. in level 4, there was a significant difference between Medial･Lateral. it was concluded that low step length, stride length, funcional ambulatory profiles due to the experience of falling, and a decrease in balance ability on unstable ground. Therefore, the results of this study are expected to be helpful as basic data for constructing an exercise program for improving spatial walking ability and balance ability on unstable ground in planning an exercise program for preventing falls in elderly women.

Isolating the speed factor is crucial in gait analysis for Parkinson's disease.

Parkinson's disease (PD) is characterized by an alteration of the walking gait, frequently including a slower self-selected walking speed (SSWS). Although the reduction of walking speed is inherent to people with PD, such speed reduction also represents a potential confounding factor that might partly explain the observed gait differences between PD and control participants. In this study, each participant walked along a 25 m level corridor during which vertical ground reaction force signals were recorded using shoes equipped with eight pressure sensors. Vertical ground reaction force signals (using statistical parametric mapping) and temporal and kinetic variables as well as their related variability and asymmetry (using Student's t-test) were compared between PD (n = 54) and walking-speed-matched control subjects (n = 39). Statistical parametric mapping did not yield significant differences between PD and control groups for the vertical ground reaction force signal along the walking stance phase. Stride time and single support time (equivalent to swing time) were shorter and peak vertical ground reaction force was larger in PD patients compared to controls (p ≤ 0.05). However, the single support time was no longer different between people with PD and healthy subjects when expressed relatively to stride time (p = 0.07). While single support, double support, and stance times were significantly more variable and asymmetric for PD than for the control group (p ≤ 0.05), stride time was similar (p ≥ 0.07). These results indicate that at matched SSWS, PD patients adopt a higher cadence than control participants. Moreover, the temporal subdivision of the walking gait of people with PD is similar to healthy individuals but the coordination during the double support phase is different. Hence, this study indicates that isolating the speed factor is crucial in gait analysis for PD.