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Gait & Posture Jul 2022Spina bifida (SB) is a complex congenital malformation, often causing impaired gait performance depending on the level and extent of malformation. Research regarding... (Observational Study)
Observational Study
BACKGROUND
Spina bifida (SB) is a complex congenital malformation, often causing impaired gait performance depending on the level and extent of malformation. Research regarding gait and balance performance in adults with SB, has not been sufficiently described yet.
RESEARCH QUESTION
What are the characteristics of spatiotemporal gait parameters and balance performance in adults with SB? Further, do persons with muscle function (MF) level 3 differ regarding gait and balance performance from those with MF level 1-2?
METHODS
Cross-sectional observational study at an outpatient clinic. 41 adults with SB (18-65 years), who walked regularly. Spatiotemporal parameters of gait was assessed with the APDM system and balance performance with the Mini Balance Evaluation Systems Test (Mini-BESTest). Muscle strength in the legs was assessed with 0-5 manual muscle test, and participants were classified according to level of MF into groups MF1, MF2, and MF3. Two-sided t-test was used for parametric independent variables, and Cohen's d was used for effect sizes. The Mann-Whitney U test was used for non-parametric independent data and effect size was calculated by the z value (r = z/√n).
RESULTS
Mean gait speed was 0.96 (SD 0.20) m/s and mean stride length 1.08 m (SD 0.17), individuals with MF3 showed significantly slower gaitspeed and shorter stride length (p < 0.05). Lumbar rotation was 21° (SD 11), and thoracic lateral sway 15° (IQR 15) with significantley difference (p < 0.001 and p < 0.05) for individuals in MF3. Mini-BESTest showed a mean score of 11.3 (SD 6.9), and individuals with MF3 showed significantly lower scores (p ≤ 0.001).
SIGNIFICANCE
Gait and balance performance was reduced compared to normative data in almost all parameters, especially in persons with less muscle function. Increased knowledge from advanced gait analysis may help healthcare professionals to design rehabilitation programmes, in order to achieve and maintain a sustainable gait and balance performance.
Topics: Adult; Cross-Sectional Studies; Gait; Humans; Postural Balance; Spinal Dysraphism; Walking Speed
PubMed: 35820238
DOI: 10.1016/j.gaitpost.2022.06.016 -
Current Protocols Aug 2021Motor deficits can significantly affect the completion of daily life activities and have a negative impact on quality of life. Consequently, motor function is an...
Motor deficits can significantly affect the completion of daily life activities and have a negative impact on quality of life. Consequently, motor function is an important behavioral endpoint to measure for in vivo pathophysiologic studies in a variety of research areas, such as toxicant exposure, drug development, disease characterization, and transgenic phenotyping. Evaluation of motor function is also critical to the interpretation of cognitive behavioral assays, as many rely on intact motor abilities to derive meaningful data. As such, gait analysis is an important component of behavioral research and can be achieved by manual or video-assisted methods. Manual gait analysis methods, however, are prone to observer bias and are unable to capture many critical parameters. In contrast, automated video-assisted gait analysis can quickly and reliably assess gait and locomotor abnormalities that were previously difficult to collect manually. Here, we describe the evaluation of gait and locomotion in rodents using the automated Noldus CatWalk XT system. We include a step-by-step guide for running an experiment using the CatWalk XT system and discuss theory and considerations when evaluating rodent gait. The protocol and discussion provided here act as a supplemental resource to the manual for this commercially available system and can assist CatWalk users in their experimental design and implementation. © 2021 Wiley Periodicals LLC.
Topics: Animals; Gait; Gait Analysis; Locomotion; Quality of Life; Rodentia
PubMed: 34370398
DOI: 10.1002/cpz1.220 -
Gait & Posture Sep 2023This paper proposes an easy to calculate and adaptable summary gait metric, the Gait Abnormality Index (GAI), which is capable of simultaneously including kinematic and...
BACKGROUND
This paper proposes an easy to calculate and adaptable summary gait metric, the Gait Abnormality Index (GAI), which is capable of simultaneously including kinematic and kinetic data, overcoming a key limitation of existing metrics.
RESEARCH QUESTION
To determine the validity, reliability and sensitivity of the GAI.
