Search Results (184)

Gait analysis is a valuable tool for a wide range of clinical applications. Until now, the standard for gait analysis has been marker-based 3D optical systems. Recently, markerless gait analysis systems that utilize pose estimation models based on Convolutional Neural Networks (CNNs) and computer vision have gained importance. In this pilot study, we validated the performance of a CNN-based, markerless pose estimation algorithm (Orthelligent^® VISION; OV) compared to a standard marker-based 3D motion capture system in 16 healthy adults. Standard gait metrics were analyzed by calculating concordance correlation coefficients (CCCs) and coefficients of variation. With regard to gait event detection, we found good overlaps for both systems. Compared to the marker-based motion analysis, OV achieved a strong to almost complete concordance regarding the sagittal measurement of cadence, gait variability, step time, stance time, step length, and double support (CCC ≥ 0.624), as well as regarding the frontal plane parameters of cadence, step time, stance time, and step width (CCC ≥ 0.805). For gait symmetry only, we found a moderate to weak correlation. These results support the CNN-based, markerless gait analysis system OV as an alternative to marker-based 3D motion capture systems for a broad variety of clinical applications. Full article

Background/Objective: The gait pattern of children born very preterm shows gait decrements compared to their full-term peers in dual-task walking. It is essential to identify children at a higher risk for these gait deficits. The aim of this study was to compare spatiotemporal gait variables in preschool-age children born very preterm at risk for developmental coordination disorder (DCD) with those not at risk. Methods: Preschool-age children born < 30 weeks’ gestation. Risk for DCD was defined as (i) ≤16th percentile on the Movement Assessment Battery for Children—Second Edition, (ii) ≥80 on the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition, and (iii) without cerebral palsy. Spatiotemporal gait variables and variability were assessed using GAITRite^® during preferred speed, cognitive and motor dual-task, and tandem conditions. Variables included speed (cm/s), step time (s), cadence (steps/min), step length (cm), base of support (BOS; cm), and single and double support time (%gait cycle). Results: Of 111 children who were assessed, 26 children were classified as at risk for DCD. Most gait variables were similar between groups at preferred speed walking. Children at risk for DCD had wider BOS and shorter single support time in motor dual-tasking (mean difference [MD] = 0.86 cm, 95% confidence interval [CI] 0.10, 1.61; MD = −1.77%, 95% CI −3.36, −0.19) compared to those not at risk. Similarly, wider BOS and higher cadence were found when tandem walking (MD = 0.63 cm, 95% CI 0.07, 1.20; MD = 0.63 steps/min, 95% CI 0.07, 1.20). Conclusions: Children born very preterm at risk for DCD had poorer walking performance than those not at risk for DCD at preschool age, especially during dual-task situations. Clinicians may incorporate complex gait assessments into early evaluations to detect subtle impairments in children. Future research is needed to investigate the impact of gait variability on children’s daily lives and participation in sports activities. Full article

Gait analysis plays a crucial role in assessing and monitoring the progress of individuals undergoing rehabilitation. This preliminary validation study aims to compare the performance of a new wearable system, NeuroSkin^®, equipped with embedded sensors (inertial measurement unit and pressure sensors), with the non-wearable gold standard, GAITRite^®, in assessing spatio-temporal parameters during gait. Data was collected from nine healthy participants wearing the NeuroSkin while walking on the GAITRite walkway. Temporal parameters were calculated using the pressure sensors of the NeuroSkin^® to detect heel strike (HS) and toe off (TO) on both sides. Distances were calculated using vertical hip acceleration with an inverted pendulum method. We found that the level of agreement between NeuroSkin^® and GAITRite^® measures was excellent for speed, cadence, as well as length and duration of stride and step (lower bound of intraclass correlation coefficients (ICCs) > 0.95), and moderate to excellent for stance and swing durations (ICC > 0.5). These levels of agreement are comparable to the known test–retest reliability of GAITRite^® measures. These results demonstrate the potential of NeuroSkin^® as an embedded gait assessment system for healthy subjects. As this study was conducted exclusively in healthy adults, the results are not directly generalizable to clinical populations. Thus, future studies are needed to investigate its use in patients. Full article

