Typical Gait Pattern Research Articles

Gait Characteristics and Development in Pediatric Populations With Visual Disorders: Where Do We Stand and Where Are We Going?

Introduction: Vision plays an important role in walking development. Understanding gait characteristics and development in infants and children with visual disorders is crucial to identify early walking impairment and promoting optimal motor performance. We aimed to identify typical gait patterns and differences between infants and children with visual disorders and their sighted peers, and how these change over time, identifying key research gaps in this area. Methods: A search of three databases identified 1,531 papers, of which eight met inclusion criteria. Results: Children who are blind showed differences in gait compared to peers with low vision or full sight. Differences were identified across age groups with slower walking, postural, head, and trunk position alterations and uncoordinated and reduced upper limb swing motions observed in children with blindness. Discussion: We identified three macro areas of interest related to gait characteristics in children with visual disorders: (1) and (2) compensation mechanisms of limbs, and (3) probing the environment. In general, children who are blind also showed the use of a wider base of support, more external rotation of the feet, and fewer steps taken per minute. There are no studies reporting gait characteristics in the early stages of walking development, scarcity of longitudinal investigations, and studies using different variables to measure gait. The lack of such evidence prevented the establishment of gait development trajectories over time in pediatric populations with visual disorders. Implications for Practitioners: This review is the first to summarize existing knowledge of gait characteristics in children with visual disorders, advancing our understanding regarding the key differences in gait patterns that are observed in this population. Information gathered in this work can help inform future studies and practitioners in this field, enhancing decision-making processes to support walking development and promoting increasing knowledge of gait progresses in infants and children with visual disorders.

Influence of femoral anteversion angle and neck-shaft angle on muscle forces and joint loading during walking.

Femoral deformities, e.g. increased or decreased femoral anteversion (AVA) and neck-shaft angle (NSA), can lead to pathological gait patterns, altered joint loads, and degenerative joint diseases. The mechanism how femoral geometry influences muscle forces and joint load during walking is still not fully understood. The objective of our study was to investigate the influence of femoral AVA and NSA on muscle forces and joint loads during walking. We conducted a comprehensive musculoskeletal modelling study based on three-dimensional motion capture data of a healthy person with a typical gait pattern. We created 25 musculoskeletal models with a variety of NSA (93°-153°) and AVA (-12°-48°). For each model we calculated moment arms, muscle forces, muscle moments, co-contraction indices and joint loads using OpenSim. Multiple regression analyses were used to predict muscle activations, muscle moments, co-contraction indices, and joint contact forces based on the femoral geometry. We found a significant increase in co-contraction of hip and knee joint spanning muscles in models with increasing AVA and NSA, which led to a substantial increase in hip and knee joint contact forces. Decreased AVA and NSA had a minor impact on muscle and joint contact forces. Large AVA lead to increases in both knee and hip contact forces. Large NSA (153°) combined with large AVA (48°) led to increases in hip joint contact forces by five times body weight. Low NSA (108° and 93°) combined with large AVA (48°) led to two-fold increases in the second peak of the knee contact forces. Increased joint contact forces in models with increased AVA and NSA were linked to changes in hip muscle moment arms and compensatory increases in hip and knee muscle forces. Knowing the influence of femoral geometry on muscle forces and joint loads can help clinicians to improve treatment strategies in patients with femoral deformities.

Walking with an ultrasound device: Can children maintain a typical gait pattern?

Walking with an ultrasound device: Can children maintain a typical gait pattern?

Symmetry of Shoe Size and Calf Girth in Children With Treated Idiopathic Clubfoot: A Longitudinal Study.

