The effect of a home-based exercise program on gait characteristics in an individual with Parkinson's disease over a one-year period: A case study.

BACKGROUND: The COVID-19 pandemic has placed a restriction on physiotherapy clinical visits for supervised exercise. It is important that individuals with Parkinson's Disease (PD) continue an exercise regime at home during the pandemic and also in normal situations. OBJECTIVE: The purpose of this study was to explore the case history of an individual with PD who used a developed home-based exercise programme for one year during the COVID-19 pandemic. METHODS: A 67 year-old married woman was diagnosed with PD stage 2.5 on the modified Hoehn and Yahr (HY) scale. Gait characteristics and the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor scores were assessed at baseline, 10 weeks, and 12 months. The home-based exercise program included breathing exercises, posture correction, stretching exercises, rotation of the axial segments, balance training, and task-specific gait training. RESULTS: After 12 months, her MDS-UPDRS motor scores decreased when compared to baseline and 10 weeks, and gait characteristics at 12 months showed an increase in the degree of foot rotation, step length, cadence, and gait speed when compared to baseline and 10 weeks. CONCLUSION: This case study showed that improvements in MDS-UPDRS and gait characteristics can continue over a 12 month period as a result of a home-based exercise programme. Therefore, home-based exercise programs should be encouraged with weekly monitoring, especially in individuals with gait disorders which show deterioration.

Beyond gait speed: exploring the added value of Inertial Measurement Unit-based measurements of gait in the estimation of the walking ability in daily life.

BACKGROUND: Gait speed is often used to estimate the walking ability in daily life in people after stroke. While measuring gait with inertial measurement units (IMUs) during clinical assessment yields additional information, it remains unclear if this information can improve the estimation of the walking ability in daily life beyond gait speed. OBJECTIVE: We evaluated the additive value of IMU-based gait features over a simple gait-speed measurement in the estimation of walking ability in people after stroke. METHODS: Longitudinal data during clinical stroke rehabilitation were collected. The assessment consisted of two parts and was administered every three weeks. In the first part, participants walked for two minutes (2MWT) on a fourteen-meter path with three IMUs attached to low back and feet, from which multiple gait features, including gait speed, were calculated. The dimensionality of the corresponding gait features was reduced with a principal component analysis. In the second part, gait was measured for two consecutive days using one ankle-mounted IMU. Next, three measures of walking ability in daily life were calculated, including the number of steps per day, and the average and maximal gait speed. A gait-speed-only Linear Mixed Model was used to estimate the association between gait speed and each of the three measures of walking ability. Next, the principal components (PC), derived from the 2MWT, were added to the gait-speed-only model to evaluate if they were confounders or effect modifiers. RESULTS: Eighty-one participants were measured during rehabilitation, resulting in 198 2MWTs and 135 corresponding walking-performance measurements. 106 Gait features were reduced to nine PCs with 85.1% explained variance. The linear mixed models demonstrated that gait speed was weakly associated with the average and maximum gait speed in daily life and moderately associated with the number of steps per day. The PCs did not considerably improve the outcomes in comparison to the gait speed only models. CONCLUSIONS: Gait in people after stroke assessed in a clinical setting with IMUs differs from their walking ability in daily life. More research is needed to determine whether these discrepancies also occur in non-laboratory settings, and to identify additional non-gait factors that influence walking ability in daily life.

Square-stepping exercise in older inpatients in early geriatric rehabilitation. A randomized controlled pilot study.

