THREE-DIMENSIONAL GAIT ANALYSIS AS A POTENTIAL AND QUANTIFIABLE MEASUREMENT IN THE CLINICAL EVALUATION OF ANKYLOSING SPONDYLITIS

The present study aimed to investigate the potential clinical value of three-dimensional gait analysis (3D-GA) system in evaluating ankylosing spondylitis (AS). Thirty-one patients with AS from September 2010 to August 2011, with 32 involved and 30 uninvolved lower limbs, were enrolled. Data of spatio-temporal parameters (step and stride length, velocity and cadence), time parameters (stance, single stance, double stance and swing phases) and kinematics parameters associated with spinal mobility (spinal lateral bending, spinal forward bending and spinal rotation) were analyzed by 3D-GA system, as well as curative effects of biologic therapy. Compared with normal values, AS patients showed decreased step and stride length ([Formula: see text]), increased cadence, longer swing and single stance phases ([Formula: see text]) and shorter stance and double stance phases ([Formula: see text]) in uninvolved lower limbs. In AS patients, reduced step length, stride length, velocity and cadence, shorter swing and single stance phases, longer stance and double stance phases ([Formula: see text]), increased lateral bending angle and decreased spinal rotation ([Formula: see text]) were detected by 3D-GA in involved lower limbs compared with uninvolved ones. In the 16 patients with decreased levels of ESR and CRP and improved ASAS scores after biology therapy, increased step length, stride length, velocity and cadence of the involved lower limbs were detected by 3D-GA ([Formula: see text]), as well as improved spinal mobility ([Formula: see text]). Hence, we concluded that 3D-GA has great potential value of clinical application for assessing and monitoring AS.

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The Biomechanical Effect of the Sensomotor Insole on a Pediatric Intoeing Gait

ISRN Orthopedics ◽

10.5402/2012/396718 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 6

Author(s):

Akiyoshi Mabuchi ◽

Hiroshi Kitoh ◽

Masato Inoue ◽

Mitsuhiko Hayashi ◽

Naoki Ishiguro ◽

...

Keyword(s):

Gait Analysis ◽

Internal Rotation ◽

Stance Phase ◽

Three Dimensional ◽

Step Length ◽

Femoral Anteversion ◽

Swing Phase ◽

Gait Patterns ◽

Abnormal Gait ◽

Biomechanical Effect

Background. The sensomotor insole (SMI) has clinically been shown to be successful in treating an intoeing gait. We investigated the biomechanical effect of SMI on a pediatric intoeing gait by using three-dimensional gait analysis. Methods. Six patients with congenital clubfeet and four patients with idiopathic intoeing gait were included. There were five boys and five girls with the average age at testing of 5.6 years. The torsional profile of the lower limb was assessed clinically. Three-dimensional gait analysis was performed in the same shoes with and without SMI. Results. All clubfeet patients exhibited metatarsal adductus, while excessive femoral anteversion and/or internal tibial torsion was found in patients with idiopathic intoeing gait. SMI showed significant decreased internal rotation of the proximal femur in terminal swing phase and loading response phase. The internal rotation of the tibia was significantly smaller in mid stance phase and terminal stance phase by SMI. In addition, SMI significantly increased the walking speed and the step length. Conclusions. SMI improved abnormal gait patterns of pediatric intoeing gait by decreasing femoral internal rotation through the end of the swing phase and the beginning of the stance phase and by decreasing tibial internal rotation during the stance phase.

