WorldWideScience

Sample records for ledge test gait

  1. Test-retest reliability of trunk accelerometric gait analysis

    DEFF Research Database (Denmark)

    Henriksen, Marius; Lund, Hans; Moe-Nilssen, R

    2004-01-01

    The purpose of this study was to determine the test-retest reliability of a trunk accelerometric gait analysis in healthy subjects. Accelerations were measured during walking using a triaxial accelerometer mounted on the lumbar spine of the subjects. Six men and 14 women (mean age 35.2; range 18...... a definite potential in clinical gait analysis....

  2. 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

  3. [Measuring gait velocity in the elderly with a gait analysis system and a 10-meter walk test. A comparison].

    Science.gov (United States)

    Wewerka, G; Wewerka, G; Iglseder, B

    2015-01-01

    Gait disorders are common in the elderly, compromising quality of life and increasing the risk for falls. Mobility and fall risk assessment usually includes measurement of gait velocity. Computerized gait analyses are able to measure additional gait parameters. This study addressed the question whether elderly patients (n=66) change their self-selected gait speed when walking on a computerized platform compared to a 10-m walk test. A second aim was to compare gait velocity, gait parameters, and clinical measurements (TUG, POMA) in subgroups of patients with a history of a fall (n=27) vs. without a history of a fall (n=39). Our results demonstrate that gait velocity was significantly reduced in the subgroup of fallers, but not in the group of nonfallers. Moreover, other gait parameters and the clinical tests differed significantly between fallers and nonfallers. A possible explanation could be the visual requirements of the test environment, which may influence the walking speed in terms of a dual-task paradigm in those participants with mobility problems.

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

    Science.gov (United States)

    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.

  5. Test-retest reliability of daily life gait speed as measured by smartphone global positioning system.

    Science.gov (United States)

    Obuchi, Shuichi P; Tsuchiya, Shuichi; Kawai, Hisashi

    2018-01-30

    Gait speed is useful in predicting adverse health outcomes among older adults. In previous studies, gait speed has typically been measured when subjects walk in laboratory settings, where they are able to intentionally change their gait speed. Thus, it is unclear whether the gait speed captured in a laboratory setting is representative of the subjects' actual walking pace in daily life. This study proposes using the more accurate "daily life gait speed" (DGS), measured as the subject's average gait speed over a week-long period using the global positioning system (GPS) in their smartphone. We examined the test-retest reliability of the DGS measure in the present study. Three daily life gait parameters with 186 volunteers (57 men and 129 women), aged 19 to 84 years, were measured using a smartphone application: DGS, average of daily gait cycle during a week (DCY), and average of daily cadence during a week (DCA). Test-retest reliability of the daily gait parameters between test week (T1) and retest week (T2) was assessed with the intraclass correlation coefficient, ICC (2,1), and systematic biases were observed via Bland-Altman plots. The ICCs between the daily gait parameters at T1 and T2 were 0.902 for DGS, 0.916 for DCY, and 0.917 for DCA. The Bland-Altman plots showed no significant fixed or proportional bias between the measurements at T1 and T2. These results verify that the test-retest reliability of the daily gait parameters in the present study was adequate. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Automated on-line L-edge measurement of SNM concentration for near-real-time accounting

    International Nuclear Information System (INIS)

    Russo, P.A.; Marks, T. Jr.; Stephens, M.M.; Baker, A.L.; Cobb, D.D.

    1982-09-01

    An L-edge densitometer has been modified, tested, and demonstrated for on-line assay of special nuclear material concentration in flowing solution streams. The demonstration was part of a larger demonstration of near-real-time nuclear materials accounting during a continuous, week-long, cold operation of the Barnwell facility. The L-edge data were automatically analyzed and the results were transmitted to the materials accounting computer once every 5.5 min for the duration of the cold run. This report compares the results of the L-edge analyses with the delayed results obtained from destructive analysis of samples withdrawn from the same process line. Comparisons are also made with the results obtained in near real time from an automated process control instrument installed in series with the L-edge densitometer. The performance of the L-edge instrument was reliable throughout the continuous operation. The assay precision was consistent with that predicted by the counting statistics of the measurement. The results of the L-edge assays show good agreement with those of the destructive assays. A gradually varying discrepancy (of a few percent) between the L-edge and the process control results remains unexplained

  7. Gait velocity in senior people. An easy test for detecting mobility impairment in community elderly.

    Science.gov (United States)

    Montero-Odasso, M; Schapira, M; Varela, C; Pitteri, C; Soriano, E R; Kaplan, R; Camera, L A; Mayorga, L M

    2004-01-01

    Functional assessment is an important part of the evaluation of elderly patients. Mobility problems detected by functional tests predict the development of more severe disability and injurious events such as falls and hip fractures. Several tests to evaluate mobility have been described, but most of them are difficult to perform by a primary care physicians or take much time in the ambulatory setting. To evaluate different mobility test to detect mobility impairment in community senior people. Select an easier test to perform on the ambulatory ward by a GP with the hypothesis that gait velocity could be an easier test to detect early mobility impairment. A cohort of 100 elderly subjects of 75 year and older were selected from our database and contacted by phone. The subjects were appointed and assessed by three geriatricians from January to May 2000. The measures including MMSE, Yesavage Test, ADL (Barhtel) and IADL (Lawton), the Get Up and Go test, the POMA, one leg balance test and the Gait Velocity (GV). A gait velocity of 0.8 m/s or lower was defined as a pathological gait velocity (PGV). 95 subjects, mean age 79.63 (+/- 4) ranged form 75 to 95. Women in 71.3%. The ADLs were normal on 85% of the patients and the MMSE was normal on 78%. There was a significant association between pathological gait velocity (gait velocity reported recurrent falls in the previous 6 months while 35% of subjects with pathological gait velocity did. (OR 0.32 CI95% 010-099 p gait velocity (gait velocity could be a test easy to perform, no time consuming, and an operative tool to apply in the ambulatory care to detect elderly patients with mobility impairment.

  8. Assessment of test-retest reliability and internal consistency of the Wisconsin Gait Scale in hemiparetic post-stroke patients

    Directory of Open Access Journals (Sweden)

    Guzik Agnieszka

    2016-09-01

    Full Text Available Introduction: A proper assessment of gait pattern is a significant aspect in planning the process of teaching gait in hemiparetic post-stroke patients. The Wisconsin Gait Scale (WGS is an observational tool for assessing post-stroke patients’ gait. The aim of the study was to assess test-retest reliability and internal consistency of the WGS and examine correlations between gait assessment made with the WGS and gait speed, Brunnström scale, Ashworth’s scale and the Barthel Index.

  9. Psychometric evaluation of the adolescent and parent versions of the Gaming Addiction Identification Test (GAIT).

    Science.gov (United States)

    Vadlin, Sofia; Åslund, Cecilia; Rehn, Mattias; Nilsson, Kent W

    2015-12-01

    The objective of the study is to evaluate the psychometric properties of the Gaming Addiction Identification Test (GAIT) and its parent version (GAIT-P), in a representative community sample of adolescents and parents in Västmanland, Sweden. Self-rated and parent-rated gaming addictive symptoms identified by GAIT and GAIT-P were analyzed for frequency of endorsement, internal consistency, concordance, factor structure, prevalence of Internet gaming disorder (IGD), concurrence with the Gaming Addiction Scale for Adolescents, 7-item version (GAS) and the parent version of GAS (GAS-P), and for sex differences. The 12-month prevalence of IGD was found to be 1.3% with GAIT and 2.4% with GAIT-P. Results also indicate promising psychometric results within this population, with high internal consistency, and high concurrent validity with GAS and GAS-P. Concordance between adolescents and parents ratings was high, although moderate in girls. Although exploratory factor analysis indicated poor model fit, it also indicated unidimensionality and high factor loadings in all analyses. GAIT and GAIT-P are suitable for continued use in measuring gaming addiction in adolescents, and, with the additional two items, they now cover all nine IGD criteria. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  10. Single-task and dual-task tandem gait test performance after concussion.

    Science.gov (United States)

    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.

  11. Viability of gait speed test in hospitalized elderly patients.

    Science.gov (United States)

    Martinez, Bruno Prata; Batista, Anne Karine Menezes Santos; Ramos, Isis Resende; Dantas, Júlio Cesar; Gomes, Isabela Barboza; Forgiarini, Luiz Alberto; Camelier, Fernanda Rosa Warken; Camelier, Aquiles Assunção

    2016-01-01

    The gait speed test (GST) is a physical test that can predict falls and aid in the diagnosis of sarcopenia in the elderly. However, to our knowledge, there have been no studies evaluating its reproducibility in hospitalized elderly patients. The objective of this study was to evaluate the safety and reproducibility of the six-meter GST (6GST) in hospitalized elderly patients. This repeated measures study involved hospitalized elderly patients (≥ 60 years of age) who underwent the 6GST by the fifth day of hospitalization, were able to walk without assistance, and presented no signs of dyspnea or pain that would prevent them from performing the test. The 6GST was performed three times in sequence, with a rest period between each test, in a level corridor. Gait speed was measured in meters/second. Reproducibility was assessed by comparing the means, intraclass correlation coefficients (ICCs) and Bland-Altman plots. We evaluated 110 elderly patients in a total of 330 tests. All participants completed all of the tests. The comparisons between the speeds obtained during the three tests showed high ICCs and a low mean bias (Bland-Altman plots). The correlation and accuracy were greatest when the mean maximum speed was compared with that obtained in the third test (1.26 ± 0.44 m/s vs. 1.22 ± 0.44 m/s; ICC = 0.99; p = 0.001; mean bias = 0.04; and limits of agreement = -0.27 to 0.15). The 6GST was proven to be safe and to have good reproducibility in this sample of hospitalized elderly patients. The third measurement seems to correspond to the maximum speed, since the first two measurements underestimated the actual performance. O teste de velocidade de marcha (TVM) é um teste físico que pode predizer quedas e auxiliar no diagnóstico de sarcopenia em idosos da comunidade. Entretanto, pelo que sabemos, não há estudos que avaliaram sua reprodutibilidade em idosos hospitalizados. O objetivo deste estudo foi avaliar a segurança e a reprodutibilidade do TVM de seis

  12. Spatiotemporal gait characteristics in patients with COPD during the Gait Real-time Analysis Interactive Lab-based 6-minute walk test.

    Science.gov (United States)

    Liu, Wai-Yan; Spruit, Martijn A; Delbressine, Jeannet M; Willems, Paul J; Franssen, Frits M E; Wouters, Emiel F M; Meijer, Kenneth

    2017-01-01

    Overground gait assessment is limited by the analysis of multiple strides or both spatiotemporal gait characteristics, while fixed speed treadmill walking restricts natural gait speed variations. The Gait Real-time Analysis Interactive Lab (GRAIL)-based 6-minute walk test (6MWT) enables 3D motion analysis and self-paced treadmill walking, and could provide insight in gait alterations in patients with chronic obstructive pulmonary disease (COPD). The aim of this study is to compare spatiotemporal gait characteristics between patients with COPD and healthy elderly during the GRAIL-based 6MWT. Eighty COPD patients (60% male; 62±7 years; FEV1:56±19% predicted) and 38 healthy elderly (63% male; 62±6 years; FEV1:119±17% predicted) performed two GRAIL-based 6MWTs. Mean differences and coefficient of variation of spatiotemporal gait characteristics were calculated using the trial with the largest walk distance. Sub-analyses were conducted to account for walking speed differences between groups, and muscle strength and COPD severity within the patient group. COPD patients showed increased temporal gait characteristics, decreased stride and step lengths, and increased gait variability compared to healthy elderly (pgait characteristics, while COPD severity is associated with stride time (left MD:-0.02s, CI:-0.04-0.01, p = 0.003; right MD:-0.02s, CI:-0.04-0.01, p = 0.003). COPD patients performed the GRAIL-based 6MWT differently compared to healthy elderly. Further research should use other variability measures to investigate gait characteristics in COPD, to assess subtle alterations in gait and to enable development of rehabilitation strategies to improve gait, and possibly balance and fall risk in COPD. Other lower limb muscle groups should be considered when investigating gait alterations in COPD. COPD patients have different gait characteristics compared to healthy elderly. Independent of walking speed, COPD patients demonstrate increased stride length variability

  13. Oxygen consumption and gait variables of Arabian endurance horses measured during a field exercise test.

    Science.gov (United States)

    Cottin, F; Metayer, N; Goachet, A G; Julliand, V; Slawinski, J; Billat, V; Barrey, E

    2010-11-01

    Arabian horses have morphological, muscular and metabolic features designed for endurance races. Their gas exchange and gait variables were therefore measured during a field exercise test. This study presents original respiratory and locomotor data recorded in endurance horses under field conditions. Respiratory gas exchange ratio (RER) of Arabian horses at the speed required to win endurance races (18 km/h for 120-160 km) are endurance horses running in the field in order to estimate RER and RE. Five Arabian horses trained for endurance racing were test ridden at increasing speeds on the field. Their speed was recorded and controlled by the rider using a GPS logger. Each horse was equipped with a portable respiratory gas analyser, which measured breath-by-breath respiratory variables and heart rate. The gait variables were recorded using tri-axial accelerometer data loggers and software for gait analysis. Descriptive statistics and linear regressions were used to analyse the speed related changes in each variable with P speed corresponding to endurance race winning speed (18 km/h), horses presented a VO(2) = 42 ± 9 ml/min/kg bwt, RER = 0.96 ± 0.10 and RE (= VO(2) /speed) = 134 ± 27 l/km/kg bwt. Linear relationships were observed between speed and VO(2,) HR and gait variables. Significant correlations were observed between VO(2) and gait variables. The RER of 0.96 at winning endurance speed indicates that Arabian horses mainly use aerobic metabolism based on lipid oxidation and that RER may also be related to a good coordination between running speed, respiratory and gait parameters. © 2010 EVJ Ltd.

  14. Gait velocity and the Timed-Up-and-Go test were sensitive to changes in mobility in frail elderly patients.

    Science.gov (United States)

    van Iersel, Marianne B; Munneke, Marten; Esselink, Rianne A J; Benraad, Carolien E M; Olde Rikkert, Marcel G M

    2008-02-01

    To estimate clinically relevant changes in functional mobility tests and quantitative gait measures at group and individual level in frail elderly patients. This study was a cohort study of consecutively admitted frail elderly patients. Gait velocity, Timed-Up-and-Go test (TUG), and other mobility tests were measured on admission and 2 weeks later. In between, patients received multidisciplinary treatment. Three experts decided from video recordings if patients had a clinically relevant change in gait, defined as change in the expected risk of falling. A total of 85 patients (mean age 75.8 years, 46 female) participated. Of whom, 45% had dementia; 59 patients were stable and 26 showed a clinically relevant change in gait. Gait velocity and TUG were most sensitive to change at group level. In individual patients, a 5% change from baseline in gait velocity and 9% change in TUG had a sensitivity of 92% and 93% for detection of clinically relevant change, but specificity of 27% and 34%, respectively. At group level, gait velocity and TUG were, from all investigated tests, most sensitive to change and in this perspective the best outcome variables. In individual patients, the high intraindividual variability makes these measures unsuitable as independent screening instruments for clinically relevant changes in gait.

  15. Gait velocity and the Timed-Up-and-Go test were sensitive to changes in mobility in frail elderly patients.

    NARCIS (Netherlands)

    Iersel, M.B. van; Munneke, M.; Esselink, R.A.J.; Benraad, C.E.; Olde Rikkert, M.G.M.

    2008-01-01

    OBJECTIVE: To estimate clinically relevant changes in functional mobility tests and quantitative gait measures at group and individual level in frail elderly patients. STUDY DESIGN AND SETTING: This study was a cohort study of consecutively admitted frail elderly patients. Gait velocity,

  16. Test-retest reliability and minimal detectable change of three-dimensional gait analysis in chronic low back pain patients

    NARCIS (Netherlands)

    Fernandes, R.; Armada-da-Silva, P.; Pool-Goudzwaard, A.; Moniz-Pereira, V.; Veloso, A.P.

    2015-01-01

    Background and aim: Three-dimensional gait analysis (3DGA) can provide detailed data on gait impairment in chronic low back pain (CLBP) patients. However, data about reliability and measurement error of 3DGA in this population is lacking. The aim of this study is to investigate test-retest

  17. Test-Retest Reliability of an Automated Infrared-Assisted Trunk Accelerometer-Based Gait Analysis System.

    Science.gov (United States)

    Hsu, Chia-Yu; Tsai, Yuh-Show; Yau, Cheng-Shiang; Shie, Hung-Hai; Wu, Chu-Ming

    2016-07-23

    The aim of this study was to determine the test-retest reliability of an automated infrared-assisted, trunk accelerometer-based gait analysis system for measuring gait parameters of healthy subjects in a hospital. Thirty-five participants (28 of them females; age range, 23-79 years) performed a 5-m walk twice using an accelerometer-based gait analysis system with infrared assist. Measurements of spatiotemporal gait parameters (walking speed, step length, and cadence) and trunk control (gait symmetry, gait regularity, acceleration root mean square (RMS), and acceleration root mean square ratio (RMSR)) were recorded in two separate walking tests conducted 1 week apart. Relative and absolute test-retest reliability was determined by calculating the intra-class correlation coefficient (ICC3,1) and smallest detectable difference (SDD), respectively. The test-retest reliability was excellent for walking speed (ICC = 0.87, 95% confidence interval = 0.74-0.93, SDD = 13.4%), step length (ICC = 0.81, 95% confidence interval = 0.63-0.91, SDD = 12.2%), cadence (ICC = 0.81, 95% confidence interval = 0.63-0.91, SDD = 10.8%), and trunk control (step and stride regularity in anterior-posterior direction, acceleration RMS and acceleration RMSR in medial-lateral direction, and acceleration RMS and stride regularity in vertical direction). An automated infrared-assisted, trunk accelerometer-based gait analysis system is a reliable tool for measuring gait parameters in the hospital environment.

  18. The Effect of Two Different Cognitive Tests on Gait Parameters during Dual Tasks in Healthy Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Magdalena Hagner-Derengowska

    2016-01-01

    Full Text Available Introduction. The paper aims to evaluate the influence of two different demanding cognitive tasks on gait parameters using BTS SMART system analysis. Patients and Methods. The study comprised 53 postmenopausal women aged 64.5 ± 6.7 years (range: 47–79. For every subject, gait analysis using a BTS SMART system was performed in a dual-task study design under three conditions: (I while walking only (single task, (II walking while performing a simultaneous simple cognitive task (SCT (dual task, and (III walking while performing a simultaneous complex cognitive task (CCT (dual task. Time-space parameters of gait pertaining to the length of a single support phase, double support phase, gait speed, step length, step width, and leg swing speed were analyzed. Results. Performance of cognitive tests during gait resulted in a statistically significant prolongation of the left (by 7% and right (by 7% foot gait cycle, shortening of the length of steps made with the right extremity (by 4%, reduction of speed of swings made with the left (by 11% and right (by 8% extremity, and reduction in gait speed (by 6%. Conclusions. Performance of cognitive tests during gait changes its individual pattern in relation to the level of the difficulty of the task.

  19. 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.

  20. 77 FR 16674 - Establishment of the Wisconsin Ledge Viticultural Area

    Science.gov (United States)

    2012-03-22

    .... All of the comments expressed support for the proposed Wisconsin Ledge viticultural area. TTB... label reference on a wine that indicates or implies an origin other than the wine's true place of origin... or other term identified as being viticulturally significant in part 9 of the TTB regulations, at...

  1. Are the Timed Up and Go Test and Functional Reach Test Useful Predictors of Temporal and Spatial Gait Parameters in Elderly People?

    OpenAIRE

    Sadowska Dorota; Gumny Margareta; Osiński Wiesław

    2016-01-01

    Purpose. The study aim was to analyse the relationships between the results of the Timed Up and Go (TUG) test and the Functional Reach Test (FRT), and the temporal and spatial gait parameters determined with the GAITRite system.

  2. Test-Retest Reliability of an Automated Infrared-Assisted Trunk Accelerometer-Based Gait Analysis System

    Directory of Open Access Journals (Sweden)

    Chia-Yu Hsu

    2016-07-01

    Full Text Available The aim of this study was to determine the test-retest reliability of an automated infrared-assisted, trunk accelerometer-based gait analysis system for measuring gait parameters of healthy subjects in a hospital. Thirty-five participants (28 of them females; age range, 23–79 years performed a 5-m walk twice using an accelerometer-based gait analysis system with infrared assist. Measurements of spatiotemporal gait parameters (walking speed, step length, and cadence and trunk control (gait symmetry, gait regularity, acceleration root mean square (RMS, and acceleration root mean square ratio (RMSR were recorded in two separate walking tests conducted 1 week apart. Relative and absolute test-retest reliability was determined by calculating the intra-class correlation coefficient (ICC3,1 and smallest detectable difference (SDD, respectively. The test-retest reliability was excellent for walking speed (ICC = 0.87, 95% confidence interval = 0.74–0.93, SDD = 13.4%, step length (ICC = 0.81, 95% confidence interval = 0.63–0.91, SDD = 12.2%, cadence (ICC = 0.81, 95% confidence interval = 0.63–0.91, SDD = 10.8%, and trunk control (step and stride regularity in anterior-posterior direction, acceleration RMS and acceleration RMSR in medial-lateral direction, and acceleration RMS and stride regularity in vertical direction. An automated infrared-assisted, trunk accelerometer-based gait analysis system is a reliable tool for measuring gait parameters in the hospital environment.

  3. Computerized Dual-Task Testing of Gait and Visuospatial Cognitive Functions; Test-Retest Reliability and Validity.

    Science.gov (United States)

    Szturm, Tony J; Sakhalkar, Vedant S; Kanitkar, Anuprita; Nankar, Mayur

    2017-01-01

    The common occurrence of age decline in mobility and cognition does cause a decrease in the level of physical activity and an increased falls risk. Consequently, dual -task (DT) assessment that simultaneously addresses both mobility skills and cognitive functions are important because, continued difficulties and fall injuries will have a sizable impact in this population. The first objective of the present study was to assess test-retest reliability of a computerized DT treadmill walking protocol and concurrent outcome measures of gait and visuospatial executive function in a group of healthy older adults. Secondly, discriminative validity was evaluated by examining the effect of DT conditions (single task vs. dual-task) on; (a) spatiotemporal gait measures (average and coefficient of variation) and (b) visuomotor and visuospatial executive performance measures. Twenty-five community-dwelling individuals median age 65 (range 61-67) were recruited from a Fitness Facility. Participants performed a computerized visuomotor tracking task and a visuospatial executive game task in standing and while treadmill walking. Testing was conducted on two occasions, 1 week apart. Moderate to high test-retest reliability (ICC values of 0.65-0.88) were observed for spatiotemporal gait variables. No significant differences between the group means were observed between test periods in any gait variable. Moderate test-retest reliability (ICC values of 0.6-0.65) was observed for measures of visuomotor and visuospatial executive performance during treadmill walking. Significant DT effects were observed for both spatiotemporal gait variables and visuospatial executive performance measures. This study demonstrates the reliability and reproducibility of the computer-based assessment tool for dual task treadmill walking. The high to moderate ICC values and the lack of systematic errors in the measures indicate that this tool has the ability to repeatedly record reliable data from community

  4. Normal gait speed, grip strength and thirty seconds chair stand test among older Indians.

    Science.gov (United States)

    Gunasekaran, Venugopalan; Banerjee, Joyita; Dwivedi, Sada Nand; Upadhyay, Ashish Datt; Chatterjee, Prashun; Dey, Aparajit Ballav

    2016-01-01

    Gait speed, maximum grip strength and thirty seconds chair stand test are quick, reliable measures of functional capacity in older adults. The objective of this study was to develop normative data of the said parameters, which is lacking in older Indians. In a cross sectional study, 723 participants of ≥60 years without any morbidity, were recruited with written consent at Geriatric Medicine clinic of All India Institute of Medical sciences, New Delhi. Time taken to walk comfortably (4m) was taken as Gait speed. Maximum grip strength was assessed by using dynamometer by pressing it for 3 times in each hand, and the best of six values noted. Thirty second chair stand was assessed by the number of repetitions to stand and sit from a chair in thirty second. The Cut-off (25th percentile) of gait speed for both male and female in all age group was 0.6m/s. The Cut-off for maximum grip strength in 60-65 years, 66-70 years and >70 years for male were 20, 15 and 15 and for females were 8, 6 and 6 in kg, respectively. The Cut-off for thirty second chair stand test in 60-65 years, 66-70 years and >70 years for male were 10, 9 and 8 and for females was 8, 8 and 7, respectively. These normative data would be useful to the clinicians and researcher as Indian reference value, which is less as compared to western data. Community based multi-centre study is needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Quadriceps femoris spasticity in children with cerebral palsy: measurement with the pendulum test and relationship with gait abnormalities.

    Science.gov (United States)

    Szopa, Andrzej; Domagalska-Szopa, Małgorzata; Kidoń, Zenon; Syczewska, Małgorzata

    2014-12-16

    Development of a reliable and objective test of spasticity is important for assessment and treatment of children with cerebral palsy. The pendulum test has been reported to yield reliable measurements of spasticity and to be sensitive to variations in spasticity in these children. However, the relationship between the pendulum test scores and other objective measures of spasticity has not been studied. The present study aimed to assess the effectiveness of an accelerometer-based pendulum test as a measurement of spasticity in CP, and to explore the correlation between the measurements of this test and the global index of deviation from normal gait in in children with cerebral palsy. We studied thirty-six children with cerebral palsy, including 18 with spastic hemiplegia and 18 with spastic diplegia, and a group of 18 typically-developing children. Knee extensor spasticity was assessed bilaterally using the accelerometer-based pendulum test and three-dimensional gait analysis. The Gillette Gait Index was calculated from the results of the gait analysis. The data from the accelerometer-based pendulum test could be used to distinguish between able-bodied children and children with cerebral palsy. Additionally, two of the measurements, first swing excursion and relaxation index, could be used to differentiate the degree of knee extensor spasticity in the children with cerebral palsy. Only a few moderate correlations were found between the Gillette Gait Index and the pendulum test data. This study demonstrates that the pendulum test can be used to discriminate between typically developing children and children with CP, as well as between various degrees of spasticity, such as spastic hemiplegia and spastic diplegia, in the knee extensor muscle of children with CP. Deviations from normal gait in children with CP were not correlated with the results of the pendulum test.

  6. Compact L-edge densitometer for uranium concentration assay

    International Nuclear Information System (INIS)

    Brooks, M.L.; Russo, P.A.; Sprinkle, J.K. Jr.

    1985-02-01

    A new L-edge densitometer has been designed around a compact, commercial x-ray generator weighing less than 5 kg. The dc generator x-ray spectrum was tailored to produce a continuum of x-ray energies from 14 to 20 keV. The x rays were transmitted through uranium reference solutions, and the measured transmissions near the uranium L/sub III/-absorption edge were used to compute the uranium concentration assay result. The range of uranium concentrations in the reference solutions included 5 to 50 g/l. In this concentration range, the assay uncertainty for short count times and the flatness of the specific assay response were better than 0.5%. Thus, the precision and accuracy of this compact densitometer are equal to those demonstrated previously for the L-edge technique. The compact dimensions and optimized transmission geometry increase the practicality, versatility, and range of the L-edge applications. 12 references, 12 figures, 4 tables

  7. Test-retest reliability and minimal detectable change of three-dimensional gait analysis in chronic low back pain patients.

    Science.gov (United States)

    Fernandes, Rita; Armada-da-Silva, Paulo; Pool-Goudzwaard, Annelies L; Moniz-Pereira, Vera; Veloso, António P

    2015-10-01

    Three-dimensional gait analysis (3DGA) can provide detailed data on gait impairment in chronic low back pain (CLBP) patients. However, data about reliability and measurement error of 3DGA in this population is lacking. The aim of this study is to investigate test-retest reliability and minimal detectable change of 3DGA in a sample of CLBP patients. A test-retest study was conducted with a sample of 14 CLBP patients that underwent two biomechanical gait assessments with an interval of 7.6 ± 1.8 days. Anthropometric and time-distance parameters, as well as peak values for lower limb and trunk joint angles and moments, were computed. Intraclass Correlation Coefficient (ICC3,k) and their 95% confidence intervals were calculated. Standard error of measurement (SEM), minimal detectable change (MDC) and limits of agreement (LOA) were also estimated. The obtained ICC values demonstrate high test-retest reliability for most joint angles, with low SEM ( 0.86). The results of this study show high test-retest reliability for lower limb and trunk joint angles, and time-distance parameters during gait in CLBP individuals, together with a low measurement error. These results also support the use of this method in clinical assessments of CLBP patients' gait patterns. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Test-Retest Reliability and Concurrent Validity of a Single Tri-Axial Accelerometer-Based Gait Analysis in Older Adults with Normal Cognition

    Science.gov (United States)

    Byun, Seonjeong; Han, Ji Won; Kim, Tae Hui; Kim, Ki Woong

    2016-01-01

    Objective We investigated the concurrent validity and test-retest reliability of spatio-temporal gait parameters measured with a single tri-axial accelerometer (TAA), determined the optimal number of steps required for obtaining acceptable levels of reliability, and compared the validity and reliability of the estimated gait parameters across the three reference axes of the TAA. Methods A total of 82 cognitively normal elderly participants walked around a 40-m long round walkway twice wearing a TAA at their center of body mass. Gait parameters such as cadence, gait velocity, step time, step length, step time variability, and step time asymmetry were estimated from the low pass-filtered signal of the TAA. The test-retest reliability and concurrent validity with the GAITRite® system were evaluated for the estimated gait parameters. Results Gait parameters using signals from the vertical axis showed excellent reliability for all gait parameters; the intraclass correlation coefficient (ICC) was 0.79–0.90. A minimum of 26 steps and 14 steps were needed to achieve excellent reliability in step time variability and step time asymmetry, respectively. A strong level of agreement was seen for the basic gait parameters between the TAA and GAITRiteⓇ (ICC = 0.91–0.96). Conclusions The measurement of gait parameters of elderly individuals with normal cognition using a TAA placed on the body’s center of mass was reliable and showed superiority over the GAITRiteⓇ with regard to gait variability and asymmetry. The TAA system was a valid tool for measuring basic gait parameters. Considering its wearability and low price, the TAA system may be a promising alternative to the pressure sensor walkway system for measuring gait parameters. PMID:27427965

  9. Test-Retest Reliability and Concurrent Validity of a Single Tri-Axial Accelerometer-Based Gait Analysis in Older Adults with Normal Cognition.

    Directory of Open Access Journals (Sweden)

    Seonjeong Byun

    Full Text Available We investigated the concurrent validity and test-retest reliability of spatio-temporal gait parameters measured with a single tri-axial accelerometer (TAA, determined the optimal number of steps required for obtaining acceptable levels of reliability, and compared the validity and reliability of the estimated gait parameters across the three reference axes of the TAA.A total of 82 cognitively normal elderly participants walked around a 40-m long round walkway twice wearing a TAA at their center of body mass. Gait parameters such as cadence, gait velocity, step time, step length, step time variability, and step time asymmetry were estimated from the low pass-filtered signal of the TAA. The test-retest reliability and concurrent validity with the GAITRite® system were evaluated for the estimated gait parameters.Gait parameters using signals from the vertical axis showed excellent reliability for all gait parameters; the intraclass correlation coefficient (ICC was 0.79-0.90. A minimum of 26 steps and 14 steps were needed to achieve excellent reliability in step time variability and step time asymmetry, respectively. A strong level of agreement was seen for the basic gait parameters between the TAA and GAITRiteⓇ (ICC = 0.91-0.96.The measurement of gait parameters of elderly individuals with normal cognition using a TAA placed on the body's center of mass was reliable and showed superiority over the GAITRiteⓇ with regard to gait variability and asymmetry. The TAA system was a valid tool for measuring basic gait parameters. Considering its wearability and low price, the TAA system may be a promising alternative to the pressure sensor walkway system for measuring gait parameters.

  10. Test-Retest Reliability and Concurrent Validity of a Single Tri-Axial Accelerometer-Based Gait Analysis in Older Adults with Normal Cognition.

    Science.gov (United States)

    Byun, Seonjeong; Han, Ji Won; Kim, Tae Hui; Kim, Ki Woong

    2016-01-01

    We investigated the concurrent validity and test-retest reliability of spatio-temporal gait parameters measured with a single tri-axial accelerometer (TAA), determined the optimal number of steps required for obtaining acceptable levels of reliability, and compared the validity and reliability of the estimated gait parameters across the three reference axes of the TAA. A total of 82 cognitively normal elderly participants walked around a 40-m long round walkway twice wearing a TAA at their center of body mass. Gait parameters such as cadence, gait velocity, step time, step length, step time variability, and step time asymmetry were estimated from the low pass-filtered signal of the TAA. The test-retest reliability and concurrent validity with the GAITRite® system were evaluated for the estimated gait parameters. Gait parameters using signals from the vertical axis showed excellent reliability for all gait parameters; the intraclass correlation coefficient (ICC) was 0.79-0.90. A minimum of 26 steps and 14 steps were needed to achieve excellent reliability in step time variability and step time asymmetry, respectively. A strong level of agreement was seen for the basic gait parameters between the TAA and GAITRiteⓇ (ICC = 0.91-0.96). The measurement of gait parameters of elderly individuals with normal cognition using a TAA placed on the body's center of mass was reliable and showed superiority over the GAITRiteⓇ with regard to gait variability and asymmetry. The TAA system was a valid tool for measuring basic gait parameters. Considering its wearability and low price, the TAA system may be a promising alternative to the pressure sensor walkway system for measuring gait parameters.

  11. Knee osteoarthritis, degenerative meniscal lesion and osteonecrosis of the knee: Can a simple gait test direct us to a better clinical diagnosis.

    Science.gov (United States)

    Debi, R; Elbaz, A; Mor, A; Kahn, G; Peskin, B; Beer, Y; Agar, G; Morag, G; Segal, G

    2017-06-01

    The purpose of the current study was to compare the gait patterns in patients with three differing knee pathologies - knee osteoarthritis (OA), degenerative meniscal lesion (DML) and spontaneous osteonecrosis of the knee (SONK) and a group of healthy controls. A simple gait test will detect differences between different knee pathologies. Forty-seven patients with bilateral knee OA, 47 patients with DML, 28 patients with SONK and 27 healthy controls were included in this analysis. Patients underwent a spatiotemporal gait assessment and were asked to complete the Western Ontario and McMaster University (WOMAC) Index and the Short-Form (SF)-36 Health Survey. ANOVA tests, followed by Bonferroni multiple comparison tests and the Chi 2 tests were performed for continuous and categorical variables, respectively. Significant differences were found for all gait measures and clinical questionnaires between healthy controls and all knee conditions. Patients with SONK differed from patients with bilateral knee OA and DML in all gait measures and clinical questionnaires, except for WOMAC subscales. There were no significant differences between patients with bilateral knee OA and patients with DML. Symmetry was also examined and revealed asymmetry in some gait parameters in patients with SONK and DML. Based on the differences in gait parameters that were found in the current study, adding an objective functional spatiotemporal gait test may assist in the diagnostic process of knee pathologies. Case Control study Level III. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Are the Timed Up and Go Test and Functional Reach Test Useful Predictors of Temporal and Spatial Gait Parameters in Elderly People?

    Directory of Open Access Journals (Sweden)

    Sadowska Dorota

    2016-09-01

    Full Text Available Purpose. The study aim was to analyse the relationships between the results of the Timed Up and Go (TUG test and the Functional Reach Test (FRT, and the temporal and spatial gait parameters determined with the GAITRite system.

  13. Analyzing gait variability and dual-task interference in patients with Parkinson's disease and freezing by means of the word-color Stroop test.

    Science.gov (United States)

    Kleiner, Ana Francisca Rozin; Pagnussat, Aline S; Prisco, Giulia di; Vagnini, Alessandro; Stocchi, Fabrizio; De Pandis, Maria Francesca; Galli, Manuela

    2017-12-02

    The ability to carry out two tasks at once is critical to effective functioning in the real world and deficits are termed Dual-task interference or effect-DTE. DTE substantially compromised the gait of subjects with Parkinson's disease and freezing of gait (PD + FOG), leading to exaggerated slowing, increasing gait dysrhythmicity, and inducing FOG episodes. This study aimed to investigate the DTE in gait variability of subjects with PD and freezing of gait (PD + FOG). Thirty-three patients with PD + FOG and 14 healthy individuals (REFERENCE) took part at this study. Two gait conditions were analyzed: usual walking (single task) and walking while taking the word-color Stroop test (dual task). The computed variables were as follows: gait velocity, step length, step timing, gait asymmetry, variability measures and DTE of each variable. The PD + FOG group has presented negative DTE values for all analyzed variables, indicating dual task cost. The REFERENCE group has presented dual-task benefits for step length standard deviation and step time. Differences between both groups and conditions were found for all variables, except for step time. Taking the word-color Stroop test while walking led to a larger dual-task cost in subjects with PD + FOG.

  14. Assessing the reliability and validity of a shorter walk test compared with the 10-Meter Walk Test for measurements of gait speed in healthy, older adults.

    Science.gov (United States)

    Peters, Denise M; Fritz, Stacy L; Krotish, Debra E

    2013-01-01

    Walking speed is associated with several health-related outcomes. Research examining how differences in test walking distance affect walking speed reliability and validity is limited. The primary purpose of this study was to examine the reliability and concurrent validity of gait speed measurements obtained from a 4-Meter Walk Test compared with the commonly used 10-Meter Walk Test. A second objective was to similarly examine 2 different timing methods: stopwatch and automatic timers. Forty-three healthy, older adults (mean age = 84.3 ± 6.9 years) performed 3 consecutive walking trials on the 4- and 10-Meter Walk Tests at their self-selected walking speed. Gait speed measurements for both tests were shown to have excellent test-retest reliability (ICC values of 0.96-0.98), with similar results for stopwatch and automatic timer assessments (ICC values of 0.99-1.00). Standard error of the measurement (SEM) values were small (0.004-0.008 m/s) across measurement methods. While the ICC value for gait speed measurements between the 2 walk tests was 0.93, the Bland-Altman analysis revealed a discrepancy of ±0.15 to ±0.17 m/s between measurement methods. Both 4- and 10-m gait speed assessments had excellent test-retest reliability with similar SEM and minimal detectable change values. There was little difference in SEM values between the 2 timing methods. While the mean difference in gait speed between the 4- and 10-Meter Walk Tests was small, the range of the measurement differences was large enough to potentially mask meaningful changes in gait speed over time if both methods were used interchangeably. While the reliability of both walking tests is excellent, the 4-Meter Walk Test does not exhibit a high enough degree of concurrent validity with the 10-Meter Walk Test to be used interchangeably for gait speed assessments in healthy, older adults. We therefore recommend using the 10-Meter Walk Test to obtain the most valid clinical assessment of walking speed when

  15. Development and content validity of a screening instrument for gaming addiction in adolescents: the Gaming Addiction Identification Test (GAIT).

    Science.gov (United States)

    Vadlin, Sofia; Åslund, Cecilia; Nilsson, Kent W

    2015-08-01

    This study describes the development of a screening tool for gaming addiction in adolescents - the Gaming Addiction Identification Test (GAIT). Its development was based on the research literature on gaming and addiction. An expert panel comprising professional raters (n = 7), experiential adolescent raters (n = 10), and parent raters (n = 10) estimated the content validity of each item (I-CVI) as well as of the whole scale (S-CVI/Ave), and participated in a cognitive interview about the GAIT scale. The mean scores for both I-CVI and S-CVI/Ave ranged between 0.97 and 0.99 compared with the lowest recommended I-CVI value of 0.78 and the S-CVI/Ave value of 0.90. There were no sex differences and no differences between expert groups regarding ratings in content validity. No differences in the overall evaluation of the scale emerged in the cognitive interviews. Our conclusions were that GAIT showed good content validity in capturing gaming addiction. The GAIT needs further investigation into its psychometric properties of construct validity (convergent and divergent validity) and criterion-related validity, as well as its reliability in both clinical settings and in community settings with adolescents. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  16. Associations between Quantitative Mobility Measures Derived from Components of Conventional Mobility Testing and Parkinsonian Gait in Older Adults

    Science.gov (United States)

    Buchman, Aron S.; Leurgans, Sue E.; Weiss, Aner; VanderHorst, Veronique; Mirelman, Anat; Dawe, Robert; Barnes, Lisa L.; Wilson, Robert S.; Hausdorff, Jeffrey M.; Bennett, David A.

    2014-01-01

    Objective To provide objective measures which characterize mobility in older adults assessed in the community setting and to examine the extent to which these measures are associated with parkinsonian gait. Methods During conventional mobility testing in the community-setting, 351 ambulatory non-demented Memory and Aging Project participants wore a belt with a whole body sensor that recorded both acceleration and angular velocity in 3 directions. We used measures derived from these recordings to quantify 5 subtasks including a) walking, b) transition from sit to stand, c) transition from stand to sit, d) turning and e) standing posture. Parkinsonian gait and other mild parkinsonian signs were assessed with a modified version of the original Unified Parkinson’s Disease Rating Scale (mUPDRS). Results In a series of separate regression models which adjusted for age and sex, all 5 mobility subtask measures were associated with parkinsonian gait and accounted for 2% to 32% of its variance. When all 5 subtask measures were considered in a single model, backward elimination showed that measures of walking sit to stand and turning showed independent associations with parkinsonian gait and together accounted for more than 35% of its variance. Cross-validation using data from a 2nd group of 258 older adults showed similar results. In similar analyses, only walking was associated with bradykinesia and sway with tremor. Interpretation Quantitative mobility subtask measures vary in their associations with parkinsonian gait scores and other parkinsonian signs in older adults. Quantifying the different facets of mobility has the potential to facilitate the clinical characterization and understanding the biologic basis for impaired mobility in older adults. PMID:24465997

  17. Associations between quantitative mobility measures derived from components of conventional mobility testing and Parkinsonian gait in older adults.

    Directory of Open Access Journals (Sweden)

    Aron S Buchman

    Full Text Available OBJECTIVE: To provide objective measures which characterize mobility in older adults assessed in the community setting and to examine the extent to which these measures are associated with parkinsonian gait. METHODS: During conventional mobility testing in the community-setting, 351 ambulatory non-demented Memory and Aging Project participants wore a belt with a whole body sensor that recorded both acceleration and angular velocity in 3 directions. We used measures derived from these recordings to quantify 5 subtasks including a walking, b transition from sit to stand, c transition from stand to sit, d turning and e standing posture. Parkinsonian gait and other mild parkinsonian signs were assessed with a modified version of the original Unified Parkinson's Disease Rating Scale (mUPDRS. RESULTS: In a series of separate regression models which adjusted for age and sex, all 5 mobility subtask measures were associated with parkinsonian gait and accounted for 2% to 32% of its variance. When all 5 subtask measures were considered in a single model, backward elimination showed that measures of walking sit to stand and turning showed independent associations with parkinsonian gait and together accounted for more than 35% of its variance. Cross-validation using data from a 2(nd group of 258 older adults showed similar results. In similar analyses, only walking was associated with bradykinesia and sway with tremor. INTERPRETATION: Quantitative mobility subtask measures vary in their associations with parkinsonian gait scores and other parkinsonian signs in older adults. Quantifying the different facets of mobility has the potential to facilitate the clinical characterization and understanding the biologic basis for impaired mobility in older adults.

  18. Comparing the Effects of Dual-Task Gait Testing in New and Established Ambulators With Lower Extremity Amputations.

    Science.gov (United States)

    Frengopoulos, Courtney; Payne, Michael W C; Holmes, Jeffrey D; Viana, Ricardo; Hunter, Susan W

    2018-04-05

    Gait is a complex process that involves coordinating motor and sensory systems through higher-order cognitive processes. Walking with a prosthesis after lower extremity amputation challenges these processes. However, the factors that influence the cognitive-motor interaction in gait among lower extremity amputees has not been evaluated. To assess the interaction of cognition and mobility, individuals must be evaluated using the dual-task paradigm. To investigate the effect of etiology and time with prosthesis on dual-task performance in those with lower extremity amputations. Cross-sectional study. Outpatient and inpatient amputee clinics at an academic rehabilitation hospital. Sixty-four individuals (aged 58.20±12.27 years; 74.5% male) were stratified into 3 groups; 1 group of new prosthetic ambulators with transtibial amputations (NewPA) and 2 groups of established ambulators: transtibial amputations of vascular etiology (TTA-vas), transtibial amputations of nonvascular etiology (TTA-nonvas). Not applicable. Time to complete the L Test measured functional mobility under single and dual-task conditions. A serial arithmetic task (subtraction by 3s) was paired with the L Test to create the dual-task test condition. Single-task performance on the cognitive arithmetic task was also recorded. Dual-task costs (DTCs) were calculated for performance on the cognitive and gait tasks. Analysis of variance determined differences between groups. A performance-resource operating characteristic (POC) graph was used to graphically display DTCs. Gait performance was worse under dual-task conditions for all groups. Gait was significantly slower under dual-task conditions for the TTA-vas (P Dual-task conditions also had a negative impact on cognitive task performance for the TTA-nonvas (P = .02) and NewPA groups (P dual-task conditions and has a positive DTCcog as a result (P = .04). However, no between-group differences were seen for DTCcog. The POC graph demonstrated that many

  19. Climbing favours the tripod gait over alternative faster insect gaits

    Science.gov (United States)

    Ramdya, Pavan; Thandiackal, Robin; Cherney, Raphael; Asselborn, Thibault; Benton, Richard; Ijspeert, Auke Jan; Floreano, Dario

    2017-02-01

    To escape danger or catch prey, running vertebrates rely on dynamic gaits with minimal ground contact. By contrast, most insects use a tripod gait that maintains at least three legs on the ground at any given time. One prevailing hypothesis for this difference in fast locomotor strategies is that tripod locomotion allows insects to rapidly navigate three-dimensional terrain. To test this, we computationally discovered fast locomotor gaits for a model based on Drosophila melanogaster. Indeed, the tripod gait emerges to the exclusion of many other possible gaits when optimizing fast upward climbing with leg adhesion. By contrast, novel two-legged bipod gaits are fastest on flat terrain without adhesion in the model and in a hexapod robot. Intriguingly, when adhesive leg structures in real Drosophila are covered, animals exhibit atypical bipod-like leg coordination. We propose that the requirement to climb vertical terrain may drive the prevalence of the tripod gait over faster alternative gaits with minimal ground contact.

  20. Improved Leg Tracking Considering Gait Phase and Spline-Based Interpolation during Turning Motion in Walk Tests

    Directory of Open Access Journals (Sweden)

    Ayanori Yorozu

    2015-09-01

    Full Text Available Falling is a common problem in the growing elderly population, and fall-risk assessment systems are needed for community-based fall prevention programs. In particular, the timed up and go test (TUG is the clinical test most often used to evaluate elderly individual ambulatory ability in many clinical institutions or local communities. This study presents an improved leg tracking method using a laser range sensor (LRS for a gait measurement system to evaluate the motor function in walk tests, such as the TUG. The system tracks both legs and measures the trajectory of both legs. However, both legs might be close to each other, and one leg might be hidden from the sensor. This is especially the case during the turning motion in the TUG, where the time that a leg is hidden from the LRS is longer than that during straight walking and the moving direction rapidly changes. These situations are likely to lead to false tracking and deteriorate the measurement accuracy of the leg positions. To solve these problems, a novel data association considering gait phase and a Catmull–Rom spline-based interpolation during the occlusion are proposed. From the experimental results with young people, we confirm   that the proposed methods can reduce the chances of false tracking. In addition, we verify the measurement accuracy of the leg trajectory compared to a three-dimensional motion analysis system (VICON.

  1. Improved Leg Tracking Considering Gait Phase and Spline-Based Interpolation during Turning Motion in Walk Tests

    Science.gov (United States)

    Yorozu, Ayanori; Moriguchi, Toshiki; Takahashi, Masaki

    2015-01-01

    Falling is a common problem in the growing elderly population, and fall-risk assessment systems are needed for community-based fall prevention programs. In particular, the timed up and go test (TUG) is the clinical test most often used to evaluate elderly individual ambulatory ability in many clinical institutions or local communities. This study presents an improved leg tracking method using a laser range sensor (LRS) for a gait measurement system to evaluate the motor function in walk tests, such as the TUG. The system tracks both legs and measures the trajectory of both legs. However, both legs might be close to each other, and one leg might be hidden from the sensor. This is especially the case during the turning motion in the TUG, where the time that a leg is hidden from the LRS is longer than that during straight walking and the moving direction rapidly changes. These situations are likely to lead to false tracking and deteriorate the measurement accuracy of the leg positions. To solve these problems, a novel data association considering gait phase and a Catmull–Rom spline-based interpolation during the occlusion are proposed. From the experimental results with young people, we confirm that the proposed methods can reduce the chances of false tracking. In addition, we verify the measurement accuracy of the leg trajectory compared to a three-dimensional motion analysis system (VICON). PMID:26404302

  2. Gait characteristics and influence of fatigue during the 6-minute walk test in patients with post-polio syndrome.

    Science.gov (United States)

    Vreede, Katarina Skough; Henriksson, Jan; Borg, Kristian; Henriksson, Marketta

    2013-09-01

    To evaluate gait in patients with post-polio syndrome, using the 6-minute walk test (6MWT) combined with three-dimensional kinematic analysis. Descriptive study. Eighteen patients and 11 healthy controls. Kinematic data were obtained during a 6MWT by a Vicon motion capture system. Distance, heart rate, leg tiredness, dyspnoea and exertion were also recorded. Patients with post-polio syndrome showed larger increases in leg tiredness (p post-polio syndrome, and this was reflected in the kinematic data. Walking speed was negatively correlated with the increased hip flexion, but not with the ankle plantar-flexion at foot-off in the patients with post-polio syndrome. The three-dimensional results underscore the importance of hip function in this patient group.

  3. Improved Gait Performance in a Patient With Hereditary Spastic Paraplegia After a Continuous Intrathecal Baclofen Test Infusion and Subsequent Pump Implantation : A Case Report

    NARCIS (Netherlands)

    Heetla, Herre W.; Halbertsma, Jan P.; Dekker, Rienk; Staal, Michiel J.; van Laar, Teus

    Objective: To show the benefits of a continuous intrathecal baclofen (ITB) test infusion in a patient with hereditary spastic paraplegia (HSP), with an improved gait performance after ITB pump implantation. Design: Case report. Setting: University hospital. Participant: A 49-year old man with HSP

  4. 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…

  5. 76 FR 63852 - Proposed Establishment of the Wisconsin Ledge Viticultural Area

    Science.gov (United States)

    2011-10-14

    ... than the surrounding land, moderating the summer mean maximum and winter mean minimum temperatures in... degree Fahrenheit that a day's mean temperature is above 50 degrees, the minimum temperature required for... adopted as a final rule, wine bottlers using ``Wisconsin Ledge'' in a brand name, including a trademark...

  6. Rapid inversion: running animals and robots swing like a pendulum under ledges.

    Directory of Open Access Journals (Sweden)

    Jean-Michel Mongeau

    Full Text Available Escaping from predators often demands that animals rapidly negotiate complex environments. The smallest animals attain relatively fast speeds with high frequency leg cycling, wing flapping or body undulations, but absolute speeds are slow compared to larger animals. Instead, small animals benefit from the advantages of enhanced maneuverability in part due to scaling. Here, we report a novel behavior in small, legged runners that may facilitate their escape by disappearance from predators. We video recorded cockroaches and geckos rapidly running up an incline toward a ledge, digitized their motion and created a simple model to generalize the behavior. Both species ran rapidly at 12-15 body lengths-per-second toward the ledge without braking, dove off the ledge, attached their feet by claws like a grappling hook, and used a pendulum-like motion that can exceed one meter-per-second to swing around to an inverted position under the ledge, out of sight. We discovered geckos in Southeast Asia can execute this escape behavior in the field. Quantification of these acrobatic behaviors provides biological inspiration toward the design of small, highly mobile search-and-rescue robots that can assist us during natural and human-made disasters. We report the first steps toward this new capability in a small, hexapedal robot.

  7. Rapid Inversion: Running Animals and Robots Swing like a Pendulum under Ledges

    Science.gov (United States)

    Mongeau, Jean-Michel; McRae, Brian; Jusufi, Ardian; Birkmeyer, Paul; Hoover, Aaron M.; Fearing, Ronald; Full, Robert J.

    2012-01-01

    Escaping from predators often demands that animals rapidly negotiate complex environments. The smallest animals attain relatively fast speeds with high frequency leg cycling, wing flapping or body undulations, but absolute speeds are slow compared to larger animals. Instead, small animals benefit from the advantages of enhanced maneuverability in part due to scaling. Here, we report a novel behavior in small, legged runners that may facilitate their escape by disappearance from predators. We video recorded cockroaches and geckos rapidly running up an incline toward a ledge, digitized their motion and created a simple model to generalize the behavior. Both species ran rapidly at 12–15 body lengths-per-second toward the ledge without braking, dove off the ledge, attached their feet by claws like a grappling hook, and used a pendulum-like motion that can exceed one meter-per-second to swing around to an inverted position under the ledge, out of sight. We discovered geckos in Southeast Asia can execute this escape behavior in the field. Quantification of these acrobatic behaviors provides biological inspiration toward the design of small, highly mobile search-and-rescue robots that can assist us during natural and human-made disasters. We report the first steps toward this new capability in a small, hexapedal robot. PMID:22701594

  8. Test-retest reliability of spatial and temporal gait parameters in children with cerebral palsy as measured by an electronic walkway.

    Science.gov (United States)

    Sorsdahl, Anne Brit; Moe-Nilssen, Rolf; Strand, Liv Inger

    2008-01-01

    The purpose of this study was to examine test-retest reliability of seven selected temporal and spatial gait parameters and asymmetry measures in children with cerebral palsy. Seventeen children with CP between 3 and 13 years of age walked at three different speeds across an electronic walkway of 5.2m. The tests were repeated after approximately 25 min. The scores were normalized to a walking speed of 1.1m/s to avoid the confounding effect of gait speed on speed dependent gait parameters. Intraclass correlation coefficients (ICC(1,1) and ICC(3,1)) with 95% confidence intervals, within-subject standard deviation (S(w)) and smallest detectable difference (SDD) were calculated. The relative reliability of cadence, step length, stride length and single stance time was high to excellent (ICC(1,1) between 0.73 and 0.95), while it was poor for step width (ICC(1,1)=0.27 and 0.35). The relative reliability for two calculated asymmetry measures were high for the step length index (ICC(1,1)=0.82) and moderate for the single stance time index (ICC(1,1)=0.49). The absolute reliability values for all gait parameters are reported. Five of seven gait parameters measured by an electronic walkway and normalized to a common walking speed, appear to be highly repeatable in a short-term time span in children with CP who were able to walk without assistive walking devices, provided sufficient cognitive function.

  9. Association between lower digit symbol substitution test score and slower gait and greater risk of mortality and of developing incident disability in well-functioning older adults.

    Science.gov (United States)

    Rosano, Caterina; Newman, Anne B; Katz, Ronit; Hirsch, Calvin H; Kuller, Lewis H

    2008-09-01

    To determine whether, in well-functioning older adults, a lower score on the Digit Symbol Substitution Test (DSST) and slower gait are associated with greater risk of mortality and of developing incident disability independent of other risk factors, including brain structural abnormalities (white matter hyperintensities, brain infarcts, ventricular enlargement) and whether the combination of varying levels of DSST score and gait speed are associated with a greater risk of mortality and disability than low DSST or slow gait alone. Observational cohort study. Community. Three thousand one hundred fifty-six (43% men, 29% black, mean age 70.4) participants in the Cardiovascular Health Study (CHS), free from stroke and physical disability and with a modified Mini-Mental State Examination (3MS) score of 80 or higher. Total mortality and incident disability (self-report of any difficulty performing one or more of the six activities of daily living) ascertained over a median follow-up time of 8.4 years. By the end of follow-up, 704 participants had died and 1,096 had incident disability. In Cox proportional hazards models adjusted for age, sex, race, education, cardiovascular disease, and brain magnetic resonance imaging abnormalities, lower DSST score and slower gait remained significantly associated with greater risk of mortality and of incident disability. Mortality rates were higher in those who had both low DSST score (<27 points) and slow gait (speed <1.0 m/s) than in those who had only low DSST score, only slow gait, or neither (rates per 1,000 person years (p-y): 61.2, 42.8, 20.8, and 16.3, respectively). A similar risk gradient was observed for incident disability (82.0, 57.9, 47.9, and 36.0/1,000 p-y, respectively). In well-functioning older adults, low DSST score and slow gait, alone or in combination, could be risk factors for mortality and for developing disability, independent of other risk factors, including measures of brain integrity.

  10. Concurrent Validity and Test-retest Reliability of the OPTOGait Photoelectric Cell System for the Assessment of Spatio-temporal Parameters of the Gait of Young Adults

    OpenAIRE

    Lee, Myung Mo; Song, Chang Ho; Lee, Kyoung Jin; Jung, Sang Woo; Shin, Doo Chul; Shin, Seung Ho

    2014-01-01

    [Purpose] The purpose of this study was to investigate the concurrent validity and test-retest reliability of the recently introduced OPTOGait Photoelectric Cell System for the assessment of spatio-temporal parameters of gait. [Subjects] Twenty healthy young adults (mean age = 27.35, SD = 7.4) were asked to walk 3 times on walkway at a comfortable speed. [Methods] Concurrent validity was assessed by comparing data obtained using the OPTOGait and GAITRite systems, and reliability was assessed ...

