scholarly journals Functional Electrical Stimulation for Foot Drop in Post-Stroke People: Quantitative Effects on Step-to-Step Symmetry of Gait Using a Wearable Inertial Sensor

Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 921
Author(s):  
Giulia Schifino ◽  
Veronica Cimolin ◽  
Massimiliano Pau ◽  
Maira Jaqueline da Cunha ◽  
Bruno Leban ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Inertial Sensor ◽  
Foot Drop ◽  
Stroke Patients ◽  
Gait Patterns ◽  
Temporal Parameters ◽  
Additional Information ◽  
Acceleration Data ◽  
Trunk Acceleration ◽  
Spatio Temporal

The main purpose of the present study was to assess the effects of foot drop stimulators (FDS) in individuals with stroke by means of spatio-temporal and step-to-step symmetry, harmonic ratio (HR), parameters obtained from trunk accelerations acquired using a wearable inertial sensor. Thirty-two patients (age: 56.84 ± 9.10 years; 68.8% male) underwent an instrumental gait analysis, performed using a wearable inertial sensor before and a day after the 10-session treatment (PRE and POST sessions). The treatment consisted of 10 sessions of 20 min of walking on a treadmill while using the FDS device. The spatio-temporal parameters and the HR in the anteroposterior (AP), vertical (V), and mediolateral (ML) directions were computed from trunk acceleration data. The results showed that time had a significant effect on the spatio-temporal parameters; in particular, a significant increase in gait speed was detected. Regarding the HRs, the HR in the ML direction was found to have significantly increased (+20%), while those in the AP and V directions decreased (approximately 13%). Even if further studies are necessary, from these results, the HR seems to provide additional information on gait patterns with respect to the traditional spatio-temporal parameters, advancing the assessment of the effects of FDS devices in stroke patients.

scholarly journals Smoothness of Gait in Healthy and Cognitively Impaired Individuals: A Study on Italian Elderly Using Wearable Inertial Sensor

Sensors ◽  
2020 ◽  
Vol 20 (12) ◽  
pp. 3577 ◽  
Author(s):  
Massimiliano Pau ◽  
Ilaria Mulas ◽  
Valeria Putzu ◽  
Gesuina Asoni ◽  
Daniela Viale ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Gait Speed ◽  
Stride Length ◽  
Inertial Sensor ◽  
Cognitive Impairments ◽  
Gait Parameters ◽  
Acceleration Data ◽  
Trunk Acceleration ◽  
Spatio Temporal

The main purpose of the present study was to compare the smoothness of gait in older adults with and without cognitive impairments, using the harmonic ratio (HR), a metric derived from trunk accelerations. Ninety older adults aged over 65 (age: 78.9 ± 4.8 years; 62% female) underwent instrumental gait analysis, performed using a wearable inertial sensor and cognitive assessment with the Mini Mental State Examination (MMSE) and Addenbrooke’s Cognitive Examination Revised (ACE-R). They were stratified into three groups based on their MMSE performance: healthy controls (HC), early and advanced cognitive decline (ECD, ACD). The spatio-temporal and smoothness of gait parameters, the latter expressed through HR in anteroposterior (AP), vertical (V) and mediolateral (ML) directions, were derived from trunk acceleration data. The existence of a relationship between gait parameters and degree of cognitive impairment was also explored. The results show that individuals with ECD and ACD exhibited significantly slower speed and shorter stride length, as well as reduced values of HR in the AP and V directions compared to HC, while no significant differences were found between ECD and ACD in any of the investigated parameters. Gait speed, stride length and HR in all directions were found to be moderately correlated with both MMSE and ACE-R scores. Such findings suggest that, in addition to the known changes in gait speed and stride length, important reductions in smoothness of gait are likely to occur in older adults, owing to early/prodromal stages of cognitive impairment. Given the peculiar nature of these metrics, which refers to overall body stability during gait, the calculation of HR may result in being useful in improving the characterization of gait patterns in older adults with cognitive impairments.

