Stride Length Research Articles

The eye movement and gait variability analysis in Chinese patients with Huntington's disease.

Huntington's disease disease (HD) is characterized by motor, cognitive, and neuropsychiatric symptoms. Oculomotor impairments and gait variability have been independently considered as potential markers in HD. But there lacks an integration analysis of eye movement and gait. We assessed multiple examinations of eye movement and gait variability in HTT mutation carriers, analyzed the consistency between these parameters and clinical severity, then examined the association between oculomotor impairments and gait deficits. Seven pre-HD, 30 HD patients and 30 age-matched controls were included. We collected demographics and assessed the Unified Huntington's Disease Rating Scale (UHDRS). Examinations including saccade, smooth pursuit and optokinetic (OPK) test were performed to evaluate eye movement function. The parameters of gait include stride length, walking velocity, step deviation, step length and gait phase. There are significant impairments in HD patients in the latency and velocity of saccades, the gain of smooth pursuit as well as the gain and slow phase velocities (SPV) of OPK tests. Only the speed of saccades has significant difference between pre-HD and controls. There are significant impairments of stride length, walking velocity, step length and gait phase in HD patients. Parameters of eye movement and gait variability in HD patients showed consistency with the scores of UHDRS. There were significant correlations between eye movement and gait parameters. Our results show that eye movement and gait are impaired in HD patients, and speed of saccades is early impaired in pre-HD. Eye movement and gait abnormalities in HD are significantly correlated with clinical disease severities.

Effectiveness of unilateral lower-limb exoskeleton robot on balance and gait recovery and neuroplasticity in patients with subacute stroke: a randomized controlled trial

BackgroundImpaired balance and gait in stroke survivors are associated with decreased functional independence. This study aimed to evaluate the effectiveness of unilateral lower-limb exoskeleton robot-assisted overground gait training compared with conventional treatment and to explore the relationship between neuroplastic changes and motor function recovery in subacute stroke patients.MethodsIn this randomized, single-blind clinical trial, 40 patients with subacute stroke were recruited and randomly assigned to either a robot-assisted training (RT) group or a conventional training (CT) group. All outcome measures were assessed at the enrollment baseline (T0), 2nd week (T1) and 4th week (T2) of the treatment. The primary outcome was the between-group difference in the change in the Berg balance scale (BBS) score from baseline to T2. The secondary measures included longitudinal changes in the Fugl-Meyer assessment of the lower limb (FMA-LE), modified Barthel index (mBI), functional ambulation category (FAC), and locomotion assessment with gait analysis. In addition, the cortical activation pattern related to robot-assisted training was measured before and after intervention via functional near-infrared spectroscopy.ResultsA total of 30 patients with complete data were included in this study. Clinical outcomes improved after 4 weeks of training in both groups, with significantly better BBS (F = 6.341, p = 0.018, partial η2 = 0.185), FMA-LE (F = 5.979, p = 0.021, partial η2 = 0.176), FAC (F = 7.692, p = 0.010, partial η2 = 0.216), and mBI scores (F = 7.255, p = 0.042, partial η2 = 0.140) in the RT group than in the CT group. Both groups showed significant improvement in gait speed and stride cadence on the locomotion assessment. Only the RT group presented a significantly increased stride length (F = 4.913, p = 0.015, partial η2 = 0.267), support phase (F = 5.335, p = 0.011, partial η2 = 0.283), and toe-off angle (F = 3.829, p = 0.035, partial η2 = 0.228) on the affected side after the intervention. The RT group also showed increased neural activity response over the ipsilesional motor area and bilateral prefrontal cortex during robot-assisted weight-shift and gait training following 4 weeks of treatment.ConclusionsOverground gait training with a unilateral exoskeleton robot showed improvements in balance and gait functions, resulting in better gait patterns and increased gait stability for stroke patients. The increased cortical response related to the ipsilesional motor areas and their related functional network is crucial in the rehabilitation of lower limb gait in post-stroke patients.

