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Children born very preterm ( 32 weeks' gestation) are at greater risk of motor impairment and executive/attentional dysfunctions than term-born children; however, little is known about how functional tasks, including walking, may be affected by very preterm birth.How does the gait pattern of preschool-age children born 30 weeks compare with term-born controls under a variety of walking conditions?In this prospective cohort study, children born 30 weeks and at term were assessed at 4.5-5 years' corrected age, blinded to birth group. Four walking conditions were assessed using the GAITRite® system: preferred speed, cognitive dual-task, motor dual-task, and tandem walking. Gait variables analysed included speed, cadence, step length, step time, base of support (BOS), and single and double support time. Spatiotemporal variables were compared between groups using linear regression, adjusting for lower-limb length, corrected age at assessment, and number of trials.224 children (112 30 weeks and 112 term-born) were assessed. Gait variables of children born 30 weeks did not differ from their term-born peers when walking at their preferred speed, except for higher BOS variability (mean difference [MD] = 0.19 cm, 95% confidence interval [CI] 0.10, 0.27, p 0.001). Under the motor dual-task condition, children born 30 weeks walked faster (MD= 3.06 cm/s, 95% CI 0.14, 5.97, p = 0.040), with a longer step length (MD= 1.10 cm, 95%CI 0.19, 2.01, p = 0.018), and a wider BOS (MD= 0.37 cm, 95%CI 0.06, 0.67, p = 0.019). In cognitive dual-task and tandem conditions, children born 30 weeks walked with a wider BOS compared with term-born peers (MD= 0.43 cm, 95%CI 0.05, 0.81, p = 0.028; and MD= 0.30 cm, 95%CI 0.09, 0.51, p = 0.005, respectively).This research highlights the need to consider the walking performance of preschool-age children born 30 weeks under challenging conditions, such as dual-task or tandem walking, when assessing gait patterns and planning interventions.

Background: The identification of patients with gait disturbance associated with idiopathic normal pressure hydrocephalus (iNPH) is challenging. This is due to the multifactorial causes of gait disturbance in elderly people and the single moment examination of laboratory tests. Objective: We aimed to assess whether the use of gait sensors in a patient's home environment could help establish a reliable diagnostic tool to identify patients with iNPH by differentiating them from elderly healthy controls (EHC). Methods: Five wearable inertial measurement units were used in 11 patients with iNPH and 20 matched EHCs. Data were collected in the home environment for 72 h. Fifteen spatio-temporal gait parameters were analyzed. Patients were examined preoperatively and postoperatively. We performed an iNPH sub-group analysis to assess differences between responders vs. non-responders. We aimed to identify parameters that are able to predict a reliable response to VP-shunt placement. Results: Nine gait parameters significantly differ between EHC and patients with iNPH preoperatively. Postoperatively, patients with iNPH showed an improvement in the swing phase (p = 0.042), and compared to the EHC group, there was no significant difference regarding the cadence and traveled arm distance. Patients with a good VP-shunt response (NPH recovery rate of ≥5) significantly differ from the non-responders regarding cycle time, cycle time deviation, number of steps, gait velocity, straight length, stance phase, and stance to swing ratio. A receiver operating characteristic analysis showed good sensitivity for a preoperative stride length of ≥0.44 m and gait velocity of ≥0.39 m/s. Conclusion: There was a significant difference in 60% of the analyzed gait parameters between EHC and patients with iNPH, with a clear improvement toward the normalization of the cadence and traveled arm distance postoperatively, and a clear improvement of the swing phase. Patients with iNPH with a good response to VP-shunt significantly differ from the non-responders with an ameliorated gait pattern., Frontiers in Neurology, 14, ISSN:1664-2295

During everyday walking, we encounter challenges such as uneven terrain or curbs, all requiring adjustments to our gait patterns. These adjustments are made to circumvent the given obstacles and avoid falling or tripping. Exoskeletons have proven to assist walking by increasing walking speed and step length. However, most exoskeleton studies are traditionally carried out in a laboratory setting, which is an inaccurate depiction of everyday outdoor walking conditions. This study investigated the spatiotemporal gait parameters and hip kinematics during outdoor walking situations while wearing a passive-assistive hip exoskeleton (aLQ). Eleven healthy male participants walked on three 10-meter obstacle tracks at their self-selected walking speed with and without aLQ. The tracks were designed for the participants to (1) step up onto a sidewalk, (2) step over a pothole, and (3) walk without any obstacle (control situation). The cadence, gait velocity, step length, double stance time, and the 3D hip range of motion angles were extracted and compared for each track with and without aLQ. No significant changes were found for the spatiotemporal parameters with and without exoskeleton when navigating the obstacles. However, a significant decrease in the right hip internal rotation was observed when wearing the exoskeleton compared with without while stepping over (21%, p = 0.05) and while walking with no obstacle (6%, p = 0.04). These findings indicate that the gait of able-bodied adults was mostly unaffected during overground walking with a passive-assistive hip exoskeleton while navigating obstacles, proving that exoskeletons could be used safely in everyday situations.

