Total Double Support Research Articles

Exploring Teslasuit's Potential in Detecting Sequential Slip-Induced Kinematic Changes among Healthy Young Adults.

This study aimed to assess whether the Teslasuit, a wearable motion-sensing technology, could detect subtle changes in gait following slip perturbations comparable to an infrared motion capture system. A total of 12 participants wore Teslasuits equipped with inertial measurement units (IMUs) and reflective markers. The experiments were conducted using the Motek GRAIL system, which allowed for accurate timing of slip perturbations during heel strikes. The data from Teslasuit and camera systems were analyzed using statistical parameter mapping (SPM) to compare gait patterns from the two systems and before and after slip. We found significant changes in ankle angles and moments before and after slip perturbations. We also found that step width significantly increased after slip perturbations (p = 0.03) and total double support time significantly decreased after slip (p = 0.01). However, we found that initial double support time significantly increased after slip (p = 0.01). However, there were no significant differences observed between the Teslasuit and motion capture systems in terms of kinematic curves for ankle, knee, and hip movements. The Teslasuit showed promise as an alternative to camera-based motion capture systems for assessing ankle, knee, and hip kinematics during slips. However, some limitations were noted, including kinematics magnitude differences between the two systems. The findings of this study contribute to the understanding of gait adaptations due to sequential slips and potential use of Teslasuit for fall prevention strategies, such as perturbation training.

The effects of different carrying methods on human gait parameters

Lifting and carrying are essential tasks that affect human balance and gait. Choosing a certain gait pattern could help reduce the risk of falling. This study investigates the differences in human gait parameters and lateral bending of the trunk when carrying a 5-gallon water bottle, compared to that of normal walking. Several gait parameters were considered, including the cadence, stride width, step length, total double support duration, walking speed, toe angle, and single support duration. A laboratory experiment was conducted considering 23 healthy males, 18–30 years in age, performing several carrying scenarios, with and without the use of two assistive devices (a bottle lifting handgrip handle and back and lumbar support). The ProtoKinetics Zeno™ Walkway Gait Analysis System and the ProtoKinetics Movement Analysis Software were used to measure the spatiotemporal gait parameters. In addition, the lumbar spine's lateral bending was measured using Kinovea software. The results showed that the assistive carrying devices helped achieve less deviation in the walking pattern while carrying, compared to that of normal walking, and reduced the lateral bending of the trunk, resulting in greater balance while carrying. This, in turn, helps reduce the chance of falling and the stress in the joints and muscles, thereby increasing stability. In conclusion, carrying two 5-gallon water bottles using a handgrip handle assistive device was the most preferred carrying method.

Comparison ofgender,age, andbodymassindex forspatiotemporalparameters ofbilateralgaitpattern.

Background:Studies on thegaitsparameters have been identified on the patient population. Most researchers confirm thatthe patientswalk differently than normal people and they may have agreaterriskoffalls. Consistent finding and description of gender, age, and body mass index differences in gait studiesisrare in healthy subjects. This research wasperformedto compare spatiotemporal parameters of gait between gender, as per their age and body mass index level. Methods:A cross-sectional study was conductedwithforty-five young adults (F=20, M=25). Stadiometer andPhysilog4 inertial sensors were used for data collection.Agait analyzer 5.2 software (GaitUp, S.A. Lausanne, Switzerland) was used to determine spatiotemporal parameters. Results: Females were found withhighermean score of total double support and cadence than males. Cadence also increases with age. Obese people showed lower gait speed, cadence, andtotaldouble support.No statistically significant differences were found in any bilateral foot gait parameters with respect to gender, age, and body mass index. Conclusion:The findings of the study may be beneficial to those who haveabnormalgait pattern due to age, body mass index differences, decreased muscle strength, spasticity, and joint mobility. Thisimportant information should be considered to rehabilitate patients with abnormal gait patterns tocontrollingdynamic balance and risk of falling.

