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Dubbioso R, Spisto M, Hausdorff JM, Aceto G, Iuzzolino VV, Senerchia G, De Marco S, Marcuccio L, Femiano C, Iodice R, Salvatore E, Santangelo G, Trojano L, Moretta P. Cognitive impairment is associated with gait variability and fall risk in amyotrophic lateral sclerosis. Eur J Neurol 2023; 30:3056-3067. [PMID: 37335396 DOI: 10.1111/ene.15936] [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: 04/05/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND In amyotrophic lateral sclerosis (ALS), gait abnormalities contribute to poor mobility and represent a relevant risk for falls. To date, gait studies in ALS patients have focused on the motor dimension of the disease, underestimating the cognitive aspects. METHODS Using a wearable gait analysis device, we compared gait patterns in ambulatory ALS patients with mild cognitive impairment (ALS MCI+; n = 18), and without MCI (ALS MCI-; n = 24), and healthy subjects (HS; n = 16) under two conditions: (1) normal gait (single task) and (2) walking while counting backward (dual task). Finally, we examined if the occurrence and number of falls in the 3 months following the baseline test were related to cognition. RESULTS In the single task condition, ALS patients, regardless of cognition, displayed higher gait variability than HS, especially for stance and swing time (p < 0.001). The dual task condition revealed additional differences in gait variability parameters between ALS MCI+ and ALS MCI- for cadence (p = 0.005), stance time (p = 0.04), swing time (p = 0.04) and stability index (p = 0.02). Moreover, ALS MCI+ showed a higher occurrence (p = 0.001) and number of falls (p < 0.001) at the follow-up. Regression analyses demonstrated that MCI condition predicted the occurrence of future falls (β = 3.649; p = 0.01) and, together with executive dysfunction, was associated with the number of falls (cognitive impairment: β = 0.63; p < 0.001; executive dysfunction: β = 0.39; p = 0.03), regardless of motor impairment at clinical examination. CONCLUSION In ALS, MCI is associated with exaggerated gait variability and predicts the occurrence and number of short-term falls.
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Affiliation(s)
- Raffaele Dubbioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, Italy
| | - Myriam Spisto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, Italy
- Department of Psychology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Rush Alzheimer's Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Gabriella Aceto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, Italy
| | - Valentina Virginia Iuzzolino
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, Italy
| | - Gianmaria Senerchia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, Italy
| | - Stefania De Marco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, Italy
- Department of Psychology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Laura Marcuccio
- Istituti Clinici Scientifici Maugeri IRCCS, Neurological Rehabilitation Unit of Telese Terme Institute, Benevento, Italy
| | - Cinzia Femiano
- Istituti Clinici Scientifici Maugeri IRCCS, Neurological Rehabilitation Unit of Telese Terme Institute, Benevento, Italy
| | - Rosa Iodice
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, Italy
| | - Elena Salvatore
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pasquale Moretta
- Istituti Clinici Scientifici Maugeri IRCCS, Neurological Rehabilitation Unit of Telese Terme Institute, Benevento, Italy
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Saad N, Moustafa IM, Ahbouch A, Alsaafin NM, Oakley PA, Harrison DE. Are Rotations and Translations of Head Posture Related to Gait and Jump Parameters? J Clin Med 2023; 12:6211. [PMID: 37834858 PMCID: PMC10573992 DOI: 10.3390/jcm12196211] [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: 07/09/2023] [Revised: 08/13/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
This study assessed the relationship between head posture displacements and biomechanical parameters during gait and jumping. One hundred male and female students (20 ± 3 yrs) were assessed via the PostureScreen Mobile® app to quantify postural displacements of head rotations and translations including: (1) the cranio-vertebral angle (CVA) (°), (2) anterior head translation (AHT) (cm), (3) lateral head translation in the coronal plane (cm), and (4) lateral head side bending (°). Biomechanical parameters during gait and jumping were measured using the G-Walk sensor. The assessed gait spatiotemporal parameters were cadence (steps/min), speed (m/s), symmetry index, % left and right stride length (% height), and right and left propulsion index. The pelvic movement parameters were (1) tilt symmetry index, (2) tilt left and right range, (3) obliquity symmetry index, (4) obliquity left and right range, (5) rotation symmetry index, and (6) rotation left and right range. The jump parameters measured were (1) flight height (cm), (2) take off force (kN), (3) impact Force (kN), (4) take off speed (m/s), (5) peak speed (m/s), (6) average speed concentric phase (m/s), (7) maximum concentric power (kW), (8) average concentric power (kW) during the counter movement jump (CMJ), and (9) CMJ with arms thrust (CMJAT). At a significance level of p ≤ 0.001, moderate-to-high correlations (0.4 < r < 0.8) were found between CVA, AHT, lateral translation head, and all the gait and jump parameters. Weak correlations (0.2 < r < 0.4) were ascertained for lateral head bending and all the gait and jump parameters except for gait symmetry index and pelvic symmetry index, where moderate correlations were identified (0.4 < r < 0.6). The findings indicate moderate-to-high correlations between specific head posture displacements, such as CVA, lateral head translation and AHT with the various gait and jump parameters. These findings highlight the importance of considering head posture in the assessment and optimization of movement patterns during gait and jumping. Our findings contribute to the existing body of knowledge and may have implications for clinical practice and sports performance training. Further research is warranted to elucidate the underlying mechanisms and establish causality in these relationships, which could potentially lead to the development of targeted interventions for improving movement patterns and preventing injuries.
