scholarly journals Smoothness of Gait in Healthy and Cognitively Impaired Individuals: A Study on Italian Elderly Using Wearable Inertial Sensor

Sensors ◽  
2020 ◽  
Vol 20 (12) ◽  
pp. 3577 ◽  
Author(s):  
Massimiliano Pau ◽  
Ilaria Mulas ◽  
Valeria Putzu ◽  
Gesuina Asoni ◽  
Daniela Viale ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Gait Speed ◽  
Stride Length ◽  
Inertial Sensor ◽  
Cognitive Impairments ◽  
Gait Parameters ◽  
Acceleration Data ◽  
Trunk Acceleration ◽  
Spatio Temporal

The main purpose of the present study was to compare the smoothness of gait in older adults with and without cognitive impairments, using the harmonic ratio (HR), a metric derived from trunk accelerations. Ninety older adults aged over 65 (age: 78.9 ± 4.8 years; 62% female) underwent instrumental gait analysis, performed using a wearable inertial sensor and cognitive assessment with the Mini Mental State Examination (MMSE) and Addenbrooke’s Cognitive Examination Revised (ACE-R). They were stratified into three groups based on their MMSE performance: healthy controls (HC), early and advanced cognitive decline (ECD, ACD). The spatio-temporal and smoothness of gait parameters, the latter expressed through HR in anteroposterior (AP), vertical (V) and mediolateral (ML) directions, were derived from trunk acceleration data. The existence of a relationship between gait parameters and degree of cognitive impairment was also explored. The results show that individuals with ECD and ACD exhibited significantly slower speed and shorter stride length, as well as reduced values of HR in the AP and V directions compared to HC, while no significant differences were found between ECD and ACD in any of the investigated parameters. Gait speed, stride length and HR in all directions were found to be moderately correlated with both MMSE and ACE-R scores. Such findings suggest that, in addition to the known changes in gait speed and stride length, important reductions in smoothness of gait are likely to occur in older adults, owing to early/prodromal stages of cognitive impairment. Given the peculiar nature of these metrics, which refers to overall body stability during gait, the calculation of HR may result in being useful in improving the characterization of gait patterns in older adults with cognitive impairments.

What Gait Features Influence the Amount and Intensity of Physical Activity in People with Multiple Sclerosis?

2020 ◽  
Author(s):  
Massimiliano Pau ◽  
Micaela Porta ◽  
Giuseppina Pilloni ◽  
Giancarlo Coghe ◽  
Eleonora Cocco
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Gait Speed ◽  
Stride Length ◽  
Inertial Sensor ◽  
Rank Correlation ◽  
Double Support ◽  
Temporal Parameters ◽  
Gait Parameters ◽  
Spatio Temporal

Abstract Background: Although the mutual relationship between ambulation and Physical Activity (PA) in people with Multiple Sclerosis (pwMS) has been described in several studies, there is still a lack of detailed information about the way in which specific aspects of the gait cycle are associated with amount and intensity of PA. This study aimed to verify the existence of possible relationships among PA parameters and the spatio-temporal parameters of gait when both are instrumentally assessed.Methods: Thirty-one pwMS (17F, 14M, mean age 52.5, mean Expanded Disability Status Scale score 3.1) were requested to wear a tri-axial accelerometer 24h/day for 7 consecutive days and underwent an instrumental gait analysis, performed using an inertial sensor located on the low back, immediately before the PA assessment period. Main spatio-temporal parameters of gait (i.e. gait speed, stride length, cadence and duration of stance, swing and double support phase) were extracted by processing trunk accelerations. PA was quantified using average number of daily steps and percentage of time spent at different PA intensity, the latter calculated using cut-point sets previously validated for MS. The existence of possible relationships between PA and gait parameters was assessed using Spearman’s rank correlation coefficient rho.Results: Gait speed and stride length were the parameters with the highest number of significant correlations with PA features. In particular, they were found moderately to largely correlated with number of daily steps (rho 0.62, p<0.001), percentage of sedentary activity (rho = -0.44, p<0.001) and percentage of moderate-to-vigorous activity (rho = 0.48, p<0.001). Small to moderate significant correlations were observed between PA intensity and duration of stance, swing and double support phases.Conclusions: The data obtained suggest that the most relevant determinants associated with higher and more intense levels of physical activity in free-living conditions are gait speed and stride length.The simultaneous quantitative assessment of gait parameters and PA levels might represent a useful support for physical therapists in tailoring optimized rehabilitative and training interventions.

