Identifying trippers and non-trippers based on knee kinematics during obstacle-free walking

Effects of self-controlled feedback on learning range of motion measurement techniques and self-efficacy among physical therapy students: a preliminary study

BACKGROUND

Measuring range of motion (ROM) accurately using a universal goniometer or visual estimation is challenging for physical therapy students. Self-controlled (SC) feedback, where learners decide whether to receive feedback, can enhance learning and foster self-efficacy (SE) by promoting self-regulation. However, the impact of SC feedback on skill acquisition in ROM measurement technique and SE in physical therapy students remains unclear. This study investigates the effects of SC feedback on skill acquisition in ROM measurement techniques and students' SE.

METHODS

Thirty physical therapy students were quasi-randomly assigned to an SC group, which chose feedback during practice, or a Yoked (Yk) group, which received feedback based on the SC group's schedule. A goniometric measurement task, in which participants measure the ROM of left knee flexion using a universal goniometer, and a visual estimation task, in which they estimate it visually, were set as the learning tasks. After a pretest, they completed the practice (3 trials × 4 blocks) followed by short-term retention test (STRT) and LTRT (LTRT). All tests consisted of 3 trials. Measurement accuracy and time were used as test performance for both tasks. SE of ROM measurements was measured before the start of each test using a 10-point Likert scale. Feedback related to measurement errors were provided during practice in line with each group's conditions.

RESULTS

The SC group maintained high feedback frequency (80.0 ± 30.3%) during the practice. Both groups improved measurement accuracy and reduced time for goniometric measurement and visual estimation tasks, but no significant group differences were found. Goniometric accuracy exceeded visual estimation in both groups. SE before the pretest did not correlate with pretest accuracy. However, SE before the STRT correlated with accuracy at that time in both groups. In the SC group, SE before the LTRT test was related to the accuracy at the STRT.

CONCLUSION

SC feedback did not demonstrate superior effectiveness, but external feedback improved ROM measurement accuracy and reduced measurement time. Moreover, SE after the practice was temporarily associated with accuracy, suggesting a potential link between SE and performance in skill acquisition.

Cross-sectional analysis of speed-up mechanism in normal gait among healthy older adults with and without falls - Results from the Baltimore Longitudinal Study of Aging

BACKGROUND

Falls in older adults increase the risk of mobility loss. Proper understanding of gait mechanisms related to falls may provide novel solutions for maintaining mobility in older adults.

RESEARCH QUESTION

Identify fall-related gait patterns through analyzing alterations in gait parameters to walk faster than usual pace in older adults.

METHODS

A Total of 519 participants (mean age = 73.12 years; 51.05 % female), including non-fallers (n = 396) and fallers (n = 123), aged 60-96 years were assessed in the Baltimore Longitudinal Study of Aging. Participants completed gait assessments at both usual and fast paces. Range of motions (ROM) for the hip, knee, and ankle joint in the sagittal plane and hip abductor ROM during normal and fast pace gait were measured by 3D motion capture system (Vicon 612). For all gait variables, percentage-changes (PC; (((fast-walking_parameter - usual-walking_parameter) /usual-walking_parameter)*100)) was calculated. Associations of PC for gait speed and PC for other gait parameters were compared between fallers and non-fallers.

RESULTS

Compared to non-fallers, fallers walked with shorter stride, elongated double support time and shorter knee ROM in the faster pace walk (p = 0.044, p = 0.019, and p = 0.036, respectively). PCs of all gait related variables were significantly associated with PC of gait speed in non-fallers (ps < 0.005), while in the fallers, only PC for stride length, cadence, and hip ROM were associated with PC for gait speed (ps < 0.001).

SIGNIFICANCE

Among non-fallers related PC for gait speed was associated with PC across gait parameters suggesting the use of similar biomechanical approaches in usual and fast gait. Compared to non-fallers, fallers demonstrated different mechanisms of transition from usual to fast gait. Evaluating speed-up strategies could provide insight into subtle yet important gait modifications in apparently well-functioning older adults that would help identify individuals at high risk of falling.

