Background: The effects of gait training based on the positioning of affected foot muscle activity, gait parameters, and balance ability were investigated in patients with subacute stroke. Material and Methods: Forty-five patients with subacute stroke were randomly assigned to three groups: straight gait training (SGT) group (n = 15), outward curved gait training group with the paretic foot positioned laterally (n = 15), or inward curved gait training (ICGT) group with the paretic foot positioned medially (n = 15). All groups received 30-minute interventions, comprising 15 min of gait training, five times per week for four weeks. Outcomes were measured in terms of muscle activation of the gluteus maximus (GM), vastus medialis, and vastus lateralis; five gait parameters (step length, stance phase, swing phase, velocity, and maximum force); and balance ability assessed using the timed up and go (TUG) test. Results: All groups exhibited significant improvements in all variables after the 4-week intervention period (p < 0.05). However, except for comparisons between the SGT and ICGT groups in terms of GM muscle activity and TUG, no significant differences were observed between the groups for the other variables (p > 0.05). Conclusions: Although patients with subacute stroke can improve their overall physical function regardless of the gait training method, ICGT may be more effective in enhancing muscle activity and balance ability.

Background: The prevalence of falls among the older population underscores the imperative of comprehending human adaptations to gait perturbations. Dual-belt treadmills offer a controlled setting for such investigations. The purpose of this study was to examine the effect of acceleration of one belt of the treadmill during three different phases of the gait cycle on kinematic and kinetic parameters and relate these changes to unperturbed gait. Methods: Twenty-one healthy young females walked on a treadmill in a virtual environment, in which five unexpected perturbations were applied to the left belt at the Initial Contact (IC), Mid Stance (MS), and Pre-Swing (PS) phase of the gait cycle. Data from the undisturbed gait and the first disturbance of each trial were extracted for analysis. Results: All perturbations significantly affected the gait pattern, mainly by decreasing the knee extension angle. The perturbation in the IC phase had the most significant effect, resulting in a 248.48% increase in knee flexion torque. The perturbation in the MS phase mainly affected plantar flexion torque, increasing it by 118.18%, while perturbation in the PS phase primarily increased the hip extension torque by 73.02%. Conclusions: The presence of perturbations in the IC and PC phases caused the most aggressive and significant changes in gait parameters.

Studies on the gait's parameters have been identified on the patients population. Most researchers confirm that the patients walk differently than normal people and they may have a risk for falls. Consistent finding and description of gender, age, and body mass index differences in gait studies is rare in healthy subjects. A cross-sectional study with forty-five young adult (F = 20, M = 25) was conducted. Stadiometer and Physilog 4 inertial sensors were used for data collection. A gait analyser 5.2 software (GaitUp, S.A. Lausanne, Switzerland) was used to determine spatiotemporal parameters. No statistically significant differences were found in any bilateral foot gait parameters with respect to gender, age, and body mass index. Females are found with higher total double support and cadence than males. Cadence also increases with age. Obese people showed lower gait speed, cadence, and total double support. These findings may be beneficial to those who have abnormal gait pattern due to age, body mass index differences, decreased muscle strength, spasticity, and joint mobility. This important informations should be considered to rehabilitate patients with abnormal gait patterns to controlling dynamic balance and riks to falling.

This study assessed the relationship between head posture displacements and biomechanical parameters in three different tasks. One hundred male and female students (20 ± 3yrs) were assessed via the PostureScreen Mobile app to quantify postural displacements of head rotations and translations including: 1) the cranio-vertebral angle (CVA) (°), 2) anterior head translation (AHT) (cm), 3) lateral head translation in the coronal plane (cm), and 4) lateral head side bending (°). Biomechanical parameters during gait and jumping were measured using the G-Walk sensor. The assessed gait spatiotemporal parameters were cadence (steps / min), speed (m / s), symmetry index, % left and right stride length (% height), and right and left propulsion index. The pelvic movement parameters were: 1) tilt symmetry index, 2) tilt left and right range, 3) obliquity symmetry index, 4) obliquity left and right range, 5) rotation symmetry index, and 6) rotation left and right range. The jump parameters measured were: 1) flight height (cm), 2) take off force (kN), 3) impact Force (kN), 4) take off speed (m / s), 5) peak speed (m / s), 6) average speed concentric phase (m / s), 7) maximum concentric power (kW), 8) average concentric power (kW) during the counter movement jump (CMJ), and 9) CMJ with arms thrust (CMJAT). At a significance-level of p ≤ 0.001, moderate to high correlations (0.4 < r < 0.8) were found between CVA, AHT, lateral translation head and all the gait and jump parameters. Weak correlations (0.2 < r <  0.4) were ascertained for lateral head bending and all the gait and jump parameters except for gait symmetry index and pelvic symmetry index, where moderate correlations were identified (0.4 < r < 0.6). The findings indicate moderate to high correlations between specific head posture displacements, such as CVA, lateral head translation and AHT with the various gait and jump parameters. These findings highlight the importance of considering head posture in the assessment and optimization of movement patterns during gait and jumping. Our findings contribute to the existing body of knowledge and may have implications for clinical practice and sports performance training. Further research is warranted to elucidate the underlying mechanisms and establish causality in these relationships, which could potentially lead to the development of targeted interventions for improving movement patterns and preventing injuries.

Freezing of gait (FOG), a debilitating symptom of Parkinson’s disease (PD), can be safely studied using the stepping in place (SIP) task. However, clinical, visual identification of FOG during SIP is subjective and time consuming, and automatic FOG detection during SIP currently requires measuring center of pressure on dual force plates. This study examines whether FOG elicited during SIP in 10 individuals with PD could be reliably detected using kinematic data measured from wearable inertial measurement unit sensors (IMUs). A general, logistic regression model (AUC = 0.81) determined that three gait parameters together were overall the most robust predictors of FOG during SIP: arrhythmicity, swing time coefficient of variation, and swing angular range. Participant-specific models revealed varying sets of gait parameters that best predicted FOG for each participant, highlighting variable FOG behaviors, and demonstrated equal or better performance for 6 out of the 10 participants, suggesting the opportunity for model personalization. The results of this study demonstrated that gait parameters measured from wearable IMUs reliably detected FOG during SIP, and the general and participant-specific gait parameters allude to variable FOG behaviors that could inform more personalized approaches for treatment of FOG and gait impairment in PD.

Crouch gait is one of the most common gait abnormalities. In the literature, there are few works related to the crouch gait recognition. In this work, we aim at the integration of a framework for multiclass crouch gait recognition using synthetic eight-DoF model gait data in anatomical space. The main contribution of our study is the joint function generator algorithm, which could be used to generate other physiological signals; and the gait data validation stage. In addition, we use a feature selection method and a body region segmentation approach to improve classification performance. We generated a gait dataset containing 25 join functions of each DoF for each gait class (4 crouched and normal). The algorithms that we evaluated for classification were: K-nearest neighbors (kNN), Naive Bayes (NB), discriminant analysis (DA), decision trees (DT), and an artificial neural network (ANN). We calculated the metrics: accuracy (Acc), recall (R), specificity (SP), precision (P) and the F-measure (FM) to asses the classification performance. In general, for this work, the best algorithms were discriminant analysis and artificial neural networks. The main results of the proposed recognition framework provide evidence that can be used in real clinical settings to diagnose and make decisions about treatments related to crouch gait diseases.

