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Ramadhan GT, Haris F, Jan YK, Liau BY, Chang WT, Tai CC, Lung CW. Effect of different inner pressures of air insoles and walking durations on plantar pressure time integral. Sci Rep 2024; 14:19272. [PMID: 39164374 PMCID: PMC11336220 DOI: 10.1038/s41598-024-70312-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 08/14/2024] [Indexed: 08/22/2024] Open
Abstract
Air insoles have provided insights for reducing the risk of diabetic foot ulcers (DFU). The pressure time integral (PTI) is an effective assessment that considers the time effect in various physical activities. We investigated the interactions between three different insole inner pressures (80, 160, and 240 mmHg) and two walking durations (10 and 20 min). The big toe (T1), first metatarsal head (M1), and second metatarsal head (M2) were investigated in 13 healthy participants. One-way analysis of variance (ANOVA) showed that the effects of each insole inner pressure significantly differed (P < 0.05) with a 10 min walking duration. The PTI values resulting from 80 mmHg in M2 (38.4 ± 3.8, P = 0.002) and 160 mmHg in M1 (44.3 ± 4.3, P = 0.027) were lower than those from 240 mmHg. Additionally, the paired t test showed that the effects of each walking duration were also considerably different at 160 mmHg. The PTI at 10 min was lower than that at 20 min in M1 (44.31 ± 4.31, P = 0.015) and M2 (47.14 ± 5.27, P = 0.047). Thus, we suggest that walking with a pressure of 160 mmHg for 10 min has a lower risk of DFU.
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Affiliation(s)
- Gilang Titah Ramadhan
- Department of Computer Science and Information Engineering, Asia University, Taichung, 413305, Taiwan
| | - Fahni Haris
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, 55183, Indonesia
| | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, 61820, USA
| | - Ben-Yi Liau
- Department of Automatic Control Engineering, Feng Chia University, Taichung, 407102, Taiwan
| | - Wen-Thong Chang
- Department of Computer Science and Information Engineering, Asia University, Taichung, 413305, Taiwan
| | - Chien-Cheng Tai
- School of Public Health, Taipei Medical University, New Taipei City, 235603, Taiwan
| | - Chi-Wen Lung
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, 61820, USA.
- Department of Creative Product Design, Asia University, Taichung, 413305, Taiwan.
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Miyazaki T, Kiyama R, Takeshita Y, Shimose D, Araki S, Matsuura H, Uto Y, Nakashima S, Nakai Y, Kawada M. Inertial measurement unit-based real-time feedback gait immediately changes gait parameters in older inpatients: a pilot study. Front Physiol 2024; 15:1384313. [PMID: 39165280 PMCID: PMC11333335 DOI: 10.3389/fphys.2024.1384313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 07/24/2024] [Indexed: 08/22/2024] Open
Abstract
The effect of gait feedback training for older people remains unclear, and such training methods have not been adapted in clinical settings. This study aimed to examine whether inertial measurement unit (IMU)-based real-time feedback gait for older inpatients immediately changes gait parameters. Seven older inpatients (mean age: 76.0 years) performed three types of 60-s gait trials with real-time feedback in each of the following categories: walking spontaneously (no feedback trial); focused on increasing the ankle plantarflexion angle during late stance (ankle trial); and focused on increasing the leg extension angle, which is defined by the location of the ankle joint relative to the hip joint in the sagittal plane, during late stance (leg trial). Tilt angles and accelerations of the pelvis and lower limb segments were measured using seven IMUs in pre- and post-feedback trials. To examine the immediate effects of IMU-based real-time feedback gait, multiple comparisons of the change in gait parameters were conducted. Real-time feedback increased gait speed, but it did not significantly differ in the control (p = 0.176), ankle (p = 0.237), and leg trials (p = 0.398). Step length was significantly increased after the ankle trial (p = 0.043, r = 0.77: large effect size). Regarding changes in gait kinematics, the leg trial increased leg extension angle compared to the no feedback trial (p = 0.048, r = 0.77: large effect size). IMU-based real-time feedback gait changed gait kinematics immediately, and this suggests the feasibility of a clinical application for overground gait training in older people.
