Effect of wearing diapers on toddler’s gait

AbstractGait maturation in infants develops gradually through several phases. However, external factors such as childrearing practices, especially the wearing of diapers, may affect an infant’s motor development. This study investigated the influence of different bulk stresses on the gait of toddlers wearing a disposable diaper. Twenty-six healthy toddlers (age: 19.2 ± 0.9 months) participated in this study. We measured the joint kinematics (pelvis angle and hip-joint angle) and spatiotemporal parameters (step length and step width) of the toddlers’ gait under four dress conditions (wearing Type A_WET, Type A_DRY, and Type B_WET diapers and naked). Type B_WET had a higher bulk stress than Type A_WET, and Type A_DRY had lower stress than Type A _ WET. Our results indicate that the walk of toddlers when wearing a diaper differs from that when naked. This difference is due to the effect of the bulk of the diaper on the lower limb. A high bulk stress has a greater influence than that of a low bulk stress on joint dynamics and step width. Therefore, our findings suggest that wearing diapers with high bulk stress may inhibit the natural gait patterns of toddlers.

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Altering Footwear Type Influences Gait During Level Walking and Downhill Transitions

Journal of Applied Biomechanics ◽

10.1123/jab.28.5.481 ◽

2012 ◽

Vol 28 (5) ◽

pp. 481-490 ◽

Cited By ~ 4

Author(s):

Keith A. Stern ◽

Jinger S. Gottschall

Keyword(s):

Gait Cycle ◽

Dynamic Balance ◽

Step Length ◽

Lower Leg ◽

Step Width ◽

Lateral Gastrocnemius ◽

Gait Patterns ◽

Level Walking ◽

Stance Time ◽

Stable Gait

The purpose of our study was to determine if altering the insoles within footwear or walking barefoot, as an attempt to increase or decrease cutaneous stimuli, would improve dynamic balance during a hill-walking task. We hypothesize that compared with foam insoles or iced bare feet, textured insoles or bare feet will result in greater speeds, longer step lengths, narrower step width, shorter stance time, and less tibialis anterior (TA), soleus (SOL), and lateral gastrocnemius (LG) activity during key gait cycle phases. Ten, healthy college students, 5 men and 5 women, completed the protocol that consisted of level walking and downhill transition walking in five different footwear insole or barefoot conditions. During level walking, conditions with the hypothesized greater cutaneous stimuli resulted in greater step length, which relates to a more stable gait. In detail, the texture insole condition average step length was 3% longer than the regular insole condition, which was 5% longer than the ice condition (p < .01). The same signals of increased stability were evident during the more challenging downhill transition stride. Step length during the barefoot condition was 8% longer than the ice condition (p < .05) and step width during the regular footwear condition was 5% narrower than the foam condition (p = .05). To add, during the preswing phase of level walking, TA activity of the textured insole condition was 30% less than the foam insole. Although our data show that footwear conditions alter gait patterns and lower leg muscle activity during walking, there is not enough evidence to support the hypothesis that textured insoles will improve dynamic balance as compared with other footwear types.

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Regional Associations of Cortical Thickness With Gait Variability: The Tasmanian Study of Cognition and Gait

Innovation in Aging ◽

10.1093/geroni/igaa057.750 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 232-233

Author(s):

Oshadi Jayakody ◽

Monique Breslin ◽

Richard Beare ◽

Velandai Srikanth ◽

Helena Blumen ◽

...

Keyword(s):

Cortical Thickness ◽

Step Length ◽

Gait Variability ◽

Thickness Ratio ◽

Sensory Function ◽

Time Variability ◽

Step Width ◽

Time Step ◽

Cortical Regions ◽

Regional Associations

Abstract Gait variability is a marker of cognitive decline. However, there is limited understanding of the cortical regions associated with gait variability. We examined associations between regional cortical thickness and gait variability in a population-based sample of older people without dementia. Participants (n=350, mean age 71.9±7.1) were randomly selected from the electoral roll. Variability in step time, step length, step width and double support time (DST) were calculated as the standard deviation of each measure, obtained from the GAITRite walkway. MRI scans were processed through FreeSurfer to obtain cortical thickness of 68 regions. Bayesian regression was used to determine regional associations of mean cortical thickness and thickness ratio (regional thickness/overall mean thickness) with gait variability. Smaller overall cortical thickness was only associated with greater step width and step time variability. Smaller mean thickness in widespread regions important for sensory, cognitive and motor functions were associated with greater step width and step time variability. In contrast, smaller thickness in a few frontal and temporal regions were associated with DST variability and the right cuneus was associated with step length variability. Smaller thickness ratio in frontal and temporal regions important for motor planning, execution and sensory function and, greater thickness ratio in the anterior cingulate was associated with greater variability in all measures. Examining individual cortical regions is important in understanding the relationship between gray matter and gait variability. Cortical thickness ratio highlights that smaller regional thickness relative to global thickness may be important for the consistency of gait.