Gait pattern generation plays a significant role in the quality of a walking robot. This paper mainly focuses on hip vertical motion effects on gait pattern generation for biped robots. Inspired by human walking, gait pattern with hip undulating motion (GPHUM) is proposed. Firstly, we defined cyclic gaits for a seven-link biped robot with several design parameters. Then, design parameters are obtained by optimization. The optimization criterion is minimizing the energy consumption of the joint actuators. Finally, optimal walking gait is simulated. In order to compare the performance of the proposed common gait pattern with fixed hip height pattern (GPFHH), we generated the optimal gait for the two gait patterns with different step lengths and different walking periods. The comparison of simulation results shows that GPHUM is more than 20% energy-efficient than GPFHH; therefore, the proposed GPHUM can greatly improve the walking time of the robot with battery as the power source. Moreover, the hip height parameters are related to the step length, and the change of the walking period has no significant effect on these parameters; thus, hip height parameters corresponding to different step length can be calculated off-line for the online gait pattern generation. In addition, the proposed GPHUM has larger optimal step length than GPFHH, and it allows the biped robot walk more efficiently with a larger stride.

Background: Alterations in the lower limb kinematics and kinetics of diabetic patients have been reported in previous studies. Inappropriate choices of orthopedic insole materials, however, fail to prevent diabetic foot ulcers and modify abnormal gait. The aim of this study was to quantitatively compare the effects of contoured insoles with different materials on the kinematics of and kinetics changes in the diabetic elderly during gait. Methods: There were 21 diabetic patients who participated in this study. Three-dimensional (3D) experimental contoured insoles constructed of soft (i.e., Nora Lunalastik EVA and PORON® Medical 4708) and rigid (i.e., Nora Lunalight A fresh and Pe-Lite) materials with Langer Biomechanics longitudinal PPT® arch pads were adopted. An eight-camera motion capture system (VICON), two force plates, and an insole measurement system—Pedar® with 99 sensors—were utilized to obtain the kinematics and kinetics data. The plug-in lower body gait model landmarks were used for dynamic data acquisition during gait. The corresponding data from five gait cycles were selected and calculated. Results: The range of motions (ROMs) of the ankle joint (p = 0.001) and knee joint (p = 0.044) were significantly influenced when the contoured insoles were worn in comparison to the barefoot condition. The joint moments of the lower limbs with maximum ankle plantarflexion during the loading response and maximum knee and hip flexions were significantly influenced by the use of contoured insoles with different materials in the diabetic elderly. The peak plantar pressure (PPP) of the forefoot (p < 0.001), midfoot (p = 0.009), and rearfoot (p < 0.001) was significantly offloaded by the contoured insoles during the stance phase, whilst the PPP of the rearfoot (p < 0.001) was significantly offloaded during the swing phase. Conclusions: The contoured insoles, especially those constructed with soft materials, significantly offloaded the PPP during gait—hence accommodating certain abnormal gait patterns more effectively compared to going barefoot.

Shoe abrasion data can be used as major evidence to distinguish suspects, but their actual application in the field is limited due to a lack of associated empirical studies. This study analyzed the significant factors of shoe abrasion by identifying significant differences between gait, personal characteristics, and shoe abrasion patterns. Experiments were conducted on 291 Korean subjects, and data were analyzed using cluster analysis and cross-tabulation analysis with data collected to identify significant factors. As a result, overall, medial abrasion was very rare and would be useful for human identification. The greater the gait characteristics of the knee valgus, the greater the inner abrasion characteristics shown. In the case of knee varus, outer abrasion characteristics occurred more often. Additionally, in the double support phase while walking, the greater the tilt to the left or right, the more the outer parts of the shoes tend to wear out. Men have the characteristic of wearing out the outer side of their shoes more compared to women. Regarding human body dimensions, there were significant differences between the abrasion patterns of the shoes with some body dimensions. The results of this study could be used effectively in the identification of suspects using shoe abrasion patterns.

BACKGROUND CONTEXT: Radiographic evaluation in adult spinal deformity (ASD) offers no information on spinopelvic alignment and compensation during dynamic conditions. Motion analysis offers the potential to bridge the gap between static radiographic and dynamic alignment measurement, increasing our understanding on how ASD impacts function. PURPOSE: This study aimed to explore the changes in sagittal alignment and compensation strategies in ASD between upright standing and walking, compared to control subjects and within different sagittal alignment groups. Ten patients were measured pre- and six months postoperatively to explore the impact of surgical alignment correction on gait. STUDY DESIGN: Prospective study. SAMPLE SIZE: Full protocol: 58 ASD and 20 controls; Spinal kinematic analysis: 43 ASD and 18 controls; Postoperative analysis: 10 ASD. OUTCOME MEASURES: Standing and walking sagittal spinopelvic (thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvis), and lower limb kinematics, spinopelvic changes between standing and walking (∆ ie, difference between mean dynamic and static angle), lower limb kinetics, spatiotemporal parameters, balance (BESTest), patient-reported outcome scores (SRS-22r, ODI, and FES-I) and radiographic parameters. METHODS: Motion analysis was used to assess the standing and walking spinopelvic and lower limb kinematics, as well as the lower limb kinetics during walking. All parameters were compared between controls and patients with ASD, divided in three groups based on their sagittal alignment (ASD 1: decompensated sagittal malalignment; ASD 2: compensated sagittal malalignment; ASD 3: scoliosis and normal sagittal alignment). Ten patients were reassessed 6 months after spinal corrective surgery. Continuous kinematic and kinetic data were analyzed through statistical parametric mapping. RESULTS: All patient groups walked with increased forward trunk tilt (∆SVA=41.43 mm, p

The aim of this study was to verify whether providing older adults with actual corrected glasses for refractive errors would have a positive impact on their gait patterns. This study included 30 subjects with an average age of 78.77 ± 7.27 years. The measurement of gait patterns was performed using the Optogait analysis system, and a comparative analysis was performed to compare the patients before and after they wore correction glasses. Step length, stride length, and width showed significant increases after the patients wore correction glasses, and cadence showed a decrease compared to before they wore correction glasses (p < 0.05). A strong positive correlation was observed between step length and stride length (r = 0.779, p < 0.001), and a decrease in cadence (r = −0.686, p < 0.001) was observed with increasing step length. In addition, a proportional increase in speed with increasing step length was observed after the patients wore correction glasses (r = 0.416, p < 0.05). The correction of residual refractive errors in order to provide optimal visual information can have a positive effect on gait patterns. Therefore, efforts by optometry professionals to provide the accurate correction of refractive errors in elderly patients can contribute to the prevention of falls, and collaboration with other experts is needed.

