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 Human Gait Analysis Metric for Gait Retraining

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Tyagi Ramakrishnan ◽  
Seok Hun Kim ◽  
Kyle B. Reed
Keyword(s):  
Reaction Force ◽  
Step Length ◽  
Human Gait ◽  
Gait Velocity ◽  
Timed Up And Go ◽  
Gait Parameters ◽  
Gait Asymmetry ◽  
Before And After ◽  
Single Number ◽  
Human Gait Analysis

The combined gait asymmetry metric (CGAM) provides a method to synthesize human gait motion. The metric is weighted to balance each parameter’s effect by normalizing the data so all parameters are more equally weighted. It is designed to combine spatial, temporal, kinematic, and kinetic gait parameter asymmetries. It can also combine subsets of the different gait parameters to provide a more thorough analysis. The single number quantifying gait could assist robotic rehabilitation methods to optimize the resulting gait patterns. CGAM will help define quantitative thresholds for achievable balanced overall gait asymmetry. The study presented here compares the combined gait parameters with clinical measures such as timed up and go (TUG), six-minute walk test (6MWT), and gait velocity. The comparisons are made on gait data collected on individuals with stroke before and after twelve sessions of rehabilitation. Step length, step time, and swing time showed a strong correlation to CGAM, but the double limb support asymmetry has nearly no correlation with CGAM and ground reaction force asymmetry has a weak correlation. The CGAM scores were moderately correlated with TUG and strongly correlated to 6MWT and gait velocity.

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.

The Effect of Prosthesis Alignment on the Symmetry of Gait in Subjects with Unilateral Transtibial Amputation

2006 ◽  
Vol 30 (2) ◽  
pp. 114-128 ◽  
Author(s):  
Daniel H. K. Chow ◽  
Andrew D. Holmes ◽  
Christina K. L. Lee ◽  
S. W. Sin
Keyword(s):  
Knee Flexion ◽  
Dynamic Testing ◽  
Reaction Force ◽  
Step Length ◽  
Gait Pattern ◽  
Vertical Ground Reaction Force ◽  
Gait Symmetry ◽  
Prosthetic Alignment ◽  
Gait Parameters ◽  
Study Results

A high degree of gait symmetry is characteristic of healthy gait. The aim of this study is to examine the symmetry of various gait parameters in subjects with unilateral trans-tibial amputation over a range of acceptable anteroposterior translational and tilt alignments, and further to examine if a consistent alignment of highest symmetry can be found. Acceptable alignments were determined by bench, static and dynamic testing on level and non-level surfaces. A total of 15 kinetic and kinematic parameters were then measured in the seven subjects participating in this study. Results indicate that some parameters show consistently higher symmetries, particularly the vertical ground reaction force parameters and the stance duration, step length and time to full knee flexion during the swing phase. Symmetries in other parameters such as knee flexion at loading response, acceleration impulse, and peak anteroposterior propulsive force seem to have little relevance in determining whether the gait pattern for that prosthetic alignment is acceptable or not. While analysis of the symmetry of more relevant gait parameters may assist the prosthetist in consistently and objectively identifying a most symmetrical alignment within the acceptable range, further clinical study is required before any conclusions can be drawn regarding evaluation of symmetry as a tool in defining any optimum alignment.

Effect of osteopathic manipulation on gait asymmetry

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Cherice N. Hill ◽  
M’Lindsey Romero ◽  
Mark Rogers ◽  
Robin M. Queen ◽  
Per Gunnar Brolinson
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Step Length ◽  
Vertical Ground Reaction Force ◽  
Osteopathic Manipulation ◽  
Somatic Dysfunction ◽  
Peak Knee ◽  
Gait Asymmetry ◽  
Stance Time ◽  
Vertical Ground

