Three-dimensional Gait Analysis System Research Articles

The influence of knee position during static calibration trials on evaluation of knee loading during gait in individual with medial knee osteoarthritis

Quantitative three-dimensional gait analysis has been used to evaluate the loading at the knee (i.e. external knee adduction moment, EKAM) during level ground walking in individuals with knee osteoarthritis (OA). The magnitude of EKAM can be influenced by some factors, such as knee marker position and foot placement angles in static calibration trials, which may lead to inaccurate functional assessments and intervention planning. This study aimed to clarify the effects of knee position during static calibration trials on the evaluation of knee loading during gait in individuals with medial knee OA. Seventeen individuals with medial knee OA completed three different static standing trials; (1) knee flexed at 0 degrees, (2) knee flexed at 15 degrees, and (3) knee flexed at 30 degrees before walking at their self-selected speed. A sixteen-camera three-dimensional VICON gait analysis system with four AMTI force platforms was used to collect the EKAM, knee adduction angular impulse (KAAI), knee joint center (KJC), and other knee kinematic and kinetic variables during gait. A repeated measures ANOVA was used to investigate the differences between conditions. The 1st peak of EKAM, the 1st peak EKAM arm, KAAI, and knee extension moment were significantly increased at the 15-degree and 30-degree conditions in comparison with the 0-degree condition (P < 0.05). Additionally, the knee flexion moment and knee external rotation moment were significantly reduced at the 15-degree and 30-degree conditions in comparison with the 0-degree condition (P < 0.05). All biomechanical variables were influenced by the localization of the KJC during static calibration trials. The changes in knee position during static trials significantly affected the 1st peak EKAM, KAAI, and other knee kinematics and kinetics variables during gait. Therefore, future studies should consider keeping the participants’ knees in a consistent position during static trials between visits, as the variations in knee position could mask or exaggerate the differences between groups and interventions.

Lasso Analysis of Gait Characteristics and Correlation with Spinopelvic Parameters in Patients with Degenerative Lumbar Scoliosis.

This study quantifies the gait characteristics of patients with degenerative lumbar scoliosis (DLS) and patients with simple lumbar spinal stenosis (LSS) by means of a three-dimensional gait analysis system, aiming to determine the image of spinal deformity on gait and the correlation between spinal-pelvic parameters and gait characteristics in patients with DLS to assist clinical work. From June 2020 to December 2021, a total of 50 subjects were enrolled in this study, of whom 20 patients with DLS served as the case group and 30 middle-aged and elderly patients with LSS were selected as the control group according to the general conditions (sex, age, and BMI) of the case group. Spinal-pelvic parameters were measured by full-length frontal and lateral spine films one week before surgery, and kinematics were recorded on the same day using a gait analysis system. Compared to the control group, DLS patients exhibited significantly reduced velocity and cadence; gait variability and symmetry of both lower limbs were notably better in the LSS group than in the DLS group; joint ROM (range of motion) across multiple dimensions was also lower in the DLS group; and correlation analysis revealed that patients with a larger Cobb angle, T1PA, and higher CSVA tended to walk more slowly, and those with a larger PI, PT, and LL usually had smaller stride lengths. The greater the PI-SS mismatch, the longer the patient stayed in the support phase. Furthermore, a larger Cobb angle correlated with worse coronal hip mobility. DLS patients demonstrate distinctive gait abnormalities and reduced hip mobility compared to LSS patients. Significant correlations between crucial spinopelvic parameters and these gait changes underline their potential influence on gait disturbances in DLS. Our study identifies a Cobb angle cut-off of 16.1 as a key predictor for gait abnormalities. These insights can guide personalized treatment and intervention strategies, ultimately improving the quality of life for DLS patients.

Two Cases of Korean Medicine Treatment for Patients with Parkinson’s Disease Evaluated Using a Three-Dimensional Gait Analysis System

Objective: This study examined the effectiveness of Korean medicine treatments in two patients with Parkinson’s disease complaining of discomfort stemming from postural instability and gait disturbance (PIGD).Methods: Two patients were treated for 3 months. They visited the clinic once a week for the first month and thereafter once every 2 weeks. The Unified Parkinson’s Disease Rating Scale (UPDRS) and a three-dimensional gait analysis were performed at the first visit and at 1, 2, and 3 months thereafter.Results: In Case 1, gait speed, stride length, and swing phase increased. Double support decreased until 2 months after treatment but increased slightly after 3 months. Among the kinematic parameters, tilt and rotation increased. The total UPDRS Part III score decreased from 51 points to 29 points after 3 months of treatment. In Case 2, gait speed, stride length, and swing phase increased, but double support decreased. Among the kinematic parameters, tilt, rotation, and obliquity decreased. The total UPDRS Part III score decreased from 11 points to 7 points after 3 months of treatment.Conclusions: This study suggests that Korean medicine can be an effective treatment for patients with Parkinson’s disease who experience discomfort due to PIGD.

