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Yu JS, Zhuang C, Guo WX, Chen JJ, Wu XK, Xie W, Zhou X, Su H, Chen YX, Wang LK, Li WK, Tian K, Zhuang RJ. Reference values of gait parameters in healthy Chinese university students: A cross-sectional observational study. World J Clin Cases 2023; 11:7061-7074. [PMID: 37946765 PMCID: PMC10631401 DOI: 10.12998/wjcc.v11.i29.7061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/04/2023] [Accepted: 09/18/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Gait is influenced by race, age, and diseases type. Reference values for gait are closely related to numerous health outcomes. To gain a comprehensive understanding of gait patterns, particularly in relation to race-related pathologies and disorders, it is crucial to establish reference values for gait in daily life considering sex and age. Therefore, our objective was to present sex and age-based reference values for gait in daily life, providing a valuable foundation for further research and clinical applications. AIM To establish reference values for lower extremity joint kinematics and kinetics during gait in asymptomatic adult women and men. METHODS Spatiotemporal, kinematics and kinetics parameters were measured in 171 healthy adults (70 males and 101 females) using the computer-aided soft tissue foot model. Full curve statistical parametric mapping was performed using independent and paired-samples t-tests. RESULTS Compared with females, males required more time (cycle time, double-limb support time, stance time, swing time, and stride time), and the differences were statistically significant. In addition, the step and stride lengths of males were longer. Compared to males, female cadence was faster, and statures-per-second and stride-per-minute were higher. There were no statistical differences in speed and stride width between the two groups. After adjusting for height, it was observed that women walked significantly faster than men, and they also had a higher cadence. However, in terms of step length, stride length, and stride width, both genders exhibited similarities. CONCLUSION We established reference values for gait speed and spatiotemporal gait parameters in Chinese university students. This contributes to a valuable database for gait assessment and evaluation of preventive or rehabilitative programs.
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Affiliation(s)
- Jin-Sheng Yu
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Chen Zhuang
- Alberta Institute, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
| | - Wen-Xuan Guo
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Jun-Jie Chen
- Department of Orthopedics, Shaoxing TCM Hospital Affiliated to Zhejiang Chinese Medical University, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing 312099, Zhejiang Province, China
| | - Xiang-Ke Wu
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
- Department of Orthopedics, Quzhou TCM Hospital at the Junction of Four Provinces Affiliated to Zhejiang Chinese Medical University, Quzhou 324002, Zhejiang Province, China
| | - Wei Xie
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
- Department of Orthopedics, Quzhou TCM Hospital at the Junction of Four Provinces Affiliated to Zhejiang Chinese Medical University, Quzhou 324002, Zhejiang Province, China
| | - Xing Zhou
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Hui Su
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Yi-Xuan Chen
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Li-Kang Wang
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Wen-Kai Li
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Kun Tian
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Ru-Jie Zhuang
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310003, Zhejiang Province, China
- Department of Orthopedics, Quzhou TCM Hospital at the Junction of Four Provinces Affiliated to Zhejiang Chinese Medical University, Quzhou 324002, Zhejiang Province, China
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Dapp U, Vinyard D, Golgert S, Krumpoch S, Freiberger E. Reference values of gait characteristics in community-dwelling older persons with different physical functional levels. BMC Geriatr 2022; 22:713. [PMID: 36038832 PMCID: PMC9422159 DOI: 10.1186/s12877-022-03373-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/05/2022] [Indexed: 11/24/2022] Open
Abstract
Background Mobility is one major component of healthy ageing of older persons. It includes gait speed, nowadays valued as the sixth vital sign of ageing. Quantitative gait analysis can support clinical diagnostics, monitor progression of diseases and provide information about the efficacy of interventions. Fast gait speed is an additional marker in the area of functional ability. Our aim was to contribute reference values of gait parameters of older persons based on their functional ability. Methods We visualised and combined three different established frameworks that assess gait characteristics into a new framework based approach that comprises eight gait parameters: gait speed, stride length, walk ratio, single and double support time, step width, step width CV (coefficient of variance), stride length CV. Gait parameters were stratified by two instruments that indicate levels of functional ability: First, the LUCAS Functional Ability Index (FAI), a self-administered screening tool easy to apply to a public-health orientated approach and second the Short Physical Performance Battery (SPPB), an established performance test widely used in comprehensive geriatric assessments (CGA). Gait parameters of older community-dwelling persons were measured with an objective Gait system (GAITRite) across differing functional ability ranging from robust to transient (postrobust and prefrail) to frail physical status. Results Of 642 community-dwelling participants (age 78.5 ± 4.8; n = 233 male, n = 409 female) categorisations by SPPB were 27.1% for robust (11–12 points), 44.2% for transient (8–10 points), 28.7% for frail (0–7 points), and 16.2, 50.3, 33.5% for robust, transient, frail by LUCAS FAI. Overall, our results showed that distinction by functional level only uncovers a wide spectrum of functional decline for all investigated gait parameters. Stratification by functional ability (biological age) revealed a greater range of differentiation than chronological age. Conclusions Gait parameters, carefully selected by literature, showed clinically meaningful differences between the functional featuring a gradient declining from robust over transient to frail in most gait parameters. We found discriminative power of stratifications by SPPB to be the highest, closely followed by LUCAS FAI, age groups and dichotomous age making the application of the LUCAS FAI more cost and time effective than conducting SPPB. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03373-0.
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Affiliation(s)
- Ulrike Dapp
- Scientific Department at the University of Hamburg, Albertinen-Haus Geriatrics Center, Sellhopsweg 18-22, 22459, Hamburg, Germany.
| | - Dominic Vinyard
- Scientific Department at the University of Hamburg, Albertinen-Haus Geriatrics Center, Sellhopsweg 18-22, 22459, Hamburg, Germany
| | - Stefan Golgert
- Scientific Department at the University of Hamburg, Albertinen-Haus Geriatrics Center, Sellhopsweg 18-22, 22459, Hamburg, Germany
| | - Sebastian Krumpoch
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Kobergerstr. 60, 90408, Nürnberg, Germany
| | - Ellen Freiberger
- Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Kobergerstr. 60, 90408, Nürnberg, Germany.
