Reliability of the OptoGait portable photoelectric cell system for the quantification of spatial-temporal parameters of gait in young adults

From lab to field: validity and reliability of inertial measurement unit-derived gait parameters during a standardised run

The aim was to assess concurrent validity and test-retest reliability of spatiotemporal gait parameters from a thoracic-placed inertial measurement unit (IMU) in lab- (Phase One) and field-based (Phase Two) conditions. Spatiotemporal gait parameters were compared (target speeds 3, 5 and 7.5 m·s-1) between a 100 Hz IMU and an optical measurement system (OptoJump Next, 1000 hz) in 14 trained individuals (Phase One). Additionally, 29 English Premier League football players performed weekly 3 × 60 m runs (5 m·s-1; observations = 1227; Phase Two). Mixed effects modelling assessed the effect of speed on agreement between systems (Phase One) and test-retest reliability (Phase Two). IMU step time showed strong agreement (<0.3%) regardless of individual or running speed. Direction of mean biases up to 40 ms for contact and flight time depended on the running speed and individual. Step time, length and frequency were most reliable (coefficient of variation = 1.3-1.4%) but confounded by running speed. Step time, length and frequency derived from a thoracic-placed IMU can be used confidently. Contact time could be used if bias is corrected for each individual. To optimise test-retest reliability, a minimum running distance of 40 m is needed to ensure 10 constant-speed steps is gathered.

Analyzing population-level trials as N-of-1 trials: An application to gait

Studying individual causal effects of health interventions is important whenever intervention effects are heterogeneous between study participants. Conducting N-of-1 trials, which are single-person randomized controlled trials, is the gold standard for their analysis. As an alternative method, we propose to re-analyze existing population-level studies as N-of-1 trials, and use gait as a use case for illustration. Gait data were collected from 16 young and healthy participants under fatigued and non-fatigued, as well as under single-task (only walking) and dual-task (walking while performing a cognitive task) conditions. As a reference to the N-of-1 trials approach, we first computed standard population-level ANOVA models to evaluate differences in gait parameters (stride length and stride time) across conditions. Then, we estimated the effect of the interventions on gait parameters on the individual level through Bayesian repeated-measures models, viewing each participant as their own trial, and compared the results. The results illustrated that while few overall population-level effects were visible, individual-level analyses revealed differences between participants. Baseline values of the gait parameters varied largely among all participants, and the effects of fatigue and cognitive task were also heterogeneous, with some individuals showing effects in opposite directions. These differences between population-level and individual-level analyses were more pronounced for the fatigue intervention compared to the cognitive task intervention. Following our empirical analysis, we discuss re-analyzing population studies through the lens of N-of-1 trials more generally and highlight important considerations and requirements. Our work encourages future studies to investigate individual effects using population-level data.

Limb asymmetries persist 6 months after anterior cruciate ligament reconstruction according to the results of a jump test battery

Objectives

Test batteries used to assess a patient's return-to-sports (RTS) following anterior cruciate ligament reconstruction (ACLR) are currently undergoing continual development, although no consensus exist on tests to be administered to athletes before allowing return to play. A simple standardized jump test battery was developed to objectively evaluate knee function following ACLR, thereby aiding in RTS decision-making.

Methods

Thirty-three patients who underwent ACLR were prospectively assessed pre-operatively, 6, and 12 months after surgery. Knee function was assessed using a device for optical detection using a test battery consisting of three jump tests: monopodalic countermovement jump (CMJ), drop jump, and monopodalic side-hop. Limb symmetry index (LSI) was reported for all tests at all time points. LSI ≥90% was defined as RTS criteria.

Results

At 12-month evaluation, mean LSI significantly improved compared to 6-month follow up (p < 0.01), and also compared to baseline (p < 0.01), reporting a mean value of 92.6% for CMJ, 90.6 for drop jump and 96.9% for side hop test. Most patients fulfilled the RTS criteria 12 months after surgery (LSI ≥90%). The percentages of patients demonstrating LSI ≥90% at 6 months was 7/33 (21.2%) for CMJ, 12/33 (36.4%) for drop jump, and 11/33 (33.3%) for side-hop test. One year after surgery, percentages grew up to 66.6% (22/33), 63.6% (21/33), and 81.8% (27/33) respectively.

Conclusion

Six months after ACLR, knee functional performance was unsatisfactory in most patients, whereas a significantly higher percentage of patients met RTS criteria 1 year after surgery. The results of the jump test battery proposed in this study support the idea that timing for resumption of cutting and pivoting sports should be delayed later than 6 months, as still limb asymmetries persist at this time point.

Does Lower-Limb Tendon Structure Influence Walking Gait?

BACKGROUND

Within the exploration of human gait, key focal points include the examination of functional rockers and the influential role of tendon behavior in the intricate stretch-shortening cycle. To date, the possible relationship between these two fundamental factors in the analysis of human gait has not been studied. Therefore, this study aimed to analyze the relationship between the morphology of the patellar and Achilles tendons and plantar fascia with respect to the duration of the rockers.

METHODS

Thirty-nine healthy men (age: 28.42 ± 6.97 years; height: 173 ± 7.17 cm; weight: 67.75 ± 9.43 kg) were included. Data of the rockers were recorded using a baropodometric platform while participants walked over a 10 m walkway at a comfortable velocity. Before the trials, the thickness and cross-sectional area were recorded for the patellar tendon, Achilles tendon and plantar fascia using ultrasound examination. The relationship between the morphology of the soft tissue and the duration of the rockers was determined using a pairwise mean comparison (t-test).

RESULTS

A significant difference was found for rocker 1 duration, where a longer duration was found in the group of subjects with thicker patellar tendons. Regarding the Achilles tendon and plantar fascia, no significant differences were observed in terms of tendon morphology. However, subjects with thicker Achilles tendons showed a longer duration of rocker 1.

CONCLUSIONS

The findings underscore a compelling association, revealing that an increased thickness of the patellar tendon significantly contributes to the extension of rocker 1 duration during walking in healthy adults.

