Spatiotemporal Parameters Research Articles

Validity of assessing level walking with the 2D motion analysis software TEMPLO and reliability of 3D marker application

In gait analysis, knowledge on validity and reliability of instruments and influences caused by the examiner’s performance is of crucial interest. These measurement properties are not yet known for commonly used, low-cost two-dimensional (2D) video-based systems. The purpose of this study was to assess the concurrent validity of a video-based 2D system against a three-dimensional (3D) reference standard, as well as the inter-rater reliability, and test–retest reliability of 3D marker application. Level walking was captured simultaneously by a 2D and a 3D system. Reflective markers were applied independently by three raters and repeated by one rater on a second day. We assessed the agreement between the two systems, as well as reproducibility, and inter-rater agreement of derived spatio-temporal parameters and sagittal kinematics. Nineteen healthy participants completed this study. 2D gait analysis provides a possibility to accurately assess parameters such as stride time, stride length, gait velocity, and knee RoM. Interrater and test–retest reliability of 3D gait analysis are generally acceptable, except for the parameters toe-off and pelvic RoM. This is the first study to publish measurement properties of a commercially available 2D video-based gait analysis system, which can support interpretation of gait pattern near the sagittal plane.

Can external work during walking in scoliosis patients be estimated from spatiotemporal parameters?

BackgroundPatients with scoliosis present gait impairments compared to healthy subjects. Clinically, spine deformity is evaluated with Cobb angle, a standard measurement to determine and track the progression of scoliosis. Scoliosis is a biomechanical trouble, dependant of external forces and muscular activity. External work is currently analyzed in patients with scoliosis because this work sums up consequences and evolutions of spine deformity. Habitually, biomechanics approach is used to compute this work. For asymptomatic subjects, a regression model let to compute external work. So, considering the area of research to facilitate the follow-up at lower cost, this regression function could be applied to patients with scoliosis but need to be validated. Research question: can external work during walking in scoliosis patients be estimated from spatiotemporal parameters with a regression model? MethodThis retrospective study included twenty untreated patients with idiopathic scoliosis and sixteen asymptomatic participants. We used a regression model defined in case of asymptomatic subjects in literature and proposed a new specific model in case of patients with scoliosis. FindingsThe external work in patients with scoliosis calculated with the Wirta's regression eq. (0.23 ± 0.04 J.kg−1.m−1) was underestimated compared to the external work calculated using a biomechanical method (0.33 ± 0.06 J.kg−1.m−1). A new regression model including Cobb angle and spatio-temporal parameter presents a high coefficient of determination. InterpretationIn opposition to biomechanical method, our new model let to compute external work without expensive gait laboratory. This specific model is more reliable than the model developed from asymptomatic subjects.

Physical activity components associated with gait parameters in community-dwelling older adults

ObjectiveTo investigate the association between components of physical activity and spatiotemporal gait parameters in community-dwelling older adults. MethodsCross-sectional study with 134 independent community-dwelling older adults. A questionnaire was applied to obtain information related to the components of physical activity (frequency, duration, modality, and history of physical activity in the life course) and the GAITRite System was used to quantify gait parameters. Three MANOVA models adjusted for potential confounders were conducted to identify associations between components of physical activity (predictors) and gait performance (outcome). ResultsHigher weekly frequency but not daily hours of physical activity and sports practice (tennis, boxing, football, volleyball, and tai chi) were significantly associated with better gait performance, specifically gait speed and stride length. ConclusionUnderstanding the most effective components of physical activity to maintain functional capacity and independence in community-dwelling older adults, allowing for active aging, is essential for formulating more effective strategies.

Residual effects of combined vibratory and plantar stimulation while seated influences plantar pressure and spatiotemporal gait measures in individuals with Parkinson's disease exhibiting freezing of gait.

