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Mihai EE, Papathanasiou J, Panayotov K, Kashilska Y, Rosulescu E, Foti C, Berteanu M. Conventional physical therapy combined with extracorporeal shock wave leads to positive effects on spasticity in stroke survivors: a prospective observational study. Eur J Transl Myol 2023; 33:11607. [PMID: 37667862 PMCID: PMC10583146 DOI: 10.4081/ejtm.2023.11607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 09/06/2023] Open
Abstract
The study aimed to evaluate the effectiveness of radial extracorporeal shock wave therapy (rESWT) and conventional physical therapy (CPT) protocol on the gait pattern in stroke survivors through a new gait analysis technology. Fifteen (n=15) stroke survivors took part in this prospective, observational study and were assessed clinically and through an instrumented treadmill before and after rESWT and CPT. Spasticity grade 95% CI 0.93 (0.79 +/- 1.08), pain intensity 95% CI 1.60 (1.19 +/- 2.01), and clonus score decreased significantly 95% CI 1.13 (0.72 +/- 1.54). The sensorimotor function 95% CI -2.53 (-3.42 +/- 1.65), balance 95% CI -5.67 (-6.64 +/- - 4.69), and gait parameters were enhanced at the end of the program. Step length 95% CI -3.47 (-6.48 +/- 0.46) and step cycle were improved 95% CI -0.09 (-0.17 +/- -0.01), and hip 95% CI -3.90 (-6.92 +/- -0.88), knee 95% CI -2.08 (-3.84 +/- -0.32) and ankle flexion-extension 95% CI -2.08 (-6.64 +/- -4.69) were augmented. Adding the quantitative analysis to the clinical assessment, we gained easy access to track progress and obtained an individualized therapeutic approach for stroke survivors.
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Affiliation(s)
- Emanuela Elena Mihai
- Physical and Rehabilitation Medicine Department, Carol Davila University of Medicine and Pharmacy, Bucharest.
| | - Jannis Papathanasiou
- Department of Medical Imaging, Allergology and Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, Bulgaria; Department of Kinesitherapy, Faculty of Public Health "Prof. Dr. Tzecomir Vodenicharov, DSc.", Medical University of Sofia.
| | - Kiril Panayotov
- Department of Medical and Clinical Activities, Faculty of Public Health and Healthcare, "Angel Kanchev" University of Ruse.
| | | | - Eugenia Rosulescu
- Department of Physical Therapy and Sports Medicine, Faculty of Physical Education and Sport, University of Craiova.
| | - Calogero Foti
- Physical Medicine and Rehabilitation, Clinical Sciences and Translational Medicine, Tor Vergata University, Rome.
| | - Mihai Berteanu
- Physical and Rehabilitation Medicine Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Physical and Rehabilitation Medicine Department, Elias University Emergency Hospital, Bucharest.
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Feyzioğlu Ö, Öztürk Ö, Muğrabi S. Is Morton's neuroma in a pes planus or pes cavus foot lead to differences in pressure distribution and gait parameters? Heliyon 2023; 9:e19111. [PMID: 37636349 PMCID: PMC10448470 DOI: 10.1016/j.heliyon.2023.e19111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/19/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023] Open
Abstract
Morton's neuroma (MN) is a compressive neuropathy of the common digital plantar nerve causing forefoot pain. Foot posture and altered plantar pressure distribution have been identified as predispoing factors, however no studies have compared individuls with different foot postures with MN. Thus, we aimed to compare the effect of MN on spatiotemporal gait parameters and foot-pressure distribution in individuals with pes planus and pes cavus. Thirty-eight patients with unilateral MN were evaluated between June and August 2021. Nineteen patients with bilateral pes planus and 19 age and gender-matched patients with pes cavus who had no prior surgery were recruited. A Zebris FDM-THM-S treadmill system (Zebris Medical GmbH, Germany) was used to evaluate step length, stride length, step width, step time, stride time, cadence, velocity, foot-pressure distribution, force and whole stance phase, loading response, mid stance, pre-swing and swing phase percentages. There were no significant differences between the groups in spatiotemporal gait parameters (p > 0.05). Patients with pes planus displayed the following results for step length (49.36 ± 8.38), step width (9.05 ± 2.12), stance phase percentage (65.92 ± 2.11), swing phase percentage (34.08 ± 2.12), gait speed (2.96 ± 0.55), and cadence (100.57 ± 8.84). In contrast, patients with pes cavus displayed the following results for step length (49.06 ± 8.37), step width (8.10 ± 2.46), stance phase percentage (64.96 ± 1.61), swing phase percentage (34.79 ± 1.60), gait speed (2.95 ± 0.65), and cadence (99.73 ± 13.81). Foot-pressure distribution values showed no differences were detected in force, forefoot, and rearfoot pressure distribution, except for midfoot force (p < 0.05). The forefoot, midfoot, and rearfoot pressure values for the pronated group were 32.14 ± 10.90, 13.80 ± 3.03, and 22.78 ± 5.10, and for the supinated group were 33.50 ± 11.49, 14.23 ± 3.11 and 24.93 ± 6.52. MN does not significantly affect spatiotemporal gait parameters or foot-pressure distribution in patients with pes cavus or pes planus.
