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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 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

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.

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.

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.

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.

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.

Joint impedance plays an important role in postural control and movement. However, current experimental knowledge on lower limb impedance during gait is limited to the ankle joint. We designed the LOwer limb PERturbator (LOPER) aimed to assess knee and hip joint impedance during gait. The LOPER applies force perturbations with a 39 Hz bandwidth, tested on a free-hanging leg. In minimal impedance mode, peak interaction forces during walking are low (< 5 N). Also, this mode has a negligible effect on the gait pattern, as it is smaller than the within-subject variability during normal walking. In short, the LOPER is a transparent device able to elicit a clear response at both hip and knee joints to investigate lower limb dynamics. A second motor added to the LOPER could improve isolation of the perturbation contribution to knee and hip dynamics. People with neurological disorders can benefit from knowledge of joint impedance during gait through improved biomimetic devices and clinical decision making.

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.

There is a great need for quantitative outcomes reflecting the functional status in patients with knee or hip osteoarthritis (OA) to advance the development and investigation of interventions for OA. The purpose of this study was to determine if gait kinematics specific to the disease—i.e., knee versus hip OA—can be identified using wearable sensors and statistical parametric mapping (SPM) and whether disease-related gait deviations are associated with patient reported outcome measures. 113 participants (N = 29 unilateral knee OA, N = 30 unilateral hip OA, N = 54 age-matched asymptomatic persons) completed gait analysis with wearable sensors and the Knee/Hip Osteoarthritis Outcome Score (KOOS/HOOS). Data were analyzed using SPM. Knee and hip kinematics differed between patients with knee OA and patients with hip OA (up to 14°, p &lt, 0.001 for knee and 8°, p = 0.003 for hip kinematics), and differences from controls were more pronounced in the affected than unaffected leg of patients. The observed deviations in ankle, knee and hip kinematic trajectories from controls were associated with KOOS/HOOS in both groups. Capturing gait kinematics using wearables has a large potential for application as outcome in clinical trials and for monitoring treatment success in patients with knee or hip OA and in large cohorts representing a major advancement in research on musculoskeletal diseases.

Scoliosis is a 3-dimensional spinal deformity defined as lateral curvature of the spine in the coronal plane of more than 10°. This study describes a case of functional scoliosis after hip injury. In this case, the patient fell whilst inline skating (June 2015) causing severe tilting of her spine, and left hip pain. She received outpatient treatment from July 14, 2015 to December 28, 2015. For approximately 5 months, acupuncture therapy was performed to relax the tension in both hips, Chuna therapy, and foot orthosis were applied to reduce the body’s imbalance. Based on X-ray images, the Cobb angle had decreased from 14.73° (pretreatment) to 1.90° (posttreatment). This case report suggested that Korean medicine treatment could be an effective therapeutic choice for functional scoliosis.

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.

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.

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).

Intensive gait training is important for effective rehabilitation of people after stroke. “Stappy” is a sensor-feedback system that provides real-time feedback on the persons gait pattern/performance during training. The main aim of this study was to assess attitudes towards “Stappy” in people after stroke to practise walking performance independently at home. Demographics were collected. Frequency of practice with “Stappy” was monitored through the system. Participants used “Stappy” at home for two weeks. Semi-structured interviews were conducted to explore patient experiences with “Stappy” afterwards. Interviews were analysed using thematic analysis. Seventeen people after stroke (13 males, mean age 65, 17 to 172 months after stroke) were interviewed. There was a large variability (ranging from 0 to 14 days) in frequency of use over the two-week period. Although, thirty-eight percent were non-users, participants seemed satisfied about the option of feedback of the system on people’s gait pattern. Moderate to frequent users reported the ability to integrate “Stappy” into daily walking and the presence of support by the social environment as important factors for use. In a sub sample of stroke patients the ability to receive real-time feedback during practice about walking performance at home was viewed positively. Six participants did not or hardly used the sensor-feedback technology, even though they were positive about potential benefits. This implies that mHealth is not eligible for all individuals. To improve adherence various considerations were derived from this study, that may further optimise the frequency and personalise the use of the technology.IMPLICATIONS FOR REHABILITATIONThe frequency of use of a sensor-feedback technology in gait rehabilitation varied a lot in a cross-sectional sample of people after stroke.Patients after stroke seemed to have a positive attitude towards a sensor-feedback technology to support unsupervised practice of walking. However, this was unrelated to whether they had used or had not used the technology.Moderate and frequent users of the sensor-feedback technology reported the ability to integrate sensor-feedback technology in daily life and social support as important factors for use.For clinical practice in gait rehabilitation it is important to screen which patients are capable to use and may benefit from a technology as the one used in this study. The frequency of use of a sensor-feedback technology in gait rehabilitation varied a lot in a cross-sectional sample of people after stroke. Patients after stroke seemed to have a positive attitude towards a sensor-feedback technology to support unsupervised practice of walking. However, this was unrelated to whether they had used or had not used the technology. Moderate and frequent users of the sensor-feedback technology reported the ability to integrate sensor-feedback technology in daily life and social support as important factors for use. For clinical practice in gait rehabilitation it is important to screen which patients are capable to use and may benefit from a technology as the one used in this study.

