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Armand S, Sawacha Z, Goudriaan M, Horsak B, van der Krogt M, Huenaerts C, Daly C, Kranzl A, Boehm H, Petrarca M, Guiotto A, Merlo A, Spolaor F, Campanini I, Cosma M, Hallemans A, Horemans H, Gasq D, Moissenet F, Assi A, Sangeux M. Current practices in clinical gait analysis in Europe: A comprehensive survey-based study from the European society for movement analysis in adults and children (ESMAC) standard initiative. Gait Posture 2024; 111:65-74. [PMID: 38653178 DOI: 10.1016/j.gaitpost.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Clinical gait analysis (CGA) is a systematic approach to comprehensively evaluate gait patterns, quantify impairments, plan targeted interventions, and evaluate the impact of interventions. However, international standards for CGA are currently lacking, resulting in various national initiatives. Standards are important to ensure safe and effective healthcare practices and to enable evidence-based clinical decision-making, facilitating interoperability, and reimbursement under national healthcare policies. Collaborative clinical and research work between European countries would benefit from common standards. RESEARCH OBJECTIVE This study aimed to review the current laboratory practices for CGA in Europe. METHODS A comprehensive survey was conducted by the European Society for Movement Analysis in Adults and Children (ESMAC), in close collaboration with the European national societies. The survey involved 97 gait laboratories across 16 countries. The survey assessed several aspects related to CGA, including equipment used, data collection, processing, and reporting methods. RESULTS There was a consensus between laboratories concerning the data collected during CGA. The Conventional Gait Model (CGM) was the most used biomechanical model for calculating kinematics and kinetics. Respondents also reported the use of video recording, 3D motion capture systems, force plates, and surface electromyography. While there was a consensus on the reporting of CGA data, variations were reported in training, documentation, data preprocessing and equipment maintenance practices. SIGNIFICANCE The findings of this study will serve as a foundation for the development of standardized guidelines for CGA in Europe.
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Affiliation(s)
- Stéphane Armand
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
| | - Zimi Sawacha
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Marije Goudriaan
- Utrecht University, University Corporate Offices, Student and Academic Affairs Office, Utrecht, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam, the Netherlands
| | - Brian Horsak
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Marjolein van der Krogt
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Catherine Huenaerts
- Clinical Motion Analysis Laboratory, University Hospital Leuven, Leuven, Belgium
| | - Colm Daly
- National Centre for Movement Analysis, Central Remedial Clinic, Dublin, Ireland; CP-Life Research Centre, Royal College of Surgeons, Dublin, Ireland
| | - Andreas Kranzl
- Laboratory for Gait and Movement Analysis, Orthopaedic Hospital Speising, Vienna, Austria
| | - Harald Boehm
- Orthopaedic Hospital for Children, Aschau im Chiemgau, Germany
| | - Maurizio Petrarca
- Movement Analysis and Robotics Laboratory, "Bambino Gesù" Children's Hospital - IRCCS, Rome, Italy
| | - Anna Guiotto
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Andrea Merlo
- Gait & Motion Analysis Laboratory, Sol et Salus Hospital, Rimini, Italy; LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio, Italy
| | - Fabiola Spolaor
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Isabella Campanini
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio, Italy
| | - Michela Cosma
- Motion Analysis Laboratory, Neuroscience and Rehabilitation Department, University Hospital of Ferrara, Italy
| | - Ann Hallemans
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
| | - Herwin Horemans
- Department of Rehabilitation, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - David Gasq
- Department of Functional Physiological Explorations, University Hospital of Toulouse, Hôpital de Rangueil, Toulouse, France; ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Florent Moissenet
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Ayman Assi
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Morgan Sangeux
- University Children's Hospital Basel, Basel, Switzerland
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Horsak B, Durstberger S, Krondorfer P, Thajer A, Greber-Platzer S, Kranzl A. Which method should we use to determine the hip joint center location in individuals with a high amount of soft tissue? Clin Biomech (Bristol, Avon) 2024; 115:106254. [PMID: 38669918 DOI: 10.1016/j.clinbiomech.2024.106254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/26/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND This study investigated the most accurate method for estimating the hip joint center position in clinical 3D gait analysis for young individuals with high amounts of soft tissue. We compared position estimates of five regression-based and two functional methods to the hip joint center position obtained through 3D free-hand ultrasound. METHODS For this purpose, the data of 14 overweight or obese individuals with a mean age of 13.6 (SD 2.1 yrs) and a BMI of 36.5 (SD 7.1 kg/m2, range 26-52 kg/m2) who underwent standard clinical 3D gait analysis were used. The data of each participant were processed with five regression-based and two functional methods and compared to the hip joint center identified via 3D free-hand ultrasound. FINDINGS The absolute location errors to 3D free-hand ultrasound for each anatomical plane and the Euclidean distances served as outcomes next to their effects on gait variables. The data suggest that regression-based methods are preferable to functional methods in this population, as the latter demonstrated the highest variability in accuracy with large errors for some individuals. INTERPRETATION Based on our findings we recommend using the regression method presented by Hara et al. due to its superior overall accuracy of <9 mm on average in all planes and the lowest impact on kinematic and kinetic output variables. We do not recommend using the Harrington equations (single and multiple) in populations with high amounts of soft tissue as they require pelvic depth as input, which can be massively biased when a lot of soft tissue is present around the pelvis.
