Gait and Balance Research Papers (original) (raw)

Background: Cognitive-motor interference, as measured by dual-task walking (performing a mental task while walking), affects many clinical populations. Ankle-foot orthoses (AFOs) are lower-leg splints prescribed to provide stability to the foot and ankle, as well as prevent foot drop, a gait deficit common after stroke. AFO use has been shown to improve gait parameters such as speed and step time, which are often negatively impacted by dual-task walking. Objectives: Our objective was to establish whether AFOs could protect against cognitive-motor interference, as measured by dual-task walking, following post-stroke hemiplegia. Methods: A total of 21 individuals with post-stroke hemiplegia that use an AFO completed a dual-task walking paradigm in the form of a 2 (walking with vs. without a concurrent cognitive task) by 2 (walking with vs. without an AFO) repeated-measures design. Changes to both motor and cognitive performance were analyzed. Results: The results suggest that the use of an AFO improves gait overall in both single-and dual-task walking, particularly with respect to stride regularity, but there were no interactions to suggest that AFOs reduce the cognitive-motor dual-task costs themselves. A lack of differences in cognitive performance during dual-task walking with and without the AFO suggests that the AFO's benefit to motor performance cannot be attributed to task prioritization. Conclusions: These data support the use of AFOs to improve certain gait parameters for post-stroke hemiplegia, but AFOs do not appear to protect against cognitive-motor interference during dual-task walking. Future research should pursue alternate therapeutics for ameliorating task-specific declines under cognitively demanding circumstances.

- by and +2
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- Cognitive Interference, Gait and Balance, Stroke, Hemiplegia

In this study, we experimentally investigated the effect of shoes on gait with new elastomer-embedded flexible joint (EEFJ). We designed the EEFJ to support plantar flexion moments on ankle joints. A strength test was conducted for the EEFJ. According to the results of the test, moments in plantar flexion were significantly stronger than those in dorsiflexion. We prototyped gait support shoes with the EEFJ. The weight of the EEFJ unit for a single foot was 32.5 g. We also conducted gait experiment on a healthy subject with and without the shoes. The results showed reductions in electromyograms of the tibialis anterior muscle in the initial phases of gait.

- by IJIRAE - International Journal of Innovative Research in Advanced Engineering and +1
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- Gait Biomechanics, Carmen Martin Gaite, Elastomers, Shoes
- by Giuseppe Franco Ferrari
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- Neurosurgery, Human Gait Analysis, Gait and Balance, Gait

Clubfoot is a congenital anomaly of a foot involving soft tissue that results in mal-alignment of bony structures. The deformity seen in clubfoot is C.A.V.E i.e cavus of the midfoot, adduction of the forefoot, varus
of midfoot and equinous of the hindfoot. If left untreated, it leads to long term disability and low self-esteem on the patient. Ponseti method of treatment involves serial manipulations and castings. of the affected feet. this may require tenotomy of the Achilles tendon. the desired outcome is a foot that should allow a child to wear shoes and be able to fit into the community, without having low self-esteem. However, not all patients presenting with clubfoot will get corrected due to many factors, among then being compliance of the caregiver's inconsistent use of abduction shoe braces. Hence soe patients present with relapse of clubfoot, requiring surgical intervention. My research will look at the early outcomes of posteromedial release in patients failing the ponseti method of correction.

Global increase in elderly population and associated health care requires an economic planning and preventive care strategies in geriatric rehabilitation provided with cases like Parkinson's disease, Stroke etc. Increased life expectancy with systemic ailments involved and problems with ageing need a revisit by geriatric healthcare professionals. Aims and objectives of this study where to analyze a nine year follow up (2010-2019) on a subject with dyskinesia, (Parkinson's disease) were falls, its causes and impact evaluated with clinical and functional outcome with specific physiotherapy measures. Materials and Methods of this research where the subject continued his prescribed medication and his daily routine. For the initial 5 years period the subject was attending the centre and later domiciliary physiotherapy was given since the last two years with a frequency of 30-35 minutes of each session the nature of exercises were balance training, Proprioceptive exercises, core strengthening, irradiation techniques and incentive Spirometry. Results: The prognosis of the case was analyzed with Falls Efficacy scale and Barthel Index and the result was a negative prognosis with an increased falls, dependency for ADL was recorded. Conclusion: The falls prevention, promoting physical activities, custom based regular specific physiotherapy among geriatric subjects should be major component of elderly care as findings of the study points out, as nature PD is progressive along with ageing.

