Publication date: July 2017
Source:Gait & Posture, Volume 56
Author(s): Xiaofei Cheng, Kai Zhang, Xiaojiang Sun, Changqing Zhao, Hua Li, Jie Zhao
The objective was to analyze the compensatory effect of the pelvis and lower extremities on sagittal spinal malalignment in patients with pelvic incidence (PI) and lumbar lordosis (LL) mismatch. A series of parameters including PI, LL, PI-LL, thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), knee flexion angle (KFA), tibial obliquity angle (TOA), femoral obliquity angle (FOA), femur pelvis angle (FPA) and pelvic shift (PS) were measured. Patients with PI-LL mismatch were divided into pelvic retroversion group and pelvic retroposition group based on their PT and PS, and then the parameters were compared within the two groups and with the control group. All variables were significantly different when comparing the pelvic retroversion and retroposition group with the control group except for PI, FOA and PS in the pelvic retroversion group. The pelvic retroposition group had significantly greater value of PI-LL, PI, PT, KFA, FOA and PS and contribution ratio of FOA and PS, and smaller value of LL, TK and FPA and contribution ratio of PT, TOA and FPA compared with the pelvic retroversion group. Patients with lesser PI-LL mismatch rely more on hip extension to increase pelvic retroversion while those with greater PI-LL mismatch tend to add extra femoral obliquity. When compensating for larger PI-LL mismatch, the importance of hip extension is decreased and the effect of the knee and ankle joint becomes more important by providing greater femoral incline and relatively lesser ankle dorsiflexion respectively.
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Σάββατο 6 Μαΐου 2017
Reliable sagittal plane kinematic gait assessments are feasible using low-cost webcam technology
Publication date: July 2017
Source:Gait & Posture, Volume 56
Author(s): Robert J. Saner, Edward P. Washabaugh, Chandramouli Krishnan
Three-dimensional (3-D) motion capture systems are commonly used for gait analysis because they provide reliable and accurate measurements. However, the downside of this approach is that it is expensive and requires technical expertise; thus making it less feasible in the clinic. To address this limitation, we recently developed and validated (using a high-precision walking robot) a low-cost, two-dimensional (2-D) real-time motion tracking approach using a simple webcam and LabVIEW Vision Assistant. The purpose of this study was to establish the repeatability and minimal detectable change values of hip and knee sagittal plane gait kinematics recorded using this system. Twenty-one healthy subjects underwent two kinematic assessments while walking on a treadmill at a range of gait velocities. Intraclass correlation coefficients (ICC) and minimal detectable change (MDC) values were calculated for commonly used hip and knee kinematic parameters to demonstrate the reliability of the system. Additionally, Bland-Altman plots were generated to examine the agreement between the measurements recorded on two different days. The system demonstrated good to excellent reliability (ICC>0.75) for all the gait parameters tested on this study. The MDC values were typically low (<5°) for most of the parameters. The Bland-Altman plots indicated that there was no systematic error or bias in kinematic measurements and showed good agreement between measurements obtained on two different days. These results indicate that kinematic gait assessments using webcam technology can be reliably used for clinical and research purposes.
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Source:Gait & Posture, Volume 56
Author(s): Robert J. Saner, Edward P. Washabaugh, Chandramouli Krishnan
Three-dimensional (3-D) motion capture systems are commonly used for gait analysis because they provide reliable and accurate measurements. However, the downside of this approach is that it is expensive and requires technical expertise; thus making it less feasible in the clinic. To address this limitation, we recently developed and validated (using a high-precision walking robot) a low-cost, two-dimensional (2-D) real-time motion tracking approach using a simple webcam and LabVIEW Vision Assistant. The purpose of this study was to establish the repeatability and minimal detectable change values of hip and knee sagittal plane gait kinematics recorded using this system. Twenty-one healthy subjects underwent two kinematic assessments while walking on a treadmill at a range of gait velocities. Intraclass correlation coefficients (ICC) and minimal detectable change (MDC) values were calculated for commonly used hip and knee kinematic parameters to demonstrate the reliability of the system. Additionally, Bland-Altman plots were generated to examine the agreement between the measurements recorded on two different days. The system demonstrated good to excellent reliability (ICC>0.75) for all the gait parameters tested on this study. The MDC values were typically low (<5°) for most of the parameters. The Bland-Altman plots indicated that there was no systematic error or bias in kinematic measurements and showed good agreement between measurements obtained on two different days. These results indicate that kinematic gait assessments using webcam technology can be reliably used for clinical and research purposes.