Background : The quantification of electromyographic activity using surface electrodes is inval-uable for understanding gait disorders in patients with central nervous system lesions. We propose to evaluate a commercially available low-cost system compared to a reference system in partic-ipants with stroke-related movement disorders in functional situations. Methods : Three hemiparetic participants performed three functional tasks: two treadmill walks at different speeds and a sit-to-stand test. The vastus lateralis and gastrocnemius medialis muscles were equipped with two EMG sensors. The comparison between the two EMG systems was based on 883 identified cycles. Spearman’s correlation coefficients (SC), linear correlation coefficients (LCC), and cross-correlation coefficients (CCC) were calculated. Results : The main results indicate good to very good similarity of the EMG signals collected from the two tested sEMG systems. In the comfortable walking condition, an SC of 0.894±0.091 and an LCC of 0.909±0.094 were noted. In the fast walking condition, an SC of 0.918±0.064 and an LCC of 0.935±0.056 were observed. For the 1-minute sit-to-stand test an SC of 0.880±0.058 and an LCC of 0.881±0.065 were noted. Conclusions : This study demonstrates good to very good similarity between the two sEMG systems, enabling the analysis of muscle activity during functional tasks.

Sleep quality is known to affect automatic and executive brain functions such as gait control and cognitive processing. This study aimed to assess the effect of dual tasks on gait spatiotemporal parameters among young adults with good and poor sleep quality in the United Arab Emirates. In total, 65 young adults with a mean age of 21.1±2.5 were assessed for gait analysis during single-task and dual-task conditions. The participants’ sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and gait was assessed using the BTS Gaitlab System. The participants were asked to walk at natural speed as a single-task condition, followed by walking while performing a cognitive task as a dual-task condition. The parameters assessed included the gait velocity (m/s), cadence (steps/min), step width (m), and stride length (m). The DTC on each gait parameter was calculated. The Mann–Whitney U test was used to compare the differences in the DTC on gait variables between the good and poor sleep quality groups, and the Spearman correlation test was used to assess the correlation between total PSQI scores and the DTC. At a significance level of p<0.05, a significant difference in cadence between the two sleep quality groups was observed, in addition to a positive correlation between sleep quality and the DTC effect on gait mean velocity, cadence, and stride length. Our findings also revealed a greater DTC on participants with poorer sleep quality. These findings contribute to our understanding of the significance of sleep quality in gait performance while multitasking in younger populations.

Total hip arthroplasty (THA) is a preferred treatment for primary osteoarthritis (OA) or secondary due to developmental hip dysplasia (DDH). Gait analysis is considered a golden standard for evaluating post-arthroplasty walking patterns. This study compared post-THA spatiotemporal gait parameters (SGPs) between OA and DDH patients and explored correlations with demographic and clinical variables. Thirty patients (15 per group) were recorded during gait, and their SGPs were analyzed. Functionality was evaluated with the Oxford Hip Score (OHS). The OA patients were significantly older than DDH (pr< 0.51, all p< 0.05). The preoperative gait alterations associated with OA or DDH were improved to similar levels in both groups after THA. Post-arthroplasty SGPs and OHS correlations indicate limitations in certain activities. These find-ings must be correlated with kinetic gait analysis data to fully evaluate gait and functionality dif-ferences among patient groups.

Lower extremity joint kinetic factors are thought to modulate walk–to–run transition (WRT) and run–to–walk transition (RWT). This study aimed to investigate joint stiffness and energetic patterns during the WRT and RWT processes and identify whether gait transitions occurred within a single step or not. Ten healthy subjects participated in treadmill WRT (1.8 m/s – 2.4 m/s) and RWT (2.4 m/s – 1.8 m/s) tests. We investigated two steps before transition (S–2, S–1), two steps after transition (S1, S2) and the transition step (S0). We found significant differences between S2 and S–2 for ankle joint stiffness during WRT and RWT (p &lt; 0.001); and for hip joint stiffness, we found significant differences between S1 and S–1 during WRT and RWT (p ≤ 0.001). Additionally, stance phase mechanical energy generation was observed to transfer from proximal to distal joints at S0 during WRT, and from distal to proximal at S0 during RWT. Transition step ankle kinematic and kinetic patterns were similar to the target locomotion task gait format in both WRT and RWT. Moreover, RWT required longer adaptation time compared with WRT. These findings indicate that WRT and RWT were modulated before and after the actual transitions, not within a single step. Redistribution of joint mechanical work generation was related to gait transition triggers, which modulate the WRT and RWT process.

Today, rupture of the anterior cruciate ligament is the most common heavy injury in athletes, but it can also occur in sedentary subjects. Its treatment, always adapted to the lifestyle, age and will of the patient, often remains surgical. However, despite its frequency and universality, there are still walking disorders following the operation. These disorders sometimes persist for several months, or even several years after surgery. The present study is therefore interested in determining the risk factors linked to walking disorders following reconstruction of the anterior cruciate ligament. The objective of this study is to determine what risk factors associated with walking disorders are after reconstruction of the anterior cruciate ligament by hamstring graft. This study focused on factors that may exist at 3 and 6 months postoperatively. Two populations participated in this study, a healthy population and a population having benefited from reconstruction of the anterior cruciate ligament. The operated test group is divided into two subgroups, one with a postoperative period of 3 months and the second at 6 months. All subjects were subjected to the same protocol, their gait on the treadmill was analyzed and evaluated with an Optogait® analysis system. A univariate analysis was carried out first. Then, a multivariate analysis by adjustment method was carried out in order to eliminate the potential confounding factors. The comparison of the results between the populations in the univariate analysis shows an absence of significant results however there are trends. The statistical results of the multivariate analysis showed interactions in the two subgroups of the operated population.In fact, it turns out that at 3 months there is a tendency to worse gait disorders in subjects with a high BMI reflecting overweight, when an associated surgical procedure has taken place on the meniscus, in subjects over 35 years of age and males. On the other hand, at 6 months, the tendency to worsening is visible only in the strata represented by subjects with a BMI corresponding to overweight, as well as in subjects having benefited from a meniscal suture associated with ACL reconstruction. .The results of the present study show that there are certain factors which tend to increase the risk of these walking disorders after reconstruction of the anterior cruciate ligament by hamstring graft, these factors are different depending on the time postoperative.

Computer vision-based gait recognition (CVGR) is a biometric technology that has gained considerable attention in recent years due to its non-invasive, unobtrusive, and difficult-to-conceal nature. Current CVGR systems often transmit collected data to a cloud server for machine-learning-based gait pattern recognition. While effective, this cloud-centric approach can lead to increased system response times. Alternatively, the emerging paradigm of edge computing, which involves moving computational processes to local devices, offers the potential to reduce latency, enable real-time surveillance, and eliminate reliance on internet connectivity. Furthermore, recent advancements in low-cost, compact microcomputers capable of handling complex inference tasks (e.g., Jetson Nano, Xavier NX, AGX Xavier, Raspberry Pi, and Khadas) have created exciting opportunities for deploying CVGR systems at the edge. This paper reports the state of the art in gait data acquisition modalities, feature representations, models, and architectures for CVGR systems amenable for edge computing. Moreover, this paper addresses the general limitations and highlights new avenues for future research in the promising intersection of CVGR and edge computing.