Digital Biomarkers of Cognitive Frailty: The Value of Detailed Gait Assessment Beyond Gait Speed

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
He Zhou ◽  
Catherine Park ◽  
Mohammad Shahbazi ◽  
Michele K. York ◽  
Mark E. Kunik ◽  
...  
Keyword(s):  
Older Adults ◽  
Steady State ◽  
Dual Task ◽  
Gait Speed ◽  
Stride Length ◽  
Cognitive Frailty ◽  
Single Task ◽  
Double Support ◽  
Gait Parameters ◽  
Digital Biomarkers

<b><i>Background:</i></b> Cognitive frailty (CF), defined as the simultaneous presence of cognitive impairment and physical frailty, is a clinical symptom in early-stage dementia with promise in assessing the risk of dementia. The purpose of this study was to use wearables to determine the most sensitive digital gait biomarkers to identify CF. <b><i>Methods:</i></b> Of 121 older adults (age = 78.9 ± 8.2 years, body mass index = 26.6 ± 5.5 kg/m<sup>2</sup>) who were evaluated with a comprehensive neurological exam and the Fried frailty criteria, 41 participants (34%) were identified with CF and 80 participants (66%) were identified without CF. Gait performance of participants was assessed under single task (walking without cognitive distraction) and dual task (walking while counting backward from a random number) using a validated wearable platform. Participants walked at habitual speed over a distance of 10 m. A validated algorithm was used to determine steady-state walking. Gait parameters of interest include steady-state gait speed, stride length, gait cycle time, double support, and gait unsteadiness. In addition, speed and stride length were normalized by height. <b><i>Results:</i></b> Our results suggest that compared to the group without CF, the CF group had deteriorated gait performances in both single-task and dual-task walking (Cohen’s effect size <i>d</i> = 0.42–0.97, <i>p</i> &#x3c; 0.050). The largest effect size was observed in normalized dual-task gait speed (<i>d</i> = 0.97, <i>p</i> &#x3c; 0.001). The use of dual-task gait speed improved the area under the curve (AUC) to distinguish CF cases to 0.76 from 0.73 observed for the single-task gait speed. Adding both single-task and dual-task gait speeds did not noticeably change AUC. However, when additional gait parameters such as gait unsteadiness, stride length, and double support were included in the model, AUC was improved to 0.87. <b><i>Conclusions:</i></b> This study suggests that gait performances measured by wearable sensors are potential digital biomarkers of CF among older adults. Dual-task gait and other detailed gait metrics provide value for identifying CF above gait speed alone. Future studies need to examine the potential benefits of gait performances for early diagnosis of CF and/or tracking its severity over time.

scholarly journals Functional Electrical Stimulation for Foot Drop in Post-Stroke People: Quantitative Effects on Step-to-Step Symmetry of Gait Using a Wearable Inertial Sensor

Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 921
Author(s):  
Giulia Schifino ◽  
Veronica Cimolin ◽  
Massimiliano Pau ◽  
Maira Jaqueline da Cunha ◽  
Bruno Leban ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Inertial Sensor ◽  
Foot Drop ◽  
Stroke Patients ◽  
Gait Patterns ◽  
Temporal Parameters ◽  
Additional Information ◽  
Acceleration Data ◽  
Trunk Acceleration ◽  
Spatio Temporal