- by Annie Thomas
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- Physical Therapy, Gait and Balance, Gait and Posture, Parkinsonism

— in this study the best position of a double-strap backpack which is popular among college students against spine in comparison with two other kinds of packs which can be used by college students are investigated during static standing and walking on force plate. The Amount of Changing in forward COM due to backpack carriage is the base reference of this study to compare different conditions. There are lots of studies about the weight of backpack and its effect on spinal curvature. The purpose of this study was to find the Best position of backpack against spine via test 1 and differences between three different types of packs which can be used by college students via test 2. Twenty uninjured college students (mean age = 23) were instructed to stand on force plate then walk along the laboratory room and pass the force plate respectively. Another time they repeated the same job with backpacks (10% body weight) which are used for two different tests. These tests continued until the desired vertical ground reaction force curve was appeared. All data were measured from force plate at different time points. Results show that minimum change in COM appears when subjects wear double-strap in case which backpack is placed at the middle against spine. According to the second test it is not possible to exactly choose a kind of backpack that can be offered to all college students as a best one and it may depend on students' anatomical properties.

- by Mehrdad Javidi
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- Spine Biomechanics, Low back pain, Human Gait Analysis, Gait and Balance
- by GÜLDEN Polat
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- Gait and Balance, Holography, Wrist-Hand, Balance
- by saroja rai
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- Human Gait Analysis, Gait and Balance, Clinical Gait Analysis
- by Jean-Michel Albaret
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- Evidence Based Practice, Aging, Gait and Balance, Psychomotor Therapy

Injurious motion and/or ambient pressure changes to the head are caused by vehicle-related accelerations, impacts, and vibrations, as well as explosions, barotraumas, and job-related or recreational falls or head injuries. Such injuries occur during land, sea, and air operations. Precipitous changes in head velocity or ambient pressure cause concussion, traumatic brain injury (TBI), whiplash, and/or vestibulocochlear injury. Associated signs and symptoms
include fatigue, headache, dizziness, vertigo, imbalance, disorientation, poor gaze control, and cognitive effects. This paper considers the vestibular implications of head injury. The vestibular system controls balance and gaze – functions which are critical to human sensorimotor activity and most military missions. The vestibulocochlear end organ is exquisitely sensitive to sudden changes in velocity or pressure, a fact underscored by a recent study which found evidence of vestibular pathology in most of the mild TBI (MTBI) cases suffered by a sample of military personnel
who had served in Operation Iraqi Freedom (OIF). This paper reviews the evidence for a relation between head acceleration/pressure and vestibular injury/dysfunction and argues that assessment of vestibular function is important following exposure to such insults. This paper briefly describes the rationale for a few candidate vestibular tests which would augment existing evaluations and aid return-to-duty decisions following head injury. The tests that are introduced include dynamic posturography, dynamic visual acuity, subjective visual vertical, and vestibular evoked myogenic reflex function. Tests such as these are recommended for mild TBI patients who have been exposed to
improvised explosive devices (IEDs). Additionally, better balance rehabilitation tools are recommended. This paper briefly describes the rationale for a biofeedback device which provides tactile sway feedback to augment physical therapy (PT). The prototype will be developed and tested to determine if it fosters more rapid or complete recovery of balance following TBI.

- by Ben Lawson
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- Gait and Balance, Brain injury, VESTIBULAR, Concussion

Background: Balance efficacy starts declining from middle age. Information on the relationship between specific sub-components of balance and gait stability in a middle-aged group is crucial to implement effective preventive measures of falls in the elderly. Methods: Healthy volunteers (n=50) between 45 to 65 years of both genders underwent a quantitative measurement of balance and gait on both single and dual-task paradigms. Results: Significant positive correlation was found between anteroposterior index (API) with Coefficient variation of Step Length of both lower limbs (r = 0 .289, p = 0.042 & r = (0.372), p =0.008 and (r = 0.444, p = 0.001 & r = 0.444, p = 0.001) at single and dual task respectively. Conclusion: API was found to be associated with gait stability in the middle age group. However, considering the crosssectional nature of this study, the inference needs to be confirmed in future studies to establish the causal relationship.

- by Journal of Geriatric Care and Research (JGCR) and +2
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- Gait Biomechanics, Older Adults, Human Gait Analysis, Gait and Balance

