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Objective:To determine the evolution of gait impairment over the course of Parkinson′s disease (PD) by assessing the changes of gait characteristics in different disease stages, which could be helpful for disease monitoring.Methods:A total of 276 PD patients [PD group, Hoehn-Yahr (H-Y) stage 1-3] and 63 healthy controls (control group) enrolled in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2019 to September 2021 were included in this cross-sectional study. The gait spatiotemporal variables were recorded by a portable inertial measurement unit system. Exploratory factor analysis was performed to obtain gait domains representing different gait characteristics. One way analysis of variance was used to evaluate the differences of gait variables and gait domains among the control group and 3 different H-Y stages of the PD group, as well as the differences among the control group and 2 motor subtypes of PD in different stages. The sensitivity of different gait variables and gait domains in evaluating the severity of gait impairments at different disease stages was compared.Results:Eleven gait spatiotemporal variables were grouped in 4 gait domains: pace (step length, gait speed and stride length), rhythm/phase (cadence, stride time and double support time), pace-related variability/asymmetry [step length coefficient of variation (CV), gait speed CV and step length asymmetry] and rhythm/phase-related variability/asymmetry (swing time CV and swing time asymmetry). As the disease progresses, most evolution trends of the 4 gait domains in the tremor-dominant PD patients were consistent with those in the non-tremor-dominant subtype. Compared with the control group, PD patients at H-Y stage 1 began to show the mild impairment of rhythm/phase-related variability/asymmetry (effect size 0.42; standardized score -0.03±0.69 vs -0.33±0.49, P<0.05), especially swing time asymmetry in tremor-dominant patients; the pace domain was damaged moderately in PD patients at H-Y stage 2 (effect size 0.64; standardized score 0.12±0.80 vs 0.64±0.81, P<0.05), especially in non-tremor-dominant PD patients, but not in PD patients at H-Y stage 1 ( P>0.05). Pace-related variability/asymmetry showed great impairment in PD patients at H-Y stage 3 (effect size 0.62; standardized score 0.27±1.12 vs -0.27±0.52, P<0.05), but not in PD patients at H-Y stages 1 and 2 ( P>0.05). Conclusions:The characteristic impairments of gait in PD evolve in the process of disease progression. The rhythm/phase-related variability/asymmetry domain may be a marker to distinguish early PD from healthy controls. The pace domain and the pace-related variability/asymmetry domain are important markers to evaluate the progression of PD.
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@#<p style="text-align: justify;"><strong>Background and Purpose:</strong> Gait is one of the outcome measures used in evaluation in the field of rehabilitation and there is a need for reference data of gait parameters primarily to understand the physiological significance of these parameters, describe their changes in pathologic gait for better understanding of pathophysiology and be able to provide the appropriate therapeutic approach. The purpose of this study was: 1) To derive a reference data of spatiotemporal parameters of gait among Filipinos, which include step time, stride time, stance time, swing time, single limb support time, double limb support time, cadence, speed, step length, stride length, and step width; 2) To determine correlation of age, gender, and anthropometric measures with spatiotemporal parameters, and 3) To determine<br />gait symmetry.</p><p style="text-align: justify;"><strong>Materials and Methods:</strong> In this cross-sectional study, 374 participants aged 20-69 years (males = 181, females = 193) were included. They were asked to walk in their comfortable speed. Spatiotemporal parameters were obtained using the Vicon motion capture system.</p><p style="text-align: justify;"><strong>Results:</strong> The walking speed, step length, stride length, and step width declined with age. Filipino men demonstrated higher values in all parameters except cadence which is higher in Filipino women. Height and leg length both have positive correlation with all parameters except for cadence. Weight has a positive correlation with all spatiotemporal parameters except for cadence, swing time, single limb support time, and speed. Cadence and stride length were symmetrical between right and left lower extremities.</p><p style="text-align: justify;"><strong>Conclusion:</strong> Spatiotemporal parameters among healthy Filipinos 20-69 years old were presented including their correlations with age, gender, and anthropometric measures. This can serve as a reference for future studies in gait where Filipinos are the participants.</p>
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Gait Analysis , Reference ValuesABSTRACT
Background: the deformation of the hallux into a valgus constitutes the most frequent deformation of the forefoot and one of the most performed corrective surgeries in the region. This deformation is the cause of many biomechanical disorders and causes gait disturbances. This review aims to analyze the restoration of space-time and kinematic parameters of walking in the aftermath of corrective surgery for hallux valgus. Methods: four studies were analyzed according to the main criteria of walking speed, support time, step length and kinematics of the ankle and foot before and after the intervention. Results: If some of the results obtained in the analyzed works show an improvement of these criteria in post-operative, the subjects having benefited from hallux valgus surgery seem to present some persistent issues in the spatiotemporal and kinematic parameters. Conclusion: This work does not demonstrate the superiority of one surgical technique over another in the recovery of gait. This recovery does not seem absolute, but this review highlights above all the lack of literature on this subject.