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Affiliation(s)
- Brian Horsak
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten 3100, Austria; Institute of Health Sciences, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten 3100, Austria.
| | - Sebastian Durstberger
- FH Campus Wien - University of Applied Sciences, Department Health Sciences, Favoritenstrasse 226, 1100 Vienna, Austria; Orthopaedic Hospital Speising, Laboratory of Gait and Movement Analysis, Speisinger Str. 109, Vienna 1130, Austria
| | - Philipp Krondorfer
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten 3100, Austria
| | - Alexandra Thajer
- Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Guertel 18-20, Vienna 1090, Austria
| | - Susanne Greber-Platzer
- Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Guertel 18-20, Vienna 1090, Austria
| | - Andreas Kranzl
- Orthopaedic Hospital Speising, Laboratory of Gait and Movement Analysis, Speisinger Str. 109, Vienna 1130, Austria
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Horsak B, Prock K, Krondorfer P, Siragy T, Simonlehner M, Dumphart B. Inter-trial variability is higher in 3D markerless compared to marker-based motion capture: Implications for data post-processing and analysis. J Biomech 2024; 166:112049. [PMID: 38493576 DOI: 10.1016/j.jbiomech.2024.112049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/22/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
Markerless motion capture has recently attracted significant interest in clinical gait analysis and human movement science. Its ease of use and potential to streamline motion capture recordings bear great potential for out-of-the-laboratory measurements in large cohorts. While previous studies have shown that markerless systems can achieve acceptable accuracy and reliability for kinematic parameters of gait, they also noted higher inter-trial variability of markerless data. Since increased inter-trial variability can have important implications for data post-processing and analysis, this study compared the inter-trial variability of simultaneously recorded markerless and marker-based data. For this purpose, the data of 18 healthy volunteers were used who were instructed to simulate four different gait patterns: physiological, crouch, circumduction, and equinus gait. Gait analysis was performed using the smartphone-based markerless system OpenCap and a marker-based motion capture system. We compared the inter-trial variability of both systems and also evaluated if changes in inter-trial variability may depend on the analyzed gait pattern. Compared to the marker-based data, we observed an increase of inter-trial variability for the markerless system ranging from 6.6% to 22.0% for the different gait patterns. Our findings demonstrate that the markerless pose estimation pipelines can introduce additionally variability in the kinematic data across different gait patterns and levels of natural variability. We recommend using averaged waveforms rather than single ones to mitigate this problem. Further, caution is advised when using variability-based metrics in gait and human movement analysis based on markerless data as increased inter-trial variability can lead to misleading results.
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Affiliation(s)
- Brian Horsak
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria; Institute of Health Sciences, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria.
| | - Kerstin Prock
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria
| | - Philipp Krondorfer
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria
| | - Tarique Siragy
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria
| | - Mark Simonlehner
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria; Institute of Health Sciences, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria
| | - Bernhard Dumphart
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria; Institute of Health Sciences, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria
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Horsak B, Eichmann A, Lauer K, Prock K, Krondorfer P, Siragy T, Dumphart B. Concurrent validity of smartphone-based markerless motion capturing to quantify lower-limb joint kinematics in healthy and pathological gait. J Biomech 2023; 159:111801. [PMID: 37738945 DOI: 10.1016/j.jbiomech.2023.111801] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/24/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023]
Abstract
Markerless motion capturing has the potential to provide a low-cost and accessible alternative to traditional marker-based systems for real-world biomechanical assessment. However, before these systems can be put into practice, we need to rigorously evaluate their accuracy in estimating joint kinematics for various gait patterns. This study evaluated the accuracy of a low-cost, open-source, and smartphone-based markerless motion capture system, namely OpenCap, for measuring 3D joint kinematics in healthy and pathological gait compared to a marker-based system. 21 healthy volunteers were instructed to walk with four different gait patterns: physiological, crouch, circumduction, and equinus gait. Three-dimensional kinematic data were simultaneously recorded using the markerless and a marker-based motion capture system. The root mean square error (RMSE) and the peak error were calculated between every joint kinematic variable obtained by both systems. We found an overall RMSE of 5.8 (SD: 1.8 degrees) and a peak error of 11.3 degrees (SD: 3.9). A repeated measures ANOVA with post hoc tests indicated significant differences in RMSE and peak errors between the four gait patterns (p ¡ 0.05). Physiological gait presented the lowest, crouch and circumduction gait the highest errors. Our findings indicate a roughly comparable accuracy to IMU-based approaches and commercial markerless multi-camera solutions. However, errors are still above clinically desirable thresholds of two to five degrees. While our findings highlight the potential of markerless systems for assessing gait kinematics, they also underpin the need to further improve the underlying deep learning algorithms to make markerless pose estimation a valuable tool in clinical settings.
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Affiliation(s)
- Brian Horsak
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria; Institute of Health Sciences, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria.
| | - Anna Eichmann
- Study Program Gait Analysis and Rehabilitation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria
| | - Kerstin Lauer
- Study Program Gait Analysis and Rehabilitation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria
| | - Kerstin Prock
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria
| | - Philipp Krondorfer
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria
| | - Tarique Siragy
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria
| | - Bernhard Dumphart
- Center for Digital Health and Social Innovation, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria; Institute of Health Sciences, St. Pölten University of Applied Sciences, Campus-Platz 1, St. Pölten, 3100, Austria
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Dumphart B, Slijepcevic D, Zeppelzauer M, Kranzl A, Unglaube F, Baca A, Horsak B. Robust deep learning-based gait event detection across various pathologies. PLoS One 2023; 18:e0288555. [PMID: 37566568 PMCID: PMC10420363 DOI: 10.1371/journal.pone.0288555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 06/29/2023] [Indexed: 08/13/2023] Open
Abstract
The correct estimation of gait events is essential for the interpretation and calculation of 3D gait analysis (3DGA) data. Depending on the severity of the underlying pathology and the availability of force plates, gait events can be set either manually by trained clinicians or detected by automated event detection algorithms. The downside of manually estimated events is the tedious and time-intensive work which leads to subjective assessments. For automated event detection algorithms, the drawback is, that there is no standardized method available. Algorithms show varying robustness and accuracy on different pathologies and are often dependent on setup or pathology-specific thresholds. In this paper, we aim at closing this gap by introducing a novel deep learning-based gait event detection algorithm called IntellEvent, which shows to be accurate and robust across multiple pathologies. For this study, we utilized a retrospective clinical 3DGA dataset of 1211 patients with four different pathologies (malrotation deformities of the lower limbs, club foot, infantile cerebral palsy (ICP), and ICP with only drop foot characteristics) and 61 healthy controls. We propose a recurrent neural network architecture based on long-short term memory (LSTM) and trained it with 3D position and velocity information to predict initial contact (IC) and foot off (FO) events. We compared IntellEvent to a state-of-the-art heuristic approach and a machine learning method called DeepEvent. IntellEvent outperforms both methods and detects IC events on average within 5.4 ms and FO events within 11.3 ms with a detection rate of ≥ 99% and ≥ 95%, respectively. Our investigation on generalizability across laboratories suggests that models trained on data from a different laboratory need to be applied with care due to setup variations or differences in capturing frequencies.