Spor alanlarında insan hareketlerini ölçme yeteneği performans ölçüm ve gelişimi için önemli konular arasındadır. Bu durum aynı zamanda klinik değerlendirmelerin de önemli bir parçasıdır. Özellikle elektromanyetik sistemler insan hareketlerini değerlendirmek için en yaygın kullanılan yöntemler arasında yer alır. Buradaki çalışmada 100 metre uzunluğunda bir koridorda 50 farklı kişinin yürüme verileri kullanılmıştır. Yürüme verileri akıllı telefon için geliştirilen bir yazılım ile ivmeölçer sensöründen elde edilmiştir. Verilere üç boyutlu Local Binary Pattern (LBP) yöntemi uygulanmış ve toplam 768 öznitelik çıkarılmıştır. Farklı sınıflandırma algoritmaları ile testler yapılmış ve Subspace KNN ile %97,2 başarılı sınıflandırma elde edilmiştir. Cinsiyete göre yapılan sınıflandırmada ise %99,7 başarılı sınıflandırma elde edilmiştir. Bu yöntem ile yürüme bozukluğu tespitinde yüksek maliyetli cihazlar yerine daha ekonomik yöntemler geliştirileceği düşünülmektedir. The ability to measure human movements in sports fields is among the important issues for performance measurement and development. This instance is also an important part of clinical evaluations. Electromagnetic systems are among the most widely used methods to evaluate human movements. In this study, walking data of 50 different people were used in a 100-meter-long corridor. The walking dataset was obtained from the accelerometer sensor with a software developed for the smartphone. Three-dimensional Local Binary Pattern (LBP) method was applied to the dataset and a total of 768 features were generated. Datasets were made with different classification algorithms and 97.2% successful classification was achieved with Subspace KNN. In the classification according to gender, 99.7% successful classification was obtained. With this method, it is thought that more economical methods will be developed instead of high-cost devices in detecting gait disorders.

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.

The aim of the present systematic review was to describe the gait pattern in people with multiple sclerosis (MS) by compiling the main findings obtained from studies using three-dimensional capture systems of human movement. The search was carried out in PubMed, Web of Science, Physiotherapy Evidence Database (PEDro), and the Cumulative Index to Nursing and Allied Health (CINAHL) databases. Studies that used three-dimensional gait analysis systems and that analyzed spatiotemporal, kinematic, kinetic, or electromyographic parameters, were included. The quality of the studies was assessed using the Critical Review Form–Quantitative Studies scale. 12 articles were included with 523 (342 women and 181 men) people with a diagnosis of MS. The present work suggests that people with MS have a decrease in speed and stride length, as well as an increase in double-stance intervals during gait. Likewise, it is common to observe a decrease in hip extension during the stance period, a decrease in knee flexion in the swing period, a decrease in ankle dorsiflexion in the initial contact and a decrease in ankle plantar flexion during the pre-swing phase. The subjects with MS decrease the hip extensor moment and the ankle power during the stance period of walking.