Change in Spatiotemporal Parameters During Running at Different Degrees of Inclination: Systematic Review

Background:Running is one of the simplest and most popular forms of exercise. Biomechanical evaluation of running is one of the elements of evaluating running technique and, consequently, improving sports performance. Running uphill and downhill is one of the components of daily running but also an element of training used by recreational runners. The aim of this study is to optimize running training and minimize the risk of injury by identifying changes in the spatiotemporal structure of running at different inclinations. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The protocol has been registered on the international platform INPLASY under the number INPLASY202430094U2. The search was conducted up to 30 March 2024 using the Scopus, PubMed, and Web of Science databases. Results: Spatiotemporal parameters were most frequently analyzed at 2.8–3.35 m/s velocities and inclinations in the range of −11% to 11%. Decreases in stride length (SL) and flight time (FT), and increases in step frequency (SF) were the most frequently reported changes from all parameters analyzed as a function of inclination and velocity. Significant increases or decreases in individual parameters were more often observed for positive inclination values than negative ones. Conclusions: The heterogeneous results of the study limit the possibility of determining the changes that occur in the spatiotemporal structure of the run under the impact of different inclinations. The variation in the results for negative inclination values indicates the different characteristics of running uphill and downhill. However, for uphill running, SF, SL, and FT are closely related to the increase in inclination.

Efficacy of Foot Orthoses With Sensorimotor Bars on Gait, Postural Control, and Muscle Activity in Healthy Individuals and Those With Musculoskeletal Disorders: A Systematic Review

Objectives: The foot and ankle complex is crucial in stability, propulsion, and musculoskeletal interactions. Optimizing orthotic interventions in this anatomical region is essential to improve motor outcomes. This systematic review investigates the impact of foot orthoses (FOs) with sensorimotor bars on gait, postural control, and muscle activity in healthy individuals and those with musculoskeletal disorders. Methods: We conducted an electronic search in January 2024 using the PubMed, Web of Science, and Scopus databases. The article identification, screening, and selection followed the PISMA (the preferred reporting items for systematic reviews and meta-analysis) guidelines. We conducted the quality assessment using the PEDro (the physiotherapy evidence database) checklist. Data extraction and synthesis were performed using the Cochrane handbook for systematic review of interventions. Results: FOs with sensorimotor bars can increase foot external rotation, dorsiflexion, and abduction while decreasing foot eversion. Additionally, they can reduce anteroposterior displacement of the hip, shoulder, and head. Furthermore, significant improvements have been observed in spatiotemporal parameters such as walking speed, stride length, stance time, swing time, and kinetic parameters such as plantar pressure. These orthoses can also impact clinical tasks and decrease center-of-pressure movements. Discussion: Sensorimotor bars have demonstrated beneficial effects on gait (kinematic, kinetic, and spatial-temporal measures), balance control (clinical performance and center of pressure displacement measures), and muscle activity recording.

PHYSICS PERSPECTIVES ON HUMAN LOCOMOTION: INVESTIGATING THE MECHANICS OF WALKING PATTERNS

This study investigated the gait metric differences between males and females aged 18 to 22. Our investigation revealed some significant changes in gait metrics between the two genders. Firstly, males exhibited greater leg and step lengths than females. Males exhibited wider strides, suggesting typical anthropometric variations. Except for BMI and cadence, males had more variation in practically every other gait metric, whereas females had more variability. There was a non-significant positive connection between BMI and gait metrics such as height, stride length, and step width, with BMI having a minor effect on those measures. Overall, both genders showed a distinct pattern of variability, revealing individual variances in gait analysis across the same genders. A direct correlation was observed between the Froude number and height, indicating that individuals with a higher Froude number exhibit a more dynamic and faster walking style. This phenomenon can be ascribed to the biomechanical superiority that taller individuals may possess, enabling them to generate longer strides and achieve higher speeds. A thorough study of walking speed and gait parameters revealed difficulty in finding the right balance between stability, efficiency, and speed in human movement. Understanding these connections will help people develop more efficient training programs, assistive technologies, and more efficient and safe walking in general.

