scholarly journals Lower-Extremity Intra-Joint Coordination and Its Variability between Fallers and Non-Fallers during Gait

2021 ◽  
Vol 11 (6) ◽  
pp. 2840
Author(s):  
Hassan Sadeghi ◽  
Seyed Sadredin Shojaedin ◽  
Ali Abbasi ◽  
Elham Alijanpour ◽  
Marcus Fraga Vieira ◽  
...  
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Walking Speed ◽  
Sagittal Plane ◽  
Sampling Rate ◽  
Neuromuscular Control ◽  
Stride Time ◽  
Joint Coordination ◽  
Double Support ◽  
Gait Parameters

Falling is one of the most common causes of hip fracture and death in older adults. A comparison of the biomechanics of the gait in fallers and non-fallers older adults, especially joint coordination and coordination variability, enables the understanding of mechanisms that underpin falling. Therefore, we compared lower-extremity intra-joint coordination and its variability between fallers and non-fallers older adults during gait. A total of 26 older adults, comprising 13 fallers, took part in this study. The participants walked barefoot at a self-selected speed on a 10-m walkway. Gait kinematics in the dominant leg during 10 cycles were captured with 10 motion tracking cameras at a sampling rate of 100 Hz. Spatiotemporal gait parameters, namely, cadence, walking speed, double support time, stride time, width, and length, as well as intra-joint coordination and coordination variability in the sagittal plane were compared between the two groups. Results showed that fallers walked with significant lower cadence, walking speed, and stride length but greater double support and stride time than non-fallers. Significant differences in the ankle-to-knee, knee-to-hip, and ankle-to-hip coordination patterns between fallers and non-fallers and less coordination variability in fallers compared to non-fallers in some instants of the gait cycles were observed. The differences in spatiotemporal gait parameters in fallers compared to non-fallers may indicate an adaptation resulting from decreased efficiency to decrease the risk of falling. Moreover, the differences in segment coordination and its variability may indicate an inconsistency in neuromuscular control. It may also indicate reduced ability to control the motion of the leg in preparation for foot contact with the ground and the knee and ankle motions during loading response. Finally, such differences may show less control in generating power during the push-off phase in fallers.

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 Effectiveness of an ankle–foot orthosis on walking in patients with stroke: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoo Jin Choo ◽  
Min Cheol Chang
Keyword(s):  
Stride Length ◽  
Walking Speed ◽  
Sagittal Plane ◽  
Meta Analysis ◽  
Step Length ◽  
Stride Time ◽  
Plane Angle ◽  
Ankle Foot Orthosis ◽  
Biomechanical Parameters ◽  
Foot Orthosis

AbstractWe conducted a meta-analysis to investigate the effectiveness of ankle–foot orthosis (AFO) use in improving gait biomechanical parameters such as walking speed, mobility, and kinematics in patients with stroke with gait disturbance. We searched the MEDLINE (Medical Literature Analysis and Retrieval System Online), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, Embase, and Scopus databases and retrieved studies published until June 2021. Experimental and prospective studies were included that evaluated biomechanics or kinematic parameters with or without AFO in patients with stroke. We analyzed gait biomechanical parameters, including walking speed, mobility, balance, and kinematic variables, in studies involving patients with and without AFO use. The criteria of the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate the methodological quality of the studies, and the level of evidence was evaluated using the Research Pyramid model. Funnel plot analysis and Egger’s test were performed to confirm publication bias. A total of 19 studies including 434 participants that reported on the immediate or short-term effectiveness of AFO use were included in the analysis. Significant improvements in walking speed (standardized mean difference [SMD], 0.50; 95% CI 0.34–0.66; P < 0.00001; I2, 0%), cadence (SMD, 0.42; 95% CI 0.22–0.62; P < 0.0001; I2, 0%), step length (SMD, 0.41; 95% CI 0.18–0.63; P = 0.0003; I2, 2%), stride length (SMD, 0.43; 95% CI 0.15–0.71; P = 0.003; I2, 7%), Timed up-and-go test (SMD, − 0.30; 95% CI − 0.54 to − 0.07; P = 0.01; I2, 0%), functional ambulation category (FAC) score (SMD, 1.61; 95% CI 1.19–2.02; P < 0.00001; I2, 0%), ankle sagittal plane angle at initial contact (SMD, 0.66; 95% CI 0.34–0.98; P < 0.0001; I2, 0%), and knee sagittal plane angle at toe-off (SMD, 0.39; 95% CI 0.04–0.73; P = 0.03; I2, 46%) were observed when the patients wore AFOs. Stride time, body sway, and hip sagittal plane angle at toe-off were not significantly improved (p = 0.74, p = 0.07, p = 0.07, respectively). Among these results, the FAC score showed the most significant improvement, and stride time showed the lowest improvement. AFO improves walking speed, cadence, step length, and stride length, particularly in patients with stroke. AFO is considered beneficial in enhancing gait stability and ambulatory ability.