Combined plantar pressure and vibratory stimulation has been shown to decrease freezing of gait (FOG) episodes and improve spatiotemporal gait parameters compared to single stimulation in Parkinson's disease (PD) patients with FOG. However, the effect of combined plantar stimulations on plantar pressure analysis has never been explored. Forty PD patients with frequent FOG were allocated to either FOG shoes embedded with a 100 Hz vibratory stimulation at the Achilles tendons and a soft thickened silicone pad at the hallux and sole, or sham shoes with a non-working vibratory motor and a flat non-pressure silicone pad (20 patients per arm) while seated for 96 s. The objective gait and plantar pressure analysis were measured immediately after the stimulation. Outcomes included the normalized percentage of changes in percent FOG (%FOG) and plantar pressure in the heel-strike and push-off phase that were compared between pre- and post-stimulations. The FOG shoes group showed significantly decreased %FOG (81.5 ± 28.9% vs. 6.8 ± 22.1%, p < 0.001), plantar pressure in the heel-strike (47.8 ± 43.7% vs. 4.3 ± 9.8%, p < 0.001), plantar pressure in the push-off (57.7 ± 59.6% vs. 6.2 ± 11.6%, p < 0.001), force time integral (FTI) (40.9 ± 32.5% vs. 6.6 ± 17.3%, p < 0.001), and decreased heel contact time (19.3 ± 12.3% vs. 22.7 ± 32.5%, p < 0.001) when compared to the sham group. There was a strong negative correlation between %FOG and peak plantar pressure (r = -0.440, p = 0.005), plantar pressure in the heel-strike (r = -0.847, p < 0.001). Our study demonstrated that the FOG shoe could decrease FOG episodes by improving the heel-strike pressure, toe push-off and normalized heel-to-toe plantar pressure, suggesting that modification inputs from the peripheral sensory systems might significant improvement in FOG in PD.

Reliability and validity of three portable devices for quantifying spatiotemporal parameters in runners of different athletic abilities during treadmill running

ABSTRACT This study aimed to evaluate the validity and reliability of a wearable device and a phone application for measuring spatiotemporal parameters and their relationship with running economy (RE) by comparing them with photocell data in runners of different abilities. Twenty-three male runners were divided into well-trained and recreational groups and performed a 4-min running bout at 17 and 13 km·h−1 respectively. During the bout, were measured the spatiotemporal parameters with three devices (Stryd, Runmatic, and Optojump) and RE with a gas analyser. Pearson correlation showed perfect relationships for stride frequency (SF) and stride length (SL) between the devices, and moderate for flight time (FT) and contact time (CT). There were no correlations between the spatiotemporal parameters and RE measurements. Coefficient of variation was ~ 5% in all devices for CT, SF, and SL, and higher for FT (15–24%). CT was underestimated (15–16% with Runmatic and Stryd, respectively) and FT was overestimated (36–40%) compared to Optojump. Bland-Altman plots revealed that Runmatic could be a more accurate system than Stryd. In conclusion, both devices were valid tools for measuring spatiotemporal parameters during running at RE speed. Runmatic was more valid and reliable in comparison with Stryd. In addition, at lower running speeds the devices showed less reliability.

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.

Center of mass motion and plantar pressure distribution during walking in overweight individuals