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Affiliation(s)
- Takasuke Miyazaki
- Department of Orthopedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Ryoji Kiyama
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Yasufumi Takeshita
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
- Sports Science Area, Department of Mechanical Systems Engineering, Daiichi Institute of Technology, Kagoshima, Japan
| | - Daichi Shimose
- Course of Health Sciences, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
- Department of Rehabilitation, Tarumizu Municipal Medical Center, Tarumizu Central Hospital, Kagoshima, Japan
| | - Sota Araki
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Hisanori Matsuura
- Course of Health Sciences, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Yuki Uto
- Course of Health Sciences, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Shobu Nakashima
- Course of Health Sciences, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Yuki Nakai
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
- Sports Science Area, Department of Mechanical Systems Engineering, Daiichi Institute of Technology, Kagoshima, Japan
| | - Masayuki Kawada
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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Seok MA, Choi JH, Roh YH, Lee SY, Lee HJ. Can Older Adult Patients with Hip Fractures Have Their Discharge Destination Predicted by Physical Performance Measures? MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1017. [PMID: 39064446 PMCID: PMC11278835 DOI: 10.3390/medicina60071017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 06/16/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: The majority of patients who undergo hip fracture surgery do not recover their former level of physical function; hence, it is essential to establish a specific rehabilitation strategy for maximal functional recovery of patients after a hip fracture. Knowing which indicators of physical function in hip fracture patients have a significant impact on the decision regarding the place or timing of discharge would make it possible to plan and prepare for discharge as soon as possible. Therefore, this study aimed to investigate the relationship between physical function and discharge destination for older adult patients with hip fracture. Materials and Methods: In this retrospective cohort study, 150 hip fracture patients (mean age 78.9 ± 10.6 years) between January 2019 and June 2021 were enrolled. Patients were categorized into two groups according to their discharge destination, either home or facility. Demographic and disease-related characteristic data were collected from the medical records. All the patients completed performance-based physical function tests including the 10 Meter Walk Test (10MWT), Timed Up and Go test (TUG), Koval's grade, and Berg Balance Scale (BBS) at the start of rehabilitation and at discharge. A backward stepwise binary logistic regression analysis was then performed to determine the independent factors of the discharge destination. Results: The home discharge group had a significantly lower Koval's grade, lower TUG, higher BBS both at baseline and discharge, and younger age. Backward stepwise logistic binary regression analysis showed that TUG, BBS, and 10MWT at baseline and discharge were significant variables affecting the discharge destination after hip fracture. Conclusions: These results demonstrate that balance and gait in older adult patients with hip fractures are highly influential factors in the determining the discharge destination.
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Affiliation(s)
- Min-A Seok
- Department of Rehabilitation Medicine, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju National University College of Medicine, Jeju 63241, Republic of Korea; (M.-A.S.); (S.-Y.L.); (H.-J.L.)
| | - Jun-Hwan Choi
- Department of Rehabilitation Medicine, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju National University College of Medicine, Jeju 63241, Republic of Korea; (M.-A.S.); (S.-Y.L.); (H.-J.L.)
| | - Young-Ho Roh
- Department of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju National University College of Medicine, Jeju 63241, Republic of Korea;
| | - So-Young Lee
- Department of Rehabilitation Medicine, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju National University College of Medicine, Jeju 63241, Republic of Korea; (M.-A.S.); (S.-Y.L.); (H.-J.L.)
| | - Hyun-Jung Lee
- Department of Rehabilitation Medicine, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju National University College of Medicine, Jeju 63241, Republic of Korea; (M.-A.S.); (S.-Y.L.); (H.-J.L.)
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Peoples BM, Harrison KD, Santamaria-Guzman KG, Campos-Vargas SE, Monaghan PG, Roper JA. Functional lower extremity strength influences stepping strategy in community-dwelling older adults during single and dual-task walking. Sci Rep 2024; 14:13379. [PMID: 38862689 PMCID: PMC11166924 DOI: 10.1038/s41598-024-64293-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 06/06/2024] [Indexed: 06/13/2024] Open
Abstract
As age increases, a decline in lower extremity strength leads to reduced mobility and increased fall risks. This decline outpaces the age-related reduction in muscle mass, resulting in mobility limitations. Older adults with varying degrees of mobility-disability use different stepping strategies. However, the link between functional lower extremity strength and stepping strategy is unknown. Therefore, understanding how age-related reductions in functional lower extremity strength influence stepping strategy is vital to unraveling mobility limitations. Twenty participants (17F, 72 ± 6 years) were recruited and tested at a local community event. Participants were outfitted with inertial measurement units (IMU) and walked across a pressurized walkway under single and dual motor task conditions (walking with and without carrying a tray with water) at their usual and fast speeds. Participants were dichotomized into normal (11) or low functional strength groups (9) based on age-specific normative cutoffs using the instrumented 5-repetition Sit-to-Stand test duration. Our study reveals that older adults with normal strength prefer adjusting their step time during walking tasks, while those with reduced strength do not exhibit a preferred stepping strategy. This study provides valuable insights into the influence of functional lower extremity strength on stepping strategy in community-dwelling older adults during simple and complex walking tasks. These findings could aid in diagnosing gait deviations and developing appropriate treatment or management plans for mobility disability in older adults.