ABSTRACT
The purpose of this study is to examine the effect of 8-week plyometric training on young male basketball players on static and dynamic balance values. 28 athletes (age: 14.00 ±.00 years; sports age: 7.01 ±1.84 years) participated voluntarily. Two separate groups were selected randomly, namely the sportsmen, the experimental (EG) and control (CG) groups. Participants were selected among those who had not suffered lower-extremity injuries in the past two years. Balance pre- and post-tests were performed before and after the 8-week plyometric training program (PTP). The athletes in the EG participated in the PTP, which was prepared 2 days a week in addition to their own training. A digital weighing scale (Desis weighing expert) and a balance instrument (Prokin 5.0 Tecnobody) were used in the study. For statistical analysis, SPSS 17 package program was used. Descriptive statistics (mean standard deviation, minimum and maximum) as well as paired t test for pre-test post-test difference were performed. At the beginning, the level of significance was determined as p<0.05. As a result, significant differences were found between the pretest and posttest in the EG (p <0.05). There was no difference in the CG in the same tests (p>0.05). In the EG and CG, no statistically significant difference was found between the left and right leg tests (p>0.05). On the other hand, in the EG and CG, significant differences were found between the two groups in the dynamic balance tests (p<0.05). As a result, it was seen that plyometric exercises made for 8 weeks were a program with significant effects on the development of some static balance values on the experimental group in this study. It is believed that this positive effect will be even more intense with new work to be done on the basketball in this area.
Keywords: Static/Dynamic Balance, Plyometric, Basketball.
ÖZET
Bu çalışmanın amacı, genç erkek basketbolcularda 8 haftalık pliometrik antrenmanların, statik ve dinamik denge değerlerine etkisini incelemektir. Araştırmaya iki ayrı kulüpte U15 takımında basketbol oynayan 28 sporcu (yaş: 14,00 ±.00yıl; spor yaşı: 7.01 ±1.84yıl) gönüllü olarak katıldı. Sporcular, deney (DG) ve kontrol (KG) grubu olmak üzere iki ayrı gruba ayrıldılar. Sporcular, son iki yıl içinde alt ekstrimite yaralanması geçirmemiş olanlar arasından seçildi. Sekiz haftalık pliometrik antrenman programı (PAP) öncesi ve sonrasında denge ön ve son testleri yapıldı. DG sporcuları, kendi antrenmanlarına ek olarak haftada 2 gün olmak üzere PAP katıldılar. Araştırmada boy ve ağırlık ölçümünde digital tartı-boy ölçer (Desis weighing expert) ve denge aleti (Prokin 5.0 Tecnobody) kullanıldı. İstatistiksel analizlerde, SPSS 17 paket programı kullanıldı. Tanımlayıcı istatistik (ortalama standart sapma, minimum ve maksimum) ayrıca öntest sontest farkı için eşleştirilmiş t testi yapıldı. Başlangıçta anlamlılık düzeyi p<0.05 olarak belirlendi. Sonuç olarak DG da statik dengede, hem gözler açık, hem de gözler kapalı çift ayak denge alanı testinde, öntest sontest arasında anlamlı farklar tespit edildi (p<0.05). Aynı testlerde CG da fark bulunmadı (p>0.05). DG ve CG da, statik dengede hem sol, hem de sağ ayak ile yapılan testlerde anlamlı farklar bulunmadı (p>0.05). Diğer taraftan DG ve KG da, dinamik denge testlerinde her iki grupta da öntest sontest arasında anlamlı farklar tespit edildi (p<0.05). Sonuç olarak 8 hafta süreyle yapılan pliometrik antrenmanların, bu çalışmadaki deney grubu üzerinde, bazı statik denge değerlerinin geliştirilmesinde anlamlı etkileri olan bir program olduğu görüldü. Basketbolda bu alanda yapılacak olan yeni çalışmalar ile bu olumlu
etkinin daha da pekişeceğine inanılmaktadır.
Anahtar Kelimeler: Statik/Dinamik Denge, Pliometrik, Basketbol.

- by Zeynep İnci Karadenizli
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- Gait and Balance, Basketball, Plyometric Training

A bipedal walking robot is a kind of humanoid robot. It is suppose to mimics human behavior and designed to perform human specific tasks. Currently, humanoid robots are not capable to walk like human being. To perform the walking task, in the current work, human gait data of six different walking styles named brisk walk, normal walk, very slow walk, medium walk, jogging and fast walk is collected through our configured IMU sensor and mobile-based accelerometers device. To capture the pattern for six different walking styles, data is extracted for hip, knee, ankle, shank, thigh and foot. A total six classes of walking activities are explored for clinical examination. The accelerometer is placed at center of the human body of 15 male and 10 female subjects. In the experimental setup, we have done exploratory analysis over the different gait capturing techniques, different gait features and different gait classification techniques. For the classification purpose, three state of art techniques are used as artificial neural network, extreme learning machine and deep neural network learning based CNN mode. The model classification accuracy is obtained as 87.4%, 88% and 92%, respectively. Here, WISDM activity data set is also used for verification purpose.

- by Vijay Bhaskar Semwal and +1
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- Robotics, Machine Learning, Classification (Machine Learning), Gait Biomechanics

The Mini-BESTest is a relatively new outcome measure used to measure dynamic balance. This talk discusses advantages and disadvantages of using the Mini-BESTest. Reliability, validity, and accuracy of the Mini-BEST are compared with other... more

- by Stephanie Weyrauch
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- Physiotherapy, Neurology, Rehabilitation, Neurorehabilitation