Crouch gait is a motor complication commonly associated with cerebral palsy, spastic diplegia, stroke, and motor-neurological pathologies, broadly defined as knee flexion in excess of 20° in the gait cycle. Uncorrected crouch gait results in fatigue, joint degradation, and loss of ambulation. Torsion springs have been used in cycling to store energy in knee flexion to reduce fatigue in the quadriceps during knee extension. SolidWorks was used to design a passive exoskeleton for the knee, incorporating torsion springs of stiffnesses 20,000 N/mm and 30,000 N/mm at the knee joint to correct four different crouch gaits. OpenSim was used to gather data from moments produced and knee angles from each crouch gait and the normal gait. Motion analysis of the exoskeleton was simulated using knee angles for each crouch gait and compared with moments produced with the normal gait moments in the stance phase of the gait cycle. All crouch gait moments were significantly reduced, and the correction of peak crouch moments was achieved corresponding to the normal gait cycle during the stance phase. These results offer significant potential for nonsurgical and less invasive options for wearable exoskeletons in crouch gait correction.

The use of inertial measurement units (IMUs) to compute gait outputs such as the 3D lower limb kinematics is of huge potential, but no consensus on the procedures and algorithms exists. This study aimed at evaluating the validity of a 7-IMUs system against the optoelectronic system. Ten asymptomatic subjects were included. They wore IMUs on their feet, shanks, thighs and pelvis. The IMUs were embedded in clusters with reflective markers. Reference kinematics was computed from anatomical markers. Gait kinematics was obtained from accelerometer and gyroscope data after sensor orientation estimation and sensor-to-segment (S2S) calibration steps. The S2S calibration steps were also applied to the cluster data. IMU-based and cluster-based kinematics were compared to the reference through root mean square errors (RMSEs), centered RMSEs (after mean removal), correlation coefficients (CCs) and differences of amplitude. The mean RMSE and centered RMSE were respectively 7.5° and 4.0° for IMU-kinematics, and 7.9° and 3.8° for cluster-kinematics. Very good CCs were found in the sagittal plane for both IMUs and cluster-based kinematics at the hip, knee and ankle levels (CCs&gt;0.85). The overall mean amplitude difference was about 7°. These results reflected good accordance of our system with the reference, especially in the sagittal plane, but the presence of offsets requires caution for clinical use.

Many studies utilize sensors to measure foot plantar pressure and analyze gait patterns, often focusing on assessing weight-bearing symmetry or asymmetry compared to control groups. However, a critical question arises: does the selection of the control group significantly impact study outcomes? Does chronic low back pain affect foot plantar pressure measurements? This experimental study involved 23 participants, including healthy individuals and those without foot disorders but with chronic low back pain. Dynamic foot pressure measurements were conducted using the Ortopiezometr, and data were analyzed using the "Steps" program. Participants were divided into two groups: Group 1 comprised completely healthy individuals, while Group 2 consisted of individuals without foot problems but with moderate chronic low back pain. The findings highlight a prevalence of energy release in the forefoot sensors compared to the hindfoot for both the right and left legs in most cases. Even among healthy volunteers, achieving perfect symmetry in the maximum values on the sensors for the right and left feet was a challenge. Results showed no statistically significant differences in energy released on specific sensors or duration of gait phases between the groups. Essentially, this suggests that foot pressure patterns are comparable between healthy individuals and those with low back pain. The use of sensor-equipped inserts for pedobarographic examinations indicates that, in cases of degenerative changes in the lumbar and sacral spine without accompanying acute pain, gait patterns resemble those of the healthy population.

The goal of this study was to analyze the instability during stepping of young and older adults at fast and spontaneous speed. To this aim, the anteroposterior and the mediolateral distances between the body center of mass (COM) and the minimum moment axis (MMA) were computed. A total of 15 young adults (25y.o. [19-29]) and 15 older adults 68.7y.o. [63-77] volunteered for this study. For the computation of the distances, a complete biomechanical protocol combining two force platforms and a 3D motion capture analysis system was setup. The subjects were equipped with 47 reflective markers and were modeled as a frictionless multibody with 19 segments, 18 joints and 42 degrees of freedom and were asked to perform a stepping at both speeds. The stepping was divided in 5 phases with successive swing and double stance phases. The greater instability was observed during the swing phases. The distances indicate a significant higher instability at fast speed for both groups (p &lt; 0.001) for all the phases. The anteroposterior distance also increases significantly for older adults highlighting greater instability while no differences were observed for the mediolateral distance all along the 5 phases suggesting higher risks of backward of forward falls during stepping.

As there is lack of understanding about the effect of transitioning between different flooring materials on the gait of older adults, this study investigated the effect of transitioning between a carpeted floor and a vinyl floor on the gait characteristics of older adults. Fourteen older (65 years old and over) and 14 younger (18 to 35 years old) adults walked on different transitional floors by measuring various gait parameters. While the older participants had greater toe clearance than their younger counterparts, the older participants had smaller toe clearance on a carpeted floor than on a vinyl floor, which would increase the probability of a trip-induced fall. Further, the study found the slower transitional acceleration of the whole body COM and the increased friction demand, especially during the toe-off phase, rather than heel contact phase, which will lead to a slip-induced fall on a vinyl floor shortly after transitioning from a carpeted floor to a vinyl floor. Although the increased likelihood of a slip or trip accident was found throughout the changes in gait parameters, the older participants did not perceive of slipping and tripping much. Therefore, older adults are recommended to be made aware of the danger of slipping and tripping while transitioning between different flooring materials.

Tripping is the largest cause of falls and low swing foot ground clearance during the mid-swing phase, particularly at the critical gait event known as Minimum Foot Clearance (MFC) is the major risk factor for tripping-related falls. Intervention strategies to increase MFC height can be effective if applied in real-time based on feed-forward prediction. The current study investigated the capability of machine learning models to classify the MFC into various categories using toe-off kinematics data. Specifically, three MFC sub-categories (less than 1.5cm, between 1.5-2.0cm and higher than 2.0cm) were predicted applying machine learning approaches. A total of 18,490 swing phase gait cycles’ data were extracted from six healthy young adults, each walking for 5-minutes at a constant speed of 4km/h on a motorised treadmill. Both K-Nearest Neighbour (KNN) and Random-Forest were utilised for prediction based on the data from toe-off for five consecutive frames (0.025s duration). Foot kinematics data were obtained from inertial measurement unit attached to the mid-foot, recording tri-axial linear accelerations and angular velocities of the local coordinate. KNN and Random-Forest achieved 84% and 86% accuracy, respectively, in classifying MFC into the three sub-categories with run time of 0.39 seconds and 13.98 seconds respectively. The KNN-based model was found to be more effective if incorporated into an active exoskeleton as the intelligent system to control MFC based on the preceding gait event, toe-off due to its quicker computation time. The machine learning based prediction model shows promise for the prediction of critical MFC data indicating higher tripping risk.

