Instrumented gait analysis defines the walking signature of CACNA1A disorders

Background Gait disturbances are a frequent symptom in CACNA1A disorders. Even though, data about their severity and progression are lacking and no CACNA1A-specific scale or assessment for gait is available. Methods We applied a gait assessment protocol in 20 ambulatory patients with genetically confirmed CACNA1A disorders and 39 matched healthy controls. An instrumented gait analysis (IGA) was performed by means of wearable sensors in basal condition and after a treadmill/cycloergometer challenge in selected cases. Results CACNA1A patients displayed lower gait speed, shorter steps with increased step length variability, a reduced landing acceleration as well as a reduced range of ankle motion compared to controls. Furthermore, gait-width in patients with episodic CACNA1A disorders was narrower as compared to controls. In one patient experiencing mild episodic symptoms after the treadmill challenge, the IGA was able to detect a deterioration over all gait parameters. Conclusions In CACNA1A patients, the IGA with wearable sensors unravels specific gait signatures which are not detectable at naked eye. These features (narrow-based gait, lower landing acceleration) distinguish these patients from other ataxic disorders and may be target of focused rehabilitative interventions. IGA can potentially be applied to monitor the neurological fluctuations associated with CACNA1A disorders.

Instrumented gait analysis of stroke patients after FES-cycling therapy.

Background: Functional electrical stimulation (FES) is a modality of motor rehabilitation that consists of the programmed application of bursts of electrical current to the a ected neuromuscular region that aims to improve muscle strength, increase the range of motion, facilitate movement control and decrease spasticity. The present study aimed to measure the changes in gait biomechanics of people with Stroke after a FES-cycling rehabilitation program for the lower extremities. Methods: 39 subjects with chronic stroke received 24 sessions of multi-channel FES synchronized with a cycle-ergometer for the lower extremities. The gait of all subjects was evaluated before and after the intervention by an instrumented gait analysis. Results: Signifcant changes were found in the spatio-temporal parameters of gait, mainly in the speed and stride length when considering the general sample. Additionally, in people under 60 years of age, there are signi cant changes in joint kinematics after FES. Conclusions: The rehabilitation using a multi-channel FES-cycling system for lower extremities improve gait biomechanics in people with Stroke. Trial registration: This study was registered as Instrumental Gait Analysis on People With Stroke After Rehabilitation With a Synchronized FES and Cycle-Ergometer System on July 16, 2020 in Clinical Trials with the identier No NCT04473391 (available at https://clinicaltrials.gov/ct2/show/NCT04473391).