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Tørring MF, Logacjov A, Brændvik SM, Ustad A, Roeleveld K, Bardal EM. Validation of two novel human activity recognition models for typically developing children and children with Cerebral Palsy. PLoS One 2024; 19:e0308853. [PMID: 39312531 PMCID: PMC11419372 DOI: 10.1371/journal.pone.0308853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 08/01/2024] [Indexed: 09/25/2024] Open
Abstract
Human Activity Recognition models have potential to contribute to valuable and detailed knowledge of habitual physical activity for typically developing children and children with Cerebral Palsy. The main objective of the present study was to develop and validate two Human Activity Recognition models. One trained on data from typically developing children (n = 63), the second also including data from children with Cerebral Palsy (n = 16), engaging in standardised activities and free play. Our data was collected using accelerometers and ground truth was established with video annotations. Additionally, we aimed to investigate the influence of window settings on model performance. Utilizing the Extreme gradient boost (XGBoost) classifier, twelve sub-models were created, with 1-,3- and 5-seconds windows, with and without overlap. Both Human Activity Recognition models demonstrated excellent predictive capabilities (>92%) for standardised activities for both typically developing and Cerebral Palsy. From all window sizes, the 1-second window performed best for all test groups. Accuracy was slightly lower (>75%) for the Cerebral Palsy test group performing free play activities. The impact of window size and overlap varied depending on activity. In summary both Human Activity Recognition models effectively predict standardised activities, surpassing prior models for typically developing and children with Cerebral Palsy. Notably, the model trained on combined typically developing children and Cerebral Palsy data performed exemplary across all test groups. Researchers should select window settings aligned with their specific research objectives.
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Affiliation(s)
- Marte Fossflaten Tørring
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Physiotherapy Unit, Trondheim Municipal, Trondheim, Norway
| | - Aleksej Logacjov
- Department of Computer Science, Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Siri Merete Brændvik
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Clinic of Rehabilitation, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Astrid Ustad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Karin Roeleveld
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Ellen Marie Bardal
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
- Clinic of Rehabilitation, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Bulut N, Yalçın Aİ, Topuz S, Gürbüz İ, Yılmaz Ö, Karaduman A. Effects of cycling training on balance and gait in children with Duchenne muscular dystrophy: A randomized controlled study. Eur J Paediatr Neurol 2024; 52:76-81. [PMID: 39151278 DOI: 10.1016/j.ejpn.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 07/28/2024] [Accepted: 08/10/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND AND AIMS Although aerobic exercises such as cycling and swimming are increasingly being recommended in Duchenne muscular dystrophy (DMD), their effect on gait and balance parameters is unclear. This study was aimed to investigate the effect of cycling training on balance and spatio-temporal gait parameters in children with DMD. METHODS Ambulant children (age range: 6.17-11.33 years) were randomly divided into two groups: home-based exercise training applied in the control group (n = 12) while 12 weeks of supervised submaximal lower extremity cycling training in addition to home-based exercise training performed in the study group (n = 11). Gait and balance parameters were evaluated using the GAITRite electronic walkway system and the Bertec Balance Check Screener™, respectively. Assessments were applied before and after 12 weeks of training. RESULTS The mean ages of the children in the study and control groups were 8.20 (SD:1.34) and 8.86 (SD:1.30) years, consecutively (p > 0.05). Considering the baseline values, the balance and spatio-temporal gait parameters of the children were similar except for the antero-posterior postural sway on the perturbed surface with eyes open (p > 0.05). There was a significant time x group interaction effect in favor of the study group for the antero-posterior postural sway of children on the normal surface with eyes open (F (1,58) = 12.62, p = 0.002). It was found that the antero-posterior postural sway on the normal surface with eyes open was improved in the study group within group comparison (F (1,10) = 8.50, p = 0.015). CONCLUSIONS The study showed that both the cycling and the home-based exercise training groups may maintain gait and balance parameters during the study. Adding a cycling training to the rehabilitation program can also provide additional contribution to improve antero-posterior balance.
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Affiliation(s)
- Numan Bulut
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Samanpazarı, 06100, Altındağ, Ankara, Turkey.
| | - Ali İmran Yalçın
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Samanpazarı, 06100, Altındağ, Ankara, Turkey.
| | - Semra Topuz
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Samanpazarı, 06100, Altındağ, Ankara, Turkey.
| | - İpek Gürbüz
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Samanpazarı, 06100, Altındağ, Ankara, Turkey.
| | - Öznur Yılmaz
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Samanpazarı, 06100, Altındağ, Ankara, Turkey.
| | - Ayşe Karaduman
- Lokman Hekim University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Söğütözü, 06510, Çankaya, Ankara, Turkey.
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Carroll K, Kennedy RA, Koutoulas V, Werake U, Bui M, Kraan CM. Comparability between wearable inertial sensors and an electronic walkway for spatiotemporal and relative phase data in young children aged 6-11 years. Gait Posture 2024; 111:30-36. [PMID: 38615566 DOI: 10.1016/j.gaitpost.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/26/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Approaches to gait analysis are evolving rapidly and now include a wide range of options: from e-patches to video platforms to wearable inertial measurement unit systems. Newer options for gait analysis are generally more inclusive for the assessment of children, more cost effective and easier to administer. However, there is limited data on the comparability of newer systems with more established traditional approaches in young children. RESEARCH QUESTION To determine comparability between the Physilog®5 wearable inertial sensor and GAITRite® electronic walkway for spatiotemporal (stride length, time and velocity, cadence) and relative phase (double support time, stance, swing, loading, foot flat and push off) data in young children. METHODS A total 34 typically developing participants (41% female) aged 6-11 years old median age 8.99 years old (interquartile range 2.83) were assessed walking at self-selected speed over the GAITRite® electronic walkway while concurrently wearing shoe-attached Physilog®5 IMU sensors. Level of agreement was analysed by Lin's concordance correlation coefficient (CCC), Bland-Altman plots and 95% limit of agreement. Systematic bias was assessed using 95% confidence interval of the mean difference. RESULTS Excellent to almost perfect agreement was observed between systems for spatiotemporal metrics: cadence (CCC=0.996), stride length (CCC=0.993), stride time (CCC=0.996), stride velocity (CCC=0.988). The relative phase metrics adjusted for stride velocity showed improved comparability when compared to the unadjusted metrics: swing adjusted (adj) (CCC=0.635); stance adj (CCC: 0.879); loading adj: (CCC=0.626). SIGNIFICANCE Spatiotemporal metrics are highly compatible across GAITRite® electronic walkway and Physilog®5 IMU systems in young children. Relative phase metrics were somewhat compatible between systems when adjusted for stride velocity.
