scholarly journals Relationship between Asymmetry of Gait and Muscle Torque in Patients after Unilateral Transfemoral Amputation

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Alicja Rutkowska-Kucharska ◽  
Mateusz Kowal ◽  
Sławomir Winiarski
Keyword(s):  
Hip Joint ◽  
Reaction Force ◽  
Transfemoral Amputation ◽  
Gait Symmetry ◽  
Symmetry Index ◽  
Muscle Torque ◽  
Effective Form ◽  
Gait Asymmetry ◽  
Torque Values ◽  
Therapy Programme

Many studies have shown that unilateral transfemoral amputation involves asymmetric gait. Transfemoral amputation leads to muscle atrophy in a tight stump resulting in asymmetry in muscle torque between the amputated and intact limb. This research is aimed at verifying if a relationship between torque values of hip joint flexors and extensors and gait asymmetry in patients with TFA exists. Fourteen adult subjects with unilateral TFA took part in the experiment. Gait symmetry was evaluated based on the ground reaction force (GRF). Measurements of muscle torque of hip flexors and extensors were taken with a Biodex System. All measurements were taken under isokinetic (60°/s and 120°/s) and isometric conditions. The symmetry index of vertical GRF components was from 7.5 to 11.5%, and anterio-posterior GRF from 6.2 to 9.3%. The symmetry index for muscle torque was from 24.3 to 44% for flexors, from 39 to 50.5% for extensors, and from 28.6 to 50% in the flexor/extensor ratio. Gait asymmetry correlated with muscle torque in hip joint extensors. Therapy which enhances muscle torque may be an effective form of patient therapy. The patient needs to undergo evaluation of their muscle strength and have the therapy programme adjusted to their level of muscle torque deficit.

scholarly journals Are wearable insoles a validated tool for quantifying transfemoral amputee gait asymmetry?

2019 ◽  
Vol 43 (5) ◽  
pp. 492-499 ◽  
Author(s):  
Isabelle Loiret ◽  
Coralie Villa ◽  
Boris Dauriac ◽  
Xavier Bonnet ◽  
Noël Martinet ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Ground Reaction Force ◽  
Walking Speed ◽  
Reaction Force ◽  
Symmetry Index ◽  
Gait Asymmetry ◽  
Transfemoral Amputees ◽  
Mean Square Errors ◽  
Amputee Gait

Background: Amputee gait is known to be asymmetrical, especially during loading of the lower limb. Monitoring asymmetry could be useful in quantifying patient performance during rehabilitation. Wearable insoles can provide normal ground reaction force asymmetry in real-life conditions. Objectives: To characterize the validity of Loadsol® insoles versus force plates in quantifying normal ground reaction force and gait asymmetry. To determine the influence walking speed has on loading asymmetry in transfemoral amputees. Study design: This is a prospective study. Methods: Six transfemoral amputees, wearing Loadsol® insoles, walked at three self-selected speeds on force plates. Validity was assessed by comparing normal ground reaction force data from the insoles and force plates. The Absolute Symmetry Index was used to calculate gait loading asymmetry at each speed. Results: Normalized root mean square errors for the normal ground reaction forces were 6.6% (standard deviation = 2.3%) and 8.9% (standard deviation = 3.8%); correlation coefficients were 0.91 and 0.95 for the prosthetic and intact limb, respectively. The mean error for Absolute Symmetry Index parameters ranged from −2.67% to 4.35%. Loading asymmetry increased with walking speed. Conclusion: This study quantified the validity of Loadsol® insoles in assessing loading asymmetry during gait in transfemoral amputees. The calibration protocol could be improved to better integrate it into a clinical setting. However, our results support the relevance of using such insoles during the clinical follow-up of transfemoral amputees. Clinical relevance This is the first study to validate Loadsol® insoles versus force plates and report on loading asymmetry during gait at three different speeds in transfemoral amputees. Loadsol® insoles, which provide visual and audio feedback, are clinically easy to use and could have beneficial application in the amputee’s rehabilitation and follow-up.

