Difference of means, variability, and extremes of spatiotemporal gait parameters during perturbed walking conditions relative to normal walking.

<p>Difference of means of (A) stride length, (B) step width, and (C) cadence. Difference of variability of (D) stride length, (E) step width, and (F) cadence. Difference of 10th percentile of (G) stride length, (H) step width, and (I) cadence. Difference of 90th percentile of (J) stride length, (K) step width, and (L) cadence. <i>d</i> indicates Cohen’s <i>d</i> statistic effect size. Error bars indicate confidence intervals. (*) indicates statistically significant differences from Normal walking.</p

The effects of unexpected mechanical perturbations during treadmill walking on spatiotemporal gait parameters, and the dynamic stability measures by which to quantify postural response - Fig 1

<p>(A) A schematic drawing of the experimental setup. Forward and backward perturbations were induced by acceleration and deceleration of the treadmill’s belt. Left and right perturbations were induced by moving the treadmill surface in the ML-direction. Reflective markers were placed at specific anatomical locations in accordance with the plug-in-gait marker set. (B) MoS-AP was defined as the AP distance between the XCoM-AP and the anterior boundary of the BoS, defined by the leading toe marker (either RTOE or LTOE for the right and the left foot, respectively). MoS-ML was defined as the ML distance between the XCoM-ML and the lateral boundary of the BoS, defined by the ankle marker (RANKL and LANKL for the right and the left foot, respectively).</p

The effects of unexpected mechanical perturbations during treadmill walking on spatiotemporal gait parameters, and the dynamic stability measures by which to quantify postural response

<div><p>Most falls occur after a loss of balance following an unexpected perturbation such as a slip or a trip. Greater understanding of how humans control and maintain stability during perturbed walking may help to develop appropriate fall prevention programs. The aim of this study was to examine changes in spatiotemporal gait and stability parameters in response to sudden mechanical perturbations in medio-lateral (ML) and anterior-posterior (AP) direction during treadmill walking. Moreover, we aimed to evaluate which parameters are most representative to quantify postural recovery responses. Ten healthy adults (mean = 26.4, SD = 4.1 years) walked on a treadmill that provided unexpected discrete ML and AP surface horizontal perturbations. Participants walked under no perturbation (normal walking), and under left, right, forward, and backward sudden mechanical perturbation conditions. Gait parameters were computed including stride length (SL), step width (SW), and cadence, as well as dynamic stability in AP- (MoS-AP) and ML- (MoS-ML) directions. Gait and stability parameters were quantified by means, variability, and extreme values. Overall, participants walked with a shorter stride length, a wider step width, and a higher cadence during perturbed walking, but despite this, the effect of perturbations on means of SW and MoS-ML was not statistically significant. These effects were found to be significantly greater when the perturbations were applied toward the ML-direction. Variabilities, as well as extremes of gait-related parameters, showed strong responses to the perturbations. The higher variability as a response to perturbations might be an indicator of instability and fall risk, on the same note, an adaptation strategy and beneficial to recover balance. Parameters identified in this study may represent useful indicators of locomotor adaptation to successfully compensate sudden mechanical perturbation during walking. The potential association of the extracted parameters with fall risk needs to be determined in fall-prone populations.</p></div

Results for spatiotemporal gait parameters and margins of stability during different walking conditions (mean and SD; n = 10).

<p>Results for spatiotemporal gait parameters and margins of stability during different walking conditions (mean and SD; n = 10).</p

A Pilot Clinical Trial to Objectively Assess the Efficacy of Electroacupuncture on Gait in Patients with Parkinson's Disease Using Body Worn Sensors

<div><p>Background</p><p>Gait disorder, a key contributor to fall and poor quality of life, represents a major therapeutic challenge in Parkinson’s disease (PD). The efficacy of acupuncture for PD remains unclear, largely due to methodological flaws and lack of studies using objective outcome measures.</p><p>Objective</p><p>To objectively assess the efficacy of electroacupuncture (EA) for gait disorders using body-worn sensor technology in patients with PD.</p><p>Methods</p><p>In this randomized pilot study, both the patients and assessors were masked. Fifteen PD patients were randomly assigned to an experimental group (n = 10) or to a control group (n = 5). Outcomes were assessed at baseline and after completion of three weekly EA treatments. Measurements included gait analysis during single-task habitual walking (STHW), dual-task habitual walking (DTHW), single-task fast walking (STFW), dual-task fast walking (DTFW). In addition, Unified Parkinson's Disease Rating Scale (UPDRS), SF-12 health survey, short Falls Efficacy Scale-International (FES-I), and visual analog scale (VAS) for pain were utilized.</p><p>Results</p><p>All gait parameters were improved in the experimental group in response to EA treatment. After adjustment by age and BMI, the improvement achieved statistical significant level for gait speed under STHW, STFW, and DTFW (9%-19%, p<0.05) as well as stride length during DTFW (9%, p = 0.037) and midswing speed during STFW (6%, p = 0.033). No significant changes were observed in the control group (p>0.110). The highest correlation between gait parameters and UPRDS scores at baseline was observed between gait speed during STFW and UPDRS II (r = -0.888, p = 0.004). The change in this gait parameter in response to active intervention was positively correlated with baseline UPDRS (r = 0.595, p = 0.057). Finally, comparison of responses to treatment between groups showed significant improvement, prominently in gait speed (effect size 0.32–1.16, <i>p</i> = 0.001).</p><p>Conclusions</p><p>This study provides the objective proof of concept for potential benefits of non-pharmaceutical based EA therapy on enhancing gait in patients with PD.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/results?term=NCT02556164&Search=Search" target="_blank">NCT02556164</a></p></div

Baseline characteristics of the study population.

<p>Baseline characteristics of the study population.</p

Changes in gait speed pre- and post-treatment in the intervention group (blue color) and control group (orange color) during single-task habitual, dual-task habitual, single-task fast and dual-task fast walking conditions.

<p>Mean values and standard errors are illustrated. Only the values for those parameters, which achieved statistical significant level were illustrated.</p

CONSORT Flow Diagram.

<p>CONSORT Flow Diagram.</p

Additional file 1 of Budget impact analysis of a Lifestyle-integrated Functional Exercise (LiFE) program for older people in Germany: a Markov model based on data from the LiFE-is-LiFE trial

Supplementary Material

Additional file 3: Video C. of Association between vestibulo-ocular reflex suppression, balance, gait, and fall risk in ageing and neurodegenerative disease: protocol of a one-year prospective follow-up study

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