The aim of this study was to assess the ability of multiscale sample entropy (MSE), refined composite multiscale entropy (RCMSE), and complexity index (CI) to characterize gait complexity through trunk acceleration patterns in subjects with Parkinson's disease (swPD) and healthy subjects, regardless of age or gait speed. The trunk acceleration patterns of 51 swPD and 50 HS were acquired using a lumbar-mounted magneto-inertial measurement unit during their walking. MSE, RCMSE, and CI were calculated on 2000 data points, using scale factors (τ) 1-6. Differences between swPD and HS were calculated at each τ, and the area under the receiver operating characteristics, optimal cutoff points, post-test probabilities, and diagnostic odds ratios were calculated. MSE in the antero-posterior direction at τ 4 and τ 5, and MSE in the ML direction at τ 4 outperformed the other entropy measures in terms of discriminative ability and characterized the gait of swPD with 79%, 82%, and 78% probabilities, respectively, and correlated with the motor disability, pelvic kinematics, and stance phase. Using a time series of 2000 data points, a scale factor of 4 or 5 in the MSE procedure can be considered as a marker of gait variability and complexity in swPD.

This research article describes the creation of a mock-up for a Smart Insole prototype that employs Force Sensitive Resistors (FSRs) and an ADXL345 accelerometer. The mock-up is an early step towards realising the concept and functionality of the planned Smart Insole system. The key factors in the mock-up's design, integration, and testing are highlighted, with a focus on the iterative refining and optimisation process. The mock-up, which was carefully planned and implemented, highlights the practicality and possible applications of Smart Insole technology in healthcare, sports performance measurement, and rehabilitation. The paper outlines the development process and implementation of a "Smart Insole" utilizing Force Sensitive Resistors (FSR) and the ADXL345 accelerometer. The project aims to create an innovative wearable technology solution for monitoring foot biomechanics and enhancing human performance. The Smart Insole prototype integrates FSRs strategically placed on the insole to capture pressure distribution across the foot, along with an ADXL345 accelerometer to track foot orientation and movement. Through a combination of hardware integration, firmware development using Arduino IDE, and visualization using Processing application, the Smart Insole offers real-time monitoring and analysis of gait dynamics, pressure distribution, and foot movement.

Quantitative analysis of human gait is critical for early discovery, progressive tracking, and rehabilitation of neurological and musculoskeletal disorders, such as Parkinson’s Disease, stroke, and Cerebral Palsy. Gait analysis typically involves estimating gait characteristics, such as spatio-temporal gait parameters and gait health indicators (e.g., step time, length, symmetry, and balance). Traditional methods of gait analysis involve the use of cameras, wearables, and force plates, but are limited in operational requirements when applied in daily life - such as direct line-of-sight, carrying devices, and dense deployment. This paper introduces a novel approach for gait analysis by passively sensing footstep-induced floor vibrations during walking using vibration sensors mounted on the floor surface. Our approach is non-intrusive, scalable, and perceived as more privacy-friendly, making it suitable for continuous gait health monitoring in daily life. We developed a floor vibration-based gait analysis framework to estimate various gait parameters that are used as standard metrics in medical practices, including temporal parameters (step, stride, stance, swing, double-support, single-support time) and spatial parameters (step length, width, angle, stride length), and extracts gait health indicators (cadence/walking speed, left-right symmetry, gait balance, initial contact types). The main challenge is that floor vibrations are distinct across different floor types. To address this challenge, our approach develops floor-adaptive algorithms to extract floor-specific features and is designed to be generalizable to various settings, including homes, hospitals, and eldercare facilities. We evaluate our approach through real-world walking experiments with 20 adults with 12,231 labeled gait cycles across concrete and wooden floors. Our results show 90.5% (RMSE 0.08s), 71.3% (RMSE 0.38m), and 92.3% (RMSPE 7.7%) accuracy in estimating temporal, spatial parameters, and gait health indicators, respectively.

Adults with obesity experience high rates of disability and rapid functional decline. Identifying movement dysfunction early can direct intervention and disrupt disability development, however subtle changes in movement are difficult to detect with the naked eye. This study evaluated how a portable, inertial measurement unit (IMU)-based motion capture system compares to a laboratory-based optokinetic motion capture (OMC) system for evaluating gait kinematics in adults with obesity. Ten adults with obesity performed overground walking while equipped with the OMC and IMU systems. Fifteen gait cycles for each participant were extracted for 150 total cycles analyzed. Kinematics were compared between OMC and IMU across the gait cycles (coefficient of multiple correlations), at clinically significant time points (interclass correlations), and over clinically relevant ranges (Bland Altman plots). Sagittal plane kinematics were most similar between systems, especially at the knee. Sagittal plane joint angles at clinically meaningful timepoints were poorly associated except for ankle dorsiflexion at heel strike (ρ=0.38) and minimum angle (ρ=0.83). Most motions had more than 5° difference between systems across the range of angles measured. IMU-based motion capture shows promise for detecting subtle gait changes in adults with obesity. However, more work is needed before this method can replace traditional OMC.

The purpose of this scoping review was to examine the literature on the use of anti-gravity treadmill and its effects on lower limb motor functions in children and adolescents with locomotor impairments. Four databases (MEDLINE, CINAHL, Embase, Web of Science) were searched for articles from inception to August 2021. Inclusion criteria were: (1) experimental or quasi-experimental studies using the anti-gravity training as the primary intervention; (2) studies conducted in paediatricpediatric participants; (3) articles reporting outcomes related to the lower limb functions; and (4) studies published in French or English. Fifteen articles were included in the review. Studies included children and adolescents aged 4–18 years with locomotor impairments. The intervention duration was ranged from 2 and to 12 weeks, with 2-5 sessions per week. Included studies showed reported that anti-gravity training induces improvements in muscle strength, balance, spatiotemporal gait parameters, and walking endurance in children with locomotor impairments. This review provides relevant information about the modalities, outcomes and limits associated with the anti-gravity training protocol reported in the literature. Overall, the anti-gravity treadmill training could be viewed as a valuable training modality for children with cerebral palsy. However, more precise, and comprehensive description of anti-gravity rehabilitation protocols would be useful.

Brucellosis is a multi-system infectious disease that exhibits with various manifestations and complications. Neurobrucellosis is a rare but serious presentation of brucellosis that can be discovered in every stages of the disease. Laboratory tests and physical examination and patient history are generally the basis for diagnosing the disease. It has both insidious and prolonged clinical course of the disease and long-term therapies. Also the most common pattern of exhibition is subacute or chronic. We reported a case of young female who had history of painless weakness in the right lower limb (proximal and distal) that started gradually and had progressed over the time, and after a month she felt weakness in the left lower limb with the same pattern. Lumbosacral Magnetic resonance imaging (MRI) with and without contrast was shown evidence of enhancement thickening of caudal equina ventral roots. Brucella antigen titer was positive, the result was 1/160. And other clinical tests were normal. Patient treated with Intravenous injection (IV) Rifampicin and Intravenous Cotrimoxazole. patient was discharged with good health and continuinng all two medications for 5 months. The descision was taken to report this case as a result of entire respond in patient’s illness after a enduring disease. Neurobrucellosis is a treatable disease in which it would be better to consider a high indication of suspicion. Due to if ignored, it may cause significant morbidity and mortality.

