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Trentzsch K, Schumann P, Śliwiński G, Bartscht P, Haase R, Schriefer D, Zink A, Heinke A, Jochim T, Malberg H, Ziemssen T. Using Machine Learning Algorithms for Identifying Gait Parameters Suitable to Evaluate Subtle Changes in Gait in People with Multiple Sclerosis. Brain Sci 2021; 11:brainsci11081049. [PMID: 34439668 PMCID: PMC8391565 DOI: 10.3390/brainsci11081049] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/29/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022] Open
Abstract
In multiple sclerosis (MS), gait impairment is one of the most prominent symptoms. For a sensitive assessment of pathological gait patterns, a comprehensive analysis and processing of several gait analysis systems is necessary. The objective of this work was to determine the best diagnostic gait system (DIERS pedogait, GAITRite system, and Mobility Lab) using six machine learning algorithms for the differentiation between people with multiple sclerosis (pwMS) and healthy controls, between pwMS with and without fatigue and between pwMS with mild and moderate impairment. The data of the three gait systems were assessed on 54 pwMS and 38 healthy controls. Gaussian Naive Bayes, Decision Tree, k-Nearest Neighbor, and Support Vector Machines (SVM) with linear, radial basis function (rbf) and polynomial kernel were applied for the detection of subtle walking changes. The best performance for a healthy-sick classification was achieved on the DIERS data with a SVM rbf kernel (κ = 0.49 ± 0.11). For differentiating between pwMS with mild and moderate disability, the GAITRite data with the SVM linear kernel (κ = 0.61 ± 0.06) showed the best performance. This study demonstrates that machine learning methods are suitable for identifying pathologic gait patterns in early MS.
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Affiliation(s)
- Katrin Trentzsch
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
| | - Paula Schumann
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, 01307 Dresden, Germany; (P.S.); (G.Ś.); (A.H.); (T.J.); (H.M.)
| | - Grzegorz Śliwiński
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, 01307 Dresden, Germany; (P.S.); (G.Ś.); (A.H.); (T.J.); (H.M.)
| | - Paul Bartscht
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
| | - Rocco Haase
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
| | - Dirk Schriefer
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
| | - Andreas Zink
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
| | - Andreas Heinke
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, 01307 Dresden, Germany; (P.S.); (G.Ś.); (A.H.); (T.J.); (H.M.)
| | - Thurid Jochim
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, 01307 Dresden, Germany; (P.S.); (G.Ś.); (A.H.); (T.J.); (H.M.)
| | - Hagen Malberg
- Institute of Biomedical Engineering, TU Dresden, Fetscherstr. 29, 01307 Dresden, Germany; (P.S.); (G.Ś.); (A.H.); (T.J.); (H.M.)
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany; (K.T.); (P.B.); (R.H.); (D.S.); (A.Z.)
- Correspondence: ; Tel.: +49-351-458-4465; Fax: +49-351-458-5717
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Schlögl M, Schietzel S, Kunz R, Savaskan E, Kressig RW, Riese F. [The Physical Examination of an 'Uncooperative' Elderly Patient]. PRAXIS 2018; 107:1021-1030. [PMID: 30227797 DOI: 10.1024/1661-8157/a003038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The Physical Examination of an 'Uncooperative' Elderly Patient Abstract. The physical examination of uncooperative elderly patients regularly presents physicians in the private practice, in the hospital or nursing home with great challenges. The lack of cooperation itself can be an important indication of an underlying medical problem. Important elements to improve the patient's cooperation include ensuring basic needs, sufficient time and patience, adequate communication and good cooperation with relatives and other healthcare professionals. Targeted clinical observation as well as thinking in geriatric syndromes and unmet needs can help to raise physical findings despite limited cooperation. Pathological findings are indicators of impaired organ and functional systems and must be supplemented by a detailed examination.
