scholarly journals Gait and Axial Spondyloarthritis: Comparative Gait Analysis Study Using Foot-Worn Inertial Sensors

10.2196/27087 ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. e27087
Author(s):  
Julie Soulard ◽  
Jacques Vaillant ◽  
Athan Baillet ◽  
Philippe Gaudin ◽  
Nicolas Vuillerme
Keyword(s):  
Pain Intensity ◽  
Gait Speed ◽  
Stride Length ◽  
Healthy Controls ◽  
Double Support ◽  
Swing Time ◽  
Gait Parameters ◽  
Stance Time ◽  
Double Support Time ◽  
Support Time

Background Axial spondyloarthritis (axSpA) can lead to spinal mobility restrictions associated with restricted lower limb ranges of motion, thoracic kyphosis, spinopelvic ankylosis, or decrease in muscle strength. It is well known that these factors can have consequences on spatiotemporal gait parameters during walking. However, no study has assessed spatiotemporal gait parameters in patients with axSpA. Divergent results have been obtained in the studies assessing spatiotemporal gait parameters in ankylosing spondylitis, a subgroup of axSpA, which could be partly explained by self-reported pain intensity scores at time of assessment. Inertial measurement units (IMUs) are increasingly popular and may facilitate gait assessment in clinical practice. Objective This study compared spatiotemporal gait parameters assessed with foot-worn IMUs in patients with axSpA and matched healthy individuals without and with pain intensity score as a covariate. Methods A total of 30 patients with axSpA and 30 age- and sex-matched healthy controls performed a 10-m walk test at comfortable speed. Various spatiotemporal gait parameters were computed from foot-worn inertial sensors including gait speed in ms–1 (mean walking velocity), cadence in steps/minute (number of steps in a minute), stride length in m (distance between 2 consecutive footprints of the same foot on the ground), swing time in percentage (portion of the cycle during which the foot is in the air), stance time in percentage (portion of the cycle during which part of the foot touches the ground), and double support time in percentage (portion of the cycle where both feet touch the ground). Results Age, height, and weight were not significantly different between groups. Self-reported pain intensity was significantly higher in patients with axSpA than healthy controls (P<.001). Independent sample t tests indicated that patients with axSpA presented lower gait speed (P<.001) and cadence (P=.004), shorter stride length (P<.001) and swing time (P<.001), and longer double support time (P<.001) and stance time (P<.001) than healthy controls. When using pain intensity as a covariate, spatiotemporal gait parameters were still significant with patients with axSpA exhibiting lower gait speed (P<.001), shorter stride length (P=.001) and swing time (P<.001), and longer double support time (P<.001) and stance time (P<.001) than matched healthy controls. Interestingly, there were no longer statistically significant between-group differences observed for the cadence (P=.17). Conclusions Gait was significantly altered in patients with axSpA with reduced speed, cadence, stride length, and swing time and increased double support and stance time. Taken together, these changes in spatiotemporal gait parameters could be interpreted as the adoption of a so-called cautious gait pattern in patients with axSpA. Among factors that may influence gait in patients with axSpA, patient self-reported pain intensity could play a role. Finally, IMUs allowed computation of spatiotemporal gait parameters and are usable to assess gait in patients with axSpA in clinical routine. Trial Registration ClinicalTrials.gov NCT03761212; https://clinicaltrials.gov/ct2/show/NCT03761212 International Registered Report Identifier (IRRID) RR2-10.1007/s00296-019-04396-4

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.

scholarly journals The effects of a secondary task on gait in axial spondyloarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julie Soulard ◽  
Jacques Vaillant ◽  
Athan Baillet ◽  
Philippe Gaudin ◽  
Nicolas Vuillerme
Keyword(s):  
Dual Task ◽  
Secondary Task ◽  
Stride Length ◽  
Axial Spondyloarthritis ◽  
Healthy Controls ◽  
Dual Tasking ◽  
Double Support ◽  
Manual Task ◽  
Gait Parameters ◽  
Stance Time

AbstractStudies on the effects of dual tasking in patients with chronic inflammatory rheumatic diseases are limited. The aim of this study was to assess dual tasking while walking in patients with axial spondyloarthritis (axSpA) in comparison to healthy controls. Thirty patients with axSpA and thirty healthy controls underwent a 10-m walk test at a self-selected comfortable walking speed in single- and dual-task conditions. Foot-worn inertial sensors were used to compute spatiotemporal gait parameters. Analysis of spatiotemporal gait parameters showed that the secondary manual task negatively affected walking performance in terms of significantly decreased mean speed (p < 0.001), stride length (p < 0.001) and swing time (p = 0.008) and increased double support (p = 0.002) and stance time (p = 0.008). No significant interaction of group and condition was observed. Both groups showed lower gait performance in dual task condition by reducing speed, swing time and stride length, and increasing double support and stance time. Patients with axSpA were not more affected by the dual task than matched healthy controls, suggesting that the secondary manual task did not require greater attention in patients with axSpA. Increasing the complexity of the walking and/or secondary task may increase the sensitivity of the dual-task design to axial spondyloarthritis.