Background Previous studies have pointed to the impact of self-perceptions of aging (SPA) on self-reported physical function in later life. However, less is known about associations of SPA with objectively measured physical function, especially gait. Research that examined other psychological variables and objectively measured gait has focused on single gait parameters such as gait speed, which seems to fall short for the complexity of this movement. Some approaches have proposed ways to identify gait patterns in specific patient groups, but not in community samples. Our goal was (a) to identify gait patterns based on a combination of important gait parameters in a community sample, and (b) to investigate differential associations of gain- and loss-related SPA with these gait patterns. Methods The study used an electronic walkway to assess gait parameters of 150 community dwelling adults aged 71–93 years (61.0% women) at their usual and maximum gait speed. SPA were assessed with a questionnaire. We used latent profile analysis (LPA) to identify groups exhibiting distinct gait patterns and binary logistic regression to investigate associations of SPA with these groups, controlling for personality traits, number of illnesses, age, gender, and education. To compare overall function between groups, a t-test for scores in the Short Physical Performance Battery was used. Results LPA revealed two distinct groups in both gait speed conditions. The fit group exhibited a stable, well-coordinated and faster gait pattern, while the functionally limited group’s gait pattern was less stable, less coordinated and slower. The odds of belonging to the functionally limited group were increased by loss-related SPA at usual gait speed, while the odds of belonging to the fit group were increased by gain-related SPA at individual maximum speed. Conclusions The findings (a) suggest LPA as a useful approach to investigate complex gait patterns considering several gait parameters simultaneously, and (b) provide first evidence for differential associations of gain- and loss-related SPA with gait patterns at usual and maximum gait speed. Intervention studies addressing gait in older adults should additionally address gain-related views on aging.

Objectives: The aim of this study was to compare the smartphone-based gait analysis data of patients who underwent total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA). Patients and methods: Between January 2016 and April 2019, a total of 51 patients (3 males, 48 females; mean age: 60.92 years; range, 51 to 70 years) who were operated with UKA or TKA in our clinic were retrospectively analyzed. The patients were divided into two groups according to the type of procedure as the UKA group (n=17) and unilateral TKA group (n=34). Gait analysis was made via a smartphone application (Gait Analyzer software version 0.9.95.0) with data acquired from the accelerometer of the smartphone. This analysis was performed using data collected from the Acceleration Sensor LSM6DSO into the Samsung Galaxy Note 10 Plus phone. Gait velocity, step time, step length, cadence, step time symmetry, step length symmetry, and vertical COM (vert-COM) parameters were measured. Results: There were no statistically significant differences between the groups in respect of age, sex, body mass index, operated side, and follow-up duration. Compared to the TKA group, the UKA patients showed a better gait pattern in gait velocity (p=0.03), step time symmetry (p=0.005), and step length symmetry (p=0.024). No significant difference was detected in step time (p=0.807), step length (p=0.302), cadence (p=0.727) and vert-COM parameters (p=0.608). Conclusion: The gait of UKA patients is closer to the physiological pattern with a better gait velocity, step time symmetry, and step length symmetry than TKA patients. The surgical treatment option of UKA for knee medial compartment osteoarthritis leads to a better gait pattern than TKA.

Young people are also at risk of developing locomotive syndrome for unclear reasons. Therefore, we sought to evaluate the locomotive syndrome risk in young Japanese women and the relationship between standing posture and gait patterns. We used survey materials for physical measurements, locomotive syndrome risk tests, normal and maximum walking test, a standing posture test, and physical activity measures. A questionnaire-based cross-sectional survey was conducted with 100 Japanese female university students. The participants were divided into two groups (high-risk and low-risk groups) based on locomotive syndrome risk tests. The high-risk group accounted for 65.0% of the total participants. The high-risk group had a significantly slower walking speed and lower walking stride length than the low-risk group during maximum walking. Additionally, this high-risk group had a more prone posture than the low-risk group. Furthermore, the low-risk group included more individuals who belonged to middle and high school athletic clubs than the high-risk group. The locomotive syndrome risk was related to the walking pattern, standing posture, and past exercise habits. Therefore, long stride length, correct standing posture, and exercise habits acquired from a young age are important measures for preventing locomotive syndrome in young adults.