Three-dimensional gait analysis of the effect of directional steering on gait in patients with Parkinson's disease

IntroductionDeep Brain Stimulation (DBS) is an option to treat advanced Parkinson's Disease (PD), but can cause gait disturbance due to stimulation side efffects. This study aims to evaluate the objective effect of directional current steering by DBS on gait performance in PD, utilizing a three-dimensional gait analysis system. MethodsEleven patients diagnosed with PD and were implanted with directional lead were recruited. The direction of the pyramidal tract (identified by the directional mode screening) was set as 0°. Patients performed the six-meter-walk test and the time up-and-go (TUG) test while an analysis system recorded gait parameters utilizing a three-dimensional motion capture camera. The gait parameters were measured for the baseline, the directional steering at eight angles (0°, 45°, 90°, 135°, 180°, 225°, 270°, and 315°), and the conventional ring mode with 1, 2, and 3 mA. Pulse width and frequency were fixed. Placebo stimulation (0 mA) was used for a control. ResultsEleven patients completed the study. No significant difference were observed between gait parameters during the directional, baseline, placebo, or ring modes during the six-meter-walk test (p > 0.05). During the TUG test, stride length was significantly different between 0° and other directions (p < 0.001), but no significant differences were observed for the other gait parameters. Stride width was non-significantly narrower in the direction of 0°. ConclusionControlling stimulation using directional steering may improve gait in patients with PD, while avoiding pyramidal side effects.

Machine learning approach to gait deviation prediction based on isokinetic data acquired from biometric sensors

Background:Analyzing gait deviation is one of the crucial factors during the diagnosis and treatment of children with Cerebral Palsy (CP). The typical diagnostic procedure requires an expensive and complicated three-dimensional gait analysis system based on visual sensors. In this work, we focus on predicting well-known gait pathology scores using only information collected from the BS4P, the affordable isokinetic dynamometer. Using such equipment, it is possible to determine gait pathological indices such as the gait deviation index (GDI) or the Gillette gait index (GGI). Research question:Are there correlations between the results of examining patients with CP on the Biodex Pro 4 device and the gait quality metrics (GDI and GGI)? Methods:The isokinetic data acquired from biometric sensors (74 records) were analyzed using big data methods. We used several Machine Learning methods to find the correlation between gait deviation and isokinetic data: Adaptive Boosting Regression, K-nearest Neighbor, Decision Tree Regression, Random Forest Regression, and Gradient Boost Regression. Results:In this paper, we provided a detailed comparison of different machine learning regression models in predicting gait quality in patients with CP based only on the data gathered from affordable Biodex 4 Pro device. The best result was obtained using the gradient boosting regression model with Mean Absolute Percentage Error of 6%. However, it was not possible to precisely predict the GGI index using this method. Significance:The results obtained showed promising results in the evaluation of gait index scores, which gives the possibility of diagnosing patients with CP without the use of expensive optometric systems. Evaluating gait metrics using the approach proposed in this paper could be very helpful for both physicians and physiotherapists in assessing the condition of patients with CP, as well as other diseases related to gait problems.

The Validity and Reliability of a New Intelligent Three-Dimensional Gait Analysis System in Healthy Subjects and Patients with Post-Stroke

Odonate is a new, intelligent three-dimensional gait analysis system based on binocular depth cameras and neural networks, but its accuracy has not been validated. Twenty-six healthy subjects and sixteen patients with post-stroke were recruited to investigate the validity and reliability of Odonate for gait analysis and examine its ability to discriminate abnormal gait patterns. The repeatability tests of different raters and different days showed great consistency. Compared with the results measured by Vicon, gait velocity, cadence, step length, cycle time, and sagittal hip and knee joint angles measured by Odonate showed high consistency, while the consistency of the gait phase division and the sagittal ankle joint angle was slightly lower. In addition, the stages with statistical differences between healthy subjects and patients during a gait cycle measured by the two systems were consistent. In conclusion, Odonate has excellent inter/intra-rater reliability, and has strong validity in measuring some spatiotemporal parameters and the sagittal joint angles, except the gait phase division and the ankle joint angle. Odonate is comparable to Vicon in its ability to identify abnormal gait patterns in patients with post-stroke. Therefore, Odonate has the potential to provide accessible and objective measurements for clinical gait assessment.

