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Cuevas-Martínez C, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Casado-Hernández I, Navarro-Flores E, Pérez-Palma L, Martiniano J, Gómez-Salgado J, López-López D. Hallux Limitus Influence on Plantar Pressure Variations during the Gait Cycle: A Case-Control Study. Bioengineering (Basel) 2023; 10:772. [PMID: 37508799 PMCID: PMC10375967 DOI: 10.3390/bioengineering10070772] [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: 05/29/2023] [Revised: 06/24/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Hallux limitus is a common foot disorder whose incidence has increased in the school-age population. Hallux limitus is characterized by musculoskeletal alteration that involves the metatarsophalangeal joint causing structural disorders in different anatomical areas of the locomotor system, affecting gait patterns. The aim of this study was to analyze dynamic plantar pressures in a school-aged population both with functional hallux and without. METHODS A full sample of 100 subjects (50 male and 50 female) 7 to 12 years old was included. The subjects were identified in two groups: the case group (50 subjects characterized as having hallux limitus, 22 male and 28 female) and control group (50 subjects characterized as not having hallux limitus, 28 male and 22 female). Measurements were obtained while subjects walked barefoot in a relaxed manner along a baropodometric platform. The hallux limitus test was realized in a seated position to sort subjects out into an established study group. The variables checked in the research were the surface area supported by each lower limb, the maximum peak pressure of each lower limb, the maximum mean pressure of each lower limb, the body weight on the hallux of each foot, the body weight on the first metatarsal head of each foot, the body weight at the second metatarsal head of each foot, the body weight at the third and fourth metatarsal head of each foot, the body weight at the head of the fifth metatarsal of each foot, the body weight at the midfoot of each foot, and the body weight at the heel of each foot. RESULTS Non-significant results were obtained in the variable of pressure peaks between both study groups; the highest pressures were found in the hallux with a p-value of 0.127 and in the first metatarsal head with a p-value 0.354 in subjects with hallux limitus. A non-significant result with a p-value of 0.156 was obtained at the second metatarsal head in healthy subjects. However, significant results were observed for third and fourth metatarsal head pressure in healthy subjects with a p-value of 0.031 and regarding rearfoot pressure in subjects with functional hallux limitus with a p-value of 0.023. CONCLUSIONS School-age subjects with hallux limitus during gait exhibit more average peak plantar pressure in the heel and less peak average plantar pressure in the third and fourth metatarsal head as compared to healthy children aged between 7 and 12 years old.
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Affiliation(s)
- Claudia Cuevas-Martínez
- Research, Health, and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, 15403 Ferrol, Spain
- Departament de Podologia, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
| | | | | | - Israel Casado-Hernández
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Emmanuel Navarro-Flores
- Frailty Research Organizaded Group (FROG), Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, 46010 Valencia, Spain
| | - Laura Pérez-Palma
- Departament de Podologia, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
| | - João Martiniano
- Escola Superior de Saúde da Cruz Vermelha Portuguesa, 1300-125 Lisbon, Portugal
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21004 Huelva, Spain
- Health and Safety Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
| | - Daniel López-López
- Research, Health, and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol, Universidade da Coruña, 15403 Ferrol, Spain
- Departament de Podologia, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
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Liu W, Mei Q, Yu P, Gao Z, Hu Q, Fekete G, István B, Gu Y. Biomechanical Characteristics of the Typically Developing Toddler Gait: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:406. [PMID: 35327778 PMCID: PMC8946917 DOI: 10.3390/children9030406] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
Independent ambulation is one of the most important motor skills in typically developing toddlers. Gait analysis is a key evaluation method in basic and clinical research. A narrative review on the literature of toddler gait development was conducted following inclusion criteria, explicitly including the factors of English article, age range, no external intervention during the experimental process of studies involved, the non-symptomatic toddler, and no pathological gait. Studies about toddlers' morphological, physiological, and biomechanical aspects at this developmental stage were identified. Remarkable gait characteristics and specific development rules of toddlers at different ages were reported. Changes in gait biomechanics are age and walking experience-dependent. Gait patterns are related to the maturation of the neuro and musculoskeletal systems. This review thus provides critical and theoretical information and the nature of toddler walking development for clinicians and other scientific researchers. Future studies may systematically recruit subjects with more explicit criteria with larger samples for longitudinal studies. A particular design could be conducted to analyze empirically before practical application. Additionally, the influence of external interventions on the development of toddler gait may need consideration for gait development in the toddler cohort.
