Vision-based gait impairment analysis for aided diagnosis.

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Ortells, Javier; Herrero-Ezquerro, María Trinidad; Mollineda, Ramón A

2018-02-12

Gait is a firsthand reflection of health condition. This belief has inspired recent research efforts to automate the analysis of pathological gait, in order to assist physicians in decision-making. However, most of these efforts rely on gait descriptions which are difficult to understand by humans, or on sensing technologies hardly available in ambulatory services. This paper proposes a number of semantic and normalized gait features computed from a single video acquired by a low-cost sensor. Far from being conventional spatio-temporal descriptors, features are aimed at quantifying gait impairment, such as gait asymmetry from several perspectives or falling risk. They were designed to be invariant to frame rate and image size, allowing cross-platform comparisons. Experiments were formulated in terms of two databases. A well-known general-purpose gait dataset is used to establish normal references for features, while a new database, introduced in this work, provides samples under eight different walking styles: one normal and seven impaired patterns. A number of statistical studies were carried out to prove the sensitivity of features at measuring the expected pathologies, providing enough evidence about their accuracy. Graphical Abstract Graphical abstract reflecting main contributions of the manuscript: at the top, a robust, semantic and easy-to-interpret feature set to describe impaired gait patterns; at the bottom, a new dataset consisting of video-recordings of a number of volunteers simulating different patterns of pathological gait, where features were statistically assessed.

Linear and Nonlinear Gait Features in Older Adults Walking on Inclined Surfaces at Different Speeds.

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Vieira, Marcus Fraga; Rodrigues, Fábio Barbosa; de Sá E Souza, Gustavo Souto; Magnani, Rina Márcia; Lehnen, Georgia Cristina; Andrade, Adriano O

2017-06-01

This study evaluated linear and nonlinear gait features in healthy older adults walking on inclined surfaces at different speeds. Thirty-seven active older adults (experimental group) and fifty young adults (control group) walked on a treadmill at 100% and ±20% of their preferred walking speed for 4 min under horizontal (0%), upward (UP) (+8%), and downward (DOWN) (-8%) conditions. Linear gait variability was assessed using the average standard deviation of trunk acceleration between strides (VAR). Gait stability was assessed using the margin of stability (MoS). Nonlinear gait features were assessed by using the maximum Lyapunov exponent, as a measure of local dynamic stability (LDS), and sample entropy (SEn), as a measure of regularity. VAR increased for all conditions, but the interaction effects between treadmill inclination and age, and speed and age were higher for young adults. DOWN conditions showed the lowest stability in the medial-lateral MoS, but not in LDS. LDS was smaller in UP conditions. However, there were no effects of age for either MoS or LDS. The values of SEn decreased almost linearly from the DOWN to the UP conditions, with significant interaction effects of age for anterior-posterior SEn. The overall results supported the hypothesis that inclined surfaces modulate nonlinear gait features and alter linear gait variability, particularly in UP conditions, but there were no significant effects of age for active older adults.

Hybridization between multi-objective genetic algorithm and support vector machine for feature selection in walker-assisted gait.

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Martins, Maria; Costa, Lino; Frizera, Anselmo; Ceres, Ramón; Santos, Cristina

2014-03-01

Walker devices are often prescribed incorrectly to patients, leading to the increase of dissatisfaction and occurrence of several problems, such as, discomfort and pain. Thus, it is necessary to objectively evaluate the effects that assisted gait can have on the gait patterns of walker users, comparatively to a non-assisted gait. A gait analysis, focusing on spatiotemporal and kinematics parameters, will be issued for this purpose. However, gait analysis yields redundant information that often is difficult to interpret. This study addresses the problem of selecting the most relevant gait features required to differentiate between assisted and non-assisted gait. For that purpose, it is presented an efficient approach that combines evolutionary techniques, based on genetic algorithms, and support vector machine algorithms, to discriminate differences between assisted and non-assisted gait with a walker with forearm supports. For comparison purposes, other classification algorithms are verified. Results with healthy subjects show that the main differences are characterized by balance and joints excursion in the sagittal plane. These results, confirmed by clinical evidence, allow concluding that this technique is an efficient feature selection approach. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Analysis of Gait Pattern to Recognize the Human Activities

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Jay Prakash Gupta

2014-09-01

Full Text Available Human activity recognition based on the computer vision is the process of labelling image sequences with action labels. Accurate systems for this problem are applied in areas such as visual surveillance, human computer interaction and video retrieval. The challenges are due to variations in motion, recording settings and gait differences. Here we propose an approach to recognize the human activities through gait. Activity recognition through Gait is the process of identifying an activity by the manner in which they walk. The identification of human activities in a video, such as a person is walking, running, jumping, jogging etc are important activities in video surveillance. We contribute the use of Model based approach for activity recognition with the help of movement of legs only. Experimental results suggest that our method are able to recognize the human activities with a good accuracy rate and robust to shadows present in the videos.

An Integrated Gait and Balance Analysis System to Define Human Locomotor Control

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2016-04-29

test hypotheses they developed about how people walk. An Integrated Gait and Balance Analysis System to define Human Locomotor Control W911NF-14-R-0009...An Integrated Gait and Balance Analysis System to Define Human Locomotor Control Walking is a complicated task that requires the motor coordination...Gait and Balance Analysis System to Define Human Locomotor Control Report Title Walking is a complicated task that requires the motor coordination across

IMU-Based Gait Recognition Using Convolutional Neural Networks and Multi-Sensor Fusion

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Omid Dehzangi

2017-11-01

Full Text Available The wide spread usage of wearable sensors such as in smart watches has provided continuous access to valuable user generated data such as human motion that could be used to identify an individual based on his/her motion patterns such as, gait. Several methods have been suggested to extract various heuristic and high-level features from gait motion data to identify discriminative gait signatures and distinguish the target individual from others. However, the manual and hand crafted feature extraction is error prone and subjective. Furthermore, the motion data collected from inertial sensors have complex structure and the detachment between manual feature extraction module and the predictive learning models might limit the generalization capabilities. In this paper, we propose a novel approach for human gait identification using time-frequency (TF expansion of human gait cycles in order to capture joint 2 dimensional (2D spectral and temporal patterns of gait cycles. Then, we design a deep convolutional neural network (DCNN learning to extract discriminative features from the 2D expanded gait cycles and jointly optimize the identification model and the spectro-temporal features in a discriminative fashion. We collect raw motion data from five inertial sensors placed at the chest, lower-back, right hand wrist, right knee, and right ankle of each human subject synchronously in order to investigate the impact of sensor location on the gait identification performance. We then present two methods for early (input level and late (decision score level multi-sensor fusion to improve the gait identification generalization performance. We specifically propose the minimum error score fusion (MESF method that discriminatively learns the linear fusion weights of individual DCNN scores at the decision level by minimizing the error rate on the training data in an iterative manner. 10 subjects participated in this study and hence, the problem is a 10-class

View-invariant gait recognition method by three-dimensional convolutional neural network

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Xing, Weiwei; Li, Ying; Zhang, Shunli

2018-01-01

Gait as an important biometric feature can identify a human at a long distance. View change is one of the most challenging factors for gait recognition. To address the cross view issues in gait recognition, we propose a view-invariant gait recognition method by three-dimensional (3-D) convolutional neural network. First, 3-D convolutional neural network (3DCNN) is introduced to learn view-invariant feature, which can capture the spatial information and temporal information simultaneously on normalized silhouette sequences. Second, a network training method based on cross-domain transfer learning is proposed to solve the problem of the limited gait training samples. We choose the C3D as the basic model, which is pretrained on the Sports-1M and then fine-tune C3D model to adapt gait recognition. In the recognition stage, we use the fine-tuned model to extract gait features and use Euclidean distance to measure the similarity of gait sequences. Sufficient experiments are carried out on the CASIA-B dataset and the experimental results demonstrate that our method outperforms many other methods.

Statically vs dynamically balanced gait: Analysis of a robotic exoskeleton compared with a human.

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Barbareschi, Giulia; Richards, Rosie; Thornton, Matt; Carlson, Tom; Holloway, Catherine

2015-01-01

In recent years exoskeletons able to replicate human gait have begun to attract growing popularity for both assistive and rehabilitative purposes. Although wearable robots often need the use of external support in order to maintain stability, the REX exoskeleton by REX Bionics is able to self-balance through the whole cycle. However this statically balanced gait presents important differences with the dynamically balanced gait of human subjects. This paper will examine kinematic and kinetic differences between the gait analysis performed on a subject wearing the REX exoskeleton and human gait analysis data as presented in literature. We will also provide an insight on the impact that these differences can have for both rehabilitative and assistive applications.

The Effects of Aging and Dual Tasking on Human Gait Complexity During Treadmill Walking: A Comparative Study Using Quantized Dynamical Entropy and Sample Entropy.

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Ahmadi, Samira; Wu, Christine; Sepehri, Nariman; Kantikar, Anuprita; Nankar, Mayur; Szturm, Tony

2018-01-01

Quantized dynamical entropy (QDE) has recently been proposed as a new measure to quantify the complexity of dynamical systems with the purpose of offering a better computational efficiency. This paper further investigates the viability of this method using five different human gait signals. These signals are recorded while normal walking and while performing secondary tasks among two age groups (young and older age groups). The results are compared with the outcomes of previously established sample entropy (SampEn) measure for the same signals. We also study how analyzing segmented and spatially and temporally normalized signal differs from analyzing whole data. Our findings show that human gait signals become more complex as people age and while they are cognitively loaded. Center of pressure (COP) displacement in mediolateral direction is the best signal for showing the gait changes. Moreover, the results suggest that by segmenting data, more information about intrastride dynamical features are obtained. Most importantly, QDE is shown to be a reliable measure for human gait complexity analysis.

Biomechanics of normal and pathological gait: implications for understanding human locomotor control.

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Winter, D A

1989-12-01

The biomechanical (kinetic) analysis of human gait reveals the integrated and detailed motor patterns that are essential in pinpointing the abnormal patterns in pathological gait. In a similar manner, these motor patterns (moments, powers, and EMGs) can be used to identify synergies and to validate theories of CNS control. Based on kinetic and EMG patterns for a wide range of normal subjects and cadences, evidence is presented that both supports and negates the central pattern generator theory of locomotion. Adaptive motor patterns that are evident in peripheral gait pathologies reinforce a strong peripheral rather than a central control. Finally, a three-component subtask theory of human gait is presented and is supported by reference to the motor patterns seen in a normal gait. The identified subtasks are (a) support (against collapse during stance); (b) dynamic balance of the upper body, also during stance; and (c) feedforward control of the foot trajectory to achieve safe ground clearance and a gentle heel contact.

Hardware Development and Locomotion Control Strategy for an Over-Ground Gait Trainer: NaTUre-Gaits.

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Luu, Trieu Phat; Low, Kin Huat; Qu, Xingda; Lim, Hup Boon; Hoon, Kay Hiang

2014-01-01

Therapist-assisted body weight supported (TABWS) gait rehabilitation was introduced two decades ago. The benefit of TABWS in functional recovery of walking in spinal cord injury and stroke patients has been demonstrated and reported. However, shortage of therapists, labor-intensiveness, and short duration of training are some limitations of this approach. To overcome these deficiencies, robotic-assisted gait rehabilitation systems have been suggested. These systems have gained attentions from researchers and clinical practitioner in recent years. To achieve the same objective, an over-ground gait rehabilitation system, NaTUre-gaits, was developed at the Nanyang Technological University. The design was based on a clinical approach to provide four main features, which are pelvic motion, body weight support, over-ground walking experience, and lower limb assistance. These features can be achieved by three main modules of NaTUre-gaits: 1) pelvic assistance mechanism, mobile platform, and robotic orthosis. Predefined gait patterns are required for a robotic assisted system to follow. In this paper, the gait pattern planning for NaTUre-gaits was accomplished by an individual-specific gait pattern prediction model. The model generates gait patterns that resemble natural gait patterns of the targeted subjects. The features of NaTUre-gaits have been demonstrated by walking trials with several subjects. The trials have been evaluated by therapists and doctors. The results show that 10-m walking trial with a reduction in manpower. The task-specific repetitive training approach and natural walking gait patterns were also successfully achieved.

Reflex control of robotic gait using human walking data.

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Catherine A Macleod

Full Text Available Control of human walking is not thoroughly understood, which has implications in developing suitable strategies for the retraining of a functional gait following neurological injuries such as spinal cord injury (SCI. Bipedal robots allow us to investigate simple elements of the complex nervous system to quantify their contribution to motor control. RunBot is a bipedal robot which operates through reflexes without using central pattern generators or trajectory planning algorithms. Ground contact information from the feet is used to activate motors in the legs, generating a gait cycle visually similar to that of humans. Rather than developing a more complicated biologically realistic neural system to control the robot's stepping, we have instead further simplified our model by measuring the correlation between heel contact and leg muscle activity (EMG in human subjects during walking and from this data created filter functions transferring the sensory data into motor actions. Adaptive filtering was used to identify the unknown transfer functions which translate the contact information into muscle activation signals. Our results show a causal relationship between ground contact information from the heel and EMG, which allows us to create a minimal, linear, analogue control system for controlling walking. The derived transfer functions were applied to RunBot II as a proof of concept. The gait cycle produced was stable and controlled, which is a positive indication that the transfer functions have potential for use in the control of assistive devices for the retraining of an efficient and effective gait with potential applications in SCI rehabilitation.

Balance confidence is related to features of balance and gait in individuals with chronic stroke

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Schinkel-Ivy, Alison; Wong, Jennifer S.; Mansfield, Avril

2016-01-01

Reduced balance confidence is associated with impairments in features of balance and gait in individuals with sub-acute stroke. However, an understanding of these relationships in individuals at the chronic stage of stroke recovery is lacking. This study aimed to quantify relationships between balance confidence and specific features of balance and gait in individuals with chronic stroke. Participants completed a balance confidence questionnaire and clinical balance assessment (quiet standing, walking, and reactive stepping) at 6 months post-discharge from inpatient stroke rehabilitation. Regression analyses were performed using balance confidence as a predictor variable and quiet standing, walking, and reactive stepping outcome measures as the dependent variables. Walking velocity was positively correlated with balance confidence, while medio-lateral centre of pressure excursion (quiet standing) and double support time, step width variability, and step time variability (walking) were negatively correlated with balance confidence. This study provides insight into the relationships between balance confidence and balance and gait measures in individuals with chronic stroke, suggesting that individuals with low balance confidence exhibited impaired control of quiet standing as well as walking characteristics associated with cautious gait strategies. Future work should identify the direction of these relationships to inform community-based stroke rehabilitation programs for individuals with chronic stroke, and determine the potential utility of incorporating interventions to improve balance confidence into these programs. PMID:27955809

Decrease in Hurst exponent of human gait with aging and neurodegenerative diseases

International Nuclear Information System (INIS)

Zhauang Jianjun; Ning Xinbao; Yang Xiaodong; Huo Chengyu; Hou Fengzhen

2008-01-01

In this paper the decrease in the Hurst exponent of human gait with aging and neurodegenerative diseases was observed by using an improved rescaled range (R/S) analysis method. It indicates that the long-range correlations of gait rhythm from young healthy people are stronger than those from the healthy elderly and the diseased. The result further implies that fractal dynamics in human gait will be altered due to weakening or impairment of neural control on locomotion resulting from aging and neurodegenerative diseases. Due to analysing short-term data sequences rather than long datasets required by most nonlinear methods, the algorithm has the characteristics of simplicity and sensitivity, most importantly, fast calculation as well as powerful anti-noise capacities. These findings have implications for modelling locomotor control and also for quantifying gait dynamics in varying physiologic and pathologic states

A Comprehensive Study on Cross-View Gait Based Human Identification with Deep CNNs.

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Wu, Zifeng; Huang, Yongzhen; Wang, Liang; Wang, Xiaogang; Tan, Tieniu

2017-02-01

This paper studies an approach to gait based human identification via similarity learning by deep convolutional neural networks (CNNs). With a pretty small group of labeled multi-view human walking videos, we can train deep networks to recognize the most discriminative changes of gait patterns which suggest the change of human identity. To the best of our knowledge, this is the first work based on deep CNNs for gait recognition in the literature. Here, we provide an extensive empirical evaluation in terms of various scenarios, namely, cross-view and cross-walking-condition, with different preprocessing approaches and network architectures. The method is first evaluated on the challenging CASIA-B dataset in terms of cross-view gait recognition. Experimental results show that it outperforms the previous state-of-the-art methods by a significant margin. In particular, our method shows advantages when the cross-view angle is large, i.e., no less than 36 degree. And the average recognition rate can reach 94 percent, much better than the previous best result (less than 65 percent). The method is further evaluated on the OU-ISIR gait dataset to test its generalization ability to larger data. OU-ISIR is currently the largest dataset available in the literature for gait recognition, with 4,007 subjects. On this dataset, the average accuracy of our method under identical view conditions is above 98 percent, and the one for cross-view scenarios is above 91 percent. Finally, the method also performs the best on the USF gait dataset, whose gait sequences are imaged in a real outdoor scene. These results show great potential of this method for practical applications.

2.5D Multi-View Gait Recognition Based on Point Cloud Registration

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Tang, Jin; Luo, Jian; Tjahjadi, Tardi; Gao, Yan

2014-01-01

This paper presents a method for modeling a 2.5-dimensional (2.5D) human body and extracting the gait features for identifying the human subject. To achieve view-invariant gait recognition, a multi-view synthesizing method based on point cloud registration (MVSM) to generate multi-view training galleries is proposed. The concept of a density and curvature-based Color Gait Curvature Image is introduced to map 2.5D data onto a 2D space to enable data dimension reduction by discrete cosine transform and 2D principle component analysis. Gait recognition is achieved via a 2.5D view-invariant gait recognition method based on point cloud registration. Experimental results on the in-house database captured by a Microsoft Kinect camera show a significant performance gain when using MVSM. PMID:24686727

Gait-related cerebral alterations in patients with Parkinson's disease with freezing of gait

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Snijders, A.H.; Leunissen, H.P.; Bakker, M.; Overeem, S.; Helmich, R.C.G.; Bloem, B.R.; Toni, I.

2011-01-01

Freezing of gait is a common, debilitating feature of Parkinson’s disease. We have studied gait planning in patients with freezing of gait, using motor imagery of walking in combination with functional magnetic resonance imaging. This approach exploits the large neural overlap that exists between

Gait-related cerebral alterations in patients with Parkinson's disease with freezing of gait

NARCIS (Netherlands)

Snijders, A.H.; Leunissen, I.; Bakker, M.; Overeem, S.; Helmich, R.C.G.; Bloem, B.R.; Toni, I.

2011-01-01

Freezing of gait is a common, debilitating feature of Parkinson's disease. We have studied gait planning in patients with freezing of gait, using motor imagery of walking in combination with functional magnetic resonance imaging. This approach exploits the large neural overlap that exists between

Effect of arm swing strategy on local dynamic stability of human gait.

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Punt, Michiel; Bruijn, Sjoerd M; Wittink, Harriet; van Dieën, Jaap H

2015-02-01

Falling causes long term disability and can even lead to death. Most falls occur during gait. Therefore improving gait stability might be beneficial for people at risk of falling. Recently arm swing has been shown to influence gait stability. However at present it remains unknown which mode of arm swing creates the most stable gait. To examine how different modes of arm swing affect gait stability. Ten healthy young male subjects volunteered for this study. All subjects walked with four different arm swing instructions at seven different gait speeds. The Xsens motion capture suit was used to capture gait kinematics. Basic gait parameters, variability and stability measures were calculated. We found an increased stability in the medio-lateral direction with excessive arm swing in comparison to normal arm swing at all gait speeds. Moreover, excessive arm swing increased stability in the anterior-posterior and vertical direction at low gait speeds. Ipsilateral and inphase arm swing did not differ compared to a normal arm swing. Excessive arm swing is a promising gait manipulation to improve local dynamic stability. For excessive arm swing in the ML direction there appears to be converging evidence. The effect of excessive arm swing on more clinically relevant groups like the more fall prone elderly or stroke survivors is worth further investigating. Excessive arm swing significantly increases local dynamic stability of human gait. Copyright © 2014 Elsevier B.V. All rights reserved.

Sex differences in quadrupedal walking gaits of Uner Tan syndrome cases, healthy humans and nonhuman primates.

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Tan, Uner

2017-03-01

Uner Tan syndrome (UTS) cases with habitual quadrupedal locomotion (QL), impaired intelligence, and dysarthric or no speech predominantly use lateral sequence (LS) gait like nonprimates rather than the predominantly diagonal sequence (DS) gait of nonhuman primates. However, these studies neglected possible sex-related differences in these gait types. (1) To assess the possible sex-related gait types in UTS cases, healthy infants and adults with requested QL, and the nonhuman primates. (2) To test the hypothesis that sex differences may exist in quadrupedal walking gaits in UTS cases, healthy humans, and nonhuman primates. The UTS cases were filmed, the other study groups were taken from public open 'youtube' videos, which were used to assess the walking gait types as DS and LS. The right and left hind-limb phase values were calculated separately for males and females to allow a possible sex difference in walking gaits to be determined. Females predominantly used DS gait, contrary to males with predominantly LS gait. Consistent with the working hypothesis, the results suggested a biological sex-related trend in preferred walking gaits exists in all of the human and nonhuman primates using QL.

Secure and privacy enhanced gait authentication on smart phone.

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Hoang, Thang; Choi, Deokjai

2014-01-01

Smart environments established by the development of mobile technology have brought vast benefits to human being. However, authentication mechanisms on portable smart devices, particularly conventional biometric based approaches, still remain security and privacy concerns. These traditional systems are mostly based on pattern recognition and machine learning algorithms, wherein original biometric templates or extracted features are stored under unconcealed form for performing matching with a new biometric sample in the authentication phase. In this paper, we propose a novel gait based authentication using biometric cryptosystem to enhance the system security and user privacy on the smart phone. Extracted gait features are merely used to biometrically encrypt a cryptographic key which is acted as the authentication factor. Gait signals are acquired by using an inertial sensor named accelerometer in the mobile device and error correcting codes are adopted to deal with the natural variation of gait measurements. We evaluate our proposed system on a dataset consisting of gait samples of 34 volunteers. We achieved the lowest false acceptance rate (FAR) and false rejection rate (FRR) of 3.92% and 11.76%, respectively, in terms of key length of 50 bits.

Secure and Privacy Enhanced Gait Authentication on Smart Phone

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Thang Hoang

2014-01-01

Full Text Available Smart environments established by the development of mobile technology have brought vast benefits to human being. However, authentication mechanisms on portable smart devices, particularly conventional biometric based approaches, still remain security and privacy concerns. These traditional systems are mostly based on pattern recognition and machine learning algorithms, wherein original biometric templates or extracted features are stored under unconcealed form for performing matching with a new biometric sample in the authentication phase. In this paper, we propose a novel gait based authentication using biometric cryptosystem to enhance the system security and user privacy on the smart phone. Extracted gait features are merely used to biometrically encrypt a cryptographic key which is acted as the authentication factor. Gait signals are acquired by using an inertial sensor named accelerometer in the mobile device and error correcting codes are adopted to deal with the natural variation of gait measurements. We evaluate our proposed system on a dataset consisting of gait samples of 34 volunteers. We achieved the lowest false acceptance rate (FAR and false rejection rate (FRR of 3.92% and 11.76%, respectively, in terms of key length of 50 bits.

Adaptive control of dynamic balance in human gait on a split-belt treadmill.

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Buurke, Tom J W; Lamoth, Claudine J C; Vervoort, Danique; van der Woude, Lucas H V; den Otter, Rob

2018-05-17

Human bipedal gait is inherently unstable and staying upright requires adaptive control of dynamic balance. Little is known about adaptive control of dynamic balance in reaction to long-term, continuous perturbations. We examined how dynamic balance control adapts to a continuous perturbation in gait, by letting people walk faster with one leg than the other on a treadmill with two belts (i.e. split-belt walking). In addition, we assessed whether changes in mediolateral dynamic balance control coincide with changes in energy use during split-belt adaptation. In nine minutes of split-belt gait, mediolateral margins of stability and mediolateral foot roll-off changed during adaptation to the imposed gait asymmetry, especially on the fast side, and returned to baseline during washout. Interestingly, no changes in mediolateral foot placement (i.e. step width) were found during split-belt adaptation. Furthermore, the initial margin of stability and subsequent mediolateral foot roll-off were strongly coupled to maintain mediolateral dynamic balance throughout the gait cycle. Consistent with previous results net metabolic power was reduced during split-belt adaptation, but changes in mediolateral dynamic balance control were not correlated with the reduction of net metabolic power during split-belt adaptation. Overall, this study has shown that a complementary mechanism of relative foot positioning and mediolateral foot roll-off adapts to continuously imposed gait asymmetry to maintain dynamic balance in human bipedal gait. © 2018. Published by The Company of Biologists Ltd.

Non-invasive detection of the freezing of gait in Parkinson's disease using spectral and wavelet features.

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Nazarzadeh, Kimia; Arjunan, Sridhar P; Kumar, Dinesh K; Das, Debi Prasad

2016-08-01

In this study, we have analyzed the accelerometer data recorded during gait analysis of Parkinson disease patients for detecting freezing of gait (FOG) episodes. The proposed method filters the recordings for noise reduction of the leg movement changes and computes the wavelet coefficients to detect FOG events. Publicly available FOG database was used and the technique was evaluated using receiver operating characteristic (ROC) analysis. Results show a higher performance of the wavelet feature in discrimination of the FOG events from the background activity when compared with the existing technique.

Gait variability: methods, modeling and meaning

Directory of Open Access Journals (Sweden)

Hausdorff Jeffrey M

2005-07-01

Full Text Available Abstract The study of gait variability, the stride-to-stride fluctuations in walking, offers a complementary way of quantifying locomotion and its changes with aging and disease as well as a means of monitoring the effects of therapeutic interventions and rehabilitation. Previous work has suggested that measures of gait variability may be more closely related to falls, a serious consequence of many gait disorders, than are measures based on the mean values of other walking parameters. The Current JNER series presents nine reports on the results of recent investigations into gait variability. One novel method for collecting unconstrained, ambulatory data is reviewed, and a primer on analysis methods is presented along with a heuristic approach to summarizing variability measures. In addition, the first studies of gait variability in animal models of neurodegenerative disease are described, as is a mathematical model of human walking that characterizes certain complex (multifractal features of the motor control's pattern generator. Another investigation demonstrates that, whereas both healthy older controls and patients with a higher-level gait disorder walk more slowly in reduced lighting, only the latter's stride variability increases. Studies of the effects of dual tasks suggest that the regulation of the stride-to-stride fluctuations in stride width and stride time may be influenced by attention loading and may require cognitive input. Finally, a report of gait variability in over 500 subjects, probably the largest study of this kind, suggests how step width variability may relate to fall risk. Together, these studies provide new insights into the factors that regulate the stride-to-stride fluctuations in walking and pave the way for expanded research into the control of gait and the practical application of measures of gait variability in the clinical setting.

Kinematic and Gait Similarities between Crawling Human Infants and Other Quadruped Mammals

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Righetti, Ludovic; Nylén, Anna; Rosander, Kerstin; Ijspeert, Auke Jan

2015-01-01

Crawling on hands and knees is an early pattern of human infant locomotion, which offers an interesting way of studying quadrupedalism in one of its simplest form. We investigate how crawling human infants compare to other quadruped mammals, especially primates. We present quantitative data on both the gait and kinematics of seven 10-month-old crawling infants. Body movements were measured with an optoelectronic system giving precise data on 3-dimensional limb movements. Crawling on hands and knees is very similar to the locomotion of non-human primates in terms of the quite protracted arm at touch-down, the coordination between the spine movements in the lateral plane and the limbs, the relatively extended limbs during locomotion and the strong correlation between stance duration and speed of locomotion. However, there are important differences compared to primates, such as the choice of a lateral-sequence walking gait, which is similar to most non-primate mammals and the relatively stiff elbows during stance as opposed to the quite compliant gaits of primates. These finding raise the question of the role of both the mechanical structure of the body and neural control on the determination of these characteristics. PMID:25709597

Gait Analysis Using Wearable Sensors

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Hutian Feng

2012-02-01

Full Text Available Gait analysis using wearable sensors is an inexpensive, convenient, and efficient manner of providing useful information for multiple health-related applications. As a clinical tool applied in the rehabilitation and diagnosis of medical conditions and sport activities, gait analysis using wearable sensors shows great prospects. The current paper reviews available wearable sensors and ambulatory gait analysis methods based on the various wearable sensors. After an introduction of the gait phases, the principles and features of wearable sensors used in gait analysis are provided. The gait analysis methods based on wearable sensors is divided into gait kinematics, gait kinetics, and electromyography. Studies on the current methods are reviewed, and applications in sports, rehabilitation, and clinical diagnosis are summarized separately. With the development of sensor technology and the analysis method, gait analysis using wearable sensors is expected to play an increasingly important role in clinical applications.

Gait Analysis Using Wearable Sensors

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Tao, Weijun; Liu, Tao; Zheng, Rencheng; Feng, Hutian

2012-01-01

Gait analysis using wearable sensors is an inexpensive, convenient, and efficient manner of providing useful information for multiple health-related applications. As a clinical tool applied in the rehabilitation and diagnosis of medical conditions and sport activities, gait analysis using wearable sensors shows great prospects. The current paper reviews available wearable sensors and ambulatory gait analysis methods based on the various wearable sensors. After an introduction of the gait phases, the principles and features of wearable sensors used in gait analysis are provided. The gait analysis methods based on wearable sensors is divided into gait kinematics, gait kinetics, and electromyography. Studies on the current methods are reviewed, and applications in sports, rehabilitation, and clinical diagnosis are summarized separately. With the development of sensor technology and the analysis method, gait analysis using wearable sensors is expected to play an increasingly important role in clinical applications. PMID:22438763

Wearable Device-Based Gait Recognition Using Angle Embedded Gait Dynamic Images and a Convolutional Neural Network.

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Zhao, Yongjia; Zhou, Suiping

2017-02-28

The widespread installation of inertial sensors in smartphones and other wearable devices provides a valuable opportunity to identify people by analyzing their gait patterns, for either cooperative or non-cooperative circumstances. However, it is still a challenging task to reliably extract discriminative features for gait recognition with noisy and complex data sequences collected from casually worn wearable devices like smartphones. To cope with this problem, we propose a novel image-based gait recognition approach using the Convolutional Neural Network (CNN) without the need to manually extract discriminative features. The CNN's input image, which is encoded straightforwardly from the inertial sensor data sequences, is called Angle Embedded Gait Dynamic Image (AE-GDI). AE-GDI is a new two-dimensional representation of gait dynamics, which is invariant to rotation and translation. The performance of the proposed approach in gait authentication and gait labeling is evaluated using two datasets: (1) the McGill University dataset, which is collected under realistic conditions; and (2) the Osaka University dataset with the largest number of subjects. Experimental results show that the proposed approach achieves competitive recognition accuracy over existing approaches and provides an effective parametric solution for identification among a large number of subjects by gait patterns.

Wearable Device-Based Gait Recognition Using Angle Embedded Gait Dynamic Images and a Convolutional Neural Network

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Zhao, Yongjia; Zhou, Suiping

2017-01-01

The widespread installation of inertial sensors in smartphones and other wearable devices provides a valuable opportunity to identify people by analyzing their gait patterns, for either cooperative or non-cooperative circumstances. However, it is still a challenging task to reliably extract discriminative features for gait recognition with noisy and complex data sequences collected from casually worn wearable devices like smartphones. To cope with this problem, we propose a novel image-based gait recognition approach using the Convolutional Neural Network (CNN) without the need to manually extract discriminative features. The CNN’s input image, which is encoded straightforwardly from the inertial sensor data sequences, is called Angle Embedded Gait Dynamic Image (AE-GDI). AE-GDI is a new two-dimensional representation of gait dynamics, which is invariant to rotation and translation. The performance of the proposed approach in gait authentication and gait labeling is evaluated using two datasets: (1) the McGill University dataset, which is collected under realistic conditions; and (2) the Osaka University dataset with the largest number of subjects. Experimental results show that the proposed approach achieves competitive recognition accuracy over existing approaches and provides an effective parametric solution for identification among a large number of subjects by gait patterns. PMID:28264503

Gait Recognition Based on Outermost Contour

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Lili Liu

2011-10-01

Full Text Available Gait recognition aims to identify people by the way they walk. In this paper, a simple but e ective gait recognition method based on Outermost Contour is proposed. For each gait image sequence, an adaptive silhouette extraction algorithm is firstly used to segment the frames of the sequence and a series of postprocessing is applied to obtain the normalized silhouette images with less noise. Then a novel feature extraction method based on Outermost Contour is performed. Principal Component Analysis (PCA is adopted to reduce the dimensionality of the distance signals derived from the Outermost Contours of silhouette images. Then Multiple Discriminant Analysis (MDA is used to optimize the separability of gait features belonging to di erent classes. Nearest Neighbor (NN classifier and Nearest Neighbor classifier with respect to class Exemplars (ENN are used to classify the final feature vectors produced by MDA. In order to verify the e ectiveness and robustness of our feature extraction algorithm, we also use two other classifiers: Backpropagation Neural Network (BPNN and Support Vector Machine (SVM for recognition. Experimental results on a gait database of 100 people show that the accuracy of using MDA, BPNN and SVM can achieve 97.67%, 94.33% and 94.67%, respectively.

Human Gait Recognition Based on Multiview Gait Sequences

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Xiaxi Huang

2008-05-01

Full Text Available Most of the existing gait recognition methods rely on a single view, usually the side view, of the walking person. This paper investigates the case in which several views are available for gait recognition. It is shown that each view has unequal discrimination power and, therefore, should have unequal contribution in the recognition process. In order to exploit the availability of multiple views, several methods for the combination of the results that are obtained from the individual views are tested and evaluated. A novel approach for the combination of the results from several views is also proposed based on the relative importance of each view. The proposed approach generates superior results, compared to those obtained by using individual views or by using multiple views that are combined using other combination methods.

Multifractal Detrended Fluctuation Analysis of Human gait Diseases

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Srimonti eDutta

2013-10-01

Full Text Available IIn this paper multifractal detrended fluctuation analysis is used to study the human gait time series for normal and diseased sets. It is observed that long range correlation is primarily responsible for the origin of multifractality. The study reveals that the degree of multifractality is more for normal set compared to diseased set. However the method fails to distinguish between the two diseased sets.

Assessment of Human Bio-Behavior During Gait Process Using LifeMOD Software

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Liliana Rogozea

2011-01-01

Full Text Available In this paper we present a set of observations concerning the
analysis and assessment of human bio-behavior during gait process. In the first part of the paper the fundamental and theoretical considerations of the gait process are approached and aspects connected to malfunctions are expressed. In the second part of the paper we present the modeling methodology using
the LifeMOD software, while in the third part the results and conclusions are presented.

Detection of chaotic dynamics in human gait signals from mobile devices

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DelMarco, Stephen; Deng, Yunbin

2017-05-01

The ubiquity of mobile devices offers the opportunity to exploit device-generated signal data for biometric identification, health monitoring, and activity recognition. In particular, mobile devices contain an Inertial Measurement Unit (IMU) that produces acceleration and rotational rate information from the IMU accelerometers and gyros. These signals reflect motion properties of the human carrier. It is well-known that the complexity of bio-dynamical systems gives rise to chaotic dynamics. Knowledge of chaotic properties of these systems has shown utility, for example, in detecting abnormal medical conditions and neurological disorders. Chaotic dynamics has been found, in the lab, in bio-dynamical systems data such as electrocardiogram (heart), electroencephalogram (brain), and gait data. In this paper, we investigate the following question: can we detect chaotic dynamics in human gait as measured by IMU acceleration and gyro data from mobile phones? To detect chaotic dynamics, we perform recurrence analysis on real gyro and accelerometer signal data obtained from mobile devices. We apply the delay coordinate embedding approach from Takens' theorem to reconstruct the phase space trajectory of the multi-dimensional gait dynamical system. We use mutual information properties of the signal to estimate the appropriate delay value, and the false nearest neighbor approach to determine the phase space embedding dimension. We use a correlation dimension-based approach together with estimation of the largest Lyapunov exponent to make the chaotic dynamics detection decision. We investigate the ability to detect chaotic dynamics for the different one-dimensional IMU signals, across human subject and walking modes, and as a function of different phone locations on the human carrier.

Towards automated human gait disease classification using phase space representation of intrinsic mode functions

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Pratiher, Sawon; Patra, Sayantani; Pratiher, Souvik

2017-06-01

A novel analytical methodology for segregating healthy and neurological disorders from gait patterns is proposed by employing a set of oscillating components called intrinsic mode functions (IMF's). These IMF's are generated by the Empirical Mode Decomposition of the gait time series and the Hilbert transformed analytic signal representation forms the complex plane trace of the elliptical shaped analytic IMFs. The area measure and the relative change in the centroid position of the polygon formed by the Convex Hull of these analytic IMF's are taken as the discriminative features. Classification accuracy of 79.31% with Ensemble learning based Adaboost classifier validates the adequacy of the proposed methodology for a computer aided diagnostic (CAD) system for gait pattern identification. Also, the efficacy of several potential biomarkers like Bandwidth of Amplitude Modulation and Frequency Modulation IMF's and it's Mean Frequency from the Fourier-Bessel expansion from each of these analytic IMF's has been discussed for its potency in diagnosis of gait pattern identification and classification.

Modeling and simulation of normal and hemiparetic gait

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Luengas, Lely A.; Camargo, Esperanza; Sanchez, Giovanni

2015-09-01

Gait is the collective term for the two types of bipedal locomotion, walking and running. This paper is focused on walking. The analysis of human gait is of interest to many different disciplines, including biomechanics, human-movement science, rehabilitation and medicine in general. Here we present a new model that is capable of reproducing the properties of walking, normal and pathological. The aim of this paper is to establish the biomechanical principles that underlie human walking by using Lagrange method. The constraint forces of Rayleigh dissipation function, through which to consider the effect on the tissues in the gait, are included. Depending on the value of the factor present in the Rayleigh dissipation function, both normal and pathological gait can be simulated. First of all, we apply it in the normal gait and then in the permanent hemiparetic gait. Anthropometric data of adult person are used by simulation, and it is possible to use anthropometric data for children but is necessary to consider existing table of anthropometric data. Validation of these models includes simulations of passive dynamic gait that walk on level ground. The dynamic walking approach provides a new perspective of gait analysis, focusing on the kinematics and kinetics of gait. There have been studies and simulations to show normal human gait, but few of them have focused on abnormal, especially hemiparetic gait. Quantitative comparisons of the model predictions with gait measurements show that the model can reproduce the significant characteristics of normal gait.

A cable-driven locomotor training system for restoration of gait in human SCI.

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Wu, Ming; Hornby, T George; Landry, Jill M; Roth, Heidi; Schmit, Brian D

2011-02-01

A novel cable-driven robotic locomotor training system was developed to provide compliant assistance/resistance forces to the legs during treadmill training in patients with incomplete spinal cord injury (SCI). Eleven subjects with incomplete SCI were recruited to participate in two experiments to test the feasibility of the robotic gait training system. Specifically, 10 subjects participated in one experimental session to test the characteristics of the robotic gait training system and one subject participated in repeated testing sessions over 8 weeks with the robotic device to test improvements in locomotor function. Limb kinematics were recorded in one experiment to evaluate the system characteristics of the cable-driven locomotor trainer and the overground gait speed and 6 min walking distance were evaluated at pre, 4 and 8 weeks post treadmill training of a single subject as well. The results indicated that the cable driven robotic gait training system improved the kinematic performance of the leg during treadmill walking and had no significant impact on the variability of lower leg trajectory, suggesting a high backdrivability of the cable system. In addition, results from a patient with incomplete SCI indicated that prolonged robotic gait training using the cable robot improved overground gait speed. Results from this study suggested that a cable driven robotic gait training system is effective in improving leg kinematic performance, yet allows variability of gait kinematics. Thus, it seems feasible to improve the locomotor function in human SCI using this cable driven robotic system, warranting testing with a larger group of patients. Copyright © 2010 Elsevier B.V. All rights reserved.

Feature extraction and selection for objective gait analysis and fall risk assessment by accelerometry

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Cremer Gerald

2011-01-01

Full Text Available Abstract Background Falls in the elderly is nowadays a major concern because of their consequences on elderly general health and moral states. Moreover, the aging of the population and the increasing life expectancy make the prediction of falls more and more important. The analysis presented in this article makes a first step in this direction providing a way to analyze gait and classify hospitalized elderly fallers and non-faller. This tool, based on an accelerometer network and signal processing, gives objective informations about the gait and does not need any special gait laboratory as optical analysis do. The tool is also simple to use by a non expert and can therefore be widely used on a large set of patients. Method A population of 20 hospitalized elderlies was asked to execute several classical clinical tests evaluating their risk of falling. They were also asked if they experienced any fall in the last 12 months. The accelerations of the limbs were recorded during the clinical tests with an accelerometer network distributed on the body. A total of 67 features were extracted from the accelerometric signal recorded during a simple 25 m walking test at comfort speed. A feature selection algorithm was used to select those able to classify subjects at risk and not at risk for several classification algorithms types. Results The results showed that several classification algorithms were able to discriminate people from the two groups of interest: fallers and non-fallers hospitalized elderlies. The classification performances of the used algorithms were compared. Moreover a subset of the 67 features was considered to be significantly different between the two groups using a t-test. Conclusions This study gives a method to classify a population of hospitalized elderlies in two groups: at risk of falling or not at risk based on accelerometric data. This is a first step to design a risk of falling assessment system that could be used to provide

Detecting Gait Asymmetry with Wearable Accelerometers

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2015-03-18

by overuse. Common overuse injuries include stress fractures , tendinitis, bursitis, fasciitis, and medial tibial stress syndrome (shin splints) [11...magnitude feature values for subject 1 are shown in (a), before and after repetitive stress injury. Magnitude and pattern features are plotted in...Dudziñski, A. Lees, M. Lake, and M. Wychowañski, “Adjustments in gait symmetry with walking speed in trans-femoral and trans- tibial amputees,” Gait

Efficient Human Action and Gait Analysis Using Multiresolution Motion Energy Histogram

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Kuo-Chin Fan

2010-01-01

Full Text Available Average Motion Energy (AME image is a good way to describe human motions. However, it has to face the computation efficiency problem with the increasing number of database templates. In this paper, we propose a histogram-based approach to improve the computation efficiency. We convert the human action/gait recognition problem to a histogram matching problem. In order to speed up the recognition process, we adopt a multiresolution structure on the Motion Energy Histogram (MEH. To utilize the multiresolution structure more efficiently, we propose an automated uneven partitioning method which is achieved by utilizing the quadtree decomposition results of MEH. In that case, the computation time is only relevant to the number of partitioned histogram bins, which is much less than the AME method. Two applications, action recognition and gait classification, are conducted in the experiments to demonstrate the feasibility and validity of the proposed approach.

Design of a biologically inspired lower limb exoskeleton for human gait rehabilitation.

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Lyu, Mingxing; Chen, Weihai; Ding, Xilun; Wang, Jianhua; Bai, Shaoping; Ren, Huichao

2016-10-01

This paper proposes a novel bionic model of the human leg according to the theory of physiology. Based on this model, we present a biologically inspired 3-degree of freedom (DOF) lower limb exoskeleton for human gait rehabilitation, showing that the lower limb exoskeleton is fully compatible with the human knee joint. The exoskeleton has a hybrid serial-parallel kinematic structure consisting of a 1-DOF hip joint module and a 2-DOF knee joint module in the sagittal plane. A planar 2-DOF parallel mechanism is introduced in the design to fully accommodate the motion of the human knee joint, which features not only rotation but also relative sliding. Therefore, the design is consistent with the requirements of bionics. The forward and inverse kinematic analysis is studied and the workspace of the exoskeleton is analyzed. The structural parameters are optimized to obtain a larger workspace. The results using MATLAB-ADAMS co-simulation are shown in this paper to demonstrate the feasibility of our design. A prototype of the exoskeleton is also developed and an experiment performed to verify the kinematic analysis. Compared with existing lower limb exoskeletons, the designed mechanism has a large workspace, while allowing knee joint rotation and small amount of sliding.

Design of a biologically inspired lower limb exoskeleton for human gait rehabilitation

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Lyu, Mingxing; Chen, Weihai; Ding, Xilun; Wang, Jianhua; Bai, Shaoping; Ren, Huichao

2016-10-01

This paper proposes a novel bionic model of the human leg according to the theory of physiology. Based on this model, we present a biologically inspired 3-degree of freedom (DOF) lower limb exoskeleton for human gait rehabilitation, showing that the lower limb exoskeleton is fully compatible with the human knee joint. The exoskeleton has a hybrid serial-parallel kinematic structure consisting of a 1-DOF hip joint module and a 2-DOF knee joint module in the sagittal plane. A planar 2-DOF parallel mechanism is introduced in the design to fully accommodate the motion of the human knee joint, which features not only rotation but also relative sliding. Therefore, the design is consistent with the requirements of bionics. The forward and inverse kinematic analysis is studied and the workspace of the exoskeleton is analyzed. The structural parameters are optimized to obtain a larger workspace. The results using MATLAB-ADAMS co-simulation are shown in this paper to demonstrate the feasibility of our design. A prototype of the exoskeleton is also developed and an experiment performed to verify the kinematic analysis. Compared with existing lower limb exoskeletons, the designed mechanism has a large workspace, while allowing knee joint rotation and small amount of sliding.

Gait Analysis Study of Runner Using Force Plate

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Flaviana Catherine

2017-02-01

Full Text Available Humans do regular physical activities such as running. Gait is forward  propulsion of the human body using lower extremities as a thrust. Humans gait pattern is characterized by their limbs movement in terms of velocity, ground reaction force, work, kinetic energy and potential energy cycle . Human gait analysis is used to assess, to plan, and to deliver the treatment for individuals based on the conditions that affect their ability to move. Gait analysis is commonly used in running sport to improve the efficiency of athletes in running and to identify problems related to their posture or movement. The aim of this research is to do running gait analysis study of human, using force plate which equipped by track board. The benefit of this study is to provide information, ideas and new perspectives about running and its prevention over an injury. The main method that will be discussed in this study is system design of gait analysis with specific setting, hardware and software, in order to acquire data(s.

A brain-controlled lower-limb exoskeleton for human gait training

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Liu, Dong; Chen, Weihai; Pei, Zhongcai; Wang, Jianhua

2017-10-01

Brain-computer interfaces have been a novel approach to translate human intentions into movement commands in robotic systems. This paper describes an electroencephalogram-based brain-controlled lower-limb exoskeleton for gait training, as a proof of concept towards rehabilitation with human-in-the-loop. Instead of using conventional single electroencephalography correlates, e.g., evoked P300 or spontaneous motor imagery, we propose a novel framework integrated two asynchronous signal modalities, i.e., sensorimotor rhythms (SMRs) and movement-related cortical potentials (MRCPs). We executed experiments in a biologically inspired and customized lower-limb exoskeleton where subjects (N = 6) actively controlled the robot using their brain signals. Each subject performed three consecutive sessions composed of offline training, online visual feedback testing, and online robot-control recordings. Post hoc evaluations were conducted including mental workload assessment, feature analysis, and statistics test. An average robot-control accuracy of 80.16% ± 5.44% was obtained with the SMR-based method, while estimation using the MRCP-based method yielded an average performance of 68.62% ± 8.55%. The experimental results showed the feasibility of the proposed framework with all subjects successfully controlled the exoskeleton. The current paradigm could be further extended to paraplegic patients in clinical trials.

Design, simulation and modelling of auxiliary exoskeleton to improve human gait cycle.

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Ashkani, O; Maleki, A; Jamshidi, N

2017-03-01

Exoskeleton is a walking assistance device that improves human gait cycle through providing auxiliary force and transferring physical load to the stronger muscles. This device takes the natural state of organ and follows its natural movement. Exoskeleton functions as an auxiliary device to help those with disabilities in hip and knee such as devotees, elderly farmers and agricultural machinery operators who suffer from knee complications. In this research, an exoskeleton designed with two screw jacks at knee and hip joints. To simulate extension and flexion movements of the leg joints, bearings were used at the end of hip and knee joints. The generated torque and motion angles of these joints obtained as well as the displacement curves of screw jacks in the gait cycle. Then, the human gait cycle was simulated in stance and swing phases and the obtained torque curves were compared. The results indicated that they followed the natural circle of the generated torque in joints with a little difference from each other. The maximum displacement obtained 4 and 6 cm in hip and knee joints jack respectively. The maximum torques in hip and knee joints were generated in foot contact phase. Also the minimum torques in hip and knee joints were generated in toe off and heel off phases respectively.

An IMU-to-Body Alignment Method Applied to Human Gait Analysis

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Laura Susana Vargas-Valencia

2016-12-01

Full Text Available This paper presents a novel calibration procedure as a simple, yet powerful, method to place and align inertial sensors with body segments. The calibration can be easily replicated without the need of any additional tools. The proposed method is validated in three different applications: a computer mathematical simulation; a simplified joint composed of two semi-spheres interconnected by a universal goniometer; and a real gait test with five able-bodied subjects. Simulation results demonstrate that, after the calibration method is applied, the joint angles are correctly measured independently of previous sensor placement on the joint, thus validating the proposed procedure. In the cases of a simplified joint and a real gait test with human volunteers, the method also performs correctly, although secondary plane errors appear when compared with the simulation results. We believe that such errors are caused by limitations of the current inertial measurement unit (IMU technology and fusion algorithms. In conclusion, the presented calibration procedure is an interesting option to solve the alignment problem when using IMUs for gait analysis.

Prediction of human gait trajectories during the SSP using a neuromusculoskeletal modeling: A challenge for parametric optimization.

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Seyed, Mohammadali Rahmati; Mostafa, Rostami; Borhan, Beigzadeh

2018-04-27

The parametric optimization techniques have been widely employed to predict human gait trajectories; however, their applications to reveal the other aspects of gait are questionable. The aim of this study is to investigate whether or not the gait prediction model is able to justify the movement trajectories for the higher average velocities. A planar, seven-segment model with sixteen muscle groups was used to represent human neuro-musculoskeletal dynamics. At first, the joint angles, ground reaction forces (GRFs) and muscle activations were predicted and validated for normal average velocity (1.55 m/s) in the single support phase (SSP) by minimizing energy expenditure, which is subject to the non-linear constraints of the gait. The unconstrained system dynamics of extended inverse dynamics (USDEID) approach was used to estimate muscle activations. Then by scaling time and applying the same procedure, the movement trajectories were predicted for higher average velocities (from 2.07 m/s to 4.07 m/s) and compared to the pattern of movement with fast walking speed. The comparison indicated a high level of compatibility between the experimental and predicted results, except for the vertical position of the center of gravity (COG). It was concluded that the gait prediction model can be effectively used to predict gait trajectories for higher average velocities.

Shotgun approaches to gait analysis : insights & limitations

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Kaptein, Ronald G.; Wezenberg, Daphne; IJmker, Trienke; Houdijk, Han; Beek, Peter J.; Lamoth, Claudine J. C.; Daffertshofer, Andreas

2014-01-01

Background: Identifying features for gait classification is a formidable problem. The number of candidate measures is legion. This calls for proper, objective criteria when ranking their relevance. Methods: Following a shotgun approach we determined a plenitude of kinematic and physiological gait

Influence of artificial shock absorbers on human gait.

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Voloshin, A; Wosk, J

1981-10-01

The effect of artificial shock absorbers on the human gait and the technique for its quantitative evaluation have been studied. The results obtained have shown that viscoelastic inserts reduced the amplitude of the incoming shock waves bearing upon the musculoskeletal system as a result of the heel strike, by 42 percent (mean value). Conservative treatment, using such inserts for patients with different clinical symptoms of degenerative joint diseases, has shown excellent results. Seventy-eight percent of the clinical symptoms disappeared, while satisfactory improvement was reported in 17 percent of the subjects.

Cortical control of gait in healthy humans: an fMRI study

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ChiHong, Wang; YauYau, Wai; BoCheng, Kuo; Yei-Yu, Yeh; JiunJie Wang

2008-01-01

This study examined the cortical control of gait in healthy humans using functional magnetic resonance imaging (fMRI). Two block-designed fMRI sessions were conducted during motor imagery of a locomotor-related task. Subjects watched a video clip that showed an actor standing and walking in an egocentric perspective. In a control session, additional fMRI images were collected when participants observed a video clip of the clutch movement of a right hand. In keeping with previous studies using SPECT and NIRS, we detected activation in many motor-related areas including supplementary motor area, bilateral precentral gyrus, left dorsal premotor cortex, and cingulate motor area. Smaller additional activations were observed in the bilateral precuneus, left thalamus, and part of right putamen. Based on these findings, we propose a novel paradigm to study the cortical control of gait in healthy humans using fMRI. Specifically, the task used in this study - involving both mirror neurons and mental imagery - provides a new feasible model to be used in functional neuroimaging studies in this area of research. (author)

Research the Gait Characteristics of Human Walking Based on a Robot Model and Experiment

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He, H. J.; Zhang, D. N.; Yin, Z. W.; Shi, J. H.

2017-02-01

In order to research the gait characteristics of human walking in different walking ways, a robot model with a single degree of freedom is put up in this paper. The system control models of the robot are established through Matlab/Simulink toolbox. The gait characteristics of straight, uphill, turning, up the stairs, down the stairs up and down areanalyzed by the system control models. To verify the correctness of the theoretical analysis, an experiment was carried out. The comparison between theoretical results and experimental results shows that theoretical results are better agreement with the experimental ones. Analyze the reasons leading to amplitude error and phase error and give the improved methods. The robot model and experimental ways can provide foundation to further research the various gait characteristics of the exoskeleton robot.

Generating Human-Like Velocity-Adapted Jumping Gait from sEMG Signals for Bionic Leg’s Control

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Weiwei Yu

2017-01-01

Full Text Available In the case of dynamic motion such as jumping, an important fact in sEMG (surface Electromyogram signal based control on exoskeletons, myoelectric prostheses, and rehabilitation gait is that multichannel sEMG signals contain mass data and vary greatly with time, which makes it difficult to generate compliant gait. Inspired by the fact that muscle synergies leading to dimensionality reduction may simplify motor control and learning, this paper proposes a new approach to generate flexible gait based on muscle synergies extracted from sEMG signal. Two questions were discussed and solved, the first one concerning whether the same set of muscle synergies can explain the different phases of hopping movement with various velocities. The second one is about how to generate self-adapted gait with muscle synergies while alleviating model sensitivity to sEMG transient changes. From the experimental results, the proposed method shows good performance both in accuracy and in robustness for producing velocity-adapted vertical jumping gait. The method discussed in this paper provides a valuable reference for the sEMG-based control of bionic robot leg to generate human-like dynamic gait.

Is Freezing of Gait in Parkinson's Disease a Result of Multiple Gait Impairments? Implications for Treatment

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Plotnik, Meir; Giladi, Nir; Hausdorff, Jeffrey M.

