scholarly journals Can an observational gait scale produce a result consistent with 3-dimensional gait analysis?: a prospective observational study

2019 ◽  
Author(s):  
Agnieszka Guzik ◽  
Mariusz Drużbicki ◽  
Lidia Perenc ◽  
Justyna Podgórska-Bednarz
Keyword(s):  
Gait Analysis ◽  
Range Of Motion ◽  
Knee Flexion ◽  
Trial Registration ◽  
Ordinal Scale ◽  
3D Analysis ◽  
3 Dimensional ◽  
Observational Tool ◽  
Gait Parameters ◽  
Flexion Extension

Abstract Background: To investigate whether a simple observational tool may be a substitute to the time-consuming and costly 3-dimensional (3D) analysis, the study applied the Wisconsin Gait Scale (WGS), enabling assessment which is highly consistent with 3D gait parameters in individuals after stroke. The aim of this study was to determine whether, and to what extent, observational information obtained from WGS-based assessment can be applied to predict results of 3D gait analysis for selected symmetry indicators related to spatiotemporal and kinematic gait parameters. Methods: Fifty individuals at a chronic stage of recovery post-stroke were enrolled in the study. The spatiotemporal and kinematic gait parameters were measured using a movement analysis system. The Symmetry Index (SI), was calculated for selected gait parameters. The study participants’ gait was evaluated by means of the WGS. The regression analysis was applied to investigate whether a simple observational tool may be a substitute to the time-consuming and costly 3D analysis. Results: It was shown that 3D SI, related to Stance Time [s], Stance %, Hip and Knee Flexion-Extension Range of Motion may be described with fairly high accuracy using item questions of the WGS (0.7≤|R|<0.9; 0.9≤|R|<1). This initial finding provided a rationale for the assumption that a combination of selected WGS items may enable even more accurate estimation of SI for 3D parameters. It was shown that Stance % SI, Hip and Knee Flexion-Extension Range of Motion SI can most effectively be substituted by WGS-based estimations – coefficient of determination exceeding 80%. Conclusions: It was shown that information acquired based on the WGS can be used to obtain results comparable to those achieved in 3D assessment for selected SIs of spatiotemporal and kinematic gait parameters. The study confirms that observation of gait using the WGS, which is an ordinal scale, is consistent with the main aims of 3D assessment, therefore the scale can be recommended as a substitute tool in gait assessment. Trial registration: ANZCTR, ACTRN12617000436370. Registered 24 March 2017, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372248.

scholarly journals Can an Observational Gait Scale Produce a Result Consistent with Symmetry Indexes Obtained from 3-Dimensional Gait Analysis?: A Concurrent Validity Study

2020 ◽  
Vol 9 (4) ◽  
pp. 926
Author(s):  
Agnieszka Guzik ◽  
Mariusz Drużbicki ◽  
Lidia Perenc ◽  
Justyna Podgórska-Bednarz
Keyword(s):  
Gait Analysis ◽  
Movement Analysis ◽  
Ordinal Scale ◽  
Coefficient Of Determination ◽  
3D Analysis ◽  
3 Dimensional ◽  
Observational Tool ◽  
Gait Parameters ◽  
Flexion Extension ◽  
Analysis System

To investigate whether a simple observational tool may be a substitute to the time-consuming and costly 3-dimensional (3D) analysis, the study applied the Wisconsin Gait Scale (WGS), enabling assessment which is highly consistent with 3D gait parameters in patients after a stroke. The aim of this study was to determine whether, and to what extent, observational information obtained from WGS-based assessment can be applied to predict results of 3D gait analysis for selected symmetry indicators related to spatiotemporal and kinematic gait parameters. Fifty patients at a chronic stage of recovery post-stroke were enrolled in the study. The spatiotemporal and kinematic gait parameters were measured using a movement analysis system. The symmetry index (SI), was calculated for selected gait parameters. The patients’ gait was evaluated by means of the WGS. It was shown that stance % SI, as well as hip and knee flexion-extension range of motion SI can most effectively be substituted by WGS-based estimations (coefficient of determination exceeding 80%). It was shown that information acquired based on the WGS can be used to obtain results comparable to those achieved in 3D assessment for selected SIs of spatiotemporal and kinematic gait parameters. The study confirms that observation of gait using the WGS, which is an ordinal scale, is consistent with the selected aims of 3D assessment. Therefore, the scale can be used as a complementary tool in gait assessment.

scholarly journals Effects of selectively assisting impaired subtasks of walking in chronic stroke survivors

