Spatiotemporal Parameters Research Articles

Gait Assessment Using Smartphone Applications in Older Adults: A Scoping Review.

Spatiotemporal parameters such as gait velocity and stride length are simple indicators of functional status and can be used to predict major adverse outcomes in older adults. A smartphone can be used for gait analysis by providing spatiotemporal parameters useful for improving the diagnosis and rehabilitation processes in frail people. The aim of this study was to review articles published in the last 20 years (from 2004 to 2024) concerning the application of smartphones to assess the spatiotemporal parameters of gait in older adults. This systematic review was performed in line with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), and original articles were identified by searching seven electronic databases: SciVerse (ScienceDirect), Excerpta Medica Database (EMBASE), Medline, Scopus, PubMed, Web of Science and the Cochrane Library. Studies were rigorously screened using the inclusion criteria of smartphones and mobile apps, older adults and spatiotemporal gait parameters, and results were narratively synthesized. Seventy-three articles were initially identified while searching the scientific literature regarding this topic. Eleven articles were selected and included in this review. Analysis of these studies covered information about gait assessment using mobile apps recorded in 723 older adults and 164 control cases. Analysis of data related to the application of smartphones to assess spatiotemporal parameters of gait in older adults showed moderate-to-excellent test-retest reliability and validity (ICCs around 0.9) of gait speed, the most common parameter reported. Additionally, gait speeds recorded with mobile apps showed excellent agreement when compared to gold standard systems. Smartphones and mobile apps are useful, non-invasive, low-cost and objective tools that are being extensively used to perform gait analysis in older adults. Smartphones and mobile apps can reliably identify spatiotemporal parameters related to adverse outcomes, such as a slow gait speed, as predictors and outcomes in clinical practice and research involving older adults.

Experimental Comparison between 4D Stereophotogrammetry and Inertial Measurement Unit Systems for Gait Spatiotemporal Parameters and Joint Kinematics.

(1) Background: Traditional gait assessment methods have limitations like time-consuming procedures, the requirement of skilled personnel, soft tissue artifacts, and high costs. Various 3D time scanning techniques are emerging to overcome these issues. This study compares a 3D temporal scanning system (Move4D) with an inertial motion capture system (Xsens) to evaluate their reliability and accuracy in assessing gait spatiotemporal parameters and joint kinematics. (2) Methods: This study included 13 healthy people and one hemiplegic patient, and it examined stance time, swing time, cycle time, and stride length. Statistical analysis included paired samples t-test, Bland-Altman plot, and the intraclass correlation coefficient (ICC). (3) Results: A high degree of agreement and no significant difference (p > 0.05) between the two measurement systems have been found for stance time, swing time, and cycle time. Evaluation of stride length shows a significant difference (p < 0.05) between Xsens and Move4D. The highest root-mean-square error (RMSE) was found in hip flexion/extension (RMSE = 10.99°); (4) Conclusions: The present work demonstrated that the system Move4D can estimate gait spatiotemporal parameters (gait phases duration and cycle time) and joint angles with reliability and accuracy comparable to Xsens. This study allows further innovative research using 4D (3D over time) scanning for quantitative gait assessment in clinical practice.

Enhanced Air Quality Prediction through Spatio-temporal Feature Sxtraction and Fusion: A Self-tuning Hybrid Approach with GCN and GRU