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Affiliation(s)
| | | | | | | | - Patrick G Monaghan
- College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
| | - Jaimie A Roper
- School of Kinesiology, Auburn University, Auburn, AL, USA.
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Gil-Calvo M, de Paz JA, Herrero-Molleda A, Zecchin A, Gómez-Alonso MT, Alonso-Cortés B, Boullosa D. The 2-Minutes Walking Test Is Not Correlated with Aerobic Fitness Indices but with the 5-Times Sit-to-Stand Test Performance in Apparently Healthy Older Adults. Geriatrics (Basel) 2024; 9:43. [PMID: 38667510 PMCID: PMC11050355 DOI: 10.3390/geriatrics9020043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
The 2-minutes walking test (2-MWT) is a valid and reliable test that has a high correlation with the distance walked in the 6-minutes walking test (6-MWT). However, to date, no study has determined the relationship between 2-MWT performance and the aerobic fitness indices obtained during a maximal incremental test to confirm if this test is a valid surrogate of aerobic fitness in apparently healthy older adults. The main objective of this work was to identify the factors associated to the performance in the 2-MWT, including aerobic fitness, functional and spatial-temporal gait parameters. Seventeen elderly adults performed a maximal incremental cycling test to determine maximum oxygen consumption (VO2max) and ventilatory thresholds (VT1 and VT2), two static standing balance tests with open and close eyes, a 5-times sit-to-stand test (5-TSTS), a handgrip test, and a 2-MWT on three different days over 2 weeks. No correlations were found between aerobic fitness indices and the distance covered in 2-MWT, but significant moderate correlations were found between the distance covered in 2-MWT and the time to perform the 5-TSTS (rho = -0.49) and with stride length (rho = 0.52) during the test. In conclusion, the 2-MWT does not seem a good test to assess aerobic capacity while it showed to be associated to the 5-TSTS performance of the elderly.
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Affiliation(s)
- Marina Gil-Calvo
- Faculty of Physical Activity and Sports Sciences, Universidad de León, 24007 León, Spain; (M.G.-C.); (J.A.d.P.); (A.Z.); (M.T.G.-A.); (D.B.)
| | - José Antonio de Paz
- Faculty of Physical Activity and Sports Sciences, Universidad de León, 24007 León, Spain; (M.G.-C.); (J.A.d.P.); (A.Z.); (M.T.G.-A.); (D.B.)
- Institute of Biomedicine, University of León, 24007 León, Spain
| | - Alba Herrero-Molleda
- Faculty of Physical Activity and Sports Sciences, Universidad de León, 24007 León, Spain; (M.G.-C.); (J.A.d.P.); (A.Z.); (M.T.G.-A.); (D.B.)
| | - Arthur Zecchin
- Faculty of Physical Activity and Sports Sciences, Universidad de León, 24007 León, Spain; (M.G.-C.); (J.A.d.P.); (A.Z.); (M.T.G.-A.); (D.B.)
| | - María Teresa Gómez-Alonso
- Faculty of Physical Activity and Sports Sciences, Universidad de León, 24007 León, Spain; (M.G.-C.); (J.A.d.P.); (A.Z.); (M.T.G.-A.); (D.B.)
| | | | - Daniel Boullosa
- Faculty of Physical Activity and Sports Sciences, Universidad de León, 24007 León, Spain; (M.G.-C.); (J.A.d.P.); (A.Z.); (M.T.G.-A.); (D.B.)
