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At least 109 records · Page 6Linked to original sources
PubMed2005

Measuring gait and gait-related activities in Parkinson's patients own home environment: a reliability, responsiveness and feasibility study.

The aim of this study was to assess reliability, responsiveness and feasibility of gait and gait related tests in the home of patients with Parkinson's disease (PD). The Unified Parkinson's Disease Rating Scale, a timed walking test, the Timed Get Up and Go test the Berg Balance Scale and the Functional Reach test were applied by three independent observers on 26 PD patients. Moderate to high Intraclass Correlation Coefficients were found, ranging from 0.74 to 0.88 and 0.64 to 0.87 for the intra- and inter-observer reliability, respectively. All test showed Reliable Change Indexes under 11% and the whole test battery was applicable within 30 min.

Activities of Daily Living↗
PubMed1998

Energy expenditure during gait using the walkabout and isocentric reciprocal gait orthoses in persons with paraplegia.

OBJECTIVE: To compare the energy expenditure during walking using the Walkabout Orthosis (WO) and the Isocentric Reciprocal Gait Orthosis (IRGO) in persons with paraplegia. DESIGN: A randomized cross-over design. PATIENTS: Ten individuals with complete T9-12 paraplegia. INTERVENTIONS: Subjects were trained to walk using the WO and the IRGO with elbow crutches. MAIN OUTCOME MEASURES: Subjects' energy expenditures during walking using each orthosis over three different terrains--flat tile, flat carpet, and 4 degrees uphill ramp--were compared. Data collected included expired ventilation (L/min), heart rate (beats/ min), speed of walking (m/min), oxygen uptake (VO2; L/min and mL/kg/min), oxygen cost (O2 cost; mL/kg/m), and Physical Cost Index (PCI; beats/m). Subjects walked at a self-selected pace. RESULTS: Subjects walked significantly slower with the WO than with the IRGO, regardless of the surface (p < .05). The average speed of walking ranged from 5.2+/-1.3 for the WO on the tiled surface to 11.5+/-2.3m/min for the IRGO on the carpeted surface. Despite marked differences in self-selected walking speeds between the two orthoses, there were no differences in either heart rate or VO2 among orthoses or surfaces. However, the O2 cost of gait was significantly greater for the WO (range, 3.95 to 4.91mL/kg/m) compared with the IRGO (range, 1.6 to 1.8mL/kg/m). Likewise, the PCI was significantly greater using the WO (range, 8.4 to 10.3beats/m) than the IRGO (range, 4.3 to 7.0beats/m). CONCLUSIONS: This study shows that the metabolic demands of walking with the WO are greater than walking with the IRGO in individuals with T9-12 paraplegia.

Adult↗
PubMedDate not supplied

Measured versus predicted vertical displacement of the sacrum during gait as a tool to measure biomechanical gait performance.

The vertical displacement of the sacrum during walking is proposed as an estimation of the overall biomechanical performance of walking, independent of cardiopulmonary factors. Vertical sacral displacement during walking was measured using an optoelectronic motion analysis system in 10 normal volunteers at variable speeds. Oxygen consumption was simultaneously measured. The actual vertical displacement of the sacrum, when correlated with body weight, reliably predicted oxygen consumption (r2 = 0.91). The relationship between vertical sacral displacement and oxygen consumption persisted when controlling for the variables, velocity, square of velocity, cadence or stride length, each known to co-vary with cardiopulmonary performance. A mathematic model designed to predict the vertical displacement of the sacrum, based on sacral height and average stride length, was tested. The actual vertical sacral displacement correlated with predicted displacement (r = 0.94). Unilateral immobilization of each subject's knee resulted in a greater average vertical sacral displacement during gait than predicted. Comparing measured with predicted vertical sacral displacement may provide a clinically useful and specific overall assessment of biomechanical gait performance.

Adult↗
PubMed1993

A comparison of paraplegic gait performance using two types of reciprocating gait orthoses.

This study examined the energy cost of ambulation using the reciprocating gait orthosis (RGO) and the modified Isocentric RGO in paraplegic spinal cord injured subjects. In 4 subjects, the rates of O2 consumption per minute, O2 cost per metre, heart rate (HR), respiratory exchange ratio, velocity, and physiologic cost index (PCI) were measured during ambulation with the two orthotic devices. PCI was calculated by dividing the difference between walking and resting HR by velocity. PCI was significantly lower during ambulation trials with the Isocentric RGO compared to the RGO, but was the only measurement that detected a significant difference between the two orthotic devices. These results indicate that energy costs of ambulation at self-selected speeds were lower with the Isocentric RGO compared to the standard RGO. Furthermore, PCI could be used as a sensitive indicator of gait efficiency in spinal cord injury subjects.