The main purpose of the present study was to assess the effects of foot drop stimulators (FDS) in individuals with stroke by means of spatio-temporal and step-to-step symmetry, harmonic ratio (HR), parameters obtained from trunk accelerations acquired using a wearable inertial sensor. Thirty-two patients (age: 56.84 ± 9.10 years; 68.8% male) underwent an instrumental gait analysis, performed using a wearable inertial sensor before and a day after the 10-session treatment (PRE and POST sessions). The treatment consisted of 10 sessions of 20 min of walking on a treadmill while using the FDS device. The spatio-temporal parameters and the HR in the anteroposterior (AP), vertical (V), and mediolateral (ML) directions were computed from trunk acceleration data. The results showed that time had a significant effect on the spatio-temporal parameters; in particular, a significant increase in gait speed was detected. Regarding the HRs, the HR in the ML direction was found to have significantly increased (+20%), while those in the AP and V directions decreased (approximately 13%). Even if further studies are necessary, from these results, the HR seems to provide additional information on gait patterns with respect to the traditional spatio-temporal parameters, advancing the assessment of the effects of FDS devices in stroke patients.

Variability of gait spatio-temporal parameters during treadmill walking

2021 ◽  
Author(s):  
Miroslaw Latka ◽  
Klaudia Kozlowska ◽  
Bruce J. West
Keyword(s):  
Stride Length ◽  
Fundamental Problem ◽  
Treadmill Walking ◽  
Frequency Noise ◽  
Strongly Correlated ◽  
Nonlinear Functions ◽  
Mean Values ◽  
First Case ◽  
Gait Parameters ◽  
Spatio Temporal

Abstract During treadmill walking, the subject’s stride length (SL) and duration (ST) yield a stride speed (SS) which fluctuates over a narrow range centered on the treadmill belt’s speed. We recently demonstrated that ST and SL trends are strongly correlated and serve as control manifolds about which the corresponding gait parameters fluctuate. The fundamental problem, which has not yet been investigated, concerns the contribution of SL and ST fluctuations to SS variability. To investigate this relation, we approximate SS variance by the linear combination of SL variance and ST variance, as well as their covariance. The combination coefficients are nonlinear functions of ST and SL mean values and, consequently, depend on treadmill speed. The approximation applies to constant speed treadmill walking and walking on a treadmill whose belt speed is perturbed by strong, high-frequency noise. In the first case, up to 80% of stride speed variance comes from SL fluctuations. In the presence of perturbations, the SL contribution decreases with increasing speed, but its lowest value is still twice as large as that of either ST variance or SL-ST covariance. The presented evidence supports the hypothesis that stride length adjustments are primarily responsible for speed maintenance during walking. Such a control strategy is evolutionarily advantageous due to the weak speed dependence of the SL contribution to SS variance. The ability to maintain speed close to that of a moving cohort did increase the chance of an individual’s survival throughout most of human evolution.

scholarly journals Quantitative assessment of gait parameters in people with Parkinson's disease in laboratory and clinical setting: Are the measures interchangeable?

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Massimiliano Pau ◽  
Federica Corona ◽  
Roberta Pili ◽  
Carlo Casula ◽  
Marco Guicciardi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Setting ◽  
Stride Length ◽  
Experimental Setting ◽  
Optoelectronic System ◽  
Double Support ◽  
Gait Parameters ◽  
Spatio Temporal ◽  
Wearable Accelerometers

This study aimed to investigate possible differences in spatio-temporal gait parameters of people with Parkinson’s Disease (pwPD) when they are tested either in laboratory using 3D Gait Analysis or in a clinical setting using wearable accelerometers. The main spatio-temporal gait parameters (speed, cadence, stride length, stance, swing and double support duration) of 31 pwPD were acquired: i) using a wearable accelerometer in a clinical setting while wearing shoes (ISS); ii) same as condition 1, but barefoot (ISB); iii) using an optoelectronic system (OES) undressed and barefoot. While no significant differences were found for cadence, stance, swing and double support duration, the experimental setting affected speed and stride length that decreased (by 17% and 12% respectively, P<0.005) when passing from the clinical (ISS) to the laboratory (OES) setting. These results suggest that gait assessment should be always performed in the same conditions to avoid errors, which may lead to inaccurate patient’s evaluations.