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Affiliation(s)
- Özlem Feyzioğlu
- Acibadem Mehmet Ali Aydinlar University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Özgül Öztürk
- Acibadem Mehmet Ali Aydinlar University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
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Kim J, McSweeney SC, Hollander K, Horstman T, Wearing SC. Adolescents running in conventional running shoes have lower vertical instantaneous loading rates but greater asymmetry than running barefoot or in partial-minimal shoes. J Sports Sci 2023; 41:774-787. [PMID: 37571975 DOI: 10.1080/02640414.2023.2240174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/17/2023] [Indexed: 08/13/2023]
Abstract
Footwear may moderate the transiently heightened asymmetry in lower limb loading associated with peak growth in adolescence during running. This repeated-measures study compared the magnitude and symmetry of peak vertical ground reaction force and instantaneous loading rates (VILRs) in adolescents during barefoot and shod running. Ten adolescents (age, 10.6 ± 1.7 years) ran at self-selected speed (1.7 ± 0.3 m/s) on an instrumented treadmill under three counter-balanced conditions; barefoot and shod with partial-minimal and conventional running shoes. All participants were within one year of their estimated peak height velocity based on sex-specific regression equations. Foot-strike patterns, peak vertical ground reaction force and VILRs were recorded during 20 seconds of steady-state running. Symmetry of ground reaction forces was assessed using the symmetry index. Repeated-measures ANOVAs were used to compare conditions (α=.05). Adolescents used a rearfoot foot-strike pattern during barefoot and shod running. Use of conventional shoes resulted in a lower VILR (P < .05, dz = 0.9), but higher VILR asymmetry (P < .05) than running barefoot (dz = 1.5) or in partial-minimal shoes (dz = 1.6). Conventional running shoes result in a lower VILR than running unshod or in partial-minimal shoes but may have the unintended consequence of increasing VILR asymmetry. The findings may have implications for performance, musculoskeletal development and injury in adolescents.