Sex differences in age-related differences in joint motion during gait in community-dwelling middle-age and older individuals

BACKGROUND

Walking is the most important mode of human locomotion; however, the ability to walk often decreases with age. Age-related differences in lower-limb kinematics during gait may differ depending on sex. However, the question of the compounded effects of age and sex on gait kinematics remains unsolved.

RESEARCH QUESTION

The present study aimed to clarify the interaction between age and sex in differences in gait kinematics of community-dwelling middle-age and older individuals.

METHODS

This study included 836 community-dwelling middle-age and older adults (61.8 % female). Joint motion during comfortable gait was measured using magnetic and inertial measurement units. Hip, knee, and ankle joint angles were calculated in the sagittal plane. Participants were divided into four groups according to age: 50-59, 60-69, 70-79, and 80-89 years. The interaction of sex and age on spatiotemporal gait parameters and the peak value of joint angles was analyzed using two-way analysis of variance (ANOVA) and Tukey's post hoc test.

RESULTS

Gait speed (F = 43.92, P < 0.001), step length (F = 73.00, P < 0.001), hip extension (F = 12.89, P = 0.002), knee flexion (F = 39.99, P < 0.001), and ankle plantar flexion (F = 27.43, P < 0.001) significantly decreased with age. Significant differences according to sex were observed in all parameters except gait speed. Significant age and sex interaction effects were observed for knee flexion (F = 4.97, P = 0.002) and ankle dorsiflexion (F = 4.04, P = 0.007).

SIGNIFICANCE

A significant interaction effect of age and sex was observed for peak angle of knee flexion and ankle dorsiflexion during gait. In particular, the knee flexion angle among females during gait began to decrease from 60 years of age, and the decreasing trend was faster and more prominent than that among males.

The Relationship between Leg Extension Angle at Late Stance and Knee Flexion Angle at Swing Phase during Gait in Community-Dwelling Older Adults

This study aimed to clarify the relationship between leg extension angle and knee flexion angle during gait in older adults. The subjects of this cross-sectional study were 588 community-dwelling older adults (74.6 ± 6.1 y). Segment angles and acceleration were measured using five inertial measurement units during comfortable gait, and bilateral knee and hip joint angles, and leg extension angle, reflecting whole lower limb extension at late stance, were calculated. Propulsion force was estimated using the increase in velocity calculated from anterior acceleration of the sacrum during late stance. Correlation analysis showed that leg extension angle was associated with knee flexion angle at swing phase and hip extension angle and increase in velocity at late stance (r = 0.444–508, p < 0.001). Multiple regression analysis showed that knee flexion angle at mid-swing was more affected by leg extension angle (β = 0.296, p < 0.001) than by gait speed (β = 0.219, p < 0.001) and maximum hip extension angle (β = −0.150, p < 0.001). These findings indicate that leg extension angle may be a meaningful parameter for improving gait function in older adults due to the association with knee kinematics during swing as well as propulsion force at late stance.

Effects of Metatarsal Work Boots on Gait During Level and Inclined Walking

Footwear plays an important role in worker safety. Work boots with safety toes are often utilized at mine sites to protect workers from hazards. Increasingly, mining operations require metatarsal guards in addition to safety toe protection in boots. While these guards provide additional protection, the impact of metatarsal guards on gait are unknown. This study aimed to measure the effects of 4 safety work boots, steel toe, and steel toe with metatarsal protection in wader- and hiker-style boots, on level and inclined walking gait characteristics, during ascent and descent. A total of 10 participants completed this study. A motion capture system measured kinematics that allowed for the calculation of key gait parameters. Results indicated that gait parameters changed due to incline, similar to previous literature. Wader-style work boots reduced ankle range of motion when ascending an incline. Hip, knee, and ankle ranges of motion were also reduced during descent for this style of boot. Wader-style boots with metatarsal guards led to the smallest ankle range of motion when descending an inclined walkway. From these results, it is likely that boot style affects gait parameters and may impact a miner's risk for slips, trips, or falls.

Computer interactions during walking workstation use moderately affects spatial-temporal gait characteristics

BACKGROUND

Due to increased sedentary workstyles, active workstations have shown the ability to increase activity while only moderately affecting work ability. However, previous examinations have not examine fine motor mousing tasks on tripping descriptors.

