Gait adaptations of transfemoral prosthesis users across multiple walking tasks

2015 ◽  
Vol 40 (1) ◽  
pp. 89-95 ◽  
Author(s):  
Cynthia Kendell ◽  
Edward D Lemaire ◽  
Jonathan Kofman ◽  
Nancy Dudek
Keyword(s):  
Plantar Pressure ◽  
Dynamic Instability ◽  
Center Of Pressure ◽  
Loading Frequency ◽  
Double Support ◽  
Prosthetic Limb ◽  
Sensor Cell ◽  
Double Support Time ◽  
Support Time ◽  
Anterior Posterior

Background: For people with lower extremity amputations, the decreased confidence and suboptimal gait associated with dynamic instability can negatively affect mobility and quality of life. Quantifying dynamic instability could enhance clinical decision making related to lower extremity prosthetics and inform future prosthetic research. Objective: To quantitatively examine gait adaptations in transfemoral amputees across various walking conditions. Study design: Cross-sectional study. Methods: Plantar-pressure data were collected from 11 individuals with unilateral transfemoral amputations using an in-shoe plantar-pressure measurement system while navigating rigid and soft ground, ramp, and stair conditions. Six parameters were examined: anterior–posterior and medial–lateral center-of-pressure direction changes, sensor cell loading frequency (cell triggering), maximum lateral force position, double support time, and stride time. Paired t-tests and analyses of variance were used to examine differences between limbs and walking conditions, respectively. Results: Values for medial–lateral center-of-pressure direction change, sensor cell loading frequency, and double support time were significantly greater on the intact limb than the prosthetic limb. Significant differences between conditions occurred only for anterior–posterior center-of-pressure direction change and double support time on the prosthetic limb. Conclusion: Higher values on the intact limb suggest that it plays a key role in maintaining stability and optimizing body progression during different tasks. Differences between participants, limbs, and walking condition indicate parameter sensitivity to adaptive gait strategies. Clinical relevance This plantar-pressure-based approach is a viable option for point-of-care evaluation of locomotor performance, across common various mobility tasks and activities of daily living. The information obtained could be valuable for prosthetic prescription and optimization of prosthetic fit and alignment, potentially improving mobility for prosthetic users with dynamic stability deficits.

scholarly journals Gait Segmentation Method Using a Plantar Pressure Measurement System with Custom-Made Capacitive Sensors

Sensors ◽  
2020 ◽  
Vol 20 (3) ◽  
pp. 656 ◽  
Author(s):  
Pablo Aqueveque ◽  
Enrique Germany ◽  
Rodrigo Osorio ◽  
Francisco Pastene
Keyword(s):  
Plantar Pressure ◽  
Stance Phase ◽  
Swing Phase ◽  
Segmentation Method ◽  
Double Support ◽  
Phase Time ◽  
Custom Made ◽  
Plantar Pressure Measurement ◽  
Double Support Time ◽  
Support Time

Gait analysis has been widely studied by researchers due to the impact in clinical fields. It provides relevant information on the condition of a patient’s pathologies. In the last decades, different gait measurement methods have been developed in order to identify parameters that can contribute to gait cycles. Analyzing those parameters, it is possible to segment and identify different phases of gait cycles, making these studies easier and more accurate. This paper proposes a simple gait segmentation method based on plantar pressure measurement. Current methods used by researchers and clinicians are based on multiple sensing devices (e.g., multiple cameras, multiple inertial measurement units (IMUs)). Our proposal uses plantar pressure information from only two sensorized insoles that were designed and implemented with eight custom-made flexible capacitive sensors. An algorithm was implemented to calculate gait parameters and segment gait cycle phases and subphases. Functional tests were performed in six healthy volunteers in a 10 m walking test. The designed in-shoe insole presented an average power consumption of 44 mA under operation. The system segmented the gait phases and sub-phases in all subjects. The calculated percentile distribution between stance phase time and swing phase time was almost 60%/40%, which is aligned with literature reports on healthy subjects. Our results show that the system achieves a successful segmentation of gait phases and subphases, is capable of reporting COP velocity, double support time, cadence, stance phase time percentage, swing phase time percentage, and double support time percentage. The proposed system allows for the simplification of the assessment method in the recovery process for both patients and clinicians.

scholarly journals Split-Belt Treadmill Adaptation Transfers to Overground Walking in Persons Poststroke