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Affiliation(s)
- Nabil Saad
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates (I.M.M.)
| | - Ibrahim M. Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates (I.M.M.)
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Amal Ahbouch
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates (I.M.M.)
| | - Nour Mustafa Alsaafin
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates (I.M.M.)
| | - Paul A. Oakley
- Kinesiology and Health Sciences, York University, Toronto, ON M3J 1P3, Canada
- Independent Researcher, Newmarket, ON L3Y 8Y8, Canada
| | - Deed E. Harrison
- CBP Nonprofit (a Spine Research Foundation), Eagle, ID 83616, USA
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Polat EA, Polat Y, Karatay GM, Esmer M, Kafa N, Guzel NA. Does total knee arthroplasty affect pelvic movements? A prospective comparative study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20221231. [PMID: 37729355 PMCID: PMC10508946 DOI: 10.1590/1806-9282.20221231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/03/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE Pathology in any segment of the spine-pelvis-lower extremity may impair the global postural balance, leading to compensatory alterations in other parts. The aim of this study was to compare the pelvic movements of patients suffering from knee osteoarthritis with patients who underwent total knee arthroplasty and healthy controls. METHODS This study was performed at the Department of Orthopedics and Traumatology Clinic of a Cankiri State Hospital between April 2021 and February 2022. This study included 84 participants. Of them, 31 patients who underwent total knee arthroplasty between 2018 and 2020 years were selected as the total knee arthroplasty group, while 28 patients with knee osteoarthritis were selected as the knee osteoarthritis group. In the control group, there were 25 healthy individuals. Exclusion criteria from the study included any kind of neurological disease, an inability to walk a distance of 100 m unassisted, or a history of surgery to the lower limb. Pelvic movements (i.e., tilt, rotation, and obliquity) and gait parameters (i.e., "gait velocity," "cadence," and "stride length") were assessed using a wireless tri-axial accelerometer. RESULTS Total knee arthroplasty and control groups had decreased minimum anterior tilt of the pelvis, decreased maximum anterior tilt, and decreased oblique range of the pelvis compared with the knee osteoarthritis group. In comparison with the control group, gait velocity and length of stride during gait were remarkably lower in both knee osteoarthritis and total knee arthroplasty groups. CONCLUSION In this study, total knee arthroplasty was found to affect pelvic movements. It was thought that total knee arthroplasty changed these variables, probably owing to the frontal and sagittal plane alignment correction through surgery.
