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Quirino J, Santos TRT, Okai-Nóbrega LA, de Araújo PA, Carvalho R, Ocarino JDM, Souza TR, Fonseca ST. Runners with a history of injury have greater lower limb movement regularity than runners without a history of injury. Sports Biomech 2024; 23:1147-1159. [PMID: 34121609 DOI: 10.1080/14763141.2021.1929435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
This study aimed to investigate the regularity of the lower limb joint kinematics in runners with and without a history of running-related injuries. The second aim was to verify if the movement pattern regularities are different among the lower limb joints. Eighteen asymptomatic recreational runners with and without a history of running-related injury participated in this study. Lower limb kinematics in the sagittal plane were recorded during running on a treadmill at a self-selected speed. The regularities of the time series of hip, knee, and ankle were analysed using sample entropy (SampEn). A mixed analysis of variance was used to investigate differences between groups and among joints. Runners with a history of injury had lower SampEn values than runners without a history of injury. Ankle kinematics SampEn was higher than that of the knee and hip. Knee kinematics had higher values of SampEn than that of the hip. Runners with a history of running-related injury had greater joint kinematic's regularity. This result suggests that, even in asymptomatic runners, previous injuries could influence the movement pattern regularity. Also, the regularity was different among joints. The ankle demonstrated the lowest regularity, reinforcing the different functions that lower limb joints perform during running.
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Affiliation(s)
- Juliana Quirino
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program of Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thiago Ribeiro Teles Santos
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program of Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Liria Akie Okai-Nóbrega
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program of Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Priscila Albuquerque de Araújo
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program of Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Renatha Carvalho
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program of Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Juliana de Melo Ocarino
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program of Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thales Rezende Souza
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program of Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sérgio Teixeira Fonseca
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program of Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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van de Ven WAF, Bosga J, Hullegie W, Verra WC, Meulenbroek RGJ. Exploratory study of the lateral body sway predictability as frame of reference for gait rehabilitation following a total knee arthroplasty. Knee 2024; 49:192-200. [PMID: 39043014 DOI: 10.1016/j.knee.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/14/2024] [Accepted: 07/01/2024] [Indexed: 07/25/2024]
Abstract
AIMS The aim of the present study was to investigate whether the predictability of fronto-parallel trunk rotations (lateral body sway) could serve as a frame of reference to monitor recovery after total knee arthroplasty (TKA). METHODS Before surgery, 11 TKA patients were asked to perform a treadmill walking task at three different speeds. In addition, their gait abilities were scored on three standard clinical walking tests. The treadmill walking task was repeated at three different timepoints following surgery, i.e., at 3, 6 and 12 months post-TKA. The movements of the trunk were digitized with an inertial sensor to capture the amplitude and the sample entropy (SEn) of the lateral body sway that were evaluated in separate ANOVAs. RESULTS Before surgery the TKA group showed larger body sway (P = 0.025) with smaller SEn values (P = 0.038), which both restored to levels of healthy adults in the 12 months following surgery. Systematic correlations between the SEn values and the clinical test scores were found. CONCLUSIONS The current findings show that movement behavior of the trunk in the fronto-parallel plane was affected by knee osteoarthritis and suggest that the predictability of the lateral body sway may serve as an index of recovery after TKA.
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Affiliation(s)
- Werner A F van de Ven
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands; FysioHolland Twente, Enschede, the Netherlands.
| | - Jurjen Bosga
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands
| | - Wim Hullegie
- Physiotherapy practice Hullegie and Richter MSC, Enschede, the Netherlands
| | - Wiebe C Verra
- Medisch Spectrum Twente, Department of Orthopedic Surgery, Enschede, the Netherlands
| | - Ruud G J Meulenbroek
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands
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Emmerzaal J, Vets N, Devoogdt N, Smeets A, De Groef A, De Baets L. Upper-Limb Movement Quality before and after Surgery in Women with Breast Cancer: An Exploratory Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:3472. [PMID: 38894264 PMCID: PMC11175096 DOI: 10.3390/s24113472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024]
Abstract
(1) Background: This study aimed to describe upper-limb (UL) movement quality parameters in women after breast cancer surgery and to explore their clinical relevance in relation to post-surgical pain and disability. (2) Methods: UL movement quality was assessed in 30 women before and 3 weeks after surgery for breast cancer. Via accelerometer data captured from a sensor located at the distal end of the forearm on the operated side, various movement quality parameters (local dynamic stability, movement predictability, movement smoothness, movement symmetry, and movement variability) were investigated while women performed a cyclic, weighted reaching task. At both test moments, the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire was filled out to assess UL disability and pain severity. (3) Results: No significant differences in movement quality parameters were found between the pre-surgical and post-surgical time points. No significant correlations between post-operative UL disability or pain severity and movement quality were found. (4) Conclusions: From this study sample, no apparent clinically relevant movement quality parameters could be derived for a cyclic, weighted reaching task. This suggests that the search for an easy-to-use, quantitative analysis tool for UL qualitative functioning to be used in research and clinical practice should continue.
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Affiliation(s)
- Jill Emmerzaal
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium; (J.E.)
| | - Nieke Vets
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium; (J.E.)
- CarEdOn Research Group, 3000 Leuven, Belgium
| | - Nele Devoogdt
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium; (J.E.)
- CarEdOn Research Group, 3000 Leuven, Belgium
- Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation, Centre for Lymphoedema, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Ann Smeets
- Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Surgical Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - An De Groef
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium; (J.E.)
- CarEdOn Research Group, 3000 Leuven, Belgium
- MOVANT Research Group, Department of Rehabilitation Sciences, University of Antwerp, 2000 Antwerp, Belgium
- Pain in Motion International Research Group, 1090 Brussels, Belgium
| | - Liesbet De Baets
- Pain in Motion International Research Group, 1090 Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
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4
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van de Ven WAF, Bosga J, Hullegie W, Verra WC, Meulenbroek RGJ. Inertial-Sensor-Based Monitoring of Sample Entropy and Peak Frequency Changes in Treadmill Walking during Recovery after Total Knee Arthroplasty. SENSORS (BASEL, SWITZERLAND) 2023; 23:4968. [PMID: 37430890 DOI: 10.3390/s23104968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/06/2023] [Accepted: 05/21/2023] [Indexed: 07/12/2023]
Abstract
This study aimed to investigate whether sample entropy (SEn) and peak frequency values observed in treadmill walking could provide physical therapists valuable insights into gait rehabilitation following total knee arthroplasty (TKA). It was recognized that identifying movement strategies that during rehabilitation are initially adaptive but later start to hamper full recovery is critical to meet the clinical goals and minimize the risk of contralateral TKA. Eleven TKA patients were asked to perform clinical walking tests and a treadmill walking task at four different points in time (pre-TKA, 3, 6, and 12 months post-TKA). Eleven healthy peers served as the reference group. The movements of the legs were digitized with inertial sensors and SEn and peak frequency of the recorded rotational velocity-time functions were analyzed in the sagittal plane. SEn displayed a systematic increase during recovery in TKA patients (p < 0.001). Furthermore, lower peak frequency (p = 0.01) and sample entropy (p = 0.028) were found during recovery for the TKA leg. Movement strategies that initially are adaptive, and later hamper recovery, tend to diminish after 12 months post-TKA. It is concluded that inertial-sensor-based SEn and peak frequency analyses of treadmill walking enrich the assessment of movement rehabilitation after TKA.
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Affiliation(s)
- Werner A F van de Ven
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6525 GD Nijmegen, The Netherlands
- FysioHolland Twente, 7512 AC Enschede, The Netherlands
| | - Jurjen Bosga
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6525 GD Nijmegen, The Netherlands
| | - Wim Hullegie
- Physiotherapy Practice Hullegie and Richter MSC, 7512 AC Enschede, The Netherlands
| | - Wiebe C Verra
- Medisch Spectrum Twente, Department of Orthopedic Surgery, 7512 KZ Enschede, The Netherlands
| | - Ruud G J Meulenbroek
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6525 GD Nijmegen, The Netherlands
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Promsri A, Bangkomdet K, Jindatham I, Jenchang T. Leg Dominance—Surface Stability Interaction: Effects on Postural Control Assessed by Smartphone-Based Accelerometry. Sports (Basel) 2023; 11:sports11040075. [PMID: 37104149 PMCID: PMC10145104 DOI: 10.3390/sports11040075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/19/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
The preferential use of one leg over another in performing lower-limb motor tasks (i.e., leg dominance) is considered to be one of the internal risk factors for sports-related lower-limb injuries. The current study aimed to investigate the effects of leg dominance on postural control during unipedal balancing on three different support surfaces with increasing levels of instability: a firm surface, a foam pad, and a multiaxial balance board. In addition, the interaction effect between leg dominance and surface stability was also tested. To this end, a tri-axial accelerometer-based smartphone sensor was placed over the lumbar spine (L5) of 22 young adults (21.5 ± 0.6 years) to record postural accelerations. Sample entropy (SampEn) was applied to acceleration data as a measure of postural sway regularity (i.e., postural control complexity). The results show that leg dominance (p < 0.001) and interaction (p < 0.001) effects emerge in all acceleration directions. Specifically, balancing on the dominant (kicking) leg shows more irregular postural acceleration fluctuations (high SampEn), reflecting a higher postural control efficiency or automaticity than balancing on the non-dominant leg. However, the interaction effects suggest that unipedal balancing training on unstable surfaces is recommended to reduce interlimb differences in neuromuscular control for injury prevention and rehabilitation.
