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At least 91 records · Page 5Linked to original sources
PubMed2000

Measurements of temporal aspects of gait obtained with a multimemory stopwatch in persons with gait impairments.

STUDY DESIGN: Repeated measures of 14 temporal factors of gait obtained with a multimemory stopwatch from a variety of subjects with locomotor impairments. OBJECTIVES: To estimate the intratester and intertester reliability of 14 temporal factors of gait by using a multimemory stopwatch; to compare novice and expert clinicians at mastery of making these temporal measurements. BACKGROUND: Temporal gait measures are useful for describing the effectiveness of treatment interventions in patients with locomotor impairments. METHODS AND MEASURES: Eleven adult subjects (mean age, 48.4 years; SD, 5.7 years), 10 with locomotor impairments and 1 elderly adult, ambulated along a 6-m walkway 3 times at a self-selected walking speed. The subjects were videotaped from the side as they walked. Four physical therapists independently analyzed the videotapes on 2 occasions; 2 examiners were recent graduates, and 2 others had 23 years of clinical experience. Intraclass correlation coefficients were used to estimate intratester reliability. A component of variance analysis quantified the sources of variation. RESULTS: Intraclass correlation coefficients for each of the 14 variables varied from 0.88 to 0.98. The major contributor to variance was subject, followed by trial, error, and tester; the tester factor generally contributed less than 1% to the total variance. CONCLUSIONS: Reliable measurements of the temporal aspects of gait can be made by using a multimemory stopwatch and videotape in a clinical setting on patients with various locomotor problems. Our data suggest that measurements obtained by more experienced physical therapists were no more reliable than those made by recent graduates.

Adolescent↗
PubMed1998

A new method for evaluating motor control in gait under real-life environmental conditions. Part 2: Gait analysis.

OBJECTIVE: The validity of assessing balance in gait by measuring balance in standing is questionable. Better methods for measuring balance during walking are therefore needed. DESIGN: It is suggested that the individual will demonstrate adequate postural control by moving a reference point near the body centre of mass (CoM) smoothly towards an intentional goal, even though movements of the extremities show variability consistent with a changing environment. BACKGROUND: In spite of an increased interest in variability as a prerequisite for motor control, gait analysis methods focus, to a large extent, on symmetry and repeatability of movements in stereotyped settings. METHODS: Acceleration of a reference point over the lumbar spine is registered during walking by a portable, triaxial accelerometry system. RESULTS: A quadratic relation between acceleration root mean square (RMS) and walking speed is demonstrated, and a second degree polynomial can therefore be computed as a curve estimate, if acceleration RMS representing at least three walking speeds are available. CONCLUSIONS: The relation between acceleration over a reference point on the trunk and walking speed can be compared between trials and also when walking speeds are self-selected. Calibration procedures and testing of the instrument for precision and accuracy in a mechanical testing jig are described in a companion article. RELEVANCE: This study suggests a new alternative to the traditions of measuring balance in standing and movements of the legs in walking. The method allows balance in gait to be assessed at self-selected speeds in relevant environmental conditions, which may facilitate gait analysis in the clinic and improve the validity of the results.

Journal Article↗
PubMed2006

The sequence effect and gait festination in Parkinson disease: contributors to freezing of gait?

Festination and freezing of gait (FOG) are poorly understood gait disorders that cause disability and falls in people with Parkinson disease (PD). In PD, basal ganglia malfunction leads to motor set deficits (hypokinesia), while altered motor cue production leads to a sequence effect, whereby movements becomes progressively smaller as in festination. We suggest both factors may contribute to FOG. Disturbance of set maintenance by the basal ganglia in PD has previously been examined in gait, but limited systematic evaluation of the sequence effect exists. In this study, we investigated the step-to-step amplitude relationship in 10 PD subjects with clinical evidence of festination and FOG. Four conditions were examined: off levodopa, off with attentional strategies, off with visual cues, and on levodopa. Participants demonstrated a sequence effect (F = 6.24; P = 0.001), which was reversed only by use of visual cues. In contrast, medication, attentional strategies, and visual cues all improved hypokinesia. Variability was marked both within and between participants in all conditions. The variability of FOG is suggested to relate to a combination of factors, including the sequence effect and its variability, as well as the severity of hypokinesia and its response to medications.