Background: The aim of this study was to validate the accuracy of the spatiotemporal parameters of running provided by the Garmin HRM-Pro band through a concurrent comparison with the OptoGait system (version v.1.14.11), the Stryd power meter, and 2D photogrammetric analysis in recreational runners at different paces (9 and 12 km/h). Methods: Fifty recreational runners (mean age: 22.14 ± 2.71 years) engaged in this study. Participants ran on a treadmill for 2 min at speeds of 9 and 12 km/h. Spatiotemporal parameters (ground contact time, step length, flight time, cadence, and vertical oscillation of center of gravity) were recorded using (1) the Garmin HRM-Pro band; (2) the OptoGait system; (3) the Stryd power meter; and (4) 2D photogrammetric analysis. Results: Only in relation to the VO of the center of gravity does the Garmin device yield higher values (p = 0.006) compared to video analysis. At 12 km/h, significant differences were found between devices in all the analyzed variables. In comparison to video analysis, the Garmin device does not show significant differences in any variable at this speed. The relative reliability parameters of the Garmin device at two different speeds showed excellent values across all analyzed variables. The Bland–Altman plots showed appropriate limits of agreement indicating good agreement between devices. Conclusions: The Garmin HRM-Pro Band can be used for the assessment of spatiotemporal variables of running in sports science, clinical gait assessment, and training optimization. Full article

The ageing of the global population, especially in developed countries, is driving significant societal changes. In Portugal, demographic data reflect a marked increase in the ageing index. Understanding gait alterations associated with ageing is essential for the early detection of mobility decline and fall risk. This study aimed to analyse gait patterns in older adults to contribute to a biomechanical ageing profile. Thirty-six community-dwelling older adults (29 female, 7 male; mean age: 74 years) participated. Gait data were collected using the Xsens full-body motion capture system, which combines inertial sensors with biomechanical modelling and sensor fusion. Spatiotemporal and kinematic parameters were analysed using descriptive statistics. Compared to younger adult norms, participants showed increased stance and double support phases, reduced swing phase, and lower gait speed, stride length, and cadence, with greater step width. Kinematic data showed reduced peak plantar flexion, knee flexion, and hip extension, but increased dorsiflexion peaks—adaptations aimed at stability. Despite a limited sample size and lack of clinical subgroups, results align with age-related gait literature. Findings support the utility of wearable systems like Xsens in capturing clinically relevant gait changes, contributing to normative biomechanical profiling and future mobility interventions. Full article

Background and Objectives: Knee Osteoarthritis affects about 10% of people over 50, causing pain and functional limitation. Hyaluronic acid (HA) is crucial in regulating the osteocartilaginous matrix. Patients are usually assessed using clinical scores to examine symptoms and quality of life, and in this context, gait analysis could provide an objective assessment of walking patterns to identify any deficits. This systematic review investigates the short and long-term effects of intra-articular HA injections on gait kinematics, pain and activities of daily living (ADL), investigating the correlation between outcomes. Materials and Methods: The review followed PRISMA guidelines. The PICO model included patients with radiographic knee osteoarthritis who received intra-articular HA injections, comparing them to healthy controls or those receiving corticosteroids or placebo. Outcomes included gait kinetics and functional scales at baseline and during follow-ups. Results: From 342 identified articles, 13 were included, comprising a total of 321 patients. The gait analysis utilized optoelectronic systems, inertial sensors, and electromyographic sensors pre- and post-HA treatment. Clinical parameters were assessed using the Visual Analogue Scale, WOMAC OA, Knee Society Score, Lequesne Score, and SF-36. The data showed significant improvement in speed (p = 0.001) and step cadence (p < 0.005) 30 days post-treatment and improvements in knee adduction moment (p < 0.001) and sagittal ground reaction force vectors (p < 0.01) up to six months post-treatment. Pain reduction and improvements in VAS (p < 0.001) and Lequesne score (p < 0.001) were observed in short-term follow-ups. Conclusions: Our study suggests an improvement in pain and knee function after hyaluronic acid injection. Moreover, gait analysis is an important tool for objectively assessing deficits and developing personalized rehabilitation programs. Furthermore, combining infiltrative treatment with rehabilitation could extend the effects of hyaluronic acid and improve results. Full article