2012-01-01

Several gait impairments have been associated with freezing of gait (FOG) in patients with Parkinson's disease (PD). These include deteriorations in rhythm control, gait symmetry, bilateral coordination of gait, dynamic postural control and step scaling. We suggest that these seemingly independent gait features may have mutual interactions which, during certain circumstances, jointly drive the predisposed locomotion system into a FOG episode. This new theoretical framework is illustrated by the evaluation of the potential relationships between the so-called “sequence effect”, that is, impairments in step scaling, and gait asymmetry just prior to FOG. We further discuss what factors influence gait control to maintain functional gait. “Triggers”, for example, such as attention shifts or trajectory transitions, may precede FOG. We propose distinct categories of interventions and describe examples of existing work that support this idea: (a) interventions which aim to maintain a good level of locomotion control especially with respect to aspects related to FOG; (b) those that aim at avoiding FOG “triggers”; and (c) those that merely aim to escape from FOG once it occurs. The proposed theoretical framework sets the stage for testable hypotheses regarding the mechanisms that lead to FOG and may also lead to new treatment ideas. PMID:22288021

GaitKeeper: A System for Measuring Canine Gait

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Cassim Ladha

2017-02-01

Full Text Available It is understood gait has the potential to be used as a window into neurodegenerative disorders, identify markers of subclinical pathology, inform diagnostic algorithms of disease progression and measure the efficacy of interventions. Dogs’ gaits are frequently assessed in a veterinary setting to detect signs of lameness. Despite this, a reliable, affordable and objective method to assess lameness in dogs is lacking. Most described canine lameness assessments are subjective, unvalidated and at high risk of bias. This means reliable, early detection of canine gait abnormalities is challenging, which may have detrimental implications for dogs’ welfare. In this paper, we draw from approaches and technologies used in human movement science and describe a system for objectively measuring temporal gait characteristics in dogs (step-time, swing-time, stance-time. Asymmetries and variabilities in these characteristics are of known clinical significance when assessing lameness but presently may only be assessed on coarse scales or under highly instrumented environments. The system consists an inertial measurement unit, containing a 3-axis accelerometer and gyroscope coupled with a standardized walking course. The measurement unit is attached to each leg of the dog under assessment before it is walked around the course. The data by the measurement unit is then processed to identify steps and subsequently, micro-gait characteristics. This method has been tested on a cohort of 19 healthy dogs of various breeds ranging in height from 34.2 cm to 84.9 cm. We report the system as capable of making precise step delineations with detections of initial and final contact times of foot-to-floor to a mean precision of 0.011 s and 0.048 s, respectively. Results are based on analysis of 12,678 foot falls and we report a sensitivity, positive predictive value and F-score of 0.81, 0.83 and 0.82 respectively. To investigate the effect of gait on system performance

Quantification of human motion: gait analysis-benefits and limitations to its application to clinical problems.

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Simon, Sheldon R

2004-12-01

The technology supporting the analysis of human motion has advanced dramatically. Past decades of locomotion research have provided us with significant knowledge about the accuracy of tests performed, the understanding of the process of human locomotion, and how clinical testing can be used to evaluate medical disorders and affect their treatment. Gait analysis is now recognized as clinically useful and financially reimbursable for some medical conditions. Yet, the routine clinical use of gait analysis has seen very limited growth. The issue of its clinical value is related to many factors, including the applicability of existing technology to addressing clinical problems; the limited use of such tests to address a wide variety of medical disorders; the manner in which gait laboratories are organized, tests are performed, and reports generated; and the clinical understanding and expectations of laboratory results. Clinical use is most hampered by the length of time and costs required for performing a study and interpreting it. A "gait" report is lengthy, its data are not well understood, and it includes a clinical interpretation, all of which do not occur with other clinical tests. Current biotechnology research is seeking to address these problems by creating techniques to capture data rapidly, accurately, and efficiently, and to interpret such data by an assortment of modeling, statistical, wave interpretation, and artificial intelligence methodologies. The success of such efforts rests on both our technical abilities and communication between engineers and clinicians.

Toward new sensitive measures to evaluate gait stability in focal cerebellar lesion patients

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Hoogkamer, W.; Bruijn, S.M.; Sunaert, S.; Swinnen, S.P.; Calenbergh, F. Van; Duysens, J.E.J.

2015-01-01

The evident ataxic characteristics of gait in patients with cerebellar damage suggest that the cerebellum plays an important role in the neural control of gait. Ataxic features, such as increased gait variability and increased step width, are often related to gait stability. However, the link

Gait Recognition Using Image Self-Similarity

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Chiraz BenAbdelkader

2004-04-01

Full Text Available Gait is one of the few biometrics that can be measured at a distance, and is hence useful for passive surveillance as well as biometric applications. Gait recognition research is still at its infancy, however, and we have yet to solve the fundamental issue of finding gait features which at once have sufficient discrimination power and can be extracted robustly and accurately from low-resolution video. This paper describes a novel gait recognition technique based on the image self-similarity of a walking person. We contend that the similarity plot encodes a projection of gait dynamics. It is also correspondence-free, robust to segmentation noise, and works well with low-resolution video. The method is tested on multiple data sets of varying sizes and degrees of difficulty. Performance is best for fronto-parallel viewpoints, whereby a recognition rate of 98% is achieved for a data set of 6 people, and 70% for a data set of 54 people.

An Ambulatory Method of Identifying Anterior Cruciate Ligament Reconstructed Gait Patterns

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Matthew R. Patterson

2014-01-01

Full Text Available The use of inertial sensors to characterize pathological gait has traditionally been based on the calculation of temporal and spatial gait variables from inertial sensor data. This approach has proved successful in the identification of gait deviations in populations where substantial differences from normal gait patterns exist; such as in Parkinsonian gait. However, it is not currently clear if this approach could identify more subtle gait deviations, such as those associated with musculoskeletal injury. This study investigates whether additional analysis of inertial sensor data, based on quantification of gyroscope features of interest, would provide further discriminant capability in this regard. The tested cohort consisted of a group of anterior cruciate ligament reconstructed (ACL-R females and a group of non-injured female controls, each performed ten walking trials. Gait performance was measured simultaneously using inertial sensors and an optoelectronic marker based system. The ACL-R group displayed kinematic and kinetic deviations from the control group, but no temporal or spatial deviations. This study demonstrates that quantification of gyroscope features can successfully identify changes associated with ACL-R gait, which was not possible using spatial or temporal variables. This finding may also have a role in other clinical applications where small gait deviations exist.

Quantitative Gait Analysis in Patients with Huntington’s Disease

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Seon Jong Pyo

2017-09-01

Full Text Available Objective Gait disturbance is the main factor contributing to a negative impact on quality of life in patients with Huntington’s disease (HD. Understanding gait features in patients with HD is essential for planning a successful gait strategy. The aim of this study was to investigate temporospatial gait parameters in patients with HD compared with healthy controls. Methods We investigated 7 patients with HD. Diagnosis was confirmed by genetic analysis, and patients were evaluated with the Unified Huntington’s Disease Rating Scale (UHDRS. Gait features were assessed with a gait analyzer. We compared the results of patients with HD to those of 7 age- and sex-matched normal controls. Results Step length and stride length were decreased and base of support was increased in the HD group compared to the control group. In addition, coefficients of variability for step and stride length were increased in the HD group. The HD group showed slower walking velocity, an increased stance/swing phase in the gait cycle and a decreased proportion of single support time compared to the control group. Cadence did not differ significantly between groups. Among the UHDRS subscores, total motor score and total behavior score were positively correlated with step length, and total behavior score was positively correlated with walking velocity in patients with HD. Conclusion Increased variability in step and stride length, slower walking velocity, increased stance phase, and decreased swing phase and single support time with preserved cadence suggest that HD gait patterns are slow, ataxic and ineffective. This study suggests that quantitative gait analysis is needed to assess gait problems in HD.

Gait Analysis Using Computer Vision Based on Cloud Platform and Mobile Device

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Mario Nieto-Hidalgo

2018-01-01

Full Text Available Frailty and senility are syndromes that affect elderly people. The ageing process involves a decay of cognitive and motor functions which often produce an impact on the quality of life of elderly people. Some studies have linked this deterioration of cognitive and motor function to gait patterns. Thus, gait analysis can be a powerful tool to assess frailty and senility syndromes. In this paper, we propose a vision-based gait analysis approach performed on a smartphone with cloud computing assistance. Gait sequences recorded by a smartphone camera are processed by the smartphone itself to obtain spatiotemporal features. These features are uploaded onto the cloud in order to analyse and compare them to a stored database to render a diagnostic. The feature extraction method presented can work with both frontal and sagittal gait sequences although the sagittal view provides a better classification since an accuracy of 95% can be obtained.

Real-Time Classification of Patients with Balance Disorders vs. Normal Subjects Using a Low-Cost Small Wireless Wearable Gait Sensor

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Bhargava Teja Nukala

2016-11-01

Full Text Available Gait analysis using wearable wireless sensors can be an economical, convenient and effective way to provide diagnostic and clinical information for various health-related issues. In this work, our custom designed low-cost wireless gait analysis sensor that contains a basic inertial measurement unit (IMU was used to collect the gait data for four patients diagnosed with balance disorders and additionally three normal subjects, each performing the Dynamic Gait Index (DGI tests while wearing the custom wireless gait analysis sensor (WGAS. The small WGAS includes a tri-axial accelerometer integrated circuit (IC, two gyroscopes ICs and a Texas Instruments (TI MSP430 microcontroller and is worn by each subject at the T4 position during the DGI tests. The raw gait data are wirelessly transmitted from the WGAS to a near-by PC for real-time gait data collection and analysis. In order to perform successful classification of patients vs. normal subjects, we used several different classification algorithms, such as the back propagation artificial neural network (BP-ANN, support vector machine (SVM, k-nearest neighbors (KNN and binary decision trees (BDT, based on features extracted from the raw gait data of the gyroscopes and accelerometers. When the range was used as the input feature, the overall classification accuracy obtained is 100% with BP-ANN, 98% with SVM, 96% with KNN and 94% using BDT. Similar high classification accuracy results were also achieved when the standard deviation or other values were used as input features to these classifiers. These results show that gait data collected from our very low-cost wearable wireless gait sensor can effectively differentiate patients with balance disorders from normal subjects in real time using various classifiers, the success of which may eventually lead to accurate and objective diagnosis of abnormal human gaits and their underlying etiologies in the future, as more patient data are being collected.

Gait Disorders in Parkinson's Disease: Assessment and Management

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Pei-Hao Chen

2013-12-01

Full Text Available Gait disorder, a major cause of morbidity in the elderly population, is one of the cardinal features of Parkinson's disease. Owing to the characteristics of these gaits varying widely from festination to freezing of gait, analysis can be hardly identified in the clinical setting. Instrumented gait analysis has been widely used in a traditional gait laboratory. Recently, wireless monitoring systems have become highly informative by allowing long-term data collection in a variety of environments outside the labs. The quantitative analysis of gait patterns is probably the first step to a successful management of an individual patient. The presence of abnormal gait usually indicates advanced stages of disease and is often associated with cognitive impairment, falls, and injuries. Besides pharmacological and surgical treatments, parkinsonian gait can benefit from a variety of interventions. Assistive devices prevent patients from falls, and cueing strategies help them decrease episodes of freezing. Therefore, a multidisciplinary team approach to the optimal management is essential for an elderly patient with Parkinson's disease.

Gait analysis by high school students

NARCIS (Netherlands)

Heck, A.; van Dongen, C.

2008-01-01

Human walking is a complicated motion. Movement scientists have developed various research methods to study gait. This article describes how a high school student collected and analysed high quality gait data in much the same way that movement scientists do, via the recording and measurement of

The Golden Ratio of Gait Harmony: Repetitive Proportions of Repetitive Gait Phases

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Marco Iosa

2013-01-01

Full Text Available In nature, many physical and biological systems have structures showing harmonic properties. Some of them were found related to the irrational number known as the golden ratio that has important symmetric and harmonic properties. In this study, the spatiotemporal gait parameters of 25 healthy subjects were analyzed using a stereophotogrammetric system with 25 retroreflective markers located on their skin. The proportions of gait phases were compared with , the value of which is about 1.6180. The ratio between the entire gait cycle and stance phase resulted in 1.620 ± 0.058, that between stance and the swing phase was 1.629 ± 0.173, and that between swing and the double support phase was 1.684 ± 0.357. All these ratios did not differ significantly from each other (, , repeated measure analysis of variance or from (, resp., t-tests. The repetitive gait phases of physiological walking were found in turn in repetitive proportions with each other, revealing an intrinsic harmonic structure. Harmony could be the key for facilitating the control of repetitive walking. Harmony is a powerful unifying factor between seemingly disparate fields of nature, including human gait.

Effect of arm swing strategy on local dynamic stability of human gait

OpenAIRE

Punt, M.; Bruijn, S.M.; Wittink, H.; van Dieen, J.H.

2015-01-01

Introduction: Falling causes long term disability and can even lead to death. Most falls occur during gait. Therefore improving gait stability might be beneficial for people at risk of falling. Recently arm swing has been shown to influence gait stability. However at present it remains unknown which mode of arm swing creates the most stable gait. Aim: To examine how different modes of arm swing affect gait stability. Method: Ten healthy young male subjects volunteered for this study. All subj...

Towards more effective robotic gait training for stroke rehabilitation: a review

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Pennycott Andrew

2012-09-01

Full Text Available Abstract Background Stroke is the most common cause of disability in the developed world and can severely degrade walking function. Robot-driven gait therapy can provide assistance to patients during training and offers a number of advantages over other forms of therapy. These potential benefits do not, however, seem to have been fully realised as of yet in clinical practice. Objectives This review determines ways in which robot-driven gait technology could be improved in order to achieve better outcomes in gait rehabilitation. Methods The literature on gait impairments caused by stroke is reviewed, followed by research detailing the different pathways to recovery. The outcomes of clinical trials investigating robot-driven gait therapy are then examined. Finally, an analysis of the literature focused on the technical features of the robot-based devices is presented. This review thus combines both clinical and technical aspects in order to determine the routes by which robot-driven gait therapy could be further developed. Conclusions Active subject participation in robot-driven gait therapy is vital to many of the potential recovery pathways and is therefore an important feature of gait training. Higher levels of subject participation and challenge could be promoted through designs with a high emphasis on robotic transparency and sufficient degrees of freedom to allow other aspects of gait such as balance to be incorporated.

Design of a robotic gait trainer using spring over muscle actuators for ankle stroke rehabilitation.

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Bharadwaj, Kartik; Sugar, Thomas G; Koeneman, James B; Koeneman, Edward J

2005-11-01

Repetitive task training is an effective form of rehabilitation for people suffering from debilitating injuries of stroke. We present the design and working concept of a robotic gait trainer (RGT), an ankle rehabilitation device for assisting stroke patients during gait. Structurally based on a tripod mechanism, the device is a parallel robot that incorporates two pneumatically powered, double-acting, compliant, spring over muscle actuators as actuation links which move the ankle in dorsiflex ion/plantarflexion and inversion/eversion. A unique feature in the tripod design is that the human anatomy is part of the robot, the first fixed link being the patient's leg. The kinematics and workspace of the tripod device have been analyzed determining its range of motion. Experimental gait data from an able-bodied person wearing the working RGT prototype are presented.

Toward Multimodal Human-Robot Interaction to Enhance Active Participation of Users in Gait Rehabilitation.

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Gui, Kai; Liu, Honghai; Zhang, Dingguo

2017-11-01

Robotic exoskeletons for physical rehabilitation have been utilized for retraining patients suffering from paraplegia and enhancing motor recovery in recent years. However, users are not voluntarily involved in most systems. This paper aims to develop a locomotion trainer with multiple gait patterns, which can be controlled by the active motion intention of users. A multimodal human-robot interaction (HRI) system is established to enhance subject's active participation during gait rehabilitation, which includes cognitive HRI (cHRI) and physical HRI (pHRI). The cHRI adopts brain-computer interface based on steady-state visual evoked potential. The pHRI is realized via admittance control based on electromyography. A central pattern generator is utilized to produce rhythmic and continuous lower joint trajectories, and its state variables are regulated by cHRI and pHRI. A custom-made leg exoskeleton prototype with the proposed multimodal HRI is tested on healthy subjects and stroke patients. The results show that voluntary and active participation can be effectively involved to achieve various assistive gait patterns.

Analysis of spatial temporal plantar pressure pattern during gait in Parkinson's disease.

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Okuno, Ryuhei; Fujimoto, Satoshi; Akazawa, Jun; Yokoe, Masaru; Sakoda, Saburo; Akazawa, Kenzo

2008-01-01

Spatial temporal plantar pressure patterns measured with sheet-shaped pressure sensor were investigated to extract features of gait in Parkinson's disease. Both six subjects of Parkinson's disease (PD) and elderly fourteen normal control subjects were asked to execute usual walking on the pressure sensor sheets. Candidate features were step length, step time, gait velocity and transition of center of pressure to foot axis direction. The step length and gait velocity were smaller in PD subjects than those in normal subjects. Time of step cycle in three PD subjects were longer than that in normal subjects while the times of other PD subjects were similar to those of control subjects. The length from heel contact to toe off within one footprint was small in the subjects with short step length. Such possibility was indicated that Parkinson's disease in gait could be separated from normal subjects by these features.

Locomotion energetics and gait characteristics of a rat-kangaroo, Bettongia penicillata, have some kangaroo-like features.

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Webster, K N; Dawson, T J

2003-09-01

The locomotory characteristics of kangaroos and wallabies are unusual, with both energetic costs and gait parameters differing from those of quadrupedal running mammals. The kangaroos and wallabies have an evolutionary history of only around 5 million years; their closest relatives, the rat-kangaroos, have a fossil record of more than 26 million years. We examined the locomotory characteristics of a rat-kangaroo, Bettongia penicillata. Locomotory energetics and gait parameters were obtained from animals exercising on a motorised treadmill at speeds from 0.6 m s(-1) to 6.2 m s(-1). Aerobic metabolic costs increased as hopping speed increased, but were significantly different from the costs for a running quadruped; at the fastest speed, the cost of hopping was 50% of the cost of running. Therefore B. penicillata can travel much faster than quadrupedal runners at similar levels of aerobic output. The maximum aerobic output of B. penicillata was 17 times its basal metabolism. Increases in speed during hopping were achieved through increases in stride length, with stride frequency remaining constant. We suggest that these unusual locomotory characteristics are a conservative feature among the hopping marsupials, with an evolutionary history of 20-30 million years.

Overground robot assisted gait trainer for the treatment of drug-resistant freezing of gait in Parkinson disease.

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Pilleri, Manuela; Weis, Luca; Zabeo, Letizia; Koutsikos, Konstantinos; Biundo, Roberta; Facchini, Silvia; Rossi, Simonetta; Masiero, Stefano; Antonini, Angelo

2015-08-15

Freezing of Gait (FOG) is a frequent and disabling feature of Parkinson disease (PD). Gait rehabilitation assisted by electromechanical devices, such as training on treadmill associated with sensory cues or assisted by gait orthosis have been shown to improve FOG. Overground robot assisted gait training (RGT) has been recently tested in patients with PD with improvement of several gait parameters. We here evaluated the effectiveness of RGT on FOG severity and gait abnormalities in PD patients. Eighteen patients with FOG resistant to dopaminergic medications were treated with 15 sessions of RGT and underwent an extensive clinical evaluation before and after treatment. The main outcome measures were FOG questionnaire (FOGQ) global score and specific tasks for gait assessment, namely 10 meter walking test (10 MWT), Timed Up and Go test (TUG) and 360° narrow turns (360 NT). Balance was also evaluated through Fear of Falling Efficacy Scale (FFES), assessing self perceived stability and Berg Balance Scale (BBS), for objective examination. After treatment, FOGQ score was significantly reduced (P=0.023). We also found a significant reduction of time needed to complete TUG, 10 MWT, and 360 NT (P=0.009, 0.004 and 0.04, respectively). By contrast the number of steps and the number of freezing episodes recorded at each gait task did not change. FFES and BBS scores also improved, with positive repercussions on performance on daily activity and quality of life. Our results indicate that RGT is a useful strategy for the treatment of drug refractory FOG. Copyright © 2015 Elsevier B.V. All rights reserved.

Knock knee and the gait of six-year-old children.

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Pretkiewicz-Abacjew, E

2003-06-01

Knock knee (genu valgum) interferes with the locomotive and supporting function of the lower limb. In static conditions the load-bearing axis of the valgus limb is displaced laterally in relation to the middle of the joint, causing the knee joint, the ankle joint, and the foot as a whole to be weighted in the wrong way. The purpose of this work is to examine the influence of knock knee on gait kinematics. The gait of twenty-two 6-year-old children of both sexes in whom knock knee had been medically diagnosed was compared with the gait of 33 children of the same age whose knee joints conformed to the norm in formation and position. Gait was recorded separately for the sagittal and the frontal planes, using a video-computer system. The results of the examination indicated statistically significant differences in the gait of the two groups of children. These differences related mainly to the time features of gait and to data on the angles in the knee and ankle joints. Although the results obtained for other features of gait did not reveal statistical differences, these did indicate that the children with knock knee walked more slowly and with a lower cadence. The results indicate that knock knee in 6-year-old children has an adverse impact on the mechanics of the lower limb joints in gait and causes a deterioration in gait quality. Thus knock knee in children should not be treated merely as a superficial defect but should be subject to therapy and, more importantly, taken into account when introducing children to early sports training.

Capability of 2 gait measures for detecting response to gait training in stroke survivors: Gait Assessment and Intervention Tool and the Tinetti Gait Scale.

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Zimbelman, Janice; Daly, Janis J; Roenigk, Kristen L; Butler, Kristi; Burdsall, Richard; Holcomb, John P

2012-01-01

To characterize the performance of 2 observational gait measures, the Tinetti Gait Scale (TGS) and the Gait Assessment and Intervention Tool (G.A.I.T.), in identifying improvement in gait in response to gait training. In secondary analysis from a larger study of multimodal gait training for stroke survivors, we measured gait at pre-, mid-, and posttreatment according to G.A.I.T. and TGS, assessing their capability to capture recovery of coordinated gait components. Large medical center. Cohort of stroke survivors (N=44) greater than 6 months after stroke. All subjects received 48 sessions of a multimodal gait-training protocol. Treatment consisted of 1.5 hours per session, 4 sessions per week for 12 weeks, receiving these 3 treatment aspects: (1) coordination exercise, (2) body weight-supported treadmill training, and (3) overground gait training, with 46% of subjects receiving functional electrical stimulation. All subjects were evaluated with the G.A.I.T. and TGS before and after completing the 48-session intervention. An additional evaluation was performed at midtreatment (after session 24). For the total subject sample, there were significant pre-/post-, pre-/mid-, and mid-/posttreatment gains for both the G.A.I.T. and the TGS. According to the G.A.I.T., 40 subjects (91%) showed improved scores, 2 (4%) no change, and 2 (4%) a worsening score. According to the TGS, only 26 subjects (59%) showed improved scores, 16 (36%) no change, and 1 (2%) a worsening score. For 1 treatment group of chronic stroke survivors, the TGS failed to identify a significant treatment response to gait training, whereas the G.A.I.T. measure was successful. The G.A.I.T. is more sensitive than the TGS for individual patients and group treatment response in identifying recovery of volitional control of gait components in response to gait training. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Analysis of Big Data in Gait Biomechanics: Current Trends and Future Directions.

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Phinyomark, Angkoon; Petri, Giovanni; Ibáñez-Marcelo, Esther; Osis, Sean T; Ferber, Reed

2018-01-01

The increasing amount of data in biomechanics research has greatly increased the importance of developing advanced multivariate analysis and machine learning techniques, which are better able to handle "big data". Consequently, advances in data science methods will expand the knowledge for testing new hypotheses about biomechanical risk factors associated with walking and running gait-related musculoskeletal injury. This paper begins with a brief introduction to an automated three-dimensional (3D) biomechanical gait data collection system: 3D GAIT, followed by how the studies in the field of gait biomechanics fit the quantities in the 5 V's definition of big data: volume, velocity, variety, veracity, and value. Next, we provide a review of recent research and development in multivariate and machine learning methods-based gait analysis that can be applied to big data analytics. These modern biomechanical gait analysis methods include several main modules such as initial input features, dimensionality reduction (feature selection and extraction), and learning algorithms (classification and clustering). Finally, a promising big data exploration tool called "topological data analysis" and directions for future research are outlined and discussed.

Effect of arm swing strategy on local dynamic stability of human gait

NARCIS (Netherlands)

Punt, M.; Bruijn, S.M.; Wittink, H.; van Dieen, J.H.

2015-01-01

Introduction: Falling causes long term disability and can even lead to death. Most falls occur during gait. Therefore improving gait stability might be beneficial for people at risk of falling. Recently arm swing has been shown to influence gait stability. However at present it remains unknown which

Gait Selection and Transition of Passivity-Based Bipeds with Adaptable Ankle Stiffness

Directory of Open Access Journals (Sweden)

Yan Huang

2012-10-01

Full Text Available Stable bipedal walking is one of the most important components of humanoid robot design, which can help us better understand natural human walking. In this paper, to study gait selection and gait transition of efficient bipedal walking, we proposed a dynamic bipedal walking model with an upper body, flat feet and compliant joints. The model can achieve stable cyclic motion with different walking gaits. The hip actuation and ankle stiffness behavior of the model are quite similar to those of human normal walking. In simulation, we studied the influence of hip actuation and ankle stiffness on walking performance of each gait. The effects of ankle stiffness on gait selection are also analyzed. Gait transition is realized by adjusting ankle stiffness during walking.

FreeWalker: a smart insole for longitudinal gait analysis.

Science.gov (United States)

Wang, Baitong; Rajput, Kuldeep Singh; Tam, Wing-Kin; Tung, Anthony K H; Yang, Zhi

2015-08-01

Gait analysis is an important diagnostic measure to investigate the pattern of walking. Traditional gait analysis is generally carried out in a gait lab, with equipped force and body tracking sensors, which needs a trained medical professional to interpret the results. This procedure is tedious, expensive, and unreliable and makes it difficult to track the progress across multiple visits. In this paper, we present a smart insole called FreeWalker, which provides quantitative gait analysis outside the confinement of traditional lab, at low- cost. The insole consists of eight pressure sensors and two motion tracking sensors, i.e. 3-axis accelerometer and 3-axis gyroscope. This enables measurement of under-foot pressure distribution and motion sequences in real-time. The insole is enabled with onboard SD card as well as wireless data transmission, which help in continuous gait-cycle analysis. The data is then sent to a gateway, for analysis and interpretation of data, using a user interface where gait features are graphically displayed. We also present validation result of a subject's left foot, who was asked to perform a specific task. Experiment results show that we could achieve a data-sampling rate of over 1 KHz, transmitting data up to a distance of 20 meter and maintain a battery life of around 24 hours. Taking advantage of these features, FreeWalker can be used in various applications, like medical diagnosis, rehabilitation, sports and entertainment.

Freezing of gait: moving forward on a mysterious clinical phenomenon

NARCIS (Netherlands)

Nutt, J.G.; Bloem, B.R.; Giladi, N.; Hallett, M.; Horak, F.B.; Nieuwboer, A.

2011-01-01

Freezing of gait (FoG) is a unique and disabling clinical phenomenon characterised by brief episodes of inability to step or by extremely short steps that typically occur on initiating gait or on turning while walking. Patients with FoG, which is a feature of parkinsonian syndromes, show variability

Development and decline of upright gait stability

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Marco eIosa

2014-02-01

Full Text Available Upright gait is a peculiar characteristic of humans that requires the ability to manage upper body dynamic balance while walking, despite the perturbations that are generated by movements of the lower limbs. Most of the studies on upright gait stability have compared young adults and the elderly to determine the effects of aging. In other studies the comparison was between healthy subjects and patients to examine specific pathologies. Fewer researches have also investigated the development of upright gait stability in children.This review discusses these studies in order to provide an overview of this relevant aspect of human locomotion. A clear trend from development to decline of upright gait stability has been depicted across the entire lifespan, from toddlers at first steps to elderly. In old individuals, even if healthy, the deterioration of skeletal muscle, combined with sensorial and cognitive performance, reduces the ability to maintain an upright trunk during walking, increasing the instability and the risk of falls. Further, the pathological causes of altered development or of a sudden loss of gait stability, as well as the environmental influence are investigated. The last part of this review is focused on the control of upper body accelerations during walking, a particularly interesting topic for the recent development of low-cost wearable accelerometers.

Development of Vision Based Multiview Gait Recognition System with MMUGait Database

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Hu Ng

2014-01-01

Full Text Available This paper describes the acquisition setup and development of a new gait database, MMUGait. This database consists of 82 subjects walking under normal condition and 19 subjects walking with 11 covariate factors, which were captured under two views. This paper also proposes a multiview model-based gait recognition system with joint detection approach that performs well under different walking trajectories and covariate factors, which include self-occluded or external occluded silhouettes. In the proposed system, the process begins by enhancing the human silhouette to remove the artifacts. Next, the width and height of the body are obtained. Subsequently, the joint angular trajectories are determined once the body joints are automatically detected. Lastly, crotch height and step-size of the walking subject are determined. The extracted features are smoothened by Gaussian filter to eliminate the effect of outliers. The extracted features are normalized with linear scaling, which is followed by feature selection prior to the classification process. The classification experiments carried out on MMUGait database were benchmarked against the SOTON Small DB from University of Southampton. Results showed correct classification rate above 90% for all the databases. The proposed approach is found to outperform other approaches on SOTON Small DB in most cases.

A mechanized gait trainer for restoration of gait.

Science.gov (United States)

Hesse, S; Uhlenbrock, D

2000-01-01

The newly developed gait trainer allows wheel-chair-bound subjects the repetitive practice of a gait-like movement without overstressing therapists. The device simulates the phases of gait, supports the subjects according to their abilities, and controls the center of mass (CoM) in the vertical and horizontal directions. The patterns of sagittal lower limb joint kinematics and of muscle activation for a normal subject were similar when using the mechanized trainer and when walking on a treadmill. A non-ambulatory hemiparetic subject required little help from one therapist on the gait trainer, while two therapists were required to support treadmill walking. Gait movements on the trainer were highly symmetrical, impact free, and less spastic. The vertical displacement of the CoM was bi-phasic instead of mono-phasic during each gait cycle on the new device. Two cases of non-ambulatory patients, who regained their walking ability after 4 weeks of daily training on the gait trainer, are reported.

Proposal for a Mini Wireless Force Platform for Human Gait Analysis

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Giovani PIFFER

2011-12-01

Full Text Available This paper aims to develop a mini wireless force platform placed in the shoe sole for analysis of human gait. The platform consists of a machined aluminum mechanical structure fixed into a sole, whose sensors are electrical resistance strain gages strategically cemented at the points of greatest deformation of the structure. The strain gages are configured as a ½ Wheatstone bridge connected to an amplifier for output signals and filtered by a signal conditioner. The signals are conditioned using a data acquisition board in conjunction with a graphical interface developed in LabVIEW. The static and dynamic behavior of the eight load cells was evaluated. Calibration at static pressures has shown that the eight load cells are linear within the usage range from 0 kgf to 45 kgf. The dynamic response has determined that the first vibration mode is around 1 kHz, indicating that the load cells have no resonance during the test. Three subjects carried out gait tests to examine the range of force platform use, and these tests demonstrated that the signals obtained are consistent with the classical references in this area.

Changes in the referent body location and configuration may underlie human gait, as confirmed by findings of multi-muscle activity minimizations and phase resetting.

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Feldman, Anatol G; Krasovsky, Tal; Baniña, Melanie C; Lamontagne, Anouk; Levin, Mindy F

2011-04-01

Locomotion is presumably guided by feed-forward shifts in the referent body location in the desired direction in the environment. We propose that the difference between the actual and the referent body locations is transmitted to neurons that virtually diminish this difference by appropriately changing the referent body configuration, i.e. the body posture at which muscles reach their recruitment thresholds. Muscles are activated depending on the gap between the actual and the referent body configurations resulting in a step being made to minimize this gap. This hypothesis implies that the actual and the referent leg configurations can match each other at certain phases of the gait cycle, resulting in minimization of leg muscle activity. We found several leg configurations at which EMG minima occurred, both during forward and backward gait. It was also found that the set of limb configurations associated with EMG minima can be changed by modifying the pattern of forward and backward gait. Our hypothesis predicts that, in response to perturbations of gait, the rate of shifts in the referent body location can temporarily be changed to avoid falling. The rate influences the phase of rhythmic limb movements during gait. Therefore, following the change in the rate of the referent body location, the whole gait pattern, for all four limbs, will irreversibly be shifted in time (long-lasting and global phase resetting) with only transient changes in the gait speed, swing and stance timing and cycle duration. Aside from transient changes in the duration of the swing and/or stance phase in response to perturbation, few previous studies have documented long-lasting and global phase resetting of human gait in response to perturbation. Such resetting was a robust finding in our study. By confirming the notion that feed-forward changes in the referent body location and configuration underlie human locomotion, this study solves the classical problem in the relationship between

A method to standardize gait and balance variables for gait velocity.

NARCIS (Netherlands)

Iersel, M.B. van; Olde Rikkert, M.G.M.; Borm, G.F.

2007-01-01

Many gait and balance variables depend on gait velocity, which seriously hinders the interpretation of gait and balance data derived from walks at different velocities. However, as far as we know there is no widely accepted method to correct for effects of gait velocity on other gait and balance

Involvement of the corticospinal tract in the control of human gait

DEFF Research Database (Denmark)

Barthélemy, Dorothy; Grey, Michael James; Nielsen, Jens Bo

2011-01-01

to rehabilitation therapy, which will enhance gait ability and recovery in patients with lesions to the central nervous system (CNS). We review evidence for the involvement of the primary motor cortex and the CST during normal and perturbed walking and during gait adaptation. We will also discuss knowledge...

On the energetics of the walking gait of a human operator using a passive exoskeleton apparatus

Science.gov (United States)

Lavrovskii, E. K.

2015-01-01

We study the energy expenditures and the peak values of control torques which a human operator must apply in the process of exoskeleton displacement for various types of regular, plane, and single-support gaits. The obtained results allow us to estimate the performance of the passive exoskeleton apparatus.

On Reducing the Effect of Covariate Factors in Gait Recognition: A Classifier Ensemble Method.

Science.gov (United States)

Guan, Yu; Li, Chang-Tsun; Roli, Fabio

2015-07-01

Robust human gait recognition is challenging because of the presence of covariate factors such as carrying condition, clothing, walking surface, etc. In this paper, we model the effect of covariates as an unknown partial feature corruption problem. Since the locations of corruptions may differ for different query gaits, relevant features may become irrelevant when walking condition changes. In this case, it is difficult to train one fixed classifier that is robust to a large number of different covariates. To tackle this problem, we propose a classifier ensemble method based on the random subspace Method (RSM) and majority voting (MV). Its theoretical basis suggests it is insensitive to locations of corrupted features, and thus can generalize well to a large number of covariates. We also extend this method by proposing two strategies, i.e, local enhancing (LE) and hybrid decision-level fusion (HDF) to suppress the ratio of false votes to true votes (before MV). The performance of our approach is competitive against the most challenging covariates like clothing, walking surface, and elapsed time. We evaluate our method on the USF dataset and OU-ISIR-B dataset, and it has much higher performance than other state-of-the-art algorithms.

Gait analysis in patients with chronic obstructive pulmonary disease: a systematic review.

Science.gov (United States)

Zago, Matteo; Sforza, Chiarella; Bonardi, Daniela Rita; Guffanti, Enrico Eugenio; Galli, Manuela

2018-03-01

Gait instability is a major fall-risk factor in patients with chronic obstructive pulmonary disease (COPD). Clinical gait analysis is a reliable tool to predict fall onsets. However, controversy still exists on gait impairments associated with COPD. Thus, the aims of this review were to evaluate the current understanding of spatiotemporal, kinematic and kinetic gait features in patients with COPD. In line with PRISMA guidelines, a systematic literature search was performed throughout Web of Science, PubMed Medline, Scopus, PEDro and Scielo databases. We considered observational cross-sectional studies evaluating gait features in patients with COPD as their primary outcome. Risk of bias and applicability of these papers were assessed according to the QUADAS-2 tool. Seven articles, cross-sectional studies published from 2011 to 2017, met the inclusion criteria. Sample size of patients with COPD ranged 14-196 (mean age range: 64-75 years). The main reported gait abnormalities were reduced step length and cadence, and altered variability of spatiotemporal parameters. Only subtle biomechanical changes were reported at the ankle level. A convincing mechanistic link between such gait impairments and falls in patients with COPD is still lacking. The paucity of studies, small sample sizes, gender and disease status pooling were the main risk of biases affecting the results uncertainty. Two research directions emerged: stricter cohorts characterization in terms of COPD phenotype and longitudinal studies. Quantitative assessment of gait would identify abnormalities and sensorimotor postural deficiencies that in turn may lead to better falling prevention strategies in COPD. Copyright © 2018 Elsevier B.V. All rights reserved.

Person identification by gait analysis and photogrammetry

DEFF Research Database (Denmark)

Lynnerup, Niels; Vedel, Jens

2005-01-01

Surveillance images from a bank robbery were analyzed and compared with images of a suspect. Based on general bodily features, gait and anthropometric measurements, we were able to conclude that one of the perpetrators showed strong resemblance to the suspect. Both exhibited a gait characterized...... by hyperextension of the leg joints, and bodily measurements did not differ by more than 6 mm on average. The latter was quantified by photogrammetry: i.e., measuring by using images of the perpetrator as captured by surveillance cameras. Using the computer software Photomodeler Pro, synchronous images from...

A perceptual map for gait symmetry quantification and pathology detection.

Science.gov (United States)

Moevus, Antoine; Mignotte, Max; de Guise, Jacques A; Meunier, Jean

2015-10-29

The gait movement is an essential process of the human activity and the result of collaborative interactions between the neurological, articular and musculoskeletal systems, working efficiently together. This explains why gait analysis is important and increasingly used nowadays for the diagnosis of many different types (neurological, muscular, orthopedic, etc.) of diseases. This paper introduces a novel method to quickly visualize the different parts of the body related to an asymmetric movement in the human gait of a patient for daily clinical usage. The proposed gait analysis algorithm relies on the fact that the healthy walk has (temporally shift-invariant) symmetry properties in the coronal plane. The goal is to provide an inexpensive and easy-to-use method, exploiting an affordable consumer depth sensor, the Kinect, to measure the gait asymmetry and display results in a perceptual way. We propose a multi-dimensional scaling mapping using a temporally shift invariant distance, allowing us to efficiently visualize (in terms of perceptual color difference) the asymmetric body parts of the gait cycle of a subject. We also propose an index computed from this map and which quantifies locally and globally the degree of asymmetry. The proposed index is proved to be statistically significant and this new, inexpensive, marker-less, non-invasive, easy to set up, gait analysis system offers a readable and flexible tool for clinicians to analyze gait characteristics and to provide a fast diagnostic. This system, which estimates a perceptual color map providing a quick overview of asymmetry existing in the gait cycle of a subject, can be easily exploited for disease progression, recovery cues from post-operative surgery (e.g., to check the healing process or the effect of a treatment or a prosthesis) or might be used for other pathologies where gait asymmetry might be a symptom.

Mechanical Design Of Prototype Exoskeleton Robotic System For Human Leg Movements And Implementation Of Gait Data With Neural Network

Directory of Open Access Journals (Sweden)

Evren Meltem Toygar

2012-06-01

Full Text Available Target of this study is designing a exoskeleton system for single lower extremity disabled person and controlling this exoskeleton system with neural network. Exoskeleton system is modeled by using SolidWorks. At the same time, gait data is acquired on human body and sole is divided four parts after that reaction forces are gauged during the walking. Distributions of strain and deformation are obtained by using experimental gait data. The walking is designed using the obtained data and walking data is derived for control stage. Power requirements of actuators are defined.

Class Energy Image Analysis for Video Sensor-Based Gait Recognition: A Review

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Zhuowen Lv

2015-01-01

Full Text Available Gait is a unique perceptible biometric feature at larger distances, and the gait representation approach plays a key role in a video sensor-based gait recognition system. Class Energy Image is one of the most important gait representation methods based on appearance, which has received lots of attentions. In this paper, we reviewed the expressions and meanings of various Class Energy Image approaches, and analyzed the information in the Class Energy Images. Furthermore, the effectiveness and robustness of these approaches were compared on the benchmark gait databases. We outlined the research challenges and provided promising future directions for the field. To the best of our knowledge, this is the first review that focuses on Class Energy Image. It can provide a useful reference in the literature of video sensor-based gait representation approach.

Analysis of gait using a treadmill and a Time-of-flight camera

DEFF Research Database (Denmark)

Jensen, Rasmus Ramsbøl; Paulsen, Rasmus Reinhold; Larsen, Rasmus

2009-01-01

We present a system that analyzes human gait using a treadmill and a Time-of-flight camera. The camera provides spatial data with local intensity measures of the scene, and data are collected over several gait cycles. These data are then used to model and analyze the gait. For each frame...

Perception of Gait Patterns that Deviate from Normal and Symmetric Biped Locomotion

Directory of Open Access Journals (Sweden)

Ismet eHandzic

2015-02-01

Full Text Available This study examines the range of gait patterns that are perceived as healthy and human-like with the goal of understanding how much asymmetry is allowable in a gait pattern before other people start to notice a gait impairment. Specifically, this study explores if certain abnormal walking patterns can be dismissed as unimpaired or not uncanny. Altering gait biomechanics is generally done in the fields of prosthetics and rehabilitation, however the perception of gait is often neglected. Although a certain gait can be functional, it may not be considered as normal by observers. On the other hand, an abnormally perceived gait may be more practical or necessary in some situations, such as limping after an injury or stroke and when wearing a prosthesis. This research will help to find the balance between the form and function of gait. Gait patterns are synthetically created using a passive dynamic walker (PDW model that allows gait patterns to be systematically changed without the confounding influence from human sensorimotor feedback during walking. This standardized method allows the perception of specific changes in gait to be studied. The PDW model was used to produce walking patterns that showed a degree of abnormality in gait cadence, knee height, step length, and swing time created by changing the foot roll-over-shape, knee damping, knee location, and leg masses. The gait patterns were shown to participants who rated them according to separate scales of impairment and uncanniness. The results indicate that some pathological and asymmetric gait patterns are perceived as unimpaired and normal. Step time and step length asymmetries less than 5%, small knee location differences, and gait cadence changes of 25% do not result in a change in perception. The results also show that the parameters of a pathologically or uncanny perceived gait can be beneficially altered by increasing other independent parameters, in some sense masking the initial

Gait adjustments in obstacle crossing, gait initiation and gait termination after a recent lower limb amputation

NARCIS (Netherlands)

Vrieling, Aline H.; van Keeken, Helco G.; Schoppen, Tanneke; Hof, At L.; Otten, Bert; Halbertsma, Jan P. K.; Postema, Klaas

Objective: To describe the adjustments in gait characteristics of obstacle crossing, gait initiation and gait termination that occur in subjects with a recent lower limb amputation during the rehabilitation process. Design: Prospective and descriptive study. Subjects: Fourteen subjects with a recent

Gait asymmetry detection in older adults using a light ear-worn sensor

International Nuclear Information System (INIS)

Atallah, L; Lo, B; Yang, G-Z; Wiik, A; Cobb, J P; Amis, A A

2014-01-01

Measuring gait asymmetry is an important feature when characterizing functional imbalance between limbs. This could be due to pathologies, such as osteoarthritis, stroke, or associated with the effects of surgeries such as hip arthroplasty. Generally, the study of asymmetry or imbalance has required the use of a gait lab or force plates, which could be expensive and difficult to use in home settings. This work validates the use of a light weight ear sensor (7.4 g) with an instrumented treadmill for 64 subjects (age (60.04 (15.36)) including healthy subjects (14) as well as subjects who had been treated for hip (17), knee-replacement surgery (21) and knee osteoarthritis (12). Subjects performed treadmill walking at several speeds on flat surfaces, inclines and declines. Accelerometer data from the ear sensor were segmented into consecutive steps and temporal features were extracted. The measures of gait cycle time and step-period asymmetry obtained from the ear sensor matched well those of the treadmill for flat surfaces, inclines and declines. The key implication of the study is that the proposed method could replace expensive equipment for monitoring temporal gait features in clinics as well as free-living environments, which is important for monitoring rehabilitation after surgery and the progress of diseases affecting limb imbalance. (note)

Assessment of spatio-temporal gait parameters from trunk accelerations during human walking

NARCIS (Netherlands)

Zijlstra, W; Hof, AL

2003-01-01

This paper studies the feasibility of an analysis of spatio-temporal gait parameters based upon accelerometry. To this purpose, acceleration patterns of the trunk and their relationships with spatio-temporal gait parameters were analysed in healthy subjects. Based on model predictions of the body's

Self-esteem recognition based on gait pattern using Kinect.

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Sun, Bingli; Zhang, Zhan; Liu, Xingyun; Hu, Bin; Zhu, Tingshao

2017-10-01

Self-esteem is an important aspect of individual's mental health. When subjects are not able to complete self-report questionnaire, behavioral assessment will be a good supplement. In this paper, we propose to use gait data collected by Kinect as an indicator to recognize self-esteem. 178 graduate students without disabilities participate in our study. Firstly, all participants complete the 10-item Rosenberg Self-Esteem Scale (RSS) to acquire self-esteem score. After completing the RRS, each participant walks for two minutes naturally on a rectangular red carpet, and the gait data are recorded using Kinect sensor. After data preprocessing, we extract a few behavioral features to train predicting model by machine learning. Based on these features, we build predicting models to recognize self-esteem. For self-esteem prediction, the best correlation coefficient between predicted score and self-report score is 0.45 (pself-esteem with a fairly good criterion validity. The gait predicting model can be taken as a good supplementary method to measure self-esteem. Copyright © 2017 Elsevier B.V. All rights reserved.

User Identification Using Gait Patterns on UbiFloorII

Science.gov (United States)

Yun, Jaeseok

2011-01-01

This paper presents a system of identifying individuals by their gait patterns. We take into account various distinguishable features that can be extracted from a user’s gait and then divide them into two classes: walking pattern and stepping pattern. The conditions we assume are that our target environments are domestic areas, the number of users is smaller than 10, and all users ambulate with bare feet considering the everyday lifestyle of the Korean home. Under these conditions, we have developed a system that identifies individuals’ gait patterns using our biometric sensor, UbiFloorII. We have created UbiFloorII to collect walking samples and created software modules to extract the user’s gait pattern. To identify the users based on the gait patterns extracted from walking samples over UbiFloorII, we have deployed multilayer perceptron network, a feedforward artificial neural network model. The results show that both walking pattern and stepping pattern extracted from users’ gait over the UbiFloorII are distinguishable enough to identify the users and that fusing two classifiers at the matching score level improves the recognition accuracy. Therefore, our proposed system may provide unobtrusive and automatic user identification methods in ubiquitous computing environments, particularly in domestic areas. PMID:22163758

Evidence of Big Five and Aggressive Personalities in Gait Biomechanics.

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Satchell, Liam; Morris, Paul; Mills, Chris; O'Reilly, Liam; Marshman, Paul; Akehurst, Lucy

2017-01-01

Behavioral observation techniques which relate action to personality have long been neglected (Furr and Funder in Handbook of research methods in personality psychology, The Guilford Press, New York, 2007) and, when employed, often use human judges to code behavior. In the current study we used an alternative to human coding (biomechanical research techniques) to investigate how personality traits are manifest in gait. We used motion capture technology to record 29 participants walking on a treadmill at their natural speed. We analyzed their thorax and pelvis movements, as well as speed of gait. Participants completed personality questionnaires, including a Big Five measure and a trait aggression questionnaire. We found that gait related to several of our personality measures. The magnitude of upper body movement, lower body movement, and walking speed, were related to Big Five personality traits and aggression. Here, we present evidence that some gait measures can relate to Big Five and aggressive personalities. We know of no other examples of research where gait has been shown to correlate with self-reported measures of personality and suggest that more research should be conducted between largely automatic movement and personality.

How doing a dynamical analysis of gait movement may provide information about Autism

Science.gov (United States)

Wu, D.; Torres, E.; Nguyen, J.; Mistry, S.; Whyatt, C.; Kalampratsidou, V.; Kolevzon, A.; Jose, J.

Individuals with Autism Spectrum Disorder (ASD) are known to have deficits in language and social skills. They also have deficits on how they move. Why individuals get ASD? It is not generally known. There is, however, one particular group of children with a SHANK3 gene deficiency (Phelan-McDermid Syndrome (PMDS)) that present symptoms similar to ASD. We have been searching for universal mechanism in ASD going beyond the usual heterogeneous ASD symptoms. We studied motions in gaits for both PMDS patients and idiopathic ASD. We have examined their motions continuously at milliseconds time scale, away from naked eye detection. Gait is a complex process, requiring a complex integration and coordination of different joints' motions. Significant information about the development and/or deficits in the sensory system is hidden in our gaits. We discovered that the speed smoothness in feet motion during gaits is a critical feature that provides a significant distinction between subjects with ASD and typical controls. The differences in appearance of the speed fluctuations suggested a different coordination mechanism in subjects with disorders. Our work provides a very important feature in gait motion that has significant physiological information.

Comparison of the Classifier Oriented Gait Score and the Gait Profile Score based on imitated gait impairments.

Science.gov (United States)

Christian, Josef; Kröll, Josef; Schwameder, Hermann

2017-06-01

Common summary measures of gait quality such as the Gait Profile Score (GPS) are based on the principle of measuring a distance from the mean pattern of a healthy reference group in a gait pattern vector space. The recently introduced Classifier Oriented Gait Score (COGS) is a pathology specific score that measures this distance in a unique direction, which is indicated by a linear classifier. This approach has potentially improved the discriminatory power to detect subtle changes in gait patterns but does not incorporate a profile of interpretable sub-scores like the GPS. The main aims of this study were to extend the COGS by decomposing it into interpretable sub-scores as realized in the GPS and to compare the discriminative power of the GPS and COGS. Two types of gait impairments were imitated to enable a high level of control of the gait patterns. Imitated impairments were realized by restricting knee extension and inducing leg length discrepancy. The results showed increased discriminatory power of the COGS for differentiating diverse levels of impairment. Comparison of the GPS and COGS sub-scores and their ability to indicate changes in specific variables supports the validity of both scores. The COGS is an overall measure of gait quality with increased power to detect subtle changes in gait patterns and might be well suited for tracing the effect of a therapeutic treatment over time. The newly introduced sub-scores improved the interpretability of the COGS, which is helpful for practical applications. Copyright © 2017 Elsevier B.V. All rights reserved.

Design of a minimally constraining, passively supported gait training exoskeleton: ALEX II.

Science.gov (United States)

Winfree, Kyle N; Stegall, Paul; Agrawal, Sunil K

2011-01-01

This paper discusses the design of a new, minimally constraining, passively supported gait training exoskeleton known as ALEX II. This device builds on the success and extends the features of the ALEX I device developed at the University of Delaware. Both ALEX (Active Leg EXoskeleton) devices have been designed to supply a controllable torque to a subject's hip and knee joint. The current control strategy makes use of an assist-as-needed algorithm. Following a brief review of previous work motivating this redesign, we discuss the key mechanical features of the new ALEX device. A short investigation was conducted to evaluate the effectiveness of the control strategy and impact of the exoskeleton on the gait of six healthy subjects. This paper concludes with a comparison between the subjects' gait both in and out of the exoskeleton. © 2011 IEEE

A Full-Body Layered Deformable Model for Automatic Model-Based Gait Recognition

Science.gov (United States)

Lu, Haiping; Plataniotis, Konstantinos N.; Venetsanopoulos, Anastasios N.

2007-12-01

This paper proposes a full-body layered deformable model (LDM) inspired by manually labeled silhouettes for automatic model-based gait recognition from part-level gait dynamics in monocular video sequences. The LDM is defined for the fronto-parallel gait with 22 parameters describing the human body part shapes (widths and lengths) and dynamics (positions and orientations). There are four layers in the LDM and the limbs are deformable. Algorithms for LDM-based human body pose recovery are then developed to estimate the LDM parameters from both manually labeled and automatically extracted silhouettes, where the automatic silhouette extraction is through a coarse-to-fine localization and extraction procedure. The estimated LDM parameters are used for model-based gait recognition by employing the dynamic time warping for matching and adopting the combination scheme in AdaBoost.M2. While the existing model-based gait recognition approaches focus primarily on the lower limbs, the estimated LDM parameters enable us to study full-body model-based gait recognition by utilizing the dynamics of the upper limbs, the shoulders and the head as well. In the experiments, the LDM-based gait recognition is tested on gait sequences with differences in shoe-type, surface, carrying condition and time. The results demonstrate that the recognition performance benefits from not only the lower limb dynamics, but also the dynamics of the upper limbs, the shoulders and the head. In addition, the LDM can serve as an analysis tool for studying factors affecting the gait under various conditions.

Normal human gait patterns in Peruvian individuals: an exploratory assessment using VICON motion capture system

Science.gov (United States)

Dongo, R.; Moscoso, M.; Callupe, R.; Pajaya, J.; Elías, D.

2017-11-01

Gait analysis is of clinical relevance for clinicians. However, normal gait patterns used in foreign literature could be different from local individuals. The aim of this study was to determine the normal gait patterns and parameters of Peruvian individuals in order to have a local referent for clinical assessments and making diagnosis and treatment Peruvian people with lower motor neuron injuries. A descriptive study with 34 subjects was conducted to assess their gait cycle. VICON® cameras were used to capture body movements. For the analyses, we calculated spatiotemporal gait parameters and average angles of displacement of the hip, knee, and ankle joints with their respective 95% confidence intervals. The results showed gait speed was 0.58m/s, cadence was 102.1steps/min, and the angular displacement of the hip, knee and ankle joints were all lower than those described in the literature. In the graphs, gait cycles were close to those reported in previous studies, but the parameters of speed, cadence and angles of displacements are lower than the ones shown in the literature. These results could be used as a better reference pattern in the clinical setting.

Gait Implications of Visual Field Damage from Glaucoma.

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Mihailovic, Aleksandra; Swenor, Bonnielin K; Friedman, David S; West, Sheila K; Gitlin, Laura N; Ramulu, Pradeep Y

2017-06-01

To evaluate fall-relevant gait features in older glaucoma patients. The GAITRite Electronic Walkway was used to define fall-related gait parameters in 239 patients with suspected or manifest glaucoma under normal usual-pace walking conditions and while carrying a cup or tray. Multiple linear regression models assessed the association between gait parameters and integrated visual field (IVF) sensitivity after controlling for age, race, sex, medications, and comorbid illness. Under normal walking conditions, worse IVF sensitivity was associated with a wider base of support (β = 0.60 cm/5 dB IVF sensitivity decrement, 95% confidence interval [CI] = 0.12-1.09, P = 0.016). Worse IVF sensitivity was not associated with slower gait speed, shorter step or stride length, or greater left-right drift under normal walking conditions ( P > 0.05 for all), but was during cup and/or tray carrying conditions ( P < 0.05 for all). Worse IVF sensitivity was positively associated with greater stride-to-stride variability in step length, stride length, and stride velocity ( P < 0.005 for all). Inferior and superior IVF sensitivity demonstrated associations with each of the above gait parameters as well, though these associations were consistently similar to, or weaker than, the associations noted for overall IVF sensitivity. Glaucoma severity was associated with several gait parameters predictive of higher fall risk in prior studies, particularly measures of stride-to-stride variability. Gait may be useful in identifying glaucoma patients at higher risk of falls, and in designing and testing interventions to prevent falls in this high-risk group. These findings could serve to inform the development of the interventions for falls prevention in glaucoma patients.

An electromechanical gait trainer for restoration of gait in hemiparetic stroke patients: preliminary results.