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6
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Peoples BM, Harrison KD, Santamaria-Guzman KG, Campos-Varga SE, Monaghan PG, Roper JA. Functional Lower Extremity Strength Influences Stepping Strategy in Community-Dwelling Older Adults During Single and Dual-Task Walking. RESEARCH SQUARE 2024:rs.3.rs-3983607. [PMID: 38558996 PMCID: PMC10980153 DOI: 10.21203/rs.3.rs-3983607/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
As age increases, a decline in lower extremity strength leads to reduced mobility and increased fall risks. This decline outpaces the age-related reduction in muscle mass, resulting in mobility limitations. Older adults with varying degrees of mobility-disability use different stepping strategies. However, the link between functional lower extremity strength and stepping strategy is unknown. Therefore, understanding how age-related reductions in functional lower extremity strength influence stepping strategy is vital to unraveling mobility limitations. Participants were recruited and tested at a local community event, where they were outfitted with IMUs and walked across a pressurized walkway. Our study reveals that older adults with normal strength prefer adjusting their step time during walking tasks, while those with reduced strength do not exhibit a preferred stepping strategy. This study provides valuable insights into the influence of functional lower extremity strength on stepping strategy in community-dwelling older adults during simple and complex walking tasks. These findings could aid in diagnosing gait deviations and developing appropriate treatment or management plans for mobility disability in older adults.
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Affiliation(s)
| | | | | | | | - Patrick G Monaghan
- College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
| | - Jaimie A Roper
- School of Kinesiology, Auburn University, Auburn, AL, USA
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Abi Karam K, El Rachkidi R, Semaan K, Saad E, Fakhoury M, Saade M, Ayoub E, Rteil A, Jaber E, Mekhael E, Nassim N, Massaad A, Ghanem I, Assi A. Kinematic adaptations from self-selected to fast speed walking in patients with adult spinal deformity. Spine Deform 2024; 12:423-431. [PMID: 38200215 DOI: 10.1007/s43390-023-00799-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 11/25/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE To investigate kinematic adaptations from self-selected to fast speed walking in ASD patients. METHODS 115 primary ASD and 66 controls underwent biplanar radiographic X-rays and 3D gait analysis to calculate trunk, segmental spine and lower limb kinematics during self-selected and fast speed walking. Kinematic adaptation was calculated as the difference (Δ) between fast and self-selected speed walking. ASD with 7 or more limited kinematic adaptation parameters were classified as ASD-limited-KA, while those with less than 7 limited kinematic adaptation parameters were classified as ASD-mild-KA. RESULTS 25 patients were classified as ASD-limited-KA and 90 as ASD-mild-KA. ASD-limited-KA patients walked with a lesser increase of pelvic rotation (Δ = 1.7 vs 5.5°), sagittal hip movement (Δ = 3.1 vs 7.4°) and shoulder-pelvis axial rotation (Δ = 3.4 vs 6.4°) compared to controls (all p < 0.05). ASD-limited-KA had an increased SVA (60.6 vs - 5.7 mm), PT (23.7 vs 11.9°), PI-LL (9.7 vs - 11.7°), knee flexion (9.2 vs - 0.4°) and a decreased LL (44.0 vs 61.4°) compared to controls (all p < 0.05). Kinematic and radiographic alterations were less pronounced in ASD-mild-KA. The limited increase of walking speed was correlated to the deteriorated physical component summary score of SF-36 (r = 0.37). DISCUSSION Kinematic limitations during adaptation from self-selected to fast speed walking highlight an alteration of a daily life activity in ASD patients. ASD with limited kinematic adaptations showed more severe sagittal malalignment with an increased SVA, PT, PI-LL, and knee flexion, a decreased LL and the most deteriorated quality of life. This highlights the importance of 3D movement analysis in the evaluation of ASD.
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Affiliation(s)
- Krystel Abi Karam
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Rami El Rachkidi
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Karl Semaan
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Eddy Saad
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Marc Fakhoury
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Maria Saade
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Elma Ayoub
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Ali Rteil
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Elena Jaber
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Elio Mekhael
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Nabil Nassim
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Abir Massaad
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Ismat Ghanem
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Ayman Assi
- Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, Paris, France.
