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As part of an investigation to detect asymmetries in gait patterns in persons with shoulder injuries, the goal of the present study was to design and validate a Kinect-based motion capture system that would enable the extraction of joint kinematics curves during gait and to compare them with the data obtained through a commercial motion capture system. The study included eight male and two female participants, all diagnosed with anterolateral shoulder pain syndrome in their right upper extremity with a minimum 18 months of disorder evolution. The participants had an average age of 31.8 ± 9.8 years, a height of 173 ± 18 cm, and a weight of 81 ± 15 kg. The gait kinematics were sampled simultaneously with the new system and the Clinical 3DMA system. Shoulder, elbow, hip, and knee kinematics were compared between systems for the pathological and non-pathological sides using repeated measures ANOVA and 1D statistical parametric mapping. For most variables, no significant difference was found between systems. Evidence of a significant difference between the newly developed system and the commercial system was found for knee flexion-extension (p < 0.004, between 60 and 80% of the gait cycle), and for shoulder abduction-adduction. The good concurrent validity of the new Kinect-based motion analysis system found in this study opens promising perspectives for clinical motion tracking using an affordable and simple system.
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Análisis de la Marcha , Marcha , Humanos , Masculino , Femenino , Proyectos Piloto , Fenómenos Biomecánicos , Adulto , Análisis de la Marcha/métodos , Análisis de la Marcha/instrumentación , Marcha/fisiología , Rango del Movimiento Articular/fisiología , Dolor de Hombro/fisiopatología , Adulto JovenRESUMEN
This study presents an IoT-based gait analysis system employing insole pressure sensors to assess gait kinetics. The system integrates piezoresistive sensors within a left foot insole, with data acquisition managed using an ESP32 board that communicates via Wi-Fi through an MQTT IoT framework. In this initial protocol study, we conducted a comparative analysis using the Zeno system, supported by PKMAS as the gold standard, to explore the correlation and agreement of data obtained from the insole system. Four volunteers (two males and two females, aged 24-28, without gait disorders) participated by walking along a 10 m Zeno system path, equipped with pressure sensors, while wearing the insole system. Vertical ground reaction force (vGRF) data were collected over four gait cycles. The preliminary results indicated a strong positive correlation (r = 0.87) between the insole and the reference system measurements. A Bland-Altman analysis further demonstrated a mean difference of approximately (0.011) between the two systems, suggesting a minimal yet significant bias. These findings suggest that piezoresistive sensors may offer a promising and cost-effective solution for gait disorder assessment and monitoring. However, operational factors such as high temperatures and sensor placement within the footwear can introduce noise or unwanted signal activation. The communication framework proved functional and reliable during this protocol, with plans for future expansion to multi-device applications. It is important to note that additional validation studies with larger sample sizes are required to confirm the system's reliability and robustness for clinical and research applications.
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Marcha , Tecnología Inalámbrica , Humanos , Masculino , Femenino , Adulto , Marcha/fisiología , Tecnología Inalámbrica/instrumentación , Adulto Joven , Cinética , Monitoreo Fisiológico/instrumentación , Monitoreo Fisiológico/métodos , Internet de las Cosas , Análisis de la Marcha/métodos , Análisis de la Marcha/instrumentación , Caminata/fisiología , Zapatos , PresiónRESUMEN
The limited sample size in gait studies has hampered progress in the field. This challenge could be addressed through multicenter studies, thereby leveraging data sets from different laboratories. This study compared 3-dimensional lower-extremity running kinematics between the Biomechanics and Motor Control Laboratory, Federal University of ABC (Brazil), and the Running Injury Clinic, University of Calgary (Canada). Three-dimensional lower-extremity kinematics from 23 male runners were collected from each laboratory using comparable instrumentation and experimental procedures. The 3-dimensional hip, knee, and ankle angles were compared within and between centers using root-mean-square deviation. Two-sample t tests Statistical Parametric Mapping tested the hypothesis that the data from both laboratories were not different. The sagittal plane hip, knee, and ankle angles were similar between laboratories, while notable differences were observed for frontal (hip and ankle) and transverse (hip and knee) plane angles. The average interlaboratory root-mean-square deviation (2.6°) was lower than the intralaboratory root-mean-square deviation (Biomechanics and Motor Control = 4.8°, Running Injury Clinic = 5.6°), with the ankle transverse angle displaying the smallest, and the knee transverse angle displaying the largest variability. This study demonstrates the potential of combining gait kinematics data from different laboratories to increase sample size, but frontal and transverse plane data should be considered with caution.