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Affiliation(s)
- K Carroll
- Department of Neurology, The Royal Children's Hospital, Parkville, Victoria, Australia; Neurosciences, Clinical Sciences, Murdoch Children's Research Institutee, Parkville, Victoria, Australia
| | - R A Kennedy
- Department of Neurology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - V Koutoulas
- Faculty of Medicine, Dentistry and Health Sciences Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - U Werake
- Diagnosis and Development, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - M Bui
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - C M Kraan
- Faculty of Medicine, Dentistry and Health Sciences Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia; Diagnosis and Development, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
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Jeong HJ, Tarima S, Nguyen A, Qashqai A, Muriello M, Basel D, Slavens BA. Lower extremity inter-joint coupling angles and variability during gait in pediatric hypermobility spectrum disorder. J Biomech 2024; 170:112151. [PMID: 38851094 DOI: 10.1016/j.jbiomech.2024.112151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 05/02/2024] [Accepted: 05/13/2024] [Indexed: 06/10/2024]
Abstract
Complex musculoskeletal complications in children with hypermobility spectrum disorder (HSD) include pain, proprioception deficits, and joint instability, which may result in movement dysfunction during walking. However, no studies have explored the inter-joint coordination deficits in children with HSD. The purpose of this study was to determine the lower extremity inter-joint coupling angles, patterns, and variability during walking in children with HSD compared to children without HSD (non-HSD). Ankle, knee, and hip kinematics during the stance phase of walking in 18 children with HSD and 18 children without HSD were measured using three-dimensional motion analysis. Coupling angles, patterns, and variability of hip-knee, hip-ankle, and knee-ankle were quantified in the sagittal, frontal, and transverse planes using vector coding techniques. Statistical modeling of coupling angles on sine and cosine scales and bootstrapped standard errors were used to compare coupling angles between HSD and non-HSD groups. Permutational multivariate analysis of variance and statistical non-parametric mapping two-sample t-tests were used to compare the coupling patterns and variability between HSD and non-HSD groups, respectively. Our results indicated that coupling angles, patterns, and variability were not significantly different between the groups. These findings suggest that lower extremity inter-joint coordination and its variability during walking might not be a promising area for further research or intervention in children with HSD. Further research could use other biomechanical methods to investigate coordination deficits in pediatric patients with HSD, and how aging and disease progression are associated with coordination deficits in individuals with HSD.
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Affiliation(s)
- Hyo-Jung Jeong
- Orthopaedic and Rehabilitation Engineering Center, Marquette University, Milwaukee, WI, USA; Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Program in Physical Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
| | - Sergey Tarima
- Institute for Health & Equity, Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Anthony Nguyen
- Department of Mechanical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Anahita Qashqai
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Michael Muriello
- Division of Genetics, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Donald Basel
- Division of Genetics, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brooke A Slavens
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Department of Mechanical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Muehlbauer T, Eckardt L, Höptner L, Hill MW. Effect of low versus high balance training complexity on balance performance in male adolescents. BMC Res Notes 2024; 17:149. [PMID: 38807232 PMCID: PMC11135006 DOI: 10.1186/s13104-024-06811-x] [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: 06/21/2023] [Accepted: 05/20/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVE The current study aimed to determine the effects of low (i.e., balance task only) versus high (i.e., balance task combined with an additional motor task like dribbling a basketball) balance training complexity (6 weeks of training consisting of 2 × 30 min balance exercises per week) on measures of static and dynamic balance in 44 healthy male adolescents (mean age: 13.3 ± 1.6 years). RESULTS Irrespective of balance training complexity, significant medium- to large-sized pretest to posttest improvements were detected for static (i.e., One-Legged Stance test, stance time [s], 0.001 < p ≤ 0.008) and dynamic (i.e., 3-m Beam Walking Backward test, steps [n], 0.001 < p ≤ 0.002; Y-Balance-Test-Lower-Quarter, reach distance [cm], 0.001 < p ≤ 0.003) balance performance. Further, in all but one comparison (i.e., stance time with eyes opened on foam ground) no group × test interactions were found. These results imply that balance training is effective to improve static and dynamic measures of balance in healthy male adolescents, but the effectiveness seems unaffected by the applied level of balance training complexity.
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Affiliation(s)
- Thomas Muehlbauer
- Division of Movement and Training Sciences, Biomechanics of Sport, University of Duisburg- Essen, Essen, Germany.
| | - Lucas Eckardt
- Division of Movement and Training Sciences, Biomechanics of Sport, University of Duisburg- Essen, Essen, Germany
| | - Lukas Höptner
- Division of Movement and Training Sciences, Biomechanics of Sport, University of Duisburg- Essen, Essen, Germany
| | - Mathew W Hill
- Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK
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Kusumoto Y, Takahashi E, Endo Y, Asao A, Tanaka Y, Okazaki K, Yokozuka M, Omata J, Yabuki S, Kanzaki H. Differences in walking and running parameters in elementary school students with and without backpacks. Work 2024:WOR240111. [PMID: 38759090 DOI: 10.3233/wor-240111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Backpack syndrome (BS) is a term used to describe symptoms such as shoulder and back pain that are believed to be caused by carrying a backpack. Few studies have investigated the changes in walking and running parameters with and without backpacks. OBJECTIVE The present study aimed to investigate the differences in walking and running parameters with and without backpacks in primary school children with and without BS. METHODS This cross-sectional study included 51 children (average age 9.3 years, 6- 12 years). Two questions were asked beforehand: whether the respondents had shoulder or back pain when going to school and present; those who answered that they had pain in both cases were defined as the BS group, while the others were the control group. Walking and running at comfortable speeds and walking and running with a 6 kg backpack on their backs were measured. RESULTS During walking, there were main effects for speed, cadence, and strike angle with and without the backpack, but no interactions were identified for any of the parameters. In running, however, there were main effects for speed, stride length, strike angle, and lift-off angle, and an interaction effect was observed for speed and stride length. CONCLUSIONS During walking, carrying a 6 kg backpack increased cadence and walking speed. During running, carrying a backpack caused a decrease in stride length and running speed in the BS group, whereas there was no change in the control group, suggesting that the control and BS groups may respond differently.