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Olsen S, Rashid U, Barbado D, Suresh P, Alder G, Khan Niazi I, Taylor D. The validity of smartphone-based spatiotemporal gait measurements during walking with and without head turns: Comparison with the GAITRite® system. J Biomech 2024; 162:111899. [PMID: 38128468 DOI: 10.1016/j.jbiomech.2023.111899] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/26/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
Smartphone accelerometry has potential to provide clinicians with specialized gait analysis not available in most clinical settings. The Gait&Balance Application (G&B App) uses smartphone accelerometry to assess spatiotemporal gait parameters under two conditions: walking looking straight ahead and walking with horizontal head turns. This study investigated the validity of G&B App gait parameters compared with the GAITRite® pressure-sensitive walkway. Healthy young and older adults (age range 21-85 years) attended a single session where a smartphone was secured over the lumbosacral junction. Data were collected concurrently with the app and GAITRite® systems as participants completed the two walking conditions. Spatiotemporal gait parameters for 54 participants were determined from both systems and agreement evaluated with partial Pearson's correlation coefficients and limits of agreement. The results demonstrated moderate to excellent validity for G&B App measures of step time (rp 0.97, 95 % CI [0.96, 0.98]), walking speed (rp 0.83 [0.78, 0.87]), and step length (rp 0.74, [0.66, 0.80]) when walking looking straight ahead, and results were comparable with head turns. The validity of walking speed and step length measures was influenced by sex and height. G&B App measures of step length variability, step time variability, step length asymmetry, and step time asymmetry had poor validity. The G&B App has potential to provide valid measures of unilateral and bilateral step time, unilateral and bilateral step length, and walking speed, under two walking conditions in healthy young and older adults. Further research should validate this tool in clinical conditions and optimise the algorithm for demographic characteristics.
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Affiliation(s)
- Sharon Olsen
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand.
| | - Usman Rashid
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand; Centre for Chiropractic Research, New Zealand College of Chiropractic, PO Box 113-044, Newmarket, Auckland 1149, New Zealand
| | - David Barbado
- Department of Sport Science, Sports Research Centre, Miguel Hernandez University of Elche, Avda. de la Universidad s/n, Elche 03202, Spain; Institute for Health and Biomedical Research (ISABIAL Foundation), Avda. Pintor Baeza, 12 HGUA, Alicante 03550, Spain
| | - Priyadharshini Suresh
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
| | - Gemma Alder
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
| | - Imran Khan Niazi
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand; Centre for Chiropractic Research, New Zealand College of Chiropractic, PO Box 113-044, Newmarket, Auckland 1149, New Zealand; Centre for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Denise Taylor
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
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Raffegeau TE, Clark M, Fawver B, Engel BT, Young WR, Williams AM, Lohse KR, Fino PC. The effect of mobility-related anxiety on walking across the lifespan: a virtual reality simulation study. Exp Brain Res 2023:10.1007/s00221-023-06638-1. [PMID: 37204506 DOI: 10.1007/s00221-023-06638-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 05/12/2023] [Indexed: 05/20/2023]
Abstract
Older adults who report a fear of falling are more likely to subsequently fall, yet, some gait anxiety-related alterations may protect balance. We examined the effect of age on walking in anxiety-inducing virtual reality (VR) settings. We predicted a high elevation-related postural threat would impair gait in older age, and differences in cognitive and physical function would relate to the observed effects. Altogether, 24 adults (age (y) = 49.2 (18.7), 13 women) walked on a 2.2-m walkway at self-selected and fast speeds at low (ground) and high (15 m) VR elevation. Self-reported cognitive and somatic anxiety and mental effort were greater at high elevations (all p < 0.001), but age- and speed-related effects were not observed. At high VR elevations, participants walked slower, took shorter steps, and reduced turning speed (all p < 0.001). Significant interactions with age in gait speed and step length showed that relatively older adults walked slower (β = - 0.05, p = 0.024) and took shorter steps (β = - 0.05, p = 0.001) at self-selected speeds at high compared to low elevation settings. The effect of Age on gait speed and step length disappeared between self-selected and fast speeds and at high elevation. At self-selected speeds, older adults took shorter and slower steps at high elevation without changing step width, suggesting that in threatening settings relatively older people change gait parameters to promote stability. At fast speeds, older adults walked like relatively younger adults (or young adults walked like older adults) supporting the notion that people opt to walk faster in a way that still protects balance and stability in threatening settings.
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Affiliation(s)
- Tiphanie E Raffegeau
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA.
