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At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

The timer-logger-communicator gait monitor: recording temporal gait parameters using a portable computerized device.

A portable microprocessor-based device, the timer-logger-communicator (TLC), was adapted and connected to footswitches to monitor and record temporal gait parameters in 25 hemiplegic and 30 normal subjects. Controls walked at 1.36 m/s with symmetric gait. Hemiplegic subjects had a mean walking speed of 0.43 m/s, asymmetric gait, and varying proportions of time spent in each phase, consistent with previously reported gait parameters. Trends in objective gait measures more closely paralleled trends in functional ambulation classification than in Brunnstrom motor recovery stages. The TLC gait monitor is a useful instrument to measure temporal parameters of gait in the clinical setting.

Adult↗
PubMedDate not supplied

A mechanized gait trainer for restoration of gait.

The newly developed gait trainer allows wheel-chair-bound subjects the repetitive practice of a gait-like movement without overstressing therapists. The device simulates the phases of gait, supports the subjects according to their abilities, and controls the center of mass (CoM) in the vertical and horizontal directions. The patterns of sagittal lower limb joint kinematics and of muscle activation for a normal subject were similar when using the mechanized trainer and when walking on a treadmill. A non-ambulatory hemiparetic subject required little help from one therapist on the gait trainer, while two therapists were required to support treadmill walking. Gait movements on the trainer were highly symmetrical, impact free, and less spastic. The vertical displacement of the CoM was bi-phasic instead of mono-phasic during each gait cycle on the new device. Two cases of non-ambulatory patients, who regained their walking ability after 4 weeks of daily training on the gait trainer, are reported.

Adult↗
PubMed2005

"Fear of falling" gait: a potentially reversible psychogenic gait disorder.

OBJECTIVE: To describe "fear of falling" gait. BACKGROUND: "Fear of falling" gait is a largely psychogenic gait disorder of the elderly that is often unrecognized. METHODS: Report of a representative case and clinical experience. RESULTS: "Fear of falling" gait usually begins after a fall and is characterized by a shuffling or sliding stride and an intense need to hold on for support. It appears to be most common in elderly women, can be reversed by education, suggestion, and physical therapy, and is often mistaken for Parkinson disease. CONCLUSIONS: "Fear of falling" gait is a potentially reversible, largely psychogenic gait disorder that occurs mostly in women and must be distinguished from other gait disorders in the elderly.

Aged↗
PubMed1989

[Neurological gait changes in old age: basic principles, senile gait].

Gait abnormalities and falls often occur in the elderly, and it is often difficult for the practitioner to distinguish between a specific disease causing disordered gait and gradual changes due to "normal" involution. Based on the biomechanics and the neural control mechanisms of normal adult gait, characteristics of the "senile gait" are described. The senile gait abnormality is regarded as a clinical entity ascribed to age alone and its many cerebellar, extrapyramidal and cerebrofrontal changes, all of which may give rise to disordered central programming of upright stance and gait. The need for a careful evaluation of the elderly patient's station and gait is stressed.

Aged↗
PubMed1990

A synergetic theory of quadrupedal gaits and gait transitions.

We present a theoretical analysis of the patterns of interlimb co-ordination in the gaits of quadrupedal locomotion. Introducing as collective variables a set of relative phases that describe the co-ordination patterns, we classify gaits by their symmetry properties, which can be expressed as invariances under groups of transformations. We define dynamics of the collective variables, on which we impose symmetry restrictions. The stable observable gait patterns correspond to atractors of these dynamics. A non-trivial consequence of this theoretical viewpoint is that gait transitions can take the form of non-equilibrium phase transitions that are accompanied by loss of stability. We show how various types of such phase transitions involving hysteresis, slowing down and fluctuation enhancement can occur. Also the difference between smooth and abrupt transitions is given theoretical foundation. While existing experimental evidence is consistent with the theory developed here, we propose new experimental measures that can serve to test the present theoretical framework. Finally, the influence of underlying symmetries of the dynamics on the nature of the gait patterns and their stability is analyzed. For example, breaking of a front-hind symmetry can lead to a change from absolute to relative co-ordination in the sense of von Holst (1939, Ergebnisse der Physiologie 42, 228). Also, differential stability of straight and reverse gaits results from thus lowering the symmetry.

Gait↗
PubMed2001

Gait after stroke: initial deficit and changes in temporal patterns for each gait phase.