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Spatiotemporal Gait Analysis and Lower Limb Functioning in Foot Dystonia Treated with Botulinum Toxin

Toxins ◽

10.3390/toxins10120532 ◽

2018 ◽

Vol 10 (12) ◽

pp. 532 ◽

Cited By ~ 3

Author(s):

Anupam Datta Gupta ◽

Graeme Tucker ◽

Simon Koblar ◽

Renuka Visvanathan ◽

Ian Cameron

Keyword(s):

Botulinum Toxin ◽

Gait Analysis ◽

Lower Limb ◽

Functional Outcomes ◽

Stride Length ◽

Rating Scale ◽

Botulinum Toxin Injection ◽

Step Length ◽

Small Sample ◽

Gait Velocity

Foot dystonia (FD) is a disabling condition causing pain, spasm and difficulty in walking. We treated fourteen (14) adult patients experiencing FD with onabotulinum toxin A injection into the dystonic foot muscles. We analyzed the spatiotemporal gait utilizing the GaitRite system pre- and 3 weeks post-botulinum toxin injection along with measuring dystonia by the Fahn–Marsden Dystonia Scale (FMDS), pain by the Visual Analog Scale (VAS) and other lower limb functional outcomes such as gait velocity, the Berg Balance Scale (BBS), the Unified Parkinson’s Disease Rating Scale–Lower Limb Score (UPDRS–LL), the Timed Up and Go (TUG) test and the Goal Attainment Scale (GAS). We found that stride length increased significantly in both the affected (p = 0.02) and unaffected leg (p = 0.01) after treatment, and the improvement in stride length was roughly the same in each leg. Similar results were found for step length (p = 0.02) with improvement in the step length differential (p = 0.01). The improvements in the lower limb functional outcomes were also significant—FMDS, VAS, TUG, and UPDRS–LL decreased significantly after treatment (all p < 0.001), and BBS (p = 0.001), GAS (p < 0.001) except cadence (p = 0.37). BT injection improved walking in foot dystonia as evidenced through gait analysis, pain and lower limb functional outcomes. Main study limitations were small sample size and lack of control.

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The Effect of a Curved Non-Motorized treadmill on Running Gait Length, Imbalance and Step Angle

10.20944/preprints201806.0067.v1 ◽

2018 ◽

Author(s):

Andrew Hatchett ◽

Kaitlyn Armstrong ◽

Brian Parr ◽

Mallory Crews ◽

Charlie Tant

Keyword(s):

Gait Analysis ◽

Stride Length ◽

Step Length ◽

Warm Up ◽

Gait Characteristics ◽

Gait Mechanics

Running on a non-motorized, curved-deck treadmill is thought to improve gait mechanics. It is not known, though, if the change in gait carries over to running on a motorized treadmill or level ground. To determine the effect of running on a curved non-motorized treadmill (CNT) on gait characteristics measured during a subsequent bout of running on a traditional motorized treadmill (TMT). Sixteen healthy college-aged participants, age (mean±SD) 20.4±1.6 years volunteered to have their gait analyzed while running on a TMT and CNT. After familiarization and warm-up on both treadmills, each subject completed five, 4-minute bouts of running alternating between traditional motorized and curved non-motorized treadmills: TMT-1, CNT-1, TMT-2, CNT-2, and TMT-3. Variables of interest included step length (m), stride length (m), imbalance score (%), and step angle (°) and were measured using Optogait gait analysis equipment. Differences in gait char acteristics among TMT-1, TMT-2, and TMT-3 can be attributed to running on the CNT. The results show that running on a CNT resulted in significant changes in gait characteristics. These findings suggest that running on a CNT can significantly alter gait characteristics may result in improvements in running gait that persist to subsequent running on a TMT.

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Visualization of walking speed variation-induced synchronized dynamic changes in lower limb joint angles and activity of trunk and lower limb muscles with a newly developed gait analysis system

Journal of Orthopaedic Surgery ◽

10.1177/2309499018806688 ◽

2018 ◽

Vol 26 (3) ◽

pp. 230949901880668 ◽

Cited By ~ 1

Author(s):

Kousei Miura ◽

Hideki Kadone ◽

Masao Koda ◽

Keita Nakayama ◽

Hiroshi Kumagai ◽

...

