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Inertial measurement units (IMUs) have shown promising outcomes for estimating gait event detection (GED) and ground reaction force (GRF). This study aims to determine the best sensor location for GED and GRF prediction in gait using data from IMUs for healthy and medial knee osteoarthritis (MKOA) individuals. In this study, 27 healthy and 18 MKOA individuals participated. Participants walked at different speeds on an instrumented treadmill. Five synchronized IMUs (Physilog ® , 200 Hz) were placed on the lower limb (top of the shoe, heel, above medial malleolus, middle and front of tibia, and on medial of shank close to knee joint). To predict GRF and GED, an artificial neural network known as reservoir computing was trained using combinations of acceleration signals retrieved from each IMU. For GRF prediction, the best sensor location was top of the shoe for 72.2% and 41.7% of individuals in the healthy and MKOA populations, respectively, based on the minimum value of the mean absolute error (MAE). For GED, the minimum MAE value for both groups was for middle and front of tibia, then top of the shoe. This study demonstrates that top of the shoe is the best sensor location for GED and GRF prediction.

Segmenting the gait cycle into multiple phases using gait event detection (GED) is a well-researched subject with many accurate algorithms. However, the algorithms that are able to perform accurate and robust GED for real-life environments and physical diseases tend to be too complex for their implementation on simple hardware systems limited in computing power and memory, such as those used in wearable devices. This study focuses on a numerical implementation of a reservoir computing (RC) algorithm called the echo state network (ESN) that is based on simple computational steps that are easy to implement on portable hardware systems for real-time detection. RC is a neural network method that is widely used for signal processing applications and uses a fast-training method based on a ridge regression adapted to the large quantity and variety of IMU data needed to use RC in various real-life environment GED. In this study, an ESN was used to perform offline GED with gait data from IMU and ground force sensors retrieved from three databases for a total of 28 healthy adults and 15 walking conditions. Our main finding is that despite its low complexity, ESN is robust for GED, with performance comparable to other state-of-the-art algorithms. Our results show the ESN is robust enough to obtain good detection results in all conditions if the algorithm is trained with variable data that match those conditions. The distribution of the mean absolute errors (MAE) between the detection times from the ESN and the force sensors were between 40 and 120 ms for 6 defined gait events (95th percentile). We compared our ESN with four different state-of-the-art algorithms from the literature. The ESN obtained a MAE not more than 10 ms above three other reference algorithms for normal walking indoor and outdoor conditions and yielded the 2nd lowest MAE and the 2nd highest true positive rate and specificity when applied to outdoor walking and running conditions. Our work opens the door to using the ESN as a GED for applications in wearable sensors for long-term patient monitoring.

Background: Most previous studies reported biomechanical deficits in individuals with a trans-tibial amputation (TTA) during gait using zero-dimensional analyses. However, these analyses do not allow to precisely determine during which part of the gait cycle these deficits occur. There is a need to use more appropriate methods to map the differences, such as one-dimensional statistical parametric mapping., Research Question: What are the most relevant phases of the gait cycle during which the biomechanical deficits in TTA occur?, Methods: Eight TTA and 15 healthy counterparts (CON) underwent one biomechanical gait analysis. Pelvis, hip, knee and ankle kinematics, total support moment (TSM) and gastrocnemius lateralis, vastus lateralis and tibialis anterior muscle activity were compared between the amputated (AmLL), the intact (InLL) and the control (CnLL) lower limbs using one-dimensional statistical parametric mapping., Results: More ankle dorsiflexion and knee flexion were observed for the AmLL compared to the InLL and CnLL (ankle only) from the end of the stance phase to the beginning of the swing phase. Less knee flexion was also found for the AmLL during early stance phase. More pelvis posterior tilt and rotation toward the contralateral limb was observed during most of the gait cycle for the AmLL compared to the InLL. TSM was smaller for the AmLL compared to the CnLL during early stance phase., Significance: Using a one-dimensional statistical parametric mapping approach for TTA gait analysis, this study provides novel insights on their biomechanical gait deficits compared to CON. Greater reliance on the InLL was observed in TTA as suggested by the asymmetric kinematic and kinetic profiles., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Some studies have used load cells (LC) to measure the force applied to horizontal handrails, but no work has validated an inclined set-up that can be used to bring new insights into handrail use during staircase gait. The aim of this study was to validate the accuracy of an inclined handrail set-up instrumented with LC. A handrail set-up designed to be easily reconstructed and integrating two commercial LC is proposed. Twenty points were tested along the handrail, with four reference weights in the three orthogonal directions of the sensors (Medio-Lateral, Antero-Posterior, Vertical). For each direction, the percentage (%) of error and the cross-talk between the known and recorded forces were calculated. A linear regression of the % error was performed to evaluate measurement accuracy in relation to point of application along the handrail. The current easily replicated set-up of an inclined handrail showed accurate measures with low cross-talk. The percentage of error and cross-talk were below 3.7% and 3.7%, respectively, consistent with previous studies evaluating inclined handrail with other methods. The error and cross-talk were greater in the Medio-Lateral and Antero-Posterior directions. The error in the Antero-Posterior direction was larger over the upper part of the handrail., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2020. Published by Elsevier Ltd.)