  11. Theoretical modelling of the ionospheric F1-ledge, part 2: Characteristics points

    International Nuclear Information System (INIS)

    Zhang Shunrong; Radicella, S.M.; Huang Xinyu

    1996-01-01

    Ionospheric characteristics relevant to the F1-ledge representation are investigated by using a theoretical ionospheric model and digisonde data. Results indicate that the altitude of the maximum gradient of the electron density with height (base point) is consistent with the height of half maximum density by night, and differences of about 20 km can be seen by day when an intermediate layer appears with the former always higher. It is also pointed out that electron density is particularly sensitive to dynamic processes at that height, where there is no photochemical equilibrium although the photoionization and the chemical loss of the oxygen ions are of the same order of magnitude. The fact that the base point carries information about both F2- and F1-layers suggests a possible use of the parameter in bottom side ionospheric modelling. As the occurrence of the minimum variability of electron density found experimentally in the F1-ledge is concerned, large variabilities of dynamic transport increasing from the F1-ledge height up are considered to be the main cause of the increasing variability with height. Changes due to photoionization and chemical reactions, which increase also with height but with a less degree in the molecular ions dominated region, are considered responsible for the slight variability observed in the upper E region until the minimum is reached at F1 heights. (author). 21 refs, 7 figs

  12. Functional Balance and Motor Impairment Correlations with Gait Parameters during Timed Up and Go Test across Three Attentional Loading Conditions in Stroke Survivors

    Directory of Open Access Journals (Sweden)

    Haidzir Manaf

    2014-01-01

    Full Text Available The aim of this study was to determine whether stroke survivor’s gait performance during dual-task Timed Up and Go (TUG test is correlated with the level of functional balance and motor impairment. Thirty stroke survivors (22 men, 8 women were recruited for this study. The level of functional balance (Berg Balance Scale and motor impairment (Fugl-Meyer assessment lower extremity were assessed prior to the TUG test. TUG test was conducted under three attentional loading conditions (single, dual motor, and dual-cognitive. The time and number of steps were used to quantify gait parameters. The Spearmen’s rank correlation coefficient was used to evaluate the relationship between these variables. There was moderate to strong negative correlation between functional balance and gait parameters (range −0.53 to −0.73, P<0.05. There was a weak negative correlation observed between the time taken to complete the single task and motor impairment (rs=-0.43; P=0.02 dual motor task and motor impairment (rs=-0.41; P=0.02. However, there were no significant correlations between lower limb motor impairment and the number of steps in all conditions. These findings suggest that functional balance may be an influential domain of successful dual-task TUG in stroke.

  13. Invariant Classification of Gait Types

    DEFF Research Database (Denmark)

    Fihl, Preben; Moeslund, Thomas B.

    2008-01-01

    This paper presents a method of classifying human gait in an invariant manner based on silhouette comparison. A database of artificially generated silhouettes is created representing the three main types of gait, i.e. walking, jogging, and running. Silhouettes generated from different camera angles....... Input silhouettes are matched to the database using the Hungarian method. A classifier is defined based on the dissimilarity between the input silhouettes and the gait actions of the database. The overall recognition rate is 88.2% on a large and diverse test set. The recognition rate is better than...

  14. Acoustic Gaits: Gait Analysis With Footstep Sounds.

    Science.gov (United States)

    Altaf, M Umair Bin; Butko, Taras; Juang, Biing-Hwang Fred

    2015-08-01

    We describe the acoustic gaits-the natural human gait quantitative characteristics derived from the sound of footsteps as the person walks normally. We introduce the acoustic gait profile, which is obtained from temporal signal analysis of sound of footsteps collected by microphones and illustrate some of the spatio-temporal gait parameters that can be extracted from the acoustic gait profile by using three temporal signal analysis methods-the squared energy estimate, Hilbert transform and Teager-Kaiser energy operator. Based on the statistical analysis of the parameter estimates, we show that the spatio-temporal parameters and gait characteristics obtained using the acoustic gait profile can consistently and reliably estimate a subset of clinical and biometric gait parameters currently in use for standardized gait assessments. We conclude that the Teager-Kaiser energy operator provides the most consistent gait parameter estimates showing the least variation across different sessions and zones. Acoustic gaits use an inexpensive set of microphones with a computing device as an accurate and unintrusive gait analysis system. This is in contrast to the expensive and intrusive systems currently used in laboratory gait analysis such as the force plates, pressure mats and wearable sensors, some of which may change the gait parameters that are being measured.

  15. Characterization of heterogeneous nickel sites in CO dehydrogenase from Clostridium thermoaceticum by nickel L-edge x-ray spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Ralston, C.Y. [Univ. of California, Davis, CA (United States); Kumar, M.; Ragsdale, S.W. [Univ. of Nebraska, Lincoln, NE (United States)] [and others

    1997-04-01

    L-edge x-ray absorption spectroscopy (XAS) is a useful spectroscopic technique for determining the electronic state of transition metals. For first row transition metals, the L-edge represents a transition from 2p core levels to 3d valence levels. Coulomb and exchange interactions between the core hole and 3d valence electrons make the L-edge sensitive to the number and configuration of 3d electrons, hence to the metal spin state and oxidation state. The authors have used L-edge XAS to characterize the Ni sites in the carbon monoxide dehydrogenase (CODH) enzyme from Clostridium thermoaceticum. This CODH catalyzes both CO oxidation and acetyl-CoA synthesis at two Ni and Fe containing centers, C and A, respectively. Since the enzyme exhibits complex EPR signals that never integrate to one spin per Ni, there is evidence for heterogeneity in the types of Ni present. The Ni L-edge protein spectra were recorded at ALS beamline 9.3.2. The photon energy resolutions used for protein samples and for Ni model compound spectra were 350 and 270 meV respectively. During data collection the sample chamber was maintained at less than 5{times}10{sup {minus}9} Torr using a helium cryopump. Model compound spectra were measured using total electron yield detection, while protein spectra were recorded using fluorescence detection with a windowless 13-element germanium detector, and were calibrated using the total electron yield spectrum of NiF{sub 2} or NiO. Each protein spectrum presented represents the sum of approximately 40 15-minute scans. The authors have found that by using L-edge XAS they are able to distinguish between different spin and oxidation states of Ni compounds. They have used this result to characterize the Ni containing CODH protein in various states. The L-edge spectra are consistent with other results showing that when CODH is reacted with CO, the metal centers undergo reduction.

  16. Mobile inertial sensor based gait analysis: Validity and reliability of spatiotemporal gait characteristics in healthy seniors.

    Science.gov (United States)

    Donath, Lars; Faude, Oliver; Lichtenstein, Eric; Pagenstert, Geert; Nüesch, Corina; Mündermann, Annegret

    2016-09-01

    Gait analysis is commonly used to identify gait changes and fall risk in clinical populations and seniors. Body-worn inertial sensor based gait analyses provide a feasible alternative to optometric and pressure based measurements of spatiotemporal gait characteristics. We assessed validity and relative and absolute reliability of a body-worn inertial sensor system (RehaGait(®)) for measuring spatiotemporal gait characteristics compared to a standard stationary treadmill (Zebris(®)). Spatiotemporal gait parameters (walking speed, stride length, cadence and stride time) were collected for 24 healthy seniors (age: 75.3±6.7 years) tested on 2 days (1 week apart) simultaneously using the sensor based system and instrumented treadmill. Each participant completed walking tests (200 strides) at different walking speeds and slopes. The difference between the RehaGait(®) system and the treadmill was trivial (Cohen's dgait characteristics (cadence and stride time; ICC: 0.99-1.00) and moderate for stride length (ICC: 0.73-0.89). Both devices had excellent day-to-day reliability for all gait parameters (ICC: 0.82-0.99) except for stride length at slow speed (ICC: 0.74). The RehaGait(®) is a valid and reliable tool for assessing spatiotemporal gait parameters for treadmill walking at different speeds and slopes. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Thermal Conductivity of Compounds Present in the Side Ledge in Aluminium Electrolysis Cells

    Science.gov (United States)

    Gheribi, Aïmen E.; Chartrand, Patrice

    2017-11-01

    This paper presents a database for the temperature-dependent thermal conductivity of compounds potentially present in the side ledge formed in aluminium electrolysis cells, between the molten electrolyte used to dissolve the alumina and the side wall. The database is given in the form of an analytical model with sets of parameters for each compound. To determine the model parameters, we considered a robust optimisation approach based on reliable models derived from fundamental physics. Where data are missing, first-principles calculations are utilized to estimate the parameters directly. For all compounds for which data are available, the model's predictions are found to be in very good agreement with reported experimental data.

  18. Development of a novel virtual reality gait intervention.

    Science.gov (United States)

    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.

  19. TBI Assessment of Readiness Using a Gait Evaluation Test (TARGET): Development of a Portable mTBI Screening Device

    Science.gov (United States)

    2017-05-01

    from a host of factors, including practice effects and other physical status changes (arousal, sleep deprivation , dehydration, etc.). There was limited...possible that some participants could have presented with concussion symptoms had they been examined by a medical doctor. Thus, we cannot definitively ...brain research. 224:287-94, 2013. 47Hallemans, A., Beccu, S., Van Loock, K., Ortibus, E., Truijen, S., Aerts, P. Visual deprivation leads to gait

  20. Concurrent Validity and Test-retest Reliability of the OPTOGait Photoelectric Cell System for the Assessment of Spatio-temporal Parameters of the Gait of Young Adults.

    Science.gov (United States)

    Lee, Myung Mo; Song, Chang Ho; Lee, Kyoung Jin; Jung, Sang Woo; Shin, Doo Chul; Shin, Seung Ho

    2014-01-01

    [Purpose] The purpose of this study was to investigate the concurrent validity and test-retest reliability of the recently introduced OPTOGait Photoelectric Cell System for the assessment of spatio-temporal parameters of gait. [Subjects] Twenty healthy young adults (mean age = 27.35, SD = 7.4) were asked to walk 3 times on walkway at a comfortable speed. [Methods] Concurrent validity was assessed by comparing data obtained using the OPTOGait and GAITRite systems, and reliability was assessed by comparing data from the first and third OPTOGait sessions. [Results] Concurrent validity, as identified by intra-class correlation coefficients (ICC (2, 1) = 0.929-0.998), coefficients of variation (CVME = 0.32-11.30%), and 95% limits of agreement, showed high levels of correlation. In addition, the test-retest reliability of the OPTOGait Photoelectric Cell System was demonstrated as showing a high level of correlation with all spatio-temporal parameters by intra-class correlation coefficients (ICC (3, 1) = 0.785-0.952), coefficients of variation (CVME = 1.66-4.06%), 95% limits of agreement, standard error of measurement (SEM = 2.17-5.96%), and minimum detectable change (MDC95% = 6.01-16.52%). [Conclusion] The OPTOGait Photoelectric Cell System has strong concurrent validity along with relative and absolute test-retest reliabilities. This portable system with easy-to-use features can be used for clinical assessments or research purposes as an objective means of assessing gait.

  1. Design, Development and Testing of a Low-Cost sEMG System and Its Use in Recording Muscle Activity in Human Gait

    Directory of Open Access Journals (Sweden)

    Tamara Grujic Supuk

    2014-05-01

    Full Text Available Surface electromyography (sEMG is an important measurement technique used in biomechanical, rehabilitation and sport environments. In this article the design, development and testing of a low-cost wearable sEMG system are described. The hardware architecture consists of a two-cascade small-sized bioamplifier with a total gain of 2,000 and band-pass of 3 to 500 Hz. The sampling frequency of the system is 1,000 Hz. Since real measured EMG signals are usually corrupted by various types of noises (motion artifacts, white noise and electromagnetic noise present at 50 Hz and higher harmonics, we have tested several denoising techniques, both on artificial and measured EMG signals. Results showed that a wavelet—based technique implementing Daubechies5 wavelet and soft sqtwolog thresholding is the most appropriate for EMG signals denoising. To test the system performance, EMG activities of six dominant muscles of ten healthy subjects during gait were measured (gluteus maximus, biceps femoris, sartorius, rectus femoris, tibialis anterior and medial gastrocnemius. The obtained EMG envelopes presented against the duration of gait cycle were compared favourably with the EMG data available in the literature, suggesting that the proposed system is suitable for a wide range of applications in biomechanics.

  2. Effects of acceleration on gait measures in three horse gaits.

    Science.gov (United States)

    Nauwelaerts, Sandra; Zarski, Lila; Aerts, Peter; Clayton, Hilary

    2015-05-01

    Animals switch gaits according to locomotor speed. In terrestrial locomotion, gaits have been defined according to footfall patterns or differences in center of mass (COM) motion, which characterizes mechanisms that are more general and more predictive than footfall patterns. This has generated different variables designed primarily to evaluate steady-speed locomotion, which is easier to standardize in laboratory conditions. However, in the ecology of an animal, steady-state conditions are rare and the ability to accelerate, decelerate and turn is essential. Currently, there are no data available that have tested whether COM variables can be used in accelerative or decelerative conditions. This study used a data set of kinematics and kinetics of horses using three gaits (walk, trot, canter) to evaluate the effects of acceleration (both positive and negative) on commonly used gait descriptors. The goal was to identify variables that distinguish between gaits both at steady state and during acceleration/deceleration. These variables will either be unaffected by acceleration or affected by it in a predictable way. Congruity, phase shift and COM velocity angle did not distinguish between gaits when the dataset included trials in unsteady conditions. Work (positive and negative) and energy recovery distinguished between gaits and showed a clear relationship with acceleration. Hodographs are interesting graphical representations to study COM mechanics, but they are descriptive rather than quantitative. Force angle, collision angle and collision fraction showed a U-shaped relationship with acceleration and seem promising tools for future research in unsteady conditions. © 2015. Published by The Company of Biologists Ltd.

  3. Human Odometry Verifies the Symmetry Perspective on Bipedal Gaits

    Science.gov (United States)

    Turvey, M. T.; Harrison, Steven J.; Frank, Till D.; Carello, Claudia

    2012-01-01

    Bipedal gaits have been classified on the basis of the group symmetry of the minimal network of identical differential equations (alias "cells") required to model them. Primary gaits are characterized by dihedral symmetry, whereas secondary gaits are characterized by a lower, cyclic symmetry. This fact was used in a test of human…

  4. Volition-adaptive control for gait training using wearable exoskeleton: preliminary tests with incomplete spinal cord injury individuals.

    Science.gov (United States)

    Rajasekaran, Vijaykumar; López-Larraz, Eduardo; Trincado-Alonso, Fernando; Aranda, Joan; Montesano, Luis; Del-Ama, Antonio J; Pons, Jose L

    2018-01-03

    Gait training for individuals with neurological disorders is challenging in providing the suitable assistance and more adaptive behaviour towards user needs. The user specific adaptation can be defined based on the user interaction with the orthosis and by monitoring the user intentions. In this paper, an adaptive control model, commanded by the user intention, is evaluated using a lower limb exoskeleton with incomplete spinal cord injury individuals (SCI). A user intention based adaptive control model has been developed and evaluated with 4 incomplete SCI individuals across 3 sessions of training per individual. The adaptive control model modifies the joint impedance properties of the exoskeleton as a function of the human-orthosis interaction torques and the joint trajectory evolution along the gait sequence, in real time. The volitional input of the user is identified by monitoring the neural signals, pertaining to the user's motor activity. These volitional inputs are used as a trigger to initiate the gait movement, allowing the user to control the initialization of the exoskeleton movement, independently. A Finite-state machine based control model is used in this set-up which helps in combining the volitional orders with the gait adaptation. The exoskeleton demonstrated an adaptive assistance depending on the patients' performance without guiding them to follow an imposed trajectory. The exoskeleton initiated the trajectory based on the user intention command received from the brain machine interface, demonstrating it as a reliable trigger. The exoskeleton maintained the equilibrium by providing suitable assistance throughout the experiments. A progressive change in the maximum flexion of the knee joint was observed at the end of each session which shows improvement in the patient performance. Results of the adaptive impedance were evaluated by comparing with the application of a constant impedance value. Participants reported that the movement of the

  5. Functional Gait Assessment and Balance Evaluation System Test: Reliability, Validity, Sensitivity, and Specificity for Identifying Individuals With Parkinson Disease Who Fall

    Science.gov (United States)

    Leddy, Abigail L.; Crowner, Beth E.

    2011-01-01

    Background Gait impairments, balance impairments, and falls are prevalent in individuals with Parkinson disease (PD). Although the Berg Balance Scale (BBS) can be considered the reference standard for the determination of fall risk, it has a noted ceiling effect. Development of ceiling-free measures that can assess balance and are good at discriminating “fallers” from “nonfallers” is needed. Objective The purpose of this study was to compare the Functional Gait Assessment (FGA) and the Balance Evaluation Systems Test (BESTest) with the BBS among individuals with PD and evaluate the tests' reliability, validity, and discriminatory sensitivity and specificity for fallers versus nonfallers. Design This was an observational study of community-dwelling individuals with idiopathic PD. Methods The BBS, FGA, and BESTest were administered to 80 individuals with PD. Interrater reliability (n=15) was assessed by 3 raters. Test-retest reliability was based on 2 tests of participants (n=24), 2 weeks apart. Intraclass correlation coefficients (2,1) were used to calculate reliability, and Spearman correlation coefficients were used to assess validity. Cutoff points, sensitivity, and specificity were based on receiver operating characteristic plots. Results Test-retest reliability was .80 for the BBS, .91 for the FGA, and .88 for the BESTest. Interrater reliability was greater than .93 for all 3 tests. The FGA and BESTest were correlated with the BBS (r=.78 and r=.87, respectively). Cutoff scores to identify fallers were 47/56 for the BBS, 15/30 for the FGA, and 69% for the BESTest. The overall accuracy (area under the curve) for the BBS, FGA, and BESTest was .79, .80, and .85, respectively. Limitations Fall reports were retrospective. Conclusion Both the FGA and the BESTest have reliability and validity for assessing balance in individuals with PD. The BESTest is most sensitive for identifying fallers. PMID:21071506

  6. Comparison between clinical gait and daily-life gait assessments of fall risk in older people.

    Science.gov (United States)

    Brodie, Matthew A; Coppens, Milou J; Ejupi, Andreas; Gschwind, Yves J; Annegarn, Janneke; Schoene, Daniel; Wieching, Rainer; Lord, Stephen R; Delbaere, Kim

    2017-11-01

    Falls are a leading cause of disability in older people. Here we investigate if daily-life gait assessments are better than clinical gait assessments at discriminating between older people with and without a history of falls. A total of 96 independent-living participants (age 75.5 ± 7.8) underwent sensorimotor, psychological and cognitive assessments, and the Timed Up and Go and 10-m walk tests. Participants wore a small pendant sensor device for a week in their home environment, from which the new remote assessments of daily-life gait were determined. During daily-life, fallers had significantly lower gait quality (lower gait endurance, higher within-walk variability and lower between-walk adaptability), but not reduced gait quantity (total steps) or gait intensity (mean cadence). In the clinic, fallers had slower Timed Up and Go, but not 10-m walk test times. After adjusting for demographics, only the daily-life assessments of gait endurance and within-walk variability remained significant. Reduced daily-life gait assessments were significantly correlated with older age, higher body mass index, multiple medications, disability, more concern about falling, poor executive function and higher physiological fall risk. The new daily-life gait assessments were better than the clinical gait assessments at identifying fall risk in our sample of independent living older people. However, further research is required to validate these findings in other populations or those living in residential aged care. Daily-life gait was not only associated with demographics and physiological capacity, but also general health, executive function and the ability to undertake a variety of activities of daily living without excessive concern about falling. Geriatr Gerontol Int 2017; 17: 2274-2282. © 2017 Japan Geriatrics Society.

  7. Changes in gait symmetry, gait velocity and self-reported function following total hip replacement.

    Science.gov (United States)

    Hodt-Billington, Caroline; Helbostad, Jorunn L; Vervaat, Willemijn; Rognsvåg, Turid; Moe-Nilssen, Rolf

    2011-09-01

    To investigate the magnitude of change at different time points in measures of gait symmetry, gait velocity and self-reported function following total hip replacement. Longitudinal with test occasions pre-surgery and 3, 6 and 12 months post-surgery. Thirty-four patients with hip osteoarthritis (mean age 63 years, standard deviation 11 years). Subjects walked back and forth along a 7-m walkway at slow, preferred and fast speed. Anteroposterior, vertical and mediolateral trunk symmetry was assessed by accelerometry, while single support symmetry, step-length symmetry and gait velocity was simultaneously assessed by an electronic walkway. Self-reported function was assessed by Hip disability and Osteoarthritis Outcome Score. Gait symmetry data were normalized for gait velocity. Changes between test occasions were reported as effect size. All measures showed effect sizes > 0.30 from pre-operative to 12-months postoperative assessments, and improvements were significant (p symmetry. In general, gait symmetry and gait velocity improved most 6 and 12 months postoperatively, while self-reported function improved most 3 months postoperatively. Early improvements were seen in self-reported function, suggesting immediate relief from stiffness and pain, while gait symmetry and velocity improved later postoperatively, suggesting that gait quality and performance require prolonged rehabilitation with postoperative guidance, muscular strengthening and motor relearning.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. GaitKeeper: A System for Measuring Canine Gait

    Directory of Open Access Journals (Sweden)

    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

  10. Gait and Function in Class III Obesity

    Directory of Open Access Journals (Sweden)

    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.

  11. Flexible Piezoelectric Sensor-Based Gait Recognition

    Directory of Open Access Journals (Sweden)

    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 %.

  12. Parkinson's disease classification using gait analysis via deterministic learning.

    Science.gov (United States)

    Zeng, Wei; Liu, Fenglin; Wang, Qinghui; Wang, Ying; Ma, Limin; Zhang, Yu

    2016-10-28

    Gait analysis plays an important role in maintaining the well-being of human mobility and health care, and is a valuable tool for obtaining quantitative information on motor deficits in Parkinson's disease (PD). In this paper, we propose a method to classify (diagnose) patients with PD and healthy control subjects using gait analysis via deterministic learning theory. The classification approach consists of two phases: a training phase and a classification phase. In the training phase, gait characteristics represented by the gait dynamics are derived from the vertical ground reaction forces under the usual and self-selected paces of the subjects. The gait dynamics underlying gait patterns of healthy controls and PD patients are locally accurately approximated by radial basis function (RBF) neural networks. The obtained knowledge of approximated gait dynamics is stored in constant RBF networks. The gait patterns of healthy controls and PD patients constitute a training set. In the classification phase, a bank of dynamical estimators is constructed for all the training gait patterns. Prior knowledge of gait dynamics represented by the constant RBF networks is embedded in the estimators. By comparing the set of estimators with a test gait pattern of a certain PD patient to be classified (diagnosed), a set of classification errors are generated. The average L 1 norms of the errors are taken as the classification measure between the dynamics of the training gait patterns and the dynamics of the test PD gait pattern according to the smallest error principle. When the gait patterns of 93 PD patients and 73 healthy controls are classified with five-fold cross-validation method, the accuracy, sensitivity and specificity of the results are 96.39%, 96.77% and 95.89%, respectively. Based on the results, it may be claimed that the features and the classifiers used in the present study could effectively separate the gait patterns between the groups of PD patients and healthy

  13. Gait-Event-Based Synchronization Method for Gait Rehabilitation Robots via a Bioinspired Adaptive Oscillator.

    Science.gov (United States)

    Chen, Gong; Qi, Peng; Guo, Zhao; Yu, Haoyong

    2017-06-01

    In the field of gait rehabilitation robotics, achieving human-robot synchronization is very important. In this paper, a novel human-robot synchronization method using gait event information is proposed. This method includes two steps. First, seven gait events in one gait cycle are detected in real time with a hidden Markov model; second, an adaptive oscillator is utilized to estimate the stride percentage of human gait using any one of the gait events. Synchronous reference trajectories for the robot are then generated with the estimated stride percentage. This method is based on a bioinspired adaptive oscillator, which is a mathematical tool, first proposed to explain the phenomenon of synchronous flashing among fireflies. The proposed synchronization method is implemented in a portable knee-ankle-foot robot and tested in 15 healthy subjects. This method has the advantages of simple structure, flexible selection of gait events, and fast adaptation. Gait event is the only information needed, and hence the performance of synchronization holds when an abnormal gait pattern is involved. The results of the experiments reveal that our approach is efficient in achieving human-robot synchronization and feasible for rehabilitation robotics application.

  14. Self-reported sleep duration affects tandem gait, but not steady-state gait outcomes among healthy collegiate athletes.

    Science.gov (United States)

    Howell, David R; Berkstresser, Brant; Wang, Francis; Buckley, Thomas A; Mannix, Rebekah; Stillman, Alexandra; Meehan, William P

    2018-03-26

    Sleep deficits are associated with motor and cognitive function deficits, even in the absence of a recent concussion. Does the amount of self-reported sleep prior to pre-season concussion testing affect single-task and dual-task instrumented steady-state gait and timed tandem gait test performance? One hundred and fourteen healthy collegiate athletes (mean age 18.8 ± 0.7 years; 60% female) reported the amount of sleep they received during the prior night and completed a timed tandem gait test and an instrumented assessment of steady-state gait in both single-task and dual-task conditions. Outcome variables included spatio-temporal gait parameters during steady-state gait, best and mean tandem gait times, and cognitive test accuracy. Participants who reported sleeping steady-state gait variables or for cognitive test accuracy. Self-reported sleep duration may be associated with baseline testing tandem gait performance. Thus, as sleep can play a role in motor abilities, clinicians may consider interpreting tandem gait performance in light of sleep duration during the night prior to testing. Copyright © 2018. Published by Elsevier B.V.

  15. 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 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 analysis of dual task cost for stride frequency and stride regularity allowed the identification of 3 motor phenotypes (p Gait analysis under dual-task conditions in elderly people suffering from gait disorders or memory impairment is of great value in assessing the severity of gait disorders, differentiating between peripheral pathologies and central nervous system pathologies, and identifying motor

  16. Gait analysis: clinical facts.

    Science.gov (United States)

    Baker, Richard; Esquenazi, Alberto; Benedetti, Maria G; Desloovere, Kaat

    2016-08-01

    Gait analysis is a well-established tool for the quantitative assessment of gait disturbances providing functional diagnosis, assessment for treatment planning, and monitoring of disease progress. There is a large volume of literature on the research use of gait analysis, but evidence on its clinical routine use supports a favorable cost-benefit ratio in a limited number of conditions. Initially gait analysis was introduced to clinical practice to improve the management of children with cerebral palsy. However, there is good evidence to extend its use to patients with various upper motor neuron diseases, and to lower limb amputation. Thereby, the methodology for properly conducting and interpreting the exam is of paramount relevance. Appropriateness of gait analysis prescription and reliability of data obtained are required in the clinical environment. This paper provides an overview on guidelines for managing a clinical gait analysis service and on the principal clinical domains of its application: cerebral palsy, stroke, traumatic brain injury and lower limb amputation.

  17. Backstroke start performance: the impact of using the Omega OBL2 backstroke ledge.

    Science.gov (United States)

    Barkwell, Gordon E; Dickey, James P

    2017-10-04

    FINA recently approved the backstroke ledge (Omega OBL2) to improve backstroke start performance in competition, but its performance has not been thoroughly evaluated. The purpose of this study was to compare the mechanics of starts performed with and without the OBL2. Ten high-level backstroke swimmers performed three starts with, and three starts without, the OBL2. A wall-mounted force plate measured the lower limb horizontal impulse, vertical impulse, take-off velocity and take-off angle. Entry distance, time to 10 m and start of hip and knee extension were recorded using video cameras. Starts performed with the OBL2 had a 0.13 s lower time to 10 m, 2.5% less variability in time to 10 m and 0.14 m greater head entry distance. The OBL2 provides a performance advantage by allowing an increased head entry distance rather than larger horizontal impulse on the wall. This may be due to the swimmers assuming different body positions during the start manoeuvre. Additional studies are needed to evaluate factors that contribute to improved performance when using the OBL2. Swimmers should train with the OBL2 and use it in competition to ensure optimal start performance.

  18. 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

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

    Directory of Open Access Journals (Sweden)

    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

  20. 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...

  1. Reproducibility and Validity of the 6-Minute Walk Test Using the Gait Real-Time Analysis Interactive Lab in Patients with COPD and Healthy Elderly.

    Science.gov (United States)

    Liu, Wai-Yan; Meijer, Kenneth; Delbressine, Jeannet M; Willems, Paul J; Franssen, Frits M E; Wouters, Emiel F M; Spruit, Martijn A

    2016-01-01

    The 6-minute walk test (6MWT) in a regular hallway is commonly used to assess functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD). However, treadmill walking might provide additional advantages over overground walking, especially if virtual reality and self-paced treadmill walking are combined. Therefore, this study aimed to assess the reproducibility and validity of the 6MWT using the Gait Real-time Analysis Interactive Lab (GRAIL) in patients with COPD and healthy elderly. Sixty-one patients with COPD and 48 healthy elderly performed two 6MWTs on the GRAIL. Patients performed two overground 6MWTs and healthy elderly performed one overground test. Differences between consecutive 6MWTs and the test conditions (GRAIL vs. overground) were analysed. Patients walked further in the second overground test (24.8 m, 95% CI 15.2-34.4 m, pelderly improved their second GRAIL test (49.6 m, 95% CI 37.0-62.3 m). The GRAIL 6MWT was reproducible (intra-class coefficients = 0.65-0.80). The best GRAIL 6-minute walk distance (6MWD) in patients was shorter than the best overground 6MWD (-27.3 ± 49.1 m, pelderly walked further on the GRAIL than in the overground condition (23.6 ± 41.4 m, pelderly. The GRAIL 6MWD seems to be more comparable to the 6MWDs assessed overground than previous studies on treadmills have reported. Furthermore, good construct validity and reproducibility were established in assessing the 6MWD using the GRAIL in patients with COPD and healthy elderly.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. How Crouch Gait Can Dynamically Induce Stiff-Knee Gait

    NARCIS (Netherlands)

    Van der Krogt, M.M.; Bregman, D.J.J.; Wisse, M.; Doorenbosch, C.A.M.; Harlaar, J.; Collins, S.H.

    Children with cerebral palsy frequently experience foot dragging and tripping during walking due to a lack of adequate knee flexion in swing (stiff-knee gait). Stiff-knee gait is often accompanied by an overly flexed knee during stance (crouch gait). Studies on stiff-knee gait have mostly focused on

  4. How Crouch Gait Can Dynamically Induce Stiff-Knee Gait

    NARCIS (Netherlands)

    van der Krogt, M.M.; Bregman, D.J.J.; Wisse, M.; Doorenbosch, C.A.M.; Harlaar, J.

    2010-01-01

    Children with cerebral palsy frequently experience foot dragging and tripping during walking due to a lack of adequate knee flexion in swing (stiff-knee gait). Stiff-knee gait is often accompanied by an overly flexed knee during stance (crouch gait). Studies on stiff-knee gait have mostly focused on

  5. Gait performance of children and adolescents with sensorineural hearing loss.

    Science.gov (United States)

    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.

  6. Human Gait Recognition Based on Multiview Gait Sequences

    Directory of Open Access Journals (Sweden)

    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.

  7. 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.

  8. 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

  9. Direct Determination of Absolute Absorption Cross Sections at the L-Edge of Dilute Mn Complexes in Solution Using a Transmission Flatjet.

    Science.gov (United States)

    Kubin, Markus; Guo, Meiyuan; Ekimova, Maria; Baker, Michael L; Kroll, Thomas; Källman, Erik; Kern, Jan; Yachandra, Vittal K; Yano, Junko; Nibbering, Erik T J; Lundberg, Marcus; Wernet, Philippe

    2018-04-10

    The 3d transition metals play a pivotal role in many charge transfer processes in catalysis and biology. X-ray absorption spectroscopy at the L-edge of metal sites probes metal 2p-3d excitations, providing key access to their valence electronic structure, which is crucial for understanding these processes. We report L-edge absorption spectra of Mn II (acac) 2 and Mn III (acac) 3 complexes in solution, utilizing a liquid flatjet for X-ray absorption spectroscopy in transmission mode. With this, we derive absolute absorption cross-sections for the L-edge transitions with peak magnitudes as large as 12 and 9 Mb for Mn II (acac) 2 and Mn III (acac) 3 , respectively. We provide insight into the electronic structure with ab initio restricted active space calculations of these L-edge transitions, reproducing the experimental spectra with excellent agreement in terms of shapes, relative energies, and relative intensities for the two complexes. Crystal field multiplet theory is used to assign spectral features in terms of the electronic structure. Comparison to charge transfer multiplet calculations reveals the importance of charge transfer in the core-excited final states. On the basis of our experimental observations, we extrapolate the feasibility of 3d transition metal L-edge absorption spectroscopy using the liquid flatjet approach in probing highly dilute biological solution samples and possible extensions to table-top soft X-ray sources.

  10. Evaluation of a weighted test in the analysis of ordinal gait scores in an additivity model for five OP pesticides.

    Science.gov (United States)

    Appropriate statistical analyses are critical for evaluating interactions of mixtures with a common mode of action, as is often the case for cumulative risk assessments. Our objective is to develop analyses for use when a response variable is ordinal, and to test for interaction...

  11. Gait or Walking Problems

    Science.gov (United States)

    Gait or Walking Problems the basic facts multiple sclerosis Many people with MS will experience difficulty with walking, which is also called ambulation. The term “gait” refers more specifically to the manner or pattern ...

  12. Real-time feedback of dynamic foot pressure index for gait training of toe-walking children with spastic diplegia.

    Science.gov (United States)

    Pu, Fang; Ren, Weiyan; Fan, Xiaoya; Chen, Wei; Li, Shuyu; Li, Deyu; Wang, Yu; Fan, Yubo

    2017-09-01

    The aim of this study was to determine whether and how real-time feedback of dynamic foot pressure index (DFPI) could be used to correct toe-walking gait in spastic diplegic children with dynamic equinus. Thirteen spastic diplegic children with dynamic equinus were asked to wear a monitoring device to record their ambulation during daily gait, conventional training gait, and feedback training gait. Parameters based on their DFPI and stride duration were compared among the three test conditions. The results with feedback training were significantly better for all DFPI parameters in comparison to patients' daily gait and showed significant improvements in DFPI for toe-walking gait and percentage of normal gait in comparison to conventional training methods. Moreover, stride duration under two training gaits was longer than patient's daily gait, but there was no significant difference between the two training gaits. Although the stride duration for the two training gaits was similar, gait training with real-time feedback of DFPI did produce noticeably superior results by increasing heel-loading impulse of toe-walking gait and percentage of normal gait in comparison to convention training methods. However, its effectiveness was still impacted by the motion limitations of diplegic children. Implications for Rehabilitation The DFPI-based gait training feedback system introduced in this study was shown to be more effective at toe-walking gait rehabilitation training over conventional training methods. The feedback system accomplished superior improvement in correcting toe-walking gait, but its effectiveness in an increasing heel-loading impulse in normal gait was still limited by the motion limitations of diplegic children. Stride duration of normal gait and toe-walking gait was similar under conventional and feedback gait training.

  13. Measuring medial longitudinal arch deformation during gait. A reliability study

    DEFF Research Database (Denmark)

    Bencke, Jesper; Christiansen, Ditte; Jensen, Anne Kathrine Bendrup

    2012-01-01

    during gait and to compare this method with a static measure and a 2D dynamic method. Fifty-two feet (26 healthy male participants) were tested twice 4-9 days apart in a biomechanical gait analysis laboratory using a 3D three-marker foot model, a 2D video-based model for the measurement of MLAD during...

  14. Gait Analysis Using Wearable Sensors

    Science.gov (United States)

    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

  15. Managing variability in the summary and comparison of gait data

    Directory of Open Access Journals (Sweden)

    Chau Tom

    2005-07-01

    Full Text Available Abstract Variability in quantitative gait data arises from many potential sources, including natural temporal dynamics of neuromotor control, pathologies of the neurological or musculoskeletal systems, the effects of aging, as well as variations in the external environment, assistive devices, instrumentation or data collection methodologies. In light of this variability, unidimensional, cycle-based gait variables such as stride period should be viewed as random variables and prototypical single-cycle kinematic or kinetic curves ought to be considered as random functions of time. Within this framework, we exemplify some practical solutions to a number of commonly encountered analytical challenges in dealing with gait variability. On the topic of univariate gait variables, robust estimation is proposed as a means of coping with contaminated gait data, and the summary of non-normally distributed gait data is demonstrated by way of empirical examples. On the summary of gait curves, we discuss methods to manage undesirable phase variation and non-robust spread estimates. To overcome the limitations of conventional comparisons among curve landmarks or parameters, we propose as a viable alternative, the combination of curve registration, robust estimation, and formal statistical testing of curves as coherent units. On the basis of these discussions, we provide heuristic guidelines for the summary of gait variables and the comparison of gait curves.

  16. 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.

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

    Science.gov (United States)

    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

  18. Combined gait disorder: a diagnostic challenge –a case report

    Directory of Open Access Journals (Sweden)

    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.

  19. Minimal detectable changes of the Berg Balance Scale, Fugl-Meyer Assessment Scale, Timed "Up & Go" Test, gait speeds, and 2-minute walk test in individuals with chronic stroke with different degrees of ankle plantarflexor tone.

    Science.gov (United States)

    Hiengkaew, Vimonwan; Jitaree, Khanitha; Chaiyawat, Pakaratee

    2012-07-01

    To determine test-retest reliability and absolute and relative minimal detectable changes at the 95% confidence level (MDC(95)) of measures to detect postural balance and lower limb movements in individuals with chronic stroke who were able to walk and had differences in ankle plantarflexor tone. Test-retest study. Data were collected on 2 occasions, about 6 days apart. Outpatient physical therapy clinics. Volunteers (N=61) with chronic stroke who were able to walk and had differences in ankle plantarflexor tone: no increase in ankle plantarflexor tone (n=12), a slight increase in ankle plantarflexor tone (n=32), and a marked increase in ankle plantarflexor tone (n=17). Not applicable. Reliability and absolute and relative MDC(95) of the Berg Balance Scale (BBS), the lower limb subscale of Fugl-Meyer Assessment (FMA-LE), the Timed "Up & Go" test (TUG), the comfortable gait speed (CGS), the fast gait speed (FGS), and the 2-minute walk test (2MWT). Excellent reliability of the BBS, FMA-LE, TUG, CGS, FGS, and 2MWT for all the participants combined and for the subgroups was shown. All the participants combined showed the absolute and relative MDC(95) in the BBS of 5 points and 10%, FMA-LE of 4 points and 16%, TUG of 8 seconds and 28%, CGS of 0.2m/s and 34%, FGS of 0.1m/s and 21%, and 2MWT of 13m and 23%. The absolute and relative MDC(95) of the subgroups were varied based on ankle plantarflexor tone. The BBS, FMA-LE, TUG, CGS, FGS, and 2MWT are reliable measures to detect postural balance and lower limb movements in individuals with chronic stroke who have differences in ankle plantarflexor tone. The absolute and relative MDC(95) of each measure are dissimilar in those with differences in ankle plantarflexor tone. The relative MDC(95) seems more useful than the absolute MDC(95) because the relative value can be used for a single individual. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. 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 ...

  1. Gait Recognition Using Image Self-Similarity

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

  3. Preditores espaço-temporais do andar para testes de capacidade funcional em pacientes com doença de Parkinson Gait spatial and temporal predictors for functional capacity tests in Parkinson's disease patients

    Directory of Open Access Journals (Sweden)

    MDR Sánchez-Arias

    2008-10-01

    Full Text Available OBJETIVOS: Determinar quais parâmetros espaço-temporais são preditores do andar de indivíduos com doença de Parkinson idiopática para os testes de resistência aeróbia e agilidade, propostos pela bateria de testes da American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD. MATERIAIS E MÉTODOS: Foram selecionados seis homens e seis mulheres com comprometimento e estágio da doença em níveis leve e moderado, que realizaram os testes de agilidade e resistência aeróbia, conforme o protocolo da AAHPERD, e andaram 8m sobre uma passarela. Uma câmera digital registrou uma passada central. Marcadores foram fixados no quinto metatarso e na face lateral do calcâneo do membro inferior direito e no primeiro metatarso e na face medial do calcâneo do membro inferior esquerdo. As variáveis dependentes selecionadas foram: tempo nos testes de agilidade e resistência e as variáveis cinemáticas (comprimento da passada - CP, cadência - CAD, duração da passada - DP, duração da fase de duplo suporte - DDS, duração do suporte simples - SS, duração da fase de balanço - DB e velocidade da passada - VP. RESULTADOS: Para agilidade, o teste de Pearson apontou correlação estatisticamente significativa entre as variáveis CP (r=-0,70; pOBJECTIVE: To determine which spatial and temporal parameters are predictors of the gait pattern of individuals with idiopathic Parkinson's disease, for the aerobic endurance and agility tests included in the battery of tests of the AAHPERD protocol. METHODS: Six men and six women with mild and moderate impairment and disease stage were selected. They performed agility and aerobic endurance test in accordance with the AAHPERD protocol, and walked 8 m on a walkway. A digital video camera recorded one central stride. Markers were attached to the fifth metatarsal and lateral face of the calcaneus of the right leg and to the first metatarsal and medial face of the calcaneus of the left leg. The

  4. L-Edge X-ray Absorption Spectroscopy of Dilute Systems Relevant to Metalloproteins Using an X-ray Free-Electron Laser

    NARCIS (Netherlands)

    Mitzner, Rolf; Rehanek, Jens; Kern, Jan; Gul, Sheraz; Hattne, Johan; Taguchi, Taketo; Alonso-Mori, Roberto; Tran, Rosalie; Weniger, Christian; Schroeder, Henning; Quevedo, Wilson; Laksmono, Hartawan; Sierra, Raymond G.; Han, Guangye; Lassalle-Kaiser, Benedikt; Koroidov, Sergey; Kubicek, Katharina; Schreck, Simon; Kunnus, Kristjan; Brzhezinskaya, Maria; Firsov, Alexander; Minitti, Michael P.; Turner, Joshua J.; Moeller, Stefan; Sauter, Nicholas K.; Bogan, Michael J.; Nordlund, Dennis; Schlotter, William F.; Messinger, Johannes; Borovik, Andrew; Techert, Simone; de Groot, Frank M. F.|info:eu-repo/dai/nl/08747610X; Foehlisch, Alexander; Erko, Alexei; Bergmann, Uwe; Yachandra, Vittal K.; Wernet, Philippe; Yano, Junko

    2013-01-01

    L-edge spectroscopy of 3d transition metals provides important electronic structure information and has been used in many fields. However, the use of this method for studying dilute aqueous systems, such as metalloenzymes, has not been prevalent because of severe radiation damage and the lack of

  5. Invariant Gait Continuum Based on the Duty-Factor

    DEFF Research Database (Denmark)

    Fihl, Preben; Moeslund, Thomas B.

    2008-01-01

    In this paper we present a method to describe the continuum of human gait in an invariant manner. The gait description is based on the duty-factor which is adopted from the biomechanics literature. We generate a database of artificial silhouettes representing the three main types of gait, i...... contexts and tangent orientations. Input silhouettes are matched to the database using the Hungarian method. We define a classifier based on the dissimilarity between the input silhouettes and the gait actions of the database. This classification achieves an overall recognition rate of 87.1% on a diverse...... test set, which is better than that achieved by other approaches applied to similar data. We extend this classification and results show that our representation of the gait continuum preserves the main features of the duty-factor....

  6. Trunk movements during gait in cerebral palsy.

    Science.gov (United States)

    Attias, Michael; Bonnefoy-Mazure, Alice; Lempereur, Mathieu; Lascombes, Pierre; De Coulon, Geraldo; Armand, Stéphane

    2015-01-01

    Lower limb deficits have been widely studied during gait in cerebral palsy, deficits in upper body have received little attention. The purpose of this research was to describe the characteristics of trunk movement of cerebral palsy children in terms of type of deficits (diplegia/hemiplegia) and gross motor function classification system (1, 2 or 3). Data from 92 cerebral palsy children, which corresponds to 141 clinical gait analysis, were retrospectively selected. Kinematic parameters of trunk were extracted from thorax and spine angles in the sagittal, transverse and coronal planes. The range of motion and the mean positions over the gait cycle were analysed. Intra-group differences between the children with diplegia or hemiplegia, gross motor function classification systems 1 to 3 and typically developing participants were analysed with Kruskal-Wallis tests and post hoc tests. Pearson correlation coefficients between the gait profile score normalised walking speed and kinematic parameters of the thorax were assessed. The results revealed: 1) the range of motion of the thorax and spine exhibited more significant differences between groups than the mean positions; 2) greater levels of impairment were associated with higher thorax range of motion, and 3) the children with diplegia and gross motor function classification system 3 exhibited a greater range of motion for all planes with the exception of spine rotation. This study confirmed that greater levels of impairment in cerebral palsy are associated with greater thorax range of motion during gait. The thorax plays an important role during gait in cerebral palsy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. 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

  8. Gait disorder as a predictor of spatial learning and memory impairment in aged mice

    Directory of Open Access Journals (Sweden)

    Xin Wang

    2017-01-01

    Full Text Available Objective To investigate whether gait dysfunction is a predictor of severe spatial learning and memory impairment in aged mice. Methods A total of 100 12-month-old male mice that had no obvious abnormal motor ability and whose Morris water maze performances were not significantly different from those of two-month-old male mice were selected for the study. The selected aged mice were then divided into abnormal or normal gait groups according to the results from the quantitative gait assessment. Gaits of aged mice were defined as abnormal when the values of quantitative gait parameters were two standard deviations (SD lower or higher than those of 2-month-old male mice. Gait parameters included stride length, variability of stride length, base of support, cadence, and average speed. After nine months, mice exhibiting severe spatial learning and memory impairment were separated from mice with mild or no cognitive dysfunction. The rate of severe spatial learning and memory impairment in the abnormal and normal gait groups was tested by a chi-square test and the correlation between gait dysfunction and decline in cognitive function was tested using a diagnostic test. Results The 12-month-old aged mice were divided into a normal gait group (n = 75 and an abnormal gait group (n = 25. Nine months later, three mice in the normal gait group and two mice in the abnormal gait group had died. The remaining mice were subjected to the Morris water maze again, and 17 out of 23 mice in the abnormal gait group had developed severe spatial learning and memory impairment, including six with stride length deficits, 15 with coefficient of variation (CV in stride length, two with base of support (BOS deficits, five with cadence dysfunction, and six with average speed deficits. In contrast, only 15 out of 72 mice in the normal gait group developed severe spatial learning and memory impairment. The rate of severe spatial learning and memory impairment was

  9. 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.

  10. Functional improvement after carotid endarterectomy: demonstrated by gait analysis and acetazolamide stress brain perfusion SPECT

    International Nuclear Information System (INIS)

    Kim, J. S.; Kim, G. E.; Yoo, J. Y.; Kim, D. G.; Moon, D. H.

    2005-01-01

    Scientific documentation of neurologic improvement following carotid endarterectomy (CEA) has not been established. The purpose of this prospective study is to investigate whether CEA performed for the internal carotid artery flow lesion improves gait and cerebrovascular hemodynamic status in patients with gait disturbance. We prospectively performed pre- and postCEA gait analysis and acetazolamide stress brain perfusion SPECT (Acz-SPECT) with Tc-99m ECD in 91 patients (M/F: 81/10, mean age: 64.1 y) who had gait disturbance before receiving CEA. Gait performance was assessed using a Vicon 370 motion analyzer. The gait improvement after CEA was correlated to cerebrovascular hemodynamic change as well as symptom duration. 12 hemiparetic stroke patients (M/F=9/3, mean age: 51 y) who did not receive CEA as a control underwent gait analysis twice in a week interval to evaluate whether repeat testing of gait performance shows learning effect. Of 91 patients, 73 (80%) patients showed gait improvement (change of gait speed > 10%) and 42 (46%) showed marked improvement (change of gait speed > 20%), but no improvement was observed in control group at repeat test. Post-operative cerebrovascular hemodynamic improvement was noted in 49 (54%) of 91 patients. There was marked gait improvement in patients group with cerebrovascular hemodynamic improvement compared to no change group (p<0.05). Marked gait improvement and cerebrovascular hemodynamic improvement were noted in 53% and 61% of the patient who had less than 3 month history of symptom compared to 31% and 24% of the patients who had longer than 3 months, respectively (p<0.05). Marked gait improvement was obtained in patients who had improvement of cerebrovascular hemodynamic status on Acz-SPECT after CEA. These results suggest functional improvement such as gait can result from the improved perfusion of misery perfusion area, which is viable for a longer period compared to literatures previously reported

  11. Importance of Gait Training

    Science.gov (United States)

    ... or it could be to learn a new skill such as walking step-over-step up stairs, walking on uneven terrain, or even running. It is important that the prosthetist and therapist remain in close communication when gait train- ing is occurring since any ...

  12. 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.

  13. A Novel Downhill Gait-Training Program Following a Total Knee Arthroplasty: A Case Report Highlighting the Impacts of Self-selected Speed on Gait Symmetry.

    Science.gov (United States)

    Blue, Cody; Coomes, Sara; Yoshida, Yuri

    2018-02-01

    Study Design Case report. Background Walking plays an essential role in activities of daily living and has varied health benefits. Studies report that gait speed and symmetry are impacted in individuals following total knee arthroplasty (TKA). Unfortunately, abnormal gait patterns persist in individuals after TKA. Downhill walking may provide a simple and feasible exercise regimen to improve gait patterns. The purpose of this case report was to describe the application of a downhill treadmill training program and the subsequent changes in gait patterns in an individual following a unilateral TKA. Case Description The participant was a 59-year-old woman following a right TKA. Downhill gait training was initiated 1 month post TKA and completed for 5 weeks. Outcomes were assessed using questionnaires, mobility tests, strength of quadriceps, and gait patterns. The treadmill speed was determined by the participant's self-selected gait speed on a level surface. Outcomes The participant's eccentric quadriceps strength in the operated limb significantly increased after the gait training. Her physical function recovered to a level similar to that of previous reports. Postintervention gait analysis was conducted at 2 self-selected speeds, due to an increase in the participant's self-selected gait speed between sessions. The participant demonstrated a more symmetrical gait pattern when walking slower and a more asymmetrical gait pattern at the faster speed. Discussion After completion of downhill gait training in conjunction with therapeutic exercises, the participant showed an increase in quadriceps strength and improved physical function. This case report describes the utilization and potential feasibility of downhill gait training in conjunction with outpatient physical therapy for an individual following unilateral TKA. Level of Evidence Therapy, level 5. J Orthop Sports Phys Ther 2018;48(2):104-110. Epub 7 Nov 2017. doi:10.2519/jospt.2018.7374.

  14. Adaptive Gait Pattern Generation of Biped Robot based on Human's Gait Pattern Analysis

    OpenAIRE

    Seungsuk Ha; Youngjoon Han; Hernsoo Hahn

    2007-01-01

    This paper proposes a method of adaptively generating a gait pattern of biped robot. The gait synthesis is based on human's gait pattern analysis. The proposed method can easily be applied to generate the natural and stable gait pattern of any biped robot. To analyze the human's gait pattern, sequential images of the human's gait on the sagittal plane are acquired from which the gait control values are extracted. The gait pattern of biped robot on the sagittal plane is adaptively generated by...

  15. 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.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  18. Validation of the instrumented evaluation of spatio-temporal gait parameters in patients with motor incomplete spinal cord injury.

    Science.gov (United States)

    Pérez-Sanpablo, A I; Quinzaños-Fresnedo, J; Loera-Cruz, R; Quiñones-Uriostegui, I; Rodriguez-Reyes, G; Pérez-Zavala, R

    2017-07-01

    Observational, descriptive, transversal. To evaluate the validity and reliability of spatio-temporal gait parameters measured by GaitRite in motor incomplete spinal cord-injured (SCI) patients. National Institute of Rehabilitation, Mexico city. 23 motor subacute and chronic incomplete SCI American Spinal Cord Injury Association Impairment Scale (AIS) D subjects were measured. The 10-meter walking test (10 MWT), 6-minute walking test (6 MWT), Walking Index for Spinal Cord Injury II (WISCI-II), Spinal Cord Independence Measure III (SCIM-III) and the GaitRite evaluation were carried out concurrently in order to determine validity. The 10 MWT and GaitRite evaluation were performed at different occasions in order to determine test-retest reliability. GaitRite offers a valid and reliable way to measure the mobility, symmetry and stability characteristics of gait SCI subjects. GaitRite precision and sensitivity is approximately three times better than clinical tests. Clinical tests cannot address the stability properties of gait. Subjects' higher gait velocity is related to more independence (SCIM-III), lower use of walking aids (WISCI-II), better performance in lower extremities motor score (LEMS) and better gait's mobility. Spatio-temporal gait parameters measured by GaitRite are both valid and reliable. Further studies are necessary to establish sensitivity of the instrument.

  19. Effects of progressive backward body weight suppoted treadmill training on gait ability in chronic stroke patients: A randomized controlled trial.

    Science.gov (United States)

    Kim, Kyung Hun; Lee, Kyoung Bo; Bae, Young-Hyeon; Fong, Shirley S M; Lee, Suk Min

    2017-10-23

    A stroke patient with hemiplegic gait is generally described as being slow and asymmetric. Body weight-supported treadmill training and backward gait training are recent additions to therapeutic gait trainings that may help improve gait in stroke patient with hemiplegic gait. Therefore, we examined the effect of progressive backward body weight-supported treadmill training on gait in chronic stroke patients with hemiplegic gait. Thirty subjects were divided to the experimental and control groups. The experimental group consisted of 15 patients and underwent progressive backward body weight-supported treadmill training. The control group consisted of 15 patients and underwent general treadmill gait training five times per week, for a total of four weeks. The OptoGait was used to analyze gait kinematics, and the dynamic gait index (DGI) and results of the 6-minute walk test were used as the clinical evaluation indicators. A follow-up test was carried out four weeks later to examine persistence of exercise effects. The experimental group showed statistically significant results in all dependent variables week four compared to the control group. However, until the eighth week, only the dependent variables, of affected step length (ASL), stride length (SL), and DGI differed significantly between the two groups. This study verified that progressive bodyweight-supported treadmill training had a positive influence on the temporospatial characteristics of gait and clinical gait evaluation index in chronic stroke patients.

  20. Evaluating the Contributions of Dynamic Flow to Freezing of Gait in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Chad A. Lebold

    2010-01-01

    Full Text Available Although visual cues can improve gait in Parkinson's disease (PD, their underlying mechanism is poorly understood. Previous research suggests that cues contribute optical flow that is essential to elicit gait improvement. The present study manipulated how optic flow was provided, and how this might influence freezing of gait (FOG in PD. Therefore, three groups; 15 PD FOG, 16 PD non-FOG, and 16 healthy controls were tested in 3 narrow doorway conditions; baseline (Narrow, ground lines (Ground, and laser (Laser. Step length indicated that the PD FOG group was only able to improve with ground lines, while the laser increased gait variability and double support time. These results suggest that optic flow in itself is not enough to elicit gait improvement in PD. When PD patients use visual cues, gait becomes less automatically controlled and hence preplanned conscious control may be an important factor contributing to gait improvement.

  1. The Multifeature Gait Score: An accurate way to assess gait quality.

    Science.gov (United States)

    Ben Mansour, Khaireddine; Gorce, Philippe; Rezzoug, Nasser

    2017-01-01

    This study introduces a novel way to accurately assess gait quality. This new method called Multifeature Gait Score (MGS) is based on the computation of multiple parameters characterizing six aspects of gait (temporal, amplitude, variability, regularity, symmetry and complexity) quantified with one inertial sensor. According to the aspects described, parameters were aggregated into partial scores to indicate the altered aspect in the case of abnormal patterns. In order to evaluate the overall gait quality, partial scores were averaged to a global score. The MGS was computed for 3 groups namely: healthy adult (10 subjects), sedentary elderly (11 subjects) and active elderly (20 subjects). Data were gathered from an inertial sensor located at the lumbar region during two sessions of 12m walking. The results based on ANOVA and Tukey tests showed that the partial scores with the exception of those which describe the symmetry aspect were able to discriminate between groups (pelderly group (3.58 ±1.15) compared to the healthy adults (5.19 ±0.84) and active elderly (4.82 ±1.26). In addition, the intersession repeatability of the elaborated global score was excellent (ICC = 0.93, % SEM = 10.81). The results obtained support the reliability and the relevance of the MGS as a novel method to characterize gait quality.

  2. Gait in elderly with cerebral small vessel disease.

    Science.gov (United States)

    de Laat, Karlijn F; van Norden, Anouk G W; Gons, Rob A R; van Oudheusden, Lucas J B; van Uden, Inge W M; Bloem, Bastiaan R; Zwiers, Marcel P; de Leeuw, Frank-Erik

    2010-08-01

    Gait disorders are common in the elderly and are related to loss of functional independence and death. White matter lesions (WMLs) may be related, but only a minority of individuals with WMLs has gait disorders. Probably other factors are involved, including location and the independent effect of frequently coinciding lacunar infarcts, the other aspect of cerebral small vessel disease. The aim of our study was to investigate the effect of both the severity and location of both WMLs and lacunar infarcts on gait. Four hundred thirty-one independently living, nondemented elderly aged between 50 and 85 years with cerebral small vessel disease were included in this analysis and underwent MRI scanning. The number and location of lacunar infarcts were rated and WML volume was assessed by manual segmentation with automated delineating of different regions. Gait was assessed quantitatively with an electronic walkway as well as the semiquantitatively Tinetti and Timed-Up-and-Go test. WMLs and lacunar infarcts were both independently associated with most gait parameters with stride length as the most sensitive parameter related to WMLs. WMLs in the sublobar (basal ganglia/internal capsule) and limbic areas and lacunar infarcts in the frontal lobe and thalamus were related to a lower velocity. Cerebral small vessel disease is related to gait disturbances. Because small vessel disease may, in part, be preventable, it should be regarded as a potentially important target for postponing gait impairment.

  3. Can biomechanical variables predict improvement in crouch gait?

    Science.gov (United States)

    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

  4. Balzac and human gait analysis.

    Science.gov (United States)

    Collado-Vázquez, S; Carrillo, J M

    2015-05-01

    People have been interested in movement analysis in general, and gait analysis in particular, since ancient times. Aristotle, Hippocrates, Galen, Leonardo da Vinci and Honoré de Balzac all used observation to analyse the gait of human beings. The purpose of this study is to compare Honoré de Balzac's writings with a scientific analysis of human gait. Honoré de Balzac's Theory of walking and other works by that author referring to gait. Honoré de Balzac had an interest in gait analysis, as demonstrated by his descriptions of characters which often include references to their way of walking. He also wrote a treatise entitled Theory of walking (Théorie de la demarche) in which he employed his keen observation skills to define gait using a literary style. He stated that the walking process is divided into phases and listed the factors that influence gait, such as personality, mood, height, weight, profession and social class, and also provided a description of the correct way of walking. Balzac considered gait analysis to be very important and this is reflected in both his character descriptions and Theory of walking, his analytical observation of gait. In our own technology-dominated times, this serves as a reminder of the importance of observation. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  5. [Gait and dual-task: definition, interest, and perspectives in the elderly].