Adult↗
PubMed1997

The influence of the reciprocal cable linkage in the advanced reciprocating gait orthosis on paraplegic gait performance.

A wide variety of mechanical orthoses is available to provide ambulation to paraplegic patients. Evaluation of energy cost during walking in each of these devices has been acknowledged as an important topic in this field of research. In order to investigate the benefits of a ballistic swing on gait performance in the Advanced Reciprocating Gait Orthosis (ARGO) a study was conducted in which the ARGO was compared with an orthosis with freely swinging legs. This Non Reciprocally linked Orthosis (NRO) was obtained by removing the reciprocal linkage in the subjects' own ARGOs. Subsequently, flexion/extension limits were mounted to permit adjustment of stride length. Six male paraplegic subjects with lesions ranging from T4 to T12 were included in the study. A single case experimental design (B-A-B-A) was conducted in order to improve internal validity. Biomechanical and physiological parameters were assessed and the subjects' preference for either ARGO or NRO was determined. It was found that large inter-individual differences produced insufficient evidence in this study to draw general conclusions about difference in energy expenditure between both orthoses. However, individual analysis of the results showed a reduction of oxygen cost (range: 4%-14%) in the NRO in T9 and T12 lesions, while oxygen cost in subjects with T4 lesions increased markedly (22% and 40%). It is concluded that patients with low level lesions could benefit in terms of oxygen lost from removing the reciprocal cable linkage in the ARGO. However, only one subject preferred the NRO for walking, whereas none of the subject chose the NRO for use in daily living activities. Removal of the reciprocal cable linkage in the ARGO may not be desirable for these patients.

Adult↗
PubMed1976

[Treatment of Spastic Gait Disorders Using an "Electro-Gait-Stimulator ("Schrittstimulator") (author's transl)].

A short historical outline of electric treatment of spasticity is given. A specially developed management with a "gait-stimulator" is described. Four muscles of each lower extremity being mainly engaged in walk were electrically stimulated in the physiological sequences according to the normal gait. The used electric impulses were of a duration of 0,25 msec and an intensity up to 700 V. Using such a "gain-stimulator" in spastic-paraparetic patients a reduced spasticity has been achieved. Positive effect of this treatment has been mostly pronounced, when the programming of impulses was adjusted to the end of the expected physiological contraction of the corresponding muscles. Physiological and pathological data of the "Silent period" is proposed to be mostly involved. The application of impulses in physiological sequences seems to reactivate normal reflex - mechanisms which are disturbed by supraspinal laesion. The results indicate that the electric impulses activates muscle-sensory - organs and that impulses on these organs produce a pace-making function on the spinal cord, which lessens spasticity.

Adult↗
PubMed2001

Propulsive function during gait in diplegic children: evaluation after surgery for gait improvement.

Seventeen patients with diplegic cerebral palsy were assessed by clinical examination and three-dimensional gait analysis before and after surgery to improve gait. Selection of surgical procedures was according to a fixed set of selection criteria. The average postoperative follow-up was 3.8 years (range, 2.6-5.7 years). Clinical examination revealed an improved range of motion for the ankle and no reduction in the power grade at the hip, knee and ankle after surgery. Kinematic parameters showed improved knee extension in stance and significant changes towards a normal ankle motion pattern postoperatively. Kinetic evaluation demonstrated that most of the total power during walking was generated at the hip, with the ankle contributing a small part. After surgery, patients walked faster with an increased power generation at the hip during first double support and at the ankle during push off. Power generation at the hip in stance is pointed out to be an important mechanism for propulsion during walking.

Adolescent↗
PubMedDate not supplied

Which are the best instruments for measuring disabilities in gait and gait-related activities in patients with rheumatic disorders.

