Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “GAIT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed2005

Motor function and joint position sense in relation to gait performance in chronic stroke patients.

OBJECTIVES: To determine the association between joint position sense (JPS) and motor function of the lower extremity and gait performance of patients with chronic stroke. DESIGN: Single-group cross-sectional design. SETTING: University gait laboratory. PARTICIPANTS: Twenty-one patients with stroke onset of more than 6 months. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The isometric strength, Fugl-Meyer Assessment (FMA) motor status, and JPS of the lower extremity were tested. Spatiotemporal gait characteristics were measured using a 6-camera motion analysis system, with patients walking at their comfortable speeds while using their usual devices. RESULTS: Lower-extremity muscle strength and FMA motor score correlated significantly with the spatiotemporal characteristics of gait and contributed significantly to the variance in gait velocity, stride length, and double-stance time. The JPS was not related to gait performance, except that the ankle JPS contributed significantly to the variance in gait velocity and stride length. CONCLUSIONS: For patients with chronic stroke, motor function was significantly related to gait performance. Although the JPS was not, that of the ankle joint made a significant contribution. When enhancing gait performance is desired, improving the motor function is recommended, and the role of JPS should also be taken into consideration.

Aged↗
PubMed2006

The relation between ankle impairments and gait velocity and symmetry in people with stroke.

OBJECTIVE: To identify the most important factor among the ankle impairments on gait velocity and symmetry in stroke patients. DESIGN: Cross-sectional, descriptive analysis of convenience sample. SETTING: Patients from outpatient rehabilitation and neurovascular neurology departments in medical centers and municipal hospitals in Taiwan. PARTICIPANTS: Sixty-eight subjects with hemiparesis poststroke with the ability to walk independently. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Maximal isometric strength of plantarflexors and dorsiflexors were examined by a handheld dynamometer. Spasticity index, slope magnitudes between electromyographic activities, and muscle lengthening velocity of gastrocnemius during lengthening period of stance phases were measured to represent the dynamic spasticity. Passive stiffness of pantarflexors was indicated by degrees of dorsiflexion range that were less than normative values. Position error was measured by the degree of proprioceptive deficits of ankle joint by evaluating the joint position sense. Gait velocity, symmetry, and other gait parameters were measured by the GAITRite system. RESULTS: Regression analyses revealed that the dorsiflexors strength was the most important factor for gait velocity and temporal symmetry (R(2)=.30 for gait velocity, P<.001; R(2)=.36 for temporal asymmetry, P<.001). Dynamic spasticity was the most important determinant for gait spatial symmetry (R(2)=.53, P<.001). CONCLUSIONS: Gait velocity and temporal asymmetry are mainly affected by the dorsiflexors strength, whereas dynamic spasticity of plantarflexors influenced the degree of spatial gait asymmetry in our patients who were able to walk outdoors. Treatment aiming to improve different aspects of gait performance should emphasize on different ankle impairments.

Ankle↗
PubMed2006

Gait initiation is dependent on the function of the paretic trailing limb in individuals with stroke.

The purposes of this study were to compare the gait initiation task between individuals with chronic stroke and age-matched healthy controls, to determine whether the observed differences between groups could be attributed to the presence of a stroke or to differences in gait initiation speed, and to establish the gait initiation variables that relate with a faster gait initiation speed. All subjects initiated gait at their preferred speed, while control subjects were also asked to initiate gait at a speed that was comparable to the stroke group. It was found that while many temporal and kinetic differences were observed between the two groups, most were simply due to differences in gait initiation speed. Two variables that remained different when speed was controlled were the magnitude of the antero-posterior impulse generated by the paretic limb when it was used as either the leading or trailing limb. Kinetic parameters of the trailing limb (i.e. peak antero-posterior force and impulse) were also found to correlate with the gait initiation speed for the non-paretic lead limb condition. The results suggest that the propulsive function of the paretic limb when used as the trailing limb is a key area to address in the rehabilitation of gait initiation for individuals with stroke.

Aged↗
PubMed2006

Quantitative gait analysis in patients with dementia with Lewy bodies and Alzheimer's disease.