Mild Cognitive Impairment Affects Obstacle Negotiation in Older Adults: Results from “Gait and Brain Study”

Gerontology ◽  
2018 ◽  
Vol 65 (2) ◽  
pp. 164-173 ◽  
Author(s):  
Frederico Pieruccini-Faria ◽  
Yanina Sarquis-Adamson ◽  
Manuel Montero-Odasso
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Dual Task ◽  
Gait Speed ◽  
Step Length ◽  
Gait Control ◽  
Dual Tasking ◽  
Brain Study

Background: Older adults with Mild Cognitive Impairment (MCI) are at higher risk of falls and injuries, but the underlying mechanism is poorly understood. Inappropriate anticipatory postural adjustments to overcome balance perturbations are affected by cognitive decline. However, it is unknown whether anticipatory gait control to avoid an obstacle is affected in MCI. Objective: Using the dual-task paradigm, we aim to assess whether gait control is affected during obstacle negotiation challenges in older adults with MCI. Methods: Seventy-nine participants (mean age = 72.0 ± 2.7 years; women = 30.3%) from the “Gait and Brain Study” were included in this study (controls = 27; MCI = 52). In order to assess the anticipatory control behaviour for obstacle negotiation, a 6-m electronic walkway embedded with sensors recorded foot prints to measure gait speed and step length variability, during early (3 steps before the late phase) and late (3 steps before the obstacle) pre-crossing phases of an ad hoc obstacle, set at 15% of participant’s height. Participants walked under single- and dual-task gait (counting backwards by 1’s from 100 while walking) conditions. Three-way mixed repeated-measures analysis of variance models examined differences in gait performance between groups when transitioning between pre-crossing phases towards an obstacle during single- and dual-task conditions. Analyses were adjusted for age, sex, years of education, lower limb function, fear of falling, medical status, depressive symptoms, baseline gait speed and executive function. Results: A significant three-way interaction among groups, pre-crossing phases and task showed that participants with MCI attenuated the gait deceleration (p = 0.02) and performed fewer step length adjustments (p = 0.03) when approaching the obstacle compared with controls while dual-tasking. These interactions were attenuated when executive function performance was added as a covariate in the adjusted statistical model. Conclusion: Older adults with MCI attenuate the anticipatory gait adjustments needed to avoid an obstacle when dual-tasking. Deficits in higher-order cognitive processing may limit obstacle negotiation capabilities in MCI populations, being a potential falls risk factor.

scholarly journals Older Adults in Hospitals: Health Promotion When Hospitalized

2021 ◽  
pp. 287-301
Author(s):  
Anne-S. Helvik
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Cognitive Impairment ◽  
Nursing Care ◽  
Cognitive Impairments ◽  
Clinical Nursing ◽  
Older Inpatients ◽  
Health Promoting ◽  
To Come ◽  
Age Range

AbstractThe population of older adults (≥60 years) is currently growing. Thus, in the years to come it is expected that a high proportion of patients hospitalized will be in the older age range. In western countries, the proportion of older inpatients is about 40% in the medical and surgical hospitals units. Older people with illness is vulnerable to both physical and cognitive impairments as well as depression. Therefore, a health-promoting perspective and approach are highly warranted in clinical nursing care of older adults in medical hospitals. This chapter focuses on health promotion related to depressive symptoms, impairment in activities of daily living, and cognitive impairment in older hospitalized adults.

scholarly journals Muscular Function: An alternative way to identify cognitive impairment, Secondary Analysis From SABE-Colombia

2020 ◽  
Author(s):  
Elkin Garcia-Cifuentes ◽  
Felipe Botero-Rodríguez ◽  
Felipe Ramirez Velandia ◽  
Angela Iragorri ◽  
Isabel Marquez ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Motor Function ◽  
Gait Speed ◽  
Handgrip Strength ◽  
Secondary Analysis ◽  
Screening Tools ◽  
Cognitively Impaired ◽  
Recall Memory

