The effects of gait velocity on the gait characteristics of hemiplegic patients

Gender may have an influence on the relationship between Functional Movement Screen scores and gait parameters in elite junior athletes - A pilot study

Aims The aim of this study was to examine the effects of gender on the relationship between Functional Movement Screen (FMS) and treadmill-based gait parameters. Methods Twenty elite junior athletes (10 women and 10 men) performed the FMS tests and gait analysis at a fixed speed. Between-gender differences were calculated for the relationship between FMS test scores and gait parameters, such as foot rotation, step length, and length of gait line. Results Gender did not affect the relationship between FMS and treadmill-based gait parameters. The nature of correlations between FMS test scores and gait parameters was different in women and men. Furthermore, different FMS test scores predicted different gait parameters in female and male athletes. FMS asymmetry and movement asymmetries measured by treadmill-based gait parameters did not correlate in either gender. Conclusion There were no interactions between FMS, gait parameters, and gender; however, correlation analyses support the idea that strength and conditioning coaches need to pay attention not only to how to score but also how to correctly use FMS.

Effects of taping and proprioceptive neuromuscular facilitation for stance phase duration of stroke patients

[Purpose] The purpose of this study was to investigate the effects of taping and proprioceptive neuromuscular facilitation in stroke patients. [Subjects and Methods] Thirty patients who were diagnosed with hemiparalysis due to stroke were selected as subjects of study. Experiment group 1 patients had Kinesio taping applied before applying the PNF, while experiment group 2 patients had McConell taping applied before applying the PNF. The control group had only the PNF applied. The dartfish program was used to evaluate the stance phase of stroke patients. [Results] Experiment group 1 and experiment group 2 showed a significantly longer stance phase duration of the affected side than the control group in week 6. [Conclusion] Application of Kinesio taping has a more positive effect on the stance phase duration than McConell taping in the patients with stroke.

Usability and acceptability by a younger and older user group regarding a mobile robot-supported gait rehabilitation system

The aim of the study was to identify differences regarding usability, acceptability, and barriers of usage of a robot-supported gait rehabilitation system between a younger and older group of patients with gait impairments. A mobile robot-supported gait rehabilitation prototype was tested on a group of geriatric patients aged 60 and above, and on a group of young patients aged 59 and below in a clinical setting during five therapy sessions. The involved therapists received 2 days training with the system and could test it profoundly. Data on usability, acceptability, and barriers to system usage were collected with questionnaires and structured interviews with the patients. The robotic system received overall moderate usability and good acceptability ratings; it was rated as clearly structured, practical, and safe. Analyses identified a few barriers, such as time-intensive setup of the system or tight leg shells, which can be minimized with regular training and system adaptations. Differences between the two user groups could be revealed and will be used for future investigation. This study showed the potential of the mobile robot-supported system for gait rehabilitation, but also pointed out further need for action. Efficacy studies are the next step in the evaluation process.

Effects of treadmill speed on the knee angle and stance time of white rats with knee osteoarthritis according to the treadmill speed

[Purpose] The purpose of this study was to identify whether walking on a treadmill at an adjusted speed is suitable for humans by examining the effects of exercise on the joint functions of white rats with induced knee osteoarthritis. [Subjects and Methods] The subjects were 20 Sprague-Dawley white rats, aged eight weeks, weighing 250 to 300 g. The moderate-speed exercise group performed their exercise at a gradient of 0% and a speed of 15 m/min, and the high-speed exercise group performed their exercise at a gradient of 0% and a speed of 26 m/min. [Results] Statistically significant changes were elicited by the moderate-speed and high-speed exercises. [Conclusion] In conclusion, the results of the present study present the importance of walking exercise. In particular, they demonstrate that changes in knee ROM and stance time are elicited by changes in walking speed.

The dead spot phenomenon in prosthetic gait: Quantified with an analysis of center of pressure progression and its velocity in the sagittal plane

BACKGROUND

The "dead spot" phenomenon in prosthetics is a disruption in forward progression observed in the rearfoot of passive prosthetic foot-ankle systems which results in a compensatory and inefficient gait pattern by amputees. A metric to quantify the dead spot as a kinetic event has not yet been introduced. The present study implements a three-part metric to evaluate the dead spot in terms of time, magnitude, and total area using center of pressure velocity and a novel threshold value calculation.