Effects of Different Nordic Walking Training Frequencies on Gait Performance in Elderly Adults

<p>目的：台灣的高齡人口比例持續攀升，而透過北歐式健走訓練能改善步態特性能並有效預防跌倒，然而現未有足夠的研究，探討不同週訓練次數的北歐式健走，對健康高齡者步態特性之影響。方法：48名65歲以上高齡者，隨機分成每週訓練5次為：NW5組；3次為：NW3組；1次為：NW1 組 (NW代表北歐式健走組，數字代表每週健走次數) ，進行12週北歐式健走運動。在介入前後，測試自然速度和最快速度之步態特性。以相依樣本t檢定比較前、後測之差異。結果：(1) 自然速度步態結果發現，NW5組之步行速度與步頻顯著變快，擺動期時間與單腳支撐期時間顯著縮短；NW3組之各個步態參數皆未達顯著差異；NW1組之雙腳支撐期總時間、負重反應期時間、擺動前期時間顯著增加。 (2) 最快速度步態結果發現，NW5組之擺動期時間、單腳支撐期時間顯著縮短；NW3組之腳跟觸地期時間顯著縮短；NW1組之各個步態參數皆未達顯著差異。結論：不同週訓練次數的北歐式健走，對高齡者步態特性有不同的影響；每週訓練5次的北歐式健走較能改善步態特性，並可做為高齡者進行北歐式健走訓練的處方。</p> <p> </p><p>Purpose: The purpose of this study was to investigate the effects of different Nordic walking training frequencies on gait parameters in elderly adults. Methods: 48 healthy elderly adults were randomly assigned into three groups, five (NW5), three (NW3), and one (NW1) times of Nordic walking training per week. The preferred speed gait and fastest speed gait were measured before and after 12 weeks of Nordic walking intervention. The differences between the pre-training and post-training were compared by the paired sample t-test. Results: (1) In the preferred speed gait measurement, the walking speed and cadence in NW5 group were significantly faster, as well as swing time and single support time were significantly shortened. All gait parameters in NW3 group was no significant changed. The total double support time, loading response time, and pre-swing time were significantly increased in NW1 group. (2) In the fastest speed gait measurement, the swing time and single support time in NW5 group were significantly decreased. Heel contact time in NW3 group was significantly decreased. All gait parameters in NW1 group was no significantly changed. Conclusion: The gait performance of elderly adults were changed result from different weekly training times of Nordic walking after 12-weeks intervention. The Nordic walking training with 5 times per week is positive training protocol for elderly adults because some gait performance were improved.</p> <p> </p>

Balance Evaluation and Gait Analysis After Arthroscopic Partial Meniscectomy.

The purpose of this study is to investigate how walking and balance are affected at different time intervals after arthroscopic partial meniscectomy (APM). Forty-five patients with APM and a healthy control group of 46 people were included in the study. Gait and bipedal balance analysis were performed to the patient group twice in 4 weeks and 12weeks after surgery. In the gait analysis performed after 4 weeks, stance phase (SP), step time (ST), and total double support (TDS) were higher, and step length (SL), swing phase (SWP), cadence (C), and speed (V) in the patient group were lower. After 12weeks, SP, TDS, and step width (SW) data were higher in the patient group and SWP was lower. In both measurements, the gait of the patient group is not symmetrical. In open-eye balance test, it was observed that the data of length of ellipse (LoE), area of ellipse (AoE), and path length of CoP (PL) were different after 4 weeks but these differences disappeared after 12weeks. Width of ellipse (WoE), LoE, AoE, and PL data were different in the test performed with eyes closed after 4 weeks. In addition to the same data after 12weeks, the medio-lateral direction (ML) was also higher than the patient group. After 12weeks, walking has not fully recovered. There was no difference in the balance analysis with eyes open, but the differences were still present in the eyes-closed analysis.