Aged↗
PubMed1980

Electronic studies of gait disturbances. A new method of gait examination in patients with arthrodesis of the ankle and/or subtalar joint.

A follow-up study on 160 patients with an arthrodesis of the ankle and/or subtalar joint has been made. Besides clinical and roentgenological examinations the gait of the patients was checked with a new electronic device. In addition we tested the pressure distribution underneath the sole of the affected foot and compared it to the contralateral side. This was found to be a valuable contribution to the examination methods used and can help to give a more objective judgement of the patients subjective complaints. Besides confirming known facts it was found that there were divergent results of electronic gait studies from examinations which are based on the usual clinical and X-ray studies. This may help to improve the patient's gait by correcting mechanical aids or, in rare cases, indicating another operation.

Ankle Joint↗
PubMed2001

Simulation of gait and gait initiation associated with body oscillating behavior in the gravity environment on the moon, mars and Phobos.

A double-inverted pendulum model of body oscillations in the frontal plane during stepping [Brenière and Ribreau (1998) Biol Cybern 79: 337-345] proposed an equivalent model for studying the body oscillating behavior induced by step frequency in the form of: (1) a kinetic body parameter, the natural body frequency (NBF), which contains gravity and which is invariable for humans, (2) a parametric function of frequency, whose parameter is the NBF, which explicates the amplitude ratio of center of mass to center of foot pressure oscillation, and (3) a function of frequency which simulates the equivalent torque necessary for the control of the head-arms-trunk segment oscillations. Here, this equivalent model is used to simulate the duration of gait initiation, i.e., the duration necessary to initiate and execute the first step of gait in subgravity, as well as to calculate the step frequencies that would impose the same minimum and maximum amplitudes of the oscillating responses of the body center of mass, whatever the gravity value. In particular, this simulation is tested under the subgravity conditions of the Moon, Mars, and Phobos, where gravity is 1/6, 3/8, and 1/1600 times that on the Earth, respectively. More generally, the simulation allows us to establish and discuss the conditions for gait adaptability that result from the biomechanical constraints particular to each gravity system.

Gait↗
PubMed1995

A body-worn gait analysis system for evaluating hemiplegic gait.

This paper describes a system for measuring the temporal parameters of hemiplegic gait. This system uses shoe insoles with sensors, acting as switches, placed under the heel, head of the first metatarsal, head of the fifth metatarsal and the big toe. This system is able to monitor gait for up to 10 min and can be used by the patient over any surface. Parameters for evaluating hemiplegic gait are defined, including scuffing during swing and the degree of inversion during stance.

Cerebrovascular Disorders↗
PubMed2005

Does bilateral total knee arthroplasty affect gait in women?: comparison of gait analyses before and after total knee arthroplasty compared with normal knees.

We performed gait analysis of 24 patients with bilateral knee osteoarthritis (OA) before, 1 year, and 2 years after bilateral total knee arthroplasty and compared these results to 12 normal controls. Cadence was significantly decreased in OA patients when compared with controls. Step and stride lengths were significantly different preoperatively (shorter) and postoperatively (P < .05), but postoperative results showed no significant difference when compared with normal controls (P < .05). Step and stride times were significantly different (P < .05) between the preoperative OA group and controls, but no difference was seen with the postoperative measurements when compared with controls. In the OA group, the mean vertical component of the ground reaction forces expressed as percent body weight was significantly lower when compared with controls and postoperative results. No correlation was found between the preoperative and postoperative clinical scores and objective data obtained from gait analysis. Our results demonstrate that gait analysis is not a useful tool in evaluating the success of total knee arthroplasty patient.

Aged↗
PubMed2006

Modulation of the withdrawal reflex during hemiplegic gait: effect of stimulation site and gait phase.

