Spatiotemporal Gait Variables Research Articles

Gait Analysis in Patients with Symptomatic Pes Planovalgus Following Subtalar Arthroereisis with the Talus Screw.

Pes planovalgus is one of the most common pediatric skeletal deformities. There have been no studies to analyze in detail the spatiotemporal variables of gait following arthroereisis. The purpose of our study was to assess gait parameters in patients with symptomatic flexible flatfoot following treatment with the talus screw. This was a prospective study assessing the 22 patients treated surgically due to symptomatic flexible flatfoot with the talus screw. Patients underwent gait assessment with a G-Sensor. We analyzed the following gait parameters: gait cycle duration, step length, support phase duration, swing phase duration, double support duration, single support duration, cadence, velocity, step length. The post-operative gait parameter assessment for the operated and non-operated foot showed a significant difference only in terms of step length. Cadence increased from the pre-operative mean of 82.29 steps/min to a post-operative mean of 102.94 steps/min. Gait velocity increased significantly from 0.81m/s before to 0.96m/s after surgery. Arthroereisis with the talus screw helps improve gait parameters following surgery. Post-operatively, we observed increased gait velocity and cadence and decreased gait cycle duration in the operated limb. Short-term biomechanical outcomes of pes planovalgus treatment with the talus screw are good.

Spatiotemporal variability after stroke reflects more than just slow walking velocity

BackgroundIncreased spatiotemporal gait variability is considered a clinical biomarker of ageing and pathology, and a predictor of future falls. Nevertheless, it is unclear whether the increased spatiotemporal variability observed in persons with stroke is directly related to the pathology or simply reflects their choice of walking velocity. Research questionDoes increased spatiotemporal gait variability directly relate to motor coordination deficits after stroke? MethodsForty persons with stroke participated in this cross-sectional study. Participants performed the lower-extremity motor coordination test (LEMOCOT) on an electronic mat equipped with force sensors. Then, participants walked for 120 s on a computerized treadmill at their comfortable walking velocity. For the LEMOCOT we used the traditional score of in-target touch count and computed the absolute and variable error around the targets. For gait variability, we extracted the standard deviation of step time, step length, step velocity, and step width. Using linear modeling, we tested the correlations of gait variability with the outcome measures from the LEMOCOT, after controlling for walking velocity. ResultsThe variability in step time, step length and step width correlated with walking velocity, while the variability in step velocity did not. After controlling for walking velocity, we observed that the LEMOCOT score correlated with the variance in step time, and the variable error in the LEMOCOT correlated with the variance in step length, in step width, and in step velocity. No significant correlation with any of the velocity-controlled step parameters was found for the absolute error in the LEMOCOT. SignificanceDecreased performance in the LEMOCOT was associated with increased spatiotemporal variability in persons with stroke, regardless of their walking velocity. Our results demonstrate the connection between lower-extremity coordination impairments and deficits in gait function.

Disentangling Cerebellar and Parietal Contributions to Gait and Body Schema: A Repetitive Transcranial Magnetic Stimulation Study.

The overlap between motor and cognitive signs resulting from posterior parietal cortex (PPC) and cerebellar lesions can mask their relative contribution in the sensorimotor integration process. This study aimed to identify distinguishing motor and cognitive features to disentangle PPC and cerebellar involvement in two sensorimotor-related functions: gait and body schema representation. Thirty healthy volunteers were enrolled and randomly assigned to PPC or cerebellar stimulation. Sham stimulation and 1Hz-repetitive-Transcranial-Magnetic-Stimulation were delivered over P3 or cerebellum before a balance and a walking distance estimation task. Each trial was repeated with eyes open (EO) and closed (EC). Eight inertial measurement units recorded spatiotemporal and kinematic variables of gait. Instability increased in both groups after real stimulation: PPC inhibition resulted in increased instability in EC conditions, as evidenced by increased ellipse area and range of movement in medio-lateral and anterior-posterior (ROMap) directions. Cerebellar inhibition affected both EC (increased ROMap) and EO stability (greaterdisplacement of the center of mass). Inhibitory stimulation (EC vs. EO) affected also gait spatiotemporal variability, with a high variability of ankle and knee angles plus different patterns in the two groups (cerebellar vs parietal). Lastly, PPC group overestimates distances after real stimulation (EC condition) compared to the cerebellar group. Stability, gait variability, and distance estimation parameters may be useful clinical parameters to disentangle cerebellar and PPC sensorimotor integration deficits. Clinical differential diagnosis efficiency can benefit from this methodological approach.