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Affiliation(s)
- Elif Aygun Polat
- Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation – Ankara, Turkey
| | - Yusuf Polat
- Halil Sıvgın Cubuk State Hospital, Department of Orthopedics and Traumatology – Ankara, Turkey
| | - Gökhan Mehmet Karatay
- Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation – Ankara, Turkey
| | - Murat Esmer
- Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation – Ankara, Turkey
| | - Nihan Kafa
- Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation – Ankara, Turkey
| | - Nevin Atalay Guzel
- Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation – Ankara, Turkey
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Mavragani A, Michels L, Schmidt A, Barinka F, de Bruin ED. Effectiveness of an Individualized Exergame-Based Motor-Cognitive Training Concept Targeted to Improve Cognitive Functioning in Older Adults With Mild Neurocognitive Disorder: Study Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e41173. [PMID: 36745483 PMCID: PMC9941909 DOI: 10.2196/41173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Simultaneous motor-cognitive training is considered promising for preventing the decline in cognitive functioning in older adults with mild neurocognitive disorder (mNCD) and can be highly motivating when applied in the form of exergaming. The literature points to opportunities for improvement in the application of exergames in individuals with mNCD by developing novel exergames and exergame-based training concepts that are specifically tailored to patients with mNCD and ensuring the implementation of effective training components. OBJECTIVE This study systematically explores the effectiveness of a newly developed exergame-based motor-cognitive training concept (called "Brain-IT") targeted to improve cognitive functioning in older adults with mNCD. METHODS A 2-arm, parallel-group, single-blinded randomized controlled trial with a 1:1 allocation ratio (ie, intervention: control), including 34 to 40 older adults with mNCD will be conducted between May 2022 and December 2023. The control group will proceed with the usual care provided by the (memory) clinics where the patients are recruited. The intervention group will perform a 12-week training intervention according to the "Brain-IT" training concept, in addition to usual care. Global cognitive functioning will be assessed as the primary outcome. As secondary outcomes, domain-specific cognitive functioning, brain structure and function, spatiotemporal parameters of gait, instrumental activities of daily living, psychosocial factors, and resting cardiac vagal modulation will be assessed. Pre- and postintervention measurements will take place within 2 weeks before starting and after completing the intervention. A 2-way analysis of covariance or the Quade nonparametric analysis of covariance will be computed for all primary and secondary outcomes, with the premeasurement value as a covariate for the predicting group factor and the postmeasurement value as the outcome variable. To determine whether the effects are substantive, partial eta-squared (η2p) effect sizes will be calculated for all primary and secondary outcomes. RESULTS Upon the initial submission of this study protocol, 13 patients were contacted by the study team. Four patients were included in the study, 2 were excluded because they were not eligible, and 7 were being informed about the study in detail. Of the 4 included patients, 2 already completed all premeasurements and were in week 2 of the intervention period. Data collection is expected to be completed by December 2023. A manuscript of the results will be submitted for publication in a peer-reviewed open-access journal in 2024. CONCLUSIONS This study contributes to the evidence base in the highly relevant area of preventing disability because of cognitive impairment, which has been declared a public health priority by the World Health Organization. TRIAL REGISTRATION ClinicalTrials.gov NCT05387057; https://clinicaltrials.gov/ct2/show/NCT05387057. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41173.
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Affiliation(s)
| | - Lars Michels
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - André Schmidt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Filip Barinka
- Clinic for Neurology, Hirslanden Hospital Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Motor Control and Learning Group - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.,Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
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ZORLULAR A, AYGUN POLAT E, KAFA N, ATALAY GÜZEL N. THE RELATIONSHIP BETWEEN TRUNK MUSCLE STRENGTH AND PELVIC OSCILLATION IN HEALTHY ADULTS. TÜRK FIZYOTERAPI VE REHABILITASYON DERGISI 2022. [DOI: 10.21653/tjpr.998024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose: Pelvis and trunk structure are body segments that are integrated with each other. Collaboration between pelvic mobility and trunk muscles plays a significant role in walking and energy consumption. The aim of this study is to investigate the relationship between trunk muscle strength and pelvic oscillations. Methods: Twenty-eight healthy individuals volunteered for the study (16 women, 12 man; mean age 24.46 ± 2.97 yrs., height 172.03 ± 9.41cm, weight 67.78 ± 16.31 kg). Gait characteristics and pelvic oscillation were measured by using wireless tri-axial accelerometer. Trunk muscle strength were evaluated with Isokinetic Dynamometer (Cybex Humac Norm Testing & Rehabilitation System, USA). The trunk extensors and flexors were tested concentrically at 60°s. Statistically, the direction and level of the relationship were examined by using Spearman Correlation Analysis. Results: Correlation analysis showed significant relationships between concentric strength of trunk flexion and anterior-posterior pelvic tilt (r=-0.419), lateral pelvic tilt (r=-0.768) and hip rotation (r=-0.382). A statistically significant relationship was not observed between concentric strength of trunk extension and anterior-posterior pelvic tilt, hip rotation (p>0.05). Conclusion: The current study reports that trunk muscle strength is associated with pelvic oscillations. Also, these results suggest that maintaining optimal levels of trunk muscle strength prepares a healthful basis for the pelvis during walking. Therefore, it contributes to the prevention of possible pathologies related to lower extremity. Although trunk muscle strength and pelvic mobility are important determinants of gait, these factors are insufficient to evaluate the whole gait cycle and energy expenditure of individuals.
