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Jeong MG, Kim J, Lee Y, Kim KT. Validation of a newly developed low-cost, high-accuracy, camera-based gait analysis system. Gait Posture 2024; 114:8-13. [PMID: 39208540 DOI: 10.1016/j.gaitpost.2024.08.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 07/12/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Gait analysis is essential for evaluating locomotor function and fall risk, particularly in the elderly and in various musculoskeletal disorders. Traditional gait analysis systems face challenges such as technical difficulties, high cost, and complexity of use. Therefore, there is a need for a more accessible and cost-effective system with a wider clinical applicability. RESEARCH QUESTION This study aimed to validate the newly developed IB-gait® system (InBody, Republic of Korea), a camera-based gait analysis tool, by comparing it against the VICON system. METHODS A total of 28 community-dwelling adults without gait abnormalities (mean age 24.9 years) were enrolled in this study. The participants underwent gait analysis at their self-selected speed using VICON and IB-gait® simultaneously. Nine spatiotemporal gait parameters, including stride length (m), step length (m), stride duration (s), double-limb duration (s), stance phase (s), swing phase (s), cadence (velocity × 120/stride length), and gait velocity (m/s) were measured. The agreement between the two systems was tested using Bland-Altman plots and intraclass correlation coefficients (ICC). RESULTS The IB-gait® showed a high degree of agreement with the VICON system in most gait parameters. The ICC showed excellent reliability for stride length (0.97), step length (0.92), gait velocity (0.97), cadence (0.97), and stride duration (0.79). However, it showed lower reliability in time-based parameters, including double-limb duration (0.12), stance phase (0.54), swing phase (0.241), and stance/swing phase ratio (0.11). SIGNIFICANCE The IB-gait® system appears to be a feasible and cost-effective alternative to VICON system for gait analysis, particularly showing a high level of agreement in the distance-based parameters. Its practicality in clinical settings makes it a valuable tool for widespread use in gait analysis. However, further refinement of time-based parameter measurements and validation in diverse patient populations are needed to enhance its applicability.
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Affiliation(s)
- Myeong Geun Jeong
- Department of Rehabilitation Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Jeongmin Kim
- Daegu Research Center for Medical Devices and Green Energy, Korea Institute of Machinery and Materials, Republic of Korea
| | - Yongkoo Lee
- Daegu Research Center for Medical Devices and Green Energy, Korea Institute of Machinery and Materials, Republic of Korea
| | - Kyoung Tae Kim
- Department of Rehabilitation Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea.
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Zarei H, Norasteh AA, Lieberman LJ, Ertel MW, Brian A. Effects of proprioception and core stability training on gait parameters of deaf adolescents: a randomized controlled trial. Sci Rep 2023; 13:21867. [PMID: 38072849 PMCID: PMC10710996 DOI: 10.1038/s41598-023-49335-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
The current study aimed to explore the effects of proprioception versus core stability training over 8 weeks on the gait parameters of deaf adolescents. A total of 20 deaf adolescents were randomized into two groups: one group receiving proprioception training (PT, n = 10), another group receiving core stability training (CST, n = 10), and eleven typically developing adolescents assigned into the control group (CON; n = 11). Gait was recorded by two digital cameras; then, using the Kinovea software, the parameters of gait included: gait velocity, cadence, stride length, stride time, stance time, and swing time were calculated in terms of percentages of the walking cycle. After 8 weeks of PT, no significant differences were observed for all gait parameters between PT and control groups (p > 0.05). Also, after 8 weeks of CST, no significant differences were observed in gait velocity and cadence between the CST and control groups (p > 0.05). However, after 8 weeks of CST, stride length (p = 0.02) was higher in the control group; Stride time (p = 0.03), stance time (p = 0.04) and swing time (p = 0.04) were higher in the CST group. Moreover, after 8 weeks of PT, values showed significant improvements in all gait parameters (p = 0.001). Also, after 8 weeks of CST, values showed significant improvements in gait velocity and cadence (p = 0.001), but no significant differences were observed in other gait parameters (p > 0.05). The findings of this study indicated that PT improved all gait parameters, whereas CST improved gait velocity and cadence. The results of the present study also demonstrated that PT had a greater effect on gait parameters of deaf adolescents compared with CST. It seems that PT induces more training effects than CTS for enhancing gait parameters of deaf adolescents.Trial registration: Clinical trial registry number: IRCT20170312033029N2. URL: https://en.irct.ir/trial/25584 .
