A Proof-of-Concept Study for Measuring Gait Speed, Steadiness, and Dynamic Balance Under Various Footwear Conditions Outside of the Gait Laboratory

2010 ◽  
Vol 100 (4) ◽  
pp. 242-250 ◽  
Author(s):  
James S. Wrobel ◽  
Sarah Edgar ◽  
Dana Cozzetto ◽  
James Maskill ◽  
Paul Peterson ◽  
...  
Keyword(s):  
Gait Speed ◽  
Walking Speed ◽  
Dynamic Balance ◽  
Objective Assessment ◽  
Center Of Mass ◽  
Mass Motion ◽  
Foot Orthoses ◽  
Gait Adaptation ◽  
Spatiotemporal Parameters ◽  
The Impact

Background: This pilot study examined the effect of custom and prefabricated foot orthoses on self-selected walking speed, walking speed variability, and dynamic balance in the mediolateral direction. Methods: The gait of four healthy participants was analyzed with a body-worn sensor system across a distance of at least 30 m outside of the gait laboratory. Participants walked at their habitual speed in four conditions: barefoot, regular shoes, prefabricated foot orthoses, and custom foot orthoses. Results: In the custom foot orthoses condition, gait speed was improved on average 13.5% over the barefoot condition and 9.8% over the regular shoe condition. The mediolateral range of motion of center of mass was reduced 55% and 56% compared with the shoes alone and prefabricated foot orthoses conditions, respectively. This may suggest better gait efficiency and lower energy cost with custom foot orthoses. This tendency remained after normalizing center of mass by gait speed, suggesting that irrespective of gait speed, custom foot orthoses improve center of mass motion in the mediolateral direction compared with other footwear conditions. Gait intercycle variability, measured by intercycle coefficient of variation of gait speed, was decreased on average by 25% and 19% compared with the barefoot and shoes-alone conditions, respectively. The decrease in gait unsteadiness after wearing custom foot orthoses may suggest improved proprioception from the increased contact area of custom foot orthoses versus the barefoot condition. Conclusions: These findings may open new avenues for objective assessment of the impact of prescribed footwear on dynamic balance and spatiotemporal parameters of gait and assess gait adaptation after use of custom foot orthoses. (J Am Podiatr Med Assoc 100(4): 242–250, 2010)

The Gait of Children With and Without Cerebral Palsy: Work, Energy, and Angular Momentum

2011 ◽  
Vol 27 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Shawn Russell ◽  
Bradford Bennett ◽  
Pradip Sheth ◽  
Mark Abel
Keyword(s):  
Cerebral Palsy ◽  
Angular Momentum ◽  
Walking Speed ◽  
Center Of Mass ◽  
Whole Body ◽  
Mass Motion ◽  
Bipedal Locomotion ◽  
Kinematic Data ◽  
Internal Work ◽  
Body Energy

This paper describes a method to characterize gait pathologies like cerebral palsy using work, energy, and angular momentum. For a group of 24 children, 16 with spastic diplegic cerebral palsy and 8 typically developed, kinematic data were collected at the subjects self selected comfortable walking speed. From the kinematics, the work—internal, external, and whole body; energy—rotational and relative linear; and the angular momentum were calculated. Our findings suggest that internal work represents 53% and 40% respectively of the whole body work in gait for typically developed children and children with cerebral palsy. Analysis of the angular momentum of the whole body, and other subgroupings of body segments, revealed a relationship between increased angular momentum and increased internal work. This relationship allows one to use angular momentum to assist in determining the kinetics and kinematics of gait which contribute to increased internal work. Thus offering insight to interventions which can be applied to increase the efficiency of bipedal locomotion, by reducing internal work which has no direct contribution to center of mass motion, in both normal and pathologic populations.

scholarly journals DUAL-TASK BALANCE CONTROL IN ADOLESCENT ATHLETES FOLLOWING CONCUSSION