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Marcha , Carrera , Humanos , Masculino , Fenómenos Biomecánicos , Carrera/fisiología , Marcha/fisiología , Adulto , Canadá , Brasil , Extremidad Inferior/fisiología , Análisis de la Marcha/métodosRESUMEN
Given the high morbidity related to the progression of gait deficits in spinocerebellar ataxias (SCA), there is a growing interest in identifying biomarkers that can guide early diagnosis and rehabilitation. Spatiotemporal parameter (STP) gait analysis using inertial measurement units (IMUs) has been increasingly studied in this context. This study evaluated STP profiles in SCA types 3 and 10, compared them to controls, and correlated them with clinical scales. IMU portable sensors were used to measure STPs under four gait conditions: self-selected pace (SSP), fast pace (FP), fast pace checking-boxes (FPCB), and fast pace with serial seven subtractions (FPS7). Compared to healthy subjects, both SCA groups had higher values for step time, variability, and swing time, with lower values for gait speed, cadence, and step length. We also found a reduction in speed gain capacity in both SCA groups compared to controls and an increase in speed dual-task cost in the SCA10 group. However, there were no significant differences between the SCA groups. Swing time, mean speed, and step length were correlated with disease severity, risk of falling and functionality in both clinical groups. In the SCA3 group, fear of falling was correlated with cadence. In the SCA10 group, results of the Montreal cognitive assessment test were correlated with step time, mean speed, and step length. These results show that individuals with SCA3 and SCA10 present a highly variable, short-stepped, slow gait pattern compared to healthy subjects, and their gait quality worsened with a fast pace and dual-task involvement.
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Análisis de la Marcha , Enfermedad de Machado-Joseph , Ataxias Espinocerebelosas , Humanos , Masculino , Femenino , Persona de Mediana Edad , Análisis de la Marcha/métodos , Ataxias Espinocerebelosas/fisiopatología , Ataxias Espinocerebelosas/diagnóstico , Adulto , Enfermedad de Machado-Joseph/diagnóstico , Enfermedad de Machado-Joseph/fisiopatología , Trastornos Neurológicos de la Marcha/diagnóstico , Trastornos Neurológicos de la Marcha/fisiopatología , Marcha/fisiología , Análisis Espacio-Temporal , Anciano , Expansión de las Repeticiones de ADNRESUMEN
Technological advancements have expanded the range of methods for capturing human body motion, including solutions involving inertial sensors (IMUs) and optical alternatives. However, the rising complexity and costs associated with commercial solutions have prompted the exploration of more cost-effective alternatives. This paper presents a markerless optical motion capture system using a RealSense depth camera and intelligent computer vision algorithms. It facilitates precise posture assessment, the real-time calculation of joint angles, and acquisition of subject-specific anthropometric data for gait analysis. The proposed system stands out for its simplicity and affordability in comparison to complex commercial solutions. The gathered data are stored in comma-separated value (CSV) files, simplifying subsequent analysis and data mining. Preliminary tests, conducted in controlled laboratory environments and employing a commercial MEMS-IMU system as a reference, revealed a maximum relative error of 7.6% in anthropometric measurements, with a maximum absolute error of 4.67 cm at average height. Stride length measurements showed a maximum relative error of 11.2%. Static joint angle tests had a maximum average error of 10.2%, while dynamic joint angle tests showed a maximum average error of 9.06%. The proposed optical system offers sufficient accuracy for potential application in areas such as rehabilitation, sports analysis, and entertainment.
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Algoritmos , Antropometría , Análisis de la Marcha , Marcha , Humanos , Antropometría/métodos , Marcha/fisiología , Análisis de la Marcha/métodos , Análisis de la Marcha/instrumentación , Masculino , Fenómenos Biomecánicos , Adulto , Captura de MovimientoRESUMEN