Accurate prediction of air quality change is essential for air pollution control and human daily mobility. Due to the strong spatial and temporal correlation of air quality changes, existing air quality prediction methods often face the problem of low prediction accuracy due to insufficient extraction of spatio-temporal features. In this paper, we proposed a self-tuning spatio-temporal neural network (ST2NN) to enhance air quality prediction. ST2NN model consisted of four modules. First, ST2NN model constructed a temporal feature extraction module and a spatial feature extraction module based on gated recurrent unit (GRU) and graph convolutional neural network (GCN), respectively, and the two feature extraction modules adopted a parallel structure, which could effectively extract the spatio-temporal features in data. Additionally, ST2NN model constructed a feature fusion module based on gating mechanism to delineate the contribution of spatio-temporal features to the predicted values. Further, ST2NN model constructed a Hyperband hyperparameter optimization module based on Hyperband optimization algorithm to automatically adjust the network hyperparameters. The structure of ST2NN model endowed it with excellent spatio-temporal feature extraction and parameter adaptability. ST2NN model was evaluated and compared with existing models, including convolutional long short-term memory neural network (ConvLSTM), GRU, combined convolutional neural network and long short-term memory neural network (CNN-LSTM), and GCN-LSTM for air quality index (AQI) prediction using data from twelve monitoring stations in Beijing, China. Across all four evaluation indexes, ST2NN model outperformed the comparative models, improving prediction accuracy by 0.51%-10.18% (measured using R2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${R}^{2}$$\\end{document}). From the experimental results, it can be seen that ST2NN model constructed from the perspective of spatio-temporal feature extraction has better prediction performance compared with the existing air quality prediction model, which provides a new method for air quality prediction and has certain application value.

Knee sleeves improve gait symmetry during fast walking in older adults.

Knee sleeves are commonly used to address knee-related concerns, particularly in older individuals. Although previous studies have demonstrated their efficacy in improving gait and functional outcomes in knees with pathological conditions, the effectiveness of knee sleeves for improving gait characteristics in healthy older adults remains unclear. The harmonic ratio (HR), an index for assessing gait symmetry commonly used to discriminate between individuals with different functional levels, can be used to detect alterations in gait characteristics. This study investigated the effects of knee sleeves on gait symmetry in healthy older adults. Sixteen healthy community-dwelling older adults walked barefoot with and without knee sleeves at normal and fast speeds. Gait symmetry indices (HR and improved HR [iHR]) and spatiotemporal gait parameters were compared under different conditions. A significant interaction between knee condition and walking speed was observed for mean iHR in the anteroposterior direction (p = 0.006). A significant simple main effect of knee condition was found during fast walking, with a larger iHR with knee sleeves than without (p = 0.002). In the condition without knee sleeves, the iHR was significantly lower during fast walking than during normal walking (p = 0.035). Furthermore, a significant main effect of knee condition was observed for the variability of iHR in the anteroposterior direction, with a smaller variability when walking with knee sleeves than when walking without (p = 0.006). These results suggest that knee sleeves may enhance gait symmetry along the anteroposterior direction, particularly during fast walking, where symmetry disruption is more likely than walking at a comfortable pace. A significant reduction in gait symmetry variability also suggests a stabilizing effect on gait dynamics. These findings provide the first evidence supporting the efficacy of knee sleeves for improving gait symmetry. The use of knee sleeves could be a valuable option for restoring disrupted gait symmetry during fast walking, with potential implications for reducing the risk of falls.

Analysis of kinematic changes of hip joint after total hip arthroplasty

To analyze the kinematic changes of the hip joint after total hip arthroplasty (THA) through three-dimensional gait analysis. Patients with hip joint diseases admitted between October 2022 and June 2023 were selected as the subjects. The patients who met the selective criteria were finally included in the THA group. The healthy volunteers matched with the THA group in the same age were included as the control group. Baseline data including age, gender, body mass index (BMI), and laterality were compared between the two groups. The Harris hip score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were recorded preoperatively and at last follow-up in the THA group. Three-dimensional motion capture system was utilized to collect spatiotemporal parameters and kinematic data during walking, including stride length, cadence, and maximum/minimum values, range of motion (ROM) in hip joint abduction/adduction, external/internal rotation, and flexion/extension, as well as gait scores. Differences between the two groups were analyzed. Additionally, the correlation between gait scores and postoperative HHS and WOMAC scores were analyzed in the THA group. Finally, the kinematic data of each degree of freedom (DOF) were fitted into a gait diagram, and the dynamic changes of the 3-DOF of the hip joint during the gait cycle were quantitatively analyzed. There was no significant difference in gender, age, laterality, and BMI between the two groups ( n=20, P>0.05). The mean follow-up time in the THA group was 9.9 months (range, 6-12 months). The HHS and WOMAC scores at last follow-up in the THA group showed significant improvement when compared with preoperative scores ( P<0.05). Gait scores were positively correlated with postoperative HHS score ( r=0.585, P=0.007) and negatively correlated with WOMAC score ( r=-0.619, P=0.004). There was no significant difference in stride length and cadence between the THA and control groups ( P>0.05), but gait score was significantly lower in the THA group than in the control group ( P<0.05). There was no significant difference in maximum and minimum values of flexion/extension, external/internal rotation, and abduction/adduction between the two groups ( P>0.05); however, ROM in the THA group was significantly lower than that in the control group ( P<0.05). There were significant differences between the two groups of flexion/extension in multiple phases of the gait cycle ( P<0.05). Early post-THA hip joint kinematics exhibit relative adduction, external rotation, and flexion during the gait cycle compared to normal individuals, with incomplete recovery of kinematic parameters in three degrees of freedom. Significant differences in flexion are observed at multiple phases of the gait cycle compared to normal individuals.