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Affiliation(s)
- Yasuaki Kusumoto
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Fukushima, Japan
| | - Eri Takahashi
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Fukushima, Japan
| | - Yasuhiro Endo
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Fukushima, Japan
| | - Akihiko Asao
- Department of Occupational Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Fukushima, Japan
| | - Yoshinobu Tanaka
- Department of Occupational Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Fukushima, Japan
| | - Kanako Okazaki
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Fukushima, Japan
| | - Mieko Yokozuka
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Fukushima, Japan
| | - Junichi Omata
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Fukushima, Japan
| | - Shoji Yabuki
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Fukushima, Japan
| | - Hideto Kanzaki
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima City, Fukushima, Japan
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Gröble S, van Hedel HJA, Keller JW, Ammann-Reiffer C. Differences in gait parameters when crossing real versus projected everyday life obstacles in healthy children and adolescents. Sci Rep 2023; 13:7848. [PMID: 37188711 DOI: 10.1038/s41598-023-34276-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/27/2023] [Indexed: 05/17/2023] Open
Abstract
Practicing complex everyday life walking activities is challenging in paediatric neurorehabilitation, although it would prepare patients more comprehensively for the requirements of daily life. Floor projections allow simulation and training of such situations in therapy. Twenty healthy youths aged 6-18 years stepped over a tree trunk and balanced over kerbstones in a real and projected condition. Spatiotemporal and kinematic parameters of the two conditions were compared by equivalence analysis, using the medians of the differences between the two conditions with their bootstrapped 95% confidence intervals. Velocity, step and stride length, step width, and single support time were generally equivalent between the two conditions. Knee and hip joint angles and toe clearance decreased substantially during the execution phase of the projected tree trunk condition. The largest differences were found at the end of the execution phase in both tasks for the ankle joints. As spatiotemporal parameters were equivalent between the conditions, floor projections seem suitable to train precise foot placement. However, differences in knee and hip joint kinematics and toe clearance revealed that floor projections are not applicable for obstacles with a vertical extension. Therefore, exercises aiming at knee and hip flexion improvement should favourably be trained with real objects.
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Affiliation(s)
- Sabrina Gröble
- Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland.
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
- Department of Health Sciences and Technology, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093, Zurich, Switzerland.
- Department of Health Professions, Applied Research & Development in Nursing, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland.
| | - Hubertus J A van Hedel
- Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Jeffrey W Keller
- Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
- Federal Office of Public Health FOPH, Schwarzenburgstrasse 157, 3003, Bern, Switzerland
| | - Corinne Ammann-Reiffer
- Swiss Children's Rehab, University Children's Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern am Albis, Switzerland
- Children's Research Center, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
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Daunoraviciene K, Pauk J, Ziziene J, Belickiene V, Raistenskis J. Study of foot support during gait in healthy children from neighbouring countries. Technol Health Care 2023; 31:2457-2466. [PMID: 37955070 DOI: 10.3233/thc-235011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND Healthy children's gait support patterns play a critical role in their development and overall well-being. Therefore, in order to develop a correct gait, it is necessary to constantly update knowledge. OBJECTIVE To identify differences in gait support among children in neighbouring countries. METHODS 44 healthy children from Poland and Lithuania (4-11 years old) participated in the study. The spatiotemporal and plantar pressure parameters of 88 neutrally aligned feet were analysed and compared. RESULTS Statistically significant differences between stance, single-limb support, double support, swing duration, cadence, and velocity, max. force and pressure in the forefoot, as well as in the times of occurrence of max. forces in all three zones. Defined that age is related (p< 0.05) to cadence (R= 0.32), swing phase (R= 0.53), max. force under the midfoot (R= 0.35) and the heel (R= 0.47), max. pressure under the forefoot (R=-0.52), midfoot (R=-0.63) and heel (R=-0.47). CONCLUSION The results can help caregivers, as well as clinicians and researchers, understand how gait mechanics change with development and the growth course of the children of that country. Also, the results are important for the analysis and comparison of children's gait, as control reference data from the same country.
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Affiliation(s)
| | - Jolanta Pauk
- Bialystok University of Technology, Bialystok, Poland
| | | | - Vaida Belickiene
- Department of Rehabilitation, Physical and Sports Medicine, Health Science Institute, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Juozas Raistenskis
- Department of Rehabilitation, Physical and Sports Medicine, Health Science Institute, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Rygelová M, Uchytil J, Torres IE, Janura M. Comparison of spatiotemporal gait parameters and their variability in typically developing children aged 2, 3, and 6 years. PLoS One 2023; 18:e0285558. [PMID: 37167236 PMCID: PMC10174554 DOI: 10.1371/journal.pone.0285558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 04/25/2023] [Indexed: 05/13/2023] Open
Abstract
Independent walking is an important milestone in a child's development. The maturation of central nervous system, changes in body proportions, spatiotemporal parameters of gait and their variability change are dependent on age. The first aim of this study was to compare non-normalized and normalized spatiotemporal parameters and their variability in children. The second aim was to determine which spatiotemporal parameters are most affected by aging. Data from 64 typically developing children (age: 2.0-6.9 years), who walked at a self-selected speed along a 10m walkway, were collected with a motion capture system. Spatiotemporal parameters were normalized based on leg length. The main effect of the non-normalized walking speed revealed a moderate effect size (ES = 0.72) comparing 2- and 3-years-old, a large effect size comparing 2- and 6-years-old (ES = 1.77), and a large ES comparing 3- and 6-years-old (ES = 1.22). The normalized stride width parameter showed a statistically significant difference with large effect size between 2 vs 3 (ES = 1.00), 2 vs 6 (ES = 3.17), and 3 vs 6 (ES = 1.96). A statistically significant decrease in intra-individual gait variability with increasing age was observed in all parameters except for stride width. The variability of stride width may serve as a parameter in 2-year-olds to assess deviations from typically developing children. The assessment of effect size could be a useful indicator for clinical practice.