Gait disorders in people with dementia have been documented in a number of studies. There is some preliminary evidence suggesting there may be a relationship between dementia type and gait abnormality. Quantitative gait analysis has not previously been reported for people diagnosed with dementia with Lewy bodies (DLB). Therefore, this study aimed to quantify gait patterns of people with DLB and compare them with those of people with Alzheimer's disease (AD) and control subjects. Two groups of 10 subjects divided according to a diagnosis of DLB and AD, and 10 control subjects underwent gait analysis using an electronic walkway. Participants were required to walk at self-selected slow, preferred and fast speeds. There were no differences between the DLB and AD patient groups for any of the measured gait variables. Velocity and stride length values were significantly reduced in both patient groups compared to the control group at all speeds and percentage of time spent in double limb support was significantly increased in both patient groups compared to the control group at all walking speeds. Significant correlations were found between gait speeds and gait outcome variables. Spatiotemporal gait characteristics of people with AD and DLB are similar, but significantly different from the normal population.

Aged↗
PubMed2003

Immediate effects of speed-dependent treadmill training on gait parameters in early Parkinson's disease.

OBJECTIVE: To compare the immediate effects of different training interventions on gait parameters in patients with early Parkinson's disease (PD). DESIGN: Randomized, multiple intervention crossover pilot study. SETTING: A rehabilitation center for adult persons with neurologic disorders. PARTICIPANTS: Seventeen patients with early PD (Hoehn and Yahr stages I through III) and gait disturbances. INTERVENTION: Patients were randomly assigned to varying sequences of the following interventions over 4 consecutive days: structured speed-dependent treadmill training (STT), limited progressive treadmill training (LTT), conventional gait training (CGT), and a control intervention. MAIN OUTCOME MEASURES: Basic gait parameters (overground walking speed and stride length at self-adapted speeds) and parameters of gait analysis based on vertical ground reaction forces. RESULTS: STT and LTT improved all basic gait parameters and the double stance duration compared with preintervention values (P<.05). No changes were found after CGT and the control intervention (P<.05). Significantly higher gains were observed in all basic gait parameters after STT and LTT when compared with CGT and the control intervention (P<.05). Additionally, a greater reduction of double stance duration was found after STT than after the control intervention (P<.001). No significant differences in gains were observed between STT and LTT, or between CGT and the control intervention, in all gait parameters. CONCLUSION: The main disturbances of gait in PD, namely, speed and stride length, can be improved through a single intervention of STT or LTT, but not through CGT and the control intervention.

Adaptation, Physiological↗
PubMed1999

Analysis of gait abnormalities in Huntington disease.

OBJECTIVE: To evaluate patterns of successful gait strategy in Huntington disease (HD) at various stages of illness to improve fall avoidance and maintenance of independence. DESIGN: Repeated measurements of gait kinematic parameters and joint performance during gait cycles of six HD patients compared to 30 age-matched controls. SETTING: A standard gait laboratory. SUBJECTS: Six HD patients, rank-ordered for disease severity from minimal chorea to generalized dystonia, selected because they were ambulatory despite 3 to 17 years' disease duration. One patient was from a nursing home (walked with assistance) and five were living independently, either alone or with a working spouse who was the caregiver. MAIN OUTCOME MEASURES: Standardized gait evaluations (retroreflective markers on standard bony landmarks) from five video angles, fed into digitizer to computer-generate joint angles and standard gait kinematic parameters. RESULTS: Wide variability in gait kinematic parameters and joint interaction plots (phase plane and angle-angle plots) was observed between individuals and successive trials of the same limb, tending to increase with disease severity. Joint interaction plots show that random, highly variable distractions from planned trajectories are more apparent distally. CONCLUSIONS: Chorea in HD does not appreciably affect the center of gravity during ambulation, and the consistency of gait profiles at heel strike shows that the ultimate target is achieved in each step despite random and frequent variability during the gait cycle.

Adult↗
PubMed2002

[Development of a clinical test of gait in frail elderly by a cognitive approach of locomotion].