ANTECEDENTES: En el marco de la metodología ad hoc para evaluar solicitudes de tecnologías sanitarias, aprobada mediante Resolución de Instituto de Evaluación de Tecnologías en Salud e Investigación N° 111 -IETSI-ESSALUD-2021 y ampliada mediante Resolución de Instituto de Evaluación de Tecnologías en Salud e Investigación N° 97-IETSI-ESSALUD2022, se ha elaborado el presente dictamen sobre la evaluación de la eficacia y seguridad del sistema robotizado para la rehabilitación de adultos con trastorno de la marcha debido a accidente cerebrovascular. ASPECTOS GENERALES: El accidente cerebrovascular (ACV) es una afección que se produce cuando se interrumpe el suministro de sangre al sistema nervioso central (cerebro, retina, columna espinal), lo que puede dañar las células cerebrales y provocar discapacidad o la muerte (Sacco et al., 2013). Existen dos tipos principales de ACV: el isquémico, que se produce cuando un coágulo o placa ateroesclerótica bloquea un vaso sanguíneo y deja sin oxígeno a alguna región del sistema nervioso central, y el hemorrágico, que se produce comúnmente tras una vasculopatía que causa una hemorragia (Campbell & Khatri, 2020). El ACV es una condición que afecta a las personas de todas las edades y géneros, siendo la segunda causa de muerte y tercera causa de discapacidad en todo el mundo (Feigin et al., 2021). Se estima que una de cada cuatro personas puede verse afectada por esta condición en algún momento de su vida (Feigin et al., 2018). Además, es especialmente frecuente en personas mayores de 65 años (Rajati et al., 2023). La prevención, la identificación temprana y el tratamiento adecuado son fundamentales para prevenir las complicaciones del ACV y mejorar los resultados del paciente. METODOLOGÍA: Se realizó una búsqueda bibliográfica exhaustiva con el objetivo de identificar la mejor evidencia sobre la evaluación de la eficacia y seguridad del sistema robotizado para la rehabilitación de adultos con trastorno de la marcha debido a accidente cerebrovascular. La búsqueda bibliográfica se llevó a cabo en las bases de datos PubMed, The Cochrane Library, Web of Science y LILACS. Además, se realizó una búsqueda manual en Google y dentro de las páginas web pertenecientes a grupos que realizan evaluaciones de tecnologías sanitarias (ETS) y guías de práctica clínica (GPC), incluyendo el Centro Nacional de Excelencia Tecnológica en Salud (CENETEC), National Institute for Health and Care Excellence (NICE), la Agency for Healthcare Research and Quality's (AH RQ), Scottish I ntercollegiate Guidelines Network (SIGN), The Guidelines International Network (GIN), National Health and Medical Research Council (NHMRC), Base Regional de Informes de Evaluación de Tecnologías en Salud de las Américas (BRISA), Comissáo Nacional de Incorporacáo de Tecnologias no Sistema Único de Saúde (CONITEC), Instituto de Evaluación Tecnológica en Salud (IETS), Instituto de Efectividad Clínica y Sanitaria (IECS), Scottish Medicines Consortium (SMC), Canadian Agency for Drugs and Technologies in Health (CADTH), Instituto de Calidad y Eficiencia en la Atención de la Salud (IQWiG, por sus siglas en alemán), y Hauté Autorité de Santé (HAS). Asimismo, se realizó una búsqueda de GPC en las páginas web de las principales sociedades o instituciones especializadas en el manejo del accidente cerebrovascular o trastorno de la marcha, tales como: American Heart Association/American Stroke Association (AHA/ASA), European Stroke Organisation, Academy of Neurologic Physical Therapy (APTA). Finalmente, se realizó una búsqueda de estudios en curso aún no publicados en las páginas web de ClinicalTrials.gov y la International Clinical Trials Registry Platform. RESULTADOS: La búsqueda bibliográfica se realizó el 16 de marzo de 2023 y se identificaron cinco guías de práctica clínica (GPC) que contenían recomendaciones acerca del dispositivo en evaluación para la población objetivo (Haute Autorité de Santé, 2022; Hornby et al., 2020; National Institute for Health and Care Excellence, 2013; Teasell et al., 2020; Winstein et al., 2016). También se incluyeron cinco revisiones sistemáticas (RS) con metaanálisis (MA) que realizaron comparaciones directas de la intervención y comparador de la pregunta PICO planteada (Baronchelli et al., 2021; Calafiore et al., 2022; Loro et al., 2023; Mehrholz et al., 2020; Wang et al., 2021). Sin embargo, una de las RS evaluó como intervención la combinación del sistema robotizado y la fisioterapia, lo que limitó la evaluación del efecto aislado del sistema robotizado (Mehrholz et al., 2020). Durante la revisión de los ensayos clínicos aleatorizados (ECA) en la fase de texto completo, se encontró que la mayoría de ellos ya habían sido considerados en los análisis cualitativos y cuantitativos de las RS, por lo que se decidió no incluirlos en el análisis final. Además, se incluyó un protocolo de ECA (University Hospital Ostrava, 2022) en el que planea determinar el efecto de la rehabilitación de la marcha con Lokomat en comparación con la terapia convencional con un protocolo de tratamiento definido. CONCLUSIÓN: Por lo expuesto, el Instituto de Evaluación de Tecnologías en Salud e Investigación- 'ETS' no aprueba el uso del sistema robotizado para la rehabilitación de adultos con trastorno de la marcha debido a accidente cerebrovascular. Se recomienda a los especialistas que, en caso de identificar nueva evidencia que responda a la población de la PICO de interés, envíen sus propuestas para ser evaluadas en el marco de la Directiva N° 001-IETSI-ESSALUD-2018.