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Affiliation(s)
- Bernhard Dumphart
- Center for Digital Health & Social Innovation, St. Pölten University of Applied Sciences, St. Pölten, Austria
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
- Doctoral School of Pharmaceutical, Nutritional and Sport Sciences, University of Vienna, Vienna, Austria
| | - Djordje Slijepcevic
- Institute of Creative\Media/Technologies, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Matthias Zeppelzauer
- Institute of Creative\Media/Technologies, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Andreas Kranzl
- Laboratory of Gait and Movement Analysis, Orthopaedic Hospital Vienna-Speising, Vienna, Austria
| | - Fabian Unglaube
- Laboratory of Gait and Movement Analysis, Orthopaedic Hospital Vienna-Speising, Vienna, Austria
| | - Arnold Baca
- Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Brian Horsak
- Center for Digital Health & Social Innovation, St. Pölten University of Applied Sciences, St. Pölten, Austria
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
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Horst F, Slijepcevic D, Simak M, Horsak B, Schöllhorn WI, Zeppelzauer M. Modeling biological individuality using machine learning: A study on human gait. Comput Struct Biotechnol J 2023; 21:3414-3423. [PMID: 37416082 PMCID: PMC10319823 DOI: 10.1016/j.csbj.2023.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 07/08/2023] Open
Abstract
Human gait is a complex and unique biological process that can offer valuable insights into an individual's health and well-being. In this work, we leverage a machine learning-based approach to model individual gait signatures and identify factors contributing to inter-individual variability in gait patterns. We provide a comprehensive analysis of gait individuality by (1) demonstrating the uniqueness of gait signatures in a large-scale dataset and (2) highlighting the gait characteristics that are most distinctive to each individual. We utilized the data from three publicly available datasets comprising 5368 bilateral ground reaction force recordings during level overground walking from 671 distinct healthy individuals. Our results show that individuals can be identified with a prediction accuracy of 99.3% by using the bilateral signals of all three ground reaction force components, with only 10 out of 1342 recordings in our test data being misclassified. This indicates that the combination of bilateral ground reaction force signals with all three components provides a more comprehensive and accurate representation of an individual's gait signature. The highest accuracy was achieved by (linear) Support Vector Machines (99.3%), followed by Random Forests (98.7%), Convolutional Neural Networks (95.8%), and Decision Trees (82.8%). The proposed approach provides a powerful tool to better understand biological individuality and has potential applications in personalized healthcare, clinical diagnosis, and therapeutic interventions.
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Affiliation(s)
- Fabian Horst
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Djordje Slijepcevic
- Institute of Creative Media Technologies, Department of Media & Digital Technologies, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Marvin Simak
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Brian Horsak
- Center for Digital Health & Social Innovation, Department of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Wolfgang Immanuel Schöllhorn
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Matthias Zeppelzauer
- Institute of Creative Media Technologies, Department of Media & Digital Technologies, St. Pölten University of Applied Sciences, St. Pölten, Austria
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Thajer A, Skacel G, Truschner K, Jorda A, Vasek M, Horsak B, Strempfl J, Kautzky-Willer A, Kainberger F, Greber-Platzer S. Comparison of Bioelectrical Impedance-Based Methods on Body Composition in Young Patients with Obesity. Children (Basel) 2021; 8:children8040295. [PMID: 33920492 PMCID: PMC8070058 DOI: 10.3390/children8040295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 11/20/2022]
Abstract
(1) Background: The determination of body composition is an important method to investigate patients with obesity and to evaluate the efficacy of individualized medical interventions. Bioelectrical impedance-based methods are non-invasive and widely applied but need to be validated for their use in young patients with obesity. (2) Methods: We compiled data from three independent studies on children and adolescents with obesity, measuring body composition with two bioelectrical impedance-based devices (TANITA and BIACORPUS). For a small patient group, additional data were collected with air displacement plethysmography (BOD POD) and dual-energy X-ray absorptiometry (DXA). (3) Results: Our combined data on 123 patients (age: 6–18 years, body mass index (BMI): 21–59 kg/m²) and the individual studies showed that TANITA and BIACORPUS yield significantly different results on body composition, TANITA overestimating body fat percentage and fat mass relative to BIACORPUS and underestimating fat-free mass (p < 0.001 for all three parameters). A Bland–Altman plot indicated little agreement between methods, which produce clinically relevant differences for all three parameters. We detected gender-specific differences with both methods, with body fat percentage being lower (p < 0.01) and fat-free mass higher (p < 0.001) in males than females. (4) Conclusions: Both bioelectrical impedance-based methods provide significantly different results on body composition in young patients with obesity and thus cannot be used interchangeably, requiring adherence to a specific device for repetitive measurements to ascertain comparability of data.
