Clinical skills and assessment

Mapping Intimacies ◽

10.1093/med/9780199592630.003.0001 ◽

2012 ◽

Keyword(s):

Lower Limb ◽

Limb Development ◽

Gait Cycle ◽

Clinical Skills ◽

History Taking ◽

Normal Variants ◽

Gait Patterns ◽

Musculoskeletal Development ◽

Normal Gait ◽

Abnormal Gait

Epidemiology of paediatric musculoskeletal conditions 2History taking, physical examination, and approaches to investigation 4Normal variants of lower limb development 9The gait cycle and abnormal gait patterns 11Normal gait and musculoskeletal development 15pGALS: paediatric gait, arms, legs, spine musculoskeletal screening examination ...

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Newly designed computer controlled knee-ankle-foot orthosis (Intelligent Orthosis)

Prosthetics and Orthotics International ◽

10.3109/03093649809164488 ◽

1998 ◽

Vol 22 (3) ◽

pp. 230-239 ◽

Cited By ~ 26

Author(s):

T. Suga ◽

O. Kameyama ◽

R. Ogawa ◽

M. Matsuura ◽

H. Oka

Keyword(s):

Lower Limb ◽

Stance Phase ◽

Gait Cycle ◽

Normal Subjects ◽

Swing Phase ◽

Ankle Foot Orthosis ◽

Normal Gait ◽

Heel Contact ◽

Computer Controlled ◽

Foot Orthosis

The authors have developed a knee-ankle-foot orthosis with a joint unit that controls knee movements using a microcomputer (Intelligent Orthosis). The Intelligent Orthosis was applied to normal subjects and patients, and gait analysis was performed. In the gait cycle, the ratio of the stance phase to the swing phase was less in gait with the knee locked using a knee-ankle-foot orthosis than in gait without an orthosis or gait with the knee controlled by a microcomputer. The ratio of the stance phase to the swing phase between controlled gait and normal gait was similar. For normal subjects the activity of the tibialis anterior was markedly increased from the heel-off phase to the swing phase in locked gait. The muscle activities of the lower limb were lower in controlled force in locked gait showed spikes immediately after heel-contact in the vertical at heel-contact in the sagittal to locked gait, gait with the Intelligent Orthosis is smooth and close to normal gait from the viewpoint of biomechanics. Even in patients with muscle weakness of the quadriceps, control of the knee joint using the Intelligent Orthosis resulted in a more smooth gait with low muscle discharge.

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The validity of video clips in the diagnosis of gait disorder

Journal of Telemedicine and Telecare ◽

10.1258/135763307782215406 ◽

2007 ◽

Vol 13 (7) ◽

pp. 333-336 ◽

Cited By ~ 7

Author(s):

Salih A Salih ◽

Richard Wootton ◽

Elaine Beller ◽

Len Gray

Keyword(s):

Gold Standard ◽

Video Clip ◽

Clinical Documentation ◽

Gait Disorder ◽

Average Sensitivity ◽

Gait Patterns ◽

Video Clips ◽

Normal Gait ◽

Abnormal Gait ◽

Gait Abnormalities

We investigated the accuracy and validity of clinical gait assessment, performed by experienced geriatricians viewing video clips of 10 s duration. Nineteen patients with normal or characteristic abnormal gait patterns were studied. The treating physician's diagnosis served as the gold standard. Another live assessment was then performed by a geriatrician blinded to the medical record to establish inter-rater reliability of live assessments. Subsequently, each gait video clip was examined by two independent geriatricians without any background clinical documentation. Diagnostic accuracy was tested at two levels – whether the gait was abnormal, and the specific gait diagnosis. The agreement of the video clip examination with the gold standard to identify abnormal gait from normal gait ranged from substantial to excellent among assessors ( κ = 0.68–0.85), although low agreement with the gold standard was achieved in the detection of specific gait diagnosis (average agreement between both viewing geriatricians 50%). The technique appears to be a valid screening procedure for detecting gait abnormalities (average sensitivity 100%, specificity 70%).