Keyword(s):

Gait Analysis ◽

Hip Joint ◽

Lower Limb ◽

Three Dimensional ◽

Lower Limbs ◽

Joint Angles ◽

Dynamic Changes ◽

Maximum Flexion ◽

Lower Limb Muscles ◽

Limb Muscles

Purpose: To evaluate a newly developed system for dynamic analysis of gait kinematics and muscle activity. Methods: We recruited 10 healthy men into this study. Analyses of three-dimensional motion and wireless surface electromyogram (EMG) were integrated to achieve synchronous measurement. The participants walked continuously for 10 min under two conditions: comfortable and quick pace. Outcome measures were joint angles of the lower limbs determined from reflective markers and myoelectric activity of trunk and lower limbs determined from EMG sensors, comparing comfortable and quick gait pace. Results: Lower limb joint angle was significantly greater at the quick pace (maximum flexion of the hip joint: 4.1°, maximum extension of hip joint: 2.3°, and maximum flexion of the knee joint while standing: 7.4°). The period of maximum flexion of the ankle joint during a walking cycle was 2.5% longer at a quick pace. EMG amplitudes of all trunk muscles significantly increased during the period of support by two legs (cervical paraspinal: 55.1%, latissimus dorsi: 31.3%, and erector spinae: 32.6%). EMG amplitudes of quadriceps, femoral biceps, and tibialis anterior increased significantly by 223%, 60.9%, and 67.4%, respectively, between the periods of heel contact and loading response. EMG amplitude of the gastrocnemius significantly increased by 102% during the heel-off period. Conclusion: Our gait analysis synchronizing three-dimensional motion and wireless surface EMG successfully visualized dynamic changes in lower limb joint angles and activity of trunk and lower limb muscles induced by various walking speeds.

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Kinematic and Kinetic Waveform Changes of the Knee Joint Following a Mobile Bearing Total Knee Arthroplasty—Gait Analysis and Single Step Ascent

The Journal of Knee Surgery ◽

10.1055/s-0039-1688963 ◽

2019 ◽

Vol 33 (10) ◽

pp. 978-986

Author(s):

A. P. Apostolopoulos ◽

E. Chronopoulos ◽

I. V. Michos ◽

D. Mastrokalos ◽

N. Darras ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Gait Analysis ◽

Knee Arthroplasty ◽

Stride Length ◽

Mobile Bearing ◽

Step Length ◽

Single Step ◽

Knee Adduction Moment ◽

Distribution Analysis ◽

Total Knee

AbstractThe objective of this study is to analyze the kinetic and kinematic changes of the osteoarthritic knee after a mobile bearing total knee arthroplasty. Kinematic and kinetic gait analysis of level walking was performed in 15 patients (eight female and seven male) with knee ostoarthritis. All patients were free of any neurological diseases that could affect their normal gait. Mean age was 68.6 ± 5.2 years, mean height 159.8 ± 6.9 cm, and mean weight was 78.5 ± 10.1 kg. Full body gait analysis was performed using the BioKin three-dimensional (3D) motion analysis system preoperatively and 9 months after total knee arthroplasty. A single-step ascending kinetic analysis and a plantar pressure distribution analysis were also performed in all patients. An increased average cadence (mean 99.39 step/min preoperatively and 104.64 step/min postoperatively; p = 0.152), step length (0.44 m preoperatively and 0.52 m postoperatively; p < 0.001), stride length (0.89 m preoperatively and 1.0 m postoperatively; p < 0.007), and walking velocity (0.73 m/sec preoperatively and 0.90 m/sec postoperatively; p = 0.005) were noted postoperatively and postoperatively. A decrease in the stance duration percentage and the knee adduction moment was also reported postoperatively. All patients showed a significant improvement of knee kinetics and kinematics after a mobile bearing total knee arthroplasty. Statistically significant differences were found in the step length, stride length, and walk velocity postoperatively. The knee adduction moment was also significantly reduced. Further research is warranted to determine the clinical relevance of these findings. This study is a prospective comparative one and reflects level II evidence.