—Freezing of gait (FoG) in people with Parkinson's disease (PD) is an environmentally sensitive, intermittent problem that occurs most often during turning. FoG is difficult for clinicians to evaluate and treat because it can be difficult to elicit during a clinical visit. Here, we aimed to develop a clinically valid objective measure of freezing severity during a 2-min 360-degree turning-in-place. Twenty-eight subjects with PD (16 freezers, FoG+, and 12 nonfreezers, FoGÀ) in the ''off " state and 14 healthy control subjects were tested. Subjects wore three inertial sensors (one on each shin and one on the waist) while (1) turning in place for 2 min (alternating 360 degrees to the right with 360 degrees to the left) and (2) performing an Instrumented 7-m Timed Up and Go test (ITUG). Performance was videotaped, and clinical severity of FoG was independently rated by two movement disorders specialists (co-authors). Turning in place consistently resulted in FoG (13 out of 16 subjects with PD) while FoG was clinically observed in only two subjects with PD during the ITUG test. The Freezing Ratio during the turning test was significantly correlated with the clinical ratings (q = 0.7, p = 0.003) and with score on the new FoG questionnaire (q = 0.5, p = 0.03). After correcting for symptom severity (UPDRS-III), out of the four objective measures of the turning test (total number of turns, average turn peak speed and average turn smoothness), only the Freezing Ratio was significantly different across groups (p = 0.04). Freezing can be well quantified with body-worn inertial sensors during a 2-min turning-in-place protocol.

- by Rajal G Cohen
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- Bioengineering, Rehabilitation, Parkinson's Disease, Gait Biomechanics

Continuous advances in sensors, semiconductors, wireless networks, mobile and cloud computing enable the development of integrated wearable computing systems for continuous health monitoring. These systems can be used as a part of diagnostic procedures, in the optimal maintenance of chronic conditions, in the monitoring of adherence to treatment guidelines, and for supervised recovery. In this paper, we describe a wearable system called Smart Button designed to assess mobility of elderly. The Smart Button is easily mounted on the chest of an individual and currently quantifies the Timed-Up-and-Go and 30-Second Chair Stand tests. These two tests are routinely used to assess mobility, balance, strength of the lower extremities, and fall risk of elderly and people with Parkinson’s disease. The paper describes the design of the Smart Button, parameters used to quantify the tests, signal processing used to extract the parameters, and integration of the Smart Button into a broader mHealth system.

The aim of this study is to provide mechanical information about healthy adult locomotor mechanical efficiency from the perspective of a dynamic approach to walking focusing on step-to-step transition (STST) mechanical cost of transport (MCOT) at high intensity walking gait. A purposive sample of twenty-five healthy adult males from Sport science and physical education students, Hashemite University, Jordan, participated in the study.
Subjects come to laboratory on two occasions. On the first occasion, the researcher used Ariel performance analysis system (APAS) to find the preferred transition speed (PTS), the second occasion the researcher used the BTS SMART-DX
Analysis System to explore kinematical characteristics. The results show stance phase duration of 0.479 ± 0.03 s for trailing leg (T.leg) and 0.447 ± 0.02 s for leading leg (L.leg), where the double stance phase (DSt) is 0.110 ± 0.03 s for T.leg and 0.100 ± 0.03 s for the L.leg with STST-MCOT 9.6 ± 0.06 J and mechanical efficiency percentage of 9.6 % .
It is highly recommended to consider locomotor mechanical efficiency assessment as essential of life style and to maintain stride-to-stride fluctuations, which may correlate to loss of stability. In addition, to further study the effect of race walkers and its related effects of STST adaptation.

- by samer abueid
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- Biomechanics, Kinesiology, Motion Analysis, Gait and Balance

This is a brief summary of the 2015 paper of similar name

- by Rajal G Cohen
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- Parkinson's Disease, Alexander Technique, Postural Control, Gait and Balance

Background: Muscle energy technique (MET) is asn osteopathic treatment technique that is utilized frequently in the clinical setting, yet the overall effectiveness is minimally supported within literature. MET is an osteopathic technique that involves an isometric contract relax technique intended to improve alignment and enhance neuromuscular education. Objective: The purpose of this study was to determine the effectiveness of MET on running kinetics on subjects with low back pain. Method: A quasi-experimental research design was implemented and subjects, all of whom either had a history of or currently experience low back pain, underwent pre-intervention data collection of: anthropometric measurements, medical history, dorsaVi 3D running analysis, and a musculoskeletal and neurological clinical exam. Subjects underwent 6 weeks of isolated lumbo-pelvic MET at a frequency of twice a week, and were instructed to avoid all other treatment. Post-intervention data collected included a clinical exam and another dorsaVI running analysis. Results: Data was analyzed including: pre and post-treatment initial peak acceleration, ground contact time, and ground reaction force. A paired t-test comparing pre and post mean kinetic changes demonstrated the following p values: initial peak acceleration p = .80, ground contact time p = .96, and ground reaction force p = .68. Conclusion: This study demonstrated that isolated MET treatment is not statistically significant for changing 3D kinetic running variable in subjects with low back pain. Clinical Implications: Recommend healthcare providers to use a multi-treatment approach for low back pain. Future research should include a control group and larger sample size.