OBJECTIVE: From a cognitive approach of locomotion, we studied the feasibility and the reproducibility of a clinical test of gait which is devoted to predict fall. METHODOLOGY: With a cross-sectional design, we studied the gait of 30 old subjects (average age 82.6+/-7.1 years). The gait course consisted of a 10m length in a well light room, with regular walking shoes. Two conditions were examined: walking with and without explicit cognitive task (mental arithmetic and verbal flow task). Time (seconds) and number of steps were collected by two operators Deviations and stops were video-taped. Number of figures was recorded with a tape recorder. The difficulty to perform gait conditions was estimated by each subject with a quotation ranging from 0 (easy gait) to 10 (difficult gait). RESULTS: Increases of time, steps, deviations and stops were observed when gait was associated to a cognitive task (6.4 seconds and 4.6 steps with mental arithmetic; 10.5 seconds and 6.7 steps with verbal flow task). All subjects managed this test. These results were reproducible across tests and operators. Walking with mental arithmetic was the most easy gait condition for subjects. CONCLUSIONS: The simplicity and the reproducibility of this test make it as adequate instrument of gait evaluation in geriatrics. Walking with mental arithmetic is the condition that must to be used. Validation of its predictive value for fall in frail elderly subjects remains to be shown.

Accidental Falls↗
PubMed1999

Exploration of paretic gait by differential loading in normals.

OBJECTIVE: To determine if the gait patterns of artificially loaded healthy subjects resemble those of patients with weak ambulatory muscles. DESIGN: The gaits of artificially loaded healthy subjects and their controls were compared with the gaits of amputees and paretic patients, using analysis of variance. BACKGROUND: Muscle weakness due to paresis or limb amputation results in a misrelation between muscle power and body weight borne during ambulation. When body weight is increased by artificial loading of a normal subject, a misrelation between muscle strength and body weight results. METHODS: The gaits of paretic patients and artificially loaded normal subjects were recorded in the laboratory, by means of foot-switches. Stride length and stride frequency were used to calculate stride ratio which was used to compare the different gaits. RESULTS: Mean stride ratios of paraparetics, peroneal paretics and healthy subjects who carried load in the hand showed no statistically significant difference, while the ratio for hemiparetics differed significantly from the value for the artificially loaded healthy subjects. Below-knee amputees had a similar stride ratio to normal subjects who carried load on the ankles, while the above-knee stride ratio differed significantly from ankle-loaded normal subjects. CONCLUSION: Paraparetic and peroneal paretic gaits were approximated by the gaits of normal subjects who carried artificial load in the hand while the below-knee amputee gait was mimicked by normal subjects who carried load on the ankles. The two models of artificial loading could not generate any semblance with hemiparetic and above-knee gaits.

Adult↗
PubMed1988

Impressions of people created by age-related qualities of their gaits.

Drawing on the ecological theory of social perception, we investigated the impact of age-related gait qualities on trait impressions. In Study 1, subjects observed 5- to 70-year-old walkers depicted in point-light displays, and rated the walkers' traits, gaits, and ages. Younger walkers were perceived as more powerful and happier than older walkers. A composite of youthful gait qualities predicted trait impressions regardless of the walkers' masculine gait qualities, sex, and perceived age. In Study 2, subjects observed young adult walkers depicted in point-light displays and rated their traits, gaits, and ages. Consistent with the effects of real age found in Study 1, young adults with youthful gaits were perceived as more powerful and happier than peers with older gaits, irrespective of their masculine gait qualities, sex, and perceived age. Study 3 replicated Study 2 using displays showing walkers' full bodies and faces. A youthful gait predicted trait impressions even when subjects could discern the walkers' age and sex.

Adolescent↗
PubMed1998

[Evaluation with biomechanical gait analysis of various treatment methods after rupture of the anterior cruciate ligament].