METHODS
The GAI is calculated by averaging Gait Abnormality Scores, which are normalised distance metrics used to describe the deviation of pathological gait data from that of healthy controls. Validity was assessed using Pearson's correlation analysis to explore relationships between the GAI and the Gait Profile Score. Test-retest reliability of the GAI was assessed using intra-class correlation coefficients (ICC) and standard error of the measurement (SEM), and data from total hip arthroplasty patients. An independent samples t-test was used to compare GAI scores between knee osteoarthritis and total hip arthroplasty patients to explore the metrics sensitivity.
RESULTS
A strong positive correlation (r ≥ 0.896; p < 001) was reported between the GAI and the Gait Profile Score. Good test-retest reliability (ICC =0.830) was reported for the GAI. Knee osteoarthritis patients displayed significantly (p = .017; Hedge's g effect size = 0.98) greater GAI scores compared to total hip arthroplasty patients, with the mean difference (0.34 a.u) above the SEM (0.15 a.u).
SIGNIFICANCE
The GAI offers an easy to calculate summary metric for three-dimensional gait analysis, which displays good validity and reliability, and is sensitive to different pathological conditions.
Topics: Humans; Osteoarthritis, Knee; Gait Analysis; Reproducibility of Results; Gait; Arthroplasty, Replacement, Hip
PubMed: 37499421
DOI: 10.1016/j.gaitpost.2023.07.281 -
Frontiers in Endocrinology 2022To investigate the relationship between diabetic peripheral neuropathy (DPN) and gait abnormality in diabetic patients. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To investigate the relationship between diabetic peripheral neuropathy (DPN) and gait abnormality in diabetic patients.
METHODS
Related research concerning the gait of diabetic patients with and without DPN was collected and analyzed by searching PubMed, Embase, and Web of Science. Statistical analysis was performed by using RevMan 5.3 software.
RESULTS
Twenty-one studies were included in this meta-analysis, consisting of 499 diabetic neuropathy patients and 467 diabetes controls without neuropathy. Meta-analysis results showed lower gait velocity, shorter stride length, longer stride time, longer stance time, and higher maximum knee extension moment in the DPN group, compared with their counterparts.
CONCLUSION
Among diabetic patients, those complicated with DPN possess lower gait velocity, shorter stride length, longer stride time, longer stance time, and higher maximum knee extension moment.
Topics: Humans; Diabetes Mellitus; Diabetic Neuropathies; Gait; Knee Joint
PubMed: 35721708
DOI: 10.3389/fendo.2022.891356 -
Journal of Healthcare Engineering 2021Gait and posture studies have gained much prominence among researchers and have attracted the interest of clinicians. The ability to detect gait abnormality and posture... (Review)
Review
Gait and posture studies have gained much prominence among researchers and have attracted the interest of clinicians. The ability to detect gait abnormality and posture disorder plays a crucial role in the diagnosis and treatment of some diseases. Microsoft Kinect is presented as a noninvasive sensor essential for medical diagnostic and therapeutic purposes. There are currently no relevant studies that attempt to summarise the existing literature on gait and posture abnormalities using Kinect technology. The purpose of this study is to critically evaluate the existing research on gait and posture abnormalities using the Kinect sensor as the main diagnostic tool. Our studies search identified 458 for gait abnormality, 283 for posture disorder of which 26 studies were included for gait abnormality, and 13 for posture. The results indicate that Kinect sensor is a useful tool for the assessment of kinematic features. In conclusion, Microsoft Kinect sensor is presented as a useful tool for gait abnormality, postural disorder analysis, and physiotherapy. It can also help track the progress of patients who are undergoing rehabilitation.
Topics: Biomechanical Phenomena; Gait; Humans; Posture; Software
PubMed: 34760141
DOI: 10.1155/2021/4360122 -
Gait & Posture Sep 2022Objective gait analysis that fully captures the multi-segmental foot movement of a clubfoot may help in early identification of a relapse clubfoot. Unfortunately, this...
BACKGROUND
Objective gait analysis that fully captures the multi-segmental foot movement of a clubfoot may help in early identification of a relapse clubfoot. Unfortunately, this type of objective measure is still lacking in a clinical setting and it is unknown how it relates to clinical assessment.
RESEARCH QUESTION
The aim of this study was to identify differences in total gait and foot deviations between clubfoot patients with and without a relapse clubfoot and to evaluate their relationship with clinical status.