Treatments for idiopathic clubfoot focus on obtaining a functional foot, typical gait pattern, and activity participation. Patients and families are also concerned about practical considerations regarding shoe wear and the appearance of the calf. The purpose of this study was to quantify whether children treated for idiopathic clubfoot have symmetry differences in shoe size and calf girth when presenting with unilateral versus bilateral involvement. Participants with a diagnosis of idiopathic clubfoot (treated with Ponseti or French functional methods) were prospectively recruited along with children who are typically developing. Shoe size and calf girth were measured at 5, 7, and 10 years of age. Sixty-five participants, 45 with a diagnosis of idiopathic clubfoot (26 unilateral and 19 bilateral) and 20 who were typically developing, began the study at age 5. Children with clubfoot treated with the Ponseti versus French methods showed no differences in shoe size asymmetry, calf girth asymmetry, or absolute calf girth at age 5. Participants with unilateral clubfoot demonstrated an average of 1.5 size smaller shoes for the involved side at all 3 ages. Participants with bilateral clubfeet had a significantly smaller, <0.75 size difference between both feet. Participants with unilateral clubfoot demonstrated about a 2cm smaller calf girth on the involved side compared with the uninvolved side at all 3 ages. Participants with bilateral clubfeet had a smaller, <0.5cm calf difference between sides. Calf girths for involved limbs were significantly smaller than for uninvolved limbs. Children with unilateral clubfeet can expect to need a smaller shoe on their involved side. Children with bilateral clubfeet can expect a minimal shoe size discrepancy between limbs. All limbs with clubfoot involvement can expect to have a smaller calf girth than limbs that are typically developing. Level II. This is considered a prognostic study-investigating the effect of a treated clubfoot on shoe size and calf girth. This is a lesser-quality prospective study in which <80% of persons completed follow-up.

The Design and Control of a Footplate-Based Gait Robo-Assisted System for Lower Limb Actuator

Stroke causes disability in the lower-limb symmetry gait pattern in affected patients. The patients would not be able to regain their usual walking ability independently unless they benefit from rehabilitation therapies. Footplate-based gait robo-assisted systems can help patients to conduct effective training/exercising while tracking their progress of recovery and can dramatically reduce the clinical labor costs of physiotherapy. In the sense of simulation and not the design of the mechanical structure, this study aims to perform a combination of dynamic and control simulation of a five degrees-of-freedom footplate-based gait robo-assisted system established according to the Stewart platform structure for use in lower limb rehabilitation of stroke patients. The effectiveness and performance of the proposed mechanism were assessed through a clinical gait pattern of a healthy male individual. The proposed robo-assisted system enables the simulation of the hip and knee flexion/extension as well as the ankle dorsiflexion/plantar flexion of stroke patients to reproduce their typical symmetry gait pattern. The results were interpreted as the dynamic movement characteristics of the right and left thigh, leg, and foot compared to the clinical gait pattern with a mean percentage error of 6.70% to show the effectiveness and accuracy of the developed robo-assisted system for lower limb actuation in the simulation process.

Performance of Deep Learning Models in Forecasting Gait Trajectories of Children with Neurological Disorders.

Forecasted gait trajectories of children could be used as feedforward input to control lower limb robotic devices, such as exoskeletons and actuated orthotic devices (e.g., Powered Ankle Foot Orthosis—PAFO). Several studies have forecasted healthy gait trajectories, but, to the best of our knowledge, none have forecasted gait trajectories of children with pathological gait yet. These exhibit higher inter- and intra-subject variability compared to typically developing gait of healthy subjects. Pathological trajectories represent the typical gait patterns that rehabilitative exoskeletons and actuated orthoses would target. In this study, we implemented two deep learning models, a Long-Term Short Memory (LSTM) and a Convolutional Neural Network (CNN), to forecast hip, knee, and ankle trajectories in terms of corresponding Euler angles in the pitch, roll, and yaw form for children with neurological disorders, up to 200 ms in the future. The deep learning models implemented in our study are trained on data (available online) from children with neurological disorders collected by Gillette Children’s Speciality Healthcare over the years 1994–2017. The children’s ages range from 4 to 19 years old and the majority of them had cerebral palsy (73%), while the rest were a combination of neurological, developmental, orthopaedic, and genetic disorders (27%). Data were recorded with a motion capture system (VICON) with a sampling frequency of 120 Hz while walking for 15 m. We investigated a total of 35 combinations of input and output time-frames, with window sizes for input vectors ranging from 50–1000 ms, and output vectors from 8.33–200 ms. Results show that LSTMs outperform CNNs, and the gap in performance becomes greater the larger the input and output window sizes are. The maximum difference between the Mean Absolute Errors (MAEs) of the CNN and LSTM networks was 0.91 degrees. Results also show that the input size has no significant influence on mean prediction errors when the output window is 50 ms or smaller. For output window sizes greater than 50 ms, the larger the input window, the lower the error. Overall, we obtained MAEs ranging from 0.095–2.531 degrees for the LSTM network, and from 0.129–2.840 degrees for the CNN. This study establishes the feasibility of forecasting pathological gait trajectories of children which could be integrated with exoskeleton control systems and experimentally explores the characteristics of such intelligent systems under varying input and output window time-frames.