BACKGROUND: Preservation of mobility and fall prevention have a high priority in geriatric rehabilitation. Square-Stepping Exercise (SSE) as an evaluated and standardized program has been proven to be an effective training for older people in the community setting to reduce falls and improve subjectively perceived health status. This randomized controlled trial (RCT), for the first time, examines SSE in the context of inpatient early geriatric rehabilitation compared to conventional physiotherapy (cPT). METHODS: Data were collected in a general hospital in the department of acute geriatric care at admission and discharge. Fifty-eight inpatients were randomized to control (CG, n = 29) or intervention groups (IG, n = 29). CG received usual care with cPT five days per week during their hospital stay. For the IG SSE replaced cPT for at least six sessions, alternating with cPT. Physical function was measured with the Short Physical Performance Battery (SPPB) and Timed "Up & Go" (TUG). Gait speed was measured over a distance of 10 m. In a subgroup (n = 17) spatiotemporal gait parameters were analyzed via a GAITRite® system. RESULTS: Both the SPPB total score improved significantly (p = < 0.001) from baseline to discharge in both groups, as did the TUG (p < 0.001). In the SPPB Chair Rise both groups improved with a significant group difference in favor of the IG (p = 0.031). For both groups gait characteristics improved: Gait speed (p = < 0.001), walk ratio (p = 0.011), step length (p = < 0.001), stride length (p = < 0.001) and double support (p = 0.009). For step length at maximum gait speed (p = 0.054) and stride length at maximum gait speed (p = 0.060) a trend in favor of the IG was visible. CONCLUSIONS: SSE in combination with a reduced number of sessions of cPT is as effective as cPT for inpatients in early geriatric rehabilitation to increase physical function and gait characteristics. In the Chair Rise test SSE appears to be superior. These results highlight that SSE is effective, and may serve as an additional component for cPT for older adults requiring geriatric acute care. TRIAL REGISTRATION: DRKS00026191.

Gait alterations in patients with adult spinal deformity.

Background: Adult spinal deformity patients (ASD) experience altered spinal alignment affecting spatiotemporal parameters and joint kinematics. Differences in spinal deformity between patients with symptomatic idiopathic scoliosis (ID-ASD) and patients with "de novo" scoliosis (DN-ASD) may affect gait characteristics differently. This study aims to compare gait characteristics between ID-ASD, DN-ASD, and asymptomatic healthy matched controls. Methods: In this observational case-control study, ID-ASD (n = 24) and DN-ASD (n = 26) patients visiting the out-patient spine clinic and scheduled for long-segment spinal fusion were included. Patients were matched, based on age, gender, leg length and BMI, with asymptomatic healthy controls. Gait was measured at comfortable walking speed on an instrumented treadmill with 3D motion capture system. Trunk, pelvic and lower extremities range of motion (ROM) and spatiotemporal parameters (SPT) are presented as median (first and thirds quartile). Independent t-test or Mann-Whitney U test was used to compare ID-ASD, DN-ASD and controls. Statistical Parametric Mapping (independent t-test) was used to compare 3D joint kinematics. Results: DN-ASD patients walk with increased anterior trunk tilt during the whole gait cycle compared with ID-ASD patients and controls. ID-ASD walk with decreased trunk lateroflexion compared with DN-ASD and controls. DN-ASD showed decreased pelvic obliquity and -rotation, increased knee flexion, and decreased ankle plantar flexion. ID-ASD and DN-ASD displayed decreased trunk, pelvic and lower extremity ROM compared with controls, but increased pelvic tilt ROM. ID-ASD patients walked with comparable SPT to controls, whereas DN-ASD patients walked significantly slower with corresponding changes in SPT and wider steps. Conclusions: DN-ASD patients exhibit distinct alterations in SPT and kinematic gait characteristics compared with ID-ASD and controls. These alterations seem to be predominantly influenced by sagittal spinal malalignment and kinematic findings in ASD patients should not be generalized as such, but always be interpreted with consideration for the nature of the ASD.

Usefulness of one-arm motorized gait device for chronic hemiplegic stroke survivors.

