Evaluation of Gait Pattern and Lower Extremity Kinematics of Children with Morquio Syndrome (MPS IV)

Morquio syndrome (mucopolysaccharidosis IV/MPS IV) is a genetic disorder leading to skeletal abnormalities and gait deviations. Research on the gait patterns and lower extremity physical characteristics associated with skeletal dysplasia in children with MPS IV is currently limited. This research aimed to provide baseline gait patterns and lower limb skeletal alignment of children with MPS IV utilizing three-dimensional instrumented gait analysis. This Institutional Review Board-approved retrospective study evaluates the kinematics of the lower extremities of children with MPS IV during gait, comparing them with an age-matched group of typically developing children. Thirty-three children with MPS IV were included (8.6 ± 4.0 years old). Children with MPS IV walk with increased anterior pelvic tilt, knee valgus, knee flexion, external tibial torsion, and reduced walking speed and stride length (p < 0.001). Multiplanar abnormal alignment results in abnormal knee moments (p < 0.001). Limited correlations exist (r = 0.69–0.28) between dynamic three-dimensional measurements of knee varus/valgus and rotational alignment and traditional static two-dimensional measures (physical examination or radiographs) suggesting the possibility of knee instability during gait and the benefits of dynamic assessment.

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The Effects of Application Site and Time of Vibration Stimulation: Changes in Gait Pattern and Muscle Activity

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.479-480.475 ◽

2013 ◽

Vol 479-480 ◽

pp. 475-479 ◽

Cited By ~ 1

Author(s):

Ha Ju So ◽

Seong Hyun Kim ◽

Dong Wook Kim

Keyword(s):

Young Adults ◽

Lower Extremity ◽

Muscle Activity ◽

Gait Cycle ◽

Mechanical Vibration ◽

Gait Pattern ◽

Application Site ◽

Threshold Intensity ◽

Somatosensory Stimulation ◽

Soles Of The Feet

This study was conducted to investigate changes in gait pattern that appear after somatosensory stimulation evoked by applying mechanical vibration to the ankle. The gait pattern was observed in a real time using a footswitch mounted on the soles of the feet in order to increase the effectiveness of vibration stimulation. Based on the observed gait pattern, the application site and time of vibration stimulation were determined. The changes in the gait pattern that appear after the application of vibration stimulation were analyzed by comparing the percentage of the gait cycle and the activation of the lower extremity muscles. This study was conducted on young adults, and the result showed that the gait cycle was changed according to the application site of vibrating stimulation, and that the vibration stimulation with intensity less than the threshold, induced a similar effect as shown in vibration stimulation with threshold intensity. The result of this study shows that vibration stimulation could be effectively utilized for gait correction and rehabilitation. It can be also used as basic data for inferring the correlation of the characteristics of vibration stimulation with gait variability.

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Effects of Medial Thrust Gait on Lower Extremity Kinetics in Patients with Knee Osteoarthritis

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0014.8141 ◽

2021 ◽

Vol 23 (2) ◽

pp. 115-120

Author(s):

Hamid Reza Bokaeian ◽

Fateme Esfandiarpour ◽

Shahla Zahednejad ◽

Hossein Kouhzad Mohammadi ◽

Farzam Farahmand

Keyword(s):