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Affiliation(s)
- Markéta Rygelová
- Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic
| | - Jaroslav Uchytil
- Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic
| | - Isaac Estevan Torres
- Department of Teaching Corporal Expression, University of Valencia, Valencia, Spain
| | - Miroslav Janura
- Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czech Republic
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Muehlbauer T, Hill MW, Schedler S. Effect of arm movement and task difficulty level on balance performance in healthy children: are there sex differences? BMC Res Notes 2022; 15:362. [PMID: 36494858 PMCID: PMC9733316 DOI: 10.1186/s13104-022-06195-w] [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: 03/04/2022] [Accepted: 09/07/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE In children, studies have shown that balance performance is worse in boys compared to girls and further studies revealed inferior performance when arm movement was restricted during balance assessment. However, it remains unclear whether restriction of arm movement during balance testing differentially affects children's balance performance (i.e., boys more than girls). Thus, we compared the influence of arm movement on balance performance in healthy boys versus girls (mean age: ~ 11.5 years) while performing balance tasks with various difficulty level. RESULTS In nearly all tests, balance performance (i.e., timed one-legged stance, 3-m beam walking backward step number, Lower Quarter Y-Balance test reach distance) was significantly worse during restricted compared to free arm movement but without any differences between sexes or varying levels of task difficulty. These findings indicated that balance performance is negatively affected by restriction of arm movement, but this does not seem to be additionally influenced by children's sex and the level of task difficulty.
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Affiliation(s)
- Thomas Muehlbauer
- grid.5718.b0000 0001 2187 5445Division of Movement and Training Sciences, Biomechanics of Sport, University of Duisburg-Essen, Gladbecker Str. 182, 45141 Essen, Germany
| | - Mathew W. Hill
- grid.8096.70000000106754565Center for Sport, Exercise and Life Sciences, School of Life Sciences, Coventry University, Warwickshire, UK
| | - Simon Schedler
- grid.5718.b0000 0001 2187 5445Division of Movement and Training Sciences, Biomechanics of Sport, University of Duisburg-Essen, Gladbecker Str. 182, 45141 Essen, Germany
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Muehlbauer T, Schedler S. No sex-specific effects of balance training on dynamic balance performance in healthy children. Front Sports Act Living 2022; 4:1019093. [PMID: 36329853 PMCID: PMC9623005 DOI: 10.3389/fspor.2022.1019093] [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: 08/14/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022] Open
Abstract
Background Cross-sectional studies in children reported better balance performance for girls than for boys. Thus, balance trainability might be different between female and male children. The aim of the present study was to examine the effects of balance training (BT) on dynamic balance performance in girls compared to boys. Methods Seventeen girls (age: 11.1 ± 0.7 years) and 22 boys (age: 11.1 ± 0.8 years) were assigned to either a BT-group or an active control (CON) group. BT was conducted over eight weeks (two sessions/week) while the CON-groups received their regular physical education lessons during the same period. Before and after treatment, dynamic balance performance was assessed by using the Lower Quarter Y-Balance (YBT-LQ) test. A series of three-way analyses of covariance (ANCOVA) were undertaken to test for within-between effects of Test [×2 (pretest vs. posttest)], Group [×2 (BT-group vs. CON-group)] and Sex [×2 (boys vs. girls)]. Results The three-way ANCOVA yielded a significant main effect of Test (p = 0.002-0.043, η p 2 = 0.122-0.262) and of Group (all p < 0.001, η p 2 = 0.330-0.651) but not of sex for all YBT-LQ reach directions and the composite score. Further, there were significant Test × Group interactions (all p < 0.001, η p 2 = 0.330-0.651) in favor of both BT-groups but neither Test × Sex nor Test × Group × Sex interactions were detected. Conclusions We conclude that BT is an effective treatment to improve dynamic balance performance in healthy children regardless of their sex. Consequently, girls and boys can be provided with the same BT regime to enhance their postural control.
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Reference Values of Spatial and Temporal Gait Parameters in a Contemporary Sample of Spanish Preschool Children: A Cross-Sectional Study. CHILDREN 2022; 9:children9081150. [PMID: 36010041 PMCID: PMC9406986 DOI: 10.3390/children9081150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 12/02/2022]
Abstract
The aim of this study was to analyze the influence of age and sex on kinematic gait parameters in preschool children, and derive reference values for this population. A total of 383 preschool children (age 3–5 years; 207 girls, 176 boys) participated in this study. We used the OptoGait system to assess the kinematics of gait at a comfortable and self-determined speed. No significant differences between the sexes were found for the main gait parameters. Among the participants, there was a significant increase in double support, reductions in absolute cadence and the coefficient of variation (CV) of cadence, an increase in absolute step length (SL), and an increase in the walk ratio (WR) from 3 to 5 years of age. However, the normalized SL and normalized WR displayed a significant reduction in both sexes. Partial correlation indicated a significant association of age with SL and normalized SL, and WR. Additionally, WR showed a significant correlation with the CV of cadence. To summarize, no relevant differences in gait performance were found according to sex; however, age was found to influence gait maturation. The normative values established for Spanish preschool children can be used to monitor healthy gait development.
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Identifying the Effects of Age and Speed on Whole-Body Gait Symmetry by Using a Single Wearable Sensor. SENSORS 2022; 22:s22135001. [PMID: 35808494 PMCID: PMC9269851 DOI: 10.3390/s22135001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 01/27/2023]
Abstract
Studies on gait symmetry in healthy population have mainly been focused on small range of age categories, neglecting Teenagers (13–18 years old) and Middle-Aged persons (51–60 years old). Moreover, age-related effects on gait symmetry were found only when the symmetry evaluation was based on whole-body acceleration than on spatiotemporal parameters of the gait cycle. Here, we provide a more comprehensive analysis of this issue, using a Symmetry Index (SI) based on whole-body acceleration recorded on individuals aged 6 to 84 years old. Participants wore a single inertial sensor placed on the lower back and walked for 10 m at comfortable, slow and fast speeds. The SI was computed using the coefficient of correlation of whole-body acceleration measured at right and left gait cycles. Young Adults (19–35 years old) and Adults (36–50 years old) showed stable SI over the three speed conditions, while Children (6–12 years old), Teenagers (13–18 years old), Middle-Aged persons and Elderly (61–70 and 71–84 years old) exhibited lower SI values when walking at fast speed. Overall, this study confirms that whole-body gait symmetry is lower in Children and in Elderly persons over 60 years of age, showing, for the first time, that asymmetries appear also during teenage period and in Middle-Aged persons (51–60 years old).