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Affiliation(s)
- Ali ZORLULAR
- GAZİ ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ ENSTİTÜSÜ, FİZYOTERAPİ VE REHABİLİTASYON (DR)
| | | | - Nihan KAFA
- GAZI UNIVERSITY, FACULTY OF HEALTH SCIENCES
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Fernández-Gorgojo M, Salas-Gómez D, Sánchez-Juan P, Barbado D, Laguna-Bercero E, Pérez-Núñez MI. Clinical-Functional Evaluation and Test-Retest Reliability of the G-WALK Sensor in Subjects with Bimalleolar Ankle Fractures 6 Months after Surgery. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22083050. [PMID: 35459036 PMCID: PMC9032166 DOI: 10.3390/s22083050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 05/14/2023]
Abstract
Ankle fractures can cause significant functional impairment in the short and long term. In recent years, gait analysis using inertial sensors has gained special relevance as a reliable measurement system. This study aimed to evaluate the differences in spatiotemporal gait parameters and clinical−functional measurements in patients with bimalleolar ankle fracture and healthy subjects, to study the correlation between the different variables, and to analyze the test−retest reliability of a single inertial sensor in our study population. Twenty-two subjects with bimalleolar ankle fracture six months after surgery and eleven healthy subjects were included in the study. Spatiotemporal parameters were analyzed with the G-WALK sensor. Functional scales and clinical measures were collected beforehand. In the ankle fracture group, the main differences were obtained in bilateral parameters (effect size: 0.61 ≤ d ≤ 0.80). Between-group differences were found in cadence, speed, stride length, and stride time (effect size: 1.61 ≤ d ≤ 1.82). Correlation was moderate (0.436 < r < 0.554) between spatiotemporal parameters and clinical−functional measures, explaining up to 46% of gait performance. Test−retest reliability scores were high to excellent (0.84 ≤ ICC ≤ 0.98), with the worst results in the gait phases. Our study population presents evident clinical−functional impairments 6 months after surgery. The G-WALK can be considered a reliable tool for clinical use in this population.
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Affiliation(s)
- Mario Fernández-Gorgojo
- Escuelas Universitarias Gimbernat (EUG), Physiotherapy School Cantabria, Movement Analysis Laboratory, University of Cantabria, 39005 Torrelavega, Spain; (M.F.-G.); (P.S.-J.); (E.L.-B.); (M.I.P.-N.)
- International Doctoral School, Rey Juan Carlos University (URJC), 28032 Madrid, Spain
| | - Diana Salas-Gómez
- Escuelas Universitarias Gimbernat (EUG), Physiotherapy School Cantabria, Movement Analysis Laboratory, University of Cantabria, 39005 Torrelavega, Spain; (M.F.-G.); (P.S.-J.); (E.L.-B.); (M.I.P.-N.)
- Correspondence:
| | - Pascual Sánchez-Juan
- Escuelas Universitarias Gimbernat (EUG), Physiotherapy School Cantabria, Movement Analysis Laboratory, University of Cantabria, 39005 Torrelavega, Spain; (M.F.-G.); (P.S.-J.); (E.L.-B.); (M.I.P.-N.)
- Alzheimer’s Centre Reina Sofia-CIEN Foundation, 28031 Madrid, Spain
| | - David Barbado
- Sports Research Centre, Department of Sport Science, Miguel Hernández University of Elche, 03202 Elche, Spain;
- Alicante Institute for Health and Biomedical Research (ISABIAL), 03550 Alicante, Spain
| | - Esther Laguna-Bercero
- Escuelas Universitarias Gimbernat (EUG), Physiotherapy School Cantabria, Movement Analysis Laboratory, University of Cantabria, 39005 Torrelavega, Spain; (M.F.-G.); (P.S.-J.); (E.L.-B.); (M.I.P.-N.)
- Traumatology Service and Orthopedic Surgery, University Hospital “Marqués de Valdecilla” (UHMV), 39008 Santander, Spain
| | - María Isabel Pérez-Núñez
- Escuelas Universitarias Gimbernat (EUG), Physiotherapy School Cantabria, Movement Analysis Laboratory, University of Cantabria, 39005 Torrelavega, Spain; (M.F.-G.); (P.S.-J.); (E.L.-B.); (M.I.P.-N.)