Background: A recent amputation leads to decreased functional capacities in the lower limb amputees (LLA), especially during walking. Assessments of LLA's gait in clinical settings are used to provide feedback on their evolution without quantifying gait parameters distinctly, unlike new technologies, such as inertial sensors (IMUs), which have demonstrated their effectiveness in different environments and populations., Research Question: How do the spatial-temporal gait parameters and kinematics of the LLA evolve quantitatively over a six-minute walk test (6MWT) and is the use of inertial sensors relevant in clinical practice to quantify those parameters?, Methods: Fifteen LLA from a study cohort performed a 6MWT post-rehabilitation, wearing inertial sensors on both feet to provide gait parameters (i.e., minimum toe clearance (minTC), speed, cadence, stance time and foot flat ratio (FFr)) over this test. A non-parametric ANOVA was conducted comparing the evolution of each parameter over the 6MWT (12 intervals of 30 s). Significance level was set at P ≤  0.05. Post-hoc Wilcoxon signed-rank tests were performed if a main effect was detected., Results: MinTC and stance phase variability along the 6MWT were significantly different over time. Cadence variability and speed variation were significantly different between both feet (amputated and non-amputated leg)., Significance: The increased variability in gait parameters along the 6MWT suggests a greater risk of future mobility problems following a return in community. The data provided by the IMUs reflect the potential of the clinical rehabilitation programme and could, therefore, help clinicians to refine their interventions., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: The purpose of this prospective study was to investigate the influence of body mass index (BMI) on gait parameters preoperatively and 1 year after total knee arthroplasty (TKA)., Methods: Seventy-nine patients were evaluated before and 1 year after TKA using clinical gait analysis. The gait velocity, the knee range of motion (ROM) during gait, their gains (difference between baseline and 1 year after TKA), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), quality of life, and patient satisfaction were assessed. Nonobese (BMI <30 kg/m 2 ) and obese patients (BMI ≥30 kg/m 2 ) were compared. Healthy controls were also assessed. Univariate and multivariate linear regression analyses were used to assess the association between gait speed and ROM gains. Adjustment was performed for gender, age, and WOMAC pain improvement., Results: At baseline, gait velocity and knee ROM were significantly lower in obese compared with those in the nonobese patients (0.99 ± 0.27 m/s vs 1.11 ± 0.18 m/s; effect size, 0.53; P = .021; and ROM, 41.33° ± 9.6° vs 46.05° ± 8.39°; effect size, 0.52; P = .022). Univariate and multivariate linear regressions did not show any significant relation between gait speed gain or knee ROM gain and BMI. At baseline, obese patients were more symptomatic than nonobese (WOMAC pain: 36.1 ± 14.0 vs 50.4 ± 16.9; effect size, 0.9; P < .001), and their improvement was significantly higher (WOMAC pain gain, 44.5 vs 32.3; effect size, 0.59; P = .011)., Conclusion: These findings show that all patients improved biomechanically and clinically, regardless of their BMI., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: The International Committee of the Red Cross supports a worldwide program of prosthetic fitting and rehabilitation. In this context, a prosthetic foot was developed and widely distributed in least developed countries., Study Design: Prospective, randomized, double-blind, controlled study., Objective: To compare patient satisfaction and energy expenditure during ambulation between a low-cost prosthetic foot designed with a polypropylene keel (CR-Equipements ™ solid ankle cushion heel, International Committee of the Red Cross) to a well-recognized solid ankle cushion heel foot with a wooden keel (solid ankle cushion heel foot, Otto Bock)., Methods: A total of 15 participants with unilateral transtibial amputation were evaluated using the two prosthetic feet in a randomized prospective double-blind crossover study. Main outcomes were patient satisfaction questionnaires (Satisfaction with Prosthesis Questionnaire and prosthetic foot satisfaction) and energy expenditure (oxygen consumption-mL/kg/min, oxygen cost-mL/kg/m, and heart rate-bpm)., Results: There were no significant differences between the two prosthetic feet for satisfaction and energy expenditure., Conclusion: The low-cost solid ankle cushion heel foot with polypropylene keel provides comparable satisfaction and similar energy expenditure as the solid ankle cushion heel foot with wooden keel. Clinical relevance The results of this study support the application and widespread use of the CR-Equipements ™ solid ankle cushion heel foot. From a cost-effectiveness standpoint, patients are well satisfied and exhibit similar outcomes at a substantially lower cost.