Children who idiopathically toe-walk have greater plantarflexor effective mechanical advantage compared to typically developing children

PurposeThe effective mechanical advantage (EMA) of the plantarflexor muscles is important for gait function and is likely different from typical in equinus gait. However, this has never been quantified for children who idiopathically toe-walk (ITW), despite being routinely altered through clinical intervention.MethodsThis study quantified the Achilles tendon and ground reaction force (GRF) moment arms, and the plantarflexor EMA of 5 children who ITW and 14 typically developing (TD) children, whilst walking on an instrumented treadmill.ResultsThere was no difference in the Achilles tendon moment arm length throughout stance between groups (p > 0.05). Children who ITW had a significantly greater GRF moment arm length in early stance (20–24% p = 0.001), but a significantly shorter GRF moment arm length during propulsion (68–74% of stance; p = 0.013) than TD children. Therefore, children who ITW had a greater plantarflexor EMA than TD children when active plantarflexion moments were being generated (60–70% of stance; p = 0.007). Consequently, it was estimated that children who ITW required 30% less plantarflexor muscle force for propulsion.ConclusionClinical decision making should fully consider that interventions which aim to restore a typical heel-toe gait pattern risk compromising this advantageous leverage and thus, may increase the strength requirements for gait.

Adaptive Interlimb Coordination Mechanism for Hexapod Locomotion Based on Active Load Sensing.

Insects can flexibly coordinate their limbs to adapt to various locomotor conditions, e.g., complex environments, changes in locomotion speed, and leg amputation. An interesting aspect of insect locomotion is that the gait patterns are not necessarily stereotypical but are often highly variable, e.g., searching behavior to obtain stable footholds in complex environments. Several previous studies have focused on the mechanism for the emergence of variable limb coordination patterns. However, the proposed mechanisms are complicated and the essential mechanism underlying insect locomotion remains elusive. To address this issue, we proposed a simple mathematical model for the mechanism of variable interlimb coordination in insect locomotion. The key idea of the proposed model is “decentralized active load sensing,” wherein each limb actively moves and detects the reaction force from the ground to judge whether it plays a pivotal role in maintaining the steady support polygon. Based on active load sensing, each limb stays in the stance phase when the limb is necessary for body support. To evaluate the proposed model, we conducted simulation experiments using a hexapod robot. The results showed that the proposed simple mechanism allows the hexapod robot to exhibit typical gait patterns in response to the locomotion speed. Furthermore, the proposed mechanism improves the adaptability of the hexapod robot for leg amputations and lack of footholds by changing each limb's walking and searching behavior in a decentralized manner based on the physical interaction between the body and the environment.

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.

Physical therapy treatments incorporating equine movement: a pilot study exploring interactions between children with cerebral palsy and the horse

BackgroundPhysical therapy treatments incorporating equine movement are recognized as an effective tool to treat functional mobility and balance in children with cerebral palsy (CP). To date, only a few studies examined kinematic outputs of the horses and children when mounted. In this pilot study, to better understand the effectiveness of this type of treatment, we examined the interaction between the horses and children with CP during physical therapy sessions where equine movement was utilized.MethodsFour children with CP participated in eight physical therapy sessions incorporating hippotherapy as a treatment intervention. Functional mobility was assessed using the Timed Up Go or the 10 m Walk Test. Inertial measurement unit sensors, attached to children and horses, recorded movements and tracked acceleration, angular velocity, and body orientation. Correlation between vertical accelerations of children and horses were analyzed. In addition, peak frequencies of vertical accelerations of children and horses were compared.ResultsFunctional tests modestly improved over time. The children’s movements, (quantified in frequency and temporal domains) increasingly synchronized to the vertical movement of the horse’s walk, demonstrated by reduced frequency errors and increased correlation.ConclusionsThe findings suggest that as the sessions progressed, the participants appeared to become more familiar with the horse’s movement. Since the horse’s gait at a walk mimics the human gait this type of treatment may provide individuals with CP, who have abnormal gait patterns, an opportunity for their neuromuscular system to experience a typical gait pattern. The horse’s movement at the walk are consistent, cyclical, rhythmical, reciprocal and multi-dimensional, all of which can facilitate motor learning. The increased synchronization between horse and the mounted participant suggests that physical therapy utilizing equine movement is a viable treatment tool to enhance functional mobility. This study may provide a useful baseline for future work.Trial registrationTexas A&M University Institutional Review Board. IRB2018-0064. Registered 8 March 2018. Link: https://rcb.tamu.edu/humans/irb and https://github.com/pilwonhur/HPOT

Comfortable walking with an ultrasound device: Can children maintain a typical gait pattern?