Abstract Background Traditionally, the identification of cognitive impairment is based on neuropsychological tests and supported with not widely available biomarkers. This study aimed to establish the association between motor function (Gait Speed and Handgrip Strength) and the performance in a global cognitive performance and various cognitive domains. Our secondary objective was to determine a cut-off point for Gait Speed and Handgrip Strength to classify older adults as cognitively impaired. Methods This is a secondary analysis from the SABE Colombia study (Health, Well-Being, and Aging) conducted in 2015. We performed linear regression models, to establish association with motor function, clinical, and sociodemographic variables, and predict the scores of the Mini-mental State Examination and its domains (i.e. orientation, recall, counting, and language). The evaluation of the motor function variables as an instrument to separate cognitively impaired older adults was evaluated by developing a receiving operating characteristic curve (ROC). Results Gait speed was associated with orientation (r2 = 0.16), language (r2 = 0.15), recall memory (r2 = 0.14) and counting (r2 = 0.08). Similarly, handgrip strength was associated with orientation (r2 = 0.175), language (r2 = 0.164), recall memory (r2 = 0.137), and counting (r2 = 0.08). Slow gait had a cut-off point of 0,59 m/s, with an area under the curve (AUC) of 0.629 (0.613–0.646), whereas a weak handgrip strength had an AUC of 0.653 (0.645–0.661), with a cut-off point of 17.50 Kg for separating those older adults with cognitive impairment. Conclusions Gait Speed or Handgrip Strength are similarly associated with cognitive performance, exhibiting the larger associations with orientation and language domains. Gait Speed and Handgrip Strength can be easily performed by any clinician and seems to be useful screening tools to detect cognitive impairment.

scholarly journals Assessing the concurrent validity of a gait analysis system integrated into a smart walker in older adults with gait impairments

2019 ◽  
Vol 33 (10) ◽  
pp. 1682-1687 ◽  
Author(s):  
Christian Werner ◽  
Georgia Chalvatzaki ◽  
Xanthi S Papageorgiou ◽  
Costas S Tzafestas ◽  
Jürgen M Bauer ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Gait Speed ◽  
Concurrent Validity ◽  
Stride Length ◽  
Gait Parameters ◽  
Stance Time ◽  
Absolute Agreement ◽  
Analysis System ◽  
Smart Walker ◽  
Gait Impairments

Objective: To assess the concurrent validity of a smart walker–integrated gait analysis system with the GAITRite® system for measuring spatiotemporal gait parameters in potential users of the smart walker. Design: Criterion standard validation study. Setting: Research laboratory in a geriatric hospital. Participants: Twenty-five older adults (⩾65 years) with gait impairments (habitual rollator use and/or gait speed <0.6 m/s) and no severe cognitive impairment (Mini-Mental State Examination ⩾17). Main measures: Stride, swing and stance time; stride length; and gait speed were simultaneously recorded using the smart walker–integrated gait analysis system and the GAITRite system while participants walked along a 7.8-m walkway with the smart walker. Concurrent criterion-related validity was assessed using the Bland–Altman method, percentage errors (acceptable if <30%), and intraclass correlation coefficients for consistency (ICC3,1) and absolute agreement (ICC2,1). Results: Bias for stride, swing and stance time ranged from −0.04 to 0.04 seconds, with acceptable percentage errors (8.7%–23.0%). Stride length and gait speed showed higher bias (meanbias (SD) = 0.20 (0.11) m; 0.19 (0.13) m/s) and not acceptable percentage errors (31.3%–42.3%). Limits of agreement were considerably narrower for temporal than for spatial-related gait parameters. All gait parameters showed good-to-excellent consistency (ICC3,1 = 0.72–0.97). Absolute agreement was good-to-excellent for temporal (ICC2,1 = 0.72–0.97) but only poor-to-fair for spatial-related gait parameters (ICC2,1 = 0.37–0.52). Conclusion: The smart walker–integrated gait analysis system has good concurrent validity with the GAITRite system for measuring temporal but not spatial-related gait parameters in potential end-users of the smart walker. Stride length and gait speed can be measured with good consistency, but with only limited absolute accuracy.

P1-629: CORRELATION BETWEEN FALLS AND GAIT SPEED DURING A DIVIDED ATTENTION TASK IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT

2006 ◽  
Vol 14 (7S_Part_10) ◽  
pp. P582-P582
Author(s):  
Sheila de Melo Borges ◽  
Marcia Radanovic ◽  
Orestes Vicente Forlenza
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Divided Attention ◽  
Gait Speed ◽  
Attention Task ◽  
Divided Attention Task
Sign in / Sign up

Export Citation Format

Share Document