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Affiliation(s)
- Arunee Promsri
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence in Neuromechanics, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
- Correspondence: ; Tel.: +66-54-466-666 (ext. 3817)
| | - Kotchakorn Bangkomdet
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
| | - Issariya Jindatham
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
| | - Thananya Jenchang
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
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van de Ven WAF, Bosga J, Hullegie W, Verra WC, Meulenbroek RGJ. More Predictable and Less Automatized Movements during Walking -not during Repetitive Punching- in Knee Osteoarthritis. J Mot Behav 2023; 55:499-512. [PMID: 36990461 DOI: 10.1080/00222895.2023.2194242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 03/08/2023] [Accepted: 03/17/2023] [Indexed: 03/31/2023]
Abstract
Using the non-affected leg as stable frame of reference for the affected leg in gait assessment in knee osteoarthritis (KO) fails due to compensatory mechanisms. Assessing the cyclical movements of the upper extremities in a frequency-controlled repetitive punching task may provide an alternative frame of reference in gait assessment in patients with KO. Eleven participants with unilateral KO and eleven healthy controls were asked to perform treadmill walking and repetitive punching. The KO group showed more predictable (p = 0.020) and less automatized (p = 0.007) movement behavior than controls during treadmill walking. During repetitive punching, the KO group showed a similar degree of predictability (p = 0.784) but relative more automatized movement behavior (p = 0.013). Thus, the predictability of the movement behavior of the upper extremities during repetitive punching seems unaffected by KO and could provide an alternative frame of reference in gait assessment in patients with KO.
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Affiliation(s)
- Werner A F van de Ven
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
- FysioHolland Twente, Enschede, The Netherlands
| | - Jurjen Bosga
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Wim Hullegie
- Physiotherapy practice Hullegie and Richter MSC, Enschede, The Netherlands
| | - Wiebe C Verra
- Department of Orthopedic Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Ruud G J Meulenbroek
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
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Liu Y, Li X, Dou X, Huang Z, Wang J, Liao B, Zhang X. Correlational analysis of three-dimensional spinopelvic parameters with standing balance and gait characteristics in adolescent idiopathic scoliosis: A preliminary research on Lenke V. Front Bioeng Biotechnol 2022; 10:1022376. [PMID: 36532594 PMCID: PMC9747941 DOI: 10.3389/fbioe.2022.1022376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/18/2022] [Indexed: 09/21/2023] Open
Abstract
Background: Adolescent idiopathic scoliosis (AIS), the most common spinal deformity, possibly develops due to imbalanced spinal loading following asymmetric development. Since altered loading patterns may affect standing balance and gait, we investigated whether a correlation exists between balance ability, gait pattern, and the three-dimensional radiographic spinopelvic parameters in AIS patients. Methods: A cross-sectional observational study was conducted with 34 AIS patients (aged 10-18 years) and an equal number of healthy age and sex-matched teenagers (normal group). We obtained the spinopelvic three-dimensional parameters and balance parameters simultaneously through the EOS imaging system and gait and center of pressure (CoP) characteristics using a plantar pressure measurement mat. Besides determining the intergroup differences in balance and gait parameters, multiple linear regression analyses were performed to identify any correlation between the static plantar pressure and radiographic parameters. Results: Compared to the normal group, the CoPx is lower, the CoP path length and 90% confidence ellipse area were significantly higher in AIS patients (AIS: -13.7 ± 5.7 mm, 147.4 ± 58.1 mm, 150.5 ± 62.8 mm2; normal: -7.0 ± 5.4 mm, 78.8 ± 32.0 mm, 92.1 ± 41.7 mm2, respectively), correlated with apical vertebra translation, sagittal pelvic tilt, and pelvis axial rotation, respectively. Moreover, AIS patients had a shorter stance phase (61.35 ± 0.97 s vs. 62.39 ± 1.09 s), a longer swing phase (38.66 ± 0.97 s vs. 37.62 ± 1.08 s), and smaller maximum pressure peaks in the gait cycle, especially on the left foot, as compared to healthy subjects. Moreover, the CoP trajectory in AIS patients was different from the latter, and changes in the bipedal trend were not consistent. Conclusion: The standing balance and gait characteristics of AIS patients are different from those of healthy subjects, as reflected in their three-dimensional spinopelvic radiographic parameters. Trial registration: The study protocol was registered with the Chinese Clinical Trial Registry (Number ChCTR1800018310) and the Human Subject Committee of Guangzhou Sport University (Number: 2018LCLL003).
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Affiliation(s)
- Yanan Liu
- Department of Sports Medicine, Guangzhou Sport University, Guangzhou, China
| | - Xianglan Li
- Department of Sports Medicine, Guangzhou Sport University, Guangzhou, China
| | - Xiaoran Dou
- Department of Sports Medicine, Guangzhou Sport University, Guangzhou, China
| | - Zhiguan Huang
- School of Sports and Health, Guangzhou Sport University, Guangzhou, China
| | - Jun Wang
- Gosun Medical Imaging Diagnosis Center of Guangdong Province, Guangzhou, China
| | - Bagen Liao
- Department of Sports Medicine, Guangzhou Sport University, Guangzhou, China
| | - Xiaohui Zhang
- Department of Sports Medicine, Guangzhou Sport University, Guangzhou, China
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Boekesteijn RJ, van Gerven J, Geurts ACH, Smulders K. Objective gait assessment in individuals with knee osteoarthritis using inertial sensors: A systematic review and meta-analysis. Gait Posture 2022; 98:109-120. [PMID: 36099732 DOI: 10.1016/j.gaitpost.2022.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 06/16/2022] [Accepted: 09/01/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Objective assessment of gait using inertial sensors has shown promising results for functional evaluations in individuals with knee osteoarthritis (OA). However, the large number of possible outcome measures calls for a systematic evaluation of most relevant parameters to be used for scientific and clinical purposes. AIM This systematic review and meta-analysis aimed to identify gait parameters derived from inertial sensors that reflect gait deviations in individuals with knee OA compared to healthy control subjects (HC). METHODS A systematic search was conducted in five electronic databases (Medline, Embase, Web of Science, CINAHL, IEEE) to identify eligible articles. Risk of bias was assessed using a modified version of the Downs and Black scale. Data regarding study population, experimental procedures, and biomechanical outcomes were extracted. When a gait parameter was reported by a sufficient number of studies, a random-effects meta-analysis was conducted using the inverse variance method. RESULTS Twenty-three articles comparing gait between 411 individuals with knee OA and 507 HC were included. Individuals with knee OA had a lower gait speed than HC (standardized mean difference = -1.65), driven by smaller strides with a longer duration. Stride time variability was slightly higher in individuals with knee OA than in HC. Individuals with knee OA walked with a lower range of motion of the knee during the swing phase, less lumbar motion in the coronal plane, and a lower foot strike and toe-off angle compared to HC. SIGNIFICANCE This review shows that inertial sensors can detect gait impairments in individuals with knee OA. Large standardized mean differences found on spatiotemporal parameters support their applicability as sensitive endpoints for mobility in individuals with knee OA. More advanced measures, including kinematics of knee and trunk, may reveal gait adaptations that are more specific to knee OA, but compelling evidence was lacking.
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Affiliation(s)
- R J Boekesteijn
- Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - J van Gerven
- Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, the Netherlands.
| | - A C H Geurts
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - K Smulders
- Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands.
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High-accuracy wearable detection of freezing of gait in Parkinson's disease based on pseudo-multimodal features. Comput Biol Med 2022; 146:105629. [DOI: 10.1016/j.compbiomed.2022.105629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/25/2022] [Accepted: 04/15/2022] [Indexed: 11/22/2022]
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Movement Quality Parameters during Gait Assessed by a Single Accelerometer in Subjects with Osteoarthritis and Following Total Joint Arthroplasty. SENSORS 2022; 22:s22082955. [PMID: 35458937 PMCID: PMC9029923 DOI: 10.3390/s22082955] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 01/13/2023]
Abstract
This study’s aim is threefold: (I) Evaluate movement quality parameters of gait in people with hip or knee osteoarthritis (OA) compared to asymptomatic controls from a single trunk-worn 3D accelerometer. (II) Evaluate the sensitivity of these parameters to capture changes at 6-weeks, 3-, 6-, and 12-months following total knee arthroplasty (TKA). (III) Investigate whether observed changes in movement quality from 6-weeks and 12-months post-TKA relates to changes in patient-reported outcome measures (PROMs). We invited 20 asymptomatic controls, 20 people with hip OA, 18 people pre- and post-TKA to our movement lap. They wore a single trunk-worn accelerometer and walked at a self-selected speed. Movement quality parameters (symmetry, complexity, smoothness, and dynamic stability) were calculated from the 3D acceleration signal. Between groups and between timepoints comparisons were made, and changes in movement quality were correlated with PROMs. We found significant differences in symmetry and stability in both OA groups. Post-TKA, most parameters reflected an initial decrease in movement quality at 6-weeks post-TKA, which mostly normalised 6-months post-TKA. Finally, improved movement quality relates to improvements in PROMs. Thus, a single accelerometer can characterise movement quality in both OA groups and post-TKA. The correlation shows the potential to monitor movement quality in a clinical setting to inform objective, data-driven personalised rehabilitation.