    Science.gov (United States)

    Beauchet, Olivier; Berrut, Gilles

    2006-09-01

    Walking is an automated rythmic motor behavior that is mostly controlled by subcortical brain regions. Automaticity implies that gait can be performed without attention. However, recent works highlight the involvement of attentional resources in gait, using a "dual-task" methodology in which performance on attention-demanding tasks such as spoken verbal response and walking is compared when they are performed separately and concurrently. Changes in gait patterns due to simultaneous performance of an attention-demanding task are interpreted as interference caused by competing demands for attentional resources involving the cortical level in gait control. Dual-task related gait changes are a new way to assess age-associated change in gait control. Furthermore, new screening tools of falling risk based on the dual-task paradigm have been developed, comparing walking performance alone to walking while performing a simultaneous attention-demanding task. However, the consistent prediction of falls by dual-task testing remains difficult. The recent availability and growing number of validated, user-friendly portable gait analysis systems allow simple objective gait measurement such as gait variability. The study of gait variability under dual-task represents a new challenge for the clinicians because high stride-to-stride variability is a powerful fall predictor in older adults. Because there is increasing evidence that age-related gait changes are associated with incidence of dementia, dual-task related gait changes could provide useful information about relationship between gait disorders and cognitive decline. Furthermore, dual-task could be a new approach of the gait disorders rehabilitation.

  6. In situ investigation of wet chemical processes for chalcopyrite solar cells by L-edge XAS under ambient conditions

    Energy Technology Data Exchange (ETDEWEB)

    Greil, Stefanie M. [Helmholtz-Zentrum Berlin fuer Materialien und Energie, Albert-Einstein-Strasse 15, 12489 Berlin (Germany); Lauermann, Iver, E-mail: Iver.lauermann@helmholtz-berlin.d [Helmholtz-Zentrum Berlin fuer Materialien und Energie, Albert-Einstein-Strasse 15, 12489 Berlin (Germany); Ennaoui, Ahmed; Kropp, Timo; Lange, Kathrin M.; Weber, Matthieu [Helmholtz-Zentrum Berlin fuer Materialien und Energie, Albert-Einstein-Strasse 15, 12489 Berlin (Germany); Aziz, Emad F., E-mail: Emad.Aziz@helmholtz-berlin.d [Helmholtz-Zentrum Berlin fuer Materialien und Energie, Albert-Einstein-Strasse 15, 12489 Berlin (Germany)

    2010-02-15

    Two instrumental setups for in situ soft X-ray absorption spectroscopy in liquid systems are demonstrated in this work. One for investigating chemical reactions in solutions and a new one for the solid component of a liquid / (as in both / absorber) solid interface. We used these setups for investigating two production processes for chalcopyrite solar cells under ambient conditions, probing the L-edge of Zn and Cu. The first one is a flow cell with a silicon nitride membrane to study the chemical bath deposition process for Cd-free buffer layers. Examining the electronic structure of involved Zn complexes allows to determine the exact reaction mechanism taking place during this process. The second setup is a rotating disk for investigating the bath/absorber interface upon the etching process of superficial binary copper compounds of the absorber as a function of time. The time resolution of the chemical reaction demonstrated in this study ranges from the second to minute time scale.

  7. In situ investigation of wet chemical processes for chalcopyrite solar cells by L-edge XAS under ambient conditions

    International Nuclear Information System (INIS)

    Greil, Stefanie M.; Lauermann, Iver; Ennaoui, Ahmed; Kropp, Timo; Lange, Kathrin M.; Weber, Matthieu; Aziz, Emad F.

    2010-01-01

    Two instrumental setups for in situ soft X-ray absorption spectroscopy in liquid systems are demonstrated in this work. One for investigating chemical reactions in solutions and a new one for the solid component of a liquid / (as in both / absorber) solid interface. We used these setups for investigating two production processes for chalcopyrite solar cells under ambient conditions, probing the L-edge of Zn and Cu. The first one is a flow cell with a silicon nitride membrane to study the chemical bath deposition process for Cd-free buffer layers. Examining the electronic structure of involved Zn complexes allows to determine the exact reaction mechanism taking place during this process. The second setup is a rotating disk for investigating the bath/absorber interface upon the etching process of superficial binary copper compounds of the absorber as a function of time. The time resolution of the chemical reaction demonstrated in this study ranges from the second to minute time scale.

  8. In situ investigation of wet chemical processes for chalcopyrite solar cells by L-edge XAS under ambient conditions

    Science.gov (United States)

    Greil, Stefanie M.; Lauermann, Iver; Ennaoui, Ahmed; Kropp, Timo; Lange, Kathrin M.; Weber, Matthieu; Aziz, Emad F.

    2010-02-01

    Two instrumental setups for in situ soft X-ray absorption spectroscopy in liquid systems are demonstrated in this work. One for investigating chemical reactions in solutions and a new one for the solid component of a liquid / (as in both / absorber) solid interface. We used these setups for investigating two production processes for chalcopyrite solar cells under ambient conditions, probing the L-edge of Zn and Cu. The first one is a flow cell with a silicon nitride membrane to study the chemical bath deposition process for Cd-free buffer layers. Examining the electronic structure of involved Zn complexes allows to determine the exact reaction mechanism taking place during this process. The second setup is a rotating disk for investigating the bath/absorber interface upon the etching process of superficial binary copper compounds of the absorber as a function of time. The time resolution of the chemical reaction demonstrated in this study ranges from the second to minute time scale.

  9. Expressing gait-line symmetry in able-bodied gait

    Science.gov (United States)

    Jeleń, Piotr; Wit, Andrzej; Dudziński, Krzysztof; Nolan, Lee

    2008-01-01

    Background Gait-lines, or the co-ordinates of the progression of the point of application of the vertical ground reaction force, are a commonly reported parameter in most in-sole measuring systems. However, little is known about what is considered a "normal" or "abnormal" gait-line pattern or level of asymmetry. Furthermore, no reference databases on healthy young populations are available for this parameter. Thus the aim of this study is to provide such reference data in order to allow this tool to be better used in gait analysis. Methods Vertical ground reaction force data during several continuous gait cycles were collected using a Computer Dyno Graphy in-sole system® for 77 healthy young able-bodied subjects. A curve (termed gait-line) was obtained from the co-ordinates of the progression of the point of application of the force. An Asymmetry Coefficient Curve (AsC) was calculated between the mean gait-lines for the left and right foot for each subject. AsC limits of ± 1.96 and 3 standard deviations (SD) from the mean were then calculated. Gait-line data from 5 individual subjects displaying pathological gait due to disorders relating to the discopathy of the lumbar spine (three with considerable plantarflexor weakness, two with considerable dorsiflexor weakness) were compared to the AsC results from the able-bodied group. Results The ± 1.96 SD limit suggested that non-pathological gait falls within 12–16% asymmetry for gait-lines. Those exhibiting pathological gait fell outside both the ± 1.96 and ± 3SD limits at several points during stance. The subjects exhibiting considerable plantarflexor weakness all fell outside the ± 1.96SD limit from 30–50% of foot length to toe-off while those exhibiting considerable dorsiflexor weakness fell outside the ± 1.96SD limit between initial contact to 25–40% of foot length, and then surpassed the ± 3SD limit after 55–80% of foot length. Conclusion This analysis of gait-line asymmetry provides a reference

  10. Improved Gait Speed After Robot-Assisted Gait Training in Patients With Motor Incomplete Spinal Cord Injury: A Preliminary Study

    OpenAIRE

    Hwang, Seungwon; Kim, Hye-Ri; Han, Zee-A; Lee, Bum-Suk; Kim, Soojeong; Shin, Hyunsoo; Moon, Jae-Gun; Yang, Sung-Phil; Lim, Mun-Hee; Cho, Duk-Youn; Kim, Hayeon; Lee, Hye-Jin

    2017-01-01

    Objective To evaluate the clinical features that could serve as predictive factors for improvement in gait speed after robotic treatment. Methods A total of 29 patients with motor incomplete spinal cord injury received 4-week robot-assisted gait training (RAGT) on the Lokomat (Hocoma AG, Volketswil, Switzerland) for 30 minutes, once a day, 5 times a week, for a total of 20 sessions. All subjects were evaluated for general characteristics, the 10-Meter Walk Test (10MWT), the Lower Extremity Mo...

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

    Science.gov (United States)

    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.

  12. Gait Characteristics, Symptoms, and Function in Persons With Hip Osteoarthritis

    DEFF Research Database (Denmark)

    Eitzen, I.; Fernandes, L.; Kallerud, H.

    2015-01-01

    STUDY DESIGN: Longitudinal laboratory study. OBJECTIVES: (1) To compare gait characteristics between individuals with early-stage hip osteoarthritis who underwent total hip replacement (THR) and those who did not undergo THR, and (2) to evaluate whether gait characteristics, function, and symptoms...... declined among individuals who did not undergo THR during a 6- to 7-year follow-up. BACKGROUND: The natural history of symptoms, function, and gait changes secondary to hip osteoarthritis, including potential differences at an early stage of disease, is unknown. METHODS: Forty-three individuals (mean age......, 58.9 years) with radiographic and symptomatic hip osteoarthritis participated. Outcome measures included 3-D gait analysis; self-reported pain; stiffness, and function; hip range of motion; and the six-minute walk test. Baseline comparisons between individuals who later underwent THR and those who...

  13. 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

  14. 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...

  15. The GAIT translational control system.

    Science.gov (United States)

    Arif, Abul; Yao, Peng; Terenzi, Fulvia; Jia, Jie; Ray, Partho Sarothi; Fox, Paul L

    2018-03-01

    The interferon (IFN)-γ-activated inhibitor of translation (GAIT) system directs transcript-selective translational control of functionally related genes. In myeloid cells, IFN-γ induces formation of a multiprotein GAIT complex that binds structural GAIT elements in the 3'-untranslated regions (UTRs) of multiple inflammation-related mRNAs, including ceruloplasmin and VEGF-A, and represses their translation. The human GAIT complex is a heterotetramer containing glutamyl-prolyl tRNA synthetase (EPRS), NS1-associated protein 1 (NSAP1), ribosomal protein L13a (L13a), and glyceraldehyde-3-phosphate dehydrogenase (GAPDH). A network of IFN-γ-stimulated kinases regulates recruitment and assembly of GAIT complex constituents. Activation of cyclin-dependent kinase 5 (Cdk5), mammalian target of rapamycin complex 1 (mTORC1), and S6K1 kinases induces EPRS release from its parental multiaminoacyl tRNA synthetase complex to join NSAP1 in a 'pre-GAIT' complex. Subsequently, the DAPK-ZIPK kinase axis phosphorylates L13a, inducing release from the 60S ribosomal subunit and binding to GAPDH. The subcomplexes join to form the functional GAIT complex. Each constituent has a distinct role in the GAIT system. EPRS binds the GAIT element in target mRNAs, NSAP1 negatively regulates mRNA binding, L13a binds eIF4G to block ribosome recruitment, and GAPDH shields L13a from proteasomal degradation. The GAIT system is susceptible to genetic and condition-specific regulation. An N-terminus EPRS truncate is a dominant-negative inhibitor ensuring a 'translational trickle' of target transcripts. Also, hypoxia and oxidatively modified lipoproteins regulate GAIT activity. Mouse models exhibiting absent or genetically modified GAIT complex constituents are beginning to elucidate the physiological role of the GAIT system, particularly in the resolution of chronic inflammation. Finally, GAIT-like systems in proto-chordates suggests an evolutionarily conserved role of the pathway in innate immunity

  16. Impact of Caryolanemagnolol on Gait and Functional Mobility on ...

    African Journals Online (AJOL)

    The improvement in spatiotemporal gait parameters was measured by GAITRite, balance and/or mobility using Tinetti mobility test (TMT), five times sit-to-stand test (5TSST), and six-condition Romberg tests, as well as the function of the hand and forearm by finger tapping and Luria tests on Huntington's disease rating scale ...

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

    Science.gov (United States)

    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 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. PMID:24771566

  18. Energy Expenditure of Trotting Gait Under Different Gait Parameters

    Science.gov (United States)

    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.

  19. 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

  20. 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

  1. Single-Task and Dual-Task Gait Among Collegiate Athletes of Different Sport Classifications: Implications for Concussion Management.

    Science.gov (United States)

    Howell, David R; Oldham, Jessie R; DiFabio, Melissa; Vallabhajosula, Srikant; Hall, Eric E; Ketcham, Caroline J; Meehan, William P; Buckley, Thomas A

    2017-02-01

    Gait impairments have been documented following sport-related concussion. Whether preexisting gait pattern differences exist among athletes who participate in different sport classifications, however, remains unclear. Dual-task gait examinations probe the simultaneous performance of everyday tasks (ie, walking and thinking), and can quantify gait performance using inertial sensors. The purpose of this study was to compare the single-task and dual-task gait performance of collision/contact and noncontact athletes. A group of collegiate athletes (n = 265) were tested before their season at 3 institutions (mean age= 19.1 ± 1.1 years). All participants stood still (single-task standing) and walked while simultaneously completing a cognitive test (dual-task gait), and completed walking trials without the cognitive test (single-task gait). Spatial-temporal gait parameters were compared between collision/contact and noncontact athletes using MANCOVAs; cognitive task performance was compared using ANCOVAs. No significant single-task or dual-task gait differences were found between collision/contact and noncontact athletes. Noncontact athletes demonstrated higher cognitive task accuracy during single-task standing (P = .001) and dual-task gait conditions (P = .02) than collision/contact athletes. These data demonstrate the utility of a dual-task gait assessment outside of a laboratory and suggest that preinjury cognitive task performance during dual-tasks may differ between athletes of different sport classifications.

  2. Gait Rather Than Cognition Predicts Decline in Specific Cognitive Domains in Early Parkinson’s Disease

    Science.gov (United States)

    Morris, Rosie; Lord, Sue; Lawson, Rachael A; Coleman, Shirley; Galna, Brook; Duncan, Gordon W; Khoo, Tien K; Yarnall, Alison J; Burn, David J; Rochester, Lynn

    2017-01-01

    Abstract Background Dementia is significant in Parkinson’s disease (PD) with personal and socioeconomic impact. Early identification of risk is of upmost importance to optimize management. Gait precedes and predicts cognitive decline and dementia in older adults. We aimed to evaluate gait characteristics as predictors of cognitive decline in newly diagnosed PD. Methods One hundred and nineteen participants recruited at diagnosis were assessed at baseline, 18 and 36 months. Baseline gait was characterized by variables that mapped to five domains: pace, rhythm, variability, asymmetry, and postural control. Cognitive assessment included attention, fluctuating attention, executive function, visual memory, and visuospatial function. Mixed-effects models tested independent gait predictors of cognitive decline. Results Gait characteristics of pace, variability, and postural control predicted decline in fluctuating attention and visual memory, whereas baseline neuropsychological assessment performance did not predict decline. Conclusions This provides novel evidence for gait as a clinical biomarker for PD cognitive decline in early disease. PMID:28472409

  3. A Low-Cost Anthropometric Walking Robot for Reproducing Gait Lab Data

    Directory of Open Access Journals (Sweden)

    Rogério Eduardo da Silva Santana

    2008-01-01

    Full Text Available Human gait analysis is one of the resources that may be used in the study and treatment of pathologies of the locomotive system. This paper deals with the modelling and control aspects of the design, construction and testing of a biped walking robot conceived to, in limited extents, reproduce the human gait. Robot dimensions have been chosen in order to guarantee anthropomorphic proportions and then to help health professionals in gait studies. The robot has been assembled with low-cost components and can reproduce, in an assisted way, real-gait patterns generated from data previously acquired in gait laboratories. Part of the simulated and experimental results are addressed to demonstrate the ability of the biped robot in reproducing normal and pathological human gait.

  4. Human runners exhibit a least variable gait speed.

    Science.gov (United States)

    Cher, Pei Hua; Worringham, Charles J; Stewart, Ian B

    2017-11-01

    This study characterises the relationship between gait variability and speed in runners using data from trunk accelerations in each axis. Twelve participants of varying fitness ran on the treadmill with three sessions of six randomly ordered self-selected speeds. A VO 2max test was conducted on the fourth session. Running gait was tracked with inertial sensors. The occurrence of a mid-range speed was analysed for the anterior-posterior, vertical and lateral directional coefficient of variation (CV) of root mean square (RMS) acceleration data. One participant with noisy gait signals was omitted. The results show all remaining participants consistently showed significant quadratic U-shaped relationships between vertical RMS CV acceleration and speed. Neither anterior-posterior nor lateral RMS CV acceleration were clearly related to speed. These least variable gait speeds were similar to estimates of optimal speed derived from minimum cost of transport with speed. In conclusion, there exists a mid-range speed for each runner with the least variable gait in the vertical direction, and this occurred significantly more often than would be expected by chance (P < 0.05). However, there are no prominent patterns for the anterior-posterior and lateral directions. This finding supports anecdotal evidence from runners and coaches concerning gait consistency.

  5. Terminology and forensic gait analysis.

    Science.gov (United States)

    Birch, Ivan; Vernon, Wesley; Walker, Jeremy; Young, Maria

    2015-07-01

    The use of appropriate terminology is a fundamental aspect of forensic gait analysis. The language used in forensic gait analysis is an amalgam of that used in clinical practice, podiatric biomechanics and the wider field of biomechanics. The result can often be a lack of consistency in the language used, the definitions used and the clarity of the message given. Examples include the use of 'gait' and 'walking' as synonymous terms, confusion between 'step' and 'stride', the mixing of anatomical, positional and pathological descriptors, and inability to describe appropriately movements of major body segments such as the torso. The purpose of this paper is to share the well-established definitions of the fundamental parameters of gait, common to all professions, and advocate their use in forensic gait analysis to establish commonality. The paper provides guidance on the selection and use of appropriate terminology in the description of gait in the forensic context. This paper considers the established definitions of the terms commonly used, identifies those terms which have the potential to confuse readers, and suggests a framework of terminology which should be utilised in forensic gait analysis. Copyright © 2015 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

    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.

  7. Analysis of Gait Disturbance in Glut 1 Deficiency Syndrome.

    Science.gov (United States)

    Blumenschine, Michelle; Montes, Jacqueline; Rao, Ashwini K; Engelstad, Kristin; De Vivo, Darryl C

    2016-11-01

    Anticipating potential therapies for Glut 1 deficiency syndrome (Glut1DS) emphasizes the need for effective clinical outcome measures. The 6-minute walk test is a well-established outcome measure that evaluates walking ability in neurological diseases. Twenty-one children with Glut 1 deficiency syndrome and 21 controls performed the 6-minute walk test. Fatigue was determined by comparing distance walked in the first and sixth minutes. Gait was analyzed by stride length, velocity, cadence, base of support, and percentage time in double support. Independent sample t-tests examined differences between group. Repeated-measures analysis of variance evaluated gait parameters over time. Glut 1 deficiency syndrome patients walked less (P Glut 1 deficiency syndrome patients have impaired motor performance, walk more slowly, and have poor balance. The 6-minute walk test with gait analysis may serve as a useful outcome measure in clinical trials in Glut 1 deficiency syndrome. © The Author(s) 2016.

  8. Estimation of temporal gait parameters using Bayesian models on acceleration signals.

    Science.gov (United States)

    López-Nava, I H; Muñoz-Meléndez, A; Pérez Sanpablo, A I; Alessi Montero, A; Quiñones Urióstegui, I; Núñez Carrera, L

    2016-01-01

    The purpose of this study is to develop a system capable of performing calculation of temporal gait parameters using two low-cost wireless accelerometers and artificial intelligence-based techniques as part of a larger research project for conducting human gait analysis. Ten healthy subjects of different ages participated in this study and performed controlled walking tests. Two wireless accelerometers were placed on their ankles. Raw acceleration signals were processed in order to obtain gait patterns from characteristic peaks related to steps. A Bayesian model was implemented to classify the characteristic peaks into steps or nonsteps. The acceleration signals were segmented based on gait events, such as heel strike and toe-off, of actual steps. Temporal gait parameters, such as cadence, ambulation time, step time, gait cycle time, stance and swing phase time, simple and double support time, were estimated from segmented acceleration signals. Gait data-sets were divided into two groups of ages to test Bayesian models in order to classify the characteristic peaks. The mean error obtained from calculating the temporal gait parameters was 4.6%. Bayesian models are useful techniques that can be applied to classification of gait data of subjects at different ages with promising results.

  9. MOTOR PROTEINS Kinesin's gait captured

    NARCIS (Netherlands)

    Peterman, E.J.G.

    2016-01-01

    Kinesin is a motor protein that drives intracellular transport by stepping along microtubules in a hand-over-hand manner. Advanced dark-field microscopy has made it possible to capture the gait of this motor with unprecedented resolution.

  10. Understanding the Electronic Structure of 4d Metal Complexes: From Molecular Spinors to L-Edge Spectra of a di-Ru Catalyst

    Energy Technology Data Exchange (ETDEWEB)

    Alperovich, Igor; Smolentsev, Grigory; Moonshiram, Dooshaye; Jurss, Jonah W.; Concepcion, Javier J.; Meyer, Thomas J.; Soldatov, Alexander; Pushkar, Yulia (UNC); (Purdue); (SFU-Russia); (Lund)

    2015-09-17

    L{sub 2,3}-edge X-ray absorption spectroscopy (XAS) has demonstrated unique capabilities for the analysis of the electronic structure of di-Ru complexes such as the blue dimer cis,cis-[Ru{sub 2}{sup III}O(H{sub 2}O){sub 2}(bpy){sub 4}]{sup 4+} water oxidation catalyst. Spectra of the blue dimer and the monomeric [Ru(NH{sub 3}){sub 6}]{sup 3+} model complex show considerably different splitting of the Ru L{sub 2,3} absorption edge, which reflects changes in the relative energies of the Ru 4d orbitals caused by hybridization with a bridging ligand and spin-orbit coupling effects. To aid the interpretation of spectroscopic data, we developed a new approach, which computes L{sub 2,3}-edges XAS spectra as dipole transitions between molecular spinors of 4d transition metal complexes. This allows for careful inclusion of the spin-orbit coupling effects and the hybridization of the Ru 4d and ligand orbitals. The obtained theoretical Ru L{sub 2,3}-edge spectra are in close agreement with experiment. Critically, existing single-electron methods (FEFF, FDMNES) broadly used to simulate XAS could not reproduce the experimental Ru L-edge spectra for the [Ru(NH{sub 3}){sub 6}]{sup 3+} model complex nor for the blue dimer, while charge transfer multiplet (CTM) calculations were not applicable due to the complexity and low symmetry of the blue dimer water oxidation catalyst. We demonstrated that L-edge spectroscopy is informative for analysis of bridging metal complexes. The developed computational approach enhances L-edge spectroscopy as a tool for analysis of the electronic structures of complexes, materials, catalysts, and reactive intermediates with 4d transition metals.

  11. Executive functions are associated with gait and balance in community-living elderly people.

    NARCIS (Netherlands)

    Iersel, M.B. van; Kessels, R.P.C.; Bloem, B.R.; Verbeek, A.L.M.; Olde Rikkert, M.G.M.

    2008-01-01

    BACKGROUND: Cognition influences gait and balance in elderly people. Executive functions seem to play a key role in this mechanism. Previous studies used only a single test to probe executive functions, and outcome measures were restricted to gait variables. We extend this prior work by examining

  12. Executive Functions Are Associated With Gait and Balance in Community-Living Elderly People

    NARCIS (Netherlands)

    Iersel, M.B. van; Kessels, R.P.C.; Bloem, B.R.; Verbeek, A.L.M.; Olde Rikkert, M.G.M.

    2008-01-01

    Background. Cognition influences gait and balance in elderly people. Executive functions seem to play a key role in this mechanism. Previous studies used only a single test to probe executive functions, and outcome measures were restricted to gait variables. We extend this prior work by examining

  13. Reliability of three-dimensional gait analysis in cervical spondylotic myelopathy.

    LENUS (Irish Health Repository)

    McDermott, Ailish

    2010-10-01

    Gait impairment is one of the primary symptoms of cervical spondylotic myelopathy (CSM). Detailed assessment is possible using three-dimensional gait analysis (3DGA), however the reliability of 3DGA for this population has not been established. The aim of this study was to evaluate the test-retest reliability of temporal-spatial, kinematic and kinetic parameters in a CSM population.

  14. Qigong exercise may improve sleep quality and gait performance in Parkinson's disease: a pilot study.

    Science.gov (United States)

    Wassom, Derek J; Lyons, Kelly E; Pahwa, Rajesh; Liu, Wen

    2015-01-01

    Parkinson's disease (PD) involves a variety of motor and non-motor symptoms, several of which, including gait abnormalities and sleep disorders, are generally not adequately managed with standard therapy. This study aimed to determine the impact of Qigong as a potential complementary therapy in the management of gait and sleep-related symptoms in PD. Seven subjects (aged 66.9 ± 8.1 years) with PD participated in a six-week Qigong exercise intervention. Pre- and post-intervention testing was performed to assess sleep quality, cognitive function, fatigue, quality of life, gait performance (stride time, stride length, double support time, and velocity), and gait variability (stride time and length variability). Following Qigong, subjects showed improvement in some aspects of sleep quality. Fatigue remained unchanged. Gait function was improved by a significant reduction of stride time and a slight increase in stride length. Together these changes resulted in significant improvements to gait velocity. In addition, time spent in double limb support was reduced following the intervention. Overall gait variability improved significantly, particularly in the reduction of stride time variability. These results suggest that Qigong may provide benefit for gait performance and sleep quality in PD patients. However, larger, controlled studies are required to determine the immediate and long-term benefits of Qigong for PD sleep and gait problems as well as the impact on other aspects of the disease.

  15. 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.

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

    Science.gov (United States)

    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.

  17. Gait and Cognition: A Complementary Approach to Understanding Brain Function and the Risk of Falling

    Science.gov (United States)

    Montero-Odasso, Manuel; Verghese, Joe; Beauchet, Olivier; Hausdorff, Jeffrey M.

    2012-01-01

    Until recently, clinicians and researchers have performed gait assessments and cognitive assessments separately when evaluating older adults. Increasing evidence from clinical practice, epidemiological studies, and clinical trials shows that gait and cognition are inter-related in older adults. Quantifiable alterations in gait among older adults are associated with falls, dementia, and disability. At the same time, emerging evidence indicates that early disturbances in cognitive processes such as attention, executive function, and working memory are associated with slower gait and gait instability during single and dual-task testing, and that these cognitive disturbances assist in the prediction of future mobility loss, falls, and progression to dementia. This paper reviews the importance of the gait-cognition inter-relationship in aging and presents evidence that gait assessments can provide a window into the understanding of cognitive function and dysfunctions, and fall risk in older people in clinical practice. To this end, the benefits of dual-task gait assessments (e.g., walking while performing an attention-demanding task) as a marker of fall risk are summarized. Further, we also present a potential complementary approach for reducing the risk of falls by improving certain aspects of cognition through both non-pharmacological and pharmacological treatments. Untangling the relationship between early gait disturbances and early cognitive changes may be helpful for identifying older adults at higher risk of experiencing mobility decline, falls and the progression to dementia. PMID:23110433

  18. On Gait Analysis Estimation Errors Using Force Sensors on a Smart Rollator

    Directory of Open Access Journals (Sweden)

    Joaquin Ballesteros

    2016-11-01

    Full Text Available Gait analysis can provide valuable information on a person’s condition and rehabilitation progress. Gait is typically captured using external equipment and/or wearable sensors. These tests are largely constrained to specific controlled environments. In addition, gait analysis often requires experts for calibration, operation and/or to place sensors on volunteers. Alternatively, mobility support devices like rollators can be equipped with onboard sensors to monitor gait parameters, while users perform their Activities of Daily Living. Gait analysis in rollators may use odometry and force sensors in the handlebars. However, force based estimation of gait parameters is less accurate than traditional methods, especially when rollators are not properly used. This paper presents an evaluation of force based gait analysis using a smart rollator on different groups of users to determine when this methodology is applicable. In a second stage, the rollator is used in combination with two lab-based gait analysis systems to assess the rollator estimation error. Our results show that: (i there is an inverse relation between the variance in the force difference between handlebars and support on the handlebars—related to the user condition—and the estimation error; and (ii this error is lower than 10% when the variation in the force difference is above 7 N. This lower limit was exceeded by the 95.83% of our challenged volunteers. In conclusion, rollators are useful for gait characterization as long as users really need the device for ambulation.

  19. On Gait Analysis Estimation Errors Using Force Sensors on a Smart Rollator.

    Science.gov (United States)

    Ballesteros, Joaquin; Urdiales, Cristina; Martinez, Antonio B; van Dieën, Jaap H

    2016-11-10

    Gait analysis can provide valuable information on a person's condition and rehabilitation progress. Gait is typically captured using external equipment and/or wearable sensors. These tests are largely constrained to specific controlled environments. In addition, gait analysis often requires experts for calibration, operation and/or to place sensors on volunteers. Alternatively, mobility support devices like rollators can be equipped with onboard sensors to monitor gait parameters, while users perform their Activities of Daily Living. Gait analysis in rollators may use odometry and force sensors in the handlebars. However, force based estimation of gait parameters is less accurate than traditional methods, especially when rollators are not properly used. This paper presents an evaluation of force based gait analysis using a smart rollator on different groups of users to determine when this methodology is applicable. In a second stage, the rollator is used in combination with two lab-based gait analysis systems to assess the rollator estimation error. Our results show that: (i) there is an inverse relation between the variance in the force difference between handlebars and support on the handlebars-related to the user condition-and the estimation error; and (ii) this error is lower than 10% when the variation in the force difference is above 7 N. This lower limit was exceeded by the 95.83% of our challenged volunteers. In conclusion, rollators are useful for gait characterization as long as users really need the device for ambulation.

  20. An Ambulatory Method of Identifying Anterior Cruciate Ligament Reconstructed Gait Patterns

    Directory of Open Access Journals (Sweden)

    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.

  1. Gait and cognition: a complementary approach to understanding brain function and the risk of falling.

    Science.gov (United States)

    Montero-Odasso, Manuel; Verghese, Joe; Beauchet, Olivier; Hausdorff, Jeffrey M

    2012-11-01

    Until recently, clinicians and researchers have performed gait assessments and cognitive assessments separately when evaluating older adults, but increasing evidence from clinical practice, epidemiological studies, and clinical trials shows that gait and cognition are interrelated in older adults. Quantifiable alterations in gait in older adults are associated with falls, dementia, and disability. At the same time, emerging evidence indicates that early disturbances in cognitive processes such as attention, executive function, and working memory are associated with slower gait and gait instability during single- and dual-task testing and that these cognitive disturbances assist in the prediction of future mobility loss, falls, and progression to dementia. This article reviews the importance of the interrelationship between gait and cognition in aging and presents evidence that gait assessments can provide a window into the understanding of cognitive function and dysfunction and fall risk in older people in clinical practice. To this end, the benefits of dual-task gait assessments (e.g., walking while performing an attention-demanding task) as a marker of fall risk are summarized. A potential complementary approach for reducing the risk of falls by improving certain aspects of cognition through nonpharmacological and pharmacological treatments is also presented. Untangling the relationship between early gait disturbances and early cognitive changes may be helpful in identifying older adults at risk of experiencing mobility decline, falls, and progression to dementia. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  2. Gait analysis in children with cerebral palsy

    Science.gov (United States)

    Armand, Stéphane; Decoulon, Geraldo; Bonnefoy-Mazure, Alice

    2016-01-01

    Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations. Clinical gait analysis (CGA) is needed to identify, understand and support the management of gait deviations in CP. CGA assesses a large amount of quantitative data concerning patients’ gait characteristics, such as video, kinematics, kinetics, electromyography and plantar pressure data. Common gait deviations in CP can be grouped into the gait patterns of spastic hemiplegia (drop foot, equinus with different knee positions) and spastic diplegia (true equinus, jump, apparent equinus and crouch) to facilitate communication. However, gait deviations in CP tend to be a continuum of deviations rather than well delineated groups. To interpret CGA, it is necessary to link gait deviations to clinical impairments and to distinguish primary gait deviations from compensatory strategies. CGA does not tell us how to treat a CP patient, but can provide objective identification of gait deviations and further the understanding of gait deviations. Numerous treatment options are available to manage gait deviations in CP. Generally, treatments strive to limit secondary deformations, re-establish the lever arm function and preserve muscle strength. Additional roles of CGA are to better understand the effects of treatments on gait deviations. Cite this article: Armand S, Decoulon G, Bonnefoy-Mazure A. Gait analysis in children with cerebral palsy. EFORT Open Rev 2016;1:448-460. DOI: 10.1302/2058-5241.1.000052. PMID:28698802

  3. Effects of Acupuncture on Gait of Patients with Multiple Sclerosis.

    Science.gov (United States)

    Criado, Maria Begoña; Santos, Maria João; Machado, Jorge; Gonçalves, Arminda Manuela; Greten, Henry Johannes

    2017-11-01

    Multiple sclerosis is considered a complex and heterogeneous disease. Approximately 85% of patients with multiple sclerosis indicate impaired gait as one of the major limitations in their daily life. Acupuncture studies found a reduction of spasticity and improvement of fatigue and imbalance in patients with multiple sclerosis, but there is a lack of studies regarding gait. We designed a study of acupuncture treatment, according to the Heidelberg model of Traditional Chinese Medicine (TCM), to investigate if acupuncture can be a useful therapeutic strategy in patients with gait impairment in multiple sclerosis of relapsing-remitting type. The sample consisted of 20 individuals with diagnosis of multiple sclerosis of relapsing-remitting type. Gait impairment was evaluated by the 25-foot walk test. The results showed differences in time to walk 25 feet following true acupuncture. In contrast, there was no difference in time to walk 25 feet following sham acupuncture. When using true acupuncture, 95% of cases showed an improvement in 25-foot walk test, compared with 45% when sham acupuncture was done. Our study protocol provides evidence that acupuncture treatment can be an attractive option for patients with multiple sclerosis, with gait impairment.

  4. Sistema GaitGrabber na captação de dados cinemáticos durante a marcha GaitGrabber system on kinematic gait analyses

    Directory of Open Access Journals (Sweden)

    Renata Noce Kirkwood

    2012-09-01

    Full Text Available O objetivo do presente estudo foi desenvolver e testar a confiabilidade e validade do Sistema GaitGrabber na obtenção de dados cinemáticos no plano sagital durante a marcha. Dezoito indivíduos participaram do estudo de confiabilidade e 28 do estudo de validade concorrente. O Sistema Qualisys Pro-Reflex foi usado como padrão ouro. O GaitGrabber calcula os ângulos relativos de quadril, joelho e tornozelo no plano sagital. O Coeficiente de Correlação Intraclasse (CCI foi usado para comparação das médias dos picos angulares entre visitas. Para a validade, foi aplicada a análise de componentes principais. Os CCI variaram de moderados a excelentes e a validade do sistema foi comprovada para o tornozelo. Foi demonstrada diferença significativa na amplitude de movimento de quadril e joelho, a qual foi atribuída a características técnicas dos instrumentos. O Sistema GaitGrabber é válido e confiável e pode ser usado na clínica para análise cinemática da marcha no plano sagital.The purpose of this study was to develop and test the validity and reliability of the GaitGrabber System in measuring kinematic variables in the sagittal plane during gait. Eighteen individuals participated in the reliability study and 28 in the concurrent validity study. The Qualisys Pro-Reflex System used as a gold standard reference system. The GaitGrabber calculates the relative angles at the hip, knee and ankle in the sagittal plane. The Intraclass Correlation Coefficient (ICC was used to compare the average of the angular peaks between visits. The principal component analysis was used to test the validity of the system. The ICC ranged from moderate to excellent and the validity of the system was proved for the ankle. There were significant differences in the range of motion for the hip and knee joints which were attributed to different instrumental characteristics. The GaitGrabber system is valid and reliable and can be clinically used to analyze

  5. Neurotomy of the rectus femoris nerve: Short-term effectiveness for spastic stiff knee gait: Clinical assessment and quantitative gait analysis.

    Science.gov (United States)

    Gross, R; Robertson, J; Leboeuf, F; Hamel, O; Brochard, S; Perrouin-Verbe, B

    2017-02-01

    Stiff knee gait is a troublesome gait disturbance related to spastic paresis, frequently associated with overactivity of the rectus femoris muscle in the swing phase of gait. The aim of this study was to assess the short-term effects of rectus femoris neurotomy for the treatment of spastic stiff-knee gait in patients with hemiparesis. An Intervention study (before-after trial) with an observational design was carried out in a university hospital. Seven ambulatory patients with hemiparesis of spinal or cerebral origin and spastic stiff-knee gait, which had previously been improved by botulinum toxin injections, were proposed a selective neurotomy of the rectus femoris muscle. A functional evaluation (Functional Ambulation Classification and maximal walking distance), clinical evaluation (spasticity - Ashworth scale and Duncan-Ely test, muscle strength - Medical Research Council scale), and quantitative gait analysis (spatiotemporal parameters, stiff knee gait-related kinematic and kinetic parameters, and dynamic electromyography of rectus femoris) were performed as outcome measures, before and 3 months after rectus femoris neurotomy. Compared with preoperative values, there was a significant increase in maximal walking distance, gait speed, and stride length at 3 months. All kinematic parameters improved, and the average early swing phase knee extension moment decreased. The duration of the rectus femoris burst decreased post-op. This study is the first to show that rectus femoris neurotomy helps to normalise muscle activity during gait, and results in improvements in kinetic, kinematic, and functional parameters in patients with spastic stiff knee gait. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. 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)

  7. Regional neuromuscular regulation within human rectus femoris muscle during gait in young and elderly men.

    Science.gov (United States)

    Watanabe, Kohei; Kouzaki, Motoki; Moritani, Toshio

    2016-01-04

    Recently, we demonstrated region-specific electromyography (EMG) responses along the rectus femoris (RF) muscle during gait in healthy young men (Watanabe et al., 2014b). For the RF muscle, regional EMG response should be tested to characterize neuromuscular control and/or to assess its dysfunction and/or pathology during gait. We aimed to identify spatial distribution of EMG pattern within the RF muscle in elderly during gait. Seven young men (age: 20.4±1.0 years) and 8 elderly men (age: 73.8±5.9 years) walked on treadmill with three different speed: slow (preferred -1km/h), preferred, and fast (preferred +1km/h). The spatial distribution of surface EMG was tested by central locus activation (CLA), which is calculated from 18 surface electrodes along the longitudinal line of the muscle. CLA were not different between the groups for slow and preferred gait speed (p>0.05) during a gait cycle. In fast gait speed, CLA at 80% of a gait cycle (swing phase) for the elderly were significantly located at more distal site than the young group (pelderly and young). This difference in CLA reflected a significantly lower EMG activity at the proximal regions in the elderly group (pelderly manifest characteristic regional EMG responses within the RF muscle for leg swing movement of fast speed gait. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Validity and repeatability of inertial measurement units for measuring gait parameters.

    Science.gov (United States)

    Washabaugh, Edward P; Kalyanaraman, Tarun; Adamczyk, Peter G; Claflin, Edward S; Krishnan, Chandramouli

    2017-06-01

    Inertial measurement units (IMUs) are small wearable sensors that have tremendous potential to be applied to clinical gait analysis. They allow objective evaluation of gait and movement disorders outside the clinic and research laboratory, and permit evaluation on large numbers of steps. However, repeatability and validity data of these systems are sparse for gait metrics. The purpose of this study was to determine the validity and between-day repeatability of spatiotemporal metrics (gait speed, stance percent, swing percent, gait cycle time, stride length, cadence, and step duration) as measured with the APDM Opal IMUs and Mobility Lab system. We collected data on 39 healthy subjects. Subjects were tested over two days while walking on a standard treadmill, split-belt treadmill, or overground, with IMUs placed in two locations: both feet and both ankles. The spatiotemporal measurements taken with the IMU system were validated against data from an instrumented treadmill, or using standard clinical procedures. Repeatability and minimally detectable change (MDC) of the system was calculated between days. IMUs displayed high to moderate validity when measuring most of the gait metrics tested. Additionally, these measurements appear to be repeatable when used on the treadmill and overground. The foot configuration of the IMUs appeared to better measure gait parameters; however, both the foot and ankle configurations demonstrated good repeatability. In conclusion, the IMU system in this study appears to be both accurate and repeatable for measuring spatiotemporal gait parameters in healthy young adults. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. 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.

  10. Gait disorders are associated with non-cardiovascular falls in elderly people: a preliminary study

    Directory of Open Access Journals (Sweden)

    Schapira Marcelo

    2005-12-01

    Full Text Available Background The association between unexplained falls and cardiovascular causes is increasingly recognized. Neurally mediated cardiovascular disorders and hypotensive syndromes are found in almost 20 percent of the patients with unexplained falls. However, the approach to these patients remains unclear. Gait assessment might be an interesting approach to these patients as clinical observations suggests that those with cardiovascular or hypotensive causes may not manifest obvious gait alterations. Our primary objective is to analyze the association between gait disorders and a non-cardiovascular cause of falls in patients with unexplained falls. A second objective is to test the sensitivity and specificity of a gait assessment approach for detecting non-cardiovascular causes when compared with intrinsic-extrinsic classification. Methods Cross-sectional study performed in a falls clinic at a university hospital in 41 ambulatory elderly participants with unexplained falls. Neurally mediated cardiovascular conditions, neurological diseases, gait and balance problems were assessed. Gait disorder was defined as a gait velocity Results A cardiovascular etiology (orthostatic and postprandial hypotension, vasovagal syndrome and carotid sinus hypersensitivity was identified in 14% of participants (6/41. Of 35 patients with a gait disorder, 34 had a non-cardiovascular etiology of fall; whereas in 5 out of 6 patients without a gait disorder, a cardiovascular diagnosis was identified (p Conclusion In community dwelling older persons with unexplained falls, gait disorders were associated with non-cardiovascular diagnosis of falls. Gait assessment was a useful approach for the detection of a non-cardiovascular mediated cause of falls, providing additional value to this assessment.

  11. 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)

  12. Reliability and minimal detectable change of gait variables in community-dwelling and hospitalized older fallers.

    Science.gov (United States)

    Hars, Mélany; Herrmann, François R; Trombetti, Andrea

    2013-09-01

    Gait variables may constitute surrogate outcomes for fall risk. Their reliability in a specific population of older fallers has not been fully established, which limits their research and clinical applications. This study aimed to determine test-retest reliability and minimal detectable change (MDC) values for selected fall-related gait variables in older adults with a recent fall history. Community-dwelling (n=30) and hospitalized (n=30) fallers aged≥65 years were assessed twice using an instrumented pressure-sensitive walkway, under single- and dual-task gait conditions. Intraclass correlation coefficient (ICC(2,1)), standard error of measurement (SEM; SEM%) and MDC at 95% confidence level (MDC95; MDC95%), were used as reliability estimates. The ICC(2,1) for gait velocity was greater than 0.84 across all gait conditions and groups; SEM% and MDC95% did not exceed 6.5% and 18.1%, respectively. Gait variability measures returned lower ICC(2,1) (range 0.18-0.79), and markedly higher SEM% (16.3-31.9%) and MDC95% (45.3-88.3%). Overall, hospitalized fallers exhibited larger SEM and MDC95 values for variability measures compared to community-dwellers in all gait conditions, while larger values were found for all variables while dual-tasking compared to single-tasking in both groups. Gait velocity was found to be highly reliable and likely to be sensitive to change over repeated sessions in community-dwelling and hospitalized older fallers, both under single- and dual-task conditions. Gait variability measures showed lower reliability, irrespective of gait condition or group, displaying consistently larger measurement error, particularly under dual-task conditions. Clinicians should consider MDC95 values before using gait variability variables as evaluative outcome measures at patient level. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. HUMAN IDENTIFICATION BASED ON EXTRACTED GAIT FEATURES

    OpenAIRE

    Hu Ng; Hau-Lee Ton; Wooi-Haw Tan; Timothy Tzen-Vun Yap; Pei-Fen Chong; Junaidi Abdullah

    2011-01-01

    This paper presents a human identification system based on automatically extracted gait features. The proposed approach consists of three parts: extraction of human gait features from enhanced human silhouette, smoothing process on extracted gait features and classification by three classification techniques: fuzzy k- nearest neighbour, linear discriminate analysis and linear support vector machine. The gait features extracted are height, width, crotch height, step-size of the human silhouett...

  14. View-Invariant Gait Recognition Through Genetic Template Segmentation

    Science.gov (United States)

    Isaac, Ebenezer R. H. P.; Elias, Susan; Rajagopalan, Srinivasan; Easwarakumar, K. S.

    2017-08-01

    Template-based model-free approach provides by far the most successful solution to the gait recognition problem in literature. Recent work discusses how isolating the head and leg portion of the template increase the performance of a gait recognition system making it robust against covariates like clothing and carrying conditions. However, most involve a manual definition of the boundaries. The method we propose, the genetic template segmentation (GTS), employs the genetic algorithm to automate the boundary selection process. This method was tested on the GEI, GEnI and AEI templates. GEI seems to exhibit the best result when segmented with our approach. Experimental results depict that our approach significantly outperforms the existing implementations of view-invariant gait recognition.

  15. Skeleton-Based Abnormal Gait Detection

    Directory of Open Access Journals (Sweden)

    Trong-Nguyen Nguyen

    2016-10-01

    Full Text Available Human gait analysis plays an important role in musculoskeletal disorder diagnosis. Detecting anomalies in human walking, such as shuffling gait, stiff leg or unsteady gait, can be difficult if the prior knowledge of such a gait pattern is not available. We propose an approach for detecting abnormal human gait based on a normal gait model. Instead of employing the color image, silhouette, or spatio-temporal volume, our model is created based on human joint positions (skeleton in time series. We decompose each sequence of normal gait images into gait cycles. Each human instant posture is represented by a feature vector which describes relationships between pairs of bone joints located in the lower body. Such vectors are then converted into codewords using a clustering technique. The normal human gait model is created based on multiple sequences of codewords corresponding to different gait cycles. In the detection stage, a gait cycle with normality likelihood below a threshold, which is determined automatically in the training step, is assumed as an anomaly. The experimental results on both marker-based mocap data and Kinect skeleton show that our method is very promising in distinguishing normal and abnormal gaits with an overall accuracy of 90.12%.

  16. 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.

  17. A longitudinal study on dual-tasking effects on gait: cognitive change predicts gait variance in the elderly.

    Science.gov (United States)

    MacAulay, Rebecca K; Brouillette, Robert M; Foil, Heather C; Bruce-Keller, Annadora J; Keller, Jeffrey N

    2014-01-01

    Neuropsychological abilities have found to explain a large proportion of variance in objective measures of walking gait that predict both dementia and falling within the elderly. However, to this date there has been little research on the interplay between changes in these neuropsychological processes and walking gait overtime. To our knowledge, the present study is the first to investigate intra-individual changes in neurocognitive test performance and gait step time at two-time points across a one-year span. Neuropsychological test scores from 440 elderly individuals deemed cognitively normal at Year One were analyzed via repeated measures t-tests to assess for decline in cognitive performance at Year Two. 34 of these 440 individuals neuropsychological test performance significantly declined at Year Two; whereas the "non-decliners" displayed improved memory, working memory, attention/processing speed test performance. Neuropsychological test scores were also submitted to factor analysis at both time points for data reduction purposes and to assess the factor stability overtime. Results at Year One yielded a three-factor solution: Language/Memory, Executive Attention/Processing Speed, and Working Memory. Year Two's test scores also generated a three-factor solution (Working Memory, Language/Executive Attention/Processing Speed, and Memory). Notably, language measures loaded on Executive Attention/Processing Speed rather than on the Memory factor at Year Two. Hierarchal multiple regression revealed that both Executive Attention/Processing Speed and sex significantly predicted variance in dual task step time at both time points. Remarkably, in the "decliners", the magnitude of the contribution of the neuropsychological characteristics to gait variance significantly increased at Year Two. In summary, this study provides longitudinal evidence of the dynamic relationship between intra-individual cognitive change and its influence on dual task gait step time. These

  18. Use of Functional Ambulation Performance Score as measurement of gait ability: review.

    Science.gov (United States)

    Gouelle, Arnaud

    2014-01-01

    Gait analysis systems are widely used for the assessment of gait disabilities and provide more accurate and detailed information than clinical tests. Scores and indexes have been proposed to summarize the large volume of data produced, each emphasizing different aspects of gait. Based on specific spatiotemporal parameters, the Functional Ambulation Performance Score (FAPS) quantifies gait at a self-selected speed. Integrated within electronic walkways, the FAPS is commonly used for clinical evaluations and has been used in an increasing number of publications over the past few years. However, its use is sometimes distorted by misunderstandings of its composition and calculation, practical and/or conceptual limits, and even the meaning of the score. This technical report reviews the use of the FAPS for the evaluation of gait based on peer-reviewed articles and clinical experience and addresses important issues that must be considered for an optimal unbiased understanding and analysis of the score.

  19. The association of brain structure with gait velocity in older adults: a quantitative volumetric analysis of brain MRI

    Energy Technology Data Exchange (ETDEWEB)

    Ezzati, Ali [Albert Einstein College of Medicine of Yeshiva University, Saul B. Korey Department of Neurology, Bronx, NY (United States); Montefiore Medical Center, Department of Neurology, Bronx, NY (United States); Katz, Mindy J. [Albert Einstein College of Medicine of Yeshiva University, Saul B. Korey Department of Neurology, Bronx, NY (United States); Lipton, Michael L. [Albert Einstein College of Medicine of Yeshiva University, The Gruss Magnetic Resonance Research Center and Departments of Radiology, Psychiatry and Behavioral Sciences and the Dominick P. Purpura Department of Neuroscience, Bronx, NY (United States); Montefiore Medical Center, The Department of Radiology, Bronx, NY (United States); Lipton, Richard B. [Albert Einstein College of Medicine of Yeshiva University, Saul B. Korey Department of Neurology, Bronx, NY (United States); Albert Einstein College of Medicine of Yeshiva University, Department of Epidemiology and Population Health, Bronx, NY (United States); Verghese, Joe [Albert Einstein College of Medicine of Yeshiva University, Saul B. Korey Department of Neurology, Bronx, NY (United States); Albert Einstein College of Medicine, Division of Cognitive and Motor Aging, Bronx, NY (United States)

    2015-08-15

    While cortical processes play an important role in controlling locomotion, the underlying structural brain changes associated with slowing of gait in aging are not yet fully established. Our study aimed to examine the relationship between cortical gray matter volume (GM), white matter volume (WM), ventricular volume (VV), hippocampal and hippocampal subfield volumes, and gait velocity in older adults free of dementia. Gait and cognitive performance was tested in 112 community-residing adults, age 70 years and over, participating in the Einstein Aging Study. Gait velocity (cm/s) was obtained using an instrumented walkway. Volumetric MRI measures were estimated using a FreeSurfer software. We examined the cross-sectional relationship of GM, WM, VV, and hippocampal total and subfield volumes and gait velocity using linear regression models. In complementary models, the effect of memory performance on the relationship between gait velocity and regional volumes was evaluated. Slower gait velocity was associated with smaller cortical GM and total hippocampal volumes. There was no association between gait velocity and WM or VV. Among hippocampal subfields, only smaller presubiculum volume was significantly associated with decrease in gait velocity. Addition of the memory performance to the models attenuated the association between gait velocity and all volumetric measures. Our findings indicate that total GM and hippocampal volumes as well as specific hippocampal subfield volumes are inversely associated with locomotor function. These associations are probably affected by cognitive status of study population. (orig.)

  20. Cognition and gait show a selective pattern of association dominated by phenotype in incident Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Sue eLord

    2014-10-01

    Full Text Available Reports outlining the association between gait and cognition in Parkinson’s disease (PD are limited because of methodological issues and a bias towards studying advanced disease. This study examines the association between gait and cognition in 121 early PD who were characterized according to motor phenotype, and 184 healthy older adults. Quantitative gait was captured using a 7m GAITrite walkway whilst walking for two minutes under single task conditions and described by five domains (pace, rhythm, variability, asymmetry and postural control. Cognitive outcomes were summarized by six domains (attention, working memory, visual memory, executive function, visuospatial function and global cognition. Partial correlations and multivariate linear regression were used to determine independent associations for all participants and for PD tremor-dominant (TD and postural instability and gait disorder (PIGD phenotypes, controlling for age, sex, and premorbid intelligence using the National Adult Reading Test (NART. Cognitive and gait outcomes were significantly worse for PD. Gait, but not cognitive outcomes, were selectively worse for the PIGD phenotype. Significant associations emerged for two gait domains for controls (pace and postural control and four gait domains for PD (pace, rhythm, variability, and postural control.The strongest correlation was for pace and attention for PD and controls. Associations were not significant for participants with the TD phenotype. In early PD the cognitive correlates of gait are predominantly with fronto-executive functions, and are determined by the PIGD PD phenotype. These associations provide a basis for understanding the complex role of cognition in Parkinsonian gait.

  1. The association of brain structure with gait velocity in older adults: a quantitative volumetric analysis of brain MRI

    International Nuclear Information System (INIS)

    Ezzati, Ali; Katz, Mindy J.; Lipton, Michael L.; Lipton, Richard B.; Verghese, Joe

    2015-01-01

    While cortical processes play an important role in controlling locomotion, the underlying structural brain changes associated with slowing of gait in aging are not yet fully established. Our study aimed to examine the relationship between cortical gray matter volume (GM), white matter volume (WM), ventricular volume (VV), hippocampal and hippocampal subfield volumes, and gait velocity in older adults free of dementia. Gait and cognitive performance was tested in 112 community-residing adults, age 70 years and over, participating in the Einstein Aging Study. Gait velocity (cm/s) was obtained using an instrumented walkway. Volumetric MRI measures were estimated using a FreeSurfer software. We examined the cross-sectional relationship of GM, WM, VV, and hippocampal total and subfield volumes and gait velocity using linear regression models. In complementary models, the effect of memory performance on the relationship between gait velocity and regional volumes was evaluated. Slower gait velocity was associated with smaller cortical GM and total hippocampal volumes. There was no association between gait velocity and WM or VV. Among hippocampal subfields, only smaller presubiculum volume was significantly associated with decrease in gait velocity. Addition of the memory performance to the models attenuated the association between gait velocity and all volumetric measures. Our findings indicate that total GM and hippocampal volumes as well as specific hippocampal subfield volumes are inversely associated with locomotor function. These associations are probably affected by cognitive status of study population. (orig.)

  2. Assessment of Simple Gait Related Dual and Triple Tests in Predicting the Risk of Fall in Adults Above Age of 50 years

    OpenAIRE

    Paranjape, Swati; Chitalia, Disha

    2016-01-01

    Timed UP and Go Test (TUG) is conventionally used as predictor of falls in adults. Routine daily activities include multiple tasks performed concurrently. When two or more tasks (Dual/Triple test) needed to be carried out concurrently, task performance declined at least in one of them. Our study aimed to find temporal and demographic variations in the performance after adding a cognitive, motor or both tasks, while performing TUG, compared to performance?during conventional TUG. Sixty randoml...

  3. Symmetry Analysis of Gait between Left and Right Limb Using Cross-Fuzzy Entropy.

    Science.gov (United States)

    Xia, Yi; Ye, Qiang; Gao, Qingwei; Lu, Yixiang; Zhang, Dexiang

    2016-01-01

    The purpose of this paper is the investigation of gait symmetry problem by using cross-fuzzy entropy (C-FuzzyEn), which is a recently proposed cross entropy that has many merits as compared to the frequently used cross sample entropy (C-SampleEn). First, we used several simulation signals to test its performance regarding the relative consistency and dependence on data length. Second, the gait time series of the left and right stride interval were used to calculate the C-FuzzyEn values for gait symmetry analysis. Besides the statistical analysis, we also realized a support vector machine (SVM) classifier to perform the classification of normal and abnormal gaits. The gait dataset consists of 15 patients with Parkinson's disease (PD) and 16 control (CO) subjects. The results show that the C-FuzzyEn values of the PD patients' gait are significantly higher than that of the CO subjects with a p value of less than 10(-5), and the best classification performance evaluated by a leave-one-out (LOO) cross-validation method is an accuracy of 96.77%. Such encouraging results imply that the C-FuzzyEn-based gait symmetry measure appears as a suitable tool for analyzing abnormal gaits.

  4. Control of impact loading during distracted running before and after gait retraining in runners.

    Science.gov (United States)

    Cheung, Roy T H; An, Winko W; Au, Ivan P H; Zhang, Janet H; Chan, Zoe Y S; MacPhail, Aislinn J

    2018-07-01

    Gait retraining using visual biofeedback has been reported to reduce impact loading in runners. However, most of the previous studies did not adequately examine the level of motor learning after training, as the modified gait pattern was not tested in a dual-task condition. Hence, this study sought to compare the landing peak positive acceleration (PPA) and vertical loading rates during distracted running before and after gait retraining. Sixteen recreational runners underwent a two-week visual biofeedback gait retraining program for impact loading reduction, with feedback on the PPA measured at heel. In the evaluation of PPA and vertical loading rates before and after the retraining, the participants performed a cognitive and verbal counting task while running. Repeated measures ANOVA indicated a significant interaction between feedback and training on PPA (F = 4.642; P = 0.048) but not vertical loading rates (F > 1.953; P > 0.067). Pairwise comparisons indicated a significantly lower PPA and vertical loading rates after gait retraining (P  0.68). Visual feedback after gait retraining reduced PPA and vertical loading rates during distracted running (P  0.36). Gait retraining is effective in lowering impact loading even when the runners are distracted. In dual-task situation, visual biofeedback provided beneficial influence on kinetics control after gait retraining.

  5. Symmetry Analysis of Gait between Left and Right Limb Using Cross-Fuzzy Entropy

    Directory of Open Access Journals (Sweden)

    Yi Xia

    2016-01-01

    Full Text Available The purpose of this paper is the investigation of gait symmetry problem by using cross-fuzzy entropy (C-FuzzyEn, which is a recently proposed cross entropy that has many merits as compared to the frequently used cross sample entropy (C-SampleEn. First, we used several simulation signals to test its performance regarding the relative consistency and dependence on data length. Second, the gait time series of the left and right stride interval were used to calculate the C-FuzzyEn values for gait symmetry analysis. Besides the statistical analysis, we also realized a support vector machine (SVM classifier to perform the classification of normal and abnormal gaits. The gait dataset consists of 15 patients with Parkinson’s disease (PD and 16 control (CO subjects. The results show that the C-FuzzyEn values of the PD patients’ gait are significantly higher than that of the CO subjects with a p value of less than 10-5, and the best classification performance evaluated by a leave-one-out (LOO cross-validation method is an accuracy of 96.77%. Such encouraging results imply that the C-FuzzyEn-based gait symmetry measure appears as a suitable tool for analyzing abnormal gaits.