Evaluation of Gait Parameters on Subjects with Hallux Limitus Using an Optogait Sensor System: A Case-Control Study

Background and Objetives: The foot is a part of the body's kinetic chain and needs to be efficient during the entire gait cycle. Electronic Sensor Gait analysis is useful and an important tool within the area of podiatry to assess the physical state of patients that helps the comprehensive intervention in situations where the daily activity is limited. The aim of this research is to evaluate if the presence of a hallux limitus (HL) can alter gait space-time parameters and consequently can affect the take-off phase of the gait and the limitation of the range of motion (ROM) of the hallux. Materials and Methods: A case-control study was designed to verify whether there are alterations in the spatiotemporal parameters of the gait cycle between subjects with structural HL compared to the group of subjects with a normal hallux range. A total of n = 138 participants, cases (68 HL subjects) and healthy controls (70 subjects) were studied using an OptoGait LED sensor system to identify gait imbalances using OptoGait photocell gait analysis sensors. Results: Significant differences were found between the two groups with respect to stride length, gait cycle duration in seconds (for both feet) and for total stride and load response (p < 0.05). Conclusions: The limitation of the Hallux ROM may alter the normal gait patterns measured with an Optogait system. The early identification and treatment of gait disturbances due to HL are important to achieve normal gait physical activity to maintain a healthy lifestyle.

DUO-GAIT: A gait dataset for walking under dual-task and fatigue conditions with inertial measurement units

In recent years, there has been a growing interest in developing and evaluating gait analysis algorithms based on inertial measurement unit (IMU) data, which has important implications, including sports, assessment of diseases, and rehabilitation. Multi-tasking and physical fatigue are two relevant aspects of daily life gait monitoring, but there is a lack of publicly available datasets to support the development and testing of methods using a mobile IMU setup. We present a dataset consisting of 6-minute walks under single- (only walking) and dual-task (walking while performing a cognitive task) conditions in unfatigued and fatigued states from sixteen healthy adults. Especially, nine IMUs were placed on the head, chest, lower back, wrists, legs, and feet to record under each of the above-mentioned conditions. The dataset also includes a rich set of spatio-temporal gait parameters that capture the aspects of pace, symmetry, and variability, as well as additional study-related information to support further analysis. This dataset can serve as a foundation for future research on gait monitoring in free-living environments.

Effect of automaticity induced by treadmill walking on prefrontal cortex activation and dual-task performance in older adults

As individuals age, they may experience a decline in gait automaticity, which requires increased attentional resources for the control of gait. This age-related decline in gait automaticity has been shown to contribute to higher prefrontal cortex (PFC) activation and lower dual-task performance during dual-task walking in older adults. This study is to investigate the effect of treadmill walking on PFC activation and dual-task performance in older adults. A total of 20 older adults (mean age, 64.35 ± 2.74 years) and 20 younger adults (mean age, 30.00 ± 3.15 years) performed single- and dual-task walking in overground and treadmill conditions. A wearable functional near-infrared spectroscopy and gait analyzer were used to analyze PFC activation and dual-task performance, respectively. To determine the dual-task (gait and cognitive) performance, the dual-task cost (DTC) was calculated using the following formula: (single-task - dual-task)/single-task × 100. In both groups, dual-task treadmill walking led to reduced PFC activation and reduced DTC compared to dual-task overground walking. Furthermore, despite a higher DTC in gait variability, correct response, total response, response index and a higher error score in older adults than in younger adults during overground walking, there was no difference in treadmill walking. The difference in PFC activation between single- and dual-tasks was also observed only in overground walking. Performing dual-task walking on a treadmill compared to overground walking results in different levels of dual-task performance and PFC activity. Specifically, older adults are able to maintain similar levels of dual-task performance as younger adults while walking on a treadmill, with reduced PFC activation due to the automaticity induced by the treadmill. Therefore, older adults who exhibit low dual-task performance during overground walking may be able to improve their performance while walking on a treadmill with fewer attentional resources.

Estimation of Spatiotemporal Gait Parameters in Walking on a Photoelectric System: Validation on Healthy Children by Standard Gait Analysis

The use of stereophotogrammetry systems is challenging when targeting children's gait analysis due to the time required and the need to keep physical markers in place. For this reason, marker-less photoelectric systems appear to be a solution for accurate and fast gait analysis in youth. The aim of this study is to validate a photoelectric system and its configurations (LED filter setting) on healthy children, comparing the kinematic gait parameters with those obtained from a three-dimensional stereophotogrammetry system. Twenty-seven healthy children were enrolled. Three LED filter settings for the OptoGait were compared to the BTS P6000. The analysis included the non-parametric 80% limits of agreement and the intraclass correlation coefficient (ICC). Additionally, normalised limits of agreement and bias (NLoAs and Nbias) were compared to the clinical experience of physical therapists (i.e., assuming an error lower than 5% is acceptable). ICCs showed excellent consistency for most of the parameters and filter settings; NLoAs varied between 1.39% and 12.62%. An inverse association between the number of LEDs for filter setting and the bias values was also observed. Observations confirm the validity of the OptoGait system for the evaluation of spatiotemporal gait parameters in children.

Active Gains in brain Using Exercise During Aging (AGUEDA): protocol for a randomized controlled trial

Alzheimer's disease is currently the leading cause of dementia and one of the most expensive, lethal and severe diseases worldwide. Age-related decline in executive function is widespread and plays a key role in subsequent dementia risk. Physical exercise has been proposed as one of the leading non-pharmaceutical approaches to improve executive function and ameliorate cognitive decline. This single-site, two-arm, single-blinded, randomized controlled trial (RCT) will include 90 cognitively normal older adults, aged 65-80 years old. Participants will be randomized to a 24-week resistance exercise program (3 sessions/week, 60 min/session, n = 45), or a wait-list control group (n = 45) which will be asked to maintain their usual lifestyle. All study outcomes will be assessed at baseline and at 24-weeks after the exercise program, with a subset of selected outcomes assessed at 12-weeks. The primary outcome will be indicated by the change in an executive function composite score assessed with a comprehensive neuropsychological battery and the National Institutes of Health Toolbox Cognition Battery. Secondary outcomes will include changes in brain structure and function and amyloid deposition, other cognitive outcomes, and changes in molecular biomarkers assessed in blood, saliva, and fecal samples, physical function, muscular strength, body composition, mental health, and psychosocial parameters. We expect that the resistance exercise program will have positive effects on executive function and related brain structure and function, and will help to understand the molecular, structural, functional, and psychosocial mechanisms involved.