2009 ◽  
Vol 23 (7) ◽  
pp. 735-744 ◽  
Author(s):  
Darcy S. Reisman ◽  
Robert Wityk ◽  
Kenneth Silver ◽  
Amy J. Bastian
Keyword(s):  
Step Length ◽  
Overground Walking ◽  
Double Support ◽  
Context Switching ◽  
Before And After ◽  
Partial Transfer ◽  
And Gender ◽  
Double Support Time ◽  
Support Time ◽  
Control Locomotion

Background and Objective. Following stroke, subjects retain the ability to adapt interlimb symmetry on the split-belt treadmill. Critical to advancing our understanding of locomotor adaptation and its usefulness in rehabilitation is discerning whether adaptive effects observed on a treadmill transfer to walking over ground. We examined whether aftereffects following split-belt treadmill adaptation transfer to overground walking in healthy persons and those poststroke. Methods. Eleven poststroke and 11 age-matched and gender-matched healthy subjects walked over ground before and after walking on a split-belt treadmill. Adaptation and aftereffects in step length and double support time were calculated. Results. Both groups demonstrated partial transfer of the aftereffects observed on the treadmill ( P < .001) to overground walking ( P < .05), but the transfer was more robust in the subjects poststroke ( P < .05). The subjects with baseline asymmetry after stroke improved in asymmetry of step length and double limb support ( P = .06). Conclusions. The partial transfer of aftereffects to overground walking suggests that some shared neural circuits that control locomotion for different environmental contexts are adapted during split-belt treadmill walking. The larger adaptation transfer from the treadmill to overground walking in the stroke survivors may be due to difficulty adjusting their walking pattern to changing environmental demands. Such difficulties with context switching have been considered detrimental to function poststroke. However, we propose that the persistence of improved symmetry when changing context to overground walking could be used to advantage in poststroke rehabilitation.

scholarly journals Kinematic and Kinetic Patterns Related to Free-Walking in Parkinson’s Disease

Sensors ◽  
2018 ◽  
Vol 18 (12) ◽  
pp. 4224 ◽  
Author(s):  
Martín Martínez ◽  
Federico Villagra ◽  
Juan Castellote ◽  
María Pastor
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Feature Selection ◽  
Clinical Status ◽  
Automatic Classification ◽  
Healthy Controls ◽  
Double Support ◽  
Gait Asymmetry ◽  
Double Support Time ◽  
Support Time

The aim of this study is to compare the properties of free-walking at a natural pace between mild Parkinson’s disease (PD) patients during the ON-clinical status and two control groups. In-shoe pressure-sensitive insoles were used to quantify the temporal and force characteristics of a 5-min free-walking in 11 PD patients, in 16 young healthy controls, and in 12 age-matched healthy controls. Inferential statistics analyses were performed on the kinematic and kinetic parameters to compare groups’ performances, whereas feature selection analyses and automatic classification were used to identify the signature of parkinsonian gait and to assess the performance of group classification, respectively. Compared to healthy subjects, the PD patients’ gait pattern presented significant differences in kinematic parameters associated with bilateral coordination but not in kinetics. Specifically, patients showed an increased variability in double support time, greater gait asymmetry and phase deviation, and also poorer phase coordination. Feature selection analyses based on the ReliefF algorithm on the differential parameters in PD patients revealed an effect of the clinical status, especially true in double support time variability and gait asymmetry. Automatic classification of PD patients, young and senior subjects confirmed that kinematic predictors produced a slightly better classification performance than kinetic predictors. Overall, classification accuracy of groups with a linear discriminant model which included the whole set of features (i.e., demographics and parameters extracted from the sensors) was 64.1%.

Gait differences between K3 and K4 persons with transfemoral amputation across level and non-level walking conditions

2018 ◽  
Vol 42 (6) ◽  
pp. 626-635 ◽  
Author(s):  
James A Sturk ◽  
Edward D Lemaire ◽  
Emily Sinitski ◽  
Nancy L Dudek ◽  
Markus Besemann ◽  
...  
Keyword(s):  
Root Mean Square ◽  
Mean Square ◽  
Transfemoral Amputation ◽  
Lateral Direction ◽  
Double Support ◽  
Margin Of Stability ◽  
Trunk Acceleration ◽  
Standard Deviations ◽  
Double Support Time ◽  
Support Time