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Zanin M, Olivares F, Pulido-Valdeolivas I, Rausell E, Gomez-Andres D. Gait analysis under the lens of statistical physics. Comput Struct Biotechnol J 2022; 20:3257-3267. [PMID: 35782747 PMCID: PMC9237948 DOI: 10.1016/j.csbj.2022.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/10/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022] Open
Abstract
Human gait is a fundamental activity, essential for the survival of the individual, and an emergent property of the interactions between complex physical and cognitive processes. Gait is altered in many situations, due both to external constraints, as e.g. paced walk, and to physical and neurological pathologies. Its study is therefore important as a way of improving the quality of life of patients, but also as a door to understanding the inner working of the human nervous system. In this review we explore how four statistical physics concepts have been used to characterise normal and pathological gait: entropy, maximum Lyapunov exponent, multi-fractal analysis and irreversibility. Beyond some basic definitions, we present the main results that have been obtained in this field, as well as a discussion of the main limitations researchers have dealt and will have to deal with. We finally conclude with some biomedical considerations and avenues for further development.
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Affiliation(s)
- Massimiliano Zanin
- Instituto de Física Interdisciplinar y Sistemas Complejos IFISC (CSIC-UIB), Campus UIB, Palma de Mallorca 07122, Spain
| | - Felipe Olivares
- Instituto de Física Interdisciplinar y Sistemas Complejos IFISC (CSIC-UIB), Campus UIB, Palma de Mallorca 07122, Spain
| | - Irene Pulido-Valdeolivas
- Department of Anatomy, Histology and Neuroscience, School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo 2, Madrid 28029, Spain
| | - Estrella Rausell
- Department of Anatomy, Histology and Neuroscience, School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo 2, Madrid 28029, Spain
| | - David Gomez-Andres
- Department of Anatomy, Histology and Neuroscience, School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo 2, Madrid 28029, Spain
- Pediatric Neurology, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, ERN-RND & EURO-NMD, Pg. de la Vall d'Hebron 119-129, Barcelona 08035, Spain
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12
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Increased Speed Elicited More Automatized but Less Predictable Control in Cyclical Arm and Leg Movements. Motor Control 2021; 26:15-35. [PMID: 34768239 DOI: 10.1123/mc.2021-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/03/2021] [Accepted: 09/05/2021] [Indexed: 11/18/2022]
Abstract
The present study explores variations in the degree of automaticity and predictability of cyclical arm and leg movements. Twenty healthy adults were asked to walk on a treadmill at a lower-than-preferred speed, their preferred speed, and at a higher-than-preferred speed. In a separate, repetitive punching task, the three walking frequencies were used to cue the target pace of the cyclical arm movements. Movements of the arms, legs, and trunk were digitized with inertial sensors. Whereas absolute slope values (|β|) of the linear fit to the power spectrum of the digitized movements (p < .001, η2 = .676) were systematically smaller in treadmill walking than in repetitive punching, sample entropy measures (p < .001, η2 = .570) were larger reflecting the former task being more automated but also less predictable than the latter task. In both tasks, increased speeds enhanced automatized control (p < .001, η2 = .475) but reduced movement predictability (p = .008, η2 = .225). The latter findings are potentially relevant when evaluating effects of task demand changes in clinical contexts.
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Yentes JM, Raffalt PC. Entropy Analysis in Gait Research: Methodological Considerations and Recommendations. Ann Biomed Eng 2021; 49:979-990. [PMID: 33560467 PMCID: PMC8051436 DOI: 10.1007/s10439-020-02616-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 09/08/2020] [Indexed: 10/22/2022]
Abstract
The usage of entropy analysis in gait research has grown considerably the last two decades. The present paper reviews the application of different entropy analyses in gait research and provides recommendations for future studies. While single-scale entropy analysis such as approximate and sample entropy can be used to quantify regularity/predictability/probability, they do not capture the structural richness and component entanglement characterized by a complex system operating across multiple spatial and temporal scales. Thus, for quantification of complexity, either multiscale entropy or refined composite multiscale entropy is recommended. For both single- and multiscale-scale entropy analyses, care should be made when selecting the input parameters of tolerance window r, vector length m, time series length N and number of scales. This selection should be based on the proposed research question and the type of data collected and not copied from previous studies. Parameter consistency should be investigated and published along with the main results to ensure transparency and enable comparisons between studies. Furthermore, since the interpretation of the absolute size of both single- and multiscale entropy analyses outcomes is not straightforward, comparisons should always be made with a control condition or group.
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Affiliation(s)
- Jennifer M Yentes
- Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE, 68182-0860, USA.
| | - Peter C Raffalt
- Department of Physical Performance, Norwegian School of Sport Sciences, Sognsveien 220, 0806, Oslo, Norway
- Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
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Dasgupta P, VanSwearingen J, Godfrey A, Redfern M, Montero-Odasso M, Sejdic E. Acceleration Gait Measures as Proxies for Motor Skill of Walking: A Narrative Review. IEEE Trans Neural Syst Rehabil Eng 2021; 29:249-261. [PMID: 33315570 PMCID: PMC7995554 DOI: 10.1109/tnsre.2020.3044260] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
In adults 65 years or older, falls or other neuromotor dysfunctions are often framed as walking-related declines in motor skill; the frequent occurrence of such decline in walking-related motor skill motivates the need for an improved understanding of the motor skill of walking. Simple gait measurements, such as speed, do not provide adequate information about the quality of the body motion's translation during walking. Gait measures from accelerometers can enrich measurements of walking and motor performance. This review article will categorize the aspects of the motor skill of walking and review how trunk-acceleration gait measures during walking can be mapped to motor skill aspects, satisfying a clinical need to understand how well accelerometer measures assess gait. We will clarify how to leverage more complicated acceleration measures to make accurate motor skill decline predictions, thus furthering fall research in older adults.
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Ahmadi S, Siragy T, Nantel J. Regularity of kinematic data between single and dual-task treadmill walking in people with Parkinson's disease. J Neuroeng Rehabil 2021; 18:20. [PMID: 33526049 PMCID: PMC7852223 DOI: 10.1186/s12984-021-00807-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 01/11/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Regularity, quantified by sample entropy (SampEn), has been extensively used as a gait stability measure. Yet, there is no consensus on the calculation process and variant approaches, e.g. single-scale SampEn with and without incorporating a time delay greater than one, multiscale SampEn, and complexity index, have been used to calculate the regularity of kinematic or kinetic signals. The aim of the present study was to test the discriminatory performance of the abovementioned approaches during single and dual-task walking in people with Parkinson's disease (PD). METHODS Seventeen individuals with PD were included in this study. Participants completed two walking trials that included single and dual-task conditions. The secondary task was word searching with twelve words randomly appearing in the participants' visual field. Trunk linear acceleration at sternum level, linear acceleration of the center of gravity, and angular velocity of feet, shanks, and thighs, each in three planes of motion were collected. The regularity of signals was computed using approaches mentioned above for single and dual-task conditions. RESULTS Incorporating a time delay greater than one and considering multiple scales helped better distinguish between single and dual-task walking. For all signals, the complexity index, defined as the summary of multiscale SampEn analysis, was the most efficient discriminatory index between single-task walking and dual-tasking in people with Parkinson's disease. Specifically, the complexity index of the trunk linear acceleration of the center of gravity distinguished between the two walking conditions in all three planes of motion. CONCLUSIONS The significant results observed across the 24 signals studied in this study are illustrative examples of the complexity index's potential as a gait feature for classifying different walking conditions.
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Affiliation(s)
- Samira Ahmadi
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Tarique Siragy
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada.
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16
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Craig JJ, Bruetsch AP, Lynch SG, Huisinga JM. Trunk and foot acceleration variability during walking relates to fall history and clinical disability in persons with multiple sclerosis. Clin Biomech (Bristol, Avon) 2020; 80:105100. [PMID: 32798813 PMCID: PMC7983701 DOI: 10.1016/j.clinbiomech.2020.105100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 05/19/2019] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Persons with multiple sclerosis are often at higher risk for falling, but clinical disability scales and fall risk questionnaires are subjective and don't provide specific feedback about why an individual is unstable. The purpose of this study was to determine how relationships between trunk and foot acceleration variability relate to physiological impairments, clinical disability scales, and mobility questionnaires in persons with multiple sclerosis. METHODS 15 fallers and 25 non-fallers with multiple sclerosis walked on a treadmill at normal walking speed while trunk and foot accelerations were recorded with wireless accelerometers and variability measures were extracted and used to calculate the gait stability index metrics as a ratio of trunk acceleration variability divided foot acceleration variability. Subjects' sensorimotor delays and lower extremity vibration sensitivity were tested. Subjects also completed clinical disability scales (Guy's Neurological Disability Scale and Patient Reported Expanded Disability Status Scale) and mobility questionnaires (Falls Efficacy Scale, Activities Balance Confidence Scale, 12 Item Multiple Sclerosis Walk Scale). FINDINGS Multiple gait stability index metrics were significantly correlated with clinical measures of disability and mobility in multiple sclerosis subjects (r = 0.354-0.528), but no correlations were found for sensorimotor delays or lower extremity sensation. Multiple gait stability indices performed at least as well as clinical questionnaires for separating fallers from non-fallers. INTERPRETATION The gait stability indices can potentially be used outside of a laboratory setting to measure walking characteristics related to fall history and disability level in people with multiple sclerosis.