scholarly journals THE EFFECT OF SPEED ON GAIT ASYMMETRY IN SUBJECT WITH CONGENITAL TIBIAL DEFICIENCY: A CASE STUDY

2020 ◽  
Vol 49 (4) ◽  
pp. 112-118
Author(s):  
Jitka Marencakova ◽  
Tomas Gryc ◽  
Frantisek Zahalka
Keyword(s):  
Reaction Force ◽  
Step Length ◽  
Inverse Dynamic ◽  
Mean Values ◽  
Symmetry Index ◽  
Gait Parameters ◽  
Gait Asymmetry ◽  
Kinematic Joint ◽  
3D Motion Capture

In the case study, gait asymmetry changes in different speed of walking with ankle-foot prosthesis were identified for developmental tibial deficiency. Joint kinematic, spatial-temporal, and kinetic gait parameters were collected using 3D motion capture system and 3D treadmill simultaneously. Mean values, SD, and symmetry index were calculated for selected gait parameters and descriptively analysed. Results show gait asymmetry of all of the measured parameters. Kinematic joint angular ranges increase with increasing walking speed. Inverse dynamic results present changes in step length and duration which enhance changes in ground reaction force characteristics. The symmetry index shows gait asymmetry, which increases with faster gait speed. Further research is needed to verify this suspect gait asymmetry increasing tendency and to generalise results to ankle-foot prosthesis population with congenital tibial deficiency or transtibial amputation.

scholarly journals Association between Kinesiophobia and Gait Asymmetry after ACL Reconstruction: Implications for Prevention of Reinjury

2021 ◽  
Vol 18 (6) ◽  
pp. 3264
Author(s):  
Hossein Tajdini ◽  
Amir Letafatkar ◽  
Britton W. Brewer ◽  
Mahdi Hosseinzadeh
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Reaction Force ◽  
Muscular Activity ◽  
Vertical Ground Reaction Force ◽  
Contact Phase ◽  
Significant Positive Association ◽  
Gait Symmetry ◽  
Gait Asymmetry ◽  
The Relationship

Gait asymmetries have been documented in individuals after anterior cruciate ligament (ACL) reconstruction (ACLR). The relationship between gait asymmetry and associated psychological factors, however, is not yet known. This study aimed to examine the relationship between kinesiophobia (fear of reinjury) and asymmetry of vertical ground reaction force (vGRF) and lower-extremity muscular activity in individuals after ACLR during gait. Twenty-eight males with a history of ACLR participated in the study. Force plate and surface electromyography was used to record peak vGRF and muscular activity. The Tampa Scale of Kinesiophobia (TSK-11) was used to measure kinesiophobia. Spearman’s rank correlations analysis was used to examine the relationship between TSK-11 scores and both gait asymmetry variables. There was a significant positive relationship between TSK-11 and asymmetry of the second peak of vGRF (rs = 0.531, p = 0.002). In addition, there was a significant positive association between asymmetry of rectus femoris activity (rs = 0.460, p = 0.007) and biceps femoris activity (rs = 0.429, p = 0.011) in the contact phase. Results revealed a significant relationship between kinesiophobia and asymmetry in muscle activity and vGRF in different phases of the gait cycle. Interventions addressing kinesiophobia early in the rehabilitation after ACLR may support the restoration of gait symmetry, facilitate a more rapid return to sport, and reduce the risk of ACL reinjury.

scholarly journals Plantar load transfer in children: a descriptive study with two pathological case studies

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alexis Brierty ◽  
Christopher P. Carty ◽  
Claudia Giacomozzi ◽  
Teresa Phillips ◽  
Henry P. J. Walsh ◽  
...  
Keyword(s):  
Case Studies ◽  
Load Transfer ◽  
Descriptive Study ◽  
Transfer Phase ◽  
Gait Symmetry ◽  
Plantar Pressures ◽  
Gait Asymmetry ◽  
Mean Pressure ◽  
Pathological Case