OBJECTIVE: The objective of the study was to investigate the sensitivity of the nociceptive withdrawal reflex to stimulation of different locations on the sole of the foot during hemiplegic gait. METHODS: Reflexes were evoked by cutaneous electrical stimulation of 4 locations on the sole of the foot of 7 hemiplegic and 6 age-matched healthy persons. The stimuli were delivered at heel-contact, during foot-flat, at heel-off, and during mid-swing. Reflexes were recorded from muscles of the stimulated and the contralateral leg. Ankle, knee, and hip joints angles were recorded using goniometers. RESULTS: In the hemiplegic persons, the size of tibialis anterior reflexes, and the latency of soleus reflexes were site- and phase-modulated. In both groups, the tibialis anterior reflexes were significantly smaller with stimulation to the fifth metatarsophalangeal joint and the heel compared with the first metatarsophalangeal joint and the arch of the foot. The tibialis anterior reflexes evoked at heel-off and mid-swing were larger in hemiplegic persons than in healthy persons. Reflexes in the proximal and contralateral limb muscles were not site-modulated during hemiplegic gait. The kinematic response at the ankle joint was also different in the two groups during mid-swing. CONCLUSIONS: Hemiplegic and healthy middle-aged people presented different phase-modulation of the kinematic and muscle nociceptive reflex responses evoked by stimulation delivered on the sole of the foot. SIGNIFICANCE: The results have potential application in programs to rehabilitate hemiplegic gait.

Aged↗
PubMed2005

Relationship between energy cost, gait speed, vertical displacement of centre of body mass and efficiency of pendulum-like mechanism in unilateral amputee gait.

The energy cost of gait (C) is greater in amputee than in normal subjects. Our objective was to assess the influence of lower speed, inefficient pendulum mechanism and disturbed smoothness of centre of body mass (CM(b)) displacement on C in unilateral amputees and to have a better understanding the relationship between these variables. Twelve adult patients (six traumatic transfemoral and six vascular transtibial amputees) participated in the study. Lower limb kinematics, displacement of CM(b), mechanical work done by the muscles to move the CM(b) and the segments due to their movements relative to the CM(b), efficiency of the pendulum mechanism, and C were assessed simultaneously in the 12 amputees walking at their self-selected speed. Our results show that C depended on gait speed, and efficiency of pendulum-like mechanism of walking but did not depend on the smoothness of CM(b). The use of only a single variable to explain the extra cost in amputee gait could sometimes be misleading.

Adult↗
PubMed1993

Gait disorders in the elderly. Distinguishing between normal and dysfunctional gaits.

Normal gaits in the elderly population vary widely. Characteristics of normal and abnormal gaits often overlap, making diagnosis of ambulation disorders difficult in some patients. Abnormal gaits are usually caused by musculoskeletal and/or neurologic abnormalities, which can be readily identified in the clinical setting. Prompt diagnosis and appropriate treatment may save an elderly patient from immobility, fall-related injury, loneliness, and depression.

Aged↗
PubMed1990

Subtle abnormalities of gait detected early in vitamin B6 deficiency in aged and weanling rats with hind leg gait analysis.

Motor abnormalities have been observed in every species made vitamin B6 deficient, and have been detected and quantified early in vitamin B6 deficiency in young adult female Long-Evans rats with hind leg gait analysis. Our objective was to determine if hind leg gait analysis could be used to detect vitamin B6 deficiency in weanling (3 weeks) and aged (23 months) Fischer 344 male rats. Rats (n = 10 per group) were fed: the control diet ad libitum (AL-CON); the control diet devoid of added pyridoxine hydrochloride (DEF); or the control diet pair-fed to DEF (PF-CON). At 10 weeks, plasma pyridoxal phosphate concentration confirmed deficiency in both age groups. Gait abnormalities were detected in the absence of gross motor disturbances in both aged and weanling DEF rats at 2-3 weeks. Width of step was significantly reduced (16%, p less than 0.003) in DEF aged rats compared to AL- and PF-CON. This pattern of response was similar to that reported previously in young adult rats. In weanling rats, pair feeding alone reduced mean width of step (+/- SEM) by 25% compared to ad libitum feeding (2.7 +/- 0.1 vs 3.6 +/- 0.1 cm for PF- vs AL-CON, respectively, p less than 0.05). In DEF weanling rats, width (3.0 +/- 0.1 cm) was increased compared to PF-CON (11%, p less than 0.05) but decreased compared to AL-CON (16%, p less than 0.05). Width of step was significantly altered early in B6 deficiency in rats of different ages and strains and in both sexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1984

Gait analysis techniques. Rancho Los Amigos Hospital gait laboratory.