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Affiliation(s)
- Wei Liu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (W.L.); (P.Y.); (Z.G.); (Q.H.)
- Research Academy of Grand Health, Ningbo University, Ningbo 315211, China
- Faculty of Engineering, University of Pannonia, 8200 Veszprém, Hungary;
| | - Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (W.L.); (P.Y.); (Z.G.); (Q.H.)
- Research Academy of Grand Health, Ningbo University, Ningbo 315211, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland 1010, New Zealand
| | - Peimin Yu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (W.L.); (P.Y.); (Z.G.); (Q.H.)
- Research Academy of Grand Health, Ningbo University, Ningbo 315211, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland 1010, New Zealand
| | - Zixiang Gao
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (W.L.); (P.Y.); (Z.G.); (Q.H.)
- Research Academy of Grand Health, Ningbo University, Ningbo 315211, China
- Faculty of Engineering, University of Pannonia, 8200 Veszprém, Hungary;
| | - Qiuli Hu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (W.L.); (P.Y.); (Z.G.); (Q.H.)
| | - Gustav Fekete
- Faculty of Engineering, University of Pannonia, 8200 Veszprém, Hungary;
| | - Bíró István
- Faculty of Engineering, University of Szeged, 6724 Szeged, Hungary;
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (W.L.); (P.Y.); (Z.G.); (Q.H.)
- Research Academy of Grand Health, Ningbo University, Ningbo 315211, China
- Faculty of Engineering, University of Szeged, 6724 Szeged, Hungary;
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Jinés Viso MDM, Paez Moguer J. El tiempo de apoyo durante la marcha en relación con la edad infantil. REVISTA ESPAÑOLA DE PODOLOGÍA 2022. [DOI: 10.20986/revesppod.2022.1589/2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Abstract
Gait maturation in infants develops gradually through several phases. However, external factors such as childrearing practices, especially the wearing of diapers, may affect an infant’s motor development. This study investigated the influence of different bulk stresses on the gait of toddlers wearing a disposable diaper. Twenty-six healthy toddlers (age: 19.2 ± 0.9 months) participated in this study. We measured the joint kinematics (pelvis angle and hip-joint angle) and spatiotemporal parameters (step length and step width) of the toddlers’ gait under four dress conditions (wearing Type A_WET, Type A_DRY, and Type B_WET diapers and naked). Type B_WET had a higher bulk stress than Type A_WET, and Type A_DRY had lower stress than Type A _ WET. Our results indicate that the walk of toddlers when wearing a diaper differs from that when naked. This difference is due to the effect of the bulk of the diaper on the lower limb. A high bulk stress has a greater influence than that of a low bulk stress on joint dynamics and step width. Therefore, our findings suggest that wearing diapers with high bulk stress may inhibit the natural gait patterns of toddlers.
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Li Y, Koldenhoven RM, Liu T, Venuti CE. Age-related gait development in children with autism spectrum disorder. Gait Posture 2021; 84:260-266. [PMID: 33383537 DOI: 10.1016/j.gaitpost.2020.12.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 12/16/2020] [Accepted: 12/21/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND A better understanding of gait development and asymmetries in children with autism spectrum disorder (ASD) may improve the development of treatment programs and thus, patient outcomes. RESEARCH QUESTION Does age affect walking kinematics and symmetry in children with ASD? METHOD Twenty-nine children (aged 6-14 years old) with mild ASD (level one) were recruited and assigned to one of the three groups based on their ages: 6-8 years (U8), 9-11 years (U11) and 12-14 years (U14). Walking kinematics were captured using an inertia measurement unit system placed bilaterally on participants' foot, lower leg, upper leg, upper arm, pelvis, and thoracic spine. Joint angles were computed and compared among the age groups. Symmetry angles were used to assess the gait symmetry and were compared among the age groups. RESULTS Older children exhibited less ankle dorsiflexion and knee flexion angles at heel-strike and greater plantarflexion angles at toe-off compared with younger children. In addition, a decreased pelvis and thorax axial rotation range of motion and increased shoulder flexion/extension range of motion were observed for older children. However, no age-related difference in gait symmetry was observed. SIGNIFICANCE These findings could suggest that older children with ASD may develop gait kinematics to a more energy-efficient walking pattern.