BackgroundGait imbalance has been reported in overweight individuals and could further impair their mobility and quality of life. As the feet are the most distal part of the body and sensitively interface with external surroundings, evaluating the plantar pressure distribution can provide critical insights into their roles in regulating gait balance control. Therefore, the purpose of this study was to evaluate the effect of body weight and different gait speeds on the plantar pressure distribution and whole-body center of mass (COM) motion during walking. MethodsEleven overweight individuals (OB) and 13 non-overweight individuals (NB) walked on a 10-meter walkway at three speed conditions (preferred, 80% and 120% of preferred speed). Gait balance was quantified by the mediolateral COM sway. Plantar pressure data were obtained using wireless pressure-sensing insoles that were inserted into a pair of running shoes. Analysis of variance models were used to examine the effect of body size, gait speeds, or their interactions on peak mediolateral COM and peak plantar pressure during walking. ResultsSignificant group effects of peak plantar pressure under the lateral forefoot (P = 0.03), lateral midfoot (P = 0.02), and medial heel (P = 0.02) were observed. However, the mediolateral COM motion and spatiotemporal gait parameters only revealed significant speed effects. SignificanceFindings from this study indicated that overweight individuals exhibited increased plantar pressure under the lateral aspect of the foot, particularly during the late stance phase of walking, in an effort to maintain a comparable mediolateral COM motion to that of non-overweight individuals. Such elevated pressure in overweight individuals may potentially increase the risk of musculoskeletal pathology in the long term. The identified patterns are noteworthy as they have practical implications for designing targeted interventions and improving the overall health of individuals with a high BMI.

Accuracy validation of a wearable IMU-based gait analysis in healthy female

ObjectiveThe aim of this study was to assess the accuracy and test-retest reliability of a wearable inertial measurement unit (IMU) system for gait analysis in healthy female compared to a gold-standard optoelectronic motion capture (OMC) system.MethodsIn our study, we collected data from 5 healthy young females. Participants were attached with markers from both the OMC system and the IMU system simultaneously. Data was collected when participants walked on a 7 m walking path. Each participant performed 50 repetitions of walking on the path. To ensure the collection of complete gait cycle data, a gait cycle was considered valid only if the participant passed through the center of the walking path at the same time that the OMC system detected a valid marker signal. As a result, 5 gait cycles that met the standards of the OMC system were included in the final analysis. The stride length, cadence, velocity, stance phase and swing phase of the spatio-temporal parameters were included in the analysis. A generalized linear mixture model was used to assess the repeatability of the two systems. The Wilcoxon rank-sum test for continuous variables was used to compare the mean differences between the two systems. For evaluating the reliability of the IMU system, we calculated the Intra-class Correlation Coefficient (ICC). Additionally, Bland-Altman plots were used to compare the levels of agreement between the two systems.ResultsThe measurements of Spatio-temporal parameters, including the stance phase (P = 0.78, 0.13, L-R), swing phase (P = 0.78, 0.13, L-R), velocity (P = 0.14, 0.13, L-R), cadence (P = 0.53, 0.22, L-R), stride length (P = 0.05, 0.19, L-R), by the IMU system and OMC system were similar. Which suggested that IMU and OMC systems could be used interchangeably for gait measurements. The intra-rater reliability showed an excellent correlation for the stance phase, swing phase, velocity and cadence (Intraclass Correlation Coefficient, ICC > 0.9) for both systems. However, the correlation of stride length was poor (ICC = 0.36, P = 0.34, L) to medium (ICC = 0.56, P = 0.22, R). Additionally, the measurements of IMU systems were repeatable.ConclusionsThe results of IMU system and OMC system shown good repeatability. Wearable IMU system could analyze gait data accurately. In particular, the measurement of stance phase, swing phase, velocity and cadence showed excellent reliability. IMU system provided an alternative measurement to OMC for gait analysis. However, the measurement of stride length by IMU needs further consideration.

Ab. No. 62 Spatiotemporal Parameters of Gait Symmetry and Asymmetry in Normal Healthy Individuals