RESEARCH QUESTION

What affect do mousing tasks of varying target size have on tripping descriptors during walking workstation use?

METHODS

Three-dimensional kinematic data were collected while participants used a walking workstation completing one baseline and three mousing conditions of varying target sizes.

RESULTS

Target size main effects (p < 0.001) detected decreased stride length in all experimental conditions, which were supported by moderate effect sizes, and decreased stance width and time in double limb support (p < 0.001 for both comparisons). Stance width differences resulted in large effect sizes between baseline and all conditions, while only moderate effect sizes were observed between time in double limb support in baseline compared to all conditions. No changes in knee flexion range of motion were observed in response to target size (p = 0.278).

SIGNIFICANCE

These results indicate that walking workstation users shorten their stride length and decrease their base of support while completing mousing tasks. The placement of the upper extremities on the workstation desk likely acted as the primary mechanism to increase stability. It is concluded that performing mousing tasks of varying target size using a walking workstation does not pose greater risk for adverse gait events.

Gait profile score identifies changes in gait kinematics in nonfaller, faller and recurrent faller older adults women

BACKGROUND

Quantification of differences in gait kinematics between young and older adults provides insight on age-related gait changes and can contribute to the investigation of risk of falls. Gait Profile Score (GPS) is an index that indicates gait quality, using kinematic gait data, but so far it has not been used in an elderly population without neurological conditions.

RESEARCH QUESTION

Is the Gait Profile Score (GPS) an index that shows reliability for use in old adults? Does this index detect changes in gait quality observed by kinematic data between nonfaller, faller and recurrent faller older adults?

METHODS

Forty-nine women (mean age 72,43 ± 6,44; 27 faller and 22 nonfaller) were included in the study. Intra-session reliability was obtained from the intraclass correlation coefficient (ICC) between the five strides of each session.

RESULTS

Overall value of GPS shows no difference between nonfaller (6.65 ± 1.59º), faller (6.67 ± 2.05º) and recurrent faller (6.62 ± 0.86º) older adult. In all groups larger values of Gait Variable Scores (GVS) were observed in the hip and knee joints. Intra-session ICC values the GVS and GPS presented high stability, ranging from 0.80 to 0.99. MDC lower values in GPS were observed in the faller (0.39; ICC - 0.97) and recurrent faller (0.69; ICC - 0.90).

SIGNIFICANCE

Due to the high reliability, GPS has proven to be a valid method to analyze the gait quality of faller and nonfaller older woman. The most sensitive indexes (GPS and GVS) are the gear changes in fallers and recurrent fallers.

Defining gait patterns using Parallel Factor 2 (PARAFAC2): A new analysis of previously published data

Three-dimensional gait analysis (3D-GA) is commonly used to answer clinical questions of the form "which joints and what variables are most affected during when". When studying high-dimensional datasets, traditional dimension reduction methods (e.g. principal components analysis) require "data flattening", which may make the ensuing solutions difficult to interpret. The aim of the present study is to present a case study of how a multi-dimensional dimension reduction technique, Parallel Factor 2 (PARAFAC2), provides a clinically interpretable set of solutions to typical biomechanical datasets where different variables are collected during walking and running. Three-dimensional kinematic and kinetic data used for the present analyses came from two publicly available datasets on walking (n = 33) and running (n = 28). For each dataset, a four-dimensional array was constructed as follows: Mode A was time normalized cycle points; mode B was the number of participants multiplied by the number of speed conditions tested; mode C was the number of joint degrees of freedom, and mode D was variable (angle, velocity, moment, power). Five factors for walking and four factors for running were extracted which explained 79.23% and 84.64% of their dataset's variance. The factor which explains the greatest variance was swing-phase sagittal plane knee kinematics (walking), and kinematics and kinetics (running). Qualitatively, all extracted factors increased in magnitude with greater speed in both walking and running. This study is a proof of concept that PARAFAC2 is useful for performing dimension reduction and producing clinically interpretable solutions to guide clinical decision making.