Background: The degree of disability in patients with hereditary spastic paraplegia has been reported variable even in members of the same family (same gene mutation). Moreover, it has been established that patients with hereditary spastic paraplegia should be treated differently from cerebral palsy patients due to the progressive nature of this disease. However, the gait evolution of hereditary spastic paraplegia showing onset symptoms at an early age has been described as stable. Therefore, this study aims to evaluate the walking ability and the influence of treatments on gait evolution in a family with hereditary spastic paraplegia., Methods: Clinical gait analyses were performed in six hereditary spastic paraplegia patients from the same family with a follow-up of 4-15 years., Results: Based on the gait deviation index, results showed a large variation of walking ability in these patients and no statistical difference between the first and last examination. In fact, three patients have improved their gait (from childhood to adolescence) whereas three patients worsened their gait., Conclusions: Gait alterations in a family with hereditary spastic paraplegia are heterogeneous. Gait evolution in hereditary spastic paraplegia with early symptoms had a tendency to improve gait until adolescence with adapted treatments and to decline in the adulthood., (Copyright © 2014 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.)

The objective of this study was to investigate how gait and clinical outcomes contribute to patients' satisfaction three months following a total knee arthroplasty (TKA). Seventy-eight patients with knee osteoarthritis (OA) and a control group of twenty-nine subjects were evaluated. The gait parameters, Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain and functional levels, quality of life and patients' satisfaction following TKA were assessed. A multiple linear regression model shows that the WOMAC functional score explained 39% of the global satisfaction and 37% of the satisfaction related to pain relief following TKA. Finally, the model shows that 65% of the satisfaction related to the functional improvement was explained by a combination of clinical and gait parameters. This study demonstrated the contribution of both gait and clinical outcomes to patients' satisfaction following TKA., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: To compare the well-recognized solid ankle cushion heel (SACH) foot with the prosthetic foot developed by the International Committee of the Red Cross (CR Equipements SACH) during gait., Design: Double-blind study was conducted to compare the influence on the biomechanics of gait of the CR Equipements SACH foot and the SACH foot., Setting: University hospital research center., Participants: Participants with unilateral transtibial amputation (N=15) were included., Interventions: Three-dimensional motion analysis system and 2 forceplates were used to capture body motion and ground reaction forces during gait at a self-selected speed and at 1.2m/s., Main Outcome Measures: Nonparametric Wilcoxon matched-pairs tests were used to compare the 2 prosthetic feet with respect to their spatiotemporal (gait velocity, stride length, and percentage of stance phase), kinematic (range and peak angles of the pelvis, hip, knee, and ankle), and kinetic (peak moment and power of the hip, knee, and ankle) parameters., Results: Compared with the SACH foot, the CR Equipements SACH foot demonstrated a significantly greater stance phase symmetry ratio (SACH: 94% vs CR Equipements SACH: 97%), a more extensive ankle range of motion in the sagittal plane (SACH: 7° vs CR Equipements SACH: 12°), a greater maximal dorsiflexion angle during the terminal stance phase (SACH: 10° vs CR Equipements SACH: 13°), and a higher ankle power (SACH: .31W/kg vs CR Equipements SACH: .40W/kg). No significant difference was found for the examined knee, hip, and pelvis parameters., Conclusions: The CR Equipements SACH foot provides more symmetry and improves ankle kinematics and kinetics in the sagittal plane compared with the SACH foot. This study suggests that individuals using the CR Equipements SACH foot improve their gait biomechanics compared when using the SACH