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Three-dimensional gait analysis of lower extremity gait parameters in Japanese children aged 6 to 12 years. Sci Rep 2022; 12:7822. [PMID: 35551257 PMCID: PMC9098504 DOI: 10.1038/s41598-022-11906-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/25/2022] [Indexed: 12/05/2022] Open
Abstract
We aimed to develop gait standards for gait parameters in school-aged Japanese children and assess age-related differences in gait patterns and parameters. Children aged 6–12 years (n = 424) were recruited from two elementary schools. An instrumented three-dimensional gait analysis system was used to record each child's gait kinematics, kinetics, and spatiotemporal parameters. Participants were subdivided into three age groups (Group A, 6–8 years; Group B, 9–10 years; and Group C, 11–12 years). LMS Chartmaker, version 2.54, was used to create a developmental chart for the gait pattern. The non-normalized step and stride lengths were significantly longer, and the cadence was lower in older children; however, the opposite outcome occurred when analyzing normalized data. Ankle moment differed significantly by age, and the maximum ankle moment was higher in older children than that in younger children. Furthermore, the hip and knee flexion angles during gait and the normalized spatiotemporal parameters of Japanese children aged 6–12 years differed by age and from those of children from other countries. The centile chart of the gait pattern is a useful tool for clinicians to assess developmental changes in the gait pattern and detect gait abnormalities in children.
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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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Mani H, Miyagishima S, Kozuka N, Inoue T, Hasegawa N, Asaka T. Development of the Relationships Among Dynamic Balance Control, Inter-limb Coordination, and Torso Coordination During Gait in Children Aged 3-10 Years. Front Hum Neurosci 2021; 15:740509. [PMID: 34776908 PMCID: PMC8582286 DOI: 10.3389/fnhum.2021.740509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022] Open
Abstract
Knowledge about the developmental process of dynamic balance control comprised of upper arms and upper legs coordination and trunk and pelvis twist coordination is important to advance effective balance assessment for abnormal development. However, the mechanisms of these coordination and stability control during gait in childhood are unknown.This study examined the development of dynamic postural stability, upper arm and upper leg coordination, and trunk and pelvic twist coordination during gait, and investigated the potential mechanisms integrating the central nervous system with inter-limb coordination and trunk and pelvic twist coordination to control extrapolated center of the body mass (XCOM). This study included 77 healthy children aged 3-10 years and 15 young adults. The child cohort was divided into four groups by age: 3-4, 5-6, 7-8, and 9-10 years. Participants walked barefoot at a self-selected walking speed along an 8 m walkway. A three-dimensional motion capture system was used for calculating the XCOM, the spatial margin of stability (MoS), and phase coupling movements of the upper arms, upper legs, trunk, and pelvic segments. MoS in the mediolateral axis was significantly higher in the young adults than in all children groups. Contralateral coordination (ipsilateral upper arm and contralateral upper leg combination) gradually changed to an in-phase pattern with increasing age until age 9 years. Significant correlations of XCOMML with contralateral coordination and with trunk and pelvic twist coordination (trunk/pelvis coordination) were found. Significant correlations between contralateral coordination and trunk/pelvis coordination were observed only in the 5-6 years and at 7-8 years groups.Dynamic postural stability during gait was not fully mature at age 10. XCOM control is associated with the development of contralateral coordination and trunk and pelvic twist coordination. The closer to in-phase pattern of contralateral upper limb coordination improved the XCOM fluctuations. Conversely, the out-of-phase pattern (about 90 degrees) of the trunk/pelvis coordination increased theXCOM fluctuation. Additionally, a different control strategy was used among children 3-8 years of age and individuals over 9 years of age, which suggests that 3-4-year-old children showed a disorderly coordination strategy between limb swing and torso movement, and in children 5-8 years of age, limb swing depended on trunk/pelvis coordination.
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Affiliation(s)
- Hiroki Mani
- Faculty of Welfare and Health Science, Physical Therapy Courses, Oita University, Oita, Japan
| | - Saori Miyagishima
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo Medical University, Sapporo, Japan
| | - Naoki Kozuka
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Takahiro Inoue
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Naoya Hasegawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Tadayoshi Asaka
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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EMG Based Analysis of Gait Symmetry in Healthy Children. SENSORS 2021; 21:s21175983. [PMID: 34502872 PMCID: PMC8434681 DOI: 10.3390/s21175983] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/12/2021] [Accepted: 09/03/2021] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to examine the changes in muscular activity between the left and right lower legs during gait in healthy children throughout temporal parameters of EMG and symmetry index (SI). A total of 17 healthy children (age: 8.06 ± 1.92 years) participated in this study. Five muscles on both legs were examined via the Vicon 8-camera motion analysis system synchronized with a Trigno EMG Wireless system and a Bertec force plate; onset–offset intervals were analyzed. The highest occurrence frequency of the primary activation modality was found in the stance phase. In the swing phase, onset–offset showed only a few meaningful signs of side asymmetry. The knee flexors demonstrated significant differences between the sides (p < 0.05) in terms of onset–offset intervals: biceps femoris in stance, single support, and pre-swing phases, with SI values = −6.45%, −14.29%, and −17.14%, respectively; semitendinosus in single support phase, with SI = −12.90%; lateral gastrocnemius in swing phase, with SI = −13.33%; and medial gastrocnemius in stance and single support phases, with SI = −13.33% and −23.53%, respectively. The study outcomes supply information about intra-subject variability, which is very important in follow-up examinations and comparison with other target groups of children.
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Geil MD, Rahnama L, Sergeant E, Soulis K, Jarrells J, Poisal M. Influence of non-immersive avatar-based gamification on the Hawthorne Effect in pediatric gait. Gait Posture 2021; 88:122-125. [PMID: 34034023 DOI: 10.1016/j.gaitpost.2021.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 04/12/2021] [Accepted: 05/17/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Hawthorne Effect occurs when participants alter their behavior when they are aware that they are being examined. The effect has been reported in many experiments, including gait analysis, and is considered an important source of bias that might impact both clinical and research results. Cognitive distraction is one potential solution to reducing the Hawthorne effect during gait analysis, but it is challenging in children, and can, in itself, alter gait. This study investigated the carryover effect of an alternative low-immersion avatar-based intervention on gait and subjective feelings in typically developing children. RESEARCH QUESTION Will a low-immersion avatar-based intervention change feelings and indicators of temporospatial and kinematic outcomes in children in a laboratory setting, potentially reducing the Hawthorne Effect? METHODS Typically developing children aged 5-13 participated in a standard laboratory gait analysis before experiencing a game in which they viewed their motion on monitors around the lab as that of a cartoon avatar in a 3D virtual environment. Following this intervention, standard walking trials were repeated. In addition, participants completed a survey of their feelings about the study both before onset and after completion. RESULTS Thirty-one children participated in the study, 16 females and 15 males, mean aged 9.1 years. Arm swing, proposed as a measure of how relaxed and natural gait was, increased significantly following the intervention, while temporospatial parameters did not. The effect was more pronounced in females and younger children. Participants felt significantly happier, more excited, less scared, and less sad after the intervention. Changes in feelings were not closely associated with changes in gait. SIGNIFICANCE This study suggests that gamification may reduce the Hawthorne effect and potentially produce more natural gait in children. The game intervention had a carryover effect, producing changes in gait even after the intervention was removed.