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Affiliation(s)
- Yumeng Li
- Department of Health and Human Performance, Texas State University, San Marcos, TX, USA.
| | - Rachel M Koldenhoven
- Department of Health and Human Performance, Texas State University, San Marcos, TX, USA
| | - Ting Liu
- Department of Health and Human Performance, Texas State University, San Marcos, TX, USA
| | - Carrie E Venuti
- Department of Health and Human Performance, Texas State University, San Marcos, TX, USA
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Jandacka D, Uchytil J, Zahradnik D, Farana R, Vilimek D, Skypala J, Urbaczka J, Plesek J, Motyka A, Blaschova D, Beinhauerova G, Rygelova M, Brtva P, Balazova K, Horka V, Malus J, Silvernail JF, Irwin G, Nieminen MT, Casula V, Juras V, Golian M, Elavsky S, Knapova L, Sram R, Hamill J. Running and Physical Activity in an Air-Polluted Environment: The Biomechanical and Musculoskeletal Protocol for a Prospective Cohort Study 4HAIE (Healthy Aging in Industrial Environment-Program 4). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239142. [PMID: 33297585 PMCID: PMC7730319 DOI: 10.3390/ijerph17239142] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 12/26/2022]
Abstract
Far too little attention has been paid to health effects of air pollution and physical (in)activity on musculoskeletal health. The purpose of the Healthy aging in industrial environment study (4HAIE) is to investigate the potential impact of physical activity in highly polluted air on musculoskeletal health. A total of 1500 active runners and inactive controls aged 18–65 will be recruited. The sample will be recruited using quota sampling based on location (the most air-polluted region in EU and a control region), age, sex, and activity status. Participants will complete online questionnaires and undergo a two-day baseline laboratory assessment, including biomechanical, physiological, psychological testing, and magnetic resonance imaging. Throughout one-year, physical activity data will be collected through Fitbit monitors, along with data regarding the incidence of injuries, air pollution, psychological factors, and behavior collected through a custom developed mobile application. Herein, we introduce a biomechanical and musculoskeletal protocol to investigate musculoskeletal and neuro-mechanical health in this 4HAIE cohort, including a design for controlling for physiological and psychological injury factors. In the current ongoing project, we hypothesize that there will be interactions of environmental, biomechanical, physiological, and psychosocial variables and that these interactions will cause musculoskeletal diseases/protection.
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Affiliation(s)
- Daniel Jandacka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
- Correspondence:
| | - Jaroslav Uchytil
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - David Zahradnik
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Roman Farana
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Dominik Vilimek
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Jiri Skypala
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Jan Urbaczka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Jan Plesek
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Adam Motyka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Denisa Blaschova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Gabriela Beinhauerova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Marketa Rygelova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Pavel Brtva
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Klara Balazova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Veronika Horka
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Jan Malus
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Julia Freedman Silvernail
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
| | - Gareth Irwin
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF5 2YB, UK
| | - Miika T. Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, FI-90014 Oulu, Finland; (M.T.N.); (V.C.)
| | - Victor Casula
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, FI-90014 Oulu, Finland; (M.T.N.); (V.C.)
| | - Vladimir Juras
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria;
| | - Milos Golian
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Steriani Elavsky
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Lenka Knapova
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
| | - Radim Sram
- Institute of Experimental Medicine AS CR, 142 20 Prague, Czech Republic;
| | - Joseph Hamill
- Human Motion Diagnostic Center, Department of Human Movement Studies, University of Ostrava, 70200 Ostrava, Czech Republic; (J.U.); (D.Z.); (R.F.); (D.V.); (J.S.); (J.U.); (J.P.); (A.M.); (D.B.); (G.B.); (M.R.); (P.B.); (K.B.); (V.H.); (J.M.); (G.I.); (M.G.); (S.E.); (L.K.); (J.H.)