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0015
Author(s):  
Tracy Zaslow ◽  
Camille Burton ◽  
Nicole M. Mueske ◽  
Adriana Conrad-Forrest ◽  
Bianca Edison ◽  
...  
Keyword(s):  
Dual Task ◽  
Verbal Fluency ◽  
Walking Speed ◽  
Balance Control ◽  
Dynamic Balance ◽  
Center Of Mass ◽  
Quiet Standing ◽  
Return To Play ◽  
Treatment Protocols ◽  
Single Task

Background: Previous research has identified deficient dual-task balance control at the time of return to play (RTP) and possible worsening after RTP in older adolescents/young adults with concussion. These findings have not been investigated in younger patients with concussion. Hypothesis/Purpose: We hypothesized that concussed adolescents would have slower walking speed and increased medial-lateral (ML) center of mass (COM) movement, which would normalize by the time of RTP but worsen after resuming activity. Methods: 13 adolescent concussion patients (7 male; age 10-17 years) were prospectively evaluated at their initial visit (IV) (mean 18, range 4-43 days post-concussion), at RTP clearance (mean 46, range 12-173 days post-concussion), and one month later (mean 26, range 20-41 days post-RTP) along with 11 controls (3 male) seen for similarly timed visits. Standing balance was assessed using range and root mean squared (RMS) COM motion in the anterior-posterior (AP) and ML directions during standing on both legs with eyes open while performing quiet standing, dual-task audio Stroop, side-to-side head turns, and side-to-side thumb tracking tasks. Dynamic balance was assessed using walking speed and COM ML range and velocity during walking alone and with side-to-side head turns and verbal fluency (reciting words starting with “F”) dual tasks. Patients were compared against controls using t-tests, and changes over time were evaluated using linear mixed-effects regression. Results: During standing, patients had higher COM ML RMS than controls at IV during head turns and higher COM AP range during thumb tracking. COM ML motion decreased from IV to RTP (head turns range -6.5mm, p=0.058; head turns RMS -16.8mm, p=0.002; thumb range 9.2mm, p=0.012) and increased from RTP to 1 month follow-up (head turns RMS +10.0mm, p=0.040; Stroop RMS +8.4mm, p=0.086). Patients walked slower than controls at IV during all tasks, and COM ML range was higher in patients vs. controls during verbal fluency at IV and RTP. Walking speed increased from IV to RTP during verbal fluency (+7.8cm/s, p=0.044), from RTP to post-RTP in single task walking (+6.1cm/s, p=0.041), and at each successive visit during head turns (+6.0cm/s and +6.5cm/s, p<0.07). COM ML range also decreased in patients from IV to RTP with verbal fluency (-14.7mm, p=0.011) and from RTP to post-RTP in single task walking ( 4.0mm, p=0.061). Conclusion: Adolescent concussion patients had deficits in static and dynamic balance control at initial presentation. This tended to improve by RTP and only worsened post-RTP for dual-task ML control during standing, suggesting that current conservative treatment protocols are appropriate.

Effects of gait speed on the body’s center of mass motion relative to the center of pressure during over-ground walking

2017 ◽  
Vol 54 ◽  
pp. 354-362 ◽  
Author(s):  
Hsuan-Lun Lu ◽  
Mei-Ying Kuo ◽  
Chu-Fen Chang ◽  
Tung-Wu Lu ◽  
Shih-Wun Hong
Keyword(s):  
Gait Speed ◽  
Center Of Pressure ◽  
Center Of Mass ◽  
Mass Motion ◽  
Over Ground Walking

Strategies for maintaining dynamic balance in persons with neurological disorders during overground walking

2021 ◽  
pp. 095441192110236
Author(s):  
Tiziana Lencioni ◽  
Denise Anastasi ◽  
Ilaria Carpinella ◽  
Anna Castagna ◽  
Alessandro Crippa ◽  
...  
Keyword(s):  
Neurological Disorder ◽  
Center Of Pressure ◽  
Balance Control ◽  
Dynamic Balance ◽  
Objective Assessment ◽  
Center Of Mass ◽  
Frontal Plane ◽  
Rehabilitation Program ◽  
Lower Limbs ◽  
Lateral Direction

