Kinematics predictors of spatiotemporal parameters during gait differ by age in healthy individuals.

Joint biomechanics and spatiotemporal gait parameters change with age or disease and are used in treatment decision-making. RESEARCH QUESTION: To investigate whether kinematic predictors of spatiotemporal parameters during gait differ by age in healthy individuals. METHODS: We used an open dataset with the gait data of 114 young adults (M = 28.0 years, SD = 7.5) and 128 older adults (M = 67.5 years, SD = 3.8) walking at a comfortable self-selected speed. Linear regression models were developed to predict spatiotemporal parameters separately for each group using joint kinematics as independent variables. RESULTS: In young adults, knee flexion loading response and hip flexion/extension were the common predictors of gait speed; hip flexion and hip extension contributed to explaining the stride length; hip flexion contributed to explaining the cadence and stride time. In older adults, ankle plantarflexion, knee flexion loading response, and pelvic rotation were the common predictors of the gait speed; ankle plantarflexion and knee flexion loading response contributed to explaining the stride length; ankle plantarflexion loading response and ankle plantarflexion contributed to explain the cadence, stride width and stride time. SIGNIFICANCE: Our results suggest that the ability of joint kinematic variables to estimate spatiotemporal parameters during gait differs by age in healthy individuals. Particularly in older adults, ankle plantarflexion was the common predictor of the spatiotemporal parameters, suggesting the importance of the ankle for gait parameters in this age group. This provides insight for clinicians into the most effective evaluation and has been used by physical professionals in prescribing the most appropriate exercises to attenuate the effects produced by age-related neuromuscular changes.

Spinal cord stimulation improves motor function and gait in spastic paraplegia type 4 (SPG4): Clinical and neurophysiological evaluation.

INTRODUCTION: Hereditary spastic paraplegia is a heterogeneous group of genetic disorders characterized by degeneration of the corticospinal tracts, coursing with progressive weakness and spasticity of the lower limbs. To date, there are no effective treatments for progressive deficits or disease-modifying therapy for those patients. We report encouraging results for spastic paraparesis after spinal cord stimulation. METHODS: A 51-year-old woman suffering from progressive weakness and spasticity in lower limbs related to hereditary spastic paraplegia type 4 underwent spinal cord stimulation (SCS) and experienced also significant improvement in motor function. Maximum ballistic voluntary isometric contraction test, continuous passive motion test and gait analysis using a motion-capture system were performed in ON and OFF SCS conditions. Neurophysiologic assessment consisted of obtaining motor evoked potentials in both conditions. RESULTS: Presurgical Spastic Paraplegia Rating Scale (SPRS) score was 26. One month after effective SCS was initiated, SPRS went down to 15. At 12 months follow up, she experienced substantial improvement in motor function and in gait performance, with SPRS scores 23 (OFF) and down to 20 (ON). There was an increased isometric muscle strength (knee extension, OFF: 41 N m; ON: 71 N m), lower knee extension and flexion torque values in continuous passive motion test (decrease in spastic tone) and improvement in gait (for example, step length increase). CONCLUSION: Despite being a case study, our findings suggest innovative lines of research for the treatment of spastic paraplegia.

Associação dos níveis de GMFCS com grau de escolaridade, tipo de marcha, empregabilidade e dor em adultos com paralisia cerebral / The association of GMFCS levels with education, type of motion, pain, and employability in adults with cerebral palsy

Adultos com paralisia cerebral (PC) apresentam um envelhecimento precoce associado aodeclínio da função. E apesar da melhoria na assistência a saúde, estudos mostram que estesindivíduos possuem menos oportunidades de possuir algum grau de escolaridade e emprego.Além de apresentarem queixas com relação a dor e alteração quanto sua capacidade de marcha.Objetivo: Verificar a associação dos níveis de GMFCS para os parâmetros: empregabilidade, graude escolaridade, nível de marcha e queixa de dor em adultos com PC. Método: Foram selecionados 671 prontuários para análise de correlação entre as variáveis citadas acima. Resultado: Foi observado que aqueles com níveis mais acometidos da PC possuem menos chance de terem algum nível de escolaridade e emprego, além de apresentarem pior nível de marcha. Conclusão: Não foi encontrada correlação entre os níveis de GMFCS para o item dor.

Adults with cerebral palsy (CP) have experienced premature aging associated with functiondecline. And despite improvements in health care, studies show that these individuals havefewer opportunities to have some kind of education and employment, in addition to presentingcomplaints of pain and alterations in their ability to walk. Objective: The aim of this study was tocheck the association of GMFCS levels with the parameters of employability, education, level ofambulation, and pain in adults with CP. Method: 671 medical records were selected to analyzethe correlations among the variables mentioned above. Result: It was noticed that those withthe more severe levels of CP have fewer chances to get any level of education and employment,in addition to presenting a worse gait. Conclusion: No association was found between levels ofGMFCS and the parameter for pain.