Science.gov (United States)

Hesse, S; Werner, C; Uhlenbrock, D; von Frankenberg, S; Bardeleben, A; Brandl-Hesse, B

2001-01-01

Modern concepts of gait rehabilitation after stroke favor a task-specific repetitive approach. In practice, the required physical effort of the therapists limits the realization of this approach. Therefore, a mechanized gait trainer enabling nonambulatory patients to have the repetitive practice of a gait-like movement without overstraining therapists was constructed. This preliminary study investigated whether an additional 4-week daily therapy on the gait trainer could improve gait ability in 14 chronic wheelchair-bound hemiparetic subjects. The 4 weeks of physiotherapy and gait-trainer therapy resulted in a relevant improvement of gait ability in all subjects. Velocity, cadence, and stride length improved significantly (p gait trainer seems feasible as an adjunctive tool in gait rehabilitation after stroke; further studies are needed.

Model Predictive Control-based gait pattern generation for wearable exoskeletons.

Science.gov (United States)

Wang, Letian; van Asseldonk, Edwin H F; van der Kooij, Herman

2011-01-01

This paper introduces a new method for controlling wearable exoskeletons that do not need predefined joint trajectories. Instead, it only needs basic gait descriptors such as step length, swing duration, and walking speed. End point Model Predictive Control (MPC) is used to generate the online joint trajectories based on these gait parameters. Real-time ability and control performance of the method during the swing phase of gait cycle is studied in this paper. Experiments are performed by helping a human subject swing his leg with different patterns in the LOPES gait trainer. Results show that the method is able to assist subjects to make steps with different step length and step duration without predefined joint trajectories and is fast enough for real-time implementation. Future study of the method will focus on controlling the exoskeletons in the entire gait cycle. © 2011 IEEE

Human Body Parts Tracking and Kinematic Features Assessment Based on RSSI and Inertial Sensor Measurements

Directory of Open Access Journals (Sweden)

Gaddi Blumrosen

2013-08-01

Full Text Available Acquisition of patient kinematics in different environments plays an important role in the detection of risk situations such as fall detection in elderly patients, in rehabilitation of patients with injuries, and in the design of treatment plans for patients with neurological diseases. Received Signal Strength Indicator (RSSI measurements in a Body Area Network (BAN, capture the signal power on a radio link. The main aim of this paper is to demonstrate the potential of utilizing RSSI measurements in assessment of human kinematic features, and to give methods to determine these features. RSSI measurements can be used for tracking different body parts’ displacements on scales of a few centimeters, for classifying motion and gait patterns instead of inertial sensors, and to serve as an additional reference to other sensors, in particular inertial sensors. Criteria and analytical methods for body part tracking, kinematic motion feature extraction, and a Kalman filter model for aggregation of RSSI and inertial sensor were derived. The methods were verified by a set of experiments performed in an indoor environment. In the future, the use of RSSI measurements can help in continuous assessment of various kinematic features of patients during their daily life activities and enhance medical diagnosis accuracy with lower costs.

Smartphone User Identity Verification Using Gait Characteristics

Directory of Open Access Journals (Sweden)

Robertas Damaševičius

2016-09-01

Full Text Available Smartphone-based biometrics offers a wide range of possible solutions, which could be used to authenticate users and thus to provide an extra level of security and theft prevention. We propose a method for positive identification of smartphone user’s identity using user’s gait characteristics captured by embedded smartphone sensors (gyroscopes, accelerometers. The method is based on the application of the Random Projections method for feature dimensionality reduction to just two dimensions. Then, a probability distribution function (PDF of derived features is calculated, which is compared against known user PDF. The Jaccard distance is used to evaluate distance between two distributions, and the decision is taken based on thresholding. The results for subject recognition are at an acceptable level: we have achieved a grand mean Equal Error Rate (ERR for subject identification of 5.7% (using the USC-HAD dataset. Our findings represent a step towards improving the performance of gait-based user identity verification technologies.

Gait Dynamics Sensing Using IMU Sensor Array System

Directory of Open Access Journals (Sweden)

Slavomir Kardos

2017-01-01

Full Text Available The article deals with a progressive approach in gait sensing. It is incorporated by IMU (Inertia Measurement Unit complex sensors whose field of acting is mainly the motion sensing in medicine, automotive and other industry, self-balancing systems, etc. They allow acquiring the position and orientation of an object in 3D space. Using several IMU units the sensing array for gait dynamics was made. Based on human gait analysis the 7-sensor array was designed to build a gait motion dynamics sensing system with the possibility of graphical interpretation of data from the sensing modules in real-time graphical application interface under the LabVIEW platform. The results of analyses can serve as the information for medical diagnostic purposes. The main control part of the system is microcontroller, whose function is to control the data collection and flow, provide the communication and power management.

Energy Expenditure of Trotting Gait Under Different Gait Parameters

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Chen, Xian-Bao; Gao, Feng

2017-07-01

Robots driven by batteries are clean, quiet, and can work indoors or in space. However, the battery endurance is a great problem. A new gait parameter design energy saving strategy to extend the working hours of the quadruped robot is proposed. A dynamic model of the robot is established to estimate and analyze the energy expenditures during trotting. Given a trotting speed, optimal stride frequency and stride length can minimize the energy expenditure. However, the relationship between the speed and the optimal gait parameters is nonlinear, which is difficult for practical application. Therefore, a simplified gait parameter design method for energy saving is proposed. A critical trotting speed of the quadruped robot is found and can be used to decide the gait parameters. When the robot is travelling lower than this speed, it is better to keep a constant stride length and change the cycle period. When the robot is travelling higher than this speed, it is better to keep a constant cycle period and change the stride length. Simulations and experiments on the quadruped robot show that by using the proposed gait parameter design approach, the energy expenditure can be reduced by about 54% compared with the 100 mm stride length under 500 mm/s speed. In general, an energy expenditure model based on the gait parameter of the quadruped robot is built and the trotting gait parameters design approach for energy saving is proposed.

Comparison of trunk activity during gait initiation and walking in humans.

Directory of Open Access Journals (Sweden)

Jean-Charles Ceccato

Full Text Available To understand the role of trunk muscles in maintenance of dynamic postural equilibrium we investigate trunk movements during gait initiation and walking, performing trunk kinematics analysis, Erector spinae muscle (ES recordings and dynamic analysis. ES muscle expressed a metachronal descending pattern of activity during walking and gait initiation. In the frontal and horizontal planes, lateroflexion and rotation occur before in the upper trunk and after in the lower trunk. Comparison of ES muscle EMGs and trunk kinematics showed that trunk muscle activity precedes corresponding kinematics activity, indicating that the ES drive trunk movement during locomotion and thereby allowing a better pelvis mobilization. EMG data showed that ES activity anticipates propulsive phases in walking with a repetitive pattern, suggesting a programmed control by a central pattern generator. Our findings also suggest that the programs for gait initiation and walking overlap with the latter beginning before the first has ended.

A Computer Simulation Approach to the Study of Effects of Deck Surface Compliance on Initial Impact Impulse Forces in Human Gait

National Research Council Canada - National Science Library

Bretz, David

2000-01-01

.... One proposal for reducing knee disorders is to install more compliant decking The goal of this thesis is to develop a computer model of the human gait that estimates the transarticulation forces...

Gait Phase Recognition for Lower-Limb Exoskeleton with Only Joint Angular Sensors

Directory of Open Access Journals (Sweden)

Du-Xin Liu

2016-09-01

Full Text Available Gait phase is widely used for gait trajectory generation, gait control and gait evaluation on lower-limb exoskeletons. So far, a variety of methods have been developed to identify the gait phase for lower-limb exoskeletons. Angular sensors on lower-limb exoskeletons are essential for joint closed-loop controlling; however, other types of sensors, such as plantar pressure, attitude or inertial measurement unit, are not indispensable.Therefore, to make full use of existing sensors, we propose a novel gait phase recognition method for lower-limb exoskeletons using only joint angular sensors. The method consists of two procedures. Firstly, the gait deviation distances during walking are calculated and classified by Fisher’s linear discriminant method, and one gait cycle is divided into eight gait phases. The validity of the classification results is also verified based on large gait samples. Secondly, we build a gait phase recognition model based on multilayer perceptron and train it with the phase-labeled gait data. The experimental result of cross-validation shows that the model has a 94.45% average correct rate of set (CRS and an 87.22% average correct rate of phase (CRP on the testing set, and it can predict the gait phase accurately. The novel method avoids installing additional sensors on the exoskeleton or human body and simplifies the sensory system of the lower-limb exoskeleton.

Gait Phase Recognition for Lower-Limb Exoskeleton with Only Joint Angular Sensors

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Liu, Du-Xin; Wu, Xinyu; Du, Wenbin; Wang, Can; Xu, Tiantian

2016-01-01

Gait phase is widely used for gait trajectory generation, gait control and gait evaluation on lower-limb exoskeletons. So far, a variety of methods have been developed to identify the gait phase for lower-limb exoskeletons. Angular sensors on lower-limb exoskeletons are essential for joint closed-loop controlling; however, other types of sensors, such as plantar pressure, attitude or inertial measurement unit, are not indispensable.Therefore, to make full use of existing sensors, we propose a novel gait phase recognition method for lower-limb exoskeletons using only joint angular sensors. The method consists of two procedures. Firstly, the gait deviation distances during walking are calculated and classified by Fisher’s linear discriminant method, and one gait cycle is divided into eight gait phases. The validity of the classification results is also verified based on large gait samples. Secondly, we build a gait phase recognition model based on multilayer perceptron and train it with the phase-labeled gait data. The experimental result of cross-validation shows that the model has a 94.45% average correct rate of set (CRS) and an 87.22% average correct rate of phase (CRP) on the testing set, and it can predict the gait phase accurately. The novel method avoids installing additional sensors on the exoskeleton or human body and simplifies the sensory system of the lower-limb exoskeleton. PMID:27690023

Guidelines for Assessment of Gait and Reference Values for Spatiotemporal Gait Parameters in Older Adults: The Biomathics and Canadian Gait Consortiums Initiative

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Olivier Beauchet

2017-08-01

Full Text Available Background: Gait disorders, a highly prevalent condition in older adults, are associated with several adverse health consequences. Gait analysis allows qualitative and quantitative assessments of gait that improves the understanding of mechanisms of gait disorders and the choice of interventions. This manuscript aims (1 to give consensus guidance for clinical and spatiotemporal gait analysis based on the recorded footfalls in older adults aged 65 years and over, and (2 to provide reference values for spatiotemporal gait parameters based on the recorded footfalls in healthy older adults free of cognitive impairment and multi-morbidities.Methods: International experts working in a network of two different consortiums (i.e., Biomathics and Canadian Gait Consortium participated in this initiative. First, they identified items of standardized information following the usual procedure of formulation of consensus findings. Second, they merged databases including spatiotemporal gait assessments with GAITRite® system and clinical information from the “Gait, cOgnitiOn & Decline” (GOOD initiative and the Generation 100 (Gen 100 study. Only healthy—free of cognitive impairment and multi-morbidities (i.e., ≤ 3 therapeutics taken daily—participants aged 65 and older were selected. Age, sex, body mass index, mean values, and coefficients of variation (CoV of gait parameters were used for the analyses.Results: Standardized systematic assessment of three categories of items, which were demographics and clinical information, and gait characteristics (clinical and spatiotemporal gait analysis based on the recorded footfalls, were selected for the proposed guidelines. Two complementary sets of items were distinguished: a minimal data set and a full data set. In addition, a total of 954 participants (mean age 72.8 ± 4.8 years, 45.8% women were recruited to establish the reference values. Performance of spatiotemporal gait parameters based on the recorded

Automatic Gait Recognition for Human ID at a Distance

National Research Council Canada - National Science Library

Nixon, Mark S; Carter, John N

2004-01-01

Recognising people by their gait is a biometric of increasing interest. Now, analysis has progressed from evaluation by few techniques on small databases with encouraging results to large databases and still with encouraging results...

Gait performance and foot pressure distribution during wearable robot-assisted gait in elderly adults.

Science.gov (United States)

Lee, Su-Hyun; Lee, Hwang-Jae; Chang, Won Hyuk; Choi, Byung-Ok; Lee, Jusuk; Kim, Jeonghun; Ryu, Gyu-Ha; Kim, Yun-Hee

2017-11-28

A robotic exoskeleton device is an intelligent system designed to improve gait performance and quality of life for the wearer. Robotic technology has developed rapidly in recent years, and several robot-assisted gait devices were developed to enhance gait function and activities of daily living in elderly adults and patients with gait disorders. In this study, we investigated the effects of the Gait-enhancing Mechatronic System (GEMS), a new wearable robotic hip-assist device developed by Samsung Electronics Co, Ltd., Korea, on gait performance and foot pressure distribution in elderly adults. Thirty elderly adults who had no neurological or musculoskeletal abnormalities affecting gait participated in this study. A three-dimensional (3D) motion capture system, surface electromyography and the F-Scan system were used to collect data on spatiotemporal gait parameters, muscle activity and foot pressure distribution under three conditions: free gait without robot assistance (FG), robot-assisted gait with zero torque (RAG-Z) and robot-assisted gait (RAG). We found increased gait speed, cadence, stride length and single support time in the RAG condition. Reduced rectus femoris and medial gastrocnemius muscle activity throughout the terminal stance phase and reduced effort of the medial gastrocnemius muscle throughout the pre-swing phase were also observed in the RAG condition. In addition, walking with the assistance of GEMS resulted in a significant increase in foot pressure distribution, specifically in maximum force and peak pressure of the total foot, medial masks, anterior masks and posterior masks. The results of the present study reveal that GEMS may present an alternative way of restoring age-related changes in gait such as gait instability with muscle weakness, reduced step force and lower foot pressure in elderly adults. In addition, GEMS improved gait performance by improving push-off power and walking speed and reducing muscle activity in the lower

Rhythmic dynamics and synchronization via dimensionality reduction: application to human gait.

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Jie Zhang

Full Text Available Reliable characterization of locomotor dynamics of human walking is vital to understanding the neuromuscular control of human locomotion and disease diagnosis. However, the inherent oscillation and ubiquity of noise in such non-strictly periodic signals pose great challenges to current methodologies. To this end, we exploit the state-of-the-art technology in pattern recognition and, specifically, dimensionality reduction techniques, and propose to reconstruct and characterize the dynamics accurately on the cycle scale of the signal. This is achieved by deriving a low-dimensional representation of the cycles through global optimization, which effectively preserves the topology of the cycles that are embedded in a high-dimensional Euclidian space. Our approach demonstrates a clear advantage in capturing the intrinsic dynamics and probing the subtle synchronization patterns from uni/bivariate oscillatory signals over traditional methods. Application to human gait data for healthy subjects and diabetics reveals a significant difference in the dynamics of ankle movements and ankle-knee coordination, but not in knee movements. These results indicate that the impaired sensory feedback from the feet due to diabetes does not influence the knee movement in general, and that normal human walking is not critically dependent on the feedback from the peripheral nervous system.

Dynamic markers of altered gait rhythm in amyotrophic lateral sclerosis

Science.gov (United States)

Hausdorff, J. M.; Lertratanakul, A.; Cudkowicz, M. E.; Peterson, A. L.; Kaliton, D.; Goldberger, A. L.

2000-01-01

Amyotrophic lateral sclerosis (ALS) is a disorder marked by loss of motoneurons. We hypothesized that subjects with ALS would have an altered gait rhythm, with an increase in both the magnitude of the stride-to-stride fluctuations and perturbations in the fluctuation dynamics. To test for this locomotor instability, we quantitatively compared the gait rhythm of subjects with ALS with that of normal controls and with that of subjects with Parkinson's disease (PD) and Huntington's disease (HD), pathologies of the basal ganglia. Subjects walked for 5 min at their usual pace wearing an ankle-worn recorder that enabled determination of the duration of each stride and of stride-to-stride fluctuations. We found that the gait of patients with ALS is less steady and more temporally disorganized compared with that of healthy controls. In addition, advanced ALS, HD, and PD were associated with certain common, as well as apparently distinct, features of altered stride dynamics. Thus stride-to-stride control of gait rhythm is apparently compromised with ALS. Moreover, a matrix of markers based on gait dynamics may be useful in characterizing certain pathologies of motor control and, possibly, in quantitatively monitoring disease progression and evaluating therapeutic interventions.

A Wearable Magneto-Inertial System for Gait Analysis (H-Gait: Validation on Normal Weight and Overweight/Obese Young Healthy Adults

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Valentina Agostini

2017-10-01

Full Text Available Background: Wearable magneto-inertial sensors are being increasingly used to obtain human motion measurements out of the lab, although their performance in applications requiring high accuracy, such as gait analysis, are still a subject of debate. The aim of this work was to validate a gait analysis system (H-Gait based on magneto-inertial sensors, both in normal weight (NW and overweight/obese (OW subjects. The validation is performed against a reference multichannel recording system (STEP32, providing direct measurements of gait timings (through foot-switches and joint angles in the sagittal plane (through electrogoniometers. Methods: Twenty-two young male subjects were recruited for the study (12 NW, 10 OW. After positioning body-fixed sensors of both systems, each subject was asked to walk, at a self-selected speed, over a 14-m straight path for 12 trials. Gait signals were recorded, at the same time, with the two systems. Spatio-temporal parameters, ankle, knee, and hip joint kinematics were extracted analyzing an average of 89 ± 13 gait cycles from each lower limb. Intraclass correlation coefficient and Bland-Altmann plots were used to compare H-Gait and STEP32 measurements. Changes in gait parameters and joint kinematics of OW with respect NW were also evaluated. Results: The two systems were highly consistent for cadence, while a lower agreement was found for the other spatio-temporal parameters. Ankle and knee joint kinematics is overall comparable. Joint ROMs values were slightly lower for H-Gait with respect to STEP32 for the ankle (by 1.9° for NW, and 1.6° for OW and for the knee (by 4.1° for NW, and 1.8° for OW. More evident differences were found for hip joint, with ROMs values higher for H-Gait (by 6.8° for NW, and 9.5° for OW. NW and OW showed significant differences considering STEP32 (p = 0.0004, but not H-Gait (p = 0.06. In particular, overweight/obese subjects showed a higher cadence (55.0 vs. 52.3 strides/min and a

Use of smartphones and portable media devices for quantifying human movement characteristics of gait, tendon reflex response, and Parkinson's disease hand tremor.

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LeMoyne, Robert; Mastroianni, Timothy

2015-01-01

Smartphones and portable media devices are both equipped with sensor components, such as accelerometers. A software application enables these devices to function as a robust wireless accelerometer platform. The recorded accelerometer waveform can be transmitted wireless as an e-mail attachment through connectivity to the Internet. The implication of such devices as a wireless accelerometer platform is the experimental and post-processing locations can be placed anywhere in the world. Gait was quantified by mounting a smartphone or portable media device proximal to the lateral malleolus of the ankle joint. Attributes of the gait cycle were quantified with a considerable accuracy and reliability. The patellar tendon reflex response was quantified by using the device in tandem with a potential energy impact pendulum to evoke the patellar tendon reflex. The acceleration waveform maximum acceleration feature of the reflex response displayed considerable accuracy and reliability. By mounting the smartphone or portable media device to the dorsum of the hand through a glove, Parkinson's disease hand tremor was quantified and contrasted with significance to a non-Parkinson's disease steady hand control. With the methods advocated in this chapter, any aspect of human movement may be quantified through smartphones or portable media devices and post-processed anywhere in the world. These wearable devices are anticipated to substantially impact the biomedical and healthcare industry.

Method to assess the temporal persistence of potential biometric features: Application to oculomotor, gait, face and brain structure databases

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Nixon, Mark S.; Komogortsev, Oleg V.

2017-01-01

We introduce the intraclass correlation coefficient (ICC) to the biometric community as an index of the temporal persistence, or stability, of a single biometric feature. It requires, as input, a feature on an interval or ratio scale, and which is reasonably normally distributed, and it can only be calculated if each subject is tested on 2 or more occasions. For a biometric system, with multiple features available for selection, the ICC can be used to measure the relative stability of each feature. We show, for 14 distinct data sets (1 synthetic, 8 eye-movement-related, 2 gait-related, and 2 face-recognition-related, and one brain-structure-related), that selecting the most stable features, based on the ICC, resulted in the best biometric performance generally. Analyses based on using only the most stable features produced superior Rank-1-Identification Rate (Rank-1-IR) performance in 12 of 14 databases (p = 0.0065, one-tailed), when compared to other sets of features, including the set of all features. For Equal Error Rate (EER), using a subset of only high-ICC features also produced superior performance in 12 of 14 databases (p = 0. 0065, one-tailed). In general, then, for our databases, prescreening potential biometric features, and choosing only highly reliable features yields better performance than choosing lower ICC features or than choosing all features combined. We also determined that, as the ICC of a group of features increases, the median of the genuine similarity score distribution increases and the spread of this distribution decreases. There was no statistically significant similar relationships for the impostor distributions. We believe that the ICC will find many uses in biometric research. In case of the eye movement-driven biometrics, the use of reliable features, as measured by ICC, allowed to us achieve the authentication performance with EER = 2.01%, which was not possible before. PMID:28575030

Multiple gait parameters derived from iPod accelerometry predict age-related gait changes

NARCIS (Netherlands)

Kosse, Nienke; Vuillerme, Nicolas; Hortobagyi, Tibor; Lamoth, Claude

Introduction Normative data of how natural aging affects gait can serve as a frame of reference for changes in gait dynamics due to pathologies. Therefore, the present study aims (1) to identify gait variables sensitive to age-related changes in gait over the adult life span using the iPod and (2)

Very low cost stand-off suicide bomber detection system using human gait analysis to screen potential bomb carrying individuals

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Greneker, Gene, III

2005-05-01

Individuals who carry bombs on their bodies and detonate those bombs in public places are a security problem. There is belief that suicide bombings currently used in the mid-east may spread to the United States if the organized terrorist groups operating in the United States are not identified and the cell members arrested. While bombs in vehicles are the primary method currently used to spread terror in Iraq, U. S. warfighters are starting to face suicide bombers. This may become more of the situation if a stand-off detection capability is developed for the vehicle bomb case. This paper presents a concept, that if developed and commercialized, could provide an inexpensive suicide bomber screening system that could be used to screen individuals approaching a checkpoint while the individual is still 500 to 1,000 feet from the checkpoint. The proposed system measures both the radar cross-section of the individual and the radar derived gait characteristics that are associated with individuals carrying a bomb on their body. GTRI researchers propose to use human gait characteristics, as detected by radar, to determine if a human subject who is carrying no visible load on the body is actually carrying a concealed load under their clothes. The use of radar gait as a metric for the detection (as opposed to a video system) of a suicide bomber is being proposed because detection of gait characteristics are thought to be less sensitive to where the bomb is located on the body, lighting conditions, and the fact that the legs may be shrouded in a robe. The detection of a bomb using radar gait analysis may also prove to be less sensitive to changing tactics regarding where the bomb is placed on the body. An inert suicide bomb vest was constructed using water pipes to simulate the explosive devices. Wiring was added to simulated detonators. The vest weighs approximately 35 pounds. Radar data was taken on the volunteer subject wearing the vest that simulated the suicide bomb. This

Preliminary Results for a Monocular Marker-Free Gait Measurement System

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Jane Courtney

2006-01-01

Full Text Available This paper presents results from a novel monocular marker-free gait measurement system. The system was designed for physical and occupational therapists to monitor the progress of patients through therapy. It is based on a novel human motion capturemethod derived from model-based tracking. Testing is performed on two monocular, sagittal-view, sample gait videos – one with both the environment and the subject’s appearance and movement restricted and one in a natural environment with unrestrictedclothing and motion. Results of the modelling, tracking and analysis stages are presented along with standard gait graphs and parameters.

Measuring Gait Quality in Parkinson’s Disease through Real-Time Gait Phase Recognition

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Ilaria Mileti

2018-03-01

Full Text Available Monitoring gait quality in daily activities through wearable sensors has the potential to improve medical assessment in Parkinson’s Disease (PD. In this study, four gait partitioning methods, two based on thresholds and two based on a machine learning approach, considering the four-phase model, were compared. The methods were tested on 26 PD patients, both in OFF and ON levodopa conditions, and 11 healthy subjects, during walking tasks. All subjects were equipped with inertial sensors placed on feet. Force resistive sensors were used to assess reference time sequence of gait phases. Goodness Index (G was evaluated to assess accuracy in gait phases estimation. A novel synthetic index called Gait Phase Quality Index (GPQI was proposed for gait quality assessment. Results revealed optimum performance (G < 0.25 for three tested methods and good performance (0.25 < G < 0.70 for one threshold method. The GPQI resulted significantly higher in PD patients than in healthy subjects, showing a moderate correlation with clinical scales score. Furthermore, in patients with severe gait impairment, GPQI was found higher in OFF than in ON state. Our results unveil the possibility of monitoring gait quality in PD through real-time gait partitioning based on wearable sensors.

Effects of Subthalamic and Nigral Stimulation on Gait Kinematics in Parkinson’s Disease

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Marlieke Scholten

2017-10-01

Full Text Available Conventional subthalamic deep brain stimulation for Parkinson’s disease (PD presumably modulates the spatial component of gait. However, temporal dysregulation of gait is one of the factors that is tightly associated with freezing of gait (FOG. Temporal locomotor integration may be modulated differentially at distinct levels of the basal ganglia. Owing to its specific descending brainstem projections, stimulation of the substantia nigra pars reticulata (SNr area might modulate spatial and temporal parameters of gait differentially compared to standard subthalamic nucleus (STN stimulation. Here, we aimed to characterize the differential effect of STN or SNr stimulation on kinematic gait parameters. We analyzed biomechanical parameters during unconstrained over ground walking in 12 PD patients with subthalamic deep brain stimulation and FOG. Patients performed walking in three therapeutic conditions: (i Off stimulation, (ii STN stimulation (alone, and (iii SNr stimulation (alone. SNr stimulation was achieved by stimulating the most caudal contact of the electrode. We recorded gait using three sensors (each containing a tri-axial accelerometer, gyroscope, and magnetometer attached on both left and right ankle, and to the lumbar spine. STN stimulation improved both the spatial features (stride length, stride length variability and the temporal parameters of gait. SNr stimulation improved temporal parameters of gait (swing time asymmetry. Correlation analysis suggested that patients with more medial localization of the SNr contact associated with a stronger regularization of gait. These results suggest that SNr stimulation might support temporal regularization of gait integration.

Evaluating alternative gait strategies using evolutionary robotics.

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Sellers, William I; Dennis, Louise A; W -J, Wang; Crompton, Robin H

2004-05-01

Evolutionary robotics is a branch of artificial intelligence concerned with the automatic generation of autonomous robots. Usually the form of the robot is predefined and various computational techniques are used to control the machine's behaviour. One aspect is the spontaneous generation of walking in legged robots and this can be used to investigate the mechanical requirements for efficient walking in bipeds. This paper demonstrates a bipedal simulator that spontaneously generates walking and running gaits. The model can be customized to represent a range of hominoid morphologies and used to predict performance parameters such as preferred speed and metabolic energy cost. Because it does not require any motion capture data it is particularly suitable for investigating locomotion in fossil animals. The predictions for modern humans are highly accurate in terms of energy cost for a given speed and thus the values predicted for other bipeds are likely to be good estimates. To illustrate this the cost of transport is calculated for Australopithecus afarensis. The model allows the degree of maximum extension at the knee to be varied causing the model to adopt walking gaits varying from chimpanzee-like to human-like. The energy costs associated with these gait choices can thus be calculated and this information used to evaluate possible locomotor strategies in early hominids.

Effects of walking speed on asymmetry and bilateral coordination of gait

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Plotnik, Meir; Bartsch, Ronny P.; Zeev, Aviva; Giladi, Nir; Hausdorff, Jeffery M.

2013-01-01

The mechanisms regulating the bilateral coordination of gait in humans are largely unknown. Our objective was to study how bilateral coordination changes as a result of gait speed modifications during over ground walking. 15 young adults wore force sensitive insoles that measured vertical forces used to determine the timing of the gait cycle events under three walking conditions (i.e., usual-walking, fast and slow). Ground reaction force impact (GRFI) associated with heel-strikes was also quantified, representing the potential contribution of sensory feedback to the regulation of gait. Gait asymmetry (GA) was quantified based on the differences between right and left swing times and the bilateral coordination of gait was assessed using the phase coordination index (PCI), a metric that quantifies the consistency and accuracy of the anti-phase stepping pattern. GA was preserved in the three different gait speeds. PCI was higher (reduced coordination) in the slow gait condition, compared to usual-walking (3.51% vs. 2.47%, respectively, p=0.002), but was not significantly affected in the fast condition. GRFI values were lower in the slow walking as compared to usual-walking and higher in the fast walking condition (pgait related changes in PCI were not associated with the slowed gait related changes in GRFI. The present findings suggest that left-right anti-phase stepping is similar in normal and fast walking, but altered during slowed walking. This behavior might reflect a relative increase in attention resources required to regulate a slow gait speed, consistent with the possibility that cortical function and supraspinal input influences the bilateral coordination of gait. PMID:23680424

Gait Event Detection in Real-World Environment for Long-Term Applications: Incorporating Domain Knowledge Into Time-Frequency Analysis.

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Khandelwal, Siddhartha; Wickstrom, Nicholas

2016-12-01

Detecting gait events is the key to many gait analysis applications that would benefit from continuous monitoring or long-term analysis. Most gait event detection algorithms using wearable sensors that offer a potential for use in daily living have been developed from data collected in controlled indoor experiments. However, for real-word applications, it is essential that the analysis is carried out in humans' natural environment; that involves different gait speeds, changing walking terrains, varying surface inclinations and regular turns among other factors. Existing domain knowledge in the form of principles or underlying fundamental gait relationships can be utilized to drive and support the data analysis in order to develop robust algorithms that can tackle real-world challenges in gait analysis. This paper presents a novel approach that exhibits how domain knowledge about human gait can be incorporated into time-frequency analysis to detect gait events from long-term accelerometer signals. The accuracy and robustness of the proposed algorithm are validated by experiments done in indoor and outdoor environments with approximately 93 600 gait events in total. The proposed algorithm exhibits consistently high performance scores across all datasets in both, indoor and outdoor environments.

A Validated Smartphone-Based Assessment of Gait and Gait Variability in Parkinson's Disease.

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Robert J Ellis

Full Text Available A well-established connection exists between increased gait variability and greater fall likelihood in Parkinson's disease (PD; however, a portable, validated means of quantifying gait variability (and testing the efficacy of any intervention remains lacking. Furthermore, although rhythmic auditory cueing continues to receive attention as a promising gait therapy for PD, its widespread delivery remains bottlenecked. The present paper describes a smartphone-based mobile application ("SmartMOVE" to address both needs.The accuracy of smartphone-based gait analysis (utilizing the smartphone's built-in tri-axial accelerometer and gyroscope to calculate successive step times and step lengths was validated against two heel contact-based measurement devices: heel-mounted footswitch sensors (to capture step times and an instrumented pressure sensor mat (to capture step lengths. 12 PD patients and 12 age-matched healthy controls walked along a 26-m path during self-paced and metronome-cued conditions, with all three devices recording simultaneously.Four outcome measures of gait and gait variability were calculated. Mixed-factorial analysis of variance revealed several instances in which between-group differences (e.g., increased gait variability in PD patients relative to healthy controls yielded medium-to-large effect sizes (eta-squared values, and cueing-mediated changes (e.g., decreased gait variability when PD patients walked with auditory cues yielded small-to-medium effect sizes-while at the same time, device-related measurement error yielded small-to-negligible effect sizes.These findings highlight specific opportunities for smartphone-based gait analysis to serve as an alternative to conventional gait analysis methods (e.g., footswitch systems or sensor-embedded walkways, particularly when those methods are cost-prohibitive, cumbersome, or inconvenient.

Evidence of end-effector based gait machines in gait rehabilitation after CNS lesion.

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Hesse, S; Schattat, N; Mehrholz, J; Werner, C

2013-01-01

A task-specific repetitive approach in gait rehabilitation after CNS lesion is well accepted nowadays. To ease the therapists' and patients' physical effort, the past two decades have seen the introduction of gait machines to intensify the amount of gait practice. Two principles have emerged, an exoskeleton- and an endeffector-based approach. Both systems share the harness and the body weight support. With the end-effector-based devices, the patients' feet are positioned on two foot plates, whose movements simulate stance and swing phase. This article provides an overview on the end-effector based machine's effectiveness regarding the restoration of gait. For the electromechanical gait trainer GT I, a meta analysis identified nine controlled trials (RCT) in stroke subjects (n = 568) and were analyzed to detect differences between end-effector-based locomotion + physiotherapy and physiotherapy alone. Patients practising with the machine effected in a superior gait ability (210 out of 319 patients, 65.8% vs. 96 out of 249 patients, 38.6%, respectively, Z = 2.29, p = 0.020), due to a larger training intensity. Only single RCTs have been reported for other devices and etiologies. The introduction of end-effector based gait machines has opened a new succesful chapter in gait rehabilitation after CNS lesion.

Gait and its assessment in psychiatry

OpenAIRE

Sanders, Richard D.; Gillig, Paulette Marie

2010-01-01

Gait reflects all levels of nervous system function. In psychiatry, gait disturbances reflecting cortical and subcortical dysfunction are often seen. Observing spontaneous gait, sometimes augmented by a few brief tests, can be highly informative. The authors briefly review the neuroanatomy of gait, review gait abnormalities seen in psychiatric and neurologic disorders, and describe the assessment of gait.

Gait recognition using kinect and locally linear embedding ...

African Journals Online (AJOL)

This paper presents the use of locally linear embedding (LLE) as feature extraction technique for classifying a person's identity based on their walking gait patterns. Skeleton data acquired from Microsoft Kinect camera were used as an input for (1). Multilayer Perceptron (MLP) and (2). LLE with MLP. The MLP classification ...

A Portable Gait Asymmetry Rehabilitation System for Individuals with Stroke Using a Vibrotactile Feedback

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Muhammad Raheel Afzal

2015-01-01

Full Text Available Gait asymmetry caused by hemiparesis results in reduced gait efficiency and reduced activity levels. In this paper, a portable rehabilitation device is proposed that can serve as a tool in diagnosing gait abnormalities in individuals with stroke and has the capability of providing vibration feedback to help compensate for the asymmetric gait. Force-sensitive resistor (FSR based insoles are used to detect ground contact and estimate stance time. A controller (Arduino provides different vibration feedback based on the gait phase measurement. It also allows wireless interaction with a personal computer (PC workstation using the XBee transceiver module, featuring data logging capabilities for subsequent analysis. Walking trials conducted with healthy young subjects allowed us to observe that the system can influence abnormality in the gait. The results of trials showed that a vibration cue based on temporal information was more effective than intensity information. With clinical experiments conducted for individuals with stroke, significant improvement in gait symmetry was observed with minimal disturbance caused to the balance and gait speed as an effect of the biofeedback. Future studies of the long-term rehabilitation effects of the proposed system and further improvements to the system will result in an inexpensive, easy-to-use, and effective rehabilitation device.

Gait Deviation Index, Gait Profile Score and Gait Variable Score in children with spastic cerebral palsy

DEFF Research Database (Denmark)

Rasmussen, Helle Mätzke; Nielsen, Dennis Brandborg; Pedersen, Niels Wisbech

2015-01-01

Abstract The Gait Deviation Index (GDI) and Gait Profile Score (GPS) are the most used summary measures of gait in children with cerebral palsy (CP). However, the reliability and agreement of these indices have not been investigated, limiting their clinimetric quality for research and clinical...... to good reliability with ICCs of 0.4–0.7. The agreement for the GDI and the logarithmically transformed GPS, in terms of the standard error of measurement as a percentage of the grand mean (SEM%) varied from 4.1 to 6.7%, whilst the smallest detectable change in percent (SDC%) ranged from 11.3 to 18...

Gait analysis in a pre- and post-ischemic stroke biomedical pig model.

Science.gov (United States)

Duberstein, Kylee Jo; Platt, Simon R; Holmes, Shannon P; Dove, C Robert; Howerth, Elizabeth W; Kent, Marc; Stice, Steven L; Hill, William D; Hess, David C; West, Franklin D

2014-02-10

Severity of neural injury including stroke in human patients, as well as recovery from injury, can be assessed through changes in gait patterns of affected individuals. Similar quantification of motor function deficits has been measured in rodent animal models of such injuries. However, due to differences in fundamental structure of human and rodent brains, there is a need to develop a large animal model to facilitate treatment development for neurological conditions. Porcine brain structure is similar to that of humans, and therefore the pig may make a more clinically relevant animal model. The current study was undertaken to determine key gait characteristics in normal biomedical miniature pigs and dynamic changes that occur post-neural injury in a porcine middle cerebral artery (MCA) occlusion ischemic stroke model. Yucatan miniature pigs were trained to walk through a semi-circular track and were recorded with high speed cameras to detect changes in key gait parameters. Analysis of normal pigs showed overall symmetry in hindlimb swing and stance times, forelimb stance time, along with step length, step velocity, and maximum hoof height on both fore and hindlimbs. A subset of pigs were again recorded at 7, 5 and 3 days prior to MCA occlusion and then at 1, 3, 5, 7, 14 and 30 days following surgery. MRI analysis showed that MCA occlusion resulted in significant infarction. Gait analysis indicated that stroke resulted in notable asymmetries in both temporal and spatial variables. Pigs exhibited lower maximum front hoof height on the paretic side, as well as shorter swing time and longer stance time on the paretic hindlimb. These results support that gait analysis of stroke injury is a highly sensitive detection method for changes in gait parameters in pig. Copyright © 2013 Elsevier Inc. All rights reserved.

An intermittent control model of flexible human gait using a stable manifold of saddle-type unstable limit cycle dynamics.

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Fu, Chunjiang; Suzuki, Yasuyuki; Kiyono, Ken; Morasso, Pietro; Nomura, Taishin

2014-12-06

Stability of human gait is the ability to maintain upright posture during walking against external perturbations. It is a complex process determined by a number of cross-related factors, including gait trajectory, joint impedance and neural control strategies. Here, we consider a control strategy that can achieve stable steady-state periodic gait while maintaining joint flexibility with the lowest possible joint impedance. To this end, we carried out a simulation study of a heel-toe footed biped model with hip, knee and ankle joints and a heavy head-arms-trunk element, working in the sagittal plane. For simplicity, the model assumes a periodic desired joint angle trajectory and joint torques generated by a set of feed-forward and proportional-derivative feedback controllers, whereby the joint impedance is parametrized by the feedback gains. We could show that a desired steady-state gait accompanied by the desired joint angle trajectory can be established as a stable limit cycle (LC) for the feedback controller with an appropriate set of large feedback gains. Moreover, as the feedback gains are decreased for lowering the joint stiffness, stability of the LC is lost only in a few dimensions, while leaving the remaining large number of dimensions quite stable: this means that the LC becomes saddle-type, with a low-dimensional unstable manifold and a high-dimensional stable manifold. Remarkably, the unstable manifold remains of low dimensionality even when the feedback gains are decreased far below the instability point. We then developed an intermittent neural feedback controller that is activated only for short periods of time at an optimal phase of each gait stride. We characterized the robustness of this design by showing that it can better stabilize the unstable LC with small feedback gains, leading to a flexible gait, and in particular we demonstrated that such an intermittent controller performs better if it drives the state point to the stable manifold, rather

Contribution of the supplementary motor area and the cerebellum to the anticipatory postural adjustments and execution phases of human gait initiation.

Science.gov (United States)

Richard, Aliénor; Van Hamme, Angèle; Drevelle, Xavier; Golmard, Jean-Louis; Meunier, Sabine; Welter, Marie-Laure

2017-09-01

Several brain structures including the brainstem, the cerebellum and the frontal cortico-basal ganglia network, with the primary and premotor areas have been shown to participate in the functional organization of gait initiation and postural control in humans, but their respective roles remain poorly understood. The aim of this study was to better understand the role of the supplementary motor area (SMA) and posterior cerebellum in the gait initiation process. Gait initiation parameters were recorded in 22 controls both before and after continuous theta burst transcranial stimulation (cTBS) of the SMA and cerebellum, and were compared to sham stimulation, using a randomized double-blind design study. The two phases of gait initiation process were analyzed: anticipatory postural adjustments (APAs) and execution, with recordings of soleus and tibialis anterior muscles. Functional inhibition of the SMA led to a shortened APA phase duration with advanced and increased muscle activity; during execution, it also advanced muscle co-activation and decreased the duration of stance soleus activity. Cerebellar functional inhibition did not influence the APA phase duration and amplitude but increased muscle co-activation, it decreased execution duration and showed a trend to increase velocity, with increased swing soleus muscle duration and activity. The results suggest that the SMA contributes to both the timing and amplitude of the APAs with no influence on step execution and the posterior cerebellum in the coupling between the APAs and execution phases and leg muscle activity pattern during gait initiation. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Accuracy and precision of equine gait event detection during walking with limb and trunk mounted inertial sensors

DEFF Research Database (Denmark)

Olsen, Emil; Andersen, Pia Haubro; Pfau, Thilo

2012-01-01

The increased variations of temporal gait events when pathology is present are good candidate features for objective diagnostic tests. We hypothesised that the gait events hoof-on/off and stance can be detected accurately and precisely using features from trunk and distal limb-mounted Inertial....... Accuracy (bias) and precision (SD of bias) was calculated to compare force plate and IMU timings for gait events. Data were collected from seven horses. One hundred and twenty three (123) front limb steps were analysed; hoof-on was detected with a bias (SD) of -7 (23) ms, hoof-off with 0.7 (37) ms...... and front limb stance with -0.02 (37) ms. A total of 119 hind limb steps were analysed; hoof-on was found with a bias (SD) of -4 (25) ms, hoof-off with 6 (21) ms and hind limb stance with 0.2 (28) ms. IMUs mounted on the distal limbs and sacrum can detect gait events accurately and precisely....

A mechanized gait trainer for restoring gait in nonambulatory subjects.

Science.gov (United States)

Hesse, S; Uhlenbrock, D; Werner, C; Bardeleben, A

2000-09-01

To construct an advanced mechanized gait trainer to enable patients the repetitive practice of a gaitlike movement without overstraining therapists. DEVICE: Prototype gait trainer that simulates the phases of gait (by generating a ratio of 40% to 60% between swing and stance phases), supports the subjects according to their ability (lifts the foot during swing phase), and controls the center of mass in the vertical and horizontal directions. Two nonambulatory, hemiparetic patients who regained their walking ability after 4 weeks of daily training on the gait trainer, a 55-year-old woman and a 62-year-old man, both of whom had a first-time ischemic stroke. Four weeks of training, five times a week, each session 20 minutes long. Functional ambulation category (FAC, levels 0-5) to assess gait ability and ground level walking velocity. Rivermead motor assessment score (RMAS, 0-13) to assess gross motor function. Patient 1: At the end of treatment, she was able to walk independently on level ground with use of a walking stick. Her walking velocity had improved from .29m/sec to .59m/sec. Her RMAS score increased from 4 to 10, meaning she could walk at least 40 meters outside, pick up objects from floor, and climb stairs independently. Patient 2: At end of 4-week training, he could walk independently on even surfaces (FAC level 4), using an ankle-foot orthosis and a walking stick. His walking velocity improved from .14m/sec to .63m/sec. His RMAS increased from 3 to 10. The gait trainer enabled severely affected patients the repetitive practice of a gaitlike movement. Future studies may elucidate its value in gait rehabilitation of nonambulatory subjects.

Computational stability of human knee joint at early stance in Gait: Effects of muscle coactivity and anterior cruciate ligament deficiency.

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Sharifi, M; Shirazi-Adl, A; Marouane, H

2017-10-03

As one of the most complex and vulnerable structures of body, the human knee joint should maintain dynamic equilibrium and stability in occupational and recreational activities. The evaluation of its stability and factors affecting it is vital in performance evaluation/enhancement, injury prevention and treatment managements. Knee stability often manifests itself by pain, hypermobility and giving-way sensations and is usually assessed by the passive joint laxity tests. Mechanical stability of both the human knee joint and the lower extremity at early stance periods of gait (0% and 5%) were quantified here for the first time using a hybrid musculoskeletal model of the lower extremity. The roles of muscle coactivity, simulated by setting minimum muscle activation at 0-10% levels and ACL deficiency, simulated by reducing ACL resistance by up to 85%, on the stability margin as well as joint biomechanics (contact/muscle/ligament forces) were investigated. Dynamic stability was analyzed using both linear buckling and perturbation approaches at the final deformed configurations in gait. The knee joint was much more stable at 0% stance than at 5% due to smaller ground reaction and contact forces. Muscle coactivity, when at lower intensities (knee joint at the heel strike. It also markedly diminishes forces in lateral hamstrings (by up to 39%) and contact forces on the lateral plateau (by up to 17%). Current work emphasizes the need for quantification of the lower extremity stability margin in gait. Copyright © 2017 Elsevier Ltd. All rights reserved.

Interactive rhythmic auditory stimulation reinstates natural 1/f timing in gait of Parkinson's patients.

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Michael J Hove

Full Text Available Parkinson's disease (PD and basal ganglia dysfunction impair movement timing, which leads to gait instability and falls. Parkinsonian gait consists of random, disconnected stride times--rather than the 1/f structure observed in healthy gait--and this randomness of stride times (low fractal scaling predicts falling. Walking with fixed-tempo Rhythmic Auditory Stimulation (RAS can improve many aspects of gait timing; however, it lowers fractal scaling (away from healthy 1/f structure and requires attention. Here we show that interactive rhythmic auditory stimulation reestablishes healthy gait dynamics in PD patients. In the experiment, PD patients and healthy participants walked with a no auditory stimulation, b fixed-tempo RAS, and c interactive rhythmic auditory stimulation. The interactive system used foot sensors and nonlinear oscillators to track and mutually entrain with the human's step timing. Patients consistently synchronized with the interactive system, their fractal scaling returned to levels of healthy participants, and their gait felt more stable to them. Patients and healthy participants rarely synchronized with fixed-tempo RAS, and when they did synchronize their fractal scaling declined from healthy 1/f levels. Five minutes after removing the interactive rhythmic stimulation, the PD patients' gait retained high fractal scaling, suggesting that the interaction stabilized the internal rhythm generating system and reintegrated timing networks. The experiment demonstrates that complex interaction is important in the (reemergence of 1/f structure in human behavior and that interactive rhythmic auditory stimulation is a promising therapeutic tool for improving gait of PD patients.

Differences in center of pressure trajectory between normal and steppage gait

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Jamshidi, Nima; Rostami, Mostafa; Najarian, Siamak; Menhaj, Mohammad Bagher; Saadatnia, Mohammad; Salami, Firooz

2010-01-01

BACKGROUND: This pilot study aimed to assess the differences in center of pressure trajectory in neuropathic patients with steppage gait. Steppage gait has previously been evaluated by several biomechanical methods, but plantar pressure distribution has been much less studied. The purpose of this study was to analyze the changes in center of pressure trajectory using a force plate. METHODS: The steppage gait group was selected from the patients using drop foot brace (25 male) and the control group was selected from Isfahan university students (20 male). They walked at self- selected speed at a mean of ten trials (+2) to collect the center of pressure using a force plate. Center of pressure patterns were categorized into four patterns based on the center of pressure displacement magnitude (spatial features) through time (temporal features) when the longitudinal axis of the insole was plotted as the Y- axis and the transverse axis of the insole as X- axis during stance phase. RESULTS: The horizontal angle measured from center of pressure linear regression was positive in the control group (4.6 ± 2.4) (p < 0.005), but negative in the patient group (- 2.3 ± 1.6) (p < 0.005). CONCLUSIONS: The finding of this research measured center of pressure trajectory in steppage gait over time, which is useful for designing better shoe sole and also orthopaedic device and better understanding of stability in patients with drop foot. PMID:21526056

Differences in center of pressure trajectory between normal and steppage gait

Directory of Open Access Journals (Sweden)

Nima Jamshidi

2010-01-01

Full Text Available Background: This pilot study aimed to assess the differences in center of pressure trajectory in neuropathic patients with steppage gait. Steppage gait has previously been evaluated by several biomechanical methods, but plantar pressure distribution has been much less studied. The purpose of this study was to analyze the changes in center of pressure tra-jectory using a force plate. Methods: The steppage gait group was selected from the patients using drop foot brace (25 male and the control group was selected from Isfahan university students (20 male. They walked at self- selected speed at a mean of ten tri-als (+2 to collect the center of pressure using a force plate. Center of pressure patterns were categorized into four pat-terns based on the center of pressure displacement magnitude (spatial features through time (temporal features when the longitudinal axis of the insole was plotted as the Y- axis and the transverse axis of the insole as X- axis during stance phase. Results: The horizontal angle measured from center of pressure linear regression was positive in the control group (4.6 ± 2.4 (p < 0.005, but negative in the patient group (- 2.3 ± 1.6 (p < 0.005. Conclusions: The finding of this research measured center of pressure trajectory in steppage gait over time, which is useful for designing better shoe sole and also orthopaedic device and better understanding of stability in patients with drop foot.

Prevalence and associated features of self-reported freezing of gait in Parkinson disease: The DEEP FOG study.

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Amboni, M; Stocchi, F; Abbruzzese, G; Morgante, L; Onofrj, M; Ruggieri, S; Tinazzi, M; Zappia, M; Attar, M; Colombo, D; Simoni, L; Ori, A; Barone, P; Antonini, A

2015-06-01

Freezing of Gait (FOG) is a common and disabling symptom in patients with Parkinson disease (PD). The relationship between FOG and dopaminergic medication is complex. The aim of the present study was to estimate the prevalence of self-reported FOG, its associated clinical features, and its relationship with wearing-off in a wide PD population. This is an observational multicenter study of 634 consecutive non-demented PD patients. Patients were identified either as freezers or non-freezers based on item-3 of the Freezing of Gait-Questionnaire. FOG was then classified as on, off and onoff freezing based on its relationship with wearing-off. Patients were assessed with Unified Parkinson's Disease Rating Scale, Hoehn and Yahr scale, 8-item Parkinson's disease Questionnaire, Mini-Mental State Examination. Data from 593 patients were analyzed, 325 (54.3%) were freezers of whom 200 (61.6%) experienced FOG only during off state (off-freezers), 6 (1.8%) only during on state and 119 (36.6%) either in on and off states or independently of dopaminergic response-related symptoms (onoff-freezers). Overall, freezers vs non-freezers had longer disease duration, more advanced disease and greater disability. Moreover, freezers more frequently reported wearing-off and experienced worse quality of life. Onoff-freezers vs off-freezers were older, more severely disabled, less likely to experience wearing-off, treated with lower levodopa equivalent daily dose and with poorer cognitive performance. Self-reported FOG is mainly recognizable in advanced PD and is associated with more disability and worse quality of life. Onoff-FOG may represent the result of under-treatment or rather interpretable as a distinct clinical entity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Direct and indirect effects of attention and visual function on gait impairment in Parkinson's disease: influence of task and turning.

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Stuart, Samuel; Galna, Brook; Delicato, Louise S; Lord, Sue; Rochester, Lynn

2017-07-01

Gait impairment is a core feature of Parkinson's disease (PD) which has been linked to cognitive and visual deficits, but interactions between these features are poorly understood. Monitoring saccades allows investigation of real-time cognitive and visual processes and their impact on gait when walking. This study explored: (i) saccade frequency when walking under different attentional manipulations of turning and dual-task; and (ii) direct and indirect relationships between saccades, gait impairment, vision and attention. Saccade frequency (number of fast eye movements per-second) was measured during gait in 60 PD and 40 age-matched control participants using a mobile eye-tracker. Saccade frequency was significantly reduced in PD compared to controls during all conditions. However, saccade frequency increased with a turn and decreased under dual-task for both groups. Poorer attention directly related to saccade frequency, visual function and gait impairment in PD, but not controls. Saccade frequency did not directly relate to gait in PD, but did in controls. Instead, saccade frequency and visual function deficit indirectly impacted gait impairment in PD, which was underpinned by their relationship with attention. In conclusion, our results suggest a vital role for attention with direct and indirect influences on gait impairment in PD. Attention directly impacted saccade frequency, visual function and gait impairment in PD, with connotations for falls. It also underpinned indirect impact of visual and saccadic impairment on gait. Attention therefore represents a key therapeutic target that should be considered in future research. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Gait patterns in Prader-Willi and Down syndrome patients

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Albertini Giorgio

2010-06-01

Full Text Available Abstract Background Prader-Willi (PWS and Down Syndrome (DS are two genetic disorders characterised by some common clinical and functional features. A quantitative description and comparison of their patterns would contribute to a deeper understanding of the determinants of motor disability in these two syndromes. The aim of this study was to measure gait pattern in PWS and DS in order to provide data for developing evidence-based deficit-specific or common rehabilitation strategies. Methods 19 PWS patients (17.7-40 yr and 21 DS patients (18-39 yr were evaluated with an optoelectronic system and force platforms for measuring kinematic and kinetic parameters during walking. The results were compared with those obtained in a group of normal-weight controls (Control Group: CG; 33.4 + 9.6 yr. Results and Discussion The results show that PWS and DS are characterised by different gait strategies. Spatio-temporal parameters indicated a cautious, abnormal gait in both groups, but DS walked with a less stable strategy than PWS. As for kinematics, DS showed a significantly reduced hip and knee flexion, especially at initial contact and ankle range of motion than PWS. DS were characterised by lower ranges of motion (p Conclusions Our data show that DS walk with a less physiological gait pattern than PWS. Based on our results, PWS and DS patients need targeted rehabilitation and exercise prescription. Common to both groups is the aim to improve hypotonia, muscle strength and motor control during gait. In DS, improving pelvis and hip range of motion should represent a major specific goal to optimize gait pattern.

Gait variability measurements in lumbar spinal stenosis patients: part B. Preoperative versus postoperative gait variability

International Nuclear Information System (INIS)

Papadakis, N C; Christakis, D G; Tzagarakis, G N; Chlouverakis, G I; Kampanis, N A; Stergiopoulos, K N; Katonis, P G

2009-01-01

The objective of this study was to assess the gait variability of lumbar spinal stenosis (LSS) patients and to evaluate its postoperative progression. The hypothesis was that LSS patients' preoperative gait variability in the frequency domain was higher than the corresponding postoperative. A tri-axial accelerometer sensor was used for the gait measurement and a spectral differential entropy algorithm was used to measure the gait variability. Twelve subjects with LSS were measured before and after surgery. Preoperative measurements were performed 2 days before surgery. Postoperative measurements were performed 6 and 12 months after surgery. Preoperative gait variability was higher than the corresponding postoperative. Also, in most cases, gait variability appeared to decrease throughout the year

Variability of Stepping during a Virtual Reality Paradigm in Parkinson's Disease Patients with and without Freezing of Gait.

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Moran Gilat

Full Text Available Freezing of gait is a common and debilitating symptom affecting many patients with advanced Parkinson's disease. Although the pathophysiology of freezing of gait is not fully understood, a number of observations regarding the pattern of gait in patients with this symptom have been made. Increased 'Stride Time Variability' has been one of the most robust of these features. In this study we sought to identify whether patients with freezing of gait demonstrated similar fluctuations in their stepping rhythm whilst performing a seated virtual reality gait task that has recently been used to demonstrate the neural correlate of the freezing phenomenon.Seventeen patients with freezing and eleven non-freezers performed the virtual reality task twice, once whilst 'On' their regular Parkinsonian medication and once in their practically defined 'Off' state.All patients displayed greater step time variability during their 'Off' state assessment compared to when medicated. Additionally, in the 'Off' state, patients with freezing of gait had greater step time variability compared to non-freezers. The five steps leading up to a freezing episode in the virtual reality environment showed a significant increase in step time variability although the final three steps preceding the freeze were not characterized by a progressive shortening of latency.The results of this study suggest that characteristic features of gait disturbance observed in patients with freezing of gait can also be demonstrated with a virtual reality paradigm. These findings suggest that virtual reality may offer the potential to further explore the freezing phenomenon in Parkinson's disease.