BACKGROUND: After stroke, gait training is a key component of rehabilitation, and most individuals use a variety of walking aids depending on their physical condition and environment. OBJECTIVE: This study aimed to investigate the potential effect of a one-arm motorized gait device for gait assist of chronic hemiplegic stroke survivors through comparison with traditional gait devices (parallel bar and hemi-walker). METHODS: This study was conducted on 14 chronic hemiplegic stroke survivors. The participants were asked to walk under three conditions using different gait devices, and their gait parameters during walking were collected and analyzed. The first condition involved walking on parallel bars; second condition, walking using hemi-walkers; and third condition, walking using one-arm motorized gait devices. With the use of a gait analysis system, the spatio-temporal gait parameters in each condition were collected, such as gait velocity, cadence, step length, stride length, single support time, and double support time. RESULTS: In the results by repeated-measures ANOVA or the Friedman test, a significant difference was found in the gait parameters among all three conditions (p< 0.05). The post-hoc test showed a significant change in the spatio-temporal gait parameters (especially, velocity, cadence and affected side single and double support time) when one-arm motorized gait device were used compared with parallel bars and hemi-walkers (p< 0.05). CONCLUSION: The results of this study suggest that one-arm motorized gait devices developed for hemiplegic stroke survivors may be more effective potentially than parallel bars and hemi-walkers in gait assistance of chronic hemiplegic stroke survivors.

Comparison Between Effects of Galvanic and Vibration-Based Vestibular Stimulation on Postural Control and Gait Performance in Healthy Participants: A Systematic Review of Cross-Sectional Studies.

Electricity and vibration were two commonly used physical agents to provide vestibular stimulation in previous studies. This study aimed to systematically review the effects of galvanic (GVS) and vibration-based vestibular stimulation (VVS) on gait performance and postural control in healthy participants. Five bioscience and engineering databases, including MEDLINE via PubMed, CINAHL via EBSCO, Cochrane Library, Scopus, and Embase, were searched until March 19th, 2023. Studies published between 2000 and 2023 in English involving GVS and VVS related to gait performance and postural control were included. The procedure was followed via the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The methodological quality of included studies was assessed using the NIH study quality assessment tool for observational cohort and cross-sectional studies. A total of 55 cross-sectional studies met the inclusion criteria and were included in this study. Five studies were good-quality while 49 were moderate-quality and 1 was poor-quality. There were 50 included studies involving GVS and 5 included studies involving VVS. GVS and VVS utilized different physical agents to provide vestibular stimulation and demonstrated similar effects on vestibular perception. Supra-threshold GVS and VVS produced vestibular perturbation that impaired gait performance and postural control, while sub-threshold GVS and VVS induced stochastic resonance phenomenon that led to an improvement. Bilateral vestibular stimulation demonstrated a greater effect on gait and posture than unilateral vestibular stimulation. Compared to GVS, VVS had the characteristics of better tolerance and fewer side effects, which may substitute GVS to provide more acceptable vestibular stimulation.

Trip-Related Fall Risk Prediction Based on Gait Pattern in Healthy Older Adults: A Machine-Learning Approach.

Trip perturbations are proposed to be a leading cause of falls in older adults. To prevent trip-falls, trip-related fall risk should be assessed and subsequent task-specific interventions improving recovery skills from forward balance loss should be provided to the individuals at risk of trip-fall. Therefore, this study aimed to develop trip-related fall risk prediction models from one's regular gait pattern using machine-learning approaches. A total of 298 older adults (≥60 years) who experienced a novel obstacle-induced trip perturbation in the laboratory were included in this study. Their trip outcomes were classified into three classes: no-falls (n = 192), falls with lowering strategy (L-fall, n = 84), and falls with elevating strategy (E-fall, n = 22). A total of 40 gait characteristics, which could potentially affect trip outcomes, were calculated in the regular walking trial before the trip trial. The top 50% of features (n = 20) were selected to train the prediction models using a relief-based feature selection algorithm, and an ensemble classification model was selected and trained with different numbers of features (1-20). A ten-times five-fold stratified method was utilized for cross-validation. Our results suggested that the trained models with different feature numbers showed an overall accuracy between 67% and 89% at the default cutoff and between 70% and 94% at the optimal cutoff. The prediction accuracy roughly increased along with the number of features. Among all the models, the one with 17 features could be considered the best model with the highest AUC of 0.96, and the model with 8 features could be considered the optimal model, which had a comparable AUC of 0.93 and fewer features. This study revealed that gait characteristics in regular walking could accurately predict the trip-related fall risk for healthy older adults, and the developed models could be a helpful assessment tool to identify the individuals at risk of trip-falls.