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Gait Characteristics In patients With Ankylosing Spondylitis – a Systematic Review (Preprint)

10.2196/preprints.14175 ◽

2019 ◽

Author(s):

Julie Soulard ◽

Jacques Vaillant ◽

Clara-Thémis Agier ◽

Nicolas Vuillerme

Keyword(s):

Ankylosing Spondylitis ◽

Sagittal Plane ◽

Axial Skeleton ◽

Gait Pattern ◽

Lower Limbs ◽

Spinal Mobility ◽

Control Group ◽

Published Data ◽

Gait Characteristics ◽

Study Characteristics

BACKGROUND Ankylosing spondylitis (AS) is a chronic rheumatic disease which affects the axial skeleton and sacro-iliac joints. By impacting spinal mobility and physical functions, AS could also potentially impair gait. However, while published data are rather sparse, it appears that discrepancies exist regarding AS consequences on gait characteristics, tasks and analysis techniques used to assess gait ability of patients with AS. OBJECTIVE The review questions are twofold: (1) What are the consequences of AS on gait? and (2) How is gait assessed in patients with AS? METHODS Databases were systematically searched to identify studies satisfying the search criteria, using the synonyms of ankylosing spondylitis and gait. Two reviewers extracted from the articles study characteristics, sample descriptions, methods and main results in relation to gait. RESULTS 168 titles were extracted from databases and 17 studies were included in the review. 13 studies (76%) used clinical gait measurements, and 4 (23%) used laboratory gait measurements. Only 6 involved a healthy control group. Gait pattern of patients with AS was more cautious, associated to a decreased pelvic tilt and lower limbs angles in the sagittal plane. Studies used diverse protocols, instructions and parameters when assessing gait in AS patients. CONCLUSIONS Only few studies have assessed gait characteristics in patients with AS. Published data evidence that no consensus exists regarding gait analysis methods for patients with AS. However, published studies are encouraging as they provide us the opportunity to propose guidelines to improve the design and methodology for future studies on gait and AS. CLINICALTRIAL PROSPERO: CRD42018102540 and JMIR Res Protoc doi:10.2196/12470

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Multi-segment kinematic model to assess three-dimensional movement of the spine and back during gait

Prosthetics and Orthotics International ◽

10.1177/0309364615579319 ◽

2016 ◽

Vol 40 (5) ◽

pp. 624-635 ◽

Cited By ~ 13

Author(s):

Robert Needham ◽

Roozbeh Naemi ◽

Aoife Healy ◽

Nachiappan Chockalingam

Keyword(s):

Gait Analysis ◽

High Reliability ◽

Kinematic Model ◽

Three Dimensional ◽

Movement Analysis ◽

Lower Limbs ◽

Intervention Programme ◽

Cluster Technique ◽

Upper Thoracic ◽

Rigid Segment

Background: Relatively little is known about spine during gait compared to movement analysis of the lower extremities. The trunk is often regarded and analysed as a single rigid segment and there is a paucity of information on inter-segmental movement within the spine and its relationship to pelvis and lower limbs. Objectives: To develop and validate a new multi-segment kinematic model to assess regional three-dimensional movement of the lumbar, lower thoracic and upper thoracic spine during gait. Study design: Observational study. Methods: The study was conducted in two parts: (1) to provide validation measures on the kinematic model built in commercially available software and (2) to apply the marker configuration to the spine at T3, T8 and L3 during gait analysis on 10 healthy male volunteers. Results: Proposed model revealed excellent concurrent validation measures between an applied input angle to the recorded output angle from the kinematic model. A high reliability was observed during gait analysis, both during a single session and between sessions for all participants. Conclusion: The thoracic region of the spine should not be modelled as a single rigid segment and the proposed three-dimensional cluster is reliable and repeatable to assess the inter-segmental movement of the spine. Clinical relevance Reliable kinematic data can be collected using the three-dimensional cluster technique, thus, allowing researchers to accurately distinguish between movement patterns of healthy individuals to those with a clinical condition, and provide confidence in data acquisition during the monitoring process of an implemented rehabilitation intervention programme.