Introduction: Human gait, or the way people walk, is a complicated motor activity involving coordinated movements of different parts of the body. It is crucial in everyday activities and is influenced by a variety of factors such as age, health status, and musculoskeletal and neurological disorders. Understanding the many characteristics of gait, especially symmetry and asymmetry, is critical for getting insights into normal locomotion patterns and recognizing potential deviations associated with certain conditions. The objective of the current study is to determine the of spatiotemporal parameters of gait symmetry and asymmetry in individuals aged 20 to 79. Methods: A Cross-sectional observational study was done on 72 healthy adults (20 to 79 years) using convenience sampling. Subjects were divided into six groups according to the decade having 12 subjects in each group. Gait analysis was done using a portable single layer pressure sensitive walkway (Gait Rite). Subjects were asked to walk three times on the walkway at their preferred speed and data was collected. Result: A total of 9 spatiotemporal parameters were studied for evaluating asymmetry of these 7 spatiotemporal parameters were consistently asymmetry across the age groups and two parameters were consistently symmetrical across the age groups. Conclusion: The study establishes spatiotemporal parameters of gait symmetry and asymmetry across the age groups in normal ambulatory individuals. Implications: The identification of consistent asymmetry and symmetry in spatiotemporal gait parameters across age groups provides valuable insights for understanding the nuances of normal locomotion, aiding in the characterization of age-related variations, and serving as a foundation for detecting potential deviations associated with various conditions.

Comparison between patients with COPD and healthy subjects on spatiotemporal, moment and kinematic parameters: A quasi-experimental study.

Chronic obstructive respiratory diseases (COPD) not only cause damage to the respiratory system as well as the heart and blood vessels of the patient but also have a direct effect on the condition of the musculoskeletal system. The risk of falling is increasing due to dysfunction of the joints as well as aging, which occurs frequently in this population. Gait deficits are known as an important risk factor for falls. This research aimed to investigate the gait of COPD patients compared to healthy people to gain a better understanding of the reasons for falls. Twenty patients with COPD and 20 age and BMI-matched healthy individuals were included in this study. Sixteen markers were applied to the lower body of the subjects. Spatio-temporal, kinematic, and maximum moment parameters were measured in different phases in three lower body joints, including the hip, knee, and ankle. The results showed that all spatio-temporal parameters in patients were significantly lower than in healthy people. The ankle angle in the sagittal plane at initial contact was significantly difference (p = 0.03). As well as, in the frontal plane the hip angle in the mid-stance showed a significant difference (p = 0.02). There was also a significant difference in maximum hip moment in the sagittal plane between the two groups (p = 0.01). The larger hip angle of the patients can be related to the balance problems in the mediolateral direction. The moment showed a significant difference in the hip joint. Since the hip muscles are directly in a synergistic relationship with the trunk muscles, it seems the performance of these muscles is likely to be seriously damaged due to respiratory diseases.

The effect of single and dual task on spatiotemporal gait parameters in children with spastic cerebral palsy

Abstract Aim: Children can walk in clinical settings but have difficulty walking in schools, parks, and outdoor activity playgrounds. Most environmental distractors, namely noise from the background, and diverting visual and aural stimuli may be a source of this lack of carryover from indoor to outside settings, which is why they are unable to carry-out their activities of daily living successfully and precisely. This study was aimed to assess the impact of dual task activities on spatiotemporal aspects of gait in children with spastic cerebral palsy (CP). Materials and Methods: After screening and informed consent, participants were asked to walk on a 10-m walkway while performing a dual task (walking with visual, auditory recognition, and backward counting). Three trials of each task were obtained and spatiotemporal parameters, including speed, step length, step width, and stride length, cadence) were measured. Result: Spatiotemporal parameters, such as speed, step width, step length, right stride length, and cadence, showed significant difference with dual-task walking compared with normal walking. Conclusion: The results suggest that dual-task training should receive more attention in clinical evaluations, as well as therapy strategies for children with spastic CP.

Clinical Feasibility of a Markerless Gait Analysis System.