Physiological and Cognitive Determinants of Dual-Task Costs for Gait Parameters: The Yishun Study

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Lay Khoon Lau ◽  
Jagadish Ullal Mallya ◽  
Wei Jun Benedict Pang ◽  
Kexun Kenneth Chen ◽  
Khalid bin Abdul Jabbar ◽  
...  
Keyword(s):  
Dual Task ◽  
Gait Speed ◽  
Postural Sway ◽  
Step Length ◽  
Double Support ◽  
Immediate Memory ◽  
Gait Parameters ◽  
Primary Determinant ◽  
Double Support Time ◽  
Support Time

Background: Studies indicate that physiological and cognitive aging are causally related and functionally interdependent. However, the relative contribution of physiological factors and cognition to dual-task costs (DTC) of gait parameters has not been well studied. In this cross-sectional study, we examined the trajectory of DTC of gait parameters across the adult age spectrum for both sexes and identified the contributions of physical and cognitive performance to DTC of gait. Methods: A total of 492 community-dwelling adults, aged 21–90 years, were randomly recruited into the study. Participants were divided into 7 age groups, with 10-year age range for each group. Demographic data, height, body mass, education level, and information on comorbidities were recorded. Cognition was measured using the Repeatable Battery for the Assessment of Neuropsychological Status. Physical performance included visual contrast sensitivity, postural sway, hand reaction time, handgrip strength, knee extensor strength, and single-task and dual-task gait assessments. Stepwise multivariable regression was used to examine the association between physical and cognitive performance with DTC of gait parameters. Results: Women were found to have significantly higher DTC of gait speed (p = 0.01), cadence (p < 0.01), and double support time (p < 0.01) than men. However, significant aging effect on DTC of gait speed (p = 0.01), step length (p = 0.01), and double support time (p = 0.01) was observed in men but not in women. Immediate memory was the primary determinant for the DTC of gait speed (β = −0.25, p < 0.01), step length (β = −0.22, p < 0.01), and cadence (β = −0.15, p = 0.03) in men. Besides immediate memory, postural sway (β = −0.13, p = 0.03) and hand reaction (β = 0.14, p = 0.02) were also significantly associated with DTC of step length and cadence, respectively, in women. Conclusion: There were sex differences in the amplitude and trajectories of DTC of gait parameters. The DTC increased with age in men but not in women. Immediate memory was the primary determinant of DTC of gait parameters in men while immediate memory, postural sway, and reaction time were associated with DTC of gait in women. Future studies should investigate the clinical implications of the sex differences in the DTC with fall risks.

scholarly journals Longitudinal Changes in Temporospatial Gait Characteristics during the First Year Post-Stroke

2021 ◽  
Vol 11 (12) ◽  
pp. 1648
Author(s):  
John W. Chow ◽  
Dobrivoje S. Stokic
Keyword(s):  
Lower Extremity ◽  
Gait Speed ◽  
Stride Length ◽  
Double Support ◽  
Post Stroke ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Support Time ◽  
Post Onset ◽  
Step Parameters

Given the paucity of longitudinal data in gait recovery after stroke, we compared temporospatial gait characteristics of stroke patients during subacute (<2 months post-onset, T0) and at approximately 6 and 12 months post-onset (T1 and T2, respectively) and explored the relationship between gait characteristics at T0 and the changes in gait speed from T0 to T1. Forty-six participants were assessed at T0 and a subsample of 24 participants at T2. Outcome measures included Fugl-Meyer lower-extremity motor score, 14 temporospatial gait parameters and symmetry indices of 5 step parameters. Except for step width, all temporospatial parameters improved from T0 to T1 (p ≤ 0.0001). Additionally, significant improvements in symmetry were found for the initial double-support time and single-support time (p ≤ 0.0001). Although group results at T2 were not different from those at T1, the individual analysis revealed that 42% (10/24) of the subsample showed a significant increase in gait speed. The increase in gait speed from T0 to T1 was negatively correlated with gait speed and stride length, and positively correlated with the symmetry indices of stance and single-support times at T0 (p ≤ 0.002). Temporospatial gait parameters and stance time symmetry improve over the first 6 months after stroke with an apparent plateau thereafter. Approximately 40% of the subsample continue to increase gait speed from 6 to 12 months post-stroke. A greater increase in gait speed during the first 6 months post-stroke is associated with initially slower walking, shorter stride length, and more pronounced asymmetry in stance and single-support times. The improvement in lower-extremity motor function and bilateral improvements in step parameters collectively suggest that gait changes over the first 12 months after stroke are likely due to neurological recovery, although some compensation by the non-paretic side cannot be excluded.