Evaluating Gait Stability and Muscle Activation in Different Hand Holding Conditions Using the Robotic Walker-mTPAD.

While walkers are used as mobility aids for different gait impairments, little is known about the factors that affect the performance of such aids. Therefore, we investigated the impact of arm-holding conditions on gait stability and muscle activation. We used surface electromyography (sEMG) sensors on specific arm and leg muscles while the users took laps with a robotic walker, the mobile Tethered Pelvic Assist Device (mTPAD), on an instrumented mat. Eleven participants without gait disorders walked with and without a 10% body weight (BW) force applied on the pelvis in the following three configurations: (i) while gripping the walker's frame, (ii) while using an armrest with their arms at a 90∘ angle, and (iii) while using an armrest with their arms at a 130∘ angle for 5 min each. Our results showed that when applying a force, the users changed their gait to increase stability. We also discovered differences in muscle activation based on the user's specific arm conditions. Specifically, the 130∘ condition required the least muscle activation, while gripping the walker's frame increased specific muscle activation compared to 90∘ and 130∘. This study is the first to evaluate how arm-holding and external loading conditions alter gait and muscle activations using the mTPAD.

Comparative study of young-old and old-old people using functional evaluation, gait characteristics, and cardiopulmonary metabolic energy consumption.

BACKGROUND: Walking is an important factor in daily life. Among older adults, gait function declines with age. In contrast to the many studies revealing gait differences between young adults and older adults, few studies have further divided older adults into groups. The purpose of this study was to subdivide an older adult population by age to identify age-related differences in functional evaluation, gait characteristics and cardiopulmonary metabolic energy consumption while walking. METHODS: This was a cross-sectional study of 62 old adult participants who were classified into two age groups of 31 participants each as follows: young-old (65-74 years) and old-old (75-84 years) group. Physical functions, activities of daily living, mood state, cognitive function, quality of life, and fall efficacy were evaluated using the Short Physical Performance Battery (SPPB), Four-square Step Test (FSST), Timed Up and Go Test (TUG), Korean Version of the Modified Barthel Index, Geriatric Depression Scale (GDS), Korean Mini-mental State Examination, EuroQol-5 Dimensions (EQ-5D) questionnaire, and the Korean version of the Fall Efficacy Scale. A three-dimensional motion capture system (Kestrel Digital RealTime System®; Motion Analysis Corporation, Santa Rosa, CA, USA) and two force plates (TF-4060-B; Tec Gihan, Kyoto, Japan) were used to investigate spatiotemporal gait parameters (velocity, cadence, stride length, stride width, step length, single support, stance phase, and swing phase), kinematic variables (hip, knee, and ankle joint angles), and kinetic variables (hip, knee, and ankle joint moment and power) of gait. A portable cardiopulmonary metabolic system (K5; Cosmed, Rome, Italy) was used to measure cardiopulmonary energy consumption. RESULTS: The old-old group showed significantly lower SPPB, FSST, TUG, GDS-SF, and EQ-5D scores (p < 0.05). Among spatiotemporal gait parameters, velocity, stride length, and step length were significantly lower in the old-old group than in the young-old group (p < 0.05). Among the kinematic variables, the knee joint flexion angles during initial contact and terminal swing phase were significantly higher in the old-old than the young-old group (P < 0.05). The old-old group also showed a significantly lower ankle joint plantarflexion angle during the pre- and initial swing phases (P < 0.05). Among the kinetic variables, the hip joint flexion moment and knee joint absorption power in the pre-swing phase were significantly lower in the old-old than the young-old group (P < 0.05). CONCLUSION: This study demonstrated that participants 75-84 years of age had less functional gaits than their young-old counterparts (65-74 years old). As the walking pace of old-old people diminishes, driving strength to move ahead and pressure on the knee joint also tend to decrease together with stride length. These differences in gait characteristics according to age among older adults could improve our understanding of how aging causes variations in gait that increase the risk of falls. Older adults of different ages may require customized intervention plans, such as gait training methods, to prevent age-related falls. TRIAL REGISTRATION: Clinical trials registration information: ClinicalTrials.gov Identifier: NCT04723927 (26/01/2021).

