Temporospatial Gait Parameters Research Articles

Heel-to-toe drop effects on biomechanical and muscle synergy responses during uphill walking.

Uphill walking is a common task encountered in daily life, with steeper inclines potentially imposing greater biomechanical and neuromuscular demands on the human body. The heel-to-toe drop (HTD) in footwear may influence the biomechanical and neuromuscular pattern of uphill walking; but the impact remains unclear. Adjustments in HTD can modulate biomechanical and neuromuscular patterns, mitigating the demands and optimizing the body's response to different inclinations. We hypothesize that adjustments in HTD can modulate biomechanical and neuromuscular patterns, mitigating the demands and optimizing the body's response to different inclinations. Nineteen healthy men walked on an adjustable slope walkway, with varied inclinations (6°, 12°, 20°) and HTD shoes (10mm, 25mm, 40mm), while the marker positions, ground reaction forces and electromyography data were collected. Our study reveals that gait temporo-spatial parameters are predominantly affected by inclination over HTD. Inclination has a more pronounced effect on kinematic variables, while both inclination and HTD significantly modulate kinetic and muscle synergy parameters. This study demonstrates that an increase in the inclination leads to changes in biomechanical and neuromuscular responses during uphill walking and the adjustment of HTD can modulate these responses during uphill walking. However, the present study suggests that an increased HTD may lead to elevated loads on the knee joint and these adverse effects need more attention.

Footwear, Orthoses, and Insoles and Their Effects on Balance in Older Adults: A Scoping Review.

Footwear, orthoses, and insoles have been shown to influence balance in older adults; however, it remains unclear which features, singular or in combination, are considered optimal. The aim of this scoping review was to identify and synthesise the current evidence regarding how footwear, orthoses, and insoles influence balance in older adults. Four electronic databases (MEDLINE, CINAHL, Embase, and AMED) were searched from inception to October 2023. Key terms such as "shoe*," "orthoses," "postural balance" and "older people" were employed in the search strategy. Studies meeting the following criteria were included: (i) participants had a minimum age ≥60 years, and were free of any neurological, musculoskeletal, and cardiovascular diseases; (ii) an active intervention consisting of footwear, foot orthoses, or insoles was evaluated; and (iii) at least one objective outcome measure of balance was reported. A total of 56 studies from 17 different countries were included. Three study designs were utilised (cross-sectional study, n = 44; randomised parallel group, n = 6; cohort study n = 6). The duration of studies varied considerably, with 41 studies evaluating immediate effects, 14 evaluating effects from 3 days to 12 weeks, and 1 study having a duration of 6 months. Seventeen different interventions were evaluated, including/consisting of textured insoles (n = 12), heel elevation (n = 8), non-specific standardised footwear and changes in sole thickness or hardness (n = 7 each), sole geometry or rocker soles, contoured or custom insoles and high collar height (n = 6 each), insole thickness or hardness and vibrating insoles (n = 5 each), outsole tread (n = 4), minimalist footwear and slippers (n = 3 each), balance-enhancing shoes, footwear fit, socks, and ankle-foot orthoses (n = 2 each), and eversion insoles, heel cups, and unstable footwear (n = 1 each). Twenty-three different outcomes were assessed, and postural sway was the most common (n = 20), followed by temporo-spatial gait parameters (n = 17). There was uncertainty regarding intervention effectiveness. Overall, features such as secure fixation, a textured insole, a medium-to-hard density midsole and a higher ankle collar, in isolation, were able to positively impact balance. Conversely, footwear with an elevated heel height and the use of socks and slippers impaired balance. There is a substantial body of literature exploring the effects of footwear, orthoses, and insoles on balance in older adults. However, considerable uncertainty exists regarding the efficacy of these interventions due to variability in methodological approaches. Further high-quality research is necessary to determine whether a singular intervention or a combination of interventions is most effective for enhancing balance in older adults.

Gait pattern in patients treated with a total hip arthroplasty due to an acute displaced cervical neck fracture: a randomised comparison between 29 cases with a cemented femoral stem and 16 cases with an uncemented femoral stem.