- School of Kinesiology, George Mason University, 10890 George Mason Circle, Katherine Johnson Hall 201G, MSN 4E5, Manassas, VA, 20110, USA.
| | - Mindie Clark
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Bradley Fawver
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
- US Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
| | - Benjamin T Engel
- University of Utah, Spencer S. Eccles Health Sciences Library, Salt Lake City, UT, USA
| | - William R Young
- School of Sport and Health Science, The University of Exeter, Exeter, UK
| | - A Mark Williams
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
- School of Sport and Health Science, The University of Exeter, Exeter, UK
| | - Keith R Lohse
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
- Physical Therapy and Neurology, School of Medicine, Washington University, Saint Louis, MO, USA
| | - Peter C Fino
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
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Stotz A, Hamacher D, Zech A. Relationship between Muscle Strength and Gait Parameters in Healthy Older Women and Men. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5362. [PMID: 37047976 PMCID: PMC10094255 DOI: 10.3390/ijerph20075362] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/21/2023] [Accepted: 03/30/2023] [Indexed: 06/19/2023]
Abstract
Maintaining sufficient muscle strength is fundamental to prevent a decline in basic physical functions such as gait, and is therefore a prerequisite for a healthy independent life in older people. However, the relationship between gait parameters and the strength of single muscle groups is reported with inconclusive results. The objective of this study was to analyze the relationship of strength of nine single muscle groups of lower and upper leg muscles as well as handgrip strength for gait parameters in older adults. Sixty-nine independently living older adults participated in the study. Maximum ankle plantar- and dorsiflexion, knee flexion and extension, as well as hip abduction, adduction, flexion, and extension strength, were measured using an isokinetic dynamometer. Additionally, hand grip strength measured via a hand dynamometer was obtained. Walking gait parameters were recorded with a 3D motion capture system on an instrumented treadmill. The relationships between multiple strength and gait variables were analyzed by Pearson's correlation coefficient. Linear regression analyses were performed to identify the predictive ability of muscle strength (normalized to body weight) for gait speed, stride time, stance time, stride length and step width. Multiple significant weak to moderate positive ([r = 0.343, p = 0.047]-[r = 0.538, p = 0.002]) and negative ([r = -0.340, p = 0.046]-[r = 0.593, p = 0.001]) correlations that were unequally distributed between both sexes were detected. Significant regression models explained ([r2 = 16.6%, p = 0.015]-[r2 = 44.3 %, p = 0.003]) and ([r2 = 21.8%, p = 0.022]-[r2 = 36.1%, p = 0.044]) of the gait parameter variations for men and women, respectively. The results suggest a sex-specific relevance of single muscle groups for all gait parameters. This may be attributed to anatomical differences and it is important to prevent strength-related changes in gait parameters.
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Affiliation(s)
- Andreas Stotz
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749 Jena, Germany;
| | - Daniel Hamacher
- Methods and Statistics in Sports, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749 Jena, Germany;
| | - Astrid Zech
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Seidelstraße 20, 07749 Jena, Germany;
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11
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Teipel SJ, Amaefule CO, Lüdtke S, Görß D, Faraza S, Bruhn S, Kirste T. Prediction of Disorientation by Accelerometric and Gait Features in Young and Older Adults Navigating in a Virtually Enriched Environment. Front Psychol 2022; 13:882446. [PMID: 35548510 PMCID: PMC9083357 DOI: 10.3389/fpsyg.2022.882446] [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: 02/23/2022] [Accepted: 03/22/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To determine whether gait and accelerometric features can predict disorientation events in young and older adults. Methods Cognitively healthy younger (18–40 years, n = 25) and older (60–85 years, n = 28) participants navigated on a treadmill through a virtual representation of the city of Rostock featured within the Gait Real-Time Analysis Interactive Lab (GRAIL) system. We conducted Bayesian Poisson regression to determine the association of navigation performance with domain-specific cognitive functions. We determined associations of gait and accelerometric features with disorientation events in real-time data using Bayesian generalized mixed effect models. The accuracy of gait and accelerometric features to predict disorientation events was determined using cross-validated support vector machines (SVM) and Hidden Markov models (HMM). Results Bayesian analysis revealed strong evidence for the effect of gait and accelerometric features on disorientation. The evidence supported a relationship between executive functions but not visuospatial abilities and perspective taking with navigation performance. Despite these effects, the cross-validated percentage of correctly assigned instances of disorientation was only 72% in the SVM and 63% in the HMM analysis using gait and accelerometric features as predictors. Conclusion Disorientation is reflected in spatiotemporal gait features and the accelerometric signal as a potentially more easily accessible surrogate for gait features. At the same time, such measurements probably need to be enriched with other parameters to be sufficiently accurate for individual prediction of disorientation events.