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Humanos , Robótica/métodos , Accidente Cerebrovascular/etiología , Trastornos Neurológicos de la Marcha/terapia , Análisis de la Marcha/métodos , Eficacia , Análisis Costo-BeneficioRESUMEN
INTRODUCTION: Type 2 diabetes can lead to gait abnormalities, including a longer stance phase, shorter steps and improper foot pressure distribution. Quantitative data from objective methods for evaluating gait patterns are accurate and cost-effective. In addition, it can also help predictive methods to forecast complications and develop early strategies to guide treatments. To date, no research has systematically summarised the predictive methods used to assess type 2 diabetic gait. Therefore, this protocol aims to identify which predictive methods have been employed to assess the diabetic gait. METHODS AND ANALYSIS: This protocol will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P) statement. Electronic searches of articles from inception to January 2022 will be performed, from May 2021 to 31 January 2022, in the Web of Science, MEDLINE, Embase, IEEE Xplore Digital Library, Scopus, CINAHL, Google Scholar, APA PsycInfo, the Cochrane Library and in references of key articles and grey literature without language restrictions. We will include studies that examined the development and/or validation of predictive methods to assess type 2 diabetic gait in adults aged >18 years without amputations, use of assistive devices, ulcers or neuropathic pain. Two independent reviewers will screen the included studies and extract the data using a customised charting form. A third reviewer will resolve any disagreements. A narrative synthesis will be performed for the included studies. Risk of bias and quality of evidence will be assessed using the Prediction Model Risk of Bias Assessment Tool and the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis. ETHICS AND DISSEMINATION: Ethical approval is not required because only available secondary published data will be analysed. The findings will be disseminated through peer-reviewed journals and/or presentations at relevant conferences and other media platforms. PROSPERO REGISTRATION NUMBER: CDR42020199495.
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Diabetes Mellitus Tipo 2 , Análisis de la Marcha , Adolescente , Adulto , Análisis de la Marcha/métodos , Humanos , Proyectos de Investigación , Revisiones Sistemáticas como AsuntoRESUMEN
Patellofemoral pain (PFP) is one of the most prevalent injuries in runners. Unfortunately, a substantial part of injured athletes do not recover fully from PFP in the long-term. Although previous studies have shown positive effects of gait retraining in this condition, retraining protocols often lack clinical applicability because they are time-consuming, costly for patients and require a treadmill. The primary objective of this study will be to compare the effects of two different two-week partially supervised gait retraining programs, with a control intervention; on pain, function and lower limb kinematics of runners with PFP. It will be a single-blind randomized clinical trial with six-month follow-up. The study will be composed of three groups: a group focusing on impact (group A), a group focusing on cadence (group B), and a control group that will not perform any intervention (group C). The primary outcome measure will be pain assessed using the Visual Analog Pain scale during running. Secondary outcomes will include pain during daily activities (usual), symptoms assessed using the Patellofemoral Disorders Scale and lower limb running kinematics in the frontal (contralateral pelvic drop; hip adduction) and sagittal planes (foot inclination; tibia inclination; ankle dorsiflexion; knee flexion) assessed using the MyoResearch 3.14-MyoVideo (Noraxon U.S.A. Inc.). The study outcomes will be evaluated before (t0), immediately after (t2), and six months (t24) after starting the protocol. Our hypothesis is that both partially supervised gait retraining programs will be more effective in reducing pain, improving symptoms, and modifying lower limb kinematics during running compared with the control group, and that the positive effects from these programs will persist for six months. Also, we believe that one gait retraining group will not be superior to the other. Results from this study will help improve care in runners with PFP, while maximizing clinical applicability as well as time and cost-effectiveness.
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Terapia por Ejercicio/métodos , Marcha/fisiología , Síndrome de Dolor Patelofemoral/terapia , Adulto , Brasil , Estudios de Seguimiento , Pie/fisiopatología , Análisis de la Marcha/métodos , Humanos , Extremidad Inferior/fisiopatología , Masculino , Dolor/complicaciones , Dimensión del Dolor/métodos , Síndrome de Dolor Patelofemoral/fisiopatología , Carrera/lesiones , Método Simple CiegoRESUMEN
Parkinson's disease (PD) is often classified into tremor dominant (TD) and postural instability gait disorder (PIGD) subtypes. Degeneration of subcortical/cortical pathways is different between PD subtypes, which leads to differences in motor behavior. However, the influence of PD subtype on cortical activity during walking remains poorly understood. Therefore, we aimed to investigate the influence of PD motor subtypes on cortical activity during unobstructed walking and obstacle avoidance. Seventeen PIGD and 19 TD patients performed unobstructed walking and obstacle avoidance conditions. Brain activity was measured using a mobile functional near-infrared spectroscopy-electroencephalography (EEG) systems, and gait parameters were analyzed using an electronic carpet. Concentrations of oxygenated hemoglobin (HbO2) of the prefrontal cortex (PFC) and EEG absolute power from alpha, beta, and gamma bands in FCz, Cz, CPz, and Oz channels were calculated. These EEG channels correspond to supplementary motor area, primary motor cortex, posterior parietal cortex, and visual cortex, respectively. Postural instability gait disorder patients presented higher PFC activity than TD patients, regardless of the walking condition. Tremor dominant patients presented reduced beta power in the Cz channel during obstacle avoidance compared to unobstructed walking. Both TD and PIGD patients decreased alpha and beta power in the FCz and CPz channels. In conclusion, PIGD patients need to recruit additional cognitive resources from the PFC for walking. Both TD and PIGD patients presented changes in the activation of brain areas related to motor/sensorimotor areas in order to maintain balance control during obstacle avoidance, being that TD patients presented further changes in the motor area (Cz channel) to avoid obstacles.