The purpose of this research work is to investigate the biomechanics of pelvis, hip, knee, and ankle joint motion using a Kinect sensor & inertial measurement unit (IMU) sensor during the normal walk. In this paper, a very cost-effective gait analysis system based on Microsoft Kinect v2 and Inertial Measurement Unit (IMU) device is presented. Kinect sensor is used for acquiring 3D skeleton data (camera (x, y, z), depth (x, y) orientation (x, y, z, w), color (x, y)) with 25 human body joints. For this analysis, the lower extremities joints i.e. spinal cord joint, hip, knee, and ankle joints of both left and right legs are being considered. The main contribution of this research work is the joint angle calculation of lower extremities of human gait based on Microsoft Kinect sensor V2 and IMU sensor. From the law of cosine, the joint angle is calculated between the two joints and plotted for a single subject. We came with the observation that the characteristics of the human knee joint and ankle joint are inversely related to each other. There are two sharp humps for knee and ankle joints during the normal walk. During the swing phase, the knee joint is highly activated while during toe-off and heel strike it is least activated. This analysis of clinical data is very useful for prosthesis limb and exoskeleton design. The stability of calculated joints trajectories is validated using the limit cycle curve. A system is designed for real-time analysis of biomechanics of different lower limbs joints using gait.

Designing a balance controller that allows a robot
to perform a highly dynamic and stable walking, just like
humans do, is still a major challenge. In this work, a previously
introduced theoretical framework for the balance stability
analysis of biped systems is extended to two real multibody
biped systems: a robot and a human subject. For each system
in the single support (SS) contact configuration, the threshold
between balanced and falling state is calculated, resulting in the
biped’s specific balance stability boundary. This boundary
identifies, in the state space of the center of mass (COM), all
possible states of the given system that are balanced with
respect to the SS configuration. A COM state outside the
boundary represents, for the given system, the sufficient
condition for falling, hence changing contact configuration.
Then, the walking trajectories of both systems are analyzed in
relationship with their respective stability boundary, in order
to extrapolate useful implications on the different balance
control of robot vs. human during the SS phase of walking. In
addition, a metrics for the quantitative assessment of the
degrees of instantaneous stability/instability is formulated,
which takes into account the relative distance between a COM
state to the closest point on the stability boundary. The method
and results proposed can provide an important aid for the
improvement of current balance controllers in walking robots.

- by Carlotta Mummolo
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- Humanoid Robotics, Gait and Balance
- by Lynn Rochester
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- Disability, Gait and Balance, Gait, Humans

In this paper there is presented the design process and experimental verification of the quadruped robot wave gait. Mathematical model of a robot movement is a result of linking together derived leg movement equations with a scheme of their locomotion. The gait is designed and analysed based on two-step design procedure which consists of simulations using MSC Adams and Matlab environments and experimental verification using real quadruped robot.

- by Jakub Mozaryn
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- Robotics, Control Systems Engineering, Gait and Balance, Quadruped Robots

Different standing postures could potentially influence trunk biomechanics during task performance. The current study investigated how foot placement, especially stance width and foot angle influenced lumbopelvic rhythm during sagittal trunk flexion motion. Ten participants performed pace controlled sagittally symmetric trunk flexion motions while maintaining three different stance widths and two different foot angles. The results showed the narrower stance and angled foot placement conditions generated more in-phase lumbopelvic coordination patterns during trunk flexion motions, possibly due to the reduced base of support and the associated postural stability. Findings of this study provided important information regarding the effects of foot placement on postural control and trunk biomechanics during trunk bending motions; these results suggested that foot placement could alter the motion patterns of spinal segments.

- by Jie Zhou
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- Motion control, Motion Analysis, Spine Biomechanics, Industrial Ergonomics
- by William H Paloski and +2
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- Mechanical Engineering, Skeletal muscle biology, Blindness, Muscle strength
- by Heike Vallery
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- Robotics, Rehabilitation, Exoskeletons, Bipedal Walking

This study aims to search the effects of plyometric education trainings which was applied for 10-week on static-dynamic balance and some psychomotor characteristics of students who were been handball team of school. The female students-players (N=16) who are in age 14,57±0,92 years. All student have got 3,66±0,63 years sport experience. Plyometric education trainings were performed twice a week for 10-week in the trainings of school handball team. Parameters such as body weight, height, vertical jump, standing long jump, 30m speed, agility, flexibility, and static-dynamic balance were measured and anaerobic power was calculated by Lewis formula. The SPSS 15.0 program was preferred for the statistics. Descriptive statistics were used for the analysis of psychomotor characteristics and paired sample t test was used for the differences between the pre-test and post-test of plyometric education training of the players. The significance level was set at 0.05. The differences were observed between the pre-test and post-test of plyometric education training of flexibility t(51)=-4,518 ; p= 0,00 , standing long jump t(12)=-8,129 ; p= 0,00 , anaerobic power t(01)=-3,018 ; p= 0,05 and left leg ellipse area at unipedal static balance t(39)= 2,399 ; p= 0,04 were found to be statistically significant (p≤0.05).