The Immediate Effect of Backward Walking on External Knee Adduction Moment in Healthy Individuals.

Backward walking (BW) has been recommended as a rehabilitation intervention to prevent, manage, or improve diseases. However, previous studies showed that BW significantly increased the first vertical ground reaction force (GRF) during gait, which might lead to higher loading at the knee. Published reports have not examined the effects of BW on medial compartment knee loading. The objective of this study was to investigate the effects of BW on external knee adduction moment (EKAM). Twenty-seven healthy adults participated in the present study. A sixteen-camera three-dimensional VICON gait analysis system, with two force platforms, was used to collect the EKAM, KAAI, and other biomechanical data during BW and forward walking (FW). The first (P < 0.001) and second (P < 0.001) EKAM peaks and KAAI (P=0.02) were significantly decreased during BW when compared with FW. The BW significantly decreased the lever arm length at the first EKAM peak (P=0.02) when compared with FW. In conclusion, BW was found to be a useful strategy for reducing the medial compartment knee loading even though the first peak ground reaction force was significantly increased.

3d gait analysis in osteoarthritis patients

A three-dimensional gait analysis system is currently widely employed as a clinical tool for determining kinematic values in musculoskeletal illnesses. Osteoarthritis is a degenerative illness that first affects the articular cartilages and then progresses to the bones and joints. More often involved are load-bearing joints such as hip and knee. Types of osteoarthritis includes primary and secondary osteoarthritis depending on the cause. Gait patterns and variables are altered in individuals with osteoarthritis. In osteoarthritis individuals, 3d gait analysis is commonly used to evaluate time and distance variables of gait. Advanced electronic systems uses infrared (IRR) cameras linked to a computer to acquire kinematic data including gait speed, stride length, and joint angles, which are used to create kinematic patterns when walking. In terms of identifying the mechanisms that produce gait disturbance and understanding compensatory gait methods, these measurements appear to be relevant in OA. Kinematic data could also be used in clinical trials to assess the efficacy of OA therapies. Various intrinsic and extrinsic factors has an influence in measurement of variables. The purpose of this review is to identify the effectiveness of 3d system in evaluating kinematics in osteoarthritis patients. To find out the changes in different kinematic variables.

6DOF knee kinematic alterations due to increased load levels.

Whether load carriage leads to six-degrees-of-freedom (6DOF) knee kinematic alterations remains unclear. Exploring this mechanism may reveal meaningful knee kinematic information that can be used to improve load carriage conditions, the design of protective devices, and the knowledge of the effects of load carriage on knees. We recruited 44 subjects to explore kinematic alterations from an unloaded state to 60% bodyweight (BW) load carriage. A three-dimensional gait analysis system was used to collect the knee kinematic data. One-way repeated analysis of variance (ANOVA) was used to explore the effects of load levels on knee kinematics. The effects of increasing load levels on knee kinematics were smooth with decreased or increased trends. We found that knees significantly exhibited increased lateral tibial translation (up to 1.2 mm), knee flexion angle (up to 1.4°), internal tibial rotation (up to 1.3°), and tibial proximal translation (up to 1.0 mm) when they went from an unloaded state to 60%BW load carriage during the stance phase (p < 0.05). Significant small knee adduction/abduction angle and posterior tibial translation alterations (<1°/mm) were also identified (p < 0.05). Load carriage can cause significant 6DOF knee kinematic alterations. The results showed that knee kinematic environments are challenging during increased load. Our results contain kinematic information that could be helpful for knee-protection-related activities, such as target muscle training to reduce abnormal knee kinematics and knee brace design.