OBJECTIVE: To examine which phases of the gait cycle contributed to decreased gait velocity after stroke. DESIGN: Experimental. SETTING: Inpatient rehabilitation centers. PARTICIPANTS: Forty-two patients with unilateral first stroke who were able to walk 10 meters; and 42 age- and gender-matched controls with no history of stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Deficit and change expressed as duration (s) and proportion (%) for the 4 phases of the gait cycle at the time of admission to rehabilitation (test 1), a median of 31 days poststroke onset, and again 8 weeks later (test 2). Affected and unaffected single-limb support (SLS) and initial double-limb support (DLS) were compared. RESULTS: At tests 1 and 2, the durations of the 2 DLS and unaffected SLS phases were significantly (p <.001) longer in the stroke patients than in control subjects. No difference was found between the 2 groups for duration of affected SLS at either test time. Significant (p <.001) decreases occurred over the 8-week period in the 3 phases identified to be abnormally long at test 1. CONCLUSION: If the goal of rehabilitation is to increase gait velocity and normalize the gait pattern, treatment should focus on decreasing the DLS and unaffected SLS phases of the gait cycle.

Aged↗
PubMed1990

Gait assessment in the elderly: a gait abnormality rating scale and its relation to falls.

We evaluated the gait of 49 nursing home residents (27 of whom had a history of recent falls), and 22 controls. Measures consisted of stride length and walking speed, as well as a videotape-based analysis of 16 facets of gait. The study demonstrates that stride length, walking speed, and the assessment of videotaped gait correlated well with each other and were significantly impaired in fallers compared to controls. Arm swing amplitude, upper-lower extremity synchrony, and guardedness of gait were most impaired in fallers. Although subjects who fell were more often demented than controls, it is likely that this represents a selection bias in nursing homes. Visual rating of gait features in the nursing home population is a simple and useful alternative to established methods of gait analysis.

Accidental Falls↗
PubMedDate not supplied

Crouched gait in myelomeningocele: a comparison between the degree of knee flexion contracture in the clinical examination and during gait.

The purpose of this study was to quantitatively evaluate, in patients with low lumbar and sacral level myelomeningocele who have knee flexion contractures, whether there are significant differences between the degree of knee flexion contracture measured clinically and the degree of actual knee flexion during gait, measured by computerized gait analysis. Patients were divided into two groups, those who walked with ankle-foot orthoses (AFOs) alone and those who walked with AFOs and crutches. In both groups, the patient's knee flexion contractures were measured clinically, and the degree of knee flexion was measured dynamically at two representative points in the gait cycle. In both groups and at both points of the gait cycle, the degree of knee flexion during gait was significantly greater than the degree of clinical knee flexion contracture. This should be taken into account when evaluating the crouch gait of children with myelomeningocele and planning the proper treatment.

Adolescent↗
PubMedDate not supplied

Correlation of the Edinburgh Gait Score with the Gillette Gait Index, the Gillette Functional Assessment Questionnaire, and dimensionless speed.

This study examines the correlation of the Edinburgh Gait Score (EGS) with the Gillette Gait Index (GGI; formerly the Normalcy Index), the Gillette Functional Assessment Questionnaire, and speed, all of which are used as measures of gait quality or function. Scores were computed for 58 subjects, all with a diagnosis of cerebral palsy. The correlation of the EGS with all of the other scores was found to be significant, with r2 ranging from 0.26 to 0.79. The strongest correlation was found with the GGI, which may reflect common features in the derivation of both of these scores, although the EGS was derived from observational gait analysis and the GGI from principal component analysis of variables from computerized 3-dimensional gait data. We conclude that the EGS shows good concurrent validity with alternative gait assessment scores.

Adolescent↗
PubMed1985

In defence of gait analysis. Observation and measurement in gait assessment.

The gait pattern of five amputees was recorded by visual observation and also by a quantitative measurement system. The results were compared with the gait pattern predicted from biomechanical analysis. Visual observation was found to be an unreliable clinical skill. The observers recorded only 22.2% of the predicted gait deviations and were unable to comment on 15.6% of all the required observations. The gait parameters which were difficult to assess visually, namely step length and step time, are considered by most workers to be of particular value as diagnostic clinical indicators in gait assessment. The measurement system used was accurate in recording gait deviations and picked up 3.4 times as many deviations as visual observation. This report demonstrates the inadequacy of visual observation as a diagnostic method and emphasises the need for measurements.

Amputees↗
PubMed2003

Accuracy and reliability of observational gait analysis data: judgments of push-off in gait after stroke.