Lower Extremity ◽

Knee Osteoarthritis ◽

Center Of Pressure ◽

Reaction Force ◽

Gait Pattern ◽

Mean Difference ◽

Knee Adduction Moment ◽

Camera Motion ◽

Normal Gait ◽

Significant Difference

Background. Medial thrust (MT) gait is a nonsurgical approach for reducing the knee adduction moment (KAM) in patients with knee osteoarthritis. However, its usefulness is indeterminate due to scarcity of research about changes in lower extremity kinetics and the ground reaction force (GRF) which have been investigated in this study. Materials and methods. Twenty patients (6 males, 14 females, age: 56.2±6.2 years) with medial knee osteoarthritis participated in this cross-sectional study. A 12-camera motion analysis system and two force plates recorded kinematic and GRF data while participants walked barefoot along a 12m path with 1) their regular gait pattern and 2) MT gait pattern. The first peak adduction and flexion moments of the hip, knee, and ankle, and the sagittal and frontal GRF were measured. The center of pressure (CoP) location in the mediolateral direction at first KAM peak was also determined. Results. MT gait significantly reduced the first KAM peak (mean difference= 169.7, p<0.001) and the hip flexion moment (mean difference: 82.6, p= 0.020) compared to normal gait. The mediolateral CoP significantly shifted laterally during MT gait compared to normal gait (mean difference: -12% foot width, p<0.001). There was no significant difference in other kinetics variables between the two gait patterns (p>0.05). Conclusions. 1. Our findings show that MT gait can reduce the KAM with no significant increase in the GRF and other lower extremity moments. 2. The results suggest that the reduced KAM associated with MT gait is caused by a lateral shift of the CoP, resulting in a reduced GRF moment arm.

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Strength Training Affects Lower Extremity Gait Kinematics, Not Kinetics, in People With Diabetic Polyneuropathy

Journal of Applied Biomechanics ◽

10.1123/jab.2013-0186 ◽

2014 ◽

Vol 30 (2) ◽

pp. 221-230 ◽

Cited By ~ 7

Author(s):

Tom Melai ◽

Nicolaas C. Schaper ◽

T. Herman IJzerman ◽

Paul J.B. Willems ◽

Ton L.H. de Lange ◽

...

Keyword(s):

Lower Extremity ◽

Strength Training ◽

Intervention Group ◽

Diabetic Polyneuropathy ◽

Gait Pattern ◽

Gait Velocity ◽

Control Group ◽

Joint Moments ◽

Phase Duration ◽

Gait Characteristics

Increased forefoot loading in diabetic polyneuropathy plays an important role in the development of plantar foot ulcers and can originate from alterations in muscle strength, joint moments and gait pattern. The current study evaluated whether strength training can improve lower extremity joint moments and spatiotemporal gait characteristics in patients with diabetic polyneuropathy. An intervention group receiving strength training during 24 weeks and a control group receiving no intervention. Measurements were performed in both groups at t = 0, t = 12, t = 24 and t = 52 weeks at an individually preferred and standardized imposed gait velocity. The strength training did not affect the maximal amplitude of hip, knee and ankle joint moments, but did result in an increase in stance phase duration, stride time and stride length of approximately 5%, during the imposed gait velocity. In addition, both groups increased their preferred gait velocity over one year. Future longitudinal studies should further explore the possible effects of strength training on spatiotemporal gait characteristics. The current study provides valuable information on changes in gait velocities and the progressive lower extremity problems in patients with polyneuropathy.

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The Lower Extremity in Morquio Syndrome

Journal of Pediatric Orthopaedics ◽

10.1097/bpo.0b013e318259fe57 ◽

2012 ◽

Vol 32 (5) ◽

pp. 534-540 ◽

Cited By ~ 25

Author(s):

Arjun A. Dhawale ◽

Mihir M. Thacker ◽

Mohan V. Belthur ◽

Kenneth Rogers ◽

Michael B. Bober ◽

...

Keyword(s):

Lower Extremity ◽

Morquio Syndrome

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Rehabilitation management of the lower extremity in HIV disease

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-85-7-394 ◽

1995 ◽

Vol 85 (7) ◽

pp. 394-402 ◽

Cited By ~ 2

Author(s):

MA McReynolds

Keyword(s):

Lower Extremity ◽

Treatment Strategies ◽

Gait Pattern ◽

Hiv Disease ◽

Peripheral Neuropathies ◽

Skin Ulcers ◽

Immunodeficiency Virus ◽

And Function

The sequelae of human immunodeficiency virus (HIV) disease include a host of devastating conditions involving the lower extremity. These include rheumatologic dysfunction, Kaposi's sarcoma, peripheral neuropathies, and skin ulcers. Pain, weakness, and loss of range of motion caused by these conditions can lead to changes in gait pattern, loss of mobility and function, and limited quality of life. The role of the rehabilitation specialist in the care and treatment of HIV disease as it affects the lower extremity, and the treatment strategies, precautions, and suggestions will be discussed.