Purpose: Children with Down syndrome (DS) have multiple difficulties in gait pattern. So, the effect of the activity level and speed on the gait coordination and variability was investigated. Methods: In this case-control observational study, 24 participants in three groups of active and non-active children with DS, and the control group without intellectual disability were asked to walk on a treadmill with two speeds of 0.8 and 1.2 m/s. Continuous Relative Phase (CRP) and variability of CRP in thigh-leg and leg-foot coupling were assessed. Results: CRP and variability of CRP in the leg-foot coupling in the control group were significantly higher than active and non-active groups with DS. Speed led to increase the CRP of leg-foot in the active group with DS and increase the variability of this coupling in non-active group with DS. Conclusion: In this study, the activity level provided the compatibility with speed changes of walking in CRP of leg-foot in children with DS.

Various exoskeleton robots are being developed according to users’ conditions. Lower limb exoskeleton robots have attracted much attention for performing walking motions, a basic exercise for paralyzed patients. In this study, the walking environment of an exoskeleton robot wearer who walks using a crutch is identified as the foot position of the crutch support point and the support leg; therefore, the upcoming foothold location is calculated and sets as a control target. Rather than using preset pedestrian patterns, pedestrian patterns that can match the environment are created using the dynamic movement primitives machine learning technology. We evaluated the exoskeleton robot through an experiment with a healthy 29-year-old male. The experimental results showed that the exoskeleton robot was able to demonstrate the adaptive strides according to the wearer’s intention.

Unpowered exoskeletons (UEs) have attracted extensive research attentions for their portability, handleability and simplicity. However, designing exoskeletons without any active actuators is a great challenge because essential criteria such as performance enhancement, low impedance, and comfort must be met. This paper reviews the UEs researches from three aspects including modeling for understanding gait pattern, mechanical designs, and validation methods, which are main considerations of designing UEs. This review is based on the reported works in the past two decades and underlines some practical opportunities and challenges. Statistical data analysis and critical reviews are stated to understand human gait patterns, designing of UEs, and ergonomic validation. This review is trying to inspire a common understanding about passive exoskeletons for lower extremity and promote discussion among researchers, developers, or robotic practitioners.

Objectives: There exists no study concerning gait pattern while engaging in dual-task activities on different sizes of mobile devices. The present study aimed to compare gait patterns during normal walking, walking with smartphone use, and walking with tablet use. Methods: Seventeen healthy female participants with an age range of 19-24 years (Mean±SD age: 20.29±1.61 years, weight: 49.82±4.46 kg, height: 156.59±4.87 cm, body mass index: 20.47±0.84 kg/m2, and leg length: 81.35±3.79 cm.) participated in the present research. The study subjects were requested to walk for 10 meters under the following conditions: normal walking; walking while typing a text message with a smartphone, and walking while typing a text message with a tablet. The Vicon® Three-Dimensional (3D) motion analysis recorded the motion of reflective markers attached to the study participant’s body. Gait parameters (step length, stride length, step time, stride time, step width, velocity, and cadence) were compared between the explored walking conditions. Results: The gait parameter of normal walking, compared with walking during smartphone use as well as tablet use were significantly different in the gait pattern (P0.05). Discussion: Changes in gait pattern during walking while typing a text message with either a smartphone or tablet may lead to greater attention and concentration required to type the message; such actions resulted in decreased gait speed and step length.

A large portion of the population participate in gait rehabilitation, especially those with conditions such as increased fall risk such as stroke, or Parkinson’s Disease. Some studies have shown that auditory cues help improve gait and reduce fall risk, but relationship with gait patterns is missing. In this study, eight participants walked at their preferred cadence and at increased and reduced cadence by 20%. We found that step length and step width were not significantly different in all walking conditions. Decreased cadence resulted in an increase of swing time, stance time, stride time, and stance to swing ratio, and a decrease in stride length. Increased cadence resulted in a decrease in stance time, stride time, swing time, and stance to swing ratio, and an increase in stride length. The results suggest there is a strong correlation between auditory cues and gait patterns that can improve rehabilitative processes in the future.