The remains of soldiers who died during the two World Wars are regularly discovered by chance or during land use planning. In an archaeological, anthropological and genetic analysis of these remains, it is important to provide the most exhaustive information possible on these discoveries in order to fulfill the duty of memory. The legal aspect is a central question when it comes to the place of these human remains.This article proposes a consideration of the situation from a legal point of view and suggests avenues of reflection for a complementary approach from several disciplines.A focus on the term death for France have been proposed. This term is much more than a simple qualifier or a generic expression, it implies economic, patrimonial, but also moral consequences. It should be remembered that the dignity underlying such a status is likely to impact the meaning attached to the duty to remember.More than anything else, we can see that the study of these contexts requires genuine interdisciplinary research in which the law is not invented but in which jurists and anthropologists have every opportunity to express themselves side by side.

Comparing the kinematic output of the Oxford and Rizzoli Foot Models during normal gait and voluntary pathological gait in healthy adults

BackgroundThe Oxford Foot Model (OFM) and Rizzoli Foot Model (RFM) are the two most frequently used multi-segment models to measure foot kinematics. However, a comprehensive comparison of the kinematic output of these models is lacking. Research questionWhat are the differences in kinematic output between OFM and RFM during normal gait and typical pathological gait patterns in healthy adults?. MethodsA combined OFM and RFM marker set was placed on the right foot of ten healthy subjects. A static standing trial and six level walking trials were collected for normal gait and for four voluntarily adopted gait types: equinus, crouch, toe-in and toe-out. Joint angles were calculated for every trial for the hindfoot relative to shank (HF-SH), forefoot relative to hindfoot (FF-HF) and hallux relative to forefoot (HX-FF). Average static joint angles of both models were compared between models. After subtracting these offsets, the remaining dynamic angles were compared using statistical parametric mapping repeated measures ANOVAs and t-tests. Furthermore, range of motion was compared between models for every angle. ResultsFor the static posture, RFM compared to OFM measured more plantar flexion (Δ = 6°) and internal rotation (Δ = 7°) for HF-SH, more plantar flexion (Δ = 34°) and inversion (Δ = 13°) for FF-HF and more dorsal flexion (Δ = 37°) and abduction (Δ = 12°) for HX-FF. During normal walking, kinematic differences were found in various parts of the gait cycle. Moreover, range of motion was larger in the HF-SH for OFM and in FF-HF and HX-FF for RFM. The differences between models were not the same for all gait types. Equinus and toe-out gait demonstrated most pronounced differences. SignificanceDifferences are present in kinematic output between OFM and RFM, which also depend on gait type. Therefore, kinematic output of foot and ankle studies should be interpreted with careful consideration of the multi-segment foot model used.

Postural stability in people with visual impairment.

BackgroundThe visual system enables the brain to assess information regarding the position of the body in space. Congenital or acquired blindness leads to the development of abnormal sensory‐motor interactions that results in development of typical musculoskeletal deformities and gait patterns that cause disability. Diabetes and related complications are expected to increase exponentially in the next 10 years; thus, the number of people with visual impairment is expected to increase. However, there have been few studies regarding etio‐pathogenesis of postural alteration and balance impairment in people with visual impairment; moreover, no previous study has investigated postural stability in this population. This study aimed to assess the center of gravity (COG) velocity in subjects with visual impairment and compared with that in sighted subjects.MethodsSeventy male subjects, 20–40 years of age, participated in this study; they were divided into sighted (control) and visually impaired groups. COG velocity while standing on an unstable surface was measured using the NeuroCom® Balance Master Version 8.5.0. For the sighted group, data were recorded with eyes open and then with eyes closed. For the visually impaired group, no instructions were given with respect to eyes during data collection.ResultsMean COG velocity was significantly higher in the visually impaired group than in the sighted group with eyes open. However, there was no difference in mean COG velocity between the visually impaired group and the sighted group with eyes closed. The difference in mean COG velocity between sighted subjects with eyes open and eyes closed was also significant. Mean COG velocity while standing on a foam surface varied among visually impaired subjects and sighted subjects with eyes open and closed.ConclusionThis study showed that subjects with visual impairment, regardless of eye opening or closure, behave in the same manner as sighted subjects with eyes closed.