The choice between cemented or uncemented stem fixation in the treatment of a femoral neck fracture may influence patient rehabilitation and the resulting gait pattern, due to potential differences in implant positioning and fixation. We used gait analysis to study temporal gait parameters, hip kinematics and kinetics in patients who, 2 years previously, had been randomised to treatment with a cemented or uncemented stem and due to an acute femoral neck fracture. 45 Patients implanted with a cemented Lubinus SP II (n = 29) and an uncemented (n = 16) Corail stem were studied. Gait analysis was performed using a 16-camera motion capture system and force plates. 28 subjects served as controls. Temporal gait parameters, hip kinematics and kinetics were analysed. The patients had no or minimum pain (median Harris pain score 44, range 40-44) and the majority had no limp (median Harris limp score 11, range 5-11). Temporospatial gait parameters and abduction-adduction motions and moments did not differ between patients with cemented or uncemented stems (p > 0.05). Patients with cemented stems did, however, show more hip flexion and less extension during walking than those with an uncemented stem (p < 0.05). Moreover, the flexion-extension range was less in the cemented group (p < 0.04). Compared with controls, the hip fracture patients walked more slowly, with a shorter stride length and a longer stance phase. Increased hip flexion and reduced extension in patients using the Lubinus SP II cemented stem could be an effect of its anteverted neck, but this question requires further study. Despite acute treatment with THA, hip fracture patients demonstrated a change in gait pattern compared with controls 2 years after the operation. This suggests that these changes are caused by the presence of an implant, or the soft-tissue trauma partly caused by the surgery than by any degenerative disease present in patients undergoing elective surgery.ClinicalTrials.gov Identifier: NCT04791605.

Blast Overpressures as a Military and Occupational Health Concern.

This tutorial reviews effects of environmental stressors like blast overpressures and other well-known acoustic contaminants (continuous, intermittent, and impulsive noise) on hearing, tinnitus, vestibular, and balance-related functions. Based on the overall outcome of these effects, detailed consideration is given to the health and well-being of individuals. Because hearing loss and tinnitus are consequential in affecting quality of life, novel neuromodulation paradigms are reviewed for their positive abatement and treatment-related effects. Examples of clinical data, research strategies, and methodological approaches focus on repetitive transcranial magnetic stimulation (rTMS) and electrical stimulation of the vagus nerve paired with tones (VNSt) for their unique contributions to this area. Acoustic toxicants transmitted through the atmosphere are noteworthy for their propensity to induce hearing loss and tinnitus. Mounting evidence also indicates that high-level rapid onset changes in atmospheric sound pressure can significantly impact vestibular and balance function. Indeed, the risk of falling secondary to loss of, or damage to, sensory receptor cells in otolith organs (utricle and saccule) is a primary reason for this concern. As part of the complexities involved in VNSt treatment strategies, vocal dysfunction may also manifest. In addition, evaluation of temporospatial gait parameters is worthy of consideration based on their ability to detect and monitor incipient neurological disease, cognitive decline, and mortality. Highlighting these respective areas underscores the need to enhance information exchange among scientists, clinicians, and caregivers on the benefits and complications of these outcomes.

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

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

Acupuncture for gait disturbance of patients with subacute and chronic stroke: a systematic review and meta-analysis protocol

IntroductionHemiparetic gait is one of the most common sequelae of a stroke. Acupuncture has shown potential in correcting hemiplegic gait patterns and improving motor function recovery after stroke. However, controversial...

Does Increased Femoral Anteversion Can Cause Hip Abductor Muscle Weakness?