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Affiliation(s)
- Jae Kim
- Complete Rehab Allied Health Clinic, Brisbane, Australia
| | - Simon C McSweeney
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Karsten Hollander
- Institute of Exercise Science & Sports Medicine, Medical School Hamburg, Hamburg, Germany
| | - Thomas Horstman
- Conservative and Rehabilitative Orthopaedics, Technical University Munich, Munich, Germany
| | - Scott C Wearing
- Conservative and Rehabilitative Orthopaedics, Technical University Munich, Munich, Germany
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Roggio F, Trovato B, Zanghì M, Petrigna L, Testa G, Pavone V, Musumeci G. Running Footwear and Impact Peak Differences in Recreational Runners. BIOLOGY 2022; 11:biology11060818. [PMID: 35741339 PMCID: PMC9219650 DOI: 10.3390/biology11060818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022]
Abstract
Simple Summary Running is a physical activity practiced by many people to maintain good levels of movement. Recreational runners commonly strike the ground with the postero–lateral zone of the foot, which may be associated with a higher biomechanical load on the lower limb, called impact peak. Different running shoes with specific cushioning are available to overcome the biomechanical load, e.g., shoes with a thickness difference between the forefoot and heel parts of the sole, called heel-to-toe drop. Analyzing the running pattern of recreational runners may be challenging because biomechanics laboratories mainly analyze these characteristics in individuals with visible alterations. To overcome these limitations, we employed a 3D markerless system; furthermore, we investigated footwear use. These parameters were studied to understand the behavior of those runners with and without a higher impact peak. Thirty participants underwent a running analysis and a questionnaire about their footwear. The study’s main finding highlighted kinematic and spatiotemporal differences between the runners presenting a higher impact peak and those without it. Furthermore, we observed that runners without an impact peak prefer shoes with a lower heel-to-toe drop, while the other group prefers shoes with a higher heel-to-toe drop. Investigating biomechanics characteristics is essential to reduce possible injury. Abstract Running is a physical activity and the investigation of its biomechanical aspects is crucial both to avoid injuries and enhance performance. Recreational runners may be liable to increased stress over the body, particularly to lower limb joints. This study investigates the different running patterns of recreational runners by analyzing characteristics of the footwear impact peak, spatiotemporal, and kinematic parameters among those that present with a peak impact and those that do not, with a 3D markerless system. Thirty recreational runners were divided into two groups: impact peak group (IP) (n = 16) and no impact peak group (n = 14) (n-IP). Kinematic and spatiotemporal parameters showed a large Cohen’s d effect size between the groups. The mean hip flexion was IP 40.40° versus n-IP 32.30° (d = −0.82). Hip extension was IP 30.20° versus n-IP 27.70° (d = −0.58), and ankle dorsiflexion was IP 20.80°, versus n-IP 13.37° (d = −1.17). Stride length was IP 117.90 cm versus n-IP 105.50 cm (d = −0.84). Steps per minute was IP group 170 spm, versus n-IP 163 spm (d = −0.51). The heel-to-toe drop was mainly 10–12 mm for the IP group and 4–6 mm for the n-IP group. Recreational runners whose hip extension is around 40°, ankle dorsiflexion around 20°, and initial foot contact around 14°, may be predisposed to the presence of an impact peak.
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Affiliation(s)
- Federico Roggio
- Human, Histology and Movement Science Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy; (F.R.); (B.T.); (M.Z.); (L.P.)
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy
| | - Bruno Trovato
- Human, Histology and Movement Science Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy; (F.R.); (B.T.); (M.Z.); (L.P.)
| | - Marta Zanghì
- Human, Histology and Movement Science Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy; (F.R.); (B.T.); (M.Z.); (L.P.)
| | - Luca Petrigna
- Human, Histology and Movement Science Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy; (F.R.); (B.T.); (M.Z.); (L.P.)
| | - Gianluca Testa
- Section of Orthopaedics and Traumatology, Department of General Surgery and Medical Surgical Specialties, University Hospital Policlinico “Rodolico-San Marco”, University of Catania, 95123 Catania, Italy; (G.T.); (V.P.)
| | - Vito Pavone
- Section of Orthopaedics and Traumatology, Department of General Surgery and Medical Surgical Specialties, University Hospital Policlinico “Rodolico-San Marco”, University of Catania, 95123 Catania, Italy; (G.T.); (V.P.)
| | - Giuseppe Musumeci
- Human, Histology and Movement Science Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia n°87, 95123 Catania, Italy; (F.R.); (B.T.); (M.Z.); (L.P.)