The effect of a digital-assisted group rehabilitation on clinical and functional outcomes after total hip and knee arthroplasty-a prospective randomized controlled pilot study

BACKGROUND

The rising number of total hip and knee arthroplasties and the decreasing availability of physiotherapists require clinically and economically effective rehabilitation approaches. Therefore, the present pilot study investigated the effect of a novel digital-assisted individualized group rehabilitation program on clinical and functional outcomes after total hip and knee arthroplasty.

METHODS

In this randomized controlled pilot study, 26 patients undergoing total knee or hip replacement were randomly assigned to either the intervention group (IG, novel digital-assisted group therapy) or the control group (CG, standard postoperative physiotherapy currently carried out in Germany). The IG received the novel digital-assisted group therapy twice per week for a six-months period, while the CG received individual outpatient therapy depending on the prescription of the supervising physician. The number of therapy sessions was recorded. Moreover, subjective outcomes (EuroQol-5Dimensions (EQ-5D) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)), functional outcome (30 s sit to stand test and timed up and go test (TUG)), as well as gait parameters were quantified preoperatively as well as at three and six months after surgery. Data were analyzed using an analysis of covariance with baseline-adjustment.

RESULTS

No patient-reported falls, pain, and hospital readmissions were recorded. On average, the IG received more therapy sessions. The clinical and functional outcomes were mainly not significantly different between groups at three- and six-months follow-up, but medium to large effect sizes for the differences in quality of life (EQ-5D) as well as pain, stiffness, and physical function (WOMAC), and TUG performance were observed in favor of the IG. However, the IG showed a higher variability of gait velocity after total joint replacement.

CONCLUSION

The digital-assisted rehabilitation had positive effects on quality of life, pain, stiffness, physical function, and TUG performance. Nevertheless, the therapy concept may be improved by adding exercises focusing on gait performance to reduce gait variability. The results indicate that the digital-assisted therapy concept is effective and safe. Therefore, a consecutive full-scaled randomized controlled clinical trial is recommended.

TRIAL REGISTRATION

This study was retrospectively registered on 14/02/2022 in the German Clinical Trial Register (DRKS00027960).

Effect of Spatiotemporal Parameters on the Gait of Children Aged from 6 to 12 Years in Podiatric Tests: A Cross Sectional Study

The use of lower limb tests in the paediatric population is of great importance for diagnostic evaluations. The aim of this study is to understand the relationship between the tests performed on the feet and ankles, covering all of its planes, and the spatiotemporal parameters of children's gait.

METHODS

It is a cross-sectional observational study. Children aged between 6 and 12 years participated. Measurements were carried out in 2022. An analysis of three tests used to assess the feet and ankles (FPI, the ankle lunge test, and the lunge test), as well as a kinematic analysis of gait using OptoGait as a measurement tool, was performed.

RESULTS

The spatiotemporal parameters show how Jack's Test is significant in the propulsion phase in its % parameter, with a p-value of 0.05 and a mean difference of 0.67%. Additionally, in the lunge test, we studied the % of midstance in the left foot, with a mean difference between the positive test and the 10 cm test of 10.76 (p value of 0.04).

CONCLUSIONS

The diagnostic analysis of the functional limitation of the first toe (Jack's test) is correlated with the spaciotemporal parameter of propulsion, as well as the lunge test, which is also correlated with the midstance phase of gait.

Absolute agreement and consistency of the OptoGait system and Freemed platform for measuring walking gait

The gait cycle can be divided into four functional rocker units. Although the widespread use of the OptoGait (OG) system and the Freemed (FM) platform, their accuracy has not been tested. An observational study was completed with eighteen healthy volunteers to determine the accuracy of OG and FM for overground walking gait analysis. The pairwise comparison between data obtained from OG, FM and high-speed video analysis revealed significant differences for most of the measurements (p < 0.05). ICCs revealed an excellent absolute agreement between measurements (ICCs > 0.94) for all measures for OG systems compared to video-analysis. When considering FM vs. video-analysis, ICCs showed good absolute agreement for rocker 1 (ICC = 0.86) and 3 (ICC = 0.82), excellent for rocker 2 (ICC = 0.93) and poor (ICC < 0.5) for rocker 4. Bland-Altman plots (95% limits of agreement) revealed heteroscedasticity of error for OG in all variables for foot rockers (r² > 0.1) while no heteroscedasticity of error was found when using FM (r² < 0.1). This study indicates that the OG system and the FM platform can provide consistent foot rockers values when walking at a constant velocity. The differences between the systems assessed and their agreement and consistency values advise against their interchangeable use.

The Effect of Resist and Assist Torque of Hip Joint Motor-based Gait Assistance Robot on Gait Function in the Elderly

OBJECTIVES The purpose of this study was to investigate the effects of assist and resistance torque on the spatiotemporal gait characteristics, and the symmetry and asymmetry of gait using a Gait Enhancing and Motivating System (GEMS) in the elderly.METHODS A cross-sectional and repeated measure design was used. A total of 18 participants (9 males, 9 females; age: 63.5 ± 5.02 years; mass: 64.26 ± 6.87 kg; height: 164.06 ± 7.15 cm) were recruited from a local community, and spatiotemporal gait data were collected with OptoGait system and GEMS. Spatiotemporal gait variables and differences between the dominant and non-dominant legs of these variables were assessed (step length, step time, stance phase, swing phase, single support, load response, pre swing phase, stride time, stride length, double support, cadence, and gait speed). The effects of three modes including normal, assist, and resist modes using GEMS were investigated twice for each participant on a 9-meter walkway. A one-way repeated measure analysis of variance followed by Bonferroni post-hoc tests was conducted.RESULTS The assist mode increased step time, swing phase, stride time and reduced stance phase, pre-swing phase, double support, cadence, and gait speed as compared to normal mode. The resist mode increased stance phase, load response, pre-swing phase, double support, cadence, and reduced step time, swing phase, and stride time. In dominant leg, assist mode showed increased step time and reduced pre-swing phase than normal mode, and greater step time than resist mode (<i>p</i> < 0.05). However, there was no effect of external torque on symmetry and asymmetry between both legs (<i>p</i> > 0.05).CONCLUSIONS The resistance and assist torque of GEMS alter spatiotemporal characteristics during the stance and swing phase of gait in the elderly. However, the resistance torque and assist torque of GEMS did not increase or decrease the gait asymmetry between the dominant and non-dominant legs.

