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Spanos S, Kanellopoulos A, Petropoulakos K, Dimitriadis Z, Siasios I, Poulis I. Reliability and applicability of a low-cost, camera-based gait evaluation method for clinical use. Expert Rev Med Devices 2023; 20:63-70. [PMID: 36662510 DOI: 10.1080/17434440.2023.2171289] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND There is the need for the development of reliable and easy to use in clinical setting gait assessment tools. An open-access video analysis software that administers the calculation of kinematical and spatio-temporal characteristics of human movement is Kinovea® however, its repeatability as a gait analysis tool has not been well addressed. The purpose of the study was to examine the applicability and reliability of an objective, quantitative, low-cost and easy to use in the clinical setting, gait evaluation method, using Kinovea® software. METHODS Data collected from 44 healthy subjects recording gait in sagittal and frontal plane using two smartphones. Time consumption of the procedure was captured. Kinovea® software was used to calculate kinematical and spatial parameters. RESULTS Intra- and inter-rater reliability of the video processing as well as intra-rater reliability of the measurement procedure represented good to excellent and there were less random measurement errors. There was no measurement error due to random variation for the most of the calculated parameters, except of the pelvis position. CONCLUSIONS The results suggest that excepting low accuracy in calculation of pelvis position, gait evaluation using Kinovea® software is objective, quantitative, low-cost, reliable and easy to use in the clinical setting.
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Affiliation(s)
- Savvas Spanos
- Human Performance and Rehabilitation Laboratory, Department of Physiotherapy, University of Thessaly, Lamia, Greece.,Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Asimakis Kanellopoulos
- Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece.,Health Assessment and Quality of Life Laboratory, Department of Physiotherapy, University of Thessaly, Lamia, Greece
| | - Kyriakos Petropoulakos
- Human Performance and Rehabilitation Laboratory, Department of Physiotherapy, University of Thessaly, Lamia, Greece
| | - Zacharias Dimitriadis
- Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece.,Health Assessment and Quality of Life Laboratory, Department of Physiotherapy, University of Thessaly, Lamia, Greece
| | - Ioannis Siasios
- Department of Neurosurgery, Papageorgiou Hospital, Thessaloniki, Greece
| | - Ioannis Poulis
- Human Performance and Rehabilitation Laboratory, Department of Physiotherapy, University of Thessaly, Lamia, Greece.,Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
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Lee IC, Pacheco MM, Lewek MD, Huang H. Perceiving amputee gait from biological motion: kinematics cues and effect of experience level. Sci Rep 2020; 10:17093. [PMID: 33051494 PMCID: PMC7553956 DOI: 10.1038/s41598-020-73838-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/14/2020] [Indexed: 11/08/2022] Open
Abstract
Physical therapists (PT) and clinicians must be skilled in identifying gait features through observation to assess motor deficits in patients and intervene appropriately. Inconsistent results in the literature have led researchers to question how clinical experience influences PT's gait perception and to seek the key kinematic features that should be trained to enhance PT's skill. Thus, this study investigated (1) what are the informative kinematic features that allow gait-deviation perception in amputee gait and (2) whether there are differences in observational gait skills between PT and individuals with less clinical experience (PT students [PTS] and Novices). We introduced a new method that combines biological motion and principal component analysis to gradually mesh amputee and typical walking patterns. Our analysis showed that on average the accuracy rate in identifying gait deviations between PT and PTS was similar and better than Novices. Also, we found that PT's experience was demonstrated by their better perception of gait asymmetry. The extracted principal components demonstrated that the major gait deviation of amputees was the medial-lateral body sway and spatial gait asymmetry.
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Affiliation(s)
- I-Chieh Lee
- UNC-NC State Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, 1407 - Engineering Building III, 1840 Entrepreneur Drive, Raleigh, NC, 27695, USA.