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Affiliation(s)
- Mathias Schlögl
- 1 Klinik für Geriatrie, Universitätsspital Zürich
- 2 Klinik für Alterspsychiatrie, Psychiatrische Universitätsklinik Zürich
| | - Simeon Schietzel
- 1 Klinik für Geriatrie, Universitätsspital Zürich
- 2 Klinik für Alterspsychiatrie, Psychiatrische Universitätsklinik Zürich
| | - Roland Kunz
- 3 Universitäre Klinik für Akutgeriatrie, Stadtspital Waid, Zürich
| | - Egemen Savaskan
- 2 Klinik für Alterspsychiatrie, Psychiatrische Universitätsklinik Zürich
| | - Reto W Kressig
- 4 Universitäre Altersmedizin Basel, Felix Platter-Spital, Klinische Professur für Geriatrie, Universität Basel
| | - Florian Riese
- 2 Klinik für Alterspsychiatrie, Psychiatrische Universitätsklinik Zürich
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Niederer D, Bumann A, Mühlhauser Y, Schmitt M, Wess K, Engeroff T, Wilke J, Vogt L, Banzer W. Specific smartphone usage and cognitive performance affect gait characteristics during free-living and treadmill walking. Gait Posture 2018; 62:415-421. [PMID: 29649707 DOI: 10.1016/j.gaitpost.2018.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 04/04/2018] [Accepted: 04/05/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Mobile phone tasks like texting, typing, and dialling during walking are known to impact gait characteristics. Beyond that, the effects of performing smartphone-typical actions like researching and taking self-portraits (selfie) on gait have not been investigated yet. RESEARCH QUESTION We aimed to investigate the effects of smartphone usage on relevant gait characteristics and to reveal potential association of basic cognitive and walking plus smartphone dual-task abilities. METHODS Our cross-sectional, cross-over study on physically active, healthy participants was performed on two days, interrupted by a 24-h washout in between. Assessments were: 1) Cognitive testing battery consisting of the trail making test (TMT A and B) and the Stroop test 2) Treadmill walking under five smartphone usage conditions: no use (control condition), reading, dialling, internet searching and taking a selfie in randomized order. Kinematic and kinetic gait characteristics were assessed to estimate conditions influence. RESULTS In our sample of 36 adults (24.6 ± 1 years, 23 female, 13 male), ANCOVAs followed by post-hoc t-tests revealed that smartphone usage impaired all tested gait characteristics: gait speed (decrease, all conditions): F = 54.7, p < 0.001; cadence (increase, all): F = 38.3, p < 0.001; double stride length (decrease, all): F = 33.8, p < 0.001; foot external rotation (increase during dialling, researching, selfie): F = 16.7, p < 0.001; stride length variability (increase): F = 11.7, p < 0.001; step width variability (increase): F = 5.3, p < 0.001; step width (Friedmann test and Wilcoxon Bonferroni-Holm-corrected post-hoc analyses, increase): Z = -2.3 to -2.9; p < 0.05); plantar pressure proportion (increase during reading and researching) (Z = -2.9; p < 0.01). The ability to keep usual gait quality during smartphone usage was systematically associated with the TMT B time regarding cadence and double stride length for reading (r = -0.37), dialling (r = -0.35) and taking a selfie (r = -0.34). SIGNIFICANCE Smartphone usage substantially impacts walking characteristics in most situations. Changes of gait patterns indicate higher cognitive loads and lower awareness.