Background: Gait impairments are common in individuals with knee osteoarthritis awaiting total knee arthroplasty, affecting their mobility and quality of life. This study aimed to assess and compare biomechanical gait features between individuals awaiting total knee arthroplasty and healthy, non-arthritic controls, focusing on less-explored variables using sensor-based measurements. Methods: A cross-sectional observational study was conducted with 60 participants: 21 individuals awaiting total knee arthroplasty and 39 nonarthritic controls aged 64–85 years. Participants completed a standardized 14 m walk, and 17 biomechanical gait parameters were measured using the BTS G-Walk inertial sensor. Key variables, such as stride duration, cadence, symmetry indices, and pelvic angles, were analyzed for group differences. Results: The pre-total knee arthroplasty group exhibited significantly longer gait cycles and stride durations (p < 0.001), reduced cadence (p < 0.001), and lower gait cycle symmetry index (p < 0.001) than the control group. The pelvic angle symmetry indices for tilt (p = 0.014), rotation (p = 0.002), and obliquity (p < 0.001) were also lower. Additionally, the pre-total knee arthroplasty group had lower propulsion indices for both legs (p < 0.001) and a lower walking quality index on the right leg (p = 0.005). The number of elaborated steps was significantly greater in the pre-total knee arthroplasty group (left, p < 0.001, right: p < 0.001). No significant differences were observed in any other gait parameters. Conclusions: This study revealed significant gait impairment in individuals awaiting total knee arthroplasty. Although direct evidence for prehabilitation is lacking, future research should explore whether targeted approaches, such as strengthening exercises or gait retraining, can improve gait and functional outcomes before surgery. Full article

The high-precision and long-duration photometry provided by the $Kepler$ mission has greatly advanced frequency analyses of a large number of pulsating stars, a fundamental step in asteroseismology. For $\delta$ Scuti stars, analyses are typically confined to frequencies below the Nyquist frequency. However, signals above this limit can be reflected into the sub-Nyquist range, especially in long-cadence data, where they may overlap with genuine pulsation modes and lead to misinterpretation. To address this issue, a recently proposed method—the sliding Lomb–Scargle periodogram (sLSP)—can effectively distinguish real frequencies from aliased ones. In this study, we compiled a sample of 68 $\delta$ Scuti stars whose frequency analyses were based on the $Kepler$ photometry. Using the sLSP method, we systematically examined the 1406 reported frequencies in the literature. As a result, we identified six previously unrecognized reflected super-Nyquist frequencies in four stars: KIC 3440495, KIC 5709664, KIC 7368103, and KIC 9204718. We have once again demonstrated the ability of the sLSP method to detect and correct such artifacts. This technique improves the reliability of frequency selection, thereby enhancing the accuracy of asteroseismic interpretation and stellar modeling for pulsating stars. Full article

Diabetic foot ulcers (DFUs) are a serious complication of diabetes, associated with high recurrence and amputation rates. Adherence to offloading devices is critical for wound healing but remains inadequately monitored in real-world settings. This study evaluates the SmartBoot edge-computing system—a wearable, real-time remote monitoring solution integrating an inertial measurement unit (Sensoria Core) and smartwatch—for its validity in quantifying cadence and step count as digital biomarkers of frailty, and for detecting adherence. Twelve healthy adults wore two types of removable offloading boots (Össur and Foot Defender) during walking tasks at varied speeds; system outputs were validated against a gold-standard wearable and compared with staff-recorded adherence logs. Additionally, user experience was assessed using the Technology Acceptance Model (TAM) in healthy participants (n = 12) and patients with DFU (n = 81). The SmartBoot demonstrated high accuracy in cadence and step count across conditions (bias < 5.5%), with an adherence detection accuracy of 96% (Össur) and 97% (Foot Defender). TAM results indicated strong user acceptance and perceived ease of use across both cohorts. These findings support the SmartBoot system’s potential as a valid, scalable solution for real-time remote monitoring of adherence and mobility in DFU management. Further clinical validation in ongoing studies involving DFU patients is underway. Full article