| | - Matheus M Pacheco
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Michael D Lewek
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - He Huang
- UNC-NC State Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, 1407 - Engineering Building III, 1840 Entrepreneur Drive, Raleigh, NC, 27695, USA
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Marín J, Blanco T, Marín JJ, Moreno A, Martitegui E, Aragüés JC. Integrating a gait analysis test in hospital rehabilitation: A service design approach. PLoS One 2019; 14:e0224409. [PMID: 31665158 PMCID: PMC6821402 DOI: 10.1371/journal.pone.0224409] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/11/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Gait analysis with motion capture (MoCap) during rehabilitation can provide objective information to facilitate treatment decision making. However, designing a test to be integrated into healthcare services requires considering multiple design factors. The difficulty of integrating a 'micro-service' (gait test) within a 'macro-service' (healthcare service) has received little attention in the gait analysis literature. It is a challenge that goes beyond the gait analysis case study because service design methods commonly focus on the entire service design (macro-level). OBJECTIVE This study aims to extract design considerations and generate guidelines to integrate MoCap technology for gait analysis in the hospital rehabilitation setting. Specifically, the aim is to design a gait test to assess the response of the applied treatments through pre- and post-measurement sessions. METHODS We focused on patients with spasticity who received botulinum toxin treatment. A qualitative research design was used to investigate the integration of a gait analysis system based on inertial measurement units in a rehabilitation service at a reference hospital. The methodological approach was based on contrasted methodologies from the service design field, which materialise through observation techniques (during system use), semi-structured interviews, and workshops with healthcare professionals (13 patients, 10 'proxies', and 6 doctors). RESULTS The analysis resulted in six themes: (1) patients' understanding, (2) guiding the gait tests, (3) which professionals guide the gait tests, (4) gait test reports, (5) requesting gait tests (doctors and test guide communication), and the (6) conceptual design of the service with the gait test. CONCLUSIONS The extracted design considerations and guidelines increase the applicability and usefulness of the gait analysis technology, improving the link between technologists and healthcare professionals. The proposed methodological approach can also be useful for service design teams that deal with the integration of one service into another.
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Affiliation(s)
- Javier Marín
- IDERGO (Research and Development in Ergonomics) Research Group, I3A (Aragon Institute of Engineering Research), University of Zaragoza, Zaragoza, Spain
- Department of Design and Manufacturing Engineering, University of Zaragoza, Zaragoza, Spain
| | - Teresa Blanco
- HOWLab (Human Openware Research Lab) Research Group, I3A, University of Zaragoza, Zaragoza, Spain
- GeoSpatiumLab, S.L. Zaragoza, Spain
| | - José J. Marín
- IDERGO (Research and Development in Ergonomics) Research Group, I3A (Aragon Institute of Engineering Research), University of Zaragoza, Zaragoza, Spain
- Department of Design and Manufacturing Engineering, University of Zaragoza, Zaragoza, Spain
| | - Alejandro Moreno
- IDERGO (Research and Development in Ergonomics) Research Group, I3A (Aragon Institute of Engineering Research), University of Zaragoza, Zaragoza, Spain
- Department of Health and Sports Sciences, University of Zaragoza, Zaragoza, Spain
| | - Elena Martitegui
- Rehabilitation and Physical Medicine Service, HUMS (Miguel Servet University Hospital), Zaragoza, Spain
| | - Juan C. Aragüés
- Rehabilitation and Physical Medicine Service, HUMS (Miguel Servet University Hospital), Zaragoza, Spain
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Kim SA, Ryu YU, Shin HK. The effects of different attentional focus on poststroke gait. J Exerc Rehabil 2019; 15:592-596. [PMID: 31523682 PMCID: PMC6732553 DOI: 10.12965/jer.1938360.180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 07/12/2019] [Indexed: 11/22/2022] Open
Abstract
Attention may influence the motor performance of poststroke patients. The attentional focus implies “where” attention is focused while performing a specific movement. Focusing attention on the inside of the body while performing a specific exercise is called an internal focus (IF) and focus on the external environment is called an external focus (EF). This study examined the effect of attention on the gait of patients with chronic stroke. Sixteen subjects voluntarily participated in the study. The subjects were guided to walk while maintaining the required attentional focus, which is control, IF, and EF condition. Dependent variables were as follows: step length, stride length, step width, 10-m walk time, and weight distribution on the paretic limb. The results are as follows. First, the step length and the stride length were observed to be longer in the EF condition. Second, 10-m walk time was faster in EF condition. Third, under the EF condition, more weight was applied to the paretic limb. We suggest that EF instruction useful to improve the poststroke gait.