Gait and posture are correlated domains in Parkinson’s disease

Establishing a relationship between gait and posture in patients with Parkinson's disease (PD) is essential for PD treatment and rehabilitation. While previous studies have indicated that gait and posture are independent domains in PD, shared neuromechanisms related to gait and posture control and previous studies investigating the relationship between gait and posture parameters in stroke survivors and neurologically healthy older adults have shown a correlated domain. Thus, this study analyzed the relationship of gait and posture domains, primarily through gait temporal sub-phases (i.e., double support and stance phases) and step width. We analyzed the spatial-temporal gait parameters at the self-selected velocity and center of pressure (CoP) during quiet standing of 22 idiopathic PD participants under and without dopaminergic medication conditions. The association between quiet standing and gait variables was assessed through the Spearman test, controlled by age, disease duration, NFoG-Q, and levodopa dosage. In ON medication, CoP area showed a significant correlation with stance phase and total double support; and RMS ML CoP showed a significant correlation with stance phase, total double support, and step width. In OFF medication, CoP area, RMS AP CoP, RMS ML CoP, and ML CoP velocity significantly correlated with stance phase and total double support. By showing the relationship between gait and posture domains in PD, our study adds novel knowledge about the shared gait-posture control, which could collaborate with new approaches during mobility treatment and assessment.

Dementia, fall risk and routine clinical care: Opportunities to enhance care by incorporation of examiner‐independent analytics — Computerized cognitive evaluation and quantified digital gait analysis including dual tasking

AbstractBackgroundDementia is an encompassing term referring to conditions characterized by progressive cognitive impairment (CI) that impairs ability to function independently and simultaneously results in increased risk of falling. Falls are common and their consequence costly in cognitively impaired individuals. Clinical reports suggest that falls and gait performance during dual tasking (DT) are particularly related to executive function. Additional reports propose that DT gait abilities predict future fall risk and that interventions designed to improve DT will decrease future fall risk. Analysis of DT gait function to non‐DT gait function has been shown to be superior in discerning those at higher fall risk, in comparison to previous measures. Clinically, CI varies in degree and combination of cognitive deficits and gait disturbance but clinician recognition of such varied types/degrees of CI is likely problematic.MethodsCross sectional analysis of PwDaD who underwent both validated computerized cognitive assessment battery (CAB) and digital gait analysis in the course of routine patient care and were screened for risk of falls.Results120 PwDaD, 57.5% female, average age 74+/‐ 10 years. T‐tests were performed between gait domains scored from PKMAS for PwDaD groups for step length, stride length, stride width, velocity and total double support. All individual gait domains showed a significant change in score for t‐tests performed between preferred walking speed (PWS) and DT gait function (p<0.01). Regression analysis of PwDaD cognitive profile against DT velocity was performed as well. CAB regressions of multiple cognitive domain scores against dual task velocity which were significant included: global summary score, executive function, visuo‐spatial and motor skills’ scores (p<0.05).ConclusionThe addition of a cognitive factor to gait, i.e. dual task, demonstrates a decrease in gait parameter functions in comparison to PwDaD gait at PWS. Earlier objective patient centric identification of increased fall risk provides clinicians an opportunity to effectively and pre‐emptively intervene to reduce such increased disability consequence and costs associated with this disease related impact.

Comparison ofgender,age, andbodymassindex forspatiotemporalparameters ofbilateralgaitpattern.

Background:Studies on thegaitsparameters have been identified on the patient population. Most researchers confirm thatthe patientswalk differently than normal people and they may have agreaterriskoffalls. Consistent finding and description of gender, age, and body mass index differences in gait studiesisrare in healthy subjects. This research wasperformedto compare spatiotemporal parameters of gait between gender, as per their age and body mass index level. Methods:A cross-sectional study was conductedwithforty-five young adults (F=20, M=25). Stadiometer andPhysilog4 inertial sensors were used for data collection.Agait analyzer 5.2 software (GaitUp, S.A. Lausanne, Switzerland) was used to determine spatiotemporal parameters. Results:No statistically significant differences were found in any bilateral foot gait parameters with respect to gender, age, and body mass index. Females were found withhighertotal double support and cadence than males. Cadence also increases with age. Obese people showed lower gait speed, cadence, andtotaldouble support. Conclusion:These findings may be beneficial to those who haveabnormalgait pattern due to age, body mass index differences, decreased muscle strength, spasticity, and joint mobility. Thisimportant information should be considered to rehabilitate patients with abnormal gait patterns tocontrollingdynamic balance and risk of falling.