Background/Objectives: Gait abnormalities in advanced knee osteoarthritis (KOA) are characterized by decreased stride length, walking speed, and cadence. Total knee arthroplasty (TKA) is intended to improve temporal–spatial gait parameters; however, the extent and timing of functional recovery remain under investigation. To assess changes in stride length, walking speed, and cadence following TKA in short- and long-term perspectives, and to compare outcomes with a non-operated KOA cohort. Methods: A prospective observational study was conducted involving 46 patients with unilateral KOA (grades III–IV, Kellgren–Lawrence scale) who underwent cemented TKA via a medial parapatellar approach. Group I (n = 34) was assessed one day prior to surgery and six weeks postoperatively. Group II (n = 12), a follow-up subset, was reassessed 1.5 years postoperatively. Group III (n = 34) served as a non-operated control group, assessed only preoperatively. Temporal–spatial gait parameters were evaluated under standardized conditions using a two-dimensional video analysis (Kinovea^® software version 0.8.27). Stride length (m) and walking speed (m/s) were assessed during continuous walking along a 15 m corridor, with at least three valid gait cycles averaged per trial. Cadence (steps/min) was determined during a one-minute walk and verified frame-by-frame. No structured outpatient physiotherapy was provided; all patients followed a standardized in-hospital rehabilitation protocol. Results: In Group I, the mean stride length increased from 0.40 ± 0.10 m to 0.42 ± 0.10 m (p = 0.247), walking speed improved from 0.41 ± 0.027 m/s to 0.47 ± 0.022 m/s (p = 0.063), and cadence increased significantly from 72.9 ± 7.8 to 77.1 ± 8.6 steps/min (p = 0.044). In Group II, the mean stride length rose from 0.39 ± 0.10 m to 0.52 ± 0.09 m (p < 0.001), walking speed improved from 0.44 ± 0.02 m/s to 0.69 ± 0.01 m/s (p < 0.001), and cadence increased from 73.7 ± 8.8 to 103.6 ± 7.4 steps/min (p < 0.001). Compared to the control group (Group III: stride length 0.42 ± 0.09 m; walking speed 0.41 ± 0.02 m/s; cadence 73.9 ± 7.9 steps/min), Group II demonstrated superior values across all parameters (p < 0.001 for each comparison). No significant correlations were observed between BMI and gait outcomes. Conclusions: Total knee arthroplasty resulted in progressive improvement in temporal–spatial gait parameters. While early postoperative gains were limited, substantial functional restoration was observed at long-term follow-up, emphasizing the importance of extended recovery monitoring in post-TKA evaluation. Full article

Background: Advanced sensor insoles and motion capture technology can significantly enhance the monitoring of rehabilitation progress for patients with distal tibial fractures. This study leverages the potential of these innovative tools to provide a more comprehensive assessment of a patient’s gait and weight-bearing capacity following surgical intervention, thereby offering the possibility of improved patient outcomes. Methods: A patient who underwent distal medial tibial plating surgery in August 2023 and subsequently required revision surgery due to implant failure, involving plate removal and the insertion of an intramedullary nail in December 2023, was meticulously monitored over a 12-week period. Initial assessments in November 2023 revealed pain upon full weight-bearing without crutches. Following the revision, precise weekly measurements were taken, starting two days after surgery, which instilled confidence in accurately tracking the patient’s progress from initial crutch-assisted walking to full recovery. The monitoring tools included insoles, hand pads for force absorption of the crutches, and a motion capture system. The patient was accompanied throughout all steps of his daily life. Objectives: The study aimed to evaluate the hypothesis that the approximation and formation of a healthy gait curve are decisive tools for monitoring healing. Specifically, it investigated whether cadence, imbalance factors, and ground reaction forces could be significant indicators of healing status and potential disorders. Results: The gait parameters, cadence, factor of imbalance ground reaction forces, and the temporal progression of kinematic parameters significantly correlate with the patient’s recovery trajectory. These metrics enable the early identification of deviations from expected healing patterns, facilitating timely interventions and underscoring the transformative potential of these technologies in patient care. Conclusions: Integrating sensor insoles and motion capture technology offers a promising approach for monitoring the recovery process in patients with distal tibial fractures. This method provides valuable insights into the patient’s healing status, potentially predicting and addressing healing disorders more effectively. Future studies are recommended to validate these findings in a larger cohort and explore the potential integration of these technologies into clinical practice. Full article

Introduction: Walking is perceived as the most important bodily function for persons with multiple sclerosis (pwMS) and is impaired in more than 70% of pwMS. In addition, the effect of multiple sclerosis (MS) on gait pattern increases in fast walking and during fatiguing exercises, altering the spatiotemporal gait parameters and walking reserve. Objectives: The objective of this study is to investigate the impact of a 12 min intermittent-walking protocol on spatiotemporal gait parameters and on the fatigability of pwMS, as well as the association with perceived exertion and reported symptoms of fatigue. Methods: Twenty-six persons with relapse-remitting MS and twenty-eight healthy controls (HCs) were included in this cross-sectional study. The Modified Fatigue Impact Scale and the Symbol Digit Modality Test were used to evaluate fatigue symptoms and cognitive function, respectively. Participants walked six times during an uninterrupted 2-min period. Before, during the rest periods and after the last 2 min walk, the rate of perceived exertion (RPE) was measured using the Borg Scale, and the spatiotemporal gait parameters were assessed with GaitRite. The cut-off value of 10% deceleration of the distance walked index classified pwMS into two groups: MS Fatigable (MS-F) and MS Non-Fatigable (MS-NF). One-way and two-way Analyses of variance (ANOVAs) were used to verify the effect of time and groups, respectively. Results: PwMS walked slower, travelled shorter distances, and presented shorter step lengths compared to HCs. No effects of the intermittent-walking protocol were found for all pwMS, but the MS-F group had deteriorated walking speed, step length, and cadence. Walking dysfunction was associated with perceived fatigability, reported symptoms of fatigue, cognitive function, and disability. Reported symptoms of fatigue was associated with perceived exertion but not with performance fatigability. Conclusions: Changes in gait parameters were weak to moderately associated with performance fatigability and the perception of effort and disability but not with reported fatigue symptoms, highlighting distinct constructs. The walking speed reserve and step length reserve also emerged as potential early markers of performance decline. Full article