The Toronto Concussion Study: Reference Data for Balance and Gait Measures in Community-Dwelling Adults With Concussion

OBJECTIVE

Concussion can cause deficits in balance and gait. Much of what is known about how concussion affects balance and gait has been derived from studies involving youth, high school, and university athletes. However, investigation into the effects of concussion on balance and gait in community-dwelling young, middle-age, and older aged adults is limited. This study aimed to present descriptive reference values for common balance and gait measures in community-dwelling adults between the ages of 20 and 69 years with concussion.

METHODS

In this observational study, 318 participants were enrolled from a concussion care clinic at a rehabilitation hospital in an urban center and were assessed within 7 days of injury. Balance measures included the Balance Error Scoring System (BESS), modified BESS, and center-of-pressure root mean square during quiet standing. Gait measures included velocity (absolute and height adjusted), cadence, and step length during self-paced gait. Data were binned by decade-long age range.

RESULTS

Mean (SD) per-decade scores for the BESS ranged from 14.8 (5.1) to 21.8 (5.6) errors and 4.0 (3.0) to 9.4 (4.6) errors for the modified BESS. Mean values for center-of-pressure root mean square in the anteroposterior direction ranged from 0.42 (0.18) to 0.52 (0.26) with the eyes open, and from 0.49 (0.19) to 0.62 (0.39) with eyes closed. Mean absolute gait velocity ranged from 98.5 (9.1) to 119.3 (21.3) cm/s. The range of step length values was 58.2 (6.8) to 66.3 (7.3) cm and cadence ranged from 102.1 (9.8) to 108.6 (10.8) steps/min across age groups.

CONCLUSION

These data provide insight into the impact of concussion on balance and mobility in community-dwelling adults across the lifespan.

IMPACT

Community-dwelling adults can experience concussion across the lifespan. Availability of reference values for commonly used balance and gait measures can help to inform clinical strategies and progression of recovery of balance and mobility after injury.

Differences between Systems Using Optical and Capacitive Sensors in Treadmill-Based Spatiotemporal Analysis of Level and Sloping Gait

Modern technology has enabled researchers to analyze gait with great accuracy and in various conditions based on the needs of the trainees. The purpose of the study was to investigate the agreement between systems equipped with optical and capacitive sensors in the analysis of treadmill-based level and sloping gait. The spatiotemporal parameters of gait were measured in 30 healthy college-level students during barefoot walking on 0% (level), -10% and -20% (downhill) and +10% and +20% (uphill) slopes at hiking-related speeds using an optoelectric cell system and an instrumented treadmill. Inter-system agreement was assessed using the Intraclass Correlation Coefficients (ICCs) and the 95% limits of agreement. Our findings revealed excellent ICCs for the temporal and between moderate to excellent ICCs for the spatial parameters of gait. Walking downhill and on a 10% slope demonstrated better inter-system agreement compared to walking uphill and on a 20% slope. Inter-system agreement regarding the duration of gait phases was increased by increasing the number of LEDs used by the optoelectric cell system to detect the contact event. The present study suggests that systems equipped with optical and capacitive sensors can be used interchangeably in the treadmill-based spatiotemporal analysis of level and sloping gait.

Reliability and Repeatability of the Footwork Plantar Pressure Plate System

BACKGROUND

Plantar pressure plate instruments are commonly used in clinical practice and biomechanical analysis and are useful to establish a relationship between gait disorders and foot pressure. The aim of this study was to verify the reliability and repeatability of the Footwork pressure plate system for static and dynamic conditions.

METHODS

Forty healthy adults, without apparent gait pathology, were recruited. For the static condition, participants were asked to stand static on the Footwork pressure plate for 5 sec in natural position (arms on either side of the body, feet shoulder-width apart in a comfortable angle, and looking ahead). For the dynamic condition, subjects were told to step five times with each foot on the plate following the three-step protocol. Both conditions were performed in two testing sessions spaced by 1 week.

RESULTS

Intrasession and intersession reliability for both conditions showed substantial to almost perfect intraclass correlation coefficient (ICC) values, and low coefficient of variation, low standard error measure, and low percentage error. Intrasession ICCs were 0.724 to 0.993 for static condition evaluation and 0.639 to 0.986 for dynamic condition evaluation. Intersession reliability ICCs ranged from 0.850 to 0.987 for the static condition and from 0.781 to 0.996 for the dynamic condition. Coefficient of variation values were below 8% in both cases and percentage error calculated from standard error measure were less than 10%.

CONCLUSIONS

The present work demonstrates that the Footwork plantar pressure plate system is a reliable instrument for collecting plantar pressures in static and dynamic conditions. Reliability data were higher for the static trials, probably because of the individual physiologic fluctuations, which are larger during dynamic gait. Reliability for intersession and average intrasession trials were higher than single-test reliability. The results from the present work can be used as a starting point for future research and to establish a basis for sample sizes for investigations that would use the Footwork platform.

Locally linear embedding and plantar pressure-time graph selection in heel pain classification: An observational, case-control study

Plantar heel pain mainly manifests during the gait cycle when the whole foot is in contact with the floor, which corresponds to the second rocker of the gait. This moment can be studied through the analysis of pressure-time graphs obtained using plantar pressure plate systems. However, these graphs are complex, and a dimensionality reduction method, such as locally linear embedding (LLE), greatly assists in their comprehension. This observational, case-control pilot study included 45 subjects divided into case (n = 21) and control (n = 24) groups, depending on the presence/absence of plantar heel pain. The second rocker pressure-time graphs of the 45 subjects were obtained using the Footwork Pro® plantar pressure plate system. These graphs were analyzed and defined as the dynamic simultaneity surfaces (DSSs). This complex structure was composed of four dimensions: the dynamic simultaneity time (DST), slope upward grade (α), slope downward grade (β), and height (h), and were reduced into one dimension and classified into pathological and non-pathological subjects using the LLE method. All 45 DSSs were successfully reduced and classified to distinguish between the case (plantar heel pain) and control (non-plantar heel pain) subjects. This study is the first to use the LLE method for gait analysis. This method serves as a novel and promising tool for the study and classification of pathological and non-pathological gait cycles. This method opens the door for future research and analysis, with significant potential to assess diagnosis, treatment follow-up, and injury prevention in physical medicine consultations.