Impacts of asymmetric hip rotation angle on gait biomechanics in patients with knee osteoarthritis

BackgroundKnee Osteoarthritis (OA) is a highly prevalent age-related disease. The altered kinematic pattern of the knee joint as well as the adjacent joints affects to progression of knee OA. However, there is a lack of research on how asymmetry of the hip rotation angle affects the gait pattern in knee OA patients.Research questionWhat are the impacts of asymmetric hip rotation range on gait biomechanical characteristics and do the gait patterns differ between patients with knee OA and healthy elderly people?MethodsTwenty-nine female patients with knee OA and 15 healthy female elders as control group were enrolled in this study. The spatiotemporal parameters, kinematic and kinetic data during walking were measured using a three-dimensional motion capture system. The differences between knee OA and control group were analyzed using an independent t-test.ResultsThe knee OA group exhibited a significant reduction in hip internal rotation range and internal/external rotation ratio on more affected side (p < 0.05). Significant differences were found in spatiotemporal parameters except to the step width. Significant reductions were also found in kinematic parameters (pelvic lateral tilt range, sagittal angle ranges in hip, knee and ankle, knee adduction mean angle). There were also significant differences in vertical ground reaction force and knee adduction moment (p < 0.05).ConclusionsKnee OA patients have asymmetric hip rotation ranges. Especially limited hip internal rotation could lead to the reduction of pelvic lateral tilt, which may cause greater knee joint loading. Therefore, it is necessary to pay attention to recovery of hip rotation after knee surgery.

Lower limb kinematic changes during gait after hallux valgus surgery: A prospective observational study

BackgroundPatients with hallux valgus are known to alter lower limb joint kinematics during gait. However, little information is available about gait changes following hallux valgus surgery. We aimed to longitudinally investigate lower limb kinematic changes at the mid and terminal stances of gait after hallux valgus surgery. MethodsThis prospective observational study included 11 female patients (17 feet), who underwent first metatarsal osteotomy. Gait analyses were performed preoperatively and 1- and 2-year postoperatively using a three-dimensional motion capture system. Toe-out angle, ankle, knee, and hip joint angles during gait were calculated from the recorded data. The spatiotemporal parameters and these angles at the mid and terminal stances of gait were statistically compared between preoperative and postoperative periods. FindingsAll spatiotemporal parameters remained unchanged postoperatively. The toe-out angle was significantly greater at 1- and 2-year postoperatively. The ankle pronation angle, the knee abduction angle, and the hip adduction angle at the mid and terminal stances of gait were smaller postoperatively compared to the preoperative. These angular changes showed a similar trend at 1 and 2 years postoperatively. However, the postoperative changes of the sagittal joint angles were relatively small. InterpretationHallux valgus surgery can affect the toe-out angle and the lower limb coronal kinematics at the mid and terminal stances of gait in patients with hallux valgus. However, surgical correction of hallux valgus deformity did not directly improve the gait characteristics in patients with hallux valgus.

Concurrent Validity Evidence for Pressure-Sensing Walkways Measuring Spatiotemporal Features of Gait: A Systematic Review and Meta-Analysis.