Utilizing Functional Electrical Stimulation and Exoskeletons in Pediatrics: a Closer Look at Their Roles in Gait and Functional Changes in Cerebral Palsy

A primary focus for many children with cerebral palsy (CP) is functional independence. However, due to neurologic insults that occur early in life, typical gait pattern development is impaired. Research has shown the importance of task-oriented movements in reorganizing the central nervous system in a functionally meaningful way. Advancements in technology, when used in conjunction with conventional strategies, have made it possible for therapists to utilize devices that provide repetitive patterning and feedback for gait retraining. This enables patients the opportunity to develop normal gait patterns and improve functional independence. Interventions such as functional electrical stimulation and exoskeletons can be utilized to assist patients with sequencing motor contractions of different muscles in more physiologic patterning. Children who suffer from neurologic insults may not only benefit from the restorative properties of these interventions, but also from the active engagement that is provided through the use of this technology. Therapists, utilizing these interventions, are able to encourage their patient’s interest and motivation while providing them with a repetitive goal-oriented task to assist with cortical reorganization. This review focuses on current literature addressing the use of functional electrical stimulation and exoskeletons in pediatric rehabilitation. The results of these studies demonstrate the effectiveness of these devices when compared to conventional therapeutic interventions. This review shows that continued research is needed on specific dosage in order to determine optimal outcomes.

New considerations for collecting biomechanical data using wearable sensors: Number of level runs to define a stable running pattern with a single IMU

Wearable technology can be used to quantify running biomechanical patterns in a runner’s natural environment, however, changes in external factors during outdoor running may influence a runner’s typical gait pattern. Therefore, the purpose of this study was to determine how many runs are needed to define a stable or typical running pattern. Six biomechanical variables were recorded using a single wearable sensor placed on the lower back during ten outdoor runs for twelve runners. Univariate and multivariate distributions were created and based on the probability density function, the percent of similar data points (within 95%) from each unique run for the same runner were determined. Stability was defined when the addition of data from a new run resulted in less than a 5% change in the probability density function. To cross-validate, the percent of similar data points at stability was compared between the same and different runners using a repeated-measures MANOVA (Bonferroni-corrected α = 0.007). The maximum number of runs needed to reach stability for univariate and multivariate analyses was four and five, respectively. There was a significant overall effect on similar data points between the same and different runners (p = 0.001), with a greater percent of similar data points for the same runner compared to other runners (p < 0.007). Based on biomechanical data collected using a single wearable sensor placed on the lower back, this is the first study to show that four (univariate) to five (multivariate) runs are needed to establish a stable running pattern in real-world settings.

The Dynamic Baropodometric Profile of Children with Idiopathic Toe-Walking A Cross-Sectional Study.

Idiopathic toe-walking (ITW) gait may present in children older than 3 years and in the absence of a medical condition known to cause or be associated with toe-walking gait. It is unknown how this gait type changes pressure distribution in the growing foot. We sought to determine whether children with ITW gait exhibit different plantar pressures and temporal gait features than typically developing children. Children aged 3 to 6 years were recruited who had either a typical heel-toe gait pattern or a diagnosis of ITW. The ITW diagnosis was reported by the parent/caregiver and confirmed through history and physical examination. Temporal gait measures, peak pressures, and impulse percentages were measured. A minimum of ten unshod footprints were collected. Data were compared with unpaired t tests. The study included 40 children with typical gait and 56 with ITW gait. The ITW group displayed lower peak pressures at the hallux, midfoot, and hindfoot ( P < .05) and higher and lower pressure impulse percentages at the forefoot ( P < .001) and hindfoot ( P < .001), respectively. The ITW group spent a higher percentage of contact time at all areas of the forefoot and less at the midfoot and rearfoot ( P < .05). There were no significant differences in total step duration and foot progression angle between groups ( P > .05). There were differences in pressure distributions between groups. Understanding these differences may help us better understand the compensations or potential long-term impact that ITW gait may have on a young child's foot. Podiatric physicians may also consider the use of this equipment in the clinical setting to measure outcomes after treatment for ITW.