Concurrent validity of the step time and walking speed obtained from the smartphone application CareCoaching in independent, community-dwelling older adults

[Purpose] In this study, we verified the validity of the step time and walking speed obtained from the smartphone gait analysis application CareCoaching. [Participants and Methods] The participants were 66 independent, community-dwelling adults aged 65 years or older who performed a 10-m walking test twice each under preferred- and slow-speed conditions. We concurrently measured gait motions using CareCoaching and the OptoGait system for reference data. Both systems compute walking speed and step time as gait parameters. We examined the concurrent validity of these parameters by using intra-class correlation coefficients (ICCs) and limits of agreement (LOAs) with Bland−Altman analyses. [Results] In the preferred walking speed condition, the ICCs of walking speed and step times between the CareCoaching and the OptoGait system were 0.67 and 0.93, respectively. In the slow walking speed condition, the ICCs for walking speed and step time were 0.78 and 0.97, respectively. In addition, the LOAs for step time were −0.0941 to 0.1160 for preferred walking speed and −0.0596 to 0.0883 for slow walking speed. The LOAs for walking speed were −0.4158 to 0.0568 for preferred walking speed and −0.3348 to 0.0523 for slow walking speed. [Conclusion] CareCoaching showed excellent agreement for step time and moderate-to-good agreement for walking speed in independent, community-dwelling older adults.

Measuring Spatiotemporal Parameters on Treadmill Walking Using Wearable Inertial System

This study aims to measure and compare spatiotemporal gait parameters in nineteen subjects using a full wearable inertial mocap system Xsens (MVN Awinda, Netherlands) and a photoelectronic system one-meter OptoGaitTM (Microgait, Italy) on a treadmill imposing a walking speed of 5 km/h. A total of eleven steps were considered for each subject constituting a dataset of 209 samples from which spatiotemporal parameters (SPT) were calculated. The step length measurement was determined using two methods. The first one considers the calculation of step length based on the inverted pendulum model, while the second considers an anthropometric approach that correlates the stature with an anthropometric coefficient. Although the absolute agreement and consistency were found for the calculation of the stance phase, cadence and gait cycle, from our study, differences in SPT were found between the two systems. Mean square error (MSE) calculation of their speed (m/s) with respect to the imposed speed on a treadmill reveals a smaller error (MSE = 0.0008) using the OptoGaitTM. Overall, our results indicate that the accurate detection of heel strike and toe-off have an influence on phases and sub-phases for the entire acquisition. Future study in this domain should investigate how to design and integrate better products and algorithms aiming to solve the problematic issues already identified in this study without limiting the user's need and performance in a different environment.

Influence of Multiple Sclerosis on Spatiotemporal Gait Parameters: A Systematic Review and Meta-Regression

OBJECTIVE

To quantify the effect of multiple sclerosis (MS) on spatiotemporal gait characteristics accounting for disability severity and fall classification.

DATA SOURCES

MEDLINE (1946-August 2018), Allied and Complementary Medicine Database (1985-2018 August), and PsycINFO (1806-August 2018) were searched for terms on MS and gait.

STUDY SELECTION

Dual independent screening was conducted to identify observational, cross-sectional studies that compared adults with MS grouped according to Expanded Disability Status Scale (EDSS) level or fall history, reported on spatiotemporal gait characteristics, and were published in English. The search retrieved 5891 results, of which 12 studies satisfied the inclusion criteria.

DATA EXTRACTION

Two authors worked independently to extract and verify data on publication details, study methodology, participant characteristics, gait outcomes, conclusions, and limitations. Risk of bias was assessed using the QualSyst critical appraisal tool. A random-effects meta-regression and meta-analysis were conducted on pooled data.

DATA SYNTHESIS

All studies received quality ratings of very good to excellent and collectively examined 1513 individuals with MS. With every 1-point increase in EDSS, significant changes (P<.05) were observed in gait speed (-0.12 m/s; 95% confidence interval (CI), 0.08-0.15), step length (-0.04 m; 95% CI, 0.03-0.05), step time (+0.04 seconds; 95% CI, 0.02-0.06), step time variability (+0.009 seconds; 95% CI, 0.003-0.016), stride time (+0.08 seconds; 95% CI, 0.03-0.12), cadence (-4.4 steps per minute; 95% CI, 2.3-6.4), stance phase duration (+0.8% gait cycle; 95% CI, 0.1-1.5), and double support time (+3.5% gait cycle; 95% CI, 1.5-5.4). Recent fallers exhibited an 18% (95% CI, 13%-23%) reduction in gait speed compared with nonfallers (P<.001).

CONCLUSIONS

This review provides the most accurate reference values to-date that can be used to assess the effectiveness of MS gait training programs and therapeutic techniques for individuals who differ on disability severity and fall classification. Some gait adaptations could be part of adopting a more cautious gait strategy and should be factored into the design of future interventions.

Agreement Between the OptoGait and Instrumented Treadmill System for the Quantification of Spatiotemporal Treadmill Running Parameters

The measurement of spatiotemporal gait parameters is commonly utilized to assess gait in healthy and injured individuals. The OptoGait system is a portable system and can be mounted to a treadmill to collect data in a clinical, training, or research setting. The purpose of this method comparison study was to examine the agreement of spatiotemporal gait parameters calculated by the OptoGait compared to an instrumented treadmill system during running. Thirty healthy runners ran on an instrumented treadmill with the OptoGait 1-m system mounted along the treadmill platform. Spatiotemporal running variables of step rate, step length, and contact time were calculated during the final minute of treadmill running. The level of agreement between the OptoGait and treadmill was analyzed using intraclass correlation coefficients [ICC (2,3)] for step rate, step length, and contact time. Step rate and step length demonstrated excellent agreement. Contact time demonstrated good agreement. Intraclass correlation coefficients for spatiotemporal parameters ranged from 0.83 to 0.99. The OptoGait demonstrated good to excellent agreement in the evaluation of running step rate, step length, and contact time and should be considered for use in clinical, training, or research settings.

Effects of dichotic listening on gait domains of healthy older adults during dual-tasking: An exploratory observational study

BACKGROUND

Identification of the cognitive mechanisms behind gait changes in aging is a prime endeavor in gerontology and geriatrics. For this reason, we have implemented a new dual-task paradigm where an auditory attentional task is performed during over-ground walking. Dichotic listening assesses spontaneous attention and voluntary attention directed to right and left-ear. The uniqueness of dichotic listening relies on its requirements that vary in difficulty and recruitment of resources from whole brain to one brain hemisphere. When used in dual-tasking, asymmetric effects on certain gait parameters have been reported.