scholarly journals The Effects of Systematic Environmental Manipulation on Gait of Older Adults

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 386
Author(s):  
Max Toepfer ◽  
Alejandra Padilla ◽  
Kevin Ponto ◽  
Andrea H Mason ◽  
Kristen A Pickett
Keyword(s):  
Older Adults ◽  
Repeated Measures ◽  
Environmental Changes ◽  
Small Scale ◽  
Gait Patterns ◽  
Double Support ◽  
Single Dimension ◽  
Adult Participants ◽  
Gait Parameters ◽  
Systematic Manipulation

Quantification of gait changes in response to altered environmental stimuli may allow for improved understanding of the mechanisms that influence gait changes and fall occurrence in older adults. This study explored how systematic manipulation of a single dimension of one’s environment affects spatiotemporal gait parameters. A total of 20 older adult participants walked at a self-selected pace in a constructed research hallway featuring a mobile wall, which allowed manipulation of the hallway width between three conditions: 1.14 m, 1.31 m, and 1.48 m. Spatiotemporal data from participants’ walks were captured using an instrumented GAITRite mat. A repeated measures ANOVA revealed older adults spent significantly more time in double support in the narrowest hallway width compared to the widest, but did not significantly alter other spatiotemporal measures. Small-scale manipulations of a single dimension of the environment led to subtle, yet in some cases significant changes in gait, suggesting that small or even imperceptible environmental changes may contribute to altered gait patterns for older adults.

scholarly journals Gait Parameters Associated With Responsiveness to Treadmill Training With Body-Weight Support After Stroke: An Exploratory Study

2010 ◽  
Vol 90 (2) ◽  
pp. 209-223 ◽  
Author(s):  
Sara J. Mulroy ◽  
Tara Klassen ◽  
JoAnne K. Gronley ◽  
Valerie J. Eberly ◽  
David A. Brown ◽  
...  
Keyword(s):  
Body Weight ◽  
Lower Extremity ◽  
Muscle Activation ◽  
Walking Speed ◽  
Treadmill Training ◽  
High Response ◽  
Emg Activity ◽  
Locomotor Training ◽  
Gait Parameters ◽  
Response Group

Background Task-specific training programs after stroke improve walking function, but it is not clear which biomechanical parameters of gait are most associated with improved walking speed. Objective The purpose of this study was to identify gait parameters associated with improved walking speed after a locomotor training program that included body-weight–supported treadmill training (BWSTT). Design A prospective, between-subjects design was used. Methods Fifteen people, ranging from approximately 9 months to 5 years after stroke, completed 1 of 3 different 6-week training regimens. These regimens consisted of 12 sessions of BWSTT alternated with 12 sessions of: lower-extremity resistive cycling; lower-extremity progressive, resistive strengthening; or a sham condition of arm ergometry. Gait analysis was conducted before and after the 6-week intervention program. Kinematics, kinetics, and electromyographic (EMG) activity were recorded from the hemiparetic lower extremity while participants walked at a self-selected pace. Changes in gait parameters were compared in participants who showed an increase in self-selected walking speed of greater than 0.08 m/s (high-response group) and in those with less improvement (low-response group). Results Compared with participants in the low-response group, those in the high-response group displayed greater increases in terminal stance hip extension angle and hip flexion power (product of net joint moment and angular velocity) after the intervention. The intensity of soleus muscle EMG activity during walking also was significantly higher in participants in the high-response group after the intervention. Limitations Only sagittal-plane parameters were assessed, and the sample size was small. Conclusions Task-specific locomotor training alternated with strength training resulted in kinematic, kinetic, and muscle activation adaptations that were strongly associated with improved walking speed. Changes in both hip and ankle biomechanics during late stance were associated with greater increases in gait speed.