Background: A transfemoral amputee’s functional level can be classified from K-level 0 (lowest) to K-level 4 (highest). Knowledge of the biomechanical differences between K3 and K4 transfemoral amputation could help inform clinical professionals and researchers in amputee care and gait assessment. Objectives: Explore gait differences between K3- and K4-level transfemoral amputation across different surface conditions. Study design: Cross-sectional study. Methods: Four K3 and six K4 transfemoral amputation and 10 matched able-bodied individuals walked in a virtual environment with simulated level and non-level surfaces on a self-paced treadmill. Stability measures included medial-lateral margin of stability, step parameters, and gait variability (standard deviations for speed, temporal-spatial parameters, root-mean-square of medial-lateral trunk acceleration). Results: K3 walked slower than K4 with wider steps, greater root-mean-square of medial-lateral trunk acceleration, and greater medial-lateral margin of stability standard deviations, indicating their stability was further challenged. K3 participants had greater asymmetry in double support time and trunk acceleration root-mean-square in the medial-lateral direction, but similar asymmetry overall. K3 participants had larger differences from AB and in more parameters than K4, although K4 differed from AB in trunk acceleration root-mean-square in the medial-lateral direction, walking speed, and double support time standard deviations. Conclusion: The findings improve our understanding of K3 and K4 transfemoral amputation gait on slopes and simulated uneven surfaces. Clinical relevance High performing and community ambulatory transfemoral amputees cannot match the ambulatory abilities of ablebodied individuals. Understanding gait differences between these groups under conditions that challenge balance is required to develop rehabilitation protocols and prosthetic componentry targeted at improving transfemoral amputee gait and overall mobility in their chosen environment.

scholarly journals In-Shoe Plantar Pressure Measurement—Influence of Insole Placement on Selected Parameters during Running

Proceedings ◽  
2020 ◽  
Vol 49 (1) ◽  
pp. 50 ◽  
Author(s):  
Franziska Mally ◽  
Otto Hofstätter ◽  
Markus Eckelt
Keyword(s):  
Pressure Measurement ◽  
Plantar Pressure ◽  
Center Of Pressure ◽  
Pressure Sensing ◽  
Pressure Decrease ◽  
Running Shoes ◽  
Mean Pressure ◽  
Plantar Pressure Measurement ◽  
Healthy Participants ◽  
Anterior Posterior

While it is assumed that pressure-sensing insoles are usually placed directly below the foot and on top of the shoes’ standard insoles, nearly no previously published study actually describes the procedure, which leaves a slight uncertainty. Therefore, the aim of this study was to evaluate whether the placement has an influence on selected parameters or not. Five healthy participants took part in the measurements and ran on a treadmill at a running velocity of 10 km/h with three different running shoes. Plantar pressure was measured using pressure-sensing insoles, which were once placed on top and once below the shoes’ standard insoles. Selected parameters were the maximum and mean pressure and the range of the center of pressure (COP) in anterior–posterior and medial–lateral directions. The results indicate that maximum and mean pressure decrease when the pressure-sensing insole lies below the shoe’s insole and the medial–lateral COP is the least effected parameter.

scholarly journals Gait performance of the elderly under dual-task conditions: Review of instruments employed and kinematic parameters

2016 ◽  
Vol 19 (1) ◽  
pp. 165-182 ◽  
Author(s):  
Gisele de Cássia Gomes ◽  
Luci Fuscaldi Teixeira-Salmela ◽  
Flávia Alexandra Silveira de Freitas ◽  
Maria Luísa Morais Fonseca ◽  
Marina de Barros Pinheiro ◽  
...  
Keyword(s):  
The Elderly ◽  
Elderly Persons ◽  
Step Width ◽  
Kinematic Parameters ◽  
Time Step ◽  
Double Support ◽  
Gait Parameters ◽  
Task Conditions ◽  
Double Support Time ◽  
Support Time

Introduction The physiological deterioration associated with ageing exposes elderly persons to greater risks of falls, especially during the performance of simultaneous tasks during gait. Objectives To evaluate the effects of dual tasks (DT) on spatiotemporal gait parameters and to identify the tools and tasks most commonly used to assess the performance of DT among the elderly. Method Searches of the MEDLINE, PsycINFO, CINAHL, and SciELO databases were conducted. Observational studies, which evaluated gait changes during the performance of DT, published up to April 2014, were selected. Results A total of 385 articles were found, of which 28 were selected. Decreases in speed and increases in stride variability, stride time, step width, and double support time were observed under DT conditions. Motion analysis systems, such as the GAITRite walkway(r) system were the mostly commonly used instruments for the analyses of kinematic parameters (16 studies). DT was most commonly assessed by arithmetic calculations in 20 studies, followed by verbal fluency, in nine studies. The gait parameters most commonly assessed were speed (19 studies), followed by stride variability (14 studies). Conclusion The elderly showed changes in spatiotemporal gait parameters under DT conditions. Gait speed and stride variability were often assessed and, together, were considered good indicators of risks of falls.