OBJECTIVES

The present study aims to acquire a more global understanding on how dichotic listening affects gait domains. Specifically, we aimed to understand how spontaneous vs lateralized auditory attention altered the Principal Component Analysis (PCA) structure of gait in healthy older adults.

METHODS

Seventy-eight healthy older adults (mean age: 71.1 years; 44 women and 34 men) underwent the Bergen dichotic listening test while walking. As this study only focuses on the effects of the cognitive task on gait, only dual-task costs for gait were calculated and entered into the PCA analyses. We explored the PCA structure for the effects on bilateral gait parameters (i.e., both limbs together) as well as on lateralized gait parameters (i.e, separate parameters by limb). We first established gait domains during single-task walking. Then, dual-task cost scores for gait were entered in a series of PCAs.

RESULTS

Results from the PCAs for bilateral gait parameters showed limited alterations on gait structure. In contrast, PCAs for lateralized data demonstrated modifications of the gait structure during dichotic listening. The PCAs corresponding for all dichotic listening conditions showed different factor solutions ranging between 4 and 6 factors that explained between 73.8% to 80% of the total variance. As a whole, all conditions had an impact on "pace", "pace variability" and "base of support variability" domains. In the spontaneous attention condition, a six-factor solution explaining 78.3% of the variance showed asymmetrical disruptions on the PCA structure. When attention was focused to right-ear, a five-factor solution explaining 89% of the variance and similar to baseline was found. When attention was directed to left-ear, a four-factor solution explaining 73.8% of the variance was found with symmetrical impact on all factors.

CONCLUSIONS

These findings demonstrate for the first time that specific facets of attentional control affects gait domains both symmetrically and asymmetrically in healthy older adults.

Agreement Between Spatiotemporal Gait Parameters Measured by a Markerless Motion Capture System and Two Reference Systems-a Treadmill-Based Photoelectric Cell and High-Speed Video Analyses: Comparative Study

Background

Markerless systems to capture body motion require no markers to be attached to the body, thereby improving clinical feasibility and testing time. However, the lack of markers might affect the accuracy of measurements.

Objective

This study aimed to determine the absolute reliability and concurrent validity of the Kinect system with MotionMetrix software for spatiotemporal variables during running at a comfortable velocity, by comparing data between the combination system and two widely used systems—OptoGait and high-speed video analysis at 1000 Hz.

Methods

In total, 25 runners followed a running protocol on a treadmill at a speed of 12 km/h. The Kinect+MotionMetrix combination measured spatiotemporal parameters during running (ie, contact time, flight time, step frequency, and step length), which were compared to those obtained from two reference systems.

Results

Regardless of the system, flight time had the highest coefficients of variation (OptoGait: 16.4%; video analysis: 17.3%; Kinect+MotionMetrix: 23.2%). The rest of the coefficients of variation reported were lower than 8.1%. Correlation analysis showed very high correlations (r>0.8; P<.001) and almost perfect associations (intraclass correlation coefficient>0.81) between systems for all the spatiotemporal parameters except contact time, which had lower values. Bland-Altman plots revealed smaller systematic biases and random errors for step frequency and step length and larger systematic biases and random errors for temporal parameters with the Kinect+MotionMetrix system as compared to OptoGait (difference: contact time +3.0%, flight time −7.9%) and high-speed video analysis at 1000 Hz (difference: contact time +4.2%, flight time −11.3%). Accordingly, heteroscedasticity was found between systems for temporal parameters (r²>0.1).

Conclusions

The results indicate that the Kinect+MotionMetrix combination slightly overestimates contact time and strongly underestimates flight time as compared to the OptoGait system and high-speed video analysis at 1000 Hz. However, it is a valid tool for measuring step frequency and step length when compared to reference systems. Future studies should determine the reliability of this system for determining temporal parameters.

Algo-Functional Indexes and Spatiotemporal Parameters of Gait after Sacroiliac Joint Arthrodesis

Aims of the study were to evaluate the reliability and validity of the Italian version of the Majeed and Iowa questionnaires and to investigate the long-term surgical outcomes following sacroiliac joint arthrodesis. Twenty one patients who underwent a sacroiliac joint arthrodesis and 21 healthy subjects were evaluated. The experimental procedure consisted of gait analysis and a physical activity assessment (in both groups) and of administration of outcome questionnaires and pain assessment (in the patient group). The Majeed and Iowa questionnaires showed excellent reliability, excellent (for the Majeed questionnaire) and good (for the Iowa questionnaire) construct validity, and poor convergent validity (for both questionnaires) relative to walking speed. Most of the patients reported no pain and minimum pain-related disability and their physical activity profile was comparable to healthy controls. Patients showed an impaired walking performance (i.e., they walked slower and using shorter steps) compared with healthy controls. Long-term walking pattern abnormalities following sacroiliac joint arthrodesis may occur despite excellent clinical results. Given their excellent reliability and construct validity, the Majeed and Iowa questionnaires can be used in combination with the assessment of spatiotemporal gait parameters for the prognostic assessment and/or follow-up of surgical patients.

Time-course of running treadmill adaptation in novice treadmill runners

Studies on running biomechanics and energetics are usually conducted on a treadmill. To ensure that locomotion on a treadmill is comparable to locomotion overground, participants need to be expert in the use of the device. This study aimed to identify the number and duration of sessions needed to obtain stable measurements for spatiotemporal and metabolic parameters in unexperienced treadmill runners. Fourteen male recreational runners performed three 15-min treadmill running trials in different days at a submaximal speed. Spatiotemporal and metabolic parameters were registered at minutes: 5, 10, 15 and their within-trial and between-trial changes were analysed using a two-way repeated measures ANOVA and Bonferroni post-hoc test. Within-trial differences were found in step frequency (decreased over time), Step Length and Contact Time (increased), reaching stability at different time points. Ventilator parameters increased, reaching stability after 5-10 min, while heart rate increased progressively over time. The only between-trial differences were an increase in step length and a decrease in step frequency at min 1, between trials 1 and 3. In conclusion, at least three running trials of 15 min are required to familiarize with the device. The last 5 min of the third trial can be regarded as stable measurements.