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Affiliation(s)
- Stefan J Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) Rostock/Greifswald, Rostock, Germany.,Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany
| | - Chimezie O Amaefule
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) Rostock/Greifswald, Rostock, Germany
| | - Stefan Lüdtke
- Mobile Multimedia Information Systems, Institute for Visual and Analytic Computing, University of Rostock, Rostock, Germany.,Institute for Enterprise Systems, University of Mannheim, Mannheim, Germany
| | - Doreen Görß
- Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany
| | - Sofia Faraza
- Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany
| | - Sven Bruhn
- Institute for Sports Science, University of Rostock, Rostock, Germany
| | - Thomas Kirste
- Mobile Multimedia Information Systems, Institute for Visual and Analytic Computing, University of Rostock, Rostock, Germany
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12
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Raffegeau TE, Brinkerhoff SA, Kellaher GK, Baudendistel S, Terza MJ, Roper JA, Hass CJ. Changes to margins of stability from walking to obstacle crossing in older adults while walking fast and during a dual-task. Exp Gerontol 2022; 161:111710. [PMID: 35090973 PMCID: PMC8920466 DOI: 10.1016/j.exger.2022.111710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/08/2022] [Accepted: 01/18/2022] [Indexed: 11/29/2022]
Abstract
It is not well understood how older adults meet the combined locomotor demands of obstacle avoidance at fast speeds as compared to obstacle avoidance under cognitive loads. The purpose of this study was to quantify changes in locomotor stability (margin of stability, MOS) from walking to crossing obstacles at fast speeds versus with added cognitive demands in older adults. Community-dwelling older adults walked on an unobstructed and obstructed path at their preferred speed (preferred); during a dualtask (verbal fluency); and at their 'fastest comfortable' speed (fast). We used motion capture to calculate MOS in the anteroposterior direction, and compared minimum MOS between crossing foot and support phase (lead single support, lead double support, trail single support, trail double support) and tested for within subject changes using a linear mixed effect regression model [Condition (preferred, fluency, fast) x Walkway (unobstructed, obstructed) x Phase (single support, double support) x Foot (lead, trail)]. We examined crossing kinematics (approach distance, toe clearance, and recovery distance) between conditions. A significant omnibus effect partially supported our predictions. A Condition x Walkway x Phase interaction supported that older adults increased stability under a cognitive load and prioritized stability, demonstrated by not changing MOS from walking to obstacle crossing. During fast obstacle crossing they decreased stability during double support and exhibit more stability in single support, when vulnerable to external perturbations (contacting the obstacle). During a dual-task, older adults took shorter and higher steps over the obstacle to ensure they cleared it safely, but at fast speeds they increased the length of their crossing step without higher toe clearance. The results suggest older adults attempt to preserve stability when crossing obstacles under both cognitive and speed demands, but may be unable to ensure a safer limb elevation to avoid obstacles at fast speeds as they do under cognitive demands.
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Affiliation(s)
- Tiphanie E Raffegeau
- University of Florida, Department of Applied Physiology and Kinesiology, United States of America; Ohio University, Division of Exercise Physiology, United States of America.
| | - Sarah A Brinkerhoff
- University of Florida, Department of Applied Physiology and Kinesiology, United States of America; Auburn University, School of Kinesiology, United States of America
| | - Grace K Kellaher
- University of Florida, Department of Applied Physiology and Kinesiology, United States of America; University of Delaware, Department of Kinesiology & Applied Physiology, United States of America
| | - Sidney Baudendistel
- University of Florida, Department of Applied Physiology and Kinesiology, United States of America
| | - Matthew J Terza
- University of Florida, Department of Applied Physiology and Kinesiology, United States of America
| | - Jaimie A Roper
- University of Florida, Department of Applied Physiology and Kinesiology, United States of America; Auburn University, School of Kinesiology, United States of America
| | - Chris J Hass
- University of Florida, Department of Applied Physiology and Kinesiology, United States of America
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