Although robotic-assisted locomotor treadmill therapy is utilized on children with cerebral palsy (CP), its impact on the gait pattern in childhood is not fully described. We investigated the outcome of robotized gait training focusing on the gait pattern modifications and mobility in individuals with CP. An additional intention is to compare our results with the previous literature advancing future solutions. Twenty-four children with diplegic CP (average age 6.4 years old with Gross Motor Functional Classification System range I-IV) received robotized gait training five times per week for 4 weeks. Gait analysis and Gross Motor Function Measurement (GMFM) assessments were performed before and at the end of the treatment. Gait analysis showed inconsistent modifications of the gait pattern. GMFM showed a mild improvement of the dimension D in all subjects, while dimension E changed only in the younger and more severely affected patients. In this study, a detailed investigation comprehensive of electromyography patterns, where previous literature reported only sparse data without giving information on the whole gait pattern, were conducted. We carried on the analysis considering the age of the participants and the severity of the gait function. The findings differentiate the concept of specific pattern recovery (no gait pattern changes) from the concept of physical training (mild GMFM changes).

The progressive impairment analysis in gait from neurological diseases patients such as Hereditary Ataxias (HA) has been carried out using gait data collected with movement sensors. This research is focused on finding the minimum amount required of gait features to recognize efficiently and less intrusive way, HA patients based on data collected with iPhone movement sensors placed on the ankles from 14 HA patients and 14 healthy people. A twofold proposal is made , first a local minimum prominent peak criterion to find out the starting point of each stride, to get 10-stride window about which 56 spatial-temporal features are derived; second a search strategy based on Hill Climbing algorithm to reduce the number of gait features and sensors. The main results were the findings that with two gait patterns a 96% of classification accuracy was achieved by using K-Nearest Neighbors (KNN) and Multi-Layer Perceptron (MLP) algorithms, but in addition, MLP only right ankle sensor patterns were required which also allows to reduce the intrusion.

Background: Functional limitations may still remain even after a patient completes a traditional quadriceps-based rehabilitative program after total knee arthroplasty. Based on studies reporting that patients with knee osteoarthritis have muscle weakness around the hip joint after total knee arthroplasty, we investigated whether strengthening the hip muscles can reduce pain and improve the physical function and gait of patients who underwent total knee arthroplasty. Methods: Patients were randomly divided into three groups: hip, quadriceps, and control. The hip group (n = 19) completed an extensor, adductor, and external muscle strengthening exercise program. The quadriceps group (n = 20) completed a quadriceps strengthening exercise program. The control group (n = 16) completed an active range of motion exercises. Therapy was conducted thrice weekly for 12 weeks. Pain and function items from the Western Ontario and McMaster Universities Osteoarthritis Index, Alternate Step Test, Five Times Sit to Stand Test, and Single Leg Stance Test were performed to assess pain and physical function. In the gait analysis, stride, single-stance (%), double-stance (%), and gait speed were measured. Data were collected at baseline and at 4, 8, and 12 weeks after the intervention. Results: The hip group showed more significant improvements in pain and performance on the Alternate Step Test and Single Leg Stance Test than the quadriceps and control groups. In the gait analysis, the hip group showed the largest improvements in single stance and double stance. Conclusions: In conclusion, a 12-week hip muscle strengthening exercise program effectively improves the physical function and gait of patients who have undergone total knee arthroplasty.

Current research shows discrepancies in the gait pattern of patients with peripheral artery disease (PAD). Some studies suggest a change in gait pattern after the manifestation of claudication pain while others found patients with PAD already show a pathological gait, even before the intermittent claudication arises, and no change once the pain manifests. This exploratory research examines what change in gait pattern can be detected once claudication pain arises with the help of an accelerometer embedded in a smartphone. This study aims to contribute to the development of a process to remotely collect accelerometer data in a mobile health application, which then can be used to analyze gait pattern in patients with PAD on a larger scale. The findings of this exploratory study show that processing and analyzing accelerometer data from smartphone for gait analysis is viable and establishes a methodology for collecting and analyzing PAD patients’ data. The major limitation of this study is the small sample size that do not provide the necessary reliability of the findings, about gait pattern changes. Further gait data should be collected to help understanding the gait pattern of PAD patients and build an extended dataset to be analyzed at a larger scale.