Variation In Interlimb Coordination Of Healthy Adults At Different Backward Walking Speeds

The central pattern generator is demonstrated to produce both rhythmic forward walking (FW) and backward walking (BW). Compared with FW, BW reduces the likelihood of anterior cruciate ligament rupture and osteoarthritis. Because visual feedback is absent in BW, abundant motor units are recruited and interlimb coordination becomes more variable. Walking speed is one of the primary constraints to affect interlimb coordination in FW. However, backward walking speeds that produce the optimal coordination in foot-shank and shank-thigh couplings are unclear in the healthy group. PURPOSE: To explore the effect of different backward walking speeds on the interlimb coordination of healthy adults. METHODS: Forty healthy adults (20 males and 20 females) were recruited, and gait data at preferred backward walking speed (PBWS), maximum backward walking speed (MBWS), 80% MBWS, 60%MBWS and 40% MBWS were collected using a three-dimensional gait analysis system. Continuous relative phase (CRP) method was applied to analyze the interlimb coordination (shank-foot and thigh-shank couplings) at different backward walking speeds and respective CRP was averaged across the subjects. CRPs between the shank-foot and thigh-shank couplings at different speeds were compared using one-way ANOVA. Level of significance was set at 0.05. RESULTS: The average CRP of the shank-foot coupling was the highest at 60% MBWS, reaching 8.61° ± 0.40°, while the average CRP at 80% MBWS was the lowest, which was 6.30° ± 0.11°. The average CRPs of 100% MBWS and 40% MBWS were similar, second only to that of 60% MBWS. For the thigh-shank coupling, the average CRP of 100% MBWS was the largest among five backward walking speeds, while the minimum average CRP was 7. 18° ± 1.27° when BW was performed at 80% MBWS. The interlimb coordination of the thigh-shank and the shank-foot couplings are significantly distinct at different backward walking speeds (P < 0.01). CONCLUSIONS: The interlimb coordination of the shank-foot coupling was the largest when walking backwards at 60% MBWS, while, for the thigh-shank coupling, the largest interlimb coordination was noticed at 100% MBWS. Backward walking speed for optimal locomotion ability varied in different couplings. This study provides a preliminary insight to rehabilitative backward walking training.

ACLD patients exhibit additional knee kinematic asymmetries at the speed level of healthy subjects.

Anterior cruciate ligament deficiency (ACLD) patients tend to walk slowly but try to catch up with the speed level of healthy subjects daily. Exploring the effects of the walking speed level of healthy subjects on the ACLD patients’ knee kinematics is important to improving non-operative treatments and delaying the progression of posttraumatic knee osteoarthritis. This study aimed to explore whether healthy controls’ walking speed level leads to additional knee kinematic asymmetries in patients with ACLD. 27 ACLD patients and 29 healthy controls were recruited for the study. The ACLD patients walked at two levels of walking speed, including self-selected and healthy controls’ walking speed levels. A three-dimensional gait analysis system was used to collect their knee kinematic data. ACLD patients exhibited more kinematic asymmetries when walking at healthy controls’ walking speed level than at their self-selected speeds. The kinematic asymmetries included increased posterior tibial translation (4.6 mm) and anteroposterior tibial ROM (3.9 mm), abduction angle (1.5°), and distal tibial translation (3.2 mm) asymmetries (p < 0.05). Our findings are meaningful for developing non-operative treatment strategies for patients with ACLD. To get fewer knee kinematic asymmetries, self-selected walking speed could be suggested for patients with ACLD daily rather than the speed levels of healthy subjects.

Three-dimensional gait analysis of lower extremity gait parameters in Japanese children aged 6 to 12 years

We aimed to develop gait standards for gait parameters in school-aged Japanese children and assess age-related differences in gait patterns and parameters. Children aged 6–12 years (n = 424) were recruited from two elementary schools. An instrumented three-dimensional gait analysis system was used to record each child's gait kinematics, kinetics, and spatiotemporal parameters. Participants were subdivided into three age groups (Group A, 6–8 years; Group B, 9–10 years; and Group C, 11–12 years). LMS Chartmaker, version 2.54, was used to create a developmental chart for the gait pattern. The non-normalized step and stride lengths were significantly longer, and the cadence was lower in older children; however, the opposite outcome occurred when analyzing normalized data. Ankle moment differed significantly by age, and the maximum ankle moment was higher in older children than that in younger children. Furthermore, the hip and knee flexion angles during gait and the normalized spatiotemporal parameters of Japanese children aged 6–12 years differed by age and from those of children from other countries. The centile chart of the gait pattern is a useful tool for clinicians to assess developmental changes in the gait pattern and detect gait abnormalities in children.