- Department of Kinesiology, University of Massachusetts, Amherst, MA 01003, USA
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Beyaert C, Pierret J, Vasa R, Paysant J, Caudron S. Toe walking in children with cerebral palsy: a possible functional role for the plantar flexors. J Neurophysiol 2020; 124:1257-1269. [PMID: 32877265 DOI: 10.1152/jn.00717.2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Equinus and toe walking are common locomotor disorders in children with cerebral palsy (CP) walking barefoot or with normal shoes. We hypothesized that, regardless of the type of footwear, the plantar flexors do not cause early equinus upon initial foot contact but decelerate ankle dorsiflexion during weight acceptance (WA). This latter action promoted by early flat-foot contact is hypothesized to be functional. Hence, we performed an instrumented gait analysis of 12 children with CP (Gross Motor Function Classification System class: I or II; mean age: 7.2 yr) and 11 age-matched typically developing children. The participants walked either barefoot, with unmodified footwear (4° positive-heel shoes), or with 10° negative-heel shoes (NHSs). In both groups, wearing NHSs was associated with greater ankle dorsiflexion upon initial foot contact, and greater tibialis anterior activity (but no difference in soleus activity) during the swing phase. However, the footwear condition did not influence the direction and amplitude of the first ankle movement during WA and the associated peak negative ankle power. Regardless of the footwear condition, the CP group displayed 1) early flattening of the foot and ample dorsiflexion (decelerated by the plantar flexors) during WA and 2) low tibialis anterior and soleus activities during the second half of the swing phase (contributing to passive equinus upon foot strike). In children with CP, the early action of plantar flexors (which typically decelerate the forward progression of the center of mass) may be a compensatory mechanism that contributes to the WA's role in controlling balance during gait.NEW & NOTEWORTHY Adaptation to walking in negative-heel shoes was similar in typically developing children and children with cerebral palsy: it featured ankle dorsiflexion upon initial contact, even though (in the latter group) the soleus was always spastic in a clinical examination. Hence, in children with cerebral palsy, the early deceleration of ankle dorsiflexion by the plantar flexors (promoted by early flattening of the foot, and regardless of the type of footwear) may have a functional role.
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Affiliation(s)
- C Beyaert
- Université de Lorraine, EA3450 Développement, Adaptation et Handicap (DevAH), Nancy, France.,Institut Régional de Réadaptation, Union pour la gestion des établissements de caisses d'assurance maladie UGECAM du Nord et de l'Est, Nancy, France
| | - J Pierret
- Université de Lorraine, EA3450 Développement, Adaptation et Handicap (DevAH), Nancy, France
| | - R Vasa
- R. Vasa Foundation, Centre for Brain and Spinal Injury Rehab, Mumbai, India
| | - J Paysant
- Université de Lorraine, EA3450 Développement, Adaptation et Handicap (DevAH), Nancy, France.,Institut Régional de Réadaptation, Union pour la gestion des établissements de caisses d'assurance maladie UGECAM du Nord et de l'Est, Nancy, France
| | - S Caudron
- Université de Lorraine, EA3450 Développement, Adaptation et Handicap (DevAH), Nancy, France
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García-Liñeira J, García-Soidán JL, Romo-Pérez V, Leirós-Rodríguez R. Reliability of accelerometric assessment of balance in children aged 6-12 years. BMC Pediatr 2020; 20:161. [PMID: 32290824 PMCID: PMC7155341 DOI: 10.1186/s12887-020-02073-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/06/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Development and evaluation of an accelerometers technique for collecting data for asses balance had reported difficulty due to equilibrium reactions and continuous bursts. The aim of this study is to determine the reliability and internal consistency of accelerometric measurements, related to static equilibrium and gait in children aged 6 to 12 years. METHODS This descriptive and cross-sectional study involved 70 healthy children (50% girls) with a mean age of 9 years old. At the height of the 4th lumbar vertebra and directly on the skin, an accelerometer was placed on each participant. All of them had to complete four trials three times: balancing on one leg with eyes closed and eyes open, dynamic balancing on one leg on a foam mat, and normal gait. RESULTS Results show that tests performed in older children had higher internal consistency than those performed in younger children (vertical axis r = 0.82, sagittal axis r = 0.77, and perpendicular axis r = 0.74). Tests performed in children aged 8 years or older presented a strong correlation between trials (r > 0.71). The three static equilibrium tests obtained reliability values between 0.76 y 0.84. On the contrary, gait test obtained inferior and poorer results (0.6 < r < 0.71). CONCLUSIONS This method of assessment obtained positive results as an instrument for the quantitative assessment of balance in school-aged children. Values obtained for the three one-leg balance and static tests,were more strongly correlated than the normal gait test for all axes.
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Affiliation(s)
- J García-Liñeira
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain
| | - J L García-Soidán
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain
| | - V Romo-Pérez
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain
| | - R Leirós-Rodríguez
- Faculty of Physical Therapy, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain.