Extraction of canine gait characteristics using a mobile gait analysis system based on inertial measurement units.

This study aims to investigate two simple algorithms for extracting gait features from an inertial measurement unit (IMU) based canine gait analysis system. The first algorithm was developed to determine the hip/shoulder extension/flexion range of motion. The second algorithm automatically determines the stance and swing phase per leg. To investigate the accuracy of the algorithms, two dogs were walked on a treadmill and measured simultaneously with an IMU system, an optical tracking system and two cameras. The range of motion estimation was compared to the optical tracking systems, with a total of 280 steps recorded. To test the stance and swing phase detection, a total of 63 steps were manually annotated in the video recordings and compared with the output of the algorithm. The IMU's-based estimation of the range of motion showed an average deviation of 1.4° to 5.6° from the optical reference, while the average deviation in the detection of the beginning and end of the stance and swing phases ranged from -0.01 to 0.09 s. This study shows that even simple algorithms can extract relevant information from inertial measurements that are comparable to results from more complex approaches. However, additional studies including a wider subject pool need to be conducted to investigate the significance of the presented findings.

The effect of mechanical vibration-based stimulation on dynamic balance control and gait characteristics in healthy young and older adults: A systematic review of cross-sectional study.

BACKGROUND: A good dynamic balance control and stable gait played an important role in the daily ambulation, especially for older adults with sensorimotor degeneration. This study aimed to systematically review the effects and potential mechanisms of mechanical vibration-based stimulation (MVBS) on dynamic balance control and gait characteristics in healthy young and older adults. METHOD: Five bioscience and engineering databases, including MEDLINE via PubMed, CINAHL via EBSCO, Cochrane Library, Scopus, and Embase, were searched until September 4th, 2022. Studies published between 2000 and 2022 in English and Chinese involving mechanical vibration related to gait and dynamic balance were included. The procedure was followed via the preferred reporting items for systematic reviews and meta-analysis method. The methodological quality of included studies was assessed using the NIH study quality assessment tool for observational cohort and cross-sectional studies. RESULTS: A total of 41 cross-sectional studies met the inclusion criteria and were included in this study. Eight studies were good-quality while 26 were moderate-quality and 7 were poor-quality. There were six categories of MVBS at various frequencies and amplitudes utilized in included studies, including plantar vibration, focal muscle vibration, Achilles tendon vibration, vestibular vibration, cervical vibration, and vibration on nail of hallux. SIGNIFICANCE: Different types of MVBS targeting different sensory systems affected the dynamic balance control and gait characteristics differently. MVBS could be used to provide improvement or perturbation to specific sensory systems, to induce different sensory reweight strategies during gait.

Using Sensor Technology to Measure Gait Capacity and Gait Performance in Rehabilitation Inpatients with Neurological Disorders.

The aim of this study was to objectively assess and compare gait capacity and gait performance in rehabilitation inpatients with stroke or incomplete spinal cord injury (iSCI) using inertial measurement units (IMUs). We investigated how gait capacity (what someone can do) is related to gait performance (what someone does). Twenty-two inpatients (11 strokes, 11 iSCI) wore ankle positioned IMUs during the daytime to assess gait. Participants completed two circuits to assess gait capacity. These were videotaped to certify the validity of the IMU algorithm. Regression analyses were used to investigate if gait capacity was associated with gait performance (i.e., walking activity and spontaneous gait characteristics beyond therapy time). The ankle positioned IMUs validly assessed the number of steps, walking time, gait speed, and stride length (r ≥ 0.81). The walking activity was strongly (r ≥ 0.76) related to capacity-based gait speed. Maximum spontaneous gait speed and stride length were similar to gait capacity. However, the average spontaneous gait speed was half the capacity-based gait speed. Gait capacity can validly be assessed using IMUs and is strongly related to gait performance in rehabilitation inpatients with neurological disorders. Measuring gait performance with IMUs provides valuable additional information about walking activity and spontaneous gait characteristics to inform about functional recovery.