Increased femoral anteversion (IFA) causes functional problems (i.e., tripping, frequently falling, and fatigue) by affecting the pelvis and lower extremity biomechanics. In the frontal plane, increased contralateral pelvic drop and ipsilateral hip adduction, which are mainly considered deteriorated hip abductor muscle mechanisms, are associated with hip and knee injuries. The aim of this study was to examine the effects of femoral anteversion on hip abductor weakness and frontal plane pelvis-hip biomechanics during walking. The study included nine subjects with increased femoral anteversion and a control group of eleven subjects. Maximum isometric voluntary contraction (MIVC) values of the hip abductor muscles were measured with a handheld dynamometer. Three-dimensional gait analysis was performed for kinetic, kinematic, and temporo-spatial gait parameters. Non-parametric tests were used for statistical analysis (p < 0.05). There was no significant difference found between the MIVC values of the IFA and control groups (p = 0.14). Moreover, no significant difference was determined between the ipsilateral peak hip adduction (p = 0.088) and contralateral pelvic drop (p = 0.149) in the stance phase. Additionally, there was no correlation between the peak hip adduction angle in the stance phase and normalized MIVC values in the IFA group (r = -0.198, p = 0.44), or in the control group (r = -0.174, p = 0.55). The deviations of pelvic rotation (p = 0.022), hip internal rotation (p = 0.003), and internal foot progression (p = 0.022), were found to be higher in the IFA group than in the controls. IFA may not be associated with hip abductor muscle weakness, and it may not lead to the hip adduction and pelvic depression that can be seen in hip abductor weakness. Increased pelvic rotation and internal hip rotation during walking might be considered as a compensation for the femoral head-acetabulum alignment mechanism in the frontal plane.

Verification of gait analysis method fusing camera-based pose estimation and an IMU sensor in various gait conditions

A markerless gait analysis system can measure useful gait metrics to determine effective clinical treatment. Although this gait analysis system does not require a large space, several markers, or time constraints, it inaccurately measure lower limb joint kinematics during gait. In particular, it has a substantial ankle joint angle error. In this study, we investigated the markerless gait analysis method capability using single RGB camera-based pose estimation by OpenPose (OP) and an inertial measurement unit (IMU) sensor on the foot segment to measure ankle joint kinematics under various gait conditions. Sixteen healthy young adult males participated in the study. We compared temporo-spatial parameters and lower limb joint angles during four gait conditions with varying gait speeds and foot progression angles. These were measured by optoelectronic motion capture, markerless gait analysis method using OP, and proposed method using OP and IMU. We found that the proposed method using OP and an IMU significantly decreased the mean absolute errors of peak ankle joint angles compared with OP in the four gait conditions. The proposed method has the potential to measure temporo-spatial gait parameters and lower limb joint angles, including ankle angles, in various gait conditions as a clinical settings gait assessment tool.

P.166 Clinical outcome study of dysferlinopathy: The impact of lower limb orthoses on gait- a longitudinal single case study

Patients with limb girdle muscular dystrophy, LGMDR2/2B, caused by mutations in the <i>DYSF</i> gene, have a distinct gait pattern and may be prescribed Ankle Foot Orthosis (AFOs) to assist walking. However, there are few studies investigating the efficacy of orthoses in LGMD. In the Jain Foundation clinical outcome study for dysferlinopathy II (COSII, http://www.jain-foundation.org/dysferlinoutcomestudy), we are investigating the utility of instrumented gait analysis as a novel clinical biomarker. The aim of this study was to examine the temporospatial gait parameters of a 30-year-old male with LGMDR2, when walking shod, with and without a pair of silicon AFOs. The patient completed gait analysis at baseline and six-month visits using an instrumented walkway, the GAITRite, 240Hz. Temporospatial characteristics including gait velocity, step length, step width, stance and swing duration were extracted. The differences between walking with and without the AFO were examined at each time point and longitudinally. At baseline, when wearing the AFOs, there was negligible impact on walking speed, step length, stance time compared to shod walking without AFOs (<3% difference between walking conditions). Step width increased by 25% when wearing the AFOs. At six months, his shod walking speed and step length demonstrated little change (<5%), but step width increased by 12% and double limb support increased by 5%. When wearing the AFOs at six months, and compared to shod walking, walking speed and step length increased by <5%, double limb support reduced by 6% and step width increased by 11%. The patient reported at both time points that he wouldn't walk outside the home without wearing the AFO. This study has demonstrated that AFOs influenced gait outcomes relating to dynamic balance control and stability. Although only minimal changes were observed when wearing the AFO at baseline, substantial improvements in walking were observed when wearing the AFO at six months. Further work in a larger number of patients will help to understand indications for AFO prescription in LGMDR2 and other LGMDs.