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Rutkowski R, Gizińska M, Gałczyńska-Rusin M, Kasprzak MP, Budiman-Mak E. The Importance of Foot Function Assessment Using the Foot Function Index-Revised Short Form (FFI-RS) Questionnaire in the Comprehensive Treatment of Patients with Rheumatoid Arthritis. J Clin Med 2022; 11:2298. [PMID: 35566422 PMCID: PMC9101500 DOI: 10.3390/jcm11092298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/04/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Foot problems may have a substantial negative impact on rheumatoid arthritis (RA) patients' mobility. They affect walking and the functional capacity to perform daily tasks. METHODS This study included 61 patients with RA and foot pain or swelling. The study group comprised 37 patients (aged 54.3 ± 9.5 years) with foot lesions, as demonstrated in an ultrasound, and the control group comprised 24 patients (aged 57.3 ± 11.5 years) without foot lesions. The patients' health statuses were evaluated with the Foot Function Index-Revised Short Form (FFI-RS), the Polish version of the Health Assessment Questionnaire-Disability Index (HAQ-DI), and the Disease Activity Score 28 (DAS 28). RESULTS The FFI-RS showed significant differences between the study and control groups in total results, as well as in the pain and stiffness subscales. Subsequent analyses showed numerous significant correlations. The FFI-RS total results correlated with the HAQ's standing up, walking, and total results. The FFI-RS pain results correlated with the social issues and HAQ's total results. The FFI-RS difficulty results correlated with the disease's duration. In the study group, there were significant correlations of the FFI-RS stiffness, difficulty, and social issues results with the HAQ's standing up, walking, and total results, and also of the FFI-RS activity limitation results with the HAQ's standing up results. In the control group, there were correlations of the FFI-RS stiffness, difficulty, and activity limitation results with the HAQ's walking and total results. Finally, in the study group, we also found correlations of the FFI-RS total, pain, stiffness, difficulty, and social issues results with the Visual Analog Scale (VAS) results, as well as of the FFI-RS total results with the DAS 28 results. CONCLUSIONS The FFI-RS is an effective tool for assessing RA patients' functional status and can be used to evaluate treatment effects. The FFI-RS detected RA-related changes in the foot joint function in patients without foot lesions, as assessed by ultrasound.
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Affiliation(s)
- Radosław Rutkowski
- Department of Physical Therapy and Sports Recovery, Poznan University of Physical Education, Królowej Jadwigi Str. 27/39, 61-871 Poznan, Poland;
| | - Małgorzata Gizińska
- Department of Physical Therapy and Sports Recovery, Poznan University of Physical Education, Królowej Jadwigi Str. 27/39, 61-871 Poznan, Poland;
| | - Małgorzata Gałczyńska-Rusin
- Department of Orthodontics and Temporomandibular Disorders, University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland;
| | - Magdalena Paulina Kasprzak
- Chair and Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznań, Poland;
| | - Elly Budiman-Mak
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines VA Hospital, 5000 South 5th Ave, Hines, IL 60141-3030, USA;
- Department of Medicine, Stritch School of Medicine, Loyola University of Chicago, Maywood, IL 60513, USA
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Alkady EA, Abdelaziz MM, Abdelwahed D, Mahran SA. Falls in Rheumatoid Patients: Does Ankle and Foot Ultrasonography have a Predictive Role? A Single-blind Study. AKTUEL RHEUMATOL 2021. [DOI: 10.1055/a-1353-4415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ABSTRACT
Background Rheumatoid arthritis (RA) patients have a higher prevalence of falls compared with the healthy population. Several risk factors of falls in RA have been postulated, including high disease activity, low balance, muscle weakness and non-treatment with biologics.
Aim of the work We investigated our hypothesis that the sonographically detected ankle and foot changes in RA patients can predict falls in this population. To our knowledge, no previous study had investigated this before.
Methods In a total of 101 RA patients, we performed assessments of disease activity, disability level, gait speed, balance status, clinical examination of ankle and foot and an MSUS assessment of the ankle and foot joints and tendons as possible risk factors of falls.
Results The Berg balance test had the highest fall-predicting power (71.3%), followed by a gait speed test and restricted range of motion (ROM) of the Rt. subtalar joint, each with a predictive power of 70.3%. Of the sonographic findings, erosion of the first metatarsophalangeal (MTP) joint was the most accurate fall predictor, followed by erosion of the talonavicular joint and tenosynovitis of the ankle dorsal flexors with an area under the curve of 0.656, 0.642 and 0.614, respectively.
Conclusion The use of the MSUS as an adjunct objective method for predicting falls in RA patients has not been studied before. It was found that clinical foot and balance testing was a superior and easier way of predicting falls in RA patients than using ultrasonography.
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Affiliation(s)
- Eman A.M. Alkady
- Department of Rheumatology, Rehabilitation and Physical Medicine, Assiut University Faculty of Medicine, Assiut, Egypt
| | - Marwa Mahmoud Abdelaziz
- Department of Rheumatology, Rehabilitation and Physical Medicine, Assiut University Faculty of Medicine, Assiut, Egypt
| | - Dalia Abdelwahed
- Department of Rheumatology, Rehabilitation and Physical Medicine, Assiut University Faculty of Medicine, Assiut, Egypt
| | - Safaa A. Mahran
- Department of Rheumatology, Rehabilitation and Physical Medicine, Assiut University Faculty of Medicine, Assiut, Egypt
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Carlin T, Vuillerme N. Step and Distance Measurement From a Low-Cost Consumer-Based Hip and Wrist Activity Monitor: Protocol for a Validity and Reliability Assessment. JMIR Res Protoc 2021; 10:e21262. [PMID: 33439138 PMCID: PMC7840275 DOI: 10.2196/21262] [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: 06/09/2020] [Revised: 07/02/2020] [Accepted: 07/14/2020] [Indexed: 11/13/2022] Open
Abstract
