1,720,988 research outputs found
A proposal for a kinetic summary measure: the Gait Kinetic Index
No full textA new summary index for kinetic gait data is proposed (Gait Kinetic Index - GKI), BASED on six kinetic selected variables: hip, knee and ankle moments and powers on the sagittal plane. This method was applied on a control group (CG) of 18 subjects and on 57 patients with diplegic Cerebral Palsy (CP). CP showed statistical different GKI value in comparison with CG. The same is for the sub GKI with the exclusion of GKI Knee Power. The GKI seems to be a promising tool useful to measure extensively the gait pathology taking into consideration kinetic aspects of gait pattern
Energy analysis of gait in patients with down syndrome
Full text linkBackground: the primary aim of this study is to analyse the energy parameters of patients with Down syndrome compared to a control group and secondly to verify whether the sport activity leads to differences in energy expenditure.Methods: 3 groups of subjects were identified: 8 healthy subjects and 147 subjects with Down syndrome, of whom 14 played sports at least once a week. An energy index was calculated, given by the ratio between potential and kinetic energy. Next, kinetic ad potential energy parameters were extrapolated at 60% of the gait cycle (pro-pulsion phase).Findings: Down syndrome group was compared with the control group and emerged that the energy index was higher in the first one. No changes were found between Down syndrome and Down syndrome Sport groups. The analysis of the energy parameters showed that all parameters, except the medio-lateral kinetic energy, were higher in the control than in the Down syndrome groups. The potential energy, medio-lateral kinetic energy, and vertical were higher in the Down syndrome Sport group than in the Down syndrome group. The kinetic energy and the mean velocity were higher in the control group than in Down syndrome Sport group while the medio-lateral kinetic energy was lower.Interpretation: sport modified the parameter of potential energy but not that of kinetic energy, which continued to be different compared to the healthy group and increased the oscillations in the medio-lateral plane, which were double compared to Down syndrome group. The increase in potential energy, found to be almost equal to that of control group, indicates an increase in vertical oscillations. This could be because subjects who practise sports have stronger muscles that allow a greater push-off ability, which therefore increases their potential energy
Mechanical Work and Power Analysis in the Joints of the Lower Extremity of Adults With Down Syndrome During Plane Walking
No full textIndividuals with Down syndrome (DS) use a different motor gait strategy than healthy people. This study aims at analyzing plane walking differences between two groups of normally developed (ND) subjects and subjects with DS in terms of the generated mechanical power and work in the joints of the lower limb. Thirty-nine adults including two groups of 21 subjects with DS (age: 21.6 ± 7 years (mean ± SD)) and 18 ND subjects (age: 25.1 ± 2.4 years) participated in this study. Gait data and ground reaction forces were acquired using a quantitative movement analysis system composed of an optoelectronic motion analyzer (Elite2002, BTS) with eight infrared cameras, and two force platforms mounted in the middle of walkway. Mechanical power and work exchanges were computed during the stance phase by dedicated software, and then compared between the two groups (significance level: p-value = 0.05). Results showed that the mechanical power at the ankle joint was significantly larger in ND subjects compared to subjects with DS (0.084 ± 0.015 vs 0.027 ± 0.010 W/kg). The mechanical work of the ankle joint and the knee joint was significantly lower in ND compared to DS (0.015 ± 0.013 vs 0.028 ± 0.008 kJ/kg.m, and 0.066 ± 0.031 vs 0.109 ± 0.023 kJ/kg.m, respectively). For both groups, the mechanical work done by knee was less than that performed at the ankle and hip level, which might indicate that the knee muscles mainly absorb the energy, rather than generate it. Our results suggest that the subjects with DS walk with a different motor strategy than normal subjects in terms of mechanical power and work in the joints of the lower extremity. Further investigations are warranted to study the relation between these parameters and gait strategy in subjects with DS, which can lead to better rehabilitative strategies.</jats:p
A biomechanical study of gait initiation in Down syndrome
No full textGait Initiation (GI) is a functional task that challenges the balance control requiring weight shift and a transition from standing to walking. Individuals with Down Syndrome (DS) walk with low velocity, prolonged stance and shorter steps beside an increased support base. However, no studies performed GI analysis on this population. The aim of this study is to quantitatively characterize the GI task in subjects with DS compared with a typically developed control group
Use of 3D gait analysis as predictor of achilles tendon lengthening surgery outcomes in children with cerebral palsy
No full textBACKGROUND: In children with spastic Cerebral Palsy (CP), the treatment of equinus foot with Achilles tendon lengthening (ATL) surgery is associated with high incidence of overcorrection, which may result in crouch gait.
AIM: We aimed to assess if gait pattern in preoperative time could be a predictor of the surgery outcome.
DESIGN: Cross-sectional retrospective study.
SETTING: Movement Analysis Lab, IRCCS San Raffaele Pisana Hospital, Rome (ITALY).
POPULATION: Eighteen children (mean age 9.64.7 years) with spastic diplegia CP who underwent bilateral ATL surgery to correct equinus foot were involved.
METHODS: Participants underwent 3D gait analysis before and approximately 12 months after surgery. Primary measures were spatiotemporal, kinematic (summarized by Gait Variable Scores, GVSs) and kinetic parameters. The gait patterns for each leg was defined from kinematic data, using a quantitative classification: Plantar Flexor Knee Extension (PFKE) index. The CP group was split into true equinus and jump gait.