Reference values of gait characteristics in community-dwelling older persons with different physical functional levels.

BACKGROUND: Mobility is one major component of healthy ageing of older persons. It includes gait speed, nowadays valued as the sixth vital sign of ageing. Quantitative gait analysis can support clinical diagnostics, monitor progression of diseases and provide information about the efficacy of interventions. Fast gait speed is an additional marker in the area of functional ability. Our aim was to contribute reference values of gait parameters of older persons based on their functional ability. METHODS: We visualised and combined three different established frameworks that assess gait characteristics into a new framework based approach that comprises eight gait parameters: gait speed, stride length, walk ratio, single and double support time, step width, step width CV (coefficient of variance), stride length CV. Gait parameters were stratified by two instruments that indicate levels of functional ability: First, the LUCAS Functional Ability Index (FAI), a self-administered screening tool easy to apply to a public-health orientated approach and second the Short Physical Performance Battery (SPPB), an established performance test widely used in comprehensive geriatric assessments (CGA). Gait parameters of older community-dwelling persons were measured with an objective Gait system (GAITRite) across differing functional ability ranging from robust to transient (postrobust and prefrail) to frail physical status. RESULTS: Of 642 community-dwelling participants (age 78.5 ± 4.8; n = 233 male, n = 409 female) categorisations by SPPB were 27.1% for robust (11-12 points), 44.2% for transient (8-10 points), 28.7% for frail (0-7 points), and 16.2, 50.3, 33.5% for robust, transient, frail by LUCAS FAI. Overall, our results showed that distinction by functional level only uncovers a wide spectrum of functional decline for all investigated gait parameters. Stratification by functional ability (biological age) revealed a greater range of differentiation than chronological age. CONCLUSIONS: Gait parameters, carefully selected by literature, showed clinically meaningful differences between the functional featuring a gradient declining from robust over transient to frail in most gait parameters. We found discriminative power of stratifications by SPPB to be the highest, closely followed by LUCAS FAI, age groups and dichotomous age making the application of the LUCAS FAI more cost and time effective than conducting SPPB.

Assessment of a powered ankle exoskeleton on human stability and balance.

Wearable robotic systems, such as exoskeletons, are designed to assist human motion; however, they are typically only studied during level walking. Before exoskeletons are broadly integrated into unstructured environments, it will be important to evaluate exoskeletons in a broader set of relevant tasks. A balance beam traverse was used to represent a constrained foot placement task for examining balance and stability. Participants (n = 17) completed the task in their own shoes (Pre-Exoskeleton and Post-Exoskeleton trials), and when wearing a lower-limb exoskeleton (Dephy ExoBoot) in both powered and unpowered states. Data were collected via inertial measurement units (on the torso and feet) and analyzed on a pooled level (with data from all participants) and on an individual level (participant-specific confidence intervals). When examining pooled data, it was observed that the exoskeleton had mixed effects on stride stability metrics. When compared to the Post-Exoskeleton shoe control, it was observed that stride duration was increased when wearing the exoskeleton (both powered and unpowered states), while normalized stride length and stride speed were not affected. Despite the changes in stride stability, overall balance (as measured by torso sway) remained unaffected by exoskeleton state. On an individual level, it was observed that not all participants followed these general trends, and within each metric, some increased, some decreased, and some had no change in the Powered Exoskeleton condition when compared to the Post-Exoskeleton Shoe condition: normalized stride length (0% increased, 12% decreased, 88% no change), stride duration (35% increased, 0% decreased, 65% no change), and torso sway (0% increased, 12% decreased, 88% no change). Our findings suggest that the lower-limb exoskeleton evaluated can be used during tasks that require balancing, and we recommend that balancing tasks be included in standards for exoskeleton evaluation.

Gait characteristics and effects of early treadmill intervention in infants and toddlers with down syndrome: a systematic review.