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Dynamic Asymmetries Do Not Match Spatiotemporal Step Asymmetries during Split-Belt Walking

Symmetry ◽

10.3390/sym13061089 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1089

Author(s):

Stefano Scarano ◽

Luigi Tesio ◽

Viviana Rota ◽

Valeria Cerina ◽

Luigi Catino ◽

...

Keyword(s):

Lower Limb ◽

Step Length ◽

Centre Of Mass ◽

Mean Velocity ◽

Rehabilitation Research ◽

Joint Dynamics ◽

Stance Time ◽

After Effect ◽

The Mean ◽

Step Parameters

While walking on split-belt treadmills (two belts running at different speeds), the slower limb shows longer anterior steps than the limb dragged by the faster belt. After returning to basal conditions, the step length asymmetry is transiently reversed (after-effect). The lower limb joint dynamics, however, were not thoroughly investigated. In this study, 12 healthy adults walked on a force-sensorised split-belt treadmill for 15 min. Belts rotated at 0.4 m s−1 on both sides, or 0.4 and 1.2 m s−1 under the non-dominant and dominant legs, respectively. Spatiotemporal step parameters, ankle power and work, and the actual mean velocity of the body’s centre of mass (CoM) were computed. On the faster side, ankle power and work increased, while step length and stance time decreased. The mean velocity of the CoM slightly decreased. As an after-effect, modest converse asymmetries developed, fading within 2–5 min. These results may help to decide which belt should be assigned to the paretic and the unaffected lower limb when split-belt walking is applied for rehabilitation research in hemiparesis.

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A Dual-Learning Paradigm Simultaneously Improves Multiple Features of Gait Post-Stroke

Neurorehabilitation and Neural Repair ◽

10.1177/1545968318792623 ◽

2018 ◽

Vol 32 (9) ◽

pp. 810-820 ◽

Cited By ~ 5

Author(s):

Kendra M. Cherry-Allen ◽

Matthew A. Statton ◽

Pablo A. Celnik ◽

Amy J. Bastian

Keyword(s):

Knee Flexion ◽

Joint Angle ◽

Step Length ◽

Learning Task ◽

Gait Pattern ◽

Learning Paradigm ◽

Post Stroke ◽

Learning Conditions ◽

Hip Flexion ◽

Gait Impairments

Background. Gait impairments after stroke arise from dysfunction of one or several features of the walking pattern. Traditional rehabilitation practice focuses on improving one component at a time, which may leave certain features unaddressed or prolong rehabilitation time. Recent work shows that neurologically intact adults can learn multiple movement components simultaneously. Objective. To determine whether a dual-learning paradigm, incorporating 2 distinct motor tasks, can simultaneously improve 2 impaired components of the gait pattern in people posttroke. Methods. Twelve individuals with stroke participated. Participants completed 2 sessions during which they received visual feedback reflecting paretic knee flexion during walking. During the learning phase of the experiment, an unseen offset was applied to this feedback, promoting increased paretic knee flexion. During the first session, this task was performed while walking on a split-belt treadmill intended to improve step length asymmetry. During the second session, it was performed during tied-belt walking. Results. The dual-learning task simultaneously increased paretic knee flexion and decreased step length asymmetry in the majority of people post-stroke. Split-belt treadmill walking did not significantly interfere with joint-angle learning: participants had similar rates and magnitudes of joint-angle learning during both single and dual-learning conditions. Participants also had significant changes in the amount of paretic hip flexion in both single and dual-learning conditions. Conclusions. People with stroke can perform a dual-learning paradigm and change 2 clinically relevant gait impairments in a single session. Long-term studies are needed to determine if this strategy can be used to efficiently and permanently alter multiple gait impairments.

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Effects of selectively assisting impaired subtasks of walking in chronic stroke survivors

Journal of NeuroEngineering and Rehabilitation ◽

10.1186/s12984-020-00762-7 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Simone S. Fricke ◽

Hilde J. G. Smits ◽

Cristina Bayón ◽

Jaap H. Buurke ◽

Herman van der Kooij ◽

...