Studies on the gait's parameters have been identified on the patients population. Most researchers confirm that the patients walk differently than normal people and they may have a risk for falls. Consistent finding and description of gender, age, and body mass index differences in gait studies is rare in healthy subjects. A cross-sectional study with forty-five young adult (F = 20, M = 25) was conducted. Stadiometer and Physilog 4 inertial sensors were used for data collection. A gait analyser 5.2 software (GaitUp, S.A. Lausanne, Switzerland) was used to determine spatiotemporal parameters. No statistically significant differences were found in any bilateral foot gait parameters with respect to gender, age, and body mass index. Females are found with higher total double support and cadence than males. Cadence also increases with age. Obese people showed lower gait speed, cadence, and total double support. These findings 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 informations should be considered to rehabilitate patients with abnormal gait patterns to controlling dynamic balance and riks to falling.

A summary measure for quantification of the upper body position (Upper Body Profile Score [UBPS]) during gait was proposed and used in 38 children with Cerebral Palsy (CP) and 15 healthy children (Control Group: CG). Patients with CP exhibited higher values of most of the summary parameters of the upper body position than the CG. The higher influence on UBPS is by the upper body position in sagittal and transversal plane. A significant and fair correlation between UBPS and Gait Profile Score (a summary measure to quantify the lower limb gait pattern) suggests that altered upper body movements during walking could be associated with the presence of lower limb impairments.

Machines that are sensitive to environmental fluctuations, such as autonomous and pet robots, are currently in demand, rendering the ability to control huge and complex systems crucial. However, controlling such a system in its entirety using only one control device is difficult; for this purpose, a system must be both diverse and flexible. Herein, we derive and analyze the feature values of robot sensor and actuator data, thereby investigating the role that each feature value plays in robot locomotion. We conduct experiments using a developed quadruped robot from which we acquire multi-point motion information as the movement data; we extract the features of these movement data using an autoencoder. Next, we decompose the movement data into three features and extract various gait patterns. Despite learning only the “walking” movement, the movement patterns of trotting and bounding are also extracted herein, which suggests that movement data obtained via hardware contain various gait patterns. Although the present robot cannot locomote with these movements, this research suggests the possibility of generating unlearned movements.

Biological recognition methods often use biological characteristics such as the human face, iris, fingerprint, and palm print, however, such images often become blurred under the limitation of the complex environment of the underground, which leads to low identification rates of underground coal mine personnel. A gait recognition method via similarity learning named Two-Stream neural network (TS-Net) is proposed based on a densely connected convolution network (DenseNet) and stacked convolutional autoencoder (SCAE). The mainstream network based on DenseNet is mainly used to learn the similarity of dynamic deep features containing spatiotemporal information in the gait pattern. The auxiliary stream network based on SCAE is used to learn the similarity of static invariant features containing physiological information. Moreover, a novel feature fusion method is adopted to achieve the fusion and representation of dynamic and static features. The extracted features are robust to angle, clothing, miner hats, waterproof shoes, and carrying conditions. The method was evaluated on the challenging CASIA-B gait dataset and the collected gait dataset of underground coal mine personnel (UCMP-GAIT). Experimental results show that the method is effective and feasible for the gait recognition of underground coal mine personnel. Besides, compared with other gait recognition methods, the recognition accuracy has been significantly improved.

The aim of the study was to develop a database of biomechanical data for multiple gait tasks. This database will be used to create a real-time gait pattern classifier that will be implemented in a new-generation active knee prosthesis. With this intent, we collected kinematic and kinetic data of 40 subjects performing 16 gait tasks, categorized as periodic and transient motions. We analyzed four distinct sub-populations, differentiated by age and gender. As the classifier will be based also on inertial data, we chose to synthesize these signals within the motion capture environment. To assess the effects of gender and age we performed a correlation analysis on the signals used as input of the classifier. The results obtained indicate that there is no need to differentiate into four distinct classes for the development of the classifier. Sample data of the dataset are made publicly available.