- Traumatology Service and Orthopedic Surgery, University Hospital “Marqués de Valdecilla” (UHMV), 39008 Santander, Spain
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Mobbs RJ, Perring J, Raj SM, Maharaj M, Yoong NKM, Sy LW, Fonseka RD, Natarajan P, Choy WJ. Gait metrics analysis utilizing single-point inertial measurement units: a systematic review. Mhealth 2022; 8:9. [PMID: 35178440 PMCID: PMC8800203 DOI: 10.21037/mhealth-21-17] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/27/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Wearable sensors, particularly accelerometers alone or combined with gyroscopes and magnetometers in an inertial measurement unit (IMU), are a logical alternative for gait analysis. While issues with intrusive and complex sensor placement limit practicality of multi-point IMU systems, single-point IMUs could potentially maximize patient compliance and allow inconspicuous monitoring in daily-living. Therefore, this review aimed to examine the validity of single-point IMUs for gait metrics analysis and identify studies employing them for clinical applications. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) were followed utilizing the following databases: PubMed; MEDLINE; EMBASE and Cochrane. Four databases were systematically searched to obtain relevant journal articles focusing on the measurement of gait metrics using single-point IMU sensors. RESULTS A total of 90 articles were selected for inclusion. Critical analysis of studies was conducted, and data collected included: sensor type(s); sensor placement; study aim(s); study conclusion(s); gait metrics and methods; and clinical application. Validation research primarily focuses on lower trunk sensors in healthy cohorts. Clinical applications focus on diagnosis and severity assessment, rehabilitation and intervention efficacy and delineating pathological subjects from healthy controls. DISCUSSION This review has demonstrated the validity of single-point IMUs for gait metrics analysis and their ability to assist in clinical scenarios. Further validation for continuous monitoring in daily living scenarios and performance in pathological cohorts is required before commercial and clinical uptake can be expected.
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Affiliation(s)
- Ralph Jasper Mobbs
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
- Department of Neurosurgery, Prince of Wales Hospital, Sydney, Australia
| | - Jordan Perring
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
| | | | - Monish Maharaj
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
| | - Nicole Kah Mun Yoong
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
| | - Luke Wicent Sy
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
| | - Rannulu Dineth Fonseka
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
| | - Pragadesh Natarajan
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
| | - Wen Jie Choy
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
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Comparison of an Inertial Measurement Unit System and Baropodometric Platform for Measuring Spatiotemporal Parameters and Walking Speed in Healthy Adults. Motor Control 2020; 25:89-99. [PMID: 33207319 DOI: 10.1123/mc.2020-0060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 11/18/2022]
Abstract
Spatiotemporal parameters of walking are used to identify gait impairments and provide a tailored therapy program. Baropodometric platforms are not often used for measuring spatiotemporal parameters and walking speed and it is required to determine accuracy. The aim of this study was to compare FreeMed® Platform gait outcomes with a validated inertial measurement unit. There were 40 healthy adults without walking impairments enrolled. Each subject walked along a 15-m walkway at self and slow self-selected speed wearing an inertial measurement unit on the FreeMed® Platform. Stride length and time, right and left stance, swing time, and walking speed were recorded. Walking speed, stride length, and step time showed a very high level of agreement at slow walking speed and a high and moderate level of agreement at normal walking speed. FreeMed® Platform is useful to assess gait outcomes and could improve the exercise prescription.
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Vítečková S, Horáková H, Poláková K, Krupička R, Růžička E, Brožová H. Agreement between the GAITRite ® System and the Wearable Sensor BTS G-Walk ® for measurement of gait parameters in healthy adults and Parkinson's disease patients. PeerJ 2020; 8:e8835. [PMID: 32509441 PMCID: PMC7247524 DOI: 10.7717/peerj.8835] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 03/02/2020] [Indexed: 11/20/2022] Open
Abstract
Background Nowadays, the most widely used types of wearable sensors in gait analysis are inertial sensors. The aim of the study was to assess the agreement between two different systems for measuring gait parameters (inertial sensor vs. electronic walkway) on healthy control subjects (HC) and patients with Parkinson's disease (PD). Methods Forty healthy volunteers (26 men, 14 women, mean age 58.7 ± 7.7 years) participated in the study and 24 PD patients (19 men, five women, mean age 62.7 ± 9.8 years). Each participant walked across an electronic walkway, GAITRite, with embedded pressure sensors at their preferred walking speed. Concurrently a G-Walk sensor was attached with a semi-elastic belt to the L5 spinal segment of the subject. Walking speed, cadence, stride duration, stride length, stance, swing, single support and double support phase values were compared between both systems. Results The Passing-Bablock regression slope line manifested the values closest to 1.00 for cadence and stride duration (0.99 ≤ 1.00) in both groups. The slope of other parameters varied between 0.26 (double support duration in PD) and 1.74 (duration of single support for HC). The mean square error confirmed the best fit of the regression line for speed, stride duration and stride length. The y-intercepts showed higher systematic error in PD than HC for speed, stance, swing, and single support phases. Conclusions The final results of this study indicate that the G-Walk system can be used for evaluating the gait characteristics of the healthy subjects as well as the PD patients. However, the duration of the gait cycle phases should be used with caution due to the presence of a systematic error.