Spatiotemporal Gait Variability in Children Aged 2 to 10 Decreases throughout Pre-Adolescence

Background: Children’s gait is traditionally understood to mature as young as three years old through pre-adolescence. Studies looking at gait biomechanics suggest that gait matures around three years old, while studies investigating gait variability propose a much later maturation. The studies that have examined children’s gait variability did so while the children walked around a track or down hallways that created a discontinuous gait, potentially affecting the measures of variability and the efficacy of the results. Purpose: Therefore, the purpose of our study was to investigate the development of gait dynamics and gait variability in children in a more continuous fashion, in this case, by walking on a treadmill. Methods: To accomplish this, we included four age groups of children, ranging 2–10 years old, walking on a treadmill for at least three minutes while stride time and stride length were collected. Stride time and stride length’s variability was then analyzed using linear (mean, standard deviation, coefficient of variation) and nonlinear (sample entropy, detrended fluctuation analysis) measures across the varying ages of our participants. Results: Interestingly, both the linear and nonlinear variabilities of the stride time and stride length measures decreased as the groups of children got older. Specifically, CV ST (2–3 (9.3 ± 4%), 8–10 (3.6 ± 0.7%), p < 0.05) and CV SL (2–3 (11.4 ± 3%), 8–10 (4.6 ± 1%), p < 0.05) were our strongest linear measures, and DFA ST (2–3 (0.97 ± 0.12), 8–10 (0.82 ± 0.10), p < 0.05) and DFA SL (2–3 (0.91 ± 0.04), 8–10 (0.81 ± 0.03), p < 0.05) were our strongest nonlinear measures, particularly between the youngest and oldest groups. This trend of variability decreasing with age suggests that as children’s gait matures, their gait becomes more stable and reliable. Significance: Our study rejects the notion that children’s gait is mature by the age of three, as some would suggest. By analyzing the variability of stride time and stride length, we can see that even later into childhood, children’s gait continues to change and evolve.

Minimal clinically important differences of spatiotemporal gait variables in Parkinson disease

BackgroundAssessment of gait function in People with Parkinson Disease (PwPD) is an important tool for monitoring disease progression in PD. While comprehensive gait analysis has become increasingly popular, only one study, Hass et al. (2014), has established minimal clinically important differences (MCID) for one spatiotemporal variable (velocity) in PwPD. Research QuestionWhat are the MCIDs for velocity and additional spatiotemporal variables, including mean, variability, and asymmetry of step length, time, and width? MethodsAs part of a larger clinic-based initiative, 382 medicated, ambulatory PwPD walked on an instrumented walkway during routine clinical visits. Distribution and anchor-based methods (Unified Parkinson's Disease Rating Scale-III, Modified Hoehn and Yahr, and the mobility subsection of the Parkinson Disease Questionnaire) were used to calculate MCIDs for variables of interest in a cross-sectional approach. ResultsDistribution measures for all variables are presented. Of nine gait variables, four were significantly associated with every anchor and pooled to the following values: velocity (8.2 cm/s), step length mean (3.6 cm), step length variability (0.7%), and step time variability (0.67%). SignificanceThe finalized MCID for velocity (8.2 cm/s) was nearly half of the MCID of 15 cm/s reported by Hass et al., potentially due to differences in calculations. These results allow for evaluations of effectiveness of interventions by providing values that are specific to changes in gait for PwPD. Alterations of methodology including different versions of clinical or walking assessments, and/or different calculation and selection of gait variables necessitate careful reasoning when using presented MCIDs.