Women after Bilateral Surgical Correction of Hallux Valgus Do Not Show Improvement in Spatiotemporal Gait Parameters at 18 Weeks Postoperatively.

Background: Hallux valgus (HV) is a gait-altering orthopedic deformity, somewhat more prevalent in women, which often affects both limbs. Although surgery is a commonly applied treatment, there is no consensus in the literature on how invasive HV correction affects spatiotemporal gait parameters, or how quickly improvement can be expected. We investigated gait parameters in female HV patients who underwent bilateral surgical correction of hallux valgus, both preoperatively and 18 weeks following surgery (a timeframe relevant from the perspective of physical therapy), and also in relation to a non-HV control group. Methods: A total of 23 women aged 40–70 years, with moderate to severe HV deformity in both feet, were assessed preoperatively and 18 weeks postoperatively, and an age-matched control group of 76 healthy women was also assessed. A total of 22 spatiotemporal parameters were collected during 30 s walks over an electronic walkway (Zebris Medical System). Results: Of the 22 parameters analyzed, significant differences between the preoperative experimental and control groups were found only in 4 parameters (Velocity, Right step time, Total double support and Stride time), but in 16 parameters between the postoperative experimental and control groups (the greatest impact being found for: Left and Right Step time, Stride time, Cadence, Right Foot rotation, Left Step length (% leg length) and Stride length (% leg length)). Conclusions: Women after bilateral HV correction did not exhibit improved (i.e., more normal) gait parameters at 18 weeks postoperatively; rather, they showed more gait abnormalities than preoperatively. These findings urge longer-term planning of postoperative rehabilitation, involving continual evaluation of gait improvement.

Effects of Strengthening and Stretching Exercises on the Temporospatial Gait Parameters in Patients With Plantar Fasciitis: A Randomized Controlled Trial.

Objective To investigate the effects of physical therapy interventions using strengthening and stretching exercise programs on pain and temporospatial gait parameters in patients with plantar fasciitis (PF).MethodsEighty-four patients with PF participated in the study and were randomly assigned to the strengthening or stretching exercise groups. All patients received 8 physical therapy interventions two times per week in the first 4 weeks and performed daily strengthening or stretching exercises three times per day. After 4 weeks, they continued the assigned exercise programs every day for 8 weeks. Pain visual analogue scale (VAS) scores at the worst and in the morning and temporospatial gait parameters were evaluated at the baseline, intermediate of the intervention, end of the intervention, and the first and second month follow-up.ResultsThere were significant effects of the time on the worst pain, morning pain, cadence, stride time, stride length, total double support, and gait speed, but there was no effect on step width. In addition, the main effect of the group and the interaction effects of the time and the group were not found in any parameters. For intra-group comparisons, there were significant differences in worst pain, morning pain, cadence, and stride time among the assessment times in both groups. For inter-group comparisons, there were no significant differences in all parameters.ConclusionBoth strengthening and stretching exercise programs significantly reduced pain and improved gait in patients with PF.

Validity of Micro-Data Loggers to Determine Walking Activity of Turkeys and Effects on Turkey Gait.

Accelerometers have the potential to provide objective, non-invasive methods for detecting changes in animal behavior and health. Our objectives were to: (1) determine the effects of micro-acceleration data loggers (accelerometers) and habituation to accelerometers on turkey gait and health status, (2) determine age-related changes in gait and health status, and (3) assess the validity and reliability of the accelerometers. Thirty-six male commercial turkeys were randomly assigned to one of five groups: accelerometer and habituation period (AH), accelerometer and no habituation period (AN), VetRap bandage (no accelerometer) and habituation period (VH), bandage (no accelerometer) and no habituation period (VN), and nothing on either leg (C). Health status and body condition were assessed prior to video-recording birds as they walked across a Tekscan® pressure pad at 8, 12, and 16 weeks to determine effects of treatment on number of steps, cadence, gait time, gait distance, gait velocity, impulse, gait cycle time, maximum force, peak vertical pressure, single support time, contact time, step length, step time, step velocity, stride length, total double support time, and duty factor. Accelerometer validity and reliability were determined by comparing the number of steps detected by the accelerometer to the number of steps determined from video recordings. Several age-related changes in turkey gait were found regardless of habituation including a slower cadence at 16 weeks, shorter gait distance at 8 weeks, and slower gait velocity at 16 weeks. When comparing bandaged vs. unbandaged limbs, both treatment and age-treatment interactions were found depending on the gait parameter. Accelerometer validity and reliability were affected by both age and treatment. False discovery rate increased, while accuracy and specificity decreased with age. Validity and reliability were lowest for non-habituated birds (AN and VN). Results demonstrated that micro-data loggers do not adversely affect turkey health status, but habituation to wearing accelerometers greatly affects accelerometer reliability and validity. Accelerometer validity and turkey gait are also greatly affected by the age of the turkeys.