Background: Single-event multilevel surgery (SEMLS) approach is regarded as the golden standard in developed countries to improve gait and functional mobility in children with cerebral palsy (CP). However, this approach is not always feasible in developing countries. Therefore, orthopedic surgery based on an interval surgery approach (ISA) is still commonly used in developing countries, although little is known about the long term outcomes of an ISA. Therefore, the aim of this study was to describe the gait patterns of adults with CP, who have been treated with ISA, which started more than 15 years ago. Materials and Methods: Thirty adults with CP and spastic diplegia, who received ISA treatment 21.6–33.7 years ago, were recruited for this study and participated in three-dimensional gait analysis. Twenty kinematic and nondimensional temporal-distance parameters were captured, while the overall gait deviation index (GDI) was also calculated. Data of the adults with CP were compared to normative data of typically developing (TD) adults. Results: Although all adults with CP were still ambulant, their gait parameters significantly differed from TD adults, with a lower GDI in the adults with CP. The CP gait patterns were characterized by excessive hip flexion and hip internal rotation as well as a stiff-knee gait. Conclusion: Although different to TD adults, the gait patterns observed in the adult with CP treated with ISA is in line with other studies. Gait patterns suggest that derotation osteotomies potentially could have improved the long term gait patterns. Although SEMLS might be the preferred treatment method, potentially resulting in better outcomes, ISA can also be used to treat children with CP in developing countries as India and South Africa, where a SEMLS approach is not always feasible.

Background Balance and mobility impairments are important modifiable risk factors associated with falls in older people. Purpose To investigate how different functional fitness components relate to balance and mobility, after controlling for age, sex, body mass index (BMI), and different physical activity (PA) domains. Methods This representative cross-sectional study included 802 individuals, 401 males and 401 females (69.8 ± 5.6 years) from Madeira, Portugal. The Fullerton Advance Balance (FAB) scale was used to assess balance. Mobility in terms of gait velocity, cadence, stride length, and gait stability ratio (GSR) were assessed using the 50-foot Walk test. PA was assessed through a face-to-face interview using the Baecke questionnaire, and functional fitness was assessed with Senior Fitness tests (strength, flexibility, and aerobic endurance). Results Balance and mobility were negatively associated with age and BMI, and positively related to PA and functional fitness. Moreover, male presented better performance in balance and mobility. Hierarchical multiple regression analyses showed that functional fitness explained the highest amount of variance in balance and all mobility parameters (over and above age, sex, BMI, and PA). Specifically, entering functional fitness components significantly increased explained variance in FAB (+19%), gait velocity (+25%), cadence (+15%), stride length (+9%), and GSR (+ 31%). In these models, aerobic endurance consistently had the strongest contribution. Conclusion Strength, flexibility, and especially aerobic endurance, over and above non-modifiable variables like age and sex, are crucial for maintaining or improving balance and mobility and, thereby, prevent falls in older people.

As the potential for a treatment of Duchenne muscular dystrophy (DMD) grows, the need for methods for the early diagnosis of DMD becomes more and more important. Clinical experiences suggest that children with DMD will show some lack of motor ability in the early stage when compared with children at the same age, especially in balance and coordination abilities. Is it possible to quantify the coordination differences between DMD and typically developing (TD) children to achieve the goal of screening for DMD diseases? In this study, we introduced a Local Manifold Structure Mapping approach in phase space and extracted a novel index, relative coupling coefficient (RCC), from gait pattern signals, which were acquired by wearable accelerometers to evaluate the coordination of children with DMD during a walking task. Furthermore, we compared the RCC of 100 children with DMD and 100 TD children in four different age groups and verified the feasibility and reliability of the proposed indices to distinguish children with TD from DMD. T-test results show that, for all age groups, children of the same age with DMD and TD show significant differences in RCC (p