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123 Catania, Italy
- Correspondence: ; Tel.: +39-095-378-2043
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Vafadar S, Skalli W, Bonnet-Lebrun A, Assi A, Gajny L. Assessment of a novel deep learning-based marker-less motion capture system for gait study. Gait Posture 2022; 94:138-143. [PMID: 35306382 DOI: 10.1016/j.gaitpost.2022.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/25/2022] [Accepted: 03/14/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Marker-less systems based on digital video cameras and deep learning for gait analysis could have a deep impact in clinical routine. A recently developed system has shown promising results in terms of joint center position but has not been yet evaluated in terms of gait outcomes. RESEARCH QUESTION How does this novel marker-less system compare to a marker-based reference system in terms of clinically relevant gait parameters? METHODS The deep learning method behind the developed marker-less system was trained on a dedicated dataset consisting of forty-one asymptomatic and pathological subjects each performing ten walking trials. The system could estimate the three-dimensional position of seventeen joint centers or keypoints (e.g., neck, shoulders, hip, knee, and ankles). We evaluated the marker-less system against a marker-based system in terms of differences in joint position (Euclidean distance), detection of gait events (e.g., heel strike and toe-off), spatiotemporal parameters (e.g., step length, time), kinematic parameters (e.g., hip and knee extension-flexion), and inter-trial reliability for kinematic parameters. RESULTS The marker-less system was able to estimate the three-dimensional position of joint centers with a mean difference of 13.1 mm (SD = 10.2 mm). 99% of the estimated gait events were estimated within 10 ms of the corresponding reference values. Estimated spatiotemporal parameters showed zero bias. The mean and standard deviation of the differences of the estimated kinematic parameters varied by parameter (for example, the mean and standard deviation for knee extension flexion angle were -3.0° and 2.7°). Inter-trial reliability of the measured parameters was similar to that of the marker-based references. SIGNIFICANCE The developed marker-less system can measure the spatiotemporal parameters within the range of the minimum detectable changes obtained using the marker-based reference system. Moreover, except for hip extension flexion, the system showed promising results in terms of several kinematic parameters.
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Affiliation(s)
- Saman Vafadar
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers, Institute of Technology, Paris, France.
| | - Wafa Skalli
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers, Institute of Technology, Paris, France.
| | - Aurore Bonnet-Lebrun
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers, Institute of Technology, Paris, France.
| | - Ayman Assi
- Faculty of Medicine, University of Saint-Joseph in Beirut, Beirut, Lebanon.
| | - Laurent Gajny
- Institut de Biomecanique Humaine Georges Charpak, Arts et Metiers, Institute of Technology, Paris, France.
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Jinés Viso MDM, Paez Moguer J. El tiempo de apoyo durante la marcha en relación con la edad infantil. REVISTA ESPAÑOLA DE PODOLOGÍA 2022. [DOI: 10.20986/revesppod.2022.1589/2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Bravi M, Massaroni C, Santacaterina F, Di Tocco J, Schena E, Sterzi S, Bressi F, Miccinilli S. Validity Analysis of WalkerView TM Instrumented Treadmill for Measuring Spatiotemporal and Kinematic Gait Parameters. SENSORS 2021; 21:s21144795. [PMID: 34300534 PMCID: PMC8309770 DOI: 10.3390/s21144795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/25/2021] [Accepted: 07/09/2021] [Indexed: 11/20/2022]
Abstract
The detection of gait abnormalities is essential for professionals involved in the rehabilitation of walking disorders. Instrumented treadmills are spreading as an alternative to overground gait analysis. To date, the use of these instruments for recording kinematic gait parameters is still limited in clinical practice due to the lack of validation studies. This study aims to investigate the performance of a multi-sensor instrumented treadmill (i.e., WalkerViewTM, WV) for performing gait analysis. Seventeen participants performed a single gait test on the WV at three different speeds (i.e., 3 km/h, 5 km/h, and 6.6 km/h). In each trial, spatiotemporal and kinematic parameters were recorded simultaneously by the WV and by a motion capture system used as the reference. Intraclass correlation coefficient (ICC) of spatiotemporal parameters showed fair to excellent agreement at the three walking speeds for steps time, cadence, and step length (range 0.502–0.996); weaker levels of agreement were found for stance and swing time at all the tested walking speeds. Bland–Altman analysis of spatiotemporal parameters showed a mean of difference (MOD) maximum value of 0.04 s for swing/stance time and WV underestimation of 2.16 cm for step length. As for kinematic variables, ICC showed fair to excellent agreement (ICC > 0.5) for total range of motion (ROM) of hip at 3 km/h (range 0.579–0.735); weaker levels of ICC were found at 5 km/h and 6.6 km/h (range 0.219–0.447). ICC values of total knee ROM showed poor levels of agreement at all the tested walking speeds. Bland–Altman analysis of hip ROM revealed a higher MOD value at higher speeds up to 3.91°; the MOD values of the knee ROM were always higher than 7.67° with a 60° mean value of ROM. We demonstrated that the WV is a valid tool for analyzing the spatiotemporal parameters of walking and assessing the hip’s total ROM. Knee total ROM and all kinematic peak values should be carefully evaluated, having shown lower levels of agreement.