Bipedal gait model for precise gait recognition and optimal triggering in foot drop stimulator: a proof of concept.

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Shaikh, Muhammad Faraz; Salcic, Zoran; Wang, Kevin I-Kai; Hu, Aiguo Patrick

2018-03-10

Electrical stimulators are often prescribed to correct foot drop walking. However, commercial foot drop stimulators trigger inappropriately under certain non-gait scenarios. Past researches addressed this limitation by defining stimulation control based on automaton of a gait cycle executed by foot drop of affected limb/foot only. Since gait is a collaborative activity of both feet, this research highlights the role of normal foot for robust gait detection and stimulation triggering. A novel bipedal gait model is proposed where gait cycle is realized as an automaton based on concurrent gait sub-phases (states) from each foot. The input for state transition is fused information from feet-worn pressure and inertial sensors. Thereafter, a bipedal gait model-based stimulation control algorithm is developed. As a feasibility study, bipedal gait model and stimulation control are evaluated in real-time simulation manner on normal and simulated foot drop gait measurements from 16 able-bodied participants with three speed variations, under inappropriate triggering scenarios and with foot drop rehabilitation exercises. Also, the stimulation control employed in commercial foot drop stimulators and single foot gait-based foot drop stimulators are compared alongside. Gait detection accuracy (98.9%) and precise triggering under all investigations prove bipedal gait model reliability. This infers that gait detection leveraging bipedal periodicity is a promising strategy to rectify prevalent stimulation triggering deficiencies in commercial foot drop stimulators. Graphical abstract Bipedal information-based gait recognition and stimulation triggering.

Effects of conventional overground gait training and a gait trainer with partial body weight support on spatiotemporal gait parameters of patients after stroke.

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Park, Byoung-Sun; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Noh, Ji-Woong; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Kim, Junghwan

2015-05-01

[Purpose] The purpose of this study was to confirm the effects of both conventional overground gait training (CGT) and a gait trainer with partial body weight support (GTBWS) on spatiotemporal gait parameters of patients with hemiparesis following chronic stroke. [Subjects and Methods] Thirty stroke patients were alternately assigned to one of two treatment groups, and both groups underwent CGT and GTBWS. [Results] The functional ambulation classification on the affected side improved significantly in the CGT and GTBWS groups. Walking speed also improved significantly in both groups. [Conclusion] These results suggest that the GTBWS in company with CGT may be, in part, an effective method of gait training for restoring gait ability in patients after a stroke.

Gait characteristics after gait-oriented rehabilitation in chronic stroke.

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Peurala, Sinikka H; Titianova, Ekaterina B; Mateev, Plamen; Pitkänen, Kauko; Sivenius, Juhani; Tarkka, Ina M

2005-01-01

To assess the effects of rehabilitation in thirty-seven ambulatory patients with chronic stroke during three weeks in-patient rehabilitation period. In the intervention group, each patient received 75 min physiotherapy daily every workday including 20 minutes in the electromechanical gait trainer with body-weight support (BWS). In the control group, each patient participated in 45 min conventional physiotherapy daily. Motor ability was assessed with the first five items of the Modified Motor Assessment Scale (MMAS1-5) and ten meters walking speed. Spatio-temporal gait characteristics were recorded with an electrical walkway. The MMAS1-5 (pgait characteristics improved only in the intervention group, as seen in increased Functional Ambulation Profile score (p=0.023), velocity (p=0.023), the step lengths (affected side, p=0.011, non-affected side p=0.040), the stride lengths (p=0.018, p=0.006) and decreased step-time differential (p=0.043). Furthermore, all gait characteristics and other motor abilities remained in the discharge level at the six months in the intervention group. It appears that BWS training gives a long-lasting benefit in gait qualities even in chronic stroke patients.

Analyzing Gait Using a Time-of-Flight Camera

DEFF Research Database (Denmark)

Jensen, Rasmus Ramsbøl; Paulsen, Rasmus Reinhold; Larsen, Rasmus

2009-01-01

An algorithm is created, which performs human gait analysis using spatial data and amplitude images from a Time-of-flight camera. For each frame in a sequence the camera supplies cartesian coordinates in space for every pixel. By using an articulated model the subject pose is estimated in the depth...... map in each frame. The pose estimation is based on likelihood, contrast in the amplitude image, smoothness and a shape prior used to solve a Markov random field. Based on the pose estimates, and the prior that movement is locally smooth, a sequential model is created, and a gait analysis is done...... on this model. The output data are: Speed, Cadence (steps per minute), Step length, Stride length (stride being two consecutive steps also known as a gait cycle), and Range of motion (angles of joints). The created system produces good output data of the described output parameters and requires no user...

Quantification and recognition of parkinsonian gait from monocular video imaging using kernel-based principal component analysis

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Chen Shih-Wei

2011-11-01

Full Text Available Abstract Background The computer-aided identification of specific gait patterns is an important issue in the assessment of Parkinson's disease (PD. In this study, a computer vision-based gait analysis approach is developed to assist the clinical assessments of PD with kernel-based principal component analysis (KPCA. Method Twelve PD patients and twelve healthy adults with no neurological history or motor disorders within the past six months were recruited and separated according to their "Non-PD", "Drug-On", and "Drug-Off" states. The participants were asked to wear light-colored clothing and perform three walking trials through a corridor decorated with a navy curtain at their natural pace. The participants' gait performance during the steady-state walking period was captured by a digital camera for gait analysis. The collected walking image frames were then transformed into binary silhouettes for noise reduction and compression. Using the developed KPCA-based method, the features within the binary silhouettes can be extracted to quantitatively determine the gait cycle time, stride length, walking velocity, and cadence. Results and Discussion The KPCA-based method uses a feature-extraction approach, which was verified to be more effective than traditional image area and principal component analysis (PCA approaches in classifying "Non-PD" controls and "Drug-Off/On" PD patients. Encouragingly, this method has a high accuracy rate, 80.51%, for recognizing different gaits. Quantitative gait parameters are obtained, and the power spectrums of the patients' gaits are analyzed. We show that that the slow and irregular actions of PD patients during walking tend to transfer some of the power from the main lobe frequency to a lower frequency band. Our results indicate the feasibility of using gait performance to evaluate the motor function of patients with PD. Conclusion This KPCA-based method requires only a digital camera and a decorated corridor setup

Cognitive and motor dual task gait training improve dual task gait performance after stroke - A randomized controlled pilot trial.

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Liu, Yan-Ci; Yang, Yea-Ru; Tsai, Yun-An; Wang, Ray-Yau

2017-06-22

This study investigated effects of cognitive and motor dual task gait training on dual task gait performance in stroke. Participants (n = 28) were randomly assigned to cognitive dual task gait training (CDTT), motor dual task gait training (MDTT), or conventional physical therapy (CPT) group. Participants in CDTT or MDTT group practiced the cognitive or motor tasks respectively during walking. Participants in CPT group received strengthening, balance, and gait training. The intervention was 30 min/session, 3 sessions/week for 4 weeks. Three test conditions to evaluate the training effects were single walking, walking while performing cognitive task (serial subtraction), and walking while performing motor task (tray-carrying). Parameters included gait speed, dual task cost of gait speed (DTC-speed), cadence, stride time, and stride length. After CDTT, cognitive-motor dual task gait performance (stride length and DTC-speed) was improved (p = 0.021; p = 0.015). After MDTT, motor dual task gait performance (gait speed, stride length, and DTC-speed) was improved (p = 0.008; p = 0.008; p = 0.008 respectively). It seems that CDTT improved cognitive dual task gait performance and MDTT improved motor dual task gait performance although such improvements did not reach significant group difference. Therefore, different types of dual task gait training can be adopted to enhance different dual task gait performance in stroke.

Method for Walking Gait Identification in a Lower Extremity Exoskeleton Based on C4.5 Decision Tree Algorithm

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Qing Guo

2015-04-01

Full Text Available A gait identification method for a lower extremity exoskeleton is presented in order to identify the gait sub-phases in human-machine coordinated motion. First, a sensor layout for the exoskeleton is introduced. Taking the difference between human lower limb motion and human-machine coordinated motion into account, the walking gait is divided into five sub-phases, which are ‘double standing’, ‘right leg swing and left leg stance’, ‘double stance with right leg front and left leg back’, ‘right leg stance and left leg swing’, and ‘double stance with left leg front and right leg back’. The sensors include shoe pressure sensors, knee encoders, and thigh and calf gyroscopes, and are used to measure the contact force of the foot, and the knee joint angle and its angular velocity. Then, five sub-phases of walking gait are identified by a C4.5 decision tree algorithm according to the data fusion of the sensors' information. Based on the simulation results for the gait division, identification accuracy can be guaranteed by the proposed algorithm. Through the exoskeleton control experiment, a division of five sub-phases for the human-machine coordinated walk is proposed. The experimental results verify this gait division and identification method. They can make hydraulic cylinders retract ahead of time and improve the maximal walking velocity when the exoskeleton follows the person's motion.

Gait and Cognition in Parkinson’s Disease: Cognitive Impairment Is Inadequately Reflected by Gait Performance during Dual Task

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Heiko Gaßner

2017-10-01

Full Text Available IntroductionCognitive and gait deficits are common symptoms in Parkinson’s disease (PD. Motor-cognitive dual tasks (DTs are used to explore the interplay between gait and cognition. However, it is unclear if DT gait performance is indicative for cognitive impairment. Therefore, the aim of this study was to investigate if cognitive deficits are reflected by DT costs of spatiotemporal gait parameters.MethodsCognitive function, single task (ST and DT gait performance were investigated in 67 PD patients. Cognition was assessed by the Montreal Cognitive Assessment (MoCA followed by a standardized, sensor-based gait test and the identical gait test while subtracting serial 3’s. Cognitive impairment was defined by a MoCA score <26. DT costs in gait parameters [(DT − ST/ST × 100] were calculated as a measure of DT effect on gait. Correlation analysis was used to evaluate the association between MoCA performance and gait parameters. In a linear regression model, DT gait costs and clinical confounders (age, gender, disease duration, motor impairment, medication, and depression were correlated to cognitive performance. In a subgroup analysis, we compared matched groups of cognitively impaired and unimpaired PD patients regarding differences in ST, DT, and DT gait costs.ResultsCorrelation analysis revealed weak correlations between MoCA score and DT costs of gait parameters (r/rSp ≤ 0.3. DT costs of stride length, swing time variability, and maximum toe clearance (|r/rSp| > 0.2 were included in a regression analysis. The parameters only explain 8% of the cognitive variance. In combination with clinical confounders, regression analysis showed that these gait parameters explained 30% of MoCA performance. Group comparison revealed strong DT effects within both groups (large effect sizes, but significant between-group effects in DT gait costs were not observed.ConclusionThese findings suggest that DT gait performance is not indicative

Gait as evidence

DEFF Research Database (Denmark)

Lynnerup, Niels; Larsen, Peter Kastmand

2014-01-01

This study examines what in Denmark may constitute evidence based on forensic anthropological gait analyses, in the sense of pointing to a match (or not) between a perpetrator and a suspect, based on video and photographic imagery. Gait and anthropometric measures can be used when direct facial...

Intra-individual gait pattern variability in specific situations: Implications for forensic gait analysis.

Science.gov (United States)

Ludwig, Oliver; Dillinger, Steffen; Marschall, Franz

2016-07-01

In this study, inter- and intra-individual gait pattern differences are examined in various gait situations by means of phase diagrams of the extremity angles (cyclograms). 8 test subjects walked along a walking distance of 6m under different conditions three times each: barefoot, wearing sneakers, wearing combat boots, after muscular fatigue, and wearing a full-face motorcycle helmet restricting vision. The joint angles of foot, knee, and hip were recorded in the sagittal plane. The coupling of movements was represented by time-adjusted cyclograms, and the inter- and intra-individual differences were captured by calculating the similarity between different gait patterns. Gait pattern variability was often greater between the defined test situations than between the individual test subjects. The results have been interpreted considering neurophysiological regulation mechanisms. Footwear, masking, and fatigue were interpreted as disturbance parameters, each being a cause for gait pattern variability and complicating the inference of identity of persons in video recordings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Person re-identification using height-based gait in colour depth camera

NARCIS (Netherlands)

John, V.; Englebienne, G.; Kröse, B.

2013-01-01

We address the problem of person re-identification in colour-depth camera using the height temporal information of people. Our proposed gait-based feature corresponds to the frequency response of the height temporal information. We demonstrate that the discriminative periodic motion associated with

Effect of footwear on minimum foot clearance, heel slippage and spatiotemporal measures of gait in older women.

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Davis, Annette M; Galna, Brook; Murphy, Anna T; Williams, Cylie M; Haines, Terry P

2016-02-01

Footwear has been implicated as a factor in falls, which is a major issue affecting the health of older adults. This study investigated the effect of footwear with dorsal fixation, slippers and bare feet on minimum foot clearance, heel slippage and spatiotemporal variables of gait in community dwelling older women. Thirty women participated (mean age (SD) 69.1 (5.1) years) in a gait assessment using the GaitRITE and Vicon 612 motion analysis system. Conditions included footwear with dorsal fixation, slippers or bare feet. Footwear with dorsal fixation resulted in improved minimum foot clearance compared to the slippers and bare feet conditions and less heel slippage than slippers and an increase in double support. These features lend weight to the argument that older women should be supported to make footwear choices with optimal fitting features including dorsal fixation. Recommendations of particular styles and features of footwear may assist during falls prevention education to reduce the incidence of foot trips and falls. Copyright © 2015 Elsevier B.V. All rights reserved.

Crowd-Sourced Amputee Gait Data: A Feasibility Study Using YouTube Videos of Unilateral Trans-Femoral Gait.

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James Gardiner

Full Text Available Collecting large datasets of amputee gait data is notoriously difficult. Additionally, collecting data on less prevalent amputations or on gait activities other than level walking and running on hard surfaces is rarely attempted. However, with the wealth of user-generated content on the Internet, the scope for collecting amputee gait data from alternative sources other than traditional gait labs is intriguing. Here we investigate the potential of YouTube videos to provide gait data on amputee walking. We use an example dataset of trans-femoral amputees level walking at self-selected speeds to collect temporal gait parameters and calculate gait asymmetry. We compare our YouTube data with typical literature values, and show that our methodology produces results that are highly comparable to data collected in a traditional manner. The similarity between the results of our novel methodology and literature values lends confidence to our technique. Nevertheless, clear challenges with the collection and interpretation of crowd-sourced gait data remain, including long term access to datasets, and a lack of validity and reliability studies in this area.

Crowd-Sourced Amputee Gait Data: A Feasibility Study Using YouTube Videos of Unilateral Trans-Femoral Gait.

Science.gov (United States)

Gardiner, James; Gunarathne, Nuwan; Howard, David; Kenney, Laurence

2016-01-01

Collecting large datasets of amputee gait data is notoriously difficult. Additionally, collecting data on less prevalent amputations or on gait activities other than level walking and running on hard surfaces is rarely attempted. However, with the wealth of user-generated content on the Internet, the scope for collecting amputee gait data from alternative sources other than traditional gait labs is intriguing. Here we investigate the potential of YouTube videos to provide gait data on amputee walking. We use an example dataset of trans-femoral amputees level walking at self-selected speeds to collect temporal gait parameters and calculate gait asymmetry. We compare our YouTube data with typical literature values, and show that our methodology produces results that are highly comparable to data collected in a traditional manner. The similarity between the results of our novel methodology and literature values lends confidence to our technique. Nevertheless, clear challenges with the collection and interpretation of crowd-sourced gait data remain, including long term access to datasets, and a lack of validity and reliability studies in this area.

Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults

NARCIS (Netherlands)

Weijer, R H A; Hoozemans, M J M; van Dieën, J H; Pijnappels, M

2018-01-01

BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults. RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults.

Association of Dual-Task Gait With Incident Dementia in Mild Cognitive Impairment: Results From the Gait and Brain Study.

Science.gov (United States)

Montero-Odasso, Manuel M; Sarquis-Adamson, Yanina; Speechley, Mark; Borrie, Michael J; Hachinski, Vladimir C; Wells, Jennie; Riccio, Patricia M; Schapira, Marcelo; Sejdic, Ervin; Camicioli, Richard M; Bartha, Robert; McIlroy, William E; Muir-Hunter, Susan

2017-07-01

Gait performance is affected by neurodegeneration in aging and has the potential to be used as a clinical marker for progression from mild cognitive impairment (MCI) to dementia. A dual-task gait test evaluating the cognitive-motor interface may predict dementia progression in older adults with MCI. To determine whether a dual-task gait test is associated with incident dementia in MCI. The Gait and Brain Study is an ongoing prospective cohort study of community-dwelling older adults that enrolled 112 older adults with MCI. Participants were followed up for 6 years, with biannual visits including neurologic, cognitive, and gait assessments. Data were collected from July 2007 to March 2016. Incident all-cause dementia was the main outcome measure, and single- and dual-task gait velocity and dual-task gait costs were the independent variables. A neuropsychological test battery was used to assess cognition. Gait velocity was recorded under single-task and 3 separate dual-task conditions using an electronic walkway. Dual-task gait cost was defined as the percentage change between single- and dual-task gait velocities: ([single-task gait velocity - dual-task gait velocity]/ single-task gait velocity) × 100. Cox proportional hazard models were used to estimate the association between risk of progression to dementia and the independent variables, adjusted for age, sex, education, comorbidities, and cognition. Among 112 study participants with MCI, mean (SD) age was 76.6 (6.9) years, 55 were women (49.1%), and 27 progressed to dementia (24.1%), with an incidence rate of 121 per 1000 person-years. Slow single-task gait velocity (gait cost while counting backward (HR, 3.79; 95% CI, 1.57-9.15; P = .003) and naming animals (HR, 2.41; 95% CI, 1.04-5.59; P = .04) were associated with dementia progression (incidence rate, 155 per 1000 person-years). The models remained robust after adjusting by baseline cognition except for dual-task gait cost when dichotomized. Dual

Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes.

Science.gov (United States)

Auvinet, Bernard; Touzard, Claude; Montestruc, François; Delafond, Arnaud; Goeb, Vincent

2017-01-31

Gait disorders and gait analysis under single and dual-task conditions are topics of great interest, but very few studies have looked for the relevance of gait analysis under dual-task conditions in elderly people on the basis of a clinical approach. An observational study including 103 patients (mean age 76.3 ± 7.2, women 56%) suffering from gait disorders or memory impairment was conducted. Gait analysis under dual-task conditions was carried out for all patients. Brain MRI was performed in the absence of contra-indications. Three main gait variables were measured: walking speed, stride frequency, and stride regularity. For each gait variable, the dual task cost was computed and a quartile analysis was obtained. Nonparametric tests were used for all the comparisons (Wilcoxon, Kruskal-Wallis, Fisher or Chi 2 tests). Four clinical subgroups were identified: gait instability (45%), recurrent falls (29%), memory impairment (18%), and cautious gait (8%). The biomechanical severity of these subgroups was ordered according to walking speed and stride regularity under both conditions, from least to most serious as follows: memory impairment, gait instability, recurrent falls, cautious gait (p < 0.01 for walking speed, p = 0.05 for stride regularity). According to the established diagnoses of gait disorders, 5 main pathological subgroups were identified (musculoskeletal diseases (n = 11), vestibular diseases (n = 6), mild cognitive impairment (n = 24), central nervous system pathologies, (n = 51), and without diagnosis (n = 8)). The dual task cost for walking speed, stride frequency and stride regularity were different among these subgroups (p < 0.01). The subgroups mild cognitive impairment and central nervous system pathologies both showed together a higher dual task cost for each variable compared to the other subgroups combined (p = 0.01). The quartile analysis of dual task cost for stride frequency and stride regularity

Newly Identified Gait Patterns in Patients With Multiple Sclerosis May Be Related to Push-off Quality.

Science.gov (United States)

Kempen, Jiska C E; Doorenbosch, Caroline A M; Knol, Dirk L; de Groot, Vincent; Beckerman, Heleen

2016-11-01

Limited walking ability is an important problem for patients with multiple sclerosis. A better understanding of how gait impairments lead to limited walking ability may help to develop more targeted interventions. Although gait classifications are available in cerebral palsy and stroke, relevant knowledge in MS is scarce. The aims of this study were: (1) to identify distinctive gait patterns in patients with MS based on a combined evaluation of kinematics, gait features, and muscle activity during walking and (2) to determine the clinical relevance of these gait patterns. This was a cross-sectional study of 81 patients with MS of mild-to-moderate severity (Expanded Disability Status Scale [EDSS] median score=3.0, range=1.0-7.0) and an age range of 28 to 69 years. The patients participated in 2-dimensional video gait analysis, with concurrent measurement of surface electromyography and ground reaction forces. A score chart of 73 gait items was used to rate each gait analysis. A single rater performed the scoring. Latent class analysis was used to identify gait classes. Analysis of the 73 gait variables revealed that 9 variables could distinguish 3 clinically meaningful gait classes. The 9 variables were: (1) heel-rise in terminal stance, (2) push-off, (3) clearance in initial swing, (4) plantar-flexion position in mid-swing, (5) pelvic rotation, (6) arm-trunk movement, (7) activity of the gastrocnemius muscle in pre-swing, (8) M-wave, and (9) propulsive force. The EDSS score and gait speed worsened in ascending classes. Most participants had mild-to-moderate limitations in walking ability based on their EDSS scores, and the number of walkers who were severely limited was small. Based on a small set of 9 variables measured with 2-dimensional clinical gait analysis, patients with MS could be divided into 3 different gait classes. The gait variables are suggestive of insufficient ankle push-off. © 2016 American Physical Therapy Association.

Gait variability and basal ganglia disorders: stride-to-stride variations of gait cycle timing in Parkinson's disease and Huntington's disease

Science.gov (United States)

Hausdorff, J. M.; Cudkowicz, M. E.; Firtion, R.; Wei, J. Y.; Goldberger, A. L.

1998-01-01

The basal ganglia are thought to play an important role in regulating motor programs involved in gait and in the fluidity and sequencing of movement. We postulated that the ability to maintain a steady gait, with low stride-to-stride variability of gait cycle timing and its subphases, would be diminished with both Parkinson's disease (PD) and Huntington's disease (HD). To test this hypothesis, we obtained quantitative measures of stride-to-stride variability of gait cycle timing in subjects with PD (n = 15), HD (n = 20), and disease-free controls (n = 16). All measures of gait variability were significantly increased in PD and HD. In subjects with PD and HD, gait variability measures were two and three times that observed in control subjects, respectively. The degree of gait variability correlated with disease severity. In contrast, gait speed was significantly lower in PD, but not in HD, and average gait cycle duration and the time spent in many subphases of the gait cycle were similar in control subjects, HD subjects, and PD subjects. These findings are consistent with a differential control of gait variability, speed, and average gait cycle timing that may have implications for understanding the role of the basal ganglia in locomotor control and for quantitatively assessing gait in clinical settings.

Real time biometric surveillance with gait recognition

Science.gov (United States)

Mohapatra, Subasish; Swain, Anisha; Das, Manaswini; Mohanty, Subhadarshini

2018-04-01

Bio metric surveillance has become indispensable for every system in the recent years. The contribution of bio metric authentication, identification, and screening purposes are widely used in various domains for preventing unauthorized access. A large amount of data needs to be updated, segregated and safeguarded from malicious software and misuse. Bio metrics is the intrinsic characteristics of each individual. Recently fingerprints, iris, passwords, unique keys, and cards are commonly used for authentication purposes. These methods have various issues related to security and confidentiality. These systems are not yet automated to provide the safety and security. The gait recognition system is the alternative for overcoming the drawbacks of the recent bio metric based authentication systems. Gait recognition is newer as it hasn't been implemented in the real-world scenario so far. This is an un-intrusive system that requires no knowledge or co-operation of the subject. Gait is a unique behavioral characteristic of every human being which is hard to imitate. The walking style of an individual teamed with the orientation of joints in the skeletal structure and inclinations between them imparts the unique characteristic. A person can alter one's own external appearance but not skeletal structure. These are real-time, automatic systems that can even process low-resolution images and video frames. In this paper, we have proposed a gait recognition system and compared the performance with conventional bio metric identification systems.

Preliminary Assessment of a Compliant Gait Exoskeleton.

Science.gov (United States)

Cestari, Manuel; Sanz-Merodio, Daniel; Garcia, Elena

2017-06-01

Current commercial wearable gait exoskeletons contain joints with stiff actuators that cannot adapt to unpredictable environments. These actuators consume a significant amount of energy, and their stiffness may not be appropriate for safe human-machine interactions. Adjustable compliant actuators are being designed and implemented because of their ability to minimize large forces due to shocks, to safely interact with the user, and to store and release energy in passive elastic elements. Introduction of such compliant actuation in gait exoskeletons, however, has been limited by the larger power-to-weight and volume ratio requirement. This article presents a preliminary assessment of the first compliant exoskeleton for children. Compliant actuation systems developed by our research group were integrated into the ATLAS exoskeleton prototype. The resulting device is a compliant exoskeleton, the ATLAS-C prototype. The exoskeleton is coupled with a special standing frame to provide balance while allowing a semi-natural gait. Experiments show that when comparing the behavior of the joints under different stiffness conditions, the inherent compliance of the implemented actuators showed natural adaptability during the gait cycle and in regions of shock absorption. Torque tracking of the joint is achieved, identifying the areas of loading response. The implementation of a state machine in the control of knee motion allowed reutilization of the stored energy during deflection at the end of the support phase to partially propel the leg and achieve a more natural and free swing.

[Subjective Gait Stability in the Elderly].

Science.gov (United States)

Hirsch, Theresa; Lampe, Jasmin; Michalk, Katrin; Röder, Lotte; Munsch, Karoline; Marquardt, Jonas

2017-07-10

It can be assumed that the feeling of gait stability or gait instability in the elderly may be independent of a possible fear of falling or a history of falling when walking. Up to now, there has been a lack of spatiotemporal gait parameters for older people who subjectively feel secure when walking. The aim of the study is to analyse the distribution of various gait parameters for older people who subjectively feel secure when walking. In a cross-sectional study, the gait parameters stride time, step time, stride length, step length, double support, single support, and walking speed were measured using a Vicon three-dimensional motion capture system (Plug-In Gait Lower-Body Marker Set) in 31 healthy people aged 65 years and older (mean age 72 ± 3.54 years) who subjectively feel secure when walking. There was a homogeneous distribution in the gait parameters examined, with no abnormalities. The mean values have a low variance with narrow confidence intervals. This study provides evidence that people who subjectively feel secure when walking demonstrate similarly objective gait parameters..

Implementation An image processing technique for video motion analysis during the gait cycle canine

Science.gov (United States)

López, G.; Hernández, J. O.

2017-01-01

Nowadays the analyses of human movement, more specifically of the gait have ceased to be a priority for our species. Technological advances and implementations engineering have joined to obtain data and information regarding the gait cycle in another animal species. The aim of this paper is to analyze the canine gait in order to get results that describe the behavior of the limbs during the gait cycle. The research was performed by: 1. Dog training, where it is developed the step of adaptation and trust; 2. Filming gait cycle; 3. Data acquisition, in order to obtain values that describe the motion cycle canine and 4. Results, obtaining the kinematics variables involved in the march. Which are essential to determine the behavior of the limbs, as well as for the development of prosthetic or orthotic. This project was carried out with conventional equipment and using computational tools easily accessible.

Automated Gait Analysis Through Hues and Areas (AGATHA): a method to characterize the spatiotemporal pattern of rat gait

Science.gov (United States)

Kloefkorn, Heidi E.; Pettengill, Travis R.; Turner, Sara M. F.; Streeter, Kristi A.; Gonzalez-Rothi, Elisa J.; Fuller, David D.; Allen, Kyle D.

2016-01-01

While rodent gait analysis can quantify the behavioral consequences of disease, significant methodological differences exist between analysis platforms and little validation has been performed to understand or mitigate these sources of variance. By providing the algorithms used to quantify gait, open-source gait analysis software can be validated and used to explore methodological differences. Our group is introducing, for the first time, a fully-automated, open-source method for the characterization of rodent spatiotemporal gait patterns, termed Automated Gait Analysis Through Hues and Areas (AGATHA). This study describes how AGATHA identifies gait events, validates AGATHA relative to manual digitization methods, and utilizes AGATHA to detect gait compensations in orthopaedic and spinal cord injury models. To validate AGATHA against manual digitization, results from videos of rodent gait, recorded at 1000 frames per second (fps), were compared. To assess one common source of variance (the effects of video frame rate), these 1000 fps videos were re-sampled to mimic several lower fps and compared again. While spatial variables were indistinguishable between AGATHA and manual digitization, low video frame rates resulted in temporal errors for both methods. At frame rates over 125 fps, AGATHA achieved a comparable accuracy and precision to manual digitization for all gait variables. Moreover, AGATHA detected unique gait changes in each injury model. These data demonstrate AGATHA is an accurate and precise platform for the analysis of rodent spatiotemporal gait patterns. PMID:27554674

A mechanical energy analysis of gait initiation

Science.gov (United States)

Miller, C. A.; Verstraete, M. C.

1999-01-01

The analysis of gait initiation (the transient state between standing and walking) is an important diagnostic tool to study pathologic gait and to evaluate prosthetic devices. While past studies have quantified mechanical energy of the body during steady-state gait, to date no one has computed the mechanical energy of the body during gait initiation. In this study, gait initiation in seven normal male subjects was studied using a mechanical energy analysis to compute total body energy. The data showed three separate states: quiet standing, gait initiation, and steady-state gait. During gait initiation, the trends in the energy data for the individual segments were similar to those seen during steady-state gait (and in Winter DA, Quanbury AO, Reimer GD. Analysis of instantaneous energy of normal gait. J Biochem 1976;9:253-257), but diminished in amplitude. However, these amplitudes increased to those seen in steady-state during the gait initiation event (GIE), with the greatest increase occurring in the second step due to the push-off of the foundation leg. The baseline level of mechanical energy was due to the potential energy of the individual segments, while the cyclic nature of the data was indicative of the kinetic energy of the particular leg in swing phase during that step. The data presented showed differences in energy trends during gait initiation from those of steady state, thereby demonstrating the importance of this event in the study of locomotion.

Saccade frequency response to visual cues during gait in Parkinson's disease: the selective role of attention.

Science.gov (United States)

Stuart, Samuel; Lord, Sue; Galna, Brook; Rochester, Lynn

2018-04-01

Gait impairment is a core feature of Parkinson's disease (PD) with implications for falls risk. Visual cues improve gait in PD, but the underlying mechanisms are unclear. Evidence suggests that attention and vision play an important role; however, the relative contribution from each is unclear. Measurement of visual exploration (specifically saccade frequency) during gait allows for real-time measurement of attention and vision. Understanding how visual cues influence visual exploration may allow inferences of the underlying mechanisms to response which could help to develop effective therapeutics. This study aimed to examine saccade frequency during gait in response to a visual cue in PD and older adults and investigate the roles of attention and vision in visual cue response in PD. A mobile eye-tracker measured saccade frequency during gait in 55 people with PD and 32 age-matched controls. Participants walked in a straight line with and without a visual cue (50 cm transverse lines) presented under single task and dual-task (concurrent digit span recall). Saccade frequency was reduced when walking in PD compared to controls; however, visual cues ameliorated saccadic deficit. Visual cues significantly increased saccade frequency in both PD and controls under both single task and dual-task. Attention rather than visual function was central to saccade frequency and gait response to visual cues in PD. In conclusion, this study highlights the impact of visual cues on visual exploration when walking and the important role of attention in PD. Understanding these complex features will help inform intervention development. © 2018 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Improving Sensitivity to Detect Mild Cognitive Impairment: Cognitive Load Dual-Task Gait Speed Assessment.

Science.gov (United States)

MacAulay, Rebecca K; Wagner, Mark T; Szeles, Dana; Milano, Nicholas J

2017-07-01

Longitudinal research indicates that cognitive load dual-task gait assessment is predictive of cognitive decline and thus might provide a sensitive measure to screen for mild cognitive impairment (MCI). However, research among older adults being clinically evaluated for cognitive concerns, a defining feature of MCI, is lacking. The present study investigated the effect of performing a cognitive task on normal walking speed in patients presenting to a memory clinic with cognitive complaints. Sixty-one patients with a mean age of 68 years underwent comprehensive neuropsychological testing, clinical interview, and gait speed (simple- and dual-task conditions) assessments. Thirty-four of the 61 patients met criteria for MCI. Repeated measure analyses of covariance revealed that greater age and MCI both significantly associated with slower gait speed, pscognitive dual task within a clinically representative population. Cognitive load dual-task gait assessment may provide a cost efficient and sensitive measure to detect older adults at high risk of a dementia disorder. (JINS, 2017, 23, 493-501).

Gait adaptation to visual kinematic perturbations using a real-time closed-loop brain-computer interface to a virtual reality avatar.

Science.gov (United States)

Luu, Trieu Phat; He, Yongtian; Brown, Samuel; Nakagame, Sho; Contreras-Vidal, Jose L

2016-06-01

The control of human bipedal locomotion is of great interest to the field of lower-body brain-computer interfaces (BCIs) for gait rehabilitation. While the feasibility of closed-loop BCI systems for the control of a lower body exoskeleton has been recently shown, multi-day closed-loop neural decoding of human gait in a BCI virtual reality (BCI-VR) environment has yet to be demonstrated. BCI-VR systems provide valuable alternatives for movement rehabilitation when wearable robots are not desirable due to medical conditions, cost, accessibility, usability, or patient preferences. In this study, we propose a real-time closed-loop BCI that decodes lower limb joint angles from scalp electroencephalography (EEG) during treadmill walking to control a walking avatar in a virtual environment. Fluctuations in the amplitude of slow cortical potentials of EEG in the delta band (0.1-3 Hz) were used for prediction; thus, the EEG features correspond to time-domain amplitude modulated potentials in the delta band. Virtual kinematic perturbations resulting in asymmetric walking gait patterns of the avatar were also introduced to investigate gait adaptation using the closed-loop BCI-VR system over a period of eight days. Our results demonstrate the feasibility of using a closed-loop BCI to learn to control a walking avatar under normal and altered visuomotor perturbations, which involved cortical adaptations. The average decoding accuracies (Pearson's r values) in real-time BCI across all subjects increased from (Hip: 0.18 ± 0.31; Knee: 0.23 ± 0.33; Ankle: 0.14 ± 0.22) on Day 1 to (Hip: 0.40 ± 0.24; Knee: 0.55 ± 0.20; Ankle: 0.29 ± 0.22) on Day 8. These findings have implications for the development of a real-time closed-loop EEG-based BCI-VR system for gait rehabilitation after stroke and for understanding cortical plasticity induced by a closed-loop BCI-VR system.

Gait adaptation to visual kinematic perturbations using a real-time closed-loop brain-computer interface to a virtual reality avatar

Science.gov (United States)

Phat Luu, Trieu; He, Yongtian; Brown, Samuel; Nakagome, Sho; Contreras-Vidal, Jose L.

2016-06-01

Objective. The control of human bipedal locomotion is of great interest to the field of lower-body brain-computer interfaces (BCIs) for gait rehabilitation. While the feasibility of closed-loop BCI systems for the control of a lower body exoskeleton has been recently shown, multi-day closed-loop neural decoding of human gait in a BCI virtual reality (BCI-VR) environment has yet to be demonstrated. BCI-VR systems provide valuable alternatives for movement rehabilitation when wearable robots are not desirable due to medical conditions, cost, accessibility, usability, or patient preferences. Approach. In this study, we propose a real-time closed-loop BCI that decodes lower limb joint angles from scalp electroencephalography (EEG) during treadmill walking to control a walking avatar in a virtual environment. Fluctuations in the amplitude of slow cortical potentials of EEG in the delta band (0.1-3 Hz) were used for prediction; thus, the EEG features correspond to time-domain amplitude modulated potentials in the delta band. Virtual kinematic perturbations resulting in asymmetric walking gait patterns of the avatar were also introduced to investigate gait adaptation using the closed-loop BCI-VR system over a period of eight days. Main results. Our results demonstrate the feasibility of using a closed-loop BCI to learn to control a walking avatar under normal and altered visuomotor perturbations, which involved cortical adaptations. The average decoding accuracies (Pearson’s r values) in real-time BCI across all subjects increased from (Hip: 0.18 ± 0.31 Knee: 0.23 ± 0.33 Ankle: 0.14 ± 0.22) on Day 1 to (Hip: 0.40 ± 0.24 Knee: 0.55 ± 0.20 Ankle: 0.29 ± 0.22) on Day 8. Significance. These findings have implications for the development of a real-time closed-loop EEG-based BCI-VR system for gait rehabilitation after stroke and for understanding cortical plasticity induced by a closed-loop BCI-VR system.

DMRT3 is associated with gait type in Mangalarga Marchador horses, but does not control gait ability.

Science.gov (United States)

Patterson, L; Staiger, E A; Brooks, S A

2015-04-01

The Mangalarga Marchador (MM) is a Brazilian horse breed known for a uniquely smooth gait. A recent publication described a mutation in the DMRT3 gene that the authors claim controls the ability to perform lateral patterned gaits (Andersson et al. 2012). We tested 81 MM samples for the DMRT3 mutation using extracted DNA from hair bulbs using a novel RFLP. Horses were phenotypically categorized by their gait type (batida or picada), as recorded by the Brazilian Mangalarga Marchador Breeders Association (ABCCMM). Statistical analysis using the plink toolset (Purcell, 2007) revealed significant association between gait type and the DMRT3 mutation (P = 2.3e-22). Deviation from Hardy-Weinberg equilibrium suggests that selective pressure for gait type is altering allele frequencies in this breed (P = 1.00e-5). These results indicate that this polymorphism may be useful for genotype-assisted selection for gait type within this breed. As both batida and picada MM horses can perform lateral gaits, the DMRT3 mutation is not the only locus responsible for the lateral gait pattern. © 2015 Stichting International Foundation for Animal Genetics.

A method to simulate motor control strategies to recover from perturbations: application to a stumble recovery during gait.

Science.gov (United States)

Forner-Cordero, Arturo; Ackermann, Marko; de Lima Freitas, Mateus

2011-01-01

Perturbations during human gait such as a trip or a slip can result in a fall, especially among frail populations such as the elderly. In order to recover from a trip or a stumble during gait, humans perform different types of recovery strategies. It is very useful to uncover the mechanisms of the recovery to improve training methods for populations at risk of falling. Moreover, human recovery strategies could be applied to implement controllers for bipedal robot walker, as an application of biomimetic design. A biomechanical model of the response to a trip during gait might uncover the control mechanisms underlying the different recovery strategies and the adaptation of the responses found during the execution of successive perturbation trials. This paper introduces a model of stumble in the multibody system framework. This model is used to assess different feedforward strategies to recover from a trip. First of all, normal gait patterns for the musculoskeletal system model are obtained by solving an optimal control problem. Secondly, the reference gait is perturbed by the application of forces on the swinging foot in different ways: as an instantaneous inelastic collision of the foot with an obstacle, as an impulsive horizontal force or using a force curve measured experimentally during gait perturbation experiments. The influence of the type of perturbation, the timing of the collision with respect to the gait cycle, as well as of the coefficient of restitution was investigated previously. Finally, in order to test the effects of different muscle excitation levels on the initial phases of the recovery response, several muscle excitations were added to selected muscles of the legs, thus providing a simulation of the recovery reactions. These results pave the way for future analysis and modeling of the control mechanisms of gait.

Does robot-assisted gait training ameliorate gait abnormalities in multiple sclerosis? A pilot randomized-control trial.

Science.gov (United States)

Straudi, S; Benedetti, M G; Venturini, E; Manca, M; Foti, C; Basaglia, N

2013-01-01

Gait disorders are common in multiple sclerosis (MS) and lead to a progressive reduction of function and quality of life. Test the effects of robot-assisted gait rehabilitation in MS subjects through a pilot randomized-controlled study. We enrolled MS subjects with Expanded Disability Status Scale scores within 4.5-6.5. The experimental group received 12 robot-assisted gait training sessions over 6 weeks. The control group received the same amount of conventional physiotherapy. Outcomes measures were both biomechanical assessment of gait, including kinematics and spatio-temporal parameters, and clinical test of walking endurance (six-minute walk test) and mobility (Up and Go Test). 16 subjects (n = 8 experimental group, n = 8 control group) were included in the final analysis. At baseline the two groups were similar in all variables, except for step length. Data showed walking endurance, as well as spatio-temporal gait parameters improvements after robot-assisted gait training. Pelvic antiversion and reduced hip extension during terminal stance ameliorated after aforementioned intervention. Robot-assisted gait training seems to be effective in increasing walking competency in MS subjects. Moreover, it could be helpful in restoring the kinematic of the hip and pelvis.

Effects of conventional overground gait training and a gait trainer with partial body weight support on spatiotemporal gait parameters of patients after stroke

OpenAIRE

Park, Byoung-Sun; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Noh, Ji-Woong; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Kim, Junghwan

2015-01-01

[Purpose] The purpose of this study was to confirm the effects of both conventional overground gait training (CGT) and a gait trainer with partial body weight support (GTBWS) on spatiotemporal gait parameters of patients with hemiparesis following chronic stroke. [Subjects and Methods] Thirty stroke patients were alternately assigned to one of two treatment groups, and both groups underwent CGT and GTBWS. [Results] The functional ambulation classification on the affected side improved signifi...

Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults.

Science.gov (United States)

Weijer, R H A; Hoozemans, M J M; van Dieën, J H; Pijnappels, M

2018-05-01

Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults. We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults. In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions. High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor. The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status. Copyright © 2018 Elsevier B.V. All rights reserved.

Quantitative Gait Measurement With Pulse-Doppler Radar for Passive In-Home Gait Assessment

OpenAIRE

Wang, Fang; Skubic, Marjorie; Rantz, Marilyn; Cuddihy, Paul E.

2014-01-01

In this paper, we propose a pulse-Doppler radar system for in-home gait assessment of older adults. A methodology has been developed to extract gait parameters including walking speed and step time using Doppler radar. The gait parameters have been validated with a Vicon motion capture system in the lab with 13 participants and 158 test runs. The study revealed that for an optimal step recognition and walking speed estimation, a dual radar set up with one radar placed at foot level and the ot...

Gait, mobility, and falls in older people

OpenAIRE

Gschwind, Yves Josef

2012-01-01

My doctoral thesis contributes to the understanding of gait, mobility, and falls in older people. All presented projects investigated the most prominent and sensitive markers for fall-related gait changes, that is gait velocity and gait variability. Based on the measurement of these spatio-temporal gait parameters, particularly when using a change-sensitive dual task paradigm, it is possible to make conclusions regarding walking, balance, activities of daily living, and falls in o...

Machine learning techniques for gait biometric recognition using the ground reaction force

CERN Document Server

Mason, James Eric; Woungang, Isaac

2016-01-01

This book focuses on how machine learning techniques can be used to analyze and make use of one particular category of behavioral biometrics known as the gait biometric. A comprehensive Ground Reaction Force (GRF)-based Gait Biometrics Recognition framework is proposed and validated by experiments. In addition, an in-depth analysis of existing recognition techniques that are best suited for performing footstep GRF-based person recognition is also proposed, as well as a comparison of feature extractors, normalizers, and classifiers configurations that were never directly compared with one another in any previous GRF recognition research. Finally, a detailed theoretical overview of many existing machine learning techniques is presented, leading to a proposal of two novel data processing techniques developed specifically for the purpose of gait biometric recognition using GRF. This book · introduces novel machine-learning-based temporal normalization techniques · bridges research gaps concerning the effect of ...

Wavelet-based characterization of gait signal for neurological abnormalities.

Science.gov (United States)

Baratin, E; Sugavaneswaran, L; Umapathy, K; Ioana, C; Krishnan, S

2015-02-01

Studies conducted by the World Health Organization (WHO) indicate that over one billion suffer from neurological disorders worldwide, and lack of efficient diagnosis procedures affects their therapeutic interventions. Characterizing certain pathologies of motor control for facilitating their diagnosis can be useful in quantitatively monitoring disease progression and efficient treatment planning. As a suitable directive, we introduce a wavelet-based scheme for effective characterization of gait associated with certain neurological disorders. In addition, since the data were recorded from a dynamic process, this work also investigates the need for gait signal re-sampling prior to identification of signal markers in the presence of pathologies. To benefit automated discrimination of gait data, certain characteristic features are extracted from the wavelet-transformed signals. The performance of the proposed approach was evaluated using a database consisting of 15 Parkinson's disease (PD), 20 Huntington's disease (HD), 13 Amyotrophic lateral sclerosis (ALS) and 16 healthy control subjects, and an average classification accuracy of 85% is achieved using an unbiased cross-validation strategy. The obtained results demonstrate the potential of the proposed methodology for computer-aided diagnosis and automatic characterization of certain neurological disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

Kinematic features of rear-foot motion using anterior and posterior ankle-foot orthoses in stroke patients with hemiplegic gait.

Science.gov (United States)

Chen, Chih-Chi; Hong, Wei-Hsien; Wang, Chin-Man; Chen, Chih-Kuang; Wu, Katie Pei-Hsuan; Kang, Chao-Fu; Tang, Simon F

2010-12-01

To evaluate the kinematic features of rear-foot motion during gait in hemiplegic stroke patients, using anterior ankle-foot orthoses (AFOs), posterior AFOs, and no orthotic assistance. Crossover design with randomization for the interventions. A rehabilitation center for adults with neurologic disorders. Patients with hemiplegia due to stroke (n=14) and able-bodied subjects (n=11). Subjects with hemiplegia were measured walking under 3 conditions with randomized sequences: (1) with an anterior AFO, (2) with a posterior AFO, and (3) without an AFO. Control subjects were measured walking without an AFO to provide a normative reference. Rear-foot kinematic change in the sagittal, coronal, and transverse planes. In the sagittal plane, compared with walking with an anterior AFO or without an AFO, the posterior AFO significantly decreased plantar flexion to neutral at initial heel contact (P=.001) and the swing phase (PRehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Advanced Prosthetic Gait Training Tool

Science.gov (United States)

2015-12-01

modules to train individuals to distinguish gait deviations (trunk motion and lower-limb motion). Each of these modules help trainers improve their...AWARD NUMBER: W81XWH-10-1-0870 TITLE: Advanced Prosthetic Gait Training Tool PRINCIPAL INVESTIGATOR: Dr. Karim Abdel-Malek CONTRACTING...study is to produce a computer-based Advanced Prosthetic Gait Training Tool to aid in the training of clinicians at military treatment facilities

History of cannabis use is associated with altered gait.

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Pearson-Dennett, Verity; Todd, Gabrielle; Wilcox, Robert A; Vogel, Adam P; White, Jason M; Thewlis, Dominic

2017-09-01

Despite evidence that cannabinoid receptors are located in movement-related brain regions (e.g., basal ganglia, cerebral cortex, and cerebellum), and that chronic cannabis use is associated with structural and functional brain changes, little is known about the long-term effect of cannabis use on human movement. The aim of the current study was to investigate balance and walking gait in adults with a history of cannabis use. We hypothesised that cannabis use is associated with subtle changes in gait and balance that are insufficient in magnitude for detection in a clinical setting. Cannabis users (n=22, 24±6years) and non-drug using controls (n=22, 25±8years) completed screening tests, a gait and balance test (with a motion capture system and in-built force platforms), and a clinical neurological examination of movement. Compared to controls, cannabis users exhibited significantly greater peak angular velocity of the knee (396±30 versus 426±50°/second, P=0.039), greater peak elbow flexion (53±12 versus 57±7°, P=0.038) and elbow range of motion (33±13 versus 36±10°, P=0.044), and reduced shoulder flexion (41±19 versus 26±16°, P=0.007) during walking gait. However, balance and neurological parameters did not significantly differ between the groups. The results suggest that history of cannabis use is associated with long-lasting changes in open-chain elements of walking gait, but the magnitude of change is not clinically detectable. Further research is required to investigate if the subtle gait changes observed in this population become more apparent with aging and increased cannabis use. Copyright © 2017 Elsevier B.V. All rights reserved.

Spatio-temporal gait disorder and gait fatigue index in a six-minute walk test in women with fibromyalgia.

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Heredia-Jimenez, Jose; Latorre-Roman, Pedro; Santos-Campos, Maria; Orantes-Gonzalez, Eva; Soto-Hermoso, Victor M

2016-03-01

Gait disorders in fibromyalgia patients affect several gait parameters and different muscle recruitment patterns. The aim of this study was to assess the gait differences observed during a six-minute walk test between fibromyalgia patients and healthy controls. Forty-eight women with fibromyalgia and 15 healthy women were evaluated. Fibromyalgia patients met the American College of Rheumatology criteria for fibromyalgia selected of an ambulatory care. Both patients and controls had a negative history of musculoskeletal disease, neurological disorders, and gait abnormalities. The 15 controls were healthy women matched to the patients in age, height and body weight. Spatio-temporal gait variables and the rate of perceived exertion during the six-minute walk test (all subjects) and Fibromyalgia Impact Questionnaire (fibromyalgia subjects) were evaluated. All walking sets on the GaitRITE were collected and the gait variables were selected at three stages during the six-minute walk test: two sets at the beginning, two sets at 3 min and two sets at the end of the test. In addition, the Fibromyalgia Impact Questionnaire was used for the fibromyalgia patients. Fibromyalgia patients showed a significant decrease in all spatio-temporal gait variables at each of the three stages and had a lower walk distance covered in the six-minute walk test and higher rate of perceived exertion. No correlations were found between the Fibromyalgia Impact Questionnaire and gait variables. The fibromyalgia and control subjects showed lower gait fatigue indices between the middle and last stages. Gait analysis during a six-minute walk test is a good tool to assess the fatigue and physical symptoms of patients with fibromyalgia. Copyright © 2016 Elsevier Ltd. All rights reserved.

Android Platform for Realtime Gait Tracking Using Inertial Measurement Units.

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Aqueveque, Pablo; Sobarzo, Sergio; Saavedra, Francisco; Maldonado, Claudio; Gómez, Britam

2016-06-13

One of the most important movements performed by the humans is gait. Biomechanical Gait analysis is usually by optical capture systems. However, such systems are expensive and sensitive to light and obstacles. In order to reduce those costs a system based on Inertial Measurements Units (IMU) is proposed. IMU are a good option to make movement analisys indoor with a low post-processing data, allowing to connect those systems to an Android platform. The design is based on two elements: a) The IMU sensors and the b) Android device. The IMU sensor is simple, small (35 x 35 mm), portable and autonomous (7.8 hrs). A resolution of 0.01° in their measurements is obtained, and sends data via Bluetooth link. The Android application works for Android 4.2 or higher, and it is compatible with Bluetooth devices 2.0 or higher. Three IMU sensors send data to a Tablet wirelessly, in order to evaluate the angles evolution for each joint of the leg (hip, knee and ankle). This information is used to calculate gait index and evaluate the gait quality online during the physical therapist is working with the patient.

Computational intelligence in gait research: a perspective on current applications and future challenges.

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Lai, Daniel T H; Begg, Rezaul K; Palaniswami, Marimuthu

2009-09-01

Our mobility is an important daily requirement so much so that any disruption to it severely degrades our perceived quality of life. Studies in gait and human movement sciences, therefore, play a significant role in maintaining the well-being of our mobility. Current gait analysis involves numerous interdependent gait parameters that are difficult to adequately interpret due to the large volume of recorded data and lengthy assessment times in gait laboratories. A proposed solution to these problems is computational intelligence (CI), which is an emerging paradigm in biomedical engineering most notably in pathology detection and prosthesis design. The integration of CI technology in gait systems facilitates studies in disorders caused by lower limb defects, cerebral disorders, and aging effects by learning data relationships through a combination of signal processing and machine learning techniques. Learning paradigms, such as supervised learning, unsupervised learning, and fuzzy and evolutionary algorithms, provide advanced modeling capabilities for biomechanical systems that in the past have relied heavily on statistical analysis. CI offers the ability to investigate nonlinear data relationships, enhance data interpretation, design more efficient diagnostic methods, and extrapolate model functionality. These are envisioned to result in more cost-effective, efficient, and easy-to-use systems, which would address global shortages in medical personnel and rising medical costs. This paper surveys current signal processing and CI methodologies followed by gait applications ranging from normal gait studies and disorder detection to artificial gait simulation. We review recent systems focusing on the existing challenges and issues involved in making them successful. We also examine new research in sensor technologies for gait that could be combined with these intelligent systems to develop more effective healthcare solutions.

Development of a novel virtual reality gait intervention.

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Boone, Anna E; Foreman, Matthew H; Engsberg, Jack R

2017-02-01

Improving gait speed and kinematics can be a time consuming and tiresome process. We hypothesize that incorporating virtual reality videogame play into variable improvement goals will improve levels of enjoyment and motivation and lead to improved gait performance. To develop a feasible, engaging, VR gait intervention for improving gait variables. Completing this investigation involved four steps: 1) identify gait variables that could be manipulated to improve gait speed and kinematics using the Microsoft Kinect and free software, 2) identify free internet videogames that could successfully manipulate the chosen gait variables, 3) experimentally evaluate the ability of the videogames and software to manipulate the gait variables, and 4) evaluate the enjoyment and motivation from a small sample of persons without disability. The Kinect sensor was able to detect stride length, cadence, and joint angles. FAAST software was able to identify predetermined gait variable thresholds and use the thresholds to play free online videogames. Videogames that involved continuous pressing of a keyboard key were found to be most appropriate for manipulating the gait variables. Five participants without disability evaluated the effectiveness for modifying the gait variables and enjoyment and motivation during play. Participants were able to modify gait variables to permit successful videogame play. Motivation and enjoyment were high. A clinically feasible and engaging virtual intervention for improving gait speed and kinematics has been developed and initially tested. It may provide an engaging avenue for achieving thousands of repetitions necessary for neural plastic changes and improved gait. Copyright © 2016 Elsevier B.V. All rights reserved.

Gait as a biomarker? Accelerometers reveal that reduced movement quality while walking is associated with Parkinson's disease, ageing and fall risk.

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Brodie, Matthew A; Lovell, Nigel H; Canning, Colleen G; Menz, Hylton B; Delbaere, Kim; Redmond, Stephen J; Latt, Mark; Sturnieks, Daina L; Menant, Jasmine; Smith, Stuart T; Lord, Stephen R

2014-01-01

Humans are living longer but morbidity has also increased; threatening to create a serious global burden. Our approach is to monitor gait for early warning signs of morbidity. Here we present highlights from a series of experiments into gait as a potential biomarker for Parkinson's disease (PD), ageing and fall risk. Using body-worn accelerometers, we developed several novel camera-less methods to analyze head and pelvis movements while walking. Signal processing algorithms were developed to extract gait parameters that represented the principal components of vigor, head jerk, lateral harmonic stability, and oscillation range. The new gait parameters were compared to accidental falls, mental state and co-morbidities. We observed: 1) People with PD had significantly larger and uncontrolled anterioposterior (AP) oscillations of the head; 2) Older people walked with more lateral head jerk; and, 3) the combination of vigorous and harmonically stable gait was demonstrated by non-fallers. Our findings agree with research from other groups; changes in human gait reflect changes to well-being. We observed; different aspects of gait reflected different functional outcomes. The new gait parameters therefore may be complementary to existing methods and may have potential as biomarkers for specific disorders. However, further research is required to validate our observations, and establish clinical utility.