- by Zeynep İnci Karadenizli
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- Gait and Balance, Plyometric Training, Team Handball

When balance is exposed to perturbations, hand contacts are often used to assist postural control. We investigated the immediate and the transitionary effects of supportive hand contacts during continuous anteroposterior perturbations of stance by automated waist-pulls. Ten young adults were perturbed for 5 min and required to maintain balance by holding to a stationary, shoulder-high handle and following its removal. Center of pressure (COP) displacement, hip, knee and ankle angles, leg and trunk muscle activity and handle contact forces were acquired. The analysis of results show that COP excursions are significantly smaller when the subjects utilize supportive hand contact and that the displacement of COP is strongly correlated to the perturbation force and significantly larger in the anterior than posterior direction. Regression analysis of hand forces revealed that subjects utilized the hand support significantly more during the posterior than anterior perturbations. Moreover, kinematical analysis showed that utilization of supportive hand contacts alter posture of the whole body and that postural readjustments after the release of the handle, occur at different time scales in the hip, knee and ankle joints. Overall, our findings show that supportive hand contacts are efficiently used for balance control during continuous postural perturbations and that utilization of a handle has significant immediate and transitionary effects on whole body posture.

- by Jernej Čamernik
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- Neuromechanics, Postural Control, Gait and Balance, Human Postural Control

Neurological patients using a powered lower-body exoskeleton for rehabilitation of standing and walking skills in an upright body pose face the safety challenge of postural instability and fall. Current research, therefore, develops exoskeletons with self-balancing functions. This study suggests basing the exoskeleton’s stabilization of standing posture on a human-derived postural control mechanism. A corresponding control system has previously been successfully tested with specific balancing tasks in humanoid robots. Here, we provide a short introduction into the control method and, using a lightweight robot, present as a test of the balancing an experimental shift in the body weight distribution (as if, e.g., a human exoskeleton user was raising an arm or leaning the upper body or lifting an external weight). An overview of other specific balancing tests previously already investigated in humans and humanoids is also briefly mentioned. Overall, the tests will allow the quantificat...

- by Vittorio Lippi
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- Computer Science, Exoskeletons, Neurorobotics, Gait and Balance

Introduction: Falling is a serious concern among elderly which have made a lot of discussions between gerontologists and physical therapists. Falling is common, dangerous, and costly among the elderly population. Fear of falling again among elderly faller leads to decrease self-confidence, loss of life quality, and inability. The purpose of this study was to find the effects of core stability exercise on balance and functional mobility among elderly with a history of falling.
Materials and Methods: Thirty elderly people with a history of falling were randomly divided into control (n= 15) and experimental (n= 15) groups. The experimental group performed a 40-minute core stability exercise for eight weeks and three sessions per week. Before and after eight weeks of exercise program, static balance with open and closed eyes, Timed Up and Go (TUG) test for dynamic balance, and 10-meter walking were taken in both groups. The control group only have the daily activities. The two-way ANOVA test was used to compare the mean differences between groups.
Results: Central stability training had a significant effect on static balance with open and closed eye, TUG, and 10-meter walking (P= 0.001). The control group did not show a significant effect on the factors of static balance with open eyes, static balance of closed eyes, TUG, and 10-meter walking. Following training period, the experimental group showed significantly better status in all variables compared to control group (0.91≤ η 2≤ 0.94, P= 0.001).
Conclusion: It seems that strengthening the muscles in the central area of the body leads to maintaining balance in the elderly during daily activities.

- by Hassan Sadeghi
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- Exercise Physiology, Rehabilitation, Elderly Falls (Geriatrics), Gait Biomechanics

Background: While walking difficulties are common in people with Parkinson's disease (PD), little is known about factors that independently contribute to their perceived walking difficulties. Objective: To identify factors that independently contribute to perceived walking difficulties in people with PD. Methods: This study involved 243 (62% men) participants; their mean (min-max) age and PD duration were 70 (45–93) and 8 (1–43) years, respectively. A postal survey preceded a home visit that included observations, clinical tests, questions and questionnaires that were administered as a structured interview. Perceived walking difficulties (dependent variable) were assessed with the self-administered generic Walk-12 (Walk-12G, scored 0–42, higher = worse). Independent variables included personal (e.g., age and general self-efficacy) and social environmental factors (e.g., social support and living situation) as well as disease-related factors including motor (e.g., freezing of gait (FOG) and postural instability) and non-motor symptoms (e.g., fatigue and orthostatic hypotension). Linear multiple regression analysis was used to identify factors that independently contributed to perceived walking difficulties. Results: Eight significant independent variables explained 56.3% of the variance in perceived walking difficulties. FOG was the strongest significant contributing factor to perceived walking difficulties, followed by general self-efficacy, fatigue, PD duration, lower extremity function, orthostatic hypotension, bradykinesia and postural instability. Conclusion: Motor and non-motor symptoms as well as personal factors (i.e., general self-efficacy) seem to be of importance for perceived walking difficulties in PD. These findings might nurture future interventions that address modifiable factors in order to enhance walking ability in people with PD.

