Physiological Electromyographic Activations Patterns of Lower Limb Muscle in Children

Kinesiological electromyography (KEMG) is an essential part of gait analysis as it supports clinicians with the objective assessment of muscular function during walking. During the gait cycle muscles are active with definite actions aimed at controlling joints in order to accomplish requirements of gait such as stability, loading acceptance, and progression. The knowledge of the development of normal EMG activity is of relevance in interpreting gait analysis data. While there is a wide literature on normative kinematics and kinetics data in children, only a few studies reported reference KEMG dataset on a paediatric population and on the maturation of gait in children. The available literature reported that the surface KEMG in children has a significant amount of variability, which should be taken into consideration when performing clinical interpretations. The KEMG timing and duration in normal children can vary with age, body height, body weight, gait velocity and stride length. Moreover, there is evidence that within session EMG variability in children aged 6-8 years is twice than that of adults. Although children in this age range can be considered to have a mature walk, variability about the mean performance continues to develop for many years and stable locomotion may be achieved despite significant variability in the muscle recruitment patterns. Further studies using accurate techniques of signal detection and analysis are required to improve our knowledge on physiological and pathological patterns of muscular activation in children

Clinical and functional outcomes of the saddle prosthesis

BACKGROUND:The implantation of a saddle prosthesis after resection of a pelvic tumor has been proposed as a simple method of reconstruction that provides good stability and reduces the surgical time, thus limits the onset of intraoperative complications. There are no studies in the literature of patients evaluated using gait analysis after being implanted with a saddle prosthesis. The present study is a retrospective case review aimed at illustrating long-term clinical and functional findings in tumor patients reconstructed with a saddle prosthesis. MATERIALS AND METHODS:A series of 15 patients who received pelvic reconstruction with a saddle prosthesis were retrospectively reviewed in terms of clinical, radiographic, and functional evaluations. Two patients were additionally assessed by gait analysis. RESULTS:Long-term functional follow-up was achieved in only 6 patients, and ranged from 97 to 167 months. Function was found to be rather impaired, as a mean of only 57 % of normal activity was restored. Gait analysis demonstrated that the implant had poor biomechanics, as characterized by very limited hip motion. CONCLUSIONS: Though the saddle prosthesis was proposed as advance in tumor-related pelvic surgery, the present study indicates that it yields unsatisfactory clinical and functional results due to both clinical complications and the poor biomechanics of the device. The use of a saddle prosthesis in tumor surgery did not provide satisfactory results in long-term follow-up. It is no longer implanted at our institute, and is currently considered a "salvage technique.

Mobilise-D insights to estimate real-world walking speed in multiple conditions with a wearable device

This study aimed to validate a wearable device’s walking speed estimation pipeline, considering complexity, speed, and walking bout duration. The goal was to provide recommendations on the use of wearable devices for real-world mobility analysis. Participants with Parkinson’s Disease, Multiple Sclerosis, Proximal Femoral Fracture, Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, and healthy older adults (n = 97) were monitored in the laboratory and the real-world (2.5 h), using a lower back wearable device. Two walking speed estimation pipelines were validated across 4408/1298 (2.5 h/laboratory) detected walking bouts, compared to 4620/1365 bouts detected by a multi-sensor reference system. In the laboratory, the mean absolute error (MAE) and mean relative error (MRE) for walking speed estimation ranged from 0.06 to 0.12 m/s and − 2.1 to 14.4%, with ICCs (Intraclass correlation coefficients) between good (0.79) and excellent (0.91). Real-world MAE ranged from 0.09 to 0.13, MARE from 1.3 to 22.7%, with ICCs indicating moderate (0.57) to good (0.88) agreement. Lower errors were observed for cohorts without major gait impairments, less complex tasks, and longer walking bouts. The analytical pipelines demonstrated moderate to good accuracy in estimating walking speed. Accuracy depended on confounding factors, emphasizing the need for robust technical validation before clinical application. Trial registration: ISRCTN – 12246987