METHODS

The metrics are implemented for proof of efficacy using a convenient sample of four amputees (2 transtibial, 2 transfemoral) who walked in a 3D motion capture system with integrated force plates over five foot conditions.

FINDINGS

"Continuous-lever" feet designs showed the most favorable metric results between subjects (p<0.05) and in an ad hoc analysis compared to an ideal foot condition within subjects (p>0.05). Ten of 18 (55.6%) foot conditions found to be similar to the ideal were continuous-lever feet. Lack of significant similarity between the feet and ideal conditions (1 of 18, 5.6%) were found in transfemoral subjects.

INTERPRETATION

The metric calculations were able to show statistical difference among foot conditions between subjects. One foot (continuous-lever, glass composite) had no detectable dead spot in the transtibial subjects. The lack of significant findings in transfemoral subjects indicates a different coefficient in threshold calculations may be more appropriate for these subjects versus transtibial subjects. Further research with larger sample is needed to determine clinically significant findings among feet and between transtibial and transfemoral subjects.

Motion control for a walking companion robot with a novel human–robot interface

A walking companion robot is presented for rehabilitation from dyskinesia of lower limbs in this article. A new human–robot interface (HRI) is designed which adopts one-axis force sensor and potentiometer connector to detect the motion of the user. To accompany in displacement and angle between the user and the robot precisely in real time, the common motions are classified into two elemental motion states. With distinction method of motion states, a classification scheme of motion control is adopted. The mathematical model-based control method is first introduced and the corresponding control systems are built. Due to the unavoidable deviation of the mathematical model-based control method, a force control method is proposed and the corresponding control systems are built. The corresponding simulations demonstrate that the efficiency of the two proposed control methods. The experimental data and paths of robot verify the two control methods and indicate that the force control method can better satisfy the user’s requirements.

The contributions of balance to gait capacity and motor function in chronic stroke

[Purpose] The aim of this study was to identify the contributions of balance to gait and motor function in chronic stroke. [Subjects and Methods] Twenty-three outpatients participated in a cross-sectional assessment. Gait ability was assessed using the functional ambulation category, self-paced 10-m walking speed, and fastest 10-m walking speed. Standing balance and trunk control measures included the Berg Balance Scale and the Trunk Impairment Scale. Univariate and multivariate regression analyses were performed. [Results] Balance was the best predictor of the FAC, self-paced walking speed, and fastest walking speed, accounting for 57% to 61% of the variances. Additionally, the total score of TIS was the only predictor of the motor function of the lower limbs and the dynamic balance of TIS was a predictor of the motor function of the upper limbs, accounting for 41% and 29% of the variance, respectively. [Conclusion] This study demonstrated the relative contribution of standing balance and trunk balance to gait ability and motor function. They show that balance has a high power of explanation of gait ability and that trunk balance is a determinant of motor function rather than gait ability.

The effects of Pilates exercise training on static and dynamic balance in chronic stroke patients: a randomized controlled trial

[Purpose] The purpose of this study was to analyze the effects of Pilates exercise on static and dynamic balance in chronic stroke patients. [Subjects and Methods] Nineteen individuals with unilateral chronic hemiparetic stroke (age, 64.7 ± 6.9 years; height, 161.7 ± 7.9 cm; weight, 67.0 ± 11.1 kg) were randomly allocated to either a Pilates exercise group (PG, n=10) or a control group (CG, n=9). The PG attended 24 exercise sessions conducted over an 8-week period (3 sessions/week). Center of pressure (COP) sway and COP velocity were measured one week before and after the exercise program and compared to assess training effects. [Results] Pilates exercise positively affected both static and dynamic balance in patients with chronic stroke. For static balance, COP sway and velocity in the medial-lateral (M-L) and anterior-posterior (A-P) directions were significantly decreased in the PG after training while no significant differences were found in the CG. For dynamic balance, measured during treadmill walking, the PG showed significantly reduced COP sway and velocity in the M-L and A-P directions for both the paretic and non-paretic leg. [Conclusions] The findings provide initial evidence that Pilates exercise can enhance static and dynamic balance in patients with chronic stroke.