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Affiliation(s)
- Jordan J Craig
- Landon Center on Aging, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 1005, Kansas City, KS 66160, United States; Bioengineering Graduate Program, University of Kansas, 3135A Learned Hall, 1530 W 15(th) St, Lawrence, KS 66045, United States
| | - Adam P Bruetsch
- Landon Center on Aging, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 1005, Kansas City, KS 66160, United States
| | - Sharon G Lynch
- Department of Neurology, 3901 Rainbow Blvd., Kansas City, KS 66160, United States
| | - Jessie M Huisinga
- Department of Physical Therapy and Rehabilitation Science, 3901 Rainbow Blvd., Mail Stop 2002, Kansas City, KS 66160, United States.
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Saida T, Kawada M, Kuroki D, Nakai Y, Miyazaki T, Kiyama R, Tsuneyoshi Y. Accelerometer Measurement of Trunk Lateral Fluctuation During Walking Following Total Knee Arthroplasty in Patients With Osteoarthritis. J Aging Phys Act 2020; 28:669-674. [PMID: 32208361 DOI: 10.1123/japa.2019-0149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 12/10/2019] [Accepted: 12/14/2019] [Indexed: 11/18/2022]
Abstract
This study aimed to clarify the effect of total knee arthroplasty (TKA) on trunk fluctuation and regularity of gait in patients with knee osteoarthritis by an accelerometer. The participants included 18 patients with knee osteoarthritis undergoing TKA. The gait at a comfortable velocity was assessed pre- and post-TKA by a triaxial accelerometer attached to the neck and lumbar regions. Measurement post-TKA was performed 4 weeks after surgery. Trunk fluctuation was estimated by the root mean square (RMS) of acceleration and RMS ratio (the ratio of RMS in each direction to the total RMS). Regularity of gait was estimated using the autocorrelation function. The results showed that TKA significantly decreased the RMS ratio in mediolateral acceleration of the neck and lumbar regions and reduced gait regularity. TKA appears to reduce compensatory trunk motion through the improvement of knee function. An assessment of trunk fluctuation using an accelerometer is useful for the clinical assessment of patients with knee osteoarthritis pre- and post-TKA.
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Strongman C, Morrison A. A scoping review of non-linear analysis approaches measuring variability in gait due to lower body injury or dysfunction. Hum Mov Sci 2020; 69:102562. [DOI: 10.1016/j.humov.2019.102562] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/31/2019] [Accepted: 12/05/2019] [Indexed: 02/07/2023]
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Wang Y, Tao Y, Sheng D, Zhou Y, Wang D, Shi X, Wu J, Ma X. Quantifying the change in streamflow complexity in the Yangtze River. ENVIRONMENTAL RESEARCH 2020; 180:108833. [PMID: 31731172 DOI: 10.1016/j.envres.2019.108833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/16/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
Hydrological processes of the Yangtze River have changed over the past decades due to environmental change and human activity. This paper uses sample entropy to investigate the spatial distribution and dynamic change in streamflow series complexity in the Yangtze River, China. In this study, the complexity of the streamflow series is quantified by entropy analysis. Daily streamflow series for four stations located in the mainstem and two control stations of the two largest freshwater lakes were analysed for the past 60 years. The results showed that the complexity of the streamflow series showed an obvious spatial difference and an increasing trend from upstream to downstream in the Yangtze River. There was a negative relationship between the annual streamflow and the corresponding sample entropy, and their peak-to-valley values showed well-corresponding relationships. The complexity of the runoff series at the Cuntan, Yichang, and Datong stations showed a continuous increasing trend, while that of the Hankou station showed a decreasing trend. The Three Gorges Dam changed the streamflow series complexity in the middle reach of the Yangtze River during the initial impoundment stage, while it had only slight impacts during the fully operational stage. Compared to the mainstem reaches, the streamflow series complexity of the two lakes showed no obvious change. The complexity of the streamflow series in the mainstem of the Yangtze River has been influenced by dam construction. The study could provide a scientific reference for understanding the flow dynamic evolution in the Yangtze River.
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Affiliation(s)
- Yuankun Wang
- Key Laboratory of Surficial Geochemistry, Ministry of Education, Department of Hydrosciences, School of Earth Sciences and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Nanjing University, Nanjing, 210023, China.
| | - Yuwei Tao
- Key Laboratory of Surficial Geochemistry, Ministry of Education, Department of Hydrosciences, School of Earth Sciences and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Nanjing University, Nanjing, 210023, China
| | - Dong Sheng
- Hunan Water Resources and Hydropower Research Institute, Changsha, 410007, China
| | - Yuting Zhou
- Key Laboratory of Surficial Geochemistry, Ministry of Education, Department of Hydrosciences, School of Earth Sciences and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Nanjing University, Nanjing, 210023, China
| | - Dong Wang
- Key Laboratory of Surficial Geochemistry, Ministry of Education, Department of Hydrosciences, School of Earth Sciences and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Nanjing University, Nanjing, 210023, China.
| | - Xiaorui Shi
- Key Laboratory of Surficial Geochemistry, Ministry of Education, Department of Hydrosciences, School of Earth Sciences and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Nanjing University, Nanjing, 210023, China
| | - Jichun Wu
- Key Laboratory of Surficial Geochemistry, Ministry of Education, Department of Hydrosciences, School of Earth Sciences and Engineering, State Key Laboratory of Pollution Control and Resource Reuse, Nanjing University, Nanjing, 210023, China
| | - Xirong Ma
- Pearl River Hydraulic Research Institute, Guangzhou, 510611, China
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Terada M, Morgan KD, Gribble PA. Altered movement strategy of chronic ankle instability individuals with postural instability classified based on Nyquist and Bode analyses. Clin Biomech (Bristol, Avon) 2019; 69:39-43. [PMID: 31295669 DOI: 10.1016/j.clinbiomech.2019.06.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 05/31/2019] [Accepted: 06/28/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of the current study was to assess movement strategies during a single leg balance in chronic ankle instability individuals with unstable postural control strategy identified by Nyquist and Bode analyses in conjunction with sample entropy. METHODS Thirty-three participants with self-reported chronic ankle instability and 22 healthy controls performed single-leg eyes closed static balance trials. The sagittal and frontal plane kinematics in the lower extremity and trunk as well as center of pressure trajectories were recorded during three, 20-second trials. The Nyquist and Bode stability analyses, which classify center of pressure waveforms as stable based on the resulting gain and phase margins, were performed to identify the presence of postural control deficits. Sample entropy was implemented to analyze movement strategies during the task. FINDINGS Based on the Nyquist and Bode stability analyses, we included 19 out of 33 chronic ankle instability participants with unstable postural control strategy and 16 out of 22 controls with stable postural control strategy in the final analyses. Chronic ankle instability participants demonstrated a significantly lower sample entropy value in sagittal and frontal plane trunk kinematics and sagittal plane hip kinematics compared to the controls. No between-group differences existed in other kinematic measures. INTERPRETATION The lower sample entropy values in participants with chronic ankle instability indicates that those with postural control deficits may increase reliance on the trunk and hip joint contributions to the maintenance of postural control, reflecting changes in the sensorimotor constraints on movement patterns during the task.
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Affiliation(s)
- Masafumi Terada
- College of Sport and Health Science, Ritsumeikan University, Integration Core Building 602, 1-1-1 Noji-higashi, Kusatsu, Shiga 525-8577, Japan.
| | - Kristin D Morgan
- Department of Biomedical Engineering, University of Connecticut, A.B. Bronwell Building, Room 307, 260 Glenbrook Road, Unit 3247, Storrs, CT 06269-3247, USA.
| | - Phillip A Gribble
- College of Health Sciences, University of Kentucky, Charles T. Wethington Building, 206C, 900 South Limestone, Lexington, KY 40536-0200, USA.
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Towards Real-Time Prediction of Freezing of Gait in Patients With Parkinson's Disease: Addressing the Class Imbalance Problem. SENSORS 2019; 19:s19183898. [PMID: 31509999 PMCID: PMC6767263 DOI: 10.3390/s19183898] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/05/2019] [Accepted: 09/08/2019] [Indexed: 01/06/2023]
Abstract
Freezing of gait (FoG) is a common motor symptom in patients with Parkinson's disease (PD). FoG impairs gait initiation and walking and increases fall risk. Intelligent external cueing systems implementing FoG detection algorithms have been developed to help patients recover gait after freezing. However, predicting FoG before its occurrence enables preemptive cueing and may prevent FoG. Such prediction remains challenging given the relative infrequency of freezing compared to non-freezing events. In this study, we investigated the ability of individual and ensemble classifiers to predict FoG. We also studied the effect of the ADAptive SYNthetic (ADASYN) sampling algorithm and classification cost on classifier performance. Eighteen PD patients performed a series of daily walking tasks wearing accelerometers on their ankles, with nine experiencing FoG. The ensemble classifier formed by Support Vector Machines, K-Nearest Neighbors, and Multi-Layer Perceptron using bagging techniques demonstrated highest performance (F1 = 90.7) when synthetic FoG samples were added to the training set and class cost was set as twice that of normal gait. The model identified 97.4% of the events, with 66.7% being predicted. This study demonstrates our algorithm's potential for accurate prediction of gait events and the provision of preventive cueing in spite of limited event frequency.