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Dussa CU, Böhm H, Döderlein L, Forst R, Fujak A. Does an overcorrected clubfoot caused by surgery or by the Ponseti method behave differently? Gait Posture 2020; 77:308-314. [PMID: 32135471 DOI: 10.1016/j.gaitpost.2020.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 02/08/2020] [Accepted: 02/18/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Overcorrection is a recognized problem following surgical treatment of congenital clubfoot. Recently this complication has also been mentioned following Ponseti treatment. RESEARCH QUESTION Do overcorrected clubfeet (OCCF) caused by surgery behave differently from those caused by Ponseti treatment in terms of segmental motion of the feet and show differences in the severity of deformity on X-rays? METHODS Children between 7 and 12 years with OCCF were included in this study. Depending on the aetiology causing them, the feet were divided into 2 groups (Ponseti and peritalar release surgery). 25 typically developing children served as controls. All subjects were subjected to clinical and radiological examination and 3-Dimensional gait analysis using the Oxford Foot Model. RESULTS Thirty-two children with OCCF, of these 18 feet in the surgical and 14 feet in the Ponseti group, were included in the study. No radiological differences were seen in the flatfoot parameters between OCCF groups except in the calcaneal inclination angle that was more pathological in the Ponseti group. The clinical ankle plantar flexion was significantly reduced in the surgical group. During walking the range motion of the hindfoot in the frontal plane was significantly reduced in surgically treated feet compared to the Ponseti group. The other parameters did not show any significant difference between groups. SIGNIFICANCE The overcorrected clubfeet following surgery and Ponseti showed similar appearance and showed no significant differences in 11/12 radiological parameters. The segmental motion of the feet showed no significant differences between groups except the in the range of motion of the subtalar eversion. A considerable subtalar joint motion was present even in the surgical group. These findings might help plan the treatment of these feet.
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Affiliation(s)
- Chakravarthy U Dussa
- Department of Paediatric Orthopaedics, Orthopaedische Kinderklinik, Bernauerstrasse 18, D-83229 Aschau i. Chiemgau, Bavaria, Germany.
| | - Harald Böhm
- Gait Laboratory, Orthopaedische Kinderklinik, Bernauerstrasse 18, D-83229 Aschau i. Chiemgau, Bavaria, Germany
| | - Leonhard Döderlein
- Peadiatric Orthopaedic Surgeon, Bismarckstrasse 60, 69198 Schriesheim, Germany
| | - Raimund Forst
- Department of Orthopaedic Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Rathsberger Str. 57, D-91054 Erlangen, Bavaria, Germany
| | - Albert Fujak
- Department of Orthopaedic Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Rathsberger Str. 57, D-91054 Erlangen, Bavaria, Germany
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10
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Lower limb sagittal gait kinematics can be predicted based on walking speed, gender, age and BMI. Sci Rep 2019; 9:9510. [PMID: 31267006 PMCID: PMC6606631 DOI: 10.1038/s41598-019-45397-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 06/06/2019] [Indexed: 01/04/2023] Open
Abstract
Clinical gait analysis attempts to provide, in a pathological context, an objective record that quantifies the magnitude of deviations from normal gait. However, the identification of deviations is highly dependent with the characteristics of the normative database used. In particular, a mismatch between patient characteristics and an asymptomatic population database in terms of walking speed, demographic and anthropometric parameters may lead to misinterpretation during the clinical process. Rather than developing a new normative data repository that may require considerable of resources and time, this study aims to assess a method for predicting lower limb sagittal kinematics using multiple regression models based on walking speed, gender, age and BMI as predictors. With this approach, we were able to predict kinematics with an error within 1 standard deviation of the mean of the original waveforms recorded on fifty-four participants. Furthermore, the proposed approach allowed us to estimate the relative contribution to angular variations of each predictor, independently from the others. It appeared that a mismatch in walking speed, but also age, sex and BMI may lead to errors higher than 5° on lower limb sagittal kinematics and should thus be taken into account before any clinical interpretation.