Background Self-tracking via wearable and mobile technologies is becoming an essential part of personal health management. At this point, however, little information is available to substantiate the validity and reliability of low-cost consumer-based hip and wrist activity monitors, with regard more specifically to the measurements of step counts and distance traveled while walking. Objective The aim of our study is to assess the validity and reliability of step and distance measurement from a low-cost consumer-based hip and wrist activity monitor specific in various walking conditions that are commonly encountered in daily life. Specifically, this study is designed to evaluate whether and to what extent validity and reliability could depend on the sensor placement on the human body and the walking task being performed. Methods Thirty healthy participants will be instructed to wear four PBN 2433 (Nakosite) activity monitors simultaneously, with one placed on each hip and each wrist. Participants will attend two experimental sessions separated by 1 week. During each experimental session, two separate studies will be performed. In study 1, participants will be instructed to complete a 2-minute walk test along a 30-meter indoor corridor under 3 walking speeds: very slow, slow, and usual speed. In study 2, participants will be required to complete the following 3 conditions performed at usual walking speed: walking on flat ground, upstairs, and downstairs. Activity monitor measured step count and distance values will be computed along with the actual step count (determined from video recordings) and distance (measured using a measuring tape) to determine validity and reliability for each activity monitor placement and each walking condition. Results Participant recruitment and data collection began in January 2020. As of June 2020, we enrolled 8 participants. Dissemination of study results in peer-reviewed journals is expected in spring 2021. Conclusions To the best of our knowledge, this is the first study that examines the validity and reliability of step and distance measurement during walking using the PBN 2433 (Nakosite) activity monitor. Results of this study will provide beneficial information on the effects of activity monitor placement, walking speed, and walking tasks on the validity and reliability of step and distance measurement. We believe such information is of utmost importance to general consumers, clinicians, and researchers. International Registered Report Identifier (IRRID) DERR1-10.2196/21262
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Affiliation(s)
- Thomas Carlin
- AGEIS, University Grenoble Alpes, Grenoble, France.,LabCom Telecom4Health, University Grenoble Alpes & Orange Labs, Grenoble, France
| | - Nicolas Vuillerme
- AGEIS, University Grenoble Alpes, Grenoble, France.,LabCom Telecom4Health, University Grenoble Alpes & Orange Labs, Grenoble, France.,Institut Universitaire de France, Paris, France
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6
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Lau LK, Wee SL, Pang WJB, Chen KK, Abdul Jabbar K, Yap PLK, Mallya JU, Ng DHM, Tan QLL, Seah WT, Ng TP. Reference Values of Gait Speed and Gait Spatiotemporal Parameters for a South East Asian Population: The Yishun Study. Clin Interv Aging 2020; 15:1753-1765. [PMID: 33061327 PMCID: PMC7522423 DOI: 10.2147/cia.s270407] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/12/2020] [Indexed: 12/12/2022] Open
Abstract
Background Age-related slowing of gait has been reported to start as early as the fifth decade and accelerate beyond the seventh decade of life. A single cut-off for slow gait may not be appropriate for men and women of different ages. We aimed to report reference values for gait speed and spatiotemporal gait parameters of adult age groups in a South East Asian population. Methods A total of 507 community-dwelling adults, aged 21-90 years were recruited into the study through random sampling, filling quotas of 20-40 participants in each sex and age group (10-year age groups between 21 and 60 years; 5-year age groups beyond age 60 years). Demographic data, height, weight and information on comorbidities were recorded. Habitual gait speed and spatiotemporal parameters were measured, and the average of three trials was recorded using the GAITRite system. Results Gait speed peaked in their 40s for both men and women, but the trajectories differed slightly across age groups. Although similar for men in their 50s and 60s, gait speed was significantly slower among those aged 71 years and older. For women beyond 50 years old, gait slowed with age. After adjusting for height, women were found to walk significantly faster and with a longer step length than men. Women also walked with a significantly narrower stride width and less external rotation of the feet. The lowest quintile for gait speed in our study cohort was 0.9m/s, below the recommended cut-off of 1.0m/s. Conclusion We established the reference values as well as the quintiles for gait speed and spatiotemporal gait parameters across adult age groups in a multi-ethnic Asian population. This contributes to a valuable database for gait assessment and evaluation of preventive or rehabilitative programs.
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Affiliation(s)
- Lay Khoon Lau
- Geriatric Education and Research Institute (GERI), Singapore
| | - Shiou Liang Wee
- Geriatric Education and Research Institute (GERI), Singapore.,Faculty of Health and Social Sciences, Singapore Institute of Technology, Singapore
| | | | | | | | - Philip Lin Kiat Yap
- Geriatric Education and Research Institute (GERI), Singapore.,Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | - Jagadish Ullal Mallya
- Geriatric Education and Research Institute (GERI), Singapore.,Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | | | | | - Wei Ting Seah
- Geriatric Education and Research Institute (GERI), Singapore
| | - Tze Pin Ng
- Geriatric Education and Research Institute (GERI), Singapore.,Department of Psychological Medicine, National University of Singapore, Singapore
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Aleixo P, Vaz Patto J, Cardoso A, Moreira H, Abrantes J. Ankle kinematics and kinetics during gait in healthy and rheumatoid arthritis post-menopausal women. Somatosens Mot Res 2019; 36:171-178. [PMID: 31267798 DOI: 10.1080/08990220.2019.1634536] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: In the literature, it is not clear whether rheumatoid arthritis (RA) post-menopausal women have different ankle biomechanical parameters than healthy post-menopausal women. This study aimed to compare the ankle kinematics and kinetics during the gait stance phase of RA post-menopausal women with age-matched healthy post-menopausal women. Materials and methods: A three-dimensional motion analysis system (9 cameras; 200 Hz) synchronised with a force plate (1000 Hz) was used to assess ankle kinematics and kinetics during barefoot walking at a natural and self-selected speed. A biomechanical model was used to model body segments and joint centres (combined anthropometric measurements and the placement of 39 reflective markers). Thirty-six women (18 RA post-menopausal women and 18 age-matched healthy post-menopausal women) performed 14 valid trials (comprising seven left and seven right footsteps on a force plate). Lower limb muscle mass was evaluated by an octopolar bioimpedance analyser. Results: RA post-menopausal women yielded a longer stance phase and controlled dorsiflexion sub-phase (p < 0.001), higher dorsiflexion at the final controlled dorsiflexion sub-phase and lower plantar flexion at toe off (p < 0.05), lower angular displacements (p < 0.05), and lower ankle moment of force peak and ankle power peak (p < 0.001). No intergroup differences were found in lower limb muscle mass. Conclusions: RA post-menopausal women yielded changes in ankle kinematic and kinetic parameters during the gait stance phase, resulting in a lower capacity to produce ankle moment of force and ankle power during the propulsive gait phase.