BACKGROUND AND PURPOSE: Physical therapists routinely observe gait in clinical practice. The purpose of this study was to determine the accuracy and reliability of observational assessments of push-off in gait after stroke. SUBJECTS: Eighteen physical therapists and 11 subjects with hemiplegia following a stroke participated in the study. METHODS: Measurements of ankle power generation were obtained from subjects following stroke using a gait analysis system. Concurrent videotaped gait performances were observed by the physical therapists on 2 occasions. Ankle power generation at push-off was scored as either normal or abnormal using two 11-point rating scales. These observational ratings were correlated with the measurements of peak ankle power generation. RESULTS: A high correlation was obtained between the observational ratings and the measurements of ankle power generation (mean Pearson r=.84). Interobserver reliability was moderately high (mean intraclass correlation coefficient [ICC (2,1)]=.76). Intraobserver reliability also was high, with a mean ICC (2,1) of.89 obtained. DISCUSSION AND CONCLUSION: Physical therapists were able to make accurate and reliable judgments of push-off in videotaped gait of subjects following stroke using observational assessment. Further research is indicated to explore the accuracy and reliability of data obtained with observational gait analysis as it occurs in clinical practice.

Adult↗
PubMed1985

[Gait analysis in hemiplegic patients after gait training or surgery of a foot deformity].

The change of gait in stroke patients after gait training or surgery for foot deformity was analyzed according to walking cycle and gait speed and cadence by means of the accelorometer or the large force plate. The results were summarized as follows. Twenty patients receiving gait training. Variation of the stride duration decreased gradually on both sides. The stance phase and the double support phase had the tendency to demonstrate equal percentage on both sides, decreasing in the unaffected side. The percentage values were higher than those in the normal person except a few cases. The cadence increased in all cases except one. Twenty-two patients following surgery for foot deformities. Walking cycle revealed almost the same result as that of cases receiving gait training. The percentage of the double support phase in the unaffected side characteristically approached that of the affected side after surgery, suggesting surgical benefits. Cadence decreased in 7 cases, while gait speed increased in all cases. It may come from the wider stride length after surgery.

Adult↗
PubMed1989

Quantitative assessment of gait determinants during single stance via a three-dimensional model--Part 2. Pathological gait.

A three-dimensional model for normal gait formulated in Part 1 is now altered to simulate the dynamics of pathological walking. Mechanisms fundamental to the production of a normal gait pattern are systematically removed, in order to assess contributions from individual gait determinants. Four separate pathological cases are studied: a model neglecting ankle plantarflexor activity; absence of stance knee flexion-extension and foot and knee interaction; both pelvic list and transverse pelvic rotation removed; and finally, a model with all major gait determinants missing. These are used collectively to show that stance knee flexion-extension and foot and knee interaction successively dominate lower-extremity dynamical response during the single support phase of normal gait. The hip abductor muscles, while effecting pelvic list, serve to stabilize this limb, rather than actively determine whole-body vertical acceleration. Mechanisms compensating for a loss in joint motion are also explored. Complete ankle loss may be successfully compensated with increased hip abductor muscle activity; the loss of both ankle and knee, however, demand unacceptable levels of vertical pelvic displacement.

Adult↗
PubMed2006

Gait and gait-related activities and fatigue in Parkinson's disease: what is the relationship?

PURPOSE: To explore the relationship between gait and gait-related activities and fatigue in Parkinson's disease (PD). METHOD: Twenty people with idiopathic PD (12 male, 8 female; mean age 64.6 +/- 7.96) and 10 age, sex and education matched controls (6 male, 4 female; mean age 63.5 +/- 7.03) wore an activity monitor for approximately 24 h, from which the percentage time walking and standing, the number of periods of walking greater than 10 sec were derived. Prior to monitoring, levels of fatigue (Multi-dimensional Fatigue Index, MFI) were evaluated. RESULTS: Activity data related to gait were compared for the waking hours of the day, reflected by the period between 6 am and 10 pm. Overall, PD subjects demonstrated reduced activity compared to controls, however there was no significant difference between PD and controls for the percentage time spent walking (p = 0.149), standing (p = 1.0) or engaged in periods of walking that were greater than 10 sec (p = 0.059). Significantly greater levels of fatigue were experienced by PD subjects in all MFI domains compared to controls (physical p = 0.001; activity p = 0.001; general p = 0.001; mental p = 0.028; motivation p = 0.024). There was no clear association between activity and fatigue in PD subjects. CONCLUSIONS: Evidence of increased fatigue is not supported by evidence of significantly decreased levels of activity in PD subjects. The relationship between activity and fatigue therefore remains unclear, highlighting the complex nature of the relationship between these factors. Further work is required to increase our understanding of the impact of fatigue on gait and gait-related activity so that improved management can be explored.

Fatigue↗
PubMed1991

Influence of body weight support on normal human gait: development of a gait retraining strategy.