Pattern Analysis Using Lower Body Human Walking Data to Identify the Gaitprint

All people have a fingerprint that is unique to them and persistent throughout life. Similarly, we propose that people have a gaitprint, a persistent walking pattern that contains unique information about an individual. To provide evidence of a unique gaitprint, we aimed to identify individuals based on basic spatiotemporal variables. 81 adults were recruited to walk overground on an indoor track at their own pace for four minutes wearing inertial measurement units. A total of 18 trials per participant were completed between two days, one week apart. Four methods of pattern analysis, a) Euclidean distance, b) cosine similarity, c) random forest, and d) support vector machine, were applied to our basic spatiotemporal variables such as step and stride lengths to accurately identify people. Our best accuracy (98.63%) was achieved by random forest, followed by support vector machine (98.40%), and the top 10 most similar trials from cosine similarity (98.40%). Our results clearly demonstrate a persistent walking pattern with sufficient information about the individual to make them identifiable, suggesting the existence of a gaitprint.

Effects of foot–ground friction and age-related gait changes on falls during walking: a computational study using a neuromusculoskeletal model

We used a neuromusculoskeletal model of bipedal walking to examine the effects of foot–ground friction conditions and gait patterns on slip- and trip-induced falls. We developed three two-dimensional neuro-musculoskeletal models in a self-organized manner representing young adults, elderly non-fallers, and elderly fallers. We simulated walking under different foot-ground friction conditions. The static friction coefficient between the foot and the ground was varied from 0.05 to 2.0. Under low friction conditions, the three gait models demonstrated slip-induced falls. The elderly faller model experienced the most slip. This is because the RCOF was higher in the elderly faller model due to its short stride length but much smaller foot clearance. Under high friction conditions, only the elderly faller model demonstrated trip-induced falls. Based on the analysis using the margin of stability, the forward postural stability of the model gradually decreased under high-friction conditions, with the toe of the swing foot contacting the ground and subsequently falling forward. These results imply that there is an optimal coefficient of friction for the ground to prevent slip- and trip-induced falls by people with less stable gaits, which may provide new insights into the design of shoes and floor surfaces for the elderly.

A Prospective Study on Gait Impairment in Patients With Symptomatic Lumbar Canal Stenosis and Impact of Surgical Intervention on Gait Function.

Prospective observational cohort study. To analyze the effect of decompression surgery on gait characteristics in patients with stenosis. Also, to test the hypothesis that patient-reported functional outcomes and gait parameters (spatiotemporal, kinetic, and kinematic measures) will improve postoperatively and achieve normal values when compared with matched healthy controls. Lumbar spinal stenosis is one of the leading causes of disability among elderly population. Gait impairment is one of the primary symptoms of degenerative conditions involving lumbar spine. Research suggests that decompressive surgery can positively influence gait parameters in patients with spinal stenosis. Studies have shown improvements in walking speed, stride length, and balance post-surgery. Thirty-two patients with single-level lumbar stenosis and 32 healthy volunteers were prospectively recruited. All patients underwent gait analysis preoperatively and 6 months postoperatively as per standard protocol. Spatiotemporal, kinematic, and kinetic parameters were analyzed. Stepwise linear regression models were used to detect significant relationships between changes in functional score (Visual Analogue Scale/Oswestry Disability Index) and gait parameters. Significant improvement was noted in functional scores(P<0.05) 6 months post-surgery. Spatiotemporal (swing phase, mean velocity, cadence, stride length, step length, and step width) and kinetic parameters (hip, knee, and ankle power) were significantly better after surgery, reaching normal levels. Kinematic parameters significantly improved after surgery but did not reach normal levels when compared with controls. A significant correlation was found between changes in functional scores with changes in certain kinematic parameters (knee-power, ankle plantarflexion, swing time, peak ankle dorsiflexion in swing, peak-hip, and knee flexor moment). Decompression surgery in lumbar stenosis produces improvement in gait parameters, pain scores, and functional outcomes that significantly improve gait posture and speed.