Abstract Context Movement and loading asymmetry are associated with an increased risk of musculoskeletal injury, disease progression, and suboptimal recovery. Osteopathic structural screening can be utilized to determine areas of somatic dysfunction that could contribute to movement and loading asymmetry. Osteopathic manipulation treatments (OMTs) targeting identified somatic dysfunctions can correct structural asymmetries and malalignment, restoring the ability for proper compensation of stresses throughout the body. Little is currently known about the ability for OMTs to reduce gait asymmetries, thereby reducing the risk of injury, accelerated disease progression, and suboptimal recovery. Objectives To demonstrate whether osteopathic screening and treatment could alter movement and loading asymmetry during treadmill walking. Methods Forty-two healthy adults (20 males, 22 females) between the ages of 18 and 35 were recruited for this prospective intervention. Standardized osteopathic screening exams were completed by a single physician for each participant, and osteopathic manipulation was performed targeting somatic dysfunctions identified in the screening exam. Three-dimensional (3-D) biomechanical assessments, including the collection of motion capture and force plate data, were performed prior to and following osteopathic manipulation to quantify gait mechanics. Motion capture and loading data were processed utilizing Qualisys Track Manager and Visual 3D software, respectively. Asymmetry in the following temporal, kinetic, and kinematic measures was quantified utilizing a limb symmetry index (LSI): peak vertical ground reaction force, the impulse of the vertical ground reaction force, peak knee flexion angle, step length, stride length, and stance time. A 2-way repeated-measures analysis of variance model was utilized to evaluate the effects of time (pre/post manipulation) and sex (male/female) on each measure of gait asymmetry. Results Gait asymmetry in the peak vertical ground reaction force (−0.6%, p=0.025) and the impulse of the vertical ground reaction force (−0.3%, p=0.026) was reduced in males following osteopathic manipulation. There was no difference in gait asymmetry between time points in females. Osteopathic manipulation did not impact asymmetry in peak knee flexion angle, step length, stride length, or stance time. Among the participants, 59.5% (25) followed the common compensatory pattern, whereas 40.5% (17) followed the uncommon compensatory pattern. One third (33.3%, 14) of the participants showed decompensation at the occipitoatlantal (OA) junction, whereas 26.2% (11), one third (33.3%, 14), and 26.2% (11) showed decompensation at the cervicothoracic (CT), thoracolumbar (TL), and lumbosacral (LS) junctions, respectively. Somatic dysfunction at the sacrum, L5, right innominate, and left innominate occurred in 88.1% (37), 69.0% (29), 97.6% (41), and 97.6% (41) of the participants, respectively. Conclusions Correcting somatic dysfunction can influence gait asymmetry in males; the sex-specificity of the observed effects of osteopathic manipulation on gait asymmetry is worthy of further investigation. Osteopathic structural examinations and treatment of somatic dysfunctions may improve gait symmetry even in asymptomatic individuals. These findings encourage larger-scale investigations on the use of OMT to optimize gait, prevent injury and the progression of disease, and aid in recovery after surgery.

scholarly journals The Design of a Shoe for the Analysis of Ambulation Pattern for Diverse Age-Cohort

2021 ◽  
Vol 19 (1) ◽  
pp. 122-129
Author(s):  
Mehwish Faiz ◽  
Choudhary S. Shakeel ◽  
Munira M. Zariwala ◽  
Umer Hassan ◽  
Fatema Ilyas
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Step Length ◽  
Ultrasonic Sensor ◽  
Initial Contact ◽  
Subsequent Decrease ◽  
Gait Parameters ◽  
Significant Difference ◽  
Age Cohort ◽  
Spatio Temporal

Ambulation is one of the important activities of daily life aided by musculoskeletal system. However, with ageing due to muscle weakness and decreased range of motion of joints, different walking abnormalities may occur. These abnormalities may result in deviation of the spatio-temporal gait parameters. Mostly, alteration in pattern of locomotion has been observed with the increase in the age of an individual. This variation in the ambulation pattern and subsequent decrease in the gait parameters pertains to the onset of musculoskeletal disorders such as osteoarthritis and osteoporosis as well as various postural abnormalities. Hence, wearable technologies can aid individuals to monitor their gait parameters efficiently and alert them in case there is a significant decrease. This paper describes the design of an Arduino based monitoring system which analyzes the two significant gait parameters: step length and ground reaction force (GRF). A diverse age cohort consisting of 70 healthy individuals with ages in the range of 18 years to 80 years were recruited for this study. The shoe prototype measures the step length and ground reaction force (GRF). This is accomplished by making use of sensors including a Force Sensitive Resistive sensor (FSR) and an Ultrasonic sensor. The FSR sensor exhibits the ground reaction force that the ground exerts on a body that comes in contact with it; whereas, the ultrasonic sensor measures the step length which pertains to the distance between the initial contact of one foot and the point of initial contact of the other foot. The results of the study show that with age there is a significant decrease in the ambulation parameters. Young participants were observed to exhibit higher values of step length and ground reaction force (GRF) as compared to older participants who exhibit significant decrease in the parameter values. The results also show that there is a significant difference between the age of the individuals and the step length and ground reaction force values. The decrease in the gait parameters with increasing age permits this shoe prototype to be used for clinical settings in the future and be able to analyze the onset of any musculoskeletal disorder.

scholarly journals APPLICATION OF DOMAIN INTEGRATED DESIGN METHODOLOGY FOR BIO-INSPIRED DESIGN- A CASE STUDY OF SUTURE PIN DESIGN

2021 ◽  
Vol 1 ◽  
pp. 487-496
Author(s):  
Pavan Tejaswi Velivela ◽  
Nikita Letov ◽  
Yuan Liu ◽  
Yaoyao Fiona Zhao
Keyword(s):  
Cross Sections ◽  
Design Methodology ◽  
Reaction Force ◽  
Integrated Design ◽  
Total Deformation ◽  
Insertion Force ◽  
Force Reaction ◽  
The Moment ◽  
Work Done