  6. Height estimations based on eye measurements throughout a gait cycle

    DEFF Research Database (Denmark)

    Yang, Sylvia X M; Larsen, Peter K; Alkjær, Tine

    2014-01-01

    (EH) measurement, on the other hand, is less prone to concealment. The purpose of the present study was to investigate: (1) how the eye height varies during the gait cycle, and (2) how the eye height changes with head position. The eyes were plotted manually in APAS for 16 test subjects during...

  7. Gait characteristics under different walking conditions: Association with the presence of cognitive impairment in community-dwelling older people.

    Directory of Open Access Journals (Sweden)

    Anne-Marie De Cock

    Full Text Available Gait characteristics measured at usual pace may allow profiling in patients with cognitive problems. The influence of age, gender, leg length, modified speed or dual tasking is unclear.Cross-sectional analysis was performed on a data registry containing demographic, physical and spatial-temporal gait parameters recorded in five walking conditions with a GAITRite® electronic carpet in community-dwelling older persons with memory complaints. Four cognitive stages were studied: cognitively healthy individuals, mild cognitive impaired patients, mild dementia patients and advanced dementia patients.The association between spatial-temporal gait characteristics and cognitive stages was the most prominent: in the entire study population using gait speed, steps per meter (translation for mean step length, swing time variability, normalised gait speed (corrected for leg length and normalised steps per meter at all five walking conditions; in the 50-to-70 years old participants applying step width at fast pace and steps per meter at usual pace; in the 70-to-80 years old persons using gait speed and normalised gait speed at usual pace, fast pace, animal walk and counting walk or steps per meter and normalised steps per meter at all five walking conditions; in over-80 years old participants using gait speed, normalised gait speed, steps per meter and normalised steps per meter at fast pace and animal dual-task walking. Multivariable logistic regression analysis adjusted for gender predicted in two compiled models the presence of dementia or cognitive impairment with acceptable accuracy in persons with memory complaints.Gait parameters in multiple walking conditions adjusted for age, gender and leg length showed a significant association with cognitive impairment. This study suggested that multifactorial gait analysis could be more informative than using gait analysis with only one test or one variable. Using this type of gait analysis in clinical practice

  8. Influence of gait training and prosthetic foot category on external work symmetry during unilateral transtibial amputee gait.

    Science.gov (United States)

    Agrawal, Vibhor; Gailey, Robert; O'Toole, Christopher; Gaunaurd, Ignacio; Finnieston, Adam

    2013-10-01

    Prosthetic foot prescription guidelines lack scientific evidence and are concurrent with an amputee's concurrent with an amputee's Medicare Functional Classification Level (K-Level) and categorization of prosthetic feet. To evaluate the influence of gait training and four categories of prosthetic feet (K1, K2, K3, and microprocessor ankle/foot) on Symmetry in External Work for K-Level-2 and K-Level-3 unilateral transtibial amputees. Randomized repeated-measures trial. Five K-Level-2 and five K-Level-3 subjects were tested in their existing prosthesis during Session 1 and again in Session 2, following 2 weeks of standardized gait training. In Sessions 3-6, subjects were tested using a study socket and one of four randomized test feet. There was an accommodation period of 10-14 days with each foot. Symmetry in External Work for positive and negative work was calculated at each session to determine symmetry of gait dynamics between limbs at self-selected walking speeds. K-Level-2 subjects had significantly higher negative work symmetry with the K3 foot, compared to K1/K2 feet. For both subject groups, gait training had a greater impact on positive work symmetry than test feet. Higher work symmetry is possible for K-Level-2 amputees who are trained to take advantage of K3 prosthetic feet designs. There exists a need for an objective determinant for categorizing and prescribing prosthetic feet.

  9. Inertial Gait Phase Detection for control of a drop foot stimulator: Inertial sensing for gait phase detection

    NARCIS (Netherlands)

    Kotiadis, D.; Hermens, Hermanus J.; Veltink, Petrus H.

    An Inertial Gait Phase Detection system was developed to replace heel switches and footswitches currently being used for the triggering of drop foot stimulators. A series of four algorithms utilising accelerometers and gyroscopes individually and in combination were tested and initial results are

  10. Balance and gait problems in the elderly.

    Science.gov (United States)

    Viswanathan, Anand; Sudarsky, Lewis

    2012-01-01

    Gait and balance problems are common with advancing age. Disorders of balance and gait are particularly important in the elderly because they compromise independence and contribute to the risk of falls and injury. Although they are considered as separate clinical entities, balance and gait disturbance are often intertwined. Here, we discuss the principal anatomical and physiologic mechanisms responsible for balance and gait. We also review the different types of fall patterns commonly seen in subjects and a classification scheme for various gait disorders. Furthermore, we consider the relationship between balance and gait disorders and subcortical vascular disease. Potential interventions and therapies in those individuals with balance and gait disorders are also discussed. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. K- and L-edge X-ray Absorption Spectroscopy (XAS) and Resonant Inelastic X-ray Scattering (RIXS) Determination of Differential Orbital Covalency (DOC) of Transition Metal Sites.

    Science.gov (United States)

    Baker, Michael L; Mara, Michael W; Yan, James J; Hodgson, Keith O; Hedman, Britt; Solomon, Edward I

    2017-08-15

    Continual advancements in the development of synchrotron radiation sources have resulted in X-ray based spectroscopic techniques capable of probing the electronic and structural properties of numerous systems. This review gives an overview of the application of metal K-edge and L-edge X-ray absorption spectroscopy (XAS), as well as K resonant inelastic X-ray scattering (RIXS), to the study of electronic structure in transition metal sites with emphasis on experimentally quantifying 3d orbital covalency. The specific sensitivities of K-edge XAS, L-edge XAS, and RIXS are discussed emphasizing the complementary nature of the methods. L-edge XAS and RIXS are sensitive to mixing between 3d orbitals and ligand valence orbitals, and to the differential orbital covalency (DOC), that is, the difference in the covalencies for different symmetry sets of the d orbitals. Both L-edge XAS and RIXS are highly sensitive to and enable separation of and donor bonding and back bonding contributions to bonding. Applying ligand field multiplet simulations, including charge transfer via valence bond configuration interactions, DOC can be obtained for direct comparison with density functional theory calculations and to understand chemical trends. The application of RIXS as a probe of frontier molecular orbitals in a heme enzyme demonstrates the potential of this method for the study of metal sites in highly covalent coordination sites in bioinorganic chemistry.

  12. Ab Initio Calculations of X-ray Spectra : Atomic Multiplet and Molecular Orbital Effects in a Multiconfigurational SCF Approach to the L-Edge Spectra of Transition Metal Complexes

    NARCIS (Netherlands)

    Josefsson, Ida; Kunnus, Kristjan; Schreck, Simon; Foehlisch, Alexander; de Groot, Frank; Wernet, Philippe; Odelius, Michael

    2012-01-01

    A new ab initio approach to the calculation of X-ray spectra is demonstrated. It combines a high-level quantum chemical description of the chemical interactions and local atomic multiplet effects. We show here calculated L-edge X-ray absorption (XA) and resonant inelastic X-ray scattering spectra

  13. The effect of tooth loss on gait stability of community-dwelling older adults.

    Science.gov (United States)

    Brand, Christina; Bridenbaugh, Stephanie A; Perkovac, Mateja; Glenz, Fabienne; Besimo, Christian E; Sendi, Pedram; Kressig, Reto W; Marinello, Carlo P

    2015-12-01

    To investigate the effects of tooth loss on gait stability in a healthy elderly population. A case-control study was conducted among healthy and prosthetically well-restored seniors over the age of 65 years. The test group comprised 24 edentulous participants who were restored with complete dentures in the upper jaw and an overdenture fixed on two implants in the lower jaw. The control group comprised 25 dentate participants who either still had their natural teeth or were restored with conventional fixed partial dentures. Gait stability was evaluated by measuring the parameters 'gait velocity' and 'cycle-time variability' during self-selected normal walking speed and under dual-task performance conditions. Measurements were conducted using the GAITRite(®) electronic walkway system. Dentated and fixed restored participants (the control group) had a significantly higher gait velocity compared with denture wearers (the test group) under both normal walking (p = 0.03) and dual-task performance conditions (p = 0.01). In each test condition, among edentulous participants, gait velocity did not significantly differ according to whether the participant wore their dentures. The present results suggest that tooth loss in healthy seniors is associated with lower gait velocity and therefore may have a negative impact on gait stability. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  14. Racial differences in gait velocity in an urban elderly cohort.

    Science.gov (United States)

    Blanco, Irene; Verghese, Joe; Lipton, Richard B; Putterman, Chaim; Derby, Carol A

    2012-05-01

    To investigate whether there are racial differences in gait velocity in elderly adults. Cross-sectional analysis. Bronx, New York. Two hundred thirteen participants of the Einstein Aging Study (157 Caucasian, 56 African American), a longitudinal study of community-residing elderly adults recruited using Medicare and voter registration records. Demographic characteristics, medical history, Geriatric Depression Scale, Blessed Information-Memory-Concentration Test, Total Pain Index, gait velocity. Caucasians were older (median 79.9 vs 75.5, P = .002) and more educated (median 14 vs 12 years, P = .007) and had lower body mass index (mean 26.9 ± 4.3 vs 28.9 ± 6.4, P = .03). African Americans were more likely to be female (80.4% vs 59.9%, P = .006) and to have diabetes mellitus (28.6% vs 13.4%, P = .01). Pain levels were not significantly different between Caucasians and African Americans. African Americans had a significantly slower gait velocity (mean 90.2 ± 17.9 vs 99.1 ± 20.1 cm/s, P = .004). This difference persisted after adjusting for multiple covariates. Differences in common factors known to influence gait did not explain a 7.79-cm/s slower gait speed in African Americans than Caucasians. Differences in gait velocity persist between African Americans and Caucasians despite adjusting for many confounders. Increases of just 10 cm/s are associated with lower mortality. Further studies are needed to evaluate whether there are modifiable risk factors that may explain this difference and whether an intervention could reduce the discrepancy between the groups. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  15. Imaging gait analysis: An fMRI dual task study.

    Science.gov (United States)

    Bürki, Céline N; Bridenbaugh, Stephanie A; Reinhardt, Julia; Stippich, Christoph; Kressig, Reto W; Blatow, Maria

    2017-08-01

    In geriatric clinical diagnostics, gait analysis with cognitive-motor dual tasking is used to predict fall risk and cognitive decline. To date, the neural correlates of cognitive-motor dual tasking processes are not fully understood. To investigate these underlying neural mechanisms, we designed an fMRI paradigm to reproduce the gait analysis. We tested the fMRI paradigm's feasibility in a substudy with fifteen young adults and assessed 31 healthy older adults in the main study. First, gait speed and variability were quantified using the GAITRite © electronic walkway. Then, participants lying in the MRI-scanner were stepping on pedals of an MRI-compatible stepping device used to imitate gait during functional imaging. In each session, participants performed cognitive and motor single tasks as well as cognitive-motor dual tasks. Behavioral results showed that the parameters of both gait analyses, GAITRite © and fMRI, were significantly positively correlated. FMRI results revealed significantly reduced brain activation during dual task compared to single task conditions. Functional ROI analysis showed that activation in the superior parietal lobe (SPL) decreased less from single to dual task condition than activation in primary motor cortex and in supplementary motor areas. Moreover, SPL activation was increased during dual tasks in subjects exhibiting lower stepping speed and lower executive control. We were able to simulate walking during functional imaging with valid results that reproduce those from the GAITRite © gait analysis. On the neural level, SPL seems to play a crucial role in cognitive-motor dual tasking and to be linked to divided attention processes, particularly when motor activity is involved.

  16. Validation of the "Six Step Spot Test" for gait among patients with multiple sclerosis in Brazil Validação do teste de marcha "Six Step Spot Test" em pacientes com esclerose múltipla no Brasil

    Directory of Open Access Journals (Sweden)

    Karina Pavan

    2010-04-01

    Full Text Available The clinical manifestations of multiple sclerosis (MS are variable among patients, and the course of disease is not linear. Different symptoms are presented, with gradual accumulation of disability. These variations are difficult to quantify in clinical practice, and several studies have attempted to create instruments capable of measuring these disabilities. The Six Step Spot Test (SSST was developed for quantitative evaluation of the lower limbs (LL over time. Performance in this test reflects the complexity of sensory-motor function, including LL strength, spasticity, coordination and balance, going beyond vision and cognition. The aim of the present study was to validate the SSST in a population of MS patients in Brazil. This prospective study included 75 patients with MS, with EDSS 0 to 6.5 in the study group. Ninety-one healthy subjects were randomly selected for the control group. The results showed that the groups were similar, and that the SSST is a reliable and reproducible test. According to the statistical analysis on the data in this study, the SSST is a valid, reliable and reproducible tool for use in the Brazilian MS patient population.As manifestações clínicas da esclerose múltipla (EM são variáveis e o curso da doença não é linear, caracterizado por sintomas, acúmulo progressivo de incapacidades. Estas variações são difíceis de quantificar na prática clínica, motivo pelo qual surgiram diversos estudos para criação de instrumentos capazes de mensurar essas incapacidades. O Six Step Spot Test (SSST foi desenvolvido para avaliar função dos membros inferiores (MMII de forma quantitativa, mensurado no domínio tempo, avaliando a complexa função sensório-motora, como força em MMII, espasticidade, coordenação e equilíbrio, além da visão e cognição. Este estudo teve como objetivo validar o SSST para pacientes com EM no Brasil. Estudo prospectivo do qual participaram 75 pacientes com EM e EDSS de 0 a 6,5 no

  17. Can change in prolonged walking be inferred from a short test of gait speed among older adults who are initially well-functioning?

    Science.gov (United States)

    White, Daniel K; Neogi, Tuhina; King, Wendy C; LaValley, Michael P; Kritchevsky, Stephen B; Nevitt, Michael C; Harris, Tamara B; Ferrucci, Luigi; Simonsick, Eleanor M; Satterfield, Suzanne; Strotmeyer, Elsa S; Zhang, Yuqing

    2014-09-01

    The ability to walk for short and prolonged periods of time is often measured with separate walking tests. It is unclear whether decline in the 2-minute walk coincides with decline in a shorter 20-m walk among older adults. The aim of this study was to describe patterns of change in the 20-m walk and 2-minute walk over 8 years among a large cohort of older adults. Should change be similar between tests of walking ability, separate retesting of prolonged walking may need to be reconsidered. A longitudinal, observational cohort study was conducted. Data were from 1,893 older adults who were well-functioning (≥70 years of age). The 20-m walk and 2-minute walk were repeatedly measured over 8 years to measure change during short and prolonged periods of walking, respectively. Change was examined using a dual group-based trajectory model (dual model), and agreement between walking trajectories was quantified with a weighted kappa statistic. Three trajectory groups for the 20-m walk and 2-minute walk were identified. More than 86% of the participants were in similar trajectory groups for both tests from the dual model. There was high chance-corrected agreement (kappa=.84; 95% confidence interval=.82, .86) between the 20-m walk and 2-minute walk trajectory groups. One-third of the original Health, Aging and Body Composition (Health ABC) study cohort was excluded from analysis due to missing clinic visits, followed by being excluded for health reasons for performing the 2-minute walk, limiting generalizability to healthy older adults. Patterns of change in the 2-minute walk are similar to those in the 20-m walk. Thus, separate retesting of the 2-minute walk may need to be reconsidered to gauge change in prolonged walking. © 2014 American Physical Therapy Association.

  18. Poor Gait Performance and Prediction of Dementia: Results From a Meta-Analysis.

    Science.gov (United States)

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

    2016-06-01

    Poor gait performance predicts risk of developing dementia. No structured critical evaluation has been conducted to study this association yet. The aim of this meta-analysis was to systematically examine the association of poor gait performance with incidence of dementia. An English and French Medline search was conducted in June 2015, with no limit of date, using the medical subject headings terms "Gait" OR "Gait Disorders, Neurologic" OR "Gait Apraxia" OR "Gait Ataxia" AND "Dementia" OR "Frontotemporal Dementia" OR "Dementia, Multi-Infarct" OR "Dementia, Vascular" OR "Alzheimer Disease" OR "Lewy Body Disease" OR "Frontotemporal Dementia With Motor Neuron Disease" (Supplementary Concept). Poor gait performance was defined by standardized tests of walking, and dementia was diagnosed according to international consensus criteria. Four etiologies of dementia were identified: any dementia, Alzheimer disease (AD), vascular dementia (VaD), and non-AD (ie, pooling VaD, mixed dementias, and other dementias). Fixed effects meta-analyses were performed on the estimates in order to generate summary values. Of the 796 identified abstracts, 12 (1.5%) were included in this systematic review and meta-analysis. Poor gait performance predicted dementia [pooled hazard ratio (HR) combined with relative risk and odds ratio = 1.53 with P analysis provides evidence that poor gait performance predicts dementia. This association depends on the type of dementia; poor gait performance is a stronger predictor of non-AD dementias than AD. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  19. Foot placement control and gait instability among people with stroke.

    Science.gov (United States)

    Dean, Jesse C; Kautz, Steven A

    2015-01-01

    Gait instability is a common problem following stroke, as evidenced by increases in fall risk and fear of falling. However, the mechanism underlying gait instability is currently unclear. We recently found that young, healthy humans use a consistent gait stabilization strategy of actively controlling their mediolateral foot placement based on the concurrent mechanical state of the stance limb. In the present work, we tested whether people with stroke (n = 16) and age-matched controls (n = 19) used this neuromechanical strategy. Specifically, we used multiple linear regressions to test whether (1) swing phase gluteus medius (GM) activity was influenced by the simultaneous state of the stance limb and (2) mediolateral foot placement location was influenced by swing phase GM activity and the mechanical state of the swing limb at the start of the step. We found that both age-matched controls and people with stroke classified as having a low fall risk (Dynamic Gait Index [DGI] score >19) essentially used the stabilization strategy previously described in young controls. In contrast, this strategy was disrupted for people with stroke classified as higher fall risk (DGI foot placement may contribute to poststroke instability.

  20. Analysis of modifications of the plantar parameters after the use of a proprioceptive insole: regular gait.

    Science.gov (United States)

    Nobili, Carlotta O; Mannacio, Elena; Ciccarelli, Antonello; Tajani, Filippo; Ripani, Maurizio

    2017-10-27

    The human foot is the basis of support and propulsion for gait and it provides support and flexibility for effective weight transfer. Therefore a correct distribution of loads and pressures on the surface of the foot is of fundamental importance to ensure a correct walking and maintaining balance in both static and dynamic conditions. The aim of our study was to evaluate the effects of innovative insoles, named Regular Gait, on plantar pressures distribution during standing position and walking in healthy subjects; therefore, we investigated whether these effects are maintained after insole removing. 50 subjects were tested; these were free of foot diseases or damage to the anatomical structures involved in the processes above posture. These subjects underwent rating scales and static and dynamic baropodometric examination before and after using Regular Gait. The results obtained shown that the Regular Gait, for as we have designed, are able to change the distribution of the parameters both in static and dynamic conditions. We have also shown that the best results were obtained only after a month of treatment with Regular Gait and that the results obtained persist even in the tests post-treatment without insoles. In conclusion, the data obtained in this study suggest that Regular Gait could be efficient in acting on parameters related to maintenance of upright posture and gait. This would allow the treated subjects to improve their posture both while walking and during the maintenance of the upright position.

  1. Effects of pharmacological therapy on gait and cognitive function in depressed patients.

    Science.gov (United States)

    Paleacu, Diana; Shutzman, Agatha; Giladi, Nir; Herman, Talia; Simon, Ely S; Hausdorff, Jeffrey M

    2007-01-01

    To investigate the relationship among affective status, cognitive function, and gait in depressed patients and to evaluate the effects of treatment of depression on gait and cognitive function. Nineteen patients recently diagnosed with clinical depression (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) were recruited from a psychiatric outpatient clinic. Evaluation included the Hamilton Depression Rating Scale (HAM-D), the Mini-Mental State Examination, a computerized neuropsychological battery (Mindstreams, NeuroTrax Corp, New York, NY), and Barthel's Index of Instrumental Activities of Daily Living. Temporal parameters of gait were quantified using a stopwatch and force-sensitive insoles. All assessments were performed at baseline and after approximately 10 weeks of treatment with antidepressants. The patients' mean age was 68.6 +/- 9.1 years (15 women). Therapy significantly (P HAM-D scores). There were small but significant improvements in gait speed (P = 0.033), stride time variability (P = 0.036), and gait asymmetry (P = 0.038). With the exception of the hand-eye coordination index, all tested cognitive domains also improved significantly. Baseline depression scores correlated with changes in depression: patients with higher HAM-D scores at baseline had more significant improvement in their affect (P HAM-D were not significantly correlated with changes in gait or changes on computerized tests of cognitive function (P > 0.10). Depressive symptoms are associated with gait and cognitive impairment. Moreover, the present results suggest that these domains improve in response to antidepressant medication.

  2. Dual-channel functional electrical stimulation improvements in speed-based gait classifications

    Directory of Open Access Journals (Sweden)

    Springer S

    2013-02-01

    Full Text Available Shmuel Springer,1,2 Yocheved Laufer,1 Meni Becher,1,2 Jean-Jacques Vatine3,41Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, 2Clinical Department, Bioness Neuromodulation, Ra'anana, 3Outpatient and Research Division, Reuth Medical Center, Tel Aviv, 4Department of Rehabilitation Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, IsraelBackground: Functional electrical stimulation (FES is becoming an accepted treatment method for enhancing gait performance in patients who present with gait difficulties resulting from hemiparesis. The purpose of this study was to test whether individuals with hemiparesis who have varied gait speeds, which place them in different functional categories, benefit to the same extent from the application of FES.Methods: Thirty-six subjects with chronic hemiparesis demonstrating foot-drop and deficits in knee and/or hip control were fitted with a dual-channel FES system activating the dorsiflexors and hamstring muscles. Gait was assessed during a 2-minute walk test with and without stimulation. A second assessment was conducted after 6 weeks of daily use. Analysis was performed with the subjects stratified into three functional ambulation classes according to their initial gait categories.Results: The dual-channel FES improved the gait velocity of all three subgroups. No minimal gait velocity was required in order to gain benefits from FES. For example, subjects with limited household ambulation capabilities improved their gait speed by 63.3% (from 0.30 ± 0.09 m/sec to 0.49 ± 0.20 m/sec; P < 0.01, while subjects with functional community ambulation capabilities improved their gait speed by 25.5% (from 0.90 ± 0.11 m/sec to 1.13 ± 0.22 m/sec; P < 0.01.Conclusion: Dual-channel FES positively affects gait velocity in patients with chronic hemiparesis, regardless of their initial gait velocity. Furthermore, gait velocity gains may be large enough

  3. [Can a newly-established test for assessing standing and balance function be an alternative to the timed up-and-go test?--functional assessment of gait and balance in elderly patients for a comprehensive geriatric assessment initiative named 'Dr. SUPERMAN'].

    Science.gov (United States)

    Otoguro, Motohide; Ohnuma, Takeshi; Hirao, Kentarou; Iwamoto, Toshihiko

    2012-01-01

    To identify elderly patients who are at high risk for falls, we used the timed up-and-go test (TUG) as an assessment tool for gait and balance function in a comprehensive geriatric assessment (CGA) initiative named 'Dr. SUPERMAN'. However, this test is difficult to perform in a small area because it requires at least 3 meters of movement space. Therefore, we investigated whether another, newly-developed test, based on the Berg balance test, could be an alternative to the TUG test. We enrolled a total of 99 eligible subjects out of 105 elderly patients with disorders such as Alzheimer disease, Parkinson disease, cerebral infarction, osteoporosis and vascular risk factors, and administered the TUG test and the newly-developed standing and balance test (SBT). Of these 99, 6 patients could not stand independently. While the time to accomplish TUG was determined, any unsteadiness during TUG was also recorded. The SBT consists of 3 components: standing up independently, standing on a narrow base for 15 seconds without any swaying of the trunk, and a timed one-leg standing test (TOLS) for 15 seconds on both sides. Taking more than 14 seconds to accomplish the TUG or abnormal unsteadiness during the test was defined as positive, and each cut-off point was measured on the TOLS, with or without swaying of the trunk. The time to accomplish TUG significantly increased with age, and positive TUG findings were observed in 43 subjects. The mean TOLS time significantly and suddenly worsened at over 75 years of age, including among those subjects who showed swaying of the trunk and who could only perform the TOLS for less than 1 second. The receiver operating curve indicated that a TOLS cut-off point of less than 3 seconds, together with standing with help or swaying of the trunk during the SBT, most efficiently determined a positive TUG score, with high sensitivity (86%), high specificity (87.5%), and a high positive predictive value (84.1%). In a narrow space, the SBT can

  4. The application of multilevel modelling to account for the influence of walking speed in gait analysis.

    Science.gov (United States)

    Keene, David J; Moe-Nilssen, Rolf; Lamb, Sarah E

    2016-01-01

    Differences in gait performance can be explained by variations in walking speed, which is a major analytical problem. Some investigators have standardised speed during testing, but this can result in an unnatural control of gait characteristics. Other investigators have developed test procedures where participants walking at their self-selected slow, preferred and fast speeds, with computation of gait characteristics at a standardised speed. However, this analysis is dependent upon an overlap in the ranges of gait speed observed within and between participants, and this is difficult to achieve under self-selected conditions. In this report a statistical analysis procedure is introduced that utilises multilevel modelling to analyse data from walking tests at self-selected speeds, without requiring an overlap in the range of speeds observed or the routine use of data transformations. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Investigating the function spiral in later life: Aging attitudes, physical activity, and gait.

    Science.gov (United States)

    Whitehead, Brenda R

    2017-06-01

    This study tests the Function Spiral Model, which proposes that functional decline often occurs prematurely: negative aging attitudes reduce activity engagement, which then advances functional decline via physical deconditioning. A total of 89 adults aged 61-96 ( M = 77) years completed a questionnaire assessing aging attitudes and physical activity and participated in a follow-up assessment of gait/balance and function. Results supported the process model: physical activity mediated the impact of negative aging attitudes on gait/balance, and gait/balance mediated the impact of physical activity on function. Findings highlight multiple points of intervention that could mitigate the acceleration of functional decline in later life.

  6. Inertial sensor based gait analysis discriminates subjects with and without visual impairment caused by simulated macular degeneration.

    Science.gov (United States)

    Kanzler, Christoph M; Barth, Jens; Klucken, Jochen; Eskofier, Bjoern M

    2016-08-01

    Macular degeneration is the third leading cause of blindness worldwide and the leading cause of blindness in the developing world. The analysis of gait parameters can be used to assess the influence of macular degeneration on gait. This study examines the effect of macular degeneration on gait using inertial sensor based 3D spatio-temporal gait parameters. We acquired gait data from 21 young and healthy subjects during a 40 m obstacle walk. All subjects had to perform the gait trial with and without macular degeneration simulation glasses. The order of starting with or without glasses alternated between each subject in order to test for training effects. Multiple 3D spatio-temporal gait parameters were calculated for the normal vision as well as the impaired vision groups. The parameters trial time, stride time, stride time coefficient of variation (CV), stance time, stance time CV, stride length, cadence, gait velocity and angle at toe off showed statistically significant differences between the two groups. Training effects were visible for the trials which started without vision impairment. Inter-group differences in the gait pattern occurred due to an increased sense of insecurity related with the loss of visual acuity from the simulation glasses. In summary, we showed that 3D spatio-temporal gait parameters derived from inertial sensor data are viable to detect differences in the gait pattern of subjects with and without a macular degeneration simulation. We believe that this study provides the basis for an in-depth analysis regarding the impact of macular degeneration on gait.

  7. Modulation of the Left Prefrontal Cortex with High Frequency Repetitive Transcranial Magnetic Stimulation Facilitates Gait in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Amer M. Burhan

    2015-01-01

    Full Text Available Multiple Sclerosis (MS is a chronic central nervous system (CNS demyelinating disease. Gait abnormalities are common and disabling in patients with MS with limited treatment options available. Emerging evidence suggests a role of prefrontal attention networks in modulating gait. High-frequency repetitive transcranial magnetic stimulation (rTMS is known to enhance cortical excitability in stimulated cortex and its correlates. We investigated the effect of high-frequency left prefrontal rTMS on gait parameters in a 51-year-old Caucasian male with chronic relapsing/remitting MS with residual disabling attention and gait symptoms. Patient received 6 Hz, rTMS at 90% motor threshold using figure of eight coil centered on F3 location (using 10-20 electroencephalography (EEG lead localization system. GAITRite gait analysis system was used to collect objective gait measures before and after one session and in another occasion three consecutive daily sessions of rTMS. Two-tailed within subject repeated measure t-test showed significant enhancement in ambulation time, gait velocity, and cadence after three consecutive daily sessions of rTMS. Modulating left prefrontal cortex excitability using rTMS resulted in significant change in gait parameters after three sessions. To our knowledge, this is the first report that demonstrates the effect of rTMS applied to the prefrontal cortex on gait in MS patients.

  8. Analysis of spastic gait in cervical myelopathy: Linking compression ratio to spatiotemporal and pedobarographic parameters.

    Science.gov (United States)

    Nagai, Taro; Takahashi, Yasuhito; Endo, Kenji; Ikegami, Ryo; Ueno, Ryuichi; Yamamoto, Kengo

    2018-01-01

    Gait dysfunction associated with spasticity and hyperreflexia is a primary symptom in patients with compression of cervical spinal cord. The objective of this study was to link maximum compression ratio (CR) to spatiotemporal/pedobarographic parameters. Quantitative gait analysis was performed by using a pedobarograph in 75 elderly males with a wide range of cervical compression severity. CR values were characterized on T1-weighted magnetic resonance imaging (MRI). Statistical significances in gait analysis parameters (speed, cadence, stride length, step with, and toe-out angle) were evaluated among different CR groups by the non-parametric Kruskal-Wallis test followed by the Mann-Whitney U test using Bonferroni correction. The Spearman test was performed to verify correlations between CR and gait parameters. The Kruskal-Wallis test revealed significant decline in gait speed and stride length and significant increase in toe-out angle with progression of cervical compression myelopathy. The post-hoc Mann-Whitney U test showed significant differences in these parameters between the control group (0.45test revealed that CR was significantly correlated with speed, cadence, stride length, and toe-out angle. Gait speed, stride length, and toe-out angle can serve as useful indexes for evaluating progressive gait abnormality in cervical myelopathy. Our findings suggest that CR≤0.25 is associated with significantly poorer gait performance. Nevertheless, future prospective studies are needed to determine a potential benefit from decompressive surgery in such severe compression patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Effects of gait rehabilitation with a footpad-type locomotion interface in patients with chronic post-stroke hemiparesis: a pilot study.

    Science.gov (United States)

    Tanaka, Naoki; Saitou, Hideyuki; Takao, Toshifumi; Iizuka, Noboru; Okuno, Junko; Yano, Hiroaki; Tamaoka, Akira; Yanagi, Hisako

    2012-08-01

    We developed a footpad-type locomotion interface called the GaitMaster. The purpose of this pilot study was to examine the effects of gait rehabilitation using the GaitMaster in chronic stroke patients. Randomized cross-over design. An outpatient department. Twelve patients with chronic post-stroke hemiparesis. In group A, patients underwent an 'intervention phase' followed by a 'non-intervention phase', whereas in group B, patients underwent the non-intervention phase first, followed by the intervention phase. In the four- or six-week intervention phase, participants underwent twelve 20-minute sessions of gait rehabilitation using the GaitMaster4. We measured gait speed and timed up-and-go test. No differences between the two groups were observed in the baseline clinical data. For the combined groups A and B, the maximum gait and timed up-and-go test speeds improved significantly only in the intervention phase (P = 0.0001 and P = 0.003, respectively). The percentages of improvement from baseline at the end of GaitMaster training were 16.6% for the maximum gait speed and 8.3% for the timed up-and-go test. The effect size for GaitMaster4 training was 0.58 on the maximum gait speed and 0.43 on the timed up-and-go test. This pilot study showed that gait rehabilitation using the GaitMaster4 was a feasible training method for chronic stroke patients. Calculation of the sample size indicated that a sample size of 38 participants would be adequate to test a null hypothesis of nil benefit additional to routine rehabilitation for chronic stroke patients in a future randomized controlled trial.

  10. Evaluation of Clinical Gait Analysis parameters in patients affected by Multiple Sclerosis: Analysis of kinematics.

    Science.gov (United States)

    Severini, Giacomo; Manca, Mario; Ferraresi, Giovanni; Caniatti, Luisa Maria; Cosma, Michela; Baldasso, Francesco; Straudi, Sofia; Morelli, Monica; Basaglia, Nino

    2017-06-01

    Clinical Gait Analysis is commonly used to evaluate specific gait characteristics of patients affected by Multiple Sclerosis. The aim of this report is to present a retrospective cross-sectional analysis of the changes in Clinical Gait Analysis parameters in patients affected by Multiple Sclerosis. In this study a sample of 51 patients with different levels of disability (Expanded Disability Status Scale 2-6.5) was analyzed. We extracted a set of 52 parameters from the Clinical Gait Analysis of each patient and used statistical analysis and linear regression to assess differences among several groups of subjects stratified according to the Expanded Disability Status Scale and 6-Minutes Walking Test. The impact of assistive devices (e.g. canes and crutches) on the kinematics was also assessed in a subsample of patients. Subjects showed decreased range of motion at hip, knee and ankle that translated in increased pelvic tilt and hiking. Comparison between the two stratifications showed that gait speed during 6-Minutes Walking Test is better at discriminating patients' kinematics with respect to Expanded Disability Status Scale. Assistive devices were shown not to significantly impact gait kinematics and the Clinical Gait Analysis parameters analyzed. We were able to characterize disability-related trends in gait kinematics. The results presented in this report provide a small atlas of the changes in gait characteristics associated with different disability levels in the Multiple Sclerosis population. This information could be used to effectively track the progression of MS and the effect of different therapies. Copyright © 2017. Published by Elsevier Ltd.

  11. Gait apraxia in communicating hydrocephalus.

    Science.gov (United States)

    Estañol, B V

    1981-01-01

    Apraxia of gait in patients with communicating hydrocephalus appears in the context of a generalised motor disorder that includes defective righting reflexes, generalised increased tone to passive movements, grasp reflexes, difficulty with serial movements of the hands and defective smooth pursuit eye movements. The inability to walk does not appear to be due to a motor disorder but to release of proprioceptive supporting reactions. This mechanism is triggered by proprioceptive stimuli. PMID:7241157

  12. Increased gait unsteadiness in community-dwelling elderly fallers

    Science.gov (United States)

    Hausdorff, J. M.; Edelberg, H. K.; Mitchell, S. L.; Goldberger, A. L.; Wei, J. Y.

    1997-01-01

    OBJECTIVE: To test the hypothesis that quantitative measures of gait unsteadiness are increased in community-dwelling elderly fallers. STUDY DESIGN: Retrospective, case-control study. SETTING: General community. PARTICIPANTS: Thirty-five community-dwelling elderly subjects older than 70 years of age who were capable of ambulating independently for 6 minutes were categorized as fallers (age, 82.2 +/- 4.9 yrs [mean +/- SD]; n = 18) and nonfallers (age, 76.5 +/- 4.0 yrs; n = 17) based on history; 22 young (age, 24.6 +/- 1.9 yrs), healthy subjects also participated as a second reference group. MAIN OUTCOME MEASURES: Stride-to-stride variability (standard deviation and coefficient of variation) of stride time, stance time, swing time, and percent stance time measured during a 6-minute walk. RESULTS: All measures of gait variability were significantly greater in the elderly fallers compared with both the elderly nonfallers and the young subjects (p elderly fallers was similar to that of the nonfallers. There were little or no differences in the variability measures of the elderly nonfallers compared with the young subjects. CONCLUSIONS: Stride-to-stride temporal variations of gait are relatively unchanged in community-dwelling elderly nonfallers, but are significantly increased in elderly fallers. Quantitative measurement of gait unsteadiness may be useful in assessing fall risk in the elderly.

  13. Walking Gait Step Length Asymmetry Induced by Handheld Device.

    Science.gov (United States)

    Abid, Mahdi; Renaudin, Valerie; Aoustin, Yannick; Le-Carpentier, Eric; Robert, Thomas

    2017-11-01

    The modeling and feature extraction of human gait motion are crucial in biomechanics studies, human localization, and robotics applications. Recent studies in pedestrian navigation aim at extracting gait features based on the data of low-cost sensors embedded in handheld devices, such as smartphones. The general assumption in pedestrian dead reckoning (PDR) strategy for navigation application is that the presence of a device in hand does not impact the gait symmetry and that all steps are identical. This hypothesis, which is used to estimate the traveled distance, is investigated in this paper with an experimental study. Ten healthy volunteers participated in motion lab tests with a 0.190 kg device in hand. Several walking trials with different device carrying modes and several gait speeds were performed. For a fixed walking speed, it is shown that the steps differ in their duration when holding a mass equivalent to a smartphone mass, which invalidates classical symmetry hypothesis in the PDR step length modeling. It is also shown that this hypothesis can lead to a 2.5% to 6.3% error on the PDR estimated traveled distance for the different walking trials.

  14. Gait assessment with solesound instrumented footwear in spinal muscular atrophy.

    Science.gov (United States)

    Montes, Jacqueline; Zanotto, Damiano; Dunaway Young, Sally; Salazar, Rachel; De Vivo, Darryl C; Agrawal, Sunil

    2017-08-01

    Gait impairment is common in spinal muscular atrophy (SMA) and is described using clinical assessments and instrumented walkways. Continuous over-ground walking has not been studied. Nine SMA participants completed the 6-minute walk test (6MWT) and 10-meter walk/run wearing instrumented footwear (SoleSound). Data were simultaneously collected using a reference system (GAITRite). The root-mean-square error (RMSE) indicated criterion validity. The decrease in walking speed represented fatigue. Foot loading patterns were evaluated using force sensors. The RMSE for stride time, length, and velocity ranged from 1.3% to 1.7%. Fatigue was 11.6 ± 9.1%, which corresponded to an average deceleration of 0.37 ± 0.28 mm/s 2 . Participants spent most of their stance without heel contact. Forefoot contact occurred early in the gait cycle. These results suggest that footwear-based devices are an alternative to specialized equipment for gait assessment. Better understanding of gait disturbances should inform ongoing treatment efforts and provide a more sensitive outcome measure. Muscle Nerve 56: 230-236, 2017. © 2016 Wiley Periodicals, Inc.

  15. An online gait generator for quadruped walking using motor primitives

    Directory of Open Access Journals (Sweden)

    Chunlin Zhou

    2016-11-01

    Full Text Available This article presents implementation of an online gait generator on a quadruped robot. Firstly, the design of a quadruped robot is presented. The robot contains four leg modules each of which is constructed by a 2 degrees of freedom (2-DOF five-bar parallel linkage mechanism. Together with other two rotational DOF, the leg module is able to perform 4-DOF movement. The parallel mechanism of the robot allows all the servos attached on the body frame, so that the leg mass is decreased and motor load can be balanced. Secondly, an online gait generator based on dynamic movement primitives for the walking control is presented. Dynamic movement primitives provide an approach to generate periodic trajectories and they can be modulated in real time, which makes the online adjustment of walking gaits possible. This gait controller is tested by the quadruped robot in regulating walking speed, switching between forward\\backward movements and steering. The controller is easy to apply, expand and is quite effective on phase coordination and online trajectory modulation. Results of simulated experiments are presented.

  16. Gait Impairment in a Rat Model of Focal Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Saara Parkkinen

    2013-01-01

    Full Text Available The availability of proper tests for gait evaluation following cerebral ischemia in rats has been limited. The automated, quantitative CatWalk system, which was initially designed to measure gait in models of spinal cord injury, neuropathic pain, and peripheral nerve injury, is said to be a useful tool for the study of motor impairment in stroke animals. Here we report our experiences of using CatWalk XT with rats subjected to transient middle cerebral artery occlusion (MCAO, during their six-week followup. Large corticostriatal infarct was confirmed by MRI in all MCAO rats, which was associated with severe sensorimotor impairment. In contrast, the gait impairment was at most mild, which is consistent with seemingly normal locomotion of MCAO rats. Many of the gait parameters were affected by body weight, walking speed, and motivation despite the use of a goal box. In addition, MCAO rats showed bilateral compensation, which was developed to stabilize proper locomotion. All of these interferences may confound the data interpretation. Taken together, the translational applicability of CatWalk XT in evaluating motor impairment and treatment efficacy remains to be limited at least in rats with severe corticostriatal infarct and loss of body weight.

  17. Local dynamic stability and variability of gait are associated with fall history in elderly subjects.

    Science.gov (United States)

    Toebes, Marcel J P; Hoozemans, Marco J M; Furrer, Regula; Dekker, Joost; van Dieën, Jaap H

    2012-07-01

    Gait parameters that can be measured with simple instrumentation may hold promise for identifying individuals at risk of falling. Increased variability of gait is associated with increased risk of falling, but research on additional parameters indicates that local dynamic stability (LDS) of gait may also be a predictor of fall risk. The objective of the present study was to assess the association between gait variability, LDS of gait and fall history in a large sample of elderly subjects. Subjects were recruited and tested at a large national fair. One hundred and thirty four elderly, aged 50-75, who were able to walk without aids on a treadmill, agreed to participate. After subjects walked on a treadmill, LDS (higher values indicate more instability) and variability parameters were calculated from accelerometer signals (trunk worn). Fall history was obtained by self-report of falls in the past 12 months. Gait variability and short-term LDS were, individually and combined, positively associated with fall history. In conclusion, both increased gait variability and increased short-term LDS are possible risk factors for falling in the elderly. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. Biomechanical gait features associated with hip osteoarthritis: Towards a better definition of clinical hallmarks.

    Science.gov (United States)

    Meyer, Christophe A G; Corten, Kristoff; Fieuws, Steffen; Deschamps, Kevin; Monari, Davide; Wesseling, Mariska; Simon, Jean-Pierre; Desloovere, Kaat

    2015-10-01

    Critical appraisal of the literature highlights that the discriminative power of gait-related features in patients with hip osteoarthritis (OA) has not been fully explored. We aimed to reduce the number of gait-related features and define the most discriminative ones comparing the three-dimensional gait analysis of 20 patients with hip osteoarthritis (OA) with those of 17 healthy peers. First, principal component analysis was used to reduce the high-dimensional gait data into a reduced set of interpretable variables for further analysis, including tests for group differences. These differences were indicative for the selection of the top 10 variables to be included into linear discriminant analysis models (LDA). Our findings demonstrated the successful data reduction of hip osteoarthritic-related gait features with a high discriminatory power. The combination of the top variables into LDA models clearly separated groups, with a maximum misclassification error rate of 19%, estimated by cross-validation. Decreased hip/knee extension, hip flexion and internal rotation moment were gait features with the highest discriminatory power. This study listed the most clinically relevant gait features characteristics of hip OA. Moreover, it will help clinicians and physiotherapists understand the movement pathomechanics related to hip OA useful in the management and design of rehabilitation intervention. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  19. Effects of Dual-Channel Functional Electrical Stimulation on Gait Performance in Patients with Hemiparesis

    Directory of Open Access Journals (Sweden)

    Shmuel Springer

    2012-01-01

    Full Text Available The study objective was to assess the effect of functional electrical stimulation (FES applied to the peroneal nerve and thigh muscles on gait performance in subjects with hemiparesis. Participants were 45 subjects (age 57.8 ± 14.8 years with hemiparesis (5.37 ± 5.43 years since diagnosis demonstrating a foot-drop and impaired knee control. Thigh stimulation was applied either to the quadriceps or hamstrings muscles, depending on the dysfunction most affecting gait. Gait was assessed during a two-minute walk test with/without stimulation and with peroneal stimulation alone. A second assessment was conducted after six weeks of daily use. The addition of thigh muscles stimulation to peroneal stimulation significantly enhanced gait velocity measures at the initial and second evaluation. Gait symmetry was enhanced by the dual-channel stimulation only at the initial evaluation, and single-limb stance percentage only at the second assessment. For example, after six weeks, the two-minute gait speed with peroneal stimulation and with the dual channel was 0.66 ± 0.30 m/sec and 0.70 ± 0.31 m/sec, respectively (. In conclusion, dual-channel FES may enhance gait performance in subjects with hemiparesis more than peroneal FES alone.

  20. Gait rehabilitation machines based on programmable footplates

    OpenAIRE

    Schmidt, H.; Werner, C.; Bernhardt, R.; Hesse, S.; Krüger, J.

    2007-01-01

    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 traini...

  1. 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...

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

    NARCIS (Netherlands)

    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

  3. 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

  4. Association of gait and balance disorders with age-related white matter changes: the LADIS study

    DEFF Research Database (Denmark)

    Baezner, H.; Blahak, C.; Poggesi, A.

    2008-01-01

    . Quantitative tests of gait and balance include the Short Physical Performance Battery (SPPB; range: 0 [poor] to 12 [normal]), a timed 8-m walk, and a timed single leg stance test. RESULTS: In cross-sectional analysis, deficiencies in gait and balance performance were correlated with the severity of ARWMC (SPPB...... on different objective measures of gait and balance. METHODS: Six hundred thirty-nine nondisabled individuals were prospectively enrolled and are being followed-up for 3 years. Subjects are graded in three standardized categories of ARWMC (mild, moderate, and severe) according to central MRI reading......% CI 1.02 to 2.52; severe vs mild ARWMC: odds ratio 1.75, 95% CI 1.09 to 2.80). CONCLUSIONS: Our findings support a strong association between the severity of age-related white matter changes and the severity of gait and motor compromise. Physical activity might have the potential to reduce the risk...

  5. Gait recognition based on integral outline

    Science.gov (United States)

    Ming, Guan; Fang, Lv

    2017-02-01

    Biometric identification technology replaces traditional security technology, which has become a trend, and gait recognition also has become a hot spot of research because its feature is difficult to imitate and theft. This paper presents a gait recognition system based on integral outline of human body. The system has three important aspects: the preprocessing of gait image, feature extraction and classification. Finally, using a method of polling to evaluate the performance of the system, and summarizing the problems existing in the gait recognition and the direction of development in the future.

  6. Optics in gait analysis and anthropometry

    Science.gov (United States)

    Silva Moreno, Alejandra Alicia

    2013-11-01

    Since antiquity, human gait has been studied to understand human movement, the kind of gait, in some cases, can cause musculoskeletal disorders or other health problems; in addition, also from antiquity, anthropometry has been important for the design of human items such as workspaces, tools, garments, among others. Nowadays, thanks to the development of optics and electronics, more accurate studies of gait and anthropometry can be developed. This work will describe the most important parameters for gait analysis, anthropometry and the optical systems used.

  7. Variations in Kinematics during Clinical Gait Analysis in Stroke Patients

    OpenAIRE

    Boudarham, Julien; Roche, Nicolas; Pradon, Didier; Bonnyaud, C?line; Bensmail, Djamel; Zory, Raphael

    2013-01-01

    In addition to changes in spatio-temporal and kinematic parameters, patients with stroke exhibit fear of falling as well as fatigability during gait. These changes could compromise interpretation of data from gait analysis. The aim of this study was to determine if the gait of hemiplegic patients changes significantly over successive gait trials. Forty two stroke patients and twenty healthy subjects performed 9 gait trials during a gait analysis session. The mean and variability of spatio-tem...

  8. Backward compared to forward over ground gait retraining have additional benefits for gait in individuals with mild to moderate Parkinson's disease: A randomized controlled trial.

    Science.gov (United States)

    Grobbelaar, Roné; Venter, Ranel; Welman, Karen Estelle

    2017-10-01

    Over ground gait retraining in the reverse direction has shown to be beneficial for neurological rehabilitation, but has not yet been investigated in Parkinson's disease (PD). Backwards walking (BW) might be a useful training alternative to improve PD gait and possibly reduce fall risk during complex multi-directional daily activities. The primary aim was to compare the effect of an eight-week forward (FWG) and backwards (BWG) gait retraining program on gait parameters in PD individuals. Twenty-nine participants (aged 71.0±8.8years; UPDRS-III 38.1±12.3; H&Y 2.7±0.5) were randomly assigned to either the control (FWG; n=14) or experimental group (BWG; n=15). Baseline measures included disease severity (UPDRS III), global cognition (MoCA) and depression (PHQ-9). Outcome measures were selected gait variables on the 10m-instrumented-walk-test (i10mWT) assessed before and after the interventions. Both groups improved usual gait speed (FWG: p=0.03, d=0.35; BWG: p<0.01, d=0.35) and height-normalized gait speed (FWG: p=0.04, d=0.35; BWG: p<0.01, d=0.57). Additionally, the BWG demonstrated improved cadence (p<0.01, d=0.67) and stride length (SL; p=0.02, d=0.39). Both interventions were effective to improved gait speed sufficiently to independently navigate in the community. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Navigated Transcranial Magnetic Stimulation: A Biologically Based Assay of Lower Extremity Impairment and Gait Velocity

    OpenAIRE

    Peters, Heather T.; Dunning, Kari; Belagaje, Samir; Kissela, Brett M.; Ying, Jun; Laine, Jarmo; Page, Stephen J.

    2017-01-01

    Objectives. (a) To determine associations among motor evoked potential (MEP) amplitude, MEP latency, lower extremity (LE) impairment, and gait velocity and (b) determine the association between the presence of a detectable MEP signal with LE impairment and with gait velocity. Method. 35 subjects with chronic, stable LE hemiparesis were undergone TMS, the LE section of the Fugl-Meyer Impairment Scale (LE FM), and 10-meter walk test. We recorded presence, amplitude, and latency of MEPs in the a...

  10. Chemotherapy-induced-peripheral neuropathy, gait and fall risk in older adults following cancer treatment

    Directory of Open Access Journals (Sweden)

    Timothy F. Marshall

    2017-12-01

    Conclusion: Our investigation suggested that gait speed and step length are key indicators for fall risk. Compared to controls, cancer patients with CIPN may display slower gait velocities, shorter step length, and are at an increased fall risk as indicated by TUG scores. The presence of CIPN appears to increase fall risk, which may easily be assessed in a clinical setting using the TUG test.

  11. Balance and Gait Impairment in Transient Ischemic Attack and Minor Stroke.

    Science.gov (United States)

    Batchelor, Frances A; Williams, Susan B; Wijeratne, Tissa; Said, Catherine M; Petty, Sandra

    2015-10-01

    There has been little research into gait and balance impairment in transient ischemic attack (TIA) and minor stroke, despite these conditions affecting large numbers of people and the potential impact on function. The aim of this study was to determine the impact of TIA and minor stroke on gait and balance. Twelve people with TIA or minor stroke without previous gait/balance problems and 12 age- and sex-matched controls were recruited. Participants (mean age 67 years) underwent a comprehensive assessment including physiological, balance, and gait measures (clinical and computerized [NeuroCom/GAITRite]). Matched-pairs analysis was undertaken. Groups were similar in body mass index, vision, leg proprioception/strength, and reaction time. Cognition was worse in the TIA/minor stroke group: mean Montreal Cognitive Assessment score 22.2 versus 26.6, P = .001. People with TIA/minor stroke were significantly worse on all but one clinical test. Median scores for TIA/minor stroke versus control were as follows: Timed Up and Go (TUG), 9.4 versus 7.6 seconds, P = .019; TUG dual task, 12.3 versus 8.5 seconds, P = .012; Four Square Step Test, 10.9 versus 7.2 seconds, P = .006. Mean Step Test score for TIA/minor stroke versus control was 14.1 versus 17.7, P = .021. The TIA/minor stroke group also had significantly worse performance on computerized tests: increased turn time/sway, increased step length, slower comfortable/fast gait speeds, and greater proportion of gait cycle spent in double support. This study found that people with TIA/minor stroke have gait and balance dysfunction despite having no obvious physiological impairments. Intervention studies aimed at improving balance and gait in this population are needed. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  12. Gait of dairy cows on floors with different slipperiness.

    Science.gov (United States)

    Telezhenko, E; Magnusson, M; Bergsten, C

    2017-08-01

    This study assessed the slip resistance of different types of solid flooring in cattle housing using a range of technical tests and gait analysis. Dynamic and static coefficient of friction, skid resistance, and abrasiveness were tested on concrete flooring with a smooth finish, a grooved pattern, or a tamped pattern, acid-resistant mastic asphalt, soft rubber mats, and a worn slatted concrete floor. Coefficients of friction and skid resistance were tested under clean and slurry-soiled conditions. Linear kinematic variables were assessed in 40 cows with trackway measurements after the cows passed over the floors in a straight walk. All gait variables were assessed as deviations from those obtained on the slatted concrete floor, which was used as a baseline. The coefficient of friction tests divided the floors into 3 categories: concrete flooring, which had a low coefficient of friction (0.29-0.41); mastic asphalt flooring, which had medium values (0.38-0.45); and rubber mats, which had high values (0.49-0.57). The highest abrasion (g/10 m) was on the asphalt flooring (4.48), and the concrete flooring with a tamped pattern had significantly higher abrasiveness (2.77) than the other concrete floors (1.26-1.60). Lowest values on the skid-resistance tests (dry/wet) were for smooth concrete (79/35) and mastic asphalt (65/47), especially with a slurry layer on the surface. Gait analysis mainly differentiated floors with higher friction and abrasion by longer strides and better tracking. Step asymmetry was lower on floors with high skid-resistance values. The most secure cow gait, in almost every aspect, was observed on soft rubber mats. Relationships between gait variables and physical floor characteristics ranged from average to weak (partial correlations 0.54-0.16). Thus, none of the physical characteristics alone was informative enough to characterize slip resistance. With reference to gait analysis, the abrasiveness of the hard surfaces was more informative than the

  13. 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.

  14. Three-Dimensional Trunk and Lower Limbs Characteristics during Gait in Patients with Huntington's Disease

    Directory of Open Access Journals (Sweden)

    Elzbieta Mirek

    2017-10-01

    Full Text Available Objective: A number of studies on gait disturbances have been conducted, however, no clear pattern of gait disorders was described. The aim of the study was to characterize the gait pattern in HD patients by conducting analysis of mean angular movement changes the lower limb joints and trunk (kinematics parameters.Methods: The study group consisted of 30 patients with HD (17 women and 13 men. The reference data include the results of 30 healthy subjects (17 women and 13 men. Registration of gait with the Vicon 250 system was performed using passive markers attached to specific anthropometric points directly on the skin, based on the Golem biomechanical model (Oxford Metrics Ltd.. The research group and the control group were tested once.Results: Statistically significant (p < 0.05 angular changes in gait cycle for HD patients were observed in: insufficient plantar flexion during Loading Response and Pre-swing phases; insufficient flexion of the knee joint during Initial Swing and Mid Swing phases; excessive flexion of the hip in Terminal Stance and Pre-swing phases and over-normative forward inclination of the trunk in all gait phases. It should be noted that the group of patients with HD obtained, for all the mean angular movement changes higher standard deviation.Conclusion: A characteristic gait disorder common to all patients with HD occurring throughout the whole duration of the gait cycle is a pathological anterior tilt of the trunk. The results will significantly contribute to programming physiotherapy for people with HD, aimed at stabilizing the trunk in a position of extension during gait.

  15. The neural substrate of gait and executive function relationship in elderly women: A PET study.

    Science.gov (United States)

    Sakurai, Ryota; Ishii, Kenji; Yasunaga, Masashi; Takeuchi, Rumi; Murayama, Yoh; Sakuma, Naoko; Sakata, Muneyuki; Oda, Keiichi; Ishibashi, Kenji; Ishiwata, Kiichi; Fujiwara, Yoshinori; Montero-Odasso, Manuel

    2017-11-01

    Understanding the relationship between age-related gait impairment, such as slow gait, and executive functioning in seniors may help identify individuals at higher risk of mobility decline, falls, and progression to dementia at earlier stages. We aim to identify brain regions concomitantly associated with poor gait and executive functioning in a cohort of well-functioning elderly women. In total, 149 well-functioning women aged 70.1 ± 6.2 years underwent FDG-PET to evaluate regional cerebral metabolic rates of glucose normalized in reference to cerebellar glucose metabolic value (normalized-rCMRglc) in 16 brain areas. We assessed gait speed, step length and cadence under usual and fast conditions. Executive function was assessed using Trail-Making-Tests (TMT) A and B. Adjusted multiple regression analyses for potential covariates showed that TMT-B and ΔTMT (TMT B-A) were associated with gait speed and cadence at fast condition. Lower normalized-rCMRglc in the posterior cingulate and primary sensorimotor cortices were associated with longer TMT-B and ΔTMT times (i.e., lower executive function) as well as with slower gait speed and lower cadence at fast condition. Slower gait speed and lower cadence at fast condition were also associated with lower normalized-rCMRglc in the occipital and parietal cortices. There were no other significant associations. In healthy elderly women without impending disability or cognitive impairment, reduced glucose metabolism in the posterior cingulate and primary sensorimotor cortices were associated with both lower gait performance and executive functioning. Our results suggest that gait control and executive functions might share the same neural substrate. Geriatr Gerontol Int 2017; 17: 1873-1880. © 2017 Japan Geriatrics Society.