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Affiliation(s)
- Hamed Zarei
- Corrective Exercises and Sports Injury Department, College of Physical Education & Sport Sciences, Faculty of Physical Education & Sport Sciences, University of Guilan, kilometers 10 Rasht-Ghazvin Road, Rasht, 4199613776, Iran.
| | - Ali Asghar Norasteh
- Physiotherapy Department, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, 4199613776, Iran
| | - Lauren J Lieberman
- Department of Kinesiology, Sport Studies and Physical Education, State University of New York (SUNY), Brockport, NY, 14420, USA
| | - Michael W Ertel
- Department of Physical Education, University of South Carolina, Columbia, SC, USA
| | - Ali Brian
- Department of Physical Education, University of South Carolina, Columbia, SC, USA
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3
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Civil DA, Orlando JM, Cunha AB, Li B, Lobo MA. Development and Initial Evaluation of a Soft Ankle Support for Children With Ankle Impairments. Pediatr Phys Ther 2023; 35:268-276. [PMID: 36989055 DOI: 10.1097/pep.0000000000001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
PURPOSE Develop and initially evaluate a soft ankle support (SAS) garment for children with ankle impairments. DESCRIPTION OF CASES Two participants were evaluated at baseline and interviews with their parent(s) to identify wants and needs for the SAS. The SAS was developed and evaluated via participant report and functional measures in barefoot, ankle-foot orthosis (AFO), and SAS conditions. OUTCOMES Children and parents expressed dissatisfaction with AFOs' dimensions, weight, adjustability, comfort, and ease of use. Gait and gross motor function were similar for SAS and AFOs' conditions; however, participants rated the SAS better for weight and bulk, integration with shoes, adjustability, comfort, cost, and washability. DISCUSSION The SAS and AFOs performed similarly in this initial testing, yet the SAS also met participants' needs across key metrics not well addressed by AFOs. Ankle support devices that meet users' broad needs may support improved adherence and user satisfaction.
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Affiliation(s)
- Danielle A Civil
- Fashion and Apparel Studies Department (Ms Civil and Dr Lobo), Biomechanics & Movement Science Program (Drs Orlando, Li, and Lobo), and Physical Therapy Department (Drs Cunha and Lobo), University of Delaware, Newark, Delaware
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4
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Spanos S, Kanellopoulos A, Petropoulakos K, Dimitriadis Z, Siasios I, Poulis I. Reliability and applicability of a low-cost, camera-based gait evaluation method for clinical use. Expert Rev Med Devices 2023; 20:63-70. [PMID: 36662510 DOI: 10.1080/17434440.2023.2171289] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND There is the need for the development of reliable and easy to use in clinical setting gait assessment tools. An open-access video analysis software that administers the calculation of kinematical and spatio-temporal characteristics of human movement is Kinovea® however, its repeatability as a gait analysis tool has not been well addressed. The purpose of the study was to examine the applicability and reliability of an objective, quantitative, low-cost and easy to use in the clinical setting, gait evaluation method, using Kinovea® software. METHODS Data collected from 44 healthy subjects recording gait in sagittal and frontal plane using two smartphones. Time consumption of the procedure was captured. Kinovea® software was used to calculate kinematical and spatial parameters. RESULTS Intra- and inter-rater reliability of the video processing as well as intra-rater reliability of the measurement procedure represented good to excellent and there were less random measurement errors. There was no measurement error due to random variation for the most of the calculated parameters, except of the pelvis position. CONCLUSIONS The results suggest that excepting low accuracy in calculation of pelvis position, gait evaluation using Kinovea® software is objective, quantitative, low-cost, reliable and easy to use in the clinical setting.