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Affiliation(s)
- Alexandra Thajer
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
- Correspondence:
| | - Gabriele Skacel
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
| | - Katharina Truschner
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
| | - Anselm Jorda
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
| | - Martin Vasek
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
| | - Brian Horsak
- Institute of Health Sciences, St. Pölten University of Applied Sciences, Matthias-Corvinus-Straße 15, 3100 St. Pölten, Austria;
| | - Johanna Strempfl
- Department of Physiotherapy, St. Pölten University of Applied Sciences, Matthias-Corvinus-Straße 15, 3100 St. Pölten, Austria;
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria;
| | - Franz Kainberger
- Division of Neuro- and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria;
| | - Susanne Greber-Platzer
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
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Thajer A, Truschner K, Jorda A, Skacel G, Horsak B, Greber‐Platzer S. A strength and neuromuscular exercise programme did not improve body composition, nutrition and psychological status in children with obesity. Acta Paediatr 2021; 110:288-289. [PMID: 32725666 PMCID: PMC7818106 DOI: 10.1111/apa.15498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Alexandra Thajer
- Department of Pediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
| | - Katharina Truschner
- Department of Pediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
| | - Anselm Jorda
- Department of Pediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
| | - Gabriele Skacel
- Department of Pediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
| | - Brian Horsak
- Institute of Health Sciences St. Pölten University of Applied Sciences St. Pölten Austria
| | - Susanne Greber‐Platzer
- Department of Pediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
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Horsak B, Schwab C, Leboeuf F, Kranzl A. Reliability of walking and stair climbing kinematics in a young obese population using a standard kinematic and the CGM2 model. Gait Posture 2021; 83:96-99. [PMID: 33129173 DOI: 10.1016/j.gaitpost.2020.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Recently, the successor of the Conventional Gait Model, the CGM2 was introduced. Even though achievable reliability of gait kinematics is a well-assessed topic in gait analysis for several models, information about reliability in difficult study samples with high amount of subcutaneous fat is scarce and to date, not available for the CGM2. Therefore, this study evaluated the test-retest reliability of the CGM2 model for difficult data with high amount of soft tissue artifacts. RESEARCH QUESTION What is the test-retest reliability of the CGM2 during level walking and stair climbing in a young obese population? Is there a clinically relevant difference in reliability between a standard direct kinematic model and the CGM2? METHODS A retrospective test-retest dataset from eight male and two female volunteers was used. It comprised standard 3D gait analysis data of three walking conditions: level walking, stair ascent and descent. To quantify test-retest reliability the Standard Error of Measurement (SEM) was calculated for each kinematic waveform for a direct kinematic model (Cleveland clinic marker set) and the CGM2. RESULTS Both models showed an acceptable level of test-retest reliability in all three walking conditions. However, SEM ranged between two and five degrees (∘) for both models and, thus, needs consideration during interpretation. The choice of model did not affect reliability considerably. Differences in SEM between stair climbing and level walking were small and not clinically relevant (<1°). SIGNIFICANCE Results showed an acceptable level of reliability and only small differences between the models. It is noteworthy, that the SEM was increased during the first half of swing in all walking conditions. This might be attributed to increased variability resulting for example from inaccurate knee and ankle axis definitions or increased variability in the gait pattern and needs to be considered during data interpretation.
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Affiliation(s)
- Brian Horsak
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria.
| | - Caterine Schwab
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria
| | - Fabien Leboeuf
- University Hospital of Nantes, Rehabilitation service, Nantes, France; School of Health & Society, The University of Salford, UK
| | - Andreas Kranzl
- Orthopaedic Hospital Vienna-Speising, Laboratory of Gait and Movement Analysis, Vienna, Austria
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Horsak B, Slijepcevic D, Raberger AM, Schwab C, Worisch M, Zeppelzauer M. GaiTRec, a large-scale ground reaction force dataset of healthy and impaired gait. Sci Data 2020; 7:143. [PMID: 32398644 PMCID: PMC7217853 DOI: 10.1038/s41597-020-0481-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/06/2020] [Indexed: 11/21/2022] Open
Abstract
The quantification of ground reaction forces (GRF) is a standard tool for clinicians to quantify and analyze human locomotion. Such recordings produce a vast amount of complex data and variables which are difficult to comprehend. This makes data interpretation challenging. Machine learning approaches seem to be promising tools to support clinicians in identifying and categorizing specific gait patterns. However, the quality of such approaches strongly depends on the amount of available annotated data to train the underlying models. Therefore, we present GAITREC, a comprehensive and completely annotated large-scale dataset containing bi-lateral GRF walking trials of 2,084 patients with various musculoskeletal impairments and data from 211 healthy controls. The dataset comprises data of patients after joint replacement, fractures, ligament ruptures, and related disorders at the hip, knee, ankle or calcaneus during their entire stay(s) at a rehabilitation center. The data sum up to a total of 75,732 bi-lateral walking trials and enable researchers to classify gait patterns at a large-scale as well as to analyze the entire recovery process of patients.