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Simone S. Fricke ◽  
Hilde J. G. Smits ◽  
Cristina Bayón ◽  
Jaap H. Buurke ◽  
Herman van der Kooij ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Step Length ◽  
Gait Training ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Baseline Trial ◽  
Gait Parameters ◽  
Flexion Extension ◽  
Spatiotemporal Parameters ◽  
Length Width

Abstract Background Recently developed controllers for robot-assisted gait training allow for the adjustment of assistance for specific subtasks (i.e. specific joints and intervals of the gait cycle that are related to common impairments after stroke). However, not much is known about possible interactions between subtasks and a better understanding of this can help to optimize (manual or automatic) assistance tuning in the future. In this study, we assessed the effect of separately assisting three commonly impaired subtasks after stroke: foot clearance (FC, knee flexion/extension during swing), stability during stance (SS, knee flexion/extension during stance) and weight shift (WS, lateral pelvis movement). For each of the assisted subtasks, we determined the influence on the performance of the respective subtask, and possible effects on other subtasks of walking and spatiotemporal gait parameters. Methods The robotic assistance for the FC, SS and WS subtasks was assessed in nine mildly impaired chronic stroke survivors while walking in the LOPES II gait trainer. Seven trials were performed for each participant in a randomized order: six trials in which either 20% or 80% of assistance was provided for each of the selected subtasks, and one baseline trial where the participant did not receive subtask-specific assistance. The influence of the assistance on performances (errors compared to reference trajectories) for the assisted subtasks and other subtasks of walking as well as spatiotemporal parameters (step length, width and height, swing and stance time) was analyzed. Results Performances for the impaired subtasks (FC, SS and WS) improved significantly when assistance was applied for the respective subtask. Although WS performance improved when assisting this subtask, participants were not shifting their weight well towards the paretic leg. On a group level, not many effects on other subtasks and spatiotemporal parameters were found. Still, performance for the leading limb angle subtask improved significantly resulting in a larger step length when applying FC assistance. Conclusion FC and SS assistance leads to clear improvements in performance for the respective subtask, while our WS assistance needs further improvement. As effects of the assistance were mainly confined to the assisted subtasks, tuning of FC, SS and WS can be done simultaneously. Our findings suggest that there may be no need for specific, time-intensive tuning protocols (e.g. tuning subtasks after each other) in mildly impaired stroke survivors.

scholarly journals KNEE ISOKINETIC TORQUE IMBALANCE IN FEMALE FUTSAL PLAYERS

2017 ◽  
Vol 23 (5) ◽  
pp. 352-356
Author(s):  
Ana Carolina de Mello Alves Rodrigues ◽  
Nathália Arnosti Vieira ◽  
Ana Lorena Marche ◽  
Juliana Exel Santana ◽  
Marco Aurélio Vaz ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Knee Flexion ◽  
Peak Torque ◽  
Joint Angles ◽  
Muscle Imbalance ◽  
Flexion Extension ◽  
Isokinetic Torque ◽  
Extensor Torque ◽  
Joint Range

ABSTRACT Introduction: The specificity of sports training can lead to muscle specialization with a possible change in the natural hamstring/quadriceps torque ratio (HQ ratio), constituting a risk factor for muscle injury at the joint angles in which muscle imbalance may impair dynamic stability. Objective: The aim was to evaluate the torque distribution of the hamstrings and quadriceps and the HQ ratio throughout the range of motion in order to identify possible muscle imbalances at the knee of female futsal athletes. Methods: Nineteen amateur female futsal athletes had their dominant limb HQ ratio evaluated in a series of five maximum repetitions of flexion/extension of the knee at 180°/second in the total joint range of motion (30° to 80°). The peak flexor and extensor torque and the HQ ratio (%) were compared each 5° of knee motion using one-way repeated measures ANOVA and Tukey’s post hoc test (p<0.05) to determine the joint angles that present muscular imbalance. Results: Quadriceps torque was higher than 50° to 60° of knee flexion, while hamstrings torque was higher than 55° to 65°. The HQ ratio presented lower values than 30° to 45° of knee flexion and four athletes presented values lower than 60%, which may represent a risk of injury. However, the HQ ratio calculated by the peak torque showed only one athlete with less than 60%. Conclusion: The HQ ratio analyzed throughout the knee range of motion allowed identifying muscle imbalance at specific joint angles in female futsal players.