The role of ankle and knee muscle characteristics in spatiotemporal gait parameters at different walking speeds: A cross-sectional study

BackgroundUnderstanding the intricate interplay between ankle and knee muscle characteristics and their impact on gait parameters is crucial for enhancing our comprehension of human locomotion, particularly in the context of varying walking speeds among healthy young adults. Research question: The study aimed to identify the relative importance of ankle and knee flexor and extensor muscle characteristics (e.g., strength estimated by peak torque [PT] and rate of torque development [RTD]) in the spatiotemporal gait parameters and variability in self-selected (SSWS) and fast walking speeds (FWS) in healthy young adults. MethodsOne hundred and thirty-nine adults (75 men – 54% and 64 women – 46%; 29.04 ± 9.55 years) were assessed about their muscle characteristics (PT and RTD by an isokinetic dynamometer) and spatiotemporal gait parameters at different walking speeds (SSWS and FWS by an instrumented walkway). ResultsData analysis indicated a weak relationship between the PT and RTD of the ankle and knee and spatiotemporal gait parameters and variability in both walking conditions (SSWS: R2 0.14–0.05; FWS: R2 0.40–0.05). The strength of the knee muscles was more relevant when walking at a self-selected speed, while the strength of the ankle muscles played a more prominent role when walking at a fast pace. SignificanceThe findings underscore the critical role of ankle muscles (plantar and dorsiflexors) at fast walking speeds. Therefore, targeted interventions for strength and optimization of these muscles are paramount.

Ankle Sprain History Does Not Significantly Alter Single- and Dual-Task Spatiotemporal Gait Mechanics.

Single- and dual-task walking gait assessments have been used to identify persistent movement and cognitive dysfunction among athletes with concussions. However, it is unclear whether previous ankle sprain injuries confound these outcomes during baseline testing. The purpose of this study was to determine the effects of (1)ankle sprain history and (2)time since prior ankle sprain injury on single- and dual-task spatiotemporal gait outcomes and cognitive measures. Cross-sectional study. We assessed 60 college Division-I athletes (31 with ankle sprain history; 13 females and 18 males, 19.3 [0.8]y; 29 with no ankle sprain history, 14 females and 15 males, 19.7 [0.9]y) who completed injury history forms and underwent concussion baseline testing. Athletes completed single- and dual-task gait assessments by walking back and forth along an 8-m walkway for 40seconds. Athletes wore a smartphone with an associated mobile application on their lumbar spine to record spatiotemporal gait parameters and dual-task cognitive performance. Separate multivariate analyses of variance were used to assess the effects of ankle sprain injury history on spatiotemporal measures, gait variability, and cognitive performance. We performed a multivariate regression subanalysis on athletes who reported time since injury (n = 23) to assess temporal effects on gait and cognitive performance. Athletes with and without a history of ankle sprains had comparable spatiotemporal and gait variability outcomes during single- (P = .42; P = .13) and dual-task (P = .75; P = .55) conditions. Additionally, ankle sprain injury history did not significantly influence cognitive performance (P = .35). Finally, time since ankle sprain did not significantly affect single- (P = .75) and dual-task gait (P = .69), nor cognitive performance (P = .19). Ankle sprain injury history did not significantly alter spatiotemporal gait outcomes nor cognitive performance during this common clinical assessment. Future studies may consider including athletes with ankle sprain injury history during concussion assessments.

Determinants and Characterization of Locomotion in Adults with Late-Onset Pompe Disease: New Clinical Biomarkers.

The late-onset form of Pompe disease (LOPD) is characterized by muscle weakness, locomotor limitations and a risk of falls. The mechanisms responsible for altered locomotion in adults with LOPD are unknown. The identification of clinical biomarkers is essential for clinical follow-up and research. To identify muscle determinants of impaired locomotor performance, gait stability and gait pattern, and biomechanical determinants of falls in adults with LOPD. In this cross-sectional, case-control study, LOPD and control participants underwent 3D gait analysis, locomotor performance tests and muscle strength measurements (isokinetic dynamometer). We explored the muscular determinants of locomotor performance (gait speed, 6-minute walk test distance and timed up and go test), gait stability (spatiotemporal gait variables) and the gait pattern. We also explored biomechanical gait determinants of falls. After intergroup comparisons, determinants were sought to use forward stepwise multiple regression. Eighteen participants with LOPD and 20 control participants were included. Locomotor performance, gait stability, and the gait pattern were significantly altered in LOPD compared to control participants. Hip abductor strength was the main common determinant of locomotor performance, gait stability and pelvic instability. Hip flexor strength was the main determinant of abnormal gait kinematics at the hip and knee. Percentage duration of single support phase during the gait cycle was the main determinant of falls. Hip abductor strength and percentage duration of single support during gait were the major determinants of locomotor performance, gait stability, falls and the gait pattern in LOPD. These new clinical biomarkers should therefore be systematically assessed using instrumented tools to improve the follow-up of adults with LOPD. They should also be considered in future studies to accurately assess the effects of new therapies. Hip abductor strength and single support phase should also be priority targets for rehabilitation.