Technologies that capture and analyze movement patterns for diagnostic or therapeutic purposes are a major locus of innovation in the United States. Several studies have evaluated their measurement properties in different conditions with variable findings. To date, the authors are not aware of any systematic review of studies conducted to assess the concurrent validity of pressure-sensing walkway technologies. The results of such an analysis could establish the body of evidence needed to confidently use these systems as reference or gold-standard systems when validating novel tools or measures. A comprehensive search of electronic databases including MEDLINE, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed. The initial search yielded 7670 papers. After removing duplicates and applying study inclusion/exclusion criteria, 11 papers were included in the systematic review with 10 included in a meta-analysis. There were 25 spatial and temporal gait parameters extracted from the included studies. The results showed there was not a significant bias for nearly all spatiotemporal gait parameters when the walkway system was compared to the reference systems. The findings from this analysis should provide confidence in using the walkway systems as reference systems in future studies to support the evaluation and validation of novel technologies deriving gait parameters.

Investigating spatiotemporal and kinematic gait parameters in individuals with Parkinson's disease with a history of freezing of gait and exploring the effects of dopaminergic therapy on freezing of gait subtypes.

Freezing of Gait (FOG) is a prevalent and debilitating symptom in idiopathic Parkinson's disease (PD). This study evaluated spatiotemporal and kinematic gait parameters in individuals with PD with a history of FOG and explored the effects of dopaminergic therapy on FOG subtypes. One hundred and nine individuals with PD underwent clinical assessments and quantitative biomechanical measures during walking cycles before and after dopaminergic therapy. Individuals with FOG were classified into levodopa-responsive and levodopa-unresponsive groups. Individuals with FOG displayed longer disease duration and higher Unified Parkinson's Disease Rating Scale (UPDRS) II, III, IV scores, and total scores and levodopa equivalent dose, than those without FOG (all p < 0.0001). Following propensity score matching of 15 pairs based on UPDRS total score and disease duration during the off-medication state, the analysis comparing the FOG and non-FOG groups revealed no significant differences in spatiotemporal and kinematic parameters. In 39 cases of FOG, dopaminergic therapy improved gait performance in individuals with PD, enhancing spatiotemporal parameters (speed, stride length, step length, step variability) and kinematic parameters (shoulder and elbow flexion/extension range of motion (ROM), pelvic rotation, and hip abduction/adduction ROM) regardless of FOG responsiveness to dopaminergic therapy. A significant difference in trunk sway ROM (p = 0.029) remained before and after dopaminergic therapy, even after adjusting for disease duration and clinical severity. Dopaminergic therapy had varying effects on PD with FOG, improving several spatiotemporal and kinematic gait parameters but being less effective in levodopa-unresponsive cases. Quantitative biomechanical measures offer detailed insights into gait performance, aiding personalized fall risk assessment and guiding individualized rehabilitation programs.

Comparison of postoperative gait parameters after total ankle arthroplasty and ankle fusion: A systematic review.

Ankle pathology, such as severe arthritis, often necessitates surgical intervention to restore mobility and alleviate pain. Two commonly performed procedures for end-stage ankle disease are ankle fusion (AF) and total ankle arthroplasty (TAA). This review aims to compare the impact of AF and TAA on postoperative gait parameters. An extensive search in PubMed, Scopus, and Web of Science electronic databases was conducted with the use of the keywords ("ankle arthrodesis" OR "ankle fusion") AND ("ankle replacement" OR "ankle arthroplasty") AND "gait." Clinical studies in terms of postoperative gait parameters were included in this review. At least one of the following gait parameters, included in gait analysis, should be researched: spatiotemporal variables and joint kinematics and kinetics. An initial search revealed 221 studies. After the removal of duplicates and screening of titles,10 studies (7 prospective and 3 retrospective case series) were included for qualitative analysis. In the majority of studies, there is no significant difference in spatiotemporal parameters, such as walking speed, cadence, stance duration, step length, and stride length among AF and TAA patients. Postoperative sagittal ankle ROM, mainly maximum ankle dorsiflexion angle is significantly higher in TAA patients, while results concerning hip and knee ROM are variable. The comparison of AF and TAA in terms of postoperative gait parameters has shown variable results. In the majority of studies, there is no significant difference in spatiotemporal and kinetic parameters among AF and TAA patients. Further high-quality prospective studies are needed to fully elucidate the comparison of postoperative gait parameters.