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Deterioration of specific aspects of gait during the instrumented 6-min walk test among people with multiple sclerosis. J Neurol 2019; 266:3022-3030. [PMID: 31493037 DOI: 10.1007/s00415-019-09500-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/04/2019] [Accepted: 08/06/2019] [Indexed: 10/26/2022]
Abstract
Prolonged walking is typically impaired among people with multiple sclerosis (pwMS), however, it is unclear what the contributing factors are or how to evaluate this deterioration. We aimed to determine which gait features become worse during sustained walking and to examine the clinical correlates of gait fatigability in pwMS. Fifty-eight pwMS performed the 6-min walk test while wearing body-fixed sensors. Multiple gait domains (e.g., pace, rhythm, variability, asymmetry and complexity) were compared across each minute of the test and between mild- and moderate-disability patient groups. Associations between the decline in gait performance (i.e., gait fatigability) and patient-reported gait disability, fatigue and falls were also determined. Cadence, stride time variability, stride regularity, step regularity and gait complexity significantly deteriorated during the test. In contrast, somewhat surprisingly, gait speed and swing time asymmetry did not change. As expected, subjects with moderate disability (n = 24) walked more poorly in most gait domains compared to the mild-disability group (n = 34). Interestingly, a group × fatigue interaction effect was observed for cadence and gait complexity; these measures decreased over time in the moderate-disability group, but not in the mild group. Gait fatigability rate was significantly correlated with physical fatigue, gait disability, and fall history. These findings suggest that sustained walking affects specific aspects of gait, which can be used as markers for fatigability in MS. This effect on gait depends on the degree of disability, and may increase fall risk in pwMS. To more fully understand and monitor correlates that reflect everyday walking in pwMS, multiple domains of gait should be quantified.
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Combs-Miller SA, Dugan EL, Beachy A, Derby BB, Hosinski AL, Robbins K. Physiological complexity of gait between regular and non-exercisers with Parkinson's disease. Clin Biomech (Bristol, Avon) 2019; 68:23-28. [PMID: 31146080 DOI: 10.1016/j.clinbiomech.2019.05.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Physiological complexity represents overall health of a system and its underlying capacity to adapt to stresses. The primary purpose of this study was to determine if physiological complexity of gait both ON and OFF anti-Parkinson medication differed between regular and non-exercisers with Parkinson's disease. METHODS Twenty participants with idiopathic Parkinson's disease were enrolled in this cross-sectional study (regular exercisers n = 10, non-exercisers n = 10). Two data collection sessions were completed during a single visit, first after a 12-hour overnight withdrawal from anti-Parkinson medications (OFF), and again one-hour after taking anti-Parkinson medications (ON). During each session participants completed a 2-minute walking task at their preferred pace while wearing wireless inertial measurement units on each lower extremity segment (thigh, shank, foot). Multivariate multiscale entropy was calculated from the tri-axial accelerometer signals and converted to a complexity index for analysis. FINDINGS Regular exercisers demonstrated significantly higher complexity indices ON and OFF anti-Parkinson medications compared to non-exercisers (ON F = 3.84 P = 0.02; OFF F = 3.61, P < 0.03). Regular exercisers did not significantly differ in complexity between OFF and ON states (most affected leg F = 0.15 P = 0.71; least affected leg F = 0.30 P = 0.60), but non-exercisers demonstrated significantly decreased complexity in the least affected leg OFF anti-Parkinson medications (F = 5.17 P < 0.04). INTERPRETATION Enhanced gait complexity in the regular exercisers may indicate that ongoing exercise is a key ingredient contributing to health in persons with Parkinson's disease. Exercising on a regular basis with Parkinson's disease may augment one's ability to adapt to barriers encountered during gait regardless of medication state.
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Affiliation(s)
- Stephanie A Combs-Miller
- University of Indianapolis, Krannert School of Physical Therapy, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA.
| | - Eric L Dugan
- Texas Children's Hospital, Motion Analysis and Human Performance Program, 17580 Interstate 45 South, The Woodlands, TX 77384, USA; Baylor College of Medicine, Department of Orthopaedic Surgery, 17580 Interstate 45 South, The Woodlands, TX 77384, USA
| | - Ann Beachy
- University of Indianapolis, Krannert School of Physical Therapy, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA
| | - Brook B Derby
- University of Indianapolis, Krannert School of Physical Therapy, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA
| | - Alicia L Hosinski
- University of Indianapolis, Krannert School of Physical Therapy, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA
| | - Kristen Robbins
- University of Indianapolis, Krannert School of Physical Therapy, 1400 E. Hanna Ave., Indianapolis, IN 46227, USA
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Altered visual and somatosensory feedback affects gait stability in persons with multiple sclerosis. Hum Mov Sci 2019; 66:355-362. [PMID: 31150900 PMCID: PMC7309345 DOI: 10.1016/j.humov.2019.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 05/20/2019] [Accepted: 05/23/2019] [Indexed: 12/20/2022]
Abstract
Persons with multiple sclerosis (PwMS) often report problems due to sensory loss and have an inability to appropriately reweight sensory information. Both of these issues can affect individual's ability to maintain stability when walking under challenging conditions. The purpose of the current study was to determine how gait stability is adapted when walking under challenging sensory conditions where vision and somatosensation at the feet is manipulated. 25 healthy adults and 40 PwMS (15 fallers, 25 non-fallers) walked on a treadmill at their preferred normal walking speed under 3 conditions: normal walking, altered vision using goggles that shifted visual field laterally, and altered somatosensation using shoes with compliant foam soles. Inertial measurement united recorded acceleration at the lumbar and right ankle, and acceleration variability measures were calculated including root mean square (RMS), range, sample entropy (SaEn), and Lyapunov exponents (LyE). A gait stability index (GSI) was calculated using each of the four variability measures as the ratio of lumbar acceleration variability divided by foot acceleration variability in the frontal and sagittal planes. The sagittal and frontal GSIRMS were larger in the somatosensory condition compared to the normal and visual conditions (p < 0.001). The frontal GSISaEn was greater in the visual condition compared to the somatosensory condition (p = 0.021). The frontal and sagittal GSILyE was greater in the somatosensory condition compared to the normal and visual conditions (p < 0.002). The current study showed that HC, MS non-fallers and MS fallers largely adapted to altered sensory feedback during walking in a similar manner. However, MS faller subjects may be more reliant on visual feedback compared to MS non-fallers and HC subjects.
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Gao CC, Chern JS, Chang CJ, Lai PL, Lung CW. Center of pressure progression patterns during level walking in adolescents with idiopathic scoliosis. PLoS One 2019; 14:e0212161. [PMID: 31009471 PMCID: PMC6476471 DOI: 10.1371/journal.pone.0212161] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 01/29/2019] [Indexed: 12/05/2022] Open
Abstract
The purpose of this study was to determine whether functional walking performance measured with Timed Up-and-Go (TUG) and center of pressure (CoP) progression pattern is different across adolescents with various curve severity of idiopathic scoliosis (IS). The CoP coordinates during a stance phase for self-paced level walking between adolescent with three different severities of IS (mild IS, moderate IS, and severe IS) and age-matched normal subjects were measured with foot pressure measurement. The average data of three trials were compared among groups with repeated measure analysis of variance. Results showed that the TUG was different between normal and AIS subjects, indicating use of TUG as a marker of functional walking performance in AIS is plausible but studies with larger sample size is needed before using TUG to identify AIS with different scoliosis severity. The results also showed that the CoP displacement, velocity and acceleration during a stance phase was different across groups, and with the most prominent deviations found in the moderate IS group. The medial-lateral shifting of the CoP trajectory at mid-foot regions in all IS groups deviated the most. A tendency of asymmetry in CoP progression pattern between feet in IS groups was also found. The deviation of the spine alignment in frontal plane could change the CoP progression patterns during level walking, suggesting the risk of the locomotors subjecting to abnormal loading during daily walking. Education and conservative interventions might be needed for preservation of medical outcome and prevention of back pain and/or musculoskeletal consequences later in the lives of AIS with and without surgical correction.