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Affiliation(s)
- Brian Horsak
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria.
| | - Djordje Slijepcevic
- St. Pölten University of Applied Sciences, Institute of Creative Media Technologies, St. Pölten, Austria
| | - Anna-Maria Raberger
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria
| | - Caterine Schwab
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria
| | - Marianne Worisch
- Rehabilitation Center Weißer Hof, Austrian Workers' Compensation Board (AUVA), Klosterneuburg, Austria
| | - Matthias Zeppelzauer
- St. Pölten University of Applied Sciences, Institute of Creative Media Technologies, St. Pölten, Austria
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Slijepcevic D, Zeppelzauer M, Schwab C, Raberger AM, Breiteneder C, Horsak B. Input representations and classification strategies for automated human gait analysis. Gait Posture 2020; 76:198-203. [PMID: 31862670 DOI: 10.1016/j.gaitpost.2019.10.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Quantitative gait analysis produces a vast amount of data, which can be difficult to analyze. Automated gait classification based on machine learning techniques bear the potential to support clinicians in comprehending these complex data. Even though these techniques are already frequently used in the scientific community, there is no clear consensus on how the data need to be preprocessed and arranged to assure optimal classification accuracy outcomes. RESEARCH QUESTION Is there an optimal data aggregation and preprocessing workflow to optimize classification accuracy outcomes? METHODS Based on our previous work on automated classification of ground reaction force (GRF) data, a sequential setup was followed: firstly, several aggregation methods - early fusion and late fusion - were compared, and secondly, based on the best aggregation method identified, the expressiveness of different combinations of signal representations was investigated. The employed dataset included data from 910 subjects, with four gait disorder classes and one healthy control group. The machine learning pipeline comprised principle component analysis (PCA), z-standardization and a support vector machine (SVM). RESULTS The late fusion aggregation, i.e., utilizing majority voting on the classifier's predictions, performed best. In addition, the use of derived signal representations (relative changes and signal differences) seems to be advantageous as well. SIGNIFICANCE Our results indicate that great caution is needed when data preprocessing and aggregation methods are selected, as these can have an impact on classification accuracies. These results shall serve future studies as a guideline for the choice of data aggregation and preprocessing techniques to be employed.
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Affiliation(s)
- Djordje Slijepcevic
- St. Pölten University of Applied Sciences, Institute for Creative Media Technologies, St. Pölten, Austria.
| | - Matthias Zeppelzauer
- St. Pölten University of Applied Sciences, Institute for Creative Media Technologies, St. Pölten, Austria
| | - Caterine Schwab
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria
| | - Anna-Maria Raberger
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria
| | - Christian Breiteneder
- TU Wien, Institute of Visual Computing and Human-Centered Technology, Vienna, Austria
| | - Brian Horsak
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria
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Horsak B, Schwab C, Baca A, Greber-Platzer S, Kreissl A, Nehrer S, Keilani M, Crevenna R, Kranzl A, Wondrasch B. Effects of a lower extremity exercise program on gait biomechanics and clinical outcomes in children and adolescents with obesity: A randomized controlled trial. Gait Posture 2019; 70:122-129. [PMID: 30851623 DOI: 10.1016/j.gaitpost.2019.02.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Research highlights the detrimental effects of obesity on gait biomechanics and the accompanied risk of lower-extremity skeletal malalignments, increased joint stress, pain and discomfort. Individuals with obesity typically show increased knee valgus angles combined with an increased step width. Accompanying muscular dysfunctions impede their ability to compensate for these alterations, especially in the frontal plane. To date, no studies are available, which evaluated the potential effects of an exercise program (EP) in reducing these unfavorable biomechanical changes. RESEARCH QUESTIONS Is a 12-week EP, which includes hip abductor and knee extensor strength exercises and fosters dynamic knee alignment, effective in positively altering gait biomechanics in children and adolescents with obesity? METHODS This study was a randomized controlled trial having children and adolescents with obesity assigned to an EP (n = 19) or control (n = 16) group. Pain, self-rated knee function, muscle strength and 3D gait analysis during walking and stair climbing were evaluated. RESULTS Results indicate that the EP was able to increase muscular strength especially in the hip abductors. In addition, children from the EP group walked with less maximum hip adduction and reduced pelvic drop during weight acceptance at follow-up. No changes were present in self-rated knee function, pain or discomfort. SIGNIFICANCE Even though effects were small, results indicate that an EP is an effective short-term possibility to counteract the progressive development of biomechanical malalignments of the lower extremity. Clinical parameters indicated that the program was feasible. Nonetheless, low adherence highlights the need to develop more attractive programs. CLINICAL TRIALS REG. NO: clinicaltrials.gov (NCT02545764).
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Affiliation(s)
- B Horsak
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria.
| | - C Schwab
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria
| | - A Baca
- University of Vienna, Department of Biomechanics, Kinesiology and Computer Science in Sport, Vienna, Austria
| | - S Greber-Platzer
- Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Vienna, Austria
| | - A Kreissl
- Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Vienna, Austria
| | - S Nehrer
- Danube-University Krems, Center for Regenerative Medicine and Orthopedics, Krems, Austria
| | - M Keilani
- Medical University of Vienna, Department of Physical Medicine, Rehabilitation and Occupational Medicine, Vienna, Austria
| | - R Crevenna
- Medical University of Vienna, Department of Physical Medicine, Rehabilitation and Occupational Medicine, Vienna, Austria
| | - A Kranzl
- Orthopaedic Hospital Vienna-Speising, Laboratory of Gait and Movement Analysis, Vienna, Austria
| | - B Wondrasch
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria
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Wagner M, Slijepcevic D, Horsak B, Rind A, Zeppelzauer M, Aigner W. KAVAGait: Knowledge-Assisted Visual Analytics for Clinical Gait Analysis. IEEE Trans Vis Comput Graph 2019; 25:1528-1542. [PMID: 29993807 DOI: 10.1109/tvcg.2017.2785271] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In 2014, more than 10 million people in the US were affected by an ambulatory disability. Thus, gait rehabilitation is a crucial part of health care systems. The quantification of human locomotion enables clinicians to describe and analyze a patient's gait performance in detail and allows them to base clinical decisions on objective data. These assessments generate a vast amount of complex data which need to be interpreted in a short time period. We conducted a design study in cooperation with gait analysis experts to develop a novel Knowledge-Assisted Visual Analytics solution for clinical Gait analysis (KAVAGait). KAVAGait allows the clinician to store and inspect complex data derived during clinical gait analysis. The system incorporates innovative and interactive visual interface concepts, which were developed based on the needs of clinicians. Additionally, an explicit knowledge store (EKS) allows externalization and storage of implicit knowledge from clinicians. It makes this information available for others, supporting the process of data inspection and clinical decision making. We validated our system by conducting expert reviews, a user study, and a case study. Results suggest that KAVAGait is able to support a clinician during clinical practice by visualizing complex gait data and providing knowledge of other clinicians.