The mental representation of the human gait in hip osteoarthrosis and total hip arthroplasty patients: A clinical cross-sectional study

Objective: To explore differences in gait-specific long-term memory structures and actual gait performance between patients with hip osteoarthrosis, patients seen six months after total hip arthroplasty and healthy controls to gain insights into the role of the gait-specific mental representation for rehabilitation. Design: Cross-sectional study Subjects: Twenty hip osteoarthrosis patients, 20 patients seen six months after total hip arthroplasty and 20 healthy controls Methods: Spatio-temporal (gait speed, step length) and temporophasic (stance time, swing time, single support time, total double support time) gait parameters, and gait variability were measured with an electronic walkway (OptoGait). The gait-specific mental representation was assessed using the structural dimensional analysis of mental representations (SDA-M). Results: Hip osteoarthrosis patients showed significantly longer stance and total double support times, shorter swing and single support times, and a decreased gait speed as compared with healthy controls (all P < 0.01). The differences in double support times were still evident in patients seen six months after total hip arthroplasty (P < 0.01). The gait-specific mental representation differed between hip osteoarthrosis patients and healthy controls with regard to mid-stance and mid-swing phases; the mid-stance phase was still affected six months after total hip arthroplasty (both P < 0.05). Conclusion: Our data indicated that actual gait performance and gait-specific long-term memory structures differ between hip osteoarthrosis patients and healthy controls. Important, some of these disease-related changes were still evident in patients seen six months after total hip arthroplasty.

The mental representation of the human gait in patients with severe knee osteoarthrosis: a clinical study to aid understanding of impairment and disability

Objective: Objectives were (1) to explore differences in gait-specific long-term memory structures and gait performance between knee osteoarthrosis patients and healthy subjects and (2) to identify the extent to which the gait-specific mental representation is associated with gait performance. Design: Cross-sectional study. Subjects: In total, 18 knee osteoarthrosis patients and 18 control subjects. Methods: Spatio-temporal (gait speed, step length) and temporophasic (stance time, swing time, single support time, total double support time) gait parameters and gait variability were measured with an electronic walkway (OptoGait). The mental representation was assessed using the structural dimensional analysis of mental representations (SDA-M). Results: (1) Patients showed significantly longer stance times (P < 0.002) and total double support times, shorter swing times and single support times, a decreased gait speed (P-values < 0.001) and structural differences in the gait-specific mental representation as compared with the healthy controls. (2) Correlation analyses revealed the mental representation of the human gait to be associated with actual gait performance in osteoarthrosis patients. Double support times were positively associated with the structural quality of the mental representation and step length variability was positively associated with the number of sequencing errors in the representation. Conclusion: The gait-specific mental representation and actual gait performance differ between patients with severe knee osteoarthrosis and healthy controls, and both are linked to one another. This finding suggests that musculoskeletal disorders can lead to changes in the mental representation of the gait, and as such the SDA-M could provide useful information to improve the rehabilitation following osteoarthrosis.

First signs of elderly gait for women.