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Affiliation(s)
- P Aleixo
- a Lab of Interactions and Interfaces (MovLab), Centre for Research in Applied Communication, Culture and New Technologies (CICANT) , Universidade Lusófona de Humanidades e Tecnologias , Lisbon , Portugal
| | - J Vaz Patto
- b Portuguese Institute of Rheumatology , Lisbon , Portugal
| | - A Cardoso
- b Portuguese Institute of Rheumatology , Lisbon , Portugal
| | - H Moreira
- c Research Centre in Sports Science, Health and Human Development (CIDESD) , Universidade de Trás-os-Montes e Alto Douro (UTAD) , Vila Real , Portugal
| | - J Abrantes
- a Lab of Interactions and Interfaces (MovLab), Centre for Research in Applied Communication, Culture and New Technologies (CICANT) , Universidade Lusófona de Humanidades e Tecnologias , Lisbon , Portugal
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El Megid SAEHA, El Gendy SS, Yassin HAEA, El Rahim MMMAA, Moussa MAEHAER. Patellar tendon ultrasonographic properties and lower limb function in rheumatoid arthritis patients. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2019. [DOI: 10.4103/err.err_35_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lindemann U. Spatiotemporal gait analysis of older persons in clinical practice and research : Which parameters are relevant? Z Gerontol Geriatr 2019; 53:171-178. [PMID: 30770991 DOI: 10.1007/s00391-019-01520-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 01/25/2019] [Accepted: 01/31/2019] [Indexed: 01/01/2023]
Abstract
For older persons walking is a basic activity of daily life which characterizes the person's functional mobility. Therefore, the improvement of walking performance is a major clinical outcome during geriatric rehabilitation. Furthermore, walking performance is relevant for several geriatric research issues. Quantitative gait analysis can describe walking performance in detail. Besides gait speed, various qualitative parameters related to different aspects of walking performance, such as symmetry, regularity, coordination, dynamic balance and foot movement during the swing phase, can serve as outcome parameters in geriatric research and in clinical practice. Clinicians and researchers have to decide which parameters are appropriate to be used as relevant outcome parameters in the investigated person or group of persons.
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Affiliation(s)
- Ulrich Lindemann
- Department of Clinical Gerontology and Rehabilitation, Robert-Bosch-Hospital, Auerbachstr. 110, 70376, Stuttgart, Germany.
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Stewart S, Morpeth T, Dalbeth N, Vandal AC, Carroll M, Davidtz L, Mawston G, Otter S, Rome K. Foot-related pain and disability and spatiotemporal parameters of gait during self-selected and fast walking speeds in people with gout: A two-arm cross sectional study. Gait Posture 2016; 44:18-22. [PMID: 27004627 DOI: 10.1016/j.gaitpost.2015.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/09/2015] [Accepted: 11/04/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To examine gait parameters in people with gout during different walking speeds while adjusting for body mass index (BMI) and foot-pain, and to determine the relationship between gait parameters and foot-pain and disability. METHOD Gait parameters were measured using the GAITRite™ walkway in 20 gout participants and 20 age- and sex-matched controls during self-selected and fast walking speeds. Foot-pain and disability was measured using the Manchester Foot Pain and Disability Index (MFPDI) which contains four domains relating to function, physical appearance, pain and work/leisure. RESULTS At the self-selected speed, gout participants demonstrated increased step time (p=0.017), and stance time (p=0.012), and reduced velocity (p=0.031) and cadence (p=0.013). At the fast speed, gout participants demonstrated increased step time (p=0.007), swing time (p=0.005) and stance time (p=0.019) and reduced velocity (p=0.036) and cadence (p=0.009). For participants with gout, step length was correlated with total MFPDI (r=-0.62, p=0.008), function (r=-0.65, p=0.005) and physical appearance (r=-0.50, p=0.041); stride length was correlated with total MFPDI (r=-0.62, p=0.008), function (r=-0.65, p=0.005) and physical appearance (r=-0.50, p=0.041); and velocity was correlated with total MFPDI (r=-0.60, p=0.011), function (r=-0.63, p=0.007) and work/leisure (r=-0.53, p=0.030). CONCLUSION Gait patterns exhibited by people with gout are different from controls during both self-selected and fast walking speeds, even after adjusting for BMI and foot-pain. Additionally, gait parameters were strongly correlated with patient-reported functional limitation, physical appearance and work/leisure difficulties, while pain did not significantly influence gait in people with gout.
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Affiliation(s)
- Sarah Stewart
- Department of Podiatry, School of Clinical Sciences, Health & Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand Zealand.
| | - Trish Morpeth
- Department of Podiatry, School of Clinical Sciences, Health & Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand Zealand
| | - Nicola Dalbeth
- Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand; Department of Rheumatology, Auckland District Health Board, P.O. Box 92189, Auckland, New Zealand
| | - Alain C Vandal
- Department of Biostatistics & Epidemiology, School of Public Health & Psychosocial Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand; Health Intelligence and Informatics, Ko Awatea, Counties Manukau Health, Private Bag 93311, Auckland, 1640, New Zealand
| | - Matthew Carroll
- Department of Podiatry, School of Clinical Sciences, Health & Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand Zealand
| | - Lisa Davidtz
- Department of Podiatry, School of Clinical Sciences, Health & Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand Zealand
| | - Grant Mawston
- Department of Physiotherapy, School of Clinical Sciences, Health & Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand
| | - Simon Otter
- Department of Podiatry, School of Clinical Sciences, Health & Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand Zealand; School of Health Science, University of Brighton, 49 Darley Rd, Eastbourne, BN20 7UR, UK
| | - Keith Rome
- Department of Podiatry, School of Clinical Sciences, Health & Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand Zealand
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Keene DJ, Moe-Nilssen R, Lamb SE. The application of multilevel modelling to account for the influence of walking speed in gait analysis. Gait Posture 2016; 43:216-9. [PMID: 26602593 DOI: 10.1016/j.gaitpost.2015.09.026] [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: 04/28/2015] [Revised: 09/17/2015] [Accepted: 09/23/2015] [Indexed: 02/02/2023]
Abstract
Differences in gait performance can be explained by variations in walking speed, which is a major analytical problem. Some investigators have standardised speed during testing, but this can result in an unnatural control of gait characteristics. Other investigators have developed test procedures where participants walking at their self-selected slow, preferred and fast speeds, with computation of gait characteristics at a standardised speed. However, this analysis is dependent upon an overlap in the ranges of gait speed observed within and between participants, and this is difficult to achieve under self-selected conditions. In this report a statistical analysis procedure is introduced that utilises multilevel modelling to analyse data from walking tests at self-selected speeds, without requiring an overlap in the range of speeds observed or the routine use of data transformations.