The Immediate Effect of the Novel Hybrid Passive Spring Damper Ankle-Foot Orthosis on Spatiotemporal Parameters of Walking in Patients with Multiple Sclerosis

ABSTRACT Introduction Patients with multiple sclerosis (PwMS) experience damage to their central nervous system, which can lead to unilateral or bilateral drop foot. The presently utilized ankle-foot orthoses (AFOs) for PwMS have exhibited limited clinical efficacy. Objective This current study evaluated the immediate effects of the Novel Hybrid Passive Spring Damper Ankle-Foot Orthosis (HPSDAFO) on walking in PwMS. Study design A cohort trial. Methods Twelve PwMS suffering of unilateral drop foot took part in this study. They were given the novel HPSDAFO and underwent kinematic assessment including walking along a 10-m walkway at a self-selected speed, both with and without the HPSDAFO. Results The novel HPSDAFO device significantly changed gait parameters of ankle range of motion, single limb support duration, and step and stride length of the affected side (P &lt; 0001). Furthermore, the device also improved the symmetry index and resulted in increased walking speed and cadence. Conclusions The application of the novel HPSDAFO on the affected side of PwMS resulted in a notable enhancement in the symmetry of spatial parameters, which highlights the need for additional research in this area. Clinical Relevance Using the novel HPSDAFO, PwMS can walk without adverse effects, promoting the normalization of their spatiotemporal walking parameters.

Mallard hindlimbs locomotion system respond to changes in sandy ground hardness and slope

Mallards inhabit soft grounds such as mudflats, marshes, and beaches, demonstrating remarkable proficiency in traversing these grounds. This adeptness is closely linked to the adjustments in the operation of their hindlimbs. This study employs high-speed videography to observe postural adjustments during locomotion across mudflats. Analysis of spatiotemporal parameters of the hindlimbs reveals transient and continuous changes in joints (tarsometatarso-phalangeal joint (TMTPJ), intertarsal joint (ITJ), knee, and hip) during movement on different ground hardness and slope (horizontal and uphill). The results indicate that as the stride length of the mallard increases, its speed also increases. Additionally, the stance phase duration decreases, leading to a decrease in the duty factor. Reduced ground hardness and increased slope lead to delayed adjustment of the TMTPJ, ITJ, and knee. Mallards adjust their stride length by augmenting ITJ flexion on steeper slopes, while reduced hardness prompts a decrease in TMTPJ flexion at touch-down. Additionally, the hip undergoes two brief extensions during the stance phase, indicating its crucial role in posture adjustment and propulsion on uphill grounds. Overall, the hindlimb joints of the mallard function as a whole musculoskeletal system, with each joint employing a distinct strategy for adjusting to adapt to various ground conditions.

Gait Analysis and Magnetic Resonance Imaging Characteristics in Patients with Isolated Rapid Eye Movement Sleep Behavior Disorder.

Isolated rapid eye movement sleep behavioral disorder (iRBD) can precede neurodegenerative diseases. There is an urgent need for biomarkers to aid early intervention and neuroprotection. The aim is to assess quantitative motor, cognitive, and brain magnetic resonance imaging (MRI) characteristics in iRBD patients. Thirty-eight polysomnography-confirmed iRBD patients and 28 age- and sex-matched healthy controls underwent clinical, cognitive, and motor functional evaluations, along with brain MRI. Motor tasks included nine-hole peg test, five-times-sit-to-stand test, timed-up-and-go test, and 4-meter walking test with and without cognitive dual task. Quantitative spatiotemporal gait parameters were obtained using an optoelectronic system. Brain MRI analysis included functional connectivity (FC) of the main resting-state networks, gray matter (GM) volume using voxel-based morphometry, cortical thickness, and deep GM and brainstem volumes using FMRIB's Integrated Registration and Segmentation Tool and FreeSurfer. iRBD patients relative to healthy subjects exhibited a poorer performance during the nine-hole peg test and five-times-sit-to-stand test, and greater asymmetry of arm-swing amplitude and stride length variability during dual-task gait. Dual task significantly worsened the walking performance of iRBD patients more than healthy controls. iRBD patients exhibited nonmotor symptoms, and memory, abstract reasoning, and visuospatial deficits. iRBD patients exhibited decreased FC of pallidum and putamen within the basal ganglia network and occipital and temporal areas within the visuo-associative network, and a reduced volume of the supramarginal gyrus. Brain functional alterations correlated with gait changes. Subtle motor and nonmotor alterations were identified in iRBD patients, alongside brain structural and functional MRI changes. These findings may represent early signs of neurodegeneration and contribute to the development of predictive models for progression to parkinsonism. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