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Trastornos Neurológicos de la Marcha , Oxihemoglobinas/análisis , Enfermedad de Parkinson , Equilibrio Postural/fisiología , Corteza Prefrontal , Temblor , Anciano , Electroencefalografía/métodos , Neuroimagen Funcional/métodos , Análisis de la Marcha/métodos , Trastornos Neurológicos de la Marcha/metabolismo , Trastornos Neurológicos de la Marcha/fisiopatología , Humanos , Enfermedad de Parkinson/clasificación , Enfermedad de Parkinson/metabolismo , Enfermedad de Parkinson/fisiopatología , Corteza Prefrontal/metabolismo , Corteza Prefrontal/fisiopatología , Espectroscopía Infrarroja Corta/métodos , Temblor/metabolismo , Temblor/fisiopatología , Caminata/fisiología , Caminata/psicologíaRESUMEN
O objetivo desse estudo foi verificar a concordância na velocidade da marcha (VM) a partir dos testes de caminhada de seis minutos (6MWT) e de quatro metros (4MWT) em mulheres diabéticas tipo 2 (DM2). Os testes foram realizados antes e após intervenção de 12 semanas com exercícios físicos. O 4MWT foi realizado em espaço de quatro metros, sendo o resultado do teste medido como o tempo gasto (segundos) no percurso. O 6MWT foi realizado em modelo de ir e vir em uma distância de 15 metros e o resultado foi a distância total (metros) percorrida. Os resultados foram padronizados para velocidade de deslocamento (m/s). Para avaliar a concordância (6MWTpré x 4MWTpré) e (6MWTpósx 4MWTpós), utilizou-se o teste de Bland-Altman (B-A) e o coeficiente de concordância de correlação de Lin. O nível de significância aceito para o estudo foi α 5%. Foram medidas 39 mulheres, com idade média de 58,79 ± 10,03 anos e diagnóstico de DM2 a 8,64 ± 8,53 anos. Verificou-se, pelo teste de B-A, diferenças na VM dos testes de -0,001 ± 0,19 m/s (IC95%: -0,37 a 0,37 m/s) no início e 0,02 ± 0,21 m/s (IC95%: -0,39 a 0,42 m/s) ao final e concordância de 0,60 (IC95%: 0,41 a 0,79; p < 0,001) e 0,52 (IC95%: 0,31 a 0,73; p < 0,001) pré e pós, respectivamente, pelo coeficiente de concordância de correlação Lin. Através dos dados obtidos, sugere-se que os dois testes podem ser utilizados para avaliar a VM das mulheres DM2, porém o 6MWT apresentou maior reprodutibilidade para detectar mudanças na VM ao longo do tempo
This study aimed to test the agreement in the gait speed (GS) between the 6-minute walk test and the 4-me-ter gait speed (6MWT - 4MWT) in type 2 diabetic women (T2DM). The tests were performed before and after a 12-week physical exercise intervention. The 4MWT was performed in a space of four meters, with results based on the time spent (seconds) to complete a 4-meter distance. The 6MWT was carried out similar to a yo-yo test in 15 meters and the result was operationalized by the total distance (meters) covered. The results of the tests were standardized as speed (m/s). To evaluate agreements (6MWTbefore x 4MWTbefore) and (6MWTafter x 4MWTafter), Bland-Altman (B-A), and Lin's agreements were used. The level of significance was set at 5%. A total of 39 women were evaluated, mean age 58.79 ± 10.03 years, diagnosis of diabetes at 8.64 ± 8.53 years.The B-A test showed a mean difference in GS of -0.001 ± 0.19 m/s (95%CI: -0.37 to 0.37 m/s) before and 0.02 ± 0.21 m/s (95%CI: -0.39 to 0.42 m/s) after, and Lin's agreements of 0.60 (95%CI: 0.41 to 0.79; p < 0.001) and 0.52 (95%CI: 0.31 to 0.73; p < 0.001) before and after, respectively. Based on our data it is suggested that the two tests can be used to evaluate the GS of T2DM women, but the 6MWT was more reproductible to detect changes in GS over time
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Humanos , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Diabetes Mellitus Tipo 2/diagnóstico , Prueba de Paso/métodos , Análisis de la Marcha/métodos , Factores Socioeconómicos , Escala de Fujita-Pearson , Velocidad al CaminarRESUMEN
Gait parameters have been investigated as an additional tool for differential diagnosis in neurocognitive disorders, especially among healthy elderly (HE), those with mild cognitive impairment (MCI), and Alzheimer's disease (AD) patients. A videogrammetry system could be used as a low-cost and clinically practical equipment to capture and analyze gait in older adults. The aim of this study was to select the better gait parameter to differentiate these groups among different motor test conditions with videogrammetry analyses. Different motor conditions were used in three specific assessments: 10-meter walk test (10mWT), timed up and go test (TUGT), and treadmill walk test (TWT). These tasks were compared among HE (n=17), MCI (n=23), and AD (n=23) groups. One-way ANOVA, Kruskal-Wallis, and Bonferroni post-hoc tests were used to compare variables among groups. Then, an effect size (ES) and a linear regression analysis were calculated. The gait parameters showed significant differences among groups in all conditions, but not in TWT. Controlled by confounding variables, the gait velocity in 10mWT at usual speed, and TUGT in dual-task condition, predicts 39% and 53% of the difference among diagnoses, respectively. Finally, these results suggest that a low-cost and practical video analysis could be able to differentiate HE, those with MCI, and AD patients in clinical assessments.