“Acute responses to barefoot running are related to changes in kinematics, mechanical load, and inflammatory profile”

This study investigated the acute effects of barefoot (BF) running on biomechanical parameters and cytokine concentrations. Seventy-one habitually shod runners had biomechanical parameters evaluated during running shod (SH) and BF, while a sub-group of 19 runners had their inflammatory profile analyzed before and after a running session, using their habitual shoes or barefoot. Running BF changed spatiotemporal and joint kinematics, including the stride frequency (increased) and length (decreased), and foot strike pattern (more plantarflexed ankle at initial contact). An increased impact force was observed (p < 0.05), while joint moment, power, and work were also affected by BF running: a shift of joint load from the knee and hip to the ankle occurred (p < 0.05). In cytokine levels, maintenance (all cytokines, except Eotaxin, IL-12p40, IL-2, IL5, and MIP-1 beta) or reductions (IL-12p40, IL-2, and IL5) were observed as an acute response to BF running, what means to keep or reduce the levels of pro-inflammatory cytokines and immunological/chemoattraction proteins when compared to SH. Summarily, a single session of BF running may not represent enough stress to induce changes in the inflammatory profile. Besides the increased impact force, the joint load was reduced during short-term BF running. Nevertheless, short-term BF running should be cautiously applied due to the shift of joint load from the knee and hip to the ankle.

Examination of Gait Characteristics Related to Sarcopenia in Community-Dwelling Older Adults: A Study Focusing on Plantar Pressure.

Sarcopenia is a condition characterized by a decrease in skeletal muscle mass and strength with age, which results in a lower gait speed. Decreased gait speed in older individuals with sarcopenia can lead to adverse events such as falls and mortality. It is a major health issue; several studies have investigated gait speed in sarcopenia. However, plantar pressure has not been sufficiently evaluated. Plantar pressure facilitates gait analysis, including gait speed, and plays an important role in preventing adverse events such as falls and mortality. Therefore, the current study aimed to validate gait characteristics, including plantar pressure in community-dwelling older adults with sarcopenia. The current study included community-dwelling Japanese adults aged ≥60 years who participated in health checkups between 2013 and 2018. Sarcopenia was diagnosed by measuring muscle mass and strength based on clinical definition (nonsarcopenia: n = 7662; probable sarcopenia: n = 1208; and sarcopenia: n = 477). Gait parameters (including gait speed, relative plantar pressure, cadence, stride length, step length, step width and foot angle) were measured at a comfortable speed using a computerized electronic walkway. Gait parameters between groups were compared via an analysis of covariance adjusted for age and BMI. In addition, post hoc analyses were performed with Bonferroni correction. The sarcopenia and probable sarcopenia groups had a significantly lower gait speed than the nonsarcopenia group (p < 0.01). Further, the sarcopenia and probable sarcopenia groups had a significantly lower forefoot plantar pressure, stride length and cadence than the nonsarcopenia group (all p < 0.01). When comparing, the sarcopenia group had a greater medial plantar pressure, step length, and foot angle and a lower lateral plantar pressure, cadence, and step width than the probable sarcopenia group (all p < 0.01). The sarcopenia, probable sarcopenia and nonsarcopenia groups differed concerning gait characteristics, including plantar pressure. It is thought that exercise instruction that takes into account walking characteristics is important for probable sarcopenia and sarcopenia.