foot., (Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Patients with knee osteoarthritis present an altered gait pattern. Amongst many factors, the lower limb alignment (varus, valgus) has been identified as an important risk factor for the progression of knee osteoarthritis. Among the large number of studies on knee osteoarthritis gait, only a few have included patients with a valgus deformity. The aims of this study were to determine how knee alignment influences full-body gait in patients with knee osteoarthritis and if knee malalignment is associated with pain and functional capacity., Methods: Sixty patients with severe knee osteoarthritis scheduled for a total knee arthroplasty were included in this study. Twenty-six subjects were recruited as the control group. The spatio-temporal parameters, three-dimensional full-body kinematics, and lower body kinetics were evaluated during a comfortable gait and compared between the groups. Pain and function were assessed with the WOMAC questionnaire., Findings: The full-body gait analysis demonstrated substantially different gait patterns and compensation mechanisms between the three groups. Patients with varus knee alignment significantly augmented their trunk movements in sagittal and frontal planes compared to patients with a valgus knee. In addition, patients with a valgus knee reported lower pain and lower functional deficits compared to patients with a varus knee., Interpretation: We found that gait compensations were significantly influenced by lower limb alignment. These new insights related to different knee osteoarthritis gait patterns might help in the understanding of gait compensation behaviours prior to total knee arthroplasty and better manage the strategies of rehabilitation following surgery., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: The purpose of this systematic review was to identify which biomechanical and physiological parameters are the most relevant, commonly used, able to discriminate and/or have specific clinical relevance for the gait analysis of lower-limb amputees (LLA)., Methods: We performed an electronic search via the PubMed, EMBASE and ISI Web of Knowledge databases from 1979 to May 2009. Two independent reviewers assessed the title and abstract of each identified study. The quality assessment of the full text was undertaken using a 13-item checklist divided into three levels: A, B, and C., Results: The literature search identified 584 abstracts to be considered. After applying the inclusion criteria, we reviewed the full text of a total of 89 articles. The mean article quality was 8±2. No A-level article was found; the primary reason was a negative score in blinded outcome assessment. Sixty-six articles (74%) corresponded to a B-level, and two articles (2%) corresponded to a C-level. Twenty-one articles (24%) did not acquire enough points to be assigned to any level. In this study, we present and discuss the most commonly used and most relevant 32 parameters. Many of the parameters found were not reported in enough studies or in enough detail to allow a useful evaluation., Conclusion: This systematic review can help researchers compare, choose and develop the most appropriate gait evaluation protocol for their field of study, based on the articles with best scores on the criteria list and the relevance of specific biomechanical and physiological parameters., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Background: Interpreting gait data is challenging due to intersubject variability observed in the gait pattern of both normal and pathological populations. The objective of this study was to investigate the impact of using principal component analysis for grouping knee osteoarthritis (OA) patients' gait data in more homogeneous groups when studying the effect of a physiotherapy treatment., Methods: Three-dimensional (3D) knee kinematic and kinetic data were recorded during the gait of 29 participants diagnosed with knee OA before and after they received 12 weeks of physiotherapy treatment. Principal component analysis was applied to extract groups of knee flexion/extension, adduction/abduction and internal/external rotation angle and moment data. The treatment's effect on parameters of interest was assessed using paired t-tests performed before and after grouping the knee kinematic data., Findings: Increased quadriceps and hamstring strength was observed following treatment (P<0.05). Except for the knee flexion/extension angle, two different groups (G(1) and G(2)) were extracted from the angle and moment data. When pre- and post-treatment analyses were performed considering the groups, participants exhibiting a G(2) knee moment pattern demonstrated a greater first peak flexion moment, lower adduction moment impulse and smaller rotation angle range post-treatment (P<0.05). When pre- and post-treatment comparisons were performed without grouping, the data showed no treatment effect., Interpretation: The results of the present study suggest that the effect of physiotherapy on gait mechanics of knee osteoarthritis patients may be masked or underestimated if kinematic data are not separated into more homogeneous groups when performing pre- and post-treatment comparisons., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