Transfer Effects of Fall Training on Balance Performance and Spatiotemporal Gait Parameters in Healthy Community-Dwelling Older Adults: A Pilot Study

2014 ◽  
Vol 22 (3) ◽  
pp. 324-333 ◽  
Author(s):  
Lars Donath ◽  
Oliver Faude ◽  
Stephanie A. Bridenbaugh ◽  
Ralf Roth ◽  
Martin Soltermann ◽  
...  
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Stride Length ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Stride Time ◽  
Balance Performance ◽  
Transfer Effects ◽  
Gait Parameters ◽  
Community Dwelling Older Adults

This study examined transfer effects of fall training on fear of falling (Falls Efficacy Scale—International [FES–I]), balance performance, and spatiotemporal gait characteristics in older adults. Eighteen community-dwelling older adults (ages 65–85) were randomly assigned to an intervention or control group. The intervention group completed 12 training sessions (60 min, 6 weeks). During pre- and posttesting, we measured FES–I, balance performance (double limb, closed eyes; single limb, open eyes; double limb, open eyes with motor-interfered task), and gait parameters (e.g., velocity; cadence; stride time, stride width, and stride length; variability of stride time and stride length) under single- and motor-interfered tasks. Dual tasks were applied to appraise improvements of cognitive processing during balance and gait. FES–I (p = .33) and postural sway did not significantly change (0.36 < p < .79). Trends toward significant interaction effects were found for step width during normal walking and stride length variability during the motor dual task (p = .05, ηp2 = .22). Fall training did not sufficiently improve fear of falling, balance, or gait performance under single- or dual-task conditions in healthy older adults.

The Effects of Mobile Texting and Walking Speed on Gait Characteristics of Normal Weight and Obese Adults

Motor Control ◽  
2020 ◽  
Vol 24 (4) ◽  
pp. 588-604
Author(s):  
Jongil Lim ◽  
Jiyeon Kim ◽  
Kyoungho Seo ◽  
Richard E.A. van Emmerik ◽  
Sukho Lee
Keyword(s):  
Dual Task ◽  
Walking Speed ◽  
Normal Weight ◽  
Obese Adults ◽  
Double Support ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Dual Task Cost ◽  
Gait Mechanics ◽  
Stance Time

The aim of this study was to examine how usage of mobile devices while simultaneously walking affects walking characteristics and texting performance of normal weight (NW) and obese (OB) individuals. Thirty-two OB (body mass index [BMI] = 34.4) and NW (BMI = 22.7) adults performed two 60-s walking trials at three-step frequencies along a rectangular walkway in two conditions (No Texting and Texting). Dual-task cost as well as unadjusted spatial and temporal gait characteristics were measured. Dual-task costs for the gait parameters as well as texting performance were not different between the groups, except for the lateral step variability showing a larger variability at the preferred frequency in OB individuals. For the unadjusted variables, OB exhibited longer double support, longer stance time, and lower turn velocity compared with NW. Overall, the results highlight a similar dual-task cost for the OB individuals compared with the NW individuals, in spite of underlying differences in gait mechanics.

Intralimb Joint Coordination Patterns of the Lower Extremity in Maximal Velocity Phase Sprint Running

2010 ◽  
Vol 26 (2) ◽  
pp. 188-195 ◽  
Author(s):  
Marianne J.R. Gittoes ◽  
Cassie Wilson
Keyword(s):  
Lower Extremity ◽  
Sagittal Plane ◽  
Coordination Pattern ◽  
Maximal Velocity ◽  
Joint Coordination ◽  
Sprint Running ◽  
Joint Coupling ◽  
Plane Joint ◽  
Coordination Patterns ◽  
Coordinate Data