Abstract Background Typical gait is often considered to be highly symmetrical, with gait asymmetries typically associated with pathological gait. Whilst gait symmetry is often expressed in symmetry ratios, measures of symmetry do not provide insight into how these asymmetries affect gait variables. To fully understand changes caused by gait asymmetry, we must first develop a normative database for comparison. Therefore, the aim of this study was to describe normative reference values of regional plantar load and present comparisons with two pathological case studies. Methods A descriptive study of the load transfer of plantar pressures in typically developed children was conducted to develop a baseline for comparison of the effects of gait asymmetry in paediatric clinical populations. Plantar load and 3D kinematic data was collected for 17 typically developed participants with a mean age of 9.4 ± 4.0 years. Two case studies were also included; a 10-year-old male with clubfoot and an 8-year-old female with a flatfoot deformity. Data was analysed using a kinematics-pressure integration technique for anatomical masking into 5 regions of interest; medial and lateral forefoot, midfoot, and medial and lateral hindfoot. Results Clear differences between the two case studies and the typical dataset were seen for the load transfer phase of gait. For case study one, lateral bias was seen in the forefoot of the trailing foot across all variables, as well as increases in contact area, force and mean pressure in the lateral hindfoot of the leading foot. For case study two, the forefoot of the trailing foot produced results very similar to the typical dataset across all variables. In the hindfoot of the leading foot, medial bias presents most notably in the force and mean pressure graphs. Conclusions This study highlights the clinical significance of the load transfer phase of gait, providing meaningful information for intervention planning.

scholarly journals Spatio-temporal gait parameters obtained from foot-worn inertial sensors are reliable in healthy adults in single- and dual-task conditions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
J. Soulard ◽  
J. Vaillant ◽  
R. Balaguier ◽  
N. Vuillerme
Keyword(s):  
Dual Task ◽  
Inertial Sensors ◽  
Healthy Adults ◽  
Gait Symmetry ◽  
Symmetry Index ◽  
Task Effects ◽  
Gait Parameters ◽  
Task Conditions ◽  
Healthy Participants ◽  
Absolute Reliability

AbstractInertial measurement units (IMUs) are increasingly popular and may be usable in clinical routine to assess gait. However, assessing their intra-session reliability is crucial and has not been tested with foot-worn sensors in healthy participants. The aim of this study was to assess the intra-session reliability of foot-worn IMUs for measuring gait parameters in healthy adults. Twenty healthy participants were enrolled in the study and performed the 10-m walk test in single- and dual-task ('carrying a full cup of water') conditions, three trials per condition. IMUs were used to assess spatiotemporal gait parameters, gait symmetry parameters (symmetry index (SI) and symmetry ratio (SR)), and dual task effects parameters. The relative and the absolute reliability were calculated for each gait parameter. Results showed that spatiotemporal gait parameters measured with foot-worn inertial sensors were reliable; symmetry gait parameters relative reliability was low, and SR showed better absolute reliability than SI; dual task effects were poorly reliable, and taking the mean of the second and the third trials was the most reliable. Foot-worn IMUs are reliable to assess spatiotemporal and symmetry ratio gait parameters but symmetry index and DTE gait parameters reliabilities were low and need to be interpreted with cautious by clinicians and researchers.

scholarly journals Balancing on a narrow ridge: biomechanics and control

1999 ◽  
Vol 354 (1385) ◽  
pp. 869-875 ◽  
Author(s):  
E. Otten
Keyword(s):  
Hip Joint ◽  
Ground Reaction Force ◽  
Inverted Pendulum ◽  
Reaction Force ◽  
Angular Acceleration ◽  
Centre Of Mass ◽  
Inverted Pendulum Model ◽  
Pendulum Model ◽  
Narrow Ridge ◽  
Standing Humans