The 6DOF knee kinematics of healthy subjects during sloped walking compared to level walking

BackgroundLevel Walking is a frequent functional movement during daily life. However, sloped walking is also common. Exploring 6DOF knee kinematics during sloped walking is important. It provides a reference for the rehabilitation, safety, and knee health of patients with knee diseases walking on sloped surfaces. Research questionThe study aimed to explore 6DOF knee kinematics characteristics during sloped walking compared to level walking. We hypothesized that tibial anteroposterior translation and flexion angle (the sagittal plane) were significantly different from those of level walking. MethodsOne hundred young, healthy adults (50 males and 50 females) were recruited for this study. A three-dimensional gait analysis system was used to collect 6DOF knee kinematics during level and sloped walking. The slope was set to ± 15% when the sloped walking was performed. ResultsSloped walking mainly increased knee flexion angle (upslope, 2.5–26.2°, 1–100% gait cycle (GC), p < 0.05; downslope, 1.7–11.9°, 15–95% GC, p < 0.05) and anterior tibial translation (upslope, 0.7–4.1 mm, 3–54% GC & 0.6–2.1 mm, 80–94% GC; downslope, 1.0–2.2 mm, 21–69% GC) in the participants’ knees. However, participants' other 4DOF knee kinematics during sloped walking were significantly different from those during level walking (p < 0.05). Participants had ‘drastically changeable’ knee kinematic alterations in the transverse and coronal plane (the other 4DOF knee kinematics) during sloped walking compared to level walking. SignificanceOur results confirmed the hypothesis. Sloped walking significantly increased anterior tibial translation (in most GC) and flexion angle. These kinematic changes in healthy subjects should be evaluated and further explored for patients with knee diseases, such as anterior cruciate ligament deficiency. Our findings are meaningful for their rehabilitation or safety or knee health while walking on sloped surfaces. Our study may provide a pilot reference for the 6DOF knee kinematic exploration of sloped walking.

Quantitative Three-Dimensional Gait Evaluation in Patients With Glucose Transporter 1 Deficiency Syndrome

BackgroundOf the patients with glucose transporter 1 deficiency syndrome (GLUT1-DS), 90% have a pathologic gait. Ataxic-spastic and ataxic gaits are seen in 35% of patients each. A ketogenic diet and modified Atkins diet (MAD) are effective therapy in GLUT1-DS in terms of both the seizures and movement disorder. A three-dimensional gait analysis (3DGA) system can be used to evaluate gait quantitatively using spatiotemporal data and gait kinematics. We performed 3DGA in three ambulatory patients with GLUT1-DS to evaluate the characteristics of their gait pathology, and we compared the gait variables before and after enhancing the MAD in one patient. MethodsAfter examination by pediatric neurologists and pediatric orthopedic surgeons, 3DGA was performed. We assessed walking speed, step length, step width, gait variability, Gait Deviation Index (GDI), Gait Profile Score (GPS), and Gait Variable Score (GVS). ResultsAll three patients had a low GDI and high GPS, comprehensive indices of gait pathology. The unstable gait pattern featured a wide step width in one patient and high gait variability in two patients. In the sagittal plane, the patients had increased GVSs in the knee and ankle joints due to excessive knee flexion or extension and excessive ankle plantarflexion. In the horizontal plane, the patients had increased GVSs in the pelvis, hips, and foot due to excessive rotation during walking. After enhancing the MAD, GDI, GPS, and GVSs improved. Conclusions3DGA has potential for quantifying the characteristics of gait pathology and its improvement with dietary therapy in patients with GLUT1-DS.

Is Static Alignment a Good Predictor of Dynamic Alignment after Total Knee Arthroplasty?