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EXPLOITING VISUAL CUES FOR LEARNING GAIT PATTERNS ASSOCIATED WITH NEUROLOGICAL DISORDERS

Jurnal Teknologi ◽

10.11113/jt.v79.7898 ◽

2017 ◽

Vol 79 (3) ◽

Author(s):

Kuhelee Roy ◽

Geelapaturu Subrahmanya Venkata Radha Krish Rao ◽

Savarimuthu, Margret Anouncia

Keyword(s):

Early Diagnosis ◽

Real Time ◽

Neurological Disorders ◽

Visual Cues ◽

Gait Pattern ◽

Shape Features ◽

Gait Patterns ◽

Normal Gait ◽

Abnormal Gait ◽

Gait Abnormalities

Records of cases involving neurological disorders often exhibit abnormalities in the gait pattern of an individual. As mentioned in various articles, the causes of various gait disorders can be attributed to neurological disorders. Hence analysis of gait abnormalities can be a key to predict the type of neurological disorders as a part of early diagnosis. A number of sensor-based measurements have aided towards quantifying the degree of abnormalities in a gait pattern. A shape oriented motion based approach has been proposed in this paper to envisage the task of classifying an abnormal gait pattern into one of the five types of gait viz. Parkinsonian, Scissor, Spastic, Steppage and Normal gait. The motion and shape features for two cases viz. right-leg-front and left-leg-front will be taken into account. Experimental results of application on real-time videos suggest the reliability of the proposed method.

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Measuring Dynamic Leg Length during Normal Gait

Sensors ◽

10.3390/s18124191 ◽

2018 ◽

Vol 18 (12) ◽

pp. 4191 ◽

Cited By ~ 1

Author(s):

Sam Khamis ◽

Shmuel Springer ◽

Dror Ovadia ◽

Sima Krimus ◽

Eli Carmeli

Keyword(s):

Normative Data ◽

Stance Phase ◽

Gait Cycle ◽

Leg Length ◽

Normal Gait ◽

Abnormal Gait ◽

Lower Limb Movement ◽

New Perspective ◽

Analysis System ◽

Healthy Participants

Dynamic leg length [DLL] is a resultant factor of anatomic leg length and lower limb movement that is measured by the distance from the hip to the heel, ankle, and forefoot during the gait cycle. The aim of this study was to present DLL measurement during normal gait. Forty healthy participants underwent a gait evaluation using a motion analysis system. The average DLLs were compared between sides during the gait cycle using the paired t-test at 51 sample points. Time of maximal and minimal DLLs and the ratio between maximal and minimal DLLs during the gait cycle were calculated. DLLs were found to be consistent, indicated by a within standard deviation of <6.65 mm and by being symmetrical with no significant differences between sides [p > 0.103]. DLL patterns and time of maximal and minimal DLLs were established. The ratio between maximal DLLs during the stance phase and minimal DLLs during the swing phase was also defined and found to be symmetrical. Normative data of DLL measures were set with respect to magnitude and pattern during the gait cycle. These data might serve as a reference for abnormal gait deviation reflected by abnormal DLLs, thus promoting a new perspective in gait analysis.

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Electromyographic Study on Lower Limb Muscle Activities During Normal Gait Cycle

The Journal of Kansai Medical University ◽

10.5361/jkmu1956.36.1_131 ◽

1984 ◽

Vol 36 (1) ◽

pp. 131-152 ◽

Cited By ~ 5

Author(s):

Hideo Oka

Keyword(s):

Lower Limb ◽

Gait Cycle ◽

Lower Limb Muscle ◽

Limb Muscle ◽

Normal Gait

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A comparison of the SACH and single axis foot in the gait of unilateral below-knee amputees

Prosthetics and Orthotics International ◽

10.3109/03093648309146713 ◽

1983 ◽

Vol 7 (1) ◽

pp. 33-36 ◽

Cited By ~ 29

Author(s):

N. E. Doane ◽

L. E. Holt

Keyword(s):

Lower Limb ◽

Gait Cycle ◽

Knee Prosthesis ◽

Statistical Significance ◽

Swing Phase ◽

Joint Angles ◽

Gait Patterns ◽

Prosthetic Devices ◽

Prosthetic Limb ◽

Points Of View

The gait patterns of unilateral below-knee amputees wearing prostheses with either a SACH foot or a single axis foot were compared. A temporary below-knee prosthesis was fabricated for each subject using plaster of Paris and Plastazote for the socket, a pylon and an artificial foot. Eight subjects were filmed at two separate sessions, one in which the SACH foot was worn on their prosthesis and one with the single axis foot on their prosthesis. Measurements of the normal leg with a SACH foot on the prosthetic limb were compared to measurements of the normal leg with a single axis foot on the prosthesis. Measurements of the prosthetic leg with both devices were also compared. A one tailed t test (p<.05) was used to determine statistical significance of the results obtained in six measurements of lower limb joint angles and on the percentage of the time of gait cycle for stance and swing phase of the prosthetic leg. Discussion centres on the interpretation of the results from both statistical and clinical points of view. Major differences (excepting the ankle at foot-flat) between the prosthetic devices were not found.