The balance of standing humans is usually explained by the inverted pendulum model. The subject invokes a horizontal ground–reaction force in this model and controls it by changing the location of the centre of pressure under the foot or feet. In experiments I showed that humans are able to stand on a ridge of only a few millimetres wide on one foot for a few minutes. In the present paper I investigate whether the inverted pendulum model is able to explain this achievement. I found that the centre of mass of the subjects sways beyond the surface of support, rendering the inverted pendulum model inadequate. Using inverse simulations of the dynamics of the human body, I found that hip–joint moments of the stance leg are used to vary the horizontal component of the ground–reaction force. This force brings the centre of mass back over the surface of support. The subjects generate moments of force at the hip–joint of the swing leg, at the shoulder–joints and at the neck. These moments work in conjunction with a hip strategy of the stance leg to limit the angular acceleration of the head–arm–trunk complex. The synchrony of the variation in moments suggests that subjects use a motor programme rather than long latency reflexes.

scholarly journals Association between pain and gait instability in patients with lumbar disc herniation

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110393
Author(s):  
Keunjae Lee ◽  
Eun-San Kim ◽  
Boyoung Jung ◽  
Sang-Won Park ◽  
In-Hyuk Ha
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Rating Scale ◽  
Lumbar Disc ◽  
Linear Regression Analysis ◽  
Lumbar Pain ◽  
Multivariate Linear Regression Analysis ◽  
Cross Sectional ◽  
Gait Symmetry ◽  
Symmetry Index

Objective To determine whether pain is associated with gait instability in patients with lumbar disc herniation (LDH). Methods This retrospective cross-sectional study used data from electronic medical records. Among patients with lumbar back pain caused by LDH between January 2017 and July 2019, patients that underwent gait analysis were included. LDH was diagnosed using magnetic resonance imaging. An OptoGait photoelectric cell system was used for gait evaluation. Instability was measured using a gait symmetry index. Multivariate linear regression analysis was performed to determine the association between lumbar pain and gait instability. Results A total of 29 patients (12 females [41.4%] and 17 males [58.6%]; mean ± SD age, 40.6 ± 12.0 years) with LDH were enrolled in the study. With each 1-point increase in lumbar pain on the numeric rating scale, the symmetry index of the stance phase (0.33; 95% confidence interval [CI] 0.04, 0.62), swing phase (0.78; 95% CI 0.14, 1.43) and single support (0.79; 95% CI 0.15, 1.43) increased. Conclusions Gait instability in patients with LDH may occur due to an increase in pain.

scholarly journals Measurement of Human Gait Symmetry using Body Surface Normals Extracted from Depth Maps

Sensors ◽  
2019 ◽  
Vol 19 (4) ◽  
pp. 891 ◽  
Author(s):  
Trong-Nguyen Nguyen ◽  
Huu-Hung Huynh ◽  
Jean Meunier
Keyword(s):  
Body Surface ◽  
Lower Limbs ◽  
Upper Body ◽  
Whole Body ◽  
Human Gait ◽  
Gait Symmetry ◽  
Symmetry Index ◽  
Depth Maps ◽  
Abnormal Gait ◽  
3D Information

In this paper, we introduce an approach for measuring human gait symmetry where the input is a sequence of depth maps of subject walking on a treadmill. Body surface normals are used to describe 3D information of the walking subject in each frame. Two different schemes for embedding the temporal factor into a symmetry index are proposed. Experiments on the whole body, as well as the lower limbs, were also considered to assess the usefulness of upper body information in this task. The potential of our method was demonstrated with a dataset of 97,200 depth maps of nine different walking gaits. An ROC analysis for abnormal gait detection gave the best result ( AUC = 0.958 ) compared with other related studies. The experimental results provided by our method confirm the contribution of upper body in gait analysis as well as the reliability of approximating average gait symmetry index without explicitly considering individual gait cycles for asymmetry detection.

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