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Interlimb transfer of motor skill learning during walking: No evidence for asymmetric transfer
Publication date: July 2017
Source:Gait & Posture, Volume 56
Author(s): Chandramouli Krishnan, Rajiv Ranganathan, Manik Tetarbe
Several studies have shown that learning a motor skill in one limb can transfer to the opposite limb—a phenomenon called as interlimb transfer. The transfer of motor skills between limbs, however, has shown to be asymmetric, where one side benefits to a greater extent than the other. While this phenomenon has been well-documented in the upper-extremity, evidence for interlimb transfer in the lower-extremity is limited and mixed. This study investigated the extent of interlimb transfer during walking, and tested whether this transfer was asymmetric using a foot trajectory-tracking paradigm that has been specifically used for gait rehabilitation. The paradigm involved learning a new gait pattern which required greater hip and knee flexion during the swing phase of the gait while walking on a treadmill. Twenty young adults were randomized into two equal groups, where one group (right-to-left: RL) practiced the task initially with the dominant right leg and the other group (left-to-right: LR) practiced the task initially with their non-dominant left leg. After training, both groups practiced the task with their opposite leg to test the transfer effects. The changes in tracking error on each leg were computed to quantify learning and transfer effects. The results indicated that practice with one leg improved the motor performance of the other leg; however, the amount of transfer was similar across groups, indicating that there was no asymmetry in transfer. This finding is contradictory to most upper-extremity studies (where asymmetric transfer has been reported) and points out that both differences in neural processes and types of tasks may mediate interlimb transfer.
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Source:Gait & Posture, Volume 56
Author(s): Chandramouli Krishnan, Rajiv Ranganathan, Manik Tetarbe
Several studies have shown that learning a motor skill in one limb can transfer to the opposite limb—a phenomenon called as interlimb transfer. The transfer of motor skills between limbs, however, has shown to be asymmetric, where one side benefits to a greater extent than the other. While this phenomenon has been well-documented in the upper-extremity, evidence for interlimb transfer in the lower-extremity is limited and mixed. This study investigated the extent of interlimb transfer during walking, and tested whether this transfer was asymmetric using a foot trajectory-tracking paradigm that has been specifically used for gait rehabilitation. The paradigm involved learning a new gait pattern which required greater hip and knee flexion during the swing phase of the gait while walking on a treadmill. Twenty young adults were randomized into two equal groups, where one group (right-to-left: RL) practiced the task initially with the dominant right leg and the other group (left-to-right: LR) practiced the task initially with their non-dominant left leg. After training, both groups practiced the task with their opposite leg to test the transfer effects. The changes in tracking error on each leg were computed to quantify learning and transfer effects. The results indicated that practice with one leg improved the motor performance of the other leg; however, the amount of transfer was similar across groups, indicating that there was no asymmetry in transfer. This finding is contradictory to most upper-extremity studies (where asymmetric transfer has been reported) and points out that both differences in neural processes and types of tasks may mediate interlimb transfer.
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Transition from shod to barefoot alters dynamic stability during running
Publication date: July 2017
Source:Gait & Posture, Volume 56
Author(s): Antonis Ekizos, Alessandro Santuz, Adamantios Arampatzis
IntroductionBarefoot running recently received increased attention, with controversial results regarding its effects on injury risk and performance. Numerous studies examined the kinetic and kinematic changes between the shod and the barefoot condition. Intrinsic parameters such as the local dynamic stability could provide new insight regarding neuromuscular control when immediately transitioning from one running condition to the other. We investigated the local dynamic stability during the change from shod to barefoot running. We further measured biomechanical parameters to examine the mechanisms governing this transition.MethodsTwenty habitually shod, young and healthy participants ran on a pressure plate-equipped treadmill and alternated between shod and barefoot running. We calculated the largest Lyapunov exponents as a measure of errors in the control of the movement. Biomechanical parameters were also collected.ResultsLocal dynamic stability decreased significantly (d=0.41; 2.1%) during barefoot running indicating worse control over the movement. We measured higher cadence (d=0.35; 2.2%) and total flight time (d=0.58; 19%), lower total contact time (d=0.58; −5%), total vertical displacement (d=0.39; −4%), and vertical impulse (d=1.32; 11%) over the two minutes when running barefoot. The strike index changed significantly (d=1.29; 237%) towards the front of the foot.ConclusionsImmediate transition from shod to the barefoot condition resulted in an increased instability and indicates a worst control over the movement. The increased instability was associated with biomechanical changes (i.e. foot strike patterns) of the participants in the barefoot condition. Possible reasons why this instability arises, might be traced in the stance phase and particularly in the push-off. The decreased stability might affect injury risk and performance.
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Source:Gait & Posture, Volume 56
Author(s): Antonis Ekizos, Alessandro Santuz, Adamantios Arampatzis
IntroductionBarefoot running recently received increased attention, with controversial results regarding its effects on injury risk and performance. Numerous studies examined the kinetic and kinematic changes between the shod and the barefoot condition. Intrinsic parameters such as the local dynamic stability could provide new insight regarding neuromuscular control when immediately transitioning from one running condition to the other. We investigated the local dynamic stability during the change from shod to barefoot running. We further measured biomechanical parameters to examine the mechanisms governing this transition.MethodsTwenty habitually shod, young and healthy participants ran on a pressure plate-equipped treadmill and alternated between shod and barefoot running. We calculated the largest Lyapunov exponents as a measure of errors in the control of the movement. Biomechanical parameters were also collected.ResultsLocal dynamic stability decreased significantly (d=0.41; 2.1%) during barefoot running indicating worse control over the movement. We measured higher cadence (d=0.35; 2.2%) and total flight time (d=0.58; 19%), lower total contact time (d=0.58; −5%), total vertical displacement (d=0.39; −4%), and vertical impulse (d=1.32; 11%) over the two minutes when running barefoot. The strike index changed significantly (d=1.29; 237%) towards the front of the foot.ConclusionsImmediate transition from shod to the barefoot condition resulted in an increased instability and indicates a worst control over the movement. The increased instability was associated with biomechanical changes (i.e. foot strike patterns) of the participants in the barefoot condition. Possible reasons why this instability arises, might be traced in the stance phase and particularly in the push-off. The decreased stability might affect injury risk and performance.