The gait analysis method that has been used in clinical practice to date is an optical tracking system (OTS) using a marker, but a markerless gait analysis (MGA) system is being developed because of the expensive cost and complicated examination of the OTS. To apply this MGA clinically, a comparative study of the MGA and OTS methods is necessary. The purpose of this study was to evaluate the compatibility between the OTS and the MGA methods and to evaluate the usefulness of the MGA system in actual clinical settings. From March 2021 to August 2021, 14 patients underwent gait analysis using the OTS and MGA system, and the spatiotemporal parameters and kinematic results obtained by the 2 methods were compared. To evaluate the practicality of the MGA system in an actual clinical setting, MGA was performed on 14 symptomatic children with idiopathic toe walking, who had been treated with a corrective cast, and the pre-cast and post-cast results were compared. For the OTS, the Motion Analysis Eagle system was used, and for MGA, DH Walk was used. The spatiotemporal parameters showed no significant difference between the OTS and MGA system. The joint angle graphs of the kinematics along the sagittal plane showed similar shapes as a whole, with particularly high correlations in the hip and knee (pelvis: 29.4%, hip joint: 96.7%, knee joint: 94.9%, and ankle joint: 68.5%). A quantified comparison using the CORrelation and Analysis (CORA) score also showed high similarity between the 2 methods. The MGA results of pre-cast application and post-cast removal for children with idiopathic toe walking showed a statistically significant improvement in ankle dorsiflexion after treatment (p < 0.001). MGA showed a good correlation with the conventional OTS in terms of spatiotemporal parameters and kinematics. We demonstrated that ankle sagittal kinematics improved after treatment by corrective cast in children with idiopathic toe walking using the MGA method. Thus, after the improvement of a few limitations, the MGA system may soon be able to be clinically applied.

Does the Chêneau brace affect gait pattern and body balance of adolescents with idiopathic scoliosis?

Purpose This study evaluated changes in selected spatiotemporal and kinematic gait parameters and balance in girls with Adolescent idiopathic scoliosis (AIS) with and without the Chêneau brace. Methods 15 subjects with scoliosis wearing the Chêneau brace and an equal comparative control group underwent objective gait analysis with the 3D BTS motion caption system. Balance assessment was done with the Kistler platform. The analysis was performed at comparison of gait and balance parameters in patients with scoliosis in two conditions: with and without the Chêneau brace during the study. Results Statistically significant differences occurred in many spatiotemporal and kinematic parameters both for the AIS group with and without the Chêneau brace and in the AIS group with and without the Chêneau brace as compared to the control group. When comparing adolescents with AIS with and without the Chêneau brace, statistically significant differences were noted in the COP-X amplitude and in the path length in trials with closed eyes. Compared to the control group the following differences were statistically significant: the value of the the COP-Y amplitude during the trial with closed eyes, both with and without the Chêneau brace, and the Equivalent area of the COP during the trial with closed eyes with the Chêneau brace. Conclusions The Chêneau brace in patients with juvenile idiopathic scoliosis affects the level of selected balance and gait parameters.

The Traffic Congestion Prediction Using Machine Learning

Around the world, traffic congestion is a major issue that affects everyday commutes, economic activity, and the sustainability of the environment. The goal of this research project is to use machine learning approaches to address the problem of traffic congestion. Through the utilization of an extensive dataset that encompasses several spatiotemporal parameters, including date, time, weather, and holiday indicators, the research creates predictive models that enable precise forecasting of traffic congestion levels. In order to determine how well machine learning predicts congestion dynamics, the research uses multiple regression methods, such as MLP Regressor, Stacking Regressor, and SVR. Historical traffic volume data is used to train and assess the models, making it possible to identify the main variables impacting patterns of congestion. The findings demonstrate how weather, time of day, and holidays all have a major impact on traffic congestion. Transportation authorities and urban planners may enhance overall urban mobility, optimise infrastructure utilisation, and regulate traffic flows proactively by leveraging the predictive capabilities of machine learning models. This work advances intelligent transport systems by offering a strong framework for anticipating and controlling traffic congestion. The results highlight the significance of utilising data-driven methodologies to tackle intricate urban issues, ultimately cultivating more effective and sustainable urban settings.

Comparison of Foot Kinematics Between Normal Arch and Flexible Flatfoot Using the Oxford Foot Model: A Matched Case-Control Study.