This study aimed to develop insight into the lower extremity joint coupling motions used in the maximal velocity phase of sprint running. Two-dimensional coordinate data were used to derive sagittal plane joint angle profiles of sprint running trials. Intralimb joint coupling motions were examined using a continuous relative phase (CRP) analysis. The knee-ankle (KA) coupling was more out of phase compared with the hip-knee (HK) coupling across the step phase (mean CRP: KA 89.9° HK 34.2°) and produced a lower within-athlete CRP variability (VCRP) in stance. Touchdown (TD) produced more out-of-phase motions and a larger VCRP than toe-off. A destabilization of the lower extremity coordination pattern was considered necessary at TD to allow for the swing-to-stance transition. The key role that the KA joint motion has in the movement patterns used by healthy athletes in the maximal velocity phase of sprint running was highlighted.

scholarly journals Women after Bilateral Surgical Correction of Hallux Valgus Do not Show Improvement in Spatiotemporal Gait Parameters at 18 Weeks Postoperatively

2021 ◽  
Vol 10 (4) ◽  
pp. 608
Author(s):  
Katarzyna Kaczmarczyk ◽  
Gabor J. Barton ◽  
Ida Wiszomirska ◽  
Michal Wychowanski
Keyword(s):  
Hallux Valgus ◽  
Surgical Correction ◽  
Control Group ◽  
Stride Time ◽  
Leg Length ◽  
Control Groups ◽  
Postoperative Rehabilitation ◽  
Double Support ◽  
Gait Parameters ◽  
And Control

Background: Hallux valgus (HV) is a gait-altering orthopedic deformity, somewhat more prevalent in women, which often affects both limbs. Although surgery is a commonly applied treatment, there is no consensus in the literature on how invasive HV correction affects spatiotemporal gait parameters, or how quickly improvement can be expected. We investigated gait parameters in female HV patients who underwent bilateral surgical correction of hallux valgus, both preoperatively and 18 weeks following surgery (a timeframe relevant from the perspective of physical therapy), and also in relation to a non-HV control group. Methods: A total of 23 women aged 40–70 years, with moderate to severe HV deformity in both feet, were assessed preoperatively and 18 weeks postoperatively, and an age-matched control group of 76 healthy women was also assessed. A total of 22 spatiotemporal parameters were collected during 30 s walks over an electronic walkway (Zebris Medical System). Results: Of the 22 parameters analyzed, significant differences between the preoperative experimental and control groups were found only in 4 parameters (Velocity, Right step time, Total double support and Stride time), but in 16 parameters between the postoperative experimental and control groups (the greatest impact being found for: Left and Right Step time, Stride time, Cadence, Right Foot rotation, Left Step length (% leg length) and Stride length (% leg length)). Conclusions: Women after bilateral HV correction did not exhibit improved (i.e., more normal) gait parameters at 18 weeks postoperatively; rather, they showed more gait abnormalities than preoperatively. These findings urge longer-term planning of postoperative rehabilitation, involving continual evaluation of gait improvement.

scholarly journals Hemodialysis Impact on Motor Function Beyond Aging and Diabetes – Objectively Assessing Gait and Balance by Wearable Technology

2018 ◽  
Author(s):  
He Zhou ◽  
Fadwa Al-Ali ◽  
Hadi Rahemi ◽  
Nishat Kulkarni ◽  
Abdullah Hamad ◽  
...  
Keyword(s):  
Older Adults ◽  
Motor Function ◽  
Effect Size ◽  
Motor Performance ◽  
Stride Length ◽  
Gait Cycle ◽  
Center Of Mass ◽  
Static Balance ◽  
Double Support ◽  
Gait Parameters