Individuals may exhibit altered foot mechanics, in this case foot pronation, only when fatigue sets in. Therefore, a more evidence-based understanding of these fatigue-induced changes may be helpful for future gait analysis and return to play tests, since fatigue could provide new insights that might explain a person’s complaints. Methods: 25 healthy test persons (24.3±2.7 years, BMI: 22.7±2.8) participated in this controlled non-randomized study of unilateral fatigue of the right foot stabilizing muscles with regard to the pronation of the foot, measured by navicular drop (ND) in a static (statND) und dynamic (dynND) state. The left foot served as a control. Surface electromyography was used to verify fatigue. Results: While statND didn’t change, the dynND increased significantly by 1.44±2.1 mm (= 22.3 %) after fatigue of the foot stabilizing muscles. No correlation was found between statND and dynND. Conclusion: Muscular fatigue can affect foot pronation. The dynND appears to be more representative of the loads in everyday life, whereby most studies work with the statND.

Previous studies have reported that clinical walk tests could not predict development of frailty. With advancements in wearable technology, it may be possible to predict the development of frailty using loading asymmetry parameters during clinical walk test. This prospective cohort study aimed to test the hypothesis that increased limb loading asymmetry predicts frailty risk in community-living older adults. Sixty-two independently ambulant community-living adults aged ≥ 65 years were recruited, and forty-seven subjects completed the one-year follow-up after baseline. Loading asymmetry index of net and regional (forefoot, midfoot, and rearfoot) plantar forces were collected using force sensing insoles (100 Hz) during a 10-m walk test with their maximum speed. Development of frailty was defined if the participant progressed from baseline at least one grading group of frailty at follow-up period using the Kihon Checklist. Fourteen subjects developed frailty at follow-up period. Increased risk of frailty was associated with each 1% increase in loading asymmetry of net impulse (Odds ratio 1.153, 95% CI 1.001 to 1.329). Loading asymmetry of net impulse significantly correlated with asymmetry of peak force in midfoot force. These results indicate the feasibility of measuring plantar forces of gait during clinical walking tests, and underscore the potential of using load asymmetry as a tool to augment frailty risk assessment in community-dwelling older adults.

Techniques have been developed to determine whether a horse is in resting or running mode by measuring at least one of the following: the horse's body temperature, heart rate, oxygen saturation, and exercise level. However, the existing technology has not reached a level where a trainer can accurately assess a horse's running conditions, such as speed, acceleration, stride, limb rotation, ground impact, and frontal balance, during the training of racehorses. In addition, data is needed to quickly detect abnormalities during training and provide a basis for changing the intensity of training or deciding to give a rest to the horse. Devices that detect abnormalities in equine gait with high sensitivity will contribute to animal welfare and increase the athletic longevity of horses. This paper reports the development results of a new IoT device that acquires, processes, and analyzes information such as heart rate, position, speed, acceleration, pitch, stride, and ground contact during a training of racehorses. The purpose of this development is to provide an information on a novel processing system, device, method, and program that can analyze training condition of racehorses from multiple angles.

The purpose of the present study was to investigate the effect of the laterally moving tactile stimuli to the sole on the anticipatory postural adjustment (APA) of the gait initiation. Thirteen healthy males participated in this study. A sound cue was provided at the beginning of each trial. The moving tactile stimuli were delivered to the sole after the start cue. The loci of the tactile stimuli moved from the left to right most side of the sole, and then moved from the right to left most side of that in a stimuli cycle. The duration of one stimuli cycle was 960 ms, and this cycle repeated 16 times in a trial. The participants made three steps forward from quiet stance at the participants' preferred time after the start cue. The APA did not onset at the specific direction or phase of the moving tactile stimuli, indicating that they did not use the stimuli as a trigger for initiating the gait. The moving tactile stimuli decreased the amplitude and increased the duration of the APA. The moving tactile stimuli increased the time between the APA onset and toe-off of the initial support leg, indicating that they moved slower when initiating gait during the moving tactile stimuli. Those findings are explained by the view that suppression of the APA induced by the moving tactile stimuli to the sole is caused by the decrease in the velocity of the gait initiation, and the slower velocity of the gait initiation is caused by masking tactile sensation of the sole.

The way in which a person walks, known as human gait, is a significant indicator of overall health and well-being. Abnormalities in gait can indicate the presence of metabolic disorders, such as diabetes or obesity. However, detecting these disorders can be challenging using traditional methods, which often involve subjective assessments or invasive procedures. In this study, a novel methodology known as Criticality Analysis (CA) was proposed for the detection and monitoring of human gait in people with metabolic disorders taking part in an intervention to increase activity and reduce weight. The CA approach utilised inertial measurement unit gait data, alongside clinical health measures. This allows for the control of nonlinear growth in the system, resulting in lower dimensional, nonlinear, free-scale, stable, controlled, and organised trajectories. These trajectories were then analysed using a Support Vector Machine (SVM) algorithm, which is well-suited for this task due to its ability to handle nonlinear and dynamic data. The combination of the CA approach and the SVM algorithm demonstrated high accuracy and non-invasiveness in detecting metabolic disorders, yielding an average accuracy within the range of 78.2% to 90%. Additionally, the classification technique accuracy, at a group level was observed to reduce during period of the intervention (e.g., from week 2 to week 3) alongside changes in fitness and health, which indicates the potential of using the approach to measure and monitor biological systems. As such, this novel methodology has the potential to be a valuable tool for healthcare professionals in detecting and monitoring metabolic disorders, as well as other unknown diseases associated with the human biological system.

Background: This study aims to set out key clinical features of different Motoric Cognitive Risk (MCR) subtypes based on individual quantitative measures of cognitive impairment and to compare their predictive power on survival over an 8-year observation time. Methods: We analyzed data from a population-based study of 1138 subjects aged 65 years and older in south Italy. These individuals were targeted and allocated to subtypes of the MCR phenotype according to the slowness criterion plus one other different cognitive domain for each characterized phenotype. Clinical evaluation and laboratory assays, along with a comprehensive battery of neuropsychological and physical tests, completed the sample investigation. Results: MCR prevalence was found to be 9.8% (N=112), 3.6% (N=41), 3.4% (N=39), and 1.8% (N=21) for the MCR, MCR-GlobalFunction, MCR-StructuredSCC, and MCR-SCC&amp;GlobalFunction, respectively. Univariate Cox survival analysis showed an association only of the MCR-GlobalFunction subtype with a significant, 1.5-fold increased risk of overall death as compared to the other counterparts (HR 2.53, 95%CI 1.28 to 4.99, P-value&lt;0.01) over an 8-year observation period, even after major adjustment (HR 2.02, 95%CI 1.02 to 4.02). Conclusions: MCR phenotypes assigned to the MMSE cognitive domain are more likely to have an increased risk of overall mortality, 1.5-fold higher than counterparts, over 8-year observation.

The genetic development of commercial broiler led to body misconfiguration and consequent walking disabilities, mainly at the slaughter age. The present study aimed to identify broiler locomotion ability using image analysis automatically. A total of 40 broiler 40 d-old were placed to walk on a specially built runway, and their locomotion was recorded. An image segmentation algorithm was developed, and the coordinates of the bird's center of mass were extracted from the segmented images for each frame analyzed, and the Unrest Index (UI) was applied. We calculated the center of mass's movement of the broiler walking's lateral images, therefore, capturing the bird's displacement speed in the onward direction. Results indicated that broiler speed on the runway tends to decrease with the increase of the gait score. The locomotion did not differ between males or females. The proposed algorithm was efficient if predicting the broiler gait score based on their displacement speed.