The use of double support time for monitoring the gait of muscular dystrophy patients

1987 ◽  
Vol 2 (2) ◽  
pp. 68-70 ◽  
Author(s):  
S. Khodadadeh ◽  
M.R. McClelland ◽  
A.V. Nene ◽  
J.H. Patrick
Keyword(s):  
Muscular Dystrophy ◽  
Double Support ◽  
Double Support Time ◽  
Support Time

scholarly journals THE EFFECTS OF TRAINING ON DIFFERENT SURFACES, ON BALANCE AND GAIT PERFORMANCE IN STROKE HEMIPLEGIA

2021 ◽  
Vol 27 (6) ◽  
pp. 592-596
Author(s):  
Hyun-Seung Rhyu ◽  
Soung-Yob Rhi
Keyword(s):  
Gait Analysis ◽  
Cycle Time ◽  
Dynamic Balance ◽  
Static Balance ◽  
Stroke Patients ◽  
Elderly Male ◽  
Gait Performance ◽  
Double Support ◽  
Double Support Time ◽  
Support Time

ABSTRACT Although many studies have focused on balance exercises for elderly or stroke patients, no comprehensive studies have investigated the use of training on different surfaces (TDS) with analysis of gait performance in elderly male stroke patients. The active properties of balance and subjective reporting of functional gait ability were used to identify the effects of TDS. Static balance (SB), dynamic balance (DB) and gait analysis was measured in 30 elderly stroke patients. The patients were divided into the TDS group (n=15) and a control group (CG, n=15). Fifteen elderly stroke patients underwent TDS five times a week for 12 weeks. The data was analyzed using repeated measures analysis of variance. Significant differences were observed between the two groups (TDS and Control): SB (p < 0.0001), DB (OSI: p < 0.0001, APSI: p < 0.001, MLSI: p < 0.004) and gait analysis (right: temporal step time: p < 0.0001, temporal cycle time: p < 0.001, temporal double support time: p < 0.0001; left: temporal step time: p < 0.0001, temporal cycle time: p < 0.0001, temporal double support time: p < 0.0001). TDS in elderly male stroke patients suggests that the characteristics of gait performance in these patients may be improved by increasing static balance, dynamic balance and gait velocity. It is hoped that the results of this trial will provide new information on the effects of TDS on balance stability and gait ability in stroke patients, through changes in stability of the lower extremities. Level III, Case-control Study.

A Multiple Regression Approach to Normalization of Spatiotemporal Gait Features

2016 ◽  
Vol 32 (2) ◽  
pp. 128-139 ◽  
Author(s):  
Ferdous Wahid ◽  
Rezaul Begg ◽  
Noel Lythgo ◽  
Chris J. Hass ◽  
Saman Halgamuge ◽  
...  
Keyword(s):  
Multiple Regression ◽  
Stride Length ◽  
Walking Speed ◽  
Double Support ◽  
Gait Features ◽  
Regression Approach ◽  
Stance Time ◽  
Double Support Time ◽  
Support Time ◽  
Dimensionless Equations

Normalization of gait data is performed to reduce the effects of intersubject variations due to physical characteristics. This study reports a multiple regression normalization approach for spatiotemporal gait data that takes into account intersubject variations in self-selected walking speed and physical properties including age, height, body mass, and sex. Spatiotemporal gait data including stride length, cadence, stance time, double support time, and stride time were obtained from healthy subjects including 782 children, 71 adults, 29 elderly subjects, and 28 elderly Parkinson’s disease (PD) patients. Data were normalized using standard dimensionless equations, a detrending method, and a multiple regression approach. After normalization using dimensionless equations and the detrending method, weak to moderate correlations between walking speed, physical properties, and spatiotemporal gait features were observed (0.01 < |r| < 0.88), whereas normalization using the multiple regression method reduced these correlations to weak values (|r| < 0.29). Data normalization using dimensionless equations and detrending resulted in significant differences in stride length and double support time of PD patients; however the multiple regression approach revealed significant differences in these features as well as in cadence, stance time, and stride time. The proposed multiple regression normalization may be useful in machine learning, gait classification, and clinical evaluation of pathological gait patterns.

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