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Affiliation(s)
- Chia-Chi Gao
- Department of Occupational Therapy and Graduate Institute of Behavioral Science, School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Occupational Therapy in Rehabilitation Department, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Jen-Suh Chern
- Graduate Institute of Rehabilitation Counseling, National Taiwan Normal University, Taipei, Taiwan
- * E-mail:
| | - Chun-Ju Chang
- Master of Business Administration Program, Rotterdam School of Management, Erasmus University, Rotterdam, Netherlands
| | - Po-Liang Lai
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Wen Lung
- Department of Creative Product Design, Asia University, Taichung, Taiwan
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Naghavi N, Wade E. Prediction of Freezing of Gait in Parkinson's Disease Using Statistical Inference and Lower-Limb Acceleration Data. IEEE Trans Neural Syst Rehabil Eng 2019; 27:947-955. [PMID: 30990186 DOI: 10.1109/tnsre.2019.2910165] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The freezing of gait (FoG) is a common type of motor dysfunction in advanced Parkinson's disease (PD) associated with falls. Over the last decade, a significant amount of studies has been focused on detecting FoG episodes in clinical and home environments. Yet, there remains a paucity of techniques regarding real-time prediction of FoG before its occurrence. In this paper, a new algorithm was employed to define the best combination of sensor position, axis, sampling window length, and features to predict FoG. We hypothesized that gait deterioration before FoG onsets can be discriminated from normal gait using statistical analysis of features from successive windows of data collected from lower-limb accelerometers. We defined a new performance measure, "predictivity", to compare the number of correctly predicted FoG events among different combinations. We characterized the system performance using data from 10 PD patients, who experienced FoG while performing several walking tasks in a lab environment. The analysis of 120 different combinations revealed that prediction of FoG can be realized by using an individual shank sensor and sample entropy calculated from the horizontal forward axis with window length of 2 s (88.8%, 92.5%, and 89.0% for average predictivity, sensitivity, and specificity, respectively).
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TERADA MASAFUMI, JOHNSON NATHAN, KOSIK KYLE, GRIBBLE PHILLIP. Quantifying Brain White Matter Microstructure of People with Lateral Ankle Sprain. Med Sci Sports Exerc 2019; 51:640-646. [DOI: 10.1249/mss.0000000000001848] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Dugan EL, Combs-Miller SA. Physiological complexity of gait is decreased in individuals with chronic stroke. Comput Methods Biomech Biomed Engin 2019; 22:658-663. [DOI: 10.1080/10255842.2019.1578961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Eric L. Dugan
- Department of Kinesiology, Center for Orthopaedic and Biomechanics Research, Boise State University, Boise, ID, USA
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29
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Schütte KH, Seerden S, Venter R, Vanwanseele B. Influence of outdoor running fatigue and medial tibial stress syndrome on accelerometer-based loading and stability. Gait Posture 2018; 59:222-228. [PMID: 29080511 DOI: 10.1016/j.gaitpost.2017.10.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 10/05/2017] [Accepted: 10/17/2017] [Indexed: 02/02/2023]
Abstract
Medial tibial stress syndrome (MTSS) is a common overuse running injury with pathomechanics likely to be exaggerated by fatigue. Wearable accelerometry provides a novel alternative to assess biomechanical parameters continuously while running in more ecologically valid settings. The purpose of this study was to determine the influence of outdoor running fatigue and MTSS on both dynamic loading and dynamic stability derived from trunk and tibial accelerometery. Runners with (n=14) and without (n=16) history of MTSS performed an outdoor fatigue run of 3200m. Accelerometer-based measures averaged per lap included dynamic loading of the trunk and tibia (i.e. axial peak positive acceleration, signal power magnitude, and shock attenuation) as well as dynamic trunk stability (i.e. tri-axial root mean square ratio, step and stride regularity, and sample entropy). Regression coefficients from generalised estimating equations were used to evaluate group by fatigue interactions. No evidence could be found for dynamic loading being higher with fatigue in runners with MTSS history (all measures p>0.05). One significant group by running fatigue interaction effect was detected for dynamic stability. Specifically, in MTSS only, decreases mediolateral sample entropy i.e. loss of complexity was associated with running fatigue (p<0.01). The current results indicate that entire acceleration waveform signals reflecting mediolateral trunk control is related to MTSS history, a compensation that went undetected in the non-fatigued running state. We suggest that a practical outdoor running fatigue protocol that concurrently captures trunk accelerometry-based movement complexity warrants further prospective investigation as an in-situ screening tool for MTSS individuals.
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Affiliation(s)
- Kurt H Schütte
- Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium; Movement Laboratory, Department of Sport Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa.
| | - Stefan Seerden
- Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Rachel Venter
- Movement Laboratory, Department of Sport Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Benedicte Vanwanseele
- Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
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30
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Takakura IT, Hoshi RA, Santos MA, Pivatelli FC, Nóbrega JH, Guedes DL, Nogueira VF, Frota TQ, Castelo GC, Godoy MFD. Recurrence Plots: a New Tool for Quantification of Cardiac Autonomic Nervous System Recovery after Transplant. Braz J Cardiovasc Surg 2017; 32:245-252. [PMID: 28977195 PMCID: PMC5613725 DOI: 10.21470/1678-9741-2016-0035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 02/09/2017] [Indexed: 02/06/2023] Open
Abstract
Objective To evaluate a possible evolutionary post-heart transplant return of autonomic
function using quantitative and qualitative information from recurrence
plots. Methods Using electrocardiography, 102 RR tachograms of 45 patients (64.4% male) who
underwent heart transplantation and that were available in the database were
analyzed at different follow-up periods. The RR tachograms were collected
from patients in the supine position for about 20 minutes. A time series
with 1000 RR intervals was analyzed, a recurrence plot was created, and the
following quantitative variables were evaluated: percentage of determinism,
percentage of recurrence, average diagonal length, Shannon entropy, and
sample entropy, as well as the visual qualitative aspect. Results Quantitative and qualitative signs of heart rate variability recovery were
observed after transplantation. Conclusion There is evidence that autonomic innervation of the heart begins to happen
gradually after transplantation. Quantitative and qualitative analyses of
recurrence can be useful tools for monitoring cardiac transplant patients
and detecting the gradual return of heart rate variability.
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Affiliation(s)
- Isabela Thomaz Takakura
- Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, SP, Brazil.,Universidade de Fortaleza (Unifor), Fortaleza, CE, Brazil
| | - Rosangela Akemi Hoshi
- Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, SP, Brazil
| | - Márcio Antonio Santos
- Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, SP, Brazil
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31
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Schütte KH, Sackey S, Venter R, Vanwanseele B. Energy cost of running instability evaluated with wearable trunk accelerometry. J Appl Physiol (1985) 2017; 124:462-472. [PMID: 28751372 DOI: 10.1152/japplphysiol.00429.2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Maintaining stability under dynamic conditions is an inherent challenge to bipedal running. This challenge may impose an energetic cost (Ec) thus hampering endurance running performance, yet the underlying mechanisms are not clear. Wireless triaxial trunk accelerometry is a simple tool that could be used to unobtrusively evaluate these mechanisms. Here, we test a cost of instability hypothesis by examining the contribution of trunk accelerometry-based measures (triaxial root mean square, step and stride regularity, and sample entropy) to interindividual variance in Ec (J/m) during treadmill running. Accelerometry and indirect calorimetry data were collected concurrently from 30 recreational runners (16 men; 14 women) running at their highest steady-state running speed (80.65 ± 5.99% V̇o2max). After reducing dimensionality with factor analysis, the effect of dynamic stability features on Ec was evaluated using hierarchical multiple regression analysis. Three accelerometry-based measures could explain an additional 10.4% of interindividual variance in Ec after controlling for body mass, attributed to anteroposterior stride regularity (5.2%), anteroposterior root mean square ratio (3.2%), and mediolateral sample entropy (2.0%). Our results lend support to a cost of instability hypothesis, with trunk acceleration waveform signals that are 1) more consistent between strides anteroposterioly, 2) larger in amplitude variability anteroposterioly, and 3) more complex mediolaterally and are energetically advantageous to endurance running performance. This study shows that wearable trunk accelerometry is a useful tool for understanding the Ec of running and that running stability is important for economy in recreational runners. NEW & NOTEWORTHY This study evaluates and more directly lends support to a cost of instability hypothesis between runners. Moreover, this hypothesis was tested using a minimalist setup including a single triaxial trunk mounted accelerometer, with potential transferability to biomechanical and performance analyses in typical outdoor settings.
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Affiliation(s)
- Kurt H Schütte
- Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven , Belgium.,Movement Laboratory, Department of Sport Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Saint Sackey
- Movement Laboratory, Department of Sport Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Rachel Venter
- Movement Laboratory, Department of Sport Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Benedicte Vanwanseele
- Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven , Belgium
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32
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Thomas KS, Russell DM, Van Lunen BL, Colberg SR, Morrison S. The impact of speed and time on gait dynamics. Hum Mov Sci 2017. [PMID: 28641172 DOI: 10.1016/j.humov.2017.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
To determine the effects of speed on gait previous studies have examined young adults walking at different speeds; however, the small number of strides may have influenced the results. The aim of this study was to investigate the immediate and long-term impact of continuous slow walking on the mean, variability and structure of stride-to-stride measures. Fourteen young adults walked at a constant pace on a treadmill at three speeds (preferred walking speed (PWS), 90% and 80% PWS) for 30 min each. Spatiotemporal gait parameters were computed over six successive 5-min intervals. Walking slower significantly decreased stride length, while stride period and width increased. Additionally, stride period and width variability increased. Signal regularity of stride width increased and decreased in stride period. Persistence of stride period and width increased significantly at slower speeds. While several measures changed during 30min of walking, only stride period variability and signal regularity revealed a significant speed and time interaction. Healthy young adults walking at slower than preferred speeds demonstrated greater persistence and signal regularity of stride period while spatiotemporal changes such as increased stride width and period variability arose. These results suggest that different control processes are involved in adapting to the slower speeds.