The aims of this study have been twofold: to attempt to reduce the number of spatiotemporal parameters used for describing gait through the factor analysis and component analysis; and to explore the critical age of decline for other gait parameters for healthy women. A total of 106 women (aged ≥ 40 years old (N = 76) and ≤ 31 years old (N = 30)) were evaluated using a pressure-sensitive mat (Zebris Medical System, Tübingen, Germany) for collecting spatiotemporal gait parameters. The factor analysis identified 2 factors - labelled Time and Rhythm - that accounted for 72% of the variation in significant free-gait parameters; the principal component analysis identified 4 of these parameters that permit full clinical evaluation of gait quality. No difference was found between the groups in terms of the values of parameters reflecting the temporal nature of gait (Rhythm), namely step time, stride time and cadence, whereas significant differences were found for total double support phase (p < 0.001). Next, seeking evidence of a critical decline in gait, we selected 3 parameters: total double support, stride time and velocity. We concluded that the women taking part in the experiment manifested significant signs of senile gait after the age of 60 years old, with the first symptoms thereof already manifesting themselves after 50 years of age. We show that among 26 spatiotemporal parameters that may be used for characterizing gait, at least a half of them may be omitted in the assessment of gait correctness; a finding that may be useful in clinical practice. The finding that the onset of senile gait occurs in the case of women after the age of 60 years old, in turn, may be useful in evaluating the ability for performing types of physical work that mainly require ambulation. Med Pr 2017;68(4):441-448.

Carrying shopping bags does not alter static postural stability and gait parameters in healthy older females

Food shopping is an important aspect of maintaining independence and social interaction in older age. Carriage of shopping bags alters the body's weight distribution which, depending on load distribution, could potentially increase instability during standing and walking. The study examined the effect of carrying UK style shopping bags on static postural stability and gait in healthy older and young females. Nine older (71.0±6.0 years) and 10 young (26.7±5.2 years) females were assessed in five conditions carrying no bags, one 1.5kg bag in each hand, one 3kg bag in each hand, one 1.5kg bag in preferred hand, one 3kg bag in preferred hand. Antero-posterior and medio-lateral displacement, and 95% ellipse area from a 30s quiet standing were used for postural stability assessment. Stride length and its coefficient of variation, total double support time, step asymmetry and gait stability ratio were calculated from 1min treadmill walking at self-selected speed for gait assessment. Carrying shopping bags did not negatively affect postural stability or gait variables, in either group. Further, in older individuals, a decrease in sway velocity was found when holding bags during the postural stability assessment (p<0.05), suggesting that carriage of bags, irrespective of the load distribution, may have a stabilising effect during quiet standing. These results should help to alleviate concerns regarding safety of carrying shopping bags and help encourage shopping, both as a social and as a physical activity.

Effects of forward &amp;amp; backward walking training with progressive body weight supported on stroke patients’ ambulatory ability

Objective: In the present study, the effects of progressive body weight support treadmill forward & backward walking training (FBWT), progressive body weight support treadmill forward walking training (FWT), and progressive body weight support treadmill backward walking training (BWT), and on stroke patients` ambulatory abilities were examined. Design: Randomized controlled trial. Methods: A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the step length, total double support, cadence, gait were measured using optogait and the 10-m walk test (10MWT), 6 minutes walk test (6MWT). Results: In the within group comparisons, all the three groups showed significant differences between before and after the intervention (p<0.05). In the comparison of the three groups, there were significant differences among the three groups in stride length, double limb support stance, cadence, 10MWT, and 6MWT in the third week, and only in stride length, 10MWT, and 6MWT test in the sixth week (p<0.05). Conclusions: This study verified that progressive body weight-supported treadmill gait training positively affected the gait ability of stroke patients in an actual gait environment. It also showed that FBWT group was more effective than FWT group and BWT group training.