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Affiliation(s)
- Marco Bravi
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 5, 00128 Rome, Italy; (M.B.); (F.S.); (S.S.); (F.B.); (S.M.)
| | - Carlo Massaroni
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 21, 00128 Rome, Italy; (J.D.T.); (E.S.)
- Correspondence:
| | - Fabio Santacaterina
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 5, 00128 Rome, Italy; (M.B.); (F.S.); (S.S.); (F.B.); (S.M.)
| | - Joshua Di Tocco
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 21, 00128 Rome, Italy; (J.D.T.); (E.S.)
| | - Emiliano Schena
- Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 21, 00128 Rome, Italy; (J.D.T.); (E.S.)
| | - Silvia Sterzi
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 5, 00128 Rome, Italy; (M.B.); (F.S.); (S.S.); (F.B.); (S.M.)
| | - Federica Bressi
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 5, 00128 Rome, Italy; (M.B.); (F.S.); (S.S.); (F.B.); (S.M.)
| | - Sandra Miccinilli
- Unit of Physical Medicine and Rehabilitation, Università Campus Bio-Medico di Roma, via Alvaro Del Portillo 5, 00128 Rome, Italy; (M.B.); (F.S.); (S.S.); (F.B.); (S.M.)
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Häusler KA, Braun D, Liu NC, Penrose F, Sutcliffe MPF, Allen MJ. Evaluation of the repeatability of kinetic and temporospatial gait variables measured with a pressure-sensitive treadmill for dogs. Am J Vet Res 2020; 81:922-929. [PMID: 33251838 DOI: 10.2460/ajvr.81.12.922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate intrasession and intersession repeatability of measurements for temporospatial and kinetic variables obtained with a pressure-sensitive treadmill designed for gait analysis of dogs. ANIMALS 16 client-owned dogs. PROCEDURES The influence of treadmill speed on accuracy of ground reaction force (GRF) measurements was assessed by simulated gait analysis at 0 to 7.5 km/h with a custom test device. A similar test was performed with 1 client-owned dog ambulating on the treadmill at 5 speeds (3 to 7 km/h) for GRF calculations. Fifteen client-owned dogs were then walked on the treadmill at 3 km/h for collection of temporospatial and kinetic data. Intrasession repeatability was determined by comparing 2 sets of measurements obtained ≤ 2 hours apart. Intersession repeatability was determined by comparing the first set of these measurements with those for a second session ≥ 4 days later. Intraclass correlation coefficients (ICCs; consistency test) and difference ratios were calculated to assess repeatability. RESULTS Increases in treadmill speed yielded a mean 9.1% decrease in weight-normalized force data at belt speeds of up to 7.5 km/h for the test device, compared with the value when the treadmill belt was stationary. Results were similar for the dog at increasing treadmill speeds (mean decrease, 12.4%). For temporospatial data, intrasession ICCs were > 0.9 and intersession ICCs ranged from 0.75 to 0.9; for GRFs, intrasession and intersession ICCs ranged from 0.68 to 0.97 and from 0.35 to 0.78, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Repeatability of temporospatial data for healthy dogs was good to excellent; results for kinetic data varied. Further research is needed to investigate use of this system for gait analysis with larger samples of dogs and dogs with lameness.
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