PEMOCS: Evaluating the effects of a concept-guided, PErsonalised, MOtor-Cognitive exergame training on cognitive functions and gait in chronic Stroke—study protocol for a randomised controlled trial

BackgroundMany stroke survivors remain with residual cognitive and motor impairments despite receiving timely acute and sub-acute rehabilitation. This indicates that rehabilitation following stroke should be continuous to meet the needs of individual stroke patients. Both cognitive and motor functions are essential for mastering daily life and, therefore, should be aimed at with rehabilitation. Exergames, motor-cognitive exercises performed using video games, are an auspicious method to train both motor and cognitive functions and at the same time may foster the long-term motivation for training. This study aims to assess the effect of concept-guided, personalised, motor-cognitive exergame training on cognitive and motor functions in chronic stroke survivors.MethodsThis study is a single-blinded, randomised controlled trial. Assessments are performed at baseline, after a 12-week intervention, and at a 24-weeks follow-up. Chronic stroke patients (≥ 18 years old, ≥ 6 months post-stroke) able to stand for 3 min, independently walk 10 m, follow a two-stage command, and without other neurological diseases apart from cognitive deficits or dementia are included. Participants in the intervention group perform the exergame training twice per week for 30 (beginning) up to 40 (end) minutes additionally to their usual care programme. Participants in the control group receive usual care without additional intervention(s). Global cognitive functioning (total Montreal Cognitive Assessment (MoCA) score) is the primary outcome. Secondary outcomes include health-related quality of life, specific cognitive functions, single- and dual-task mobility, and spatiotemporal gait parameters. The target sample size for this trial is 38 participants. Linear mixed models with the post-outcome scores as dependent variables and group and time as fixed effects will be performed for analysis.DiscussionSuperior improvements in global cognitive functioning and in the abovementioned secondary outcomes in the intervention group compared to the control group are hypothesised. The results of this study may guide future design of long-term rehabilitation interventions after stroke.Trial registrationClinicalTrials.gov (NCT05524727). Registered on September 1, 2022.

1103 Gait Analysis Using Wearables and AI in Predicting Peripheral Arterial Disease: A Systematic Review

Abstract Introduction Peripheral arterial disease (PAD) affects over 230 million people globally. The trajectory of this disease process can culminate in major amputation. These patients demonstrate statistically significant changes in gait including changes in stride length, plantarflexion and other spatiotemporal parameters. Aim To determine if alterations in gait parameters can be detected and measured accurately by wearables and AI in PAD patients and if these measurements are predictive of PAD progression. Method A systematic review was performed in line with PRISMA guidelines. MEDLINE, Embase, Web of Science and Scopus were used for database searches. A combination of medical subject headings (MeSH) regarding ‘PAD’, ‘gait’, ‘kinetics’, ‘biomechanics’, ‘ambulation’, ‘artificial intelligence’, ‘sensors’ and ‘smartphone data’ were employed in the primary search string. Screening, full text reviews and data extraction was conducted by 2 reviewers using Covidence. Bias was assessed using the Newcastle-Ottawa scale. Results 4719 studies were identified. 3873 were screened after de-duplication. 5 studies were included in the final review. The main methods of gait measurements included smartphones (iPhone and Samsung Galaxy), wearable sensors and motion sensor technology. Gait initiation parameters were sensitive in detecting gait impairment. iPhone pedometer demonstrated accuracy measuring steps comparable to reference Actigraph but was inaccurate measuring distance. Machine learning models including Random Forest algorithms and extreme gradient boosting, detected PAD patients with 89% and 92% accuracy respectively. Conclusions Wearables and AI algorithms can detect gait changes and differentiate PAD from non-PAD gait. All studies showed detective capability, however none demonstrated predictability of PAD. Limitations include accuracy and validation of measurement methods.