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Affiliation(s)
- Kathleen S Thomas
- Department of Health, Physical Education and Exercise Science, Norfolk State University, Norfolk, VA 23504, USA.
| | - Daniel M Russell
- School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA 23529, USA
| | - Bonnie L Van Lunen
- School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA 23529, USA
| | - Sheri R Colberg
- Human Movement Sciences Department, Old Dominion University, Norfolk, VA 23529, USA
| | - Steven Morrison
- School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA 23529, USA
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33
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Barden JM, Clermont CA, Kobsar D, Beauchet O. Accelerometer-Based Step Regularity Is Lower in Older Adults with Bilateral Knee Osteoarthritis. Front Hum Neurosci 2016; 10:625. [PMID: 28008312 PMCID: PMC5143349 DOI: 10.3389/fnhum.2016.00625] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 11/23/2016] [Indexed: 01/09/2023] Open
Abstract
Purpose: To compare the regularity and symmetry of gait between a cohort of older adults with bilateral knee osteoarthritis (OA) and an age and sex-matched control group of older adults with healthy knees. Methods: Fifteen (8 females) older adults with knee OA (64.7 ± 6.7 years) and fifteen (8 females) pain-free controls (66.1 ± 10.0 years) completed a 9-min. walk at a self-selected, comfortable speed while wearing a single waist-mounted tri-axial accelerometer. The following gait parameters were compared between the two groups according to sex: mean step time, mean stride time, stride and step regularity (defined as the consistency of the stride-to-stride or step-to-step pattern) and the symmetry of gait (defined as the difference between step and stride regularity) as determined by an unbiased autocorrelation procedure that analyzed the pattern of acceleration in the vertical, mediolateral and anteroposterior directions. Results: Older adults with knee OA displayed significantly less step regularity in the vertical (p < 0.05) and anteroposterior (p < 0.05) directions than controls. Females with knee OA were also found to have significantly less mediolateral step regularity than female controls (p < 0.05), whereas no difference was found between males. Conclusion: The results showed that the regularity of the step pattern in individuals with bilateral knee OA was less consistent compared to similarly-aged older adults with healthy knees. The findings suggest that future studies should investigate the relationship between step regularity, sex and movement direction as well as the application of these methods to the clinical assessment of knee OA.
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Affiliation(s)
- John M Barden
- Faculty of Kinesiology and Health Studies, Neuromechanical Research Centre, University of Regina Regina, SK, Canada
| | | | - Dylan Kobsar
- Faculty of Kinesiology, University of Calgary Calgary, AB, Canada
| | - Olivier Beauchet
- Division of Geriatric Medicine, Department of Medicine, McGill University Montreal, QC, Canada
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34
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Clermont CA, Barden JM. Accelerometer-based determination of gait variability in older adults with knee osteoarthritis. Gait Posture 2016; 50:126-130. [PMID: 27607303 DOI: 10.1016/j.gaitpost.2016.08.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 07/25/2016] [Accepted: 08/23/2016] [Indexed: 02/02/2023]
Abstract
Knee osteoarthritis (KOA) can affect the spatiotemporal (ST) aspects of gait as well as the variability of select ST parameters based on standard linear measures of variability (e.g., standard deviation (SD) and coefficient of variation). Non-linear measures (e.g., fractal scaling index (FSI) and sample entropy) can be more sensitive to changes in gait variability, and have been used to quantify differences in the stride patterns of patients with Parkinson's disease and the motion of ACL-deficient knees. However, the effect of KOA on the dynamic complexity of the stride pattern has not been investigated. Therefore, the purpose of this study was to investigate the effect of KOA on gait variability (linear and non-linear measures) in a group of older adults, and to compare these results to a healthy control group. Participants walked for 10min with a tri-axial accelerometer placed at the lower back. Mean and SDs of stride time and step time as well as the FSI for the entire series of stride times were calculated for each participant. Participants with KOA had significantly greater mean stride time (p=0.031) and step time (p=0.024) than control group participants. While stride and step time variability (SD) were greater in the KOA group, the differences were not significant, nor was the difference in the FSI. Low statistical power (β=0.40 and 0.30 for stride and step time SD, respectively) combined with the confounding effects of walking speed and heterogeneous KOA severity likely prevented significant differences from being found.
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Affiliation(s)
- Christian A Clermont
- University of Regina, Faculty of Kinesiology & Health Studies, University of Regina 3737 Wascana Parkway Regina, Saskatchewan, S4S 0A2, Canada.
| | - John M Barden
- University of Regina, Faculty of Kinesiology & Health Studies, University of Regina 3737 Wascana Parkway Regina, Saskatchewan, S4S 0A2, Canada.
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35
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Craig JJ, Bruetsch A, Huisinga JM. Relationship between trunk and foot accelerations during walking in healthy adults. Gait Posture 2016; 49:25-29. [PMID: 27344450 PMCID: PMC5035185 DOI: 10.1016/j.gaitpost.2016.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 05/02/2016] [Accepted: 06/02/2016] [Indexed: 02/02/2023]
Abstract
Understanding upper body and lower body segment relationships may be an important step in assessing stability during gait. This study explored the relationship between acceleration patterns at the trunk and at the foot during treadmill walking at self-selected pace in healthy adults. Forty healthy subjects walked on a treadmill for 3 minutes at self-selected speed. Root mean square (RMS) and approximate entropy (ApEn) were derived from the acceleration time series at the trunk and at the foot in the frontal and sagittal plane. RMS of accelerations at the trunk were strongly correlated with RMS values at the foot in the sagittal plane (r=0.883, p<0.01) and in the frontal plane (r=0.811, p<0.01). ApEn values at the trunk were moderately correlated with ApEn values at the foot in the sagittal plane (r=0.603, p<0.01) only. These results show that acceleration variability at the foot is related to acceleration variability at the trunk, specifically that increased variability at the foot is tied to increased variability at the trunk in healthy adults. Portable inertial sensors can potentially be used in any environment including a laboratory, clinic, or at home to measure lower and upper body segment motion, and assessing relationships between upper and lower body motion may provide a more comprehensive evaluation of overall stability.
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Affiliation(s)
- Jordan J. Craig
- Landon Center on Aging, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 1005, Kansas City, KS 66160, United States of America,Bioengineering Graduate Program, University of Kansas, 3135A Learned Hall, 1530 W 15th St, Lawrence, KS 66045, United States of America
| | - Adam Bruetsch
- Landon Center on Aging, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 1005, Kansas City, KS 66160, United States of America
| | - Jessie M. Huisinga
- Landon Center on Aging, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 1005, Kansas City, KS 66160, United States of America,Bioengineering Graduate Program, University of Kansas, 3135A Learned Hall, 1530 W 15th St, Lawrence, KS 66045, United States of America,Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 2002, Kansas City, KS 66160, United States of America
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36
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Jayaraman C, Moon Y, Sosnoff JJ. Shoulder pain and time dependent structure in wheelchair propulsion variability. Med Eng Phys 2016; 38:648-655. [PMID: 27134151 PMCID: PMC4884508 DOI: 10.1016/j.medengphy.2016.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 02/26/2016] [Accepted: 04/03/2016] [Indexed: 11/15/2022]
Abstract
Manual wheelchair propulsion places considerable repetitive mechanical strain on the upper limbs leading to shoulder injury and pain. While recent research indicates that the amount of variability in wheelchair propulsion and shoulder pain may be related. There has been minimal inquiry into the fluctuation over time (i.e. time-dependent structure) in wheelchair propulsion variability. Consequently the purpose of this investigation was to examine if the time-dependent structure in the wheelchair propulsion parameters are related to shoulder pain. 27 experienced wheelchair users manually propelled their own wheelchair fitted with a SMARTWheel on a roller at 1.1m/s for 3min. Time-dependent structure of cycle-to-cycle fluctuations in contact angle and inter push time interval was quantified using sample entropy (SampEn) and compared between the groups with/without shoulder pain using non-parametric statistics. Overall findings were, (1) variability observed in contact angle fluctuations during manual wheelchair propulsion is structured (Z=3.15;p<0.05), (2) individuals with shoulder pain exhibited higher SampEn magnitude for contact angle during wheelchair propulsion than those without pain (χ(2)(1)=6.12;p<0.05); and (3) SampEn of contact angle correlated significantly with self-reported shoulder pain (rs (WUSPI) =0.41;rs (VAS)=0.56;p<0.05). It was concluded that the time-dependent structure in wheelchair propulsion may provide novel information for tracking and monitoring shoulder pain.