Spatiotemporal gait parameters in adults with premanifest and manifest Huntington's Disease: A systematic review.

To systematically review and critically evaluate literature on spatiotemporal gait deviations in individuals with premanifest and manifest Huntington's Disease (HD) in comparison with healthy cohorts. We conducted a systematic review, guided by the Joanna Briggs Institute's Manual for Evidence Synthesis and pre-registered with the International Prospective Register of Systematic Reviews. Eight electronic databases were searched. Studies comparing spatiotemporal footstep parameters in adults with premanifest and manifest HD to healthy controls were screened, included and critically appraised by independent reviewers. Data on spatiotemporal gait changes and variability were extracted and synthesised. Meta-analysis was performed on gait speed, cadence, stride length and stride length variability measures. We screened 2721 studies, identified 1245 studies and included 25 studies (total 1,088 participants). Sample sizes ranged from 14 to 96. Overall, the quality of the studies was assessed as good, but reporting of confounding factors was often unclear. Meta-analysis found spatiotemporal gait deviations in participants with HD compared to healthy controls, commencing in the premanifest stage. Individuals with premanifest HD walk significantly slower (-0.17m/s; 95% confidence interval (CI) [-0.22,-0.13]), with reduced cadence (-6.63 steps/min; 95%CI [-10.62, -2.65]) and stride length (-0.09m; 95%CI [-0.13, -0.05]). Stride length variability was also increased in premanifest cohorts by 2.18% (95% CI [0.69, 3.68]), with these changes exacerbated in participants with manifest disease. Findings suggest individuals with premanifest and manifest HD display significant spatiotemporal footstep deviations. Clinicians could monitor individuals in the premanifest stage of disease for gait changes to identify the onset of Huntington's symptoms.

Gait asymmetry in children with Duchenne muscular dystrophy: evaluated through kinematic synergies and muscle synergies of lower limbs

BackgroundGait is a complex, whole-body movement that requires the coordinated action of multiple joints and muscles of our musculoskeletal system. In the context of Duchenne muscular dystrophy (DMD), a disease characterized by progressive muscle weakness and joint contractures, previous studies have generally assumed symmetrical behavior of the lower limbs during gait. However, such a symmetric gait pattern of DMD was controversial. One aspect of this is criticized, because most of these studies have primarily focused on univariate variables, rather than on the coordination of multiple body segments and even less investigate gait symmetry under a motor synergy of view.MethodsWe investigated the gait pattern of 20 patients with DMD, compared to 18 typical developing children (TD) through 3D Gait Analysis. Kinematic and muscle synergies were extracted with principal component analysis (PCA) and non-negative matrix factorization (NNMF), respectively. The synergies extracted from the left and right sides were compared with each other to obtain a symmetry value. In addition, bilateral spatiotemporal variables of gait, such as stride length, percentage of stance and swing phase, step length, and percentage of double support phase, were used for calculating the symmetry index (SI) to evaluate gait symmetry as well.ResultsCompared with the TD group, the DMD group walked with decreased gait velocity (both p < 0.01), stride length (both p < 0.01), and step length (both p < 0.001). No significant difference was found between groups in SI of all spatiotemporal parameters extracted between the left and right lower limbs. In addition, the DMD group exhibited lower kinematic synergy symmetry values compared to the TD group (p < 0.001), while no such significant group difference was observed in symmetry values of muscle synergy.ConclusionsThe findings of this study suggest that DMD influences, to some extent, the symmetry of synergistic movement of multiple segments of lower limbs, and thus kinematic synergy appears capable of discriminating gait asymmetry in children with DMD when conventional spatiotemporal parameters are unchanged.

Multicomponent and mat Pilates training increased gait speed in individuals with Parkinson's disease when walking and carrying a load: A single-blinded randomized controlled trial.

