Evaluation of Gait Characteristics in Subjects With Locomotive Syndrome Using the Wearable Gait Sensors

Background: Locomotive syndrome (LS) is a condition where a person requires nursing care services due to problems with locomotive abilities and musculoskeletal systems. Individuals with LS have a reduced walking speed compared to those without LS. However, differences in lower-limb kinematics and during walking between individuals with and without LS are not fully understood. The purpose of this study is to clarify the characteristics of gait kinematics using wearable sensors for individuals with LS.Methods: We assessed 125 people aged 65 years and older who utilized a public health promotion facility. The participants were grouped into Non-LS, LS-stage 1, LS-stage 2 (large number indicate worse locomotive ability) based on 25-question Geriatric Locomotive Function Scale (GLFS-25). Spatiotemporal parameters and lower-limb kinematics during 10-m walking test were analyzed by 7-inertia-sensors based motion analysis system. Peak joint angles during stance and swing phase as well as gait speed, cadence and step length were compared among all groups.Results: The number of each LS stage was 69, 33, 23 for Non-LS, LS-stage 1, LS-stage 2, respectively. LS-stage2 group showed significantly smaller peak hip extension angle, hip flexion angle and knee flexion angle than Non-LS group (hip extension: Non-LS: 9.5 ± 5.3°, LS-stage 2: 4.2 ± 8.2°, P = 0.002; hip flexion: No-LS: 34.2 ± 8.8°, LS-stage 2: 28.5 ± 9.5°, P = 0.026; knee flexion: Non-LS: 65.2 ± 18.7°, LS-stage 2: 50.6 ± 18.5°, P = 0.005). LS-stage 1 and LS-stage 2 groups showed significantly slower gait speed than Non-LS group (Non-LS 1.3 ± 0.2 m/s, LS-stage1 1.2 ± 0.2 m/s, LS-stage2 1.1 ± 0.2 m/s, P < 0.001).Conclusions: LS-stage2 group showed significantly different lower-limb kinematics compared with Non-LS group including smaller hip extension, hip flexion and knee flexion. The intervention based on these kinematic characteristics measured by wearable sensors would be useful to improve the locomotive ability for individuals classified LS-stage2.

Reliability of hip joint position sense tests using a clinically applicable measurement tool in elderly participants with unilateral hip osteoarthritis

Hip joint proprioception is vital in maintaining posture and stability in elderly individuals. Examining hip joint position sense (JPS) using reliable tools is important in contemporary clinical practice. The objective of this study is to evaluate the intra-rater and inter-rater reliability of hip JPS tests using a clinically applicable measurement tool in elderly individuals with unilateral hip osteoarthritis (OA). Sixty-two individuals (mean age = 67.5 years) diagnosed with unilateral hip OA participated in this study. The JPS tests were evaluated using a digital inclinometer in hip flexion and abduction directions. The absolute difference between target and reproduced angle (repositioning error) in degrees was taken to measure JPS accuracy. The intraclass correlation coefficient (ICC (2.k), was used to assess the reliability. The Intra rater-reliability for hip JPS tests showed very good agreement in the lying position (hip flexion-ICC = 0.88–0.92; standard error of measurement (SEM) = 0.06–0.07, hip abduction-ICC = 0.89–0.91; SEM = 0.06–0.07) and good agreement in the standing position (hip flexion-ICC = 0.69–0.72; SEM = 0.07, hip abduction-ICC = 0.66–0.69; SEM = 0.06–0.08). Likewise, inter-rater reliability for hip JPS tests demonstrated very good agreement in the lying position (hip flexion-ICC = 0.87–0.89; SEM = 0.06–0.07, hip abduction-ICC = 0.87–0.91; SEM = 0.07) and good agreement in the standing position (hip flexion-ICC = 0.64–0.66; SEM = 0.08, hip abduction-ICC = 0.60–0.72; SEM = 0.06–0.09). The results support the use of hip JPS tests in clinical practice and should be incorporated in assessing and managing elderly participants with hip OA.

