Gait Parameters in Healthy Preschool and School Children Assessed Using Wireless Inertial Sensor

Background: The objective gait assessment in children has become more popular. Basis parameters for comparison during the examination are advisable. Objectives: The study aim was to investigate the typical gait parameters of healthy preschool and school children, using a wireless inertial sensor as the reference for atypical gait. The additional aim was to compare the specific gait parameters in the younger and older group of children. Methods: One hundred and sixty-one children’s gait parameters were evaluated by a G-Walk BTS G-SENSOR smart analyzer. The children were walking barefoot, at a self-selected speed, on a five-meter walkway, and they turned around and go back twice. Results: Age significantly influences most of the spatiotemporal parameters. The support phase becomes shorter with age. Accordingly, the swing phase becomes longer with age. The results also show that older children need shorter double support and have longer single support. Moreover, the pelvic tilt symmetry index is higher with increasing age. In each age division, the smallest variation in all gait parameters within the oldest group of examined children was observed. A comparison between the left and right side gait parameters shows the higher difference in boys than in girls. A significant difference was calculated in the pelvic obliquity symmetry index. Girls had significantly more symmetrical obliquity than boys. Conclusions: the research indicates the basic parameters of typical children’s gait, which may be a reference to atypical gait in the case of trauma or disability.

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Effects of Robot-Assisted Therapy on Gait Parameters in Pediatric Patients With Spastic Cerebral Palsy

Frontiers in Neurology ◽

10.3389/fneur.2021.724009 ◽

2021 ◽

Vol 12 ◽

Author(s):

Faustyna Manikowska ◽

Sabina Brazevic ◽

Anna Krzyżańska ◽

Marek Jóźwiak

Keyword(s):

Cerebral Palsy ◽

Gait Training ◽

Spastic Cerebral Palsy ◽

Gait Symmetry ◽

Double Support ◽

Patient Profile ◽

Gait Parameters ◽

Gait Deviation Index ◽

Spatiotemporal Parameters

Background: Gait dysfunction is a crucial factor that restricts independence and quality of life in children with cerebral palsy (CP). Gait training based on robotic-assisted therapy (RAT) is widely used, but information about effectiveness and ideal patient profile is not sufficient. Aim of this study was to assess the effect of RAT on gait parameters in spastic children with CP, and to determine whether changes in gait parameters are different among patients on different ambulatory levels.Method: A total of 26 children with bilateral spastic CP were divided into two groups based on their functional ability: non-assisted ambulator (NAS) or assisted ambulator (AS); and underwent a RAT program (30 training sessions of RAT during 10 weeks). Gait analysis was performed: before the therapy (t1), right after (t2), and 6 weeks later (t3).Results: No significant changes in spatiotemporal parameters or gait deviation index at t2 or t3. Double support symmetry significantly improved (t1 vs. t3, p = 0.03) for the whole group (NAS + AS). Walking speed symmetry significantly improved (t2 vs. t3, p = 0.02) for group AS.Conclusion: RAT based on our protocol did not change spatiotemporal parameters and kinematics of walking except limited improvement in some aspects of gait symmetry. We did not find differences in changes in selected objective gait parameters among children with CP in different ambulatory levels.

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Self-Perception of Malocclusion Among Nigerian Adolescents Using The Aesthetic Component of The IOTN

The Open Dentistry Journal ◽

10.2174/1874210601206010061 ◽

2012 ◽

Vol 6 (1) ◽

pp. 61-66 ◽

Cited By ~ 16

Author(s):

E.A Aikins ◽

O.O daCosta ◽

C.O Onyeaso ◽

M.C Isiekwe

Keyword(s):

School Children ◽

Orthodontic Treatment ◽

Base Line ◽

Older Children ◽

Self Perception ◽

Treatment Need ◽

Significant Difference ◽

Professional Assessment ◽

And Gender ◽

The Aesthetic

Introduction:The practice of orthodontics is very young in South-South Nigeria and there is need for base line data for informed planning. This study was carried out to investigate the self-perception of malocclusion among Nigerian school children aged 12 to 18 years in order to compare their perception with that of an orthodontist and also to determine the influence of gender and age on self-perception.Materials and Methodology:A total of 612 randomly selected schoolchildren comprising 299 (48.9%) males and 313 (51.1%) females with a mean age of 15 + 2.0 years were included in the study, the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) was the instrument used to measure the perception of malocclusion by both the school children and the orthodontist.Results:Majority of the students (82.5%) rated their teeth towards the more attractive end of the scale (Grades 1-4). Although self - perception was not found to be related to gender, older children (16-18 years) had an increased level of perception of need. Males and older children were found to be more in need of treatment by the orthodontist.Conclusions:A significant difference was found between the orthodontist’s rating and the students’ ratings of the attractiveness of their occlusions. Age and gender were not found to influence self- perceived orthodontic treatment need. Therefore, for effective orthodontic care, self- perception and not only professional assessment must be taken into consideration when formulating treatment plans to ensure patient satisfaction.