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Affiliation(s)
- Slávka Vítečková
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Hana Horáková
- Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Kamila Poláková
- Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Radim Krupička
- Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Evžen Růžička
- Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Hana Brožová
- Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
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Leirós-Rodríguez R, García-Soidán JL, Romo-Pérez V. Analyzing the Use of Accelerometers as a Method of Early Diagnosis of Alterations in Balance in Elderly People: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2019; 19:E3883. [PMID: 31505828 PMCID: PMC6767154 DOI: 10.3390/s19183883] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/04/2019] [Accepted: 09/06/2019] [Indexed: 11/30/2022]
Abstract
Alterations of balance are a growing public health problem as they affect one in three adults over the age of 65, and one in two over the age of 80. Identifying the factors that affect postural stability is essential in designing specific interventions to maintain the independence and mobility of older people. The aim of this review was to understand the use of accelerometers in order to assess the balance in older people. Analyzing the most appropriate evaluation methodology and protocolizing it will optimize the processes of early identification of balance alterations. However, quantitative assessment methods of balance are usually limited to a laboratory environment, a factor that can be overcome by accelerometers. A systematic search was carried out across eight databases where accelerometers were employed to assess balance in older people. Articles were excluded if they focused on sensor design and did not measure balance or apply the technology on targeted participants. A total of 19 articles were included for full-text analysis, where participants took part in the balance evaluation monitored by accelerometers. The analysis of spatio-temporal parameters and the magnitude of the accelerations recorded by the devices were the most common study variables. Accelerometer usage has potential to positively influence interventions based on physical exercise to improve balance and prevent falls in older people.
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Affiliation(s)
- Raquel Leirós-Rodríguez
- Faculty of Physical Therapy, University of Vigo; Campus a Xunqueira, s/n, 36156 Pontevedra, Spain.
| | - Jose L García-Soidán
- Faculty of Education and Sport Sciences, University of Vigo; Campus a Xunqueira, s/n, 36156 Pontevedra, Spain.
| | - Vicente Romo-Pérez
- Faculty of Education and Sport Sciences, University of Vigo; Campus a Xunqueira, s/n, 36156 Pontevedra, Spain.
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Kim CH, Chu H, Park C, Kang GH, Seo J, Sung KK, Lee S. Comparison of recovery patterns of gait patterns according to the paralyzed side in Korean stroke patients: Protocol for a retrospective chart review. Medicine (Baltimore) 2018; 97:e12095. [PMID: 30170431 PMCID: PMC6392952 DOI: 10.1097/md.0000000000012095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION In Traditional Korean Medicine (TKM), diseases on the left or right side of the human body have been treated differently according to the theory of Donguibogam, which is an encyclopedic source for TKM. In the Wind chapter of Donguibogam, left hemiparesis due to stroke is called Tan, a sort of Hyeol-Byeong, and right hemiparesis due to stroke is called Tan, a sort of Gi-Byeong. As neuroscience develops, it has been shown that the functions of the left and right hemispheres differ, as do the symptoms caused by differently located lesions in the brain. In light of these recent findings and the theory of Donguibogam, it may be useful when treating patients in clinical practice to consider the side of the human body on which symptoms appear. The aim here is to establish whether side-dependent treatments are more effective in treating patients with symptoms on different sides of the body. Specifically, this exploratory study investigates changes in gait pattern among stroke patients with hemiparesis or hemiplegia during gait recovery. METHODS To develop this protocol, a retrospective review of charts will be used to assess differences in gait recovery patterns among stroke patients with left or right hemiparesis, using gait analysis systems that include GAITRite, G-walk, and Treadmill. The data will be selected from gait analysis performed more than twice in the period from September 1, 2017 to June 31, 2018 at Wonkwang University Gwangju Hospital (WKUGH). RESULTS The primary outcomes include spatiotemporal parameters obtained using GAITRite (FAP, velocity, step length, swing time, and stance time); symmetric parameters obtained using G-walk (tilt, obliquity, and pelvis rotation symmetry); and center of pressure (COP) area and velocity as measured by Treadmill. DISCUSSION This will be the first study to analyze the gait recovery pattern of stroke patients according to the paralyzed side by comparing spatiotemporal, symmetric, and COP parameters using gait analysis systems. Like all retrospective studies, the present research was subject to certain limitations related to bias (selection bias, recall bias, misclassification bias, confounding value bias), difficulty in assessing temporal relationships, and small sample size. However, these limitations were of less significance here because gait parameters and body side of symptoms of hemiplegia or hemiparesis are relatively clear. CONCLUSION If the use of gait analysis systems (GAITRite, G-walk, and Treadmill) confirms differences in gait recovery pattern among stroke patients according to the paralyzed side, the findings will provide essential evidence for differential treatment of stroke patients on that basis.