Gait variability predicts real-life falls in high-functioning stroke survivors

BackgroundWhile over 60 % of adults with stroke fall each year, the risk is greatest in high-functioning individuals with mild motor impairments and greater physical mobility. We lack sensitive predictors of falls in this population. Therefore, our study aimed to determine the relative contribution of gait variability and widely used tests of balance and mobility in predicting real-life falls in high-functioning adults with stroke. MethodsTwenty-four adults with stroke who had the ability to walk independently, Fugl-Meyer lower-extremity score of ≥19/34, and Frenchay Activities Index ≥16/45 performed overground walking, Timed-up and go, and Berg balance scale. We quantified the gait speed, and gait variability for stride length and stride time. We recorded the history of falls in the past one year. FindingsThe incidence rate of past falls was 50 %. Stride length variability and Berg balance scale score were associated with previous falls in univariate analyses and were subsequently included in the multivariate model. Multivariate analyses showed that only stride length variability significantly predicted past falls (OR = 2.73, 95 % CI 1.05–7.08, p = 0.03). A cut-off of 3.98 % for stride length variability had 75 % sensitivity and 91.7 % specificity in predicting previous falls (AUC = 0.83, 95 % CI 0.64–1.00, p < 0.001). InterpretationIn high-functioning adults with stroke, stride length variability during overground walking is a strong predictor of the past incidence of falls compared with traditional balance and mobility tests. Our findings highlight the importance of gait variability in accurately determining fall risk among high-functioning post-stroke individuals.

The difference in gait pattern between adults with obesity and adults with a normal weight, assessed with 3D-4D gait analysis devices: a systematic review and meta-analysis.

A systematic review and meta-analysis were performed following PRISMA 2020 guidelines to identify the difference in gait pattern between adults with obesity and adults with a normal bodyweight assessed with 3D-4D gait analysis (3D-4DGA) devices. Articles about the spatiotemporal parameters of adults with obesity compared with adults with a normal bodyweight using a 3DGA were sought on the 4th of October 2023 in three different databases (PubMed, Web of Science and IEEE). A total of 3371 articles were found: 2065 with PubMed, 1185 with Web of Science, and 121 with IEEE. The data was screened double-blind. Fourteen case control studies were included in the systematic review and meta-analysis, and for all of them, the risk of bias was determined. Obesity was defined using the BMI, with a range of 30 kg/m² until 54.06 kg/m². Participants from both sexes (35% men and 65% women) were included, and they had an age range of 18-65 years. The risk of bias was assessed with the Newcastle Ottowa Scale (NOS), and the certainty of evidence was assessed with the Evidence-Based Richtlijn Ontwikkeling (EBRO). The meta-analysis showed a decrease in gait speed and cadence and an increase in stance phase, double stance, and step width. No significant difference was found regarding stride length. In the systematic review, step length, step rate, and swing phase were found to have decreased. Regarding the single stance, step time, CoM, and CoP, no conclusions could be drawn. There is a difference in gait parameters between adults with obesity and adults with a normal bodyweight. Namely, the gait speed, step rate, step length, swing phase is decreased in adults with obesity. However, there is an increase in step width, stance phase, and double stance phase.

Muscle type-specific effects of bilateral abobotulinumtoxinA injection on muscle growth and contractile function in spastic mice.

Intramuscular injection of botulinum neurotoxin type A (BoNT-A) is commonly used to improve or maintain the joint range of motion in young children with spasticity. However, the effectiveness of BoNT-A treatment is variable and movement limitations are recurrent. Here we show long-term effects of a single, bilateral abobotulinumtoxinA (aboBoNT-A) injection in the gastrocnemius medialis and soleus muscles of wild-type and spastic (B6.Cg-Glrbspa/J with a mutation in the glycine receptor) mice at a young age (6-7 days). Specifically, we evaluated the impact of aboBoNT-A-A on gait, physical performance, and spontaneous physical behavior, as well as on contractile force characteristics, morphology, and histological phenotype of soleus and gastrocnemius muscles by comparing their results to those of saline-injected controls up to 9 weeks after the injection. The detailed time course of the study specifies the timing of the aboBoNT-A injection at 1 week, the period of behavioral studies from 4-9 weeks, and the age of the mice (10 weeks) at the time of contractile force characteristics and histology assessments. In spastic mice, aboBoNT-A injection had a minor and very specific effect on physical performance, by only modestly increasing stride length as a function of age. aboBoNT-A injection caused a reduction in the force-generating capacity and a slightly smaller physiological cross-sectional area in gastrocnemius medialis, but not in soleus. Reduced physiological cross-sectional area in aboBoNT-A-injected muscles was due to a lower number of muscle fibers, rather than reduced muscle fiber cross-sectional area. The percentage of slow-type muscle fibers and mitochondrial succinate dehydrogenase activity were increased, which was associated with an improved muscle endurance capacity. In conclusion, aboBoNT-A injection reduced the number of muscle fibers, causing muscle hypertrophy in remaining fibers and a shift towards more oxidative fibers, resulting in an improved endurance capacity and gait. This study proposed potential cellular mechanisms for the therapeutic efficacy of aboBoNT-A in spasticity.

