Immediate changes in post-stroke gait using a shoe lift on the nonaffected lower limb: A preliminary study

Ten Meter Walk Test for motor function assessment with technological devices based on lower members' movements: A systematic review

OBJECTIVE

The Ten Meter Walk Test (10MWT) is a vital diagnostic tool for identifying neuromuscular and neurodegenerative conditions. This systematic review explores the potential of wearables, mobile devices, and sensors to enhance the 10MWT's use in medical gait analysis based on lower limb movements.

METHODS

This systematic review explores the use of wearables, mobile devices, and sensors to improve the 10MWT in medical gait analysis based on lower limb movements. The study uses the PRISMA approach to assess literature from January 2010 to October 2023, highlighting the importance of new technologies like machine learning and artificial intelligence in improving the accuracy and efficiency of the 10MWT.

RESULTS

The findings demonstrate how technology-enabled 10MWT can help develop specialized treatment strategies and provide a more accurate understanding of disease pathophysiology.

CONCLUSIONS

The paper reviews 17 studies on lower limb movements during the 10MWT, highlighting their importance in assessing medical diseases and gait analysis as a diagnostic tool. It emphasizes the role of technology in rehabilitation and physical therapy, where some studies combine Transcranial Direct Current Stimulation with robotic or wearable technologies.

SIGNIFICANCE

The review comprehensively explains these technologies' advantages and current use in therapeutic contexts.

Immediate effects of insoles applied to the sound side lower extremity of patients with chronic hemiplegia during walking

Background

Asymmetric gait patterns are mostly observed in hemiplegic stroke patients. These abnormal gait patterns resulting in abnormal speed, and decreased ability in daily of activity living.

Objective

This study aimed to determine the immediate changes in gait parameters and plantar pressure during elevation by wearing an insole on the sound side lower extremity of patients with hemiplegia.

Methods

Thirty-six participants were recruited, comprising those with a post-stroke follow-up of ≥3 months and a functional ambulation category score of ≥2. The participants were asked to walk with and without a 1 cm insole in the shoe of their sound side, and the order of wearing or not wearing the insole was randomized. Gait parameters, bilateral gait parameters, and dynamic plantar pressure were measured using the GAITRite Walkway System.

Results

Paired t-test was used to examine immediate changes in gait parameters and plantar pressure with and without insoles during walking in the same group. Overall, gait velocity and step length significantly decreased (p < 0.05), whereas step time significantly increased (p < 0.05). The swing phase of the affected sidelower extremities significantly increased (p < 0.05), and the stance phase significantly decreased (p < 0.05). Double-support unloading phase (pre-swing phase) significantly increased (p < 0.05). The changes in plantar pressure were significantly increased in some lateral zones and significantly decreased in the medial zone of the mid-hindfoot, both in terms of pressure per time and peak pressure (p < 0.05).

Conclusion

Although this study did not show immediate positive effects on gait parameters and gait cycle, it is expected that sensory input from the sole of the foot through changes in plantar pressure may help improve gait asymmetry and regulate postural symmetry.

Mobile and wearable technologies for the analysis of Ten Meter Walk Test: A concise systematic review

Physical issues started to receive more attention due to the sedentary lifestyle prevalent in modern culture. The Ten Meter Walk Test allows measuring the person's capacity to walk along 10 m and analyzing the advancement of various medical procedures for ailments, including stroke. This systematic review is related to the use of mobile or wearable devices to measure physical parameters while administering the Ten Meter Walk Test for the analysis of the performance of the test. We applied the PRISMA methodology for searching the papers related to the Ten Meter Walk Test. Natural Language Processing (NLP) algorithms were used to automate the screening process. Various papers published in two decades from multiple scientific databases, including IEEE Xplore, Elsevier, Springer, EMBASE, SCOPUS, Multidisciplinary Digital Publishing Institute (MDPI), and PubMed Central were analyzed, focusing on various diseases, devices, features, and methods. The study reveals that chronometer and accelerometer sensors measuring spatiotemporal features are the most pertinent in the Gait characterization of most diseases. Likewise, all studies emphasized the close relation between the quality of the sensor's data obtained and the system's ultimate accuracy. In other words, calibration procedures are needed because of the body part where the sensor is worn and the type of sensor. In addition, using ambient sensors providing kinematic and kinetic features in conjunction with wearable sensors and consistently acquiring walking signals can enhance the system's performance. The most common weaknesses in the analyzed studies are the sample size and the unavailability of continuous monitoring devices for measuring the Ten Meter Walk Test.

Test-Retest Reliability of a Conventional Gait Model for Registering Joint Angles during Initial Contact and Toe-Off in Healthy Subjects

The aim of this study was to evaluate the test-retest reliability of a conventional gait model (CGM), the Plug-in Gait model, to calculate the angles of the hip, knee, and ankle during initial contact (IC) and toe-off (TO). Gait analysis was performed using the Vicon Motion System^® (Oxford Metrics, Oxford, UK). The study group consisted of 50 healthy subjects. To evaluate the test-retest reliability, the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the minimal detectable change (MDC), and the Bland-Altman analysis with 95% limits of agreement were calculated. The ICC for the joint angles of the hip, knee, and ankle was higher than 0.80. However, the ankle angle at IC had an ICC lower than 0.80. The SEM was <5° for all parameters. The MDC was large (>5°) for the hip angle at IC. The Bland-Altman analysis indicated that the magnitude of divergence was between ±5° and ±9° at IC and around ±7° at TO. In conclusion, the ICC for the plug-in gait model was good for the hip, knee, and ankle angles during IC and TO. The plots revealed a disagreement between measurements that should be considered in patients' clinical assessments.