Background: The uncemented collum femoris-preserving (CFP) stem offers preservation of the femoral neck and a more conservative soft tissue resection, which may facilitate a more normal walking pattern. We used gait analysis to evaluate if patients operated with a CFP stem showed more favourable hip kinematics and kinetics when compared with a group of patients operated with a conventional uncemented stem. Methods: 44 patients randomised to receive either a CFP or a Corail stem were studied and were operated using a direct lateral incision. Gait analysis was performed 2 years after the operation with a 12-camera motion capture system and 2 force plates. Hip kinematics and kinetics were analysed and 66 subjects served as controls. Results: None of the variables: speed, stride, cadence and stance showed any statistical significant difference between the 2 study groups. Neither did the hip kinematics and kinetics. Compared to controls, patients operated with the CFP stem showed an increased stance (62.5% vs. 61.1%, p < 0.006) and decreased hip abduction (−2.1° vs. −6.5°). Patients operated with the Corail stem showed decreased speed (1.18 vs. 1.23 m/second), and stride length (1.26 vs. 1.33 m), decreased hip extension (−7.5° vs. −12.8°) and range of hip flexion/extension (38° vs. 40.9°), as well as their hip adduction that was increased (6.3° vs. 4°), whereas their hip abduction was reduced (−2.8° vs. −6.5°), ( p < 0.004) compared to the controls. Conclusions: Use of a CFP stem did not significantly influence any of the gait parameters studied when compared to a standard stem, but still both stems studied were associated with gait deviations when compared to controls. Whether these differences could be attributed to the stem used, the underlying hip disease, or both is still unknown.

Vertical Ground Reaction Force (VGRF) is a force obtained during gait cycle beneath the feet and is used to screen the severity of Parkinson’s disease (PD) patient’s in clinical environment. This article investigates the VGRF signals (left and right) semblance nature among PD patients and control subjects as a function of time and possibility of reconstructing dual tasking VGRF signal from normal walking VGRF signals using radial basis function (RBF) based artificial intelligence (AI). There are many traditional methods for gait analysis and these methods are purely subjective and none made semblance analysis of same subjects gait pattern in different tasking. In order to overcome the difficulties faced by PD patients, RBF based AI is proposed in this research to reconstruct the dual tasking VGRF signal from normal walking VGRF signal. 93 PD patients with mean age: 66.3 years (63% men), and 73 healthy controls with mean age: 66.3 years (55% men) datasets are used in this work. Proposed RBF network is trained on VGRF signals obtained in normal walking and dual tasking conditions from control. The network was trained with 60% of VGRF data and tested on remaining 40% data. Semblance analysis results are encouraging, and it shows that semblance is high in PD patients than control subjects during dual tasking (P

Background/Aims The changes in body weight, body shape and hormones of pregnant women alter the posture and gait pattern of these individuals compared to non-pregnant women. The purpose of this study was to determine the effect of pregnancy on selected gait parameters by evaluating footprints at the second and third trimesters of pregnancy and comparing with apparently healthy, non-pregnant women. Methods A total of 40 consenting women (20 pregnant and 20 non-pregnant age-matched women) aged 22–35 years old (mean 28.25±0.68 years) participated in this study. Footprints were obtained from each participant and selected gait parameters were computed from the footprints. Paired t-tests and independent t-tests were used to compare the variables at PResults There was a significant difference in the gait parameters measured between the pregnant and non-pregnant women: gait velocity (P=0.001), cadence (P=0.001), right foot angle (P=0.001), left foot angle (P=0.002), base of support (P=0.001), right step length (P=0.001), left step length (P=0.001). However, there was no significant difference in the gait parameters measured between the pregnant women in their second and third trimesters. Conclusions Pregnancy is associated with significant changes in most gait variables compared to non-pregnant women, although no significant change was observed between the second and third trimesters of pregnancy. The inclusion of gait training during antenatal care may help reduce the effect on the musculoskeletal system.

In general, legged robots are designed to walk with a fixed rhythmic pattern. However, most animals can adapt their limb movements while walking. It is necessary to understand the mechanism of adaptability during locomotion when designing bio-inspired legged robots. In this paper, we propose an approach to analyze the flexible locomotion pattern of animals using a polar histogram. Field crickets were used to investigate variations in leg movement of insects depending on the environment. Crickets have a tripod gait; however, their leg movement changes depending on the texture of the ground. There was a significant difference between the leg movement when walking and when swimming. Our approach can explain how animals move their legs during locomotion. This study is useful for evaluating the movements of legged robots.

Gait is, quite simply, the pattern of how a person walks. These gait parameters vary due to age, weight, height and the duration of a mode of work stress on the individual. Gait pattern is used to identify the individuals with the help of anthropological adoptions of the individual. The present study, it is a standardized pattern of collection and with the purpose of compression of gait patterns among two different occupations. In this present study different occupations like officials and labours are taken as subjects of sampling. And samples are in number of 30 each, and were observed under 7 parameters. From these parameters we get to know that the subject with different occupation will change the gait parameters such as stride length and step length shorten while the stride width widens to achieve postural stability and kinematic adaption. There is a significant difference in mean value and value of gait parameters across the different occupation for the angle of left shoe print, the distance between left to right and right to left shoe step and gait base in both the occupations. It appeared that the occupational stress of different mode of occupations would change the orientation of the lower extremity segments with particular changes occurring at the ankle and knee due to which to maintain balance smaller steps taken by the subject. Keywords: Gait, Anthropological, Postural stability, Kinematic adaption, Footwear garments.