Mobility and cognition: End points for dietary interventions in aging

BACKGROUND: Healthy aging is associated with functional declines in mobility and cognition among both humans and non-human animals. OBJECTIVE: This study combines human measures of mobility and cognition to develop a test battery for evaluating the effects of dietary supplements among older adults. Selected measures parallel behavior tasks used to assess the efficacy of dietary interventions in rodent models of aging. METHODS: Seventy six healthy adults, between the ages of 21 and 75, completed a 1 hour mobility and cognition assessment. Postural sway and spatiotemporal gait parameters were measured using a Zebris ™ instrumented treadmill system. A computerbased virtual water maze and the trail-making test were used to assess spatial memory and executive function, respectively. RESULTS: Sway velocity during quiet standing increased with age. Preferred gait speed declined with age and changes in the gait cycle reveal an age-related increase in total double support during normal walking. In the virtual water maze, latency to locate a hidden or visible platform increased with age; meanwhile, probe test performance declined with age. CONCLUSIONS: Healthy adults show age-related declines in measures of mobility and cognition. These measures are a useful tool for translating research on dietary interventions to older adults.

A hippotherapy simulator is effective to shift weight bearing toward the affected side during gait in patients with stroke

We investigated whether a hippotherapy simulator has influence on symmetric body weight bearing during gait in patients with stroke. Stroke patients were divided into a control group (n = 10) that received conventional rehabilitation for 60 min/day, 5 times/week for 4 weeks and an experimental group (n = 10) that used a hippotherapy simulator for 15 min/day, 5 times/week for 4 weeks after conventional rehabilitation for 45 min/day. Temporospatial gait assessed using OptoGait and trunk muscles (abdominis and erector spinae on affected side) activity evaluated using surface electromyography during sit-to-stand and gait. Prior to starting the experiment, pre-testing was performed. At the end of the 4-week intervention, we performed post-testing. Activation of the erector spinae in the experimental group was significantly increased compared to that in the control group (p < 0.01), whereas activation of the rectus abdominis decreased during sit-to-stand. Of the gait parameters, load response, single support, total double support, and pre-swing showed significant changes in the experimental group with a hippotherapy simulator compared to control group (p < 0.05). Moreover, activation of the erector spinae and rectus abdominis in gait correlate with changes of gait parameters including load response, single support, total double support, and pre-swing in experimental group. These findings suggest that use of a hippotherapy simulator to patients with stroke can improve asymmetric weight bearing by influencing trunk muscles.

Retest Reliability of the Temporal and Distance Characteristics of Hemiplegic Gait Using a Footswitch System

Using a footswitch system, the retest reliability of the temporal and distance parameters of gait was investigated within a session for 22 stroke patients in the early phase of rehabilitation. High to very high reliability was found for the temporal and distance parameters of gait, and the temporal symmetry index based on the difference in single-limb support duration between each leg (r = 0.85 to 0.98; intraclass correlation coefficients (ICC)(2,1) = 0.82 to 0.98). Significant differences were found between the two trials for velocity, stride length, and total double support (p < .05). Despite the high reliability coefficients, 95% confidence intervals, which take into account the random and systematic error, were wide for all parameters. These wide confidence intervals indicate that the use of two consecutive measurements for interpreting an individual patient's change would not be a sensitive method for monitoring progress or deterioration during rehabilitation. Strategies that may improve the clinical usefulness of temporal and distance gait measures in stroke rehabilitation are discussed. These include further reducing error sources, increasing data collection per measurement, using serial measurements on each patient, or using less rigorous confidence intervals.

The effects of body weight support on the locomotor pattern of spastic paretic patients.

The effects of mechanically supporting a percentage of body weight on the gait pattern of spastic paretic subjects during treadmill locomotion was investigated. Electromyographic (EMG), joint angular displacement and temporal distance data were simultaneously recorded while 7 spastic paretic subjects walked at 0% and 40% body weight support (BWS) at their maximal comfortable treadmill speed. Forty percent BWS produced a general decrease in EMG mean burst amplitude for the lower limb muscles investigated with instances of more appropriate EMG timing in relation to the gait cycle. The joint angular displacement data at 40% BWS revealed straighter trunk and knee alignment during the weight bearing phase especially at initial foot-floor contact and midstance. An increase in single limb support time and a decrease in percentage total double support time were evident at 40% BWS. An increase in stride length and maximum comfortable walking speed was also seen with BWS. The use of BWS during treadmill locomotion as a therapeutic approach to retrain gait in neurologically impaired patients is discussed.