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Affiliation(s)
- Chandrasekaran Jayaraman
- Department of Industrial and Enterprise Systems Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Yaejin Moon
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Jacob J Sosnoff
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
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37
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Bisi MC, Stagni R. Complexity of human gait pattern at different ages assessed using multiscale entropy: From development to decline. Gait Posture 2016; 47:37-42. [PMID: 27264400 DOI: 10.1016/j.gaitpost.2016.04.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/24/2016] [Accepted: 04/01/2016] [Indexed: 02/02/2023]
Abstract
Multiscale entropy (MSE) has been applied in biomechanics to evaluate gait stability during human gait and was found to be a promising method for evaluating fall risk in elderly and/or pathologic subjects. The hypothesis of this work is that gait complexity is a relevant parameter of gait development during life, decreasing from immature to mature gait and then increasing again during old age. In order to verify this hypothesis, MSE was applied on trunk acceleration data collected during gait of subjects of different ages: toddlers at the onset of walking, pre-scholar and scholar children, adolescents, young adults, adults and elderlies. MSE was estimated by calculating sample entropy (SEN) on raw unfiltered data of L5 acceleration along the three axes, using values of τ ranging from 1 to 6. In addition, other performance parameters (cadence, stride time variability and harmonic ratio) were evaluated. The results followed the hypothesized trend when MSE was applied on the vertical and/or anteroposterior axis of trunk acceleration: an age effect was found and adult SEN values were significantly different from children ones. From young adults to elderlies a slight increase in SEN values was shown although not statistically significant. While performance gait parameters showed adolescent gait similar to the one of adults, SEN highlighted that their gait maturation is not complete yet. In conclusion, present results suggest that the complexity of gait, evaluated on the sagittal plane, can be used as a characterizing parameter of the maturation of gait control.
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Affiliation(s)
- M C Bisi
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy.
| | - R Stagni
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
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38
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Schütte KH, Maas EA, Exadaktylos V, Berckmans D, Venter RE, Vanwanseele B. Wireless Tri-Axial Trunk Accelerometry Detects Deviations in Dynamic Center of Mass Motion Due to Running-Induced Fatigue. PLoS One 2015; 10:e0141957. [PMID: 26517261 PMCID: PMC4627812 DOI: 10.1371/journal.pone.0141957] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 10/15/2015] [Indexed: 12/05/2022] Open
Abstract
Small wireless trunk accelerometers have become a popular approach to unobtrusively quantify human locomotion and provide insights into both gait rehabilitation and sports performance. However, limited evidence exists as to which trunk accelerometry measures are suitable for the purpose of detecting movement compensations while running, and specifically in response to fatigue. The aim of this study was therefore to detect deviations in the dynamic center of mass (CoM) motion due to running-induced fatigue using tri-axial trunk accelerometry. Twenty runners aged 18–25 years completed an indoor treadmill running protocol to volitional exhaustion at speeds equivalent to their 3.2 km time trial performance. The following dependent measures were extracted from tri-axial trunk accelerations of 20 running steps before and after the treadmill fatigue protocol: the tri-axial ratio of acceleration root mean square (RMS) to the resultant vector RMS, step and stride regularity (autocorrelation procedure), and sample entropy. Running-induced fatigue increased mediolateral and anteroposterior ratios of acceleration RMS (p < .05), decreased the anteroposterior step regularity (p < .05), and increased the anteroposterior sample entropy (p < .05) of trunk accelerometry patterns. Our findings indicate that treadmill running-induced fatigue might reveal itself in a greater contribution of variability in horizontal plane trunk accelerations, with anteroposterior trunk accelerations that are less regular from step-to-step and are less predictable. It appears that trunk accelerometry parameters can be used to detect deviations in dynamic CoM motion induced by treadmill running fatigue, yet it is unknown how robust or generalizable these parameters are to outdoor running environments.
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Affiliation(s)
- Kurt H. Schütte
- Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
- Measure, Model & Manage Bioresponses (M3-BIORES) Group, Department of Biosystems, KU Leuven, Leuven, Belgium
- Movement Laboratory, Department of Sport Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa
- * E-mail:
| | - Ellen A. Maas
- Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Vasileios Exadaktylos
- Measure, Model & Manage Bioresponses (M3-BIORES) Group, Department of Biosystems, KU Leuven, Leuven, Belgium
| | - Daniel Berckmans
- Measure, Model & Manage Bioresponses (M3-BIORES) Group, Department of Biosystems, KU Leuven, Leuven, Belgium
| | - Rachel E. Venter
- Movement Laboratory, Department of Sport Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Benedicte Vanwanseele
- Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
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39
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Terada M, Bowker S, Thomas AC, Pietrosimone B, Hiller CE, Rice MS, Gribble PA. Alterations in stride-to-stride variability during walking in individuals with chronic ankle instability. Hum Mov Sci 2015; 40:154-62. [DOI: 10.1016/j.humov.2014.12.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/02/2014] [Accepted: 12/08/2014] [Indexed: 12/26/2022]
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40
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Jarchi D, Wong C, Kwasnicki RM, Heller B, Tew GA, Yang GZ. Gait parameter estimation from a miniaturized ear-worn sensor using singular spectrum analysis and longest common subsequence. IEEE Trans Biomed Eng 2014; 61:1261-73. [PMID: 24658250 DOI: 10.1109/tbme.2014.2299772] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper presents a new approach to gait analysis and parameter estimation from a single miniaturized ear-worn sensor embedded with a triaxial accelerometer. Singular spectrum analysis combined with the longest common subsequence algorithm has been used as a basis for gait parameter estimation. It incorporates information from all axes of the accelerometer to estimate parameters including swing, stance, and stride times. Rather than only using local features of the raw signals, the periodicity of the signals is also taken into account. The hypotheses tested by this study include: 1) how accurate is the ear-worn sensor in terms of gait parameter extraction compared to the use of an instrumented treadmill; 2) does the ear-worn sensor provide a feasible option for assessment and quantification of gait pattern changes. Key gait events for normal subjects such as heel contact and toe off are validated with a high-speed camera, as well as a force-plate instrumented treadmill. Ten healthy adults walked for 20 min on a treadmill with an increasing incline of 2% every 2 min. The upper and lower limits of the absolute errors using 95% confidence intervals for swing, stance, and stride times were obtained as 35.5 ±3.99 ms, 36.9 ±3.84 ms, and 17.9 ±2.29 ms, respectively.
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41
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Riva F, Toebes MJP, Pijnappels M, Stagni R, van Dieën JH. Estimating fall risk with inertial sensors using gait stability measures that do not require step detection. Gait Posture 2013; 38:170-4. [PMID: 23726429 DOI: 10.1016/j.gaitpost.2013.05.002] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Falls have major consequences both at societal (health-care and economy) and individual (physical and psychological) levels. Questionnaires to assess fall risk are commonly used in the clinic, but their predictive value is limited. Objective methods, suitable for clinical application, are hence needed to obtain a quantitative assessment of individual fall risk. Falls in older adults often occur during walking and trunk position is known to play a critical role in balance control. Therefore, analysis of trunk kinematics during gait could present a viable approach to the development of such methods. In this study, nonlinear measures such as harmonic ratio (HR), index of harmonicity (IH), multiscale entropy (MSE) and recurrence quantification analysis (RQA) of trunk accelerations were calculated. These measures are not dependent on step detection, a potentially critical source of error. The aim of the present study was to investigate the association between the aforementioned measures and fall history in a large sample of subjects (42 fallers and 89 non - fallers) aged 50 or older. Univariate associations with fall history were found for MSE and RQA parameters in the AP direction; the best classification results were obtained for MSE with scale factor τ = 2 and for maximum length of diagonals in RQA (72.5% and 71% correct classifications, respectively). MSE and RQA were found to be positively associated with fall history and could hence represent useful tools in the identification of subjects for fall prevention programs.
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Affiliation(s)
- F Riva
- DEIS - Department of Electronics, Computer Sciences and Systems, University of Bologna, Italy.
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Tri-axial accelerometer analysis techniques for evaluating functional use of the extremities. J Electromyogr Kinesiol 2013; 23:924-9. [PMID: 23642841 DOI: 10.1016/j.jelekin.2013.03.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 03/20/2013] [Accepted: 03/20/2013] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Activity monitors provide an objective mechanism for evaluating patient function. It is unclear what similarities or unique information may be yielded using different analyses. Fifteen patients scheduled to undergo shoulder arthroplasty and fifteen matched control subjects wore tri-axial accelerometer activity monitors bilaterally at the lower (wrist) and upper (biceps) arm for 3days. Measures of central tendency, variance, sample entropy, and asymmetry were calculated. A novel technique to evaluate time distribution of activity intensity was also performed. Within both groups there was a difference in central tendency and variance when comparing dominant and non-dominant limbs for both the lower ( CONTROLS Mean Activity, P<0.001; Max Activity, P<0.001; PATIENTS Mean Activity, P=0.044; Max Activity, P=0.009) and upper ( CONTROLS Mean Activity, P<0.001; Max Activity, P=0.046; PATIENTS Mean Activity, P=0.002; Max Activity, P=0.049) arm. Within group differences were also present for lower arm entropy in both groups (CONTROLS, P<0.001; PATIENTS P=0.041), and at the upper arm for patients (P=0.003). There were differences between groups for the asymmetry index for both the lower (P=0.033) and upper arm (P=0.005), and maximum activity level of the lower arm (P=0.05). Between group differences were present for time distribution of activity intensity, as the involved upper arm of patients was inactive for a greater time than controls (P=0.013). These results highlight unique information provided by multiple analysis methods, and include a novel approach of evaluating the distribution of time spent across variable intensity activities.
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