Gait disorder rehabilitation using vision and non-vision based sensors: A systematic review

Directory of Open Access Journals (Sweden)

Asraf Ali

2012-08-01

Full Text Available Even though the amount of rehabilitation guidelines has never been greater, uncertainty continues to arise regarding the efficiency and effectiveness of the rehabilitation of gait disorders. This question has been hindered by the lack of information on accurate measurements of gait disorders. Thus, this article reviews the rehabilitation systems for gait disorder using vision and non-vision sensor technologies, as well as the combination of these. All papers published in the English language between 1990 and June, 2012 that had the phrases “gait disorder” “rehabilitation”, “vision sensor”, or “non vision sensor” in the title, abstract, or keywords were identified from the SpringerLink, ELSEVIER, PubMed, and IEEE databases. Some synonyms of these phrases and the logical words “and” “or” and “not” were also used in the article searching procedure. Out of the 91 published articles found, this review identified 84 articles that described the rehabilitation of gait disorders using different types of sensor technologies. This literature set presented strong evidence for the development of rehabilitation systems using a markerless vision-based sensor technology. We therefore believe that the information contained in this review paper will assist the progress of the development of rehabilitation systems for human gait disorders.

Gait Partitioning Methods: A Systematic Review

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Juri Taborri

2016-01-01

Full Text Available In the last years, gait phase partitioning has come to be a challenging research topic due to its impact on several applications related to gait technologies. A variety of sensors can be used to feed algorithms for gait phase partitioning, mainly classifiable as wearable or non-wearable. Among wearable sensors, footswitches or foot pressure insoles are generally considered as the gold standard; however, to overcome some inherent limitations of the former, inertial measurement units have become popular in recent decades. Valuable results have been achieved also though electromyography, electroneurography, and ultrasonic sensors. Non-wearable sensors, such as opto-electronic systems along with force platforms, remain the most accurate system to perform gait analysis in an indoor environment. In the present paper we identify, select, and categorize the available methodologies for gait phase detection, analyzing advantages and disadvantages of each solution. Finally, we comparatively examine the obtainable gait phase granularities, the usable computational methodologies and the optimal sensor placements on the targeted body segments.

Gait Partitioning Methods: A Systematic Review

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Taborri, Juri; Palermo, Eduardo; Rossi, Stefano; Cappa, Paolo

2016-01-01

In the last years, gait phase partitioning has come to be a challenging research topic due to its impact on several applications related to gait technologies. A variety of sensors can be used to feed algorithms for gait phase partitioning, mainly classifiable as wearable or non-wearable. Among wearable sensors, footswitches or foot pressure insoles are generally considered as the gold standard; however, to overcome some inherent limitations of the former, inertial measurement units have become popular in recent decades. Valuable results have been achieved also though electromyography, electroneurography, and ultrasonic sensors. Non-wearable sensors, such as opto-electronic systems along with force platforms, remain the most accurate system to perform gait analysis in an indoor environment. In the present paper we identify, select, and categorize the available methodologies for gait phase detection, analyzing advantages and disadvantages of each solution. Finally, we comparatively examine the obtainable gait phase granularities, the usable computational methodologies and the optimal sensor placements on the targeted body segments. PMID:26751449

Unstable gait due to spasticity of the rectus femoris: gait analysis and motor nerve block.

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Gross, R; Leboeuf, F; Rémy-Néris, O; Perrouin-Verbe, B

2012-12-01

We present the case of a 54 year-old man presenting with a right Brown-Séquard plus syndrome (BSPS) after a traumatic cervical spinal cord injury. After being operated on with selective tibial neurotomy and triceps surae lengthening because of a right spastic equinus foot, he developed a gait disorder at high speed. The patient complained about an instability of the right knee. Observational gait analysis exhibited an oscillating, flexion/extension motion of the right knee during stance, which was confirmed by gait analysis. Dynamic electromyographic recordings exhibited a clonus of the right rectus femoris (RF) during stance. The spastic activity of the RF and the abnormal knee motion totally reversed after a motor nerve block of the RF, as well as after botulinum toxin type A injection into the RF. We emphasize that complex, spastic gait disorders can benefit from a comprehensive assessment including gait analysis and nerve blocks. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Asymmetry of Anticipatory Postural Adjustment During Gait Initiation

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Hiraoka Koichi

2014-10-01

Full Text Available The purpose of this study was to investigate the asymmetry of anticipatory postural adjustment (APA during gait initiation and to determine whether the process of choosing the initial swing leg affects APA during gait initiation. The participants initiated gait with the leg indicated by a start tone or initiated gait with the leg spontaneously chosen. The dependent variables of APA were not significantly different among the condition of initiating gait with the preferred leg indicated by the start tone, the condition of initiating gait with the non-preferred leg indicated by the start tone, and the condition of initiating gait with the leg spontaneously chosen. These findings fail to support the view that the process of choosing the initial swing leg affects APA during gait initiation. The lateral displacement of the center of pressure in the period in which shifting the center of pressure to the initial swing phase before initiating gait with the left leg indicated by the external cue was significantly larger than that when initiating gait with the right leg indicated by the external cue, and significantly larger than that when initiating gait with the leg spontaneously chosen. Weight shift to the initial swing side during APA during gait initiation was found to be asymmetrical when choosing the leg in response to an external cue

Tic-induced gait dysfunction.

NARCIS (Netherlands)

Fasano, A.; Ruzicka, E.; Bloem, B.R.

2012-01-01

BACKGROUND: Many neurological disorders impair gait, but only a few of them are episodic or paroxysmal, the most important ones being freezing of gait and paroxysmal dyskinesias. METHODS: We describe 4 patients with tic disorders (3 with Tourette syndrome, and 1 with a tic disorder secondary to

Neuromorphic walking gait control.

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Still, Susanne; Hepp, Klaus; Douglas, Rodney J

2006-03-01

We present a neuromorphic pattern generator for controlling the walking gaits of four-legged robots which is inspired by central pattern generators found in the nervous system and which is implemented as a very large scale integrated (VLSI) chip. The chip contains oscillator circuits that mimic the output of motor neurons in a strongly simplified way. We show that four coupled oscillators can produce rhythmic patterns with phase relationships that are appropriate to generate all four-legged animal walking gaits. These phase relationships together with frequency and duty cycle of the oscillators determine the walking behavior of a robot driven by the chip, and they depend on a small set of stationary bias voltages. We give analytic expressions for these dependencies. This chip reduces the complex, dynamic inter-leg control problem associated with walking gait generation to the problem of setting a few stationary parameters. It provides a compact and low power solution for walking gait control in robots.

LOPES: Selective control of gait functions during the gait rehabilitation of CVA patients

NARCIS (Netherlands)

Ekkelenkamp, R.; Veneman, J.F.; van der Kooij, Herman

2005-01-01

LOPES aims for an active role of the patient by selective and partial support of gait functions during robotic treadmill training sessions. Virtual model control (VMC) was applied to the robot as an intuitive method for translating current treadmill gait rehabilitation therapy programs into robotic

Characteristics of the gait adaptation process due to split-belt treadmill walking under a wide range of right-left speed ratios in humans.

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Yokoyama, Hikaru; Sato, Koji; Ogawa, Tetsuya; Yamamoto, Shin-Ichiro; Nakazawa, Kimitaka; Kawashima, Noritaka

2018-01-01

The adaptability of human bipedal locomotion has been studied using split-belt treadmill walking. Most of previous studies utilized experimental protocol under remarkably different split ratios (e.g. 1:2, 1:3, or 1:4). While, there is limited research with regard to adaptive process under the small speed ratios. It is important to know the nature of adaptive process under ratio smaller than 1:2, because systematic evaluation of the gait adaptation under small to moderate split ratios would enable us to examine relative contribution of two forms of adaptation (reactive feedback and predictive feedforward control) on gait adaptation. We therefore examined a gait behavior due to on split-belt treadmill adaptation under five belt speed difference conditions (from 1:1.2 to 1:2). Gait parameters related to reactive control (stance time) showed quick adjustments immediately after imposing the split-belt walking in all five speed ratios. Meanwhile, parameters related to predictive control (step length and anterior force) showed a clear pattern of adaptation and subsequent aftereffects except for the 1:1.2 adaptation. Additionally, the 1:1.2 ratio was distinguished from other ratios by cluster analysis based on the relationship between the size of adaptation and the aftereffect. Our findings indicate that the reactive feedback control was involved in all the speed ratios tested and that the extent of reaction was proportionally dependent on the speed ratio of the split-belt. On the contrary, predictive feedforward control was necessary when the ratio of the split-belt was greater. These results enable us to consider how a given split-belt training condition would affect the relative contribution of the two strategies on gait adaptation, which must be considered when developing rehabilitation interventions for stroke patients.

Freezing of Gait Detection in Parkinson's Disease: A Subject-Independent Detector Using Anomaly Scores.

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Pham, Thuy T; Moore, Steven T; Lewis, Simon John Geoffrey; Nguyen, Diep N; Dutkiewicz, Eryk; Fuglevand, Andrew J; McEwan, Alistair L; Leong, Philip H W

2017-11-01

Freezing of gait (FoG) is common in Parkinsonian gait and strongly relates to falls. Current clinical FoG assessments are patients' self-report diaries and experts' manual video analysis. Both are subjective and yield moderate reliability. Existing detection algorithms have been predominantly designed in subject-dependent settings. In this paper, we aim to develop an automated FoG detector for subject independent. After extracting highly relevant features, we apply anomaly detection techniques to detect FoG events. Specifically, feature selection is performed using correlation and clusterability metrics. From a list of 244 feature candidates, 36 candidates were selected using saliency and robustness criteria. We develop an anomaly score detector with adaptive thresholding to identify FoG events. Then, using accuracy metrics, we reduce the feature list to seven candidates. Our novel multichannel freezing index was the most selective across all window sizes, achieving sensitivity (specificity) of (). On the other hand, freezing index from the vertical axis was the best choice for a single input, achieving sensitivity (specificity) of () for ankle and () for back sensors. Our subject-independent method is not only significantly more accurate than those previously reported, but also uses a much smaller window (e.g., versus ) and/or lower tolerance (e.g., versus ).Freezing of gait (FoG) is common in Parkinsonian gait and strongly relates to falls. Current clinical FoG assessments are patients' self-report diaries and experts' manual video analysis. Both are subjective and yield moderate reliability. Existing detection algorithms have been predominantly designed in subject-dependent settings. In this paper, we aim to develop an automated FoG detector for subject independent. After extracting highly relevant features, we apply anomaly detection techniques to detect FoG events. Specifically, feature selection is performed using correlation and clusterability metrics. From

The effect of virtual reality on gait variability.

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Katsavelis, Dimitrios; Mukherjee, Mukul; Decker, Leslie; Stergiou, Nicholas

2010-07-01

Optic Flow (OF) plays an important role in human locomotion and manipulation of OF characteristics can cause changes in locomotion patterns. The purpose of the study was to investigate the effect of the velocity of optic flow on the amount and structure of gait variability. Each subject underwent four conditions of treadmill walking at their self-selected pace. In three conditions the subjects walked in an endless virtual corridor, while a fourth control condition was also included. The three virtual conditions differed in the speed of the optic flow displayed as follows--same speed (OFn), faster (OFf), and slower (OFs) than that of the treadmill. Gait kinematics were tracked with an optical motion capture system. Gait variability measures of the hip, knee and ankle range of motion and stride interval were analyzed. Amount of variability was evaluated with linear measures of variability--coefficient of variation, while structure of variability i.e., its organization over time, were measured with nonlinear measures--approximate entropy and detrended fluctuation analysis. The linear measures of variability, CV, did not show significant differences between Non-VR and VR conditions while nonlinear measures of variability identified significant differences at the hip, ankle, and in stride interval. In response to manipulation of the optic flow, significant differences were observed between the three virtual conditions in the following order: OFn greater than OFf greater than OFs. Measures of structure of variability are more sensitive to changes in gait due to manipulation of visual cues, whereas measures of the amount of variability may be concealed by adaptive mechanisms. Visual cues increase the complexity of gait variability and may increase the degrees of freedom available to the subject. Further exploration of the effects of optic flow manipulation on locomotion may provide us with an effective tool for rehabilitation of subjects with sensorimotor issues.

An accelerometry-based comparison of 2 robotic assistive devices for treadmill training of gait.

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Regnaux, Jean-Philippe; Saremi, Kaveh; Marehbian, Jon; Bussel, Bernard; Dobkin, Bruce H

2008-01-01

Two commercial robotic devices, the Gait Trainer (GT) and the Lokomat (LOKO), assist task-oriented practice of walking. The gait patterns induced by these motor-driven devices have not been characterized and compared. A healthy participant chose the most comfortable gait pattern on each device and for treadmill (TM) walking at 1, 2 (maximum for the GT), and 3 km/h and over ground at similar speeds. A system of accelerometers on the thighs and feet allowed the calculation of spatiotemporal features and accelerations during the gait cycle. At the 1 and 2 km/h speed settings, single-limb stance times were prolonged on the devices compared with overground walking. Differences on the LOKO were decreased by adjusting the hip and knee angles and step length. At the 3 km/h setting, the LOKO approximated the participant's overground parameters. Irregular accelerations and decelerations from toe-off to heel contact were induced by the devices, especially at slower speeds. The LOKO and GT impose mechanical constraints that may alter leg accelerations-decelerations during stance and swing phases, as well as stance duration, especially at their slower speed settings, that are not found during TM and overground walking. The potential impact of these perturbations on training to improve gait needs further study.

Robot-Crawler: Statically Balanced Gaits

Directory of Open Access Journals (Sweden)

S. Parasuraman

2012-12-01

Full Text Available This paper presents a new statically balanced walking technique for a robot-crawler. The gait design and the control of the robot crawler aim to achieve stability while walking. This statically balanced gait has to be designed in a different fashion to a wheeled robot, as there are discrete changes in the support of the robot when its legs are lifted or placed on the ground. The stability of the robot depends on how the legs are positioned relative to the body and also on the sequence and timing with which the legs are lifted and placed. In order to reduce the risk of stability loss while walking, a measure for the robot stability (so-called stability margin is typically used in the gait and motion planning. In this paper different biological behaviours of four-legged animals are studied and mapped on a quad-legrobot-crawler. Experiments were carried out on the forward walking gaits of lizards and horses. Based on these results, the stability margins of different gaits are discussed and compared.

Crouch gait patterns defined using k-means cluster analysis are related to underlying clinical pathology.

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Rozumalski, Adam; Schwartz, Michael H

2009-08-01

In this study a gait classification method was developed and applied to subjects with Cerebral palsy who walk with excessive knee flexion at initial contact. Sagittal plane gait data, simplified using the gait features method, is used as input into a k-means cluster analysis to determine homogeneous groups. Several clinical domains were explored to determine if the clusters are related to underlying pathology. These domains included age, joint range-of-motion, strength, selective motor control, and spasticity. Principal component analysis is used to determine one overall score for each of the multi-joint domains (strength, selective motor control, and spasticity). The current study shows that there are five clusters among children with excessive knee flexion at initial contact. These clusters were labeled, in order of increasing gait pathology: (1) mild crouch with mild equinus, (2) moderate crouch, (3) moderate crouch with anterior pelvic tilt, (4) moderate crouch with equinus, and (5) severe crouch. Further analysis showed that age, range-of-motion, strength, selective motor control, and spasticity were significantly different between the clusters (p<0.001). The general tendency was for the clinical domains to worsen as gait pathology increased. This new classification tool can be used to define homogeneous groups of subjects in crouch gait, which can help guide treatment decisions and outcomes assessment.

Memory of Gender and Gait Direction from Biological Motion: Gender Fades Away but Directions Stay

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Poom, Leo

2012-01-01

The delayed discrimination methodology has been used to demonstrate a high-fidelity nondecaying visual short-term memory (VSTM) for so-called preattentive basic features. In the current Study, I show that the nondecaying high VSTM precision is not restricted to basic features by using the same method to measure memory precision for gait direction…

First signs of elderly gait for women.

Science.gov (United States)

Kaczmarczyk, Katarzyna; Wiszomirska, Ida; Błażkiewicz, Michalina; Wychowański, Michał; Wit, Andrzej

2017-06-27

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 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. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Accuracy and reliability of observational gait analysis data: judgments of push-off in gait after stroke.

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McGinley, Jennifer L; Goldie, Patricia A; Greenwood, Kenneth M; Olney, Sandra J

2003-02-01

Physical therapists routinely observe gait in clinical practice. The purpose of this study was to determine the accuracy and reliability of observational assessments of push-off in gait after stroke. Eighteen physical therapists and 11 subjects with hemiplegia following a stroke participated in the study. Measurements of ankle power generation were obtained from subjects following stroke using a gait analysis system. Concurrent videotaped gait performances were observed by the physical therapists on 2 occasions. Ankle power generation at push-off was scored as either normal or abnormal using two 11-point rating scales. These observational ratings were correlated with the measurements of peak ankle power generation. A high correlation was obtained between the observational ratings and the measurements of ankle power generation (mean Pearson r=.84). Interobserver reliability was moderately high (mean intraclass correlation coefficient [ICC (2,1)]=.76). Intraobserver reliability also was high, with a mean ICC (2,1) of.89 obtained. Physical therapists were able to make accurate and reliable judgments of push-off in videotaped gait of subjects following stroke using observational assessment. Further research is indicated to explore the accuracy and reliability of data obtained with observational gait analysis as it occurs in clinical practice.

Dynamic optimization of a biped model: Energetic walking gaits with different mechanical and gait parameters

Directory of Open Access Journals (Sweden)

Kang An

2015-05-01

Full Text Available Energy consumption is one of the problems for bipedal robots walking. For the purpose of studying the parameter effects on the design of energetic walking bipeds with strong adaptability, we use a dynamic optimization method on our new walking model to first investigate the effects of the mechanical parameters, including mass and length distribution, on the walking efficiency. Then, we study the energetic walking gait features with the combinations of walking speed and step length. Our walking model is designed upon Srinivasan’s model. Dynamic optimization is used for a free search with minimal constraints. The results show that the cost of transport of a certain gait increases with the increase in the mass and length distribution parameters, except for that the cost of transport decreases with big length distribution parameter and long step length. We can also find a corresponding range of walking speed and step length, in which the variation in one of the two parameters has no obvious effect on the cost of transport. With fixed mechanical parameters, the cost of transport increases with the increase in the walking speed. There is a speed–step length relationship for walking with minimal cost of transport. The hip torque output strategy is adjusted in two situations to meet the walking requirements.

Exoskeleton-assisted gait training to improve gait in individuals with spinal cord injury: a pilot randomized study.

Science.gov (United States)

Chang, Shuo-Hsiu; Afzal, Taimoor; Berliner, Jeffrey; Francisco, Gerard E

2018-01-01

Robotic wearable exoskeletons have been utilized as a gait training device in persons with spinal cord injury. This pilot study investigated the feasibility of offering exoskeleton-assisted gait training (EGT) on gait in individuals with incomplete spinal cord injury (iSCI) in preparation for a phase III RCT. The objective was to assess treatment reliability and potential efficacy of EGT and conventional physical therapy (CPT). Forty-four individuals were screened, and 13 were eligible to participate in the study. Nine participants consented and were randomly assigned to receive either EGT or CPT with focus on gait. Subjects received EGT or CPT, five sessions a week (1 h/session daily) for 3 weeks. American Spinal Injury Association (ASIA) Lower Extremity Motor Score (LEMS), 10-Meter Walk Test (10MWT), 6-Minute Walk Test (6MWT), Timed Up and Go (TUG) test, and gait characteristics including stride and step length, cadence and stance, and swing phase durations were assessed at the pre- and immediate post- training. Mean difference estimates with 95% confidence intervals were used to analyze the differences. After training, improvement was observed in the 6MWT for the EGT group. The CPT group showed significant improvement in the TUG test. Both the EGT and the CPT groups showed significant increase in the right step length. EGT group also showed improvement in the stride length. EGT could be applied to individuals with iSCI to facilitate gait recovery. The subjects were able to tolerate the treatment; however, exoskeleton size range may be a limiting factor in recruiting larger cohort of patients. Future studies with larger sample size are needed to investigate the effectiveness and efficacy of exoskeleton-assisted gait training as single gait training and combined with other gait training strategies. Clinicaltrials.org, NCT03011099, retrospectively registered on January 3, 2017.

Fixating the pelvis in the horizontal plane affects gait characteristics

NARCIS (Netherlands)

Veneman, J.F.; Menger, Jasper; van Asseldonk, Edwin H.F.; van der Helm, F.C.T.; van der Kooij, Herman

2008-01-01

In assistive devices for neuro-rehabilitation, natural human motions are partly restricted by the device. This may affect the normality of walking during training. This research determines effects on gait of fixating the pelvis translations in the horizontal plane during treadmill walking. Direct

Gait analysis in hip viscosupplementation for osteoarthritis: a case report

Directory of Open Access Journals (Sweden)

L. Di Lorenzo

2013-10-01

Full Text Available Hip is a site very commonly affected by osteoarthritis and the intra-articular administration of hyaluronic acid in the management of osteoarthritic pain is increasingly used. However, the debate about its usefulness is still ongoing, as not all results of clinical trials confirm its effectiveness. In order to achieve the best outcome, clinical assessment and treatment choices should be based on subjective outcome, pathological and mechanical findings that should be integrated with qualitative analysis of human movement. After viscosupplementation, clinical trials often evaluate as endpoint subjective outcomes (i.e. pain visual analogic scale and static imaging such as radiographs and magnetic resonance imaging. In our clinical practice we use gait analysis as part of rehabilitation protocol to measure performance, enhancement and changes of several biomechanical factors. Taking advantage of available resources (BTS Bioengineering gait analysis Elite System we studied a patient’s gait after ultrasound guided hip injections for viscosupplementation. He showed an early clinical and biomechanical improvement during walking after a single intra articular injection of hyaluronic acid. Gait analysis parameters obtained suggest that the pre-treatment slower speed may be caused by antalgic walking patterns, the need for pain control and muscle weakness. After hip viscosupplementation, the joint displayed different temporal, kinetic and kinematic parameters associated with improved pain patterns.

["Jaques-Dalcroze eurhythmics" improves gait and prevents falls in the elderly].

Science.gov (United States)

Trombetti, Andrea; Hars, Mélany; Herrmann, François; Kressig, Reto; Ferrari, Serge; Rizzoli, René

2011-06-15

Given the significant health and socioeconomic consequences of falls, to develop and promote effective falls prevention strategies among older adults represents a major issue. Jaques-Dalcroze eurhythmics is a music education program through movement method developed in Geneva, Switzerland, in the early 20th century. This new exercise form, adapted for elderly people, features various multitask exercises performed to the rhythm of improvised piano music and mainly challenge gait and balance, but also memory, attention and coordination. We report here the results of a randomized controlled trial conducted in Geneva showing that Jaques-Dalcroze eurythmics practice can improve gait performance under single and dual-task conditions, and balance, as well as reduce both rate of falls and the risk of falling in at-risk elderly community-dwellers.

Inertial Sensor-Based Gait Recognition: A Review

Science.gov (United States)

Sprager, Sebastijan; Juric, Matjaz B.

2015-01-01

With the recent development of microelectromechanical systems (MEMS), inertial sensors have become widely used in the research of wearable gait analysis due to several factors, such as being easy-to-use and low-cost. Considering the fact that each individual has a unique way of walking, inertial sensors can be applied to the problem of gait recognition where assessed gait can be interpreted as a biometric trait. Thus, inertial sensor-based gait recognition has a great potential to play an important role in many security-related applications. Since inertial sensors are included in smart devices that are nowadays present at every step, inertial sensor-based gait recognition has become very attractive and emerging field of research that has provided many interesting discoveries recently. This paper provides a thorough and systematic review of current state-of-the-art in this field of research. Review procedure has revealed that the latest advanced inertial sensor-based gait recognition approaches are able to sufficiently recognise the users when relying on inertial data obtained during gait by single commercially available smart device in controlled circumstances, including fixed placement and small variations in gait. Furthermore, these approaches have also revealed considerable breakthrough by realistic use in uncontrolled circumstances, showing great potential for their further development and wide applicability. PMID:26340634

Exercises to Improve Gait Abnormalities

Science.gov (United States)

... Articles Directories Videos Resources Contact Exercises to Improve Gait Abnormalities Home » Article Categories » Exercise and Fitness Font Size: A A A A Exercises to Improve Gait Abnormalities Next Page The manner of how a ...

Asymmetry of Anticipatory Postural Adjustment During Gait Initiation

OpenAIRE

Hiraoka, Koichi; Hatanaka, Ryota; Nikaido, Yasutaka; Jono, Yasutomo; Nomura, Yoshifumi; Tani, Keisuke; Chujo, Yuta

2014-01-01

The purpose of this study was to investigate the asymmetry of anticipatory postural adjustment (APA) during gait initiation and to determine whether the process of choosing the initial swing leg affects APA during gait initiation. The participants initiated gait with the leg indicated by a start tone or initiated gait with the leg spontaneously chosen. The dependent variables of APA were not significantly different among the condition of initiating gait with the preferred leg indicated by the...

Effect of Cue Timing and Modality on Gait Initiation in Parkinson Disease With Freezing of Gait.

Science.gov (United States)

Lu, Chiahao; Amundsen Huffmaster, Sommer L; Tuite, Paul J; Vachon, Jacqueline M; MacKinnon, Colum D

2017-07-01

To examine the effects of cue timing, across 3 sensory modalities, on anticipatory postural adjustments (APAs) during gait initiation in people with Parkinson disease (PD). Observational study. Biomechanics research laboratory. Individuals with idiopathic PD (N=25; 11 with freezing of gait [FOG]) were studied in the off-medication state (12-h overnight withdrawal). Gait initiation was tested without cueing (self-initiated) and with 3 cue timing protocols: fixed delay (3s), random delay (4-12s), and countdown (3-2-1-go, 1-s intervals) across 3 sensory modalities (acoustic, visual, and vibrotactile). The incidence and spatiotemporal characteristics of APAs during gait initiation were analyzed, including vertical ground reaction forces and center of pressure. All cue timings and modalities increased the incidence and amplitude of APAs compared with self-initiated stepping. Acoustic and visual cues, but not vibrotactile stimulation, improved the timing of APAs. Fixed delay or countdown timing protocols were more effective at decreasing APA durations than random delay cues. Cue-evoked improvements in APA timing, but not amplitude, correlated with the level of impairment during self-initiated gait. Cues did not improve the late push-off phase in the FOG group. External cueing improves gait initiation in PD regardless of cue timing, modality, or clinical phenotype (with and without FOG). Acoustic or visual cueing with predictive timing provided the greatest improvements in gait initiation; therefore, these protocols may provide the best outcomes when applied by caregivers or devices. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Gait pattern of severely disabled hemiparetic subjects on a new controlled gait trainer as compared to assisted treadmill walking with partial body weight support.

Science.gov (United States)

Hesse, S; Uhlenbrock, D; Sarkodie-Gyan, T

1999-10-01

To investigate to what extent and with how much therapeutic effort nonambulatory stroke patients could train a gait-like movement on a newly developed, machine-supported gait trainer. Open study comparing the movement on the gait trainer with assisted walking on the treadmill. Motion analysis laboratory of a rehabilitation centre. Fourteen chronic, nonambulatory hemiparetic patients. Complex gait analysis while training on the gait trainer and while walking on the treadmill. Gait kinematics, kinesiological EMG of several lower limb muscles and the required assistance. Patients could train a gait-like movement on the gait trainer, characterized kinematically by a perfect symmetry, larger hip extension during stance, less knee flexion and less ankle plantar flexion during swing as compared to treadmill walking (p gait trainer (p gait trainer offered severely disabled hemiparetic subjects the possibility of training a gait-like, highly symmetrical movement with a favourable facilitation of relevant anti-gravity muscles. At the same time, the effort required of the therapists was reduced.

Development of an advanced mechanised gait trainer, controlling movement of the centre of mass, for restoring gait in non-ambulant subjects.

Science.gov (United States)

Hesse, S; Sarkodie-Gyan, T; Uhlenbrock, D

1999-01-01

The study aimed at further development of a mechanised gait trainer which would allow non-ambulant people to practice a gait-like motion repeatedly. To simulate normal gait, discrete stance and swing phases, lasting 60% and 40% of the gait cycle respectively, and the control of the movement of the centre of mass were required. A complex gear system provided the gait-like movement of two foot plates with a ratio of 60% to 40% between the stance and swing phases. A controlled propulsion system adjusted its output according to patient's efforts. Two eccenters on the central gear controlled phase-adjusted the vertical and horizontal position of the centre of mass. The patterns of sagittal lower limb joint kinematics and of muscle activation of a normal subject were similar when using the mechanised trainer and when walking on a treadmill. A non-ambulatory hemiparetic subject required little help from one therapist on the gait trainer, while two therapists supported treadmill walking. Gait movements on the trainer were highly symmetrical, impact-free, and less spastic. The weight-bearing muscles were activated in a similar fashion during both conditions. The vertical displacement of the centre of mass was bi-instead of mono-phasic during each gait cycle on the new device. In conclusion, the gait trainer allowed wheelchair-bound subjects the repetitive practice of a gait-like movement without overstraining therapists.

Appearance-based human gesture recognition using multimodal features for human computer interaction

Science.gov (United States)

Luo, Dan; Gao, Hua; Ekenel, Hazim Kemal; Ohya, Jun

2011-03-01

The use of gesture as a natural interface plays an utmost important role for achieving intelligent Human Computer Interaction (HCI). Human gestures include different components of visual actions such as motion of hands, facial expression, and torso, to convey meaning. So far, in the field of gesture recognition, most previous works have focused on the manual component of gestures. In this paper, we present an appearance-based multimodal gesture recognition framework, which combines the different groups of features such as facial expression features and hand motion features which are extracted from image frames captured by a single web camera. We refer 12 classes of human gestures with facial expression including neutral, negative and positive meanings from American Sign Languages (ASL). We combine the features in two levels by employing two fusion strategies. At the feature level, an early feature combination can be performed by concatenating and weighting different feature groups, and LDA is used to choose the most discriminative elements by projecting the feature on a discriminative expression space. The second strategy is applied on decision level. Weighted decisions from single modalities are fused in a later stage. A condensation-based algorithm is adopted for classification. We collected a data set with three to seven recording sessions and conducted experiments with the combination techniques. Experimental results showed that facial analysis improve hand gesture recognition, decision level fusion performs better than feature level fusion.

Structure design of lower limb exoskeletons for gait training

Science.gov (United States)

Li, Jianfeng; Zhang, Ziqiang; Tao, Chunjing; Ji, Run

2015-09-01

Due to the close physical interaction between human and machine in process of gait training, lower limb exoskeletons should be safe, comfortable and able to smoothly transfer desired driving force/moments to the patients. Correlatively, in kinematics the exoskeletons are required to be compatible with human lower limbs and thereby to avoid the uncontrollable interactional loads at the human-machine interfaces. Such requirement makes the structure design of exoskeletons very difficult because the human-machine closed chains are complicated. In addition, both the axis misalignments and the kinematic character difference between the exoskeleton and human joints should be taken into account. By analyzing the DOF(degree of freedom) of the whole human-machine closed chain, the human-machine kinematic incompatibility of lower limb exoskeletons is studied. An effective method for the structure design of lower limb exoskeletons, which are kinematically compatible with human lower limb, is proposed. Applying this method, the structure synthesis of the lower limb exoskeletons containing only one-DOF revolute and prismatic joints is investigated; the feasible basic structures of exoskeletons are developed and classified into three different categories. With the consideration of quasi-anthropopathic feature, structural simplicity and wearable comfort of lower limb exoskeletons, a joint replacement and structure comparison based approach to select the ideal structures of lower limb exoskeletons is proposed, by which three optimal exoskeleton structures are obtained. This paper indicates that the human-machine closed chain formed by the exoskeleton and human lower limb should be an even-constrained kinematic system in order to avoid the uncontrollable human-machine interactional loads. The presented method for the structure design of lower limb exoskeletons is universal and simple, and hence can be applied to other kinds of wearable exoskeletons.

Predictive Simulations of Neuromuscular Coordination and Joint-Contact Loading in Human Gait.

Science.gov (United States)

Lin, Yi-Chung; Walter, Jonathan P; Pandy, Marcus G

2018-04-18

We implemented direct collocation on a full-body neuromusculoskeletal model to calculate muscle forces, ground reaction forces and knee contact loading simultaneously for one cycle of human gait. A data-tracking collocation problem was solved for walking at the normal speed to establish the practicality of incorporating a 3D model of articular contact and a model of foot-ground interaction explicitly in a dynamic optimization simulation. The data-tracking solution then was used as an initial guess to solve predictive collocation problems, where novel patterns of movement were generated for walking at slow and fast speeds, independent of experimental data. The data-tracking solutions accurately reproduced joint motion, ground forces and knee contact loads measured for two total knee arthroplasty patients walking at their preferred speeds. RMS errors in joint kinematics were joint kinematics, ground forces, knee contact loads and muscle activation patterns measured for slow and fast walking. The results demonstrate the feasibility of performing computationally-efficient, predictive, dynamic optimization simulations of movement using full-body, muscle-actuated models with realistic representations of joint function.

Flexible Piezoelectric Sensor-Based Gait Recognition

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Youngsu Cha

2018-02-01

Full Text Available Most motion recognition research has required tight-fitting suits for precise sensing. However, tight-suit systems have difficulty adapting to real applications, because people normally wear loose clothes. In this paper, we propose a gait recognition system with flexible piezoelectric sensors in loose clothing. The gait recognition system does not directly sense lower-body angles. It does, however, detect the transition between standing and walking. Specifically, we use the signals from the flexible sensors attached to the knee and hip parts on loose pants. We detect the periodic motion component using the discrete time Fourier series from the signal during walking. We adapt the gait detection method to a real-time patient motion and posture monitoring system. In the monitoring system, the gait recognition operates well. Finally, we test the gait recognition system with 10 subjects, for which the proposed system successfully detects walking with a success rate over 93 %.

Measurement instruments to assess posture, gait, and balance in Parkinson's disease: Critique and recommendations

NARCIS (Netherlands)

Bloem, B.R.; Marinus, J.; Almeida, Q.; Dibble, L.; Nieuwboer, A.; Post, B.; Ruzicka, E.; Goetz, C.; Stebbins, G.; Martinez-Martin, P.; Schrag, A.

2016-01-01

BACKGROUND: Disorders of posture, gait, and balance in Parkinson's disease (PD) are common and debilitating. This MDS-commissioned task force assessed clinimetric properties of existing rating scales, questionnaires, and timed tests that assess these features in PD. METHODS: A literature review was

Detecting gait abnormalities after concussion or mild traumatic brain injury: A systematic review of single-task, dual-task, and complex gait.

Science.gov (United States)

Fino, Peter C; Parrington, Lucy; Pitt, Will; Martini, Douglas N; Chesnutt, James C; Chou, Li-Shan; King, Laurie A

2018-05-01

While a growing number of studies have investigated the effects of concussion or mild traumatic brain injury (mTBI) on gait, many studies use different experimental paradigms and outcome measures. The path for translating experimental studies for objective clinical assessments of gait is unclear. This review asked 2 questions: 1) is gait abnormal after concussion/mTBI, and 2) what gait paradigms (single-task, dual-task, complex gait) detect abnormalities after concussion. Data sources included MEDLINE/PubMed, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) accessed on March 14, 2017. Original research articles reporting gait outcomes in people with concussion or mTBI were included. Studies of moderate, severe, or unspecified TBI, and studies without a comparator were excluded. After screening 233 articles, 38 studies were included and assigned to one or more sections based on the protocol and reported outcomes. Twenty-six articles reported single-task simple gait outcomes, 24 reported dual-task simple gait outcomes, 21 reported single-task complex gait outcomes, and 10 reported dual-task complex gait outcomes. Overall, this review provides evidence for two conclusions: 1) gait is abnormal acutely after concussion/mTBI but generally resolves over time; and 2) the inconsistency of findings, small sample sizes, and small number of studies examining homogenous measures at the same time-period post-concussion highlight the need for replication across independent populations and investigators. Future research should concentrate on dual-task and complex gait tasks, as they showed promise for detecting abnormal locomotor function outside of the acute timeframe. Additionally, studies should provide detailed demographic and clinical characteristics to enable more refined comparisons across studies. Copyright © 2018 Elsevier B.V. All rights reserved.

Gait analysis in forensic medicine

DEFF Research Database (Denmark)

Larsen, Peter K; Simonsen, Erik B; Lynnerup, Niels

2008-01-01

Recordings from video surveillance systems are used as evidence from crime scenes. It would be useful to perform comparisons between disguised perpetrators and suspects based on their gait. We applied functional anatomical and biomechanical knowledge to analyze the gait of perpetrators, as record...

Muscle Coordination and Locomotion in Humans.

Science.gov (United States)

Sylos-Labini, Francesca; Zago, Myrka; Guertin, Pierre A; Lacquaniti, Francesco; Ivanenko, Yury P

2017-01-01

Locomotion is a semi-automatic daily task. Several studies show that muscle activity is fairly stereotyped during normal walking. Nevertheless, each human leg contains over 50 muscles and locomotion requires flexibility in order to adapt to different conditions as, for instance, different speeds, gaits, turning, obstacle avoidance, altered gravity levels, etc. Therefore, locomotor control has to deal with a certain level of flexibility and non-linearity. In this review, we describe and discuss different findings dealing with both simplicity and variability of the muscular control, as well as with its maturation during development. Despite complexity and redundancy, muscle activity patterns and spatiotemporal maps of spinal motoneuron output during human locomotion show both stereotypical features as well as functional re-organization. Flexibility and different solutions to adjust motor patterns should be considered when considering new rehabilitation strategies to treat disorders involving deficits in gait. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Predictors of Gait Speeds and the Relationship of Gait Speeds to Falls in Men and Women with Parkinson Disease

Directory of Open Access Journals (Sweden)

Samuel T. Nemanich

2013-01-01

Full Text Available Gait difficulties and falls are commonly reported in people with Parkinson disease (PD. Reduction in gait speed is a major characteristic of Parkinsonian gait, yet little is known about its underlying determinants, its ability to reflect an internal reservation about walking, or its relationship to falls. To study these issues, we selected age, disease severity, and nonmotor factors (i.e., depression, quality of life, balance confidence, and exercise beliefs and attitudes to predict self-selected (SELF, fast-as-possible (FAST, and the difference (DIFF between these walking speeds in 78 individuals with PD. We also examined gender differences in gait speeds and evaluated how gait speeds were related to a retrospective fall report. Age, disease severity, and balance confidence were strong predictors of SELF, FAST, and, to a lesser extent, DIFF. All three parameters were strongly associated with falling. DIFF was significantly greater in men compared to women and was significantly associated with male but not female fallers. The results supported the clinical utility of using a suite of gait speed parameters to provide insight into the gait difficulties and differentiating between fallers in people with PD.

Gait, posture and cognition in Parkinson's disease

Directory of Open Access Journals (Sweden)

Alessandra Ferreira Barbosa

Full Text Available ABSTRACT Gait disorders and postural instability are the leading causes of falls and disability in Parkinson's disease (PD. Cognition plays an important role in postural control and may interfere with gait and posture assessment and treatment. It is important to recognize gait, posture and balance dysfunctions by choosing proper assessment tools for PD. Patients at higher risk of falling must be referred for rehabilitation as early as possible, because antiparkinsonian drugs and surgery do not improve gait and posture in PD.

Gait Disorders In Patients After Polytrauma

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Jakušonoka Ruta

2015-04-01

Full Text Available Evaluation of the gait of patients after polytrauma is important, as it indicates the ability of patients to the previous activities and work. The aim of our study was to evaluate the gait of patients with lower limb injuries in the medium-term after polytrauma. Three-dimensional instrumental gait analysis was performed in 26 polytrauma patients (16 women and 10 men; mean age 38.6 years, 14 to 41 months after the trauma. Spatio-temporal parameters, motions in pelvis and lower extremities joints in sagittal plane and vertical load ground reaction force were analysed. Gait parameters in polytrauma patients were compared with a healthy control group. Polytrauma patients in the injured side had decreased step length, cadence, hip extension, maximum knee flexion, vertical load ground reaction force, and increased stance time and pelvic anterior tilt; in the uninjured side they had decreased step length, cadence, maximum knee flexion, vertical load ground reaction force and increased stance time (p < 0.05. The use of the three-dimensional instrumental gait analysis in the evaluation of polytrauma patients with lower limb injuries consequences makes it possible to identify the gait disorders not only in the injured, but also in the uninjured side.

A non linear analysis of human gait time series based on multifractal analysis and cross correlations

International Nuclear Information System (INIS)

Munoz-Diosdado, A

2005-01-01

We analyzed databases with gait time series of adults and persons with Parkinson, Huntington and amyotrophic lateral sclerosis (ALS) diseases. We obtained the staircase graphs of accumulated events that can be bounded by a straight line whose slope can be used to distinguish between gait time series from healthy and ill persons. The global Hurst exponent of these series do not show tendencies, we intend that this is because some gait time series have monofractal behavior and others have multifractal behavior so they cannot be characterized with a single Hurst exponent. We calculated the multifractal spectra, obtained the spectra width and found that the spectra of the healthy young persons are almost monofractal. The spectra of ill persons are wider than the spectra of healthy persons. In opposition to the interbeat time series where the pathology implies loss of multifractality, in the gait time series the multifractal behavior emerges with the pathology. Data were collected from healthy and ill subjects as they walked in a roughly circular path and they have sensors in both feet, so we have one time series for the left foot and other for the right foot. First, we analyzed these time series separately, and then we compared both results, with direct comparison and with a cross correlation analysis. We tried to find differences in both time series that can be used as indicators of equilibrium problems

A non linear analysis of human gait time series based on multifractal analysis and cross correlations

Energy Technology Data Exchange (ETDEWEB)

Munoz-Diosdado, A [Department of Mathematics, Unidad Profesional Interdisciplinaria de Biotecnologia, Instituto Politecnico Nacional, Av. Acueducto s/n, 07340, Mexico City (Mexico)

2005-01-01

We analyzed databases with gait time series of adults and persons with Parkinson, Huntington and amyotrophic lateral sclerosis (ALS) diseases. We obtained the staircase graphs of accumulated events that can be bounded by a straight line whose slope can be used to distinguish between gait time series from healthy and ill persons. The global Hurst exponent of these series do not show tendencies, we intend that this is because some gait time series have monofractal behavior and others have multifractal behavior so they cannot be characterized with a single Hurst exponent. We calculated the multifractal spectra, obtained the spectra width and found that the spectra of the healthy young persons are almost monofractal. The spectra of ill persons are wider than the spectra of healthy persons. In opposition to the interbeat time series where the pathology implies loss of multifractality, in the gait time series the multifractal behavior emerges with the pathology. Data were collected from healthy and ill subjects as they walked in a roughly circular path and they have sensors in both feet, so we have one time series for the left foot and other for the right foot. First, we analyzed these time series separately, and then we compared both results, with direct comparison and with a cross correlation analysis. We tried to find differences in both time series that can be used as indicators of equilibrium problems.

Plantar Pressure During Gait in Pregnant Women.

Science.gov (United States)

Bertuit, Jeanne; Leyh, Clara; Rooze, Marcel; Feipel, Véronique

2016-11-01

During pregnancy, physical and hormonal modifications occur. Morphologic alterations of the feet are found. These observations can induce alterations in plantar pressure. This study sought to investigate plantar pressures during gait in the last 4 months of pregnancy and in the postpartum period. A comparison with nulliparous women was conducted to investigate plantar pressure modifications during pregnancy. Fifty-eight women in the last 4 months of pregnancy, nine postpartum women, and 23 healthy nonpregnant women (control group) performed gait trials on an electronic walkway at preferred speeds. The results for the three groups were compared using analysis of variance. During pregnancy, peak pressure and contact area decreased for the forefoot and rearfoot. These parameters increased significantly for the midfoot. The gait strategy seemed to be lateralization of gait with an increased contact area of the lateral midfoot and both reduced pressure and a later peak time on the medial forefoot. In the postpartum group, footprint parameters were modified compared with the pregnant group, indicating a trend toward partial return to control values, although differences persisted between the postpartum and control groups. Pregnant women had altered plantar pressures during gait. These findings could define a specific pattern of gait footprints in late pregnancy because plantar pressures had characteristics that could maintain a stable and safe gait.

Gait Stability in Children with Cerebral Palsy

Science.gov (United States)

Bruijn, Sjoerd M.; Millard, Matthew; van Gestel, Leen; Meyns, Pieter; Jonkers, Ilse; Desloovere, Kaat

2013-01-01

Children with unilateral Cerebral Palsy (CP) have several gait impairments, amongst which impaired gait stability may be one. We tested whether a newly developed stability measure (the foot placement estimator, FPE) which does not require long data series, can be used to asses gait stability in typically developing (TD) children as well as…

Influence of gait mode and body orientation on following a walking avatar.

Science.gov (United States)

Meerhoff, L Rens A; de Poel, Harjo J; Jowett, Tim W D; Button, Chris

2017-08-01

Regulating distance with a moving object or person is a key component of human movement and of skillful interpersonal coordination. The current set of experiments aimed to assess the role of gait mode and body orientation on distance regulation using a cyclical locomotor tracking task in which participants followed a virtual leader. In the first experiment, participants moved in the backward-forward direction while the body orientation of the virtual leader was manipulated (i.e., facing towards, or away from the follower), hence imposing an incongruence in gait mode between leader and follower. Distance regulation was spatially less accurate when followers walked backwards. Additionally, a clear trade-off was found between spatial leader-follower accuracy and temporal synchrony. Any perceptual effects were overshadowed by the effect of one's gait mode. In the second experiment we examined lateral following. The results suggested that lateral following was also constrained strongly by perceptual information presented by the leader. Together, these findings demonstrated how locomotor tracking depends on gait mode, but also on the body orientation of whoever is being followed. Copyright © 2017 Elsevier B.V. All rights reserved.

Office management of gait disorders in the elderly.

Science.gov (United States)

Lam, Robert

2011-07-01

To provide family physicians with an approach to office management of gait disorders in the elderly. Ovid MEDLINE was searched from 1950 to July 2010 using subject headings for gait or neurologic gait disorders combined with physical examination. Articles specific to family practice or family physicians were selected. Relevant review articles and original research were used when appropriate and applicable to the elderly. Gait and balance disorders in the elderly are difficult to recognize and diagnose in the family practice setting because they initially present with subtle undifferentiated manifestations, and because causes are usually multifactorial, with multiple diseases developing simultaneously. To further complicate the issue, these manifestations can be camouflaged in elderly patients by the physiologic changes associated with normal aging. A classification of gait disorders based on sensorimotor levels can be useful in the approach to management of this problem. Gait disorders in patients presenting to family physicians in the primary care setting are often related to joint and skeletal problems (lowest-level disturbances), as opposed to patients referred to neurology specialty clinics with sensory ataxia, myelopathy, multiple strokes, and parkinsonism (lowest-, middle-, and highest-level disturbances). The difficulty in diagnosing gait disorders stems from the challenge of addressing early undifferentiated disease caused by multiple disease processes involving all sensorimotor levels. Patients might present with a nonspecific "cautious" gait that is simply an adaptation of the body to disease limitations. This cautious gait has a mildly flexed posture with reduced arm swing and a broadening of the base of support. This article reviews the focused history (including medication review), practical physical examination, investigations, and treatments that are key to office management of gait disorders. Family physicians will find it helpful to classify gait

A Surgical Model of Posttraumatic Osteoarthritis With Histological and Gait Validation.

Science.gov (United States)

Zahoor, Talal; Mitchell, Reed; Bhasin, Priya; Schon, Lew; Zhang, Zijun

2016-07-01

Posttraumatic osteoarthritis (PTOA) is secondary to an array of joint injuries. Animal models are useful tools for addressing the uniqueness of PTOA progression in each type of joint injury and developing strategies for PTOA prevention and treatment. Intra-articular fracture induces PTOA pathology. Descriptive laboratory study. Through a parapatellar incision, the medial tibial plateau was exposed in the left knees of 8 Sprague-Dawley rats. Osteotomy at the midpoint between the tibial crest and the outermost portion of the medial tibial plateau, including the covering articular cartilage, was performed using a surgical blade. The fractured medial tibial plateau was fixed with 2 needles transversely. The fractured knees were not immobilized. Before and after surgery, rat gait was recorded. Rats were sacrificed at week 8, and their knees were harvested for histology. After intra-articular fracture, the affected limbs altered gait from baseline (week 0). In the first 2 weeks, the gait of the operated limbs featured a reduced paw print intensity and stride length but increased maximal contact and stance time. Reduction of maximal and mean print area and duty cycle (the percentage of stance phase in a step) was present from week 1 to week 5. Only print length was reduced in weeks 7 and 8. At week 8, histology of the operated knees demonstrated osteoarthritic pathology. The severity of the PTOA pathology did not correlate with the changes of print length at week 8. Intra-articular fracture of the medial tibial plateau effectively induced PTOA in rat knees. During PTOA development, the injured limbs demonstrated characteristic gait. Intra-articular fracture represents severe joint injury and associates with a high rate of PTOA. This animal model, with histologic and gait validations, can be useful for future studies of PTOA prevention and early diagnosis.

Gait parameters in patients with diabetes mellitus

Directory of Open Access Journals (Sweden)

Cristina Elena Prado Teles Fregonesi

2010-02-01

Full Text Available Diabetes mellitus is a chronic disease that results in sensorimotor alterations. These changes affect balance and walking and predispose affected patients to falls. The aim of this review was to identify studies in the recent literature that assess gait parameters and aspects involved in walking. The MEDLINE, SciELO, LILACS and PEDro databases were searched using the following combination of keywords: diabetic neuropathies x gait; diabetes mellitus x gait, and diabetic foot x gait. After the application of selection criteria, 15 articles were retrieved, summarized, discussed, and are included in this review. Diabetic neuropathy was found to lead to deficits in step amplitude, gait velocity and gait cadence on flat surfaces, without sudden changes in direction or stops, and to balance and coordination deficits on inclined and uneven terrain. Diabetic neuropathies also increase plantar pressure rates and lead to difficulties in the terminal stance phase and pre-swing phase due to changes in triceps surae activation. Thus, the next initial contact occurs in an inadequate manner, with the forefoot and without absorption of shocks.

Skeletal and Clinical Effects of Exoskeleton-Assisted Gait

Science.gov (United States)

2015-10-01

robotic exoskeletons to enable gait in individuals with a complete spinal cord injury, the health benefits of exoskeleton -assisted gait have not been...for the use of robotic exoskeletons to enable gait in individuals with a complete spinal cord injury, clinical teams are not provided with...appropriate tools to estimate or predict potential health benefits (e.g. bone health) associated with exoskeleton -assisted gait. What was the impact on other

Dual task interference on postural sway, postural transitions and gait in people with Parkinson's disease and freezing of gait.

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de Souza Fortaleza, Ana Claudia; Mancini, Martina; Carlson-Kuhta, Patty; King, Laurie A; Nutt, John G; Chagas, Eliane Ferrari; Freitas, Ismael Forte; Horak, Fay B

2017-07-01

Freezing of gait (FoG) is associated with less automatic gait and more impaired cognition, balance and postural transitions compared to people with PD who do not have FoG. However, it is unknown whether dual-task cost during postural sway, postural transitions (such as gait initiation and turning), and gait are more in subjects with Parkinson's disease (PD) who have freezing of gait (FoG+) compared to those who do not have FoG (FoG-). Here, we hypothesized that the effects of a cognitive dual task on postural sway, postural transitions and gait would be larger in FoG+ than FoG-. Thirty FoG- and 24 FoG+ performed an Instrumented Stand and Walk test in OFF medication state, with and without a secondary cognitive task (serial subtraction by 3s). Measures of postural sway, gait initiation, turning, and walking were extracted using body-worn inertial sensors. FoG+ showed significantly larger dual task cost than FoG- for several gait metrics, but not during postural sway or postural transitions. During walking, FoG+ exhibited a larger dual task cost than FoG- resulting in shorter stride length and slower stride velocity. During standing, FoG+ showed a larger postural sway compared to FoG- and during gait initiation, FoG+, but not FoG-, showed a longer first step duration during the dual-task condition compared to single-task condition (interaction effect, p=0.04). During turning, both groups showed a slower turn peak speed in the dual-task condition compared to single task condition. These findings partly support our hypothesis that dual task cost on walking is greater in FoG+ than FoG-. Copyright © 2017. Published by Elsevier B.V.

Evidence of Big Five and Aggressive Personalities in Gait Biomechanics

OpenAIRE

Satchell, Liam; Morris, Paul; Mills, Chris; O?Reilly, Liam; Marshman, Paul; Akehurst, Lucy

2016-01-01

Behavioral observation techniques which relate action to personality have long been neglected (Furr and Funder in Handbook of research methods in personality psychology, The Guilford Press, New York, 2007) and, when employed, often use human judges to code behavior. In the current study we used an alternative to human coding (biomechanical research techniques) to investigate how personality traits are manifest in gait. We used motion capture technology to record 29 participants walking on a t...

Can biomechanical variables predict improvement in crouch gait?

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Hicks, Jennifer L.; Delp, Scott L.; Schwartz, Michael H.

2011-01-01

Many patients respond positively to treatments for crouch gait, yet surgical outcomes are inconsistent and unpredictable. In this study, we developed a multivariable regression model to determine if biomechanical variables and other subject characteristics measured during a physical exam and gait analysis can predict which subjects with crouch gait will demonstrate improved knee kinematics on a follow-up gait analysis. We formulated the model and tested its performance by retrospectively analyzing 353 limbs of subjects who walked with crouch gait. The regression model was able to predict which subjects would demonstrate ‘improved’ and ‘unimproved’ knee kinematics with over 70% accuracy, and was able to explain approximately 49% of the variance in subjects’ change in knee flexion between gait analyses. We found that improvement in stance phase knee flexion was positively associated with three variables that were drawn from knowledge about the biomechanical contributors to crouch gait: i) adequate hamstrings lengths and velocities, possibly achieved via hamstrings lengthening surgery, ii) normal tibial torsion, possibly achieved via tibial derotation osteotomy, and iii) sufficient muscle strength. PMID:21616666

Asymmetry in gait pattern following tibial shaft fractures

DEFF Research Database (Denmark)

Larsen, Peter; Læssøe, Uffe; Rasmussen, Sten

2017-01-01

INTRODUCTION: Despite the high number of studies evaluating the outcomes following tibial shaft fractures, the literature lacks studies including objective assessment of patients' recovery regarding gait pattern. The purpose of the present study was to evaluate whether gait patterns at 6 and 12...... months post-operatively following intramedullary nailing of a tibial shaft fracture are different compared with a healthy reference population. PATIENTS AND METHODS: The study design was a prospective cohort study. The primary outcome measurement was the gait patterns at 6 and 12 months post......-operatively measured with a 6-metre-long pressure-sensitive mat. The mat registers footprints and present gait speed, cadence as well as temporal and spatial parameters of the gait cycle. Gait patterns were compared to a healthy reference population. RESULTS: 49 patients were included with a mean age of 43.1 years (18...

Gait training of patients after stroke using an electromechanical gait trainer combined with simultaneous functional electrical stimulation.