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Hallemans A, Verbecque E, Dumas R, Cheze L, Van Hamme A, Robert T. Developmental changes in spatial margin of stability in typically developing children relate to the mechanics of gait. Gait Posture 2018; 63:33-38. [PMID: 29705520 DOI: 10.1016/j.gaitpost.2018.04.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 03/27/2018] [Accepted: 04/13/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Immature balance control is considered an important rate limiter for maturation of gait. The spatial margin of stability (MoS) is a biomechanical measure of dynamic balance control that might provide insights into balance control strategies used by children during the developmental course of gait. RESEARCH HYPOTHESIS We hypothesize there will be an age-dependent decrease in MoS in children with typical development. To understand the mechanics, relations between MoS and spatio-temporal parameters of gait are investigated. METHODS Total body gait analysis of typically developing children (age 1-10, n = 84) were retrospectively selected from available databases. MoS is defined as the minimum distance between the center of pressure and the extrapolated center of mass along the mediolateral axis during the single support phases. RESULTS MoS shows a moderate negative correlation with stride length (rho = -0.510), leg length (rho = -0.440), age (rho = -0.368) and swing duration (rho = -0.350). A weak correlation was observed between MoS and walking speed (rho = -0.243) and step width (rho = 0.285). A stepwise linear regression model showed only one predictor, swing duration, explaining 18% of the variance in MoS. MoS decreases with increasing duration of swing (β = -0.422). This relation is independent of age. SIGNIFICANCE A larger MoS induces a larger lateral divergence of the CoM that could be compensated by a quicker step. Future research should compare the observed strategies in children to those used in adults and in children with altered balance control related to pathology.
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Affiliation(s)
- Ann Hallemans
- Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Science, University of Antwerp, Belgium; Multidisciplinary Motor Center Antwerp, M²OCEAN, University of Antwerp, Belgium.
| | - Evi Verbecque
- Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Science, University of Antwerp, Belgium; Multidisciplinary Motor Center Antwerp, M²OCEAN, University of Antwerp, Belgium
| | - Raphael Dumas
- Laboratoire de Biomécanique et Mécanique des Chocs, Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France
| | - Laurence Cheze
- Laboratoire de Biomécanique et Mécanique des Chocs, Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France
| | - Angèle Van Hamme
- Laboratoire de Biomécanique et Mécanique des Chocs, Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France
| | - Thomas Robert
- Laboratoire de Biomécanique et Mécanique des Chocs, Univ Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406, F69622, Lyon, France
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Pesenti S, Blondel B, Peltier E, Viehweger E, Pomero V, Authier G, Fuentes S, Jouve JL. Spinal alignment evolution with age: A prospective gait analysis study. World J Orthop 2017; 8:256-263. [PMID: 28361018 PMCID: PMC5359761 DOI: 10.5312/wjo.v8.i3.256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/14/2016] [Accepted: 12/28/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To describe, using gait analysis, the development of spinal motion in the growing child.
METHODS Thirty-six healthy children aged from 3 to 16 years old were included in this study for a gait analysis (9 m-walk). Various kinematic parameters were recorded and analyzed such as thoracic angle (TA), lumbar angle (LA) and sagittal vertical axis (SVA). The kinetic parameters were the net reaction moments (N.m/kg) at the thoracolumbar and lumbosacral junctions.
RESULTS TA and LA curves were not statistically correlated to the age (respectively, P = 0.32 and P = 0.41). SVA increased significantly with age (P < 0.001). Moments in sagittal plane at the lumbosacral junction were statistically correlated to the age (P = 0.003), underlining the fact that sagittal mechanical constraints at the lumbosacral junction increase with age. Moments in transversal plane at the thoracolumbar and lumbosacral junctions were statistically correlated to the age (P = 0.0002 and P = 0.0006), revealing that transversal mechanical constraints decrease with age.
CONCLUSION The kinetic analysis showed that during growth, a decrease of torsional constraint occurs while an increase of sagittal constraint is observed. These changes in spine biomechanics are related to the crucial role of the trunk for bipedalism acquisition, allowing stabilization despite lower limbs immaturity. With the acquisition of mature gait, the spine will mainly undergo constraints in the sagittal plane.
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Kraan CM, Tan AHJ, Cornish KM. The developmental dynamics of gait maturation with a focus on spatiotemporal measures. Gait Posture 2017; 51:208-217. [PMID: 27816899 DOI: 10.1016/j.gaitpost.2016.10.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 10/27/2016] [Accepted: 10/27/2016] [Indexed: 02/02/2023]
Abstract
Gait analysis is recognised as a powerful clinical tool for studying relationships between motor control and brain function. By drawing on the literature investigating gait in individuals with neurological disorders, this review provides insight into the neural processes that contribute to and regulate specific spatiotemporal sub-components of gait and how they may mature across early to late childhood. This review also discusses the roles of changing anthropomorphic characteristics, and maturing sensory and higher-order cognitive processes in differentiating the developmental trajectories of the sub-components of gait. Importantly, although studies have shown that cognitive-gait interference is larger in children compared to adults, the contributing neurocognitive mechanisms may vary across age groups who have different types of attentional or cognitive vulnerabilities. These findings have implications for current models of gait maturation by highlighting the need for a dynamic model that focuses on the integration of various factors that contribute to gait though experience and practice. This is essential to elucidating why gait and other motor deficits are often contiguous with cognitive neurodevelopmental disorders.