Texting While Walking Induces Gait Pattern Alterations in Healthy Older Adults

2018 ◽  
Vol 62 (1) ◽  
pp. 1908-1912 ◽  
Author(s):  
Massimiliano Pau ◽  
Micaela Porta ◽  
Giuseppina Pilloni ◽  
Federica Corona ◽  
Maria Chiara Fastame ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Complexity ◽  
Gait Pattern ◽  
Middle Aged ◽  
Similar Reduction ◽  
Gait Patterns ◽  
Healthy Older Adults ◽  
Double Support ◽  
Temporal Parameters ◽  
Spatio Temporal

The use of a mobile phone for texting purposes results in distracted walking which may lead to injuries. In particular, texting while walking has been shown to induce significant alterations in gait patterns. This study aimed to assess whether changes in the main spatio-temporal parameters of gait when simultaneously engaged in texting on a smartphone and walking are different in older adults relative to young and middle- aged individuals. A total of 57 participants divided in three groups (19 older adults aged over 65, 19 young aged 20-40 and 19 middle-aged aged 41-64) were tested in two conditions: walking, and walking while texting on a smartphone. Spatio-temporal parameters of gait were assessed using a wearable accelerometer located on the lower back. The results show that texting induced similar reduction of gait speed, stride length and cadence in all groups. Slight (although significant) alterations of stance, swing and double support phases duration were found only for middle-aged participants. Such findings suggest that modifications of gait patterns due to texting seem unaffected by age, probably due to different perceptions of the cognitive complexity of the task and differential prioritization of its motor and cognitive aspects.

CLINICAL USE OF FUNCTIONAL ELECTRICAL STIMULATION FOR CORRECTION OF FOOT DROP: A COMPARISON BETWEEN SUBACUTE AND CHRONIC STROKE PATIENTS

2011 ◽  
Vol 11 (05) ◽  
pp. 1165-1177 ◽  
Author(s):  
SUKANTA K. SABUT ◽  
CHHANDA SIKDAR ◽  
RATNESH KUMAR ◽  
MANJUNATHA MAHADEVAPPA
Keyword(s):  
Electrical Stimulation ◽  
Lower Extremity ◽  
Functional Electrical Stimulation ◽  
Rehabilitation Program ◽  
Chronic Stroke ◽  
Motor Recovery ◽  
Calf Muscle ◽  
Foot Drop ◽  
Stroke Patients ◽  
Muscle Spasticity

Functional electrical stimulation (FES) allows active exercises for correction of foot drop in stroke patients. Our objective is to evaluate and compare the effects of FES therapy in walking ability, calf muscle spasticity, and lower-extremity motor recovery between subacute and chronic stroke patients. Twenty consecutive hemiplegic patients having foot drop were assigned either to subacute or chronic group. Both group subjects were treated with conventional rehabilitation program combined with FES therapy for 12 weeks. All subjects received the electrical stimulation to the peroneal nerve of paretic limb for 15–30 min while walking.After being treated with FES-based rehabilitation program, subacute subjects showed a mean increase in walking speed of 31.3% and chronic subjects of 19.1% and the physiological cost index (PCI), with a reduction of 66.7% in subacute subjects and 46.4% in chronic subjects between the beginning and end of the trial. Improvement was also measured in gait parameters such as cadence, step and stride lengths, ankle joint range of motion (ROM), calf muscle spasticity, and lower-extremity motor recovery assessed by Fugl-Meyer score in both group subjects, but subacute subjects improved better compared with chronic subjects. In conclusion, early and intensive interventions of FES therapy combine with conventional rehabilitation program could significantly improve the waking ability and recovery of lower-extremity motor functions in stroke survivors.

scholarly journals Auditory Cue Based on the Golden Ratio Can Improve Gait Patterns in People with Parkinson’s Disease

Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 911
Author(s):  
Valeria Belluscio ◽  
Marco Iosa ◽  
Giuseppe Vannozzi ◽  
Stefano Paravati ◽  
Antonella Peppe
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Muscle Activation ◽  
Irrational Number ◽  
Golden Ratio ◽  
Yahr Stage ◽  
Gait Patterns ◽  
Temporal Parameters ◽  
Auditory Cue ◽  
Spatio Temporal