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The Ankle Energetic Effect of Functional Insoles on Walking

10.21203/rs.3.rs-1037491/v1 ◽

2021 ◽

Author(s):

Maki Nagai ◽

Masayuki Tazawa ◽

Takahumi Kanaya ◽

Hironori Arii ◽

Yoko Ibe ◽

...

Keyword(s):

Anterior Part ◽

Force Plate ◽

Three Dimensional ◽

Step Length ◽

Sport Performance ◽

Lower Limbs ◽

Walking Ability ◽

Cuboid Bone ◽

Sport Activities ◽

Group B

Abstract Background：Although insoles made of various materials and shapes have been developed to improve performance in sport activities, few objective evaluations on their effectiveness have been conducted. We investigated the effect of insoles supporting the cuboid bone and anterior part of the calcaneus in healthy individuals.Methods:The subjects included 18 healthy males and females. They walked in standardized shoes with a flat insole (a flat insole made of polyurethane without an arched shape on the surface) and a functional insole (made of carbon and supporting the cuboid and anterior part of the calcaneus). We used a three-dimensional motion analysis device and a force plate to analyze gait and quantitatively compared the effect of functional insoles.Results:There was no difference in the parameters of gait analysis (walking speed, cadence, step length, stride length) between flat insoles and functional insoles. The functional insoles reduced ankle power without reducing walking ability. A comparison between Group A (n = 7), in which the left-right difference in ankle power was more than 20%, and Group B (n = 11), in which the left-right difference in ankle power was less than 20%, indicated that the use of functional insoles reduces the left-right difference of ankle power in the group with a larger difference in power.Conclusion：We believe that the use of functional insoles reduced ankle power without reducing walking ability and equalized left-right power. It may therefore reduce the burden on the muscles of the unilateral lower limbs and improve sport performance.Trial registration：The medical research ethics review committee for individuals at Gunma University (study number HS2017-229)　Registered 20 febluary 2018, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034362

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An innovative prone positioning system for advanced deformity and frailty in complex spine surgery

Journal of Neurosurgery Spine ◽

10.3171/2019.7.spine19161 ◽

2020 ◽

Vol 32 (2) ◽

pp. 229-234

Author(s):

Benjamin Kolb ◽

John Large ◽

Stuart Watson ◽

Glyn Smurthwaite

Keyword(s):

Ankylosing Spondylitis ◽

Three Dimensional ◽

Technical Note ◽

Positioning System ◽

Prone Positioning ◽

Economic Implications ◽

Potential Safety ◽

Chest Deformity ◽

Positioning Device ◽

Skin Quality

The authors present a technical note for a prone positioning system developed to facilitate cervical extension osteotomy for ankylosing spondylitis in the presence of severe deformity and frailty. Chin-on-chest deformity represents one of the most debilitating changes of ankylosing spondylitis. Where the chin-brow angle approaches or exceeds 90°, prone positioning becomes problematic due to the fixed position of the head. Furthermore, the challenge is compounded where physiological deconditioning leads to frailty, and the side effects of medical therapies decrease muscle mass and skin quality. Conventional prone positioning equipment is not able to cater to all patients. A versatile system was developed using a 3D reconstruction to enable a positioning simulation and verification tool. The tool was used to comprehensively plan the perioperative episode, including spatial orientation and associated equipment. Three-dimensional printing was used to manufacture a bespoke positioning device that precisely matched the contours of the patient, reducing contact pressure and risk of skin injury. The authors were able to safely facilitate surgery for a patient whose deformity and frailty may otherwise have precluded this possibility. The system has potential safety and economic implications that may be of significant utility to other institutions engaging in complex spinal surgery.

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