Background: Total knee arthroplasty (TKA) is the only effective treatment of end-stage knee osteoarthritis (OA). Lower limb neutral alignment has been a criterion to predict prosthesis life; however, there has been recent controversy over this. Some researchers believe that lower limb static alignment does not significantly affect prosthesis life and some researchers have found that dynamic mechanical alignment may affect prosthesis life, which needs to be further studied. Methods: Eighty-seven patients with knee OA were evaluated by a three-dimensional (3D) gait analysis system before TKA and six months after TKA, dynamic mechanical alignment and basic gait parameters were then calculated. Based on the static alignment of the lower limb on the postoperative X-radiographs, they were divided into a neutral alignment group (58 cases), varus alignment group (20 cases), and valgus alignment group (9 cases). Simple linear regression was used to assess the correlation between static and dynamic alignment. One-way analysis of variance (ANOVA) was used to compare the differences in gait parameters between and within groups. Results: Eighty-seven patients were followed up for an average of six months after the operation. There was no significant difference in all gait parameters among the three groups after TKA. There was no correlation found between static alignment and dynamic alignment/knee adduction moment (KAM) after TKA, although patients showed a significant linear correlation before operation. There was a significant linear correlation between dynamic alignment and KAM before and after the operation. Conclusions: Static alignment has no significant effect on postoperative gait function. Static alignment is no longer an effective predictor of the dynamic alignment or KAM six months after TKA, although they are correlated before TKA. The dynamic alignment allows for better prediction of KAM, which may be a risk factor for the life of the prosthesis.

The Effect of Functional Biomechanics Garment for Walking.

The purpose of this study was to investigate the effects of a functional biomechanics garment (FBG) with a lower extremity assist function. 32 healthy male participants were included in this study. Participants were divided into an FBG with taping function group (FBG group) and a compression garment group (CG group). Cadence (steps/min), step length (m), and usual walking speed (m/s) were measured as spatio-temporal data. Kinetics, kinematics data, and dynamic joint stiffness (DJS) of the lower extremity were calculated using a three-dimensional gait analysis system. The FBG group showed significantly faster walking speed (FBG, 1.54 ± 0.12 m/s; CG, 1.42 ± 0.15 m/s, p < 0.05) and reduced hip DJS in terminal stance (FBG, 0.033 ± 0.014 Nm/kg/degree; CG: 0.049 ± 0.016 Nm/kg/degree, p < 0.05) compared to the CG group. The FBG decreased hip DJS in the terminal stance and affected walking speed. The passive elastic moment generated by the high elasticity part of the hip joint front in the FBG supported the internal hip flexion moment. Therefore, our FBG has a biomechanical effect. The FBG may be useful as a tool to promote health activities.

Changes in Gait Characteristics of Stroke Patients with Foot Drop after the Combination Treatment of Foot Drop Stimulator and Moving Treadmill Training.

Objective To study the changes in gait characteristics of stroke patients with foot drop after the combination treatment of foot drop stimulator and moving treadmill training and thus provide a basis for the improvement in a foot drop gait after stroke. Methods Sixty patients with hemiplegia and foot drop caused by stroke were randomly divided into two groups of 30: the test group and the control group. Both groups received basic rehabilitation training. On this basis, the test group received the combination treatment of foot drop stimulator and moving treadmill training. The control group received foot drop stimulator training. Both groups received consecutive treatment for 3 weeks, five times a week, and every single time lasted for 30 minutes. Before and after the treatment, a gait watch three-dimensional gait analysis system was used to measure and record the maximum angles of flexion of the affected side's hip, knee, and ankle; the pace; the step length asymmetry; the iEMG of the tibialis anterior muscle; the functional ambulation category; and Ashworth's modified spasticity classification of the gastrocnemius. Results After treatment, in the two groups, the maximum angles of flexion of the affected side's hip, knee, and ankle improved, the pace increased, the step length asymmetry decreased, the iEMG of the tibialis anterior muscle increased, the functional ambulation category improved, and Ashworth's modified spasticity classification of the gastrocnemius decreased, but the above changes in the test group were better than those in the control group. The difference is statistically significant (p < 0.05). Conclusions The combination treatment of the foot drop stimulator and moving treadmill can significantly improve stroke patients' foot gait and promote the normalization of hip flexion, knee flexion, and ankle flexion. It can increase the pace, significantly reduce the step length asymmetry, reduce the muscle tone of the gastrocnemius, and improve walking function.