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Affiliation(s)
- Savvas Spanos
- Human Performance and Rehabilitation Laboratory, Department of Physiotherapy, University of Thessaly, Lamia, Greece.,Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
| | - Asimakis Kanellopoulos
- Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece.,Health Assessment and Quality of Life Laboratory, Department of Physiotherapy, University of Thessaly, Lamia, Greece
| | - Kyriakos Petropoulakos
- Human Performance and Rehabilitation Laboratory, Department of Physiotherapy, University of Thessaly, Lamia, Greece
| | - Zacharias Dimitriadis
- Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece.,Health Assessment and Quality of Life Laboratory, Department of Physiotherapy, University of Thessaly, Lamia, Greece
| | - Ioannis Siasios
- Department of Neurosurgery, Papageorgiou Hospital, Thessaloniki, Greece
| | - Ioannis Poulis
- Human Performance and Rehabilitation Laboratory, Department of Physiotherapy, University of Thessaly, Lamia, Greece.,Department of Physiotherapy, School of Health Sciences, University of Thessaly, Lamia, Greece
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Reliability and Convergent Validity of Digital Photography in Assessing Postural Orientation of Children with Cerebral Palsy: A Methodological Study. ARCHIVES OF NEUROSCIENCE 2022. [DOI: 10.5812/ans-129929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: This study aimed to assess the test-retest intra-rater reliability and convergent validity of digital photography (DP) in detecting the postural orientation of children with cerebral palsy (CP). Methods: The study recruited children with various types of CP with the Gross Motor Function Classification System level I or II and spasticity < 2 on the Ashworth Scale, without any visual or cognitive impairments. Children who had undergone any surgical intervention or received a botulinum toxin injection within the previous six months were excluded. A digital camera was fixed at 1.5 meters from the participants at the height of 90 cm. Non-reflective markers were attached to eight anatomical landmarks to localize the upper and lower center of mass on both sides. The same examiner took three digital photos to detect intra-rater reliability using the intraclass correlation coefficient (ICC). Pearson's correlation and linear regression analysis were used to assess the convergent validity of the DP method compared with the Pediatric Balance Scale (PBS) scores. Results: Thirty children (7.44 ± 2.38 years) were assessed to test the reliability of DP, and 55 others (8.06 ± 2.19 years) participated in the convergent validity study. Intra-rater reliability was found to be perfect (ICC > 0.995) and there was a strong significant negative correlation between DP measures and PBS scores (Pearson's correlation > 0.75) with high adjusted R2 (R2 > 0.567), indicating goodness of fit between the measures. Conclusions: Digital photography (DP) is a reliable and valid method for assessing postural orientation in children with various types of CP.
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6
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An evaluation of temporal and club angle parameters during golf swings using low cost video analyses packages. Sci Rep 2022; 12:14012. [PMID: 35977946 PMCID: PMC9385988 DOI: 10.1038/s41598-022-17175-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/21/2022] [Indexed: 12/03/2022] Open
Abstract
The purpose of this study was to compare swing time and golf club angle parameters during golf swings using three, two dimensional (2D) low cost, Augmented-Video-based-Portable-Systems (AVPS) (Kinovea, SiliconCoach Pro, SiliconCoach Live). Twelve right-handed golfers performed three golf swings whilst being recorded by a high-speed 2D video camera. Footage was then analysed using AVPS-software and the results compared using both descriptive and inferential statistics. There were no significant differences for swing time and the golf phase measurements between the 2D and 3D software comparisons. In general, the results showed a high Intra class Correlation Coefficient (ICC > 0.929) and Cronbach’s Coefficient Alpha (CCA > 0.924) reliability for both the kinematic and temporal parameters. The inter-rater reliability test for the swing time and kinematic golf phase measurements on average were strong. Irrespective of the AVPS software investigated, the cost effective AVPS can produce reliable output measures that benefit golf analyses.
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7
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Teyfouri N, Shirvani H, Shamsoddini A. Designing a Glass Mounted Warning System to Prevent Drivers to Fall in Sleep Based on Neck Posture and Blinking Duration. JOURNAL OF MEDICAL SIGNALS & SENSORS 2021; 11:217-221. [PMID: 34466401 PMCID: PMC8382034 DOI: 10.4103/jmss.jmss_31_20] [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: 05/11/2020] [Revised: 05/30/2020] [Accepted: 08/01/2020] [Indexed: 11/17/2022]
Abstract
Background: In this study, an electronic system based on driver's neck position and blinking duration is designed to help prevent car crashed due to driver drowsiness. When a driver falls in sleep his/her head is felled down. Hence, driver's neck posture can be a good sign of sleep which is measured utilizing a two?dimensional accelerator. However, this sign is not enough because he/she may need to look down during a drive and alarming driver by every moving down of head can be annoying. Methods: Thus, in this system, we used blinking duration too. When a person is awake, blinks more frequently than when he is drowsy. Result: As a result, in this system, blinking is detected using an infrared transceiver and if both conditions, i.e., neck posture and blinking duration are showing signs of sleep mode, driver will be alarmed. Conclusion: In this study, it is designed 2D accelerometer and IR sensor based system to measure the driver's neck angle and detect driver's blinking to realize the drowsiness of vehicle drivers and alert them using these signs of drowsiness.