Dynamic evaluation of community health services and health quality based on biomechanical time series

Background: Evaluating community health services and fitness exceptional is important for identifying areas of development and making sure powerful healthcare shipping. Biomechanical assessment, especially reading joint movements, provides valuable insights into people’s fitness popularity and useful capabilities. Although biomechanical time-collecting information has terrific promise, there is not much thorough research that comprises those parameters in population health checks. Aim: This study evaluates the dynamic relationship between biomechanical time series data of joint movements and community health quality metrics. It also finds important factors for good health and gives practical advice for improving community health services. Methods: The study utilizes a biomechanical time series dataset from Kaggle. The collected time series data was preprocessed using Z-score standardization to ensure comparability. Gated Refined Long Short-Term Memory (GRLSTM) networks were employed for tasks due to their ability to capture long-term dependencies and temporal relationships inherent in time series data. Results: Statistical analyses such as regression and ANOVA were conducted to explore relationships between joint movement patterns and health quality predictors. The GRLSTM indicates significant associations between specific joint movement patterns and health quality indicators. Regression analyses confirmed key predictors of health quality, while ANOVA demonstrated significant differences in joint movement patterns among different health quality groups. The GRLSTM model demonstrates exceptional performance, with 94% precision and 95% recall rates, an accuracy of 98% and a robust F1-score of 96%, indicating a strong equilibrium between recall and accuracy. The ANOVA shows joint angles as the strongest predictor (p &lt; 0.001). The regression analysis identifies stride length (β = 2.30, p &lt; 0.001) as the strongest positive predictor. Conclusion: This observation emphasizes the importance of incorporating biomechanical assessments into community health reviews, highlighting the capability of GRLSTM networks and predictive analytics in improving fitness satisfaction and healthcare strategies.

Influence of regional anesthesia on fall risk in adults over 60 years

BackgroundAge-related changes can influence gait and contribute to a higher fall risk. Other influencing factors might be certain anesthetic procedures which affect therapeutic decisions. The study's goal was to evaluate whether brachial plexus blockade impacts the postoperative fall risk in adults ≥60 years. Methods40 adults ≥60 years without predisposing fall risk factors receiving brachial plexus blockade were included. Gait parameters during single- and dual-task conditions were assessed using the GAITRite® walkway at three measurement points: preoperatively, within 24 h, and two weeks postoperatively. Additionally, a geriatric assessment including Berg Balance Scale, Timed Up and Go test and Montreal Cognitive Assessment was conducted, alongside pain intensity via Numeric Rating Scale. Statistical analysis involved ANOVA with repeated measures. FindingsAll gait parameters showed a performance reduction within 24 h. Significant changes occurred during single-task in stride length (P = 0.018) and stride width variability (P < 0.01), further during dual-task in stride width (P = 0.015) and velocity (P = 0.039). Notable changes were also observed in the Berg Balance Scale (P < 0.0001), the Timed Up and Go test (P < 0.001), and Montreal Cognitive Assessment (P = 0.037). After two weeks the study parameters returned to the performance prior to surgery. Performance declined with increasing age. Pain intensity remained low. InterpretationWhile brachial plexus blockade offers various advantages for patients due to its tolerability and controllability an increased gait instability and thus fall risk within the first postoperative day must be considered especially in older adults.