Symptomatic flexible flatfoot causes alterations in gait, but exactly how this condition affects the intersegmental motion of the foot during the gait cycle remains unclear. Previous studies have examined the kinematics, yielding inconsistent findings. Therefore, the objective of this study was to investigate how flexible flatfoot deformity, defined as Johnson and Strom classification staging II, affects the intersegmental motion of the foot during fast walking based on a comparison with the matched control group. Eleven participants with symptomatic flexible flatfoot and 11 healthy matched control participants were recruited using a foot screening protocol incorporated through a foot physical examinations and radiographic measurements. All demographic characteristics exhibited comparable profiles between the groups. During controlled walking, kinematic outcomes pertaining to the hallux, hindfoot, forefoot, and tibia were collected using the multisegmental Oxford Foot Model. All spatiotemporal parameters were comparable between the groups. In comparison to the control group, individuals with symptomatic flexible flatfoot demonstrated increased hallux valgus and plantarflexion, increased forefoot abduction, heightened hindfoot eversion, and internal rotation. Notably, no significant major differences were observed in the tibia motion segment. Further, significant correlations were identified between static foot measurements and the extent of the maximum deviation observed during dynamic kinematic assessments. Compared with age- and gender-matched controls, participants with symptomatic flexible flatfoot exhibited significant gait pattern deviations. A significant correlation also exists between static foot deformity measurements and dynamic kinematic deviations. Collectively, these findings have implications for developing targeted therapeutic interventions to address flexible flatfoot. Level III, diagnostic study.

Global Sagittal Angle and T9-tilt seem to be the most clinically and functionally relevant global alignment parameters in patients with Adult Spinal Deformity

IntroductionRadiographic analysis is necessary for the assessment and the surgical planning in adults with spinal deformity (ASD). Restoration of global alignment is key to improving patient's quality of life. However, the large number of existing global alignment parameters can be confusing for surgeons. Research questionTo determine the most clinically and functionally relevant global alignment parameters in ASD. Material and methodsASD and controls underwent full body biplanar X-ray to calculate global alignment parameters: odontoid to hip axis angle (OD-HA), global sagittal angle (GSA), global tilt (GT), SVA, center of auditory meatus to hip axis (CAM-HA), SSA, T1-tilt and T9-tilt. All subjects filled HRQoL questionnaires: ODI, SF-36, VAS for pain and BDI (Beck's Depression Inventory). 3D gait analysis was performed to calculate kinematic and spatio-temporal parameters. A machine learning model predicted gait parameters and HRQoL scores from global alignment parameters. Results124 primary ASD and 47 controls were enrolled. T9 tilt predicted the most BDI (31%), hip flexion/extension during gait (36%), and double support time (39%). GSA predicted the most ODI (26%), thorax flexion/extension during gait (33%), and cadence (36%). Discussion and conclusionAmong all global alignment parameters, GSA, evaluating both trunk shift and knee flexion, and T9 tilt, evaluating the shift of the center of mass, were the best predictors for most of HRQoL scores and gait kinematics. Therefore, we recommend using GSA and T9 tilt in clinical practice when evaluating ASD because they represent the most quality of life and functional kinematic of these patients.

Improving Walking Energy Efficiency in Transtibial Amputees Through the Integration of a Low-Power Actuator in an ESAR Foot.

Reducing energy consumption during walking is a critical goal for transtibial amputees. The study presents the evaluation of a semi-active prosthesis with five transtibial amputees. The prosthesis has a low-power actuator integrated in parallel into an energy-storing-and-releasing foot. The actuator is controlled to compress the foot during the stance phase, supplementing the natural compression due to the user's dynamic interaction with the ground, particularly during the ankle dorsiflexion phase, and to release the energy stored in the foot during the push-off phase, to enhance propulsion. The control strategy is adaptive to the user's gait patterns and speed. The clinical protocol to evaluate the system included treadmill and overground walking tasks. The results showed that walking with the semi-active prosthesis reduced the Physiological Cost Index of transtibial amputees by up to 16% compared to walking using the subjects' proprietary prosthesis. No significant alterations were observed in the spatiotemporal gait parameters of the participants, indicating the module's compatibility with users' natural walking patterns. These findings highlight the potential of the mechatronic actuator in effectively reducing energy expenditure during walking for transtibial amputees. The proposed prosthesis may bring a positive impact on the quality of life, mobility, and functional performance of individuals with transtibial amputation.