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Affiliation(s)
- Niloufar Teyfouri
- Medical Image and Signal Processing Research Center, Department of Bioelectrics and Biomedical Engineering, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Shirvani
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Alireza Shamsoddini
- Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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8
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Gait Analysis Accuracy Difference with Different Dimensions of Flexible Capacitance Sensors. SENSORS 2021; 21:s21165299. [PMID: 34450739 PMCID: PMC8401030 DOI: 10.3390/s21165299] [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: 06/17/2021] [Revised: 07/29/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022]
Abstract
Stroke causes neurological pathologies, including gait pathologies, which are diagnosed by gait analysis. However, existing gait analysis devices are difficult to use in situ or are disrupted by external conditions. To overcome these drawbacks, a flexible capacitance sensor was developed in this study. To date, a performance comparison of flexible sensors with different dimensions has not been carried out. The aim of this study was to provide optimized sensor dimension information for gait analysis. To accomplish this, sensors with seven different dimensions were fabricated. The dimensions of the sensors were based on the average body size and movement range of 20- to 59-year-old adults. The sensors were characterized by 100 oscillations. The minimum hysteresis error was 8%. After that, four subjects were equipped with the sensor and walked on a treadmill at a speed of 3.6 km/h. All walking processes were filmed at 50 fps and analyzed in Kinovea. The RMS error was calculated using the same frame rate of the video and the sampling rate of the signal from the sensor. The smallest RMS error between the sensor data and the ankle angle was 3.13° using the 49 × 8 mm sensor. In this study, we confirm the dimensions of the sensor with the highest gait analysis accuracy; therefore, the results can be used to make decisions regarding sensor dimensions.
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9
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Roggio F, Ravalli S, Maugeri G, Bianco A, Palma A, Di Rosa M, Musumeci G. Technological advancements in the analysis of human motion and posture management through digital devices. World J Orthop 2021; 12:467-484. [PMID: 34354935 PMCID: PMC8316840 DOI: 10.5312/wjo.v12.i7.467] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/15/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023] Open
Abstract
Technological development of motion and posture analyses is rapidly progressing, especially in rehabilitation settings and sport biomechanics. Consequently, clear discrimination among different measurement systems is required to diversify their use as needed. This review aims to resume the currently used motion and posture analysis systems, clarify and suggest the appropriate approaches suitable for specific cases or contexts. The currently gold standard systems of motion analysis, widely used in clinical settings, present several limitations related to marker placement or long procedure time. Fully automated and markerless systems are overcoming these drawbacks for conducting biomechanical studies, especially outside laboratories. Similarly, new posture analysis techniques are emerging, often driven by the need for fast and non-invasive methods to obtain high-precision results. These new technologies have also become effective for children or adolescents with non-specific back pain and postural insufficiencies. The evolutions of these methods aim to standardize measurements and provide manageable tools in clinical practice for the early diagnosis of musculoskeletal pathologies and to monitor daily improvements of each patient. Herein, these devices and their uses are described, providing researchers, clinicians, orthopedics, physical therapists, and sports coaches an effective guide to use new technologies in their practice as instruments of diagnosis, therapy, and prevention.