Gait disorders in individuals with Parkinson's disease (IwPD) are among the most disabling symptoms. Physical exercise has been proposed for the treatment of IwPD because it shows positive effects on gait variables. Given the importance of physical activity in the rehabilitation process of IwPD, the assessment of interventions to identify those most promising for improving or maintaining gait performance is of great relevance. Therefore, this study evaluated the effects of Mat Pilates Training (MPT) and Multicomponent Training (MCT) on the spatiotemporal variables of gait in situations of daily dual-task performance in IwPD. Gait analysis in a daily dual-task context allows the simulation of real-life conditions where individuals have a higher risk of falling than in single-task walking. We conducted a single-blinded randomized controlled trial with 34 mild-to-moderate IwPD (Hoehn-Yahr stage 1-2). They were randomized to one of two interventions: MPT or MCT. All participants performed the training for 60min, three times per week, for 20weeks. Spatiotemporal gait variables were evaluated in a daily life situation to increase the ecological validity of the measurements, which included gait speed, stride time, double support time, swing time, and cadence. The individuals walked on a platform holding two bags with a load corresponding to 10% of their body mass. After the intervention, there was a significant improvement in gait speed in both groups: MPT (p=0.047) and MCT (p=0.015). The MPT group reduced the cadence (p=0.005) and the MCT group increased the stride length (p=0.026) after the intervention. Both groups had positive effects on gait speed with load transport resulting from the two proposed interventions. However, the MPT group showed a spatiotemporal adjustment of speed and cadence that can increase gait stability, which was not found in the MCT group.

Asymmetric shoe height induces reactive changes in gait kinematics but not kinetics in healthy young adults

BackgroundFootwear interventions are a potential avenue to correct walking asymmetry in neurologic populations, such as stroke. However, the motor learning mechanisms that underlie the changes in walking imposed by asymmetric footwear are unclear. Research questionThe objectives of this study were to examine symmetry changes during and after an asymmetric shoe height intervention in (1) vertical impulse and (2) spatiotemporal gait parameters and (3) joint kinematics, in healthy young adults MethodsEleven healthy young adults (3 males, 8 females; 21.2 ± 3.1 years old) participated in this study. Participants walked on an instrumented treadmill at 1.3 m/s for four conditions: (1) a 5-minute familiarization with equal shoe height, (2) a 5-minute baseline with equal shoe height, (3) a 10-minute intervention, where participants walked with asymmetric shoe height with a 10 mm shoe insert in one shoe, and (4) a 10-minute post-intervention, where participants walked with equal shoe height. Asymmetry in kinetics and kinematics were used to identify changes during intervention and aftereffects, a hallmark of feedforward adaptation ResultsParticipants did not alter vertical impulse asymmetry (p = 0.667) nor stance time asymmetry (p = 0.228). During the intervention, step time asymmetry (p = 0.003) and double support asymmetry (p < 0.001) were greater compared to baseline. Leg joint asymmetry during stance (Ankle plantarflexion: p < 0.001; Knee flexion: p < 0.001; Hip extension: p = 0.011) was greater during the intervention compared to baseline. However, changes in spatiotemporal gait variables and joint mechanics did not demonstrate aftereffects. SignificanceOur results show that healthy human adults change gait kinematics, but not weight-bearing symmetry with asymmetrical footwear. This suggests that healthy humans prioritize maintaining vertical impulse by changing their kinematics. Further, the changes in gait kinematics are short-lived, suggesting feedback-based control, and a lack of feedforward motor adaptations

Assessment of functional mobility and gait during a timed up and go test in adults with total blindness

BackgroundThe loss of vision leads to behavioral and motor adaptations that do not necessarily translate to good functioning with regards to daily tasks. AimTo investigate differences in functional mobility in adults with total blindness, and analyze differences in spatiotemporal gait variables with and without the use of a cane, and wearing shoes or barefoot. MethodsWe used an inertial measurement unit to assess the spatiotemporal parameters of the gait and functional mobility in seven subjects with total blindness and four sighted participants during the timed up and go test (TUG) test performed under conditions: barefoot/shod; and with/without a cane (blind subjects). ResultsSignificant differences between groups were found in total TUG test time and in the sub-phases when the blind subjects executed the TUG barefoot and without a cane (p < .01). Other differences were found in trunk movement during sit-to-stand, and stand-to-sit where blind subjects when without cane and barefoot, they had a greater range of motion than sighted subjects (p < .01). Also, BMI has a moderate to strong influence in the execution of the TUG in blind subjects (p < .05) ConclusionThis study showed that, when using a gait-assistance device and wearing shoes, blind subjects have similar functional mobility and gait as sighted subjects, suggesting that an external haptic reference can compensate for the lack of vision. Knowledge of these differences can provide a better understanding of the adaptive behavior in this population, thereby assisting in minimizing the occurrence of trauma and falls.