Maintaining a stable gait requires a dynamic balance control, that can be altered in persons with Multiple Sclerosis (MS), Stroke (ST), and Parkinson’s disease (PD). The understanding of the strategy for Center of Mass (CoM) positioning adopted by patients during walking is important to be able to program treatments aimed at improving gait control and preventing falls. Forty-four persons with a mild-to-moderate neurological disorder (20 with MS, 14 with ST, 10 with PD) underwent clinical examination and gait analysis. Ten Healthy Subjects (HS) walking at matched speed provided the normative data. Dynamic balance was assessed using the margin of stability (MoS). It was calculated as the distance between the extrapolated Center of Pressure and the extrapolated CoM at mid-stance. The MoS values for lower limbs were calculated in patients and compared with speed-matched values of HS. Persons with neurological disorder showed increased MoS in the medio-lateral direction with respect to HS. Within-group comparison analysis showed a symmetry between lower limbs in HS (Mean (95%CI) [mm], dominant vs non-dominant limb, 43.3 (31.9–54.6) vs 42.9 (28.8–56.9)) and PD (less affected vs more affected limb, 71.1 (59.8–82.5) vs 72.5 (58.5–86.6)), while a significant asymmetry was found in MS (54.4 (46.4–62.4) vs 81.1 (71.2–91.1)) and ST (52.1 (42.6–61.7) vs 74.7 (62.8–86.6)) participants. The history of falls was comparable among PD, MS, and ST groups, and the MoS in the frontal plane showed a strong correlation with these records. Objective assessment of MoS revealed pathology-specific strategies showing different impacts in MS, ST, and PD on the ability to control CoM information to manage the balance between limbs during gait. MoS evaluation will provide useful information to address a tailored rehabilitation program and to monitor disease progression.

scholarly journals ANALYSIS OF DYNAMIC BALANCE CONTROL IN TRANSTIBIAL AMPUTEES WITH USE OF A POWERED PROSTHETIC FOOT

2016 ◽  
Vol 28 (02) ◽  
pp. 1650011
Author(s):  
Shaun C. Resseguie ◽  
Li Jin ◽  
Michael E. Hahn
Keyword(s):  
Balance Control ◽  
Dynamic Balance ◽  
Center Of Mass ◽  
Whole Body ◽  
Mass Motion ◽  
Camera System ◽  
Prosthetic Foot ◽  
Motion Data ◽  
Walking Speeds ◽  
Transtibial Amputees

Powered prosthetic feet (PPF) are designed to provide transtibial amputees (TTA) with active propulsion and range of motion similar to that of the biological limb. Previous studies have demonstrated the PPF’s ability to increase TTA walking speeds while reducing the energetic costs, however, little is known about its effects on dynamic balance control. The purpose of this pilot study was to assess dynamic balance control in TTA subjects during level ground walking and obstacle-crossing tasks. Control subjects ([Formula: see text]) and TTA subjects ([Formula: see text]) were instructed to complete a series of functional walking tasks. The TTA subjects completed the walking protocol twice, first in their passive energy-storing prosthetic foot (ESPF) and again in the prescribed PPF after two weeks of acclimation. Motion data were collected via a 10-camera system with a 53-marker and 15-segment body model. Whole body medial-lateral center of mass motion (displacement and peak velocity) was analyzed and used as a functional indicator of dynamic balance control. Findings indicate no difference in the dynamic balance control of TTA wearing the PPF compared to the ESPF. However, there was an observed trend of walking speed and obstacle height affecting balance control within the groups.

scholarly journals A Pilot Study to Assess the Immediate Effect of Dynamic Carbon Ground Reaction Ankle Foot Orthoses on Balance in Individuals with Charcot-Marie-Tooth in a Clinical Setting