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Affiliation(s)
- David J Keene
- Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 9DU, UK.
| | - Rolf Moe-Nilssen
- Department of Public Health and Primary Health Care, Physiotherapy Science, University of Bergen, P.O. Box 7804, N-5020, Norway
| | - Sarah E Lamb
- Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford OX3 9DU, UK; Warwick Clinical Trials Unit, University of Warwick, Coventry CV4 7AL, UK
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Morpeth T, Brenton-Rule A, Carroll M, Frecklington M, Rome K. Fear of falling and foot pain, impairment and disability in rheumatoid arthritis: a case-control study. Clin Rheumatol 2015; 35:887-91. [PMID: 26592931 DOI: 10.1007/s10067-015-3124-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 10/04/2015] [Accepted: 11/17/2015] [Indexed: 10/22/2022]
Abstract
Fear of falling, foot pain, impairment and disability are commonly reported in rheumatoid arthritis (RA). However, the relationship between fear of falling and foot pain, impairment and disability has not been investigated in established RA. The aim of the study was to evaluate the relationship between fear of falling and foot pain, walking velocity and foot impairment and disability in women with established RA. A secondary aim was to evaluate differences between fear of falling, foot pain, walking velocity and foot impairment and disability in women with established RA and age- and sex-matched control participants. Twenty-one women with established RA and twenty-one age- and sex-matched controls were assessed for fear of falling, foot pain, foot impairment and disability and walking velocity. Pearson's r-correlations were used to examine relationships between fear of falling and the foot measures. Independent samples t tests evaluated the differences in fear of falling and foot measures between the two groups. In people with RA, significant correlations were found between fear of falling and foot impairment (r = 0.53, p = 0.015), foot disability (r = 0.77, p <0.001) and walking velocity (r = 0.56, p < 0.001). No correlation was found between fear of falling and foot pain (r = 0.36; p = 0.11). Significant differences between cases and control participants were found between fear of falling (p = 0.001), foot impairment (p = 0.004) and foot disability (p < 0.001). Foot impairment and disability relates to fear of falling in women with established RA. A better understanding of fear of falling in people with established RA may contribute to more efficient falls assessments in order to identify at risk individuals.
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Affiliation(s)
- Tricia Morpeth
- Department of Podiatry, Health & Research Rehabilitation Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1020, New Zealand
| | - Angela Brenton-Rule
- Department of Podiatry, Health & Research Rehabilitation Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1020, New Zealand
| | - Matthew Carroll
- Department of Podiatry, Health & Research Rehabilitation Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1020, New Zealand
| | - Mike Frecklington
- Department of Podiatry, Health & Research Rehabilitation Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1020, New Zealand
| | - Keith Rome
- Department of Podiatry, Health & Research Rehabilitation Institute, Auckland University of Technology, Private Bag 92006, Auckland, 1020, New Zealand.
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Carroll M, Parmar P, Dalbeth N, Boocock M, Rome K. Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta-analysis. BMC Musculoskelet Disord 2015; 16:134. [PMID: 26044780 PMCID: PMC4455329 DOI: 10.1186/s12891-015-0596-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 05/27/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gait analysis is increasingly being used to characterise dysfunction of the lower limb and foot in people with inflammatory arthritis (IA). The aim of the systematic review was to evaluate the spatiotemporal, foot and ankle kinematic, kinetic, peak plantar pressure and muscle activity parameters between patients with inflammatory arthritis and healthy controls. METHODS An electronic literature search was performed on Medline, CINAHL, SportsDiscus and The Cochrane Library. Methodological quality was assessed using a modified Quality Index. Effect sizes with 95% confidence intervals (CI) were calculated as the standardised mean difference (SMD). Meta-analysis was conducted if studies were homogenous. RESULTS Thirty six studies with quality ranging from high to low met the inclusion criteria. The majority of studies reported gait parameters in Rheumatoid arthritis (RA). The gait pattern in RA was characterised by decreased walking speed (SMD 95% CI -1.57, -2.25 to -0.89), decreased cadence (SMD -0.97, -1.49 to -0.45), decreased stride length (SMD -1.66, -1.84 to -1.49), decreased ankle power (SMD -1.36, -1.70 to -1.02), increased double limb support time (SMD 1.03, 0.84 to 1.22), and peak plantar pressures at the forefoot (SMD 1.11, 0.76 to 1.45). Walking velocity was reduced in psoriatic arthritis and gout with no differences in ankylosing spondylitis. No studies have been conducted in polymyalgia rheumatica, systemic sclerosis or systemic lupus erythematosus. CONCLUSIONS The review identified the majority of studies reporting gait adaptations in RA, but limited evidence relating to other IA conditions. Poor data reporting, small sample sizes and heterogeneity across IA conditions limit the interpretation of the findings. Future studies may consider a standardised analytical approach to gait analysis that will provide clinicians and researchers with objective evidence of foot function in people with IA.
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Affiliation(s)
- Matthew Carroll
- Department of Podiatry, Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
| | - Priya Parmar
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand.
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand.
| | - Mark Boocock
- Department of Physiotherapy, Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
| | - Keith Rome
- Department of Podiatry, Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
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14
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Tierney M, Fraser A, Kennedy N. Criterion validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) for use in patients with rheumatoid arthritis: comparison with the SenseWear Armband. Physiotherapy 2015; 101:193-7. [DOI: 10.1016/j.physio.2014.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 07/25/2014] [Indexed: 01/28/2023]
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Kwon JW, Son SM, Lee NK. Changes of kinematic parameters of lower extremities with gait speed: a 3D motion analysis study. J Phys Ther Sci 2015; 27:477-9. [PMID: 25729195 PMCID: PMC4339165 DOI: 10.1589/jpts.27.477] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 09/02/2014] [Indexed: 12/02/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the changes in hip, knee and ankle kinematic variables of the lower extremities at different gait speeds. [Subjects and Methods] Forty healthy subjects who had no previous history of neurological, musculo-skeletal or other medical conditions that could affect gait were recruited. The subjects were asked to walk 10 m down a walkway at three different gait speeds: normal gait speed, and self-selected fast, and slow speeds. The experimental order was randomly chosen across these gaits. The hip, knee and ankle kinematic data were evaluated using a VICON 3D motion analysis system and force plates. [Results] The flexion peak and external rotation peak of the knee joint significantly increased with the increase of gait speed. The plantarflexion peaks of the ankle joint significantly increased with increase of gait speed. However, none of the kinematic data of the hip joint were significantly dependent on increase of gait speed. [Conclusion] The relationship of the knee and ankle joint can be described as coupling motion which is dependent on gait speed. Our present findings suggest that coupling motion of the knee joint and plantarflexion of the ankle joint significantly increase with increase of gait speed. These results will provide important insight into gait mechanisms for the evaluation of pathological populations.