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

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

Modeling the Heterogeneity of Post-Stroke Gait Control in Free-Living Environments Using a Personalized Causal Network.

Post-stroke gait control is a complex, often fail to account for the heterogeneity and continuity of gait in existing gait models. Precisely evaluating gait speed adjustability and gait instability in free-living environments is important to understand how individuals with post-stroke gait dysfunction approach diverse environments and contexts. This study aimed to explore individual causal interactions in the free-living gait control of persons with stroke. To this end, fifty persons with stroke wore an accelerometer on the fifth lumbar vertebra (L5) for 24 h in a free-living environment. Individually directed acyclic graphs (DAGs) were generated based on the spatiotemporal gait parameters at contemporaneous and temporal points calculated from the acceleration data. Spectral clustering and Bayesian model comparison were used to characterize the DAGs. Finally, the DAG patterns were interpreted via Bayesian logistic analysis. Spectral clustering identified three optimal clusters from the DAGs. Cluster 1 included persons with moderate stroke who showed high gait asymmetry and gait instability and primarily adjusted gait speed based on cadence. Cluster 2 included individuals with mild stroke who primarily adjusted their gait speed based on step length. Cluster 3 comprised individuals with mild stroke who primarily adjusted their gait speed based on both step length and cadence. These three clusters could be accurately classified based on four variables: Ashman's D for step velocity, Fugl-Meyer Assessment, step time asymmetry, and step length. The diverse DAG patterns of gait control identified suggest the heterogeneity of gait patterns and the functional diversity of persons with stroke. Understanding the theoretical interactions between gait functions will provide a foundation for highly tailored rehabilitation.

Cognitive-motor interference during walking with modified leg mechanics: a dual-task walking study.

The use of mobile exoskeletons as assistive walking devices has the potential to affect the biomechanics of the musculoskeletal system due to their weight and restricted range of motion. This may result in physical and cognitive load for the user. Understanding how lower extremity loading affects cognitive-motor interference is crucial for the design of wearable devices, including powered exoskeletons, and the development of effective training interventions. This study aims to examine the effects of modified leg mechanics on cognitive-motor interference in dual-task walking. Gait variability, as an indicator of motor control, was analyzed to investigate its relation to cognitive task difficulty and to determine whether lower extremity loading modifies this relationship. Additionally, the impact on the gait pattern, as represented by the mean values of spatio-temporal gait parameters were investigated. Fifteen healthy young adults walked on a treadmill with and without weight cuffs bilaterally attached to their thighs and shanks while performing a visual-verbal Stroop test (simple task) and a serial subtraction task (difficult task). Dependent variables include mean values and variability (coefficients of variation) of step length, step width, stride time and double support time. Additionally, secondary task performance as correct response rates and perceived workload were assessed. Double support time variability decreased during dual-task walking, but not during walking with modified leg mechanics while performing the difficult secondary task. Walking with modified leg mechanics resulted in increased gait variability compared to normal walking, regardless of cognitive load. During walking with modified leg mechanics, step length, step width, and stride time increased, while double support time decreased. The secondary tasks did not affect the gait pattern. The interplay between an external focus of attention and competition for attentional resources may influence the variability of double support time. The findings suggest that walking with modified leg mechanics could increase cognitive-motor interference for healthy young adults in demanding dual-task situations. Therefore, it is important to analyze the underlying mechanisms of cognitive-motor interference in the context of human-exoskeleton interaction.