Walking speed and patient-reported outcomes in young adults with cerebral palsy.

To examine the relationship between quantitative gait measurements and self-reported physical, psychological, cognitive, and social function status in young adults with cerebral palsy (CP). Seventy-two adults with CP (range 18-48y; median age 23y [interquartile range 21-27y]; 34 males, 38 females), in Gross Motor Function Classification System levels I to IV, who previously underwent an instrumented gait analysis (IGA) at our center as children were recruited. Participants underwent a repeated IGA. National Institutes of Health Patient-Reported Outcomes Information System (PROMIS) instruments including the PROMIS-57, Applied Cognition - General Concerns (Short Form), and Applied Cognition - Executive Function (Short Form) were administered. Data derived from current and prior IGA were compared via non-parametric correlation analysis with PROMIS subscores. Subscores for anxiety, depression, sleep, and fatigue did not significantly correlate with any IGA data. Walking speed, adjusted for stature, correlated strongly with multiple subscores: physical function (p<0.001, rs =0.708); participation in social roles (p=0.007, rs =0.319); executive function (p=0.005, rs =0.335). Pain interference correlated with longitudinal change in adjusted walking speed (p=0.032, rs =-0.259). The Applied Cognition - General Concerns (Short Form) correlated with prior absolute walking speed, but not adjusted values. This study underscores the importance of walking speed and its association with a variety of functional domains in adults with CP. Patient-Reported Outcomes Information System measures provide useful clinical data in young adults with cerebral palsy. Temporospatial gait parameters have wide-reaching functional influence in this population. Walking speed is strongly correlated with physical, social, and executive function.

Are we missing parameters to early detect risk factors of falling in older adults?

Falls in older adults constitutes a major health problem and a burden for public health systems worldwide. Despite the high prevalence of falls in older people over the past decades, a fall episode is preventable when early assessment is performed to identify the modifiable risk factors. Unfortunately, health care providers lack technical knowledge to do that, and many non-instrumented clinical tests used to detect those factors also lack responsiveness. To counteract those issues and perform a comprehensive assessment, the care provider already has access to valid, sensitive and affordable tools to measure physical markers of motor deterioration, such as body balance, temporospatial gait parameters, muscle strength and power. They all demand little investment and training, with promising results for early diagnostic and intervention. We hypothesize that majoring the knowledge and the investment on those low-cost missing parameters could change the current numbers and minimize the impact of a fall episode for both the individual and the public health care system.

Analysis of time series of surface electromyography and accelerometry in dogs

Accelerometers may be used as a tool for objective analysis of kinetic and/or temporospatial gait parameters; however, only a few studies have been done in small animals. Therefore, this study analysed surface electromyography (sEMG) signals related to inertial sensors (accelerometry), aiming to create a reproducible standard in dogs. The hypothesis was that the combined use of an accelerometer and sEMG sensors could be used to identify the phases of the gait cycle and that the standard data established in healthy dogs could be used to compare data obtained from dogs with hip dysplasia. These signs were obtained from two different muscles, the biceps femoris and vastus lateralis muscles, from two breeds of dogs (Labrador retriever and golden retriever), during a walking gait at a controlled velocity. After signal processing, a second-order low-pass Butterworth filter with a cut-off frequency of 6 Hz was used, and an algorithm was applied to determine a threshold value for the gait cycle phases. Then, correlations between signals from both transducers were determined. Data relating to percent muscle activity, correlation and asymmetric functions, stance time and swing during the gait cycle in healthy dogs were generated after signal processing. Signals collected from dogs with hip dysplasia fell outside of the reference intervals established in healthy dogs. In conclusion, the methods applied for signal analysis and processing allowed the identification of structures of muscular activity during the gait cycle and the establishment of normal distribution values in healthy dogs.

Walking with and without a robotic exoskeleton in people with incomplete spinal cord injury compared to a typical gait pattern.