- by Manzur Kader
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- Gait and Balance, Parkinsons Disease

Numerous physical capacities have been said to contribute to change-of-direction speed (CODS), including technique, strength, power, and dynamic stability. Out of these capacities, the relationship dynamic stability has with CODS has received very little analysis in the literature. Therefore, this study analyzed whether time to stabilization (TTS) as a dynamic stability assessment could differentiate between faster (n = 13) and slower (n = 13) recreational male team sport athletes in the 505 CODS test, and the modified T-test. TTS was measured via a force plate as the duration for the vertical force component to reach and stay within 5% of the participant's body weight following a unilateral vertical jump landing for each leg. Between-leg TTS differences were also derived. A one-way analysis of variance (p < 0.05) determined significant differences in TTS and the CODS tests; effect sizes (d) were also calculated. Pearson's correlations (p < 0.05) were calculated from the pooled data (N = 26) in order to ascertain relationships between TTS, and 505 and modified T-test performance. Results indicated the faster group were quicker in all CODS tests (p ≤ 0.001-0.042; d = 0.85-2.84). There were no differences in TTS (p = 0.071-0.961). Additionally, there were no significant correlations between TTS and the CODS tests (p = 0.138-0.963). TTS does

- by Robert Lockie and +1
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- Gait and Balance, Agility

Physical exercise would improve postural stability, which is an essential factor in preventing accidental fall among the elderly population. The aim of this study is to examine the effectiveness of treadmill walking on balance improvement among the elderly people. A total of 30 community dwelling older adults with a Berg Balance Scale score of 36-48 and the ability to walk without aid were considered and divided into control (n=15) and experimental (n=15) groups. Individuals in the experimental group participated in 30 minutes of forward and backward treadmill training based on three times a week interval for a period of four weeks. Individuals in the control group were instructed to continue with their daily routine activity. Before and after training, gait speed was measured by six-minute walk test and balance ability was evaluated by Fullerton Advanced Balance Scale (FABS) and Berg Balance Scale (BBS) tests. Postural sway items such as the Center of Pressure (COP), average displacement and velocity were evaluated by using a force platform system. Data were collected in quiet standing, tandem position and standing on foam pads before and after intervention. After intervention, balance variables in the experimental group indicated a significant improvement in quiet standing on firm and foam surfaces, but no considerable improvement was shown in tandem position. A between-group comparison showed a significant reduction in COP velocity in the sagittal plane (P=0.030) during quiet standing and in the frontal plane (P=0.001) during standing on foam, whereas no significant reduction in COP parameters during tandem position was found. It is recommended that twelve sessions of forward and backward treadmill walk are effective in balance improvement in elderly people.

- by Alireza Motealleh and +2
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- Gait and Balance, Elderly

Objective: To present an objective method to evaluate gait improvements after tap test in idiopathic normal pressure hydrocephalus (iNPH). Tap test is often used to prognosticate shunt responsiveness, although test accuracy is limited by the lack of quantitative outcome measures.
Design: Retrospective analysis of gait data.
Setting: Public tertiary care center, day hospital. Gait analysis was performed before and 2-4 hours after tap test.
Participants: 60 iNPH patients and 50 age and sex matched controls (used to obtain reference intervals). From an initial referred sample of 79 patients, we excluded those unable to walk without walking aids (n = 9) or with incomplete (pre/post tap test) gait data (n=10). Thirteen out of 60 patients were shunted and then reappraised after 6 months.
Intervention: Not applicable.
Main Outcome Measures: Mahalanobis distance from controls, before and after tap test. Eleven gait parameters were combined in a single quantitative score. Walking velocity was also evaluated, since it is frequently used in tap test assessment.
Results: Patients were classified as: (A) tap test responders (n=22 patients, 9 of them were shunted), or (B) not suitable for shunt (n=38 patients, 4 of them were shunted). In group A, 9 out of 9 patients improved after shunt. In group B, 3 out of 4 patients did not improve. Gait velocity increased after tap test in 53% of responders and in 37% of patients not suitable for shunt.
Conclusions: The new method is applicable to the clinical practice and allows for selecting tap test responders in an objective way, quantifying the improvements. Our results suggest that gait velocity alone is not sufficient to reliably assess tap test effects.

- by Valentina Agostini and +4
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- Neurosurgery, Human Gait Analysis, Gait and Balance, Clinical Gait Analysis
- by Seyed Hojjat Zamani Sani
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- Gait and Balance

Gait and balance disorders represent a major therapeutic challenge in Parkinson's disease (PD). These symptoms respond poorly to dopaminergic treatments, except in the early phase of the disease. Currently, no other treatment is particularly efficient and rehabilitation appears to be the most effective approach. Since these gait and balance deficits are resistant to dopaminergic drugs, their occurrence could be related to the development of extradopaminergic lesions in PD patients. We provide a comprehensive description of the clinical features of gait and balance disorders in PD. We also highlight the brain networks involved in gait and balance control in animals and humans with a particular focus on the relevant structures in the context of PD, such as the mesencephalic locomotor region. We also review other neuronal systems that may be involved in the physiopathology of gait and balance disorders in PD (noradrenergic and serotoninergic systems, cerebellum and cortex). In addition, we review recent evidence regarding functional neurosurgery for gait disorders in PD and propose new directions for future therapeutic research.