  16. Gait Variability Related to Muscle Quality and Muscle Power Output in Frail Nonagenarian Older Adults.

    Science.gov (United States)

    Martinikorena, Ion; Martínez-Ramírez, Alicia; Gómez, Marisol; Lecumberri, Pablo; Casas-Herrero, Alvaro; Cadore, Eduardo L; Millor, Nora; Zambom-Ferraresi, Fabricio; Idoate, Fernando; Izquierdo, Mikel

    2016-02-01

    Frailty has become the center of attention of basic, clinical, and demographic research because of its incidence level and the gravity of adverse outcomes with age. Moreover, with advanced age, motor variability increases, particularly in gait. Muscle quality and muscle power seem to be closely associated with performance on functional tests in frail populations. Insight into the relationships among muscle power, muscle quality, and functional capacity could improve the quality of life in this population. In this study, the relationship between the quality of the muscle mass and muscle strength with gait performance in a frail population was examined. Twenty-two institutionalized frail elderly individuals (93.1 ± 3.6) participated in this study. Muscle quality was measured by segmenting areas of high- and low-density fibers as observed in computed tomography images. The assessed functional outcomes were leg strength and power, velocity of gait, and kinematic gait parameters obtained from a tri-axial inertial sensor. Our results showed that a greater number of high-density fibers, specifically those of the quadriceps femoris muscle, were associated with better gait performance in terms of step time variability, regularity, and symmetry. Additionally, gait variability was associated with muscle power. In contrast, no significant relationship was observed between gait velocity and either muscle quality or muscle power. Gait pattern disorders could be explained by a deterioration of the lower limb muscles. It is known that an impaired gait is an important predictor of falls in older populations; thus, the loss of muscle quality and power could underlie the impairments in motor control and balance that lead to falls and adverse outcomes. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  17. Gait Is Associated with Cognitive Flexibility: A Dual-Tasking Study in Healthy Older People

    Directory of Open Access Journals (Sweden)

    Markus A. Hobert

    2017-05-01

    Full Text Available Objectives: To analyze which gait parameters are primarily influenced by cognitive flexibility, and whether such an effect depends on the walking condition used.Design: Cross-sectional analysis.Setting: Tübingen evaluation of Risk factors for Early detection of Neurodegenerative Disorders.Participants: A total of 661 non-demented individuals (49–80 years.Measurements: A gait assessment with four conditions was performed: a 20 m walk at convenient speed (C, at fast speed (F, at fast speed while checking boxes (FB, and while subtracting serial 7s (FS. Seven gait parameters from a wearable sensor-unit (McRoberts, Netherlands were compared with delta Trail-Making-Test (dTMT values, which is a measure of cognitive flexibility. Walking strategies of good and poor dTMT performers were compared by evaluating the patterns of gait parameters across conditions.Results: Five parameters correlated significantly with the dTMT in the FS condition, two parameters in the F and FB condition, and none in the C condition. Overall correlations were relatively weak. Gait speed was the gait parameter that most strongly correlated with the dTMT (r2 = 7.4%. In good, but not poor, dTMT performers differences between FB and FS were significantly different in variability-associated gait parameters.Conclusion: Older individuals need cognitive flexibility to perform difficult walking conditions. This association is best seen in gait speed. New and particularly relevant for recognition and training of deficits is that older individuals with poor cognitive flexibility have obviously fewer resources to adapt to challenging walking conditions. Our findings partially explain gait deficits in older adults with poor cognitive flexibility.

  18. Balance and Gait Represent Independent Domains of Mobility in Parkinson Disease

    Science.gov (United States)

    Horak, Fay B.; Carlson-Kuhta, Patricia; Nutt, John G.; Salarian, Arash

    2016-01-01

    Background The Instrumented Stand and Walk (ISAW) test, which includes 30 seconds of stance, step initiation, gait, and turning, results in many objective balance and gait metrics from body-worn inertial sensors. However, it is not clear which metrics provide independent information about mobility. Objective It was hypothesized that balance and gait represent several independent domains of mobility and that not all domains would be abnormal in individuals with Parkinson disease (PD) or would change with levodopa therapy. Design This was a cross-sectional study. Methods A factor analysis approach was used to identify independent measures of mobility extracted from the ISAW in 100 participants with PD and 21 control participants. First, a covariance analysis showed that postural sway measures were independent of gait measures. Then, the factor analysis revealed 6 independent factors (mobility domains: sway area, sway frequency, arm swing asymmetry, trunk motion during gait, gait speed, and cadence) that accounted for 87% of the variance of performance across participants. Results Sway area, gait speed, and trunk motion differed between the PD group in the off-levodopa state and the control group, but sway frequency (but not sway area) differed between the PD group in the off-levodopa state and the control group. Four of the 6 factors changed significantly with levodopa (off to on): sway area, sway frequency, trunk motion during gait, and cadence. When participants were on levodopa, the sway area increased compared with off levodopa, becoming more abnormal, whereas the other 3 significant metrics moved toward, but did not reach, the healthy control values. Limitations Exploratory factor analysis was limited to the PD population. Conclusions The different sensitivity various balance and gait domains to PD and to levodopa also support neural control of at least 6 independent mobility domains, each of which warrants clinical assessment for impairments in mobility. PMID

  19. Balance and Gait Represent Independent Domains of Mobility in Parkinson Disease.

    Science.gov (United States)

    Horak, Fay B; Mancini, Martina; Carlson-Kuhta, Patricia; Nutt, John G; Salarian, Arash

    2016-09-01

    The Instrumented Stand and Walk (ISAW) test, which includes 30 seconds of stance, step initiation, gait, and turning, results in many objective balance and gait metrics from body-worn inertial sensors. However, it is not clear which metrics provide independent information about mobility. It was hypothesized that balance and gait represent several independent domains of mobility and that not all domains would be abnormal in individuals with Parkinson disease (PD) or would change with levodopa therapy. This was a cross-sectional study. A factor analysis approach was used to identify independent measures of mobility extracted from the ISAW in 100 participants with PD and 21 control participants. First, a covariance analysis showed that postural sway measures were independent of gait measures. Then, the factor analysis revealed 6 independent factors (mobility domains: sway area, sway frequency, arm swing asymmetry, trunk motion during gait, gait speed, and cadence) that accounted for 87% of the variance of performance across participants. Sway area, gait speed, and trunk motion differed between the PD group in the off-levodopa state and the control group, but sway frequency (but not sway area) differed between the PD group in the off-levodopa state and the control group. Four of the 6 factors changed significantly with levodopa (off to on): sway area, sway frequency, trunk motion during gait, and cadence. When participants were on levodopa, the sway area increased compared with off levodopa, becoming more abnormal, whereas the other 3 significant metrics moved toward, but did not reach, the healthy control values. Exploratory factor analysis was limited to the PD population. The different sensitivity various balance and gait domains to PD and to levodopa also support neural control of at least 6 independent mobility domains, each of which warrants clinical assessment for impairments in mobility. © 2016 American Physical Therapy Association.

  20. 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

  1. Gait variability and motor control in people with knee osteoarthritis.

    Science.gov (United States)

    Alkjaer, Tine; Raffalt, Peter C; Dalsgaard, Helle; Simonsen, Erik B; Petersen, Nicolas C; Bliddal, Henning; Henriksen, Marius

    2015-10-01

    Knee osteoarthritis (OA) is a common disease that impairs walking ability and function. We compared the temporal gait variability and motor control in people with knee OA with healthy controls. The purpose was to test the hypothesis that the temporal gait variability would reflect a more stereotypic pattern in people with knee OA compared with healthy age-matched subjects. To assess the gait variability the temporal structure of the ankle and knee joint kinematics was quantified by the largest Lyapunov exponent and the stride time fluctuations were quantified by sample entropy and detrended fluctuation analysis. The motor control was assessed by the soleus (SO) Hoffmann (H)-reflex modulation and muscle co-activation during walking. The results showed no statistically significant mean group differences in any of the gait variability measures or muscle co-activation levels. The SO H-reflex amplitude was significantly higher in the knee OA group around heel strike when compared with the controls. The mean group difference in the H-reflex in the initial part of the stance phase (control-knee OA) was -6.6% Mmax (95% CI: -10.4 to -2.7, p=0.041). The present OA group reported relatively small impact of their disease. These results suggest that the OA group in general sustained a normal gait pattern with natural variability but with suggestions of facilitated SO H-reflex in the swing to stance phase transition. We speculate that the difference in SO H-reflex modulation reflects that the OA group increased the excitability of the soleus stretch reflex as a preparatory mechanism to avoid sudden collapse of the knee joint which is not uncommon in knee OA. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Gait analysis in a mouse model resembling Leigh disease.

    Science.gov (United States)

    de Haas, Ria; Russel, Frans G; Smeitink, Jan A

    2016-01-01

    Leigh disease (LD) is one of the clinical phenotypes of mitochondrial OXPHOS disorders and also known as sub-acute necrotizing encephalomyelopathy. The disease has an incidence of 1 in 77,000 live births. Symptoms typically begin early in life and prognosis for LD patients is poor. Currently, no clinically effective treatments are available. Suitable animal and cellular models are necessary for the understanding of the neuropathology and the development of successful new therapeutic strategies. In this study we used the Ndufs4 knockout (Ndufs4(-/-)) mouse, a model of mitochondrial complex I deficiency. Ndusf4(-/-) mice exhibit progressive neurodegeneration, which closely resemble the human LD phenotype. When dissecting behavioral abnormalities in animal models it is of great importance to apply translational tools that are clinically relevant. To distinguish gait abnormalities in patients, simple walking tests can be assessed, but in animals this is not easy. This study is the first to demonstrate automated CatWalk gait analysis in the Ndufs4(-/-) mouse model. Marked differences were noted between Ndufs4(-/-) and control mice in dynamic, static, coordination and support parameters. Variation of walking speed was significantly increased in Ndufs4(-/-) mice, suggesting hampered and uncoordinated gait. Furthermore, decreased regularity index, increased base of support and changes in support were noted in the Ndufs4(-/-) mice. Here, we report the ability of the CatWalk system to sensitively assess gait abnormalities in Ndufs4(-/-) mice. This objective gait analysis can be of great value for intervention and drug efficacy studies in animal models for mitochondrial disease. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease?

    Directory of Open Access Journals (Sweden)

    Ryan P. Duncan

    2012-01-01

    Full Text Available Introduction. We aimed to determine whether gait velocity is as useful as a balance test, a self-report measure of freezing of gait (FOG, and/or a measure of motor symptom severity for predicting falls among people with Parkinson Disease (PD. Methods. Fifty-six individuals with idiopathic PD completed a baseline assessment consisting of these measures: (1 MDS-UPDRS III, (2 Mini-BESTest, (3 gait velocity (forward, backward, dual task, and fast, and (4 FOGQ. Retrospective fall history was collected at baseline and six months later. Participants were considered fallers if they had two or more falls in the surveillance period. Ability of the tests to discriminate between fallers and nonfallers was determined using ROC curves followed by pairwise statistical noninferiority comparisons (P=.05 of the area under the ROC curve (AUC for each test. Results. At six months, 22% (n=21 of the sample were fallers. Fallers differed significantly from nonfallers on the MDS-UPDRS III, Mini-BESTest, backward gait velocity, and FOGQ. The Mini-BESTest had the highest AUC and was superior to all gait velocity measures at identifying fallers. Conclusion. A single measure of gait velocity, even in a challenging condition, may not be as effective as the Mini-BESTest in identifying fallers among people with PD.

  4. First signs of elderly gait for women

    Directory of Open Access Journals (Sweden)

    Katarzyna Kaczmarczyk

    2017-08-01

    Full Text Available Background: 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. Material and Methods: 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. Results: The factor analysis identified 2 factors – labelled Time and Rhythm – that accounted for 72% of the variation in significant free-gait parameters; the principal component analysis identified 4 of these parameters that permit full clinical evaluation of gait quality. No difference was found between the groups in terms of the values of parameters reflecting the temporal nature of gait (Rhythm, namely step time, stride time and cadence, whereas significant differences were found for total double support phase (p < 0.001. Next, seeking evidence of a critical decline in gait, we selected 3 parameters: total double support, stride time and velocity. We concluded that the women taking part in the experiment manifested significant signs of senile gait after the age of 60 years old, with the first symptoms thereof already manifesting themselves after 50 years of age. Conclusions: 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

  5. 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.

  6. Underwater gait analysis in Parkinson's disease.

    Science.gov (United States)

    Volpe, Daniele; Pavan, Davide; Morris, Meg; Guiotto, Annamaria; Iansek, Robert; Fortuna, Sofia; Frazzitta, Giuseppe; Sawacha, Zimi

    2017-02-01

    Although hydrotherapy is one of the physical therapies adopted to optimize gait rehabilitation in people with Parkinson disease, the quantitative measurement of gait-related outcomes has not been provided yet. This work aims to document the gait improvements in a group of parkinsonians after a hydrotherapy program through 2D and 3D underwater and on land gait analysis. Thirty-four parkinsonians and twenty-two controls were enrolled, divided into two different cohorts. In the first one, 2 groups of patients underwent underwater or land based walking training; controls underwent underwater walking training. Hence pre-treatment 2D underwater and on land gait analysis were performed, together with post-treatment on land gait analysis. Considering that current literature documented a reduced movement amplitude in parkinsonians across all lower limb joints in all movement planes, 3D underwater and on land gait analysis were performed on a second cohort of subjects (10 parkinsonians and 10 controls) who underwent underwater gait training. Baseline land 2D and 3D gait analysis in parkinsonians showed shorter stride length and slower speed than controls, in agreement with previous findings. Comparison between underwater and on land gait analysis showed reduction in stride length, cadence and speed on both parkinsonians and controls. Although patients who underwent underwater treatment exhibited significant changes on spatiotemporal parameters and sagittal plane lower limb kinematics, 3D gait analysis documented a significant (p<0.05) improvement in all movement planes. These data deserve attention for research directions promoting the optimal recovery and maintenance of walking ability. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  7. Vyšetření chůze : srovnání testů a vyšetřovacích metod

    OpenAIRE

    Vobrubová, Dita

    2010-01-01

    This thesis focuses on gait examination of hemiparetic patients. The first part addresses general pieces of knowledge about gait, examination options, application of examinational gait tests in the physical therapy, and description of hemiparesis. The second part is summary of my practical experience with gait examinations of hemiparetic patients. The goal of this thesis is to try and evaluate options of tests and gait examinational methods: The Rancho Los Amigos Observational Gait Analysis...

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

    Science.gov (United States)

    van Iersel, Marianne B; Olde Rikkert, Marcel G M; Borm, George F

    2007-07-01

    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 measures. We developed a simple statistical method to obtain gait and balance variables for each participant that are independent of gait velocity. The first step of our standardization method was the transformation of the gait and balance data to obtain a normal distribution and decrease the influence of outliers. Thereafter, we constructed a formula, based on regression analysis that described how these data varied with gait velocity in each participant during walking without an additional task. Last, this formula was used to standardize the gait and balance data for the effect of gait velocity for each individual participant. As example we present the analysis of mediolateral displacements of the trunk in fit elderly people during walking with and without a dual task.

  9. Effect of Virtual Reality Training on Balance and Gait Ability in Patients With Stroke: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    de Rooij, Ilona J M; van de Port, Ingrid G L; Meijer, Jan-Willem G

    2016-12-01

    Virtual reality (VR) training is considered to be a promising novel therapy for balance and gait recovery in patients with stroke. The aim of this study was to conduct a systematic literature review with meta-analysis to investigate whether balance or gait training using VR is more effective than conventional balance or gait training in patients with stroke. A literature search was carried out in the databases PubMed, Embase, MEDLINE, and Cochrane Library up to December 1, 2015. Randomized controlled trials that compared the effect of balance or gait training with and without VR on balance and gait ability in patients with stroke were included. Twenty-one studies with a median PEDro score of 6.0 were included. The included studies demonstrated a significant greater effect of VR training on balance and gait recovery after stroke compared with conventional therapy as indicated with the most frequently used measures: gait speed, Berg Balance Scale, and Timed "Up & Go" Test. Virtual reality was more effective to train gait and balance than conventional training when VR interventions were added to conventional therapy and when time dose was matched. The presence of publication bias and diversity in included studies were limitations of the study. The results suggest that VR training is more effective than balance or gait training without VR for improving balance or gait ability in patients with stroke. Future studies are recommended to investigate the effect of VR on participation level with an adequate follow-up period. Overall, a positive and promising effect of VR training on balance and gait ability is expected. © 2016 American Physical Therapy Association.

  10. Assessment of changes in gait parameters and vertical ground reaction forces after total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Bhargava P

    2007-01-01

    Full Text Available The principal objectives of arthroplasty are relief of pain and enhancement of range of motion. Currently, postoperative pain and functional capacity are assessed largely on the basis of subjective evaluation scores. Because of the lack of control inherent in this method it is often difficult to interpret data presented by different observers in the critical evaluation of surgical method, new components and modes of rehabilitation. Gait analysis is a rapid, simple and reliable method to assess functional outcome. This study was undertaken in an effort to evaluate the gait characteristics of patients who underwent arthroplasty, using an Ultraflex gait analyzer. Materials and Methods: The study was based on the assessment of gait and weight-bearing pattern of both hips in patients who underwent total hip replacement and its comparison with an age and sex-matched control group. Twenty subjects of total arthroplasty group having unilateral involvement, operated by posterior approach at our institution with a minimum six-month postoperative period were selected. Control group was age and sex-matched, randomly selected from the general population. Gait analysis was done using Ultraflex gait analyzer. Gait parameters and vertical ground reaction forces assessment was done by measuring the gait cycle properties, step time parameters and VGRF variables. Data of affected limb was compared with unaffected limb as well as control group to assess the weight-bearing pattern. Statistical analysis was done by′t′ test. Results: Frequency is reduced and gait cycle duration increased in total arthroplasty group as compared with control. Step time parameters including Step time, Stance time and Single support time are significantly reduced ( P value < .05 while Double support time and Single swing time are significantly increased ( P value < .05 in the THR group. Forces over each sensor are increased more on the unaffected limb of the THR group as compared to

  11. Spinal cord stimulation therapy for gait dysfunction in advanced Parkinson's disease patients.

    Science.gov (United States)

    Samotus, Olivia; Parrent, Andrew; Jog, Mandar

    2018-02-14

    Benefits of dopaminergic therapy and deep brain stimulation are limited and unpredictable for axial symptoms in Parkinson's disease. Dorsal spinal cord stimulation may be a new therapeutic approach. The objective of this study was to investigate the therapeutic effect of spinal cord stimulation on gait including freezing of gait in advanced PD patients. Five male PD participants with significant gait disturbances and freezing of gait underwent midthoracic spinal cord stimulation. Spinal cord stimulation combinations (200-500 μs/30-130 Hz) at suprathreshold intensity were tested over a 1- to 4-month period, and the effects of spinal cord stimulation were studied 6 months after spinal cord stimulation surgery. Protokinetics Walkway measured gait parameters. Z scores per gait variable established each participant's best spinal cord stimulation setting. Timed sit-to-stand and automated freezing-of-gait detection using foot pressures were analyzed. Freezing of Gait Questionnaire (FOG-Q), UPDRS motor items, and activities-specific balance confidence scale were completed at each study visit. Spinal cord stimulation setting combinations of 300-400 μs/30-130 Hz provided gait improvements. Although on-medication/on-stimulation at 6 months, mean step length, stride velocity, and sit-to-stand improved by 38.8%, 42.3%, and 50.3%, respectively, mean UPDRS, Freezing of Gait Questionnaire, and activities-specific balance confidence scale scores improved by 33.5%, 26.8%, and 71.4%, respectively. The mean number of freezing-of-gait episodes reduced significantly from 16 presurgery to 0 at 6 months while patients were on levodopa and off stimulation. By using objective measures to detect dynamic gait characteristics, the therapeutic potential of spinal cord stimulation was optimized to each participant's characteristics. This pilot study demonstrated the safety and significant therapeutic outcome of spinal cord stimulation in advanced PD patients, and thus a larger and longer

  12. A protocol to examine vision and gait in Parkinson’s disease: impact of cognition and response to visual cues [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Samuel Stuart

    2016-03-01

    Full Text Available Background Cognitive and visual impairments are common in Parkinson’s disease (PD and contribute to gait deficit and falls. To date, cognition and vision in gait in PD have been assessed separately. Impact of both functions (which we term ‘visuo-cognition’ on gait however is likely interactive and can be tested using visual sampling (specifically saccadic eye movements to provide an online behavioural measure of performance. Although experiments using static paradigms show saccadic impairment in PD, few studies have quantified visual sampling during dynamic motor tasks such as gait. This article describes a protocol developed for testing visuo-cognition during gait in order to examine the: 1 independent roles of cognition and vision in gait in PD, 2 interaction between both functions, and 3 role of visuo-cognition in gait in PD. Methods Two groups of older adults (≥50 years old were recruited; non-demented people with PD (n=60 and age-matched controls (n=40. Participants attended one session and a sub-group (n=25 attended two further sessions in order to establish mobile eye-tracker reliability. Participants walked in a gait laboratory under different attentional (single and dual task, environmental (walk straight, through a door and turning, and cueing (no visual cues and visual cues conditions. Visual sampling was recorded using synchronised mobile eye-tracker and electrooculography systems, and gait was measured using 3D motion analysis. Discussion This exploratory study examined visuo-cognitive processes and their impact on gait in PD. Improved understanding of the influence of cognitive and visual functions on visual sampling during gait and gait in PD will assist in development of interventions to improve gait and reduce falls risk. This study will also help establish robust mobile eye-tracking methods in older adults and people with PD.

  13. Implementation of an iPhone as a wireless accelerometer for quantifying gait characteristics.

    Science.gov (United States)

    Lemoyne, Robert; Mastroianni, Timothy; Cozza, Michael; Coroian, Cristian; Grundfest, Warren

    2010-01-01

    The capacity to quantify and evaluate gait beyond the general confines of a clinical environment under effectively autonomous conditions may alleviate rampant strain on limited and highly specialized medical resources. An iPhone consists of a three dimensional accelerometer subsystem with highly robust and scalable software applications. With the synthesis of the integral iPhone features, an iPhone application, which constitutes a wireless accelerometer system for gait quantification and analysis, has been tested and evaluated in an autonomous environment. The acquired gait cycle data was transmitted wireless and through email for subsequent post-processing in a location remote to the location where the experiment was conducted. The iPhone application functioning as a wireless accelerometer for the acquisition of gait characteristics has demonstrated sufficient accuracy and consistency.

  14. Relation of Stump Length with Various Gait Parameters in Trans-tibial Amputee

    Directory of Open Access Journals (Sweden)

    Koyel Majumdar

    2008-07-01

    Full Text Available The purpose of this paper is evaluating the impact of stump length of unilateral below knee amputees (BKA on different gait parameters. Nine unilateral BKA were chosen and divided into three groups comprising patients with short, medium, and long stump length. Each of them underwent gait analysis test by Computer Dynography (CDG system to measure the gait parameters. It was found that the ground reaction force is higher in the patients with medium stump length whereas the velocity, step length both for the prosthetic and sound limb and cadence were high in longer stump length. Statistical analysis shows a significant difference (p<0.05 between the gait parameters of BKA with medium and longer stump length. The patients with longer stump length were more efficient than medium and short stump patients as they consumed comparatively lesser energy while walking with self-selected velocity and conventional (Solid ankle cushioned heel SACH foot.

  15. A Manipulation of Visual Feedback during Gait Training in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Quincy J. Almeida

    2012-01-01

    Full Text Available Visual cues are known to improve gait in Parkinson's disease (PD; however, the contribution of optic flow continues to be disputed. This study manipulated transverse line cues during two gait training interventions (6 weeks. PD subjects (N=42 were assigned to one of three groups: treadmill (TG, overground (OG, or control group (CG. Participants walked across lines placed on either treadmills or 16-meter carpets, respectively. The treadmill (TG offered a reduced dynamic flow from the environment, while lines presented on the ground (OG emphasized optic flow related to the participant's own displacement. Both interventions significantly improved (and maintained through retention period step length, thus improving walking velocity. Only the OG improved in the TUG test, while only the TG showed hints of improving (and maintaining motor symptoms. Since gait improvements were found in both training groups, we conclude that by reducing optic flow, gait benefits associated with visual cueing training can still be achieved.

  16. Partition of aerobic and anaerobic swimming costs related to gait transitions in a labriform swimmer

    DEFF Research Database (Denmark)

    Svendsen, Jon Christian; Tudorache, Christian; Jordan, Anders D.

    2010-01-01

    was to partition aerobic and anaerobic swimming costs at speeds below and above the Up–c in the striped surfperch Embiotoca lateralis using swimming respirometry and video analysis to test the hypothesis that the gait transition marks the switch from aerobic to anaerobic power output. Exercise oxygen consumption......Members of the family Embiotocidae exhibit a distinct gait transition from exclusively pectoral fin oscillation to combined pectoral and caudal fin propulsion with increasing swimming speed. The pectoral–caudal gait transition occurs at a threshold speed termed Up–c. The objective of this study...... included caudal fin propulsion in a mostly steady and unsteady (burst-assisted) mode, respectively. There was no evidence of EPOC after swimming at 1.4 and 1.9 L s–1, indicating that the pectoral–caudal gait transition was not a threshold for anaerobic metabolism. At 2.3 L s–1, E. lateralis switched...

  17. Lateral balance control for robotic gait training

    NARCIS (Netherlands)

    Koopman, Bram; Meuleman, Jos; van Asseldonk, Edwin H.F.; van der Kooij, Herman

    2013-01-01

    For the rehabilitation of neurological patients robot-aided gait training is increasingly being used. Lack of balance training in these robotic gait trainers might contribute to the fact that they do not live up to the expectations. Therefore, in this study we developed and evaluated an algorithm to

  18. Gait Analysis by Multi Video Sequence Analysis

    DEFF Research Database (Denmark)

    Jensen, Karsten; Juhl, Jens

    2009-01-01

    and the calcaneus angle during gait. In the introductory phase of the project the task has been to select, purchase and draw up hardware, select and purchase software concerning video streaming and to develop special software concerning automated registration of the position of the foot during gait by Multi Video...

  19. 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...

  20. Estimating Instantaneous Energetic Cost During Gait Adaptation

    Science.gov (United States)

    2014-08-31

    energetic penalties imposed by various gait disabilities, and the 30   evaluation of the effectiveness of rehabilitation interventions at mitigating...Jarasch R. Energy expenditure and biomechanical characteristics of 412   lower limb amputee gait:: The influence of prosthetic alignment and

  1. Shotgun approaches to gait analysis : insights & limitations

    NARCIS (Netherlands)

    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

  2. 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

  3. Gait Analysis by High School Students

    Science.gov (United States)

    Heck, Andre; van Dongen, Caroline

    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 motions with a video analysis tool and via…

  4. Gender may have an influence on the relationship between Functional Movement Screen scores and gait parameters in elite junior athletes - A pilot study.

    Science.gov (United States)

    Magyari, N; Szakács, V; Bartha, C; Szilágyi, B; Galamb, K; Magyar, M O; Hortobágyi, T; Kiss, R M; Tihanyi, J; Négyesi, J

    2017-09-01

    Aims The aim of this study was to examine the effects of gender on the relationship between Functional Movement Screen (FMS) and treadmill-based gait parameters. Methods Twenty elite junior athletes (10 women and 10 men) performed the FMS tests and gait analysis at a fixed speed. Between-gender differences were calculated for the relationship between FMS test scores and gait parameters, such as foot rotation, step length, and length of gait line. Results Gender did not affect the relationship between FMS and treadmill-based gait parameters. The nature of correlations between FMS test scores and gait parameters was different in women and men. Furthermore, different FMS test scores predicted different gait parameters in female and male athletes. FMS asymmetry and movement asymmetries measured by treadmill-based gait parameters did not correlate in either gender. Conclusion There were no interactions between FMS, gait parameters, and gender; however, correlation analyses support the idea that strength and conditioning coaches need to pay attention not only to how to score but also how to correctly use FMS.

  5. Average Gait Differential Image Based Human Recognition

    Directory of Open Access Journals (Sweden)

    Jinyan Chen

    2014-01-01

    Full Text Available The difference between adjacent frames of human walking contains useful information for human gait identification. Based on the previous idea a silhouettes difference based human gait recognition method named as average gait differential image (AGDI is proposed in this paper. The AGDI is generated by the accumulation of the silhouettes difference between adjacent frames. The advantage of this method lies in that as a feature image it can preserve both the kinetic and static information of walking. Comparing to gait energy image (GEI, AGDI is more fit to representation the variation of silhouettes during walking. Two-dimensional principal component analysis (2DPCA is used to extract features from the AGDI. Experiments on CASIA dataset show that AGDI has better identification and verification performance than GEI. Comparing to PCA, 2DPCA is a more efficient and less memory storage consumption feature extraction method in gait based recognition.

  6. Gait outcome following outpatient physiotherapy based on the Bobath concept in people post stroke.

    Science.gov (United States)

    Lennon, Sheila; Ashburn, Ann; Baxter, David

    The purpose of this study was to characterize the gait cycle of patients with hemiplegia before and after a period of outpatient physiotherapy based on the Bobath concept. Nine patients, at least 6 weeks post stroke and recently discharged from a stroke unit, were measured before and after a period of outpatient physiotherapy (mean duration = 17.4 weeks). Therapy was documented using a treatment checklist for each patient. The primary outcome measures were a number of gait variables related to the therapists' treatment hypothesis, recorded during the gait cycle using the CODA motion analysis system. Other secondary outcome measures were the Motor Assessment Scale, Modified Ashworth Scale, subtests of the Sodring Motor Evaluation Scale, the Step test, a 10-m walk test, the Barthel Index and the London Handicap Score. Recovery of more normal gait patterns in the gait cycle (using motion analysis) did not occur. Significant changes in temporal parameters (loading response, single support time) for both legs, in one kinematic (dorsiflexion during stance) and one kinetic variable on the unaffected side (hip flexor moment), and most of the clinical measures of impairment, activity and participation (with the exception of the Modified Ashworth Scale and the 10-m walk) were noted. Study findings did not support the hypothesis that the Bobath approach restored more normal movement patterns to the gait cycle. Further research is required to investigate the treatment techniques that are effective at improving walking ability in people after stroke.

  7. The relationship between anterior pelvic tilt and gait, balance in patient with chronic stroke.

    Science.gov (United States)

    Kim, Myoung-Kwon; Kim, Seong-Gil; Shin, Young-Jun; Choi, Eun-Hong; Choe, Yu-Won

    2018-01-01

    [Purpose] The aim of this study is to find out the association between anterior pelvic tilt and gait and balance in chronic stroke. [Subjects and Methods] Fourteen chronic stroke patients were included in this study. A palpation meter was employed to measure the anterior inclination of the pelvis. A GAITRite system automates measuring temporal and spatial gait parameters. A 10-Meter Walk test was used to measure gait speed. The Timed Up and Go test was used to measure the dynamic balance ability and gait ability of the participants. A BioRescue was used to assess balance by measuring the moving distance and area of the center of pressure. [Results] There were significant negative correlations between pelvic anterior tilt and velocity, step length, and stride. There were significant positive correlations between velocity and cadence, step length, and stride length. There were significant negative correlations between velocity and cycle time, H-H base, TUG, and 10MWT. There was significant negative correlation between cadence and cycle time and H-H base. [Conclusion] This study showed a negative correlation between pelvic anterior tilt and gait function including gait speed and step length.

  8. CatWalk gait analysis in a rat model of multiple sclerosis.

    Science.gov (United States)

    Herold, Sabine; Kumar, Prateek; Jung, Klaus; Graf, Irina; Menkhoff, Henrike; Schulz, Xenia; Bähr, Mathias; Hein, Katharina

    2016-11-30

    Myelin oligodendrocyte glycoprotein (MOG)-induced experimental autoimmune encephalomyelitis (EAE) is a widely used animal model for multiple sclerosis. The characteristic feature of the MOG-EAE model in Brown Norway rats is consistent involvement of the spinal cord resulting in limb paresis. The aim of the study was to investigate whether early subclinical gait abnormalities are present in this animal model and can be detected by CatWalk XT, a fully automated gait analysis system. Furthermore, we investigated the usability of CatWalk system for treatment studies. Our gait analysis showed no preclinical abnormalities in MOG-EAE animals. Nevertheless, we characterized a combination of gait parameters that display a high predictive capacity in regard to disease onset. Our detailed histopathological analysis of the spinal cord revealed that lesion formation starts in the lumbar region and propagates toward the cervical part of the spinal cord during the disease course. In the treatment study, the stabilization of gait parameters under the treatment with methylprednisolone was detected in CatWalk as well as in traditional EAE-scoring system. The results from CatWalk test indicate no benefit of lab-intensive automated gait system in EAE-model with chronic-progressive disease course as well as in therapeutic studies with pronounced effect on the severity of clinical symptoms. However, due to its quantitative and objective nature this system may display a refined test to detect small but functional relevant changes in regeneration-orientated studies.

  9. Effects of an inclined walking surface and balance abilities on spatiotemporal gait parameters of older adults.

    Science.gov (United States)

    Ferraro, Richard A; Pinto-Zipp, Genevieve; Simpkins, Susan; Clark, MaryAnn

    2013-01-01

    To date, few studies have investigated how walking patterns on inclines change in healthy older adults. The purpose of the study was to examine the effects of an inclined walking surface and balance abilities on various spatiotemporal gait parameters of healthy older adults. Seventy-eight self-reported independent community ambulators (mean age, 77.8 years; SD, 4.8) participated in this study. After completing the Berg Balance Scale and Dynamic Gait Index (DGI), all participants were asked to walk on the GaitRite on level and inclined surfaces (10° slope). Dependent t tests were used to determine statistical significance between level and inclined surfaces for cadence, step length, velocity, and gait stability ratio (GSR). GSR is a measure of the degree of adaptation an individual makes to increase stability during gait derived from a ratio of cadence/velocity. A 2 2 analysis of variance was performed to determine differences in means among the higher-risk participants (as determined by the Berg Balance Scale and Dynamic Gait Index) comparing their level and incline walking patterns. The level of significance was set at P 0.05. During incline walking a significant decrease occurred in mean step length, 63.1(8.8) cm, P 0.001, mean cadence, 111.6 (8.9) step/min, P 0.01 and mean normalized velocity, 1.4 (0.23), P 0.001. However, mean GSR increased on inclines, 1.62 (0.22) steps/m, P 0.004. Main effects were evident for both walking surface and fall risk for all gait parameters tested. Healthy older adults adopt a more stable gait pattern on inclines decreasing velocity and spending more time in the double support despite the increased physiological demands to perform this task. Clear changes were evident between level and incline surfaces regardless of fall risk as defined by 2 different objective balance measures [corrected].

  10. 3D gait assessment in young and elderly subjects using foot-worn inertial sensors.

    Science.gov (United States)

    Mariani, Benoit; Hoskovec, Constanze; Rochat, Stephane; Büla, Christophe; Penders, Julien; Aminian, Kamiar

    2010-11-16

    This study describes the validation of a new wearable system for assessment of 3D spatial parameters of gait. The new method is based on the detection of temporal parameters, coupled to optimized fusion and de-drifted integration of inertial signals. Composed of two wirelesses inertial modules attached on feet, the system provides stride length, stride velocity, foot clearance, and turning angle parameters at each gait cycle, based on the computation of 3D foot kinematics. Accuracy and precision of the proposed system were compared to an optical motion capture system as reference. Its repeatability across measurements (test-retest reliability) was also evaluated. Measurements were performed in 10 young (mean age 26.1±2.8 years) and 10 elderly volunteers (mean age 71.6±4.6 years) who were asked to perform U-shaped and 8-shaped walking trials, and then a 6-min walking test (6MWT). A total of 974 gait cycles were used to compare gait parameters with the reference system. Mean accuracy±precision was 1.5±6.8cm for stride length, 1.4±5.6cm/s for stride velocity, 1.9±2.0cm for foot clearance, and 1.6±6.1° for turning angle. Difference in gait performance was observed between young and elderly volunteers during the 6MWT particularly in foot clearance. The proposed method allows to analyze various aspects of gait, including turns, gait initiation and termination, or inter-cycle variability. The system is lightweight, easy to wear and use, and suitable for clinical application requiring objective evaluation of gait outside of the lab environment. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. Positive outcomes following gait therapy intervention for hip osteoarthritis: A longitudinal study.

    Science.gov (United States)

    Solomonow-Avnon, Deborah; Herman, Amir; Levin, Daniel; Rozen, Nimrod; Peled, Eli; Wolf, Alon

    2017-10-01

    Footwear-generated biomechanical manipulation of lower-limb joints was shown to beneficially impact gait and quality of life in knee osteoarthritis patients, but has not been tested in hip osteoarthritis patients. We examined a customized gait treatment program using a biomechanical device shown in previous investigations to be capable of manipulating hip biomechanics via foot center of pressure (COP) modulation. The objective of this study was to assess the treatment program for hip osteoarthritis patients, enrolled in a 1-year prospective investigation, by means of objective gait and spatiotemporal parameters, and subjective quality of life measures. Gait analysis and completion of questionnaires were performed at the start of the treatment (baseline), and after 3, 6, and 12 months. Outcome parameters were evaluated over time using linear mixed effects models, and association between improvement in quality of life measures and change in objective outcomes was tested using mixed effect linear regression models. Quality of life measures improved compared to baseline, accompanied by increased gait speed and cadence. Sagittal-plane hip joint kinetics, kinematics, and spatiotemporal parameters changed throughout the study compared to baseline, in a manner suggesting improvement of gait. The most substantial improvement occurred within 3 months after treatment initiation, after which improvement approximately plateaued, but was sustained at 12 months. Speed and cadence, as well as several sagittal-plane gait parameters, were significant predictors of improvement in quality of life. Evidence suggests that a biomechanical gait therapy program improves subjective and objective outcomes measures and is a valid treatment option for hip osteoarthritis. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2222-2232, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  12. Gait parameter and event estimation using smartphones.

    Science.gov (United States)

    Pepa, Lucia; Verdini, Federica; Spalazzi, Luca

    2017-09-01

    The use of smartphones can greatly help for gait parameters estimation during daily living, but its accuracy needs a deeper evaluation against a gold standard. The objective of the paper is a step-by-step assessment of smartphone performance in heel strike, step count, step period, and step length estimation. The influence of smartphone placement and orientation on estimation performance is evaluated as well. This work relies on a smartphone app developed to acquire, process, and store inertial sensor data and rotation matrices about device position. Smartphone alignment was evaluated by expressing the acceleration vector in three reference frames. Two smartphone placements were tested. Three methods for heel strike detection were considered. On the basis of estimated heel strikes, step count is performed, step period is obtained, and the inverted pendulum model is applied for step length estimation. Pearson correlation coefficient, absolute and relative errors, ANOVA, and Bland-Altman limits of agreement were used to compare smartphone estimation with stereophotogrammetry on eleven healthy subjects. High correlations were found between smartphone and stereophotogrammetric measures: up to 0.93 for step count, to 0.99 for heel strike, 0.96 for step period, and 0.92 for step length. Error ranges are comparable to those in the literature. Smartphone placement did not affect the performance. The major influence of acceleration reference frames and heel strike detection method was found in step count. This study provides detailed information about expected accuracy when smartphone is used as a gait monitoring tool. The obtained results encourage real life applications. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. A Machine Learning Framework for Gait Classification Using Inertial Sensors: Application to Elderly, Post-Stroke and Huntington's Disease Patients.

    Science.gov (United States)

    Mannini, Andrea; Trojaniello, Diana; Cereatti, Andrea; Sabatini, Angelo M

    2016-01-21

    Machine learning methods have been widely used for gait assessment through the estimation of spatio-temporal parameters. As a further step, the objective of this work is to propose and validate a general probabilistic modeling approach for the classification of different pathological gaits. Specifically, the presented methodology was tested on gait data recorded on two pathological populations (Huntington's disease and post-stroke subjects) and healthy elderly controls using data from inertial measurement units placed at shank and waist. By extracting features from group-specific Hidden Markov Models (HMMs) and signal information in time and frequency domain, a Support Vector Machines classifier (SVM) was designed and validated. The 90.5% of subjects was assigned to the right group after leave-one-subject-out cross validation and majority voting. The long-term goal we point to is the gait assessment in everyday life to early detect gait alterations.

  14. Changes in executive functions and self-efficacy are independently associated with improved usual gait speed in older women

    Directory of Open Access Journals (Sweden)

    Hsu Chun

    2010-05-01

    Full Text Available Abstract Background Improved usual gait speed predicts substantial reduction in mortality. A better understanding of the modifiable factors that are independently associated with improved gait speed would ensure that intervention strategies are developed based on a valid theoretical framework. Thus, we examined the independent association of change in executive functions and change in falls-related self-efficacy with improved gait speed among community-dwelling senior women. Methods A secondary analysis of the 135 senior women aged 65 to 75 years old who completed a 12-month randomized controlled trial of resistance training. Usual gait speed was assessed using a 4-meter walk. Three executive processes were assessed by standard neuropsychological tests: 1 set shifting; 2 working memory; and 3 selective attention and response inhibition. A linear regression model was constructed to determine the independent association of change in executive functions and falls-related self-efficacy with change in gait speed. Results Improved selective attention and conflict resolution, and falls-related self-efficacy, were independently associated with improved gait speed after accounting for age, global cognition, baseline gait speed, and change in quadriceps strength. The total variance explained was 24%. Conclusions Interventions that target executive functions and falls-related self-efficacy, in addition to physical functions, to improve gait speed may be more efficacious than those that do not. Trial Registration ClinicalTrials.gov Identifier: NCT00426881

  15. Gait biomechanics following lower extremity trauma: Amputation vs. reconstruction.

    Science.gov (United States)

    Russell Esposito, Elizabeth; Stinner, Daniel J; Fergason, John R; Wilken, Jason M

    2017-05-01

    Surgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive. To compare gait biomechanics after lower limb reconstruction and transtibial amputation. Twenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length. Lower extremity joint angles, moments, and powers, and ground reaction forces were analyzed on the affected limb of patients and right limb of able-bodied individuals. ANOVA with Tukeys post-hoc tests determined differences among groups and post-hoc paired t-tests with Bonferroni-Holm corrections determined differences between limbs. The ankle, knee, and hip exhibited significant kinematic differences between amputated, reconstructed and able-bodied limbs. The reconstruction group exhibited less ankle power and range of motion while the amputee group exhibited lower knee flexor and extensor moments and power generation. Gait deficiencies were more pronounced at the ankle following limb reconstruction with orthosis use and at the knee following transtibial amputation with prosthesis use. Although both groups in the cohorts tested can replicate many key aspects of normative gait mechanics, some deficiencies still persist. These results add to the growing body of literature comparing amputation and limb reconstruction and provide information to inform the patient on functional expectations should either procedure be considered. Copyright © 2017. Published by Elsevier B.V.

  16. Segmentation of Gait Sequences in Sensor-Based Movement Analysis: A Comparison of Methods in Parkinson's Disease.

    Science.gov (United States)

    Haji Ghassemi, Nooshin; Hannink, Julius; Martindale, Christine F; Gaßner, Heiko; Müller, Meinard; Klucken, Jochen; Eskofier, Björn M

    2018-01-06

    Robust gait segmentation is the basis for mobile gait analysis. A range of methods have been applied and evaluated for gait segmentation of healthy and pathological gait bouts. However, a unified evaluation of gait segmentation methods in Parkinson's disease (PD) is missing. In this paper, we compare four prevalent gait segmentation methods in order to reveal their strengths and drawbacks in gait processing. We considered peak detection from event-based methods, two variations of dynamic time warping from template matching methods, and hierarchical hidden Markov models (hHMMs) from machine learning methods. To evaluate the methods, we included two supervised and instrumented gait tests that are widely used in the examination of Parkinsonian gait. In the first experiment, a sequence of strides from instructed straight walks was measured from 10 PD patients. In the second experiment, a more heterogeneous assessment paradigm was used from an additional 34 PD patients, including straight walks and turning strides as well as non-stride movements. The goal of the latter experiment was to evaluate the methods in challenging situations including turning strides and non-stride movements. Results showed no significant difference between the methods for the first scenario, in which all methods achieved an almost 100% accuracy in terms of F-score. Hence, we concluded that in the case of a predefined and homogeneous sequence of strides, all methods can be applied equally. However, in the second experiment the difference between methods became evident, with the hHMM obtaining a 96% F-score and significantly outperforming the other methods. The hHMM also proved promising in distinguishing between strides and non-stride movements, which is critical for clinical gait analysis. Our results indicate that both the instrumented test procedure and the required stride segmentation algorithm have to be selected adequately in order to support and complement classical clinical examination

  17. Feasibility study of a wearable exoskeleton for children: is the gait altered by adding masses on lower limbs?

    Directory of Open Access Journals (Sweden)

    Stefano Rossi

    Full Text Available We are designing a pediatric exoskeletal ankle robot (pediatric Anklebot to promote gait habilitation in children with Cerebral Palsy (CP. Few studies have evaluated how much or whether the unilateral loading of a wearable exoskeleton may have the unwanted effect of altering significantly the gait. The purpose of this study was to evaluate whether adding masses up to 2.5 kg, the estimated overall added mass of the mentioned device, at the knee level alters the gait kinematics. Ten healthy children and eight children with CP, with light or mild gait impairment, walked wearing a knee brace with several masses. Gait parameters and lower-limb joint kinematics were analyzed with an optoelectronic system under six conditions: without brace (natural gait and with masses placed at the knee level (0.5, 1.0, 1.5, 2.0, 2.5 kg. T-tests and repeated measures ANOVA tests were conducted in order to find noteworthy differences among the trial conditions and between loaded and unloaded legs. No statistically significant differences in gait parameters for both healthy children and children with CP were observed in the five "with added mass" conditions. We found significant differences among "natural gait" and "with added masses" conditions in knee flexion and hip extension angles for healthy children and in knee flexion angle for children with CP. This result can be interpreted as an effect of the mechanical constraint induced by the knee brace rather than the effect associated with load increase. The study demonstrates that the mechanical constraint induced by the brace has a measurable effect on the gait of healthy children and children with CP and that the added mass up to 2.5 kg does not alter the lower limb kinematics. This suggests that wearable devices weighing 25 N or less will not noticeably modify the gait patterns of the population examined here.

  18. Segmentation of Gait Sequences in Sensor-Based Movement Analysis: A Comparison of Methods in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Nooshin Haji Ghassemi

    2018-01-01

    Full Text Available Robust gait segmentation is the basis for mobile gait analysis. A range of methods have been applied and evaluated for gait segmentation of healthy and pathological gait bouts. However, a unified evaluation of gait segmentation methods in Parkinson’s disease (PD is missing. In this paper, we compare four prevalent gait segmentation methods in order to reveal their strengths and drawbacks in gait processing. We considered peak detection from event-based methods, two variations of dynamic time warping from template matching methods, and hierarchical hidden Markov models (hHMMs from machine learning methods. To evaluate the methods, we included two supervised and instrumented gait tests that are widely used in the examination of Parkinsonian gait. In the first experiment, a sequence of strides from instructed straight walks was measured from 10 PD patients. In the second experiment, a more heterogeneous assessment paradigm was used from an additional 34 PD patients, including straight walks and turning strides as well as non-stride movements. The goal of the latter experiment was to evaluate the methods in challenging situations including turning strides and non-stride movements. Results showed no significant difference between the methods for the first scenario, in which all methods achieved an almost 100% accuracy in terms of F-score. Hence, we concluded that in the case of a predefined and homogeneous sequence of strides, all methods can be applied equally. However, in the second experiment the difference between methods became evident, with the hHMM obtaining a 96% F-score and significantly outperforming the other methods. The hHMM also proved promising in distinguishing between strides and non-stride movements, which is critical for clinical gait analysis. Our results indicate that both the instrumented test procedure and the required stride segmentation algorithm have to be selected adequately in order to support and complement classical

  19. Executive functions are associated with gait and balance in community-living elderly people.

    Science.gov (United States)

    van Iersel, Marianne B; Kessels, Roy P C; Bloem, Bastiaan R; Verbeek, André L M; Olde Rikkert, Marcel G M

    2008-12-01

    Cognition influences gait and balance in elderly people. Executive functions seem to play a key role in this mechanism. Previous studies used only a single test to probe executive functions, and outcome measures were restricted to gait variables. We extend this prior work by examining the association between two different executive functions and measures of both gait and balance, with and without two different cognitive dual tasks. This is a cross-sectional study with randomly selected community-living elderly people. Executive functions were tested with the Trail Making Test Parts A and B and the Stroop Color Word Test; memory with Cambridge Neuropsychological Test Automated Battery (CANTAB) subtests. Patients walked without and with two dual tasks (subtracting serial sevens and animal naming). Main outcomes focused on gait (velocity, stride length, and stride time variability), measured on an electronic walkway, and balance, measured as trunk movements during walking. Associations were assessed with multiple regression models. One hundred elderly people, with a mean age 80.6 years (range 75-93 years) participated. Both dual tasks decreased gait velocity and increased variability and trunk sway. Executive functions were associated with only stride length variability and mediolateral trunk sway during performance of animal naming as the dual task. Memory was not associated with the gait and balance variables. In community-living elderly people, executive functions are associated with gait and balance impairment during a challenging dual-task condition that also depends on executive integrity. Next steps will be to explore the value of executive functions in defining fall-risk profiles and in fall-prevention interventions for frail patients.

  20. Specific smartphone usage and cognitive performance affect gait characteristics during free-living and treadmill walking.

    Science.gov (United States)

    Niederer, Daniel; Bumann, Anke; Mühlhauser, Yvonne; Schmitt, Mareike; Wess, Katja; Engeroff, Tobias; Wilke, Jan; Vogt, Lutz; Banzer, Winfried

    2018-04-06

    Mobile phone tasks like texting, typing, and dialling during walking are known to impact gait characteristics. Beyond that, the effects of performing smartphone-typical actions like researching and taking self-portraits (selfie) on gait have not been investigated yet. We aimed to investigate the effects of smartphone usage on relevant gait characteristics and to reveal potential association of basic cognitive and walking plus smartphone dual-task abilities. Our cross-sectional, cross-over study on physically active, healthy participants was performed on two days, interrupted by a 24-h washout in between. Assessments were: 1) Cognitive testing battery consisting of the trail making test (TMT A and B) and the Stroop test 2) Treadmill walking under five smartphone usage conditions: no use (control condition), reading, dialling, internet searching and taking a selfie in randomized order. Kinematic and kinetic gait characteristics were assessed to estimate conditions influence. In our sample of 36 adults (24.6 ± 1 years, 23 female, 13 male), ANCOVAs followed by post-hoc t-tests revealed that smartphone usage impaired all tested gait characteristics: gait speed (decrease, all conditions): F = 54.7, p usage was systematically associated with the TMT B time regarding cadence and double stride length for reading (r = -0.37), dialling (r = -0.35) and taking a selfie (r = -0.34). Smartphone usage substantially impacts walking characteristics in most situations. Changes of gait patterns indicate higher cognitive loads and lower awareness. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Instrumented gait analysis: a measure of gait improvement by a wheeled walker in hospitalized geriatric patients.

    Science.gov (United States)

    Schülein, Samuel; Barth, Jens; Rampp, Alexander; Rupprecht, Roland; Eskofier, Björn M; Winkler, Jürgen; Gaßmann, Karl-Günter; Klucken, Jochen

    2017-02-27

    In an increasing aging society, reduced mobility is one of the most important factors limiting activities of daily living and overall quality of life. The ability to walk independently contributes to the mobility, but is increasingly restricted by numerous diseases that impair gait and balance. The aim of this cross-sectional observation study was to examine whether spatio-temporal gait parameters derived from mobile instrumented gait analysis can be used to measure the gait stabilizing effects of a wheeled walker (WW) and whether these gait parameters may serve as surrogate marker in hospitalized patients with multifactorial gait and balance impairment. One hundred six patients (ages 68-95) wearing inertial sensor equipped shoes passed an instrumented walkway with and without gait support from a WW. The walkway assessed the risk of falling associated gait parameters velocity, swing time, stride length, stride time- and double support time variability. Inertial sensor-equipped shoes measured heel strike and toe off angles, and foot clearance. The use of a WW improved the risk of spatio-temporal parameters velocity, swing time, stride length and the sagittal plane associated parameters heel strike and toe off angles in all patients. First-time users (FTUs) showed similar gait parameter improvement patterns as frequent WW users (FUs). However, FUs with higher levels of gait impairment improved more in velocity, stride length and toe off angle compared to the FTUs. The impact of a WW can be quantified objectively by instrumented gait assessment. Thus, objective gait parameters may serve as surrogate markers for the use of walking aids in patients with gait and balance impairments.

  2. 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.

  3. Design and development of a prototype platform for gait analysis

    Science.gov (United States)

    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.

  4. The motor signature of mild cognitive impairment: results from the gait and brain study.

    Science.gov (United States)

    Montero-Odasso, Manuel; Oteng-Amoako, Afua; Speechley, Mark; Gopaul, Karen; Beauchet, Olivier; Annweiler, Cedric; Muir-Hunter, Susan W

    2014-11-01

    Early motor changes associated with aging predict cognitive decline, which suggests that a "motor signature" can be detected in predementia states. In line with previous research, we aim to demonstrate that individuals with mild cognitive impairment (MCI) have a distinct motor signature, and specifically, that dual-task gait can be a tool to distinguish amnestic (a-MCI) from nonamnestic MCI. Older adults with MCI and controls from the "Gait and Brain Study" were assessed with neurocognitive tests to assess cognitive performance and with an electronic gait mat to record temporal and spatial gait parameters. Mean gait velocity and stride time variability were evaluated under simple and three separate dual-task conditions. The relationship between cognitive groups (a-MCI vs nonamnestic MCI) and gait parameters was evaluated with linear regression models and adjusted for confounders. Ninety-nine older participants, 64 MCI (mean age 76.3±7.1 years; 50% female), and 35 controls (mean age 70.4±3.9 years; 82.9% female) were included. Forty-two participants were a-MCI and 22 were nonamnestic MCI. Multivariable linear regression (adjusted for age, sex, physical activity level, comorbidities, and executive function) showed that a-MCI was significantly associated with slower gait and higher dual-task cost under dual-task conditions. Participants with a-MCI, specifically with episodic memory impairment, had poor gait performance, particularly under dual tasking. Our findings suggest that dual-task assessment can help to differentiate MCI subtyping, revealing a motor signature in MCI. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America.

  5. Gait analysis in children with haemophilia: first Italian experience at the Turin Haemophilia Centre.

    Science.gov (United States)

    Forneris, E; Andreacchio, A; Pollio, B; Mannucci, C; Franchini, M; Mengoli, C; Pagliarino, M; Messina, M

    2016-05-01

    To investigate the functional status in haemophilia patients referred to an Italian paediatric haemophilia centre using gait analysis, verifying any differences between mild, moderate or severe haemophilia at a functional level. Forty-two patients (age 4-18) presenting to the Turin Paediatric Haemophilia Centre who could walk independently were included. Therapy included prophylaxis (n = 21), on-demand (n = 17) or immune tolerance induction + inhibitor (n = 4). Patients performed a test of gait analysis. Temporal, spatial and kinematic parameters were calculated for patient subgroups by disease severity and background treatment, and compared with normal values. Moderate (35.7%) or severe (64.3%) haemophilia patients showed obvious variations from normal across a variety of temporal and spatial gait analysis parameters, including step speed and length, double support, swing phase, load asymmetry, stance phase, swing phase and speed. Kinematic parameters were characterized by frequent foot external rotation with deficient plantar flexion during the stance phase, retropelvic tilt, impaired power generation distally and reduced ground reaction forces. Both Gait Deviation Index and Gait Profile Score values for severe haemophilia patients indicated abnormal gait parameters, which were worst in patients with a history of past or current use of inhibitors and those receiving on-demand therapy. Functional evaluation identified changes in gait pattern in patients with severe and moderate haemophilia, compared with normal values. Gait analysis may be a useful tool to facilitate early diagnosis of joint damage, prevent haemophilic arthropathy, design a personalized rehabilitative treatment and monitor functional status over time. © 2016 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    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.

  7. Reliability of the OptoGait portable photoelectric cell system for the quantification of spatial-temporal parameters of gait in young adults.

    Science.gov (United States)

    Gomez Bernal, Antonio; Becerro-de-Bengoa-Vallejo, Ricardo; Losa-Iglesias, Marta Elena

    2016-10-01

    Determining progress in gait requires a reliable method. However, achieving standard assessment results in the clinical setting can be challenging. Searching for a reliable tool, we tested OptoGait, a tool that has floor-level, high-density photoelectric cells that can be used to determine patterns of spatial-temporal gait on the basis of 19 variables: step length, stride length, distance, total contact time, step time, walking speed, acceleration, progressive step time, cadence, gait cycle, stance phase, swing phase, heel contact phase, flatfoot phase, takeoff phase, single limb support, double limb support, load response phase, and pre-swing phase. The gait of 126 study participants (41 males, 85 females; 27.37±1.77 years) was assessed twice for each participant during 10 episodes of walking on a 10m walkway each 2 weeks apart. Intra-session and inter-session results were compared using data for each foot alone as well as both feet together. All variables resulted in a high consistency except for acceleration. The intra-session data showed substantial agreement; the intra-class correlation coefficient (ICC) ranged from 0.72-0.78 in the heel contact phase, 0.72-0.76 in the load response phase, and 0.76-0.85 in the pre-swing phase and a low SEM. The inter-session data for each foot alone and both feet together showed substantial agreement (0.77-0.79 in the load response phase) and slight agreement for acceleration (0.06-0.22) with a low SEM. Based on these results, we conclude that the OptoGait system can be used with confidence to evaluate spatial-temporal gait except for acceleration and progressive step time assessment. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Gait Rather Than Cognition Predicts Decline in Specific Cognitive Domains in Early Parkinson's Disease.

    Science.gov (United States)

    Morris, Rosie; Lord, Sue; Lawson, Rachael A; Coleman, Shirley; Galna, Brook; Duncan, Gordon W; Khoo, Tien K; Yarnall, Alison J; Burn, David J; Rochester, Lynn

    2017-11-09

    Dementia is significant in Parkinson's disease (PD) with personal and socioeconomic impact. Early identification of risk is of upmost importance to optimize management. Gait precedes and predicts cognitive decline and dementia in older adults. We aimed to evaluate gait characteristics as predictors of cognitive decline in newly diagnosed PD. One hundred and nineteen participants recruited at diagnosis were assessed at baseline, 18 and 36 months. Baseline gait was characterized by variables that mapped to five domains: pace, rhythm, variability, asymmetry, and postural control. Cognitive assessment included attention, fluctuating attention, executive function, visual memory, and visuospatial function. Mixed-effects models tested independent gait predictors of cognitive decline. Gait characteristics of pace, variability, and postural control predicted decline in fluctuating attention and visual memory, whereas baseline neuropsychological assessment performance did not predict decline. This provides novel evidence for gait as a clinical biomarker for PD cognitive decline in early disease. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America.