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Changes in Gait Parameters and Gait Variability in Young Adults during a Cognitive Task While Slope and Flat Walking

Healthcare ◽

10.3390/healthcare8010030 ◽

2020 ◽

Vol 8 (1) ◽

pp. 30

Author(s):

Ga Young Park ◽

Sang Seok Yeo ◽

Young Chan Kwon ◽

Hyeong Seok Song ◽

Yu Jin Lim ◽

...

Keyword(s):

Young Adults ◽

Fall Risk ◽

Flat Surface ◽

Cognitive Task ◽

Gait Variability ◽

Measurement Unit ◽

Gait Parameters ◽

Significant Difference ◽

Spatiotemporal Parameters ◽

Young Subjects

This study investigates the effects of a cognitive task while walking on a slope or a flat surface on gait parameters and gait variability in young adults. The participants consisted of thirty healthy young subjects. They were instructed to walk on a slope or on a flat surface while performing or not performing a cognitive task, which involved speaking a four-syllable word in reverse. A wearable inertia measurement unit (IMU) system was used to measure spatiotemporal parameters and gait variability. Flat gait (FG) while performing the cognitive task (FGC) and uphill gait (UG) while performing the cognitive task (UGC) significantly altered stride times, gait speeds, and cadence as compared with FG and UG, respectively. Downhill gait (DG) while performing the cognitive task (DGC) caused no significant difference as compared with DG. Gait variability comparisons showed no significant difference between UGC and UG or between FGC and FG, respectively. On the other hand, variabilities of stride times and gait speeds were significantly greater for DGC than DG. FGC and UGC induce natural changes in spatiotemporal gait parameters that enable the cognitive task to be performed safely. DGC should be regarded as high complexity tasks involving greater gait variability to reduce fall risk.

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The Effect of Physical Activity on Residual Limb Volume, Comfort, and Gait Symmetry of Transfemoral Amputees

Journal of Engineering and Science in Medical Diagnostics and Therapy ◽

10.1115/1.4049524 ◽

2021 ◽

Vol 4 (2) ◽

Author(s):

Sara Salazar-Salgado ◽

Fanny Valencia ◽

Alejandro Uribe ◽

Elizabeth Rendón-Vélez

Keyword(s):

Physical Activity ◽

Treadmill Walking ◽

Residual Limb ◽

Gait Symmetry ◽

Symmetry Index ◽

Ankle Kinematics ◽

Gait Parameters ◽

Significant Difference ◽

Transfemoral Amputees ◽

Almost All

Abstract For lower limb amputees, the socket fit is affected by the physical activity performed during the day. The majority of the studies in this field include only transtibial amputees and do not examine the effects of this variable. This paper aims to determine the effect of physical activity on the volume of the residual limb (RL), the comfort, and the symmetry of gait in traumatic transfemoral amputees. RL volume and gait data of five individuals were obtained at the first time of the day and after three sessions of treadmill walking. The ratio symmetry index of selected points of gait parameters was calculated. A short comfort test was used after each session. Data were analyzed throughout the tests within each subject, and statistical analysis was performed. After the physical activity, a tendency toward volume decrease was found on almost all subjects, although it was not significant. Transfemoral amputees may have smaller volume variations than transtibial after treadmill walking tasks. Significant difference was found on the symmetry index of “swing phase (SWP).” The values of gait symmetry were consistent with previous findings regarding transfemoral amputees. The lowest symmetry was noticed on the ankle kinematics. The comfort did not significantly change with the selected amount of physical activity. In subsequent research, it is recommended to increase the intensity or time of physical activity and/or increase the number of participants. These results can help the understanding of how the socket/RL interface behaves, which can improve the design and prescription of prosthetic components.