Stroke often results in impaired gait, which can limit community ambulation and the quality of life. Recent works have shown the feasibility of transcranial Direct Current Stimulation (tDCS) as an adjuvant treatment to facilitate gait rehabilitation. Since the cerebellum plays an essential role in balance and movement coordination, which is crucial for independent overground ambulation, so, we investigated the effects of cerebellar tDCS (ctDCS) on the post-stroke overground gait performance in chronic stroke survivors. Fourteen chronic post-stroke male subjects were recruited based on convenience sampling at the collaborating hospitals where ten subjects finally participated in the ctDCS study. We evaluated the effects of two ctDCS montages with 2mA direct current, a) optimized configuration for dentate stimulation with 3.14cm² disc anode at PO10h (10/5 EEG system) and 3.14cm² disc cathode at PO9h (10/5 EEG system), and b) optimized configuration for leg lobules VII-IX stimulation with 3.14cm² disc anode at Exx8 (electrodes defined by ROAST) and 3.14cm² disc cathode at Exx7. We found ctDCS to be acceptable by all the exposed subjects. The ctDCS intervention had an effect on the 'Normalised Step length Affected side' (p=0.1) and 'Gait Stability Ratio' (p=0.0569), which was found using Wilcoxon signed-rank test at 10% significance level. Also, ctDCS montage specific effect was found using a two-sided Wilcoxon rank-sum test at a 5% significance level for 'Step Time Affected Leg' (p=0.0257) and '%Stance Time Unaffected Leg' (p=0.0376). Moreover, the changes in the quantitative gait parameters across both the montages were found to be correlated to the mean electric field strength in the lobules based on partial least squares regression analysis (R² statistic = 0.6574) where the mean electric field strength at the cerebellar lobules, Vermis VIIIb, Ipsilesional IX, Vermis IX, Ipsilesional X, had the most loading. In conclusion, our feasibility study indicated the potential of a single session of ctDCS to contribute to the immediate improvement in the balance and gait performance in terms of gait-related indices and clinical gait measures.

Digital gait monitoring is increasingly used to assess locomotion and fall risk. The aim of this work is analyzing the changes in the foot-floor contact sequences of Parkinson’s Disease (PD) patients in the year following the implant for deep brain stimulation (DBS). During their best-ON condition, 30 PD patients underwent gait analysis at baseline (T0), at 3 months (T1), and 12 months (T2) after the DBS neurosurgery for bilateral high-frequency subthalamic nucleus stimulation. Thirty age-matched controls underwent gait analysis once. Each subject was equipped with bilateral foot-switches and a 5-minute walk was recorded, including both straight-line and turnings. The walking speed, turning time, stride time variability, percentage of atypical gait cycles, stance, swing, and double support duration were estimated. Overall, the gait performance of PD patients improved after DBS, as also confirmed by the decrease in the UPDRS-III score from 19.4±1.8 to 10.2±1.0 points (T0 vs. T2) (p < 0.001). In particular, the percentage change of atypical gait cycles of PD more affected side decreased at T1 (Straigh-line: -72%; Turnings: -43%) and at T2 (Straigh-line: -54%; Turnings: -20%). The percentage of atypical gait cycles proved an informative digital biomarker for quantifying PD gait changes after DBS, both in straight-line paths and turnings.

Background: Three-dimensional gait analysis plays a crucial role in the rehabilitation assessment of post-stroke hemiplegic patients. However, the data generated from such analysis is often complex and difficult to interpret in clinical practice, requiring extensive time and complicated procedures. The Gait Deviation Index (GDI) serves as a simplified metric for quantifying the severity of pathological gait. Although isokinetic dynamometry is widely employed in muscle function assessment and rehabilitation, its application in gait analysis remains underexplored. Objective: This study aims to investigate the use of isokinetic muscle strength data obtained from the Biodex system, combined with machine learning techniques, to predict the GDI in hemiplegic patients. Methods: A cohort of 150 post-stroke hemiplegic patients was evaluated. The peak torque, peak torque/body weight, maximum work of repeated actions, coefficient of variation, average power, total work, acceleration time, deceleration time, range of motion, and average peak torque for both flexor and extensor muscles on the affected side were measured at three angular velocities (60°/s, 90°/s, and 120°/s) using the Biodex System 4 Pro. GDI was calculated using data from a Vicon three-dimensional motion capture system. The study employed four machine learning models—Lasso regression, random forest (RF), support vector regression (SVR), and BP neural networks—to model and validate the data. Model performance was evaluated using mean squared error (MSE), the coefficient of determination (R²), and mean absolute error (MAE). SHapley Additive exPlanations (SHAP) analysis was used to enhance model interpretability. Results: The RF model outperformed others in predicting GDI, with an MSE of 16.18, an R² of 0.89, and an MAE of 2.99. In contrast, the Lasso regression model yielded an MSE of 22.29, an R² of 0.85, and an MAE of 3.71. The SVR model had an MSE of 31.58, an R² of 0.82, and an MAE of 7.68, while the BP neural network exhibited the poorest performance with an MSE of 50.38, an R² of 0.79, and an MAE of 9.59. SHAP analysis identified the maximum work of repeated actions of the extensor muscles at 60°/s and 120°/s as the most critical features for predicting GDI, underscoring the importance of muscle strength metrics at varying speeds in rehabilitation assessments. Conclusion: This study highlights the potential of machine learning techniques in analyzing complex clinical data. The developed GDI prediction model, based on isokinetic dynamometry data, offers a novel, streamlined, and effective tool for assessing rehabilitation progress in post-stroke hemiplegic patients, with promising implications for broader clinical application.

Background : Drug treatments for gait disorders in post-stroke patients aim to reduce muscular hyperactivity. Analysis of muscle activity is essential to help clinicians understand these disorders. The aim of this study was to quantify changes in muscle synergies before (PRE) and after (POST) rectus femoris nerve block. Methods : Gait analysis of 8 post-stroke patients before and immediately after nerve block. Muscle synergies were quantified from electromyographic signals. We have selected: the account for variance indicating the robustness of the synergies, the recruitment selectivity index indicating the degree of multiplexing of the synergies, and the recruitment consistency index indicating the variability of the synergies. Results : A decrease in VAF is observed, suggesting a reduction in gait pattern robustness. We also note that spatial and temporal primitives are slightly different (IRC, IRS) in PRE vs. POST, and that their activation is more nested in POST than in PRE. Conclusions : The motor nerve block has not created new muscle synergies of the paretic limb during gait, but indicates that there is flexibility in motor organization. This method of quanti-fication may enable clinicians to assess the motor adaptation potential of their post-stroke patient.