Changes in 6DOF knee kinematics during gait with decreasing gait speed

BackgroundGait speed is recognized to correlate to knee kinematic alterations. Clinically, patients with knee diseases tend to walk slowly compared to healthy controls. Hence, gait speed may serve as a confounding factor in the kinematic characteristics of patients during gait compared to healthy controls. Research questionWhether and how gait speed affects six degrees of freedom (6DOF) knee kinematics remains unclear. The current study was designed to explore whether and how decreased gait speeds affect 6DOF knee kinematics. MethodsThirty subjects (15 males and 15 females) were recruited for this study. A three-dimensional gait analysis system was used to assess the 6DOF knee kinematics of subjects at gait speeds of 4.0 km/h, 3.5 km/h, 3.0 km/h, 2.5 km/h, 2.0 km/h, 1.5 km/h, and 1.0 km/h. Kinematics of gait cycle (GC) were assessed at all gait speed levels. ResultsDecreased adduction angle (0.5–3.2 °, p < 0.05), increased external rotation (0.6–3.3 °, p < 0.05) and decreased flexion angle (1.5–17.4 °, p < 0.05) were found during most GC as gait speed level decreased. Greater anterior tibial translation (0.9−2.6 mm, p < 0.05), greater proximal translation (0.4–2.4 mm, p < 0.05) and decreased lateral tibial translation (0.5–3.0 mm, p < 0.05) were found during most GC as gait speed level decreased. Gender was also found to have great effects on 6DOF knee kinematics (p < 0.05). Interactions between gender and gait speed were also found (p < 0.05). SignificanceOur findings suggest that additional attention should be paid when dealing with kinematic comparisons of GC between controls and patients with significantly different gait speeds or genders than controls. Kinematic alterations induced by gait speed may raise concern for patients with knee diseases who struggle to walk faster than their normal speed. This may enhance our knowledge of the relationship between gait speed and 6DOF knee kinematics.

THREE DIMENSIONAL GAIT ANALYSIS OF EXERCISE REHABILITATION AND MUSCLE TENSION

ABSTRACT Introduction: Timely assessment and correction of post-stroke hemiplegia gait, to improve walking ability, has become an urgent problem for patients with hemiplegia. Objective: In order to improve the effect of exercise rehabilitation and tensile strength testing, a three-dimensional gait analysis method was proposed. Methods: The kinematics, dynamics, ground reaction force and surface EMG of lower limbs were measured by VICON (Nexus 1.8.5), a three-dimensional gait analysis system, and Noraxon, a wireless surface EMG, while 13 healthy subjects walked. The intra-group correlation coefficient (ICC) and standard error of measurement (SEM) were used to compare the relative and absolute reliability of the two test results. Results: the re-testability ICC was 78~0.96, the standard error SEM% of kinematics parameters was 4.18~15.6, and the SEM% of dynamic parameters was 3.31~21.82. The SEM% of ground reaction force was 1.70~16.67, and the SEM% of surface EMG signal was 8.00~11.11. Conclusions: 3D gait analysis can improve the effect of exercise rehabilitation and tensile strength testing, and has good retesting reliability. Level of evidence II; Therapeutic studies - investigation of treatment results.

Improvement of freezing of gait in patients with Parkinson\u2019s disease by music exercise therapy: a study protocol for a randomized controlled trial

BackgroundProgression of freezing of gait, a common pathological gait in Parkinson’s disease, is an important risk factor for diagnosing the disease and has been shown to predispose patients to easy falls, loss of independent living ability, and reduced quality of life. Treating Parkinson’s disease with freezing of gait is very difficult, while the use of medicine and operation has been ineffective. Music exercise therapy, which entails listening to music as you exercise, has been proposed as a treatment technology that can change patients’ behavior, emotions, and physiological activity. In recent years, music exercise therapy has been widely used in treatment of motor disorders and neurological diseases and achieved remarkable results. Results from our earlier pilot study revealed that music exercise therapy can improve the freezing of gait of Parkinson’s patients and improve their quality of life. Therefore, we aim to validate clinical efficacy of this therapy on freezing of gait of Parkinson’s patients using a larger sample size.Methods/designThis three-arm randomized controlled trial will evaluate clinical efficacy of music exercise therapy in improving the freezing of gait in Parkinson’s patients. We will recruit a total of 81 inpatients with Parkinson’s disease, who meet the trial criteria. The patients will randomly receive music exercise with and without music as well as routine rehabilitation therapies, followed by analysis of changes in their gait and limb motor function after 4 weeks of intervention. We will first use a three-dimensional gait analysis system to evaluate changes in patients’ gait, followed by assessment of their limb function, activity of daily living and fall risk.DiscussionThe findings of this trial are expected to affirm the clinical application of this therapy for future management of the disease.Trial registrationChinese Clinical Trial Registry ChiCTR1900026063. Registered on September 20, 2019