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Variance of the Gait Parameters and Fraction of Double-Support Interval for Determining the Severity of Parkinson’s Disease

Applied Sciences ◽

10.3390/app10020577 ◽

2020 ◽

Vol 10 (2) ◽

pp. 577

Author(s):

Sana M. Keloth ◽

Sridhar P. Arjunan ◽

Dinesh K. Kumar

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Statistical Significance ◽

Mean Values ◽

Support Interval ◽

Double Support ◽

Gait Parameters ◽

Significant Difference ◽

The Mean ◽

The Difference

The aim of this study was to determine the gait features that are most suitable for the quantified assessment of the severity of Parkinson’s disease (PD). This study computed the mean and variance of the four phases of gait intervals, i.e., stride, swing, stance and double-support intervals, and lateral difference to determine the difference between three groups, i.e., control subjects and PD patients with two severity levels (early and advanced stage) of the disease, PD1 and PD2. Data from 31 subjects were used in the study. The data were obtained from the public database (16 control healthy subjects, 6 Parkinson’s disease patients with early stages, and 9 Parkinson’s disease patients with advanced stages based on the Hoehn and Yahr scale). The main outcome measure of the study was the group difference of the four gait interval parameters and the statistical significance of this difference. The results show that there was a significant increase in the variance of the four gait intervals with the severity of the disease. However, there was no significant difference in the mean values between the three groups. It was also observed that the fraction corresponding to the double-support interval was significantly higher for PD patients. This study has shown that the variance of the gait parameters and the fraction of double-support interval are associated with the severity of PD and may be suitable measures for a quantified evaluation of the disease.

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What Gait Features Influence the Amount and Intensity of Physical Activity in People with Multiple Sclerosis?

10.21203/rs.2.22011/v1 ◽

2020 ◽

Author(s):

Massimiliano Pau ◽

Micaela Porta ◽

Giuseppina Pilloni ◽

Giancarlo Coghe ◽

Eleonora Cocco

Keyword(s):

Physical Activity ◽

Multiple Sclerosis ◽

Gait Speed ◽

Stride Length ◽

Inertial Sensor ◽

Rank Correlation ◽

Double Support ◽

Temporal Parameters ◽

Gait Parameters ◽

Spatio Temporal

Abstract Background: Although the mutual relationship between ambulation and Physical Activity (PA) in people with Multiple Sclerosis (pwMS) has been described in several studies, there is still a lack of detailed information about the way in which specific aspects of the gait cycle are associated with amount and intensity of PA. This study aimed to verify the existence of possible relationships among PA parameters and the spatio-temporal parameters of gait when both are instrumentally assessed.Methods: Thirty-one pwMS (17F, 14M, mean age 52.5, mean Expanded Disability Status Scale score 3.1) were requested to wear a tri-axial accelerometer 24h/day for 7 consecutive days and underwent an instrumental gait analysis, performed using an inertial sensor located on the low back, immediately before the PA assessment period. Main spatio-temporal parameters of gait (i.e. gait speed, stride length, cadence and duration of stance, swing and double support phase) were extracted by processing trunk accelerations. PA was quantified using average number of daily steps and percentage of time spent at different PA intensity, the latter calculated using cut-point sets previously validated for MS. The existence of possible relationships between PA and gait parameters was assessed using Spearman’s rank correlation coefficient rho.Results: Gait speed and stride length were the parameters with the highest number of significant correlations with PA features. In particular, they were found moderately to largely correlated with number of daily steps (rho 0.62, p<0.001), percentage of sedentary activity (rho = -0.44, p<0.001) and percentage of moderate-to-vigorous activity (rho = 0.48, p<0.001). Small to moderate significant correlations were observed between PA intensity and duration of stance, swing and double support phases.Conclusions: The data obtained suggest that the most relevant determinants associated with higher and more intense levels of physical activity in free-living conditions are gait speed and stride length.The simultaneous quantitative assessment of gait parameters and PA levels might represent a useful support for physical therapists in tailoring optimized rehabilitative and training interventions.