Motor functions are deteriorated by aging. Some conditions may magnify this deterioration. To examine whether hemodialysis (HD) process would negatively impact gait and balance beyond diabetes condition among mid-age adults (48-64 years) and older adults (65+ years). One hundred and ninety-six subjects (age=66.2&plusmn;9.1 years, body-mass-index=30.1&plusmn;6.4 kg/m2, female=56%) in 5 groups were recruited: mid-age adults with diabetes undergoing HD (Mid-age HD+, n=38) and without HD (Mid-age HD-, n=40); older adults with diabetes undergoing HD (Older HD+, n=36) and without HD (Older HD-, n=37); and non-diabetic older adults (Older DM-, n=45). Gait parameters (stride velocity, stride length, gait cycle time, and double support) and balance parameters (ankle, hip, and center of mass sways) were quantified using validated wearable platforms. Groups with diabetes had overall poorer gait and balance compared to the non-diabetic group (p&lt;0.050). Among people with diabetes, the HD+ had significantly worsened gait and balance when comparing to the HD- (Cohen&rsquo;s effect size d=0.63-2.32, p&lt;0.050). Between-group difference was more pronounced among older adults with the largest effect size observed for stride length (d=2.32, p&lt;0.001). Results suggested that deterioration in gait speed among the HD+ was correlated with age (r=-0.440, p&lt;0.001), while this correlation was diminished among the HD-. Interestingly, results also suggested that poor gait in the Older HD- related to poor balance, while no correlation was observed between poor balance and poor gait among the Older HD+. Using objective assessments, results confirmed that the presence of diabetes can deteriorate gait and balance, and this deterioration can be magnified by HD process. Among non-HD people with diabetes, poor static balance described poor gait. However, among people with diabetes undergoing HD, age was a dominate factor describing poor gait irrespective of static balance. Results also suggested feasibility of using wearable platforms to quantify motor performance during routine dialysis clinic visits. These objective assessments may assist in identifying early deterioration in motor function, which in turn may promote timely intervention.

scholarly journals Hemodialysis Impact on Motor Function beyond Aging and Diabetes—Objectively Assessing Gait and Balance by Wearable Technology

Sensors ◽  
2018 ◽  
Vol 18 (11) ◽  
pp. 3939 ◽  
Author(s):  
He Zhou ◽  
Fadwa Al-Ali ◽  
Hadi Rahemi ◽  
Nishat Kulkarni ◽  
Abdullah Hamad ◽  
...  
Keyword(s):  
Older Adults ◽  
Motor Function ◽  
Effect Size ◽  
Stride Length ◽  
Gait Cycle ◽  
Center Of Mass ◽  
Clinic Visit ◽  
Double Support ◽  
Ankle Stability ◽  
Gait Parameters

Motor functions are deteriorated by aging. Some conditions may magnify this deterioration. This study examined whether hemodialysis (HD) process would negatively impact gait and balance beyond diabetes condition among mid-age adults (48–64 years) and older adults (65+ years). One hundred and ninety-six subjects (age = 66.2 ± 9.1 years, body-mass-index = 30.1 ± 6.4 kg/m2, female = 56%) in 5 groups were recruited: mid-age adults with diabetes undergoing HD (Mid-age HD+, n = 38) and without HD (Mid-age HD−, n = 40); older adults with diabetes undergoing HD (Older HD+, n = 36) and without HD (Older HD−, n = 37); and non-diabetic older adults (Older DM−, n = 45). Gait parameters (stride velocity, stride length, gait cycle time, and double support) and balance parameters (ankle, hip, and center of mass sways) were quantified using validated wearable platforms. Groups with diabetes had overall poorer gait and balance compared to the non-diabetic group (p < 0.050). Among people with diabetes, HD+ had significantly worsened gait and balance when comparing to HD− (Cohen’s effect size d = 0.63–2.32, p < 0.050). Between-group difference was more pronounced among older adults with the largest effect size observed for stride length (d = 2.32, p < 0.001). Results suggested that deterioration in normalized gait speed among HD+ was negatively correlated with age (r = −0.404, p < 0.001), while this correlation was diminished among HD−. Interestingly, results also suggested that poor gait among Older HD− is related to poor ankle stability, while no correlation was observed between poor ankle stability and poor gait among Older HD+. Using objective assessments, results confirmed that the presence of diabetes can deteriorate gait and balance, and this deterioration can be magnified by HD process. Among HD− people with diabetes, poor ankle stability described poor gait. However, among people with diabetes undergoing HD, age was a dominate factor describing poor gait irrespective of static balance. Results also suggested feasibility of using wearable platforms to quantify motor performance during routine dialysis clinic visit. These objective assessments may assist in identifying early deterioration in motor function, which in turn may promote timely intervention.

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