The purpose of the present study is to evaluate the rehabilitation of different treatments of ACL ruptured knees by means of gait parameters. The gait analysis results in two surgically treated patient groups (patellar tendon autograft reconstructions (n = 35) and augmented repairs (n = 15) and one non-surgically treated patient group (n = 19) are evaluated by means of gait parameters of normal controls (n = 30). The technical equipment included an optoelectronic system for recording the kinematics of gait (Primas, NL) and two force plates for measuring the ground reaction forces (Kistler, CH). The moments acting on joints can be determined experimentally with both systems. It can be shown from special gait tests that the derived quantitative evaluation parameters are independent from the gait analysis conditions. One year after surgery, both the patellar tendon autograft reconstruction group and the augmented repair group show clear deficiencies in gait parameters compared with the controls. In particular this concerns the midstance extension motion of the knee (p < = 0.01) and the extension moments acting on the knee joint during the stance phase (sagittal plane, p < = 0.01). The deficiencies of both surgically treated groups are approximately the same. However, one year after occurrence of the disruption the non-surgically treated group cannot be distinguished from the controls. From this and from additional pre-surgical measurements, it can be concluded, that operating has an important influence on gait parameters. The role of the gait analysis results has been discussed.

Adult↗
PubMed2005

Footprint peak time and functional ambulation profile reflect the potential for hemiparetic gait recovery.

OBJECTIVE: Gait disturbances were monitored in patients with chronic stroke with a walkway built with pressure sensors in order to assess whether detailed gait and footprint information could provide verification for the potential for gait recovery. METHODS: Gait variables (footprint peak times, temporal and spatial parameters and Functional Ambulation Profile, FAP, scores), were first recorded in 25 patients with chronic stroke at their preferred speed and 10 healthy volunteers walking from very slow to very fast. Patients and controls were divided into four groups based on the velocity performance. Secondly, the effect of rehabilitation on the footprint peak times was evaluated in another group of 20 chronic stroke patients. RESULTS AND CONCLUSIONS: The footprint peak time behaviour of different patients with chronic stroke reflected their hemiparetic gait pattern. The slower patients had prolonged footprint peak times on the non-affected side (NS) and shorter values on the lateral footprint on the affected side (AS). The increased gait velocity and the FAP scores decreased the footprint peak times on both sides, especially on the NS. The rehabilitation increased the gait velocity with 18.2%, decreased the duration of the mid-foot and forefoot peak times on the NS and the lateral mid-foot peak times on the AS. A detailed analysis of the individual gait performance allows more accurate assessment of the potential for gait recovery.

Adult↗
PubMed1998

4-Aminopyridine alters gait characteristics and enhances locomotion in spinal cord injured humans.

Recovery of useful motor function in humans with spinal cord injury (SCI) is a primary and elusive goal. In this preliminary study, we describe efforts to delineate the pharmacological effects of 4-aminopyridine (4-AP) on gait parameters in spinal cord injured humans who have retained some capacity to ambulate bipedally. A sequential entry, open label study was made of the effects of a single oral administration of an immediate-release formulation of 4-AP on the time-course profile of changes in component parameters of bipedal gait in ambulatory volunteers with chronic SCI. Nine healthy, rehabilitated, community-adapted male volunteers (six tetraparetic, three paraparetic), who sustained their injuries more than one year prior to entry into the study, ingested a single 10-mg dose of 4-aminopyridine after an overnight fast. Gait analysis parameters included velocity (meters/min), cadence (steps/min), stride length (meters), gait cycle (seconds), and double limb support (percent of gait cycle). They were measured for 24 hours using a sampling-rich strategy (nine duplicate measurements over 24 hrs). Repeated measures (randomized block) analysis of variance (ANOVA) and paired t-tests were used to test for the significance of differences between means and variances. The apparent pharmacological effect of 4-AP is associated with statistically significant changes in one or more of the component elements used to assess the characteristics and efficiency of bipedal gait. These changes in gait analysis parameters correspond temporally with the improvements in pulmonary function and heart rate variability previously described by us. 4-AP appears to enhance gait in a subset of humans with SCI. In this preliminary study we report, for the first time, an apparent effect of 4-AP on gait in spinal cord injured humans and suggest that the pharmacological effects of 4-AP may have clinically significant application in the restoration of useful motor function.

4-Aminopyridine↗
PubMed2006

Timed Gait test: normative data for the assessment of the AIDS dementia complex.