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Quantifying Gait Impairment Using an Instrumented Treadmill in People with Multiple Sclerosis

ISRN Neurology ◽

10.1155/2013/867575 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 26

Author(s):

Alon Kalron ◽

Zeevi Dvir ◽

Lior Frid ◽

Anat Achiron

Keyword(s):

Multiple Sclerosis ◽

Attractive Alternative ◽

Functional Impairments ◽

Double Support ◽

Gait Parameters ◽

Spatiotemporal Parameters ◽

Edss Score ◽

Base Of Support ◽

Single Support Phase ◽

Support Phase

Background and Objective. Treadmill gait analysis has been proposed as an attractive alternative for overground walking measuring systems. The purpose of this study was twofold: first to determine spatiotemporal parameters of treadmill gait in patients with multiple sclerosis (MS) and second to examine whether these parameters are associated with specific functional impairments in this cohort. Method. Eighty-seven relapsing-remitting patients diagnosed with MS, 50 women and 37 men, aged 40.9 ± 11.9 with an expanded disability status scale (EDSS) score of 2.7 ± 1.6, participated in this study. Twenty-five apparently healthy subjects, 14 women and 11 men, aged 38.5 ± 9.4, served as controls. Spatiotemporal gait parameters were obtained using the Zebris FDM-T Treadmill (Zebris Medical GmbH, Germany). People with MS demonstrated significantly shorter steps, extended stride time, wider base of support, longer step time, reduced single support phase, and a prolonged double support phase compared to the healthy controls. The EDSS score was significantly correlated with all spatiotemporal gait parameters. Conclusion. The instrumented treadmill may be an effective tool in assessing ambulation capabilities of people with MS.

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Agreement between the GAITRite® System and the Wearable Sensor BTS G-Walk® for measurement of gait parameters in healthy adults and Parkinson’s disease patients

PeerJ ◽

10.7717/peerj.8835 ◽

2020 ◽

Vol 8 ◽

pp. e8835 ◽

Cited By ~ 6

Author(s):

Slávka Vítečková ◽

Hana Horáková ◽

Kamila Poláková ◽

Radim Krupička ◽

Evžen Růžička ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Systematic Error ◽

Stride Length ◽

Walking Speed ◽

Inertial Sensor ◽

Pressure Sensors ◽

Double Support ◽

Gait Parameters ◽

Stride Duration

Background Nowadays, the most widely used types of wearable sensors in gait analysis are inertial sensors. The aim of the study was to assess the agreement between two different systems for measuring gait parameters (inertial sensor vs. electronic walkway) on healthy control subjects (HC) and patients with Parkinson’s disease (PD). Methods Forty healthy volunteers (26 men, 14 women, mean age 58.7 ± 7.7 years) participated in the study and 24 PD patients (19 men, five women, mean age 62.7 ± 9.8 years). Each participant walked across an electronic walkway, GAITRite, with embedded pressure sensors at their preferred walking speed. Concurrently a G-Walk sensor was attached with a semi-elastic belt to the L5 spinal segment of the subject. Walking speed, cadence, stride duration, stride length, stance, swing, single support and double support phase values were compared between both systems. Results The Passing-Bablock regression slope line manifested the values closest to 1.00 for cadence and stride duration (0.99 ≤ 1.00) in both groups. The slope of other parameters varied between 0.26 (double support duration in PD) and 1.74 (duration of single support for HC). The mean square error confirmed the best fit of the regression line for speed, stride duration and stride length. The y-intercepts showed higher systematic error in PD than HC for speed, stance, swing, and single support phases. Conclusions The final results of this study indicate that the G-Walk system can be used for evaluating the gait characteristics of the healthy subjects as well as the PD patients. However, the duration of the gait cycle phases should be used with caution due to the presence of a systematic error.

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

Gerontology ◽

10.1159/000515939 ◽

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

Background: 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. Methods: Of 121 older adults (age = 78.9 ± 8.2 years, body mass index = 26.6 ± 5.5 kg/m2) 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. Results: 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 d = 0.42–0.97, p < 0.050). The largest effect size was observed in normalized dual-task gait speed (d = 0.97, p < 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. Conclusions: 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.

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Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

European Journal of Pediatrics ◽

10.1007/s00431-021-04169-x ◽

2021 ◽

Author(s):

Giorgio Cozzi ◽

Marta Cognigni ◽

Riccardo Busatto ◽

Veronica Grigoletto ◽

Manuela Giangreco ◽

...

Keyword(s):

Emergency Department ◽

Pain Relief ◽

Local Anaesthesia ◽

Cross Sectional Study ◽

Emergency Setting ◽

Older Children ◽

Cross Sectional ◽

Paediatric Emergency Department ◽

Paediatric Emergency ◽

Significant Difference

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

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