Introduction One of the most common and life-altering consequences of Multiple Sclerosis (MS) is walking impairment. The distance, speed, and Gait pattern functions are components of the International Classification of Functioning, Disability, and Health (ICF) and are also predictors of dependency in terms of daily living activities in patients with MS (pwMS). Areas covered This article provides an overview of walking impairment in pwMS, with focus on the assessment of gait and the rehabilitation approaches. Expert opinion The authors recommend that pwMS undergo gait assessment integrating the ICF perspective using validated clinical outcome measures that cover spatiotemporal gait parameters. Moreover, assessment of walking speed with short walking capacity tests such as the timed 25-foot walk (T25FW) or the 10-m walk test (10 MWT) and tests for walking distance with middle distance tests such as the 2-min walk test (2MWT) and the 6-min walk test (6MWT). This review further highlights strategies that may restore walking function including pharmacological symptomatic treatment and non-pharmacological rehabilitation approaches such as exercise and task-specific training providing an appraisal of mobility targeted therapies to be considered when planning multidisciplinary comprehensive-care of pwMS. Finally, new and novel strategies such as motor imagery and rhythmic auditory stimulation have been developed to improve walking speed and distance in pwMS.

Purpose To explore how children with cerebral palsy (CP) experience participation in leisure activities and to describe the environmental barriers and facilitators. Methods Sixteen children with cerebral palsy aged 7 to 17 years participated in 3 focus groups. Data were analyzed thematically by 3 researchers on the basis of the International Classification of Functioning, Disability and Health. Results A total of 38 International Classification of Functioning, Disability and Health categories were identified (4 linked to Body functions; 2 linked to Body structures; 8 linked to Activities & Participation, and 24 to Environmental factors: 10 facilitators and 14 barriers). The most mentioned categories were Voluntary movement control functions, Functions related to gait pattern, Structure of upper arm, Recreation and leisure, Nuclear family and finally, and Individual attitudes of acquaintances. Conclusions The main barriers identified by children with cerebral palsy highlight aspects of the physical, social, and attitudinal environment that could be modified to enhance participation in leisure activities.

The aim of this study was to determine the effect of two in-vivo-determined gait patterns, one with low and one with high anteroposterior (AP) motion, on total and backside polyethylene insert wear in comparison with the ISO (International Organization for Standardization) standard 14243-3. In order to differentiate and accurately quantify topside and backside wear, a novel technique was employed where different lanthanide tracers were incorporated into the polyethylene during manufacture. Wear particle analysis was conducted following established protocols. For all tested liners and motion protocols, the chemically calculated wear rates correlated closely with gravimetrically determined wear. Both in vivo motion groups displayed higher wear rates than the ISO group following the order of the AP motion amplitudes. Backside wear for ISO constituted 2.76% ± 0.90% (mean ± SE) of the total wear, increasing significantly to 15.8% ± 3.2% for the low AP and further increasing to 19.3% ± 0.95% for the high AP motion protocol. The mean wear particle sizes were under 200 nm for all three motion patterns, being largest for the protocol with high AP motion. Particle release from the low and high AP gait patterns was 1.9 to 2.8 times that from the ISO protocol. Testing for the proportion of backside wear across various activities of daily living should be an important consideration in evaluating knee prostheses wear.

Background An intensive task-oriented circuit training (TOCT) provides a valid approach in improving motor function in Multiple Sclerosis (MS). Objective We aimed at testing the efficacy of TOCT on gait kinematics in MS patients with mild-moderate disability. Methods Nineteen MS patients able of independent walking performed 3-D Gait Analysis before (T0) and after (T1) a two-week TOCT program. Patients were clustered in two different subgroups, according to clinical neurological impairments assessed with specific functional system of Expanded Disability Status Scale (EDSS): pyramidal (Group 1) and cerebellar (Group 2) subjects. Spatio-temporal and kinematic data were compared before and after the TOCT intervention in the total sample of patients and in the two selected subgroups at two time intervals. Results Data obtained revealed increased dynamic ROM at knee joint after training in the whole study sample. Of note, knee dynamic excursion improved significantly in Group 1 but not in Group 2 patients after TOCT. Moreover, sagittal plane kinematics revealed significant modifications on knee and ankle biomechanics in Group 1 after rehabilitation. Conclusions These data point out the benefits of the task specific training on gait dynamics in mild impaired MS subjects, linking to treatment opportunity in patients with a prevalent pyramidal impairment.

The intervertebral efforts, i.e., forces and torques, during gait have been recognized as influencing the progression of scoliosis, due to the mechanical modulations according to the Hueter-Volkmann Law. Therefore, these efforts are key variables for posture correction and to control the progression of scoliosis. Using the intervertebral efforts during gait for the clinical follow-ups has never been performed. For this, it would be necessary to identify amongst all these efforts the most relevant ones, which is the objective of this study. A previously developed dynamical model of the human body was used to compute the 3 D intervertebral efforts during the gait of 15 participants with adolescent idiopathic scoliosis (AIS) and 12 typically developed adolescents (TDA). Kolmogorov-Smirnov and Two-sample t-test were applied on the calculated intervertebral efforts and the graphs of intervertebral efforts were studied. Antero-posterior (AP) forces and torques and medio-lateral (ML) forces are the most relevant intervertebral efforts amongst the other efforts in adolescents with AIS during gait. Discussion: Gait analysis in adolescents with AIS based on the relevant intervertebral efforts could be an effective means to follow-up and evaluate the progression of scoliosis during their treatment period. This study highlights the most relevant intervertebral efforts of individuals with AIS during gait. As future work, the identified intervertebral efforts could be implemented in a quantified and visual feedback tool for therapeutic and performance evaluation or interactive sessions in physiotherapy, e.g., via video games for dynamic posture self-correction.