The Timed Gait test is a standardized procedure assessing motor dysfunction of lower extremities and gait abnormalities associated with AIDS dementia complex. Heretofore, interpretations of Timed Gait results have been hampered by the lack of normative data. We provide results on this test derived from 1,549 subjects (HIV-seronegatives (HIV-) and seropositives (HIV+) classified according to ADC stage). Timed Gait was found to be a useful screening and assessment tool for evaluating ADC and correlated with clinical ADC staging as well as more extensive structured neurological and neuropsychological evaluations. Analysis of covariance results (with age and education as covariates) revealed symptomatic HIV+(SX) and AIDS groups having significantly slower Timed Gait scores than those in the HIV- and asymptomatic HIV+(ASX) groups. The SX group obtained significantly slower timed gait scores than those in the AIDS group. There was a significant increase in Timed Gait scores with each increase in dementia staging with the HIV- subjects having the fastest mean Timed Gait scores and the HIV+ dementia stage 2+ having the slowest. These normative data should prove useful in both recognition of ADC and treatment response. Given its minimal training requirements, the Timed Gait would have utility in resource limited settings.

AIDS Dementia Complex↗
PubMed1996

Gait disturbance in Alzheimer's disease: a clinical study.

Gait disturbance is common in patients with Alzheimer's disease (AD). The aim of this study was to analyse the clinical gait syndromes of patients with AD using Nutt's classification. Fifty-five patients who satisfied the NINCDS-ADRDA criteria for probable AD and 55 controls were recruited from a geriatric and a psychogeriatric unit. Patients with classical musculoskeletal or neurological syndromes causing gait disturbance were excluded. A standardized neurological examination was carried out in all subjects. Twenty-two (40%) patients and ten (18%) controls had a higher level gait disorder (p < 0.01). The pattern of gait disturbance in AD patients varied according to the stage of the disease. Cautious gait was the commonest gait disorder in AD patients with mild dementia, while frontal gait disorder was the commonest disturbance in patients with severe dementia. The prevalence of frontal release signs (gegenhalten or any primitive reflex) was highest among patients with frontal gait disorder.

Activities of Daily Living↗
PubMed2000

Conventional physiotherapy and treadmill re-training for higher-level gait disorders in cerebrovascular disease.

OBJECTIVES: to compare the therapeutic effects of two approaches to gait re-training--a schedule of conventional physiotherapy and treadmill re-training--in patients with higher-level gait disorders associated with cerebral multiinfarct states. DESIGN: single-blind crossover study involving a 4-week baseline period, 4 weeks of treadmill re-training and 4 weeks of conventional physiotherapy. SETTING: a large teaching hospital. SUBJECTS: patients with cerebral multi-infarct states who met the criteria for higher-level gait disorders. Computed tomographic brain scans showed at least one large vessel infarct, basal ganglia and white matter lacunes or extensive leukoaraiosis. INTERVENTIONS: a schedule of treadmill re-training and a specific schedule of physiotherapy containing 31 interventions in three treatment modules: (i) for gait ignition failure and turning; (ii) to improve postural alignment and enhance balance reactions; and (iii) for other components of cerebral multi-infarct state disordered gait. MAIN OUTCOME MEASURES: spatial and temporal gait measures and activity of daily living assessments. RESULTS: we recruited 18 patients, mean (SD) age 79.1 (6.8) years. Patients walked an average of 7.9 (5.5) km on the treadmill and had an average of 6.7 (3.2) h of physiotherapy. There were clinically moderate but highly statistically significant (P < 0.001) improvements in the following indices: time taken to complete the sit-to-stand test; time taken to walk 10 m; number of steps over 10 m; walking velocity; right and left step lengths; and time taken to complete the 'S' test. There were no differences in the results obtained in each limb of the study. CONCLUSION: there is no difference between the effects of conventional physiotherapy and treadmill re-training on the gait of patients with higher-level gait disorders associated with cerebral multi-infarct states. However, the improvements seen during the treatment period suggest that there is scope to improve the gait of this group of frail, elderly patients.

Aged↗
PubMed1999

Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy.