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BACKGROUND: Dual-task walking is more common in daily life, and more challenging than single-task walking. It is more conducive to find potential gait abnormalities in daily life activities. It is widely used to evaluate the changes in motor performance and gait control when attention is distracted. OBJECTIVE: The three-dimensional gait analysis system was applied to compare the difference of gait characteristics under dual-task walking between healthy young people and elderly people so as to provide reference for preventing the elderly people from falling. METHODS: In the youth group, there were 21 cases aged (24.57±2.27) years old and with the height of (1.64±0.08) m. In the elderly group, there were 25 cases aged (62.72±2.39) years old and with the height of (1.60±0.07) m. The two groups of subjects performed the calculation task of “minus 1 (reciprocal) starting from any number within 100” during level walking. Motion Analysis system and Visual 3D software were applied to collect and analyze the gait data. The differences of gait spatiotemporal and kinetic parameters between the two groups were compared when performing dual-task walking. RESULTS AND CONCLUSION: (1) Spatiotemporal parameters: Compared with youth group, both stride length [(1.14±0.09) m vs. (1.20±0.07) m, P < 0.05] and right step length [(0.57±0.04) m vs. (0.60±0.04) m, P < 0.01] were smaller in the elderly group. (2) Kinetic parameters: Compared with the youth group, the left second peak hip abduction moment was higher [(0.94±0.1) Nm/kg vs. (0.86±0.16) Nm/kg, P < 0.01]; the left ankle plantar flexor moment was lower [(1.27±0.11) Nm/kg vs. (1.35±0.15) Nm/kg, P < 0.05]; and bilateral ankle valgus muscle moments were lower [(0.31±0.14) Nm/kg vs. (0.45±0.16) Nm/kg, P < 0.01; (0.38±0.15) Nm/kg vs. (0.51±0.14) Nm/kg, P < 0.01] in the elderly group. (3) These results suggest that the walking automation ability of the elderly group was lower than youth group during dual-task walking. Dual-task walking mainly affects the hip and ankle joints of the elderly, which may be related to the challenge of dual-task walking to the elderly so that they could adapt the corresponding compensatory mode to maintain stability. The characteristics of gait changes in the elderly under dual tasks can be considered as a reference for the prevention of falls.
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Aim: To compare the immediate effect of functional electrical stimulation (FES) to solid ankle foot orthosis (SAFO) concerning spatiotemporal parameters and ankle kinematics during gait in hemiplegic cerebral palsy (CP). Methodology: Thirty spastic hemiplegic cerebral palsied children were randomly distributed into two equal groups; group A, who used the functional electrical stimulation (FES) and group B, who worn the solid ankle foot orthosis (SAFO). Vicon 3D motion analysis system was used to measure the spatiotemporal parameters of gait and ankle dorsiflexion angle at initial contact and mid-swing before intervention and with application of either FES or SAFO. Spasticity was ranged between 2 and 1+ and determined by Modified Ashworth Scale score. Results: Following the application of solid AFO, stride length and walking speed significantly increased than next to FES (p=0.0001, p=0.001) respectively. Whereas, number of steps/minute significantly decreased (p=0.001). Further, Solid AFO increased ankle dorsiflexion at initial contact (6.2±4.7º) and mid-swing (3.4±0.6º) more than FES at initial contact (1.86±3.9º) and mid-swing (-4.6± 5º). Conclusion: FES, unlikely found to evoke an immediate effect of spatiotemporal parameters while solid AFO improved the gait efficiency by enhancing spatiotemporal parameters. Both treatment interventions increased ankle dorsiflexion at initial contact and mid-swing but solid AFO was more effective immediately than FES.