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Burke K ◽  
◽  
Cornell K ◽  
Swartz Ellrodt A ◽  
Grant N ◽  
...  
Keyword(s):  
Pilot Study ◽  
Clinical Setting ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Dynamic Balance ◽  
Clinical Test ◽  
Foot Orthoses ◽  
Charcot Marie Tooth ◽  
Ankle Foot Orthoses ◽  
The Impact

Charcot-Marie-Tooth (CMT) causes muscle weakness and atrophy generally in distal extremities, with or without sensory changes. These impairments contribute to impaired balance and gait and increase risk for falls and secondary injuries. Dynamic Carbon Ground Reaction Ankle Foot Orthoses (DCGR-AFOs) are one type of lower extremity orthosis that can be prescribed to help improve gait and balance in this patient population. To our knowledge, no studies have evaluated the immediate impact of DCGR-AFOs on gait and balance in this population. In this pilot study, 9 individuals with CMT and gait impairment were seen in clinical setting by a physical therapist and orthotist. Participants were asked to complete the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) and tasks on the 4-Item Dynamic Gait Index (DGI) with and without bilateral DCGR-AFOs to assess static and dynamic balance. The average DGI scores were 6/12 without the DCGR-AFOs and 10/12 with the DCGR-AFOs. Improvements on the mCTSIB varied. The findings in this study suggest an immediate improvement in dynamic balance during ambulation with the use of DCGR-AFOs, as assessed by the 4-Item DGI. Data on static balance did not reach significance suggesting the need for future studies to further assess the effects of DCGR-AFOs on static standing balance, as well as the impact of training with physical therapists. This pilot study demonstrates that it is possible to demonstrate potential benefits of DCGR-AFOs with a gross fitting in a clinical setting, prior to referral to an orthotist for custom fitting.

scholarly journals Does the Low-Carbon City Pilot Policy Promote Green Technology Innovation? Based on Green Patent Data of Chinese A-Share Listed Companies

2021 ◽  
Vol 18 (7) ◽  
pp. 3695
Author(s):  
Jintao Ma ◽  
Qiuguang Hu ◽  
Weiteng Shen ◽  
Xinyi Wei
Keyword(s):  
Technological Innovation ◽  
Technology Innovation ◽  
Objective Assessment ◽  
Green Technology ◽  
Low Carbon ◽  
Corporate Financing ◽  
Multiple Dimensions ◽  
Low Carbon City ◽  
The Impact ◽  
A Share

To cope with climate change and achieve sustainable development, low-carbon city pilot policies have been implemented. An objective assessment of the performance of these policies facilitates not only the implementation of relevant work in pilot areas, but also the further promotion of these policies. This study uses A-share listed enterprises from 2005 to 2019 and creates a multi-period difference-in-differences model to explore the impact of low-carbon city pilot policies on corporate green technology innovation from multiple dimensions. Results show that (1) low-carbon city pilot policies stimulates the green technological innovation of enterprises as manifested in their application of green invention patents; (2) the introduction of pilot policies is highly conducive to green technological innovation in eastern cities and enterprises in high-carbon emission industries; and (3) tax incentives and government subsidies are important fiscal and taxation tools that play the role of pilot policies in low-carbon cities. By alleviating corporate financing constraints, these policies effectively promote the green technological innovation of enterprises. This study expands the research on the performance of low-carbon city pilot policies and provides data support for a follow-up implementation and promotion of policies from the micro perspective at the enterprise level.

scholarly journals FRI0612-HPR EFFECT OF THERMOFORMABLE ORTHOSES ON FOOT FUNCTION IN RHEUMATOID ARTHRITIS PATIENTS: PRELIMINARY RESULTS FROM AN OPEN CLINICAL TRIAL.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 911.2-912
Author(s):  
I. Aachari ◽  
H. Rkain ◽  
F. Safaa ◽  
L. Benzakour ◽  
T. Latifa ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Small Sample ◽  
Activity Limitation ◽  
Foot Orthoses ◽  
Functional Impact ◽  
Pain Disability ◽  
Before And After ◽  
Foot Function ◽  
The Impact