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Affiliation(s)
- Jung Won Kwon
- Department of Physical Therapy, College of Rehabilitation
Science, Daegu University, Republic of Korea
| | - Sung Min Son
- Department of Physical Therapy, College of Health Science,
Cheongju University, Republic of Korea
| | - Na Kyung Lee
- Department of Physical Therapy, College of Rehabilitation
Science, Daegu University, Republic of Korea
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Staab W, Hottowitz R, Sohns C, Sohns JM, Gilbert F, Menke J, Niklas A, Lotz J. Accelerometer and gyroscope based gait analysis using spectral analysis of patients with osteoarthritis of the knee. J Phys Ther Sci 2014; 26:997-1002. [PMID: 25140082 PMCID: PMC4135223 DOI: 10.1589/jpts.26.997] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 01/08/2014] [Indexed: 02/02/2023] Open
Abstract
[Purpose] A wide variety of accelerometer tools are used to estimate human movement, but
there are no adequate data relating to gait symmetry parameters in the context of knee
osteoarthritis. This study’s purpose was to evaluate a 3D-kinematic system using
body-mounted sensors (gyroscopes and accelerometers) on the trunk and limbs. This is the
first study to use spectral analysis for data post processing. [Subjects] Twelve patients
with unilateral knee osteoarthritis (OA) (10 male) and seven age-matched controls (6 male)
were studied. [Methods] Measurements with 3-D accelerometers and gyroscopes were compared
to video analysis with marker positions tracked by a six-camera optoelectronic system
(VICON 460, Oxford Metrics). Data were recorded using the 3D-kinematic system. [Results]
The results of both gait analysis systems were significantly correlated. Five parameters
were significantly different between the knee OA and control groups. To overcome time
spent in expensive post-processing routines, spectral analysis was performed for fast
differentiation between normal gait and pathological gait signals using the 3D-kinematic
system. [Conclusions] The 3D-kinematic system is objective, inexpensive, accurate and
portable, and allows long-term recordings in clinical, sport as well as ergonomic or
functional capacity evaluation (FCE) settings. For fast post-processing, spectral analysis
of the recorded data is recommended.
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Affiliation(s)
- Wieland Staab
- Institute for Diagnostic and Interventional Radiology, Heart Center, University Medical Center Goettingen, Germany ; DZHK, German Center for Heart Research, Germany ; Department of Sports Medicine, University Medical Center Goettingen, Germany
| | - Ralf Hottowitz
- Department of Sports Medicine, University Medical Center Goettingen, Germany
| | - Christian Sohns
- DZHK, German Center for Heart Research, Germany ; Department of Cardiology and Pneumology, Heart Center, University Medical Center Goettingen, Germany ; Division of Imaging Sciences and Biomedical Engineering, King's College London, United Kingdom
| | - Jan Martin Sohns
- Institute for Diagnostic and Interventional Radiology, Heart Center, University Medical Center Goettingen, Germany ; DZHK, German Center for Heart Research, Germany
| | - Fabian Gilbert
- Department of Orthopedics, University Medical Center Würzburg, Germany
| | - Jan Menke
- Institute for Diagnostic and Interventional Radiology, Heart Center, University Medical Center Goettingen, Germany
| | - Andree Niklas
- Department of Sports Medicine, University Medical Center Goettingen, Germany
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, Heart Center, University Medical Center Goettingen, Germany ; DZHK, German Center for Heart Research, Germany
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Nishiguchi S, Ito H, Yamada M, Yoshitomi H, Furu M, Ito T, Shinohara A, Ura T, Okamoto K, Aoyama T. Self-assessment tool of disease activity of rheumatoid arthritis by using a smartphone application. Telemed J E Health 2014; 20:235-40. [PMID: 24404820 DOI: 10.1089/tmj.2013.0162] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The disease activities of rheumatoid arthritis (RA) tend to fluctuate between visits to doctors, and a self-assessment tool can help patients accommodate to their current status at home. The aim of the present study was to develop a novel modality to assess the disease activity of RA by a smartphone without the need to visit a doctor. SUBJECTS AND METHODS This study included 65 patients with RA, 63.1 ± 11.9 years of age. The 28-joint disease activity score (DAS28) was measured for all participants at each clinic visit. The patients assessed their status with the modified Health Assessment Questionnaire (mHAQ), a self-assessed tender joint count (sTJC), and a self-assessed swollen joint count (sSJC) in a smartphone application. The patients' trunk acceleration while walking was also measured with a smartphone application. The peak frequency, autocorrelation (AC) peak, and coefficient of variance of the acceleration peak intervals were calculated as the gait parameters. RESULTS Univariate analyses showed that the DAS28 was associated with mHAQ, sTJC, sSJC, and AC (p<0.05). In a stepwise linear regression analysis, mHAQ (β = 0.264, p<0.05), sTJC (β = 0.581, p<0.001), and AC (β = -0.157, p<0.05) were significantly associated with DAS28 in the final model, and the predictive model explained 67% of the DAS28 variance. CONCLUSIONS The results suggest that noninvasive self-assessment of a combination of joint symptoms, limitations of daily activities, and walking ability can adequately predict disease activity of RA with a smartphone application.
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Affiliation(s)
- Shu Nishiguchi
- 1 Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine , Kyoto, Japan
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Esbjörnsson AC, Rozumalski A, Iversen MD, Schwartz MH, Wretenberg P, Broström EW. Quantifying gait deviations in individuals with rheumatoid arthritis using the Gait Deviation Index. Scand J Rheumatol 2013; 43:124-31. [PMID: 24090053 DOI: 10.3109/03009742.2013.822095] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES In this study we evaluated the usability of the Gait Deviation Index (GDI), an index that summarizes the amount of deviation in movement from a standard norm, in adults with rheumatoid arthritis (RA). The aims of the study were to evaluate the ability of the GDI to identify gait deviations, assess inter-trial repeatability, and examine the relationship between the GDI and walking speed, physical disability, and pain. METHOD Sixty-three adults with RA and 59 adults with typical gait patterns were included in this retrospective case-control study. Following a three-dimensional gait analysis (3DGA), representative gait cycles were selected and GDI scores calculated. To evaluate the effect of walking speed, GDI scores were calculated using both a free-speed and a speed-matched reference set. Physical disability was assessed using the Health Assessment Questionnaire (HAQ) and subjects rated their pain during walking. RESULTS Adults with RA had significantly increased gait deviations compared to healthy individuals, as shown by lower GDI scores [87.9 (SD = 8.7) vs. 99.4 (SD = 8.3), p < 0.001]. This difference was also seen when adjusting for walking speed [91.7 (SD = 9.0) vs. 99.9 (SD = 8.6), p < 0.001]. It was estimated that a change of ≥ 5 GDI units was required to account for natural variation in gait. There was no evident relationship between GDI and low/high RA-related physical disability and pain. CONCLUSIONS The GDI seems to useful for identifying and summarizing gait deviations in individuals with RA. Thus, we consider that the GDI provides an overall measure of gait deviation that may reflect lower extremity pathology and may help clinicians to understand the impact of RA on gait dynamics.