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Affiliation(s)
- Cheol-Hyun Kim
- Department of Internal Medicine and Neuroscience, College of Korean Medicine, Wonkwang University, Iksan
| | - Hongmin Chu
- Department of Internal Medicine and Neuroscience, College of Korean Medicine, Wonkwang University, Iksan
| | - Chanran Park
- Department of Internal Medicine and Neuroscience, College of Korean Medicine, Wonkwang University, Iksan
| | - Geon-hui Kang
- Clinical Trial Center, Wonkwang University Gwangju Hospital, Gwangju
| | - Jihye Seo
- Clinical Trial Center, Wonkwang University Gwangju Hospital, Gwangju
| | - Kang-keyng Sung
- Department of Internal Medicine and Neuroscience, College of Korean Medicine, Wonkwang University, Iksan
- Internal Medicine and Neuroscience, Jangheung Integrative Medical Hospital, Wonkwang University, Jangheung
| | - Sangkwan Lee
- Department of Internal Medicine and Neuroscience, College of Korean Medicine, Wonkwang University, Iksan
- Clinical Trial Center, Wonkwang University Gwangju Hospital, Gwangju
- Hanbang Cardio-Renal Syndrome Research Center, College of Oriental Medicine, Wonkwang University, Iksan, Jeonbuk, Republic of Korea
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12
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An B, Woo Y. Center of mass with the use of smartphone during walking in healthy individuals. J Phys Ther Sci 2017; 29:1426-1428. [PMID: 28878476 PMCID: PMC5574343 DOI: 10.1589/jpts.29.1426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 05/26/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to measure the center of mass using a smartphone application during walking in healthy. [Subjects and Methods] Forty eight healthy participants volunteered for this study. Measurements of center of mass were obtained by gait analysis application using smartphone while subjects performed 6 meter walking test. The measured data were automatically calculated by the application, subjects performed three trial walks to get a more accurate data analysis. [Results] There were no significant differences among subjects or between genders during the three trials in the vertical and lateral displacement of COM, and the results of the Kolmogorov-Simirnov test showed no differences in vertical and lateral displacement of COM in all subjects or between genders. However, the vertical displacement of COM significantly varied in male subjects than in female subjects, but the lateral displacement of COM did not significantly differ between the male and female subjects. [Conclusion] We can use the Smartphone application to measure the COM for walking; however more studies comparing advanced technological instruments with the smartphone application are needed.
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Affiliation(s)
- Bora An
- Department of Physical Therapy, Raon Hue Hospital, Republic of Korea
| | - Youngkeun Woo
- Department of Physical Therapy, College of Medical Sciences, Jeonju University, Republic of Korea
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13
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Lim SY, Lee WH. Comparison of accelerometer-based and treadmill-based analysis systems for measuring gait parameters in healthy adults. J Phys Ther Sci 2017; 29:651-653. [PMID: 28533603 PMCID: PMC5430266 DOI: 10.1589/jpts.29.651] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 12/25/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to determine the correlation between accelerometer-based and treadmill-based analysis systems for measuring gait parameters during comfortable walking in healthy young adults. [Subjects and Methods] Twenty-three healthy adults participated in this study. Gait parameters were measured with simultaneous use of accelerometer-based and treadmill-based gait analysis systems, while participants walked for 30 s. [Results] There was a highly-significant correlation between the two systems with respect to cadence and velocity. The cadence, speed, and stride measured with the accelerometer system were significantly and highly correlated with the cadence, velocity, and number of steps measured with the treadmill-based system. The gait cycle duration measured with the accelerometer system was significantly and highly correlated with the step time and stride time measured with the treadmill-based gait system. [Conclusion] Gait analysis using an accelerometer system is a valid method for assessment of the effectiveness of therapeutic interventions in a clinical setting.