Impacts of external rotators and the ischiofemoral ligament on preventing excessive internal hip rotation: a cadaveric study

Background This study examined the biomechanics of preventing excessive internal hip joint rotation related to the hip flexion angle. Method An intramedullary nail with a circular plate equipped with a protractor was installed in the femur of nine normal hips. The circular plate was pulled by 3.15 Nm of force in the internal rotation direction. The external rotators were individually resected, finally cutting the ischiofemoral ligament. The cutting order of the external rotators differed on each side to individually determine the internal rotation resistance. The external rotators were resected from the piriformis to the obturator externus in the right hips and the reverse order in the left hips. Traction was performed after excising each muscle and ischiofemoral ligament. Measurements were taken at 0°, 30°, and 60° of hip flexion, and the differences from baseline were calculated. Results For the right hip measurements, the piriformis and ischiofemoral ligament resection significantly differed at 0° of flexion (p = 0.02), each external rotator and the ischiofemoral ligament resections significantly differed at 30° of flexion (p < 0.01), and the ischiofemoral ligament and piriformis and inferior gemellus resections significantly differed at 60° of flexion (p = 0.04 and p = 0.02, respectively). In the left hips, the ischiofemoral ligament and obturator externus, inferior gemellus, and obturator internus resections significantly differed at 0° of flexion (p < 0.01, p < 0.01, and p = 0.01, respectively), as did each external rotator and the ischiofemoral ligament resections at 30° of flexion (p < 0.01). Conclusion The ischiofemoral ligament primarily restricted the internal rotation of the hip joint. The piriformis and obturator internus may restrict internal rotation at 0° and 60° of flexion.

Comparison of Distance and Angular Analysis for Measurement of Hamstring Flexibility in Preschoolers

The study aimed to (1) investigate the reliability and usefulness of a proposed angular analysis during a modified sit-and-reach (MSR) test, and (2) compare the proposed MSR angular analysis and the commonly used MSR distance to verify the influence of the anthropometric characteristics in preschoolers. 194 preschoolers participated in the study. Before testing, the anthropometric characteristics were collected. Each participant performed the MSR test twice. The MSR distance score was obtained from the starting point to the reaching point, while the MSR angle score was calculated according to the approximate hip flexion angle. Both the relative and absolute reliability were good for the angular analysis during an MSR test in preschoolers (ICC ranging from 0.82 to 0.91, CV% ranging from 8.21 to 9.40). The angular analysis demonstrated good usefulness, with a lower typical error than the smallest worthwhile change in 3- and 5-year-old groups. The MSR angle scores could eliminate the concern of the influence of anthropometric characteristics, while MSR distance and anthropometric characteristics (i.e., sitting height and arm length) were found to be weakly correlated. In conclusion, the angular analysis when performing the MSR test is reliable and appears to eliminate the concern regarding the limb length bias.

The Biomechanical Consequences of Arthroscopic Hip Capsulotomy and Repair in Positions at Risk for Dislocation

Background: The effect of interportal (IP) capsulotomy, short T-capsulotomy, and long T-capsulotomy, and their repairs, on resistance to anterior and posterior “at risk for dislocation” positions has not been quantified. Hypotheses: Our primary hypothesis was that an IP capsulotomy would have a minimal effect on hip resistive torque compared with both short and long T-capsulotomies in the at-risk dislocation positions. Our secondary hypothesis was that capsule repair would significantly increase hip resistive torque for all capsulotomies. Study Design Controlled laboratory study. Methods: We mounted 10 cadaveric hips on a biaxial test frame in an anterior dislocation high-risk position (20° of hip extension and external rotation) and posterior dislocation high-risk position (90° of hip flexion and internal rotation). An axial force of 100 N was applied to the intact hip while the femur was internally or externally rotated at 15° per second to a torque of 5 N·m. The rotatory position at 5 N·m was recorded and set as a target for each subsequent condition. Hips were then sequentially tested with IP, short T-, and long T-capsulotomies and with corresponding repairs randomized within each condition. Peak resistive torques were compared using generalized estimating equation modeling and post hoc Bonferroni-adjusted tests. Results: For the anterior position, the IP and long T-capsulotomies demonstrated significantly lower resistive torques compared with intact. For the posterior position, both the short and long T-capsulotomies resulted in significantly lower resistive torques compared with intact. Repairs for all 3 capsulotomy types were not significantly different from the intact condition at anterior and posterior positions. Conclusion: An IP incision resulted in a decrease in capsular resistive torque in the anterior but not the posterior at-risk dislocation position, in which direction only T-capsulotomies led to a significant decrease. All capsulotomy repair conditions resulted in hip resistive torques that were similar to the intact hip in both dislocation positions. Clinical Relevance Our results suggest that it is biomechanically advantageous to repair IP, short T-, and long T-capsulotomies, particularly for at-risk anterior dislocation positions.