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Affiliation(s)
- A-C Esbjörnsson
- Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden
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Oda R, Fujiwara H, Tokunaga D, Nakamura S, Taniguchi D, Kawahito Y, Seno T, Matsui T, Kubo T. How do anti-TNF therapies affect gait function in patients with rheumatoid arthritis? Int J Rheum Dis 2013; 17:57-62. [DOI: 10.1111/1756-185x.12128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ryo Oda
- Department of Orthopaedics; Graduate School of Medical Science; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Hiroyoshi Fujiwara
- Department of Orthopaedics; Graduate School of Medical Science; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Daisaku Tokunaga
- Department of Orthopaedics; Graduate School of Medical Science; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Satoru Nakamura
- Department of Orthopaedics; Graduate School of Medical Science; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Daigo Taniguchi
- Department of Orthopaedics; Graduate School of Medical Science; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Yutaka Kawahito
- Department of Inflammation and Immunology; Graduate School of Medical Science; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Takahiro Seno
- Department of Inflammation and Immunology; Graduate School of Medical Science; Kyoto Prefectural University of Medicine; Kyoto Japan
- Department of Rheumatic Diseases and Joint Function; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Tomoyuki Matsui
- Rehabilitation Unit; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Toshikazu Kubo
- Department of Orthopaedics; Graduate School of Medical Science; Kyoto Prefectural University of Medicine; Kyoto Japan
- Department of Rheumatic Diseases and Joint Function; Kyoto Prefectural University of Medicine; Kyoto Japan
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20
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Broström EW, Esbjörnsson AC, Heideken JV, Larsson P, Wretenberg P, Iversen M. Change in Gait Deviation Index after anti-tumour necrosis factor-α treatment in individuals with rheumatoid arthritis: a pilot study. Scand J Rheumatol 2013; 42:356-61. [DOI: 10.3109/03009742.2013.776102] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dubbeldam R, Baan H, Nene AV, Drossaers-Bakker KW, van de Laar MAFJ, Hermens HJ, Buurke JH. Foot and Ankle Kinematics in Rheumatoid Arthritis: Influence of Foot and Ankle Joint and Leg Tendon Pathologies. Arthritis Care Res (Hoboken) 2013; 65:503-11. [DOI: 10.1002/acr.21852] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 09/05/2012] [Indexed: 11/12/2022]
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Baan H, Dubbeldam R, Nene AV, van de Laar MA. Gait Analysis of the Lower Limb in Patients with Rheumatoid Arthritis: A Systematic Review. Semin Arthritis Rheum 2012; 41:768-788.e8. [DOI: 10.1016/j.semarthrit.2011.11.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 11/16/2011] [Accepted: 11/17/2011] [Indexed: 01/09/2023]
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Rombaut L, Malfait F, De Wandele I, Thijs Y, Palmans T, De Paepe A, Calders P. Balance, gait, falls, and fear of falling in women with the hypermobility type of Ehlers-Danlos syndrome. Arthritis Care Res (Hoboken) 2011; 63:1432-9. [DOI: 10.1002/acr.20557] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Hodt-Billington C, Helbostad JL, Vervaat W, Rognsvåg T, Moe-Nilssen R. Criteria of gait asymmetry in patients with hip osteoarthritis. Physiother Theory Pract 2011; 28:134-41. [PMID: 21722001 DOI: 10.3109/09593985.2011.574783] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Gait symmetry is often a goal for physiotherapy in patients with hip osteoarthritis and after total hip replacement. However, there is no agreement on criteria for pathological gait asymmetry. In this study we investigated discriminative abilities of trunk and footfall gait symmetry measures, and thereafter assessed whether a 10% cutoff value is valid as a general criterion of pathological gait asymmetry across measures. Anteroposterior, vertical, and mediolateral trunk symmetry, single support, and step length symmetry were obtained simultaneously by trunk accelerometry and an electronic walkway in 37 patients with end-stage hip osteoarthritis and 56 controls. Subjects walked six times along a 7-meter walkway at slow, preferred, and fast speed, before data were normalized for gait velocity. Anteroposterior, vertical, and single support symmetry measures showed best discriminating abilities. The general 10% criterion of gait asymmetry and optimal cutoff criteria calculated for each symmetry measure showed approximately equal total classification ability. However, the optimal cutoff criteria classified a high number of controls as having pathological gait asymmetry. The general criterion of 10% is valid with high total classification ability, does not classify asymmetry in able-bodied subjects as pathological, and is feasible for use on individual patients in the clinic as well as in research.
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Affiliation(s)
- Caroline Hodt-Billington
- Section of Physiotherapy Science, Department of Public Health and Primary Health Care, Faculty of Medicine and Dentistry, University of Bergen, Norway.
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25
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Dubbeldam R, Nene AV, Buurke JH, Groothuis-Oudshoorn CGM, Baan H, Drossaers-Bakker KW, van de Laar MAFJ, Hermens H. Foot and ankle joint kinematics in rheumatoid arthritis cannot only be explained by alteration in walking speed. Gait Posture 2011; 33:390-5. [PMID: 21295983 DOI: 10.1016/j.gaitpost.2010.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 12/03/2010] [Accepted: 12/09/2010] [Indexed: 02/02/2023]
Abstract
Rheumatoid arthritis (RA) manifests itself in the foot and ankle of RA patients. The foot and ankle joint kinematics of these patients differ from that of healthy subjects. However, the factors that lead to these differences are not yet fully understood. The aim of this study was to analyse the effect of walking speed and the disease process on foot and ankle joint kinematics of RA subjects. Gait recordings of 23 RA and 14 age-matched healthy subjects were performed and their foot and ankle joint kinematics were analysed during the stance phase of the gait cycle. Stance phase characteristics of the group of RA subjects and of the group of healthy subjects were compared. The healthy subjects walked at 100% (Vc), 75% (V75) and 50% (V50) of their comfortable walking speed. In a multi-level linear model significant differences between the two groups due to the factors walking speed and the disease process were analysed. The ankle dorsi-flexion, medial arch and hallux abduction motion at single-stance and toe-off were only influenced by the walking speed. The hallux maximum flexion at toe-off and the midfoot supination at single-stance were influenced by both the walking speed and the disease process. The hindfoot eversion motion at single-stance was only influenced by the disease process. In conclusion, the reduction of walking speed of RA subjects compared to healthy subjects does not explain all of the observed foot and ankle kinematics differences.
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Affiliation(s)
- R Dubbeldam
- Roessingh Research and Development, Roessinghsbleekweg 33b,7522 AH Enschede, The Netherlands.