Gait alteration during turning while walking in older adults with benign paroxysmal positioning vertigo

Background Older adults with Benign Paroxysmal Positioning Vertigo (BPPV) may present with unsteadiness that affects gait patterns. Objective This study investigated the spatiotemporal gait parameters and indicators of turning difficulty during the Timed Up and Go (TUG) test in older adults with BPPV. Methods This case-controlled study collected data from older adults aged 65 and above with BPPV, young adults with BPPV and older adults without BPPV. Postural stability and self-perception of stability were measured using the Functional Gait Analysis and the Malay version of the Dizziness Handicap Inventory, respectively. The spatiotemporal gait parameters were recorded using a camera. The one-way ANOVA test was used for statistical analysis. Results Older adults with BPPV presented with alteration in gait parameters (time and number of steps) compared to older adults without BPPV and adults with BPPV during the TUG test (p < 0.05). During the straight walking tasks of the TUG test, there were significant differences in stride length and velocity between the three groups (p < 0.05). Older adults with BPPV presented with less pivoting and took longer time and more steps to complete the turning phase of the TUG. Conclusions The findings suggest that gait performance was compromised in older adults with BPPV.

Association Between Standard Gait Measures and Anterior Quadriceps Muscle Thickness as Measured by Point of Care Ultrasound (POCUS).

Background: Gait parameters and sarcopenia both predict falls risk among older adults. Our objective was to evaluate whether fast, easy-to-obtain measures of anterior thigh muscle by point of care ultrasound (POCUS) are significantly associated with standard gait measures. Methods: All subjects were referred from ambulatory geriatric medicine clinics at an academic center. Quadriceps muscle thickness was measured by a portable ultrasound device. Gait variables were measured by the patient in comfortable walking shoes walking for six minutes. The primary response variables were gait variables, and the predictor variables were age, biological sex, body mass index, and muscle thickness. Univariate and multivariate regression analyses were performed. Results: A total of 150 participants were recruited from geriatric medicine clinics (65 women, 84 men). Muscle thickness was measured in 149 participants, and the mean (SD) was 1.91 (0.52) (median 1.82 cm, 0.96 to 3.68 cm). Univariate analysis of gait parameters with age showed a statistically significant correlation with gait speed (R2=0.16, P < 0.000), average stride length (R2=0.142, P < 0.000), and average stride velocity (R2=0.182, P < 0.000). Among all the gait variables, average swing time (P = 0.010) and average stance time (P = 0.010) were correlated significantly with muscle thickness. For multivariate analysis with age and gait variables, age was a significant independent variable for all gait variables that were significant in univariate analysis. Conclusion: POCUS showed a significant association with average swing time, average stance time, and step time variability. Although more work needs to be done, POCUS has the potential to be a rapid screening tool for gait assessment.

Gait abnormalities and longitudinal fall risk in older patients with end-stage kidney disease and sarcopenia

BackgroundSarcopenia, gait disturbance, and intradialytic hypotension are among the various factors that contribute to fall risk. This study aimed to investigate the relationship between risk of sarcopenia, hemodialysis (HD) session, and long-term fall risk in older end-stage kidney disease (ESKD) patients by analyzing their spatiotemporal gait characteristics.MethodsWe recruited 22 non-demented patients aged ≥ 65 years who were undergoing maintenance HD. Participants were divided into two groups based on their SARC-F score (< 4 and ≥ 4) to identify those with higher and lower risk of sarcopenia. Demographics, comorbidities, and renal parameters were compared between groups. Inertial measurement unit-based technology equipped with triaxial accelerometry and gyroscope was used to evaluate gait characteristics. The gait task was assessed both before and after dialysis using the Timed-Up and Go (TUG) test and a 10-meter walking test at a regular pace. Essential gait parameters were thoroughly analyzed, including gait speed, stride time, stride length, double-support phase, stability, and symmetry. We investigated the interaction between the dialysis procedure and gait components. Outcome of interest was any occurrence of injurious fall during follow-up period. Logistic regression models were employed to examine the relationship between baseline gait markers and long-term fall risk.ResultsThe SARC-F ≥ 4 group showed various gait abnormalities, including longer TUG time, slower gait speed, longer stride time, shorter stride length, and longer double support time compared to counterpart (SARC-F < 4). After HD sessions, the SARC-F ≥ 4 group showed a 2.0-second decrease in TUG task time, an 8.0 cm/s increase in gait speed, an 11.6% lower stride time, and a 2.4% increase in gait symmetry with significant group-time interactions. Shorter stride length and longer double support time were associated with injurious falls during the two-year follow-up.ConclusionOur study demonstrated the utility of triaxial accelerometers in extracting gait characteristics in older HD patients. High-risk sarcopenia (SARC-F ≥ 4) was associated with various gait abnormalities, some of which partially improved after HD sessions. These gait abnormalities were predictive of future falls, highlighting their prognostic significance.