A Wearable Biofeedback Device to Increase Gait Swing Time Could Have Positive Effects on Gait among Older Adults

Older adults walk with a shorter stride length, reduced hip range of motion (ROM) and higher cadence. These are signs of reductions in walking ability. This study investigated whether using a wireless smart insole system that monitored and provided biofeedback to encourage an extension of swing time could increase stride length and hip flexion, while reducing the cadence. Seven older adults were tested in this study, with and without the biofeedback device, in an outdoor environment. Gait analysis was performed by using GaitRite system and Xsens MVN. Repeated measures analysis demonstrated that with biofeedback, the swing time increased by 6.45%, stride length by 4.52% and hip flexion by 14.73%, with statistical significance. It also decreased the cadence significantly by 5.5%. This study has demonstrated that this smart insole system modified positively the studied gait parameters in older adults and has the potential to improve their walking ability.

The Impact of Different Periods of Walking Experience on Kinematic Gait Parameters in Toddlers

This study aimed to analyse the kinematic differences in gait between three groups of toddlers who differed in their weeks of independent walking (IW) experience, but not in anthropometrical characteristics, to determine the relationship between walking experience without the side effect of morphological differences on gait parameters. Twenty-six toddlers participated in this study. Depending on the week of their IW, toddlers were divided into three groups: Group 1 (1–5 weeks of IW), Group 2 (6–10 weeks of IW), and Group 3 (11–15 weeks of IW). Each toddler walked barefooted over a 2-m long pathway, and 3D kinematic data were obtained. A decrease in the upper limb position, hip flexion, and step width, i.e., changes towards the adult gait pattern, were observed in Group 3. Less experienced walkers exhibited a wider step width despite no statistically significant difference in body mass and height between groups. Results of this study show no statistically significant difference in step length between groups, suggesting that step length is more related to height than to the walking experience. The increased step length in more experienced walkers reported in previous studies may therefore be a result of different heights and not walking experience.

Kinetic and Kinematic Characteristics of Proficient and Non-Proficient 2-Point and 3-Point Basketball Shooters

The purpose of this study was to examine kinetic and kinematic characteristics of various types of 2-point and 3-point basketball shooting approaches and determine which variables have the greatest contribution in discriminating proficient (PRO) from non-proficient (N-PRO) shooters. While standing on a force plate, twenty-nine recreationally active males performed a total of 1740 shots by utilizing stationary and step-in shooting approaches. Two high-definition cameras were used to simultaneously capture kinematic parameters of shooting motions. The type of shooting approach showed as a non-influential factor. During the preparatory phase of the shooting motion, PRO 2-point shooters demonstrated higher elbow and basketball height placements, greater flexion in the shoulder and elbow joints while attaining greater release and entry ball angles during the release phase. PRO 3-point shooters demonstrated greater elbow flexion, higher basketball placement, and less hip flexion during the preparatory phase while attaining greater heel, release, and trajectory heights during the release phase. When entered into a full-model discriminant function analysis, elbow angle, elbow height, and release angle variables correctly classified PRO from N-PRO 2-point shooters in 62.1% of cases and hip angle, heel height, and elbow angle variables correctly classified PRO from N-PRO 3-point shooters in 81.6% of cases.

Validity and reliability of a smartphone goniometer application for measuring hip range of motions

BACKGROUND: Mobile applications which are designed to assess the range of motion (ROM) are widely used. OBJECTIVE: The aim of this cross-sectional observational study was to determine the inter-observer and intra-observer reliability of a smartphone application “PT Goniometer” (PTG) and determine the correlation between PTG and universal goniometer (UG) regarding active ROMs of the hip in healthy participants. METHODS: Thirty-four healthy young participants were included in the study. Two physiotherapists performed active hip flexion, abduction, internal rotation and external rotation ROM measurements of dominant legs of the participants by using PTG and UG. Intraclass correlation coefficients (ICC) were calculated to determine the intra-observer and inter-observer reliability. Level of correlations between PTG and UG were used to establish concurrent validity of PTG. RESULTS: The PTG demonstrated excellent inter-observer and intra-observer reliability (ICC > 0.90) for all measured hip movements. The minimum detectable change (MDC95) was ranged from 3.29° to 5.1° for the intra-observer reliability, and from 2.55° to 3.21° for the inter-observer reliability. Additionally, the concurrent validity was found excellent (r = 0.91–0.93). CONCLUSION: The results of the present study suggest that PTG is a valid and a reliable mobile technology for measuring hip ROMs.