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Affiliation(s)
- C M Kraan
- School of Psychological Sciences and The Monash Institute of Cognitive and Clinical and Neurosciences, Monash University, Clayton, Victoria, 3800, Australia
| | - A H J Tan
- School of Psychological Sciences and The Monash Institute of Cognitive and Clinical and Neurosciences, Monash University, Clayton, Victoria, 3800, Australia
| | - K M Cornish
- School of Psychological Sciences and The Monash Institute of Cognitive and Clinical and Neurosciences, Monash University, Clayton, Victoria, 3800, Australia.
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Lye J, Parkinson S, Diamond N, Downs J, Morris S. Propulsion strategy in the gait of primary school children; the effect of age and speed. Hum Mov Sci 2016; 50:54-61. [DOI: 10.1016/j.humov.2016.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 10/13/2016] [Accepted: 10/13/2016] [Indexed: 10/20/2022]
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Van Hamme A, El Habachi A, Samson W, Dumas R, Chèze L, Dohin B. Gait parameters database for young children: The influences of age and walking speed. Clin Biomech (Bristol, Avon) 2015; 30:572-7. [PMID: 25911204 DOI: 10.1016/j.clinbiomech.2015.03.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 03/24/2015] [Accepted: 03/24/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Reference databases are mandatory in orthopaedics because they enable the detection of gait abnormalities in patients. Such databases rarely include data on children under seven years of age. In young children, gait is principally influenced by age and walking speed. The influence of the age-speed interaction has not been well established. Therefore, the objective of the present study is to propose normative values for biomechanical gait parameters in children taking into account age, walking speed, and the age-speed interaction. METHODS Gait analyses were performed on 106 healthy children over a large age range (between one and seven years of age) during gait trials at a self-selected speed. From these gait cycles, biomechanical parameters, such as the joint angles and joint power of the lower limbs, were computed. Specific peak values and the times of occurrence of each biomechanical gait parameter were identified. Linear regressions are proposed for studying the influence of age, walking speed and the age-speed interaction. FINDINGS Most of the regressions achieved good accuracy in fitting the curve peaks and times of occurrence, and the normal reference targets of biomechanical parameters could be deduced from these regressions. The biomechanical gait parameters of a pathological case were plotted against the normal reference targets to illustrate the relevance of the proposed targeting method. INTERPRETATION The normal reference targets for biomechanical gait parameters based on age-speed regressions in a large database might help clinicians detect gait abnormalities in children from one to seven years of age.
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Affiliation(s)
- A Van Hamme
- Université de Lyon, France; Université Claude Bernard Lyon 1, Villeurbanne, France; IFSTTAR, UMR_T9406, LBMC Laboratoire de Biomécanique et Mécanique des Chocs, F-69675, Bron, France; CTC, 4 rue Hermann Frenkel 69367 Lyon Cedex 7, France
| | - A El Habachi
- Université de Lyon, France; Université Claude Bernard Lyon 1, Villeurbanne, France; IFSTTAR, UMR_T9406, LBMC Laboratoire de Biomécanique et Mécanique des Chocs, F-69675, Bron, France
| | - W Samson
- Laboratory of Anatomy, Biomechanics and Organogenesis, CP 619, Université Libre de Bruxelles (ULB), Lennik Street 808, 1070 Brussels, Belgium
| | - R Dumas
- Université de Lyon, France; Université Claude Bernard Lyon 1, Villeurbanne, France; IFSTTAR, UMR_T9406, LBMC Laboratoire de Biomécanique et Mécanique des Chocs, F-69675, Bron, France
| | - L Chèze
- Université de Lyon, France; Université Claude Bernard Lyon 1, Villeurbanne, France; IFSTTAR, UMR_T9406, LBMC Laboratoire de Biomécanique et Mécanique des Chocs, F-69675, Bron, France.
| | - B Dohin
- Université Jean Monnet Saint-Etienne, Service de Chirurgie Pédiatrique CHU Nord, 42055 Saint Etienne cedex 2, France
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