Keyword(s):

Knee Flexion ◽

Step Length ◽

Gait Training ◽

Chronic Stroke ◽

Stroke Survivors ◽

Baseline Trial ◽

Gait Parameters ◽

Flexion Extension ◽

Spatiotemporal Parameters ◽

Length Width

Abstract Background Recently developed controllers for robot-assisted gait training allow for the adjustment of assistance for specific subtasks (i.e. specific joints and intervals of the gait cycle that are related to common impairments after stroke). However, not much is known about possible interactions between subtasks and a better understanding of this can help to optimize (manual or automatic) assistance tuning in the future. In this study, we assessed the effect of separately assisting three commonly impaired subtasks after stroke: foot clearance (FC, knee flexion/extension during swing), stability during stance (SS, knee flexion/extension during stance) and weight shift (WS, lateral pelvis movement). For each of the assisted subtasks, we determined the influence on the performance of the respective subtask, and possible effects on other subtasks of walking and spatiotemporal gait parameters. Methods The robotic assistance for the FC, SS and WS subtasks was assessed in nine mildly impaired chronic stroke survivors while walking in the LOPES II gait trainer. Seven trials were performed for each participant in a randomized order: six trials in which either 20% or 80% of assistance was provided for each of the selected subtasks, and one baseline trial where the participant did not receive subtask-specific assistance. The influence of the assistance on performances (errors compared to reference trajectories) for the assisted subtasks and other subtasks of walking as well as spatiotemporal parameters (step length, width and height, swing and stance time) was analyzed. Results Performances for the impaired subtasks (FC, SS and WS) improved significantly when assistance was applied for the respective subtask. Although WS performance improved when assisting this subtask, participants were not shifting their weight well towards the paretic leg. On a group level, not many effects on other subtasks and spatiotemporal parameters were found. Still, performance for the leading limb angle subtask improved significantly resulting in a larger step length when applying FC assistance. Conclusion FC and SS assistance leads to clear improvements in performance for the respective subtask, while our WS assistance needs further improvement. As effects of the assistance were mainly confined to the assisted subtasks, tuning of FC, SS and WS can be done simultaneously. Our findings suggest that there may be no need for specific, time-intensive tuning protocols (e.g. tuning subtasks after each other) in mildly impaired stroke survivors.

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Evaluation of the Effectiveness of Nordic Walking Training in Improving the Gait of Persons with Down Syndrome

BioMed Research International ◽

10.1155/2019/6353292 ◽

2019 ◽

Vol 2019 ◽

pp. 1-11

Author(s):

Agnieszka Skiba ◽

Jakub Marchewka ◽

Amadeusz Skiba ◽

Szymon Podsiadło ◽

Iwona Sulowska ◽

...

Keyword(s):

Down Syndrome ◽

Three Dimensional ◽

Training Group ◽

Step Length ◽

Positive Influence ◽

Control Group ◽

Kinematic Parameters ◽

Nordic Walking ◽

Infrared Video ◽

Spatiotemporal Parameters

People with Down syndrome (DS) show dysfunction of gait, expressed by disturbed character of angular changes and values of the spatiotemporal parameters as compared to the physiological norm. It is known that exercises and various activities have positive effect on balance and gait, but there are only a few scientific proofs concerning above-mentioned in people with DS. Furthermore, the effect of Nordic Walking (NW) training on gait in people with DS is unexplored. We enrolled 22 subjects with DS, aged 25-40 years, with moderate intellectual disability. Participants were randomly divided into 2 groups: NW training group which underwent 10 weeks of training at a frequency of 3 times a week and control group with no specific intervention. Subjects were examined twice: 1 week before training and a week immediately after intervention. Gait was evaluated by the Vicon 250: a computerized system of three-dimensional analysis of motion, connected to 5 infrared video cameras. We conducted mixed-design ANOVA model to assess the effects of time and type of training on spatiotemporal parameters. We found significant favorable time by group interaction in the following parameters: step length in right leg: F(1,15) =14,47, p=0.002; left leg accordingly F(1,15) =5,15, p=0.038, cycle length in right leg: F(1,15) =14,48, p=0.002; left leg accordingly F(1,15) =15,09, p=0.001; and gait standardised speed F(1,15) =5,35, p=0.035. Statistically significant changes were observed in numerous kinematic parameters of ankle, knee, pelvis, and shoulder in NW group. Regular NW training has positive influence on selected spatiotemporal and kinematic parameters in people with Down Syndrome and may be an attractive and safe form of rehabilitation.

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Feasibility of Using Foot–Ground Clearance Biofeedback Training in Treadmill Walking for Post-Stroke Gait Rehabilitation

Brain Sciences ◽

10.3390/brainsci10120978 ◽

2020 ◽

Vol 10 (12) ◽

pp. 978

Author(s):

Hanatsu Nagano ◽

Catherine M. Said ◽

Lisa James ◽

Rezaul K. Begg

Keyword(s):