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Affiliation(s)
- Mark D Geil
- Kennesaw State University, Kennesaw, GA, USA.
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Methods of 10-Meter Walk Test and Repercussions for Reliability Obtained in Typically Developing Children. Rehabil Res Pract 2020; 2020:4209812. [PMID: 32884845 PMCID: PMC7455832 DOI: 10.1155/2020/4209812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 01/01/2023] Open
Abstract
Introduction Research and clinical settings use the 10-meter walk test (10MWT) to measure locomotor capacity with considerable methodological diversity. Comparison between healthy and disabled children is frequent; however, the reproducibility of 10MWT using different methods is unknown. Objectives This study analysed intrasubject, test-retest reliability, and agreement of four methods of 10MWT, exploring the influence of pace, acceleration-deceleration phases, and anthropometric measurements when calculating mean velocity. Methods This cross-sectional study evaluated 120 typical children, both sexes, aged 6, 8, 10, and 12 (n = 30 for each age). The mean times and velocities of the path (10 m) and middle path (6 m) obtained at a self-selected and fast pace were analysed. Initial assessment and another after seven days recorded three measurements per method (sV6 = self-selected pace and 6 m; sV10 = self-selected pace and 10 m; fV6 = fast pace and 6 m; fV10 = fast pace and 10 m). Interclass correlation coefficient (ICC), multiple regression, and Snedecor-F test (5% significance level) were used. Results The fV10 method had high intrasubject reliability for all tested ages (0.70 < ICC > 0.89); sV10 exhibited high intrasubject reliability for ages 6, 8, and 12 (0.70 < ICC > 0.89) and moderate for age 10 (0.50 < ICC < 0.69).Test-retest reliability at sV6 and fV6 did not reach high ICC in any tested ages. The test-retest reliability at sV10 and fV10 was moderate for ages 6, 8, and 12 (0.50 < ICC > 0.69) and poor for age 10 (0.25 < ICC > 0.49). There was no agreement between methods: sV6 versus sV10 (mean difference = 0.91 m/s; SEM = 0.036); fV6 versus fV10 (mean difference = 1.70; SEM = 0.046). The fV6 method versus fV10 overestimated the velocity (bias = 1.70 m/s). Conclusions For typical children, the method that ensured the highest intrasubject reliability used fast pace and 10 m. Moreover, test-retest reliability increased when adopting 10 m at both self-selected and fast pace. The methods were not equivalent but were related, and those that did not compute the entire pathway overestimated the results.
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Voss S, Joyce J, Biskis A, Parulekar M, Armijo N, Zampieri C, Tracy R, Palmer S, Fefferman M, Ouyang B, Liu Y, Berry-Kravis E, O’Keefe JA. Normative database of spatiotemporal gait parameters using inertial sensors in typically developing children and young adults. Gait Posture 2020; 80:206-213. [PMID: 32531757 PMCID: PMC7388584 DOI: 10.1016/j.gaitpost.2020.05.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/20/2020] [Accepted: 05/09/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Inertial sensors are increasingly useful to clinicians and researchers to detect gait deficits. Reference values are necessary for comparison to children with gait abnormalities. OBJECTIVE To present a normative database of spatiotemporal gait and turning parameters in 164 typically developing children and young adults ages 5-30 utilizing the APDM Mobility Lab® system. METHODS Participants completed the i-WALK test at both self-selected (SS) and fast as possible (FAP) walking speeds. Spatiotemporal gait and turning parameters included stride length, stride length variability, gait speed, cadence, stance, swing, and double support times, and foot strike, toe-off, and toe-out angles, turn duration, peak turn velocity and number of steps to turn. RESULTS Absolute stride length and gait speed increased with age. Normalized gait speed, absolute and normalized cadence, and stride length variability decreased with age. Normalized stride length and all parameters of gait cycle phase and foot position remained unaffected by age except for greater FSA in children 7-8. Foot position parameters in children 5-6 were excluded due to aberrant values and high standard deviations. Turns were faster in children ages 5-13 and 7-13 in the SS and FAP conditions, respectively. There were no differences in number of steps to turn. Similar trends were observed in the FAP condition except: normalized gait speed did not demonstrate a relationship with age and children ages 5-8 demonstrated increased stance and double support times and decreased swing time compared to children 11-13 and young adults (ages 5-6 only). Females ages 5-6 demonstrated increased stride length variability in the SS condition; males ages 7-8 and 14-30 ha d increased absolute stride length in the FAP condition. Similarities and differences were found between our values and previous literature. SIGNIFICANCE This normative database can be used by clinicians and researchers to compare abnormal gait patterns and responses to interventions.