The effect of anxiety on gait: a threat-of-scream study.

It is known that fear responses to clearly identified threats can inhibit motion, slowing down gait and inducing postural freezing. Nonetheless, it is less clear how anxiety, which emerges during threat anticipation, affects gait parameters. In the present work, we used a threat-of-scream paradigm to study the effects of anxiety on gait. Twenty-five participants (15 female, aged 23.4 ± 1.8) were instructed to walk on a 5-m walking track, while motion was recorded in 3D, via a VICON system. Four alternating blocks, two "threat" and two "safe" blocks of 10 trials each, were signaled by colored stripes on a screen in front of the walking path. Participants were informed that they could hear a human scream in their headphones at any time during threat blocks, which were in fact always delivered during walking. On the contrary, no screams were delivered in the safe blocks. Results indicated that participants reported higher subjective anxiety during threat vs. safe blocks. Furthermore, increases in self-reported anxiety from safe to threat showed significant moderate correlations with increased stride speed and length, decreased stride time and decreased stance phase duration. Increases in anxiety were also moderately correlated with increased arm/leg swing amplitude, an effect that was fully mediated by increased stride speed. Overall, these results indicate that anxiety invigorates motion in healthy subjects, by increasing speed. These results are discussed in terms of the recent advancements in the understanding of defensive behavior, its neural correlates and on clinical implications relative to pathological anxiety.

Cross-sectional analysis of speed-up mechanism in normal gait among healthy older adults with and without falls – Results from the Baltimore Longitudinal Study of Aging

BackgroundFalls in older adults increase the risk of mobility loss. Proper understanding of gait mechanisms related to falls may provide novel solutions for maintaining mobility in older adults. Research questionIdentify fall-related gait patterns through analyzing alterations in gait parameters to walk faster than usual pace in older adults. MethodsA Total of 519 participants (mean age = 73.12 years; 51.05 % female), including non-fallers (n = 396) and fallers (n = 123), aged 60–96 years were assessed in the Baltimore Longitudinal Study of Aging. Participants completed gait assessments at both usual and fast paces. Range of motions (ROM) for the hip, knee, and ankle joint in the sagittal plane and hip abductor ROM during normal and fast pace gait were measured by 3D motion capture system (Vicon 612). For all gait variables, percentage-changes (PC; (((fast-walking_parameter – usual-walking_parameter) /usual-walking_parameter)*100)) was calculated. Associations of PC for gait speed and PC for other gait parameters were compared between fallers and non-fallers. ResultsCompared to non-fallers, fallers walked with shorter stride, elongated double support time and shorter knee ROM in the faster pace walk (p = 0.044, p = 0.019, and p = 0.036, respectively). PCs of all gait related variables were significantly associated with PC of gait speed in non-fallers (ps < 0.005), while in the fallers, only PC for stride length, cadence, and hip ROM were associated with PC for gait speed (ps < 0.001). SignificanceAmong non-fallers related PC for gait speed was associated with PC across gait parameters suggesting the use of similar biomechanical approaches in usual and fast gait. Compared to non-fallers, fallers demonstrated different mechanisms of transition from usual to fast gait. Evaluating speed-up strategies could provide insight into subtle yet important gait modifications in apparently well-functioning older adults that would help identify individuals at high risk of falling.