Quantitative gait analysis has been used to elucidate characteristic features of neurological gait disturbances. Although a number of studies compared single patient groups with controls, there are only a few studies comparing gait parameters between patients with different neurological disorders affecting gait. In the present study, gait parameters were compared between control subjects, patients with parkinsonian gait due to idiopathic Parkinson's disease, subjects suffering from cerebellar ataxia and patients with gait disturbance due to subcortical arteriosclerotic encephalopathy. In addition to recording of baseline parameters during preferred walking velocity, subjects were required to vary velocity from very slow to very fast. Values of velocity and stride length from each subject were then used for linear regression analysis. Whereas all patient groups showed slower walking velocity and reduced step length compared with healthy controls when assessed during preferred walking, patients with ataxia and subcortical arteriosclerotic encephalopathy had, in addition, increased variability of amplitude and timing of steps. Regression analysis showed that with changing velocity, subjects with Parkinson's disease changed their stride length in the same proportion as that measured in controls. In contrast, patients with ataxia and subcortical arteriosclerotic encephalopathy had a disproportionate contribution of stride length when velocity was increased. Whereas the findings in patients with Parkinson's disease can be explained as a reduction of force gain, the observations for patients with ataxia and subcortical arteriosclerotic encephalopathy reflect an altered spatiotemporal gait strategy in order to compensate for instability. The similarity of gait disturbance in subcortical arteriosclerotic encephalopathy and cerebellar ataxia suggests common mechanisms.

Adult↗
PubMed1980

System of reporting and comparing influence of ambulatory aids on gait.

The purposes of this study were to 1) present a standardized approach for describing gait when assistive devices are used, 2) report reference data for unassisted and assisted gait patterns for normal adults, and 3) discuss clinical implications for selected variables of gait. Using an automated gait system, measurements for temporal and distance factors and accelerometry were obtained for 25 normal young adults. In addition to the formulation of a new system for describing gait patterns when assistive devices are used, the results of the study were that 1) subjects walked slower with ambulatory aids than without them, 2) assisted gaits with the same number of counts per cycle tended to have similar measurements, 3) reciprocal swing times and stance times were symmetrical for all types of gait studied, 4) double stance times and step times were asymmetrical for three types of assisted gait, and 5) vertical accelerations were disproportionately elevated for most assisted gaits.

Acceleration↗
PubMed1999

Subthalamic nucleus stimulation for gait disturbance in Parkinson's disease.

OBJECTIVE: A preliminary study of subthalamic nucleus (STN) stimulation was performed to determine its applicability for the treatment of gait and postural disturbances in Parkinson's disease. METHODS: Five Parkinson's disease patients with freezing gait and postural instability were selected for this study. Their ages ranged from 60 to 73 years (mean+/-standard deviation, 65.6+/-4.8 years). Semi-microelectrode recording was used to identify the STN and to place a chronic electrical stimulation electrode within the right STN in all patients. The Unified Parkinson's Disease Rating Scale and the modified Hoehn and Yahr Staging Scale were used to assess patients in on- and off-drug conditions before surgery and 3 months after surgery. RESULTS: The scores on the Hoehn and Yahr Staging Scale and the total Unified Parkinson's Disease Rating Scale for akinesia (P < 0.05), gait (P < 0.05), and gait and posture (P < 0.01) in off-drug on-stimulation conditions significantly improved over the preoperative and postoperative off-drug off-stimulation conditions (analysis of variance [ANOVA], P < 0.01). Improvement over the preoperative scores was 24% on the Hoehn and Yahr Staging Scale, 43.6% on the total Unified Parkinson's Disease Rating Scale, 33.4% for akinesia, 36.6% for gait, and 38.7% for gait and posture. However, stimulation in the on-drug phase did not show a significant difference compared with pre- and postoperative conditions (ANOVA, P > 0.05). Comparisons between preoperative on-drug and postoperative off-drug on-stimulation conditions revealed that there were no significant differences in the scores, except for gait (ANOVA, P < 0.05). The scores on subscales for falling, freezing, walking, and gait in off-drug on-stimulation conditions were significantly improved over the scores for preoperative and postoperative off-stimulation (ANOVA, P < 0.05), but the score for postural stability remained unchanged. CONCLUSION: Our findings showed that STN stimulation effectively alleviates freezing gait and improves walking to its status during the preoperative on-drug phase and can be applied for treatment of Parkinson's disease patients with these symptoms.

Aged↗