Forestry is recognized as one of the most physically demanding professions. Walking in presents unique biomechanical challenges due to complex, irregular terrain, with several possible risks. This study investigated how human gait adapts across solid surfaces, forest trails, and natural forest environments. Fifteen healthy adult participants (average age 38.3; ten males and five females) completed 150 walking trials, with full-body motion captured via a 17 Inertial Measurement Unit (IMU) sensors (Xsens MVN Awinda system). The analysis focused on spatial and temporal gait parameters, including cadence, step length, foot strike pattern, and center of mass variability. Statistical methods (ANOVA and Kruskal–Wallis) revealed that surface type significantly influenced gait mechanics. On forest terrain, participants exhibited wider steps, reduced cadence, increased step and stride variability, and a substantial shift from heel-to-toe strikes. Gait adaptations reflect compensatory neuromuscular strategies to maintain body balance. The findings confirm that forestry terrain complexity compromises human gait stability and increases physical demands, supporting step variability and slip, trip, and fall risk. By identifying key biomechanical markers of instability, this study contributes to understanding human locomotion principles. Understanding these changes can help design safety measures for outdoor professions, particularly forestry. Full article

Background and Objective: Fatigue represents a hallmark symptom in Multiple Sclerosis (MS), but its diagnosis and clinical evaluation is difficult because it is described as a subjective feeling of exhausted physical and mental sensation. Studies have also shown that approaches based on assisted therapies and robotics, as well as the use of vibration, which are used to improve sensory integration, reduce fatigue. The primary outcome in this study is to evaluate the effects of the application of focal vibrations on the reduction in fatigue, muscle strength, and endurance in MS patients with moderate disability. The secondary outcome is to assess the effects on quality of life, cognitive status, and mood. Methods: We enrolled 40 MS patients. The study was designed as a parallel randomized controlled trial: 20 patients were assigned to the experimental group (EG), who received vibration training, and 20 to the control group (CG), who received traditional physical exercise. Results: We found significant differences in the EG in fatigue, motor, and cognitive outcome and improvement of some aspects of quality of life (QoL). There are correlations between perceived multidimensional fatigue and cadence, step length, and health quality of life composite. Conclusions: Our study demonstrated the potential effectiveness of vibration training in balance, walking endurance, and reduction in the risk of falls in patients with Multiple Sclerosis. In addition, we added evidence about fatigue, non-motor outcomes, in particular promoting mental and physical QoL and individual life satisfaction. The name of the registry is clinicaltrial.gov; the number of registration id NCT05783999; and the date of registration is 14 March 2023. Full article

Fatigability, a phenotype of poor energy regulation, is associated with lower physical activity in older adults, but independent associations with sedentary behavior are unknown. We examined whether sedentary behavior was associated with fatigability using cross-sectional data from the Study of Muscle, Mobility and Aging. Mean sedentary time, sedentary bout length, and sedentary breaks/day were measured using 7-day waking hour data collected from a thigh-worn accelerometer. Fatigability was assessed using the Pittsburgh Fatigability Scale Physical subscale (PFS, score 0–50, higher = greater fatigability) and the Pittsburgh Performance Fatigability Index (PPFI), a percentage decline of observed cadence to maximal cadence from a wrist-worn accelerometer captured during a usual-paced 400 m walk (range 0–100%, higher = more performance deterioration). The participants (N = 663; 76.4 ± 5.1 years, 58% women, 54% high PFS, median PPFI 1.4%) were sedentary for 614.8 ± 111.7 min/day, with a mean 15.0 ± 5.5 min/day bout length and mean 46.1 ± 13.2 sedentary breaks/day. Higher total sedentary time was associated with greater PFS Physical score (β = 0.71, p = 0.0368), but this association was not independent of step count/day. After adjusting for step count/day, higher sedentary time was associated with lower PPFI score (β = −0.44, p = 0.0039). Sedentary bout length and breaks/day were not associated with perceived or performance fatigability. Future studies should aim to better understand the inter-relatedness of these behaviors. Full article