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Enfermedad de Alzheimer/fisiopatología , Disfunción Cognitiva/fisiopatología , Análisis de la Marcha/métodos , Grabación en Video/métodos , Accidentes por Caídas , Anciano , Anciano de 80 o más Años , Estudios Transversales , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Estudios de Tiempo y Movimiento , Prueba de Paso/métodosRESUMEN
Abstract Aim: The present study aimed to perform a literature review on the use of wearable inertial sensors for gait analysis of children in clinical practice. Methods: Searches were performed in the MEDLINE, EMBASE, Cochrane Library, and PEDro databases for studies involving children or adolescents submitted to gait analysis with the use of wearable inertial sensors. No restrictions were imposed regarding the date of publication or language. Results: Three hundred twenty articles were retrieved, 14 of which met the eligibility criteria and were selected for the present systematic review. Two independent reviewers assessed the risk of bias and study quality using the ROBINS-I and AXIS scale. The studies included in the present review reported multiple outcomes of kinematic gait assessments calculated from the signals provided by the wearable sensors, performed in a hospital setting, outpatient clinic, and a familiar environment, with several types of pediatric conditions. Conclusion: The findings suggest that wearable sensors are effective for the evaluation of quantitative gait variables in children with different pediatric conditions, enabling an objective analysis that should prove useful in the processes of clinical diagnosis and rehabilitation. However, given the relatively small number of studies published on this topic, it is difficult to make strong recommendations regarding the most appropriate equipment, sensor placement, and outcomes for assessing gait in children.
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Humanos , Garantía de la Calidad de Atención de Salud , Salud Infantil , Análisis de la Marcha/métodos , MovimientoRESUMEN
BACKGROUND: Minimum and maximum values of gait kinematics and kinetics data are commonly used to quantitatively describe a walking pattern. RESEARCH QUESTION: The purposes of this study were to determine the effect of speed on the minimum and maximum values of gait kinematics and kinetics variables and to test two prediction methods for the estimation of these minimum and maximum values at different gait speeds. METHODS: An open dataset with the data of 24 healthy adults (age: 27.6⯱â¯4.4 years, height: 171.1⯱â¯10.5â¯cm, body mass: 68.4⯱â¯12.2â¯kg) walking on a treadmill at eight gait speeds was employed in this study. The minimum and maximum angles and moments of the hip, knee, and ankle joints were extracted from speed-dependent prediction curves solely for the minimum and maximum values (PEAK method) and from speed-dependent prediction curves for the entire gait cycle (CYCLE method). The overall error, computed as the root-mean-square error (RMSE), for the minimum and maximum values predicted by these two methods were compared with the experimental true values. RESULTS: The RMSEs for the joint angles were PEAK: 3.86⯱â¯1.21°, CYCLE: 3.88⯱â¯1.18° and for the joint moments were PEAK: 0.129⯱â¯0.052 Nm/kg, CYCLE: 0.131⯱â¯0.052 Nm/kg. SIGNIFICANCE: The two prediction methods tested can be used to estimate the minimum and maximum values of biomechanical gait variables at a certain speed.