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26
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Rome K, Survepalli D, Sanders A, Lobo M, McQueen FM, McNair P, Dalbeth N. Functional and biomechanical characteristics of foot disease in chronic gout: A case-control study. Clin Biomech (Bristol, Avon) 2011; 26:90-4. [PMID: 20950904 DOI: 10.1016/j.clinbiomech.2010.09.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 09/07/2010] [Accepted: 09/09/2010] [Indexed: 02/07/2023]
Abstract
OBJECTIVES despite the predilection of gout to the feet, the impact of gout on foot function and biomechanics is currently unknown. The aim of this study was to describe the effects of chronic gout upon function and selected biomechanical parameters associated with gait. METHODS twenty-five patients with a history of gout were compared with 25 age and gender matched control participants with no history of gout or other forms of arthritis. General function, foot specific disease activity and lower limb activities were determined using the Health Assessment Questionnaire, Foot Function Index (pain domain), and Leeds Foot Impact Scale respectively. Each patient also underwent a gait assessment that included plantar pressure measurements and an evaluation of temporal-spatial gait parameters. FINDINGS patients with chronic gout had higher levels of general and foot-specific disability, pain and impairment (P ≤0.001). Significantly lower peak plantar pressures were observed in the hallux of patients with chronic gout (P ≤0.05). Significantly higher pressure-time integrals were observed in the cases at the midfoot (P ≤0.05), but lower values were observed at the hallux (P ≤0.05). Patients with chronic gout walked slower, with longer step and stride lengths compared to the controls. INTERPRETATION patients with chronic gout experience pain and disability associated with their feet. Different toe-off strategies may account for functional changes and pain associated with foot problems in chronic gout.
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Affiliation(s)
- Keith Rome
- AUT University, Health & Rehabilitation Research Institute, Auckland, New Zealand.
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27
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Mancuso CA, Perna M, Sargent AB, Salmon JE. Perceptions and measurements of physical activity in patients with systemic lupus erythematosus. Lupus 2010; 20:231-42. [DOI: 10.1177/0961203310383737] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Promoting physical activity should be a priority for patients with systemic lupus erythematosus (SLE) because a sedentary lifestyle compounds patients’ already disproportionately high risk for cardiovascular events and other adverse health outcomes. The objectives of this pilot study were to assess physical activity in 50 patients with SLE and to compare activity levels with clinical and psychosocial variables, such as fatigue, depressive symptoms, and social support and stress. Patients were asked open-ended questions about physical activity, and responses were coded according to Grounded Theory. Patients then completed the Paffenbarger Physical Activity and Exercise Index, a survey of lifestyle energy expenditure reported in kilocalories/week, performed a 2-minute walk test according to a standard protocol, and completed questionnaires measuring fatigue, depressive symptoms and social support and stress. Most patients (92%) were women, had a mean age of 45 years, and did not have extensive SLE. In response to open-ended questions, patients reported they avoided physical activity because they did not want to exacerbate SLE in the short term. However, if they could overcome initial hurdles, 46 patients (92%) thought physical activity ultimately would improve SLE symptoms. Walking was the preferred activity and 45 (90%) thought they could walk more. According to the Paffenbarger Index, mean energy expenditure was 1466 ± 1366 kilocalories/week and mean time spent in moderate-intensity activity was 132 ± 222 min/week. In total, 18 patients (36%) and 14 patients (28%) met physical activity goals for these values, respectively. Mean distance walked during the 2-minute test was 149 ± 28 m, equivalent to two blocks, which is similar to reports for stable patients with other chronic diseases. Patients with more social stress and more fatigue reported less physical activity. We conclude that the proportion of patients meeting physical activity goals was low; however, patients performed well on a standard walking test. Most patients believed physical activity provided long-term benefits for SLE and that they could be more physically active.
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Affiliation(s)
- CA Mancuso
- Research Division and Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
| | - M Perna
- Research Division, Hospital for Special Surgery, New York, USA
| | - AB Sargent
- Research Division, Hospital for Special Surgery, New York, USA
| | - JE Salmon
- Research Division and Division of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
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Dubbeldam R, Buurke JH, Simons C, Groothuis-Oudshoorn CGM, Baan H, Nene AV, Hermens HJ. The effects of walking speed on forefoot, hindfoot and ankle joint motion. Clin Biomech (Bristol, Avon) 2010; 25:796-801. [PMID: 20619515 DOI: 10.1016/j.clinbiomech.2010.06.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2009] [Revised: 06/03/2010] [Accepted: 06/03/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND Foot and ankle joint kinematic differences have been identified between healthy subjects and subjects with various pathologies suffering from foot and ankle impairments. Changes in temporal factors such as walking speed and double stance time are also found in these pathological conditions. As such, in theory, these factors would also influence the kinematics and hence make it difficult to ascertain the effects of the disease on the kinematics. The aim of this study was to analyse foot and ankle kinematics from gait recordings of healthy subjects walking at comfortable and slower speeds. METHODS Gait patterns of 14 healthy subjects were recorded. The subjects were first asked to walk at a comfortable speed and then at predefined speeds of 75% and 50% of their comfortable walking speed respectively. Temporal variables were calculated. Foot and ankle joint kinematics were determined from marker-recordings. FINDINGS The subjects walked at mean velocities of 1.28 m/s, 0.97 m/s and 0.65 m/s. With decreasing walking speed the minimum tibio-talar plantar-flexion and maximum hallux dorsi-flexion at toe-off decreased significantly between 3 degrees and 9 degrees. The minimum medial arch at toe-off and minimum midfoot supination at mid-stance were significantly affected by the walking speed. The corresponding individual session differences were small (1 degrees -2 degrees), but the reliability was high and hence the differences were considered clinically relevant. INTERPRETATION Walking speed significantly affected foot and ankle kinematics. Studies aiming to improve the understanding of the effects of foot and ankle pathologies on foot and ankle kinematics should take the walking speed into account.
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Affiliation(s)
- R Dubbeldam
- Roessingh Research and Development, Roessinghsbleekweg 33b, 7522 AH Enschede, The Netherlands.
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Abstract
Total ankle replacement in the rheumatoid patient is a feasible and effective treatment for ankle arthritis. The benefits of ankle prosthesis are good pain relief, acceptable function, and patient satisfaction. It is a joint-sparing procedure for restoring functionality. All investigators of total ankle replacement feel that, as clinicians gain experience with the procedure and related products, difficulties and risks associated with the procedure will decline. Following an early history of failure and poor patient satisfaction, more recent results have shown promise.
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30
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Abstract
This article examines synovectomy and ankle arthrodesis for the rheumatoid ankle joint. Reviews of osteoimmunology and gait analyses specific to rheumatoid arthritis are included. Comparison studies including ankle arthrodesis and total ankle arthroplasty are reviewed.
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Affiliation(s)
- Joseph R Treadwell
- Foot & Ankle Specialists of Connecticut, PC, 6 Germantown Road, Danbury, CT 06810, USA.
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