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Horsak B, Pobatschnig B, Schwab C, Baca A, Kranzl A, Kainz H. Reliability of joint kinematic calculations based on direct kinematic and inverse kinematic models in obese children. Gait Posture 2018; 66:201-207. [PMID: 30199779 DOI: 10.1016/j.gaitpost.2018.08.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND In recent years, the reliability of inverse (IK) and direct kinematic (DK) models in gait analysis have been assessed intensively, but mainly for lean populations. However, obesity is a growing issue. So far, the sparse results available for the reliability of clinical gait analysis in obese populations are limited to direct kinematic models. Reliability error-margins for inverse kinematic models in obese populations have not been reported yet. RESEARCH QUESTIONS Is there a difference in the reliability of IK models compared with a DK model in obese children? Are there any differences in the joint kinematic output between IK and DK models? METHODS A test-retest study was conducted using three-dimensional gait analysis data from two obese female and eight obese male participants from an earlier study. Data were analyzed using a DK model and two OpenSim-based IK models. Test-retest reliability was compared by calculating the Standard Error of Measurement (SEM) along with similar absolute reliability measures. A Friedman Test was used to assess whether there were any significant differences in the reliability between the models. Kinematic output of the models was compared by using Statistical Parametric Mapping (SPM). RESULTS No significant differences were found in the reliability between the DK and IK models. The SPM analysis indicated several significant differences between both IK models and the DK approach. Most of these differences were continuous offsets. SIGNIFICANCE Reliability values showed clinically acceptable error-margins and were comparable between all models. Therefore, our results support the careful use of IK models in overweight or obese populations, e.g. for musculoskeletal modelling studies. The inconsistent kinematic output can mainly be explained by different model conventions and anatomical segment coordinate frame definitions.
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Affiliation(s)
- B Horsak
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria.
| | - B Pobatschnig
- Orthopaedic Hospital Vienna-Speising, Laboratory of Gait and Movement Analysis, Vienna, Austria
| | - C Schwab
- St. Pölten University of Applied Sciences, Institute of Health Sciences, St. Pölten, Austria
| | - A Baca
- University of Vienna, Department of Biomechanics, Kinesiology and Applied Computer Science, Vienna, Austria
| | - A Kranzl
- Orthopaedic Hospital Vienna-Speising, Laboratory of Gait and Movement Analysis, Vienna, Austria
| | - H Kainz
- Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
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Horsak B, Wunsch R, Bernhart P, Gorgas AM, Bichler R, Lampel K. Trunk muscle activation levels during eight stabilization exercises used in the functional kinetics concept: A controlled laboratory study. J Back Musculoskelet Rehabil 2018; 30:497-508. [PMID: 28505963 DOI: 10.3233/bmr-140259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND To ensure accurate implementation of stabilization exercises in rehabilitation, physical therapists need to understand the muscle activation patterns of prescribed exercise. OBJECTIVE Compare muscle activity during eight trunk and lumbar spine stabilization exercises of the Functional Kinetics concept by Klein-Vogelbach. METHODS A controlled laboratory study with a single-group repeated-measures design was utilized to analyze surface electromyographic intensities of 14 female and 6 male young healthy participants performing eight exercises. Data were captured from the rectus abdominis, external/internal oblique and lumbar paraspinalis. The normalized muscle activation levels (maximum voluntary isometric contraction, MVIC) for three repetitions during each exercise and muscle were analyzed. RESULTS Side bridging (28 ± 20%MVIC) and advanced planking (29 ± 20%MVIC) reached the highest activity in the rectus abdominis. For external and internal oblique muscles, side bridging also showed the greatest activity of 99 ± 36%MVIC and 52 ± 25%MVIC, respectively. Apart from side bridging (52 ± 14%MVIC), the supine roll-out (31 ± 12%MVIC) and prone roll-out (31 ± 9%MVIC) showed the greatest activity for the paraspinalis. The advanced quadruped, seated back extension and flexion on chair/Swiss Ball, prone roll-out and advanced one-leg back bridging only yielded negligible muscle activities for the rectus abdominis (< 5%MVIC). CONCLUSION Based on the data obtained, recommendations for selective trunk muscle activation during eight stabilization exercises were established, which will guide physical therapists in the development of exercises tailored to the needs of their patients.