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Tong, Raymond K Y; Ng, Maple F W; Li, Leonard S W; So, Elaine F M

2006-09-01

This case report describes the implementation of gait training intervention that used an electromechanical gait trainer with simultaneous functional electrical stimulation (FES) for 2 patients with acute ischemic stroke. Two individuals with post-stroke hemiplegia of less than 6 weeks' duration participated in a 4-week gait training program as an adjunct to physical therapy received at a hospital. After the 4-week intervention, both patients were discharged from the hospital, and they returned after 6 months for a follow-up evaluation. By the end of the 4-week intervention, both patients had shown improvements in scores on the Barthel Index, Berg Balance Scale, Functional Ambulation Categories Scale, 5-m timed walking test, and Motricity Index. In the 6-month follow-up evaluation, both patients continued to have improvements in all outcome measures. This case report shows that, following the use of an electromechanical gait trainer simultaneously with FES, patients after acute stroke had improvements in gait performance, functional activities, balance, and motor control in the long term.

Locomotion Gait Planning of Climber Snake-Like Robot

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Mohammad Nezaminia

2013-04-01

Full Text Available In this article a novel breed of snake-like climber robots has been introduced. Structure and operation of the first generation of snake-like climber robot "Marak I" has been discussed. The gait planning for two dimensional locomotion of a novel snake-like climber robot "Marak I" is presented. The types of locomotion investigated were rectilinear and wheeling gaits. The gaits of locomotion were experimented and their suitability for various applications has been mentioned. Some encountered practical problems plus solutions were addressed. Finally we found out that: the vertical motion was producing more fault than horizontal locomotion, and notably the fastest gait of locomotion was the wheeling gait

Balance and gait improved in patients with MS after physiotherapy based on the Bobath concept.

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Smedal, Tori; Lygren, Hildegunn; Myhr, Kjell-Morten; Moe-Nilssen, Rolf; Gjelsvik, Bente; Gjelsvik, Olav; Strand, Liv Inger; Inger, Liv

2006-06-01

Patients with multiple sclerosis (MS) tend to have movement difficulties, and the effect of physiotherapy for this group of patients has been subjected to limited systematic research. In the present study physiotherapy based on the Bobath concept, applied to MS patients with balance and gait problems, was evaluated. The ability of different functional tests to demonstrate change was evaluated. A single-subject experimental study design with ABAA phases was used, and two patients with relapsing-remitting MS in stable phase were treated. Tests were performed 12 times, three at each phase: A (at baseline); B (during treatment); A (immediately after treatment); and A (after two months). The key feature of treatment was facilitation of postural activity and selective control of movement. Several performance and self report measures and interviews were used. After intervention, improved balance was shown by the Berg Balance Scale (BBS) in both patients, and improved quality of gait was indicated by the Rivermead Visual Gait Assessment (RVGA). The patients also reported improved balance and gait function in the interviews and scored their condition as 'much improved'. Gait parameters, recorded by an electronic walkway, changed, but differently in the two patients. Among the physical performance tests the BBS and the RVGA demonstrated the highest change, while no or minimal change was demonstrated by the Rivermead Mobility Index (RMI) and Ratings of Perceived Exertion (RPE). The findings indicate that balance and gait can be improved after physiotherapy based on the Bobath concept, but this should be further evaluated in larger controlled trials of patients with MS.

Hip mechanics underlie lower extremity power training-induced increase in old adults' fast gait velocity : The Potsdam Gait Study (POGS)

NARCIS (Netherlands)

Beijersbergen, Chantal M. I.; Granacher, Urs; Gäbler, Martijn; DeVita, Paul; Hortobagyi, Tibor

Background: Aging is associated with slowed gait and old compared with young adults generally walk with greater positive hip work (H1) and reduced positive ankle work (A2). The role of exercise interventions on old adults' gait mechanics that underlie training-induced improvements in gait velocity

Age-related decline of gait variability in children with attention-deficit/hyperactivity disorder: Support for the maturational delay hypothesis in gait.

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Manicolo, Olivia; Grob, Alexander; Lemola, Sakari; Hagmann-von Arx, Priska

2016-02-01

Previous findings showed a tendency toward higher gait variability in children with attention-deficit/hyperactivity disorder (ADHD) compared to controls. This study examined whether gait variability in children with ADHD eventually approaches normality with increasing age (delay hypothesis) or whether these gait alterations represent a persistent deviation from typical development (deviation hypothesis). This cross-sectional study compared 30 children with ADHD (25 boys; Mage=10 years 11 months, range 8-13 years; n=21 off medication, n=9 without medication) to 28 controls (25 boys; Mage=10 years 10 months, range 8-13 years). Gait parameters (i.e. velocity and variability in stride length and stride time) were assessed using an electronic walkway system (GAITRite) while children walked at their own pace. Children with ADHD walked with significantly higher variability in stride time compared to controls. Age was negatively associated with gait variability in children with ADHD such that children with higher age walked with lower variability, whereas in controls there was no such association. Children with ADHD displayed a less regular gait pattern than controls, indicated by their higher variability in stride time. The age-dependent decrease of gait variability in children with ADHD showed that gait performance became more regular with age and converged toward that of typically developing children. These results may reflect a maturational delay rather than a persistent deviation of gait regularity among children with ADHD compared to typically developing children. Copyright © 2015 Elsevier B.V. All rights reserved.

Relationships of stroke patients' gait parameters with fear of falling.

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Park, Jin; Yoo, Ingyu

2014-12-01

[Purpose] The purpose of this study was to assess the correlation of gait parameters with fear of falling in stroke survivors. [Subjects] In total, 12 patients with stroke participated. [Methods] The subjects performed on a Biodex Gait Trainer 2 for 5 min to evaluate characteristic gait parameters. The kinematic gait parameters measured were gait speed, step cycle, step length, and time on each foot (step symmetry). All the subjects also completed a fall anxiety survey. [Results] Correlations between gait parameters and fear of falling scores were calculated. There was a moderate degree of correlation between fear of falling scores and the step cycle item of gait parameters. [Conclusions] According to our results, the step cycle gait parameter may be related to increased fall anxiety.

The effect of gait training with shoe inserts on the improvement of pain and gait in sacroiliac joint patients.

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Cho, Byung-Yun; Yoon, Jung-Gyu

2015-08-01

[Purpose] The purpose of the current research was to identify how gait training with shoe inserts affects the pain and gait of sacroiliac joint dysfunction patients. [Subjects and Methods] Thirty subjects were randomly selected and assigned to be either the experimental group (gait training with shoe insert group) or control group. Each group consisted of 15 patients. Pain was measured by Visual Analogue Scale, and foot pressure in a standing position and during gait was measured with a Gateview AFA-50 system (Alpus, Seoul, Republic of Korea). A paired sample t-test was used to compare the pain and gait of the sacroiliac joint before and after the intervention. Correlation between pain and walking after gait training with shoe inserts was examined by Pearson test. The level of significance was set at α=0.05. [Results] It was found that application of the intervention to the experimental group resulted in a significant decrease in sacroiliac joint pain. It was also found that there was a significant correlation between Visual Analogue Scale score and dynamic asymmetric index (r= 0.796) and that there was a negative correlation between Visual Analogue Scale score and forefoot/rear foot peak pressure ratio (r=-0.728). [Conclusion] The results of our analysis lead us to conclude that the intervention with shoe inserts had a significant influence on the pain and gait of sacroiliac joint patients.

Extract the Relational Information of Static Features and Motion Features for Human Activities Recognition in Videos

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Li Yao

2016-01-01

Full Text Available Both static features and motion features have shown promising performance in human activities recognition task. However, the information included in these features is insufficient for complex human activities. In this paper, we propose extracting relational information of static features and motion features for human activities recognition. The videos are represented by a classical Bag-of-Word (BoW model which is useful in many works. To get a compact and discriminative codebook with small dimension, we employ the divisive algorithm based on KL-divergence to reconstruct the codebook. After that, to further capture strong relational information, we construct a bipartite graph to model the relationship between words of different feature set. Then we use a k-way partition to create a new codebook in which similar words are getting together. With this new codebook, videos can be represented by a new BoW vector with strong relational information. Moreover, we propose a method to compute new clusters from the divisive algorithm’s projective function. We test our work on the several datasets and obtain very promising results.

Stepping strategies for regulating gait adaptability and stability.

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Hak, Laura; Houdijk, Han; Steenbrink, Frans; Mert, Agali; van der Wurff, Peter; Beek, Peter J; van Dieën, Jaap H

2013-03-15

Besides a stable gait pattern, gait in daily life requires the capability to adapt this pattern in response to environmental conditions. The purpose of this study was to elucidate the anticipatory strategies used by able-bodied people to attain an adaptive gait pattern, and how these strategies interact with strategies used to maintain gait stability. Ten healthy subjects walked in a Computer Assisted Rehabilitation ENvironment (CAREN). To provoke an adaptive gait pattern, subjects had to hit virtual targets, with markers guided by their knees, while walking on a self-paced treadmill. The effects of walking with and without this task on walking speed, step length, step frequency, step width and the margins of stability (MoS) were assessed. Furthermore, these trials were performed with and without additional continuous ML platform translations. When an adaptive gait pattern was required, subjects decreased step length (padaptations resulted in the preservation of equal MoS between trials, despite the disturbing influence of the gait adaptability task. When the gait adaptability task was combined with the balance perturbation subjects further decreased step length, as evidenced by a significant interaction between both manipulations (p=0.012). In conclusion, able-bodied people reduce step length and increase step width during walking conditions requiring a high level of both stability and adaptability. Although an increase in step frequency has previously been found to enhance stability, a faster movement, which would coincide with a higher step frequency, hampers accuracy and may consequently limit gait adaptability. Copyright © 2012 Elsevier Ltd. All rights reserved.

Combined gait disorder: a diagnostic challenge –a case report

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Ioana Stanescu

2017-02-01

Full Text Available Gait disorders are a major cause of functional impairment and morbidity, especially in the elderly population. Prevalence of gait disorders is higher in persons over 60: is estimated to be around 15% at 60 years of age and more than 50% in people > 80 years. Most gait disorders are multifactorial and have both neurologic and non-neurologic components. Neurological gait abnormalities result from focal or diffuse lesions occurring in the neural pathways linking the cortical motor centers to the peripheral neuromuscular systems. Nonneurological gait abnormalities include gait limitations caused by musculoskeletal, cardiac, or respiratory diseases. Assessment of a gait abnormality should include history, clinical presentation and additional diagnostic tests. Finding the ethiology of a gait disorder could be a challenge for the practitioners in many cases, requiring interdisciplinary cooperation.

Gait rehabilitation machines based on programmable footplates.

Science.gov (United States)

Schmidt, Henning; Werner, Cordula; Bernhardt, Rolf; Hesse, Stefan; Krüger, Jörg

2007-02-09

Gait restoration is an integral part of rehabilitation of brain lesioned patients. Modern concepts favour a task-specific repetitive approach, i.e. who wants to regain walking has to walk, while tone-inhibiting and gait preparatory manoeuvres had dominated therapy before. Following the first mobilization out of the bed, the wheelchair-bound patient should have the possibility to practise complex gait cycles as soon as possible. Steps in this direction were treadmill training with partial body weight support and most recently gait machines enabling the repetitive training of even surface gait and even of stair climbing. With treadmill training harness-secured and partially relieved wheelchair-mobilised patients could practise up to 1000 steps per session for the first time. Controlled trials in stroke and SCI patients, however, failed to show a superior result when compared to walking exercise on the floor. Most likely explanation was the effort for the therapists, e.g. manually setting the paretic limbs during the swing phase resulting in a too little gait intensity. The next steps were gait machines, either consisting of a powered exoskeleton and a treadmill (Lokomat, AutoAmbulator) or an electromechanical solution with the harness secured patient placed on movable foot plates (Gait Trainer GT I). For the latter, a large multi-centre trial with 155 non-ambulatory stroke patients (DEGAS) revealed a superior gait ability and competence in basic activities of living in the experimental group. The HapticWalker continued the end effector concept of movable foot plates, now fully programmable and equipped with 6 DOF force sensors. This device for the first time enables training of arbitrary walking situations, hence not only the simulation of floor walking but also for example of stair climbing and perturbations. Locomotor therapy is a fascinating new tool in rehabilitation, which is in line with modern principles of motor relearning promoting a task-specific repetitive

Gait rehabilitation machines based on programmable footplates

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Bernhardt Rolf

2007-02-01

Full Text Available Abstract Background Gait restoration is an integral part of rehabilitation of brain lesioned patients. Modern concepts favour a task-specific repetitive approach, i.e. who wants to regain walking has to walk, while tone-inhibiting and gait preparatory manoeuvres had dominated therapy before. Following the first mobilization out of the bed, the wheelchair-bound patient should have the possibility to practise complex gait cycles as soon as possible. Steps in this direction were treadmill training with partial body weight support and most recently gait machines enabling the repetitive training of even surface gait and even of stair climbing. Results With treadmill training harness-secured and partially relieved wheelchair-mobilised patients could practise up to 1000 steps per session for the first time. Controlled trials in stroke and SCI patients, however, failed to show a superior result when compared to walking exercise on the floor. Most likely explanation was the effort for the therapists, e.g. manually setting the paretic limbs during the swing phase resulting in a too little gait intensity. The next steps were gait machines, either consisting of a powered exoskeleton and a treadmill (Lokomat, AutoAmbulator or an electromechanical solution with the harness secured patient placed on movable foot plates (Gait Trainer GT I. For the latter, a large multi-centre trial with 155 non-ambulatory stroke patients (DEGAS revealed a superior gait ability and competence in basic activities of living in the experimental group. The HapticWalker continued the end effector concept of movable foot plates, now fully programmable and equipped with 6 DOF force sensors. This device for the first time enables training of arbitrary walking situations, hence not only the simulation of floor walking but also for example of stair climbing and perturbations. Conclusion Locomotor therapy is a fascinating new tool in rehabilitation, which is in line with modern principles

Gait biometrics under spoofing attacks: an experimental investigation

Science.gov (United States)

Hadid, Abdenour; Ghahramani, Mohammad; Kellokumpu, Vili; Feng, Xiaoyi; Bustard, John; Nixon, Mark

2015-11-01

Gait is a relatively biometric modality which has a precious advantage over other modalities, such as iris and voice, in that it can be easily captured from a distance. Although it has recently become a topic of great interest in biometric research, there has been little investigation into gait spoofing attacks where a person tries to imitate the clothing or walking style of someone else. We recently analyzed for the first time the effects of spoofing attacks on silhouette-based gait biometric systems and showed that it was indeed possible to spoof gait biometric systems by clothing impersonation and the deliberate selection of a target that has a similar build to the attacker. To gain deeper insight into the performance of current gait biometric systems under spoofing attacks, we provide a thorough investigation on how clothing can be used to spoof a target and evaluate the performance of two state-of-the-art recognition methods on a gait spoofing database recorded at the University of Southampton. Furthermore, we describe and evaluate an initial solution coping with gait spoofing attacks. The obtained results are very promising and point out interesting findings which can be used for future investigations.

Markedly impaired bilateral coordination of gait in post-stroke patients: Is this deficit distinct from asymmetry? A cohort study

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van Lummel Rob C

2011-05-01

Full Text Available Abstract Background Multiple aspects of gait are typically impaired post-stroke. Asymmetric gait is common as a consequence of unilateral brain lesions. The relationship between the resulting asymmetric gait and impairments in the ability to properly coordinate the reciprocal stepping activation of the legs is not clear. The objective of this exploratory study is to quantify the effects of hemiparesis on two putatively independent aspects of the bilateral coordination of gait to gain insight into mechanisms and their relationship and to assess their potential as clinical markers. Methods Twelve ambulatory stroke patients and age-matched healthy adults wore a tri-axial piezo-resistive accelerometer and walked back and forth along a straight path in a hall at a comfortable walking speed during 2 minutes. Gait speed, gait asymmetry (GA, and aspects of the bilateral coordination of gait (BCG were determined. Bilateral coordination measures included the left-right stepping phase for each stride φi, consistency in the phase generation φ_CV, accuracy in the phase generation φ_ABS, and Phase Coordination Index (PCI, a combination of accuracy and consistency of the phase generation. Results Group differences (p Conclusions In ambulatory post-stroke patients, two gait coordination properties, GA and PCI, are markedly impaired. Although these features are not related to each other in healthy controls, they are strongly related in stroke patients, which is a novel finding. A measurement approach based on body-fixed sensors apparently may provide sensitive markers that can be used for clinical assessment and for enhancing rehabilitation targeting in post-stroke patients.

Markedly impaired bilateral coordination of gait in post-stroke patients: Is this deficit distinct from asymmetry? A cohort study

Science.gov (United States)

2011-01-01

Background Multiple aspects of gait are typically impaired post-stroke. Asymmetric gait is common as a consequence of unilateral brain lesions. The relationship between the resulting asymmetric gait and impairments in the ability to properly coordinate the reciprocal stepping activation of the legs is not clear. The objective of this exploratory study is to quantify the effects of hemiparesis on two putatively independent aspects of the bilateral coordination of gait to gain insight into mechanisms and their relationship and to assess their potential as clinical markers. Methods Twelve ambulatory stroke patients and age-matched healthy adults wore a tri-axial piezo-resistive accelerometer and walked back and forth along a straight path in a hall at a comfortable walking speed during 2 minutes. Gait speed, gait asymmetry (GA), and aspects of the bilateral coordination of gait (BCG) were determined. Bilateral coordination measures included the left-right stepping phase for each stride φi, consistency in the phase generation φ_CV, accuracy in the phase generation φ_ABS, and Phase Coordination Index (PCI), a combination of accuracy and consistency of the phase generation. Results Group differences (p stroke patients (r = 0.94; p stroke patients, two gait coordination properties, GA and PCI, are markedly impaired. Although these features are not related to each other in healthy controls, they are strongly related in stroke patients, which is a novel finding. A measurement approach based on body-fixed sensors apparently may provide sensitive markers that can be used for clinical assessment and for enhancing rehabilitation targeting in post-stroke patients. PMID:21545703

Self-Tuning Threshold Method for Real-Time Gait Phase Detection Based on Ground Contact Forces Using FSRs

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Jing Tang

2018-02-01

Full Text Available This paper presents a novel methodology for detecting the gait phase of human walking on level ground. The previous threshold method (TM sets a threshold to divide the ground contact forces (GCFs into on-ground and off-ground states. However, the previous methods for gait phase detection demonstrate no adaptability to different people and different walking speeds. Therefore, this paper presents a self-tuning triple threshold algorithm (STTTA that calculates adjustable thresholds to adapt to human walking. Two force sensitive resistors (FSRs were placed on the ball and heel to measure GCFs. Three thresholds (i.e., high-threshold, middle-threshold andlow-threshold were used to search out the maximum and minimum GCFs for the self-adjustments of thresholds. The high-threshold was the main threshold used to divide the GCFs into on-ground and off-ground statuses. Then, the gait phases were obtained through the gait phase detection algorithm (GPDA, which provides the rules that determine calculations for STTTA. Finally, the STTTA reliability is determined by comparing the results between STTTA and Mariani method referenced as the timing analysis module (TAM and Lopez–Meyer methods. Experimental results show that the proposed method can be used to detect gait phases in real time and obtain high reliability when compared with the previous methods in the literature. In addition, the proposed method exhibits strong adaptability to different wearers walking at different walking speeds.

A Wearable System for Gait Training in Subjects with Parkinson’s Disease

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Filippo Casamassima

2014-03-01

Full Text Available In this paper, a system for gait training and rehabilitation for Parkinson’s disease (PD patients in a daily life setting is presented. It is based on a wearable architecture aimed at the provision of real-time auditory feedback. Recent studies have, in fact, shown that PD patients can receive benefit from a motor therapy based on auditory cueing and feedback, as happens in traditional rehabilitation contexts with verbal instructions given by clinical operators. To this extent, a system based on a wireless body sensor network and a smartphone has been developed. The system enables real-time extraction of gait spatio-temporal features and their comparison with a patient’s reference walking parameters captured in the lab under clinical operator supervision. Feedback is returned to the user in form of vocal messages, encouraging the user to keep her/his walking behavior or to correct it. This paper describes the overall concept, the proposed usage scenario and the parameters estimated for the gait analysis. It also presents, in detail, the hardware-software architecture of the system and the evaluation of system reliability by testing it on a few subjects.

Speeding up or slowing down?: Gait adaptations to preserve gait stability in response to balance perturbations

NARCIS (Netherlands)

Hak, L.; Houdijk, J.H.P.; Steenbrink, F.; van der Wurff, P.; Beek, P.J.; van Dieen, J.H.

2012-01-01

It has frequently been proposed that lowering walking speed is a strategy to enhance gait stability and to decrease the probability of falling. However, previous studies have not been able to establish a clear relation between walking speed and gait stability. We investigated whether people do

Gait and Function in Class III Obesity

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Catherine Ling

2012-01-01

Full Text Available Walking, more specifically gait, is an essential component of daily living. Walking is a very different activity for individuals with a Body Mass Index (BMI of 40 or more (Class III obesity compared with those who are overweight or obese with a BMI between 26–35. Yet all obesity weight classes receive the same physical activity guidelines and recommendations. This observational study examined the components of function and disability in a group with Class III obesity and a group that is overweight or has Class I obesity. Significant differences were found between the groups in the areas of gait, body size, health condition, and activity capacity and participation. The Timed Up and Go test, gait velocity, hip circumference, and stance width appear to be most predictive of activity capacity as observed during gait assessment. The findings indicate that Class III-related gait is pathologic and not a normal adaptation.

A Wearable Gait Phase Detection System Based on Force Myography Techniques

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Xianta Jiang

2018-04-01

Full Text Available (1 Background: Quantitative evaluation of gait parameters can provide useful information for constructing individuals’ gait profile, diagnosing gait abnormalities, and better planning of rehabilitation schemes to restore normal gait pattern. Objective determination of gait phases in a gait cycle is a key requirement in gait analysis applications; (2 Methods: In this study, the feasibility of using a force myography-based technique for a wearable gait phase detection system is explored. In this regard, a force myography band is developed and tested with nine participants walking on a treadmill. The collected force myography data are first examined sample-by-sample and classified into four phases using Linear Discriminant Analysis. The gait phase events are then detected from these classified samples using a set of supervisory rules; (3 Results: The results show that the force myography band can correctly detect more than 99.9% of gait phases with zero insertions and only four deletions over 12,965 gait phase segments. The average temporal error of gait phase detection is 55.2 ms, which translates into 2.1% error with respect to the corresponding labelled stride duration; (4 Conclusions: This proof-of-concept study demonstrates the feasibility of force myography techniques as viable solutions in developing wearable gait phase detection systems.

Kinematic analysis quantifies gait abnormalities associated with lameness in broiler chickens and identifies evolutionary gait differences.

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Gina Caplen

Full Text Available This is the first time that gait characteristics of broiler (meat chickens have been compared with their progenitor, jungle fowl, and the first kinematic study to report a link between broiler gait parameters and defined lameness scores. A commercial motion-capturing system recorded three-dimensional temporospatial information during walking. The hypothesis was that the gait characteristics of non-lame broilers (n = 10 would be intermediate to those of lame broilers (n = 12 and jungle fowl (n = 10, tested at two ages: immature and adult. Data analysed using multi-level models, to define an extensive range of baseline gait parameters, revealed inter-group similarities and differences. Natural selection is likely to have made jungle fowl walking gait highly efficient. Modern broiler chickens possess an unbalanced body conformation due to intense genetic selection for additional breast muscle (pectoral hypertrophy and whole body mass. Together with rapid growth, this promotes compensatory gait adaptations to minimise energy expenditure and triggers high lameness prevalence within commercial flocks; lameness creating further disruption to the gait cycle and being an important welfare issue. Clear differences were observed between the two lines (short stance phase, little double-support, low leg lift, and little back displacement in adult jungle fowl; much double-support, high leg lift, and substantial vertical back movement in sound broilers presumably related to mass and body conformation. Similarities included stride length and duration. Additional modifications were also identified in lame broilers (short stride length and duration, substantial lateral back movement, reduced velocity presumably linked to musculo-skeletal abnormalities. Reduced walking velocity suggests an attempt to minimise skeletal stress and/or discomfort, while a shorter stride length and time, together with longer stance and double-support phases, are associated

Basal ganglia and gait control: apomorphine administration and internal pallidum stimulation in Parkinson's disease.

Science.gov (United States)

Grasso, R; Peppe, A; Stratta, F; Angelini, D; Zago, M; Stanzione, P; Lacquaniti, F

1999-05-01

Gait coordination was analyzed (four-camera 100 Hz ELITE system) in two groups of idiopathic Parkinson disease (PD) patients. Five patients underwent continuous infusion of apomorphine and were recorded in two different sessions (APO OFF and APO ON) in the same day. Three patients with a previous chronic electrode implantation in both internal globi pallidi (GPi) were recorded in the same experimental session with the electrodes on and off (STIM ON and STIM OFF). The orientation of both the trunk and the lower-limb segments was described with respect to the vertical in the sagittal plane. Lower-limb inter-segmental coordination was evaluated by analyzing the co-variation between thigh, shank, and foot elevation angles by means of orthogonal planar regression. At least 30 gait cycles per experimental condition were processed. We found that the trunk was bent forward in STIM OFF, whereas it was better aligned with the vertical in STIM ON in both PD groups. The legs never fully extended during the gait cycle in STIM OFF, whereas they extended before heel strike in STIM ON. The multisegmental coordination of the lower limb changed almost in parallel with the changes in trunk orientation. In STIM OFF, both the shape and the spatial orientation of the planar gait loops (thigh angle vs. shank angle vs. foot angle) differed from those of physiological locomotion, whereas in STIM ON the gait loop tended to resume features closer to the control. Switching the electrodes on and off in patients with GPi electrodes resulted in quasi-parallel changes of the trunk inclination and of the planar gait loop. The bulk of the data suggest that the basal-ganglia circuitry may be relevant in locomotion by providing an appropriate spatio-temporal framework for the control of posture and movement in a gravity-based body-centered frame of reference. Pallido-thalamic and/or pallido-mesencephalic pathways may influence the timing of the inter-segmental coordination for gait.

Entrainment to a real time fractal visual stimulus modulates fractal gait dynamics.

Science.gov (United States)

Rhea, Christopher K; Kiefer, Adam W; D'Andrea, Susan E; Warren, William H; Aaron, Roy K

2014-08-01

Fractal patterns characterize healthy biological systems and are considered to reflect the ability of the system to adapt to varying environmental conditions. Previous research has shown that fractal patterns in gait are altered following natural aging or disease, and this has potential negative consequences for gait adaptability that can lead to increased risk of injury. However, the flexibility of a healthy neurological system to exhibit different fractal patterns in gait has yet to be explored, and this is a necessary step toward understanding human locomotor control. Fifteen participants walked for 15min on a treadmill, either in the absence of a visual stimulus or while they attempted to couple the timing of their gait with a visual metronome that exhibited a persistent fractal pattern (contained long-range correlations) or a random pattern (contained no long-range correlations). The stride-to-stride intervals of the participants were recorded via analog foot pressure switches and submitted to detrended fluctuation analysis (DFA) to determine if the fractal patterns during the visual metronome conditions differed from the baseline (no metronome) condition. DFA α in the baseline condition was 0.77±0.09. The fractal patterns in the stride-to-stride intervals were significantly altered when walking to the fractal metronome (DFA α=0.87±0.06) and to the random metronome (DFA α=0.61±0.10) (both p<.05 when compared to the baseline condition), indicating that a global change in gait dynamics was observed. A variety of strategies were identified at the local level with a cross-correlation analysis, indicating that local behavior did not account for the consistent global changes. Collectively, the results show that a gait dynamics can be shifted in a prescribed manner using a visual stimulus and the shift appears to be a global phenomenon. Copyright © 2014 Elsevier B.V. All rights reserved.

Assessing interactions among multiple physiological systems during walking outside a laboratory: An Android based gait monitor

Science.gov (United States)

Sejdić, E.; Millecamps, A.; Teoli, J.; Rothfuss, M. A.; Franconi, N. G.; Perera, S.; Jones, A. K.; Brach, J. S.; Mickle, M. H.

2015-01-01

Gait function is traditionally assessed using well-lit, unobstructed walkways with minimal distractions. In patients with subclinical physiological abnormalities, these conditions may not provide enough stress on their ability to adapt to walking. The introduction of challenging walking conditions in gait can induce responses in physiological systems in addition to the locomotor system. There is a need for a device that is capable of monitoring multiple physiological systems in various walking conditions. To address this need, an Android-based gait-monitoring device was developed that enabled the recording of a patient's physiological systems during walking. The gait-monitoring device was tested during self-regulated overground walking sessions of fifteen healthy subjects that included 6 females and 9 males aged 18 to 35 years. The gait-monitoring device measures the patient's stride interval, acceleration, electrocardiogram, skin conductance and respiratory rate. The data is stored on an Android phone and is analyzed offline through the extraction of features in the time, frequency and time-frequency domains. The analysis of the data depicted multisystem physiological interactions during overground walking in healthy subjects. These interactions included locomotion-electrodermal, locomotion-respiratory and cardiolocomotion couplings. The current results depicting strong interactions between the locomotion system and the other considered systems (i.e., electrodermal, respiratory and cardivascular systems) warrant further investigation into multisystem interactions during walking, particularly in challenging walking conditions with older adults. PMID:26390946

Can we improve gait skills in chronic hemiplegics? A randomised control trial with gait trainer.

Science.gov (United States)

Dias, D; Laíns, J; Pereira, A; Nunes, R; Caldas, J; Amaral, C; Pires, S; Costa, A; Alves, P; Moreira, M; Garrido, N; Loureiro, L

2007-12-01

Partial body weight support (PBWS) is an accepted treatment for hemiplegic patients. The aim of this study is to compare the efficiency of gait trainer with conventional treatment on the gait management after stroke. Forty chronic post-stroke hemiplegics were part of a prospective research. Inclusion criteria were: first ever stroke in a chronic stage with stabilised motor deficits; age >18 and gait trainer, for the same period of time and frequency. Assessment tools: Motricity Index (MI); Toulouse Motor Scale (TMS); modified Ashworth Spasticity Scale (mASS); Berg Balance Scale (BBS); Rivermead Mobility Index (RMI); Fugl-Meyer Stroke Scale (F-MSS); Functional Ambulation Category (FAC); Barthel Index (BI); 10 meters, time up and go (TUG), 6 minutes, and step tests. EG and CG did the assessments before treatment (T(0)), right after treatment (T(1)), and on follow-up, 3 months later (T(2)). CG and EG were homogenous in all the variables at T(0). CG and EG showed improvement in almost all the assessment scales after treatment, although only some with relevant differences. EG showed statistically relevant improvement on T(1) and on T(2) in several of the assessment tools, whereas CG only showed statistically significant improvement after T(1) and only in some of the assessment tools. Both groups of chronic hemiplegic patients improved after either PBWS with gait trainer or Bobath treatment. Only subjects undergoing PBWS with gait trainer maintained functional gain after 3 months.

Robot-assisted gait training versus treadmill training in patients with Parkinson's disease: a kinematic evaluation with gait profile score.

Science.gov (United States)

Galli, M; Cimolin, V; De Pandis, M F; Le Pera, D; Sova, I; Albertini, G; Stocchi, F; Franceschini, M

2016-01-01

The purpose of this study was to quantitatively compare the effects, on walking performance, of end-effector robotic rehabilitation locomotor training versus intensive training with a treadmill in Parkinson's disease (PD). Fifty patients with PD were randomly divided into two groups: 25 were assigned to the robot-assisted therapy group (RG) and 25 to the intensive treadmill therapy group (IG). They were evaluated with clinical examination and 3D quantitative gait analysis [gait profile score (GPS) and its constituent gait variable scores (GVSs) were calculated from gait analysis data] at the beginning (T0) and at the end (T1) of the treatment. In the RG no differences were found in the GPS, but there were significant improvements in some GVSs (Pelvic Obl and Hip Ab-Add). The IG showed no statistically significant changes in either GPS or GVSs. The end-effector robotic rehabilitation locomotor training improved gait kinematics and seems to be effective for rehabilitation in patients with mild PD.

Gait Recognition Using Wearable Motion Recording Sensors

Directory of Open Access Journals (Sweden)

Davrondzhon Gafurov

2009-01-01

Full Text Available This paper presents an alternative approach, where gait is collected by the sensors attached to the person's body. Such wearable sensors record motion (e.g. acceleration of the body parts during walking. The recorded motion signals are then investigated for person recognition purposes. We analyzed acceleration signals from the foot, hip, pocket and arm. Applying various methods, the best EER obtained for foot-, pocket-, arm- and hip- based user authentication were 5%, 7%, 10% and 13%, respectively. Furthermore, we present the results of our analysis on security assessment of gait. Studying gait-based user authentication (in case of hip motion under three attack scenarios, we revealed that a minimal effort mimicking does not help to improve the acceptance chances of impostors. However, impostors who know their closest person in the database or the genders of the users can be a threat to gait-based authentication. We also provide some new insights toward the uniqueness of gait in case of foot motion. In particular, we revealed the following: a sideway motion of the foot provides the most discrimination, compared to an up-down or forward-backward directions; and different segments of the gait cycle provide different level of discrimination.

Quantitative gait measurement with pulse-Doppler radar for passive in-home gait assessment.

Science.gov (United States)

Wang, Fang; Skubic, Marjorie; Rantz, Marilyn; Cuddihy, Paul E

2014-09-01

In this paper, we propose a pulse-Doppler radar system for in-home gait assessment of older adults. A methodology has been developed to extract gait parameters including walking speed and step time using Doppler radar. The gait parameters have been validated with a Vicon motion capture system in the lab with 13 participants and 158 test runs. The study revealed that for an optimal step recognition and walking speed estimation, a dual radar set up with one radar placed at foot level and the other at torso level is necessary. An excellent absolute agreement with intraclass correlation coefficients of 0.97 was found for step time estimation with the foot level radar. For walking speed, although both radars show excellent consistency they all have a system offset compared to the ground truth due to walking direction with respect to the radar beam. The torso level radar has a better performance (9% offset on average) in the speed estimation compared to the foot level radar (13%-18% offset). Quantitative analysis has been performed to compute the angles causing the systematic error. These lab results demonstrate the capability of the system to be used as a daily gait assessment tool in home environments, useful for fall risk assessment and other health care applications. The system is currently being tested in an unstructured home environment.

Robotic Pectoral Fin Thrust Vectoring Using Weighted Gait Combinations

Directory of Open Access Journals (Sweden)

John S. Palmisano

2012-01-01

Full Text Available A method was devised to vector propulsion of a robotic pectoral fin by means of actively controlling fin surface curvature. Separate flapping fin gaits were designed to maximize thrust for each of three different thrust vectors: forward, reverse, and lift. By using weighted combinations of these three pre-determined main gaits, new intermediate hybrid gaits for any desired propulsion vector can be created with smooth transitioning between these gaits. This weighted gait combination (WGC method is applicable to other difficult-to-model actuators. Both 3D unsteady computational fluid dynamics (CFD and experimental results are presented.

Inter-Trial Gait Variability Reduction Using Continous Curve Registration

National Research Council Canada - National Science Library

Sadeghi, H

2001-01-01

Timing in peak gait values shifts slightly between gait trials. When gait data are averaged, some of the standard deviation can be associated to this inter-trial variability unless normalization is carried out beforehand...

Performance analysis for gait in camera networks

OpenAIRE

Michela Goffredo; Imed Bouchrika; John Carter; Mark Nixon

2008-01-01

This paper deploys gait analysis for subject identification in multi-camera surveillance scenarios. We present a new method for viewpoint independent markerless gait analysis that does not require camera calibration and works with a wide range of directions of walking. These properties make the proposed method particularly suitable for gait identification in real surveillance scenarios where people and their behaviour need to be tracked across a set of cameras. Tests on 300 synthetic and real...

Gait, posture and cognition in Parkinson's disease

OpenAIRE

Barbosa, Alessandra Ferreira; Chen, Janini; Freitag, Fernanda; Valente, Debora; Souza, Carolina de Oliveira; Voos, Mariana Callil; Chien, Hsin Fen

2016-01-01

ABSTRACT Gait disorders and postural instability are the leading causes of falls and disability in Parkinson's disease (PD). Cognition plays an important role in postural control and may interfere with gait and posture assessment and treatment. It is important to recognize gait, posture and balance dysfunctions by choosing proper assessment tools for PD. Patients at higher risk of falling must be referred for rehabilitation as early as possible, because antiparkinsonian drugs and surgery do n...

Human Activity Recognition Using Hierarchically-Mined Feature Constellations

NARCIS (Netherlands)

Oikonomopoulos, A.; Pantic, Maja

In this paper we address the problem of human activity modelling and recognition by means of a hierarchical representation of mined dense spatiotemporal features. At each level of the hierarchy, the proposed method selects feature constellations that are increasingly discriminative and

Ultrasonic motion analysis system - measurement of temporal and spatial gait parameters

NARCIS (Netherlands)

Huitema, RB; Hof, AL; Postema, K

The duration of stance and swing phase and step and stride length are important parameters in human gait. In this technical note a low-cost ultrasonic motion analysis system is described that is capable of measuring these temporal and spatial parameters while subjects walk on the floor. By using the

Gait Strategy in Patients with Ehlers-Danlos Syndrome Hypermobility Type: A Kinematic and Kinetic Evaluation Using 3D Gait Analysis

Science.gov (United States)

Galli, Manuela; Cimolin, Veronica; Rigoldi, Chiara; Castori, Marco; Celletti, Claudia; Albertini, Giorgio; Camerota, Filippo

2011-01-01

The aim of this study was to quantify the gait patterns of adults with joint hypermobility syndrome/Ehlers-Danlos syndrome (JHS/EDS-HT) hypermobility type, using Gait Analysis. We quantified the gait strategy in 12 JHS/EDS-HT adults individuals (age: 43.08 + 6.78 years) compared to 20 healthy controls (age: 37.23 plus or minus 8.91 years), in…

Robotic gait trainer in water: development of an underwater gait-training orthosis.

Science.gov (United States)

Miyoshi, Tasuku; Hiramatsu, Kazuaki; Yamamoto, Shin-Ichiro; Nakazawa, Kimitaka; Akai, Masami

2008-01-01

To develop a robotic gait trainer that can be used in water (RGTW) and achieve repetitive physiological gait patterns to improve the movement dysfunctions. The RGTW is a hip-knee-ankle-foot orthosis with pneumatic actuators; the control software was developed on the basis of the angular motions of the hip and knee joint of a healthy subject as he walked in water. Three-dimensional motions and electromyographic (EMG) activities were recorded in nine healthy subjects to evaluate the efficacy of using the RGTW while walking on a treadmill in water. The device could preserve the angular displacement patterns of the hip and knee and foot trajectories under all experimental conditions. The tibialis anterior EMG activities in the late swing phase and the biceps femoris throughout the stance phase were reduced whose joint torques were assisted by the RGTW while walking on a treadmill in water. Using the RGTW could expect not only the effect of the hydrotherapy but also the standard treadmill gait training, in particular, and may be particularly effective for treating individuals with hip joint movement dysfunction.

Relationships of Stroke Patients’ Gait Parameters with Fear of Falling

OpenAIRE

Park, Jin; Yoo, Ingyu

2014-01-01

[Purpose] The purpose of this study was to assess the correlation of gait parameters with fear of falling in stroke survivors. [Subjects] In total, 12 patients with stroke participated. [Methods] The subjects performed on a Biodex Gait Trainer 2 for 5 min to evaluate characteristic gait parameters. The kinematic gait parameters measured were gait speed, step cycle, step length, and time on each foot (step symmetry). All the subjects also completed a fall anxiety survey. [Results] Correlations...

Pregnancy-related changes in center of pressure during gait.

Science.gov (United States)

Bertuit, Jeanne; Leyh, Clara; Rooze, Marcel; Feipe, Véronique

2017-01-01

Physical and hormonal modifications occuring during the pregnancy, can lead to an increase in postural instability and to a higher risk of falls during gait. The first objective was to describe the center of pressure (COP) during late pregnancy at different gait velocity. Comparison of nulliparous women with postpartum women were conducted in order to investigate the effects of pregnancy. The second objective was to analyse COP variability between pregnant and non-pregnant women in order to investigate the effects of pregnancy on gait variability. Fifty-eight pregnant women in the last four months of pregnancy, nine postpartum women and twenty-three healthy non-pregnant women performed gait trials at three different speeds: preferred, slow and fast. In the last four months of pregnancy gait velocity decreased. During the pregnancy, gait velocity decreased by 22%, stopover time increased by 6-12%, COP excursion XY decreased by 5% and COP velocity decreased by 16% and 20% along the anteroposterior and transverse axes, respectively. After delivery, gait velocity increased by 3% but remained a lower compared to non-pregnant women (-12%). Intra-individual variability was greater for non-pregnant than pregnant women. COP parameters were influenced by pregnancy. This suggests that pregnant women establish very specific and individual strategies with the aim of maintaining stability during gait.

Apolipoprotein E4 Allele and Gait Performance in Mild Cognitive Impairment: Results From the Gait and Brain Study.

Science.gov (United States)

Sakurai, Ryota; Montero-Odasso, Manuel

2017-11-09

The apolipoprotein E polymorphism ε4 allele (ApoE4) and gait impairment are both known risk factors for developing cognitive decline and dementia. However, it is unclear the interrelationship between these factors, particularly among older adults with mild cognitive impairment (MCI) who are considered as prodromal for Alzheimer's disease. This study aimed to determine whether ApoE4 carrier individuals with MCI may experience greater impairment in gait performance. Fifty-six older adults with MCI from the "Gait and Brain Study" who were identified as either ApoE4 carriers (n = 20) or non-ApoE4 carriers (n = 36) with 1 year of follow-up were included. Gait variability, the main outcome variable, was assessed as stride time variability with an electronic walkway. Additional gait variables and cognitive performance (mini-mental state examination [MMSE] and Montreal Cognitive Assessment [MoCA]) were also recorded. Covariates included age, sex, education level, body mass index, and number of comorbidities. Baseline characteristics were similar for both groups. Repeated measures analysis of covariance showed that gait stride time and stride length variabilities significantly increased in ApoE4 carriers but was maintained in the non-ApoE4 carriers. Similarly, ApoE4 carriers showed greater decrease in MMSE score at follow-up. In this sample of older adults with MCI, the presence of at least one copy of ApoE4 was associated with the development of both increased gait variability and cognitive decline during 1 year of follow-up. ApoE4 genotype might be considered as a potential mediator of decline in mobility function in MCI; future studies with larger samples are needed to confirm our preliminary findings. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Advances in biometrics for secure human authentication and recognition

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Kisku, Dakshina Ranjan; Sing, Jamuna Kanta

2013-01-01

GENERAL BIOMETRICSSecurity and Reliability Assessment for Biometric Systems; Gayatri MirajkarReview of Human Recognition Based on Retinal Images; Amin DehghaniADVANCED TOPICS IN BIOMETRICSVisual Speech as Behavioral Biometric; Preety Singh, Vijay Laxmi, and Manoj Singh GaurHuman Gait Signature for Biometric Authentication; Vijay JohnHand-Based Biometric for Personal Identification Using Correlation Filter Classifier; Mohammed Saigaa , Abdallah Meraoumia , Salim Chitroub, and Ahmed BouridaneOn Deciding the Dynamic Periocular Boundary for Human Recognition; Sambit Bakshi , Pankaj Kumar Sa, and Banshidhar MajhiRetention of Electrocardiogram Features Insignificantly Devalorized as an Effect of Watermarking for a Multimodal Biometric Authentication System; Nilanjan Dey, Bijurika Nandi, Poulami Das, Achintya Das, and Sheli Sinha ChaudhuriFacial Feature Point Extraction for Object Identification Using Discrete Contourlet Transform and Principal Component Analysis; N. G. Chitaliya and A. I. TrivediCASE STUDIES AND LA...

Abnormalities of the First Three Steps of Gait Initiation in Patients with Parkinson's Disease with Freezing of Gait

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Yohei Okada

2011-01-01

Full Text Available The purpose of this study was to investigate abnormalities of the first three steps of gait initiation in patients with Parkinson's disease (PD with freezing of gait (FOG. Ten PD patients with FOG and 10 age-matched healthy controls performed self-generated gait initiation. The center of pressure (COP, heel contact positions, and spatiotemporal parameters were estimated from the vertical pressures on the surface of the force platform. The initial swing side of gait initiation was consistent among the trials in healthy controls but not among the trials in PD patients. The COP and the heel contact position deviated to the initial swing side during the first step, and the COP passed medial to each heel contact position during the first two steps in PD patients. Medial deviation of the COP from the first heel contact position had significant correlation with FOG questionnaire item 5. These findings indicate that weight shifting between the legs is abnormal and that medial deviation of the COP from the first heel contact position sensitively reflects the severity of FOG during the first three steps of gait initiation in PD patients with FOG.

Effects of obesity and chronic low back pain on gait

OpenAIRE

Cimolin, Veronica; Vismara, Luca; Galli, Manuela; Zaina, Fabio; Negrini, Stefano; Capodaglio, Paolo

2011-01-01

Abstract Background Obesity is often associated with low back pain (LBP). Despite empirical evidence that LBP induces gait abnormalities, there is a lack of quantitative analysis of the combined effect of obesity and LBP on gait. The aim of our study was to quantify the gait pattern of obese subjects with and without LBP and normal-mass controls by using Gait Analysis (GA), in order to investigate the cumulative effects of obesity and LBP on gait. Methods Eight obese females with chronic LBP ...

Does a single gait training session performed either overground or on a treadmill induce specific short-term effects on gait parameters in patients with hemiparesis? A randomized controlled study.

Science.gov (United States)

Bonnyaud, Céline; Pradon, Didier; Zory, Raphael; Bensmail, Djamel; Vuillerme, Nicolas; Roche, Nicolas

2013-01-01

Gait training for patients with hemiparesis is carried out independently overground or on a treadmill. Several studies have shown differences in hemiparetic gait parameters during overground versus treadmill walking. However, few studies have compared the effects of these 2 gait training conditions on gait parameters, and no study has compared the short-term effects of these techniques on all biomechanical gait parameters. To determine whether a gait training session performed overground or on a treadmill induces specific short-term effects on biomechanical gait parameters in patients with hemiparesis. Twenty-six subjects with hemiparesis were randomly assigned to a single session of either overground or treadmill gait training. The short-term effects on spatiotemporal, kinematic, and kinetic gait parameters were assessed using gait analysis before and immediately after the training and after a 20-minute rest. Speed, cadence, percentage of single support phase, peak knee extension, peak propulsion, and braking on the paretic side were significantly increased after the gait training session. However, there were no specific changes dependent on the type of gait training performed (overground or on a treadmill). A gait training session performed by subjects with hemiparesis overground or on a treadmill did not induce specific short-term effects on biomechanical gait parameters. The increase in gait velocity that followed a gait training session seemed to reflect specific modifications of the paretic lower limb and adaptation of the nonparetic lower limb.

Gait bradykinesia in Parkinson's disease: a change in the motor program which controls the synergy of gait.

Science.gov (United States)

Warabi, Tateo; Furuyama, Hiroyasu; Sugai, Eri; Kato, Masamichi; Yanagisawa, Nobuo

2018-01-01

This study examined how gait bradykinesia is changed by the motor programming in Parkinson's disease. Thirty-five idiopathic Parkinson's disease patients and nine age-matched healthy subjects participated in this study. After the patients fixated on a visual-fixation target (conditioning-stimulus), the voluntary-gait was triggered by a visual on-stimulus. While the subject walked on a level floor, soleus, tibialis anterior EMG latencies, and the y-axis-vector of the sole-floor reaction force were examined. Three paradigms were used to distinguish between the off-/on-latencies. The gap-task: the visual-fixation target was turned off; 200 ms before the on-stimulus was engaged (resulting in a 200 ms-gap). EMG latency was not influenced by the visual-fixation target. The overlap-task: the on-stimulus was turned on during the visual-fixation target presentation (200 ms-overlap). The no-gap-task: the fixation target was turned off and the on-stimulus was turned on simultaneously. The onset of EMG pause following the tonic soleus EMG was defined as the off-latency of posture (termination). The onset of the tibialis anterior EMG burst was defined as the on-latency of gait (initiation). In the gap-task, the on-latency was unchanged in all of the subjects. In Parkinson's disease, the visual-fixation target prolonged both the off-/on-latencies in the overlap-task. In all tasks, the off-latency was prolonged and the off-/on-latencies were unsynchronized, which changed the synergic movement to a slow, short-step-gait. The synergy of gait was regulated by two independent sensory-motor programs of the off- and on-latency levels. In Parkinson's disease, the delayed gait initiation was due to the difficulty in terminating the sensory-motor program which controls the subject's fixation. The dynamic gait bradykinesia was involved in the difficulty (long off-latency) in terminating the motor program of the prior posture/movement.

Robot-assisted gait training versus treadmill training in patients with Parkinson’s disease: a kinematic evaluation with gait profile score

Science.gov (United States)

Galli, Manuela; Cimolin, Veronica; De Pandis, Maria Francesca; Le Pera, Domenica; Sova, Ivan; Albertini, Giorgio; Stocchi, Fabrizio; Franceschini, Marco

2016-01-01

Summary The purpose of this study was to quantitatively compare the effects, on walking performance, of end-effector robotic rehabilitation locomotor training versus intensive training with a treadmill in Parkinson’s disease (PD). Fifty patients with PD were randomly divided into two groups: 25 were assigned to the robot-assisted therapy group (RG) and 25 to the intensive treadmill therapy group (IG). They were evaluated with clinical examination and 3D quantitative gait analysis [gait profile score (GPS) and its constituent gait variable scores (GVSs) were calculated from gait analysis data] at the beginning (T0) and at the end (T1) of the treatment. In the RG no differences were found in the GPS, but there were significant improvements in some GVSs (Pelvic Obl and Hip Ab-Add). The IG showed no statistically significant changes in either GPS or GVSs. The end-effector robotic rehabilitation locomotor training improved gait kinematics and seems to be effective for rehabilitation in patients with mild PD. PMID:27678210

Non-surgical management of a pediatric "intoed" gait pattern - a systematic review of the current best evidence.

Science.gov (United States)

Uden, Hayley; Kumar, Saravana

2012-01-01

An intoed gait pattern is one of the most common referrals for children to an orthopedic consultation. Parental concern as to the aesthetics of the child's gait pattern and/or its symptomatic nature will primarily drive these referrals during a child's early developmental years. Whilst some of these referrals prove to be the result of a normal growth variant, some children will present with a symptomatic intoed gait pattern. Various treatments, both conservative and surgical, have been proposed including: braces, wedges, stretches and exercises, shoe modifications, and surgical procedures. However, which treatments are effective and justified in the management of this condition is not clear within the literature. The aim of this systematic review was to therefore identify and critique the best available evidence for the non-surgical management of an intoed gait pattern in a pediatric population. A systematic review was conducted of which only experimental studies investigating a management option for an intoeing gait pattern were included. Studies needed to be written in English, pertaining to a human pediatric population, and published within a peer reviewed journal. Electronic databases were searched: Ovid (Medline), EMBASE, AMED, PubMed, SportDiscus, CINAHL, and Cochrane Library. The National Health and Medical Research Council's designation of levels of hierarchy and the Critical Appraisal Skills Programme cohort studies critical appraisal tool were used. Five level IV studies were found. The studies were of varied quality and with mixed results. Gait plates, physiologic/standardized shoes, and orthotic devices (with gate plate extension) were shown to produce a statistically significant improvement to an intoed gait pattern. Shoe wedges, torqheels, and a leather counter splint were not able to reduce an intoed gait pattern. There is limited evidence to inform the non-surgical management of a pediatric intoed gait pattern. The body of evidence that does exist

Changes of gait pattern in children with Charcot-Marie-Tooth disease type 1A: a 18 months follow-up study.

Science.gov (United States)

Ferrarin, Maurizio; Lencioni, Tiziana; Rabuffetti, Marco; Moroni, Isabella; Pagliano, Emanuela; Pareyson, Davide

2013-07-02

In a previous study we identified 3 different gait patterns in a group of children with CMT1A disease: Normal-like (NL), Foot-drop (FD), Foot-drop and Push-off Deficit (FD&POD). Goal of the present study was to perform a follow-up evaluation of the same group of patients to analyze possible changes of gait features in relation to disease progression or specific therapy. Nineteen children with CMT1A were evaluated clinically (CMT-Examination Score and Overall Neuropathy Limitation Scale) and through gait analysis 18.2±1.5 months after a baseline evaluation. Meanwhile, 3 of them had foot surgery. Fifteen out of the 16 non-operated patients significantly changed at least one of the two parameters associated to primary signs (FD and/or POD). Eleven participants worsened at least one parameter and 9 improved one parameter. CMTES significantly worsened for the group of non-operated patients. However, there was no change in CMTES score in 4 patients and in ONLS score in 11. At subgroup level, participants originally belonging to NL group showed a trend towards a foot-drop deficit (-15%, ns); FD and FD&POD subgroups did not change their primary signs, although significant changes were identified individually. All 3 patients operated have improved push-off and proximal joint patterns during walking. Clinical scores did not change within any sub-group. Subtle changes occurring in 1.5 year in gait features of CMT1A children can be instrumentally identified. Such changes show a large inter-subject variability, with some patients even improving their walking pattern. There is anecdotal evidence that foot surgery may improve the push-off phase of gait.

Postural Sway Parameters and Gait Symmetry in Preschool Children: Cross-sectional study

Directory of Open Access Journals (Sweden)

Fabiane E de Sá

Full Text Available Abstract The most important function of posture is to ensure the maintenance of control during the start and the continuation of human movement, moreover, posture serves as a reference for the production of precise movements. The aim of this study was to relate the postural sway parameters and gait symmetry in preschool children.This study is a cross-sectional study, conducted in 49 children with a mean age of 4.65 ± 0.44 years. Initially, height and body mass of children were measured using anthropometric scales. Next, an electronic baropodometer was used to evaluate the distribution of dynamic plantar pressure (gait and stabilometry (balance.A Student t test or Mann-Whitney test for comparing two groups was used. To correlate variables, a Pearson's correlation or Spearman's correlation coefficient was used. The stabilometric parameters showed no significant difference between an eyes open test and eyes closed test in preschool child. We found a moderate relationship between axis inclination and cadence symmetry (R=0.40;p=0.007. Postural sway parameters have relationship cadence symmetry of the gait in preschool children.

Identification of fall risk predictors in daily life measurements: gait characteristics' reliability and association with self-reported fall history.

Science.gov (United States)

Rispens, Sietse M; van Schooten, Kimberley S; Pijnappels, Mirjam; Daffertshofer, Andreas; Beek, Peter J; van Dieën, Jaap H

2015-01-01

Background. Gait characteristics extracted from trunk accelerations during daily life locomotion are complementary to questionnaire- or laboratory-based gait and balance assessments and may help to improve fall risk prediction. Objective. The aim of this study was to identify gait characteristics that are associated with self-reported fall history and that can be reliably assessed based on ambulatory data collected during a single week. Methods. We analyzed 2 weeks of trunk acceleration data (DynaPort MoveMonitor, McRoberts) collected among 113 older adults (age range, 65-97 years). During episodes of locomotion, various gait characteristics were determined, including local dynamic stability, interstride variability, and several spectral features. For each characteristic, we performed a negative binomial regression analysis with the participants' self-reported number of falls in the preceding year as outcome. Reliability of gait characteristics was assessed in terms of intraclass correlations between both measurement weeks. Results. The percentages of spectral power below 0.7 Hz along the vertical and anteroposterior axes and below 10 Hz along the mediolateral axis, as well as local dynamic stability, local dynamic stability per stride, gait smoothness, and the amplitude and slope of the dominant frequency along the vertical axis, were associated with the number of falls in the preceding year and could be reliably assessed (all P 0.75). Conclusions. Daily life gait characteristics are associated with fall history in older adults and can be reliably estimated from a week of ambulatory trunk acceleration measurements. © The Author(s) 2014.