Accuracy Verification of Spatio-Temporal and Kinematic Parameters for Gait Using Inertial Measurement Unit System

Inertial measurement unit systems are wearable sensors that can measure the movement of a human in real-time with relatively little space and high portability. The purpose of this study was to investigate the accuracy of the inertial measurement unit (IMU) system for gait analysis by comparing it with measurements obtained using an optical motion capture (OMC) system. To compare the accuracies of these two different motion capture systems, the Spatio-temporal and kinematic parameters were measured in young adults during normal walking. Thirty healthy participants participated in the study. Data were collected while walking 5 strides on a 7 m walkway at a self-selected speed. Results of gait analysis showed that the Spatio-temporal (stride time, stride length, cadence, step length) and kinematic (knee joint peak to peak of movement) parameters were not significantly different in the participant. Spatio-temporal and kinematic parameters of the two systems were compared using the Bland–Altman method. The results obtained showed that the measurements of Spatio-temporal and kinematic parameters of gait by the two systems were similar, which suggested that IMU and OMC systems could be used interchangeably for gait measurements. Therefore, gait analysis performed using the wearable IMU system might efficiently provide gait measurements and enable accurate analysis.

Variation of spatiotemporal parameters in school children carrying different backpack loads: a cross sectional study

The purpose of this study was to analyze spatiotemporal parameters of gait in children using varyingly loaded Backpacks(BP). This cross-sectional study examined 231 schoolchildren (118 boys, 113 girls) aged six to 12 years, carrying a traditional BP to manipulate loading (Crossing Backpack Children Arpenaz 7 Litres, Junior Red Quechua). Load was added to the BPs in increments of 5%, 10%, 15% and 20% of the child's body weight. Spatio-temporal parameters were measured with the OptoGait system. Significant differences were observed in single support (p < 0.001), and double support (p < 0.001). No statistically significant differences were observed in step length (p = 0.959) between the five loading conditions. Similarly, no statistically significant differences were found in the contact phase (p = 0.208), although significant changes were seen between baseline, 15% of body weight (p < 0.005), and 20% of body weight (p < 0.005). The effect sizes from the ANOVA in the single support was low (0.015), and double support was moderate (0.02). Increased weight in BPs reduced both children's balance and single support, increased double support, but did not change step length. The children increase double support with heavier loads to help their balance. The spatio-temporal changes were most evident with BP loads between 15-20% of body weight. Affective responses, including the perception of heaviness or difficulty in carrying the schoolbags need to be included in further and prospective investigations.

Agreement between spatiotemporal parameters from a photoelectric system with different filter settings and high-speed video analysis during running on a treadmill at comfortable velocity

The aim of this study was to determine the level of agreement between spatiotemporal gait characteristics from a photoelectric system with different filter settings and high-speed video analysis during running on a treadmill at comfortable velocity. Forty-nine runners performed a running protocol on a treadmill at comfortable velocity. Two systems were used to determine spatiotemporal parameters (i.e. contact time [CT], flight time [FT], step frequency [SF] and step length [SL]) during running: OptoGait system and high-speed video analysis at 1000 Hz. The collected data was re-filtered in the OptoGait software by using nine different settings (i.e. 0_0, 1_1, 2_2, 3_3, 3_4, 4_4, 4_5, 5_4 and 5_5), and compared to those obtained through video analysis. The Pearson correlation analysis revealed very large correlations (r > 0.9, p < 0.001) in CT, FT, SF and SL between both systems, regardless of the OptoGait's filter settings. The ICC reported an almost perfect association (ICC > 0.9) for both SL and SF regardless of the filter setting. However, large variations between filter settings according to the data from video analysis were reported in CT and FT (0_0, 1_1 and 2_2 filter settings obtained an association ICC > 0.9, whereas other filters obtained lower ICCs). Bland-Altman plots revealed small bias and error and no presence of heteroscedasticity of error for 1_1 setting. In conclusion, the filter setting for the OptoGait system should be considered to minimize the bias and error of spatiotemporal parameters measurement. For running on a treadmill, the 1_1 filter setting is recommended if gait parameters are to be compared to a high-speed video analysis (1000 Hz).

The influence of childhood obesity on spatio-temporal gait parameters

The musculoskeletal and neurosensorial development of children can be affected by excess body weight. Studies have examined how childhood obesity affects gait, but much about the influence of this factor remains to be determined. The aim of our study is to analyse, in a large sample of children, the influence of obesity on the spatiotemporal parameters of the gait cycle, in the most natural way possible, with the subjects walking overground at a self-selected speed.

METHOD

For this study, the sample was composed of 238 healthy school children, composed of 114 (47.9%) girls and 124 (52.1%) boys, aged 7-11 years. For each one, the body mass index was calculated, according to which the subjects were classified by percentiles as low weight, normal weight, overweight or obese. Anthropometric variables were measured and the spatiotemporal parameters of gait were assessed by the OptoGait^® portable photocell system.

RESULTS

The spatial variables did not reveal significant differences between the children with normal weight and those with obesity. However, the differences for stance phase, load response and pre-swing phase (p = 0.0001, p = 0.016 and p = 0.0001, respectively) were clearly significant.

CONCLUSIONS

Childhood obesity exerts a significant influence on gait by increasing the duration of load response and that of the pre-swing towards the oscillation phase and therefore the total duration of the support phase. This outcome requires greater energy expenditure to stabilise the gait of children with obesity, and could have biomechanical repercussions.

Agreement Between the Spatiotemporal Gait Parameters of Healthy Adults From the OptoGait System and a Traditional Three-Dimensional Motion Capture System

While previous research has assessed the validity of the OptoGait system to the GAITRite walkway and an instrumented treadmill, no research to date has assessed this system against a traditional three-dimensional motion analysis system. Additionally, previous research has shown that the OptoGait system shows systematic bias when compared to other systems due to the configuration of the system's hardware. This study examined the agreement between the spatiotemporal gait parameters calculated from the OptoGait system and a three-dimensional motion capture (14 camera Vicon motion capture system and 2 AMTI force plates) in healthy adults. Additionally, a range of filter settings for the OptoGait were examined to determine if it was possible to eliminate any systematic bias between the OptoGait and the three-dimensional motion analysis system. Agreement between the systems was examined using 95% limits of agreement by Bland and Altman and the intraclass correlation coefficient. A repeated measure ANOVA was used to detect any systematic differences between the systems. Findings confirm the validity of the OptoGait system for the evaluation of spatiotemporal gait parameters in healthy adults. Furthermore, recommendations on filter settings which eliminate the systematic bias between the OptoGait and the three-dimensional motion analysis system are provided.