This study aimed at evaluating spatiotemporal parameters (STP) and symmetry index (SI), commonly used for evaluating amputee gait for routine clinical use, in individuals with unilateral transtibial amputations wearing energy storage and return (ESAR) feet with fixed ankles, prosthetic feet with adaptive ankles (PFAA) and prosthetic feet with microcontrolled adaptive ankles (PFAA-MC) in ramp ascent and descent. Thirteen individuals with transtibial amputations walked up and down a ramp. The STPs were measured in the amputated and intact legs and the relationship between them was quantified using the SI. The results showed that the use of PFAA-MC decreases walking speed in ramp descent (P < 0.018). However, this was the only parameter that showed a significant change. Hence, the differences in the amputees’ gait pattern when using the above-mentioned prostheses may not be reflected by STP and their SI.

Posttraumatic osteoarthritis may lead to surgical fusion of the ankle joint if non-surgical therapy fails. The indication for a fusion of the joint is based on the pain and disability of the patient, radiographic imaging, and surgeon experience, with no strict guidelines. We aimed to compare outcomes after tibiotalocalcaneal arthrodesis (TTCA) and tibiotalar arthrodesis (TTA) to highlight the functional importance of the subtalar joint. In total, 432 patients with ankle arthrodesis were retrospectively enrolled. Group A (n = 216) underwent TTCA; group B (n = 216) underwent TTA. Demographics, Olerud & Molander Ankle Score (OMAS), Foot Function Index (FFI-D), and Short Form-12 Questionnaire (SF-12) were recorded at a mean follow-up of 6.2 years. The mean OMAS was 50.7; the mean FFI-D was 68.9; the mean SF-12 physical component summary was 39.1. These scores differed significantly between the groups (p < 0.001). The overall revision rate was 18%, primarily for revision of non-union and infection (p < 0.001). Approximately 16% of group A and 26% of group B were able to return to previous work (p < 0.001). Based on significantly worse clinical scores of TTCA compared to TTA and the prolonged downtime and permanent incapacity, the indication for a generous subtalar joint arthrodesis with planned ankle arthrodesis should always be critically examined.

Background: Studies on the gaits parameters have been identified on the patient population. Most researchers confirm that the patients walk differently than normal people and they may have a greater risk of falls. Consistent finding and description of gender, age, and body mass index differences in gait studies is rare in healthy subjects. This research was performed to compare spatiotemporal parameters of gait between gender, as per their age and body mass index level. Methods: A cross-sectional study was conducted with forty-five young adults (F=20, M=25). Stadiometer and Physilog 4 inertial sensors were used for data collection. A gait analyzer 5.2 software (GaitUp, S.A. Lausanne, Switzerland) was used to determine spatiotemporal parameters. Results: Females were found with higher mean score of total double support and cadence than males. Cadence also increases with age. Obese people showed lower gait speed, cadence, and total double support. No statistically significant differences were found in any bilateral foot gait parameters with respect to gender, age, and body mass index. Conclusion: The findings of the study may be beneficial to those who have abnormal gait pattern due to age, body mass index differences, decreased muscle strength, spasticity, and joint mobility. This important information should be considered to rehabilitate patients with abnormal gait patterns to controlling dynamic balance and risk of falling.

Background: Many patients after acute stage of stroke are present with abnormal gait pattern due to weakness or hypertonicity of the affected limbs. Facilitation of normal gait is a primary goal of rehabilitation on these patients. Objective: We aimed to investigate whether walking assist device with auxiliary illuminator (quad-cane with laser) providing visual feedback during ambulation could improve parameters of gait cycle immediately among patients with subacute and chronic stroke. Methods: This was a cross-sectional study and 30 participants (male 23, female 7, group 1) with mean age [Formula: see text] years were recruited. Among them, 22 used ankle-foot orthosis [(AFO), group 2] and 8 did not use AFO (group 3) at usual walking. All the participants walked along a strait corridor with even surface for 20[Formula: see text]m without and with using a quad-cane with laser, respectively. A gait analyzer (Reha-Watch1 system) was used to measure the changes of the parameters of gait cycle, including stride length, cadence, gait speed, stance phase, swing phase, duration of single support and double support, the angle between toes and the ground at the time of toe-off (the toe-off angle) and the angle between calcaneus and the ground at the time of heel-strike (the heel-strike angle), before and with the use of a quad-cane with laser. Results: The increase in the heel-strike angle reached a significant difference in groups 1 2, and 3 ([Formula: see text], and [Formula: see text], respectively). However, the stride length, the gait speed, the cadence, percentage of the stance phase, swing phase, single-support phase, and double-support phase in a gait cycle, and the toe-off angle showed no significant change with the use of quad-cane with laser. Conclusion: Patients after acute stroke had an immediate and significant increase in the heel-stroke angle by using a quad-cane with laser during ambulation, which might help the patients to reduce knee hyperextension moment and lessen the pressure of heel at loading phase.

Altered knee motion is one of the most common gait deviations in pediatric populations with gait disorders. The potential for pediatric gait retraining using visual feedback based on knee kinematic patterns is under-explored.This study investigated whether pediatric participants could successfully modify knee flexion patterns in response to a visual kinematic feedback system (VKFS).Knee flexion angles from twelve typically developing children and adolescents (6 M, 6 F; 11.9 ± 2.7 years) were calculated using wearable inertial measurement units. Participants were tested while walking on a treadmill using pattern based visual feedback (FB). Four novel target patterns which amplified or attenuated swing phase peak knee flexion were tested. No feedback (NFB) tests assessed the participant's ability to independently reproduce the patterns. Mean absolute cycle error (MACE) and magnitude of peak knee flexion error (PK) were calculated during the last 10 strides of FB and NFB trials. Pre-exposure reference values (R) were also calculated.PK-FB was significantly smaller (p 0.05) than PK-R for all targets. Average values for PK-NFB were higher than for PK-FB, although PK-NFB remained significantly lower than PK-R for two targets. Contrary to one of the study's hypotheses, MACE-FB and MACE-NFB were larger than MACE-R. The study provided evidence that pediatric participants were able to modify peak knee flexion during gait in the sense targeted by the VKFS. Analysis suggested that MACE increases were explained by increases in gait cycle deviation outside of the changed region.