AbstractThis paper investigates the design and development of bio-inspired suture pins that would reduce the insertion force and thereby reducing the pain in the patients. Inspired by kingfisher's beak and porcupine quills, the conceptual design of the suture pin is developed by using a unique ideation methodology that is proposed in this research. The methodology is named as Domain Integrated Design, which involves in classifying bio-inspired structures into various domains. There is little work done on such bio-inspired multifunctional aspect. In this research we have categorized the vast biological functionalities into domains namely, cellular structures, shapes, cross-sections, and surfaces. Multi-functional bio-inspired structures are designed by combining different domains. In this research, the hypothesis is verified by simulating the total deformation of tissue and the needle at the moment of puncture. The results show that the bio-inspired suture pin has a low deformation on the tissue at higher velocities at the puncture point and low deformation in its own structure when an axial force (reaction force) is applied to its tip. This makes the design stiff and thus require less force of insertion.

scholarly journals A Proposal of a Motion Measurement System to Support Visually Impaired People in Rehabilitation Using Low-Cost Inertial Sensors

Entropy ◽  
2021 ◽  
Vol 23 (7) ◽  
pp. 848
Author(s):  
Karla Miriam Reyes Leiva ◽  
Milagros Jaén-Vargas ◽  
Miguel Ángel Cuba ◽  
Sergio Sánchez Lara ◽  
José Javier Serrano Olmedo
Keyword(s):  
Visually Impaired ◽  
Inertial Sensors ◽  
Personal Autonomy ◽  
Low Cost ◽  
Step Length ◽  
Hand Position ◽  
Visually Impaired People ◽  
Gait Parameters ◽  
Impaired Person ◽  
Further Development

The rehabilitation of a visually impaired person (VIP) is a systematic process where the person is provided with tools that allow them to deal with the impairment to achieve personal autonomy and independence, such as training for the use of the long cane as a tool for orientation and mobility (O&M). This process must be trained personally by specialists, leading to a limitation of human, technological and structural resources in some regions, especially those with economical narrow circumstances. A system to obtain information about the motion of the long cane and the leg using low-cost inertial sensors was developed to provide an overview of quantitative parameters such as sweeping coverage and gait analysis, that are currently visually analyzed during rehabilitation. The system was tested with 10 blindfolded volunteers in laboratory conditions following constant contact, two points touch, and three points touch travel techniques. The results indicate that the quantification system is reliable for measuring grip rotation, safety zone, sweeping amplitude and hand position using orientation angles with an accuracy of around 97.62%. However, a new method or an improvement of hardware must be developed to improve gait parameters’ measurements, since the step length measurement presented a mean accuracy of 94.62%. The system requires further development to be used as an aid in the rehabilitation process of the VIP. Now, it is a simple and low-cost technological aid that has the potential to improve the current practice of O&M.

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.

Feasibility and Preliminary Efficacy of Gait Training Assisted by Multichannel Functional Electrical Stimulation in Early Stroke Rehabilitation: A Pilot Randomized Controlled Trial

2021 ◽  
Vol 35 (2) ◽  
pp. 131-144
Author(s):  
Maijke van Bloemendaal ◽  
Sicco A. Bus ◽  
Frans Nollet ◽  
Alexander C. H. Geurts ◽  
Anita Beelen
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Step Length ◽  
Gait Training ◽  
Control Group ◽  
Significant Group ◽  
Gait Symmetry ◽  
Gait Parameters ◽  
Walking Capacity ◽  
Experimental Group

Background. Many stroke survivors suffer from leg muscle paresis, resulting in asymmetrical gait patterns, negatively affecting balance control and energy cost. Interventions targeting asymmetry early after stroke may enhance recovery of walking. Objective. To determine the feasibility and preliminary efficacy of up to 10 weeks of gait training assisted by multichannel functional electrical stimulation (MFES gait training) applied to the peroneal nerve and knee flexor or extensor muscle on the recovery of gait symmetry and walking capacity in patients starting in the subacute phase after stroke. Methods. Forty inpatient participants (≤31 days after stroke) were randomized to MFES gait training (experimental group) or conventional gait training (control group). Gait training was delivered in 30-minute sessions each workday. Feasibility was determined by adherence (≥75% sessions) and satisfaction with gait training (score ≥7 out of 10). Primary outcome for efficacy was step length symmetry. Secondary outcomes included other spatiotemporal gait parameters and walking capacity (Functional Gait Assessment and 10-Meter Walk Test). Linear mixed models estimated treatment effect postintervention and at 3-month follow-up. Results. Thirty-seven participants completed the study protocol (19 experimental group participants). Feasibility was confirmed by good adherence (90% of the participants) and participant satisfaction (median score 8). Both groups improved on all outcomes over time. No significant group differences in recovery were found for any outcome. Conclusions. MFES gait training is feasible early after stroke, but MFES efficacy for improving step length symmetry, other spatiotemporal gait parameters, or walking capacity could not be demonstrated. Trial Registration. Netherlands Trial Register (NTR4762).

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