Robotic exoskeleton (RE) enables individuals with lower extremity weakness or paralysis to stand and walk in a stereotypical pattern. Examine whether people with chronic incomplete spinal cord injury (SCI) demonstrate a more typical gait pattern when walking overground in a RE than when walking without. Motion analysis system synchronized with a surface electromyographic (EMG) was used to obtain temporospatial gait parameters, lower extremity kinematics, and muscle activity in ambulatory individuals with SCI and healthy adults. Temporospatial parameters and kinematics for participants with SCI (n = 12; age 41.4±12.5 years) with and without RE were significantly different than a typical gait (healthy adults: n = 15; age 26.2±8.3 years). EMG amplitudes during the stance phase of a typical gait were similar to those with SCI with and without RE, except the right rectus femoris (p = 0.005) and left gluteus medius (p = 0.014) when participants with SCI walked with RE. EMG amplitudes of participants with SCI during the swing phase were significantly greater compared to those of a typical gait, except for left medial hamstring with (p = 0.025) and without (p = 0.196) RE. First-time walking in a RE does not appear to produce a typical gait pattern in people with incomplete SCI.

Longitudinal Changes in Temporospatial Gait Characteristics during the First Year Post-Stroke.

Given the paucity of longitudinal data in gait recovery after stroke, we compared temporospatial gait characteristics of stroke patients during subacute (<2 months post-onset, T0) and at approximately 6 and 12 months post-onset (T1 and T2, respectively) and explored the relationship between gait characteristics at T0 and the changes in gait speed from T0 to T1. Forty-six participants were assessed at T0 and a subsample of twenty-four participants were assessed at T2. Outcome measures included Fugl-Meyer lower-extremity motor score, 14 temporospatial gait parameters, and symmetry indices of 5 step parameters. Except for step width, all temporospatial parameters improved from T0 to T1 (p ≤ 0.0001). Additionally, significant improvements in symmetry were found for the initial double-support time and single-support time (p ≤ 0.0001). As a group, no significant differences were found between T1 and T2 in any of the temporospatial measures. However, the individual analysis revealed that 42% (10/24) of the subsample showed a significant increase in gait speed (Welch’s t-test, p ≤ 0.002). Yet, only 5/24 (21%) of the participants improved speed from T1 to T2 according to speed-based minimum detectable change criteria. The increase in gait speed from T0 to T1 was negatively correlated with gait speed and stride length and positively correlated with the symmetry indices of stance and single-support times at T0 (p ≤ 0.002). Temporospatial gait parameters and stance time symmetry improved over the first 6 months after stroke with an apparent plateau thereafter. A greater increase in gait speed during the first 6 months post-stroke is associated with initially slower walking, shorter stride length, and more pronounced asymmetry in stance and single-support times. The improvement in lower-extremity motor function and bilateral improvements in step parameters collectively suggest that gait changes over the first 6 months after stroke are likely due to a combination of neurological recovery, compensatory strategies, and physical therapy received during that time.

Validity of self-reporting of gait alteration after tap test among patients with idiopathic normal pressure hydrocephalus

PurposeThe study aimed to examine the validity of self-reporting as an additional method to indicate gait alteration among patients with idiopathic normal pressure hydrocephalus. The score from self-reporting of gait alteration was validated with the data obtained from gait pressure measuring plate. In addition, temporo-spatial gait parameters among 3 groups classified by overall gait improvement (no change, slight, and good) were compared.MethodsThis study employed a cross-sectional design and investigated 31 patients with idiopathic normal pressure hydrocephalus. Gait performance was determined by a gait pressure measuring plate before and 24 hours after a tap test. Patients rated the changed score for gait behaviours using a questionnaire once on the day after the tap test. Criterion validity of the changed scores from patients’ self-reporting and data from the gait pressure measuring plate was examined. In addition, temporo-spatial gait parameters were compared among 3 groups with one-way analysis of variance and the Bonferroni posthoc test to determine pairwise difference.ResultsSignificant correlations were found for the temporo-spatial gait parameters between data from self-reporting and the gait pressure measuring plate. Comparisons of temporo-spatial gait parameters among groups demonstrated significant differences in all parameters.ConclusionsGait alteration identified by self-reporting was valid with gait performance measured by the gait pressure measuring plate. To achieve timely and appropriate medical management, we recommend health care professionals to request patients and caregivers to recognize gait alterations in assisting the disease progression identification.