Postoperative rehabilitation is led by physiotherapists and is a vital program that re-establishes joint motion and strengthens the muscles around the joint after an orthopedic surgery. Modern smart devices have affected every aspect of human life. Newly developed technologies have disrupted the way various industries operate, including the healthcare one. Extensive research has been carried out on how smartphone inertial sensors can be used for activity recognition. However, there are very few studies on systems that monitor patients and detect different gait patterns in order to assist the work of physiotherapists during the said rehabilitation phase, even outside the time-limited physiotherapy sessions. In this paper, we are presenting a gait recognition system that was developed to detect different gait patterns. The proposed system was trained, tested and validated with data of people who have undergone lower body orthopedic surgery, recorded by Hirslanden Clinique La Colline, an orthopedic clinic in Geneva, Switzerland. Nine different gait classes were labeled by professional physiotherapists. After extracting both time and frequency domain features from the time series data, several machine learning models were tested including a fully connected neural network. Raw time series data were also fed into a convolutional neural network.

Introduction: The total knee replacement is the definitive treatment for knee osteoarthritis (OA). It is an effective intervention to correct OA-related functional limitation. In such patients postoperatively are observed significant differences in the biomechanics of the two knee joints. While bearing the body weight the unoperated knee joint becomes very painful, stiff and incapable of neutral positioning. These factors significantly hamper the initial training in gait with aids in the standard locomotive stereotype immediately after surgery for knee joint replacement, where walking plays an essential role in daily activities and has varied health benefits. Aim: The aim of the study was to check whether different types of gait with aids in the early postoperative period after total knee replacement have a different influence on the recovery process. Material and methods: This study was conducted between January 2017 and July 2018 in the Department of Orthopedics and Traumatology of the University Hospital “Kanev” – Rousse. It included 56 patients with unilateral total knee replacement after gonarthrosis, divided into a control and experimental group, each of 28 patients. All patients in both groups had knee extension deficit of the untreated knee joint. The patients in both groups followed the same physiotherapy programs, performed from about the 2nd postoperative day to the 21st day when they were discharged from the department. The difference between the patients in both subgroups was their gait pattern with two axillary crutches. Results and Discussion: There were statistically significant differences between both groups. One of the most significant differences was in ROM. In the experimental group patients, flexion was improved with an average of 20° more than in the control group patients. Also, in the operated joint, the patients in the experimental group had no contracture, whereas those in the control group showed 15° at the end of the follow-up period. Conclusion: The results of the study show that the choice of gait training in the following order “crutches, operated leg, crutches, untreated leg” in patients with extensor deficiency and contracture in the untreated knee is more appropriate than the standard type of training in walking with aids.

Research suggests that certain individuals exhibit vulnerability through their gait, and that observers select such individuals as those most likely to experience victimization. It is currently assumed that the vulnerable gait pattern is an expression of one’s submissiveness. To isolate gait movement, Study 1 utilized kinematic point-light display to record 28 individuals walking. The findings suggested that victimization history was related to gait vulnerability. The results also indicated that, contrary to expectation, individuals with more vulnerable features in their gait were more likely to self-report dominant personality characteristics, rather than submissive characteristics. In Study 2, a sample of 129 observers watched the point-light recordings and rated the walkers on their vulnerability to victimization. The results suggested that observers agreed on which walkers were easy targets; they were also accurate in that the walkers they rated as most likely to experience victimization tended to exhibit vulnerable gait cues. The current research is one of the few to explore the relationship between internal dispositions and non-verbal behavior in a sample of self-reported victims. The findings provide exciting insights related to the communicative function of gait, and the characteristics that may put some individuals at a greater risk to be criminally targeted.

Previous peak tibial shock gait retraining programs, which were usually conducted on a treadmill, were reported to be effective on impact loading reduction in runners. However, whether the trained runners can translate the training effect at different running modes (treadmill/overground), or running slopes (uphill/downhill), remains unknown.Is the training effect from a treadmill-based gait retraining translatable to unconstrained running conditions, including overground and uphill/downhill running?The peak tibial shock was measured during treadmill/overground running, as well as level/uphill/downhill running before and after a course of treadmill-based gait retraining. The 8-session training aimed to soften footfalls using real-time biofeedback of tibial shock data. Repeated measures ANOVA was used to examine the effect of training, running mode, and running slope, on a group level. Reliable change index of each participant was used to assess the individual response to the training protocol used in this study.Eighty percent of the participants were responsive to the gait retraining and managed to reduce their peak tibial shock following training. They managed to translate the training effect to treadmill slope running (Level: p 0.05, Cohen's d = 1.65; Uphill: p = 0.001, Cohen's d = 0.91; Downhill: p 0.05; Cohen's d = 1.29) and overground level running (p = 0.014, Cohen's d = 0.85). However, their peak tibial shock were not reduced during overground slope running (Uphill: p = 0.054; Cohen's d = 0.62; Downhill p = 0.12; Cohen's d = 0.48).Our findings indicated that a newly learned gait pattern may not fully translate to running outside of the laboratory environment.