Validity and reliability of the safe driving behavior measure in community-dwelling self-drivers with stroke

[Purpose] Driving is a vital component of recovery for stroke survivors facilitating restoration of their family roles and reintegration back into their communities and associations. The purpose of this study was to evaluate the validity and reliability of the Safe Driving Behavior Measure (SDBM) in community-dwelling self-drivers post-stroke. [Subjects and Methods] Participants were sixty-seven community-dwelling self-drivers who had received a diagnosis of first stroke in the past twelve months. To investigate the validity and reliability of the SDBM, this study evaluated two sessions, held three days apart in a quiet and well-organized assessment room. Cronbach’s alpha and the Intraclass Correlation Coefficient [ICC (2.1)] were used to evaluate statistically concurrent validity and reliability of the overall and three domain scores. Pearson’s correlations were used to quantify the bivariate associations among the three domains. [Results] The Cronbach’s alpha coefficients for the three domains of person-vehicle (0.989), person-environment (0.997), and person-vehicle-environment (0.968) of the SDBM indicated high internal consistency in community-dwelling self-drivers with stroke, in addition to excellent rest-retest reliability. [Conclusion] The results of this study suggest that the SDBM could be a reliable measure to evaluate automobile driving in community-dwelling self-drivers with stroke.

Effects of ankle joint mobilization with movement and weight-bearing exercise on knee strength, ankle range of motion, and gait velocity in patients with stroke: a pilot study

[Purpose] The purpose of this study was to investigate the effects of ankle joint mobilization with movement on knee strength, ankle range of motion, and gait velocity, compared with weight-bearing exercise in stroke patients. [Subjects and Methods] Thirty subjects with chronic stroke were divided into three groups: MWM (n = 12), WBE (n = 8), and control (n = 10). All groups attended physical therapy sessions 3 times a week for 5 weeks. Subjects in the MWM group performed mobilization with movement exercises, whilst participants in the WBE group performed weight-bearing exercises. Knee peak torque, ankle range of motion, and spatiotemporal gait parameters were evaluated before and after the interventions. [Results] Knee extensor peak torque increased significantly in both MWM and WBE groups. However, only the MWM group showed significant improvement in passive and active ankle range of motion and gait velocity, among the three groups. [Conclusion] Ankle joint mobilization with movement intervention is more effective than simple weight-bearing intervention in improving gait speed in stroke patients with limited ankle motion.

Views of physiatrists and physical therapists on the use of gait-training robots for stroke patients

[Purpose] Gait-training robots have been developed for stroke patients with gait disturbance. It is important to survey the views of physiatrists and physical therapists on the characteristics of these devices during their development. [Subjects and Methods] A total of 100 physiatrists and 100 physical therapists from 38 hospitals participated in our questionnaire survey. [Results] The most common answers about the merits of gait-training robots concern improving the treatment effects (28.5%), followed by standardizing treatment (19%), motivating patients about treatment (17%), and improving patients' self-esteem (14%). The subacute period (1-3 months post-stroke onset) was most often chosen as the ideal period (47.3%) for the use of these devices, and a functional ambulation classification of 0-2 was the most selected response for the optimal patient status (27%). The preferred model was the treadmill type (47.5%) over the overground walking type (40%). The most favored commercial price was $50,000-$100,000 (38.3%). The most selected optimal duration for robot-assisted gait therapy was 30-45 min (47%), followed by 15-30 min (29%), 45-60 min (18%), ≥ 60 min (5%), and < 15 min (1%). [Conclusion] Our study findings could guide the future designs of more effective gait-training robots for stroke patients.

Comparison between a center of mass and a foot pressure sensor system for measuring gait parameters in healthy adults

[Purpose] The purpose of this study was to determine the relationship between an accelerometer system and a foot pressure sensor system for measuring gait characteristics during walking in healthy adults. [Subjects and Methods] Thirty-five healthy participants with no neurological, musculoskeletal, or cardiopulmonary disorders volunteered for this study. Gait characteristics were measured while participants walked freely along a 10-m walkway using two different measurement systems simultaneously. The first analysis system was based on center of mass using a wireless tri-axial accelerometer and the second system was a foot pressure sensor system. [Results] There was a significant and high correlation between the two systems with respect to gait velocity and cadence. The stride length as a percentage of the stride height measured with the center of mass system was significantly and highly correlated with stride length and stride velocity that was measured with the foot pressure system. Furthermore, stride length from the center of mass system was significantly and highly correlated with stride length and stride velocity from the foot pressure system. [Conclusion] A gait analysis based on a center of mass system is a valid method to assess the effectiveness of therapeutic interventions in a clinical setting.