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Análisis de la Marcha/métodos , Marcha/fisiología , Velocidad al Caminar , Adulto , Articulación del Tobillo , Fenómenos Biomecánicos , Femenino , Voluntarios Sanos , Humanos , Cinética , Articulación de la Rodilla , Masculino , Adulto JovenRESUMEN
BACKGROUND: The technical difficulties in utilising the force platform have stimulated the use and development of other gait systems. Therefore, this study aimed to compare the values of gait parameters obtained from a pressure-sensitive walkway and from a treadmill in healthy dogs during walking. METHODS: Twelve healthy, privately owned, Labrador retriever dogs were used. During each trial, each dog was led across the pressure-sensitive walkway utilising a loose leash to the right of the handler. The velocity was restricted to the range of 0.9 to 1.1 m/s and the acceleration between -0.15 and 0.15 m/s2 . For the treadmill, each dog also walked with leash loose on the treadmill. The treadmill speed was maintained at 0.9m/s. The temporospatial variables, and percentage of body weight distribution/percentage of pressure were evaluated between the two gait systems. RESULTS: For both forelimbs and hind limbs, significant differences were found between stance percentage, which was higher on treadmill, and swing percentage and stride length/stance distance, which were higher on the pressure-sensitive walkway. The duty factor value was 0.57 for the pressure-sensitive walkway and 0.60 for treadmill. CLINICAL RELEVANCE: Each gait system has limitations, but also advantages that must be considered depending upon the variable and animal to be evaluated. The gait parameters obtained from the Tekscan pressure-sensitive walkway and Gait4Dog treadmill revealed differences in the temporospatial parameters between systems, but similarity in body-weight distribution/pressure percentage.
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Perros/fisiología , Prueba de Esfuerzo/veterinaria , Análisis de la Marcha/veterinaria , Caminata/fisiología , Animales , Fenómenos Biomecánicos , Prueba de Esfuerzo/métodos , Femenino , Análisis de la Marcha/métodos , Miembro Posterior/fisiología , MasculinoRESUMEN
AIM: To evaluate the effects of low-volume resistance training on the physical and functional capacity of older patients with Parkinson's disease. METHODS: A total of 54 patients (aged ≥60 years) were randomly divided into two groups: (i) a control group comprising 13 men and 14 women; and (ii) a resistance training group with 14 men and 13 women. The resistance training group, in addition to maintaining their pharmacological treatments, carried out 6 months of resistance training twice a week, whereas the control group maintained their pharmacological treatments. Handgrip strength, flexibility, aerobic endurance, gait speed and balance were assessed in both groups. RESULTS: After 6 months, patient functionality in the control group was reduced, whereas patients who carried out low training volumes showed significantly improved flexibility (Pre × Post: P = 0.008), aerobic resistance (Pre × Post: P = 0.006), gait speed (Pre × Post: P = 0.006) and balance (Pre × Post: P = 0.043). Significant improvement (P = 0.042) was also observed in right handgrip strength in the resistance training group. CONCLUSIONS: The results of the present study showed that low-volume resistance training improves the physical capacity of older people with Parkinson's disease. Therefore, we suggest that resistance training be a central component in exercise programs for patients with Parkinson's disease. Geriatr Gerontol Int 2019; 19: 635-640.
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Análisis de la Marcha/métodos , Fuerza de la Mano , Enfermedad de Parkinson , Equilibrio Postural , Entrenamiento de Fuerza/métodos , Velocidad al Caminar , Anciano , Femenino , Humanos , Masculino , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/terapia , Recuperación de la Función , Resultado del TratamientoRESUMEN
INTRODUCTION: Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterized by a triad composed of cognitive alteration, urinary incontinence, and gait impairment associated with ventricular enlargement and normal cerebrospinal fluid pressure. Gait impairment is among the earliest symptoms; however, the reliability of the evaluation is not well-established and no consensus has been reaching regarding variables that should be analyzed and which parameters should be considered to accurately assess post-intervention improvement. RESEARCH QUESTION: Are the degree of repeatability, standard error of measurement, and minimum detectable change considered to detect changes in gait variables in iNPH patients? METHODS: A total of 84 iNPH patients with a mean age of 77.1 (±6.4) years were analyzed. Gait deviation index (GDI), speed, cadence, cycle time, stride length, single support, and first and second double support were chosen as the variables to be analyzed. Statistical analysis was performed by an independent evaluator, with gait repeatability assessed by the intraclass correlation coefficient (ICC) and the standard error of measure (SEM). RESULTS: ICC values were 0.76-0.85 with excellent repeatability, while SEM demonstrated that the variables with best repeatability were the GDI (mean, 4.94; 95% confidence interval (CI), 4.63-5.43), representing a 7.65% mean relative error of the measurement (mean, 0.05 m; 95% CI, 0.05-0.06), and stride length (mean 0.05 m; 95% CI, 0.05-0.06), with a 7.69% mean relative error. SIGNIFICANCE: We concluded that GDI and stride length were the variables with the best repeatability and lower variability in the gait of iNPH patients.