- by Brian Lau
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- Deep Brain Stimulation, Parkinson's Disease, Gait and Balance

PURPOSE:
To estimate test-retest reliability, inter-rater reliability and validation of a method for measuring balance by stepping over four squares, four square step test (FSST) in children with Down syndrome (DS).
METHODS:
A sample of 13 children with DS was recruited for the cross-sectional study. They were asked to perform FSST and the time taken was noted. For estimating test-retest reliability, FSST was done by principal investigator twice and Inter-rater reliability was assessed by principal investigator and second investigator with an interval of 7 days. FRT was used as the criterion dynamic balance measure to validate FSST. The data was tabulated and analysed statistically.
RESULTS:
The test-retest reliability and inter-rater reliability of FSST are ICC(1,1) = 0.70 (0.64-0.90) and ICC(2,1) = 0.78 (0.62-0.91) respectively. The Bland-Altman limits of agreement were also satisfied. Concurrent validity between FRT and FSST with Spearman's ρ = -0.58 (-0.86 to -0.13).
CONCLUSION:
FSST has moderate to good concurrent validity and good reliability among the children with Down syndrome.

- by ASIR JOHN SAMUEL
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- Down Syndrome, Gait and Balance, Reliability, Validity
- by Richard A P Roche and +2
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- Elderly Falls (Geriatrics), Cognitive Ageing, Gait and Locomotion (Psychology), Executive Function

The purpose of this research is to discuss the impacts of stability range exercises on certain gait parameters and quality of life among active elder women. The population of this research includes 100 women aged between 61 and 88 years who inhabit in the nursing home of Kahrizak, Karaj. Among the population, 40 individuals matched our research criterions and consequently, these 40 were selected as the sample group. The subjects’ age range was 61-88 years, also their height range was 139.5-160cms and their weight range was 48-88 kilograms. The subjects of the experimental group were administered 24 sessions of reformation exercises. In addition, the control group performed morning exercises, under the supervision of the facility’s coach. The collected statistical data were subjected to further analyses through the independent-t and independent-t tests as well as the Kolmogorov-Smirnoff test for confirming the normality of data distributions at the confidence level of P= 0.05. Results indicated that stability range exercises are capable of increasing the lengths of both the left and right paces significantly. The variables of life quality, pace speed, pace frequency, stance time and swing time were significantly increased among the subjects of experimental group, however compared to the control group; this increase was not statistically significant.

Treatments based on peripheral stimulations of the sensory motor system (bottom-up stimulation) have been inspiring new rehabilitation approaches in PD especially to reduce the levodopa washout. This study was focalized on the evaluation of a specific bottom up treatment, based on the stimulation of specific areas of both feet, also defined automated mechanical peripheral/extero
stimulation (AMPS). Franca Barbic introduced the results of the first protocol on Foot Mechanical Stimulation* - highlighting the positive results obtained on the tested patients (Effects of mechanical stimulation of the feet on gait and cardiovascular autonomic control in Parkinson's disease). This study expanded that study and evaluated a group of PD patients PRE and POST AMPS evaluated with the Timed Up and Go (TUG) test, a widely used clinical performance based measure of fall risk, measured with an inertial sensors.

- by Randy Eady
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- Parkinson's Disease, Gait Biomechanics, Gait and Balance, Acupuncture, Acupressure

Background: Gait retraining using real-time biofeedback (RTB) may have positive outcomes in decreasing knee adduction moment (KAM) in healthy individuals and has shown equal likelihood in patients with knee osteoarthritis (OA). Currently, there is no consensus regarding the most effective gait modification strategy, mode of biofeedback or treatment dosage. Objective: The purpose of this review was: i) to assess if gait retraining interventions using RTB are valuable to reduce KAM, pain, and improve function in individuals with knee osteoarthritis, ii) to evaluate the effectiveness of different gait modifications and modes of RTB in reducing KAM in healthy individuals, and iii) to assess the impact of gait retraining interventions with RTB on other variables that may affect clinical outcomes. Methods: Seven electronic databases were searched using five search terms. Studies that utilized any form of gait retraining with RTB to improve one or a combination of the following measures were included: KAM, knee pain, and function. Twelve studies met the inclusion criteria, evaluating eleven distinctive gait modifications and three modes of RTB. Results: All but one study showed positive outcomes. Self-selected and multi-parameter gait modifications showed the greatest reductions in KAM with visual and haptic RTB being more effective than auditory. Conclusions: Current evidence suggests that gait modification using RTB can Positively alter KAM in asymptomatic and symptomatic participants. However, the existing literature is limited and of low quality, with the optimal combination strategies remaining unclear (gait and biofeedback mode). Future studies should employ randomized controlled study designs to compare the effects of different gait modification strategies and biofeedback modes on individuals with knee OA.