Gait is recognized as an effective behavioral biometric trait. Gait pattern information can be captured and perceived from a distance thanks to its noninvasive and less intrusive nature. Therefore, gait could be well suited for person re-identification. However, semantic information like clothing and carrying bags has a remarkable influence on its accuracy. Unlike the existing solutions, this paper proposed a new method for gait-based person re-identification relying on dynamic selection of human parts. This method consists in computing a new person descriptor from relevant selected human parts. The selection of the most informative parts was achieved depending on the presence of semantic information. Our experiments were performed on the CASIA-B database revealing promising results and showing the effectiveness of the proposed method.

Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).

A novel approach has been proposed to generate the gait pattern of the humanoid robot with use of orbital energy concept. As the bipedal robots can be modeled as Linear Inverted Pendulum Model (LIPM) and rolling sphere model, the detailed discussion is presented here to generate stable walking pattern with help of this model. The intensive uses and advantages of the orbital energy concept have also been presented compared to different traditional approach of walking pattern generation. In this context, a novel algorithm has been proposed to generate 3D walking pattern of the bipedal robots, and how the 3D walking pattern can be approximated as the 2D walking pattern. All the analytical results are provided and verified with NaO robot (Biped robot).

The purpose of this study was to investigate the spatiotemporal and kinematic parameters of backward walking (BW) and forward walking (FW) on sand. Randomly selected subjects (n = 28) were categorized into a sand group (SG, n = 14) and an overground group (OG, n = 14). SG was directed to perform both FW and BW on sand, while OG performed the same on the overground. Spatiotemporal and kinematic parameters were measured using the LegSys + device. The comparative findings of both the groups showed that the spatiotemporal parameters of SG varied significantly from those of OG in both FW and BW conditions (p 0.05). The kinematic parameters varied significantly between the two groups only in the FW condition (p 0.05). When compared within each group, spatiotemporal and kinematic parameters in the BW condition were significantly different from those in the FW condition. However, the percentages of stance, swing, and double support were not significantly different between FW and BW conditions (p 0.05). This study suggests that sand walking is associated with a different gait pattern than overground walking, as evident from the analysis of the results of spatiotemporal and kinematic parameters in both FW and BW conditions. Therefore, sand walking can be used as a new approach to gait and balance training in clinical practice.

Faced with the rapidly aging world population, frailty has emerged as a major health burden among the elderly. This study aimed to investigate the feasibility of using temporal gait characteristics and a long short-term memory network for assessing frailty. Seventy-four community-dwelling elderly individuals participated in this study. The participants were categorized into three groups by their FRAIL scale: robust, pre-frail, and frail groups. The participants completed a 7-meter walking at the self-selected pace with a gyroscope on each foot. Analyzing the gyroscopic data produced seven temporal gait parameters per each gait cycle. Enumerating six consecutive values of each gait parameter produced the gait sequence features which were used as frailty predictors along with the demographic features. Five-fold cross-validation was applied to 70% of the data, and the remaining 30% were used as test data. An F1-score of 0.931 was achieved in classifying the robust, pre-frail, and frail groups by the random forest model trained with age, sex, and the outputs of the long short-term memory network-based classifier that used the initial and terminal double-limb support, step, and stride times as inputs. The proposed approach of assessing frailty using the arrhythmic gait pattern of the elderly and machine learning technique is novel and promising. Pioneering a way that self-monitor frailty at home without any help from experts, the study can contribute toearly diagnosis of frailty and make timely medical intervention possible.

Nowadays, convolutional neural network as a recognition model has improved human identification by gait patterns. The model recognizes personal steps of walking and its performance is up to a training dataset. After a pre-processing for human segmentation, it shows that the gaits for each person are quite similar with no significant difference. This causes a low accuracy in the recognition. To solve this issue, this paper proposes DarkNet-19 model to improve human detection and is adapted to classify gait pattern by comparing in pixel levels. A new model is developed based on CASIA-B dataset. In the experimental results, a recognition rate and identification accuracy are increased. The proposed method enhances an ability to identify person, who is walking, carrying a backpack, and wearing a coat, of 99.83%, 98.10% and 99.85% respectively.

Stroke causes disability in the lower-limb symmetry gait pattern in affected patients. The patients would not be able to regain their usual walking ability independently unless they benefit from rehabilitation therapies. Footplate-based gait robo-assisted systems can help patients to conduct effective training/exercising while tracking their progress of recovery and can dramatically reduce the clinical labor costs of physiotherapy. In the sense of simulation and not the design of the mechanical structure, this study aims to perform a combination of dynamic and control simulation of a five degrees-of-freedom footplate-based gait robo-assisted system established according to the Stewart platform structure for use in lower limb rehabilitation of stroke patients. The effectiveness and performance of the proposed mechanism were assessed through a clinical gait pattern of a healthy male individual. The proposed robo-assisted system enables the simulation of the hip and knee flexion/extension as well as the ankle dorsiflexion/plantar flexion of stroke patients to reproduce their typical symmetry gait pattern. The results were interpreted as the dynamic movement characteristics of the right and left thigh, leg, and foot compared to the clinical gait pattern with a mean percentage error of 6.70% to show the effectiveness and accuracy of the developed robo-assisted system for lower limb actuation in the simulation process.