  9. A Comparative Evaluation of Gait between Children with Autism and Typically Developing Matched Controls

    Directory of Open Access Journals (Sweden)

    Janet S. Dufek

    2017-01-01

    Full Text Available Anecdotal reports suggest children with autism spectrum disorder (ASD ambulate differently than peers with typical development (TD. Little empirical evidence supports these reports. Children with ASD exhibit delayed motor skills, and it is important to determine whether or not motor movement deficits exist during walking. The purpose of the study was to perform a comprehensive lower-extremity gait analysis between children (aged 5–12 years with ASD and age- and gender-matched-samples with TD. Gait parameters were normalized to 101 data points and the gait cycle was divided into seven sub-phases. The Model Statistic procedure was used to test for statistical significance between matched-pairs throughout the entire gait cycle for each parameter. When collapsed across all participants, children with ASD exhibited large numbers of significant differences (p < 0.05 throughout the gait cycle in hip, knee, and ankle joint positions as well as vertical and anterior/posterior ground reaction forces. Children with ASD exhibited unique differences throughout the gait cycle, which supports current literature on the heterogeneity of the disorder. The present work supports recent findings that motor movement differences may be a core symptom of ASD. Thus, individuals may benefit from therapeutic movement interventions that follow precision medicine guidelines by accounting for individual characteristics, given the unique movement differences observed.

  10. The Pediatric SmartShoe: Wearable Sensor System for Ambulatory Monitoring of Physical Activity and Gait.

    Science.gov (United States)

    Hegde, Nagaraj; Zhang, Ting; Uswatte, Gitendra; Taub, Edward; Barman, Joydip; McKay, Staci; Taylor, Andrea; Morris, David M; Griffin, Angi; Sazonov, Edward S

    2018-02-01

    Cerebral palsy (CP) is a group of nonprogressive neuro-developmental conditions occurring in early childhood that causes movement disorders and physical disability. Measuring activity levels and gait patterns is an important aspect of CP rehabilitation programs. Traditionally, such programs utilize commercially available laboratory systems, which cannot to be utilized in community living. In this study, a novel, shoe-based, wearable sensor system (pediatric SmartShoe) was tested on 11 healthy children and 10 children with CP to validate its use for monitoring of physical activity and gait. Novel data processing techniques were developed to remove the effect of orthotics on the sensor signals. Machine learning models were developed to automatically classify the activities of daily living. The temporal gait parameters estimated from the SmartShoe data were compared against reference measurements on a GAITRite mat. A leave-one-out cross-validation method indicated a 95.3% average accuracy of activity classification (for sitting, standing, and walking) for children with CP and 96.2% for healthy children. Average relative errors in gait parameter estimation (gait cycle, stance, swing, and step time, % single support time on both lower extremities, along with cadence) ranged from 0.2% to 6.4% (standard deviation range = 1.4%-9.9%). These results suggest that the pediatric SmartShoe can accurately measure physical activity and gait of children with CP and can potentially be used for ambulatory monitoring.

  11. Target of physiological gait: Realization of speed adaptive control for a prosthetic knee during swing flexion.

    Science.gov (United States)

    Cao, Wujing; Yu, Hongliu; Zhao, Weiliang; Li, Jin; Wei, Xiaodong

    2017-10-13

    Prosthetic knee is the most important component of lower limb prosthesis. Speed adaptive for prosthetic knee during swing flexion is the key method to realize physiological gait. This study aims to discuss the target of physiological gait, propose a speed adaptive control method during swing flexion and research the damping adjustment law of intelligent hydraulic prosthetic knee. According to the physiological gait trials of healthy people, the control target during swing flexion is defined. A new prosthetic knee with fuzzy logical control during swing flexion is designed to realize the damping adjustment automatically. The function simulation and evaluation system of intelligent knee prosthesis is provided. Speed adaptive control test of the intelligent prosthetic knee in different velocities are researched. The maximum swing flexion of the knee angle is set between sixty degree and seventy degree as the target of physiological gait. Preliminary experimental results demonstrate that the prosthetic knee with fuzzy logical control is able to realize physiological gait under different speeds. The faster the walking, the bigger the valve closure percentage of the hydraulic prosthetic knee. The proposed fuzzy logical control strategy and intelligent hydraulic prosthetic knee are effective for the amputee to achieve physiological gait.

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

    Science.gov (United States)

    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.

  13. The effect of knee joint Mulligan taping on balance and gait in subacute stroke patients.

    Science.gov (United States)

    Hyun, Ki-Hoon; Cho, Hwi-Young; Lim, Chae-Gil

    2015-11-01

    [Purpose] This study aimed to determine the effects of Mulligan taping on balance and gait in subacute stroke patients. [Subjects] Thirty patients with subacute stroke were randomly divided into two groups: the experimental group (n = 15) and the control group (n = 15). Mulligan taping was applied to the knee joints of participants in the experimental group while placebo taping was applied to knee joints of subjects in the control group. Biodex was used to assess their balance ability and the GAITRite System was used to test gait. All measurements were performed before and after the intervention. [Results] Dynamic standing balance of the experimental group significantly improved after taping. Gait, gait cadence, velocity, step length, and stride length also improved significantly. However, no significant differences in standing balance or gait were observed for the control group. Furthermore, significant differences in dynamic standing balance, cadence, and velocity were found between the two groups after the intervention. [Conclusion] Our results demonstrate that Mulligan taping is effective for improving balance and gait in subacute stroke patients. Thus, this technique is a potential method for actively facilitating rehabilitation programs for hemiplegia patients.

  14. Computer aided analysis of gait patterns in patients with acute anterior cruciate ligament injury.

    Science.gov (United States)

    Christian, Josef; Kröll, Josef; Strutzenberger, Gerda; Alexander, Nathalie; Ofner, Michael; Schwameder, Hermann

    2016-03-01

    Gait analysis is a useful tool to evaluate the functional status of patients with anterior cruciate ligament injury. Pattern recognition methods can be used to automatically assess walking patterns and objectively support clinical decisions. This study aimed to test a pattern recognition system for analyzing kinematic gait patterns of recently anterior cruciate ligament injured patients and for evaluating the effects of a therapeutic treatment. Gait kinematics of seven male patients with an acute unilateral anterior cruciate ligament rupture and seven healthy males were recorded. A support vector machine was trained to distinguish the groups. Principal component analysis and recursive feature elimination were used to extract features from 3D marker trajectories. A Classifier Oriented Gait Score was defined as a measure of gait quality. Visualizations were used to allow functional interpretations of characteristic group differences. The injured group was evaluated by the system after a therapeutic treatment. The results were compared against a clinical rating of the patients' gait. Cross validation yielded 100% accuracy. After the treatment the score improved significantly (Pgait alterations in the early phase after anterior cruciate ligament injury can be detected automatically. The results of the automatic analysis are comparable with the clinical rating and support the validity of the system. The visualizations allow interpretations on discriminatory features and can facilitate the integration of the results into the diagnostic process. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Correlation between gait analysis and clinical questionnaires in patients with spontaneous osteonecrosis of the knee.

    Science.gov (United States)

    Debi, Ronen; Mor, Amit; Elbaz, Avi; Segal, Ganit; Lubovsky, Omri; Kahn, Gadi; Peskin, Bezalel; Beer, Yiftah; Atoun, Ehud

    2017-05-01

    Spontaneous osteonecrosis of the knee is usually verified by magnetic resonance imaging accompanied by clinical questionnaires to assess the level of pain and functional limitation. There is a lack however, in an objective functional test that will reflect the functional severity of spontaneous osteonecrosis of the knee. The purpose of the current study was to examine the correlation between spatiotemporal gait parameters and clinical questionnaires in patients with spontaneous osteonecrosis of the knee. 28 patients (16 females and 12 males) were included in the analysis. Patients had unilateral spontaneous osteonecrosis of the knee of the medial femoral condyle confirmed by magnetic resonance imaging. All patients performed a computerized spatiotemporal gait analysis and completed the Western Ontario and McMaster University Osteoarthritis Index and the Short-Form 36. Relationships between selected spatiotemporal gait measures and self-assessment questionnaires were assessed by Spearman non-parametric correlations. Significant correlations were found between selected spatiotemporal gait parameters and clinical questionnaires (r ranged between 0.28 and 0.79). Single limb support was the gait measure with the strongest correlation to pain (r=0.58), function (r=0.56) and quality of life. Spatiotemporal gait assessment for patients with spontaneous osteonecrosis of the knee correlates with the patient's level of pain and functional limitation there by adding objective information regarding the functional condition of these patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. EFFECTIVENESS OF MOTOR TASK INTERFERENCE DURING GAIT IN SUBJECTS WITH PARKINSON'S DISEASE: A RANDOMIZED CONTROLLED TRAIL

    Directory of Open Access Journals (Sweden)

    Jaya ShankerTedla

    2017-04-01

    Full Text Available Background: In this study, was to evaluated the effectiveness of motor task and cognitive task interference while walking to improve gait parameters of subjects with Parkinson’s disease. Methods: In this Randomized Controlled trial, 30 subjects with Parkinson’s disease of age group between 50and 70 years randomly divided into two groups. The first group had motor task interference, and the second group had calculation task interference while walking along with conventional physical therapy. Gait parameters recorded as outcome measures. Both the groups received 1-hour training for three weeks for one month. Results: As per the paired t-test values, there was significant (p<0.001 improvement in the gait parameters for both the group's pre and post training. Motor task interference showed better improvements than calculation-task interference group among subjects with Parkinson’s disease in all the gait parameters measured with a p-value less than 0.001. Conclusion: To improve the gait parameters for mild to moderately disabled patients with Parkinson’s disease, the dual task training by using motor task while gait training along with conventional Physical Therapy will be more useful than using cognitive task.

  17. Evaluation and management of crouch gait.

    Science.gov (United States)

    Kedem, Paz; Scher, David M

    2016-02-01

    Crouch gait is defined as excessive ankle dorsiflexion, knee and hip flexion during the stance phase. This gait disorder is common among patients with cerebral palsy. The present article brings an up-to-date literature review on the pathoanatomy, natural history, and treatment of this frequent gait abnormality. Hamstrings are often not shortened in patients with crouch. Patella alta must be addressed if surgery is performed. Surgical correction of joint contractures and lever arm dysfunction can be effectively achieved through a single-event multilevel surgery. Crouch gait is a common gait deviation, often seen among ambulatory diplegic and quadriplegic patients, once they reach the pubertal spurt, when weak muscles can no longer support a toe walking pattern because of rapidly increased weight. This form of gait is highly ineffective and might compromise walking ability over time. The anterior knee is overloaded; pain, extensor mechanism failure, and arthritis might develop. Its progressive nature often requires surgical intervention. The cause of crouch gait is multifactorial, and surgery should be tailored to meet the individual's specific anatomic and physiologic abnormalities.

  18. Exploring phase dependent functional gait variability.

    Science.gov (United States)

    Hamacher, Daniel; Hamacher, Dennis; Müller, Roy; Schega, Lutz; Zech, Astrid

    2017-04-01

    Gait variability is frequently used to evaluate the sensorimotor system and elderly fallers compared to non-fallers exhibit an altered variability in gait parameters during unchanged conditions. While gait variability is often interpreted as movement error, it is also necessary to change the gait pattern in order to react to internal and external perturbations. This phenomenon has been described as functional variability and ensures the stability of gait motor control. The aim of the current study is to explore the functional variability in relation to the different phases of the gait cycle (phase-dependent gait variability). Kinematics of the foot, shank and thigh were registered with inertial sensors (MTw2, Xsens Technologies B.V) in 25 older participants (70±6years) during normal overground walking. Phase-dependent variability was defined as the standard deviation of the Euclidean norm of the angular velocity data. To assess differences with respect to the variability of different body segments (foot, shank, and thigh), the statistical parametric mapping method was applied. In normal walking, the variability of the time-continuous foot kinematics during parts of the swing phase was higher compared to the shank (9-14% of swing phase, pgait. In fact, we found reduced variability in the time-continuous foot kinematics in mid swing during normal walking where also the minimum toe clearance event occurs. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Functional clinical typology of the foot and kinematic gait parameters

    Directory of Open Access Journals (Sweden)

    Jitka Marenčáková

    2016-06-01

    Full Text Available Background: The foot plays a key role in a standing posture, walking and running performance. Changes in its structure or function may alter upper segments of kinematic chain which can lead to formation of musculoskeletal disorders. Although functional clinical typology provides a complex view of foot kinesiology there is a lack of knowledge and evidence about influences of different foot types on human gait. Objective: The aim of the study was to analyse differences of kinematic gait parameters of lower extremity joints and pelvis between functional clinical foot types in healthy young men. Methods: Three-dimensional kinematic analysis by the Vicon Motion Capture MX System device in synchronization with 2 Kistler force platforms was used to obtain kinematic data from 18 healthy men (mean age 23.2 ± 1.9 years. The functional clinical foot type was clinically examined and sorted into 3 basic foot type groups - forefoot varus (FFvar, rearfoot varus (RFvar and forefoot valgus (FFvalg. Peak angular values and range of an angular displacement in all of three movement planes were analysed for pelvis, hip, knee and ankle joint. For statistical analysis of kinematic gait parameters differences between foot types Mann Whitney U test at a statistical significance level p < .05 and Cohen's coefficient d for effect size were used. Results: This study showed that functional clinical foot type can affect kinematic parameters of gait in the joints of the lower limb and pelvis. Significant differences were presented in the FFvar in comparison with other two foot type groups with middle and high size of effect. The most alterations were observed in pelvis area and in a sagittal plane of movement. Nevertheless, significant differences between FFvalg and RFvar foot types were not noticed. Conclusions: Functional clinical foot typology provides one of the possible methods to describe foot structure and function. Our results showed that foot type could

  20. 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.

  1. 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

  2. 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...

  3. Autonomous Gait Event Detection with Portable Single-Camera Gait Kinematics Analysis System

    OpenAIRE

    Yang, Cheng.; Ugbolue, Ukadike C..; Kerr, Andrew.; Stankovic, Vladimir.; Stankovic, Lina.; Carse, Bruce.; Kaliarntas, Konstantinos T..; Rowe, Philip J..

    2016-01-01

    Laboratory-based nonwearable motion analysis systems have significantly advanced with robust objective measurement of the limb motion, resulting in quantified, standardized, and reliable outcome measures compared with traditional, semisubjective, observational gait analysis. However, the requirement for large laboratory space and operational expertise makes these systems impractical for gait analysis at local clinics and homes. In this paper, we focus on autonomous gait event detection with o...

  4. Effects of stationary cycling exercise on the balance and gait abilities of chronic stroke patients.

    Science.gov (United States)

    Kim, Sung-Jin; Cho, Hwi-Young; Kim, You Lim; Lee, Suk-Min

    2015-11-01

    [Purpose] The objective of this study was to investigate the effects of stationary cycling exercise on the balance and gait abilities of chronic stroke patients. [Subjects] Thirty-two chronic stroke patients were randomly assigned to an experimental group (n=16) or a control group (n=16). [Methods] All of the subjects received the standard rehabilitation program for 30 minutes, while the experimental group additionally participated in a daily session of stationary cycling exercise for 30 minutes, 5 times per week for 6 weeks. To assess balance function, the Berg Balance Scale and timed up-and-go test were used. The 10-m walking test was conducted to assess gait function. [Results] Both groups showed significant improvements in balance and gait abilities. The improvements in the Berg Balance Scale and timed up-and-go test scores (balance), and 10-m walking test score (gait) in the stationary cycling exercise group were significantly greater than those in the control group. [Conclusion] This study demonstrated that stationary cycling exercise training is an effective intervention for increasing the balance and gait abilities of chronic stroke patients. Therefore, we suggest that stationary cycling training is suitable for stroke rehabilitation and may be used in clinical practice.

  5. Influence of trunk control and lower extremity impairments on gait capacity in children with cerebral palsy.

    Science.gov (United States)

    Balzer, Julia; Marsico, Petra; Mitteregger, Elena; van der Linden, Marietta L; Mercer, Thomas H; van Hedel, Hubertus J A

    2017-09-24

    We investigated the combined impact of trunk control and lower extremities impairments on predicting gait capacity in children with cerebral palsy (CP) and evaluated relationships between trunk control and lower extremities impairments. Data of 52 children with CP [29 boys, mean age 11 years 9 months (±4 years 6 months)] were included in this observational study. Gait capacity was measured by the "modified Time Up and Go test". Experienced therapists performed the "Modified Ashworth Scale", "Manual Muscle Test", the "Selective Control Assessment of the Lower Extremity", and the "Trunk Control Measurement Scale". We calculated Spearman correlations coefficients (ρ) and performed regression analyses. Trunk control was the strongest predictor (β = -0.624, p capacity and remained in the model together with spasticity (R 2  = 0.67). Muscle strength and selectivity correlated moderately to strongly with the trunk control and gait capacity (-0.68 ≤ ρ ≤ -0.78), but correlations for the spasticity were low (ρcapacity in children with CP was shown. It indicates the significance of these impairments in gait assessment and, potentially, rehabilitation. Implications for Rehabilitation Trunk control was the strongest predictor for gait capacity in a regression model with lower extremity spasticity, muscle strength and selectivity and age as independent variables. Lower extremity muscle strength, selectivity, and trunk control explained a similar amount of gait capacity variance which is higher than that explained by lower extremity spasticity. Lower extremity muscle strength and selectivity correlated strongly with trunk control. Therefore, we cautiously suggest that a combined trunk control and lower extremity training might be promising for improving gait capacity in children with CP (Gross Motor Function Classification System level I-III), which needed to be tested in future intervention-studies.

  6. Autonomous Gait Event Detection with Portable Single-Camera Gait Kinematics Analysis System

    Directory of Open Access Journals (Sweden)

    Cheng Yang

    2016-01-01

    Full Text Available Laboratory-based nonwearable motion analysis systems have significantly advanced with robust objective measurement of the limb motion, resulting in quantified, standardized, and reliable outcome measures compared with traditional, semisubjective, observational gait analysis. However, the requirement for large laboratory space and operational expertise makes these systems impractical for gait analysis at local clinics and homes. In this paper, we focus on autonomous gait event detection with our bespoke, relatively inexpensive, and portable, single-camera gait kinematics analysis system. Our proposed system includes video acquisition with camera calibration, Kalman filter + Structural-Similarity-based marker tracking, autonomous knee angle calculation, video-frame-identification-based autonomous gait event detection, and result visualization. The only operational effort required is the marker-template selection for tracking initialization, aided by an easy-to-use graphic user interface. The knee angle validation on 10 stroke patients and 5 healthy volunteers against a gold standard optical motion analysis system indicates very good agreement. The autonomous gait event detection shows high detection rates for all gait events. Experimental results demonstrate that the proposed system can automatically measure the knee angle and detect gait events with good accuracy and thus offer an alternative, cost-effective, and convenient solution for clinical gait kinematics analysis.

  7. Gait training after spinal cord injury: safety, feasibility and gait function following 8 weeks of training with the exoskeletons from Ekso Bionics.

    Science.gov (United States)

    Bach Baunsgaard, Carsten; Vig Nissen, Ulla; Katrin Brust, Anne; Frotzler, Angela; Ribeill, Cornelia; Kalke, Yorck-Bernhard; León, Natacha; Gómez, Belén; Samuelsson, Kersti; Antepohl, Wolfram; Holmström, Ulrika; Marklund, Niklas; Glott, Thomas; Opheim, Arve; Benito, Jesus; Murillo, Narda; Nachtegaal, Janneke; Faber, Willemijn; Biering-Sørensen, Fin

    2018-02-01

    Prospective quasi-experimental study, pre- and post-design. Assess safety, feasibility, training characteristics and changes in gait function for persons with spinal cord injury (SCI) using the robotic exoskeletons from Ekso Bionics. Nine European rehabilitation centres. Robotic exoskeleton gait training, three times weekly over 8 weeks. Time upright, time walking and steps in the device (training characteristics) were recorded longitudinally. Gait and neurological function were measured by 10 Metre Walk Test (10 MWT), Timed Up and Go (TUG), Berg Balance Scale (BBS), Walking Index for Spinal Cord Injury (WISCI) II and Lower Extremity Motor Score (LEMS). Fifty-two participants completed the training protocol. Median age: 35.8 years (IQR 27.5-52.5), men/women: N = 36/16, neurological level of injury: C1-L2 and severity: AIS A-D (American Spinal Injury Association Impairment Scale). Time since injury (TSI)  1 year, N = 27. No serious adverse events occurred. Three participants dropped out following ankle swelling (overuse injury). Four participants sustained a Category II pressure ulcer at contact points with the device but completed the study and skin normalized. Training characteristics increased significantly for all subgroups. The number of participants with TSI  1 year and gait function, increased from 41 to 44% and TUG and BBS results improved (P < 0.05). Exoskeleton training was generally safe and feasible in a heterogeneous sample of persons with SCI. Results indicate potential benefits on gait function and balance.

  8. Multilevel orthopedic surgery for crouch gait in cerebral palsy: An evaluation using functional mobility and energy cost

    Directory of Open Access Journals (Sweden)

    Dhiren Ganjwala

    2011-01-01

    Full Text Available Background: The evidence for the effectiveness of orthopaedic surgery to correct crouch gait in cerebral diplegic is insufficient. The crouch gait is defined as walking with knee flexion and ankle dorsiflexion through out the stance phase. Severe crouch gait in patients with spastic diplegia causes excessive loading of the patellofemoral joint and may result in anterior knee pain, gait deterioration, and progressive loss of function. We retrospectively evaluated the effect of surgery on the mobility and energy consumption at one year or more with the help of validated scales and scores. Materials and Methods: 18 consecutive patients with mean age of 14.6 years with cerebral diplegia with crouched gait were operated for multilevel orthopaedic surgery. Decisions for surgery were made with the observations on gait analysis and physical examination. The surgical intervention consisted of lengthening of short muscle-tendon units, shortening of long muscles and correction of osseous deformities. The paired samples t test was used to compare values of physical examination findings, walking speed and physiological cost index. Two paired sample Wilcoxon signed rank test was used to compare functional walking scales. Results: After surgery, improvements in functional mobility, walking speed and physiological cost index were found. No patient was able to walk 500 meters before surgery while all were able to walk after surgery. The improvements that were noted at one year were maintained at two years. Conclusions: Multilevel orthopedic surgery for older children and adolescents with crouch gait is effective for improving function and independence.

  9. The reliability, validity and correlation of two observational gait scales assessed by video tape for Chinese subjects with hemiplegia.

    Science.gov (United States)

    Lu, Xi; Hu, Nan; Deng, Siyu; Li, Jun; Qi, Shuyan; Bi, Sheng

    2015-12-01

    To test the reliability of the Wisconsin Gait Scale (WGS) and the Gait Abnormality Rating Scale (GARS) for hemiplegic Chinese subjects, as well as to establish the concurrent validity of these two scales with clinical measurements. [Subjects] Twenty hemiplegic stroke subjects were recruited for this study. [Methods] The subjects walked along a 10-meter walkway and their gait was videotaped from 4 directions. Two physical therapists assessed the subjects' gait using the aforementioned scales by watching the video tape. The Intraclass Correlation Coefficient (ICC) was calculated for the two physiotherapists' scores for each category and the total scores to assess the reliability. Concurrent validity was tested by comparing the total scores to subjects' walking speed, the Fugl-Meyer assessment, the Motricity Index of the lower limb, and the Composite Spasticity Index of the lower limb. [Results] The ICC of WGS was 0.961 for intra-rater reliability, and 0.945 for inter-rater reliability. The ICC of GARS was 0.708 for intra-rater reliability and 0.875 for inter-rater reliability. The correlations of the two scales with walking speed, the Fugl-Meyer assessment and the Motricity Index were statistically significant. [Conclusion] Both the Wisconsin Gait Scale and the Gait Abnormality Rating Scale are reliable and valid protocols for measuring the hemiplegic gait of stroke patients.

  10. Reinforcement learning of periodical gaits in locomotion robots

    Science.gov (United States)

    Svinin, Mikhail; Yamada, Kazuyaki; Ushio, S.; Ueda, Kanji

    1999-08-01

    Emergence of stable gaits in locomotion robots is studied in this paper. A classifier system, implementing an instance- based reinforcement learning scheme, is used for sensory- motor control of an eight-legged mobile robot. Important feature of the classifier system is its ability to work with the continuous sensor space. The robot does not have a prior knowledge of the environment, its own internal model, and the goal coordinates. It is only assumed that the robot can acquire stable gaits by learning how to reach a light source. During the learning process the control system, is self-organized by reinforcement signals. Reaching the light source defines a global reward. Forward motion gets a local reward, while stepping back and falling down get a local punishment. Feasibility of the proposed self-organized system is tested under simulation and experiment. The control actions are specified at the leg level. It is shown that, as learning progresses, the number of the action rules in the classifier systems is stabilized to a certain level, corresponding to the acquired gait patterns.

  11. Metric learning for Parkinsonian identification from IMU gait measurements.

    Science.gov (United States)

    Cuzzolin, Fabio; Sapienza, Michael; Esser, Patrick; Saha, Suman; Franssen, Miss Marloes; Collett, Johnny; Dawes, Helen

    2017-05-01

    Diagnosis of people with mild Parkinson's symptoms is difficult. Nevertheless, variations in gait pattern can be utilised to this purpose, when measured via Inertial Measurement Units (IMUs). Human gait, however, possesses a high degree of variability across individuals, and is subject to numerous nuisance factors. Therefore, off-the-shelf Machine Learning techniques may fail to classify it with the accuracy required in clinical trials. In this paper we propose a novel framework in which IMU gait measurement sequences sampled during a 10m walk are first encoded as hidden Markov models (HMMs) to extract their dynamics and provide a fixed-length representation. Given sufficient training samples, the distance between HMMs which optimises classification performance is learned and employed in a classical Nearest Neighbour classifier. Our tests demonstrate how this technique achieves accuracy of 85.51% over a 156 people with Parkinson's with a representative range of severity and 424 typically developed adults, which is the top performance achieved so far over a cohort of such size, based on single measurement outcomes. The method displays the potential for further improvement and a wider application to distinguish other conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Gait termination in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A. H.; van Keeken, H. G.; Schoppen, T.; Otten, E.; Halbertsma, J. P. K.; Hof, A. L.; Postema, K.

    Objective: To study the limitations in function and adjustment strategies of lower limb amputees in gait termination. Design: Observational cohort study. Setting: University Medical Centre. Participants: Unilateral transfemoral and transtibial amputees, and able-bodied control subjects. Main outcome

  13. Gait Partitioning Methods: A Systematic Review

    Science.gov (United States)

    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

  14. Gait Recognition Using Wearable Motion Recording Sensors

    Science.gov (United States)

    Gafurov, Davrondzhon; Snekkenes, Einar

    2009-12-01

    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.

  15. 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.

  16. 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.

  17. Variations in Kinematics during Clinical Gait Analysis in Stroke Patients

    Science.gov (United States)

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

    2013-01-01

    In addition to changes in spatio-temporal and kinematic parameters, patients with stroke exhibit fear of falling as well as fatigability during gait. These changes could compromise interpretation of data from gait analysis. The aim of this study was to determine if the gait of hemiplegic patients changes significantly over successive gait trials. Forty two stroke patients and twenty healthy subjects performed 9 gait trials during a gait analysis session. The mean and variability of spatio-temporal and kinematic joint parameters were analyzed during 3 groups of consecutive gait trials (1–3, 4–6 and 7–9). Principal component analysis was used to reduce the number of variables from the joint kinematic waveforms and to identify the parts of the gait cycle which changed during the gait analysis session. The results showed that i) spontaneous gait velocity and the other spatio-temporal parameters significantly increased, and ii) gait variability decreased, over the last 6 gait trials compared to the first 3, for hemiplegic patients but not healthy subjects. Principal component analysis revealed changes in the sagittal waveforms of the hip, knee and ankle for hemiplegic patients after the first 3 gait trials. These results suggest that at the beginning of the gait analysis session, stroke patients exhibited phase of adaptation,characterized by a “cautious gait” but no fatigue was observed. PMID:23799100

  18. Clinically assessed mediolateral knee motion: impact on gait

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Creaby, Mark W; Simic, Milena

    2011-01-01

    Mediolateral knee movement can be assessed visually with clinical tests. A knee-medial-to-foot position is associated with an increased risk of knee injuries and pathologies. However, the implications of such findings on daily tasks are not well understood. The aim of this study was to investigat...... if a knee-medial-to-foot position assessed during a clinical test was associated with altered hip and knee joint kinematics and knee joint kinetics during gait compared with those with a knee-over-foot position....

  19. Factors related to gait and balance deficits in older adults

    Directory of Open Access Journals (Sweden)

    Al-Momani M

    2016-08-01

    Full Text Available Murad Al-Momani,1 Fidaa Al-Momani,2 Ahmad H Alghadir,3 Sami Alharethy,1 Sami A Gabr3,4 1Department of Otolaryngology – Head & Neck Surgery (ORL-HNS, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 4Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura, Egypt Purpose: The aim of this study was to investigate the effects of physical, mental, and cognitive disabilities on gait and balance deficits among nursing home residents with different diseases in Jordan and also to find the risk of fall associated with or without these diseases.Methods: A sample of 221 nursing home residents aged 18–100 years in Jordan was recruited for this study. All participants were assessed using the Arabic versions of the Tinetti assessment battery (TAB for gait and balance, mini–mental state examination, and disability of arm, shoulder, and hand assessment test.Results: A total of 221 nursing home residents were included in this study. Different chronic diseases were medically reported in this study. Psychiatric disorders (45.7% were shown to be the most prevalent disease seen among the participants, followed by hypertension and diabetes mellitus affecting 33.5% and 23.5% of the participants, respectively. However, the least prevalent diseases were stroke (17.2%, joint inflammation (17.2%, and arthritis (9.0%. Based on TAB scores, the participants were classified into three groups: high risk of falls (≤18; n=116, moderate risk of falls (19–23; n=25, and low risk of falls (≥24; n=80. The correlation between physical activity and mental health problems with risks of falls was reported in all participants. The data showed that participants with over 50% upper extremity

  20. Influence of functional task-oriented mental practice on the gait of transtibial amputees: a randomized, clinical trial.

    Science.gov (United States)

    Cunha, Rodrigo Gontijo; Da-Silva, Paulo José Guimarães; Dos Santos Couto Paz, Clarissa Cardoso; da Silva Ferreira, Ana Carolina; Tierra-Criollo, Carlos Julio

    2017-04-11

    Mental practice (MP) through motor imagery is a cognitive training strategy used to improve locomotor skills during rehabilitation programs. Recent works have used MP tasks to investigate the neurophysiology of human gait; however, its effect on functional performance has not been evaluated. In the present study, the influence of gait-oriented MP tasks on the rehabilitation process of gait in transtibial amputees was investigated by assessing the vertical (V), anterior-posterior (AP), and medio-lateral (ML) ground reaction forces (GRFs) and the time duration of the support phase of the prosthetic limb. Unilateral transtibial amputees, who were capable of performing motor imagination tasks (MIQ-RS score ≥4), were randomly divided into two groups: Group A (n = 10), who performed functional gait-oriented MP combined with gait training, and Group B (n = 5), who performed non-motor task MP. The MP intervention was performed in the first-person perspective for 40 min, 3 times/week, for 4 weeks. The GRF outcome measures were recorded by a force platform to evaluate gait performance during 4 distinct stages: at baseline (BL), 1 month before the MP session; Pre-MP, 1-3 days before the MP session; Post-MP, 1-3 days after the MP session; and follow-up (FU), 1 month after MP session. The gait variables were compared inter- and intra-group by applying the Mann-Whitney and Friedman tests (alpha = 0.05). All volunteers exhibited a homogenous gait pattern prior to MP intervention, with no gait improvement during the BL and Pre-MP stages. Only Group A showed significant improvements in gait performance after the intervention, with enhanced impact absorption, as indicated by decreased first V and AP peaks; propulsion capacity, indicated by increasing second V and AP peaks; and balance control of the prosthetic limb, indicated by decreasing ML peaks and increasing duration of support. This gait pattern persisted until the FU stage. MP combined with gait training

  1. Manipulation of visual biofeedback during gait with a time delayed adaptive Virtual Mirror Box

    Science.gov (United States)

    2014-01-01

    Background A mirror placed in the mid-sagittal plane of the body has been used to reduce phantom limb pain and improve movement function in medical conditions characterised by asymmetrical movement control. The mirrored illusion of unimpaired limb movement during gait might enhance the effect, but a physical mirror is only capable of showing parallel movement of limbs in real time typically while sitting. We aimed to overcome the limitations of physical mirrors by developing and evaluating a Virtual Mirror Box which delays the mirrored image of limbs during gait to ensure temporal congruency with the impaired physical limb. Methods An application was developed in the CAREN system’s D-Flow software which mirrors selected limbs recorded by real-time motion capture to the contralateral side. To achieve phase shifted movement of limbs during gait, the mirrored virtual limbs are also delayed by a continuously calculated amount derived from past gait events. In order to accommodate non-normal proportions and offsets of pathological gait, the movements are morphed so that the physical and virtual contact events match on the mirrored side. Our method was tested with a trans-femoral amputee walking on a treadmill using his artificial limb. Joint angles of the elbow and knee were compared between the intact and mirrored side using cross correlation, root mean squared difference and correlation coefficients. Results The time delayed adaptive virtual mirror box produced a symmetrical looking gait of the avatar coupled with a reduction of the difference between the intact and virtual knee and elbow angles (10.86° and 5.34° reduced to 4.99° and 2.54° respectively). Dynamic morphing of the delay caused a non-significant change of toe-off events when compared to delaying by 50% of the previous gait cycle, as opposed to the initial contact events which showed a practically negligible but statistically significant increase (p Virtual Mirror Box has extended its use to

  2. Quantitative gait analysis under dual-task in older people with mild cognitive impairment: a reliability study

    Directory of Open Access Journals (Sweden)

    Gutmanis Iris

    2009-09-01

    Full Text Available Abstract Background Reliability of quantitative gait assessment while dual-tasking (walking while doing a secondary task such as talking in people with cognitive impairment is unknown. Dual-tasking gait assessment is becoming highly important for mobility research with older adults since better reflects their performance in the basic activities of daily living. Our purpose was to establish the test-retest reliability of assessing quantitative gait variables using an electronic walkway in older adults with mild cognitive impairment (MCI under single and dual-task conditions. Methods The gait performance of 11 elderly individuals with MCI was evaluated using an electronic walkway (GAITRite® System in two sessions, one week apart. Six gait parameters (gait velocity, step length, stride length, step time, stride time, and double support time were assessed under two conditions: single-task (sG: usual walking and dual-task (dG: counting backwards from 100 while walking. Test-retest reliability was determined using intra-class correlation coefficient (ICC. Gait variability was measured using coefficient of variation (CoV. Results Eleven participants (average age = 76.6 years, SD = 7.3 were assessed. They were high functioning (Clinical Dementia Rating Score = 0.5 with a mean Mini-Mental Status Exam (MMSE score of 28 (SD = 1.56, and a mean Montreal Cognitive Assessment (MoCA score of 22.8 (SD = 1.23. Under dual-task conditions, mean gait velocity (GV decreased significantly (sGV = 119.11 ± 20.20 cm/s; dGV = 110.88 ± 19.76 cm/s; p = 0.005. Additionally, under dual-task conditions, higher gait variability was found on stride time, step time, and double support time. Test-retest reliability was high (ICC>0.85 for the six parameters evaluated under both conditions. Conclusion In older people with MCI, variability of time-related gait parameters increased with dual-tasking suggesting cognitive control of gait performance. Assessment of quantitative gait

  3. Longitudinal assessment of neuropsychological and temporal/spatial gait characteristics of elderly fallers: taking it all in stride

    Directory of Open Access Journals (Sweden)

    Rebecca K MacAulay

    2015-03-01

    Full Text Available Gait abnormalities are linked to cognitive decline and an increased fall risk within older adults. The present study addressed gaps from cross-sectional studies in the literature by longitudinally examining the interplay between temporal and spatial aspects of gait, cognitive function, age, and lower-extremity strength in elderly fallers and non-fallers. Gait characteristics, neuropsychological and physical test performance were examined at two time points spaced a year apart in cognitively intact individuals aged 60 and older (N = 416. Mixed-model repeated-measure ANCOVAs examined temporal (step time and spatial (stride length gait characteristics during a simple and cognitive-load walking task in fallers as compared to non-fallers. Fallers consistently demonstrated significant alterations in spatial, but not temporal, aspects of gait as compared to non-fallers during both walking tasks. Step time became slower as stride length shortened amongst all participants during the dual task. Shorter strides and slower step times during the dual task were both predicted by worse executive attention/processing speed performance. In summary, divided attention significantly impacts spatial aspects of gait in fallers, suggesting stride length changes may precede declines in other neuropsychological and gait characteristics, thereby selectively increasing fall risk. Our results indicate that multimodal intervention approaches that integrate physical and cognitive remediation strategies may increase the effectiveness of fall risk interventions.

  4. An innovative training program based on virtual reality and treadmill: effects on gait of persons with multiple sclerosis.

    Science.gov (United States)

    Peruzzi, Agnese; Zarbo, Ignazio Roberto; Cereatti, Andrea; Della Croce, Ugo; Mirelman, Anat

    2017-07-01

    In this single blind randomized controlled trial, we examined the effect of a virtual reality-based training on gait of people with multiple sclerosis. Twenty-five individuals with multiple sclerosis with mild to moderate disability were randomly assigned to either the control group (n = 11) or the experimental group (n = 14). The subjects in the control group received treadmill training. Subjects in the experimental group received virtual reality based treadmill training. Clinical measures and gait parameters were evaluated. Subjects in both the groups significantly improved the walking endurance and speed, cadence and stride length, lower limb joint ranges of motion and powers, during single and dual task gait. Moreover, subjects in the experimental group also improved balance, as indicated by the results of the clinical motor tests (p gait measures in individuals with multiple sclerosis. Implication of rehabilitation Gait deficits are common in multiple sclerosis (85%) and worsen during dual task activities. Intensive and progressive treadmill training, with and without virtual reality, is effective on dual task gait in persons with multiple sclerosis. Virtual reality-based treadmill training requiring obstacle negotiation increases the range of motion and the power generated at the hip, consequently allowing longer stride length and, consequently, higher gait speed.

  5. Intra-rater repeatability of gait parameters in healthy adults during self-paced treadmill-based virtual reality walking.

    Science.gov (United States)

    Al-Amri, Mohammad; Al Balushi, Hilal; Mashabi, Abdulrhman

    2017-12-01

    Self-paced treadmill walking is becoming increasingly popular for the gait assessment and re-education, in both research and clinical settings. Its day-to-day repeatability is yet to be established. This study scrutinised the test-retest repeatability of key gait parameters, obtained from the Gait Real-time Analysis Interactive Lab (GRAIL) system. Twenty-three male able-bodied adults (age: 34.56 ± 5.12 years) completed two separate gait assessments on the GRAIL system, separated by 5 ± 3 days. Key gait kinematic, kinetic, and spatial-temporal parameters were analysed. The Intraclass-Correlation Coefficients (ICC), Standard Error Measurement (SEM), Minimum Detectable Change (MDC), and the 95% limits of agreements were calculated to evaluate the repeatability of these gait parameters. Day-to-day agreements were excellent (ICCs > 0.87) for spatial-temporal parameters with low MDC and SEM values, gait performance over time.

  6. Timing of intermittent torque control with wire-driven gait training robot lifting toe trajectory for trip avoidance.

    Science.gov (United States)

    Miyake, Tamon; Kobayashi, Yo; Fujie, Masakatsu G; Sugano, Shigeki

    2017-07-01

    Gait training robots are useful for changing gait patterns and decreasing risk of trip. Previous research has reported that decreasing duration of the assistance or guidance of the robot is beneficial for efficient gait training. Although robotic intermittent control method for assisting joint motion has been established, the effect of the robot intervention timing on change of toe clearance is unclear. In this paper, we tested different timings of applying torque to the knee, employing the intermittent control of a gait training robot to increase toe clearance throughout the swing phase. We focused on knee flexion motion and designed a gait training robot that can apply flexion torque to the knee with a wire-driven system. We used a method of timing detecting for the robot conducting torque control based on information from the hip, knee, and ankle angles to establish a non-time dependent parameter that can be used to adapt to gait change, such as gait speed. We carried out an experiment in which the conditions were four time points: starting the swing phase, lifting the foot, maintaining knee flexion, and finishing knee flexion. The results show that applying flexion torque to the knee at the time point when people start lifting their toe is effective for increasing toe clearance in the whole swing phase.

  7. 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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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.

  10. Gait analysis in Down syndrome pediatric patients using a sheet-type gait analyzer: Pilot study.

    Science.gov (United States)

    Naito, Makiko; Aoki, Sayaka; Kamide, Anri; Miyamura, Kohei; Honda, Manami; Nagai, Akira; Mezawa, Hidetoshi; Hashimoto, Keiji

    2015-10-01

    Children with Down syndrome (DS), who are likely to suffer from a large number of musculoskeletal problems, tend to have a unique pattern of walking in clinical settings. Despite such apparent uniqueness, few studies have empirically investigated gait development pattern in DS children, especially at an earlier age. We therefore conducted gait analysis in young DS children who are prescribed insoles, to explore how their gait patterns develop, using the gait parameters identified by Sutherland et al. as determinants of gait maturity of typical children. Participants consisted of 63 DS children (31 boys) aged 1-6 years (mean, 4 years 1 month) with a diagnosis of flat feet who were prescribed orthotic insoles. A 2.4 m sheet-type gait analyzer was used to analyze gait pattern. We measured the following variables: walking velocity (cm/min), cadence (steps/min), step length (cm), and single-limb stance phase ratio (%), and examined their relationship with age on regression analysis. Walking velocity and step length were significantly and positively related to age. Cadence was also significantly, but negatively associated with age. In contrast, SLS phase ratio did not have a statistically significant relationship with age. Down syndrome children have unique gait development patterns. Although walking velocity, cadence, and step length were found to develop with age, as in typical children, SLS phase ratio did not change with age in DS children. Further studies with a larger sample are necessary to replicate these findings. © 2015 Japan Pediatric Society.

  11. Muscle strength is only a weak to moderate predictor of gait performance in persons with late effects of polio.

    Science.gov (United States)

    Flansbjer, Ulla-Britt; Brogårdh, Christina; Lexell, Jan

    2013-01-01

    To assess muscle strength in the knee extensors, knee flexors and ankle dorsiflexors in persons with late effects of polio, and determine how much muscle strength, gender, age and BMI are related to gait performance. Ninety community-dwelling ambulant persons (47 men and 43 women; mean age 64 years SD 8) with late effects of polio participated. Isokinetic concentric knee extensor and flexor muscle strength was measured at 60°/s and ankle dorsiflexor muscle strength at 30°/s. Gait performance was assessed by the Timed "Up & Go", the Comfortable and Fast Gait Speed tests, and the 6-Minute Walk test. There were significant correlations between knee extensor and flexor muscle strength and gait performance (p polio, but the strength of the relationships indicates that other factors are also important.

  12. [Effects of cognitive state on balance disturbances and gait disorders in institutionalised elderly].

    Science.gov (United States)

    Díaz-Pelegrina, Ana; Cabrera-Martos, Irene; López-Torres, Isabel; Rodríguez-Torres, Janet; Valenza, Marie Carmen

    2016-01-01

    Ageing has been linked to a high prevalence of cognitive impairment, which, in turn, has been related to balance disturbances and gait disorders. The aim of this study was to identify whether there are differences between subjects with and without cognitive impairment regarding the quality of gait and balance. An observational study was conducted on institutionalised people older than 65 years (n=82). Gait and balance was evaluated after the assessment of cognitive impairment using the Mini-Mental State Examination (MMSE). Single and dual tests were used including, the 6-minute walking, stride length, and gait speed. Timed Up and Go tests were also used to evaluate balance. The participants were divided into three groups: 28 subjects in the group without cognitive impairment (MMSE≥27), 29 subjects with mild (27Gait assessment showed significant between-groups differences in all the variables (Pgait, thus the clinical monitoring of these variables in population at risk is needed. Copyright © 2015 SEGG. Published by Elsevier Espana. All rights reserved.

  13. Use of wand markers on the pelvis in three dimensional gait analysis

    DEFF Research Database (Denmark)

    Smith, Martin; Curtis, Derek; Bencke, Jesper

    2013-01-01

    During clinical gait analysis, surface markers are placed over the anterior superior iliac spines (ASIS) of the pelvis. However, this can be problematic in overweight or obese subjects, where excessive adipose tissue can obscure the markers and prevent accurate tracking. A novel solution to this ......During clinical gait analysis, surface markers are placed over the anterior superior iliac spines (ASIS) of the pelvis. However, this can be problematic in overweight or obese subjects, where excessive adipose tissue can obscure the markers and prevent accurate tracking. A novel solution...... to this problem has previously been proposed and tested on a limited sample of healthy, adult subjects. This involves use of wand markers on the pelvis, to virtually recreate the ASIS markers. The method was tested here on 20 typical subjects presenting for clinical gait analysis (adults and children, including...

  14. Conflicting results of robot-assisted versus usual gait training during postacute rehabilitation of stroke patients: a randomized clinical trial.

    Science.gov (United States)

    Taveggia, Giovanni; Borboni, Alberto; Mulé, Chiara; Villafañe, Jorge H; Negrini, Stefano

    2016-03-01

    Robot gait training has the potential to increase the effectiveness of walking therapy. Clinical outcomes after robotic training are often not superior to conventional therapy. We evaluated the effectiveness of a robot training compared with a usual gait training physiotherapy during a standardized rehabilitation protocol in inpatient participants with poststroke hemiparesis. This was a randomized double-blind clinical trial in a postacute physical and rehabilitation medicine hospital. Twenty-eight patients, 39.3% women (72±6 years), with hemiparesis (Bobath approach were assigned randomly to an experimental or a control intervention of robot gait training to improve walking (five sessions a week for 5 weeks). Outcome measures included the 6-min walk test, the 10 m walk test, Functional Independence Measure, SF-36 physical functioning and the Tinetti scale. Outcomes were collected at baseline, immediately following the intervention period and 3 months following the end of the intervention. The experimental group showed a significant increase in functional independence and gait speed (10 m walk test) at the end of the treatment and follow-up, higher than the minimal detectable change. The control group showed a significant increase in the gait endurance (6-min walk test) at the follow-up, higher than the minimal detectable change. Both treatments were effective in the improvement of gait performances, although the statistical analysis of functional independence showed a significant improvement in the experimental group, indicating possible advantages during generic activities of daily living compared with overground treatment.

  15. Conflicting results of robot-assisted versus usual gait training during postacute rehabilitation of stroke patients: a randomized clinical trial

    Science.gov (United States)

    Taveggia, Giovanni; Borboni, Alberto; Mulé, Chiara; Negrini, Stefano

    2016-01-01

    Robot gait training has the potential to increase the effectiveness of walking therapy. Clinical outcomes after robotic training are often not superior to conventional therapy. We evaluated the effectiveness of a robot training compared with a usual gait training physiotherapy during a standardized rehabilitation protocol in inpatient participants with poststroke hemiparesis. This was a randomized double-blind clinical trial in a postacute physical and rehabilitation medicine hospital. Twenty-eight patients, 39.3% women (72±6 years), with hemiparesis (Bobath approach were assigned randomly to an experimental or a control intervention of robot gait training to improve walking (five sessions a week for 5 weeks). Outcome measures included the 6-min walk test, the 10 m walk test, Functional Independence Measure, SF-36 physical functioning and the Tinetti scale. Outcomes were collected at baseline, immediately following the intervention period and 3 months following the end of the intervention. The experimental group showed a significant increase in functional independence and gait speed (10 m walk test) at the end of the treatment and follow-up, higher than the minimal detectable change. The control group showed a significant increase in the gait endurance (6-min walk test) at the follow-up, higher than the minimal detectable change. Both treatments were effective in the improvement of gait performances, although the statistical analysis of functional independence showed a significant improvement in the experimental group, indicating possible advantages during generic activities of daily living compared with overground treatment. PMID:26512928

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Task-specific ankle robotics gait training after stroke: a randomized pilot study.

    Science.gov (United States)

    Forrester, Larry W; Roy, Anindo; Hafer-Macko, Charlene; Krebs, Hermano I; Macko, Richard F

    2016-06-02

    An unsettled question in the use of robotics for post-stroke gait rehabilitation is whether task-specific locomotor training is more effective than targeting individual joint impairments to improve walking function. The paretic ankle is implicated in gait instability and fall risk, but is difficult to therapeutically isolate and refractory to recovery. We hypothesize that in chronic stroke, treadmill-integrated ankle robotics training is more effective to improve gait function than robotics focused on paretic ankle impairments. Participants with chronic hemiparetic gait were randomized to either six weeks of treadmill-integrated ankle robotics (n = 14) or dose-matched seated ankle robotics (n = 12) videogame training. Selected gait measures were collected at baseline, post-training, and six-week retention. Friedman, and Wilcoxon Sign Rank and Fisher's exact tests evaluated within and between group differences across time, respectively. Six weeks post-training, treadmill robotics proved more effective than seated robotics to increase walking velocity, paretic single support, paretic push-off impulse, and active dorsiflexion range of motion. Treadmill robotics durably improved gait dorsiflexion swing angle leading 6/7 initially requiring ankle braces to self-discarded them, while their unassisted paretic heel-first contacts increased from 44 % to 99.6 %, versus no change in assistive device usage (0/9) following seated robotics. Treadmill-integrated, but not seated ankle robotics training, durably improves gait biomechanics, reversing foot drop, restoring walking propulsion, and establishing safer foot landing in chronic stroke that may reduce reliance on assistive devices. These findings support a task-specific approach integrating adaptive ankle robotics with locomotor training to optimize mobility recovery. NCT01337960. https://clinicaltrials.gov/ct2/show/NCT01337960?term=NCT01337960&rank=1.

  18. [Gait speed and the appearance of neurocognitive disorders in older adults: Results of a Peruvian cohort].

    Science.gov (United States)

    Parodi, José F; Nieto-Gutierrez, Wendy; Tellez, Walter A; Ventocilla-Gonzales, Iris; Runzer-Colmenares, Fernando M; Taype-Rondan, Alvaro

    The prevention and management of neurocognitive disorders (NCD) among older adults can be improved by early identification of risk factors such as walking speed. The objective of the study is to assess the association between gait speed and NCD onset in a population of Peruvian older adults. Cohort conducted in older adults who attended the geriatrics service of Naval Medical Center (Callao, Peru). During the baseline assessment, participants' gait speed was recorded. Subsequently, participants were followed-up annually for 5 years, with a mean of 21 months. NCD onset was defined as the occurrence of a score ≤24 points on the Mini Mental State Examination (screening test) during follow-up. The hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated using Cox regression. The study included 657 participants, with a mean age of 73.4±9.2 (SD) years, of whom 47.0% were male, 47.8% had a gait speed <0.8 m/s, and 20.1% developed NCD during the follow up. It was found that older adults who had gait speed <0.8 m/s at baseline were more likely to develop NCD than those who had a gait speed ≥0.8 m/s (adjusted HR=1.41, 95% CI=1.34-1.47). A longitudinal association was found between decreased gait speed and NCD onset, suggesting that gait speed could be useful to identify patients at risk of NCD onset. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Relationships between spasticity, strength, gait, and the GMFM-66 in persons with spastic diplegia cerebral palsy.

    Science.gov (United States)

    Ross, Sandy A; Engsberg, Jack R

    2007-09-01

    To determine the relationships between spasticity, strength, and the functional measures of gait and gross motor function in persons with spastic diplegia cerebral palsy (CP). Retrospective, cross-sectional study. Hospital clinic. Ninety-seven participants (49 boys, 48 girls; mean age+/-standard deviation, 9.11+/-4.8 y) with spastic diplegia CP were tested once. Not applicable. A KinCom dynamometer was used to objectively measure spasticity (ankle plantarflexors, knee flexors, hip adductors) and maximum strength (ankle dorsiflexors and plantarflexors, knee flexors and extensors, hip abductors and adductors). A gait analysis was conducted to evaluate linear variables (gait speed, stride length, cadence) and kinematic variables (ankle dorsiflexion, foot progression, knee and hip flexion, pelvic tilt at initial contact and ankle dorsiflexion, knee and hip flexion, pelvic tilt, trunk rotation range of motion) during gait. Gross motor function was measured using the Gross Motor Function Measure (GMFM-66) and separately, the GMFM walking, running & jumping dimension. Multiple linear regression analysis was used to determine the relationships between spasticity, strength, gait, and the GMFM (PSpasticity did not account for a substantial amount of explained variance in gait and gross motor function (up to 8% for the GMFM walking, running & jumping dimension). Moderate to high correlations existed between strength and gait linear data and function, accounting for up to 69% of the explained variance (strength and GMFM-66, r2=.69). For this cohort of participants with spastic diplegia CP who ambulated with or without an assistive device, strength was highly related to function and explained far more of the variance than spasticity. The results may not be generalized to those with more severe forms of CP.

  20. Disorders of balance and gait in essential tremor are associated with midline tremor and age.

    Science.gov (United States)

    Hoskovcová, Martina; Ulmanová, Olga; Sprdlík, Otakar; Sieger, Tomáš; Nováková, Jana; Jech, Robert; Růžička, Evžen

    2013-02-01

    Disorders of balance and gait have been observed in patients with essential tremor (ET), but their association with tremor severity remains unclear. This study aimed to evaluate postural instability and gait changes in ET patients and to investigate their relationship to tremor characteristics with regard to cerebellar dysfunction as a possible common pathogenetic mechanism in ET. Thirty ET patients (8F, mean (SD) age 55.8 (17.8), range 19-81 years) and 25 normal controls (7F, 53.0 (17.7), 19-81) were tested with the scales of Activities-specific Balance Confidence (ABC), Fullerton Advanced Balance (FAB), and International Cooperative Ataxia Rating Scale (ICARS). Posturography and gait were assessed using a Footscan® system. Tremor was evaluated by the Fahn-Tolosa-Marin Tremor Rating Scale (TRS) and accelerometry in five upper limb positions. A mean (SD) TRS sum score of 27.0 (13.2) corresponded to mild to moderate tremor severity in most patients. In comparison with controls, ET subjects exhibited lower tandem gait velocity (0.21 vs. 0.26 m/s, P = 0.028), more missteps (0.57 vs. 0.12, P = 0.039), and increased postural sway in tandem stance (sway area 301.1 vs. 202.9 mm(2), P = 0.045). In normal gait, step width increased with the midline tremor subscore of TRS (Pearson r = 0.60, P = 0.046). Moreover, significant correlations were found between age and quantitative measures of normal and tandem gait in ET patients but not in controls. ABC, FAB, and ICARS scores did not significantly differ between patients and controls. In conclusion, gait and balance alterations in ET patients occur even without subjective complaints. Their relationship with midline tremor and dependence on age suggest a connection with cerebellar dysfunction.

  1. White Matter Hyperintensities, Exercise and Improvement in Gait Speed: Does the Type of Gait Rehabilitation Matter?

    Science.gov (United States)

    Nadkarni, Neelesh K.; Studenski, Stephanie A.; Perera, Subashan; Rosano, Caterina; Aizenstein, Howard J.; Brach, Jennifer S.; VanSwearingen, Jessie M.

    2013-01-01

    Background and Objectives White matter hyperintensities (WMH) on brain MRI are associated with cognitive and mobility impairment in older adults. We examined whether WMH in tracts in older adults with mobility impairment are linked to outcomes of gait rehabilitation interventions. Design A 12-week randomized controlled single-blind trial. Setting University-based mobility research laboratory. Participants Ambulatory adults aged 65 and older with mobility impairment. Intervention A conventional gait intervention focusing on walking, endurance, balance, and strength (WEBS, n=21) compared to a task-oriented intervention focused on timing and coordination of gait (TC, n=23). Measurements We measured self-paced gait speed over an instrumented walkway, pre and post intervention, and quantified WMH and brain volumes on pre-intervention brain MRI using an automated segmentation process. We overlaid a white matter tract atlas on the segmented images to measure tract WMH volumes and normalized WMH volumes to total brain volume. Aggregate WMH volumes in all white matter tracts and individual WMH volumes in specific longitudinal tracts (the superior longitudinal fasciculus, inferior longitudinal fasciculus and the fronto-occipital fasciculus) and cingulum were obtained. Results Gait speed gains in the TC group were of the same magnitude, independent of the WMH volume measures in all except the cingulum. However, in the WEBS group, gain in gait speed was smaller with greater overall tract WMH volumes (P<0.001) and with greater WMH volume in the three longitudinal tracts (P< 0.001 to 0.025). Conclusion Gains in gait speed with two types of gait rehabilitation are associated with individual differences in WMH. Task-oriented therapy that targets timing and coordination of gait may particularly benefit older adults with WMH in brain tracts that influence gait and cognition. PMID:23590257

  2. Are gait variability and stability measures influenced by directional changes?

    Science.gov (United States)

    Riva, Federico; Grimpampi, Eleni; Mazzà, Claudia; Stagni, Rita

    2014-05-05

    Many gait variability and stability measures have been proposed in the literature, with the aim to quantify gait impairment, degree of neuro-motor control and balance disorders in healthy and pathological subjects. These measures are often obtained from lower trunk acceleration data, typically acquired during rectilinear gait, but relevant experimental protocols and data processing techniques lack in standardization. Since directional changes represent an essential aspect of gait, the assessment of their influence on such measures is essential for standardization. In addition, their investigation is needed to evaluate the applicability of these measures in laboratory trials and in daily life activity analysis. A further methodological aspect to be standardized concerns the assessment of the sampling frequency, which could affect stability measures. The aim of the present study was hence to assess if gait variability and stability measures are affected by directional changes, and to evaluate the influence of sampling frequency of trunk acceleration data on the results. Fifty-one healthy young adults performed a 6-minute walk test along a 30 m straight pathway, turning by 180 deg at each end of the pathway. Nine variability and stability measures (Standard deviation, Coefficient of variation, Poincaré plots, maximum Floquet multipliers, short-term Lyapunov exponents, Recurrence quantification analysis, Multiscale entropy, Harmonic ratio and Index of harmonicity) were calculated on stride duration and trunk acceleration data (acquired at 100 Hz and 200 Hz) coming from straight walking windows and from windows including both straight walking and the directional change. Harmonic ratio was the only measure that resulted to be affected by directional changes and sampling frequency, decreasing with the presence of a directional change task. HR was affected in the AP and V directions for the 200 Hz, but only in AP direction for the 100 Hz group. Multiscale entropy, short

  3. Physiotherapy Effects in Gait Speed in Patients with Knee Osteoarthritis

    Science.gov (United States)

    Tani, Klejda; Kola, Irena; Dhamaj, Fregen; Shpata, Vjollca; Zallari, Kiri

    2018-01-01

    BACKGROUND: Knee osteoarthritis is a chronic degenerative disease, known as the most common cause of difficulty walking in older adults and subsequently is associated with slow walking. Also one of the main symptoms is a degenerative and mechanics type of pain. Pain is very noticeable while walking in rugged terrain, during ascent and descent of stairs, when changing from sitting to standing position as well as staying in one position for a long time. Many studies have shown that the strength of the quadriceps femoris muscle can affect gait, by improving or weakening it. Kinesio Tape is a physiotherapeutic technique, which reduces pain and increases muscular strength by irritating the skin receptors. AIM: The aims of this study was first to verify if the application of Kinesio Tape on quadriceps femoris muscle increases gait speed in patients with knee osteoarthritis and secondly if applying Kinesio Tape on quadriceps femoris muscle reduces pain while walking. METHOD: Seventy-four patients with primary knee osteoarthritis, aged 50 - 73 years, participated in this study. Firstly we observed the change of gait speed, while walking for 10 meters at normal speed for each patient, before, one day and three days after the application of Kinesio Tape on quadriceps femoris muscle, with the help of the 10 - meter walk test. Secondly, we observed the change of pain, while walking for 10 meters at normal speed for each patient, before, one day and three days after the application, with the help of Numerical Pain Rating Scale - NRS. RESULTS: Our results indicated that there was a significant increase in gait speed while walking for 10 meters one day and also three days after application of Kinesio Tape on quadriceps femoris muscle. Also, there was a significant reduction of pain level 1 and 3 days after application of Kinesio Tape, compared to the level of pain before its application. CONCLUSIONS: Our results indicated that there was a significant decrease in pain and increase

  4. Variability of spatial temporal gait parameters and center of pressure displacements during gait in elderly fallers and nonfallers: A 6-month prospective study.