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Affiliation(s)
- Brian Horsak
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria.,Department of Physiotherapy, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Rüdiger Wunsch
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Philipp Bernhart
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Anna-Maria Gorgas
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria.,Department of Physiotherapy, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Romana Bichler
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria.,Department of Physiotherapy, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Kerstin Lampel
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria.,Department of Physiotherapy, St. Pölten University of Applied Sciences, St. Pölten, Austria
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Horsak B, Schwab C, Clemens C, Baca A, Greber-Platzer S, Kreissl A, Kranzl A. Is the reliability of 3D kinematics of young obese participants dependent on the hip joint center localization method used? Gait Posture 2018; 59:65-70. [PMID: 28992613 DOI: 10.1016/j.gaitpost.2017.09.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 09/15/2017] [Accepted: 09/22/2017] [Indexed: 02/02/2023]
Abstract
The aim of this study was to investigate if the test-retest reliability for three-dimensional (3D) gait kinematics in a young obese population is affected by using either a predictive (Davis) or a functional (SCoRE) hip joint center (HJC) localization approach. A secondary goal was to analyze how consistent both methods perform in estimating the HJC position. A convenience sample of ten participants, two females and eight males with an age-based body mass index (BMI) above the 97th percentile (mean±SD: 34.2±3.9kg/m2) was recruited. Participants underwent two 3D gait analysis sessions separated by a minimum of one day and a maximum of seven days. The standard error of measurement (SEM) and the root mean square error (RMSE) of key kinematic parameters along with the root mean square deviation (RMSD) of the entire waveforms were used to analyze the test-retest reliability. To get an estimate of the consistency of both HJC localization methods, the HJC positions determined by both methods were compared to each other. SEM, RMSE, and RMSD results indicate that the HJC position estimations between both methods are not different and demonstrate moderate to good reliability to estimate joint kinematics. With respect to the localization of the HJC, notable inconsistencies ranging from 0 to 5.4cm were observed. In conclusion, both approaches appear equally reliable. However, the inconsistent HJC estimation points out, that accuracy seems to be a big issue in these methods. Future research should attend to this matter.
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Affiliation(s)
- Brian Horsak
- St. Pölten University of Applied Sciences, Department of Physiotherapy, Austria.
| | - Caterine Schwab
- St. Pölten University of Applied Sciences, Department of Physiotherapy, Austria
| | - Christoph Clemens
- University of Vienna, Department of Biomechanics, Kinesiology and Applied Computer Science, Austria
| | - Arnold Baca
- University of Vienna, Department of Biomechanics, Kinesiology and Applied Computer Science, Austria
| | | | - Alexandra Kreissl
- Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Austria
| | - Andreas Kranzl
- Orthopaedic Hospital Vienna-Speising, Laboratory of Gait and Movement Analysis, Austria
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Slijepcevic D, Zeppelzauer M, Gorgas AM, Schwab C, Schuller M, Baca A, Breiteneder C, Horsak B. Automatic Classification of Functional Gait Disorders. IEEE J Biomed Health Inform 2017; 22:1653-1661. [PMID: 29990052 DOI: 10.1109/jbhi.2017.2785682] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This paper proposes a comprehensive investigation of the automatic classification of functional gait disorders (GDs) based solely on ground reaction force (GRF) measurements. The aim of this study is twofold: first, to investigate the suitability of the state-of-the-art GRF parameterization techniques (representations) for the discrimination of functional GDs; and second, to provide a first performance baseline for the automated classification of functional GDs for a large-scale dataset. The utilized database comprises GRF measurements from 279 patients with GDs and data from 161 healthy controls (N). Patients were manually classified into four classes with different functional impairments associated with the "hip", "knee", "ankle", and "calcaneus". Different parameterizations are investigated: GRF parameters, global principal component analysis (PCA) based representations, and a combined representation applying PCA on GRF parameters. The discriminative power of each parameterization for different classes is investigated by linear discriminant analysis. Based on this analysis, two classification experiments are pursued: distinction between healthy and impaired gait (N versus GD) and multiclass classification between healthy gait and all four GD classes. Experiments show promising results and reveal among others that several factors, such as imbalanced class cardinalities and varying numbers of measurement sessions per patient, have a strong impact on the classification accuracy and therefore need to be taken into account. The results represent a promising first step toward the automated classification of GDs and a first performance baseline for future developments in this direction.
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Horsak B, Pobatschnig B, Baca A, Greber-Platzer S, Kreissl A, Nehrer S, Wondrasch B, Crevenna R, Keilani M, Kranzl A. Within-assessor reliability and minimal detectable change of gait kinematics in a young obese demographic. Gait Posture 2017; 54:112-118. [PMID: 28288331 DOI: 10.1016/j.gaitpost.2017.02.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 02/15/2017] [Accepted: 02/28/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Three-dimensional gait analysis (3DGA) in obese populations is a difficult task due to a great amount of subcutaneous fat. This makes it more challenging to identify anatomical landmarks, thus leading to inconsistent marker placement. Therefore, the purpose of this study was to investigate the test-retest reliability for kinematic measurements of obese children and adolescents. METHODS Nine males and two females with an age-based BMI above the 97th percentile (age: 14.6±2.6years, BMI: 33.4±4.4kg/m2) were administered to two 3DGA sessions. To quantify reliability of discrete parameters the intraclass correlation coefficient (ICC2,k), standard error of measurement (SEM) and minimal detectable change (MDC) were calculated. To quantify waveform similarity, the coefficient of multiple correlation (CMC) and the linear fit method (LFM) were used. RESULTS From 28 kinematic parameters, 23 showed acceptable ICCs (≥0.70) and the remaining parameters demonstrated moderate values. These were peak hip extension during stance (0.58), mean pelvis rotation (0.60), mean anterior pelvic tilt (0.64), peak knee flexion during swing (0.67) and peak hip abduction during swing (0.69). The SEM was below 5° for all parameters. The MDC for the sagittal, frontal, and transversal plane were on average 7.5°±2.2, 4.6°±1.3 and 6.0°±0.9 respectively. Both the LFM and CMC showed, in general, moderate to good reliability except for pelvis tilt and hip rotation. CONCLUSION Data demonstrated acceptable error margins especially for the sagittal and frontal plane. Low reliability for the pelvis tilt indicates that great effort is necessary to position the pelvic markers consistently during repeated sessions.