The recovery of locomotion, following interactive training with graded weight support, in the adult spinal cat has led to the proposal that removal of body weight may be a therapeutic tool in human gait retraining. There would be benefits, however, in knowing normal responses of humans to partial weight bearing before applying this strategy to patients. In this study, 10 nondisabled male subjects walked on a treadmill while 0%, 30%, 50%, and 70% of their body weight was supported by a modified climbing harness. To dissociate the changes attributable to walking speed from those attributable to body weight, each subject walked at the specified body-weight-support (BWS) levels and at full weight bearing (FWB) at the same speed. Simultaneously, electromyographic data from the right leg muscles, footswitch signals, and video recording of joint motion were collected. The FWB and BWS gaits appeared similar, except at the highest level of BWS studied (ie, 70% of BWS). Significant differences among other BWS and FWB trials at comparable speeds included decreases in percentage of stance, percentage of total double-limb support time, and maximum hip and knee flexor swing angle. Other adaptations to BWS were a reduction in the mean burst amplitude of the muscles that are active during stance and an increase in the mean burst amplitude of the tibialis anterior muscle. The possible implications of this new gait retraining strategy for patients with neurological impairment are discussed. [Finch L, Barbeau H, Arsenault B. Influence of body weight support on normal human gait: development of a gait retraining strategy.

Adult↗
PubMed1993

Temporal and spatial parameters of gait in children. II: Pathological gait.

Temporal and spatial parameters of gait were measured in 72 children with anomalous walking patterns as a result of neuromuscular impairment, 21 with childhood hemiplegia, 27 with congenital paraplegia and 24 with miscellaneous neuromotor disorders. Measurements were compared with those for a group of normal children. In all three groups, step length, average maximum foot-velocity and walking speed were reduced, double support time was increased, while cadence deviated from normal in both directions. Hemiplegic children varied considerably in their measured side-to-side gait asymmetries, suggesting a range of gait abnormalities not specified by subjective means alone. Measured gait parameters were significantly related to Hoffer grade of functional mobility in paraplegic children. Objective gait analysis using established temporal and spatial measurements is of clinical value in the management of childhood neuromuscular disorders.

Adolescent↗
PubMed1997

Gait analysis by measuring ground reaction forces in children: changes to an adaptive gait pattern between the ages of one and five years.

The aim of this study was to look at the maturational profile of gait parameters by measuring ground reaction forces during independent walking in children. Fifty-four normal children aged 1 to 5 years were examined. The children walked with eight force transducers under each sole. Gait velocity and step length increased with age, whereas step frequency remained relatively constant. Phases of double ground contact expressed as percentages of the total gait cycle decreased significantly from age 1 to 5 with the steepest decrease occurring in the first year of independent walking. No asymmetry between left and right could be detected for any of these parameters. The pattern of ground reaction forces with a significant heel strike and obvious enrollment process resembling that in adults was achieved between the age of 2 and 3 years. Measuring ground reaction forces is a fast and easily manageable method of analysing gait pattern in children and is also a promising tool for detection of gait abnormalities in children with neurological disease.

Adaptation, Physiological↗
PubMedDate not supplied

Accuracy and optimization of force platform gait analysis in Labradors with cranial cruciate disease evaluated at a walking gait.

OBJECTIVE: To determine the combination of ground reaction forces (GRFs) that best discriminates between lame and non-lame dogs. To compare the sensitivity of force platform gait analysis and visual observation at detecting gait abnormalities in Labradors after surgery for rupture of the cranial cruciate ligament (CCL). ANIMALS: All dogs were adult Labrador Retrievers: 17 free of orthopedic and neurologic abnormalities, 100 with unilateral CCL rupture, and 131 studied 6 months after surgery for unilateral CCL injury, 15 with observable lameness. PROCEDURE: Dogs were walked over a force platform with GRF recorded during the stance phase. Analytic properties of force platform gait analysis were calculated for several combinations of forces. The probability of visual observation detecting a gait abnormality was compared with that of force platform gait analysis. RESULTS: We determined that a combination of peak vertical force (PVF) and falling slope were optimal for discriminating sound and lame Labradors. After surgery, many dogs (75%) with no observable lameness failed to achieve GRFs consistent with sound Labradors. CONCLUSION: A force platform is an accurate method of assessing lameness in Labradors with CCL rupture and is more sensitive than visual observation. Assessing lameness with a combination of GRFs is better than using univariate GRFs. CLINICAL RELEVANCE: Therapies for stifle lameness can be accurately and objectively evaluated using 2 vertical ground reaction forces obtained from a force platform.

Animals↗