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Affiliation(s)
- Federico Roggio
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90144, Italy
| | - Silvia Ravalli
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95123, Italy
| | - Grazia Maugeri
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95123, Italy
| | - Antonino Bianco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90144, Italy
| | - Antonio Palma
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo 90144, Italy
| | - Michelino Di Rosa
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95123, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Human Anatomy and Histology Section, School of Medicine, University of Catania, Catania 95123, Italy
- Research Center on Motor Activities, University of Catania, Catania 95123, Italy
- Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA 19122, United States
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10
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Mohan DM, Khandoker AH, Wasti SA, Ismail Ibrahim Ismail Alali S, Jelinek HF, Khalaf K. Assessment Methods of Post-stroke Gait: A Scoping Review of Technology-Driven Approaches to Gait Characterization and Analysis. Front Neurol 2021; 12:650024. [PMID: 34168608 PMCID: PMC8217618 DOI: 10.3389/fneur.2021.650024] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/07/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Gait dysfunction or impairment is considered one of the most common and devastating physiological consequences of stroke, and achieving optimal gait is a key goal for stroke victims with gait disability along with their clinical teams. Many researchers have explored post stroke gait, including assessment tools and techniques, key gait parameters and significance on functional recovery, as well as data mining, modeling and analyses methods. Research Question: This study aimed to review and summarize research efforts applicable to quantification and analyses of post-stroke gait with focus on recent technology-driven gait characterization and analysis approaches, including the integration of smart low cost wearables and Artificial Intelligence (AI), as well as feasibility and potential value in clinical settings. Methods: A comprehensive literature search was conducted within Google Scholar, PubMed, and ScienceDirect using a set of keywords, including lower extremity, walking, post-stroke, and kinematics. Original articles that met the selection criteria were included. Results and Significance: This scoping review aimed to shed light on tools and technologies employed in post stroke gait assessment toward bridging the existing gap between the research and clinical communities. Conventional qualitative gait analysis, typically used in clinics is mainly based on observational gait and is hence subjective and largely impacted by the observer's experience. Quantitative gait analysis, however, provides measured parameters, with good accuracy and repeatability for the diagnosis and comparative assessment throughout rehabilitation. Rapidly emerging smart wearable technology and AI, including Machine Learning, Support Vector Machine, and Neural Network approaches, are increasingly commanding greater attention in gait research. Although their use in clinical settings are not yet well leveraged, these tools promise a paradigm shift in stroke gait quantification, as they provide means for acquiring, storing and analyzing multifactorial complex gait data, while capturing its non-linear dynamic variability and offering the invaluable benefits of predictive analytics.
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Affiliation(s)
- Dhanya Menoth Mohan
- Department of Biomedical Engineering, Health Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Ahsan Habib Khandoker
- Department of Biomedical Engineering, Health Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Sabahat Asim Wasti
- Neurological Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Sarah Ismail Ibrahim Ismail Alali
- Department of Biomedical Engineering, Health Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Herbert F Jelinek
- Department of Biomedical Engineering, Health Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Kinda Khalaf
- Department of Biomedical Engineering, Health Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
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Reliability of Kinovea ® Software and Agreement with a Three-Dimensional Motion System for Gait Analysis in Healthy Subjects. SENSORS 2020; 20:s20113154. [PMID: 32498380 PMCID: PMC7308968 DOI: 10.3390/s20113154] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 11/17/2022]
Abstract
Gait analysis is necessary to diagnose movement disorders. In order to reduce the costs of three-dimensional motion capture systems, new low-cost methods of motion analysis have been developed. The purpose of this study was to evaluate the inter- and intra-rater reliability of Kinovea® and the agreement with a three-dimensional motion system for detecting the joint angles of the hip, knee and ankle during the initial contact phase of walking. Fifty healthy subjects participated in this study. All participants were examined twice with a one-week interval between the two appointments. The motion data were recorded using the VICON Motion System® and digital video cameras. The intra-rater reliability showed a good correlation for the hip, the knee and the ankle joints (Intraclass Correlation Coefficient, ICC > 0.85) for both observers. The ICC for the inter-rater reliability was >0.90 for the hip, the knee and the ankle joints. The Bland-Altman plots showed that the magnitude of disagreement was approximately ±5° for intra-rater reliability, ±2.5° for inter-rater reliability and around ±2.5° to ±5° for Kinovea® versus Vicon®. The ICC was good for the hip, knee and ankle angles registered with Kinovea® during the initial contact of walking for both observers (intra-rater reliability) and higher for the agreement between observers (inter-rater reliability). However, the Bland-Altman plots showed disagreement between observers, measurements and systems (Kinovea® vs. three-dimensional motion system) that should be considered in the interpretation of clinical evaluations.