Quantitative analysis of gait in the visually impaired.

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Nakamura, T

1997-05-01

In this comparative study concerning characteristics of independent walking by visually impaired persons, we used a motion analyser system to perform gait analysis of 15 late blind (age 36-54, mean 44.3 years), 15 congenitally blind (age 39-48, mean 43.8 years) and 15 sighted persons (age 40-50, mean 44.4 years) while walking a 10-m walkway. All subjects were male. Compared to the sighted, late blind and congenitally blind persons had a significantly slower walking speed, shorter stride length and longer time in the stance phase of gait. However, the relationships between gait parameters in the late and congenitally blind groups were maintained, as in the sighted group. In addition, the gait of the late blind showed a tendency to approximate the gait patterns of the congenitally blind as the duration of visual loss progressed. Based on these results we concluded that the gait of visually impaired persons, through its active use of non-visual sensory input, represents an attempt to adapt to various environmental conditions in order to maintain a more stable posture and to effect safe walking.

Implementation of a smartphone as a wireless gyroscope platform for quantifying reduced arm swing in hemiplegie gait with machine learning classification by multilayer perceptron neural network.

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LeMoyne, Robert; Mastroianni, Timothy

2016-08-01

Natural gait consists of synchronous and rhythmic patterns for both the lower and upper limb. People with hemiplegia can experience reduced arm swing, which can negatively impact the quality of gait. Wearable and wireless sensors, such as through a smartphone, have demonstrated the ability to quantify various features of gait. With a software application the smartphone (iPhone) can function as a wireless gyroscope platform capable of conveying a gyroscope signal recording as an email attachment by wireless connectivity to the Internet. The gyroscope signal recordings of the affected hemiplegic arm with reduced arm swing arm and the unaffected arm are post-processed into a feature set for machine learning. Using a multilayer perceptron neural network a considerable degree of classification accuracy is attained to distinguish between the affected hemiplegic arm with reduced arm swing arm and the unaffected arm.

Gait performance of children and adolescents with sensorineural hearing loss.

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Melo, Renato de Souza

2017-09-01

Several studies have demonstrated that children with sensorineural hearing loss (SNHL) may exhibit balance disorders, which can compromise the gait performance of this population. Compare the gait performance of normal hearing (NH) children and those with SNHL, considering the sex and age range of the sample, and analyze gait performance according to degrees of hearing loss and etiological factors in the latter group. This is a cross-sectional study that assessed 96 students, 48 NH and 48 with SNHL, aged between 7 and 18 years. The Brazilian version of the Dynamic Gait Index (DGI) was used to analyze gait and the Mann-Whitney test for statistical analysis. The group with SNHL obtained lower average gait performance compared to NH subjects (p=0.000). This was also observed when the children were grouped by sex female and male (p=0.000). The same difference occurred when the children were stratified by age group: 7-18 years (p=0.000). The group with severe and profound hearing loss exhibited worse gait performance than those with mild and moderate loss (p=0.048) and children with prematurity as an etiological factor demonstrated the worst gait performance. The children with SNHL showed worse gait performance compared to NH of the same sex and age group. Those with severe and profound hearing loss and prematurity as an etiological factor demonstrated the worst gait performances. Copyright © 2017 Elsevier B.V. All rights reserved.

Altering length and velocity feedback during a neuro-musculoskeletal simulation of normal gait contributes to hemiparetic gait characteristics.

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Jansen, Karen; De Groote, Friedl; Aerts, Wouter; De Schutter, Joris; Duysens, Jacques; Jonkers, Ilse

2014-04-30

Spasticity is an important complication after stroke, especially in the anti-gravity muscles, i.e. lower limb extensors. However the contribution of hyperexcitable muscle spindle reflex loops to gait impairments after stroke is often disputed. In this study a neuro-musculoskeletal model was developed to investigate the contribution of an increased length and velocity feedback and altered reflex modulation patterns to hemiparetic gait deficits. A musculoskeletal model was extended with a muscle spindle model providing real-time length and velocity feedback of gastrocnemius, soleus, vasti and rectus femoris during a forward dynamic simulation (neural control model). By using a healthy subject's base muscle excitations, in combination with increased feedback gains and altered reflex modulation patterns, the effect on kinematics was simulated. A foot-ground contact model was added to account for the interaction effect between the changed kinematics and the ground. The qualitative effect i.e. the directional effect and the specific gait phases where the effect is present, on the joint kinematics was then compared with hemiparetic gait deviations reported in the literature. Our results show that increased feedback in combination with altered reflex modulation patterns of soleus, vasti and rectus femoris muscle can contribute to excessive ankle plantarflexion/inadequate dorsiflexion, knee hyperextension/inadequate flexion and increased hip extension/inadequate flexion during dedicated gait cycle phases. Increased feedback of gastrocnemius can also contribute to excessive plantarflexion/inadequate dorsiflexion, however in combination with excessive knee and hip flexion. Increased length/velocity feedback can therefore contribute to two types of gait deviations, which are both in accordance with previously reported gait deviations in hemiparetic patients. Furthermore altered modulation patterns, in particular the reduced suppression of the muscle spindle feedback during

Wearable Gait Measurement System with an Instrumented Cane for Exoskeleton Control

Directory of Open Access Journals (Sweden)

Modar Hassan

2014-01-01

Full Text Available In this research we introduce a wearable sensory system for motion intention estimation and control of exoskeleton robot. The system comprises wearable inertial motion sensors and shoe-embedded force sensors. The system utilizes an instrumented cane as a part of the interface between the user and the robot. The cane reflects the motion of upper limbs, and is used in terms of human inter-limb synergies. The developed control system provides assisted motion in coherence with the motion of other unassisted limbs. The system utilizes the instrumented cane together with body worn sensors, and provides assistance for start, stop and continuous walking. We verified the function of the proposed method and the developed wearable system through gait trials on treadmill and on ground. The achievement contributes to finding an intuitive and feasible interface between human and robot through wearable gait sensors for practical use of assistive technology. It also contributes to the technology for cognitively assisted locomotion, which helps the locomotion of physically challenged people.

Technology-Based Feedback and Its Efficacy in Improving Gait Parameters in Patients with Abnormal Gait: A Systematic Review

Directory of Open Access Journals (Sweden)

Gema Chamorro-Moriana

2018-01-01

Full Text Available This systematic review synthesized and analyzed clinical findings related to the effectiveness of innovative technological feedback for tackling functional gait recovery. An electronic search of PUBMED, PEDro, WOS, CINAHL, and DIALNET was conducted from January 2011 to December 2016. The main inclusion criteria were: patients with modified or abnormal gait; application of technology-based feedback to deal with functional recovery of gait; any comparison between different kinds of feedback applied by means of technology, or any comparison between technological and non-technological feedback; and randomized controlled trials. Twenty papers were included. The populations were neurological patients (75%, orthopedic and healthy subjects. All participants were adults, bar one. Four studies used exoskeletons, 6 load platforms and 5 pressure sensors. The breakdown of the type of feedback used was as follows: 60% visual, 40% acoustic and 15% haptic. 55% used terminal feedback versus 65% simultaneous feedback. Prescriptive feedback was used in 60% of cases, while 50% used descriptive feedback. 62.5% and 58.33% of the trials showed a significant effect in improving step length and speed, respectively. Efficacy in improving other gait parameters such as balance or range of movement is observed in more than 75% of the studies with significant outcomes. Conclusion: Treatments based on feedback using innovative technology in patients with abnormal gait are mostly effective in improving gait parameters and therefore useful for the functional recovery of patients. The most frequently highlighted types of feedback were immediate visual feedback followed by terminal and immediate acoustic feedback.

Altered vision destabilizes gait in older persons.

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Helbostad, Jorunn L; Vereijken, Beatrix; Hesseberg, Karin; Sletvold, Olav

2009-08-01

This study assessed the effects of dim light and four experimentally induced changes in vision on gait speed and footfall and trunk parameters in older persons walking on level ground. Using a quasi-experimental design, gait characteristics were assessed in full light, dim light, and in dim light combined with manipulations resulting in reduced depth vision, double vision, blurred vision, and tunnel vision, respectively. A convenience sample of 24 home-dwelling older women and men (mean age 78.5 years, SD 3.4) with normal vision for their age and able to walk at least 10 m without assistance participated. Outcome measures were gait speed and spatial and temporal parameters of footfall and trunk acceleration, derived from an electronic gait mat and accelerometers. Dim light alone had no effect. Vision manipulations combined with dim light had effect on most footfall parameters but few trunk parameters. The largest effects were found regarding double and tunnel vision. Men increased and women decreased gait speed following manipulations (p=0.017), with gender differences also in stride velocity variability (p=0.017) and inter-stride medio-lateral trunk acceleration variability (p=0.014). Gender effects were related to differences in body height and physical functioning. Results indicate that visual problems lead to a more cautious and unstable gait pattern even under relatively simple conditions. This points to the importance of assessing vision in older persons and correcting visual impairments where possible.

Turtle mimetic soft robot with two swimming gaits.

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Song, Sung-Hyuk; Kim, Min-Soo; Rodrigue, Hugo; Lee, Jang-Yeob; Shim, Jae-Eul; Kim, Min-Cheol; Chu, Won-Shik; Ahn, Sung-Hoon

2016-05-04

This paper presents a biomimetic turtle flipper actuator consisting of a shape memory alloy composite structure for implementation in a turtle-inspired autonomous underwater vehicle. Based on the analysis of the Chelonia mydas, the flipper actuator was divided into three segments containing a scaffold structure fabricated using a 3D printer. According to the filament stacking sequence of the scaffold structure in the actuator, different actuating motions can be realized and three different types of scaffold structures were proposed to replicate the motion of the different segments of the flipper of the Chelonia mydas. This flipper actuator can mimic the continuous deformation of the forelimb of Chelonia mydas which could not be realized in previous motor based robot. This actuator can also produce two distinct motions that correspond to the two different swimming gaits of the Chelonia mydas, which are the routine and vigorous swimming gaits, by changing the applied current sequence of the SMA wires embedded in the flipper actuator. The generated thrust and the swimming efficiency in each swimming gait of the flipper actuator were measured and the results show that the vigorous gait has a higher thrust but a relatively lower swimming efficiency than the routine gait. The flipper actuator was implemented in a biomimetic turtle robot, and its average swimming speed in the routine and vigorous gaits were measured with the vigorous gait being capable of reaching a maximum speed of 11.5 mm s(-1).

Coding of visual object features and feature conjunctions in the human brain.

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Martinovic, Jasna; Gruber, Thomas; Müller, Matthias M

2008-01-01

Object recognition is achieved through neural mechanisms reliant on the activity of distributed coordinated neural assemblies. In the initial steps of this process, an object's features are thought to be coded very rapidly in distinct neural assemblies. These features play different functional roles in the recognition process--while colour facilitates recognition, additional contours and edges delay it. Here, we selectively varied the amount and role of object features in an entry-level categorization paradigm and related them to the electrical activity of the human brain. We found that early synchronizations (approx. 100 ms) increased quantitatively when more image features had to be coded, without reflecting their qualitative contribution to the recognition process. Later activity (approx. 200-400 ms) was modulated by the representational role of object features. These findings demonstrate that although early synchronizations may be sufficient for relatively crude discrimination of objects in visual scenes, they cannot support entry-level categorization. This was subserved by later processes of object model selection, which utilized the representational value of object features such as colour or edges to select the appropriate model and achieve identification.

Effectiveness of gait training using an electromechanical gait trainer, with and without functional electric stimulation, in subacute stroke: a randomized controlled trial.

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Tong, Raymond K; Ng, Maple F; Li, Leonard S

2006-10-01

To compare the therapeutic effects of conventional gait training (CGT), gait training using an electromechanical gait trainer (EGT), and gait training using an electromechanical gait trainer with functional electric stimulation (EGT-FES) in people with subacute stroke. Nonblinded randomized controlled trial. Rehabilitation hospital for adults. Fifty patients were recruited within 6 weeks after stroke onset; 46 of these completed the 4-week training period. Participants were randomly assigned to 1 of 3 gait intervention groups: CGT, EGT, or EGT-FES. The experimental intervention was a 20-minute session per day, 5 days a week (weekdays) for 4 weeks. In addition, all participants received their 40-minute sessions of regular physical therapy every weekday as part of their treatment by the hospital. Five-meter walking speed test, Elderly Mobility Scale (EMS), Berg Balance Scale, Functional Ambulatory Category (FAC), Motricity Index leg subscale, FIM instrument score, and Barthel Index. The EGT and EGT-FES groups had statistically significantly more improvement than the CGT group in the 5-m walking speed test (CGT vs EGT, P=.011; CGT vs EGT-FES, P=.001), Motricity Index (CGT vs EGT-FES, P=.011), EMS (CGT vs EGT, P=.006; CGT vs EGT-FES, P=.009), and FAC (CGT vs EGT, P=.005; CGT vs EGT-FES, P=.002) after the 4 weeks of training. No statistically significant differences were found between the EGT and EGT-FES groups in all outcome measures. In this sample with subacute stroke, participants who trained on the electromechanical gait trainer with body-weight support, with or without FES, had a faster gait, better mobility, and improvement in functional ambulation than participants who underwent conventional gait training. Future studies with assessor blinding and larger sample sizes are warranted.

Is adult gait less susceptible than paediatric gait to hip joint centre regression equation error?

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Kiernan, D; Hosking, J; O'Brien, T

2016-03-01

Hip joint centre (HJC) regression equation error during paediatric gait has recently been shown to have clinical significance. In relation to adult gait, it has been inferred that comparable errors with children in absolute HJC position may in fact result in less significant kinematic and kinetic error. This study investigated the clinical agreement of three commonly used regression equation sets (Bell et al., Davis et al. and Orthotrak) for adult subjects against the equations of Harrington et al. The relationship between HJC position error and subject size was also investigated for the Davis et al. set. Full 3-dimensional gait analysis was performed on 12 healthy adult subjects with data for each set compared to Harrington et al. The Gait Profile Score, Gait Variable Score and GDI-kinetic were used to assess clinical significance while differences in HJC position between the Davis and Harrington sets were compared to leg length and subject height using regression analysis. A number of statistically significant differences were present in absolute HJC position. However, all sets fell below the clinically significant thresholds (GPS <1.6°, GDI-Kinetic <3.6 points). Linear regression revealed a statistically significant relationship for both increasing leg length and increasing subject height with decreasing error in anterior/posterior and superior/inferior directions. Results confirm a negligible clinical error for adult subjects suggesting that any of the examined sets could be used interchangeably. Decreasing error with both increasing leg length and increasing subject height suggests that the Davis set should be used cautiously on smaller subjects. Copyright © 2016 Elsevier B.V. All rights reserved.

Gait disorders in patients with fibromyalgia.

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Auvinet, Bernard; Bileckot, Richard; Alix, Anne-Sophie; Chaleil, Denis; Barrey, Eric

2006-10-01

The objective of this study was to compare gait in patients with fibromyalgia and in matched controls. Measurements must be obtained in patients with fibromyalgia, as the evaluation scales for this disorder are semi-quantitative. We used a patented gait analysis system (Locometrix Centaure Metrix, France) developed by the French National Institute for Agricultural Research. Relaxed walking was evaluated in 14 women (mean age 50+/-5 years; mean height 162+/-5 cm; and mean body weight 68+/-13 kg) meeting American College of Rheumatology criteria for fibromyalgia and in 14 controls matched on sex, age, height, and body weight. Gait during stable walking was severely altered in the patients. Walking speed was significantly diminished (Pfibromyalgia.

Gait Deviation Index, Gait Profile Score and Gait Variable Score in children with spastic cerebral palsy: Intra-rater reliability and agreement across two repeated sessions.

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Rasmussen, Helle Mätzke; Nielsen, Dennis Brandborg; Pedersen, Niels Wisbech; Overgaard, Søren; Holsgaard-Larsen, Anders

2015-07-01

The Gait Deviation Index (GDI) and Gait Profile Score (GPS) are the most used summary measures of gait in children with cerebral palsy (CP). However, the reliability and agreement of these indices have not been investigated, limiting their clinimetric quality for research and clinical practice. The aim of this study was to investigate the intra-rater reliability and agreement of summary measures of gait (GDI; GPS; and the Gait Variable Score (GVS) derived from the GPS). The intra-rater reliability and agreement were investigated across two repeated sessions in 18 children aged 5-12 years diagnosed with spastic CP. No systematic bias was observed between the sessions and no heteroscedasticity was observed in Bland-Altman plots. For the GDI and GPS, excellent reliability with intraclass correlation coefficient (ICC) values of 0.8-0.9 was found, while the GVS was found to have fair to good reliability with ICCs of 0.4-0.7. The agreement for the GDI and the logarithmically transformed GPS, in terms of the standard error of measurement as a percentage of the grand mean (SEM%) varied from 4.1 to 6.7%, whilst the smallest detectable change in percent (SDC%) ranged from 11.3 to 18.5%. For the logarithmically transformed GVS, we found a fair to large variation in SEM% from 7 to 29% and in SDC% from 18 to 81%. The GDI and GPS demonstrated excellent reliability and acceptable agreement proving that they can both be used in research and clinical practice. However, the observed large variability for some of the GVS requires cautious consideration when selecting outcome measures. Copyright © 2015 Elsevier B.V. All rights reserved.

The effects of high custom made shoes on gait characteristics and patient satisfaction in hemiplegic gait.

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Eckhardt, Martine M; Mulder, Mascha C Borgerhoff; Horemans, Herwin L; van der Woude, Luc H; Ribbers, Gerard M

2011-10-01

To determine the effects of a temporary high custom made orthopaedic shoe on functional mobility, walking speed, and gait characteristics in hemiplegic stroke patients. In addition, interference of attentional demands and patient satisfaction were studied. Clinical experimental study. University Medical Centre. Nineteen stroke patients (12 males; mean age 55 years (standard deviation (SD) 10 years); mean time post onset 3.6 months (SD 1.4 months)) with a spastic paresis of the lower extremity. Functional mobility was assessed with the timed up and go test, walking speed and gait characteristics were measured with clinical gait analysis and performed with and without a verbal dual task. Patient satisfaction was determined with a questionnaire. Walking with the high orthopaedic shoe resulted in improved functional mobility (22%; pshoes. The dual task interfered with functional mobility during walking. The interference was equally big for normal shoes as for the orthopaedic shoe. Patients evaluated walking with the high orthopaedic shoe as an improvement (psafety, walking distance and walking speed. In the early recovery phase after stroke, when regaining walking ability, a temporary high orthopaedic shoe can improve hemiplegic gait, even with dual task interference. Copyright © 2011 Elsevier B.V. All rights reserved.

Estimation of Human Hip and Knee Multi-Joint Dynamics Using the LOPES Gait Trainer

NARCIS (Netherlands)

Koopman, Hubertus F.J.M.; van Asseldonk, Edwin H.F.; van der Kooij, Herman

2016-01-01

In this study, we present and evaluate a novel method to estimate multi-joint leg impedance, using a robotic gait training device. The method is based on multi-input–multi-output system identification techniques and is designed for continuous torque perturbations at the hip and knee joint

Control strategies for effective robot assisted gait rehabilitation: the state of art and future prospects.

Science.gov (United States)

Cao, Jinghui; Xie, Sheng Quan; Das, Raj; Zhu, Guo L

2014-12-01

A large number of gait rehabilitation robots, together with a variety of control strategies, have been developed and evaluated during the last decade. Initially, control strategies applied to rehabilitation robots were adapted from those applied to traditional industrial robots. However, these strategies cannot optimise effectiveness of gait rehabilitation. As a result, researchers have been investigating control strategies tailored for the needs of rehabilitation. Among these control strategies, assisted-as-needed (AAN) control is one of the most popular research topics in this field. AAN training strategies have gained the theoretical and practical evidence based backup from motor learning principles and clinical studies. Various approaches to AAN training have been proposed and investigated by research groups all around the world. This article presents a review on control algorithms of gait rehabilitation robots to summarise related knowledge and investigate potential trends of development. There are existing review papers on control strategies of rehabilitation robots. The review by Marchal-Crespo and Reinkensmeyer (2009) had a broad cover of control strategies of all kinds of rehabilitation robots. Hussain et al. (2011) had specifically focused on treadmill gait training robots and covered a limited number of control implementations on them. This review article encompasses more detailed information on control strategies for robot assisted gait rehabilitation, but is not limited to treadmill based training. It also investigates the potential to further develop assist-as-needed gait training based on assessments of patients' ability. In this paper, control strategies are generally divided into the trajectory tracking control and AAN control. The review covers these two basic categories, as well as other control algorithm and technologies derived from them, such as biofeedback control. Assessments on human gait ability are also included to investigate how to

Biofeedback for robotic gait rehabilitation

Directory of Open Access Journals (Sweden)

Colombo Gery

2007-01-01

Full Text Available Abstract Background Development and increasing acceptance of rehabilitation robots as well as advances in technology allow new forms of therapy for patients with neurological disorders. Robot-assisted gait therapy can increase the training duration and the intensity for the patients while reducing the physical strain for the therapist. Optimal training effects during gait therapy generally depend on appropriate feedback about performance. Compared to manual treadmill therapy, there is a loss of physical interaction between therapist and patient with robotic gait retraining. Thus, it is difficult for the therapist to assess the necessary feedback and instructions. The aim of this study was to define a biofeedback system for a gait training robot and test its usability in subjects without neurological disorders. Methods To provide an overview of biofeedback and motivation methods applied in gait rehabilitation, previous publications and results from our own research are reviewed. A biofeedback method is presented showing how a rehabilitation robot can assess the patients' performance and deliver augmented feedback. For validation, three subjects without neurological disorders walked in a rehabilitation robot for treadmill training. Several training parameters, such as body weight support and treadmill speed, were varied to assess the robustness of the biofeedback calculation to confounding factors. Results The biofeedback values correlated well with the different activity levels of the subjects. Changes in body weight support and treadmill velocity had a minor effect on the biofeedback values. The synchronization of the robot and the treadmill affected the biofeedback values describing the stance phase. Conclusion Robot-aided assessment and feedback can extend and improve robot-aided training devices. The presented method estimates the patients' gait performance with the use of the robot's existing sensors, and displays the resulting biofeedback

The Throw-and-Catch Model of Human Gait: Evidence from Coupling of Pre-Step Postural Activity and Step Location

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Bancroft, Matthew J.; Day, Brian L.

2016-01-01

Postural activity normally precedes the lift of a foot from the ground when taking a step, but its function is unclear. The throw-and-catch hypothesis of human gait proposes that the pre-step activity is organized to generate momentum for the body to fall ballistically along a specific trajectory during the step. The trajectory is appropriate for the stepping foot to land at its intended location while at the same time being optimally placed to catch the body and regain balance. The hypothesis therefore predicts a strong coupling between the pre-step activity and step location. Here we examine this coupling when stepping to visually-presented targets at different locations. Ten healthy, young subjects were instructed to step as accurately as possible onto targets placed in five locations that required either different step directions or different step lengths. In 75% of trials, the target location remained constant throughout the step. In the remaining 25% of trials, the intended step location was changed by making the target jump to a new location 96 ms ± 43 ms after initiation of the pre-step activity, long before foot lift. As predicted by the throw-and-catch hypothesis, when the target location remained constant, the pre-step activity led to body momentum at foot lift that was coupled to the intended step location. When the target location jumped, the pre-step activity was adjusted (median latency 223 ms) and prolonged (on average by 69 ms), which altered the body’s momentum at foot lift according to where the target had moved. We conclude that whenever possible the coupling between the pre-step activity and the step location is maintained. This provides further support for the throw-and-catch hypothesis of human gait. PMID:28066208

The Throw-and-Catch Model of Human Gait: Evidence from Coupling of Pre-Step Postural Activity and Step Location.

Science.gov (United States)

Bancroft, Matthew J; Day, Brian L

2016-01-01

Postural activity normally precedes the lift of a foot from the ground when taking a step, but its function is unclear. The throw-and-catch hypothesis of human gait proposes that the pre-step activity is organized to generate momentum for the body to fall ballistically along a specific trajectory during the step. The trajectory is appropriate for the stepping foot to land at its intended location while at the same time being optimally placed to catch the body and regain balance. The hypothesis therefore predicts a strong coupling between the pre-step activity and step location. Here we examine this coupling when stepping to visually-presented targets at different locations. Ten healthy, young subjects were instructed to step as accurately as possible onto targets placed in five locations that required either different step directions or different step lengths. In 75% of trials, the target location remained constant throughout the step. In the remaining 25% of trials, the intended step location was changed by making the target jump to a new location 96 ms ± 43 ms after initiation of the pre-step activity, long before foot lift. As predicted by the throw-and-catch hypothesis, when the target location remained constant, the pre-step activity led to body momentum at foot lift that was coupled to the intended step location. When the target location jumped, the pre-step activity was adjusted (median latency 223 ms) and prolonged (on average by 69 ms), which altered the body's momentum at foot lift according to where the target had moved. We conclude that whenever possible the coupling between the pre-step activity and the step location is maintained. This provides further support for the throw-and-catch hypothesis of human gait.

Variability of gait, bilateral coordination, and asymmetry in women with fibromyalgia.

Science.gov (United States)

Heredia-Jimenez, J; Orantes-Gonzalez, E; Soto-Hermoso, V M

2016-03-01

To analyze how fibromyalgia affected the variability, asymmetry, and bilateral coordination of gait walking at comfortable and fast speeds. 65 fibromyalgia (FM) patients and 50 healthy women were analyzed. Gait analysis was performed using an instrumented walkway (GAITRite system). Average walking speed, coefficient of variation (CV) of stride length, swing time, and step width data were obtained and bilateral coordination and gait asymmetry were analyzed. FM patients presented significantly lower speeds than the healthy group. FM patients obtained significantly higher values of CV_StrideLength (p=0.04; pGait asymmetry only showed significant differences in the fast condition. FM patients walked more slowly and presented a greater variability of gait and worse bilateral coordination than healthy subjects. Gait asymmetry only showed differences in the fast condition. The variability and the bilateral coordination were particularly affected by FM in women. Therefore, variability and bilateral coordination of gait could be analyzed to complement the gait evaluation of FM patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Flexed-knee gait in children with cerebral palsy.

Science.gov (United States)

Church, C; Ge, J; Hager, S; Haumont, T; Lennon, N; Niiler, T; Hulbert, R; Miller, F

2018-04-01

Aims The purpose of this study was to evaluate the long-term outcome of adolescents with cerebral palsy who have undergone single-event multilevel surgery for a flexed-knee gait, followed into young adulthood using 3D motion analysis. Patients and Methods A total of 59 young adults with spastic cerebral palsy, with a mean age of 26 years (sd 3), were enrolled into the study in which their gait was compared with an evaluation that had taken place a mean of 12 years (sd 2) previously. At their visits during adolescence, the children walked with excessive flexion of the knee at initial contact and surgical or therapeutic interventions were not controlled between visits. Results Based on the change in flexed-knee gait over approximately ten years, improvements were seen in increased Gait Deviation Index (p gait (p = 0.007) suggested a mild decline in function. Quality-of-life measures showed that these patients fell within normal limits compared with typical young adults in areas other than physical function. Conclusion While some small significant changes were noted, little clinically significant change was seen in function and gait, with gross motor function maintained between adolescence and young adulthood. Cite this article: Bone Joint J 2018;100-B:549-56.

Dynamic Simulation and Analysis of Human Walking Mechanism

Science.gov (United States)

Azahari, Athirah; Siswanto, W. A.; Ngali, M. Z.; Salleh, S. Md.; Yusup, Eliza M.

2017-01-01

Behaviour such as gait or posture may affect a person with the physiological condition during daily activities. The characteristic of human gait cycle phase is one of the important parameter which used to described the human movement whether it is in normal gait or abnormal gait. This research investigates four types of crouch walking (upright, interpolated, crouched and severe) by simulation approach. The assessment are conducting by looking the parameters of hamstring muscle joint, knee joint and ankle joint. The analysis results show that based on gait analysis approach, the crouch walking have a weak pattern of walking and postures. Short hamstring and knee joint is the most influence factor contributing to the crouch walking due to excessive hip flexion that typically accompanies knee flexion.

Spatial-temporal parameters of gait in women with fibromyalgia.

Science.gov (United States)

Heredia Jiménez, José María; Aparicio García-Molina, Virginia A; Porres Foulquie, Jesús M; Delgado Fernández, Manuel; Soto Hermoso, Victor M

2009-05-01

The aim of the present study was to determine if there are differences in such parameters among patients affected by fibromyalgia (FM) and healthy subjects and whether the degree of affectation by FM can decrease the gait parameters. We studied 55 women with FM and 44 controls. Gait analysis was performed using an instrumented walkway for measurement of the kinematic parameters of gait (GAITRite system), and patients completed a Spanish version of Fibromyalgia Impact Questionnaire (FIQ). Significant differences (p Gait parameters of women affected by FM were severely impaired when compared to those of healthy women. Different factors such as lack of physical activity, bradikinesia, overweight, fatigue, and pain together with a lower isometric force in the legs can be responsible for the alterations in gait and poorer life quality of women with FM.

Treadmill training with partial body weight support and an electromechanical gait trainer for restoration of gait in subacute stroke patients: a randomized crossover study.

Science.gov (United States)

Werner, C; Von Frankenberg, S; Treig, T; Konrad, M; Hesse, S

2002-12-01

The purpose of this study was to compare treadmill and electromechanical gait trainer therapy in subacute, nonambulatory stroke survivors. The gait trainer was designed to provide nonambulatory subjects the repetitive practice of a gait-like movement without overexerting therapists. This was a randomized, controlled study with a crossover design following an A-B-A versus a B-A-B pattern. A consisted of 2 weeks of gait trainer therapy, and B consisted of 2 weeks of treadmill therapy. Thirty nonambulatory hemiparetic patients, 4 to 12 weeks after stroke, were randomly assigned to 1 of the 2 groups receiving locomotor therapy every workday for 15 to 20 minutes for 6 weeks. Weekly gait ability (functional ambulation category [FAC]), gait velocity, and the required physical assistance during both kinds of locomotor therapy were the primary outcome measures, and other motor functions (Rivermead motor assessment score) and ankle spasticity (modified Ashworth score) were the secondary outcome measures. Follow-up occurred 6 months later. The groups did not differ at study onset with respect to the clinical characteristics and effector variables. During treatment, the FAC, gait velocity, and Rivermead scores improved in both groups, and ankle spasticity did not change. Median FAC level was 4 (3 to 4) in group A compared with 3 (2 to 3) in group B at the end of treatment (P=0.018), but the difference at 6-month follow up was not significant. The therapeutic effort was less on the gait trainer, with 1 instead of 2 therapists assisting the patient at study onset. All but seven patients preferred the gait trainer. The newly developed gait trainer was at least as effective as treadmill therapy with partial body weight support while requiring less input from the therapist. Further studies are warranted.

Effect of 6-month community-based exercise interventions on gait and functional fitness of an older population: a quasi-experimental study

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Ramalho F

2018-04-01

Full Text Available Fátima Ramalho,1,2 Rita Santos-Rocha,1,2 Marco Branco,1,2 Vera Moniz-Pereira,2 Helô-Isa André,2 António P Veloso,2 Filomena Carnide2 1Sport Sciences School of Rio Maior (ESDRM, Polytechnic Institute of Santarém, Rio Maior, Portugal; 2Laboratory of Biomechanics and Functional Morphology, Interdisciplinary Centre for the Study of Human Performance (CIPER, Faculty of Human Kinetics (FMH, University of Lisbon, Cruz Quebrada, Portugal Background: Gait ability in older adults has been associated with independent living, increased survival rates, fall prevention, and quality of life. There are inconsistent findings regarding the effects of exercise interventions in the maintenance of gait parameters.Objectives: The aim of the study was to analyze the effects of a community-based periodized exercise intervention on the improvement of gait parameters and functional fitness in an older adult group compared with a non-periodized program.Methods: A quasi-experimental study with follow-up was performed in a periodized exercise group (N=15 and in a non-periodized exercise group (N=13. The primary outcomes were plantar pressure gait parameters, and the secondary outcomes were physical activity, aerobic endurance, lower limb strength, agility, and balance. These variables were recorded at baseline and after 6 months of intervention.Results: Both programs were tailored to older adults’ functional fitness level and proved to be effective in reducing the age-related decline regarding functional fitness and gait parameters. Gait parameters were sensitive to both the exercise interventions. Conclusion: These exercise protocols can be used by exercise professionals in prescribing community exercise programs, as well as by health professionals in promoting active aging. Keywords: mobility, community exercise programs, active aging, plantar pressure analysis, ground reaction forces, gait properties

Muscle reflexes during gait elicited by electrical stimulation of the posterior cruciate ligament in humans

DEFF Research Database (Denmark)

Fischer-Rasmussen, T; Krogsgaard, M R; Jensen, D B

2002-01-01

over the vastus medialis, rectus femoris, vastus lateralis, biceps femoris caput longum, and semitendinosus muscles. The stimuli consisted of four pulses delivered at 200 Hz; the stimulus amplitude was two to three times the sensory threshold. The electrical stimulation of the PCL inhibited the ongoing......We investigated the influence of electrical stimulation of the posterior cruciate ligament (PCL) on the motoneuron pool of the thigh and calf muscle during gait. The study group comprised eight young men without any history of injury to the knee joints. Multistranded teflon-insulated stainless...... steel wires were inserted into the PCL guided by sonography and in four subjects also into the fat pad of the knee. The PCL was electrically stimulated during gait on a treadmill at heel strike and 100 ms after heel strike. Electromyographic signals were recorded with bipolar surface electrodes placed...

Quantifying gait patterns in Parkinson's disease

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Romero, Mónica; Atehortúa, Angélica; Romero, Eduardo

2017-11-01

Parkinson's disease (PD) is constituted by a set of motor symptoms, namely tremor, rigidity, and bradykinesia, which are usually described but not quantified. This work proposes an objective characterization of PD gait patterns by approximating the single stance phase a single grounded pendulum. This model estimates the force generated by the gait during the single support from gait data. This force describes the motion pattern for different stages of the disease. The model was validated using recorded videos of 8 young control subjects, 10 old control subjects and 10 subjects with Parkinson's disease in different stages. The estimated force showed differences among stages of Parkinson disease, observing a decrease of the estimated force for the advanced stages of this illness.

Identification of Characteristic Motor Patterns Preceding Freezing of Gait in Parkinson’s Disease Using Wearable Sensors

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Luca Palmerini

2017-08-01

Full Text Available Freezing of gait (FOG is a disabling symptom that is common among patients with advanced Parkinson’s disease (PD. External cues such as rhythmic auditory stimulation can help PD patients experiencing freezing to resume walking. Wearable systems for automatic freezing detection have been recently developed. However, these systems detect a FOG episode after it has happened. Instead, in this study, a new approach for the prediction of FOG (before it actually happens is presented. Prediction of FOG might enable preventive cueing, reducing the likelihood that FOG will occur. Moreover, understanding the causes and circumstances of FOG is still an open research problem. Hence, a quantitative characterization of movement patterns just before FOG (the pre-FOG phase is of great importance. In this study, wearable inertial sensors were used to identify and quantify the characteristics of gait during the pre-FOG phase and compare them with the characteristics of gait that do not precede FOG. The hypothesis of this study is based on the threshold-based model of FOG, which suggests that before FOG occurs, there is a degradation of the gait pattern. Eleven PD subjects were analyzed. Six features extracted from movement signals recorded by inertial sensors showed significant differences between gait and pre-FOG. A classification algorithm was developed in order to test if it is feasible to predict FOG (i.e., detect it before it happens. The aim of the classification procedure was to identify the pre-FOG phase. Results confirm that there is a degradation of gait occurring before freezing. Results also provide preliminary evidence on the feasibility of creating an automatic algorithm to predict FOG. Although some limitations are present, this study shows promising findings for characterizing and identifying pre-FOG patterns, another step toward a better understanding, prediction, and prevention of this disabling symptom.

Design and development of a prototype platform for gait analysis

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Diffenbaugh, T. E.; Marti, M. A.; Jagani, J.; Garcia, V.; Iliff, G. J.; Phoenix, A.; Woolard, A. G.; Malladi, V. V. N. S.; Bales, D. B.; Tarazaga, P. A.

2017-04-01

The field of event classification and localization in building environments using accelerometers has grown significantly due to its implications for energy, security, and emergency protocols. Virginia Tech's Goodwin Hall (VT-GH) provides a robust testbed for such work, but a reduced scale testbed could provide significant benefits by allowing algorithm development to occur in a simplified environment. Environments such as VT-GH have high human traffic that contributes external noise disrupting test signals. This paper presents a design solution through the development of an isolated platform for data collection, portable demonstrations, and the development of localization and classification algorithms. The platform's success was quantified by the resulting transmissibility of external excitation sources, demonstrating the capabilities of the platform to isolate external disturbances while preserving gait information. This platform demonstrates the collection of high-quality gait information in otherwise noisy environments for data collection or demonstration purposes.

Neuromuscular adjustments of gait associated with unstable conditions

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Ivanenko, Y. P.; d'Avella, A.; Serrao, M.; Ranavolo, A.; Draicchio, F.; Cappellini, G.; Casali, C.; Lacquaniti, F.

2015-01-01

A compact description of coordinated muscle activity is provided by the factorization of electromyographic (EMG) signals. With the use of this approach, it has consistently been shown that multimuscle activity during human locomotion can be accounted for by four to five modules, each one comprised of a basic pattern timed at a different phase of gait cycle and the weighting coefficients of synergistic muscle activations. These modules are flexible, in so far as the timing of patterns and the amplitude of weightings can change as a function of gait speed and mode. Here we consider the adjustments of the locomotor modules related to unstable walking conditions. We compared three different conditions, i.e., locomotion of healthy subjects on slippery ground (SL) and on narrow beam (NB) and of cerebellar ataxic (CA) patients on normal ground. Motor modules were computed from the EMG signals of 12 muscles of the right lower limb using non-negative matrix factorization. The unstable gait of SL, NB, and CA showed significant changes compared with controls in the stride length, stride width, range of angular motion, and trunk oscillations. In most subjects of all three unstable conditions, >70% of the overall variation of EMG waveforms was accounted for by four modules that were characterized by a widening of muscle activity patterns. This suggests that the nervous system adopts the strategy of prolonging the duration of basic muscle activity patterns to cope with unstable conditions resulting from either slippery ground, reduced support surface, or pathology. PMID:26378199

Gait Characteristics in Adolescents With Multiple Sclerosis.

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Kalron, Alon; Frid, Lior; Menascu, Shay

2017-03-01

Multiple sclerosis is a progressive autoimmune disease of the central nervous system. A presentation of multiple sclerosis before age18 years has traditionally been thought to be rare. However, during the past decade, more cases have been reported. We examined gait characteristics in 24 adolescents with multiple sclerosis (12 girls, 12 boys). Mean disease duration was 20.4 (S.D. = 24.9) months and mean age was 15.5 (S.D. = 1.1) years. The mean expanded disability status scale score was 1.7 (S.D. = 0.7) indicating minimal disability. Outcomes were compared with gait and the gait variability index value of healthy age-matched adolescents. Adolescents with multiple sclerosis walked slower with a wider base of support compared with age-matched healthy control subjects. Moreover, the gait variability index was lower in the multiple sclerosis group compared with the values in the healthy adolescents: 85.4 (S.D. = 8.1) versus 96.5 (S.D. = 7.4). We present gait parameters of adolescents with multiple sclerosis. From a clinical standpoint, our data could improve management of walking dysfunction in this relatively young population. Copyright © 2016 Elsevier Inc. All rights reserved.

Gait pattern recognition in cerebral palsy patients using neural network modelling

International Nuclear Information System (INIS)

Muhammad, J.; Gibbs, S.; Abboud, R.; Anand, S.

2015-01-01

Interpretation of gait data obtained from modern 3D gait analysis is a challenging and time consuming task. The aim of this study was to create neural network models which can recognise the gait patterns from pre- and post-treatment and the normal ones. Neural network is a method which works on the principle of learning from experience and then uses the obtained knowledge to predict the unknown. Methods: Twenty-eight patients with cerebral palsy were recruited as subjects whose gait was analysed in pre- and post-treatment. A group of twenty-six normal subjects also participated in this study as control group. All subjects gait was analysed using Vicon Nexus to obtain the gait parameters and kinetic and kinematic parameters of hip, knee and ankle joints in three planes of both limbs. The gait data was used as input to create neural network models. A total of approximately 300 trials were split into 70% and 30% to train and test the models, respectively. Different models were built using different parameters. The gait was categorised as three patterns, i.e., normal, pre- and post-treatments. Result: The results showed that the models using all parameters or using the joint angles and moments could predict the gait patterns with approximately 95% accuracy. Some of the models e.g., the models using joint power and moments, had lower rate in recognition of gait patterns with approximately 70-90% successful ratio. Conclusion: Neural network model can be used in clinical practice to recognise the gait pattern for cerebral palsy patients. (author)

Analysis of foot load during ballet dancers' gait.

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Prochazkova, Marketa; Tepla, Lucie; Svoboda, Zdenek; Janura, Miroslav; Cieslarová, Miloslava

2014-01-01

Ballet is an art that puts extreme demands on the dancer's musculoskeletal system and therefore significantly affects motor behavior of the dancers. The aim of our research was to compare plantar pressure distribution during stance phase of gait between a group of professional ballet dancers and non-dancers. Thirteen professional dancers (5 men, 8 women; mean age of 24.1 ± 3.8 years) and 13 nondancers (5 men, 8 women; mean age of 26.1 ± 5.3 years) participated in this study. Foot pressure analysis during gait was collected using a 2 m pressure plate. The participants were instructed to walk across the platform at a self-selected pace barefoot. Three gait cycles were necessary for the data analysis. The results revealed higher (p < 0.05) pressure peaks in medial edge of forefoot during gait for dancers in comparison with nondancers. Furthermore, differences in total foot loading and foot loading duration of rearfoot was higher (p < 0.05) in dancers as well. We can attribute these differences to long-term and intensive dancing exercises that can change the dancer's gait stereotype.

The Comparative Diagnostic Features of Canine and Human Lymphoma

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Davis M. Seelig

2016-06-01

Full Text Available The non-Hodgkin lymphomas (NHLs are a heterogeneous family of lymphoid malignancies that are among the most common neoplasms of both dogs and humans. Owing to shared molecular, signaling, incidence, and pathologic features, there is a strong framework supporting the utilization of canine lymphoma as a comparative, large animal model of human NHL. In alignment with the biologic similarities, the current approach towards the diagnosis and classification of canine lymphoma is based upon the human World Health Organization guidelines. While this approach has contributed to an increasing appreciation of the potential biological scope of canine lymphoma, it has also become apparent that the most appropriate diagnostic philosophy must be multimodal, namely by requiring knowledge of microscopic, immunophenotypic, and clinical features before establishing a final disease diagnosis. This review seeks to illustrate the comparative similarities and differences in the diagnosis of canine lymphoma through the presentation of the microscopic and immunophenotypic features of its most common forms.

The Comparative Diagnostic Features of Canine and Human Lymphoma.

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Seelig, Davis M; Avery, Anne C; Ehrhart, E J; Linden, Michael A

2016-06-01

The non-Hodgkin lymphomas (NHLs) are a heterogeneous family of lymphoid malignancies that are among the most common neoplasms of both dogs and humans. Owing to shared molecular, signaling, incidence, and pathologic features, there is a strong framework supporting the utilization of canine lymphoma as a comparative, large animal model of human NHL. In alignment with the biologic similarities, the current approach towards the diagnosis and classification of canine lymphoma is based upon the human World Health Organization guidelines. While this approach has contributed to an increasing appreciation of the potential biological scope of canine lymphoma, it has also become apparent that the most appropriate diagnostic philosophy must be multimodal, namely by requiring knowledge of microscopic, immunophenotypic, and clinical features before establishing a final disease diagnosis. This review seeks to illustrate the comparative similarities and differences in the diagnosis of canine lymphoma through the presentation of the microscopic and immunophenotypic features of its most common forms.

Probabilistic Gait Classification in Children with Cerebral Palsy: A Bayesian Approach

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Van Gestel, Leen; De Laet, Tinne; Di Lello, Enrico; Bruyninckx, Herman; Molenaers, Guy; Van Campenhout, Anja; Aertbelien, Erwin; Schwartz, Mike; Wambacq, Hans; De Cock, Paul; Desloovere, Kaat

2011-01-01

Three-dimensional gait analysis (3DGA) generates a wealth of highly variable data. Gait classifications help to reduce, simplify and interpret this vast amount of 3DGA data and thereby assist and facilitate clinical decision making in the treatment of CP. CP gait is often a mix of several clinically accepted distinct gait patterns. Therefore,…

Design of a gait training device for control of pelvic obliquity.

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Pietrusinski, Maciej; Severini, Giacomo; Cajigas, Iahn; Mavroidis, Constantinos; Bonato, Paolo

2012-01-01

This paper presents the design and testing of a novel device for the control of pelvic obliquity during gait. The device, called the Robotic Gait Rehabilitation (RGR) Trainer, consists of a single actuator system designed to target secondary gait deviations, such as hip-hiking, affecting the movement of the pelvis. Secondary gait deviations affecting the pelvis are generated in response to primary gait deviations (e.g. limited knee flexion during the swing phase) in stroke survivors and contribute to the overall asymmetrical gait pattern often observed in these patients. The proposed device generates a force field able to affect the obliquity of the pelvis (i.e. the rotation of the pelvis around the anteroposterior axis) by using an impedance controlled single linear actuator acting on a hip orthosis. Tests showed that the RGR Trainer is able to induce changes in pelvic obliquity trajectories (hip-hiking) in healthy subjects. These results suggest that the RGR Trainer is suitable to test the hypothesis that has motivated our efforts toward developing the system, namely that addressing both primary and secondary gait deviations during robotic-assisted gait training may help promote a physiologically-sound gait behavior more effectively than when only primary deviations are addressed.

The value of the NDT-Bobath method in post-stroke gait training.

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Mikołajewska, Emilia

2013-01-01

Stroke is perceived a major cause of disability, including gait disorders. Looking for more effective methods of gait reeducation in post-stroke survivors is one of the most important issues in contemporary neurorehabilitation. Following a stroke, patients suffer from gait disorders. The aim of this paper is to present the outcomes of a study of post-stroke gait reeducation using the NeuroDevelopmental Treatment-Bobath (NDT-Bobath) method. The research was conducted among 60 adult patients who had undergone ischemic stroke. These patients were treated using the NDT-Bobath method. These patients' gait reeducation was assessed using spatio-temporal gait parameters (gait velocity, cadence and stride length). Measurements of these parameters were conducted by the same therapist twice: on admission, and after the tenth session of gait reeducation. Among the 60 patients involved in the study, the results were as follows: in terms of gait velocity, recovery was observed in 39 cases (65%), in terms of cadence, recovery was observed in 39 cases (65%), in terms of stride length, recovery was observed in 50 cases (83.33%). Benefits were observed after short-term therapy, reflected by measurable statistically significant changes in the patients' gait parameters.

Improved walking ability and reduced therapeutic stress with an electromechanical gait device.

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Freivogel, Susanna; Schmalohr, Dieter; Mehrholz, Jan

2009-09-01

To evaluate the effectiveness of repetitive locomotor training using a newly developed electromechanical gait device compared with treadmill training/gait training with respect to patient's ambulatory motor outcome, necessary personnel resources, and discomfort experienced by therapists and patients. Randomized, controlled, cross-over trial. Sixteen non-ambulatory patients after stroke, severe brain or spinal cord injury sequentially received 2 kinds of gait training. Study intervention A: 20 treatments of locomotor training with an electromechanical gait device; control intervention B: 20 treatments of locomotor training with treadmill or task-oriented gait training. The primary variable was walking ability (Functional Ambulation Category). Secondary variables included gait velocity, Motricity-Index, Rivermead-Mobility-Index, number of therapists needed, and discomfort and effort of patients and therapists during training. Gait ability and the other motor outcome related parameters improved for all patients, but without significant difference between intervention types. However, during intervention A, significantly fewer therapists were needed, and they reported less discomfort and a lower level of effort during training sessions. Locomotor training with or without an electromechanical gait trainer leads to improved gait ability; however, using the electromechanical gait trainer requires less therapeutic assistance, and therapist discomfort is reduced.

The gait standard deviation, a single measure of kinematic variability.

Science.gov (United States)

Sangeux, Morgan; Passmore, Elyse; Graham, H Kerr; Tirosh, Oren

2016-05-01

Measurement of gait kinematic variability provides relevant clinical information in certain conditions affecting the neuromotor control of movement. In this article, we present a measure of overall gait kinematic variability, GaitSD, based on combination of waveforms' standard deviation. The waveform standard deviation is the common numerator in established indices of variability such as Kadaba's coefficient of multiple correlation or Winter's waveform coefficient of variation. Gait data were collected on typically developing children aged 6-17 years. Large number of strides was captured for each child, average 45 (SD: 11) for kinematics and 19 (SD: 5) for kinetics. We used a bootstrap procedure to determine the precision of GaitSD as a function of the number of strides processed. We compared the within-subject, stride-to-stride, variability with the, between-subject, variability of the normative pattern. Finally, we investigated the correlation between age and gait kinematic, kinetic and spatio-temporal variability. In typically developing children, the relative precision of GaitSD was 10% as soon as 6 strides were captured. As a comparison, spatio-temporal parameters required 30 strides to reach the same relative precision. The ratio stride-to-stride divided by normative pattern variability was smaller in kinematic variables (the smallest for pelvic tilt, 28%) than in kinetic and spatio-temporal variables (the largest for normalised stride length, 95%). GaitSD had a strong, negative correlation with age. We show that gait consistency may stabilise only at, or after, skeletal maturity. Copyright © 2016 Elsevier B.V. All rights reserved.

The Effects of Music Salience on the Gait Performance of Young Adults.

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de Bruin, Natalie; Kempster, Cody; Doucette, Angelica; Doan, Jon B; Hu, Bin; Brown, Lesley A

2015-01-01

The presence of a rhythmic beat in the form of a metronome tone or beat-accentuated original music can modulate gait performance; however, it has yet to be determined whether gait modulation can be achieved using commercially available music. The current study investigated the effects of commercially available music on the walking of healthy young adults. Specific aims were (a) to determine whether commercially available music can be used to influence gait (i.e., gait velocity, stride length, cadence, stride time variability), (b) to establish the effect of music salience on gait (i.e., gait velocity, stride length, cadence, stride time variability), and (c) to examine whether music tempi differentially effected gait (i.e., gait velocity, stride length, cadence, stride time variability). Twenty-five participants walked the length of an unobstructed walkway while listening to music. Music selections differed with respect to the salience or the tempo of the music. The genre of music and artists were self-selected by participants. Listening to music while walking was an enjoyable activity that influenced gait. Specifically, salient music selections increased measures of cadence, velocity, and stride length; in contrast, gait was unaltered by the presence of non-salient music. Music tempo did not differentially affect gait performance (gait velocity, stride length, cadence, stride time variability) in these participants. Gait performance was differentially influenced by music salience. These results have implications for clinicians considering the use of commercially available music as an alternative to the traditional rhythmic auditory cues used in rehabilitation programs. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Management of apraxic gait in a stroke patient.

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Jantra, P; Monga, T N; Press, J M; Gervais, B J

1992-01-01

There is little information available regarding management of apraxic gait. We present a 61-year-old man with a five-year history of right-sided cerebrovascular accident, apraxic gait, difficulty in walking, and frequent falls. A CT head scan revealed moderate cerebral atrophy, a small lacunar infarction. The patient was unable to initiate walking, was bed ridden and housebound. Traditional gait training and balance exercises failed to improve his gait. Two straight canes were modified by fixing florescent horizontal projections approximately two inches up from the tip of the cane. The patient was instructed to step over the horizontal projected portion, making use of visual cues from the florescent painted projections. The patient became independent with safe ambulation after practicing for approximately three weeks and was discharged home.

An automated procedure for identification of a person using gait analysis

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Alena Galajdová

2016-10-01

Full Text Available Different biometric methods are available for identification purpose of a person. The most commonly used are fingerprints, but there are also other biometric methods such as voice, morphology of ears, structure of iris and so on. In some cases, it is required to identify a person according to his/her biomechanical parameters or even his/her gait pattern. Gait is an outstanding biometric behavioural characteristic that is not widely used yet for identification purposes because efficient and proven automated processes are not yet available. Several systems and gait pattern databases have been developed for rapid evaluation and processing of gait. This article describes an original automated evaluation procedure of gait pattern and identification of unique gait parameters for automatic identification purposes.

A Machine Learning Approach to Automated Gait Analysis for the Noldus Catwalk System.

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Frohlich, Holger; Claes, Kasper; De Wolf, Catherine; Van Damme, Xavier; Michel, Anne

2018-05-01

Gait analysis of animal disease models can provide valuable insights into in vivo compound effects and thus help in preclinical drug development. The purpose of this paper is to establish a computational gait analysis approach for the Noldus Catwalk system, in which footprints are automatically captured and stored. We present a - to our knowledge - first machine learning based approach for the Catwalk system, which comprises a step decomposition, definition and extraction of meaningful features, multivariate step sequence alignment, feature selection, and training of different classifiers (gradient boosting machine, random forest, and elastic net). Using animal-wise leave-one-out cross validation we demonstrate that with our method we can reliable separate movement patterns of a putative Parkinson's disease animal model and several control groups. Furthermore, we show that we can predict the time point after and the type of different brain lesions and can even forecast the brain region, where the intervention was applied. We provide an in-depth analysis of the features involved into our classifiers via statistical techniques for model interpretation. A machine learning method for automated analysis of data from the Noldus Catwalk system was established. Our works shows the ability of machine learning to discriminate pharmacologically relevant animal groups based on their walking behavior in a multivariate manner. Further interesting aspects of the approach include the ability to learn from past experiments, improve with more data arriving and to make predictions for single animals in future studies.

Real-Time Gait Cycle Parameter Recognition Using a Wearable Accelerometry System

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Jun-Ming Lu

2011-07-01

Full Text Available This paper presents the development of a wearable accelerometry system for real-time gait cycle parameter recognition. Using a tri-axial accelerometer, the wearable motion detector is a single waist-mounted device to measure trunk accelerations during walking. Several gait cycle parameters, including cadence, step regularity, stride regularity and step symmetry can be estimated in real-time by using autocorrelation procedure. For validation purposes, five Parkinson’s disease (PD patients and five young healthy adults were recruited in an experiment. The gait cycle parameters among the two subject groups of different mobility can be quantified and distinguished by the system. Practical considerations and limitations for implementing the autocorrelation procedure in such a real-time system are also discussed. This study can be extended to the future attempts in real-time detection of disabling gaits, such as festinating or freezing of gait in PD patients. Ambulatory rehabilitation, gait assessment and personal telecare for people with gait disorders are also possible applications.

Music and metronome cues produce different effects on gait spatiotemporal measures but not gait variability in healthy older adults.