scholarly journals Assessment of gait in patients with fibromyalgia during motor and cognitive dual task walking: a cross-sectional study

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Goran Radunović ◽  
Zoran Veličković ◽  
Melanija Rašić ◽  
Saša Janjić ◽  
Vladana Marković ◽  
...  
Keyword(s):  
Functional Status ◽  
Dual Task ◽  
Stride Length ◽  
Clinical Symptoms ◽  
Gait Pattern ◽  
Dual Tasks ◽  
Double Support ◽  
Gait Parameters ◽  
Double Support Time ◽  
Support Time

Abstract Background The aim of the study was to assess gait pattern of patients diagnosed with fibromyalgia (FM) while performing demanding motor and/or cognitive dual tasks while walking. Further, idea was to explore possible correlations of dual task gait pattern alterations to patients’ functional status and presence or absence of clinical symptoms associated with FM. Methods Twenty-four female FM patients and 24 healthy female subjects performed a basic walking task, a dual motor, a dual mental (cognitive) and a combined, dual motor and cognitive task simultaneously. Quantitative spatial (stride length) and temporal (cycle time, swing time and double support time) gait parameters were measured using GAITRite walkway system and their variability was assessed. Patients underwent clinical examination including assessment of functional status, pain and fatigue level, psychiatric and cognitive manifestations. Results The motor, cognitive and combined dual tasks affect gait performance in FM patients. Difference in tasks between FM and healthy subjects was found as double support time prolongation. Comparison of tasks showing that cycle time in FM was longer than controls and stride length was shorter in patients for all conditions, while no changes were found in any of the gait parameters variability. Further, mental/cognitive dual tasks had a larger effect than motor tasks. Correlations were also found between depression and functional status of the patients and the gait parameters. Conclusions Gait is affected in FM patients while dual task walking. No changes in stride-to-stride variability point that patients preserve stability in complex walking situations. Analysis of gait may provide additional information for the FM identification based on presence of clinical features and cognitive status. Correlation of dual task gait alterations with occurrence of clinical symptoms and influence of cognitive changes on gait pattern could additionally define FM subgroups.

Digital Biomarkers of Cognitive Frailty: The Value of Detailed Gait Assessment Beyond Gait Speed

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
He Zhou ◽  
Catherine Park ◽  
Mohammad Shahbazi ◽  
Michele K. York ◽  
Mark E. Kunik ◽  
...  
Keyword(s):  
Older Adults ◽  
Steady State ◽  
Dual Task ◽  
Gait Speed ◽  
Stride Length ◽  
Cognitive Frailty ◽  
Single Task ◽  
Double Support ◽  
Gait Parameters ◽  
Digital Biomarkers

<b><i>Background:</i></b> Cognitive frailty (CF), defined as the simultaneous presence of cognitive impairment and physical frailty, is a clinical symptom in early-stage dementia with promise in assessing the risk of dementia. The purpose of this study was to use wearables to determine the most sensitive digital gait biomarkers to identify CF. <b><i>Methods:</i></b> Of 121 older adults (age = 78.9 ± 8.2 years, body mass index = 26.6 ± 5.5 kg/m<sup>2</sup>) who were evaluated with a comprehensive neurological exam and the Fried frailty criteria, 41 participants (34%) were identified with CF and 80 participants (66%) were identified without CF. Gait performance of participants was assessed under single task (walking without cognitive distraction) and dual task (walking while counting backward from a random number) using a validated wearable platform. Participants walked at habitual speed over a distance of 10 m. A validated algorithm was used to determine steady-state walking. Gait parameters of interest include steady-state gait speed, stride length, gait cycle time, double support, and gait unsteadiness. In addition, speed and stride length were normalized by height. <b><i>Results:</i></b> Our results suggest that compared to the group without CF, the CF group had deteriorated gait performances in both single-task and dual-task walking (Cohen’s effect size <i>d</i> = 0.42–0.97, <i>p</i> &#x3c; 0.050). The largest effect size was observed in normalized dual-task gait speed (<i>d</i> = 0.97, <i>p</i> &#x3c; 0.001). The use of dual-task gait speed improved the area under the curve (AUC) to distinguish CF cases to 0.76 from 0.73 observed for the single-task gait speed. Adding both single-task and dual-task gait speeds did not noticeably change AUC. However, when additional gait parameters such as gait unsteadiness, stride length, and double support were included in the model, AUC was improved to 0.87. <b><i>Conclusions:</i></b> This study suggests that gait performances measured by wearable sensors are potential digital biomarkers of CF among older adults. Dual-task gait and other detailed gait metrics provide value for identifying CF above gait speed alone. Future studies need to examine the potential benefits of gait performances for early diagnosis of CF and/or tracking its severity over time.