Sex-Based Differences in Oxygen Cost of Walking and Energy Equivalents in Minimally Disabled Individuals With Multiple Sclerosis and Controls.

Elevated oxygen cost of walking and energy equivalents are reported for highly and moderately disabled individuals with multiple sclerosis (MS). However, less is known about minimally impaired individuals. Moreover, no sex-based data on the metabolic rates of individuals with MS are available. In this cross-sectional study, the metabolic rates and temporospatial parameters of gait during overground walking in minimally disabled individuals with MS versus matched controls were quantified and whether sex-based differences occur was examined. Sixty-nine minimally impaired adults with MS (37, relapsing-remitting MS [RRMS]; 32, clinically isolated syndrome [CIS]) and 25 matched controls completed two 6-minute walking bouts at comfortable and fast speeds. The oxygen cost of walking, energy equivalents, and respiratory exchange ratio were recorded through breath-by-breath open-circuit spirometry. Gait analysis was performed via a portable electronic walkway. At comfortable but not at fast speed, men with RRMS showed higher oxygen cost of walking than men with CIS (+17.9%, P = .04) and male controls (+21.3%, P = .03). In the RRMS group, men showed higher oxygen cost of walking (+19.2%, P = .04) and energy equivalents (+19.2%, P = .02) than women. Elevated oxygen cost of walking and energy equivalents in men were paralleled by significantly larger base of support and step time asymmetry during walking. Metabolic demands are elevated while walking in minimally disabled individuals with RRMS. Furthermore, higher energy demands occur in men, probably due to increased step symmetry and base of support. Clinicians are advised to follow energy expenditure metrics collected while walking because they can indicate a decrease in fitness, even in the early phase of MS.

Quantitative gait analysis of idiopathic normal pressure hydrocephalus using deep learning algorithms on monocular videos

A vision-based gait analysis method using monocular videos was proposed to estimate temporo-spatial gait parameters by leveraging deep learning algorithms. This study aimed to validate vision-based gait analysis using GAITRite as the reference system and analyze relationships between Frontal Assessment Battery (FAB) scores and gait variability measured by vision-based gait analysis in idiopathic normal pressure hydrocephalus (INPH) patients. Gait data from 46 patients were simultaneously collected from the vision-based system utilizing deep learning algorithms and the GAITRite system. There was a strong correlation in 11 gait parameters between our vision-based gait analysis method and the GAITRite gait analysis system. Our results also demonstrated excellent agreement between the two measurement systems for all parameters except stride time variability after the cerebrospinal fluid tap test. Our data showed that stride time and stride length variability measured by the vision-based gait analysis system were correlated with FAB scores. Vision-based gait analysis utilizing deep learning algorithms can provide comparable data to GAITRite when assessing gait dysfunction in INPH. Frontal lobe functions may be associated with gait variability measurements using vision-based gait analysis for INPH patients.

Clinical utility of the over-ground bodyweight-supporting walking system Andago in children and youths with gait impairments