The impact of age-related hearing loss and lateralized auditory attention on spatiotemporal parameters of gait during dual-tasking among community dwelling older adults

This investigation assessed the impact of hearing loss and lateralized auditory attention on spatiotemporal parameters of gait during overground dual-tasking by the use of the dichotic listening task. Seventy-eight right-handed, healthy older adults between 60 and 88 years were assigned to a Young-Old (<70 years) or an Old-Old (>71 years) group. Cognitive assessment and pure tone audiometry were conducted. Spatiotemporal parameters of gait quantified by mean (M), and coefficient of variations (CoV) were evaluated with the OptoGait system during 3 dichotic listening conditions: Non-Forced, Forced-Right and Forced-Left. Factorial analyses of variance and covariance were used to assess group differences and the moderating effects of hearing status, respectively. Results demonstrated that three of the gait parameters assessed were affected asymmetrically by the dual-task paradigm after controlling for hearing status. Asymmetries existed on step width, gait speed and variability of stride length. Finally, correlations between gait outcomes and dichotic listening results showed that M and CoVs in gait parameters during right-ear responses were longer compared with left-ear. Left-ear responses were related to increased variability on stride length, which indicates higher difficulty level. Hearing status varying from normal to mild levels of hearing loss modulates spatiotemporal gait outcomes measured during dichotic listening execution. Findings suggest that attending to left side stimuli relates to increased gait variability, while focusing on right-side assures a safe walk. Results demonstrated that attending to right-ear stimuli is an adaptive strategy for older adults that compensates for limited sensorimotor and cognitive resources during walking.

Do spatiotemporal parameters and gait variability differ across the lifespan of healthy adults? A systematic review

BACKGROUND

Aging is often associated with changes in the musculoskeletal system, peripheral and central nervous system. These age-related changes often result in mobility problems influencing gait performance. Compensatory strategies are used as a way to adapt to these physiological changes.

RESEARCH QUESTION

The aim of this review is to investigate the differences in spatiotemporal and gait variability measures throughout the healthy adult life.

METHODS

This systematic review was conducted according to the PRISMA guidelines and registered in the PROSPERO database (no. CRD42017057720). Databases MEDLINE (Pubmed), Web of Science (Web of Knowledge), Cochrane Library and ScienceDirect were systematically searched until March 2018.

RESULTS

Eighteen of the 3195 original studies met the eligibility criteria and were included in this review. The majority of studies reported spatiotemporal and gait variability measures in adults above the age of 65, followed by the young adult population, information of middle-aged adults is lacking. Spatiotemporal parameters and gait variability measures were extracted from 2112 healthy adults between 18 and 98 years old and, in general, tend to deteriorate with increasing age. Variability measures were only reported in an elderly population and show great variety between studies.

SIGNIFICANCE

The findings of this review suggest that most spatiotemporal parameters significantly differ across different age groups. Elderly populations show a reduction of preferred walking speed, cadence, step and stride length, all related to a more cautious gait, while gait variability measures remain stable over time. A preliminary framework of normative reference data is provided, enabling insights into the influence of aging on spatiotemporal parameters, however spatiotemporal parameters of middle-aged adults should be investigated more thoroughly.

Gait pattern in patients with peripheral artery disease

Background

The aim of the present paper is to assess the gait pattern of patients with Peripheral Artery Disease (PAD). A more specific aim is to compare the gait pattern of PAD patients before and after the appearance of intermittent claudication symptoms.

Methods

The study involved 34 PAD patients with a claudication distance ≥200 m and 20 participants without PAD, who formed the control group. The gait pattern of PAD patients was assessed twice: before the appearance of intermittent claudication symptoms (pain-free conditions) and after the appearance of intermittent claudication symptoms (pain conditions).

Results

Compared to the control group, PAD patients presented a statistically significant decrease in step length both during pain-free conditions (52.6 ± 12.5 vs. 72.8 ± 18.5 cm, p = 0.008) and in pain conditions (53.3 ± 13.3 vs. 72.8 ± 18.5 cm, p = 0.006). As for the remaining spatiotemporal parameters, there were no differences observed between the patient group and the controls. Intermittent claudication symptom induced by the walking test on the treadmill did not bring about any new abnormalities in the gait pattern or intensify the existing abnormalities of the gait.

Conclusions

PAD patients have a tendency to shorten their step length regardless of the presence of intermittent claudication.

An Extreme Mountain Ultra-Marathon Decreases the Cost of Uphill Walking and Running

Purpose: To examine the effects of the world's most challenging mountain ultramarathon (MUM, 330 km, cumulative elevation gain of +24,000 m) on the energy cost and kinematics of different uphill gaits.

Methods: Before (PRE) and immediately after (POST) the competition, 19 male athletes performed three submaximal 5-min treadmill exercise trials in a randomized order: walking at 5 km·h⁻¹, +20%; running at 6 km·h⁻¹, +15%; and running at 8 km·h⁻¹, +10%. During the three trials, energy cost was assessed using an indirect calorimetry system and spatiotemporal gait parameters were acquired with a floor-level high-density photoelectric cells system.

Results: The average time of the study participants to complete the MUM was 129 h 43 min 48 s (range: 107 h 29 min 24 s to 144 h 21 min 0 s). Energy costs in walking (−11.5 ± 5.5%, P < 0.001), as well as in the first (−7.2 ± 3.1%, P = 0.01) and second (−7.0 ± 3.9%, P = 0.02) running condition decreased between PRE and POST, with a reduction both in the heart rate (−11.3, −10.0, and −9.3%, respectively) and oxygen uptake only for the walking condition (−6.5%). No consistent and significant changes in the kinematics variables were detected (P-values from 0.10 to 0.96).

Conclusion: Though fatigued after completing the MUM, the subjects were still able to maintain their uphill locomotion patterns noted at PRE. The decrease (improvement) in the energy costs was likely due to the prolonged and repetitive walking/running, reflecting a generic improvement in the mechanical efficiency of locomotion after ~130 h of uphill locomotion rather than constraints imposed by the activity on the musculoskeletal structure and function.