In the gait laboratory at Rancho Los Amigos Hospital, the emphasis is on patient testing to identify functional problems and determine the effectiveness of treatment programs. Footswitch stride analysis, dynamic EMG, energy-cost measurements, force plate, and instrumented motion analysis are the techniques most often used. Stride data define the temporal and distance factors of gait. We use this information to classify the patient's ability to walk and measure response to treatment programs. Inappropriate muscle action in the patient disabled by an upper motor neuron lesion is identified with dynamic EMG. Intramuscular wire electrodes are used to differentiate the action of adjacent muscles. We use the information to localize the source of abnormal function so that selection of treatment procedures is more precise. Force and motion data aid in determining the functional requirement and the muscular response necessary to meet the demand. Determining the optimum mode of locomotion and developing criteria for program planning have become more realistic with the aid of energy-cost measurements. Microprocessors and personal computer systems have made compact and reliable single-concept instrumentation available for basic gait analysis in the standard clinical environment at a modest cost. The more elaborate composite systems, however, still require custom instrumentation and engineering support.

Adult↗
PubMed2001

Assessment of gait irregularities in the horse: eye vs. gait analysis.

The purpose of this study was to verify the sensitivity of 2 gait analysis methods in detecting subtle lameness and to compare the results to the traditional orthopaedic evaluation. Twenty-two horses were evaluated (1) subjectively by 3 different experienced clinicians and (2) objectively with synchronised ground reaction force and accelerometric gait measurements on a treadmill. The horses were assigned for each of the 3 methods independently to one of 3 groups (GR): sound, lameness front limb, lameness hindlimb. Additionally, for each horse, the affected limb (AL) and degree of lameness (DL) were defined. The accordance between the 3 assessment methods for the categorical variables was tested with a Spearman correlation analysis. The relationship between vertical ground reaction forces and dorsoventral as well as mediolateral accelerations were studied using a Pearson correlation matrix. Significant correlation was found between the clinical GR and GR based on force (r = 0.51, P < 0.05) and acceleration data (r = 0.47, P < 0.05), respectively, and between AL based on clinical and ground reaction force (r = 0.65, P < 0.05) assessment. No significant correlation was found, neither for GR between the 2 measuring methods, nor for DL between the 3 assessment methods. The Pearson correlation matrix revealed significant correlations between peak vertical forces and dorsoventral acceleration in the hindlimbs. We conclude that the measurement of kinetic parameters represents a helpful complementary tool in the assessment of subtle gait alterations. However, this information needs to be interpreted carefully and always related to the clinical observation.

Analysis of Variance↗
PubMed1999

The functional use of the reciprocal hip mechanism during gait for paraplegic patients walking in the Louisiana State University reciprocating gait orthosis.

Reciprocally linked orthoses used for paraplegic walking have some form of linkage between the two hip joints. It has been assumed that flexion of the swinging leg is driven by extension of the stance leg. The aims of this study were to investigate the moments generated around the hip joint by the two cables in a Louisiana State University Reciprocating Gait Orthosis (LSU-RGO). Six (6) subjects were recruited from the Regional Spinal Injuries Centre at Southport, who were experienced RGO users. The cables were fitted with strain gauged transducers to measure cable tension. Foot switches were used to divide the gait into swing and stance phases. A minimum of 20 steps were analysed for each subject. Moments about the hip joint for each phase of gait were calculated. There were no moments generated by the front cable in 4 of the subjects. In only 2 subjects did the cable generate a moment that could assist hip flexion during the swing phase. These moments were very low and at best could only have made a small contribution to limb flexion. The back cable generated moments that clearly prevented bilateral flexion. It was concluded that the front cable, as used by these experienced RGO users, did not aid flexion of the swinging limb.