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Affiliation(s)
- Stephanie Voss
- Department of Occupational Therapy, Rush University, Chicago, IL, United States
| | - Jessica Joyce
- Department of Cell & Molecular Medicine, Rush University, Chicago, IL, United States
| | - Alexandras Biskis
- Department of Cell & Molecular Medicine, Rush University, Chicago, IL, United States
| | - Medha Parulekar
- Rush Medical College, Rush University, Chicago, IL, United States
| | - Nicholas Armijo
- Department of Cell & Molecular Medicine, Rush University, Chicago, IL, United States
| | - Cris Zampieri
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Rachel Tracy
- Department of Occupational Therapy, Rush University, Chicago, IL, United States
| | - Sasha Palmer
- Department of Occupational Therapy, Rush University, Chicago, IL, United States
| | - Marie Fefferman
- Rush Medical College, Rush University, Chicago, IL, United States
| | - Bichun Ouyang
- Department of Neurological Sciences, Rush University, Chicago, IL, United States
| | - Yuanqing Liu
- Department of Neurological Sciences, Rush University, Chicago, IL, United States
| | - Elizabeth Berry-Kravis
- Department of Neurological Sciences, Rush University, Chicago, IL, United States,Department of Pediatrics, Rush University, Chicago, IL, United States
| | - Joan A. O’Keefe
- Department of Occupational Therapy, Rush University, Chicago, IL, United States,Department of Cell & Molecular Medicine, Rush University, Chicago, IL, United States,Department of Neurological Sciences, Rush University, Chicago, IL, United States,Corresponding author: Joan A. O’Keefe, PhD, PT, Departments of Cell & Molecular Medicine and Neurological Sciences, Rush University, 600 South Paulina Street, Suite 507 Armour Academic Center, Chicago, IL 60612,
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Leban B, Cimolin V, Porta M, Arippa F, Pilloni G, Galli M, Pau M. Age-Related Changes in Smoothness of Gait of Healthy Children and Early Adolescents. J Mot Behav 2019; 52:694-702. [PMID: 31650909 DOI: 10.1080/00222895.2019.1680949] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In this study, we acquired and processed trunk accelerations during level walking in 85 children aged 8-13 years to calculate spatio-temporal parameters and Harmonic Ratio (HR), which is a metrics representative of gait smoothness and step-to-step symmetry. The results show that while spatio-temporal parameters remain unchanged once normalized considering individuals' anthropometry, significantly higher values of HR for both the antero-posterior and vertical directions were found in participants aged 12-13 with respect to those of 8-9. This indicates an improvement of gait symmetry, which suggests that the gait maturation process is still ongoing for the age ranges tested here.
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Affiliation(s)
- Bruno Leban
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Micaela Porta
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Federico Arippa
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Giuseppina Pilloni
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
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Three-dimensional path of the body centre of mass during walking in children: an index of neural maturation. Int J Rehabil Res 2019; 42:112-119. [PMID: 30882528 PMCID: PMC6493692 DOI: 10.1097/mrr.0000000000000345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Few studies have investigated the kinematic aspects of the body centre of mass motion, that is, its three-dimensional path during strides and their changes with child development. This study aimed to describe the three-dimensional path of the centre of mass in children while walking in order to disentangle the effect of age from that of absolute forward speed and body size and to define preliminary pediatric normative values. The three-dimensional path of the centre of mass during walking was compared across healthy children 5–6− years (n = 6), 7–8 years (n = 6), 9–10 years (n = 5), and 11–13 years of age (n = 5) and healthy adults (23–48 years, n = 6). Participants walked on a force-sensing treadmill at various speeds, and height normalization of speed was conducted with the dimensionless Froude number. The total length and maximal lateral, vertical, and forward displacements of the centre of mass path were calculated from the ground reaction forces during complete strides and were scaled to the participant’s height. The centre of mass path showed a curved figure-of-eight shape. Once adjusted for speed and participants’ height, as age increased, there was a decrease in the three-dimensional parameters and in the lateral displacement, with values approaching those of adults. At each step, lateral redirection of the centre of mass requires brisk transient muscle power output. The base of support becomes relatively narrower with increasing age. Skilled shortening of the lateral displacement of the centre of mass may therefore decrease the risk of falling sideways. The three-dimensional path of the centre of mass may represent maturation of neural control of gait during growth.
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Symmetry of Gait in Underweight, Normal and Overweight Children and Adolescents. SENSORS 2019; 19:s19092054. [PMID: 31052569 PMCID: PMC6539288 DOI: 10.3390/s19092054] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/24/2019] [Accepted: 04/30/2019] [Indexed: 12/22/2022]
Abstract
Abnormal excess or lack of body mass can influence gait patterns, but in some cases such differences are subtle and not easy to detect, even with quantitative techniques for movement analysis. In these situations, the study of trunk accelerations may represent an effective way to detecting gait anomalies in terms of symmetry through the calculation of Harmonic Ratio (HR), a parameter obtained by processing trunk accelerations in the frequency domain. In the present study we used this technique to assess the existence of differences in HR during gait in a cohort of 75 healthy children and early adolescents (aged 7-14 years) stratified into 3 equally-sized age and gender-matched groups (Underweight: UW; Normal Weight: NW; Overweight: OW). The accelerometric signal, acquired using a single wearable inertial sensor, was processed to calculate stride length, speed, cadence and HR in antero-posterior, vertical and medio-lateral directions. No differences in spatio-temporal parameters were found among groups, while the HR in the medio-lateral direction was found significantly lower in UW children, while OW exhibited the highest values. On the basis of the results obtained, HR appears capable of discriminating gait symmetry in children with different body mass even when conventional gait parameters are unchanged.
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Schedler S, Kiss R, Muehlbauer T. Age and sex differences in human balance performance from 6-18 years of age: A systematic review and meta-analysis. PLoS One 2019; 14:e0214434. [PMID: 30964877 PMCID: PMC6456289 DOI: 10.1371/journal.pone.0214434] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/11/2019] [Indexed: 11/20/2022] Open
Abstract
Background The process of growing leads to inter-individual differences in the timing of growth, maturational, and developmental processes during childhood and adolescence, also affecting balance performance in youth. However, differences in balance performance by age and sex in youth have not been systematically investigated yet. Objective The objective of the present study was to characterize and quantify age- and sex-related differences in balance performance in healthy youth. Methods A computerized systematic literature search was performed in the electronic databases PubMed, Web of Science, and SPORTDiscus. To be applicable for analysis, studies had to report at least one measure of static steady-state, dynamic steady-state, proactive or reactive balance in healthy children (6–12 years) and/or adolescents (13–18 years). Coding of the studies was done according to the following criteria: age, sex, and balance outcome. Study quality was assessed using the Appraisal tool for Cross-Sectional Studies. Weighted standardized mean differences were calculated and classified according to their magnitude. Results Twenty-one studies examined age-related differences in balance performance. A large effect for measures of static steady-state balance (SMDba = 1.20) and small effects for proxies of dynamic steady-state (SMDba = 0.26) and proactive balance (SMDba = 0.28) were found; all in favor of adolescents. Twenty-five studies investigated sex-related differences in balance performance. A small-sized effect was observed for static steady-state balance (SMDbs = 0.33) in favor of girls and for dynamic steady-state (SMDbs -0.02) and proactive balance (SMDbs = -0.15) in favor of boys. Due to a lack of studies, no analysis for measures of reactive balance was performed. Conclusions Our systematic review and meta-analysis revealed better balance performances in adolescents compared to children, irrespective of the measure considered. Sex-related differences were inconsistent. These findings may have implications for example in terms of trainability of balance in youth that should be investigated in future studies.