BackgroundThe Andago is a rehabilitation robot that allows training walking over-ground while providing bodyweight unloading (BWU). We investigated the practicability, acceptability, and appropriateness of the device in children with gait impairments undergoing neurorehabilitation. Concerning appropriateness, we investigated whether (i) stride-to-stride variability of the stride time and inter-joint coordination was higher when walking over-ground in Andago versus treadmill walking, and (ii) activation of antigravity leg muscles decreased with higher levels of BWU.MethodsEighteen children and adolescents with gait impairments participated in three sessions. Practicability was assessed by determining the time needed to get a patient in and out of Andago, the accuracy of the BWU system, and other aspects. Acceptability was assessed by patients responding to questions, while six therapists filled out the System Usability Scale. To determine appropriateness, the participants were equipped with surface electromyography (sEMG) electrodes, electrogoniometers and accelerometers. Various parameters were compared between walking over-ground and on a treadmill, and between walking with three different levels of BWU (median: 20%, 35% and 50% of the bodyweight) over-ground.ResultsPracticability: the average time needed to get in and out of Andago amounted to 60 s and 16 s, respectively. The BWU system seemed accurate, especially at higher levels. We experienced no technical difficulties and Andago prevented 12 falls. However, participants had difficulties walking through a door without bumping into it. Acceptability: after the second session, nine participants felt safer walking in Andago compared to normal walking, 15 preferred walking in Andago compared to treadmill walking, and all wanted to train again with Andago. Therapists rated the usability of the Andago as excellent. Appropriateness: stride-to-stride variability of stride duration and inter-joint coordination was higher in Andago compared to treadmill walking. sEMG activity was not largely influenced by the levels of BWU investigated in this study, except for a reduced M. Gluteus Medius activity at the highest level of BWU tested.ConclusionsThe Andago is a practical and well-accepted device to train walking over-ground with BWU in children and adolescents with gait impairments safely. The system allows individual stride-to-stride variability of temporospatial gait parameters without affecting antigravity muscle activity strongly.Trial registration: ClinicalTrials.gov Identifier: NCT03787199.

Dual Cognitive Tasks Provoke Temporo-Spatial Gait and Anticipatory Postural Adjustments in Healthy Young Adults

Usually, dual cognitive tasks require additional attention to maintain postural control during standing and walking. In certain pathologies or injuries, dual cognitive tasks, such as walking and speaking, can challenge the balance system, making certain gait deficiencies more apparent. The issue is identifying normal gait changes compared to gait impairments to understand better the impact cognitive tasks have on gait mechanics. Purpose: To identify changes in temporospatial gait parameters in healthy young adults while walking and performing a cognitive task. Methods: Thirty-four healthy young adults participated in this study. We collected gait parameters with six gyroscopes and accelerometers (distributed on all limbs and trunk) during the 7-meter walk test. Two trials were performed with just walking at a self-selected pace (single task). Then, the participant was asked to perform a cognitive task by counting backward by three from 100 while walking for 7m for two more trials (dual cognitive task). Results: Dual cognitive tasks provoked significant adaptations (p&lt;.05) in gait parameters, such as increased double limb support time and stance phase with a reduction in single limb support time and swing phase. Increase the length of the walking cycle by decreasing the cadence and speed of walking speed. In addition, an increase in mediolateral postural sway, first-step initiation time, and trunk range of motion was observed. Conclusion: Dual cognitive tasks can cause normal alterations in the gait's dynamic component and variations in walking initiation. We recommend studying neuromuscular modification, such as changes in muscle activation, during dual cognitive tasks.

The acute effects of two different rigid taping methods in patients with hallux valgus deformity

Hallux valgus (HV) is one of the most common deformities of the foot, and it causes great difficulties for the patients. We aimed to investigate the effects of different rigid taping techniques on HV angle, foot motor performance, balance and walking parameters. Twenty-two voluntary individuals (12 males, 10 females) with flexible HV deformities between 18 and 35 years of age were included in the study. All measurements were done before and after placebo, athletic and Mulligan tapings were applied. After a three-day interval, new taping was applied on the same subject. HV angle was measured by goniometer. Foot motor performance (single leg heel rise test), balance (unilateral stance, limits of stability, sensory integration of balance) and temporospatial parameters of gait (step length, stride length, step width, foot angle and cadence) were evaluated. HV angles were reduced in all taping groups (p< 0.05). The Mulligan taping method was the most effective method in reducing HV angle. Foot motor performance was not affected by any type of taping (p> 0.05). Athletic taping increased step length and step width but reduced foot angle and cadence. The Mulligan taping increased cadence and reduced foot angle (p< 0.01). Both taping methods did not affect the postural stability and fall risk (p> 0.05). Stability limits were increased in Mulligan taping group (p< 0.05). It can be concluded that Mulligan taping method may be an alternative treatment method for HV rehabilitation especially as it increased the limits of stability and maintaining the balance. Mulligan method is more effective than athletic taping in terms of reducing instant HV angle.