Background:Orthoses and footwear can play an important role in managing foot pathology in patients whose systemic disease is controlled. Foot orthoses are frequently prescribed in clinical practice as an intervention for people with rheumatoid arthritis (RA).Objectives:The aim of our study is to evaluate the impact of thermoformable orthoses on the functional index of the foot (FFI) in patients with rheumatoid arthritis.Methods:We conducted an open clinical trial, having consecutively included 14 patients (85.7% female, average age 54.8 ± 10 years) suffering from rheumatoid arthritis (median progression time of 9 years [5 - 12]). The average DAS28 was 2.7 ± 1.2 and the functional impact objectified by the Health Assessment Questionnaire (HAQ) was on average 0.9 ± 0.7.The median deadline from the start of RA and the onset of the foot problem was 3 years [0 – 7,75]. The foot problem was bilateral in 100% of the cases and inaugural in 85.7% of the cases.We evaluated the functional impact of foot injury for all our patients at baseline and 8 weeks after the use of thermoformable orthoses, based on the FFI (Foot function Index) measuring the impact of foot pathology on function in terms of pain, disability and activity limitation.The comparison of the FFI domains before and after the use of orthoses was carried out using parametric or nonparametric paired tests using The SPSS statistical software.Results:With the use of foot orthoses, FFI values decreased in all subscales (p=0,024) (pain, disability and activity limitation). This reduction was significant for disability (0,011) but not for pain and activity limitation.There were no significant correlations between the global FFI and the progression of RA, the duration of foot damage and the functional impact measured by the HAQ.Table 1. The comparison of the FFI domains before and after the use of orthoses.psignificatif if< 0,05; Test used: Non-parametric test for two linked samples.Conclusion:Foot orthoses were effective as an adjuvant in the management of rheumatoid foot. They significantly reduced disability as measured by the FFI. The absence of factors associated with pain and limitation of activity could possibly be related to the small sample size.Disclosure of Interests:None declared

The effects of aquatic therapy on mobility of individuals with neurological diseases: a systematic review

2014 ◽  
Vol 29 (8) ◽  
pp. 741-751 ◽  
Author(s):  
Andresa R Marinho-Buzelli ◽  
Alison M Bonnyman ◽  
Mary C Verrier
Keyword(s):  
Randomized Controlled Trials ◽  
Gait Speed ◽  
Neurological Diseases ◽  
Dynamic Balance ◽  
Experimental Studies ◽  
Controlled Trials ◽  
Aquatic Therapy ◽  
Randomized Controlled ◽  
Randomized Studies ◽  
Before And After

Objective:To summarize evidence on the effects of aquatic therapy on mobility in individuals with neurological diseases.Data sources:MEDLINE, EMBASE, PsycInfo, CENTRAL, CINAHL, SPORTDiscus, PEDro, PsycBITE and OT Seeker were searched from inception to 15 September 2014. Hand-searching of reference lists was performed in the selected studies.Review methods:The search included randomized controlled trials and quasi-experimental studies that investigated the use of aquatic therapy and its effect on mobility of adults with neurological diseases. One reviewer screened titles and abstracts of retrieved studies from the search strategy. Two reviewers independently examined the full texts and conducted the study selection, data extraction and quality assessment. A narrative synthesis of data was applied to summarize information from included studies. The Downs and Black Scale was used to assess methodological quality.Results:A total of 116 articles were obtained for full text eligibility. Twenty studies met the specified inclusion criteria: four Randomized Controlled Trials (RCTs), four non-randomized studies and 12 before-and-after tests. Two RCTs (30 patients with stroke in the aquatic therapy groups), three non-randomized studies and three before-and-after studies showed “fair” evidence that aquatic therapy increases dynamic balance in participants with some neurological disorders. One RCT (seven patients with stroke in the aquatic therapy group) and two before-and-after tests (20 patients with multiple sclerosis) demonstrated “fair” evidence on improvement of gait speed after aquatic therapy.Conclusion:Our synthesis showed “fair” evidence supporting the use of aquatic therapy to improve dynamic balance and gait speed in adults with certain neurological conditions.

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