Reliability and Accuracy in Three-Dimensional Gait Analysis: A Comparison of Two Lower Body Protocols

2013 ◽  
Vol 29 (1) ◽  
pp. 105-111 ◽  
Author(s):  
Felix Stief ◽  
Harald Böhm ◽  
Katja Michel ◽  
Ansgar Schwirtz ◽  
Leonhard Döderlein
Keyword(s):  
Knee Joint ◽  
Gait Analysis ◽  
Three Dimensional ◽  
Frontal Plane ◽  
Transverse Plane ◽  
Lower Body ◽  
Landmark Identification ◽  
Gait Parameters ◽  
Custom Made ◽  
Flexion Extension

The standard Plug-in-Gait (PiG) protocol used in three-dimensional gait analysis is prone to errors arising from inconsistent anatomical landmark identification and knee axis malalignment. The purpose of this study was to estimate the reliability and accuracy of a custom made lower body protocol (MA) compared with the PiG protocol. Twenty-fve subjects volunteered to evaluate the intertrial reliability. In addition, intersession reliability was examined in 10 participants. An indirect indicator of accuracy according to the knee varus/valgus and flexion/extension range of motion (ROM) was used. Regarding frontal plane knee angles and moments as well as transverse plane motions in the knee and hip joint, the intersession errors were lower for the MA compared with the standard approach. In reference to the knee joint angle cross-talk, the MA produced 4.7° more knee flexion/extension ROM and resulted in 6.5° less knee varus/valgus ROM in the frontal plane. Therefore, the MA tested in this study produced a more accurate and reliable knee joint axis compared with the PiG protocol. These results are especially important for measuring frontal and transverse plane gait parameters.

scholarly journals Estimating Minimal Clinically Important Differences for Knee Range of Motion after Stroke

2020 ◽  
Vol 9 (10) ◽  
pp. 3305
Author(s):  
Agnieszka Guzik ◽  
Mariusz Drużbicki ◽  
Andżelina Wolan-Nieroda ◽  
Andrea Turolla ◽  
Pawel Kiper
Keyword(s):  
Range Of Motion ◽  
Roc Curve ◽  
Sagittal Plane ◽  
Linear Regression Analysis ◽  
Unaffected Side ◽  
Point Change ◽  
Post Stroke ◽  
Gait Parameters ◽  
Flexion Extension ◽  
Estimate Method

The importance of knee sagittal kinematic parameters, as a predictor of walking performance in post-stroke gait has been emphasised by numerous researchers. However, no studies so far were designed to determine the minimal clinically important differences (MCID), i.e., the smallest difference in the relevant score for the kinematic gait parameters, which are perceived as beneficial for patients with stroke. Studies focusing on clinically important difference are useful because they can identify the clinical relevance of changes in the scores. The purpose of the study was to estimate the MCID for knee range of motion (ROM) in the sagittal plane for the affected and unaffected side at a chronic stage post-stroke. Fifty individuals were identified in a database of a rehabilitation clinic. We estimated MCID values using: an anchor-based method, distribution-based method, linear regression analysis and specification of the receiver operating characteristic (ROC) curve. In the anchor-based study, the mean change in knee flexion/extension ROM for the affected/unaffected side in the MCID group amounted to 8.48°/6.81° (the first MCID estimate). In the distribution-based study, the standard error of measurement for the no-change group was 1.86°/5.63° (the second MCID estimate). Method 3 analyses showed 7.71°/4.66° change in the ROM corresponding to 1.85-point change in the Barthel Index. The best cut-off point, determined with ROC curve, was the value corresponding to 3.9°/3.8° of change in the knee sagittal ROM for the affected/unaffected side (the fourth MCID estimate). We have determined that, in chronic stroke, MCID estimates of knee sagittal ROM for the affected side amount to 8.48° and for the unaffected side to 6.81°. These findings will assist clinicians and researchers in interpreting the significance of changes observed in kinematic sagittal plane parameters of the knee. The data are part of the following clinical trial: Australian New Zealand Clinical Trials Registry: ACTRN12617000436370

scholarly journals Comparison of gait using a Multiflex foot versus a Quantum foot in knee disarticulation amputees

1993 ◽  
Vol 17 (2) ◽  
pp. 90-94 ◽  
Author(s):  
A. M. Boonstra ◽  
V. Fidler ◽  
G. M. A. Spits ◽  
P. Tuil ◽  
A. L. Hof
Keyword(s):  
Gait Analysis ◽  
Range Of Motion ◽  
Frontal Plane ◽  
Gait Patterns ◽  
Subjective Responses ◽  
Temporal Parameters ◽  
Gait Parameters ◽  
Hip Range Of Motion ◽  
Temporal Factors ◽  
Knee Disarticulation