    Directory of Open Access Journals (Sweden)

    Zdenek Svoboda

    Full Text Available Considering that most of the falls in elderly population arise during walking, tests derived from walking performance would be desirable for comprehensive fall risk assessment. The analysis of spatial temporal parameters and the center of pressure displacement, which represents the interaction between the human body and the ground, would be beneficial. The aim of this study was to compare spatial temporal gait parameters and their variability and the variability of the center of pressure displacement between elderly fallers and nonfallers during gait at self-selected, defined and fast speeds. A prospective study design was used. At the baseline, measurements of ground reaction force during gait at self-selected, defined and fast walking speeds by two force plates were performed. In addition, the Tinetti balance assessment tool, the Falls Efficacy Scale-International and the Activities-Specific Balance Confidence Scale were used. Mean and coefficient of variation of spatial temporal gait parameters and standard deviations of center of pressure displacement during loading response, midstance, terminal stance and preswing phases were calculated. Comparison of the fallers and nonfallers exhibited no significant difference in clinical tool, scales or spatial temporal parameters. Compared to nonfallers' increased variability of walking speed at self-selected and defined speed, step width at fast walking speed and center of pressure displacement during preswing phase in medial-lateral directions at defined walking speed was found in fallers. However, application of the Holm-Bonferroni procedure for multiple comparisons exhibited no significant effect of group in any of the gait parameters. In general, our study did not observe an effect of group (fallers vs. nonfallers on variability of spatial temporal parameters and center of pressure movement during gait. However, walking speed, step width as well as standard deviation of COP displacement in the

  5. Variability of spatial temporal gait parameters and center of pressure displacements during gait in elderly fallers and nonfallers: A 6-month prospective study.

    Science.gov (United States)

    Svoboda, Zdenek; Bizovska, Lucia; Janura, Miroslav; Kubonova, Eliska; Janurova, Katerina; Vuillerme, Nicolas

    2017-01-01

    Considering that most of the falls in elderly population arise during walking, tests derived from walking performance would be desirable for comprehensive fall risk assessment. The analysis of spatial temporal parameters and the center of pressure displacement, which represents the interaction between the human body and the ground, would be beneficial. The aim of this study was to compare spatial temporal gait parameters and their variability and the variability of the center of pressure displacement between elderly fallers and nonfallers during gait at self-selected, defined and fast speeds. A prospective study design was used. At the baseline, measurements of ground reaction force during gait at self-selected, defined and fast walking speeds by two force plates were performed. In addition, the Tinetti balance assessment tool, the Falls Efficacy Scale-International and the Activities-Specific Balance Confidence Scale were used. Mean and coefficient of variation of spatial temporal gait parameters and standard deviations of center of pressure displacement during loading response, midstance, terminal stance and preswing phases were calculated. Comparison of the fallers and nonfallers exhibited no significant difference in clinical tool, scales or spatial temporal parameters. Compared to nonfallers' increased variability of walking speed at self-selected and defined speed, step width at fast walking speed and center of pressure displacement during preswing phase in medial-lateral directions at defined walking speed was found in fallers. However, application of the Holm-Bonferroni procedure for multiple comparisons exhibited no significant effect of group in any of the gait parameters. In general, our study did not observe an effect of group (fallers vs. nonfallers) on variability of spatial temporal parameters and center of pressure movement during gait. However, walking speed, step width as well as standard deviation of COP displacement in the medial

  6. Modeling and simulation of normal and hemiparetic gait

    Science.gov (United States)

    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.

  7. Dynamic stability and phase resetting during biped gait

    Science.gov (United States)

    Nomura, Taishin; Kawa, Kazuyoshi; Suzuki, Yasuyuki; Nakanishi, Masao; Yamasaki, Taiga

    2009-06-01

    Dynamic stability during periodic biped gait in humans and in a humanoid robot is considered. Here gait systems of human neuromusculoskeletal system and a humanoid are simply modeled while keeping their mechanical properties plausible. We prescribe periodic gait trajectories in terms of joint angles of the models as a function of time. The equations of motion of the models are then constrained by one of the prescribed gait trajectories to obtain types of periodically forced nonlinear dynamical systems. Simulated gait of the models may or may not fall down during gait, since the constraints are made only for joint angles of limbs but not for the motion of the body trunk. The equations of motion can exhibit a limit cycle solution (or an oscillatory solution that can be considered as a limit cycle practically) for each selected gait trajectory, if an initial condition is set appropriately. We analyze the stability of the limit cycle in terms of Poincaré maps and the basin of attraction of the limit cycle in order to examine how the stability depends on the prescribed trajectory. Moreover, the phase resetting of gait rhythm in response to external force perturbation is modeled. Since we always prescribe a gait trajectory in this study, reacting gait trajectories during the phase resetting are also prescribed. We show that an optimally prescribed reacting gait trajectory with an appropriate amount of the phase resetting can increase the gait stability. Neural mechanisms for generation and modulation of the gait trajectories are discussed.

  8. Feasibility and efficacy of high-speed gait training with a voluntary driven exoskeleton robot for gait and balance dysfunction in patients with chronic stroke: nonrandomized pilot study with concurrent control.

    Science.gov (United States)

    Yoshimoto, Takahiko; Shimizu, Issei; Hiroi, Yasuhiro; Kawaki, Masahiro; Sato, Daichi; Nagasawa, Makoto

    2015-12-01

    The aim of this pilot study was to investigate the feasibility of high-speed gait training with an exoskeleton robot hybrid assistive limb (HAL) in patients with chronic stroke, and to examine the efficacy of eight sessions (8 weeks) of gait training with a HAL compared with conventional physical therapy. Eighteen patients with chronic stroke were included in this study (nine each in the HAL and control groups). The HAL group underwent high-speed gait training with the HAL once a week for 8 weeks (20 min/session). The control group underwent conventional physical therapy for gait disturbance. Outcome measures were walking speed, number of steps, and cadence during a 10 m walking test, a timed up and go test, a functional reach test, and the Berg Balance Scale. Assessments were performed in the absence of the HAL before training and after the fourth and eighth training sessions. All patients in the HAL group completed the high-speed gait training without adverse events. The HAL group improved significantly in walking speed (55.9% increase, Ptraining (Ptraining with a HAL appears to be feasible and effective in improving gait and balance dysfunction despite the limitations of this nonrandomized pilot study.

  9. The effects of stair gait training using proprioceptive neuromuscular facilitation on stroke patients' dynamic balance ability.

    Science.gov (United States)

    Seo, KyoChul; Park, Seung Hwan; Park, KwangYong

    2015-05-01

    [Purpose] This study aims to examine stroke patients' changes in dynamic balance ability through stair gait training where in proprioceptive neuromuscular facilitation (PNF) was applied. [Subjects and Methods] In total 30 stroke patients participated in this experiment and were randomly and equally allocated to an experimental group and a control group. The experimental group received exercise treatment for 30 min and stair gait training where in PNF was applied for 30 min and the control group received exercise treatment for 30 min and ground gait training where in PNF was applied for 30 min. For the four weeks of the experiment, each group received training three times per week, for 30 min each time. Berg Balance Scale (BBS) values were measured and a time up and go (TUG) test and a functional reach test (FRT) were performed for a comparison before and after the experiment. [Results] According to the result of the stroke patients' balance performance through stair gait training, the BBS and FRT results significantly increased and the TUG test result significantly decreased in the experimental group. On the contrary, BBS and FRT results did not significantly increase and the TUG test result did not significantly decrease in the control group. According to the result of comparing differences between before and after training in each group, there was a significant change in the BBS result of the experimental group only. [Conclusions] In conclusion, the gait training group to which PNF was applied saw improvements in their balance ability, and a good result is expected when neurological disease patients receive stair gait training applying PNF.

  10. The effects of stair gait training using proprioceptive neuromuscular facilitation on stroke patients’ dynamic balance ability

    Science.gov (United States)

    Seo, KyoChul; Park, Seung Hwan; Park, KwangYong

    2015-01-01

    [Purpose] This study aims to examine stroke patients’ changes in dynamic balance ability through stair gait training where in proprioceptive neuromuscular facilitation (PNF) was applied. [Subjects and Methods] In total 30 stroke patients participated in this experiment and were randomly and equally allocated to an experimental group and a control group. The experimental group received exercise treatment for 30 min and stair gait training where in PNF was applied for 30 min and the control group received exercise treatment for 30 min and ground gait training where in PNF was applied for 30 min. For the four weeks of the experiment, each group received training three times per week, for 30 min each time. Berg Balance Scale (BBS) values were measured and a time up and go (TUG) test and a functional reach test (FRT) were performed for a comparison before and after the experiment. [Results] According to the result of the stroke patients’ balance performance through stair gait training, the BBS and FRT results significantly increased and the TUG test result significantly decreased in the experimental group. On the contrary, BBS and FRT results did not significantly increase and the TUG test result did not significantly decrease in the control group. According to the result of comparing differences between before and after training in each group, there was a significant change in the BBS result of the experimental group only. [Conclusions] In conclusion, the gait training group to which PNF was applied saw improvements in their balance ability, and a good result is expected when neurological disease patients receive stair gait training applying PNF. PMID:26157240

  11. Gait quality is improved by locomotor training in individuals with SCI regardless of training approach

    Directory of Open Access Journals (Sweden)

    ter Hoeve Nienke

    2009-10-01

    Full Text Available Abstract Background While various body weight supported locomotor training (BWSLT approaches are reported in the literature for individuals with spinal cord injury (SCI, none have evaluated outcomes in terms of gait quality. The purpose of this study was to compare changes in measures of gait quality associated with four different BWSLT approaches in individuals with chronic motor-incomplete SCI, and to identify how gait parameters differed from those of non-disabled (ND individuals. Methods Data were analyzed from 51 subjects with SCI who had been randomized into one of four BWSLT groups: treadmill with manual assistance (TM, treadmill with electrical stimulation (TS, overground with electrical stimulation (OG, treadmill with locomotor robot (LR. Subjects with SCI performed a 10-meter kinematic walk test before and after 12 weeks of training. Ten ND subjects performed the test under three conditions: walking at preferred speed, at speed comparable to subjects with SCI, and with a walker at comparable speed. Six kinematic gait quality parameters were calculated including: cadence, step length, stride length, symmetry index, intralimb coordination, and timing of knee extension. Results In subjects with SCI, all training approaches were associated with improvements in gait quality. After training, subjects with SCI walked at higher cadence and had longer step and stride lengths. No significant differences were found among training groups, however there was an interaction effect indicating that step and stride length improved least in the LR group. Compared to when walking at preferred speed, gait quality of ND subjects was significantly different when walking at speeds comparable to those of the subjects with SCI (both with and without a walker. Post training, gait quality measures of subjects with SCI were more similar to those of ND subjects. Conclusion BWSLT leads to improvements in gait quality (values closer to ND subjects regardless of

  12. Gait rehabilitation machines based on programmable footplates

    Directory of Open Access Journals (Sweden)

    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

  13. 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

  14. Predisability and gait patterns in older adults.

    Science.gov (United States)

    Verghese, Joe; Xue, Xiaonan

    2011-01-01

    Presence of performance inconsistency during repeated assessments of gait may reflect underlying subclinical disease, and help shed light on the earliest stages of disablement. We studied inter-session fluctuations on three selected gait measures (velocity, stride length, and stride length variability) during normal pace walking as well as during a cognitively demanding 'walking while talking' condition using a repeated measurement burst design (six sessions within a 2-week period) in 71 nondisabled and nondemented community residing older adults, 40 with predisability (does activities of daily living unassisted but with difficulty). Subjects with predisability had slower gait velocity and shorter stride length on both the normal and walking while talking conditions at baseline compared to nondisabled subjects. However, there was no significant pattern of fluctuations across the six sessions on the three selected gait variables comparing the two groups during normal walking as well as on the walking while talking conditions. Our findings support consistency of gait measurements during the earliest stages of disability. Copyright © 2010 Elsevier B.V. All rights reserved.

  15. Scrunching: a novel escape gait in planarians

    Science.gov (United States)

    Cochet-Escartin, Olivier; Mickolajczyk, Keith J.; Collins, Eva-Maria S.

    2015-10-01

    The ability to escape a predator or other life-threatening situations is central to animal survival. Different species have evolved unique strategies under anatomical and environmental constraints. In this study, we describe a novel musculature-driven escape gait in planarians, ‘scrunching’, which is quantitatively different from other planarian gaits, such as gliding and peristalsis. We show that scrunching is a conserved gait among different flatworm species, underlying its importance as an escape mechanism. We further demonstrate that it can be induced by a variety of physical stimuli, including amputation, high temperature, electric shock and low pH. We discuss the functional basis for scrunching as the preferential gait when gliding is impaired due to a disruption of mucus production. Finally, we show that the key mechanical features of scrunching are adequately captured by a simple biomechanical model that is solely based on experimental data from traction force microscopy and tissue rheology without fit parameters. Together, our results form a complete description of this novel form of planarian locomotion. Because scrunching has distinct dynamics, this gait can serve as a robust behavioral readout for studies of motor neuron and muscular functions in planarians and in particular the restoration of these functions during regeneration.

  16. 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.

  17. Gait Characteristics in Adolescents With Multiple Sclerosis.

    Science.gov (United States)

    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.

  18. Kinematic gait analyses in healthy Golden Retrievers

    Directory of Open Access Journals (Sweden)

    Gabriela C.A. Silva

    2014-12-01

    Full Text Available Kinematic analysis relates to the relative movement between rigid bodies and finds application in gait analysis and other body movements, interpretation of their data when there is change, determines the choice of treatment to be instituted. The objective of this study was to standardize the march of Dog Golden Retriever Healthy to assist in the diagnosis and treatment of musculoskeletal disorders. We used a kinematic analysis system to analyse the gait of seven dogs Golden Retriever, female, aged between 2 and 4 years, weighing 21.5 to 28 kg, clinically normal. Flexion and extension were described for shoulder, elbow, carpal, hip, femorotibialis and tarsal joints. The gait was characterized lateral and had accepted hypothesis of normality for all variables, except for the stance of hip and elbow, considering a confidence level of 95%, significance level α = 0.05. Variations have been attributed to displacement of the stripes during movement and the duplicated number of reviews. The kinematic analysis proved to be a consistent method of evaluation of the movement during canine gait and the data can be used in the diagnosis and evaluation of canine gait in comparison to other studies and treatment of dogs with musculoskeletal disorders.

  19. Gait Recognition Based on Outermost Contour

    Directory of Open Access Journals (Sweden)

    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.

  20. The effect of additional activation of the plantar intrinsic foot muscles on foot dynamics during gait.

    Science.gov (United States)

    Okamura, Kazunori; Kanai, Shusaku; Hasegawa, Masaki; Otsuka, Akira; Oki, Sadaaki

    2017-08-18

    The plantar intrinsic foot muscles (PIFMs) contribute to support the medial longitudinal arch. But the functional role of the PIFMs during dynamic activities is not clear. The purpose of this study was to examine the change in the foot dynamics during gait accompanied with the change in the PIFMs activity to determine the functional role of the PIFMs during gait. Twenty healthy male subjects were randomly assigned to the electrical stimulation group (ESG) or control group (CG). In the ESG, the electrical stimulation to the PIFMs was provided from mid-stance to pre-swing using surface electrodes to simulate reinforcement of the PIFMs. The foot dynamics during the stance phase of gait was measured using a 3D motion analysis, and the amount of change from baseline (electrical stimulation was not provided) was compared between groups using an independent sample t-test. In the ESG, the timing for the navicular height to reach the minimum value was significantly later, and the vertical ground reaction force (2nd peak) significantly decreased more. There were no group differences in the amount of change from baseline on gait velocity, stance phase duration, minimum navicular height and ground reaction force in other directions. Results from this study showed that the functions of the PIFMs most likely include shock absorption and facilitation of efficient foot ground force transmission during the stance phase of gait. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. A treadmill and motion coupled virtual reality system for gait training post-stroke.

    Science.gov (United States)

    Fung, Joyce; Richards, Carol L; Malouin, Francine; McFadyen, Bradford J; Lamontagne, Anouk

    2006-04-01

    A virtual reality (VR)-based locomotor training system has been developed for gait rehabilitation post-stroke. The system consists of a self-paced treadmill mounted onto a 6-degrees-of-freedom motion platform. Virtual environments (VEs) that are synchronized with the speed of the treadmill and the motions of the platform are rear-projected onto a screen in front of the walking subject. A feasibility study was conducted to test the capability of two stroke patients and one healthy control to be trained with the system. Three VE scenarios (corridor walking, street crossing, and park stroll) were woven into a gait-training program that provided three levels of complexity (walking speed, slopes, collision avoidances), progression criteria (number of successful trials) and knowledge of results. Results show that, with practice, patients can effectively increase their gait speed as demanded by the task and adapt their gait with respect to the change in physical terrain. However, successful completion of tasks requiring adaptation to increasing demands related to speed and physical terrains does not necessarily predict the patient's ability to anticipate and avoid collision with obstacles during walking. This feasibility study demonstrates that persons with stroke are able to adapt to this novel VR system and be immersed in the VEs for gait training.

  2. Ankle Training With a Robotic Device Improves Hemiparetic Gait After a Stroke

    Science.gov (United States)

    Forrester, Larry W.; Roy, Anindo; Krebs, Hermano Igo; Macko, Richard F.

    2013-01-01

    Background Task-oriented therapies such as treadmill exercise can improve gait velocity after stroke, but slow velocities and abnormal gait patterns often persist, suggesting a need for additional strategies to improve walking. Objectives To determine the effects of a 6-week visually guided, impedance controlled, ankle robotics intervention on paretic ankle motor control and gait function in chronic stroke. Methods This was a single-arm pilot study with a convenience sample of 8 stroke survivors with chronic hemiparetic gait, trained and tested in a laboratory. Subjects trained in dorsiflexion–plantarflexion by playing video games with the robot during three 1-hour training sessions weekly, totaling 560 repetitions per session. Assessments included paretic ankle ranges of motion, strength, motor control, and overground gait function. Results Improved paretic ankle motor control was seen as increased target success, along with faster and smoother movements. Walking velocity also increased significantly, whereas durations of paretic single support increased and double support decreased. Conclusions Robotic feedback training improved paretic ankle motor control with improvements in floor walking. Increased walking speeds were comparable with reports from other task-oriented, locomotor training approaches used in stroke, suggesting that a focus on ankle motor control may provide a valuable adjunct to locomotor therapies. PMID:21115945

  3. Gait Phases Recognition from Accelerations and Ground Reaction Forces: Application of Neural Networks

    Directory of Open Access Journals (Sweden)

    S. Rafajlović

    2009-06-01

    Full Text Available The goal of this study was to test the applicability of accelerometer as the sensor for assessment of the walking. We present here the comparison of gait phases detected from the data recorded by force sensing resistors mounted in the shoe insoles, non-processed acceleration and processed acceleration perpendicular to the direction of the foot. The gait phases in all three cases were detected by means of a neural network. The output from the neural network was the gait phase, while the inputs were data from the sensors. The results show that the errors were in the ranges: 30 ms (2.7% – force sensors; 150 ms (13.6% – nonprocessed acceleration, and 120 ms (11% – processed acceleration data. This result suggests that it is possible to use the accelerometer as the gait phase detector, however, with the knowledge that the gait phases are time shifted for about 100 ms with respect the neural network predicted times.

  4. [Gait, balance and independence rehabilitation program in elderly adults in a primary care unit].

    Science.gov (United States)

    Espinosa-Cuervo, Gisela; López-Roldán, Verónica Miriam; Escobar-Rodríguez, David Alvaro; Conde-Embarcadero, Margarita; Trejo-León, Gerardo; González-Carmona, Beatriz

    2013-01-01

    to evaluate the effect of a supervised rehabilitation program to improve gait, balance and independence in elderly patients attending a family medicine unit. we conducted a quasi-experimental study over a period of four weeks in a group of 72 patients older than 65 years. a supervised program regarding the risk factors for falling, and balance, gait, coordination and oculovestibular system, the modalities to be done two or three times a week in the primary care unit or at home. An analysis of both tests was performed by "up and go," Tinetti scale and the Katz index. "intention to treat" and "by protocol." mean age was 72 ± 5 years, 67.8% were female and 81.9% of the patients completed the program. A significant clinical improvement with statistical level were evident for gait and balance (p = 0.001), independence showed only clinical improvement (p = 0.083). The efficacy for periodicity (two or three times/week) and performance place showed same clinical improvement and statistical level for gait and balance (p = 0.001 to 0.003) and independence showed only clinical improvement (p = 0.317 to 0.991). an integral rehabilitation program improved gait, balance and clinical independence significantly. The supervised program is applicable and can be reproduced at primary care unit or home for geriatric care and preventive actions.

  5. Gait speed and cognitive score in elderly users of the primary care service.

    Science.gov (United States)

    Lenardt, Maria Helena; de Sousa, Jacy Aurelia Vieira; Grden, Clóris Regina Blanski; Betiolli, Susanne Elero; Carneiro, Nathália Hammerschmidt Kolb; Ribeiro, Dâmarys Kohlbeck de Melo Neu

    2015-01-01

    to investigate the association between gait speed and the cognitive score of elderly patients enrolled in a Basic Health Unit. a quantitative cross-sectional study with 203 elderly, a sample calculated based on the estimated population proportion. Data were collected using a sociodemographic and clinical questionnaire, gait speed test (GS) and the Mini Mental State Examination (MMSE). the illiterate patients had a mean MMSE=19.33(±3.7) and GS = 0.76m/s (±0.3); those with low/medium education had a MMSE = 25.43(±2.8) and GS = 0.92m/s (±0.2); and the elderly with higher education had a MMSE = 27.33(±2.9) and GS=1.12m/s (±0.3).There was a weak correlation (R2=00354) between gait speed and cognitive score, with statistical significance (Prob>F = 0.0072) and a positive linear trend. the better cognitive score the higher the gait speed; the illiterate elderly were those with lower gait speed, thereby indicating a poorer physical performance.

  6. Reliable sagittal plane kinematic gait assessments are feasible using low-cost webcam technology.

    Science.gov (United States)

    Saner, Robert J; Washabaugh, Edward P; Krishnan, Chandramouli

    2017-07-01

    Three-dimensional (3-D) motion capture systems are commonly used for gait analysis because they provide reliable and accurate measurements. However, the downside of this approach is that it is expensive and requires technical expertise; thus making it less feasible in the clinic. To address this limitation, we recently developed and validated (using a high-precision walking robot) a low-cost, two-dimensional (2-D) real-time motion tracking approach using a simple webcam and LabVIEW Vision Assistant. The purpose of this study was to establish the repeatability and minimal detectable change values of hip and knee sagittal plane gait kinematics recorded using this system. Twenty-one healthy subjects underwent two kinematic assessments while walking on a treadmill at a range of gait velocities. Intraclass correlation coefficients (ICC) and minimal detectable change (MDC) values were calculated for commonly used hip and knee kinematic parameters to demonstrate the reliability of the system. Additionally, Bland-Altman plots were generated to examine the agreement between the measurements recorded on two different days. The system demonstrated good to excellent reliability (ICC>0.75) for all the gait parameters tested on this study. The MDC values were typically low (gait assessments using webcam technology can be reliably used for clinical and research purposes. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Assessment of a Smart Sensing Shoe for Gait Phase Detection in Level Walking

    Directory of Open Access Journals (Sweden)

    Nicola Carbonaro

    2016-11-01

    Full Text Available Gait analysis and more specifically ambulatory monitoring of temporal and spatial gait parameters may open relevant fields of applications in activity tracking, sports and also in the assessment and treatment of specific diseases. Wearable technology can boost this scenario by spreading the adoption of monitoring systems to a wide set of healthy users or patients. In this context, we assessed a recently developed commercial smart shoe—the FootMoov—for automatic gait phase detection in level walking. FootMoov has built-in force sensors and a triaxial accelerometer and is able to transmit the sensor data to the smartphone through a wireless connection. We developed a dedicated gait phase detection algorithm relying both on force and inertial information. We tested the smart shoe on ten healthy subjects in free level walking conditions and in a laboratory setting in comparison with an optical motion capture system. Results confirmed a reliable detection of the gait phases. The maximum error committed, on the order of 44.7 ms, is comparable with previous studies. Our results confirmed the possibility to exploit consumer wearable devices to extract relevant parameters to improve the subject health or to better manage his/her progressions.

  8. Characterization of gait in female patients with moderate to severe hallux valgus deformity.

    Science.gov (United States)

    Chopra, S; Moerenhout, K; Crevoisier, X

    2015-07-01

    Hallux valgus is one of the most common forefoot problems in females. Studies have looked at gait alterations due to hallux valgus deformity, assessing temporal, kinematic or plantar pressure parameters individually. The present study, however, aims to assess all listed parameters at once and to isolate the most clinically relevant gait parameters for moderate to severe hallux valgus deformity with the intent of improving post-operative patient prognosis and rehabilitation. The study included 26 feet with moderate to severe hallux valgus deformity and 30 feet with no sign of hallux valgus in female participants. Initially, weight bearing radiographs and foot and ankle clinical scores were assessed. Gait assessment was then performed utilizing pressure insoles (PEDAR) and inertial sensors (Physilog) and the two groups were compared using a non-parametric statistical hypothesis test (Wilcoxon rank sum, Phallux valgus group compared to controls and 9 gait parameters (effect size between 1.03 and 1.76) were successfully isolated to best describe the altered gait in hallux valgus deformity (r(2)=0.71) as well as showed good correlation with clinical scores. Our results, and nine listed parameters, could serve as benchmark for characterization of hallux valgus and objective evaluation of treatment efficacy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Gait biomechanics and hip muscular strength in patients with patellofemoral osteoarthritis.

    Science.gov (United States)

    Pohl, Michael B; Patel, Chirag; Wiley, J Preston; Ferber, Reed

    2013-03-01

    A significant number of patients with patellofemoral osteoarthritis (PFOA) have described a history of patellofemoral pain syndrome (PFPS). This leads to speculation that the underpinning mechanical causes of PFPS and PFOA may be similar. Although alterations in gait biomechanics and hip strength have been reported in PFPS, this relationship has not yet been explored in PFOA. Therefore the purpose of this study was compare gait biomechanics and hip muscular strength between PFOA patients and a healthy control group. Fifteen patients with symptomatic, radiographic PFOA and 15 controls participated. All patients underwent a walking gait analysis and maximal hip strength testing. Biomechanical variables of interest included the peak angular values of contra-lateral pelvic drop, hip adduction and hip internal rotation during the stance phase. Hip abduction and external rotation strength were assessed using maximal voluntary isometric contractions. The PFOA group demonstrated significantly lower hip abduction strength compared to controls but no difference in hip external rotation strength. There were no statistical differences between the PFOA and control groups for contra-lateral pelvic drop, hip adduction and hip internal rotation angles during walking. Despite patients with PFOA exhibiting weaker hip abductor muscle strength compared to their healthy counterparts they did not demonstrate alterations in pelvis or hip biomechanics during gait. These preliminary data suggests that weaker hip abductor strength does not result in biomechanical alterations during gait in this population. Copyright © 2012 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  12. DeepGait: A Learning Deep Convolutional Representation for View-Invariant Gait Recognition Using Joint Bayesian

    Directory of Open Access Journals (Sweden)

    Chao Li

    2017-02-01

    Full Text Available Human gait, as a soft biometric, helps to recognize people through their walking. To further improve the recognition performance, we propose a novel video sensor-based gait representation, DeepGait, using deep convolutional features and introduce Joint Bayesian to model view variance. DeepGait is generated by using a pre-trained “very deep” network “D-Net” (VGG-D without any fine-tuning. For non-view setting, DeepGait outperforms hand-crafted representations (e.g., Gait Energy Image, Frequency-Domain Feature and Gait Flow Image, etc.. Furthermore, for cross-view setting, 256-dimensional DeepGait after PCA significantly outperforms the state-of-the-art methods on the OU-ISR large population (OULP dataset. The OULP dataset, which includes 4007 subjects, makes our result reliable in a statistically reliable way.

  13. Navigated Transcranial Magnetic Stimulation: A Biologically Based Assay of Lower Extremity Impairment and Gait Velocity

    Directory of Open Access Journals (Sweden)

    Heather T. Peters

    2017-01-01

    Full Text Available Objectives. (a To determine associations among motor evoked potential (MEP amplitude, MEP latency, lower extremity (LE impairment, and gait velocity and (b determine the association between the presence of a detectable MEP signal with LE impairment and with gait velocity. Method. 35 subjects with chronic, stable LE hemiparesis were undergone TMS, the LE section of the Fugl-Meyer Impairment Scale (LE FM, and 10-meter walk test. We recorded presence, amplitude, and latency of MEPs in the affected tibialis anterior (TA and soleus (SO. Results. MEP presence was associated with higher LEFM scores in both the TA and SO. MEP latency was larger in subjects with lower LEFM and difficulty walking. Conclusion. MEP latency appears to be an indicator of LE impairment and gait. Significance. Our results support the precept of using TMS, particularly MEP latency, as an adjunctive LE outcome measurement and prognostic technique.

  14. Navigated Transcranial Magnetic Stimulation: A Biologically Based Assay of Lower Extremity Impairment and Gait Velocity.

    Science.gov (United States)

    Peters, Heather T; Dunning, Kari; Belagaje, Samir; Kissela, Brett M; Ying, Jun; Laine, Jarmo; Page, Stephen J

    2017-01-01

    Objectives . (a) To determine associations among motor evoked potential (MEP) amplitude, MEP latency, lower extremity (LE) impairment, and gait velocity and (b) determine the association between the presence of a detectable MEP signal with LE impairment and with gait velocity. Method . 35 subjects with chronic, stable LE hemiparesis were undergone TMS, the LE section of the Fugl-Meyer Impairment Scale (LE FM), and 10-meter walk test. We recorded presence, amplitude, and latency of MEPs in the affected tibialis anterior (TA) and soleus (SO). Results . MEP presence was associated with higher LEFM scores in both the TA and SO. MEP latency was larger in subjects with lower LEFM and difficulty walking. Conclusion . MEP latency appears to be an indicator of LE impairment and gait. Significance . Our results support the precept of using TMS, particularly MEP latency, as an adjunctive LE outcome measurement and prognostic technique.

  15. Relationship between sex, body composition, gait speed and body satisfaction in elderly people.

    Science.gov (United States)

    Latorre Román, P A; García-Pinillos, F; Huertas Herrador, J A; Cózar Barba, M; Muñoz Jiménez, M

    2014-10-01

    The purpose of this study is to analyzebody satisfaction in non-institutionalized old people and its association with sex, body mass index (BMI) and gait speed. Hundred six people have participated, 38 men (age=74.60 ±6.67 years old) and 68 women (age=72.76 ±4.68 years old). The Body Shape Questionnaire (BSQ) has been used together with body composition and a gait speed test. Prevalence of body dissatisfaction in old people is about 5.6 %. Women have higher body fat percentage and less muscle mass. Significant differences were not found (p≥0.05) in the BSQ relating with sex. Obese old people with less gait speed showed higher score in BSQ. The Total BSQ is positively correlated with BMI (r=0.487, pgait speed (r=-0.215 pgait speed and negatively with BMI. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  16. Curve aligning approach for gait authentication based on a wearable accelerometer

    International Nuclear Information System (INIS)

    Sun, Hu; Yuao, Tao

    2012-01-01

    Gait authentication based on a wearable accelerometer is a novel biometric which can be used for identity identification, medical rehabilitation and early detection of neurological disorders. The method for matching gait patterns tells heavily on authentication performances. In this paper, curve aligning is introduced as a new method for matching gait patterns and it is compared with correlation and dynamic time warping (DTW). A support vector machine (SVM) is proposed to fuse pattern-matching methods in a decision level. Accelerations collected from ankles of 22 walking subjects are processed for authentications in our experiments. The fusion of curve aligning with backward–forward accelerations and DTW with vertical accelerations promotes authentication performances substantially and consistently. This fusion algorithm is tested repeatedly. Its mean and standard deviation of equal error rates are 0.794% and 0.696%, respectively, whereas among all presented non-fusion algorithms, the best one shows an EER of 3.03%. (paper)

  17. Control Architecture of a 10 DOF Lower Limbs Exoskeleton for Gait Rehabilitation

    Directory of Open Access Journals (Sweden)

    Natasa Koceska

    2013-01-01

    Full Text Available This paper describes the control architecture of a 10 DOF (Degrees of Freedom lower limbs exoskeleton for the gait rehabilitation of patients with gait dysfunction. The system has 4 double-acting rod pneumatic actuators (two for each leg that control the hip and knee joints. The motion of each cylinder's piston is controlled by two proportional pressure valves, connected to both cylinder chambers. The control strategy has been specifically designed in order to ensure a proper trajectory control for guiding patient's legs along a fixed reference gait pattern. An adaptive fuzzy controller which is capable of compensating for the influence of the dry friction was successfully designed, implemented and tested on an embedded real-time PC/104. In order to verify the proposed control architecture, laboratory experiments without a patient were carried out and the results are reported here and discussed.

  18. Design and Construction of a Specialised Biomimetic Robot in Multiple Swimming Gaits

    Directory of Open Access Journals (Sweden)

    Sayyed Farideddin Masoomi

    2015-11-01

    Full Text Available Efficient cruising, manoeuvrability and noiseless performance of fish robots have been attracting people in various scientific realms. Accordingly, a number of fish robots are designed and fabricated so far. However, the existing robots are only capable of one gait of locomotion. This deficiency is addressed by UC-Ika 2 with multiple gaits of locomotion including cruising and manoeuvring that are inspired from two different fishes. This paper aims at presenting the design and fabrication process of UC-Ika 2. The swimming performance of the robot is tested and compared with its previous version UC-Ika 1.

  19. The Use of Accelerometers and Gyroscopes to Estimate Hip and Knee Angles on Gait Analysis

    Directory of Open Access Journals (Sweden)

    Francesco Alonge

    2014-05-01

    Full Text Available In this paper the performance of a sensor system, which has been developed to estimate hip and knee angles and the beginning of the gait phase, have been investigated. The sensor system consists of accelerometers and gyroscopes. A new algorithm was developed in order to avoid the error accumulation due to the gyroscopes drift and vibrations due to the ground contact at the beginning of the stance phase. The proposed algorithm have been tested and compared to some existing algorithms on over-ground walking trials with a commercial device for assisted gait. The results have shown the good accuracy of the angles estimation, also in high angle rate movement.

  20. The use of accelerometers and gyroscopes to estimate hip and knee angles on gait analysis.

    Science.gov (United States)

    Alonge, Francesco; Cucco, Elisa; D'Ippolito, Filippo; Pulizzotto, Alessio

    2014-05-13

    In this paper the performance of a sensor system, which has been developed to estimate hip and knee angles and the beginning of the gait phase, have been investigated. The sensor system consists of accelerometers and gyroscopes. A new algorithm was developed in order to avoid the error accumulation due to the gyroscopes drift and vibrations due to the ground contact at the beginning of the stance phase. The proposed algorithm have been tested and compared to some existing algorithms on over-ground walking trials with a commercial device for assisted gait. The results have shown the good accuracy of the angles estimation, also in high angle rate movement.

  1. 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....

  2. Quantifying gait patterns in Parkinson's disease

    Science.gov (United States)

    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.

  3. Asymmetry of Anticipatory Postural Adjustment During Gait Initiation

    Directory of Open Access Journals (Sweden)

    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

  4. Variability and Similarity of Gait as Evaluated by Joint Angles

    DEFF Research Database (Denmark)

    Yang, Sylvia X M; Larsen, Peter Kastmand; Alkjær, Tine

    2014-01-01

    Closed-circuit television (CCTV) footage is used in criminal investigations to compare perpetrators with suspects. Usually, incomplete gait cycles are collected, making evidential gait analysis challenging. This study aimed to analyze the discriminatory power of joint angles throughout a gait cyc...

  5. Gait speed and one-leg standing time each add to the predictive ability of FRAX.

    Science.gov (United States)

    Lundin, H; Sääf, M; Strender, L-E; Nyren, S; Johansson, S-E; Salminen, H

    2017-01-01

    Gait speed or one-leg standing time (OLST) as additional predictors in FRAX. Population 351 elderly women followed 10 years. Both could improve predictions. The area under curve (AUC) for FRAX is 0.59, OLST is 0.69 and gait speed is 0.71. The net reclassification index (NRI) for classification to highest risk quartile or lowest three quartiles was 0.24 for gait speed and non-significant for OLST. The risk of falls and bone strength are two main determinants of hip fracture risk. The fracture risk assessment tool FRAX, however, lacks direct measures of fall risk 1 . A short OLST and a slow gait speed are both fall-related risk factors for hip fractures. The aim of this study was to investigate whether the addition to FRAX of either gait speed or OLST could improve the predictive ability for hip fractures, compared to FRAX alone. A population-based sample of 351 women aged between 69 and 79 years were tested for one-leg standing time with eyes open and mean gait speed over a 15 + 15-m walk. Fracture and mortality data were obtained from health care registers. The AUC for the receiver operating characteristic (ROC) increased from 0.61 to 0.71 when gait speed was added to FRAX. The AUC was 0.69 for OLST added to FRAX. The highest quartile of hip fracture risks according to FRAX had an absolute 10-year risk of ≥15%. The population was divided into one group with a hip fracture risk of ≥15% and one group with a fracture risk of <15%. NRI for addition of gait speed to FRAX was 0.24 (p = 0.023), while NRI was 0.08 (p = 0.544) for addition of OLST to FRAX. Gait speed tended to improve the predictive ability of FRAX more than OLST, but they both added value to FRAX.

  6. Powered robotic exoskeletons in post-stroke rehabilitation of gait: a scoping review.

    Science.gov (United States)

    Louie, Dennis R; Eng, Janice J

    2016-06-08

    Powered robotic exoskeletons are a potential intervention for gait rehabilitation in stroke to enable repetitive walking practice to maximize neural recovery. As this is a relatively new technology for stroke, a scoping review can help guide current research and propose recommendations for advancing the research development. The aim of this scoping review was to map the current literature surrounding the use of robotic exoskeletons for gait rehabilitation in adults post-stroke. Five databases (Pubmed, OVID MEDLINE, CINAHL, Embase, Cochrane Central Register of Clinical Trials) were searched for articles from inception to October 2015. Reference lists of included articles were reviewed to identify additional studies. Articles were included if they utilized a robotic exoskeleton as a gait training intervention for adult stroke survivors and reported walking outcome measures. Of 441 records identified, 11 studies, all published within the last five years, involving 216 participants met the inclusion criteria. The study designs ranged from pre-post clinical studies (n = 7) to controlled trials (n = 4); five of the studies utilized a robotic exoskeleton device unilaterally, while six used a bilateral design. Participants ranged from sub-acute (6 months) stroke. Training periods ranged from single-session to 8-week interventions. Main walking outcome measures were gait speed, Timed Up and Go, 6-min Walk Test, and the Functional Ambulation Category. Meaningful improvement with exoskeleton-based gait training was more apparent in sub-acute stroke compared to chronic stroke. Two of the four controlled trials showed no greater improvement in any walking outcomes compared to a control group in chronic stroke. In conclusion, clinical trials demonstrate that powered robotic exoskeletons can be used safely as a gait training intervention for stroke. Preliminary findings suggest that exoskeletal gait training is equivalent to traditional therapy for chronic stroke

  7. Interaction of obstructive sleep apnoea and cognitive impairment with slow gait speed in middle-aged and older adults.

    Science.gov (United States)

    Lee, Sunghee; Shin, Chol

    2017-07-01

    to investigate whether slow gait speed is associated with cognitive impairment and further whether the association is modified by obstructive sleep apnoea (OSA). in total, 2,222 adults aged 49-80 years, free from dementia, stroke and head injury were asked to walk a 4-m course at fast and usual gait speeds. The time taken to walk was measured. All participants completed the Korean Mini-Mental State Examination, which was validated in the Korean language, to assess cognitive function. Additionally, the participants completed a polysomnography test to ascertain OSA (defined as an apnoea-hypopnoea index ≥15). Multivariable linear regression models were utilised to test the associations. time taken to walk 4 m showed significant inverse associations with cognitive scores (P value = 0.001 at fast gait speed and P = 0.002 at usual gait speed). Furthermore, a significant interaction according to OSA on the association between time to walk and cognitive impairment was found (P value for interaction = 0.003 at fast gait speed and P value for interaction = 0.007 at usual gait speed). we found that the inverse association between the time taken to walk 4 m and a cognitive score became significantly stronger, if an individual had OSA. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  8. High-speed video gait analysis reveals early and characteristic locomotor phenotypes in mouse models of neurodegenerative movement disorders.

    Science.gov (United States)

    Preisig, Daniel F; Kulic, Luka; Krüger, Maik; Wirth, Fabian; McAfoose, Jordan; Späni, Claudia; Gantenbein, Pascal; Derungs, Rebecca; Nitsch, Roger M; Welt, Tobias

    2016-09-15

    Neurodegenerative diseases of the central nervous system frequently affect the locomotor system resulting in impaired movement and gait. In this study we performed a whole-body high-speed video gait analysis in three different mouse lines of neurodegenerative movement disorders to investigate the motor phenotype. Based on precise computerized motion tracking of all relevant joints and the tail, a custom-developed algorithm generated individual and comprehensive locomotor profiles consisting of 164 spatial and temporal parameters. Gait changes observed in the three models corresponded closely to the classical clinical symptoms described in these disorders: Muscle atrophy due to motor neuron loss in SOD1 G93A transgenic mice led to gait characterized by changes in hind-limb movement and positioning. In contrast, locomotion in huntingtin N171-82Q mice modeling Huntington's disease with basal ganglia damage was defined by hyperkinetic limb movements and rigidity of the trunk. Harlequin mutant mice modeling cerebellar degeneration showed gait instability and extensive changes in limb positioning. Moreover, model specific gait parameters were identified and were shown to be more sensitive than conventional motor tests. Altogether, this technique provides new opportunities to decipher underlying disease mechanisms and test novel therapeutic approaches. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Effects of gait velocity and center of mass acceleration during turning gait in old-old elderly women

    OpenAIRE

    Shin, Sun-Shil; Yoo, Won-Gyu

    2015-01-01

    [Purpose] This study investigated gait velocity and center of mass acceleration in three directions during square and semicircular turning gait tasks in old-old elderly women. [Subjects] Fifteen community-dwelling, old-old elderly women (?75?years old) who could walk independently were recruited. [Methods] We measured gait velocity and center of mass acceleration in three directions using an accelerometer during two different turning gait tasks. [Results] The velocity during square turning wa...

  10. Spatiotemporal gait parameters during dual task walking in need of care elderly and young adults. A cross-sectional study.

    Science.gov (United States)

    Agner, S; Bernet, J; Brülhart, Y; Radlinger, L; Rogan, S

    2015-12-01

    Up to now there have only been marginal data in the elderly in need of care regarding spatiotemporal gait parameters during single (ST) and dual tasking (DT). The aim of this study was to allocate data for gait speed, cadence and stride length cycle variability in the elderly in need of care and in young adults during ST and DT, to compare the two groups and to demonstrate the impact of ST and DT on gait parameters. This cross-sectional study investigated a group of 16 young healthy adults (mean age 23.0 ± 2.5 years) and a group of 16 elderly persons in need of care (mean age 85.5 ± 0.6 years). The RehaWatch system was used to collect the spatiotemporal gait parameters cadence, speed and stride length. The participants completed four different measurements during normal walking and fast walking during ST and DT over a walking distance of 20 m. The Wilcoxon rank sum test and Whitney-U test were used for statistical analysis. Gait speed (ST and DT: p gait variability (ST: p = 0.007, DT: p = 0.003) were significantly reduced in the elderly in need of care group compared to the young group. The gait speed in the elderly in need of care group decreased from normal to fast walking (ST = - 2.8%, DT = - 12.2%) compared to the young group (ST = 31.5%, DT = 25.2%). The results of this study are comparable with the results of existing studies, which investigated falling and non-falling participants. Elderly people in need of care cannot increase the normal gait speed.

  11. Is Trunk Posture in Walking a Better Marker than Gait Speed in Predicting Decline in Function and Subsequent Frailty?

    Science.gov (United States)

    Merchant, Reshma A; Banerji, Subhasis; Singh, Gautam; Chew, Effie; Poh, Chueh L; Tapawan, Sarah C; Guo, Yan R; Pang, Yu W; Sharma, Mridula; Kambadur, Ravi; Tay, Stacey

    2016-01-01

    Many recent guidelines and consensus on sarcopenia have incorporated gait speed and grip strength as diagnostic criteria without addressing early posture changes adopted to maintain gait speed before weakness is clinically evident. Older adults are known to compensate well for declining physiological reserve through environmental modification and posture adaptation. This study aimed to analyze and identify significant posture adaptation in older adults that is required to maintain gait speed in the face of increasing vulnerability. This would be a useful guide for early posture correction exercise interventions to prevent further decline, in addition to traditional gait, balance, and strength training. A community-based cross-sectional study. The participants comprised 90 healthy community-dwelling Chinese men between the ages of 60 and 80 years and 20 Chinese adults between the ages of 21 and 50 years within the normal BMI range as a comparison group. All the participants underwent handgrip strength testing, 6-minute walk, timed up-and-go (TUG), and motion analysis for gait characteristics. Low function was characterized by slow walking speed (10 seconds), whereas low strength was determined by hand grip dynamometer testing (posture adaptations in walking in all 3 groups, including those who maintained a good walking speed (>1.0 m/s). The extent of such adaptation was larger in the vulnerable group as compared with the healthy group. Although gait speed is a robust parameter for screening older adults for sarcopenia and frailty, our data suggest that identifying trunk posture adaptation before the onset of decline in gait speed will help in planning interventions in the at-risk community-dwelling older adults even before gait speed declines. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  12. Gait phase detection and discrimination between walking-jogging activities using hidden Markov models applied to foot motion data from a gyroscope.

    Science.gov (United States)

    Mannini, Andrea; Sabatini, Angelo Maria

    2012-09-01

    In this paper we present a classifier based on a hidden Markov model (HMM) that was applied to a gait treadmill dataset for gait phase detection and walking/jogging discrimination. The gait events foot strike, foot flat, heel off, toe off were detected using a uni-axial gyroscope that measured the foot instep angular velocity in the sagittal plane. Walking/jogging activities were discriminated by processing gyroscope data from each detected stride. Supervised learning of the classifier was undertaken using reference data from an optical motion analysis system. Remarkably good generalization properties were achieved across tested subjects and gait speeds. Sensitivity and specificity of gait phase detection exceeded 94% and 98%, respectively, with timing errors that were less than 20 ms, on average; the accuracy of walking/jogging discrimination was approximately 99%. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. A Machine Learning Framework for Gait Classification Using Inertial Sensors: Application to Elderly, Post-Stroke and Huntington’s Disease Patients

    Science.gov (United States)

    Mannini, Andrea; Trojaniello, Diana; Cereatti, Andrea; Sabatini, Angelo M.

    2016-01-01

    Machine learning methods have been widely used for gait assessment through the estimation of spatio-temporal parameters. As a further step, the objective of this work is to propose and validate a general probabilistic modeling approach for the classification of different pathological gaits. Specifically, the presented methodology was tested on gait data recorded on two pathological populations (Huntington’s disease and post-stroke subjects) and healthy elderly controls using data from inertial measurement units placed at shank and waist. By extracting features from group-specific Hidden Markov Models (HMMs) and signal information in time and frequency domain, a Support Vector Machines classifier (SVM) was designed and validated. The 90.5% of subjects was assigned to the right group after leave-one-subject–out cross validation and majority voting. The long-term goal we point to is the gait assessment in everyday life to early detect gait alterations. PMID:26805847

  14. A Machine Learning Framework for Gait Classification Using Inertial Sensors: Application to Elderly, Post-Stroke and Huntington’s Disease Patients

    Directory of Open Access Journals (Sweden)

    Andrea Mannini

    2016-01-01

    Full Text Available Machine learning methods have been widely used for gait assessment through the estimation of spatio-temporal parameters. As a further step, the objective of this work is to propose and validate a general probabilistic modeling approach for the classification of different pathological gaits. Specifically, the presented methodology was tested on gait data recorded on two pathological populations (Huntington’s disease and post-stroke subjects and healthy elderly controls using data from inertial measurement units placed at shank and waist. By extracting features from group-specific Hidden Markov Models (HMMs and signal information in time and frequency domain, a Support Vector Machines classifier (SVM was designed and validated. The 90.5% of subjects was assigned to the right group after leave-one-subject–out cross validation and majority voting. The long-term goal we point to is the gait assessment in everyday life to early detect gait alterations.

  15. An Ambulatory Gait Monitoring System with Activity Classification and Gait Parameter Calculation Based on a Single Foot Inertial Sensor.

    Science.gov (United States)

    Song, Minsu; Kim, Jonghyun

    2018-04-01

    For healthcare and clinical use, ambulatory gait monitoring systems using inertial sensors have been developed to estimate the user gait parameters, such as walking speed, stride time, and stride length. However, to adapt the systems effectively to daily-life activities, they need to be able to classify the gait activities of daily-life to obtain the parameters for each activity. In this study, we propose a simple classification algorithm based on a single inertial sensor for ease of use, which classifies three major gait activities: leveled walk, ramp walk, and stair walk. The classification can be performed with gait parameter estimation simultaneously. The developed system that includes classification and parameter estimation algorithms was evaluated with eight healthy subjects within a gait lab and on an outdoor daily-life walking course. The results showed that the estimated gait parameters were comparable to existing studies (range of walking speed root mean square error: 0.059-0.129 m/s), and the classification accuracy was sufficiently high for all three gait activities: 98.5% for the indoor gait lab experiment and 95.5% for the outdoor complex daily-life walking course experiment. The proposed system is simple and effective for daily-life gait analysis, including gait activity classification and gait parameter estimation for each activity.

  16. Improvement of Gait Symmetry in Patients with Stroke by Motor Imagery.

    Science.gov (United States)

    Pheung-phrarattanatrai, Anuchai; Bovonsunthonchai, Sunee; Heingkaew, Vimonwan; Prayoonwiwat, Naraporn; Chotik-anuchit, Songkram

    2015-06-01

    To investigate effect of gait training with motor imagery (MI) on gait symmetry and self-efficacy offalling in stroke patients. Fourteen stroke patients were categorized in the MI (n = 7) and control (n = 7) groups. They were matched by age range, stroke type, paretic side, time since stroke, and severity. All participants received physical therapy and only the MI group received additional MI training. Both groups were trained for 12 sessions over 1 month. Outcome measurements comprised gait symmetry detecting by theforce distribution measurement platform and self-efficacy offalling testing by the Fall Efficacy Scale-International (FES-I). Both groups were assessed three times:.pre-, intermediate- and post-trainings. Comparisons of all variables between and within groups were tested by Mann-Whitney U test and Friedman ANOVA test, respectively. No significant difference was observed of gait symmetry between MI and control groups. Within group comparison, tendencies of improvement were found in step length and step time symmetry for the MI group. Significant improvements in step length symmetry and FES-I score were found among assessments for the MI group (psymmetry and decreased fear offalling in patients with stroke.

  17. Reliable Gait Recognition Using 3D Reconstructions and Random Forests - An Anthropometric Approach

    DEFF Research Database (Denmark)

    Sandau, Martin; Heimbürger, Rikke V.; Jensen, Karl E.

    2016-01-01

    Photogrammetric measurements of bodily dimensions and analysis of gait patterns in CCTV are important tools in forensic investigations but accurate extraction of the measurements are challenging. This study tested whether manual annotation of the joint centers on 3D reconstructions could provide ...

  18. Markerless motion capture can provide reliable 3D gait kinematics in the sagittal and frontal plane

    DEFF Research Database (Denmark)

    Sandau, Martin; Koblauch, Henrik; Moeslund, Thomas B.

    2014-01-01

    specific articulated model was generated with three rotational and three translational degrees of freedom for each limb segment and without any constraints to the range of motion. This approach was tested on 3D gait analysis and compared to a marker based method. The experiment included ten healthy...

  19. Agreement between the spatio-temporal gait parameters from treadmill-based photoelectric cell and the instrumented treadmill system in healthy young adults and stroke patients.

    Science.gov (United States)

    Lee, Myungmo; Song, Changho; Lee, Kyoungjin; Shin, Doochul; Shin, Seungho

    2014-07-14

    Treadmill gait analysis was more advantageous than over-ground walking because it allowed continuous measurements of the gait parameters. The purpose of this study was to investigate the concurrent validity and the test-retest reliability of the OPTOGait photoelectric cell system against the treadmill-based gait analysis system by assessing spatio-temporal gait parameters. Twenty-six stroke patients and 18 healthy adults were asked to walk on the treadmill at their preferred speed. The concurrent validity was assessed by comparing data obtained from the 2 systems, and the test-retest reliability was determined by comparing data obtained from the 1st and the 2nd session of the OPTOGait system. The concurrent validity, identified by the intra-class correlation coefficients (ICC [2, 1]), coefficients of variation (CVME), and 95% limits of agreement (LOA) for the spatial-temporal gait parameters, were excellent but the temporal parameters expressed as a percentage of the gait cycle were poor. The test-retest reliability of the OPTOGait System, identified by ICC (3, 1), CVME, 95% LOA, standard error of measurement (SEM), and minimum detectable change (MDC95%) for the spatio-temporal gait parameters, was high. These findings indicated that the treadmill-based OPTOGait System had strong concurrent validity and test-retest reliability. This portable system could be useful for clinical assessments.

  20. 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.

  1. Gait analysis in lower-limb amputation and prosthetic rehabilitation.

    Science.gov (United States)

    Esquenazi, Alberto

    2014-02-01

    Gait analysis combined with sound clinical judgment plays an important role in elucidating the factors involved in the pathologic prosthetic gait and the selection and effects of available interventions to optimize it. Detailed clinical evaluation of walking contributes to the analysis of the prosthetic gait, but evaluation in the gait laboratory using kinetic and kinematic data is often necessary to quantify and identify the particular contributions of the variables impacting the gait with confidence and assess the results of such intervention. The same approach can be considered when selecting prosthetic components and assessing leg length in this patient population. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    NARCIS (Netherlands)

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

    2011-01-01

    OBJECTIVE: 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. DESIGN: Clinical experimental

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

    NARCIS (Netherlands)

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

    2011-01-01

    Objective: 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. Design: Clinical experimental

  4. Extraction of stride events from gait accelerometry during treadmill walking.

    Science.gov (United States)

    Sejdić, Ervin; Lowry, Kristin A; Bellanca, Jennica; Perera, Subashan; Redfern, Mark S; Brach, Jennifer S

    Evaluating stride events can be valuable for understanding the changes in walking due to aging and neurological diseases. However, creating the time series necessary for this analysis can be cumbersome. In particular, finding heel contact and toe-off events which define the gait cycles accurately are difficult. We proposed a method to extract stride cycle events from tri-axial accelerometry signals. We validated our method via data collected from 14 healthy controls, 10 participants with Parkinson's disease and 11 participants with peripheral neuropathy. All participants walked at self-selected comfortable and reduced speeds on a computer-controlled treadmill. Gait accelerometry signals were captured via a tri-axial accelerometer positioned over the L3 segment of the lumbar spine. Motion capture data were also collected and served as the comparison method. Our analysis of the accelerometry data showed that the proposed methodology was able to accurately extract heel and toe contact events from both feet. We used t-tests, ANOVA and mixed models to summarize results and make comparisons. Mean gait cycle intervals were the same as those derived from motion capture and cycle-to-cycle variability measures were within 1.5%. Subject group differences could be identified similarly using measures with the two methods. A simple tri-axial acceleromter accompanied by a signal processing algorithm can be used to capture stride events. Clinical Impact: The proposed algorithm enables the assessment of stride events during treadmill walking, and is the first step towards the assessment of stride events using tri-axial accelerometers in real-life settings.

  5. Gait quality assessment using self-organising artificial neural networks.

    Science.gov (United States)

    Barton, Gabor; Lisboa, Paulo; Lees, Adrian; Attfield, Steve

    2007-03-01

    In this study, the challenge to maximise the potential of gait analysis by employing advanced methods was addressed by using self-organising neural networks to quantify the deviation of patients' gait from normal. Data including three-dimensional joint angles, moments and powers of the two lower limbs and the pelvis were used to train Kohonen artificial neural networks to learn an abstract definition of normal gait. Subsequently, data from patients with gait problems were presented to the network which quantified the quality of gait in the form of a single curve by calculating the quantisation error during the gait cycle. A sensitivity analysis involving the manipulation of gait variables' weighting was able to highlight specific causes of the deviation including the anatomical location and the timing of wrong gait patterns. Use of the quantisation error can be regarded as an extension of previously described gait indices because it measures the goodness of gait and additionally provides information related to the causes underlying gait deviations.