Background: Here, we investigated the inflammaging and physical performance in older adults before and after the COVID-19 pandemic. Methods: Women(n=18) and men(n=7) older were evaluated before the COVID-19 pandemic(PRE), 12 months after the lockdown(POST), and 10 months after resuming exercise training(POS-TR). Physical tests [gait speed(GS) and timed-up-and-go(TUG)]; muscle strength (handgrip-HG), and serum cytokine levels were assessed. Results: The older women showed higher GS and TUG at POST than PRE and POST-TR, besides lower HG at POST-TR than PRE, whereas older men exhibited lower HG at POST and POST-TR than PRE. Both groups presented (1)lower IL-10 and IL-12p70 values in contrast to higher IL-6/IL-10 and IL-8/IL-10 ratios at POST than PRE; (2)higher IL-10 values and lower IL-8/IL-10 ratio at POST-TR than POST; (3)higher IL-12p70/IL-10 ratio at POST-TR than PRE and POST. Particularly older women showed: (4)lower IL-6 values at POST and POST-TR than PRE; (5)lower IL-8 and IL-10 values at POST-TR than POST; (6)and higher TNF-α/IL-10 and IFN-γ/IL-10 ratios at POST than PRE and POST-TR. Significant correlations between the variables were found in both groups. Conclusion: During the COVID-19 pandemic, detraining and resumption of exercise training promoted distinct alterations in physical capacity and inflammaging among older women and older men population.

Background: This study aimed to investigate how external perturbations caused by the treadmill belt's acceleration (Acc) and deceleration (Dec) during the Initial Contact (Initial), Mid Stance (Mid) and Pre-Swing (ToeOff) phase affect gait regularity in young adults. Methods: Twenty-one healthy young females walked on a treadmill in a virtual environment (Grail, Motek), where four unexpected perturbations were applied to the left belt at Initial, Mid, and ToeOff. Sample Entropy (SampEn) was calculated for the center of mass (CoM) displacements, for six perturbation scenarios in three directions: anterior-posterior (AP), medial-lateral (ML), and vertical (vert), with SampEn vector lengths (m) ranging from 2 to 10. Results: The CoM displacement exhibited its highest regularity (low SampEn values) in the AP and vert-directions during Dec_ToeOff, across all m values. Similarly, this pattern was observed in the ML-direction, but exclusively for m = 2 and 4. The least regular CoM trajectories (high SampEn values) were for Dec_Mid in the AP-direction, across all m values. This trend persisted in the ML-direction, only for m = 2 and 4. However, the most irregular CoM displacements in the ML-direction occurred during Dec_ToeOff for the remaining m values. Vertical CoM displacements exhibited the highest irregularities during Dec_Initial for m ≥ 4. Conclusions: Evaluating the regularity of CoM displacements using SampEn can be a useful tool for assessing how gait perturbations are handled.

This study examines the effects and durability of postural exercise on gait kinematics in people with intellectual and developmental disabilities (IDD). Thirty-four men with mild IDD were assigned to either the training group (n = 19) or the control group (n = 15). The TG performed the intervention over 8 weeks, 3 days/week, 1 h/day. The results indicated that the intervention program had a significant effect on some variables of gait. Also, in the TG between post-test and follow-up, there was no significant difference, which indicated that gait variables were maintained by the TG one month after the end of the program. This study provides evidence that postural exercises can be used as an effective intervention for improving gait in individuals with IDD.

To maintain a healthy lifestyle, adults rely on their ability to walk while simultaneously managing multiple tasks that challenge their coordination. This study investigates the impact of cognitive dual-task on lower limb muscle activities in 21 healthy young adults during both gait initiation and steady-state gait. We utilized wireless electromyography sensors to measure muscle activities, along with a 3D motion capture system and force plates to detect the phases of gait initiation and steady-state gait. Participants were asked to walk at their self-selected pace, and we compared single-task and dual-task conditions. We analyzed mean muscle activation and co-contraction in the biceps femoris, vastus lateralis, gastrocnemius, and tibialis anterior muscles. The findings revealed that during gait initiation with the dual-task condition, there was a decrease in mean muscle activation and an increase in mean muscle c-contraction between the swing and stance limb compared to the single-task condition. In steady-state gait, there was also a decrease in mean muscle activation in the dual-task condition compared to the single-task condition. When participants performed dual-task activities during gait initiation, early indicators of reduced balance capability were observed. Additionally, during dual-task steady-state gait, knee stabilizer muscles exhibited signs of altered activation, contributing to balance instability.

Background Some patients with mild cognitive impairment (MCI) experience gait disturbances. However, there are few reports on the relationship between gait disturbance and cognitive function in patients with MCI. Therefore, we investigated the neural correlates of gait characteristics related to cognitive dysfunction. Methods Eighty patients diagnosed with MCI from three dementia centres in Gangwon-do, Korea were recruited for this study. We defined MCI as a Clinical Dementia Rating global score of 0.5 or higher, with a memory domain score of 0.5 or greater. The patients were classified as having either early or late MCI based on their Mini Mental Status Examination z-scores. Multiple logistic regression analysis was performed to examine the association between the gait characteristics and cognitive impairment. Analyses included variables such as age, sex, years of education, number of comorbidities, body mass index and height. Results Gait velocity, step count, step length, heel-to-heel base support, swing and stance phase duration, and support time were associated with cognitive function. A decrease in gray matter volume in the right pericalcarine area was associated with gait characteristics related to cognitive dysfunction. An increase in the curvature of gray matter in the right entorhinal, right lateral orbitofrontal, right cuneus, and right and left pars opercularis areas was also associated with gait characteristics related to cognitive dysfunction. Conclusion Since gait impairment is an important factor in determining activities of daily living in patients with mild cognitive impairment, the evaluation of gait and cognitive functions in patients with mild cognitive impairment is important.

The potential impact of a specific physical activity program on biomechanical gait parameters and neuromuscular strategies around the ankle joint in older adults with sarcopenic obesity (SO) remains largely unexplored. The objective of this study was to investigate the effectiveness of a 24-week Posture, Strengthening, and Motricity (PSM) program in improving neuromuscular strategies and biomechanical gait parameters in older adults with SO. 40 Participants were randomly assigned to either the trained group (TG) and the control group (CG). Only the TG received the PSM program. Standardized evaluations were performed before and after the intervention, including walking tests on an instrumented gait analysis treadmill to evaluate biomechanical gait parameters and EMG activity of ankle muscles. After the PSM program, TG exhibited an increase in comfortable walking speed (+80%, p<0.001) and step length (+38%, p<0.05). Moreover, TG demonstrated a reduction in CoP velocity (-26%, p<0.01). These gait modifications were associated with a decreased muscle activity during the different gait phases (p<0.05). The PSM program effectively improved gait, and neuromuscular capacities in older adults with SO. Notably, Results sheds light on the remarkable trainability of neuromuscular capacities in older adults with SO, despite the adverse effects of aging and obesity.

The need for miniaturized shear force sensors is expanding, particularly for biomedical applications. Examples include measuring interfacial shear stresses between a human and an external device (e.g., footwear or a prosthesis). However, there are considerable challenges in designing a shear sensor for these applications due to the need for a small package, low power requirements, and resistance to interference from motion artifact and electromagnetic fields. This paper presents the design, fabrication, and characterization sensor that measures two-axis shear force by detecting displacement between a color panel and a red, green, and blue light-sensing photodiode. The sensor response to applied displacements and forces was characterized under benchtop testing conditions. We also present the design of a prototype wireless version of the sensor for integration into footwear. The sensor exhibited strong agreement with gold standard measurements for two axis shear displacements (R2>0.99, RMSE≤5.0 µm) and forces (R2>0.99, RMSE≤0.94 N). This performance, along with the sensor’s scalability, miniaturized form, and low power requirements make it well-suited a variety of biomedical applications.