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Affiliation(s)
- Simon Schedler
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
- * E-mail:
| | - Rainer Kiss
- Department of Health and Social Affairs, FHM Bielefeld—University of Applied Sciences, Bielefeld, Germany
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
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Bisi MC, Tamburini P, Stagni R. A 'Fingerprint' of locomotor maturation: Motor development descriptors, reference development bands and data-set. Gait Posture 2019; 68:232-237. [PMID: 30522021 DOI: 10.1016/j.gaitpost.2018.11.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 11/02/2018] [Accepted: 11/28/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND When aiming at studying and monitoring locomotor development in childhood, innovative indexes for the characterization of motor control performance and wearable technologies have highlighted the potential of significant advances. In particular, quantitative assessment of motor performance during natural walking (NW) and tandem walking (TW) has been proposed to highlight manifestations of motor automaticity and complexity, respectively. RESEARCH QUESTION This work aims at providing a quantitative overview of metrics characterizing locomotor maturation in a typically developing population, by analysing NW and TW. The final goal is to propose a novel graphical representation of motor development from childhood to adulthood, providing metrics for quantitative assessment with reference bands and data-set, supporting data interpretation and longitudinal assessment. METHODS 112 typically developing participants (age groups: 6-, 7-, 8-, 9-, 10-, 15-, and 25 years) walked in NW and in TW at self-selected speed. 3D acceleration and angular velocity of lower trunk and shanks were collected. Temporal parameters, their variability, and nonlinear metrics characterizing human movement (harmonic ratio, short-term Lyapunov exponents, multiscale entropy, and recurrence quantification analysis) were calculated. Effect of age was analysed on the different parameters and a graphical polar plot was defined to represent parameters that showed age effect in at least one of the two tasks. RESULTS Age effect was shown on temporal parameters, their variability, multiscale entropy and recurrence quantification analysis. These parameters were selected for monitoring locomotor development and presented on an ad-hoc designed polar plot showing age-group reference bands. SIGNIFICANCE Graphic results outline locomotor differences with maturation at first glance. The patterns in NW and TW allow to characterize specific aspects of locomotor maturation, to evaluate in which area changes occur and towards which direction, depending on the task. The novel database containing participants' raw collected data is made available as additional result of the present study.
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Affiliation(s)
- M C Bisi
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Via del Risorgimento 2, 40136 Bologna, Italy.
| | - P Tamburini
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Via del Risorgimento 2, 40136 Bologna, Italy
| | - R Stagni
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Via del Risorgimento 2, 40136 Bologna, Italy
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Cesar GM, Buster TW, Burnfield JM. Cardiorespiratory fitness, balance and walking improvements in an adolescent with cerebral palsy (GMFCS II) and autism after motor-assisted elliptical training. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2018.1536764] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Guilherme M. Cesar
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Thad W. Buster
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Judith M. Burnfield
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
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Singh B, Krishan K, Kaur K, Kanchan T. Estimation of body weight from the base of gait and the area swept in one stride—forensic implications. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2018. [DOI: 10.1186/s41935-018-0082-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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McKay MJ, Baldwin JN, Ferreira P, Simic M, Vanicek N, Wojciechowski E, Mudge A, Burns J. Spatiotemporal and plantar pressure patterns of 1000 healthy individuals aged 3-101 years. Gait Posture 2017; 58:78-87. [PMID: 28763713 DOI: 10.1016/j.gaitpost.2017.07.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/07/2017] [Accepted: 07/03/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to establish normative reference values for spatiotemporal and plantar pressure parameters, and to investigate the influence of demographic, anthropometric and physical characteristics. METHODS In 1000 healthy males and females aged 3-101 years, spatiotemporal and plantar pressure data were collected barefoot with the Zeno™ walkway and Emed® platform. Correlograms were developed to visualise the relationships between widely reported spatiotemporal and pressure variables with demographic (age, gender), anthropometric (height, mass, waist circumference) and physical characteristics (ankle strength, ankle range of motion, vibration perception) in children aged 3-9 years, adolescents aged 10-19 years, adults aged 20-59 years and older adults aged over 60 years. RESULTS A comprehensive catalogue of 31 spatiotemporal and pressure variables were generated from 1000 healthy individuals. The key findings were that gait velocity was stable during adolescence and adulthood, while children and older adults walked at a comparable slower speed. Peak pressures increased during childhood to older adulthood. Children demonstrated highest peak pressures beneath the rearfoot whilst adolescents, adults and older adults demonstrated highest pressures at the forefoot. Main factors influencing spatiotemporal and pressure parameters were: increased age, height, body mass and waist circumference, as well as ankle dorsiflexion and plantarflexion strength. CONCLUSION This study has established whole of life normative reference values of widely used spatiotemporal and plantar pressure parameters, and revealed changes to be expected across the lifespan.
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Affiliation(s)
- Marnee J McKay
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Sydney, New South Wales, Australia.
| | - Jennifer N Baldwin
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Sydney, New South Wales, Australia.
| | - Paulo Ferreira
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Sydney, New South Wales, Australia.
| | - Milena Simic
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Sydney, New South Wales, Australia.
| | - Natalie Vanicek
- Department of Sport, Health and Exercise Science, School of Life Sciences, University of Hull, United Kingdom.
| | - Elizabeth Wojciechowski
- Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network (Randwick and Westmead), New South Wales, Australia.
| | - Anita Mudge
- Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network (Randwick and Westmead), New South Wales, Australia.
| | - Joshua Burns
- The University of Sydney, Musculoskeletal Health, Faculty of Health Sciences, Sydney, New South Wales, Australia; Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network (Randwick and Westmead), New South Wales, Australia.
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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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Ateş F, Temelli Y, Yucesoy CA. The mechanics of activated semitendinosus are not representative of the pathological knee joint condition of children with cerebral palsy. J Electromyogr Kinesiol 2016; 28:130-6. [DOI: 10.1016/j.jelekin.2016.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 04/08/2016] [Accepted: 04/08/2016] [Indexed: 11/17/2022] Open
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