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Attentional load of walking in children aged 7–12 and in adults
Publication date: Available online 6 May 2017
Source:Gait & Posture
Author(s): Guillaume Chauvel, Estelle Palluel, Arthur Brandao, Guillaume Barbieri, Vincent Nougier, Isabelle Olivier
The amount of attentional resources necessary to walk in children, and how they evolve during childhood remains unclear. This study examined children's gait parameters in different dual-task conditions. 53 children, divided into two age groups (7-9 and 10-12 years old), and 18 adults walked on a mat in three different cognitive conditions: watching a video (video condition), listening its soundtrack (audio condition), and without any additional task (control condition). Questions were asked at the end of the video and audio conditions to make sure that participants were paying attention to the stimuli. A GAITRite® system was used for recording the gait data. Results showed an increase of velocity and step duration, and a decrease of cadence and percentage of double limb support duration from 7 years of age to adulthood during dual-task walking compared with single-task walking. This improvement seemed to be linear from 7 years to adults' age. The interference of dual-task on gait was larger for the video than for the auditory task and decreased with age. We concluded that walking requires a significant amount of attentional resources in children and that children rely more than adults on visual processes for walking.
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Source:Gait & Posture
Author(s): Guillaume Chauvel, Estelle Palluel, Arthur Brandao, Guillaume Barbieri, Vincent Nougier, Isabelle Olivier
The amount of attentional resources necessary to walk in children, and how they evolve during childhood remains unclear. This study examined children's gait parameters in different dual-task conditions. 53 children, divided into two age groups (7-9 and 10-12 years old), and 18 adults walked on a mat in three different cognitive conditions: watching a video (video condition), listening its soundtrack (audio condition), and without any additional task (control condition). Questions were asked at the end of the video and audio conditions to make sure that participants were paying attention to the stimuli. A GAITRite® system was used for recording the gait data. Results showed an increase of velocity and step duration, and a decrease of cadence and percentage of double limb support duration from 7 years of age to adulthood during dual-task walking compared with single-task walking. This improvement seemed to be linear from 7 years to adults' age. The interference of dual-task on gait was larger for the video than for the auditory task and decreased with age. We concluded that walking requires a significant amount of attentional resources in children and that children rely more than adults on visual processes for walking.
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Prediction of Intraoperative CSF Gusher and Postoperative Facial Nerve Stimulation in Patients With Cochleovestibular Malformations Undergoing Cochlear Implantation Surgery.
Objective: To determine parameters in computed tomography (CT) of the temporal bone that would be useful for prediction of cerebrospinal fluid (CSF) gusher during cochlear implantation (CI) surgery and postoperative facial nerve stimulation (FNS) in patients with inner ear malformations. Study Design: Retrospective study. Setting: Tertiary referral center. Patients: Three hundred seventy-five cases who had undergone CI surgery including 54 inner ear malformation cases were analyzed. Main Outcome Measures: The diameters of the cochlea modiolar base and porus of the internal auditory canal (IAC), length of IAC, diameter of the vestibular aqueduct (VA) at the operculum, and presence or absence of the modiolus of the cochlea were evaluated by using CT. Results: CSF gusher occurred in 12 (22%) cases, in whom the diameters of the cochlea modiolar base (2.7 +/- 0.6 mm, p
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Παρασκευή 5 Μαΐου 2017
Improving the Efficiency of Speech-In-Noise Hearing Screening Tests.
Objective: Speech-in-noise hearing screening tests have become increasingly popular. These tests follow an adaptive procedure with a fixed number of presentations to estimate the speech reception threshold. The speech reception threshold is compared with an established cutoff signal to noise ratio (SNR) for a pass result or refer result. A fixed SNR procedure was developed to improve the efficiency of speech-in-noise hearing screening tests. Design: The cutoff SNR is used for all presentations in the fixed-SNR procedure. After each response a reliable test result is given (pass/refer) or an extra stimulus is presented. The efficiency and pass/refer rates between the adaptive procedure and the fixed-SNR procedure were compared. Results: An average reduction of 67% in the number of presentations can be achieved (from 25 to an average of 8.3 presentations per test). Conclusions: The fixed-SNR procedure is superior in efficiency to the adaptive procedure while having nearly equal refer and pass rates. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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