PURPOSE: The aim of this study was to evaluate gait characteristics, and the effectiveness of treadmill interventions on gait in infants and toddlers with Down syndrome (DS). MATERIALS AND METHODS: A comprehensive search was performed on six databases for evidence published up to November 2020 for articles related to infants and toddlers with DS. The Clinical Appraisal Skills Programme Checklist assessed the methodological quality. Strength of evidence were evaluated Sackett's level. RESULTS: Nine articles analyzing instrumental gait met the inclusion criteria. Of these, 4 compared DS and typically developing (TD), and 5 included treadmill training interventions for DS. Kinematic analysis was applied in 8 studies and all articles presented evaluations at different times according to the walking experience. Analysis with EMG was used in only one of the intervention articles and in 3 of the 4 comparative articles. CONCLUSIONS: Although similar improvements are seen in spatiotemporal parameters for toddlers with typical development and those with DS, the decrease in step width is not similar for DS. Early treadmill training can have a positively effect on the gait characteristics of DS infants. Further research should focus on the acquisition of gait characteristics, long-term evaluations, kinetics and EMG data, for these children.Implications For RehabilitationToddlers with DS walked significantly slower, shorter stride length and less stride frequency.Treadmill training before 1-year old had positive effects on gait characteristics in infants and toddlers with DS.High-intensity treadmill training may provide early walking (2 months earlier) than the low-intensity group, therefore clinicians can add treadmill training programs in rehabilitation protocols of infants and toddlers with DS.Limited evidence for the effects of treadmill training on the kinematic and kinetic parameters of walking in DS infants and toddlers.

Test-Retest Reliability of PODOSmart® Gait Analysis Insoles.

It is recognized that gait analysis is a powerful tool used to capture human locomotion and quantify the related parameters. PODOSmart® insoles have been designed to provide accurate measurements for gait analysis. PODOSmart® insoles are lightweight, slim and cost-effective. A recent publication presented the characteristics and data concerning the validity of PODOSmart® insoles in gait analysis. In literature, there is still no evidence about the repeatability of PODOSmart® gait analysis system. Such evidence is essential in order to use this device in both research and clinical settings. The aim of the present study was to assess the repeatability of PODOSmart® system. In this context, it was hypothesized that the parameters of gait analysis captured by PODOSmart® would be repeatable. In a sample consisting of 22 healthy male adults, participants performed two walking trials on a six-meter walkway. The ICC values for 28 gait variables provided by PODOSmart® indicated good to excellent test-retest reliability, ranging from 0.802 to 0.997. The present findings confirm that PODOSmart® gait analysis insoles present excellent repeatability in gait analysis parameters. These results offer additional evidence regarding the reliability of this gait analysis tool.

Use of Pressure-Measuring Insoles to Characterize Gait Parameters in Simulated Reduced-Gravity Conditions.

Prior researchers have observed the effect of simulated reduced-gravity exercise. However, the extent to which lower-body positive-pressure treadmill (LBPPT) walking alters kinematic gait characteristics is not well understood. The purpose of the study was to investigate the effect of LBPPT walking on selected gait parameters in simulated reduced-gravity conditions. Twenty-nine college-aged volunteers participated in this cross-sectional study. Participants wore pressure-measuring insoles (Medilogic GmBH, Schönefeld, Germany) and completed three 3.5-min walking trials on the LBPPT (AlterG, Inc., Fremont, CA, USA) at 100% (normal gravity) as well as reduced-gravity conditions of 40% and 20% body weight (BW). The resulting insole data were analyzed to calculate center of pressure (COP) variables: COP path length and width and stance time. The results showed that 100% BW condition was significantly different from both the 40% and 20% BW conditions, p < 0.05. There were no significant differences observed between the 40% and 20% BW conditions for COP path length and width. Conversely, stance time significantly differed between the 40% and 20% BW conditions. The findings of this study may prove beneficial for clinicians as they develop rehabilitation strategies to effectively unload the individual's body weight to perform safe exercises.

Testing of path-based visual cues on patterned carpet to assist older adults' gait in a continuing care retirement community.