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Affiliation(s)
- Seung-Yeop Lim
- Graduate School of Physical Therapy, Sahmyook University, Republic of Korea
| | - Wan-Hee Lee
- Graduate School of Physical Therapy, Sahmyook University, Republic of Korea
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Na E, Hwang H, Woo Y. Study of acceleration of center of mass during sit-to-stand and stand-to-sit in patients with stroke. J Phys Ther Sci 2016; 28:2457-2460. [PMID: 27799669 PMCID: PMC5080151 DOI: 10.1589/jpts.28.2457] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 05/23/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to compare the center of mass during sit-to-stand
and stand-to-sit activities in the timed up and go test between healthy subjects and
patients with stroke. [Subjects and Methods] Thirty healthy participants and thirty
patients with stroke volunteered for this study. Acceleration of the center of mass was
measured using a wireless tri-axial accelerometer during sit-to-stand and stand-to-sit
activities in the timed up and go test. Accelerometer data were analyzed using BTS
G-studio software. [Results] The phase duration was significantly longer and the
anterior-posterior, mediolateral, and vertical acceleration ranges were significantly
lower during sit-to-stand for patients with stroke than for healthy controls. Further,
phase duration and the mediolateral acceleration range during stand-to-sit differed
significantly between healthy controls and subjects with stroke. [Conclusions] During
training for the sit-to-stand activity, the focus should be all three balance dimensions,
but during training for the stand-to-sit activity, the focus should be on improving
mediolateral balance and asymmetrical foot positioning should be recommended.
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Affiliation(s)
- Eunjin Na
- Department of Physical Therapy, Dream Hospital, Republic of Korea
| | - Hyesun Hwang
- Department of Physical Therapy, Dream Hospital, Republic of Korea
| | - Youngkeun Woo
- Department of Physical Therapy, College of Medical Sciences, Jeonju University, Republic of Korea
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Ko BW, Lee HY, Song WK. Rhythmic auditory stimulation using a portable smart device: short-term effects on gait in chronic hemiplegic stroke patients. J Phys Ther Sci 2016; 28:1538-43. [PMID: 27313366 PMCID: PMC4905905 DOI: 10.1589/jpts.28.1538] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/02/2016] [Indexed: 11/29/2022] Open
Abstract
[Purpose] The effects of various rhythmic auditory stimulation tempos on stroke gait
pattern changes when training patients with a smartphone-based rhythmic auditory
stimulation application were investigated. [Subjects and Methods] Fifteen patients with
chronic stroke were included. Cadence during comfortable walking was measured (baseline).
After the baseline findings were recorded, rhythmic auditory stimulation with five
different tempos (i.e., −10%, −5%, 0%, +5%, and +10% change from baseline) was randomly
applied. Finally, comfortable walking without rhythmic auditory stimulation was initiated
to evaluate gait pattern changes. [Results] As the tempo increased, the spatiotemporal
gait parameters of the stroke patients changed significantly. Gait speed, cadence, and
gait cycle duration showed the greatest improvement in the +10% rhythmic auditory
stimulation condition compared to baseline. After gait training with rhythmic auditory
stimulation, gait speed, cadence, stride length, gait cycle duration, and step length of
the affected and unaffected sides improved significantly compared to baseline.
[Conclusion] Significant changes in the gait pattern of stroke patients were noted for
various tempos after training with rhythmic auditory stimulation. These findings could be
used to customize rehabilitative gait training for patients who experience stroke with
hemiplegia.
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Affiliation(s)
- Byung-Woo Ko
- Department of Rehabilitation and Assistive Technology, National Rehabilitation Research Institute, National Rehabilitation Center, Republic of Korea
| | - Hwi-Young Lee
- Department of Rehabilitation and Assistive Technology, National Rehabilitation Research Institute, National Rehabilitation Center, Republic of Korea
| | - Won-Kyung Song
- Department of Rehabilitation and Assistive Technology, National Rehabilitation Research Institute, National Rehabilitation Center, Republic of Korea
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