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Affiliation(s)
- Daniel Niederer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany.
| | - Anke Bumann
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Yvonne Mühlhauser
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Mareike Schmitt
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Katja Wess
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Tobias Engeroff
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jan Wilke
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Winfried Banzer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
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Pliske G, Emmermacher P, Weinbeer V, Witte K. Changes in dual-task performance after 5 months of karate and fitness training for older adults to enhance fall prevention. Aging Clin Exp Res 2016; 28:1179-1186. [PMID: 26661888 DOI: 10.1007/s40520-015-0508-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/18/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Demographic changes resulting in an aging population are major factors for an increase of fall-related injuries. Especially in situations where dual tasks such as walking whilst talking have to be performed simultaneously the risk of a fall-related injury increases. It is well known that some types of martial art (e.g. Tai Chi) can reduce the risk of a fall. It is unknown if the same is true for karate. AIM AND METHODS In this randomized, controlled study 68 people with a mean age of 69 years underwent 5-month karate training, 5-month fitness training or were part of a control group. Before and after the time of intervention a gait analysis with normal walk, a cognitive dual task and a motor dual task were performed. The gait parameter step frequency, walking speed, single-step time and single-step length were investigated. RESULTS It could be seen that all groups improved their gait parameters after a 5-month period, even the control group. A sporty intervention seems to affect mainly the temporal gait parameters positively. This effect was especially demonstrated for normal walk and cognitive dual task. CONCLUSIONS An improvement of the human walk seems to be possible through karate and fitness training, even under dual-task conditions. A prolonged intervention time with multiple repetitions of gait analysis could give better evidence if karate is a useful tool to increase fall prevention.
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Affiliation(s)
- Gerald Pliske
- Department of Sports Science, Otto-von-Guericke University, Magdeburg, Zschokkestraße 32, 39104, Magdeburg, Germany.
- Department of Traumatology, Otto-von-Guericke University, Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany.
| | - Peter Emmermacher
- Department of Sports Science, Otto-von-Guericke University, Magdeburg, Zschokkestraße 32, 39104, Magdeburg, Germany
| | - Veronika Weinbeer
- Department of Sports Science, Otto-von-Guericke University, Magdeburg, Zschokkestraße 32, 39104, Magdeburg, Germany
| | - Kerstin Witte
- Department of Sports Science, Otto-von-Guericke University, Magdeburg, Zschokkestraße 32, 39104, Magdeburg, Germany
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Kim NJ, Kim JS, Wang JS, Park JH, Choi JH. The effects of isometric trunk exercises and dynamic trunk exercises on gait in elderly people. J Phys Ther Sci 2015; 27:1685-9. [PMID: 26180298 PMCID: PMC4499961 DOI: 10.1589/jpts.27.1685] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/14/2015] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to compare the effects of dynamic trunk exercises and isometric trunk exercises on gait in elderly people. [Subjects] This study randomly allocated 20 elderly people to an isometric trunk exercise group (n=10) and a dynamic trunk exercise group (n=10). The exercises were performed for 30 minutes three times a week for 12 weeks. Gait speed, stride length, cadence, and step width were measured at a normal pace using GAITRite. All groups were evaluated before and after 12 weeks. [Results] The isometric exercise group showed a significant change in gait velocity, cadence, and left and right step lengths. The dynamic trunk exercise group showed a significant change in gait velocity, cadence, left and right step lengths, left and right step times, and left and right stride lengths. Moreover, a comparison of the exercise effect between the two groups showed a significant difference in gait velocity. [Conclusion] The results of this study suggest that isometric trunk exercises and dynamic trunk exercises have a positive effect on gait function in elderly people. In particular, isometric trunk exercises are recommended to promote gait velocity.
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Affiliation(s)
- Nyeon-Jun Kim
- Department of Physical Therapy, Faculty of Medical and Health, Pohang College, Republic of Korea
| | - Ji-Sung Kim
- Department of Physical Therapy, Suwon Women's University, Republic of Korea
| | - Joong-San Wang
- Department of Physical Therapy, Yeoju Institute of Technology, Republic of Korea
| | - Joo-Hyun Park
- Department of Physical Therapy, Suwon Women's University, Republic of Korea
| | - Jung-Hyun Choi
- Department of Physical Therapy and Institute for Elderly Health and Welfare, Namseoul University: 21 Maeju-ri, Sungwan-eup, Seobuk-gu, Chonan-si 331-707, Republic of Korea
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