The harmonic structure of walking relies on an irrational number called the golden ratio (ϕ): in healthy subjects, it coincides with the stride-to-stance ratio, and it is associated with a smooth gait modality. This smoothness is lost in people with Parkinson’s disease (PD), due to deficiencies in the execution of movements. However, external auditory cues seem to facilitate movement, by enabling the timing of muscle activation, and helping in initiating and modulating motor output. Based on a harmonic fractal structure of gait, can the administration of an auditory cue based on individual’s ϕ-rhythm improve, in acute, gait patterns in people with PD? A total of 20 participants (16 males, age 70.9 ± 8.4 years, Hoehn and Yahr stage-II) were assessed through stereophotogrammetry: gait spatio-temporal parameters, and stride-to-stance ratio were computed before, during, and after the ϕ-rhythm administration. Results show improvements in terms of stride length (p = 0.018), walking speed (p = 0.014), and toe clearance (p = 0.013) when comparing gait patterns before and after the stimulus. Furthermore, the stride-to-stance ratio seems to correlate with almost all spatio-temporal parameters, but it shows the main changes in the before–during rhythm comparison. In conclusion, ϕ-rhythm seems an effective cue able to compensate for defective internal rhythm of the basal ganglia in PD.

Abstract TP162: The Therapeutic Effects of Peroneal Nerve Functional Electric Stimulation for Lower Extremity in Patients With Sub-Acute Post-Stroke Hemiplegia: A Randomized Controlled Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Shuji Matsumoto ◽  
Megumi Shimodozono
Keyword(s):  
Electrical Stimulation ◽  
Patient Satisfaction ◽  
Functional Recovery ◽  
Foot Drop ◽  
Controlled Study ◽  
Control Group ◽  
Therapeutic Effects ◽  
Walk Test ◽  
Stroke Patients ◽  
Orthotic Device

Background and Aims: The functional electrical stimulation (FES) is the electrical stimulation of a muscle deprived of nervous control for providing muscular contraction and thereby producing a functionally useful movement. FES is particularly effective for treating foot drop caused by stroke. The purpose of this study was to investigate the effect of WalkAide FES system on functional recovery and activities of daily living (ADL) in stroke patients with foot drop. Methods: Participants (n=203; 49 females and 154 males; time after stroke 61.6±31.5 days) were randomized to either FES group or the control group. All subjects participated in the same standard rehabilitation program. In addition, FES group participated in FES training for 40 mins per day, five times a week, for 8 weeks, and those in the control group participated in the usual physical therapy including gait re-education, gait training with an orthotic device, and muscle stretching. Functional recovery was assessed using 6-min walk test (6MWT), active range of motion of ankle dorsiflexion (A-ROM), and Timed Up and Go test (TUG). ADL was assessed using 10-m walk test (10MWT), Stroke Impact Scale (SIS), and patient satisfaction. Results: After intervention, there were significant improvements in 6MWT, TUG, 10MWT, SIS compared to baseline in both groups (p< 0.0001). The significant improvement in A-ROM was demonstrated only in FES group. At follow-up, AROM showed significant improvements in the FES group compared to the control group (p= 0.0011). However, when comparing average change scores from baseline to end of treatment, significant differences were noted only for the A-ROM scores. Stroke patients preferred the use of an electrical stimulation orthotic substitute device to an orthotic device, according to the questionnaire of patient satisfaction (p< 0.0001). Conclusions: The findings of the current study demonstrated the efficacy of FES on the functional recovery and ADL, and also showed the feasibility of applying FES for dropped foot during the convalescent phase of recovery after stroke. These results suggest that long-term FES use may lead to additional improvements in walking endurance and functional ambulation; further research is needed to confirm these findings.

scholarly journals Towards Inertial Sensor Based Mobile Gait Analysis: Event-Detection and Spatio-Temporal Parameters

Sensors ◽  
2018 ◽  
Vol 19 (1) ◽  
pp. 38 ◽  
Author(s):  
Wolfgang Teufl ◽  
Michael Lorenz ◽  
Markus Miezal ◽  
Bertram Taetz ◽  
Michael Fröhlich ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Event Detection ◽  
Spatial Information ◽  
Inertial Sensor ◽  
Step Length ◽  
Measurement Unit ◽  
Step Width ◽  
Validity And Reliability ◽  
Temporal Parameters ◽  
Spatio Temporal