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Walking in Simulated Martian Gravity: Influence of the Portable Life Support System’s Design on Dynamic Stability

Journal of Biomechanical Engineering ◽

10.1115/1.3148465 ◽

2009 ◽

Vol 131 (9) ◽

Cited By ~ 6

Author(s):

Melissa M. Scott-Pandorf ◽

Daniel P. O’Connor ◽

Charles S. Layne ◽

Krešimir Josić ◽

Max J. Kurz

Keyword(s):

Lower Extremity ◽

Dynamic Stability ◽

Life Support ◽

Sagittal Plane ◽

Dynamic Balance ◽

Gait Pattern ◽

Space Suit ◽

Risk Of Injury ◽

Scientists And Engineers ◽

Human Exploration

With human exploration of the moon and Mars on the horizon, research considerations for space suit redesign have surfaced. The portable life support system (PLSS) used in conjunction with the space suit during the Apollo missions may have influenced the dynamic balance of the gait pattern. This investigation explored potential issues with the PLSS design that may arise during the Mars exploration. A better understanding of how the location of the PLSS load influences the dynamic stability of the gait pattern may provide insight, such that space missions may have more productive missions with a smaller risk of injury and damaging equipment while falling. We explored the influence the PLSS load position had on the dynamic stability of the walking pattern. While walking, participants wore a device built to simulate possible PLSS load configurations. Floquet and Lyapunov analysis techniques were used to quantify the dynamic stability of the gait pattern. The dynamic stability of the gait pattern was influenced by the position of load. PLSS loads that are placed high and forward on the torso resulted in less dynamically stable walking patterns than loads placed evenly and low on the torso. Furthermore, the kinematic results demonstrated that all joints of the lower extremity may be important for adjusting to different load placements and maintaining dynamic stability. Space scientists and engineers may want to consider PLSS designs that distribute loads evenly and low, and space suit designs that will not limit the sagittal plane range of motion at the lower extremity joints.

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Gait pattern generation algorithm for lower-extremity rehabilitation–exoskeleton robot considering wearer’s condition

Intelligent Service Robotics ◽

10.1007/s11370-020-00346-3 ◽

2021 ◽

Author(s):

Seung Hoon Hwang ◽

Dong Ik Sun ◽

Jeakweon Han ◽

Wan-Soo Kim

Keyword(s):

Lower Extremity ◽

Gait Pattern ◽

Pattern Generation ◽

Generation Algorithm ◽

Exoskeleton Robot

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Walking with and without a robotic exoskeleton in people with incomplete spinal cord injury compared to a typical gait pattern

Neurorehabilitation ◽

10.3233/nre-210187 ◽

2021 ◽

pp. 1-12

Author(s):

Sattam M. Almutairi ◽

Chad Swank ◽

Sharon S. Wang-Price ◽

Fan Gao ◽

Ann Medley

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Lower Extremity ◽

Rectus Femoris ◽

Gait Pattern ◽

Healthy Adults ◽

Incomplete Spinal Cord Injury ◽

Lower Extremity Weakness ◽

Robotic Exoskeleton ◽

Cord Injury

BACKGROUND: Robotic exoskeleton (RE) enables individuals with lower extremity weakness or paralysis to stand and walk in a stereotypical pattern. OBJECTIVE: Examine whether people with chronic incomplete spinal cord injury (SCI) demonstrate a more typical gait pattern when walking overground in a RE than when walking without. METHODS: Motion analysis system synchronized with a surface electromyographic (EMG) was used to obtain temporospatial gait parameters, lower extremity kinematics, and muscle activity in ambulatory individuals with SCI and healthy adults. RESULTS: Temporospatial parameters and kinematics for participants with SCI (n = 12; age 41.4±12.5 years) with and without RE were significantly different than a typical gait (healthy adults: n = 15; age 26.2±8.3 years). EMG amplitudes during the stance phase of a typical gait were similar to those with SCI with and without RE, except the right rectus femoris (p = 0.005) and left gluteus medius (p = 0.014) when participants with SCI walked with RE. EMG amplitudes of participants with SCI during the swing phase were significantly greater compared to those of a typical gait, except for left medial hamstring with (p = 0.025) and without (p = 0.196) RE. CONCLUSIONS: First-time walking in a RE does not appear to produce a typical gait pattern in people with incomplete SCI.

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