OBJECTIVES: Our first objective was to make an inventory of available instruments for the assessment of disabilities in gait and related activities in patients with rheumatic disorders. Our second aim was to investigate which of these instruments have acceptable methodological quality with regard to reliability and validity. Our third aim was to investigate the assumption that the evaluation of convergent construct validity results in stronger correlations when validated against a more similar construct. MATERIALS: A computer-aided literature search (1982-2001) of several databases was performed to identify studies focusing on the clinimetric properties of instruments to assess impairments in function in patients with rheumatic disorders. Data on intra-rater reliability, inter-rater reliability and convergent construct validity were extracted in a standardized manner and compared to a priori defined criteria. RESULTS: In total 78 instruments were eligible. Intra-observer reliability was investigated for 28 instruments and only 7 demonstrated good reliability as well as good validity. Surprisingly, the convergent construct validation against a similar construct resulted often in lower correlations than validation against a less similar construct. CONCLUSION: Based on the available information, the Rheumatoid Arthritis Quality of Life Scale and the Health Assessment Questionnaire seem to be the best instruments for assessing disabilities in gait and related activities in patients with rheumatic disorders.

Databases, Factual↗
PubMed1979

Assessment of gait disability in hemiplegics. Hemiplegic gait.

A clinical method of recording gait patterns in patients with hemiplegia is described. The method is directed towards obtaining an objective assessment for research purposes primarily but could also be readily used clinically. The basis of the method is a pathway from which one can obtain measurements of the temporal and distance factors of gait. The data so obtained is processed to produce a comprehensive set of results presented in a readily understandable form. Sample results are illustrated and explained. Possible system improvements and applications are discussed.

Aged↗
PubMed1997

[Gait analysis in dogs. 2: Installation of a gait analysis laboratory and locomotion studies].

Following a review of the literature on dynamometric and kinemetric measurement systems in tetrapods (part 1, 19), the selection criteria and construction of a gait analysis laboratory for small animals at the Department of Veterinary Surgery of the Ludwig-Maximilians-University of Munich is described. The system consists of three units: a treadmill with integrated forceplates, a 3D-video motion analysis system, and dedicated computer and system software. The value of the equipment is demonstrated by means of results of clinical gait examinations (part 2). An advantage of the Munich system is that measurements of all four limbs on the treadmill can be repeated continuously and simultaneously.

Animals↗
PubMedDate not supplied

[Gait analysis in cerebral palsy patients--correlations between disorders of muscle coordination and gait abnormalities].

Electromyographic and gait investigations of 35 patients and 32 healthy persons were evaluated in order to get hints upon the origin of anomalous movements of the pelvis and the spine with following results: a. The amount of the spine motions of CP-patients is significantly greater than that of health persons. The motions of the pelvis of the patients also seems to be greater, but there is no significance. b. The average electromyographical activity of the hip abductors of CP-patients is not remarkably diminished, that of the hip adductors is not increased. We also found no signs of an atrophy of the hip adductors or a hypertrophy of the hip adductors. c. There is no correlation between the disturbances of coordination of the entire lower leg measured by electromyography and the amount of the pathologic motions. d. We found a distinct correlation between the disturbances especially of the hip ab- and adductors and the amount of the pathologic motions. This amount is the smaller, the worse is the coordination of these two groups of muscles. The topics a-c do not allow to find the origin of the Duchenne- and Trendelenburg limpings of CP-patients, topic d also gives explanation of this fact. In opposition we may suppose here that the bad timing of the coordination resp. the corresponding permanent electrical activity of the hip ab- and adductors has a stabilizing influence upon the pelvis and the spine. As the most probable origin of the increased Duchenne limping we not suppose the increased motions of the stance phase. Our following investigations will deal with this hypothesis.

Adolescent↗
PubMed1984

A comparison of the gaits of paretic patients with the gaits of control subjects carrying a load.

The gaits of 15 patients with peripheral and central paresis were studied. They were compared both with a control group of the same age and sex and with a group of nine subjects who carried varying weights. Velocity was low in the patients and this was due to decreases of both stride length and stride frequency. Load did not significantly decrease the velocity of the control subjects, since unlike the patients, they had the ability to compensate for a low stride length by significantly increasing stride frequency. The significant lowering of stride length in both groups was a similarity between them. The patients were also similar to the loaded normal subjects in having a shortened duration of the single support and a prolonged double support. The patients with hemisymptoms also showed significant differences between the two sides for the durations of both single and double support. The results obtained from this study justify our hypothesis that a subject who is carrying a load may in certain respects be considered as a model of a subject with paresis. The remaining differences may be explained by the fact that in the experimental situation, the leg was loaded only during stance, while in paresis the legs may be considered relatively loaded during the whole stride.

Adult↗