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%.

scholarly journals Assessing the concurrent validity of a gait analysis system integrated into a smart walker in older adults with gait impairments

2019 ◽  
Vol 33 (10) ◽  
pp. 1682-1687 ◽  
Author(s):  
Christian Werner ◽  
Georgia Chalvatzaki ◽  
Xanthi S Papageorgiou ◽  
Costas S Tzafestas ◽  
Jürgen M Bauer ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Gait Speed ◽  
Concurrent Validity ◽  
Stride Length ◽  
Gait Parameters ◽  
Stance Time ◽  
Absolute Agreement ◽  
Analysis System ◽  
Smart Walker ◽  
Gait Impairments

Objective: To assess the concurrent validity of a smart walker–integrated gait analysis system with the GAITRite® system for measuring spatiotemporal gait parameters in potential users of the smart walker. Design: Criterion standard validation study. Setting: Research laboratory in a geriatric hospital. Participants: Twenty-five older adults (⩾65 years) with gait impairments (habitual rollator use and/or gait speed <0.6 m/s) and no severe cognitive impairment (Mini-Mental State Examination ⩾17). Main measures: Stride, swing and stance time; stride length; and gait speed were simultaneously recorded using the smart walker–integrated gait analysis system and the GAITRite system while participants walked along a 7.8-m walkway with the smart walker. Concurrent criterion-related validity was assessed using the Bland–Altman method, percentage errors (acceptable if <30%), and intraclass correlation coefficients for consistency (ICC3,1) and absolute agreement (ICC2,1). Results: Bias for stride, swing and stance time ranged from −0.04 to 0.04 seconds, with acceptable percentage errors (8.7%–23.0%). Stride length and gait speed showed higher bias (meanbias (SD) = 0.20 (0.11) m; 0.19 (0.13) m/s) and not acceptable percentage errors (31.3%–42.3%). Limits of agreement were considerably narrower for temporal than for spatial-related gait parameters. All gait parameters showed good-to-excellent consistency (ICC3,1 = 0.72–0.97). Absolute agreement was good-to-excellent for temporal (ICC2,1 = 0.72–0.97) but only poor-to-fair for spatial-related gait parameters (ICC2,1 = 0.37–0.52). Conclusion: The smart walker–integrated gait analysis system has good concurrent validity with the GAITRite system for measuring temporal but not spatial-related gait parameters in potential end-users of the smart walker. Stride length and gait speed can be measured with good consistency, but with only limited absolute accuracy.

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.

scholarly journals Gait parameters and characteristics associated with increased risk of falls in people with dementia: a systematic review

2018 ◽  
Vol 31 (9) ◽  
pp. 1287-1303 ◽  
Author(s):  
Shirin Modarresi ◽  
Alison Divine ◽  
Jessica A. Grahn ◽  
Tom J. Overend ◽  
Susan W. Hunter
Keyword(s):  
Systematic Review ◽  
Rating Scale ◽  
Future Research ◽  
Time Variability ◽  
Double Support ◽  
People With Dementia ◽  
Gait Parameters ◽  
Increased Risk ◽  
Double Support Time ◽  
Support Time

ABSTRACTBackground:People with dementia fall twice as often and have more serious fall-related injuries than healthy older adults. While gait impairment as a generic term is understood as a fall risk factor in this population, a clear elaboration of the specific components of gait that are associated with falls risk is needed for knowledge translation to clinical practice and the development of fall prevention strategies for people with dementia.Objective:To review gait parameters and characteristics associated with falls in people with dementia.Methods:Electronic databases CINAHL, EMBASE, MedLine, PsycINFO, and PubMed were searched (from inception to April 2017) to identify prospective cohort studies evaluating the association between gait and falls in people with dementia.Results:Increased double support time variability, use of mobility aids, walking outdoors, higher scores on the Unified Parkinson’s Disease Rating Scale, and lower average walking bouts were associated with elevated risk of any fall. Increased double support time and step length variability were associated with recurrent falls. The reviewed articles do not support using the Performance Oriented Mobility Assessment and the Timed Up-and-Go tests to predict any fall in this population. There is limited research on the use of dual-task gait assessments for predicting falls in people with dementia.Conclusion:This systematic review shows the specific spatiotemporal gait parameters and features that are associated with falls in people with dementia. Future research is recommended to focus on developing specialized treatment methods for these specific gait impairments in this patient population.

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