The Influence of the Weight of the Backpack on the Biomechanics of the Child and Adolescent: A Systematic Review and Meta-analysis With a Meta-Regression.

To evaluate and explore the influence of the weight of a backpack on standing posture and gait in children and adolescents. We conducted a search of MEDLINE (PubMed), Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science, with the last search in July 2021. Standardized mean differences (SMD) and 95% confidence intervals were calculated for relevant outcomes and were pooled in a meta-analysis using the random-effects model. The participants were healthy children or adolescents. The outcomes were postural variables, spatiotemporal gait variables, gait kinematics, and muscle activity. We analyzed the influence of a loaded backpack on posture while standing and spatiotemporal and kinematic variables while walking. We used GRADE, Risk of Bias 2, ROBINS-I, MINORS, and PEDro scales to rate the quality, certainty, and applicability of the evidence. Wearing a loaded backpack induces a significant increase of the craniohorizontal angle while standing and a decrease of walking speed and stride length while walking. Only the craniovertebral angle had a significant relationship with the weight of the backpack. Wearing a backpack induces postural changes while standing and affects gait in children and adolescents; however, almost all the changes are not related to the backpack weight.

Effects of dance on gait and dual-task gait in Parkinson's disease.

Gait impairments in Parkinson's disease (PD) limit independence and quality of life. While dance-based interventions could improve gait, further studies are needed to determine if the benefits generalise to different terrains and when dual-tasking. The aim was to assess the effects of a dance intervention, based on the Dance for PD® (DfPD®) program, on gait under different dual-tasks (verbal fluency, serial subtraction) and surfaces (even, uneven), and to determine if a larger scale follow-up RCT is warranted. A dance group (DG; n = 17; age = 65.8 ± 11.7 years) and a control group (CG: n = 16; age = 67.0 ± 7.7 years) comprised of non-cognitively impaired (Addenbrooke's score: DG = 93.2 ± 3.6, CG = 92.6 ± 4.3) independently locomoting people with PD (Hoehn & Yahr I-III). The DG undertook a one-hour DfPD®-based class, twice weekly for 12 weeks. The CG had treatment as usual. The spatiotemporal variables of gait were assessed at baseline and post-intervention while walking on two surfaces (even, uneven) under three conditions: regular walking; dual-task: verbal-fluency (DTVERB), and serial-subtraction (DTSUBT). The data were analysed by means of a linear mixed model. At baseline, there was no significant group difference for any spatiotemporal gait variable. The DG improved significantly compared to the CG with and without a dual task when walking on even surface. During regular walking, DG improved in gait velocity (p = 0.017), cadence (p = 0.039), step length (p = 0.040) and stride length (p = 0.041). During DTVERB significant improvements were noted in gait velocity (p = 0.035), cadence (p = 0.034) and step length (p = 0.039). The DG also exhibited significant improvement compared to the CG during DTSUBT in the measures of gait velocity (p = 0.012), cadence (p = 0.021), step length (p = 0.018), and stride length (p = 0.151). On the uneven surface, improvements were noted when walking while performing serial subtractions only. During regular walking, improvements were noted for the CG but not for the DG. CG has spent less time in double support following the intervention than DG. While DTVERB condition had no significant group differences for any gait parameter (p's >0.05), in the DTSUBT condition, the DG improved significantly compared to the controls on gait velocity (p = 0.048), cadence (p = 0.026), and step length (p = 0.051). DfPD®-based classes produced clinically significant improvement in spatiotemporal gait parameters under dual-task conditions and on uneven surfaces. This could arise from improved movement confidence and coordination; emotional expression; cognitive skills (planning, multitasking), and; utilisation of external movement cues. A large-scale RCT of this program is warranted. A protocol for this study has been registered retrospectively at the Australian New Zealand Clinical Trials Registry. Identifier: ACTRN12618001834246.