  6. A point process approach for analyzing gait variability dynamics.

    Science.gov (United States)

    Ellis, Robert J; Citi, Luca; Barbieri, Riccardo

    2011-01-01

    We present a novel statistical paradigm for modeling and analysis of gait variability which captures the natural point process structure of gait intervals and allows for definition of new measures instantaneous mean and standard deviation. We validate our model using two existing data sets from physionet.org. Results show an excellent model fit and yield insights into the underlying statistical structure behind human gait. Statistical analyses further corroborate previous findings of increased variability in gait at different speeds, both self-paced and metronome-paced, and reveal a significant increase in gait variability in Parkinson's subjects, as compared to young and elderly healthy subjects. These results indicate the validity of a point process approach to the analysis of gait, and the potential utility of incorporating instantaneous measures of gait into diagnostic or patient monitoring applications.

  7. Patellar tendon shortening for flexed knee gait in spastic diplegia.

    Science.gov (United States)

    Sossai, Roberto; Vavken, Patrick; Brunner, Reinald; Camathias, Carlo; Graham, H Kerr; Rutz, Erich

    2015-02-01

    We evaluated the outcome of three different approaches to the management of flexed knee gait patients with spastic diplegia. The three surgical procedures were patellar tendon shortening (PTS), PTS combined with rotational osteotomies of the femur and/or tibia, and PTS combined with supracondylar extension osteotomy (SEO) of the distal femur. The primary outcome measure was gait kinematics. The knee gait variable score (GVS) and the gait profile score (GPS) were derived from gait kinematics. 24 patients (16 male and 8 female), mean age 16.1 years (SD 5.8 years), who had surgery between 2002 and 2008, were followed for a mean of 22 months. Knee extension during gait improved by a mean of 20° throughout the gait cycle, with an improvement in the knee GVS of 14° (pspastic diplegia is both feasible and appropriate. Level III. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Perturbation During Treadmill Training Improves Dynamic Balance and Gait in Parkinson's Disease: A Single-Blind Randomized Controlled Pilot Trial.

    Science.gov (United States)

    Steib, Simon; Klamroth, Sarah; Gaßner, Heiko; Pasluosta, Cristian; Eskofier, Björn; Winkler, Jürgen; Klucken, Jochen; Pfeifer, Klaus

    2017-08-01

    Gait and balance dysfunction are major symptoms in Parkinson's disease (PD). Treadmill training improves gait characteristics in this population but does not reflect the dynamic nature of controlling balance during ambulation in everyday life contexts. To evaluate whether postural perturbations during treadmill walking lead to superior effects on gait and balance performance compared with standard treadmill training. In this single-blind randomized controlled trial, 43 PD patients (Hoehn & Yahr stage 1-3.5) were assigned to either an 8-week perturbed treadmill intervention (n = 21) or a control group (n = 22) training on the identical treadmill without perturbations. Patients were assessed at baseline, postintervention, and at 3 months' follow-up. Primary endpoints were overground gait speed and balance (Mini-BESTest). Secondary outcomes included fast gait speed, walking capacity (2-Minute Walk Test), dynamic balance (Timed Up-and-Go), static balance (postural sway), and balance confidence (Activities-Specific Balance Confidence [ABC] scale). There were no significant between-group differences in change over time for the primary outcomes. At postintervention, both groups demonstrated similar improvements in overground gait speed ( P = .009), and no changes in the Mini-BESTest ( P = .641). A significant group-by-time interaction ( P = .048) existed for the Timed Up-and-Go, with improved performance only in the perturbation group. In addition, the perturbation but not the control group significantly increased walking capacity ( P = .038). Intervention effects were not sustained at follow-up. Our primary findings suggest no superior effect of perturbation training on gait and balance in PD patients. However, some favorable trends existed for secondary gait and dynamic balance parameters, which should be investigated in future trials.

  9. 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.

  10. Methods to quantify the velocity dependence of common gait measurements from automated rodent gait analysis devices.

    Science.gov (United States)

    Neckel, Nathan D

    2015-09-30

    Walking slowly is a different biomechanical task than walking quickly, thus measures of gait will be different at different velocities, such as pre/post injury. It is necessary to determine if the difference in gait measures are from the experimental changes, or simply from traveling at different speeds. Instead of limiting this effect, we have developed techniques to embrace the velocity dependence of gait measures. By translating the pawprints into a body coordinate frame we are able to measure location of paw placement in addition to the standard gait measures. At higher velocities rats have greater consistency of steps, place their forelimb initial contact more medially and anteriorly, and place their hindlimb toe off more medially and posteriorly. Interlimb phasing also becomes more consistent at higher velocities. Following a cervical spinal cord injury consistency is reduced and the velocity dependent behaviors are significantly different. Translating the coordinate frame improves the ability to measure changes in base of support following spinal cord injury. Employing a treadmill, or limiting analysis to a narrow velocity window does address the effects of velocity. We feel that measuring across all velocities is more appropriate than dictating that the animals match speeds. Quantifying locomotion with automated gait analysis devices is a great way to evaluate the changes that experimental treatments provide. These new methods allow for a more appropriate way to address the confound of many gait measures being velocity dependent. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Functional Neuroanatomy for Posture and Gait Control

    Directory of Open Access Journals (Sweden)

    Kaoru Takakusaki

    2017-01-01

    Full Text Available Here we argue functional neuroanatomy for posture- gait control. Multi-sensory information such as somatosensory, visual and vestibular sensation act on various areas of the brain so that adaptable posture- gait control can be achieved. Automatic process of gait, which is steady-state stepping movements associating with postural reflexes including headeye coordination accompanied by appropriate alignment of body segments and optimal level of postural muscle tone, is mediated by the descending pathways from the brainstem to the spinal cord. Particularly, reticulospinal pathways arising from the lateral part of the mesopontine tegmentum and spinal locomotor network contribute to this process. On the other hand, walking in unfamiliar circumstance requires cognitive process of postural control, which depends on knowledges of self-body, such as body schema and body motion in space. The cognitive information is produced at the temporoparietal association cortex, and is fundamental to sustention of vertical posture and construction of motor programs. The programs in the motor cortical areas run to execute anticipatory postural adjustment that is optimal for achievement of goal-directed movements. The basal ganglia and cerebellum may affect both the automatic and cognitive processes of posturegait control through reciprocal connections with the brainstem and cerebral cortex, respectively. Consequently, impairments in cognitive function by damages in the cerebral cortex, basal ganglia and cerebellum may disturb posture-gait control, resulting in falling.

  12. Soap-bubble Optimization of Gaits

    Science.gov (United States)

    Ramasamy, Suresh; Hatton, Ross

    We present a geometric gait optimizer that applies Lie bracket theory to identify optimal cost-of-transport (displacement divided by effort) gaits. This optimizer builds on our previous work, where we have shown that for drag-dominated systems, the efficiency of a gait corresponds to a ratio between ``metric-weighted perimeter length of the cycle and the area integral of the Lie bracket it encloses. In this work, we encode this geometric insight into a variational gait optimizer. For a system with two shape variables, the dynamics of this optimizer are similar to the dynamics of a soap bubble, with the Lie bracket providing internal pressure which causes the boundary of the bubble to expand, the metric-weighted path length providing surface tension constraining the growth of the soap bubble, and a pace-balancing term corresponding to the concentration gradient that evenly distributes soap across the surface of the bubble. In systems with three shape variables, the dynamics are more akin to a windsock, capturing maximum flux through a loop. The variational form of the optimizer allows us to extend it to higher dimensional shape spaces beyond these physical analogies.

  13. 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.

  14. Milestones in gait, balance, and falling

    NARCIS (Netherlands)

    Nutt, J.G.; Horak, F.B.; Bloem, B.R.

    2011-01-01

    Gait, balance, and falls have become increasingly common topics of published articles in the Movement Disorders journal since its launch in 1986. This growth represents an increasing awareness of the importance of mobility to patients' quality of life. New methods have become available that allow

  15. 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.

  16. Clinical usefulness of the virtual reality-based postural control training on the gait ability in patients with stroke.

    Science.gov (United States)

    Park, Yu-Hyung; Lee, Chi-Ho; Lee, Byoung-Hee

    2013-01-01

    This study is a single blind randomized controlled trial to determine the effect of virtual reality-based postural control training on the gait ability in patients with chronic stroke. Sixteen subjects were randomly assigned to either experimental group (VR, n= 8) or control group (CPT, n= 8). Subjects in both groups received conventional physical therapy for 60 min per day, five days per week during a period of four weeks. Subjects in the VR group received additional augmented reality-based training for 30 min per day, three days per week during a period of four weeks. The subjects were evaluated one week before and after participating in a four week training and follow-up at one month post-training. Data derived from the gait analyses included spatiotemporal gait parameters, 10 meters walking test (10 mWT). In the gait parameters, subjects in the VR group showed significant improvement, except for cadence at post-training and follow-up within the experimental group. However, no obvious significant improvement was observed within the control group. In between group comparisons, the experimental group (VR group) showed significantly greater improvement only in stride length compared with the control group (Pgait parameters. In conclusion, we demonstrate significant improvement in gait ability in chronic stroke patients who received virtual reality based postural control training. These findings suggest that virtual reality (VR) postural control training using real-time information may be a useful approach for enhancement of gait ability in patients with chronic stroke.

  17. Effects of hip abductor muscle fatigue on gait control and hip position sense in healthy older adults.

    Science.gov (United States)

    Arvin, Mina; Hoozemans, Marco J M; Burger, Bart J; Rispens, Sietse M; Verschueren, Sabine M P; van Dieën, Jaap H; Pijnappels, Mirjam

    2015-10-01

    We experimentally investigated whether unilateral hip abductor muscle fatigue affected gait control and hip position sense in older adults. Hip abductor muscles were fatigued unilaterally in side-lying position in 17 healthy older adults (mean age 73.2 SD 7.7 years). Hip joint position sense was assessed by an active-active repositioning test while standing and was expressed as absolute and relative errors. Participants walked on a treadmill at their preferred walking speed, while 3D linear accelerations were collected by an inertial sensor at the lower back. Gait parameters, including step and stride time, local divergence exponents and harmonic ratio were quantified. In fatigued gait, stride time variability and step-to-step asymmetry in the frontal plane were significantly increased. Also a significantly slower mediolateral trunk movement in fatigued leg late stance toward the non-fatigued leg was observed. Despite these temporal and symmetry changes, gait stability in terms of the local divergence exponents was not affected by fatigue. Hip position sense was also affected by fatigue, as indicated by an increased relative error of 0.7° (SD 0.08) toward abduction. In conclusion, negative effects of fatigue on gait variability, step-to-step symmetry, mediolateral trunk velocity control and hip position sense indicate the importance of hip abductor muscles for gait control. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Partial Body Weight-Supported Treadmill Training in Patients With Parkinson Disease: Impact on Gait and Clinical Manifestation.

    Science.gov (United States)

    Ganesan, Mohan; Sathyaprabha, Talakad N; Pal, Pramod Kumar; Gupta, Anupam

    2015-09-01

    To evaluate the effect of conventional gait training (CGT) and partial weight-supported treadmill training (PWSTT) on gait and clinical manifestation. Prospective experimental research design. Hospital. Patients with idiopathic Parkinson disease (PD) (N=60; mean age, 58.15±8.7y) on stable dosage of dopaminomimetic drugs were randomly assigned into the 3 following groups (20 patients in each group): (1) nonexercising PD group, (2) CGT group, and (3) PWSTT group. The interventions included in the study were CGT and PWSTT. The sessions of the CGT and PWSTT groups were given in patient's self-reported best on status after regular medications. The interventions were given for 30min/d, 4d/wk, for 4 weeks (16 sessions). Clinical severity was measured by the Unified Parkinson Disease Rating Scale (UPDRS) and its subscores. Gait was measured by 2 minutes of treadmill walking and the 10-m walk test. Outcome measures were evaluated in their best on status at baseline and after the second and fourth weeks. Four weeks of CGT and PWSTT gait training showed significant improvements of UPDRS scores, its subscores, and gait performance measures. Moreover, the effects of PWSTT were significantly better than CGT on most measures. PWSTT is a promising intervention tool to improve the clinical and gait outcome measures in patients with PD. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Gait training after stroke: a pilot study combining a gravity-balanced orthosis, functional electrical stimulation, and visual feedback.

    Science.gov (United States)

    Krishnamoorthy, Vijaya; Hsu, Wei-Li; Kesar, Trisha M; Benoit, Daniel L; Banala, Sai K; Perumal, Ramu; Sangwan, Vivek; Binder-Macleod, Stuart A; Agrawal, Sunil K; Scholz, John P

    2008-12-01

    This case report describes the application of a novel gait retraining approach to an individual with poststroke hemiparesis. The rehabilitation protocol combined a specially designed leg orthosis (the gravity-balanced orthosis), treadmill walking, and functional electrical stimulation to the ankle muscles with the application of motor learning principles. The participant was a 58-year-old man who had a stroke more than three years before the intervention. He underwent gait retraining over a period of five weeks for a total of 15 sessions during which the gravity compensation provided by the gravity-balanced orthosis and visual feedback about walking performance was gradually reduced. At the end of five weeks, he decreased the time required to complete the Timed Up and Go test; his gait speed increased during overground walking; gait was more symmetrical; stride length, hip and knee joint excursions on the affected side increased. Except for gait symmetry, all other improvements were maintained one month post-intervention. This case report describes possible advantages of judiciously combining different treatment techniques in improving the gait of chronic stroke survivors. Further studies are planned to evaluate the effectiveness of different components of this training in both the subacute and chronic stages of stroke recovery.

  20. Intensive cycle ergometer training improves gait speed and endurance in patients with Parkinson's disease: A comparison with treadmill training.

    Science.gov (United States)

    Arcolin, Ilaria; Pisano, Fabrizio; Delconte, Carmen; Godi, Marco; Schieppati, Marco; Mezzani, Alessandro; Picco, Daniele; Grasso, Margherita; Nardone, Antonio

    2015-01-01

    Cycle ergometer training improves gait in the elderly, but its effect in patients with Parkinson's disease (PD) is not completely known. Twenty-nine PD inpatients were randomized to treadmill (n = 13, PD-T) or cycle ergometer (n = 16, PD-C) training for 3 weeks, 1 hour/day. Outcome measures were distance travelled during the 6-min walking test (6MWT), spatio-temporal variables of gait assessed by baropodometry, the Timed Up and Go (TUG) duration, the balance score through the Mini-BESTest, and the score of the Unified Parkinson's Disease Rating Scale (UPDRS). Sex, age, body mass index, disease duration, Hoehn-Yahr staging, comorbidity and medication did not differ between groups. At end of training, ANCOVA showed significant improvement, of similar degree, in both groups for 6MWT, speed, step length and cadence of gait, TUG, Mini-BESTest and UPDRS. This pilot study shows that cycle ergometer training improves walking parameters and reduces clinical signs of PD, as much as treadmill training does. Gait velocity is accompanied by step lengthening, making the gait pattern close to that of healthy subjects. Cycle ergometer is a valid alternative to treadmill for improving gait in short term in patients with PD.

  1. The Parkinsonian Gait Spatiotemporal Parameters Quantified by a Single Inertial Sensor before and after Automated Mechanical Peripheral Stimulation Treatment

    Directory of Open Access Journals (Sweden)

    Ana Kleiner

    2015-01-01

    Full Text Available This study aims to evaluate the change in gait spatiotemporal parameters in subjects with Parkinson’s disease (PD before and after Automated Mechanical Peripheral Stimulation (AMPS treatment. Thirty-five subjects with PD and 35 healthy age-matched subjects took part in this study. A dedicated medical device (Gondola was used to administer the AMPS. All patients with PD were treated in off levodopa phase and their gait performances were evaluated by an inertial measurement system before and after the intervention. The one-way ANOVA for repeated measures was performed to assess the differences between pre- and post-AMPS and the one-way ANOVA to assess the differences between PD patients and the control group. Spearman’s correlations assessed the associations between patients with PD clinical status (H&Y and the percentage of improvement of the gait variables after AMPS (α<0.05 for all tests. The PD group had an improvement of 14.85% in the stride length; 14.77% in the gait velocity; and 29.91% in the gait propulsion. The correlation results showed that the higher the H&Y classification, the higher the stride length percentage of improvement. The treatment based on AMPS intervention seems to induce a better performance in the gait pattern of PD patients, mainly in intermediate and advanced stages of the condition.

  2. Correlation between static radiographic measurements and intersegmental angular measurements during gait using a multisegment foot model.

    Science.gov (United States)

    Lee, Dong Yeon; Seo, Sang Gyo; Kim, Eo Jin; Kim, Sung Ju; Lee, Kyoung Min; Farber, Daniel C; Chung, Chin Youb; Choi, In Ho

    2015-01-01

    Radiographic examination is a widely used evaluation method in the orthopedic clinic. However, conventional radiography alone does not reflect the dynamic changes between foot and ankle segments during gait. Multiple 3-dimensional multisegment foot models (3D MFMs) have been introduced to evaluate intersegmental motion of the foot. In this study, we evaluated the correlation between static radiographic indices and intersegmental foot motion indices. One hundred twenty-five females were tested. Static radiographs of full-leg and anteroposterior (AP) and lateral foot views were performed. For hindfoot evaluation, we measured the AP tibiotalar angle (TiTA), talar tilt (TT), calcaneal pitch, lateral tibiocalcaneal angle, and lateral talcocalcaneal angle. For the midfoot segment, naviculocuboid overlap and talonavicular coverage angle were calculated. AP and lateral talo-first metatarsal angles and metatarsal stacking angle (MSA) were measured to assess the forefoot. Hallux valgus angle (HVA) and hallux interphalangeal angle were measured. In gait analysis by 3D MFM, intersegmental angle (ISA) measurements of each segment (hallux, forefoot, hindfoot, arch) were recorded. ISAs at midstance phase were most highly correlated with radiography. Significant correlations were observed between ISA measurements using MFM and static radiographic measurements in the same segment. In the hindfoot, coronal plane ISA was correlated with AP TiTA (P foot motion indices at midstance phase during gait measured by 3D MFM gait analysis were correlated with the conventional radiographic indices. The observed correlation between MFM measurements at midstance phase during gait and static radiographic measurements supports the fundamental basis for the use of MFM in analysis of dynamic motion of foot segment during gait. © The Author(s) 2014.

  3. Impairments in Spatiotemporal Gait Adaptation During Obstacle Navigation in Huntington's Disease.

    Science.gov (United States)

    Anwar, Naznine; Labuschagne, Izelle; Simpson, Katrina; Smith, Luke; Georgiou-Karistianis, Nellie

    2017-01-01

    Navigating obstacles whilst walking might be associated with poorer balance and a higher risk of falling in individuals with symptomatic Huntington's disease (symp-HD). However, this issue has not been investigated within the literature. A unique obstacle navigation experiment was designed to examine adaptive gait patterns in order to identify spatiotemporal gait characteristics that might be associated with poorer balance and a higher risk of falling in symp-HD. Sixteen diagnosed symp-HD participants and 16 age- and sex-matched healthy controls were included. Gait was examined in 3 experimental conditions: baseline walking, walking while navigating around 1 obstacle, and walking while navigating around 2 obstacles. Navigation around obstacle walks was divided into three step phases (approach, navigation, recovery). Group differences in gait variables were analyzed at baseline and during walking for each obstacle condition respectively. Gait variables were also correlated with the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test. Symp-HD participants, compared with controls, performed significantly poorer on most gait variables during baseline walking. Symp-HD participants significantly decreased their step-length while navigating around 1 obstacle, and increased their step-time while navigating around 1 and 2 obstacles. There were no significant group differences in step-width. Variables associated with navigating around obstacles correlated significantly with BBS and TUG clinical tools, which have been associated in the literature with an increased risk of falling in symp-HD. These findings could aid clinicians in better managing risk of falls in people with Huntington's disease through targeted and effective strategies.

  4. Gait characterization in golden retriever muscular dystrophy dogs using linear discriminant analysis.

    Science.gov (United States)

    Fraysse, Bodvaël; Barthélémy, Inès; Qannari, El Mostafa; Rouger, Karl; Thorin, Chantal; Blot, Stéphane; Le Guiner, Caroline; Chérel, Yan; Hogrel, Jean-Yves

    2017-04-12

    Accelerometric analysis of gait abnormalities in golden retriever muscular dystrophy (GRMD) dogs is of limited sensitivity, and produces highly complex data. The use of discriminant analysis may enable simpler and more sensitive evaluation of treatment benefits in this important preclinical model. Accelerometry was performed twice monthly between the ages of 2 and 12 months on 8 healthy and 20 GRMD dogs. Seven accelerometric parameters were analysed using linear discriminant analysis (LDA). Manipulation of the dependent and independent variables produced three distinct models. The ability of each model to detect gait alterations and their pattern change with age was tested using a leave-one-out cross-validation approach. Selecting genotype (healthy or GRMD) as the dependent variable resulted in a model (Model 1) allowing a good discrimination between the gait phenotype of GRMD and healthy dogs. However, this model was not sufficiently representative of the disease progression. In Model 2, age in months was added as a supplementary dependent variable (GRMD_2 to GRMD_12 and Healthy_2 to Healthy_9.5), resulting in a high overall misclassification rate (83.2%). To improve accuracy, a third model (Model 3) was created in which age was also included as an explanatory variable. This resulted in an overall misclassification rate lower than 12%. Model 3 was evaluated using blinded data pertaining to 81 healthy and GRMD dogs. In all but one case, the model correctly matched gait phenotype to the actual genotype. Finally, we used Model 3 to reanalyse data from a previous study regarding the effects of immunosuppressive treatments on muscular dystrophy in GRMD dogs. Our model identified significant effect of immunosuppressive treatments on gait quality, corroborating the original findings, with the added advantages of direct statistical analysis with greater sensitivity and more comprehensible data representation. Gait analysis using LDA allows for improved analysis of

  5. Characterizing multisegment foot kinematics during gait in diabetic foot patients.

    Science.gov (United States)

    Sawacha, Zimi; Cristoferi, Giuseppe; Guarneri, Gabriella; Corazza, Stefano; Donà, Giulia; Denti, Paolo; Facchinetti, Andrea; Avogaro, Angelo; Cobelli, Claudio

    2009-10-23

    The prevalence of diabetes mellitus has reached epidemic proportions, this condition may result in multiple and chronic invalidating long term complications. Among these, the diabetic foot, is determined by the simultaneous presence of both peripheral neuropathy and vasculopathy that alter the biomechanics of the foot with the formation of callosity and ulcerations. To diagnose and treat the diabetic foot is crucial to understand the foot complex kinematics. Most of gait analysis protocols represent the entire foot as a rigid body connected to the shank. Nevertheless the existing multisegment models cannot completely decipher the impairments associated with the diabetic foot. A four segment foot and ankle model for assessing the kinematics of the diabetic foot was developed. Ten normal subjects and 10 diabetics gait patterns were collected and major sources of variability were tested. Repeatability analysis was performed both on a normal and on a diabetic subject. Direct skin marker placement was chosen in correspondence of 13 anatomical landmarks and an optoelectronic system was used to collect the data. Joint rotation normative bands (mean plus/minus one standard deviation) were generated using the data of the control group. Three representative strides per subject were selected. The repeatability analysis on normal and pathological subjects results have been compared with literature and found comparable. Normal and pathological gait have been compared and showed major statistically significant differences in the forefoot and midfoot dorsi-plantarflexion. Even though various biomechanical models have been developed so far to study the properties and behaviour of the foot, the present study focuses on developing a methodology for the functional assessment of the foot-ankle complex and for the definition of a functional model of the diabetic neuropathic foot. It is, of course, important to evaluate the major sources of variation (true variation in the subject

  6. Characterizing multisegment foot kinematics during gait in diabetic foot patients

    Directory of Open Access Journals (Sweden)

    Denti Paolo

    2009-10-01

    Full Text Available Abstract Background The prevalence of diabetes mellitus has reached epidemic proportions, this condition may result in multiple and chronic invalidating long term complications. Among these, the diabetic foot, is determined by the simultaneous presence of both peripheral neuropathy and vasculopathy that alter the biomechanics of the foot with the formation of callosity and ulcerations. To diagnose and treat the diabetic foot is crucial to understand the foot complex kinematics. Most of gait analysis protocols represent the entire foot as a rigid body connected to the shank. Nevertheless the existing multisegment models cannot completely decipher the impairments associated with the diabetic foot. Methods A four segment foot and ankle model for assessing the kinematics of the diabetic foot was developed. Ten normal subjects and 10 diabetics gait patterns were collected and major sources of variability were tested. Repeatability analysis was performed both on a normal and on a diabetic subject. Direct skin marker placement was chosen in correspondence of 13 anatomical landmarks and an optoelectronic system was used to collect the data. Results Joint rotation normative bands (mean plus/minus one standard deviation were generated using the data of the control group. Three representative strides per subject were selected. The repeatability analysis on normal and pathological subjects results have been compared with literature and found comparable. Normal and pathological gait have been compared and showed major statistically significant differences in the forefoot and midfoot dorsi-plantarflexion. Conclusion Even though various biomechanical models have been developed so far to study the properties and behaviour of the foot, the present study focuses on developing a methodology for the functional assessment of the foot-ankle complex and for the definition of a functional model of the diabetic neuropathic foot. It is, of course, important to evaluate

  7. Gait analysis in anorexia and bulimia nervosa.

    Science.gov (United States)

    Cimolin, Veronica; Galli, Manuela; Vismara, Luca; Vimercati, Sara Laura; Precilios, Helmer; Cattani, Laila; Fabris De Souza, Shirley; Petroni, Maria Letizia; Capodaglio, Paolo

    2013-09-13

    Anorexia (AN) and Bulimia Nervosa (BN) are two common eating disorders, which appear to share some reduced motor capacities, such as a reduced balance. The presence and the extent of other motor disorders have not been investigated in a comprehensive way. The aim of this study was to quantify gait pattern in AN and BN individuals in order to ascertain possible differences from the normality range and provide novel data for developing some evidence-based rehabilitation strategies. Nineteen AN patients (age 30.16+9.73) and 20 BN patients (age 26.8+8.41) were assessed with quantitative 3D computerized Gait Analysis. Results were compared with a group of healthy controls (CG; 30.7+5.6). AN and BN patients were characterized by different gait strategies compared to CG. Spatio-temporal parameters indicated shorter step length, with AN showing the shortest values. AN walked slower than BN and CG. As for kinematics, AN and BN showed a nonphysiologic pattern at pelvis and hip level on the sagittal and frontal plane, with BN yielding the most abnormal values. Both AN and BN patients were characterized by high ankle plantar flexion capacity at toe-off when compared to CG. As for ankle kinetics, both AN and BN showed physiologic patterns. Stiffness at hip level was close to CG in both pathologic groups; at the ankle level, stiffness was significantly decreased in both groups, with AN displaying lower values. Both AN and BN were characterized by an altered gait pattern compared to CG. Biomechanical differences were evident mainly at pelvis and hip level. Loss of lean mass may lead to musculoskeletal adaptation, ultimately causing alterations in the gait pattern.

  8. Balance and gait in older electroconvulsive therapy recipients: a pilot study

    Directory of Open Access Journals (Sweden)

    Plakiotis C

    2013-06-01

    Full Text Available Chris Plakiotis,1,2 Fay Barson,2 Bharathi Vengadasalam,3 Terry P Haines,4 Daniel W O'Connor1,2 1School of Psychology and Psychiatry, Monash University, Melbourne, VIC, Australia; 2MonashHealth, Melbourne, VIC, Australia; 3Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 4Allied Health Research Unit, Monash University and MonashHealth, Melbourne, VIC, Australia Background: Electroconvulsive therapy (ECT is commonly used to treat depression in older adults. Despite its efficacy in this regard, an associated increase in the risk of falls in this population is a downside of treatment. ECT research has focused on the incidence of falls, but its effect on balance and gait – intrinsic factors in instability and falls – has not been studied. Our aim was to examine changes in balance and gait among older adults before and after a single ECT session and explore the effect of patient-related and treatment factors on any changes found. Methods: Participants were 21 older adults requiring ECT for depression in public psychiatric services. Patients with clinically overt mobility problems (impairing test participation or increasing the risk of falls were excluded. Balance and gait testing 1 hour pre-ECT and 1, 2 and 3 hours post-ECT included: (1 steady standing test; (2 perturbation of standing balance by self-initiated movements; (3 perturbation of standing balance by an external perturbation; and (4 timed up and go test. Results: No deterioration in test performance was found, using one-way repeated measures analysis of variance. Conclusion: Balance and gait did not deteriorate immediately after ECT. Exclusion of participants with clinically overt mobility problems and falls being better attributable to factors unrelated to balance and gait (such as post-ECT confusion may account for our findings. This research does not repudiate the occurrence of ECT-related falls but calls into question the utility of introducing routine balance and gait

  9. 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

  10. 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

    2017-03-01

    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.

  11. Effects of gait velocity and center of mass acceleration during turning gait in old-old elderly women.

    Science.gov (United States)

    Shin, Sun-Shil; Yoo, Won-Gyu

    2015-06-01

    [Purpose] This study investigated gait velocity and center of mass acceleration in three directions during square and semicircular turning gait tasks in old-old elderly women. [Subjects] Fifteen community-dwelling, old-old elderly women (≥75 years old) who could walk independently were recruited. [Methods] We measured gait velocity and center of mass acceleration in three directions using an accelerometer during two different turning gait tasks. [Results] The velocity during square turning was significantly slower than that during semicircular turning gait. There were no significant differences between gait tasks with respect to normalized antero-posterior, medo-lateral, or vertical center of mass acceleration. [Conclusion] Changing the direction of travel while walking regardless of turning angle is one of the greatest challenges for balance in old-old elderly people. Furthermore, gait velocity is a useful clinical marker for predicting falls in old-old elderly populations.

  12. 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 < 0.05). Kinematic data demonstrated that anterior tilt of the pelvis and hip flexion during a gait cycle was significantly ameliorated after rhythmic auditory stimulation (P < 0.05). Gait deviation index also showed modest improvement in cerebral palsy patients treated with rhythmic auditory stimulation (P < 0.05). However, neurodevelopmental treatment showed that internal and external rotations of hip joints were significantly improved, whereas rhythmic auditory stimulation showed aggravated maximal internal rotation in the transverse plane (P < 0.05). Gait training with rhythmic auditory stimulation or neurodevelopmental treatment elicited differential effects on gait patterns in adults with cerebral palsy.

  13. Validity and reliability of an IMU-based method to detect APAs prior to gait initiation.

    Science.gov (United States)

    Mancini, Martina; Chiari, Lorenzo; Holmstrom, Lars; Salarian, Arash; Horak, Fay B

    2016-01-01

    Anticipatory postural adjustments (APAs) prior to gait initiation have been largely studied in traditional, laboratory settings using force plates under the feet to characterize the displacement of the center of pressure. However clinical trials and clinical practice would benefit from a portable, inexpensive method for characterizing APAs. Therefore, the main objectives of this study were (1) to develop a novel, automatic IMU-based method to detect and characterize APAs during gait initiation and (2) to measure its test-retest reliability. Experiment I was carried out in the laboratory to determine the validity of the IMU-based method in 10 subjects with PD (OFF medication) and 12 control subjects. Experiment II was carried out in the clinic, to determine test-retest reliability of the IMU-based method in a different set of 17 early-to-moderate, treated subjects with PD (tested ON medication) and 17 age-matched control subjects. Results showed that gait initiation characteristics (both APAs and 1st step) detected with our novel method were significantly correlated to the characteristics calculated with a force plate and motion analysis system. The size of APAs measured with either inertial sensors or force plate was significantly smaller in subjects with PD than in control subjects (p<0.05). Test-retest reliability for the gait initiation characteristics measured with inertial sensors was moderate-to-excellent (0.56gait initiation with body-worn inertial sensors that would be practical for unsupervised clinical and home settings. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Analysis of balance function, falling risk and gait in the early and middle stages of patients with Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Wang-shu YUAN

    2017-07-01

    Full Text Available Objective To analyze the balance function, falling risk and gait in the early and middle stages of patients with Parkinson's disease (PD for provide clinical basis for patients' rehabilitation treatment.  Methods There were 30 PD patients in the early and middle stages and 15 healthy subjects matched in gender, age and degree of education. Berg Balance Scale (BBS was used to evaluate balance function. Timed Up and Go Test (TUGT, Chair Rising Test (CRT and Tandem Gait Test (TGT were used to evaluate falling risk. The gait analysis system was used to evaluate gait.  Results Compared with healthy subjects, PD patients obtained lower scores on BBS (P = 0.001. In the falling risk, PD patients spent more seconds in performing TUGT (P = 0.003 and CRT (P = 0.002 and finished fewer numbers of steps on TGT (P = 0.041. In 10 - Meter Walk Test (10MWT, PD patients had shorter step length (P =0.020, decreased step speed (P = 0.038, increased ratio of toe touches (P = 0.000 and decreased left and right ankle dorsiflexion in swing phase (P = 0.005, 0.006.  Conclusions In the early and middle stages, PD patients have decreased balance function, increased falling risk and unusual gait. The rehabilitation treatment should be given as soon as possible. DOI: 10.3969/j.issn.1672-6731.2017.05.007

  15. Effects of unilateral real-time biofeedback on propulsive forces during gait.

    Science.gov (United States)

    Schenck, Christopher; Kesar, Trisha M

    2017-06-06

    In individuals with post-stroke hemiparesis, reduced push-off force generation in the paretic leg negatively impacts walking function. Gait training interventions that increase paretic push-off can improve walking function in individuals with neurologic impairment. During normal locomotion, push-off forces are modulated with variations in gait speed and slope. However, it is unknown whether able-bodied individuals can selectively modulate push-off forces from one leg in response to biofeedback. Here, in a group of young, neurologically-unimpaired individuals, we determined the effects of a real-time visual and auditory biofeedback gait training paradigm aimed at unilaterally increasing anteriorly-directed ground reaction force (AGRF) in the targeted leg. Ground reaction force data during were collected from 7 able-bodied individuals as they walked at a self-selected pace on a dual-belt treadmill instrumented with force platforms. During 11-min of gait training, study participants were provided real-time AGRF biofeedback encouraging a 20-30% increase in peak AGRF generated by their right (targeted) leg compared to their baseline (pre-training) AGRF. AGRF data were collected before, during, and after the biofeedback training period, as well as during two retention tests performed without biofeedback and after standing breaks. Compared to AGRFs generated during the pre-training gait trials, participants demonstrated a significantly greater AGRF in the targeted leg during and immediately after training, indicating that biofeedback training was successful at inducing increased AGRF production in the targeted leg. Additionally, participants continued to demonstrate greater AGRF production in the targeted leg after two standing breaks, showing short-term recall of the gait pattern learned during the biofeedback training. No significant effects of training were observed on the AGRF in the non-targeted limb, showing the specificity of the effects of biofeedback toward the

  16. Development of gait motor control: what happens after a sudden increase in height during adolescence?

    Science.gov (United States)

    Bisi, Maria Cristina; Stagni, Rita

    2016-05-20

    Basic understanding of motor control and its processes is a topic of well-known high relevance. During adolescence walking is theoretically a well-achieved fundamental skill, having reached a mature manifestation; on the other hand, adolescence is marked by a period of accelerated increases in both height and weight, referred as growth spurt. Thus, this period was chosen as a controlled and natural environment for partially isolating one of the factors influencing motor development (segment growth). The aim of the study was to compare gait performance of growing and not growing male adolescents during walking in single task (ST) and dual task (DT), in order to study which are the modifications that motor control handles when encountering a sudden change in segment length. 19 adolescents were selected as growing adolescents (they showed a height increase greater than 3 cm in 3 months). A group of BMI-matched peers were selected as not growing adolescents (they showed a height increase lower than 1 cm in 3 months). Measures of acceleration of the trunk (L5 level) were collected using one tri-axial wireless inertial sensor. The participants were asked to walk at self-selected speed back and forth four times in a 10 m long corridor in ST and DT conditions. The following characteristics of gait performance were evaluated using different indices: variability, smoothness, regularity, complexity and local dynamic stability. An unpaired t-test was performed on the two groups for each method. Different indices followed the hypothesized trend in the two groups, even if differences were not always statistically significant: not growing adolescents showed a lower variability and complexity of gait and a higher smoothness/rhythm. Stability results showed a similarly stable gait pattern (or even higher in DT) in the growing adolescents when compared to their not growing peers. The findings of the present work suggest that growth spurt affects gait variability, smoothness and

  17. Effects of ankle fatigue on functional reflex activity during gait perturbations in young and elderly men.

    Science.gov (United States)

    Granacher, Urs; Gruber, Markus; Förderer, Dominik; Strass, Dieter; Gollhofer, Albert

    2010-05-01

    There is growing evidence that aging and muscle fatigue result in impaired postural reflexes in humans. Therefore, the objective of this study was to examine the effects of ankle fatigue on functional reflex activity (FRA) during gait perturbations in young and elderly men. Twenty-eight young (27.0+/-3.1 years, n=14) and old (67.2+/-3.7 years, n=14) healthy active men participated in this study. Fatigue of the plantarflexors and dorsiflexors was induced by isokinetic contractions. Pre and post-fatigue, subjects were tested for their ability to compensate for decelerating gait perturbations while walking on a treadmill. Latency, FRA of lower extremity muscles and angular velocity of the ankle joint complex were analysed by means of surface electromyography and goniometry. After the fatigue protocol, no significant main and interaction effects were detected for the parameter latency in m. tibialis anterior (TA). For both groups, a significant pre to post-test decrease in FRA in TA (pvelocity of the ankle joint (p=.007). However, no significant groupxtest interactions were found for the three parameters. Ankle fatigue has an impact on the ability to compensate for gait perturbations in young and elderly adults. However, no significant differences in all analysed parameters were detected between young and elderly subjects. These results may imply that age-related deteriorations in the postural control system do not specifically affect the ability to compensate for gait perturbations under fatigued condition. Copyright 2010 Elsevier B.V. All rights reserved.

  18. The influence of valgus heel position on foot loading in a child's gait

    Directory of Open Access Journals (Sweden)

    Eliška Martinásková

    2012-12-01

    Full Text Available BACKGROUND: Flat foot is a typical clinical sign in childhood, expressed as valgus positioning of the heel during vertical foot loading. This may lead to medial deviation of the foot axis and cause overloading of some foot areas. OBJECTIVE: To determine the influence of valgus position of the heel (both bilateral and unilateral on foot loading during gait. METHODS: An experimental group consisting of children with bilateral heel valgus deformity (16 children, age 5.3 ± 1.3 years and children with unilateral heel valgus deformity (14 children, age 5.6 ± 1.6 years. The control group comprised of 14 children (age 4.5 ± 1.2 years. For measuring foot loading during gait, the Footscan (RSScan International, Olen, Belgium pressure plate was used. Each subject went through 8 trials of gait measurement. From each trial, 8 foot areas were evaluated. Data processing with mean values for each subject was performed by non-parametric tests (Mann-Whitney and Wilcoxon tests, Spearman correlation in the STATISTICA programme (StatSoft, Inc., Tulsa, USA. RESULTS: Pressure peak and pressure impulse in the first metatarsal was greater for the bilateral valgus group (p CONCLUSION: The results show that valgus positioning of the heel influences foot loading in children during gait. The findings of this study suggest the necessity of a complex solution to the problem of preventing further progression of pathological changes.

  19. The effects of variable practice on locomotor adaptation to a novel asymmetric gait.

    Science.gov (United States)

    Hinkel-Lipsker, Jacob W; Hahn, Michael E

    2017-09-01

    Very little is known about the effects of specific practice on motor learning of predictive balance control during novel bipedal gait. This information could provide an insight into how the direction and magnitude of predictive errors during acquisition of a novel gait task influence transfer of balance control, as well as yield a practice protocol for the restoration of balance for those with locomotor impairments. This study examined the effect of a variable practice paradigm on transfer of a novel asymmetric gait pattern in able-bodied individuals. Using a split-belt treadmill, one limb was driven at a constant velocity (constant limb) and the other underwent specific changes in velocity (variable limb) during practice according to one of three prescribed practice paradigms: serial, where the variable limb velocity increased linearly; random blocked, where variable limb underwent random belt velocity changes every 20 strides; and random practice, where the variable limb underwent random step-to-step changes in velocity. Random practice showed the highest balance control variability during acquisition compared to serial and random blocked practice which demonstrated the best transfer of balance control on one transfer test. Both random and random blocked practices showed significantly less balance control variability during a second transfer test compared to serial practice. These results indicate that random blocked practice may be best for generalizability of balance control while learning a novel gait, perhaps, indicating that individuals who underwent this practice paradigm were able to find the most optimal balance control solution during practice.

  20. Visually-guided gait training in paretic patients during the first rehabilitation phase: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Rossano, Cathia; Terrier, Philippe

    2016-10-27

    After a lesion to the central nervous system, many patients suffer from reduced walking capability. In the first rehabilitation phase, repeated walking exercises facilitate muscular strength and stimulate brain plasticity and motor relearning. However, marked limping, an unsteady gait, and poor management of obstacle clearance may persist, which increases a patient's risk of falling. Gait training with augmented reality has been recommended to improve gait coordination. The objective of this study is to test whether a gait rehabilitation program using augmented reality is superior to a conventional treadmill training program of equivalent intensity. The GASPAR trial (Gait Adaptation for Stroke Patients with Augmented Reality) is a pragmatic, parallel-arm, single-center, nonblind, superiority randomized control trial in neurorehabilitation. The setting is a rehabilitation clinic in Switzerland. The planned number of participants is 70-100. The intervention uses instrumented treadmills equipped with projectors that display shapes on the walking surface. The principle is that patients must adapt their gait to the image that unfolds in front of them. Specific exercises for gait symmetry, coordination enhancement, and gait agility are provided. The program includes twenty 30-min sessions spanning 4 weeks. The comparator group receives standard treadmill training of a similar frequency and intensity. The main outcome to be measured in the trial is walking speed, which is assessed with the 2-min Walk Test. Moreover, gait parameters are recorded during the gait training sessions. Other outcomes are balance control (Berg Balance Scale) and the fear of falling (Falls Efficacy Scale). The statistical analyses will compare the baseline assessment for each participant (before the intervention) with a post-intervention assessment (taken a few days after the end of the program). Furthermore, a follow-up assessment will take place 3 months after discharge. The study results will

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

    Directory of Open Access Journals (Sweden)

    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

  2. Biomechanical demands of the 2-step transitional gait cycles linking level gait and stair descent gait in older women.

    Science.gov (United States)

    Alcock, Lisa; O'Brien, Thomas D; Vanicek, Natalie

    2015-12-16

    Stair descent is an inherently complex form of locomotion posing a high falls risk for older adults, specifically when negotiating the transitional gait cycles linking level gait and descent. The aim of this study was to enhance our understanding of the biomechanical demands by comparing the demands of these transitions. Lower limb kinematics and kinetics of the 2-step transitions linking level and descent gait at the top (level-to-descent) and the bottom (descent-to-level) of the staircase were quantified in 36 older women with no falls history. Despite undergoing the same vertical displacement (2-steps), the following significant (pvelocity; reduced hip extension and increased ankle dorsiflexion (late stance/pre-swing); reduced ground reaction forces, larger knee extensor moments and powers (absorption; late stance); reduced ankle plantarflexor moments (early and late stance) and increased ankle powers (mid-stance). Top transition biomechanics were similar to those reported previously for continuous descent. Kinetic differences at the knee and ankle signify the contrasting and prominent functions of controlled lowering during the top transition and forward continuance during the bottom transition. The varying musculoskeletal demands encountered during each functional sub-task should be addressed in falls prevention programmes with elderly populations where the greatest clinical impact may be achieved. Knee extensor eccentric power through flexion exercises would facilitate a smooth transition at the top and improving ankle plantarflexion strength during single and double limb stance activities would ease the transition into level gait following continuous descent. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. The Influence of Video Game Training with and without Subpatelar Bandage in Mobility and Gait Speed on Elderly Female Fallers

    Directory of Open Access Journals (Sweden)

    Isabela Feitosa de Carvalho

    2018-01-01

    Full Text Available Objectives. The aim of the study was to investigate the effect of balance training with Nintendo Wii technology, with and without the use of additional sensory information (subpatellar bandage, in the functional mobility and gait speed of elderly female fallers. Methods. Twenty elderly women were divided into two groups: group I: trained with the use of the Nintendo Wii; group II: trained using the Nintendo Wii and the addition of sensory information (subpatellar bandage. The functional mobility was assessed with the Timed up and Go test (TUG and gait speed with the 10 m test. The tests were carried out with and without the use of the subpatellar bandage. The training was carried out within sessions of 30 minutes, twice a week, using three different games (Penguin Slide, Table Tilt, and Tightrope. Results. There was an increase in the gait speed and a decrease in the TUG time in both groups, independently of the sensory condition used (p<0.05. In the short term, the subpatellar bandage improved the TUG time (p<0.05 and the gait speed (p<0.01. Conclusion. The training for postural balance with virtual reality was effective for improving functional mobility and gait speed of elderly female fallers. The subpatellar bandage did not maximize the effect of training.

  4. Gait speed as a measure of functional status in COPD patients

    Directory of Open Access Journals (Sweden)

    Karpman C

    2014-11-01

    Full Text Available Craig Karpman, Roberto Benzo Mindful Breathing Laboratory, Mayo Clinic, Division of Pulmonary and Critical Care Medicine, Rochester, MN, USA Abstract: Chronic obstructive pulmonary disease (COPD is a disease associated with dyspnea, fatigue, and exercise intolerance. The degree of functional debility and level of exercise capacity greatly influences quality of life and mortality in patients with COPD, and the measures of exercise capacity are to be an integral part of patient assessment but often not feasible in routine daily practice, resulting in likely suboptimal care. There is a need for simple ways to identify functional decline in the clinical setting in order to guide resources to preventive interventions or proper care, including palliative care. Gait speed, or measuring how long it takes for a patient to walk a short distance, takes very little time and space, and can serve as a candidate measure of physical function in COPD. Gait speed has been shown to be an indicator of disability, health care utilization, and survival in older adults. It is a simple, reliable, and feasible measure to perform in the clinic and has been promoted as the next vital sign, providing insight into patients' functional capacity. Gait speed is mainly determined by exercise capacity but reflects global well-being as it captures many of the multisystemic effects of disease severity in COPD rather than pulmonary impairment alone. It is an excellent screening measure for exercise capacity and frailty; in COPD, the usual gait speed (4-m course with rolling start has been very accurate in identifying clinically relevant benchmarks of the 6-minute walk test, poor (<350 m and very poor (<200 m 6-minute walk test distances. A specific cut-off point of 0.8 m⋅s-1 had a positive predictive value of 69% and negative predictive value of 98% in predicting very poor exercise capacity. The increasing evidence on gait speed is promising as a simple test that can inform the

  5. Moving from laboratory to real life conditions: Influence on the assessment of variability and stability of gait.

    Science.gov (United States)

    Tamburini, Paola; Storm, Fabio; Buckley, Chris; Bisi, Maria Cristina; Stagni, Rita; Mazzà, Claudia

    2018-01-01

    The availability of wearable sensors allows shifting gait analysis from the traditional laboratory settings, to daily life conditions. However, limited knowledge is available about whether alterations associated to different testing environment (e.g. indoor or outdoor) and walking protocols (e.g. free or controlled), result from actual differences in the motor behaviour of the tested subjects or from the sensitivity to these changes of the indexes adopted for the assessment. In this context, it was hypothesized that testing environment and walking protocols would not modify motor control stability in the gait of young healthy adults, who have a mature and structured gait pattern, but rather the variability of their motor pattern. To test this hypothesis, data from trunk and shank inertial sensors were collected from 19 young healthy participants during four walking tasks in different environments (indoor and outdoor) and in both controlled (i.e. following a predefined straight path) and free conditions. Results confirmed what hypothesized: variability indexes (Standard deviation, Coefficient of variation and Poincaré plots) were significantly influenced by both environment and walking conditions. Stability indexes (Harmonic ratio, Short term Lyapunov exponents, Recurrence quantification analysis and Sample entropy), on the contrary, did not highlight any change in the motor control. In conclusion, this study highlighted an influence of environment and testing condition on the assessment of specific characteristics of gait (i.e. variability and stability). In particular, for young healthy adults, both environment and testing conditions affect gait variability indexes, whereas neither affect gait stability indexes. Copyright © 2017. Published by Elsevier B.V.

  6. Executive functioning, concern about falling and quadriceps strength mediate the relationship between impaired gait adaptability and fall risk in older people.

    Science.gov (United States)

    Caetano, Maria Joana D; Lord, Stephen R; Brodie, Matthew A; Schoene, Daniel; Pelicioni, Paulo H S; Sturnieks, Daina L; Menant, Jasmine C

    2018-01-01

    Reduced ability to adapt gait, particularly under challenging conditions, may be an important reason why older adults have an increased risk of falling. This study aimed to identify cognitive, psychological and physical mediators of the relationship between impaired gait adaptability and fall risk in older adults. Fifty healthy older adults (mean±SD: 74±7years) were categorised as high or low fall risk, based on past falls and their performance in the Physiological Profile Assessment. High and low-risk groups were then compared in the gait adaptability test, i.e. an assessment of the ability to adapt gait in response to obstacles and stepping targets under single and dual task conditions. Quadriceps strength, concern about falling and executive function were also measured. The older adults who made errors on the gait adaptability test were 4.76 (95%CI=1.08-20.91) times more likely to be at high risk of falling. Furthermore, each standard deviation reduction in gait speed while approaching the targets/obstacle increased the odds of being at high risk of falling approximately three fold: single task - OR=3.10,95%CI=1.43-6.73; dual task - 3.42,95%CI=1.56-7.52. Executive functioning, concern about falling and quadriceps strength substantially mediated the relationship between the gait adaptability measures and fall risk status. Impaired gait adaptability is associated with high risk of falls in older adults. Reduced executive function, increased concern about falling and weaker quadriceps strength contribute significantly to this relationship. Training gait adaptability directly, as well as addressing the above mediators through cognitive, behavioural and physical training may maximise fall prevention efficacy. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Different instructions during the ten-meter walking test determined significant increases in maximum gait speed in individuals with chronic hemiparesis Diferentes instruções durante teste de velocidade de marcha determinam aumento significativo na velocidade máxima de indivíduos com hemiparesia crônica

    Directory of Open Access Journals (Sweden)

    Lucas R. Nascimento

    2012-04-01

    Full Text Available OBJECTIVE: To evaluate the effects of different instructions for the assessment of maximum walking speed during the ten-meter walking test with chronic stroke subjects. METHODS: Participants were instructed to walk under four experimental conditions: (1 comfortable speed, (2 maximum speed (simple verbal command, (3 maximum speed (modified verbal command-"catch a bus" and (4 maximum speed (verbal command + demonstration. Participants walked three times in each condition and the mean time to cover the intermediate 10 meters of a 14-meter corridor was registered to calculate the gait speed (m/s. Repeated-measures ANOVAs, followed by planned contrasts, were employed to investigate differences between the conditions (α=5%. Means, standard deviations and 95% confidence intervals (CI were calculated. RESULTS: The mean values for the four conditions were: (1 0.74m/s; (2 0.85 m/s; (3 0.93 m/s; (4 0.92 m/s, respectively, with significant differences between the conditions (F=40.9; pOBJETIVO: Avaliar os efeitos de diferentes instruções para avaliação da velocidade de marcha máxima de indivíduos hemiparéticos durante o teste de caminhada de 10 metros. MÉTODOS: Os indivíduos deambularam em quatro condições experimentais: (1 velocidade habitual, (2 velocidade máxima (comando verbal simples, (3 velocidade máxima (comando verbal modificado: pegar ônibus, (4 velocidade máxima (comando verbal + demonstração. Solicitou-se a cada participante que deambulasse três vezes em cada condição, e a média do tempo necessário para percorrer os 10 metros intermediários de um corredor de 14 metros foi utilizada para cálculo da velocidade (m/s. A ANOVA de medidas repetidas, com contrastes pré-planejados, foi utilizada para comparação dos dados (α=5%, sendo apresentados valores de média, desvio-padrão e intervalos de confiança (IC de 95%. RESULTADOS: As médias de velocidade para as quatro condições foram: (1 0,74m/s; (2 0,85m/s; (3 0,93m/s; (4

  8. Neglected Alkaptonuric Patient Presenting with Steppage Gait

    Directory of Open Access Journals (Sweden)

    Babak Mirzashahi

    2016-04-01

    Full Text Available Even though intervertebral disc degeneration can be found in the natural course of alkaptonuria, detection of the disease by black disc color change in a patient without any other presentation of alkaptonuria is an exceptionally rare condition. We have reported a very rare case of alkaptonuria presented with low back pain and steppage gait in a 51-year-old male with a complaint of chronic low-back pain and steppage gait who was operated on for prolapsed lumbar disc herniation. Intraoperatively his lumbar disk was discovered to be black. The alkaptonuria diagnosis was considered after histopathological examination of the black disc material and elevated urinary concentration of homogentisic acid confirmed the diagnosis. To our knowledge, this presentation has not been reported previously in literature.

  9. Treatment of Gait Ignition Failure with Ropinirole

    Directory of Open Access Journals (Sweden)

    Alexis N. Cohen-Oram

    2014-10-01

    Full Text Available Gait ignition failure (GIF is a syndrome characterized by hesitation or inability to initiate gait from a static position. It may occur in a variety of conditions, including normal pressure hydrocephalus, subcortical vascular disease, parkinsonian syndromes and a variety of focal lesions. Previous information on the treatment of GIF has been primarily anecdotal, but there have been a few reports of response to dopamine agonists. We report a 63-year-old man with anoxic encephalopathy who developed GIF nine years after the initial anoxic insult. The patient’s GIF responded robustly, albeit transiently, to ropinirole. MRI was unrevealing, but a positron emission tomography scan showed hypometabolism in the deep frontal ACA/MCA watershed area; this may have disconnected the basal ganglia from the motor cortex and/or interrupted dopaminergic mesocortical transmission. Our understanding of the pathophysiology and the treatment of GIF remains limited, but there may be at least a limited therapeutic role for dopamine agonists.

  10. 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...

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

    Science.gov (United States)

    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.

  12. Detecting Gait Asymmetry with Wearable Accelerometers

    Science.gov (United States)

    2015-03-18

    goal is to utilize these features to detect actual injuries, with the quantification of rehabilitation progress as a logical future continuation. The...gait in post-stroke patients: Is this deficit distinct from asymmetry? a cohort study,” Journal of Neuroengineering and Rehabilitation 8(1), 23 (2011...symmetry and regularity in transfemoral amputees assessed by trunk accelerations,” J Neuroeng Rehabil 7(4) (2010). [16] D. Gouwanda and S. Arosha

  13. Effect of a gentle Iyengar yoga program on gait in the elderly: an exploratory study.

    Science.gov (United States)

    DiBenedetto, Margarete; Innes, Kim E; Taylor, Ann G; Rodeheaver, Pamela F; Boxer, Jennifer A; Wright, H Jeffrey; Kerrigan, D Casey

    2005-09-01

    To determine if a tailored yoga program could improve age-related changes in hip extension, stride length, and associated indices of gait function in healthy elders, changes that have been linked to increased risk for falls, dependency, and mortality in geriatric populations. Single group pre-post test exploratory study. A 3-dimensional quantitative gait evaluation, including kinematic and kinetic measurements, was performed pre- and postintervention. Changes over time (baseline to postintervention) in primary and secondary outcome variables were assessed using repeated-measures analysis of variance. Yoga exercises were performed in an academic medical center (group classes) and in the subjects' homes (yoga home-practice assignments). Pre- and postassessments were performed in a gait laboratory. Twenty-three healthy adults (age range, 62-83 y) who were naive to yoga were recruited; 19 participants completed the program. An 8-week Iyengar Hatha yoga program specifically tailored to elderly persons and designed to improve lower-body strength and flexibility. Participants attended two 90-minute yoga classes per week, and were asked to complete at least 20 minutes of directed home practice on alternate days. Peak hip extension, average anterior pelvic tilt, and stride length at comfortable walking speed. Peak hip extension and stride length significantly increased (F1,18=15.44, Pdecrease anterior pelvic tilt in healthy elders, and that yoga programs tailored to elderly adults may offer a cost-effective means of preventing or reducing age-related changes in these indices of gait function.

  14. Efficacy of Aquatic Treadmill Training on Gait Symmetry and Balance in Subacute Stroke Patients.

    Science.gov (United States)

    Lee, Mi Eun; Jo, Geun Yeol; Do, Hwan Kwon; Choi, Hee Eun; Kim, Woo Jin

    2017-06-01

    To determine the efficacy of aquatic treadmill training (ATT) as a new modality for stroke rehabilitation, by assessing changes in gait symmetry, balance function, and subjective balance confidence for the paretic and non-paretic leg in stroke patients. Twenty-one subacute stroke patients participated in 15 intervention sessions of aquatic treadmill training. The Comfortable 10-Meter Walk Test (CWT), spatiotemporal gait parameters, Berg Balance Scale (BBS), and Activities-specific Balance Confidence scale (ABC) were assessed pre- and post-interventions. From pre- to post-intervention, statistically significant improvements were observed in the CWT (0.471±0.21 to 0.558±0.23, psymmetry (1.017±0.25 to 0.990±0.19, p=0.720) and overall temporal symmetry (1.404±0.36 to 1.314±0.34, p=0.218) showed improvement without statistical significance. ATT improves the functional aspects of gait, including CWT, BBS and ABC, and spatiotemporal gait symmetry, though without statistical significance. Further studies are required to examine and compare the potential benefits of ATT as a new modality for stroke therapy, with other modalities.

  15. Video Analysis of Human Gait and Posture to Determine Neurological Disorders

    Directory of Open Access Journals (Sweden)

    Guan Ling

    2008-01-01

    Full Text Available Abstract This paper investigates the application of digital image processing techniques to the detection of neurological disorder. Visual information extracted from the postures and movements of a human gait cycle can be used by an experienced neurologist to determine the mental health of the person. However, the current visual assessment of diagnosing neurological disorder is based very much on subjective observation, and hence the accuracy of diagnosis heavily relies on experience. Other diagnostic techniques employed involve the use of imaging systems which can only be opera