Fall accidents lead to hospitalization and medical costs among all age groups, especially severe for older adults. Both intrinsic (e.g., visual impairment, fear of falling) and extrinsic (e.g., inappropriate carpet design, poor lighting) factors contribute to fall accidents. Older adults increasingly rely on visual perception to maintain balance as their health conditions decline. Patterned carpet is common in the built environment, which is one of the factors contributing to fall accidents among older adults. This study examined the role of path-based visual cues (provide visual guidance while walking along the patterned carpet) in helping older adults maintain safe movement and overcome the fear of falling. The experimental field study was conducted at a Continuing Care Retirement Community. Thirty-two residents were recruited. Within-subjects design was employed to examine the effects of path-based visual cues (light color and brightness) on the gait characteristics of older adults with and without visual impairment while walking on patterned carpet. Wearable sensors collected older adults' gait characteristics and questionnaires were used to evaluate their perceptions of confidence and safety with different visual cues provided. Individual repeated measures analysis results indicated that older adults significantly decreased stride length and stride velocity under 8.3 fc white and 7.3 fc blue lighting conditions compared to the baseline condition. In addition, the principal component analysis also indicated significant differences in gait performance among lighting colors and lighting brightness. The subjective responses indicated that the path-based visual cues were helpful in improving walking confidence, particularly for older adults with visual impairment.

Gait analysis in the elderly patients with lumbar spinal stenosis.

PURPOSE: This study aims to analyze the gait characteristics of the elderly patients with lumbar spinal stenosis by an intelligent device for energy expenditure and activity (IDEEA) to assist clinical work. METHODS: A total of 98 subjects were included in this study from January 2017 to December 2018. A total of 49 elderly outpatients with symptomatic lumbar spinal stenosis in unilateral lower extremity were included as the experimental group, and another 49 healthy subjects matched with gender, age, and body mass index (BMI) were analyzed as the control group. The gait data of the subjects (including single support, double support, SLS/DLS, swing duration, step duration, cycle duration, pulling accel, swing power, ground impact, foot fall, foot off, push off, speed, cadence, step length, and stride length) were collected to compare between the experience group and control group, the affected leg and the healthy leg in experimental group. RESULTS: The results of this study presented that small intermittent claudication occurred in all patients. The time of single support was significantly increased (p < 0.05). Double support, step duration, and pulling accel were increased (p < 0.05), and the Push off, speed, step length, and Stride length were decreased (p < 0.05) in the experimental group compared with the control group. CONCLUSION: Small intermittent claudication was the basic gait composition of the elderly patients with lumbar spinal stenosis that can reflect the abnormal gait characteristics by IDEEA.

The correlation between rhythm perception and gait characteristics at different rhythms among children with cerebral palsy and typically developing children.

BACKGROUND: It has been shown that motor training while listening to constant rhythm, is associated with coupling between movement and rhythm. To gain a better understanding of how rhythm perception may affect gait in children with cerebral palsy (CP) it seems important first to assess rhythm perception (RP) in these children. RESEARCH QUESTION: To describe and compare RP and step characteristics in children with CP and typically-developing (TD) children, and to assess the impact of RP on step characteristics during different rhythms. METHODS: The study included 24 children with CP, Gross Motor Function Classification System (GMFCS) levels I-II, age 7-12 years, who walk without assistive device, and 24 TD children matched for age and gender. RP was assessed by the perceptual beat alignment test (BAT). Gait parameters were recorded using a pressure-sensitive mat - the Gaitrite® system. Each participant walked on the mat at a comfortable walking pace and with the metronome set at 92.5 %, 100 % and 107.5 % of his preferred walking rhythm. RESULTS: No significant difference in RP was noted between groups. Children with CP presented significantly larger step time and length variability. In TD children, those with better RP walked significantly slower, with lower step variability as compared to TD children with lower RP. Children in both groups, regardless of rhythm perception, successfully matched their cadence to the metronome's pace, both at the lower and higher rhythm, except TD children with lower rhythm perception, who failed to reduce their cadence sufficiently in the 92.5 % pace. Children with better RP in both groups changed more parameters in gait in response to rhythm changes. SIGNIFICANCE: Assessing RP may predict which parameters of gait are expected to change when employing a metronome during child's walk.