RESULTS: The equinus foot was successfully corrected as demonstrated by the improvement of GVS ankle dorsi-plantarflexion. However, there was a high rate of overcorrection in the true equinus, characterized by increases in knee flexion- extension GVS (8.7° pre vs. 16.7° post P<0.05) and knee flexion angle at initial contact (5.2° vs. 20.6° P<0.05) and by a decrease in the maximum ankle power generated at push-off (1.49 vs. 0.83 W/kg P <0.05).
CONCLUSIONS: Assessment of motor phenotype in preoperative time are good predictors of the results of ATL surgery. In children with true equinus gait, the increase of knee flexion subsequent to ATL is an early indicator that this technique will lead to crouch gait. These results show the influence of true equinus and jump gait patterns on the outcomes of the ATL.
CLINICAL REHABILITATION IMPACT: Therefore, we propose that this approach could have clinical value to evaluate and prescribe rehabilitation in children with CP disease, proposing different solutions depending on motor phenotype
Quantification of the effects of robotic-assisted gait training on upper and lower body strategy during gait in diplegic children with Cerebral Palsy using summary parameters
No full textThe effects of robotic-assisted gait training on upper and lower body strategy during gait in diplegic children with Cerebral Palsy (CP) were quantified using summary parameters (Upper Body Profile Score (UBPS) and Gait Profile Score (GPS)). Firstly, the upper body strategy during gait was assessed in 73 children with 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. Then, the effects of a robotic-assisted gait training in a sub-group of 35 children by means of UBPS were evaluated. After robotic-assisted gait training program, no significant differences as for the summary parameters (UBPS and GPS). However, considering the specific variables scores, significant improvements are displayed as for the upper body parameter on the sagittal plane (Upper Body Ant/Pst index) and the lower limbs, in particular pelvis (Pelvic Ant/Pst and Pelvic Int/Ext indices) and as for walking velocity. A sort of reorganization of full-body kinematics, especially at upper body and proximal level (pelvis) seems to appear, with a new gait approach, characterised by a better strategy of the upper body associated with a significant improvement of the pelvis movement
Foot–Ground Interaction during Standing in Individuals with Down Syndrome: a Longitudinal Retrospective Study
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Down Syndrome: gait pattern alterations in posture space kinematics
No full textGait characteristics in Down Syndrome are documented in terms of discrete kinematic variables. However, such features are strictly interrelated and reflect neurological and developmental delays. A phenotypical, quantitative assessment of how multi-joint walking patterns are activated and controlled during gait would enhance the understanding of locomotor mechanisms in such patients. We adopted an analysis framework based on Principal Component Analysis: the gait kinematics of 221 patients aged 6-45 were expressed in terms of a reduced set of one-dimensional movement components. Their time course during the gait cycle was described by score vectors, here called principal positions; its second time derivative, called principal acceleration, characterized the activity of the neuromuscular controller on each component. Outcomes were compared to an age-matched group of 49 healthy individuals. After controlling for the effect of walking speed, we observed that the main alterations in gait patterns emerged in the fourth component which is mostly devoted to stability management (group differences, p<0.001). Rather, the main sagittal-plane locomotor patterns showed only subtle differences from the control group. Using statistical parametrical mapping, we found when (step-to-step transitions) and how (interrelated joints motion) the fourth movement deviated from normal: in particular, an excessive hip adduction and trunk inclination during the transition between single and double support phases. These findings match the neurological and sensorimotor trait of Down Syndrome and suggest the promotion of targeted rehabilitative interventions. Further, this study opens to the adoption of principal positions and principal accelerations to investigate the neuromuscular control of movement patterns during locomotion
Multi-segmental postural control patterns in down syndrome
No full textBackground: Patients with Down Syndrome (DS) exhibit less efficient and unstable standing postural control. The specificities of somatosensorial deficits might result in a different utilization of resources and in distinct whole-body kinematic patterns, to date still unexplored. In this paper we aim at addressing multi-segmental coordination patterns in people with DS while maintaining standing balance under different visual conditions (open and closed eyes). Methods: This cross-sectional observational cohort study involved two groups of 23 patients with DS and 12 healthy controls. A 30-s standing balance test allowed to extract (i) the length of the trajectory of the center-of-pressure sway and 95% confidence ellipse area from Ground Reaction forces, and (ii) Principal Movement (PM) components from full-body motion kinematics; the latter were obtained exploiting a Principal Component Analysis-based approach, also embracing a motor-control perspective through the evaluation of the number of modifications applied by the neuromuscular controller on segments' acceleration. Findings: Trajectory length was significantly higher in patients; 95% ellipse confidence area did not differ between groups/condition. Postural movement components differed in people with DS from healthy controls not only in the “observable”, behavioural phenotype (PM3 and PM8), but also in the amount of activation of the associated control (PM1 to PM8, over-activated in DS) in all spatial directions. Interpretation: Results reinforced the prevalence of a medio-lateral hip strategy (instead of an ankle strategy) in maintaining postural stability. Most important, they revealed a less frequent activation of postural patterns in all spatial directions
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