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Análisis de la Marcha/métodos , Trastornos Neurológicos de la Marcha/fisiopatología , Hidrocéfalo Normotenso/fisiopatología , Anciano , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Velocidad al Caminar/fisiologíaRESUMEN
INTRODUCTION: Musculoskeletal pain is a constant complaint in pediatric practice. The pain may be related to a number of organic diseases and / or be part of the amplified musculoskeletal pain syndromes. Idiopathic musculoskeletal pain (IMSP) is defined as the presence of intermittent pain in three or more body regions for at least three months, excluding organic diseases that could explain the symptoms. OBJECTIVE: To study the gait of children and adolescents with IMSP by dynamic baropodometry. METHODOLOGY: Thirty-two patients with IMSP and 32 healthy controls, matched by age, sex, social class, and body mass index (BMI) were enrolled. All were evaluated for pain intensity through the visual analogue scale (VAS) and gait evaluation using dynamic baropodometry. RESULTS: The mean age of the IMSP group was 13.6 years (SD = 2.1, range 9.8-16.9) and of the control group was 13.5 years (SD = 2.0, range 9.6-16.5). The mean pain scale was 5.4 cm in the IMSP group and 0 cm in the control group (p < 0.001). In gait, the mean right foot velocity of the IMSP group was significantly lower (p = 0.034), the time of the step of the IMSP group was significantly higher (p = 0.003) and the pace of the IMSP group was significantly lower (p = 0.001). CONCLUSION: In our study we observed differences between the gait of children with IMSP and healthy controls according to the dynamic baropodometry. This finding indicates the need for individualized attention to the gait of children with musculoskeletal pain.
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Análisis de la Marcha/métodos , Marcha/fisiología , Dolor Musculoesquelético/fisiopatología , Adolescente , Estudios de Casos y Controles , Niño , Intervalos de Confianza , Estudios Transversales , Femenino , Humanos , Masculino , Dimensión del Dolor/métodos , Estadísticas no ParamétricasRESUMEN
BACKGROUND: Osteoarthritis (OA) is a common condition in older adults, with high epidemiological, clinical, and economic burden worldwide. In clinical practice, patients with knee OA often walk with abnormal gait patterns because of pain, stiffness and/or mobility dysfunctions. Therefore, assessing the symmetry of the lower limbs might improve the rehabilitation treatment and prescription of walking devices. AIMS: To compare the symmetry of step length and single support phase between lower limbs during gait of older women with bilateral knee OA and asymptomatic controls, and to verify if there is difference between these two groups in relation to velocity, cadence, step length and single support phase. METHODS: This cross-sectional study included a convenience sample of 66 community-dwelling older women aged ≥ 65 years with a medical diagnosis of symptomatic bilateral knee OA (n = 33) and asymptomatic controls (n = 33), matched by age and body mass index. All gait parameters were obtained using the GAITRite® system. RESULTS: Mean age of the sample was 72.6 ± 4.0 years. Participants with OA walked with lower velocity (p = 0.001), cadence (p = 0.009) and step length bilaterally (both p = 0.001). No significant difference was found between groups in the symmetry of step length between lower limbs, single support phase and symmetry of single support phase between lower limbs. CONCLUSION: Older women with bilateral knee OA walk with lower velocity, cadence and step length, but have the same symmetry in the step length and single support phase between lower limbs as asymptomatic older women.
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Análisis de la Marcha/métodos , Extremidad Inferior/fisiopatología , Osteoartritis de la Rodilla/fisiopatología , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Vida Independiente/estadística & datos numéricos , Osteoartritis de la Rodilla/rehabilitaciónRESUMEN
BACKGOUND: Leg length discrepancy (LLD) can be related to different pathologies, due to an inadequate distribution of mechanical loads, as well as gait kinematics asymmetries resulted from LLD. RESEARCH QUESTION: To validate a model to predict anatomical LLD (ALLD) based on gait kinematics. METHODS: Gait of 39 participants with different lower limb pathologies and mild discrepancy were collected. Pelvic, hip, knee and ankle kinematics were measured with a 3D motion analysis system and ALLD, femur discrepancy (FD) and tibia discrepancy (TD) were measured by a computerized digital radiograph. Three multiple linear regression models were used to identify the ability of kinematic variables to predict ALLD (model 1), FD (model 2) and TD (model 3). RESULTS: Difference between peak knee and hip flexion of the long and short lower limb was selected by models 1 (pâ¯<â¯0.001) and 2 (pâ¯<â¯0.001). Hip adduction was selected as a predictor only by model 1 (pâ¯=â¯0.05). Peak pelvic obliquity and ankle dorsiflexion were not selected by any model and model 3 did not retain any dependent variable (pâ¯>â¯0.05). Regression models predicted mild ALLD with moderate accuracy based on hip and knee kinematics during gait, but not ankle strategies. Excessive hip flexion of the longer limb possibly occurs to reduce the limb to equalize the LLD, and discrepancies of the femur and tibia affects gait cycle in a different way. SIGNIFICANCE: This study showed that kinematic variables during gait could be used as a screening tool to identify patients with ALLD, reducing unnecessary x-ray exposure and assisting rehabilitation programs.