Real Time ◽

Training Session ◽

Step Length ◽

Gait Training ◽

Treadmill Walking ◽

Biofeedback Training ◽

Step Width ◽

Double Support ◽

Post Stroke ◽

Foot Clearance

Hemiplegic stroke often impairs gait and increases falls risk during rehabilitation. Tripping is the leading cause of falls, but the risk can be reduced by increasing vertical swing foot clearance, particularly at the mid-swing phase event, minimum foot clearance (MFC). Based on previous reports, real-time biofeedback training may increase MFC. Six post-stroke individuals undertook eight biofeedback training sessions over a month, in which an infrared marker attached to the front part of the shoe was tracked in real-time, showing vertical swing foot motion on a monitor installed in front of the subject during treadmill walking. A target increased MFC range was determined, and participants were instructed to control their MFC within the safe range. Gait assessment was conducted three times: Baseline, Post-training and one month from the final biofeedback training session. In addition to MFC, step length, step width, double support time and foot contact angle were measured. After biofeedback training, increased MFC with a trend of reduced step-to-step variability was observed. Correlation analysis revealed that MFC height of the unaffected limb had interlinks with step length and ankle angle. In contrast, for the affected limb, step width variability and MFC height were positively correlated. The current pilot-study suggested that biofeedback gait training may reduce tripping falls for post-stroke individuals.

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Selecting Clinically Relevant Gait Characteristics for Classification of Early Parkinson’s Disease: A Comprehensive Machine Learning Approach

Scientific Reports ◽

10.1038/s41598-019-53656-7 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 6

Author(s):

Rana Zia Ur Rehman ◽

Silvia Del Din ◽

Yu Guan ◽

Alison J. Yarnall ◽

Jian Qing Shi ◽

...

Keyword(s):

Machine Learning ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Clinical Decision Making ◽

Information Gain ◽

Step Length ◽

Support Vector ◽

Step Width ◽

Gait Characteristics

AbstractParkinson’s disease (PD) is the second most common neurodegenerative disease; gait impairments are typical and are associated with increased fall risk and poor quality of life. Gait is potentially a useful biomarker to help discriminate PD at an early stage, however the optimal characteristics and combination are unclear. In this study, we used machine learning (ML) techniques to determine the optimal combination of gait characteristics to discriminate people with PD and healthy controls (HC). 303 participants (119 PD, 184 HC) walked continuously around a circuit for 2-minutes at a self-paced walk. Gait was quantified using an instrumented mat (GAITRite) from which 16 gait characteristics were derived and assessed. Gait characteristics were selected using different ML approaches to determine the optimal method (random forest with information gain and recursive features elimination (RFE) technique with support vector machine (SVM) and logistic regression). Five clinical gait characteristics were identified with RFE-SVM (mean step velocity, mean step length, step length variability, mean step width, and step width variability) that accurately classified PD. Model accuracy for classification of early PD ranged between 73–97% with 63–100% sensitivity and 79–94% specificity. In conclusion, we identified a subset of gait characteristics for accurate early classification of PD. These findings pave the way for a better understanding of the utility of ML techniques to support informed clinical decision-making.

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Differences in spatiotemporal parameters during 200-m sprint between bilateral and unilateral transfemoral amputees

Prosthetics and Orthotics International ◽

10.1177/0309364618767142 ◽

2018 ◽

Vol 42 (6) ◽

pp. 567-570 ◽

Cited By ~ 1

Author(s):

Hiroaki Hobara ◽

Sakiko Saito ◽

Satoru Hashizume ◽

Yuta Namiki ◽

Yoshiyuki Kobayashi

Keyword(s):

Clinical Relevance ◽

Step Length ◽

Classification Rules ◽

Step Frequency ◽

Average Speed ◽

Race Time ◽

Performance Differences ◽

Spatiotemporal Parameters ◽

Transfemoral Amputees

Background and aim: Although Paralympic T42 class Men’s 200 m sprints are currently competed by athletes with bilateral and unilateral transfemoral amputations, there may be performance differences between the groups. This study aimed to compare the spatiotemporal parameters of a 200-m sprint between bilateral and unilateral transfemoral amputees wearing running-specific prostheses. Technique: We analyzed 29 races (nine sprinters) with bilateral or unilateral transfemoral amputations from publicly available Internet broadcasts. For each sprinter’s race, the average speed, step frequency, and step length were calculated using the number of steps in conjunction with the official race time. Discussion: Average speed of bilateral transfemoral amputees was 5.7% greater than in unilateral transfemoral amputees. Bilateral transfemoral amputees exhibited lower step frequency (–8.9%) but longer step length (16.3%) than unilateral transfemoral amputees. Therefore, even in the same Paralympic classification (T42), different spatiotemporal strategies exist between bilateral and unilateral transfemoral amputees wearing running-specific prostheses during 200-m sprints. Clinical relevance Since different spatiotemporal strategies exist between bilateral and unilateral transfemoral amputees during 200-m sprints, our data supports recent revisions of classification rules (1st January, 2018), which each population was allocated into the different classification (T61 and T63, respectively).

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