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Wittwer, Joanne E; Webster, Kate E; Hill, Keith

2013-02-01

Rhythmic auditory cues including music and metronome beats have been used, sometimes interchangeably, to improve disordered gait arising from a range of clinical conditions. There has been limited investigation into whether there are optimal cue types. Different cue types have produced inconsistent effects across groups which differed in both age and clinical condition. The possible effect of normal ageing on response to different cue types has not been reported for gait. The aim of this study was to determine the effects of both rhythmic music and metronome cues on gait spatiotemporal measures (including variability) in healthy older people. Twelve women and seven men (>65 years) walked on an instrumented walkway at comfortable pace and then in time to each of rhythmic music and metronome cues at comfortable pace stepping frequency. Music but not metronome cues produced a significant increase in group mean gait velocity of 4.6 cm/s, due mostly to a significant increase in group mean stride length of 3.1cm. Both cue types produced a significant but small increase in cadence of 1 step/min. Mean spatio-temporal variability was low at baseline and did not increase with either cue type suggesting cues did not disrupt gait timing. Study findings suggest music and metronome cues may not be used interchangeably and cue type as well as frequency should be considered when evaluating effects of rhythmic auditory cueing on gait. Further work is required to determine whether optimal cue types and frequencies to improve walking in different clinical groups can be identified. Copyright © 2012 Elsevier B.V. All rights reserved.

Human quadrupeds, primate quadrupedalism, and Uner Tan Syndrome.

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Liza J Shapiro

Full Text Available Since 2005, an extensive literature documents individuals from several families afflicted with "Uner Tan Syndrome (UTS," a condition that in its most extreme form is characterized by cerebellar hypoplasia, loss of balance and coordination, impaired cognitive abilities, and habitual quadrupedal gait on hands and feet. Some researchers have interpreted habitual use of quadrupedalism by these individuals from an evolutionary perspective, suggesting that it represents an atavistic expression of our quadrupedal primate ancestry or "devolution." In support of this idea, individuals with "UTS" are said to use diagonal sequence quadrupedalism, a type of quadrupedal gait that distinguishes primates from most other mammals. Although the use of primate-like quadrupedal gait in humans would not be sufficient to support the conclusion of evolutionary "reversal," no quantitative gait analyses were presented to support this claim. Using standard gait analysis of 518 quadrupedal strides from video sequences of individuals with "UTS", we found that these humans almost exclusively used lateral sequence-not diagonal sequence-quadrupedal gaits. The quadrupedal gait of these individuals has therefore been erroneously described as primate-like, further weakening the "devolution" hypothesis. In fact, the quadrupedalism exhibited by individuals with UTS resembles that of healthy adult humans asked to walk quadrupedally in an experimental setting. We conclude that quadrupedalism in healthy adults or those with a physical disability can be explained using biomechanical principles rather than evolutionary assumptions.

New lower-limb gait asymmetry indices based on a depth camera.

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Auvinet, Edouard; Multon, Franck; Meunier, Jean

2015-02-24

Various asymmetry indices have been proposed to compare the spatiotemporal, kinematic and kinetic parameters of lower limbs during the gait cycle. However, these indices rely on gait measurement systems that are costly and generally require manual examination, calibration procedures and the precise placement of sensors/markers on the body of the patient. To overcome these issues, this paper proposes a new asymmetry index, which uses an inexpensive, easy-to-use and markerless depth camera (Microsoft Kinect™) output. This asymmetry index directly uses depth images provided by the Kinect™ without requiring joint localization. It is based on the longitudinal spatial difference between lower-limb movements during the gait cycle. To evaluate the relevance of this index, fifteen healthy subjects were tested on a treadmill walking normally and then via an artificially-induced gait asymmetry with a thick sole placed under one shoe. The gait movement was simultaneously recorded using a Kinect™ placed in front of the subject and a motion capture system. The proposed longitudinal index distinguished asymmetrical gait (p indices based on spatiotemporal gait parameters failed using such Kinect™ skeleton measurements. Moreover, the correlation coefficient between this index measured by Kinect™ and the ground truth of this index measured by motion capture is 0.968. This gait asymmetry index measured with a Kinect™ is low cost, easy to use and is a promising development for clinical gait analysis.

Instrumental or Physical-Exercise Rehabilitation of Balance Improves Both Balance and Gait in Parkinson’s Disease

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Marica Giardini

2018-01-01

Full Text Available We hypothesised that rehabilitation specifically addressing balance in Parkinson’s disease patients might improve not only balance but locomotion as well. Two balance-training protocols (standing on a moving platform and traditional balance exercises were assessed by assigning patients to two groups (Platform, n=15, and Exercises, n=17. The platform moved periodically in the anteroposterior, laterolateral, and oblique direction, with and without vision in different trials. Balance exercises were based on the Otago Exercise Program. Both platform and exercise sessions were administered from easy to difficult. Outcome measures were (a balancing behaviour, assessed by both Index of Stability (IS on platform and Mini-BESTest, and (b gait, assessed by both baropodometry and Timed Up and Go (TUG test. Falls Efficacy Scale-International (FES-I and Parkinson’s Disease Questionnaire (PDQ-8 were administered. Both groups exhibited better balance control, as assessed both by IS and by Mini-BESTest. Gait speed at baropodometry also improved in both groups, while TUG was less sensitive to improvement. Scores of FES-I and PDQ-8 showed a marginal improvement. A four-week treatment featuring no gait training but focused on challenging balance tasks produces considerable gait enhancement in mildly to moderately affected patients. Walking problems in PD depend on postural instability and are successfully relieved by appropriate balance rehabilitation. This trial is registered with ClinicalTrials.gov NCT03314597.

Artificial Walking Technologies to Improve Gait in Cerebral Palsy: Multichannel Neuromuscular Stimulation.

Science.gov (United States)

Rose, Jessica; Cahill-Rowley, Katelyn; Butler, Erin E

2017-11-01

Cerebral palsy (CP) is the most common childhood motor disability and often results in debilitating walking abnormalities, such as flexed-knee and stiff-knee gait. Current medical and surgical treatments are only partially effective in improving gait abnormalities and may cause significant muscle weakness. However, emerging artificial walking technologies, such as step-initiated, multichannel neuromuscular electrical stimulation (NMES), can substantially improve gait patterns and promote muscle strength in children with spastic CP. NMES may also be applied to specific lumbar-sacral sensory roots to reduce spasticity. Development of tablet computer-based multichannel NMES can leverage lightweight, wearable wireless stimulators, advanced control design, and surface electrodes to activate lower-limb muscles. Musculoskeletal models have been used to characterize muscle contributions to unimpaired gait and identify high muscle demands, which can help guide multichannel NMES-assisted gait protocols. In addition, patient-specific NMES-assisted gait protocols based on 3D gait analysis can facilitate the appropriate activation of lower-limb muscles to achieve a more functional gait: stance-phase hip and knee extension and swing-phase sequence of hip and knee flexion followed by rapid knee extension. NMES-assisted gait treatment can be conducted as either clinic-based or home-based programs. Rigorous testing of multichannel NMES-assisted gait training protocols will determine optimal treatment dosage for future clinical trials. Evidence-based outcome evaluation using 3D kinematics or temporal-spatial gait parameters will help determine immediate neuroprosthetic effects and longer term neurotherapeutic effects of step-initiated, multichannel NMES-assisted gait in children with spastic CP. Multichannel NMES is a promising assistive technology to help children with spastic CP achieve a more upright, functional gait. © 2017 International Center for Artificial Organs and

Gait parameter control timing with dynamic manual contact or visual cues

Science.gov (United States)

Shi, Peter; Werner, William

2016-01-01

We investigated the timing of gait parameter changes (stride length, peak toe velocity, and double-, single-support, and complete step duration) to control gait speed. Eleven healthy participants adjusted their gait speed on a treadmill to maintain a constant distance between them and a fore-aft oscillating cue (a place on a conveyor belt surface). The experimental design balanced conditions of cue modality (vision: eyes-open; manual contact: eyes-closed while touching the cue); treadmill speed (0.2, 0.4, 0.85, and 1.3 m/s); and cue motion (none, ±10 cm at 0.09, 0.11, and 0.18 Hz). Correlation analyses revealed a number of temporal relationships between gait parameters and cue speed. The results suggest that neural control ranged from feedforward to feedback. Specifically, step length preceded cue velocity during double-support duration suggesting anticipatory control. Peak toe velocity nearly coincided with its most-correlated cue velocity during single-support duration. The toe-off concluding step and double-support durations followed their most-correlated cue velocity, suggesting feedback control. Cue-tracking accuracy and cue velocity correlations with timing parameters were higher with the manual contact cue than visual cue. The cue/gait timing relationships generalized across cue modalities, albeit with greater delays of step-cycle events relative to manual contact cue velocity. We conclude that individual kinematic parameters of gait are controlled to achieve a desired velocity at different specific times during the gait cycle. The overall timing pattern of instantaneous cue velocities associated with different gait parameters is conserved across cues that afford different performance accuracies. This timing pattern may be temporally shifted to optimize control. Different cue/gait parameter latencies in our nonadaptation paradigm provide general-case evidence of the independent control of gait parameters previously demonstrated in gait adaptation paradigms

Gait parameter control timing with dynamic manual contact or visual cues.

Science.gov (United States)

Rabin, Ely; Shi, Peter; Werner, William

2016-06-01

We investigated the timing of gait parameter changes (stride length, peak toe velocity, and double-, single-support, and complete step duration) to control gait speed. Eleven healthy participants adjusted their gait speed on a treadmill to maintain a constant distance between them and a fore-aft oscillating cue (a place on a conveyor belt surface). The experimental design balanced conditions of cue modality (vision: eyes-open; manual contact: eyes-closed while touching the cue); treadmill speed (0.2, 0.4, 0.85, and 1.3 m/s); and cue motion (none, ±10 cm at 0.09, 0.11, and 0.18 Hz). Correlation analyses revealed a number of temporal relationships between gait parameters and cue speed. The results suggest that neural control ranged from feedforward to feedback. Specifically, step length preceded cue velocity during double-support duration suggesting anticipatory control. Peak toe velocity nearly coincided with its most-correlated cue velocity during single-support duration. The toe-off concluding step and double-support durations followed their most-correlated cue velocity, suggesting feedback control. Cue-tracking accuracy and cue velocity correlations with timing parameters were higher with the manual contact cue than visual cue. The cue/gait timing relationships generalized across cue modalities, albeit with greater delays of step-cycle events relative to manual contact cue velocity. We conclude that individual kinematic parameters of gait are controlled to achieve a desired velocity at different specific times during the gait cycle. The overall timing pattern of instantaneous cue velocities associated with different gait parameters is conserved across cues that afford different performance accuracies. This timing pattern may be temporally shifted to optimize control. Different cue/gait parameter latencies in our nonadaptation paradigm provide general-case evidence of the independent control of gait parameters previously demonstrated in gait adaptation paradigms

Differential effects of rhythmic auditory stimulation and neurodevelopmental treatment/Bobath on gait patterns in adults with cerebral palsy: a randomized controlled trial.

Science.gov (United States)

Kim, Soo Ji; Kwak, Eunmi E; Park, Eun Sook; Cho, Sung-Rae

2012-10-01

To investigate the effects of rhythmic auditory stimulation (RAS) on gait patterns in comparison with changes after neurodevelopmental treatment (NDT/Bobath) in adults with cerebral palsy. A repeated-measures analysis between the pretreatment and posttreatment tests and a comparison study between groups. Human gait analysis laboratory. Twenty-eight cerebral palsy patients with bilateral spasticity participated in this study. The subjects were randomly allocated to either neurodevelopmental treatment (n = 13) or rhythmic auditory stimulation (n = 15). Gait training with rhythmic auditory stimulation or neurodevelopmental treatment was performed three sessions per week for three weeks. Temporal and kinematic data were analysed before and after the intervention. Rhythmic auditory stimulation was provided using a combination of a metronome beat set to the individual's cadence and rhythmic cueing from a live keyboard, while neurodevelopmental treatment was implemented following the traditional method. Temporal data, kinematic parameters and gait deviation index as a measure of overall gait pathology were assessed. Temporal gait measures revealed that rhythmic auditory stimulation significantly increased cadence, walking velocity, stride length, and step length (P rhythmic auditory stimulation (P rhythmic auditory stimulation (P rhythmic auditory stimulation showed aggravated maximal internal rotation in the transverse plane (P rhythmic auditory stimulation or neurodevelopmental treatment elicited differential effects on gait patterns in adults with cerebral palsy.

Energy Cost and Gait Efficiency of Below-Knee Amputee and Normal Subject with Similar Physical Parameters & Quality of Life: A Comparative Case Study

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Durbadal Biswas

2010-10-01

Full Text Available The study focused on the comparative analysis of energy cost and gait efficiency between a below knee (BK amputee and a reference subject (without amputation. It also attempted to indicate the specific feature responsible for a controlled gait with optimum energy cost for BK amputees. Selection criteria of the subjects were similar physical parameters and quality of life studied with WHOQOL-100 quality of life assessment. A Cosmed® k4 b2 Respiratory Analyzer system was used for the measurement of Oxygen Uptake (VO2, Energy Expenditure per minute (EE and Heart Rate (HR. Gait efficiency (p < 0.0002 was found higher for BK amputee than normal subject. The therapeutic activities and mainly walking rhythm contributed to improve the mobility & balance. This ensures the optimum time & co-ordination of movements and hence improves the gait efficiency for the BK amputee. Comparison with control group was performed to validate the data.

Effects of real-time gait biofeedback on paretic propulsion and gait biomechanics in individuals post-stroke.

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Genthe, Katlin; Schenck, Christopher; Eicholtz, Steven; Zajac-Cox, Laura; Wolf, Steven; Kesar, Trisha M

2018-04-01

Objectives Gait training interventions that target paretic propulsion induce improvements in walking speed and function in individuals post-stroke. Previously, we demonstrated that able-bodied individuals increase propulsion unilaterally when provided real-time biofeedback targeting anterior ground reaction forces (AGRF). The purpose of this study was to, for the first time, investigate short-term effects of real-time AGRF gait biofeedback training on post-stroke gait. Methods Nine individuals with post-stroke hemiparesis (6 females, age = 54 ± 12.4 years 39.2 ± 24.4 months post-stroke) completed three 6-minute training bouts on an instrumented treadmill. During training, visual and auditory biofeedback were provided to increase paretic AGRF during terminal stance. Gait biomechanics were evaluated before training, and during retention tests conducted 2, 15, and 30 minutes post-training. Primary dependent variables were paretic and non-paretic peak AGRF; secondary variables included paretic and non-paretic peak trailing limb angle, plantarflexor moment, and step length. In addition to evaluating the effects of biofeedback training on these dependent variables, we compared effects of a 6-minute biofeedback training bout to a non-biofeedback control condition. Results Compared to pre-training, significantly greater paretic peak AGRFs were generated during the 2, 15, and 30-minute retention tests conducted after the 18-minute biofeedback training session. Biofeedback training induced no significant effects on the non-paretic leg. Comparison of a 6-minute biofeedback training bout with a speed-matched control bout without biofeedback demonstrated a main effect for training type, with greater peak AGRF generation during biofeedback. Discussion Our results suggest that AGRF biofeedback may be a feasible and promising gait training strategy to target propulsive deficits in individuals post-stroke.

Polarized spectral features of human breast tissues through wavelet ...

Indian Academy of Sciences (India)

Abstract. Fluorescence characteristics of human breast tissues are investigated through wavelet transform and principal component analysis (PCA). Wavelet transform of polar- ized fluorescence spectra of human breast tissues is found to localize spectral features that can reliably differentiate different tissue types.

Estimating the Mechanical Behavior of the Knee Joint during Crouch Gait: Implications for Real-Time Motor Control of Robotic Knee Orthoses

Science.gov (United States)

Damiano, Diane L.; Bulea, Thomas C.

2016-01-01

Individuals with cerebral palsy frequently exhibit crouch gait, a pathological walking pattern characterized by excessive knee flexion. Knowledge of the knee joint moment during crouch gait is necessary for the design and control of assistive devices used for treatment. Our goal was to 1) develop statistical models to estimate knee joint moment extrema and dynamic stiffness during crouch gait, and 2) use the models to estimate the instantaneous joint moment during weight-acceptance. We retrospectively computed knee moments from 10 children with crouch gait and used stepwise linear regression to develop statistical models describing the knee moment features. The models explained at least 90% of the response value variability: peak moment in early (99%) and late (90%) stance, and dynamic stiffness of weight-acceptance flexion (94%) and extension (98%). We estimated knee extensor moment profiles from the predicted dynamic stiffness and instantaneous knee angle. This approach captured the timing and shape of the computed moment (root-mean-squared error: 2.64 Nm); including the predicted early-stance peak moment as a correction factor improved model performance (root-mean-squared error: 1.37 Nm). Our strategy provides a practical, accurate method to estimate the knee moment during crouch gait, and could be used for real-time, adaptive control of robotic orthoses. PMID:27101612

Gait post-stroke: Pathophysiology and rehabilitation strategies.

Science.gov (United States)

Beyaert, C; Vasa, R; Frykberg, G E

2015-11-01

We reviewed neural control and biomechanical description of gait in both non-disabled and post-stroke subjects. In addition, we reviewed most of the gait rehabilitation strategies currently in use or in development and observed their principles in relation to recent pathophysiology of post-stroke gait. In both non-disabled and post-stroke subjects, motor control is organized on a task-oriented basis using a common set of a few muscle modules to simultaneously achieve body support, balance control, and forward progression during gait. Hemiparesis following stroke is due to disruption of descending neural pathways, usually with no direct lesion of the brainstem and cerebellar structures involved in motor automatic processes. Post-stroke, improvements of motor activities including standing and locomotion are variable but are typically characterized by a common postural behaviour which involves the unaffected side more for body support and balance control, likely in response to initial muscle weakness of the affected side. Various rehabilitation strategies are regularly used or in development, targeting muscle activity, postural and gait tasks, using more or less high-technology equipment. Reduced walking speed often improves with time and with various rehabilitation strategies, but asymmetric postural behaviour during standing and walking is often reinforced, maintained, or only transitorily decreased. This asymmetric compensatory postural behaviour appears to be robust, driven by support and balance tasks maintaining the predominant use of the unaffected side over the initially impaired affected side. Based on these elements, stroke rehabilitation including affected muscle strengthening and often stretching would first need to correct the postural asymmetric pattern by exploiting postural automatic processes in various particular motor tasks secondarily beneficial to gait. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Primary progressive freezing gait: case report Marcha congelada progressiva primária: relato de caso

Directory of Open Access Journals (Sweden)

Denise Hack Nicaretta

1997-09-01

Full Text Available The clinical features of the primary progressive freezing gait, a rare and distinct neurological entity, have been described in some articles. This paper describes this gait disorder affecting one patient, whose condition's long course provoked no postural instability. As stated in the literature, the pathophysiology of the primary progressive freezing gait still remains unclear, although the lack of response to levodopa therapy suggests a possible involvement of nondopaminergic pathways. Alteration in the visual perception may be a potential cause for the condition.Uma rara e distinta entidade neurológica, a marcha congelada progressiva primária, tem sido relatada na literatura. Descrevemos o caso de um paciente com este distúrbio da marcha que, apesar do longo curso da doença, não apresentava instabilidade postural. Como citado na literatura, a fisiopatologia desta condição permanece obscura, embora a falta de resposta à levodopa sugira uma possível participação de vias não dopaminérgicas. Alteração na percepção visual também pode estar envolvida na gênese desta afecção.

Spatiotemporal Gait Characteristics Associated with Cognitive Impairment: A Multicenter Cross-Sectional Study, the Intercontinental "Gait, cOgnitiOn & Decline" Initiative.

Science.gov (United States)

Beauchet, Olivier; Blumen, Helena M; Callisaya, Michele L; De Cock, Anne-Marie; Kressig, Reto W; Srikanth, Velandai; Steinmetz, Jean-Paul; Verghese, Joe; Allali, Gilles

2018-01-23

The study aims to determine the spatiotemporal gait parameters and/or their combination(s) that best differentiate between cognitively healthy individuals (CHI), patients with mild cognitive impairment (MCI) and those with mild and moderate dementia, regardless of the etiology of cognitive impairment. A total of 2099 participants (1015 CHI, 478 patients with MCI, 331 patients with mild dementia and 275 with moderate dementia) were selected from the intercontinental "Gait, cOgnitiOn & Decline" (GOOD) initiative, which merged different databases from seven cross-sectional studies. Mean values and coefficients of variation (CoV) of spatiotemporal gait parameters were recorded during usual walking with the GAITRite® system. The severity of cognitive impairment was associated with worse performance on all gait parameters. Stride velocity had the strongest association with cognitive impairment, regardless of cognitive status. High mean value and CoV of stride length characterized moderate dementia, whereas increased CoV of stride time was specific to MCI status. The findings support the existence of specific cognitive impairment-related gait disturbances with differences related to stages of cognitive impairment, which may be used to screen individuals with cognitive impairment. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The effects of smartphone multitasking on gait and dynamic balance.

Science.gov (United States)

Lee, Jeon Hyeong; Lee, Myoung Hee

2018-02-01

[Purpose] This study was performed to analyze the influence of smartphone multitasking on gait and dynamic balance. [Subjects and Methods] The subjects were 19 male and 20 female university students. There were 4 types of gait tasks: General Gait (walking without a task), Task Gait 1 (walking while writing a message), Task Gait 2 (walking while writing a message and listening to music), Task Gait 3 (walking while writing a message and having a conversation). To exclude the learning effect, the order of tasks was randomized. The Zebris FDM-T treadmill system (Zebris Medical GmbH, Germany) was used to measure left and right step length and width, and a 10 m walking test (10MWT) was conducted for gait velocity. In addition, a Timed Up and Go test (TUG) was used to measure dynamic balance. All the tasks were performed 3 times, and the mean of the measured values was analyzed. [Results] There were no statistically significant differences in step length and width. There were statistically significant differences in the 10MWT and TUG tests. [Conclusion] Using a smartphone while walking decreases a person's dynamic balance and walking ability. It is considered that accident rates are higher when using a smartphone.

Relief of knee flexion contracture and gait improvement following adaptive training for an assist device in a transtibial amputee: A case study.

Science.gov (United States)

Kim, Sol-Bi; Ko, Chang-Yong; Son, Jinho; Kang, Sungjae; Ryu, Jeicheong; Mun, Museong

2017-01-01

Management of a knee contracture is important for regaining gait ability in transtibial amputees. However, there has been little study of prosthesis training for enhancing mobility and improving range of motion in cases of restricted knee extension. This study aimed to evaluate the effects of adaptive training for an assist device (ATAD) for a transtibial amputee with a knee flexion contracture (KFC). A male transtibial amputee with KFC performed 4 months of ATAD with a multidisciplinary team. During the ATAD, the passive range of motion (PROM) in the knee, amputee mobility predictor (AMP) assessment, center of pressure (COP) on a force plate-equipped treadmill, gait features determined by three-dimensional motion analysis, and Short-Form 36 Item Health Survey (SF-36) scores were evaluated. Following ATAD, PROM showed immediate improvement (135.6 ± 2.4° at baseline, 142.5 ± 1.7° at Step 1, 152.1 ± 1.8° at Step 2, 165.8 ± 1.9° at Step 3, and 166.0 ± 1.4° at Step 4); this was followed by an enhanced COP. Gradually, gait features also improved. Additionally, the AMP score (5 at baseline to 29 at Step 4) and K-level (K0 at baseline to K3 at Step 4) increased after ATAD. Along with these improvements, the SF-36 score also improved. ATAD could be beneficial for transtibial amputees by relieving knee contractures and improving gait.

Deterioration of gait and balance over time

DEFF Research Database (Denmark)

Kreisel, Stefan H; Blahak, Christian; Bäzner, Hansjörg

2013-01-01

Cross-sectional studies have shown an association between the severity of age-related white matter change (ARWMC) and lower body motor function. However, the association between prevalent ARWMC and incident deterioration of balance and gait remains insufficiently investigated. This study investig......Cross-sectional studies have shown an association between the severity of age-related white matter change (ARWMC) and lower body motor function. However, the association between prevalent ARWMC and incident deterioration of balance and gait remains insufficiently investigated. This study...... relevance: given the increasing use of neuroimaging, incidental white matter pathology is common; being able to delineate natural trajectories of balance and gait function given ARWMC may improve patient advice and help optimize allocation of care....

[Real-time Gait Training System with Embedded Functional Electrical Stimulation].

Science.gov (United States)

Gu, Linyan; Ruan, Zhaomin; Jia, Guifeng; Xla, Jing; Qiu, Lijian; Wu, Changwang; Jin, Xiaoqing; Ning, Gangmin

2015-07-01

To solve the problem that mostly gait analysis is independent from the treatment, this work proposes a system that integrates the functions of gait training and assessment for foot drop treatment. The system uses a set of sensors to collect gait parameters and designes multi-mode functional electrical stimulators as actuator. Body area network technology is introduced to coordinate the data communication and execution of the sensors and stimulators, synchronize the gait analysis and foot drop treatment. Bluetooth 4.0 is applied to low the power consumption of the system. The system realizes the synchronization of treatment and gait analysis. It is able to acquire and analyze the dynamic parameters of ankle, knee and hip in real-time, and treat patients by guiding functional electrical stimulation delivery to the specific body locations of patients.

Estimation of Temporal Gait Parameters Using a Wearable Microphone-Sensor-Based System

Directory of Open Access Journals (Sweden)

Cheng Wang

2016-12-01

Full Text Available Most existing wearable gait analysis methods focus on the analysis of data obtained from inertial sensors. This paper proposes a novel, low-cost, wireless and wearable gait analysis system which uses microphone sensors to collect footstep sound signals during walking. This is the first time a microphone sensor is used as a wearable gait analysis device as far as we know. Based on this system, a gait analysis algorithm for estimating the temporal parameters of gait is presented. The algorithm fully uses the fusion of two feet footstep sound signals and includes three stages: footstep detection, heel-strike event and toe-on event detection, and calculation of gait temporal parameters. Experimental results show that with a total of 240 data sequences and 1732 steps collected using three different gait data collection strategies from 15 healthy subjects, the proposed system achieves an average 0.955 F1-measure for footstep detection, an average 94.52% accuracy rate for heel-strike detection and 94.25% accuracy rate for toe-on detection. Using these detection results, nine temporal related gait parameters are calculated and these parameters are consistent with their corresponding normal gait temporal parameters and labeled data calculation results. The results verify the effectiveness of our proposed system and algorithm for temporal gait parameter estimation.

Shedding light on walking in the dark: the effects of reduced lighting on the gait of older adults with a higher-level gait disorder and controls

Directory of Open Access Journals (Sweden)

Gruendlinger Leor

2005-08-01

Full Text Available Abstract Objective To study the effects of reduced lighting on the gait of older adults with a high level gait disorder (HLGD and to compare their response to that of healthy elderly controls. Methods 22 patients with a HLGD and 20 age-matched healthy controls were studied under usual lighting conditions (1000 lumens and in near darkness (5 lumens. Gait speed and gait dynamics were measured under both conditions. Cognitive function, co-morbidities, depressive symptoms, and vision were also evaluated. Results Under usual lighting conditions, patients walked more slowly, with reduced swing times, and increased stride-to-stride variability, compared to controls. When walking under near darkness conditions, both groups slowed their gait. All other measures of gait were not affected by lighting in the controls. In contrast, patients further reduced their swing times and increased their stride-to-stride variability, both stride time variability and swing time variability. The unique response of the patients was not explained by vision, mental status, co-morbidities, or the values of walking under usual lighting conditions. Conclusion Walking with reduced lighting does not affect the gait of healthy elderly subjects, except for a reduction in speed. On the other hand, the gait of older adults with a HLGD becomes more variable and unsteady when they walk in near darkness, despite adapting a slow and cautious gait. Further work is needed to identify the causes of the maladaptive response among patients with a HLGD and the potential connection between this behavior and the increased fall risk observed in these patients.

Gait in children with cerebral palsy : observer reliability of Physician Rating Scale and Edinburgh Visual Gait Analysis Interval Testing scale

NARCIS (Netherlands)

Maathuis, KGB; van der Schans, CP; van Iperen, A; Rietman, HS; Geertzen, JHB

2005-01-01

The aim of this study was to test the inter- and intra-observer reliability of the Physician Rating Scale (PRS) and the Edinburgh Visual Gait Analysis Interval Testing (GAIT) scale for use in children with cerebral palsy (CP). Both assessment scales are quantitative observational scales, evaluating

Clinical gait analysis : A review of research at the Interdepartmental Research group of Kinesiology in Leiden

NARCIS (Netherlands)

Daanen, H. A M

1990-01-01

In this article the methodology used in the Interdepartmental Research Group of Kinesiology to quantify (clinical) human gait is elaborated upon. Four methods are described: analysis of temporal parameters, goniometry, accelerometry and electromyography. A correct representation of electromyographic

New Lower-Limb Gait Asymmetry Indices Based on a Depth Camera

Directory of Open Access Journals (Sweden)

Edouard Auvinet

2015-02-01

Full Text Available Background: Various asymmetry indices have been proposed to compare the spatiotemporal, kinematic and kinetic parameters of lower limbs during the gait cycle. However, these indices rely on gait measurement systems that are costly and generally require manual examination, calibration procedures and the precise placement of sensors/markers on the body of the patient. Methods: To overcome these issues, this paper proposes a new asymmetry index, which uses an inexpensive, easy-to-use and markerless depth camera (Microsoft Kinect™ output. This asymmetry index directly uses depth images provided by the Kinect™ without requiring joint localization. It is based on the longitudinal spatial difference between lower-limb movements during the gait cycle. To evaluate the relevance of this index, fifteen healthy subjects were tested on a treadmill walking normally and then via an artificially-induced gait asymmetry with a thick sole placed under one shoe. The gait movement was simultaneously recorded using a Kinect™ placed in front of the subject and a motion capture system. Results: The proposed longitudinal index distinguished asymmetrical gait (p < 0.001, while other symmetry indices based on spatiotemporal gait parameters failed using such Kinect™ skeleton measurements. Moreover, the correlation coefficient between this index measured by Kinect™ and the ground truth of this index measured by motion capture is 0.968. Conclusion: This gait asymmetry index measured with a Kinect™ is low cost, easy to use and is a promising development for clinical gait analysis.

Trunk lean gait decreases multi-segmental coordination in the vertical direction.

Science.gov (United States)

Tokuda, Kazuki; Anan, Masaya; Sawada, Tomonori; Tanimoto, Kenji; Takeda, Takuya; Ogata, Yuta; Takahashi, Makoto; Kito, Nobuhiro; Shinkoda, Koichi

2017-11-01

[Purpose] The strategy of trunk lean gait to reduce external knee adduction moment (KAM) may affect multi-segmental synergy control of center of mass (COM) displacement. Uncontrolled manifold (UCM) analysis is an evaluation index to understand motor variability. The purpose of this study was to investigate how motor variability is affected by using UCM analysis on adjustment of the trunk lean angle. [Subjects and Methods] Fifteen healthy young adults walked at their preferred speed under two conditions: normal and trunk lean gait. UCM analysis was performed with respect to the COM displacement during the stance phase. The KAM data were analyzed at the points of the first KAM peak during the stance phase. [Results] The KAM during trunk lean gait was smaller than during normal gait. Despite a greater segmental configuration variance with respect to mediolateral COM displacement during trunk lean gait, the synergy index was not significantly different between the two conditions. The synergy index with respect to vertical COM displacement during trunk lean gait was smaller than that during normal gait. [Conclusion] These results suggest that trunk lean gait is effective in reducing KAM; however, it may decrease multi-segmental movement coordination of COM control in the vertical direction.

Gait analysis in demented subjects: Interests and perspectives

Directory of Open Access Journals (Sweden)

Olivier Beauchet

2008-03-01

Full Text Available Olivier Beauchet1, Gilles Allali2, Gilles Berrut3, Caroline Hommet4, Véronique Dubost5, Frédéric Assal21Department of Geriatrics, Angers University Hospital, France; 2Department of Neurology, Geneva University Hospital, France; 3Department of Geriatrics, Nantes University Hospital, France; 4Department of Internal Medicine and Geriatrics, Tours University Hospital, France; 5Department of Geriatrics, Dijon University Hospital, FranceAbstract: Gait disorders are more prevalent in dementia than in normal aging and are related to the severity of cognitive decline. Dementia-related gait changes (DRGC mainly include decrease in walking speed provoked by a decrease in stride length and an increase in support phase. More recently, dual-task related changes in gait were found in Alzheimer’s disease (AD and non-Alzheimer dementia, even at an early stage. An increase in stride-to-stride variability while usual walking and dual-tasking has been shown to be more specific and sensitive than any change in mean value in subjects with dementia. Those data show that DRGC are not only associated to motor disorders but also to problem with central processing of information and highlight that dysfunction of temporal and frontal lobe may in part explain gait impairment among demented subjects. Gait assessment, and more particularly dual-task analysis, is therefore crucial in early diagnosis of dementia and/or related syndromes in the elderly. Moreover, dual-task disturbances could be a specific marker of falling at a pre-dementia stage.Keywords: gait, prediction of dementia, risk of falling, older adult

Evaluation of CNN architectures for gait recognition based on optical flow maps

OpenAIRE

Castro, F. M.; Marín-Jiménez, M.J.; Guil, N.; López-Tapia, S.; Pérez de la Blanca, N.

2017-01-01

This work targets people identification in video based on the way they walk (\\ie gait) by using deep learning architectures. We explore the use of convolutional neural networks (CNN) for learning high-level descriptors from low-level motion features (\\ie optical flow components). The low number of training samples for each subject and the use of a test set containing subjects different from the training ones makes the search of a good CNN architecture a challenging task. Universidad de Mál...

Gait characteristics in women's safety shoes.

Science.gov (United States)

Goto, Kanako; Abe, Kaoru

2017-11-01

Although workers in Japan are required to wear safety footwear, there is concern about occupational accidents that occur when wearing safety shoes. This study aimed to analyze the effect of wearing hardsoled safety shoes on both spatiotemporal gait characteristics and the muscle activity in the lower extremities. Seventeen young women participated in this study. A 5-m gait trial and a surface electromyography trial were conducted while the women walked in either safety shoes or sports shoes. Paired t-tests were performed to analyze the differences in gait characteristics when walking in the two different pairs of shoes. Walking in safety shoes was associated with a significant increase in vastus lateralis, biceps femoris and tibialis anterior activity. This increased muscle activity in the lower extremities is likely compensating for the lower flexibility of the safety shoes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is body-weight-supported treadmill training or robotic-assisted gait training superior to overground gait training and other forms of physiotherapy in people with spinal cord injury? A systematic review.

Science.gov (United States)

Mehrholz, J; Harvey, L A; Thomas, S; Elsner, B

2017-08-01

Systematic review about randomised trials comparing different training strategies to improve gait in people with spinal cord injuries (SCI). The aim of this systematic review was to compare the effectiveness of body-weight-supported treadmill training (BWSTT) and robotic-assisted gait training with overground gait training and other forms of physiotherapy in people with traumatic SCI. Systematic review conducted by researchers from Germany and Australia. An extensive search was conducted for randomised controlled trials involving people with traumatic SCI that compared either BWSTT or robotic-assisted gait training with overground gait training and other forms of physiotherapy. The two outcomes of interest were walking speed (m s -1 ) and walking distance (m). BWSTT and robotic-assisted gait training were analysed separately, and data were pooled across trials to derive mean between-group differences using a random-effects model. Thirteen randomised controlled trials involving 586 people were identified. Ten trials involving 462 participants compared BWSTT to overground gait training and other forms of physiotherapy, but only nine trials provided useable data. The pooled mean (95% confidence interval (CI)) between-group differences for walking speed and walking distance were -0.03 m s -1 (-0.10 to 0.04) and -7 m (-45 to 31), respectively, favouring overground gait training. Five trials involving 344 participants compared robotic-assisted gait training to overground gait training and other forms of physiotherapy but only three provided useable data. The pooled mean (95% CI) between-group differences for walking speed and walking distance were -0.04 m s -1 (95% CI -0.21 to 0.13) and -6 m (95% CI -86 to 74), respectively, favouring overground gait training. BWSTT and robotic-assisted gait training do not increase walking speed more than overground gait training and other forms of physiotherapy do, but their effects on walking distance are not clear.

Gait analysis of adults with generalised joint hypermobility

DEFF Research Database (Denmark)

Simonsen, Erik B; Tegner, Heidi; Alkjær, Tine

2012-01-01

BACKGROUND: The majority of adults with Generalised Joint Hypermobility experience symptoms such as pain and joint instability, which is likely to influence their gait pattern. Accordingly, the purpose of the present project was to perform a biomechanical gait analysis on a group of patients...

Single-task and dual-task tandem gait test performance after concussion.

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Howell, David R; Osternig, Louis R; Chou, Li-Shan

2017-07-01

To compare single-task and dual-task tandem gait test performance between athletes after concussion with controls on observer-timed, spatio-temporal, and center-of-mass (COM) balance control measurements. Ten participants (19.0±5.5years) were prospectively identified and completed a tandem gait test protocol within 72h of concussion and again 1 week, 2 weeks, 1 month, and 2 months post-injury. Seven uninjured controls (20.0±4.5years) completed the same protocol in similar time increments. Tandem gait test trials were performed with (dual-task) and without (single-task) concurrently performing a cognitive test as whole-body motion analysis was performed. Outcome variables included test completion time, average tandem gait velocity, cadence, and whole-body COM frontal plane displacement. Concussion participants took significantly longer to complete the dual-task tandem gait test than controls throughout the first 2 weeks post-injury (mean time=16.4 [95% CI: 13.4-19.4] vs. 10.1 [95% CI: 6.4-13.7] seconds; p=0.03). Single-task tandem gait times were significantly lower 72h post-injury (p=0.04). Dual-task cadence was significantly lower for concussion participants than controls (89.5 [95% CI: 68.6-110.4] vs. 127.0 [95% CI: 97.4-156.6] steps/minute; p=0.04). Moderately-high to high correlations between tandem gait test time and whole-body COM medial-lateral displacement were detected at each time point during dual-task gait (r s =0.70-0.93; p=0.03-0.001). Adding a cognitive task during the tandem gait test resulted in longer detectable deficits post-concussion compared to the traditional single-task tandem gait test. As a clinical tool to assess dynamic motor function, tandem gait may assist with return to sport decisions after concussion. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Visual dictionaries as intermediate features in the human brain

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Kandan eRamakrishnan

2015-01-01

Full Text Available The human visual system is assumed to transform low level visual features to object and scene representations via features of intermediate complexity. How the brain computationally represents intermediate features is still unclear. To further elucidate this, we compared the biologically plausible HMAX model and Bag of Words (BoW model from computer vision. Both these computational models use visual dictionaries, candidate features of intermediate complexity, to represent visual scenes, and the models have been proven effective in automatic object and scene recognition. These models however differ in the computation of visual dictionaries and pooling techniques. We investigated where in the brain and to what extent human fMRI responses to short video can be accounted for by multiple hierarchical levels of the HMAX and BoW models. Brain activity of 20 subjects obtained while viewing a short video clip was analyzed voxel-wise using a distance-based variation partitioning method. Results revealed that both HMAX and BoW explain a significant amount of brain activity in early visual regions V1, V2 and V3. However BoW exhibits more consistency across subjects in accounting for brain activity compared to HMAX. Furthermore, visual dictionary representations by HMAX and BoW explain significantly some brain activity in higher areas which are believed to process intermediate features. Overall our results indicate that, although both HMAX and BoW account for activity in the human visual system, the BoW seems to more faithfully represent neural responses in low and intermediate level visual areas of the brain.

Validation of an Accelerometer to Quantify a Comprehensive Battery of Gait Characteristics in Healthy Older Adults and Parkinson's Disease: Toward Clinical and at Home Use.

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Del Din, Silvia; Godfrey, Alan; Rochester, Lynn

2016-05-01

Measurement of gait is becoming important as a tool to identify disease and disease progression, yet to date its application is limited largely to specialist centers. Wearable devices enables gait to be measured in naturalistic environments, however questions remain regarding validity. Previous research suggests that when compared with a laboratory reference, measurement accuracy is acceptable for mean but not variability or asymmetry gait characteristics. Some fundamental reasons for this have been presented, (e.g., synchronization, different sampling frequencies) but to date this has not been systematically examined. The aims of this study were to: 1) quantify a comprehensive range of gait characteristics measured using a single triaxial accelerometer-based monitor; 2) examine outcomes and monitor performance in measuring gait in older adults and those with Parkinson's disease (PD); and 3) carry out a detailed comparison with those derived from an instrumented walkway to account for any discrepancies. Fourteen gait characteristics were quantified in 30 people with incident PD and 30 healthy age-matched controls. Of the 14 gait characteristics compared, agreement between instruments was excellent for four (ICCs 0.913-0.983); moderate for four (ICCs 0.508-0.766); and poor for six characteristics (ICCs 0.637-0.370). Further analysis revealed that differences reflect an increased sensitivity of accelerometry to detect motion, rather than measurement error. This is most likely because accelerometry measures gait as a continuous activity rather than discrete footfall events, per instrumented tools. The increased sensitivity shown for these characteristics will be of particular interest to researchers keen to interpret "real-world" gait data. In conclusion, use of a body-worn monitor is recommended for the measurement of gait but is likely to yield more sensitive data for asymmetry and variability features.

Kinematics gait disorder in men with fibromyalgia.

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Heredia-Jimenez, Jose M; Soto-Hermoso, Victor M

2014-01-01

The aim of this study was to assess the kinematics disorder of gait in men with fibromyalgia. We studied 12 male with fibromyalgia and 14 healthy men. Each participant of the study walked five trials along a 18.6-m walkway. Fibromyalgia patients completed a Spanish version of Fibromyalgia Impact Questionnaire. Significant differences between fibromyalgia and control groups were found in velocity, stride length, and cadence. Gait parameters of men affected by fibromyalgia were impaired when compared to those of healthy group due to bradykinesia. According to previous studies to assess gait variables in female patients, the male with fibromyalgia also showed lower values of velocity, cadence, and stride length than healthy group but not reported significant differences in swing, stance, single, or double support phase.

Harmony as a convergence attractor that minimizes the energy expenditure and variability in physiological gait and the loss of harmony in cerebellar ataxia.

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Serrao, Mariano; Chini, Giorgia; Iosa, Marco; Casali, Carlo; Morone, Giovanni; Conte, Carmela; Bini, Fabiano; Marinozzi, Franco; Coppola, Gianluca; Pierelli, Francesco; Draicchio, Francesco; Ranavolo, Alberto

2017-10-01

The harmony of the human gait was recently found to be related to the golden ratio value (ϕ). The ratio between the duration of the stance and that of the swing phases of a gait cycle was in fact found to be close to ϕ, which implies that, because of the fractal property of autosimilarity of that number, the gait ratios stride/stance, stance/swing, swing/double support, were not significantly different from one another. We studied a group of patients with cerebellar ataxia to investigate how the differences between their gait ratios and the golden ratio are related to efficiency and stability of their gait, assessed by energy expenditure and stride-to-stride variability, respectively. The gait of 28 patients who were affected by degenerative cerebellar ataxia and of 28 healthy controls was studied using a stereophotogrammetric system. The above mentioned gait ratios, the energy expenditure estimated using the pelvis reconstructed method and the gait variability in terms of the stride length were computed, and their relationships were analyzed. Matching procedures have also been used to avoid multicollinearity biases. The gait ratio values of the patients were farther from the controls (and hence from ϕ), even in speed matched conditions (P=0.011, Cohen's D=0.76), but not when the variability and energy expenditure were matched between the two groups (Cohen's D=0.49). In patients with cerebellar ataxia, the farther the stance-swing ratio was from ϕ, the larger the total mechanical work (R 2 adj =0.64). Further, a significant positive correlation was observed between the difference of the gait ratio from the golden ratio and the severity of the disease (R=0.421, P=0.026). Harmony of gait appears to be a benchmark of physiological gait leading to physiological energy recovery and gait reliability. Neurorehabilitation of patients with ataxia might benefit from the restoration of harmony of their locomotor patterns. Copyright © 2017. Published by Elsevier Ltd.

Non-surgical management of a pediatric “intoed” gait pattern – a systematic review of the current best evidence

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Uden H

2012-01-01

Full Text Available Hayley Uden1, Saravana Kumar21Podiatry Department, University of South Australia, Adelaide, South Australia, Australia; 2Post Doctoral Senior Research Fellow, International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, AustraliaBackground: An intoed gait pattern is one of the most common referrals for children to an orthopedic consultation. Parental concern as to the aesthetics of the child’s gait pattern and/or its symptomatic nature will primarily drive these referrals during a child’s early developmental years. Whilst some of these referrals prove to be the result of a normal growth variant, some children will present with a symptomatic intoed gait pattern. Various treatments, both conservative and surgical, have been proposed including: braces, wedges, stretches and exercises, shoe modifications, and surgical procedures. However, which treatments are effective and justified in the management of this condition is not clear within the literature. The aim of this systematic review was to therefore identify and critique the best available evidence for the non-surgical management of an intoed gait pattern in a pediatric population.Method: A systematic review was conducted of which only experimental studies investigating a management option for an intoeing gait pattern were included. Studies needed to be written in English, pertaining to a human pediatric population, and published within a peer reviewed journal. Electronic databases were searched: Ovid (Medline, EMBASE, AMED, PubMed, SportDiscus, CINAHL, and Cochrane Library. The National Health and Medical Research Council’s designation of levels of hierarchy and the Critical Appraisal Skills Programme cohort studies critical appraisal tool were used.Results: Five level IV studies were found. The studies were of varied quality and with mixed results. Gait plates, physiologic/standardized shoes, and orthotic devices (with gate plate extension

Fall-related gait characteristics on the treadmill and in daily life.

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Rispens, Sietse M; Van Dieën, Jaap H; Van Schooten, Kimberley S; Cofré Lizama, L Eduardo; Daffertshofer, Andreas; Beek, Peter J; Pijnappels, Mirjam

2016-02-02

Body-worn sensors allow assessment of gait characteristics that are predictive of fall risk, both when measured during treadmill walking and in daily life. The present study aimed to assess differences as well as associations between fall-related gait characteristics measured on a treadmill and in daily life. In a cross-sectional study, trunk accelerations of 18 older adults (72.3 ± 4.5 years) were recorded during walking on a treadmill (Dynaport Hybrid sensor) and during daily life (Dynaport MoveMonitor). A comprehensive set of 32 fall-risk-related gait characteristics was estimated and compared between both settings. For 25 gait characteristics, a systematic difference between treadmill and daily-life measurements was found. Gait was more variable, less symmetric, and less stable during daily life. Fourteen characteristics showed a significant correlation between treadmill and daily-life measurements, including stride time and regularity (0.48  0.25). Gait characteristics revealed less stable, less symmetric, and more variable gait during daily life than on a treadmill, yet about half of the characteristics were significantly correlated between conditions. These results suggest that daily-life gait analysis is sensitive to static personal factors (i.e., physical and cognitive capacity) as well as dynamic situational factors (i.e., behavior and environment), which may both represent determinants of fall risk.

Apraxia of gait- or apraxia of postural transitions?

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Dale, Marian L; Curtze, Carolin; Nutt, John G

2018-02-19

"Apraxia of gait" is not a useful concept and freezing of gait should also not be considered an apraxia. The concept of apraxia may, however, be applied to distortions of postural transitions that can accompany fronto-parietal lesions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Novel actuation design of a gait trainer with shadow leg approach.

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Meuleman, Jos; Meuleman, Jos; van Asseldonk, Edwin H F; van der Kooij, Herman

2013-06-01

Robotic gait training has developed since the end of the 20(th) century, yet there is much room for improvement in the design of the robots. With the conventional exoskeleton structures, donning of patients in a gait trainer usually is a cumbersome process due to the need of joint alignments and normal walking is often hindered due to obstructed arm swing. Our goal was to design a gait training robots that overcomes these limitations. We propose a novel design in which these drawbacks are reduced to a great amount. By using a parallel structure behind the patient (shadow leg) that is connected to the patient joints with rods, little alignment is needed, the area lateral to the hip is left free, and thus arm swing is not obstructed. The construction is lightweight, because the actuators are mounted on a fixed base and the transmission of power is executed with light weight rods. An end stop in the shadow leg prevents hyper extension of the patient's knee. The relationship between motor displacement and human joint rotations is nonlinear. In this paper we derive the nonlinear relationships between motors and patient joints and verify these. calculations with a measurement. The device has been built, now tests with subjects are required to assess if subjects can indeed walk normally in the robot.

Auditive Discrimination of Equine Gaits by Parade Horses

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Duilio Cruz-Becerra

2009-06-01

Full Text Available The purpose of this study was to examine parade horses’ auditory discriminationamong four types of equine gaits: paso-fino (“fine step”, trote-reunido(“two-beat trot”, trocha (“trot”, and galope-reunido (“gallop”. Two experimentallynaïve horses were trained to discriminate the sound of their owngait (paso-fino or fine step, through an experimental module that dispensedfood if the subject pressed a lever after hearing a sound reproduction of aparticular gait. Three experimental phases were developed, defined by theperiod of exposure to the sounds (20, 10, and 5 seconds, respectively. Thechoice between pairs of sounds including the horse’s own gait (fine stepand two-beat trot; fine step and gallop; and fine step and trot was reinforceddifferentially. The results indicate that the fine step horses are able todiscriminate their own gait from others, and that receptivity to their ownsounds could be included in their training regime.

The effect of frame rate on the ability of experienced gait analysts to identify characteristics of gait from closed circuit television footage.

Science.gov (United States)

Birch, Ivan; Vernon, Wesley; Burrow, Gordon; Walker, Jeremy

2014-03-01

Forensic gait analysis is increasingly being used as part of criminal investigations. A major issue is the quality of the closed circuit television (CCTV) footage used, particularly the frame rate which can vary from 25 frames per second to one frame every 4s. To date, no study has investigated the effect of frame rate on forensic gait analysis. A single subject was fitted with an ankle foot orthosis and recorded walking at 25 frames per second. 3D motion data were also collected, providing an absolute assessment of the gait characteristics. The CCTV footage was then edited to produce a set of eight additional pieces of footage, at various frame rates. Practitioners with knowledge of forensic gait analysis were recruited and instructed to record their observations regarding the characteristics of the subject's gait from the footage. They were sequentially sent web links to the nine pieces of footage, lowest frame rate first, and a simple observation recording form, over a period of 8 months. A sample-based Pearson product-moment correlation analysis of the results demonstrated a significant positive relationship between frame rate and scores (r=0.868, p=0.002). The results of this study show that frame rate affects the ability of experienced practitioners to identify characteristics of gait captured on CCTV footage. Every effort should therefore be made to ensure that CCTV footage likely to be used in criminal proceedings is captured at as high a frame rate as possible. © 2013.

Do sit-to-stand performance changes during gait acquisition?

OpenAIRE

Bastos, Alana Maria Ferreira Guimarães; Costa, Carolina Souza Neves da; Rocha, Nelci Adriana Cicuto Ferreira

2014-01-01

In a child's daily routine, sit-to-stand (STS) is a prerequisite activity for many functional tasks. The relationship between gait and other abilities has been pointed out by many authors, but there is no study investigating the changes in STS during gait acquisition in children. The purpose of this study was to analyse, in healthy children, changes that occur in STS performance during gait acquisition. Five healthy children were initially assessed with an average age of 13.6 months. The kine...

Effects of Gait and Cognitive Task Difficulty on Cognitive-Motor Interference in Aging

Directory of Open Access Journals (Sweden)

Prudence Plummer-D'Amato

2012-01-01

Full Text Available Although gait-related dual-task interference in aging is well established, the effect of gait and cognitive task difficulty on dual-task interference is poorly understood. The purpose of this study was to examine the effect of gait and cognitive task difficulty on cognitive-motor interference in aging. Fifteen older adults (72.1 years, SD 5.2 and 20 young adults (21.7 years, SD 1.6 performed three walking tasks of varying difficulty (self-selected speed, fast speed, and fast speed with obstacle crossing under single- and dual-task conditions. The cognitive tasks were the auditory Stroop task and the clock task. There was a significant Group × Gait Task × Cognitive Task interaction for the dual-task effect on gait speed. After adjusting for education, there were no significant effects of gait or cognitive task difficulty on the dual-task effects on cognitive task performance. The results of this study provide evidence that gait task difficulty influences dual-task effects on gait speed, especially in older adults. Moreover, the effects of gait task difficulty on dual-task interference appear to be influenced by the difficulty of the cognitive task. Education is an important factor influencing cognitive-motor interference effects on cognition, but not gait.

Quantifying stimulus-response rehabilitation protocols by auditory feedback in Parkinson's disease gait pattern

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Pineda, Gustavo; Atehortúa, Angélica; Iregui, Marcela; García-Arteaga, Juan D.; Romero, Eduardo

2017-11-01

External auditory cues stimulate motor related areas of the brain, activating motor ways parallel to the basal ganglia circuits and providing a temporary pattern for gait. In effect, patients may re-learn motor skills mediated by compensatory neuroplasticity mechanisms. However, long term functional gains are dependent on the nature of the pathology, follow-up is usually limited and reinforcement by healthcare professionals is crucial. Aiming to cope with these challenges, several researches and device implementations provide auditory or visual stimulation to improve Parkinsonian gait pattern, inside and outside clinical scenarios. The current work presents a semiautomated strategy for spatio-temporal feature extraction to study the relations between auditory temporal stimulation and spatiotemporal gait response. A protocol for auditory stimulation was built to evaluate the integrability of the strategy in the clinic practice. The method was evaluated in transversal measurement with an exploratory group of people with Parkinson's (n = 12 in stage 1, 2 and 3) and control subjects (n =6). The result showed a strong linear relation between auditory stimulation and cadence response in control subjects (R=0.98 +/-0.008) and PD subject in stage 2 (R=0.95 +/-0.03) and stage 3 (R=0.89 +/-0.05). Normalized step length showed a variable response between low and high gait velocity (0.2> R >0.97). The correlation between normalized mean velocity and stimulus was strong in all PD stage 2 (R>0.96) PD stage 3 (R>0.84) and controls (R>0.91) for all experimental conditions. Among participants, the largest variation from baseline was found in PD subject in stage 3 (53.61 +/-39.2 step/min, 0.12 +/- 0.06 in step length and 0.33 +/- 0.16 in mean velocity). In this group these values were higher than the own baseline. These variations are related with direct effect of metronome frequency on cadence and velocity. The variation of step length involves different regulation strategies and

Why is walker-assisted gait metabolically expensive?

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Priebe, Jonathon R; Kram, Rodger

2011-06-01

Walker-assisted gait is reported to be ∼200% more metabolically expensive than normal bipedal walking. However, previous studies compared different walking speeds. Here, we compared the metabolic power consumption and basic stride temporal-spatial parameters for 10 young, healthy adults walking without assistance and using 2-wheeled (2W), 4-wheeled (4W) and 4-footed (4F) walker devices, all at the same speed, 0.30m/s. We also measured the metabolic power demand for walking without any assistive device using a step-to gait at 0.30m/s, walking normally at 1.25m/s, and for repeated lifting of the 4F walker mimicking the lifting pattern used during 4F walker-assisted gait. Similar to previous studies, we found that the cost per distance walked was 217% greater with a 4F walker at 0.30m/s compared to unassisted, bipedal walking at 1.25m/s. Compared at the same speed, 0.30m/s, using a 4F walker was still 82%, 74%, and 55% energetically more expensive than walking unassisted, with a 4W walker and a 2W walker respectively. The sum of the metabolic cost of step-to walking plus the cost of lifting itself was equivalent to the cost of walking with a 4F walker. Thus, we deduce that the high cost of 4F walker assisted gait is due to three factors: the slow walking speed, the step-to gait pattern and the repeated lifting of the walker. Copyright © 2011 Elsevier B.V. All rights reserved.

Kinematic Mechanisms of How Power Training Improves Healthy Old Adults' Gait Velocity.