This study presents a new method to estimate 3-D linear accelerations at tibial and femoral functional coordinate systems. The method combines the use of 3-D accelerometers, 3-D gyroscopes and reflective markers rigidly fixed on an exoskeleton and, a functional postural calibration method. Marker positions were tracked by a six-camera optoelectronic system (VICON 460, Oxford Metrics). The purpose of this study was to determine if this method could discriminate between medial osteoarthritic and asymptomatic knees during gait. Nine patients with osteoarthritic knees and nine asymptomatic control subjects were included in this study. Eighteen parameters representing maximal, minimal, and range of acceleration values were extracted during the loading and preswing to mid-swing phase periods, and were compared in both groups. Results show good discriminative capacity of the new method. Eight parameters were significantly different between both groups. The proposed method has the potential to be used in comprehending and monitoring gait strategy in patients with osteoarthritic knee.

The aim of this work is to develop an automatic computer method to distinguish between asymptomatic (AS) and osteoarthritis (OA) knee gait patterns using 3-D ground reaction force (GRF) measurements. GRF features are first extracted from the force vector variations as a function of time and then classified by the nearest neighbor rule. We investigated two different features: the coefficients of a polynomial expansion and the coefficients of a wavelet decomposition. We also analyzed the impact of each GRF component (vertical, anteroposterior, and medial lateral) on classification. The best discrimination rate (91%) was achieved with the wavelet decomposition using the anteroposterior and the medial lateral components. These results demonstrate the validity of the representation and the classifier for automatic classification of AS and OA knee gait patterns. They also highlight the relevance of the anteroposterior and medial lateral force components in gait pattern classification.

Background: The aim of this study was to describe the evolution of kinematic and clinical outcomes of a large patient cohort with knee osteoarthritis from before surgery (V1) to 3 months (V2) and 1 year (V3) after a total knee arthroplasty (TKA).Methods: The patients were evaluated at each visit (118 patients at V1, 93 patients at V2, and 79 patients at V3) during a clinical gait analysis and were compared with a matched control group of healthy adults (CG). The kinematic parameters, the Western Ontario and MacMaster Osteoarthritis Index (WOMAC), quality of life, and patient satisfaction were assessed. Gait velocity and knee range of motion (ROM) as well as clinical parameters were compared at each visit with CG was based on the unpaired samples t-test. To determine changes in the data at baseline, 3 months, and 1 year after surgery in the patient groups, repeated-measure analysis of variance was conducted (P < .05). Pearson correlation was used to examine relationships between clinical and biomechanical outcomes.Results: One year after TKA (V3) compared to V1 and V2, the ROM of the operated knee during gait was significantly improved (V1: 44.2 ± 8.8° vs V3: 47.5 ± 7.1°, P < .001, and V2: 42.2 ± 9.3° vs V3: 47.5 ± 7.1°, P = .001), as was the gait velocity (V1: 1.0 ± 0.2 and V2: 1.1 ± 0.2 m/s vs V3: 1.3 ± 0.2 m/s, P < .001). The WOMAC and knee pain were significantly better 1 year after TKA. No strong relationships have been found between clinical parameters and knee kinematics.Conclusion: This study showed that 1 year after TKA, patients exhibited improved gait velocity and ROM and experienced a significant decrease in the level of pain and an increased clinical score (although different from CG). [ABSTRACT FROM AUTHOR]