METHODS
In this study, Ponseti-treated idiopathic clubfoot patients were included and divided into clubfoot patients with and without a relapse. Objective gait analysis was done resulting in total gait and foot scores and clinical assessment was performed using the Clubfoot Assessment Protocol (CAP). Additionally, a new clubfoot specific foot score, the clubFoot Deviation Index (cFDI*), was calculated to better capture foot kinematics of clubfoot patients.
RESULTS
Clubfoot patients with a relapse show lower total gait quality (GDI*) and lower clinical status defined by the CAP than clubfoot patients without a relapse. Abnormal cFDI* was found in relapse patients, reflected by differences in corresponding variable scores. Moderate relationships were found for the subdomains of the CAP and total gait and foot quality in all clubfoot patients.
SIGNIFICANCE
A new total foot score was introduced in this study, which was more relevant for the clubfoot population. The use of this new foot score (cFDI*) besides the GDI*, is recommended to identify gait and foot motion deviations. Along with clinical assessment, this will give an overview of the overall status of the complex, multi-segmental aspects of a (relapsed) clubfoot. The relationships found in this study suggest that clinical assessment might be indicative of a deviation in total gait and foot pattern, therefore hinting towards personalised screening for better treatment decision making.
Topics: Casts, Surgical; Clubfoot; Foot; Gait; Gait Analysis; Humans; Recurrence; Treatment Outcome
PubMed: 35995000
DOI: 10.1016/j.gaitpost.2022.07.261 -
Movement Disorders : Official Journal... Feb 2022Gait and balance abnormalities develop commonly in Parkinson's disease and are among the motor symptoms most disabling and refractory to dopaminergic or other... (Review)
Review
Gait and balance abnormalities develop commonly in Parkinson's disease and are among the motor symptoms most disabling and refractory to dopaminergic or other treatments, including deep brain stimulation. Efforts to develop effective therapies are challenged by limited understanding of these complex disorders. There is a major need for novel and appropriately targeted research to expedite progress in this area. The Scientific Issues Committee of the International Parkinson and Movement Disorder Society has charged a panel of experts in the field to consider the current knowledge gaps and determine the research routes with highest potential to generate groundbreaking data. © 2021 International Parkinson and Movement Disorder Society.
Topics: Dopamine; Gait; Gait Disorders, Neurologic; Humans; Parkinson Disease; Research
PubMed: 34939221
DOI: 10.1002/mds.28883 -
American Journal of Medical Genetics.... Jul 2023Angelman Syndrome is a rare neurodevelopmental disorder characterized by developmental delay, lack of speech, seizures, intellectual disability, characteristic behavior,...
Angelman Syndrome is a rare neurodevelopmental disorder characterized by developmental delay, lack of speech, seizures, intellectual disability, characteristic behavior, and movement disorders. Clinical gait analysis provides the opportunity for movement quantification to investigate an observed maladaptive change in gait pattern and offers an objective outcome of change. Pressure-sensor-based technology, inertial and activity monitoring, and instrumented gait analysis (IGA) were employed to define motor abnormalities in Angelman syndrome. Temporal-spatial gait parameters of persons with Angelman Syndrome (pwAS) show deficiencies in gait performance through walking speed, step length, step width, and walk ratio. pwAS walk with reduced step lengths, increased step width, and greater variability. Three-dimensional motion kinematics showed increased anterior pelvic tilt, hip flexion, and knee flexion. PwAS have a walk ratio more than two standard deviations below controls. Dynamic electromyography showed prolonged activation of knee extensors, which was associated with a decreased range of motion and the presence of hip flexion contractures. Use of multiple gait tracking modalities revealed that pwAS exhibit a change in gait pattern to a flexed knee gait pattern. Cross-sectional studies of individuals with AS show a regression toward this maladaptive gait pattern over development in pwAS ages 4-11. PwAS unexpectedly did not have spasticity associated with change in gait pattern. Multiple quantitative measures of motor patterning may offer early biomarkers of gait decline consistent with critical periods of intervention, insight into appropriate management strategies, objective primary outcomes, and early indicators of adverse events.
Topics: Humans; Angelman Syndrome; Cross-Sectional Studies; Walking; Gait; Knee Joint; Biomechanical Phenomena
PubMed: 37019838
DOI: 10.1002/ajmg.a.63192 -
Clinical Journal of the American... Jul 2019Older adults with CKD are at high risk of falls and disability. It is not known whether gait abnormalities contribute to this risk.