Noradrenergic cardiac denervation is associated with gait velocity in Parkinson disease: a dual ligand PET study.

Preliminary data suggest that gait abnormalities in Parkinson disease (PD) may be associated with sympathetic cardiac denervation. No kinematic gait studies were performed to confirm this observation. We aimed to correlate spatiotemporal kinematic gait parameters with cardiac sympathetic denervation as determined by cardiac [11C]HED PET in PD. Retrospective database analysis of 27 PD patients with cardiac sympathetic denervation. All patients underwent spatiotemporal kinematic gait assessment (medication 'off' state), cardiac [11C]HED and dopaminergic brain [11C]DTBZ PET scans. We employed a hierarchical regression approach to examine associations between the extent of cardiac denervation, dopaminergic nigrostriatal neurodegeneration, and three gait parameters - velocity, step length and cadence. More extensive cardiac denervation was associated with slower velocity (estimate: -1.034, 95% CI [-1.65, -0.42], p = 0.002), shorter step length (estimate: -0.818, 95% CI [-1.43, -0.21], p = 0.011) and lower cadence (estimate: -0.752, 95% CI [-1.28, -0.23], p = 0.007) explaining alone 30% (Adjusted-R²: 0.297), 20% (Adjusted-R²: 0.202) and 23% (Adjusted-R²: 0.227) of the variability, respecivetly. These associations remained independent of striatal dopaminergic impairment and confounding factors such as age, Hoehn and Yahr (HY) stages, peripheral neuropathy, cognition, and autonomic symptoms. In contrast, striatal dopaminergic denervation was significantly associated with step length (estimate: 0.883, 95% CI [0.29, 1.48], p = 0.005), explaining about 24% of the variability but was dependent of HY stage. More severe cardiac noradrenergic denervation was associated with lower gait velocity, independent of striatal dopaminergic denervation and HY stage, impacting both step length and cadence. These results suggest independent contributions of the peripheral autonomic system degeneration on gait dynsfunction in PD.

Current Trends in Effectiveness of Robotic Assisted Gait Training (RAGT) for Gait Recovery in Neuro Rehabilitation - An Evidence-Based Scoping Review

Robotic-assisted gait training plays a pivotal role in the rehabilitation of individuals recovering from post-stroke and post-spinal cord injuries. By employing sophisticated robotics, this therapy facilitates repetitive, task-specific movements essential for relearning walking patterns. The precision and customisation of robotic systems ensure tailored interventions targeting specific impairments. Moreover, these technologies provide real-time feedback, enhancing patient engagement and motivation. In this review, 11 articles were finalized for review, five were for post-stroke rehabilitation and 6 for spinal cord injuries. Results show that there is improvement in Spatiotemporal parameters of gait, functional outcomes and quality of life. In Conclusion, robotic-assisted gait training ultimately accelerates recovery, improves functional outcomes, and restores independence, profoundly impacting rehabilitation effectiveness. KEYWORDS: Assistive technology, Robotics, Gait parameters, Neurorehabilitation, Functional outcome.

Cautious Gait during Navigational Tasks in People with Hemiparesis: An Observational Study.

Locomotor and balance disorders are major limitations for subjects with hemiparesis. The Timed Up and Go (TUG) test is a complex navigational task involving oriented walking and obstacle circumvention. We hypothesized that subjects with hemiparesis adopt a cautious gait during complex locomotor tasks. The primary aim was to compare spatio-temporal gait parameters, indicators of cautious gait, between the locomotor subtasks of the TUG (Go, Turn, Return) and a Straight-line walk in people with hemiparesis. Our secondary aim was to analyze the relationships between TUG performance and balance measures, compare spatio-temporal gait parameters between fallers and non-fallers, and identify the biomechanical determinants of TUG performance. Biomechanical parameters during the TUG and Straight-line walk were analyzed using a motion capture system. A repeated measures ANOVA and two stepwise ascending multiple regressions (with performance variables and biomechanical variables) were conducted. Gait speed, step length, and % single support phase (SSP) of the 29 participants were reduced during Turn compared to Go and Return and the Straight-line walk, and step width and % double support phase were increased. TUG performance was related to several balance measures. Turn performance (R2 = 63%) and Turn trajectory deviation followed by % SSP on the paretic side and the vertical center of mass velocity during Go (R2 = 71%) determined TUG performance time. People with hemiparesis adopt a cautious gait during complex navigation at the expense of performance.