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The Actuation System of the Ankle Exoskeleton T-FLEX: First Use Experimental Validation in People with Stroke

Brain Sciences ◽

10.3390/brainsci11040412 ◽

2021 ◽

Vol 11 (4) ◽

pp. 412

Author(s):

Daniel Gomez-Vargas ◽

Felipe Ballen-Moreno ◽

Patricio Barria ◽

Rolando Aguilar ◽

José M. Azorín ◽

...

Keyword(s):

Inertial Sensor ◽

Movement Analysis ◽

Biomechanical Analysis ◽

Gait Patterns ◽

Positive Effects ◽

General Terms ◽

Actuation System ◽

Abnormal Gait ◽

Ankle Kinematics ◽

Robotic Devices

Robotic devices can provide physical assistance to people who have suffered neurological impairments such as stroke. Neurological disorders related to this condition induce abnormal gait patterns, which impede the independence to execute different Activities of Daily Living (ADLs). From the fundamental role of the ankle in walking, Powered Ankle-Foot Orthoses (PAFOs) have been developed to enhance the users’ gait patterns, and hence their quality of life. Ten patients who suffered a stroke used the actuation system of the T-FLEX exoskeleton triggered by an inertial sensor on the foot tip. The VICONmotion capture system recorded the users’ kinematics for unassisted and assisted gait modalities. Biomechanical analysis and usability assessment measured the performance of the system actuation for the participants in overground walking. The biomechanical assessment exhibited changes in the lower joints’ range of motion for 70% of the subjects. Moreover, the ankle kinematics showed a correlation with the variation of other movements analyzed. This variation had positive effects on 70% of the participants in at least one joint. The Gait Deviation Index (GDI) presented significant changes for 30% of the paretic limbs and 40% of the non-paretic, where the tendency was to decrease. The spatiotemporal parameters did not show significant variations between modalities, although users’ cadence had a decrease of 70% of the volunteers. Lastly, the satisfaction with the device was positive, the comfort being the most user-selected aspect. This article presents the assessment of the T-FLEX actuation system in people who suffered a stroke. Biomechanical results show improvement in the ankle kinematics and variations in the other joints. In general terms, GDI does not exhibit significant increases, and the Movement Analysis Profile (MAP) registers alterations for the assisted gait with the device. Future works should focus on assessing the full T-FLEX orthosis in a larger sample of patients, including a stage of training.

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Lower Limb Kinematics in Individuals with Hip Osteoarthritis during Gait: A Focus on Adaptative Strategies and Interlimb Symmetry

Bioengineering ◽

10.3390/bioengineering8040047 ◽

2021 ◽

Vol 8 (4) ◽

pp. 47

Author(s):

Micaela Porta ◽

Massimiliano Pau ◽

Bruno Leban ◽

Michela Deidda ◽

Marco Sorrentino ◽

...

Keyword(s):

Lower Limb ◽

Functional Limitations ◽

Hip Osteoarthritis ◽

Movement Analysis ◽

Human Movement ◽

Point Of View ◽

Negative Effects ◽

Gait Patterns ◽

Limb Kinematics

Among the functional limitations associated with hip osteoarthritis (OA), the alteration of gait capabilities represents one of the most invalidating as it may seriously compromise the quality of life of the affected individual. The use of quantitative techniques for human movement analysis has been found valuable in providing accurate and objective measures of kinematics and kinetics of gait in individuals with hip OA, but few studies have reported in-depth analyses of lower limb joint kinematics during gait and, in particular, there is a scarcity of data on interlimb symmetry. Such aspects were investigated in the present study which tested 11 individuals with hip OA (mean age 68.3 years) and 11 healthy controls age- and sex-matched, using 3D computerized gait analysis to perform point-by-point comparisons of the joint angle trends of hip, knee, and ankle. Angle-angle diagrams (cyclograms) were also built to compute several parameters (i.e., cyclogram area and orientation and Trend Symmetry) from which to assess the degree of interlimb symmetry. The results show that individuals with hip OA exhibit peculiar gait patterns characterized by severe modifications of the physiologic trend at hip level even in the unaffected limb (especially during the stance phase), as well as minor (although significant) alterations at knee and ankle level. The symmetry analysis also revealed that the effect of the disease in terms of interlimb coordination is present at knee joint as well as hip, while the ankle joint appears relatively preserved from specific negative effects from this point of view. The availability of data on such kinematic adaptations may be useful in supporting the design of specific rehabilitative strategies during both preoperative and postoperative periods.

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