WHAT IN THE “HEEL” DO THEY FEEL? 15303

INTRODUCTION&#x0D; A typical gait pattern includes a heel strike, followed by a smooth transition to foot flat through loading response. Children with poor postural control and related gait deficits often present with anterior weight lines, which result in loss of first rocker and/or a fast transition from initial contact to footflat. The foot has many important jobs, including providing proprioceptive feedback. There are 104 cutaneous mechanoreceptors on the plantar surface of the foot.1 While most of the sensors are in the metatarsal/tarsal and toe regions, we cannot forget the role of the mechanoreceptors in the heel.&#x0D; Abstract PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32044/24458&#x0D; How to cite: Smith M. WHAT IN THE “HEEL” DO THEY FEEL? 15303. CANADIAN PROSTHETICS &amp; ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32044 &#x0D; Abstracts were Peer-reviewed by the American Orthotic Prosthetic Association (AOPA) 101st National Assembly Scientific Committee. &#x0D; http://www.aopanet.org/

Clustering of Self-Organizing Maps as a means to support gait kinematics analysis and symmetry evaluation

Gait analysis is relevant for the functional diagnostic of several musculoskeletal disorders. Walking patterns can be analyzed using techniques such as video processing and inertial measurement units (IMU). In this work, a Self-Organizing Maps (SOM) algorithm is applied to reduce the complexity of kinematic features obtained by IMU sensors of a sample of 40 individuals. Our system provides a simpler data representation (2-D graphic) than conventional methods, which often applies statistical analysis. We have tested the proposed method to analyze typical and simulated limping gait pattern under well-controlled conditions. Based on kinematic parameters and symmetry-related features, SOM algorithm was able to organize the sample in groups of subjects with three different gait patterns, normal and limping with each lower limb. Moreover, our system may be used to evaluate the recovery of a patient, offering intuitive information of his walking pattern in an assessment report. However, further research with atypical-gait subjects is necessary before applying such method as a clinical tool.

Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder

Three-dimensional gait analysis (3DGA) is shown to be a useful clinical tool for the evaluation of gait abnormality due to movement disorders. However, the use of 3DGA in actual clinics remains uncommon. Possible reasons could include the time-consuming measurement process and difficulties in understanding measurement results, which are often presented using a large number of graphs. Here we present a clinician-friendly 3DGA method developed to facilitate the clinical use of 3DGA. This method consists of simplified preparation and measurement processes that can be performed in a short time period in clinical settings and intuitive results presentation to facilitate clinicians' understanding of results. The quick, simplified measurement procedure is achieved by the use of minimum markers and measurement of patients on a treadmill. To facilitate clinician understanding, results are presented in figures based on the clinicians' perspective. A Lissajous overview picture (LOP), which shows the trajectories of all markers from a holistic viewpoint, is used to facilitate intuitive understanding of gait patterns. Abnormal gait pattern indices, which are based on clinicians' perspectives in gait evaluation and standardized using the data of healthy subjects, are used to evaluate the extent of typical abnormal gait patterns in stroke patients. A graph depicting the analysis of the toe clearance strategy, which depicts how patients rely on normal and compensatory strategies to achieve toe clearance, is also presented. These methods could facilitate implementation of 3DGA in clinical settings and further encourage development of measurement strategies from the clinician's point of view.

Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder.

Three-dimensional gait analysis (3DGA) is shown to be a useful clinical tool for the evaluation of gait abnormality due to movement disorders. However, the use of 3DGA in actual clinics remains uncommon. Possible reasons could include the time-consuming measurement process and difficulties in understanding measurement results, which are often presented using a large number of graphs. Here we present a clinician-friendly 3DGA method developed to facilitate the clinical use of 3DGA. This method consists of simplified preparation and measurement processes that can be performed in a short time period in clinical settings and intuitive results presentation to facilitate clinicians' understanding of results. The quick, simplified measurement procedure is achieved by the use of minimum markers and measurement of patients on a treadmill. To facilitate clinician understanding, results are presented in figures based on the clinicians' perspective. A Lissajous overview picture (LOP), which shows the trajectories of all markers from a holistic viewpoint, is used to facilitate intuitive understanding of gait patterns. Abnormal gait pattern indices, which are based on clinicians' perspectives in gait evaluation and standardized using the data of healthy subjects, are used to evaluate the extent of typical abnormal gait patterns in stroke patients. A graph depicting the analysis of the toe clearance strategy, which depicts how patients rely on normal and compensatory strategies to achieve toe clearance, is also presented. These methods could facilitate implementation of 3DGA in clinical settings and further encourage development of measurement strategies from the clinician's point of view.