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Affiliation(s)
- Brian Horsak
- St. Pölten University of Applied Sciences, Department of Physiotherapy, Austria.
| | - Barbara Pobatschnig
- Orthopedic Hospital Vienna-Speising, Laboratory of Gait and Movement Analysis, Austria
| | - Arnold Baca
- University of Vienna, Department of Biomechanics, Kinesiology and Applied Computer Science, Austria
| | | | - Alexandra Kreissl
- Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Austria
| | - Stefan Nehrer
- Danube University Krems, Centre for Regenerative Medicine and Orthopedics, Austria
| | - Barbara Wondrasch
- St. Pölten University of Applied Sciences, Department of Physiotherapy, Austria
| | - Richard Crevenna
- Medical University of Vienna, Department of Physical Medicine and Rehabilitation, Austria
| | - Mohammad Keilani
- Medical University of Vienna, Department of Physical Medicine and Rehabilitation, Austria
| | - Andreas Kranzl
- Orthopedic Hospital Vienna-Speising, Laboratory of Gait and Movement Analysis, Austria
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Horsak B, Kiener M, Pötzelsberger A, Siragy T. Serratus anterior and trapezius muscle activity during knee push-up plus and knee-plus exercises performed on a stable, an unstable surface and during sling-suspension. Phys Ther Sport 2017; 23:86-92. [DOI: 10.1016/j.ptsp.2016.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/14/2016] [Accepted: 08/04/2016] [Indexed: 11/17/2022]
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Horsak B, Artner D, Baca A, Pobatschnig B, Greber-Platzer S, Nehrer S, Wondrasch B. The effects of a strength and neuromuscular exercise programme for the lower extremity on knee load, pain and function in obese children and adolescents: study protocol for a randomised controlled trial. Trials 2015; 16:586. [PMID: 26700568 PMCID: PMC4690219 DOI: 10.1186/s13063-015-1091-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 11/27/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood obesity is one of the most critical and accelerating health challenges throughout the world. It is a major risk factor for developing varus/valgus misalignments of the knee joint. The combination of misalignment at the knee and excess body mass may result in increased joint stresses and damage to articular cartilage. A training programme, which aims at developing a more neutral alignment of the trunk and lower limbs during movement tasks may be able to reduce knee loading during locomotion. Despite the large number of guidelines for muscle strength training and neuromuscular exercises that exist, most are not specifically designed to target the obese children and adolescent demographic. Therefore, the aim of this study is to evaluate a training programme which combines strength and neuromuscular exercises specifically designed to the needs and limitations of obese children and adolescents and analyse the effects of the training programme from a biomechanical and clinical point of view. METHODS/DESIGN A single assessor-blinded, pre-test and post-test randomised controlled trial, with one control and one intervention group will be conducted with 48 boys and girls aged between 10 and 18 years. Intervention group participants will receive a 12-week neuromuscular and quadriceps/hip strength training programme. Three-dimensional (3D) gait analyses during level walking and stair climbing will be performed at baseline and follow-up sessions. The primary outcome parameters for this study will be the overall peak external frontal knee moment and impulse during walking. Secondary outcomes include the subscales of the Knee injury and Osteoarthritis Outcome Score (KOOS), frontal and sagittal kinematics and kinetics for the lower extremities during walking and stair climbing, ratings of change in knee-related well-being, pain and function and adherence to the training programme. In addition, the training programme will be evaulated from a clinical and health status perspective by including the following analyses: cardiopulmonary testing to quantify aerobic fitness effects, anthropometric measures, nutritional status and psychological status to characterise the study sample. DISCUSSION The findings will help to determine whether a neuromuscular and strength training exercise programme for the obese children population can reduce joint loading during locomotion, and thereby decrease the possible risk of developing degenerative joint diseases later in adulthood. TRIAL REGISTRATION ClinicalTrials NCT02545764 , Date of registration: 24 September 2015.
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Affiliation(s)
- Brian Horsak
- Department of Physiotherapy, St. Pölten University of Applied Sciences, St. Pölten, Austria.
| | - David Artner
- Department of Physiotherapy, St. Pölten University of Applied Sciences, St. Pölten, Austria.
| | - Arnold Baca
- Department of Biomechanics, Kinesiology and Applied Computer Science, University of Vienna, Vienna, Austria.
| | - Barbara Pobatschnig
- Department of Biomechanics, Kinesiology and Applied Computer Science, University of Vienna, Vienna, Austria.
| | - Susanne Greber-Platzer
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
| | - Stefan Nehrer
- Centre for Regenerative Medicine and Orthopaedics, Danube University Krems, Krems, Austria.
| | - Barbara Wondrasch
- Department of Physiotherapy, St. Pölten University of Applied Sciences, St. Pölten, Austria.
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Abstract
This study investigates the accuracy of the tracking system LPM (local position measurement). The goal was to determine detailed error values of the system in the context of sports performance analyses. Six moderately trained male soccer players (amateur level) performed 276 runs on three different courses at six different speeds. Additionally, ten small-sided game plays were carried out. All runs and game plays were recorded with the LPM tracking system and the motion capture system VICON simultaneously. VICON served as the reference system. The absolute error of all LPM position estimations was on average 23.4±20.7 cm. The estimation for average velocities varied between 0.01 km h(-1) and 0.23 km h(-1), the maximum speed estimations differed by up to 2.71 km h(-1). In addition, the results showed that the accuracy of the LPM system is highly dependent on the instantaneous dynamics of the player and decreases in the margins of the observation field. These dependencies were quantified. Considering commonly used applications of position tracking systems in sports (Leser, Ogris, & Baca, 2011), the accuracy of LPM is acceptable for position and velocity estimations. The system provides valuable results for average velocities but seems to be far less reliable when dealing with high dynamic movements and measuring instantaneous velocities.
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Affiliation(s)
- Georg Ogris
- Centre for Sport Science and University Sports, University of Vienna, Austria
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