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12
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Geroin C, Artusi CA, Gandolfi M, Zanolin E, Ceravolo R, Capecci M, Andrenelli E, Ceravolo MG, Bonanni L, Onofrj M, Telese R, Bellavita G, Catalan M, Manganotti P, Mazzucchi S, Giannoni S, Vacca L, Stocchi F, Casali M, Falup-Pecurariu C, Zibetti M, Fasano A, Lopiano L, Tinazzi M. Does the Degree of Trunk Bending Predict Patient Disability, Motor Impairment, Falls, and Back Pain in Parkinson's Disease? Front Neurol 2020; 11:207. [PMID: 32296383 PMCID: PMC7136533 DOI: 10.3389/fneur.2020.00207] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/09/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Postural abnormalities in Parkinson's disease (PD) form a spectrum of functional trunk misalignment, ranging from a "typical" parkinsonian stooped posture to progressively greater degrees of spine deviation. Objective: To analyze the association between degree of postural abnormalities and disability and to determine cut-off values of trunk bending associated with limitations in activities of daily living (ADLs), motor impairment, falls, and back pain. Methods: The study population was 283 PD patients with ≥5° of forward trunk bending (FTB), lateral trunk bending (LTB) or forward neck bending (FNB). The degrees were calculated using a wall goniometer (WG) and software-based measurements (SBM). Logistic regression models were used to identify the degree of bending associated with moderate/severe limitation in ADLs (Movement Disorders Society Unified PD Rating Scale [MDS-UPDRS] part II ≥17), moderate/severe motor impairment (MDS-UPDRS part III ≥33), history of falls (≥1), and moderate/severe back pain intensity (numeric rating scale ≥4). The optimal cut-off was identified using receiver operating characteristic (ROC) curves. Results: We found significant associations between modified Hoehn & Yahr stage, disease duration, sex, and limitation in ADLs, motor impairment, back pain intensity, and history of falls. Degree of trunk bending was associated only with motor impairment in LTB (odds ratio [OR] 1.12; 95% confidence interval [CI], 1.03-1.22). ROC curves showed that patients with LTB of 10.5° (SBM, AUC 0.626) may have moderate/severe motor impairment. Conclusions: The severity of trunk misalignment does not fully explain limitation in ADLs, motor impairment, falls, and back pain. Multiple factors possibly related to an aggressive PD phenotype may account for disability in PD patients with FTB, LTB, and FNB.
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Affiliation(s)
- Christian Geroin
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Carlo Alberto Artusi
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | - Marialuisa Gandolfi
- Neuromotor and Cognitive Rehabilitation Research Center, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,Neurorehabilitation Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Elisabetta Zanolin
- Department of Public Health and Community Medicine, University and Hospital Trust of Verona, Verona, Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marianna Capecci
- Department of Experimental and Clinical Medicine, Neurorehabilitation Clinic, "Politecnica delle Marche" University, Ancona, Italy
| | - Elisa Andrenelli
- Department of Experimental and Clinical Medicine, Neurorehabilitation Clinic, "Politecnica delle Marche" University, Ancona, Italy
| | - Maria Gabriella Ceravolo
- Department of Experimental and Clinical Medicine, Neurorehabilitation Clinic, "Politecnica delle Marche" University, Ancona, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G.d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, University G.d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Roberta Telese
- Department of Neuroscience, Imaging and Clinical Sciences, University G.d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Giulia Bellavita
- Clinical Neurology Unit, Department of Medical, Surgical and Health Services, University of Trieste, Trieste, Italy
| | - Mauro Catalan
- Clinical Neurology Unit, Department of Medical, Surgical and Health Services, University of Trieste, Trieste, Italy
| | - Paolo Manganotti
- Clinical Neurology Unit, Department of Medical, Surgical and Health Services, University of Trieste, Trieste, Italy
| | - Sonia Mazzucchi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Giannoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Laura Vacca
- University and Institute for Research and Medical Care IRCCS San Raffaele, Rome, Italy
| | - Fabrizio Stocchi
- University and Institute for Research and Medical Care IRCCS San Raffaele, Rome, Italy
| | - Miriam Casali
- University and Institute for Research and Medical Care IRCCS San Raffaele, Rome, Italy
| | | | - Maurizio Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Division of Neurology, Toronto Western Hospital, UHN, University of Toronto, Toronto, ON, Canada.,Krembil Brain Institute, Toronto, ON, Canada
| | - Leonardo Lopiano
- Department of Neuroscience "Rita Levi Montalcini", University of Torino, Torino, Italy
| | - Michele Tinazzi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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