Biomechanical Phenomena↗
PubMed1980

One leg swing through gait using two crutches. An analysis of the ground reaction forces and gait phases.

Using a Force Plate the gait cycle for one leg swing-through gait of ten normal subjects on Canadian crutches was monitored, and a composite diagram of forces on the lower limb and both crutches was produced. In addition the relationship of the stance and swing phase for both the lower limb and crutches was studied and the percentage of these phases and their overlap included on the composite diagram. The average maximum vertical ground reaction to the leg was 1.32 body weight, 16 per cent higher than that reported for normal walking. The horizontal force on the lower limb in the direction of walking was 0.35 body weight, compared to 0.15 for normal walking. Vertical ground reaction to crutches was on average 0.54 body weight on the side of the landing leg and 0.51 on the contralateral side. Horizontal ground reaction on the crutches at right angles to the direction of ambulation was 0.09 body weight on the right and 0.08 on the left. The results were considered to indicate caution in the prescription of one leg swing-through gait in subjects with diseased bone and joints in the lower limb.

Adult↗
PubMedDate not supplied

Treatment of stiff-knee gait in cerebral palsy: a comparison by gait analysis of distal rectus femoris transfer versus proximal rectus release.

Two groups of patients with cerebral palsy (CP) were studied pre- and postoperatively by gait analysis after proximal release or distal transfer of the rectus femoris for treatment of knee stiffness in swing phase. In the first group studied, 12 patients underwent proximal rectus femoris muscle release. In the second group, 10 patients underwent distal rectus femoris transfer. After surgery, peak knee flexion was increased 9.1 degrees in swing phase by proximal rectus release and 16.2 degrees by distal rectus transfer. Hip motion throughout the gait cycle was not significantly affected by either operation, and no tendency for a crouch gait was observed after either procedure.

Adolescent↗
PubMed1978

The assessment of the internal rotation gait in cerebral palsy: an electromyographic gait analysis.

A study of 12 cerebral palsied children with internal rotation revealed three patterns of electromyographic activity: (1) Diagnostic pattern--where a simple muscle group stood out as the responsible agent--notably the medial hamstrings; (2) Nondiagnostic pattern--nonrecurring pattern; (3) Nondiagnostic pattern--recurring "mass limb reflex" pattern. In all cases, electromyography was useful for: (1) confirmation of clinical impressions. Electromyographic confirmation of phasic hamstring overactivity gives a firm basis for tendon surgery with expectancy of good results. (2) Detection of the responsible muscle group where clinical methods fail to do so. It detects the "at risk" patients, where follow up with tendon surgery at the appropriate time could be performed with predictable results. (3) Selection of patients who are likely to respond to tendon surgery, and those unlikely to benefit from it. The adductors and internal rotators may play only a secondary role in children whose predominant problem is internal rotation during gait. The medial hamstrings stand out as the most important single muscle group causing this problem. Consequently, it is important to analyze gait problems with the patient walking, and examine electromyographs during walking in the overall assessment of a patient with dynamic gait problem.

Adolescent↗
PubMed2005

Leg lengthening as part of gait improvement surgery in cerebral palsy: an evaluation using gait analysis.

Eleven children with hemiplegic or an asymmetric diplegic cerebral palsy who had a preoperative leg length discrepancy of more than 2.5 cm underwent gait improvement surgery which included leg length equalisation. Sagittal plane kinematics and kinetics before and about 3 years after surgery for the lengthened limb and contralateral limb were evaluated. Preoperatively the unaffected limb had excessive stance phase flexion at the hip and knee, and dorsal flexion at the ankle joint. These changes could be partially reversed to produce a kinematic gait pattern comparable to age matched normal controls on the uninvolved side after equalisation of leg length.

Adolescent↗