The aim of this study was to assess the validity and test-retest reliability of an inertial measurement unit (IMU) system for gait analysis. Twenty-four healthy subjects conducted a 6-min walking test and were instrumented with seven IMUs and retroreflective markers. A kinematic approach was used to estimate the initial and terminal contact events in real-time. Based on these events twelve spatio-temporal parameters (STP) were calculated. A marker based optical motion capture (OMC) system provided the reference. Event-detection rate was about 99%. Detection offset was below 0.017 s. Relative root mean square error (RMSE) ranged from 0.90% to 4.40% for most parameters. However, the parameters that require spatial information of both feet showed higher errors. Step length showed a relative RMSE of 6.69%. Step width and swing width revealed the highest relative RMSE (34.34% and 35.20%). Test-retest results ranged from 0.67 to 0.92, except for the step width (0.25). Summarizing, it appears that the parameters describing the lateral distance between the feet need further improvement. However, the results of the validity and reliability of the IMU system encourage its validation in clinical settings as well as further research.

scholarly journals Effect of the bilateral Dynamic Ankle-Foot Orthosis on the spatiotemporal gait patterns of a child with chemotherapy-induced peripheral neuropathy

2021 ◽  
Author(s):  
Everton Horiquini Barbosa ◽  
Thiago Felício
Keyword(s):  
Peripheral Neuropathy ◽  
Stride Length ◽  
Inertial Sensor ◽  
Timed Up And Go ◽  
Gait Patterns ◽  
Ankle Foot Orthosis ◽  
Number Of Patients ◽  
Spatio Temporal ◽  
Foot Orthosis

Introduction: Peripheral neuropathy induced by chemotherapy (CIPN) is a highly prevalent and clinically relevant sequel in the treatment of childhood cancer, impacting the patient’s functionality and also decreasing the quality of life, therefore, improvement in mobility and quality of walking are important goals during the rehabilitation process. The aim of this study was to compare the spatio-temporal gait patterns of a child with CIPN with or without the use of bilateral dynamic Ankle-Foot Orthosis. Methods: This is a descriptive case study consisting of an gait evaluation of a female patient with CIPN, 09 years old, 1.39m and 35kg. The spatio-temporal gait patterns, 6- minute walk test and Timed Up and Go test were obtained using a wireless inertial sensor system. Results: The obtained data in the 6MWT showed 160m of travelled distance, a speed of 0.55 m/s, a cadence of 94.9 steps/min and a stride length of 0.70m, compared to a travelled distance of 233.3m, a speed of 0.86 m/s, a cadence of 99.2 steps/min and a stride length of 104 m. The obtained data in the TUG test, showed that the participant used 24.37 seconds to complete the test without the orthosis and 18.54 seconds with the orthosis, changing to Semi-Independent to Independent classification, however, despite the improvement, the risk of falling was still considered high according to the values predicted by the software. Conclusion: Thus, the use of dynamic orthosis for patients with CIPN can be beneficial to improve speed, endurance and decrease the physiological cost of walking. Future studies comparing the effectiveness of dynamic orthosis in a larger number of patients are needed to elucidate the findings exposed in the present study.

scholarly journals Computation of spatio-temporal parameters in level walking using a single inertial system in lean and obese adolescents

2017 ◽  
Vol 62 (5) ◽  
Author(s):  
Veronica Cimolin ◽  
Paolo Capodaglio ◽  
Nicola Cau ◽  
Manuela Galli ◽  
Cristina Santovito ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Inertial Sensor ◽  
Normal Weight ◽  
Inertial System ◽  
Obese Adolescents ◽  
Temporal Parameters ◽  
Lower Trunk ◽  
Level Walking ◽  
Spatio Temporal ◽  
Instrumented Gait Analysis

AbstractIn recent years, the availability of low-cost equipment capable of recording kinematic data during walking has facilitated the outdoor assessment of gait parameters, thus overcoming the limitations of three-dimensional instrumented gait analysis (3D-GA). The aim of this study is twofold: firstly, to investigate whether a single sensor on the lower trunk could provide valid spatio-temporal parameters in level walking in normal-weight and obese adolescents compared to instrumented gait analysis (GA); secondly, to investigate whether the inertial sensor is capable of capturing the spatio-temporal features of obese adolescent gait. These were assessed in 10 obese and 8 non-obese adolescents using both a single inertial sensor on the lower trunk and an optoelectronic system. The parameters obtained were not statistically different in either normal-weight or obese participants between the two methods. Obese adolescents walked with longer stance and double support phase compared to normal-weight participants. The results showed that the inertial system is a valid means of evaluating spatio-temporal parameters in obese individuals.

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