Abstract: Turcot K, Aissaoui R, Boivin K, Hagemeister N, Pelletier M, de Guise JA. Test-retest reliability and minimal clinical change determination for 3-dimensional tibial and femoral accelerations during treadmill walking in knee osteoarthritis patients. Objective: To determine the test-retest reliability and the minimal clinical change determination for accelerometric parameters, estimated by a new accelerometric-based method that estimates 3-dimensional (3D) linear accelerations of the tibia and femur during comfortable and fast walking speeds. Design: Test-retest study. Setting: Gait laboratory in a research center. Participants: Patients (N=25; 6 men, 19 women) with symptomatic knee osteoarthritis (OA). Interventions: Not applicable. Main Outcomes Measures: Subjects attended 2 walking sessions in which accelerometers were rigidly fixed by means of an exoskeleton to the femoral and tibial segments. In both sessions, 3D accelerations were collected for 25 seconds for each of the walking speeds. Mean accelerometric pattern was calculated using 15 gait cycles. From each mean pattern, maximal, minimal, and range values were extracted from the loading phase period. The root mean square (RMS) value was also calculated for every pattern. Relative and absolute reliability were determined using intraclass correlation (ICC) and standard error (SE) of measurement, respectively. Minimal detectable change was calculated for each parameter as the least significant difference. Results: Tibial and femoral accelerations showed reliable values across sessions 1 and 2 with ICCs greater than or equal to .75 for 96% and 88% of the parameters at comfortable and fast speeds, respectively. The SE of measurement ranged from .01 to .05g for the RMS value and from .05 to .35g for maximal, minimum, and range point parameters. Conclusions: The proposed method is the first to have determined the reliability and the minimal detectable change for tibial and femoral acceleration parameters in knee OA patients during a treadmill walking evaluation. The minimal detectable change determined in this study will be used to determine improvement or deterioration of knee OA patients after rehabilitation. [Copyright &y& Elsevier]

Background: Total knee arthroplasty (TKA) is the operation of choice in patients with end-stage knee osteoarthritis (OA). Up to 1 in 5 patients still encounter functional limitations after TKA, partly explaining patient dissatisfaction. Which gait ability to target after TKA remains unclear. To determine whether Minimal Clinical Important Improvement (MCII) or Patient Acceptable Symptom State (PASS) values could be derived from gait parameters recorded in patients with TKA. And, if so, to define those values.Methods: In this ancillary study, we retrospectively analyzed gait parameters of patients scheduled for a unilateral TKA between 2011 and 2013. We investigated MCII and PASS values for walking speed and maximal knee flexion using anchor-based methods: 5 anchoring questions based on perceived body function and patients' satisfaction.Results: Over the study period, 79 patients performed a clinical gait analysis the week before and 1 year after surgery, and were included in the present study. All clinical and gait parameters improved 1 year after TKA. Nevertheless, changes in gait outcomes were not associated with perceived body function or patients' satisfaction, precluding any MCII estimation in gait parameters. PASS values, however, could be determined as 1.2 m/s for walking speed and 50° for maximal knee flexion.Conclusion: In this study, we found that MCII and PASS values are not necessarily determinable for gait parameters after TKA in patients with end-stage OA. Using anchor questions based on perceived body function and patient's satisfaction, MCII could not be defined while PASS values were potentially useful.Level Of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Aging is associated with changes in neuromuscular control that can lead to difficulties in performing daily living tasks. Muscle synergy analysis allows the assessment of neuromuscular control strategies and functional deficits. However, the age-related changes of muscle synergies during functional tasks are scattered throughout the literature. This review aimed to synthesize the existing literature on muscle synergies in elderly people during daily-living tasks and examine how they differ from those exhibited by young adults. The Medline, CINAHL and Web of Science databases were searched. Studies were included if they focused on muscle synergies in elderly people during walking, sit-to-stand or stair ascent, and if muscle synergies were obtained by a matrix factorization algorithm. Seventeen studies were included after the screening process. The muscle synergies