The subjective responses and gait patterns of unilateral knee disarticulation amputees wearing prostheses fitted first with the Multiflex foot and then with the Quantum foot were studied. Nine amputees were included in the trial. A questionnaire asked the amputees about their preference for one of the feet. Gait analysis was performed measuring temporal parameters and goniometry of hips, knees and ankles in the sagittal and frontal planes. There was a slight preference for the Quantum foot. Preference seemed not to be related to physical characteristics of the amputees nor to gait parameters. There were no differences in gait as far as the temporal factors were concerned. The main differences in the range of motion of the joints were in the frontal plane: the eversion-inversion movement of the ankle and the adduction-abduction movement of the hip. During walking at comfortable speed with the Multiflex foot the ankle and hip range of motion averaged 2.1 and 3.1 degrees respectively, less than during walking with the Quantum foot.

scholarly journals Gait Characteristics Based on Pain Detect Questionnaire and Pain Catastrophizing Scale in Patients with Knee Osteoarthritis

2021 ◽  
Author(s):  
Kengo Harato ◽  
Yu Iwama ◽  
Kazuya Kaneda ◽  
Shu Kobayashi ◽  
Yasuo Niki ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Knee Osteoarthritis ◽  
Gait Analysis ◽  
Knee Society Score ◽  
Pain Catastrophizing ◽  
Pain Catastrophizing Scale ◽  
Gait Parameters ◽  
Flexion Extension ◽  
Patient Reported ◽  
The Relationship

Abstract Background Although patient-reported evaluation of knee osteoarthritis has been more common, little attention has been paid to the relationship between patient-reported questionnaire and gait analysis. The purpose was to investigate the relationship between patient-reported questionnaire and gait parameters. Methods A total of 31 knees in 31 patients (22 females and 9 males) who were diagnosed as end-stage medial compartmental knee osteoarthritis participated in the present study. All the patients were evaluated based on New Knee Society Score, pain detect questionnaire and pain catastrophizing scale. They were divided into two categories based on pain detect questionnaire scores: Group Low (12 ≥ score) and Group High (score > 12). Gait analysis was performed using three-dimensional motion analysis system. Statistical analysis was done using one-tailed Mann-Whitney U-test to compare age, body mass index, Knee Society Score, pain catastrophizing scale, and gait parameters between groups. Results Twenty-six patients were allocated to Group Low, and five patients were to Group High. Subjective pain during walking was significantly worse in Group Low (P = 0.037) and helplessness in pain catastrophizing scale was notably worse in Group High (P = 0.035). Peak vertical ground reaction force (P = 0.018) and knee adduction moment (P < 0.01) were significantly greater in Group Low. Moreover, flexion-extension excursion during mid-stance phase was significantly smaller in Group Low (P = 0.038). Conclusions Patients with likely neuropathic pain had atypical osteoarthritis-related pain as well as atypical gait pattern, compared to patients without neuropathic pain.

Isolated Talonavicular Arthrodesis for Traumatic Talonavicular Arthritis: Report of 2 Cases With Gait Analyses

2021 ◽  
pp. 193864002110301
Author(s):  
Yuina Nitta ◽  
Hiroyuki Seki ◽  
Yasunori Suda ◽  
Rie Tanabe ◽  
Risa Tsuchiya ◽  
...  
Keyword(s):  
Case Report ◽  
Gait Analysis ◽  
Range Of Motion ◽  
Surgical Procedures ◽  
Clinical Results ◽  
Contralateral Side ◽  
Kinematic Data ◽  
3 Dimensional ◽  
Kinematic Behavior ◽  
Ankle Complex

Isolated talonavicular arthrodesis is one of the surgical procedures for patients with talonavicular arthritis. However, the 3-dimensional kinematic behavior of the hip, knee, and foot/ankle complex during walking after the arthrodesis remains unclear. The clinical outcomes and gait analyses of 2 cases who underwent isolated arthrodesis for talonavicular osteoarthritis with chronic dislocated navicular fracture are presented. Gait analysis was carried out in both cases 1 year after surgery to clarify the side-to-side differences in the ranges of motion of the hip, knee, and foot/ankle complex during walking. Both cases showed good clinical results and radiographic bone union. The kinematic data of the gait analyses showed considerable restriction in the range of motion of the ankle in all 3-dimensional planes for the fused foot compared with the contralateral side. Additionally, hyperextension of the knee in the late stance of gait on the operated side was observed in both cases. When talonavicular arthrodesis was performed for talonavicular osteoarthritis with chronic dislocated navicular fracture, postoperative generalized stiffness of the ankle and future disorder of the knee should be considered. Levels of Evidence: Level V: Case report

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