The spatiotemporal gait parameters among people with visual impairment: A literature review study.

Gait is an individual's walking pattern, and it is a significant part of daily living activities. Quantitative gait assessments, like spatiotemporal parameters (STPs), are related to the functional conditions to provide useful information. This study reviewed the comprehensive differences in spatiotemporal gait variability measures between visually impaired people and the sighted. The search strategy was performed in three databases (PubMed/MEDLINE, Web of Science, and Scopus) from the start date to October 2022, and the utilized keywords for this search are related to gait and blindness. This review considered only those studies that evaluated gait parameters in people with visual impairment and blind people without any limitations in age and gender. In this review, studies without a control group (sighted people) were excluded. The Newcastle-Ottawa Scale (NOS) was applied for critical appraisal. Six full manuscripts were included. The sample size ranged from 19 to 91. The mean modified NOS critical appraisal scores for cross-sectional studies were 6.0. In these studies, among nine STPs: stride length, walking speed, stance and swing phase, step width, cadence, step length, double support, and single support, at least five and at most seven factors were examined. The gait pattern of blind and low-vision people is characterized by a slower walking speed, shorter stride length, increased step width, decreased cadence, prolonged duration of double support, and reduced single support compared to the controls.

Effects of Transcranial Direct Current Stimulation Combined with Treadmill Training on Kinematics and Spatiotemporal Gait Variables in Stroke Survivors: A Randomized, Triple-Blind, Sham-Controlled Study.

The present study assessed the effects of anodal transcranial direct current stimulation (tDCS) combined with treadmill training on spatiotemporal and kinematic variables in stroke survivors using gait speed as the primary outcome. A randomized, sham-controlled, triple-blind, study was conducted involving 28 patients with hemiparesis allocated to two groups. The experimental group was submitted to treadmill training combined with anodal tDCS over the primary motor cortex (M1) of the damaged hemisphere. The control group was submitted to treadmill training combined with sham tDCS. Stimulation was administered (2 mA, 20 min) five times a week for two weeks during treadmill training. No significant differences (p > 0.05) in spatiotemporal variables were found in the intra-group and inter-group analyses. However, the experimental group demonstrated improvements in kinematic variables of the knee and ankle (p < 0.05) and these results were maintained one month after the end of the intervention. The inter-group analysis revealed significant differences (p < 0.05) with regard to the pelvis, hip and knee. Anodal tDCS over M1 of the damaged hemisphere combined with treadmill training did not affect spatiotemporal variables, but promoted improvements in kinematic variables of the pelvis, hip, knee and ankle and results were maintained one month after treatment.

Salient Targets and Fear of Falling Changed the Gait Pattern and Joint Kinematic of Older Adults

Fear of falling and environmental barriers in the home are two major factors that cause the incidence of falling. Poor visibility at night is one of the key environmental barriers that contribute to falls among older adult residents. Ensuring their visual perception of the surroundings, therefore, becomes vital to prevent falling injuries. However, there are limited works in the literature investigating the impact of the visibility of the target on older adults' walking destinations and how that impact differs across them with different levels of fear of falling. The purpose of the study was to examine the effects of target salience on older adults' walking performance and investigate whether older adults with varying levels of fear of falling behave differently. The salient target was constructed with LED strips around the destination of walking. Fifteen older adults (aged 75 years old and above), seven with low fear of falling and eight with high fear of falling, volunteered for the study. Participants walked from the designated origin (i.e., near their beds) to the destination (i.e., near the bathroom entrance), with the target turned on or off around the destination of the walking trials. Spatiotemporal gait variables and lower-body kinematics were recorded by inertial sensors and compared by using analysis of variance methods. Data from inertial sensors showed that a more salient target at the destination increased older adults' gait speed and improved their walking stability. These changes were accompanied by less hip flexion at heel strikes and toe offs during walking. In addition, older adults with low fear of falling showed more substantial lower-body posture adjustments with the salient target presented in the environment. Older adults with a low fear of falling can potentially benefit from a more salient target at their walking destination, whereas those with a high fear of falling were advised to implement a more straightforward falling intervention in their living areas.