The efficacy of 3D gait analysis to evaluate surgical (and rehabilitation) outcome after degenerative lumbar surgery

BackgroundLumbar degenerative conditions are a major cause of back pain and disability in individuals aged 45 and above. Gait analysis utilizes sensor technology to collect movement data, aiding in the evaluation of various gait aspects like spatiotemporal parameters, joint angles, neuromuscular activity, and joint forces. It is widely used in conditions such as cerebral palsy and knee osteoarthritis. This research aims to assess the effectiveness of 3D gait analysis in evaluating surgical outcomes and postoperative rehabilitation for lumbar degenerative disorders.MethodsA prospective self-controlled before-after study (n = 85) carried out at our Hospital (Sep 2018 - Dec 2021) utilized a 3D motion analysis system to analyze gait in patients with lumbar degenerative diseases. The study focused on the multifidus muscle, a crucial spinal muscle, during a minimally invasive lumbar interbody fusion surgery conducted by Shandong Weigao Pharmaceutical Co., Ltd. Pre- and postoperative assessments included time-distance parameters (gait speed, stride frequency, stride length, stance phase), hip flexion angle, and stride angle. Changes in 3D gait parameters post-surgery and during rehabilitation were examined. Pearson correlation coefficient was employed to assess relationships with the visual analog pain scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopedic Association (JOA) scores. Patient sagittal alignment was evaluated using “Surgimap” software from two types of lateral radiographs to obtain parameters like pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), intervertebral space height (DH), posterior height of the intervertebral space (PDH) at the operative segment, and anterior height of the intervertebral space (ADH).ResultsBy the 6th week post-operation, significant improvements were observed in the VAS score, JOA score, and ODI score of the patients compared to preoperative values (P < 0.05), along with notable enhancements in 3D gait quantification parameters (P < 0.05). Pearson correlation analysis revealed a significant positive correlation between improvements in 3D gait quantification parameters and VAS score, JOA score, and ODI value (all P < 0.001).Conclusion3D gait analysis is a valuable tool for evaluating the efficacy of surgery and rehabilitation training in patients.

Post-Arthroplasty Spatiotemporal Gait Parameters in Patients with Hip Osteoarthritis or Developmental Dysplasia of the Hip: An Observational Study.

Total hip arthroplasty (THA) is a preferred treatment for primary osteoarthritis (OA) or secondary degenerative arthropathy due to developmental hip dysplasia (DDH). Gait analysis is considered a gold standard for evaluating post-arthroplasty walking patterns. This study compared post-THA spatiotemporal gait parameters (SGPs) between OA and DDH patients and explored correlations with demographic and clinical variables. Thirty patients (15 per group) were recorded during gait and their SGPs were analyzed. Functionality was evaluated with the Oxford Hip Score (OHS). The OA patients were significantly older than DDH patients (p < 0.005). Significant and moderate to strong were the correlations between SGPs, age, and four items of the OHS concerning hip pain and activities of daily life (0.31 < Pearson's r < 0.51 all p < 0.05). Following THA, both groups exhibited similar levels of the examined gait parameters. Post-arthroplasty SGPs and OHS correlations indicate limitations in certain activities. Given the absence of pre-operative data and the correlation between age and SGPs and OHS, ANCOVA testing revealed that age adjusts OHS and SGP values, while pre-operative diagnosis has no main effect. These findings indicate that hip OA or DDH do not affect postoperative SGPs and patients' functionality. Future studies should examine both kinematic and kinetic data to better evaluate the post-THA gait patterns of OA and DDH patients.