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Affiliation(s)
- Sun-Ae Kim
- Department of Physical Therapy, College of Bio and Medical Science, Daegu Catholic University, Gyeongsan, Korea
| | - Young Uk Ryu
- Department of Physical Therapy, College of Bio and Medical Science, Daegu Catholic University, Gyeongsan, Korea
| | - Hwa Kyung Shin
- Department of Physical Therapy, College of Bio and Medical Science, Daegu Catholic University, Gyeongsan, Korea
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Guzik A, Drużbicki M, Wolan-Nieroda A, Przysada G, Kwolek A. The Wisconsin gait scale - The minimal clinically important difference. Gait Posture 2019; 68:453-457. [PMID: 30599331 DOI: 10.1016/j.gaitpost.2018.12.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/10/2018] [Accepted: 12/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Wisconsin Gait Scale (WGS) is an observational tool for the evaluation of gait quality in individuals after stroke with hemiplegia. It is divided into four subscales, which assess a total of fourteen spatiotemporal and kinematic parameters of gait observed during the consecutive gait phases. However, the WGS score change indicative of important and clinically meaningful change has not been determined. RESEARCH QUESTION The study has been designed to define the minimal clinically important difference (MCID) of the WGS. METHODS Four methods were used to determine the MCID for the WGS in 50 participants who had experienced a stroke: anchor-based study, distribution-based study, linear regression analysis and specification of the receiver operating characteristic (ROC) curve. RESULTS In the anchor-based study, the mean change score in the MCID group was 1.9 points (the first MCID estimate). In the distribution-based study, the standard error of measurement for the no-change group was 0.3 (the second MCID estimate). The slope of the regression line was 1.21 which means than 1-point change in the Barthel Index (BI) is associated with 1.21-point change in the WGS. This translates to 2.25 points change in the WGS with 1.85 points change in the BI (the third MCID estimate). The best cut-off point, determined with ROC curve, was the value corresponding to 1 point of change in the WGS (the fourth MCID estimate). SIGNIFICANCE We established that the MCID of the WGS was 2.25 points, based on the largest of the four MCID estimates. The value 2.25 of the MCID can help clinicians and researchers determine if the change in the scores on the WGS is clinically important. CLINICAL TRIAL REGISTRATION Data are parts of the following clinical trial: ACTRN12617000436370.
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Affiliation(s)
- Agnieszka Guzik
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Hoffmanowej 25, 35-310 Rzeszów, Poland; Centre for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Warzywna 1a, 35-310 Rzeszów, Poland.
| | - Mariusz Drużbicki
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Hoffmanowej 25, 35-310 Rzeszów, Poland; Centre for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Warzywna 1a, 35-310 Rzeszów, Poland.
| | - Andżelina Wolan-Nieroda
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Hoffmanowej 25, 35-310 Rzeszów, Poland; Centre for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Warzywna 1a, 35-310 Rzeszów, Poland.
| | - Grzegorz Przysada
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Hoffmanowej 25, 35-310 Rzeszów, Poland; Centre for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Warzywna 1a, 35-310 Rzeszów, Poland.
| | - Andrzej Kwolek
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Hoffmanowej 25, 35-310 Rzeszów, Poland; Centre for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Warzywna 1a, 35-310 Rzeszów, Poland.
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Guzik A, Drużbicki M, Maistrello L, Turolla A, Agostini M, Kiper P. Relationship Between Observational Wisconsin Gait Scale, Gait Deviation Index, and Gait Variability Index in Individuals Poststroke. Arch Phys Med Rehabil 2019; 100:1680-1687. [PMID: 30690010 DOI: 10.1016/j.apmr.2018.12.031] [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] [Received: 11/07/2018] [Accepted: 12/11/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To compare results of the observational Wisconsin Gait Scale (WGS) and global gait indexes such as Gait Deviation Index (GDI) and Gait Variability Index (GVI), constituting an objective method of assessing gait, and taking into account parameters identified during 3-dimensional gait analysis (3DGA). DESIGN A validation study. SETTING Rehabilitation clinic. PARTICIPANTS A total of 50 individuals poststroke and 50 individuals without stroke and without gait disorders (N=100). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Gait was evaluated using the WGS. GDI and GVI values were acquired using a movement analysis system. The global gait indexes GDI and GVI were determined based on the kinematic and spatiotemporal parameters, respectively. RESULTS The study showed statistically significant correlations between the parameters of GDI affected leg and WGS total score (R=-0.87), GVI affected leg and WGS total score (R=-0.93), GVI unaffected leg and WGS total score (R=-0.88), GVI affected/unaffected leg and the total score in the assessment of spatiotemporal parameters on the WGS (R=-0.81) as well as GDI affected leg and the total score in the assessment of kinematics parameters on the WGS (R=-0.85). All correlations were strong (0.7<|R|<0.9) or very strong (0.9<|R|<1). CONCLUSIONS WGS scores have a strong or very strong correlation with GDI and GVI. The WGS may be recommended as a substitute tool to be used when 3DGA is unavailable, as it is a useful ordinal scale, enabling simple and accurate observational assessment of gait in patients poststroke, with effectiveness that is comparable to the GDI and GVI.
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Affiliation(s)
- Agnieszka Guzik
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Rzeszow, Poland.
| | - Mariusz Drużbicki
- Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Lorenza Maistrello
- Laboratory of Kinematics and Robotics, Fondazione Ospedale San Camillo IRCCS, Venezia, Italy
| | - Andrea Turolla
- Laboratory of Kinematics and Robotics, Fondazione Ospedale San Camillo IRCCS, Venezia, Italy
| | - Michela Agostini
- Laboratory of Kinematics and Robotics, Fondazione Ospedale San Camillo IRCCS, Venezia, Italy
| | - Paweł Kiper
- Laboratory of Kinematics and Robotics, Fondazione Ospedale San Camillo IRCCS, Venezia, Italy
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