The Effect of Resist and Assist Torque of Hip Joint Motor-based Gait Assistance Robot on Gait Function in the Elderly

OBJECTIVES The purpose of this study was to investigate the effects of assist and resistance torque on the spatiotemporal gait characteristics, and the symmetry and asymmetry of gait using a Gait Enhancing and Motivating System (GEMS) in the elderly.METHODS A cross-sectional and repeated measure design was used. A total of 18 participants (9 males, 9 females; age: 63.5 ± 5.02 years; mass: 64.26 ± 6.87 kg; height: 164.06 ± 7.15 cm) were recruited from a local community, and spatiotemporal gait data were collected with OptoGait system and GEMS. Spatiotemporal gait variables and differences between the dominant and non-dominant legs of these variables were assessed (step length, step time, stance phase, swing phase, single support, load response, pre swing phase, stride time, stride length, double support, cadence, and gait speed). The effects of three modes including normal, assist, and resist modes using GEMS were investigated twice for each participant on a 9-meter walkway. A one-way repeated measure analysis of variance followed by Bonferroni post-hoc tests was conducted.RESULTS The assist mode increased step time, swing phase, stride time and reduced stance phase, pre-swing phase, double support, cadence, and gait speed as compared to normal mode. The resist mode increased stance phase, load response, pre-swing phase, double support, cadence, and reduced step time, swing phase, and stride time. In dominant leg, assist mode showed increased step time and reduced pre-swing phase than normal mode, and greater step time than resist mode (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). However, there was no effect of external torque on symmetry and asymmetry between both legs (&lt;i&gt;p&lt;/i&gt; &gt; 0.05).CONCLUSIONS The resistance and assist torque of GEMS alter spatiotemporal characteristics during the stance and swing phase of gait in the elderly. However, the resistance torque and assist torque of GEMS did not increase or decrease the gait asymmetry between the dominant and non-dominant legs.

Differentiating idiopathic Parkinson's disease from vascular parkinsonism and essential tremor plus with spatiotemporal variables of gait

Diagnostic accuracy to differentiate Parkinson’s Disease (PD) from other neurological disorders by movement disorder specialists is >85% for longer duration (>5years) and medication-responsive people with PD [1]. However, this accuracy remains suboptimal (<55%) in the early stages of disease, i.e. when symptoms may be very subtle [1]. Therefore, it’s of paramount importance to identify diagnostic markers which could help in timely and accurate diagnosis and in clinical management [2]. Gait may be a potential marker since its impairments appear in the very early disease, may precede the onset of overt motor signs and evolve more rapidly than other motor features [2,3]. The purpose of this work is to assess whether gait variables, known to correctly classify PD from healthy subjects [4], are capable to differentiate PD from other Parkinsonism in subjects with an onset of symptoms from less than 3 years. 17 drug-naïve individuals with PD (mean age 70.0±7.4 yrs), 9 with vascular parkinsonism (VP, mean age 76.6±5.5 yrs) and 9 with essential tremor plus (ET, mean age 65.9±8.1 yrs) were enrolled. Eight spatiotemporal variables of gait [4] were acquired using a GAITRite® electronic walkway under comfortable walking. To assess the diagnostic performance of each variable in discriminating PD from VP and ET, the area under the receiver operating characteristic curve (AUC) and its 95% Confidence Interval (95% CI) were assessed. Participants with PD were not different from VP and ET regarding sex (p=0.86 and p=0.13, respectively) and age (0.07 and 0.06, respectively). Of the gait variables considered, gait speed, step time and step time asymmetry showed a moderate ability in differentiating PD from the other movement disorders (Table 1). In addition, double support time and swing time CV were able to differentiate individuals with PD from those with ET. The gait model, obtained combining the 8 gait variables, showed the highest ability in discriminating PD from VP (AUC=0.90) and ET (AUC=0.86), with a diagnostic accuracy of 88.5% and 80.8%, respectively. This study found that spatiotemporal gait variables, assessed with a sensorized mat, can be used to differentiate PD from VAS and ET. In particular, the model of gait obtained combining several variables had a good diagnostic accuracy in the first ages of disease. This provides a foundation for future research to investigate the use of gait assessment as a clinical tool to aid diagnostic accuracy of PD subtypes, allowing the correct treatment and care to be applied [5].