BACKGROUND AND OBJECTIVES
Older adults with CKD are at high risk of falls and disability. It is not known whether gait abnormalities contribute to this risk.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
Quantitative and clinical gait assessments were performed in 330 nondisabled community-dwelling adults aged ≥65 years. CKD was defined as an eGFR <60 ml/min per 1.73 m. Cox proportional hazards models were created to examine fall risk.
RESULTS
A total of 41% (=134) of participants had CKD. In addition to slower gait speed, participants with CKD had gait cycle abnormalities including shorter stride length and greater time in the stance and double-support phases. Among people with CKD, lower eGFR was independently associated with the severity of gait cycle abnormalities (per 10 ml/min per 1.73 m lower eGFR: 3.6 cm [95% confidence interval (95% CI), 1.4 to 5.8] shorter stride length; 0.7% [95% CI, 0.3 to 1.0] less time in swing phase; 1.1% [95% CI, 0.5 to 1.7] greater time in double-support phase); these abnormalities mediated the association of lower eGFR with slower gait speed. On clinical gait exam, consistent with the quantitative abnormalities, short steps and marked swaying or loss of balance were more common among participants with CKD, yet most had no identifiable gait phenotype. A gait phenotype defined by any of these abnormal signs was associated with higher risk of falls among participants with CKD: compared with people without CKD and without the gait phenotype, the adjusted hazard ratio was 1.72 (95% CI, 1.06 to 2.81) for those with CKD and the phenotype; in comparison, the adjusted hazard ratio was 0.71 (95% CI, 0.40 to 1.25) for people with CKD but without the phenotype ( value for interaction of CKD status and gait phenotype =0.01).
CONCLUSIONS
CKD in older adults is associated with quantitative gait abnormalities, which clinically manifest in a gait phenotype that is associated with fall risk.
Topics: Accidental Falls; Aged; Aged, 80 and over; Female; Gait; Glomerular Filtration Rate; Humans; Male; Phenotype; Renal Insufficiency, Chronic; Risk
PubMed: 31235462
DOI: 10.2215/CJN.13871118 -
Gait oscillation analysis during gait and stair-stepping in elder patients with knee osteoarthritis.Journal of Orthopaedic Surgery and... Jan 2019Evaluation of knee and lower limb function alone is not sufficient to assess gait. For accurate assessment of gait abnormality, gait oscillation should also be measured....
BACKGROUND
Evaluation of knee and lower limb function alone is not sufficient to assess gait. For accurate assessment of gait abnormality, gait oscillation should also be measured. The goal of this analysis was to assess the influence of the knee joint on gait oscillation during gait and stair-stepping in patients with osteoarthritis of the knee.
METHODS
In 33 patients diagnosed with knee osteoarthritis and 33 healthy adults as the control group, we examined acceleration (anterior and lateral directions) and gait barycentric factors (single-support phase and ratio of center of gravity maximum values) during gait and stair-stepping.
RESULTS
Acceleration in the anterior direction in the sacral region was greater in healthy adults than in osteoarthritis (OA) patients during gait and stair-down. Acceleration in the anterior direction in the dorsal vertebral region was greater in OA patients than in healthy adults during (up and down) stair-stepping. Acceleration in the lateral direction in the sacral region was greater in healthy adults than in OA patients during stair-up. Acceleration in the lateral direction in the dorsal vertebral region was greater in OA patients than in healthy adults during stair-stepping. The single-support phase was close to 1 for gait and stair-stepping in healthy adults and OA patients. The single-support time was largely the same for gait and stair-stepping in healthy adults. On the other hand, the single-support time was longer for stair-stepping than for gait in OA patients. The ratio of the center of gravity maximum values was greater for the sacral region than for the dorsal vertebral region. There was a significant difference in the stair-stepping ratio of the center of gravity maximum values between healthy adults and OA patients for the sacral region.
CONCLUSION
We considered that knee OA influenced acceleration in the anterior and lateral direction in the dorsal vertebral and the ratio of the center of gravity maximum values on gait oscillation.
Topics: Acceleration; Adult; Aged; Aged, 80 and over; Case-Control Studies; Female; Gait; Gait Analysis; Humans; Knee Joint; Male; Middle Aged; Osteoarthritis, Knee; Stair Climbing; Young Adult
PubMed: 30651120
DOI: 10.1186/s13018-019-1064-6