of 295 elderly people and 182 young adults were reported, including 5 to 16 muscles per leg, or leg and trunk. Results suggest that: 1) elderly people and young adults retain similar muscle synergies' number, 2) elderly people have higher muscles weighting during walking, and 3) an increased inter and intra-subject temporal activation variability during specific tasks (i.e., walking and stair ascent, respectively) was reported in elderly people compared to young adults. This review gives a comprehensive understanding of age-related changes in neuromuscular control during daily living tasks. Our findings suggested that although the number of synergies remains similar, metrics such as spatial and temporal structures of synergies are more suitable to identify neuromuscular control deficits between young adults and elderly people. • Elderly individuals retain similar synergies number compared to young adults. • Elderly individuals showed high inter-subject temporal activation variability during stair ascent. • Increased intra and inter-subject temporal activation variability during walking was observed in elderly. • This review highlighted the presence of common synergies between walking and sit-to-stand. [ABSTRACT FROM AUTHOR]

Background: The purpose of this prospective study was to understand the relation between gait outcomes and patient satisfaction one year after total knee arthroplasty (TKA).Methods: Seventy-nine patients were evaluated before and one year after TKA using clinical gait analysis. Specific gait outcomes were analyzed: gait speed, stance phase, range of motion (ROM) knee flexion and maximal knee flexion. The parameters of interest selected for the statistical analysis were: gait speed and maximal knee flexion during gait. The Western Ontario and MacMaster Osteoarthritis Index (WOMAC) and patient satisfaction were also assessed. The satisfaction was evaluated using a questionnaire and was splited in five categories: very unsatisfied, unsatisfied, neutral, satisfied or very satisfied. To assess associations between patient satisfaction and maximal knee flexion during gait and gait speed, an unadjusted ordinal logistic regression analysis was used. The analysis was then adjusted for covariates: age and Body Mass Index (BMI) before surgery and WOMAC pain one year after surgery.Results: All gait outcomes after TKA had significantly improved. The ordinal logistic regression analysis found significant associations between patient satisfaction and maximal knee flexion after TKA (unadjusted and adjusted) but not for gait speed.Conclusion: These findings show that all patients improved their gait outcomes one year after TKA but only a higher maximal knee flexion during gait may influence the level of patient satisfaction. [ABSTRACT FROM AUTHOR]

Introduction Little is known concerning the influence of body mass index (BMI) on patient recovery after total knee arthroplasty (TKA), in terms of gait performance. Indeed, no studies have documented its influence on the recovery of range of motion (ROM) of the knee during gait and of gait velocity. Therefore, the objective of this study was to investigate the influence of BMI on these parameters before and 1 year after surgery. Materials and methods Seventy-nine patients were evaluated before and one year after TKA using clinical gait analysis. The gait velocity, the knee range of motion (ROM) during gait, their gains (difference between baseline and one year post-TKA), the Western Ontario and MacMaster Osteoarthritis Index (WOMAC), quality of life and patient satisfaction were assessed. Non-obese (BMI < 30) and obese patients (BMI ≥ 30) were compared. Healthy controls were also assessed. Uni- and multivariable linear regression analyses were used to assess the association between gait speed and ROM gains. Adjustment was performed for sex, age and WOMAC pain improvement. Results At baseline, gait velocity and knee ROM were significantly lower in obese compared to non-obese patients (0.99 ± 0.27 m/s vs. 1.11 ± 0.18 m/s, effect size, 0.53; P = 0.021. ROM: 41.33 ± 9.6 vs. 46.05 ± 8.39, effect size, 0.52; P = 0.022). Univariate and multivariate linear regressions did not show any significant relation between gait speed gain or knee ROM gain and BMI. At baseline, obese patients were more symptomatic than non-obese (WOMAC pain: 36.1 ± 14.0 vs. 50.4 ± 16.9, effect size, 0.9; P < 0.001) and their improvement was significantly higher (WOMAC pain gain: 44.5 vs. 32.3, effect size, 0.59, P = 0.011). Conclusions These findings show that all patients improved biomechanically and clinically regardless of their BMI. [ABSTRACT FROM AUTHOR]