Gait analysis has historically been implemented in laboratory settings with expensive instruments; however, recently, wearable sensors have allowed the integration into clinical applications and use in daily activities. Previous studies have shown poor validity of ankle joints using inertial measurement units (IMUs), especially for small movement ranges. The purpose of this study was to validate the ability of commercially available IMUs to accurately measure the ankle joint angles during running. Ten healthy subjects participated in the study. Validation was performed by comparing the ankle joint angles measured using the wearable device with those obtained using the gold standard motion capture system during running. Reliability was evaluated using the intraclass correlation coefficient and standard error of measurement, whereas validity was evaluated using Pearson coefficient correlation method. Day-to-day reliability was excellent in the two planes for ankle joints. Validity was good in both sagittal and frontal planes for ankle joints. The results suggested that the developed device might be used as an alternative tool to the 3D motion capture system.

AYUMI EYE is an accelerometer-based gait analysis device that measures the 3D accelerations of the human trunk. This study investigated the measurement accuracy of the AYUMI EYE as hardware as well as the accuracy of the gait cycle extraction program via simultaneous measurements using AYUMI EYE, a ground reaction force (GRF), and an optical motion capture system called VICON. The study was conducted with four healthy individuals as participants. The gait data were obtained by simulating four different patterns for three trials each: normal walking, anterior-tilt walking, hemiplegic walking, and shuffling walking. The AYUMI EYE and VICON showed good agreement for both the acceleration and displacement data. The durations of subsequent stride cycles calculated using the AYUMI EYE and GRF were in good agreement based on the calculated cross-correlation coefficients (CCs) with an r value of 0.896 and p-value less than 0.05, and their accuracies for these results were sufficient.

People with diabetic foot frequently exhibit poor gait and balance. However, there is no review to inform digital biomarkers of poor gait and balance related to diabetic foot, measurable by wearables outside traditional gait laboratories. Such information could assist in designing remote patient monitoring platform to track changes in gait and balance dysfunction among people with diabetic foot for timely referral and intervention. Accordingly, we conducted a web-based review using PubMed. Our search was limited to human subjects and English-written papers published in peer-reviewed journals. We identified 20 papers in this review. We found preliminary evidence of digital biomarkers of gait and balance dysfunction in people with diabetic foot, measured by wearables, such as slow gait speed, large gait variability, unstable gait initiation, and large body sway. However, due to heterogeneities in included papers in terms of study design, movement tasks, and small sample size, more studies are recommended to confirm this preliminary evidence. Additionally, based on our review, we recommend establishing appropriate strategies to successfully implement wearable-based assessment into clinical practice for diabetic foot care.

Several studies have analyzed human gait data obtained from inertial gyroscope and accelerometer sensors mounted on different parts of the body. In this article, we take a step further in gait analysis and provide a methodology for predicting the movements of the missing parts of the legs. In particular, we propose a method, called GaIn, to control non-invasive, robotic, prosthetic legs. GaIn can infer the movements of both missing shanks and feet for humans suffering from double trans-femoral amputation using biologically inspired recurrent neural networks. Predictions are performed for casual walking related activities such as walking, taking stairs, and running based on thigh movement. In our experimental tests, GaIn achieved a 4.55 degree prediction error for shank movements on average. However, a patient's intention to stand up and sit down cannot be inferred from thigh movements. In fact, intention causes thigh movements while the shanks and feet remain roughly still. The GaIn system can be triggered by thigh muscle activities measured with electromyography (EMG) sensors to make robotic prosthetic legs perform standing up and sitting down actions. The GaIn system has low prediction latency and is fast and computationally inexpensive to be deployed on mobile platforms and portable devices.

The progress in markerless technologies is bringing clinicians tools to rapidly evaluate tests such as Timed Up and Go (TUG) without compromising the time of the assessment, yet it raises questions about the potential trade-off in accuracy compared to traditional marker-based systems, suggesting that the precision of these evaluations is not yet conclusively established. The OpenCap system is an easy tool to process 3D kinematics with two iPhone cameras placed in front of the subject. Previous research has primarily focused on walking and movement towards the cameras with the subject facing the cameras (WF) and thus has been unable to disentangle the differences in the movement directions. We have compared the OpenCap system with a standard marker-based system for both walking directions. In OpenCap, we found significantly worse results capturing walking facing away from the cameras (RW). Compared to the marker-based system, our findings indicate troubles measuring kinematic parameters but provide good accuracy in measuring spatial-temporal parameters. These insights pave the way for refining markerless assessment technologies, potentially enhancing their utility in clinical settings.

Objectives: To compare the effects of explosive resistance training (RT) to strength RT on neu-romuscular and functional parameters and to analyze the relationship between changes in walking speed and improvements in plantar flexor (PF) neuromuscular parameters following interven-tions. Methods: 40 participants were randomly assigned to either an explosive RT group (EXG, n = 18; age = 80.41 ± 10.12 years; BMI = 22.89 ± 2.77 kg/m²) or a strength RT group (STG, n = 22; age = 82.89 ± 5.32 years; BMI = 23.81 ± 3.45 kg/m²). Both groups participated in the same PF RT regimen (3 sessions per week for 12 weeks), engaging in identical exercises. However, the EXG performed 3 to 5 sets of 12 to 14 repetitions at 40% to 45% of 1RM with a rapid concentric phase and a 3-second eccentric phase, while the STG performed 3 to 4 sets of 6 to 7 repetitions at 80% to 85% of 1RM, with both phases lasting approximately 3 seconds. Before and after the interventions, gait speed (m/s) was assessed using a 10-meter walking test, and relative maximal force (Relative F max, N/kg) was evaluated during maximal voluntary isometric contraction of PF. From the force-time curve, early (0 – 50 ms) and late (100 – 200 ms) rates of force development (RFD) were extracted from the linear slopes (Δ force / Δ time). Results: Gait speed significantly improved in both groups (p < 0.05). However, the improvement was more pronounced in the EXG compared to the STG (p < 0.05). Relative Fmax showed a more significant increase in the STG than in the EXG (p < 0.05). Moreover, a significant 10% increase in early RFD in the STG and a 20.1% increase in the EXG were observed (p < 0.05). The improvement in early RFD was greater in the EXG (p < 0.05). Additionally, late RFD improved significantly only in the EXG (+20.4%, p < 0.05). Conclusion: Explosive RT appears particularly effective in improving the ability to rapidly gen-erate force, which is essential for many daily activities requiring explosive movements and quick responses.

Objectives: To compare the effects of high-velocity resistance training to slow-velocity re-sistance training on neuromuscular and functional parameters and to analyze the relationship between changes in walking speed and improvements in neuromuscular parameters following intervetions. Methods: 40 participants were randomly assigned to either a high-speed resistance training group (GHS, n = 18; age = 80.41 ± 10.12 years; BMI = 23.81 ± 3.45 kg/m²) or a low-speed resistance training group (GLS, n = 22; age = 82.89 ± 5.32 years; BMI = 23.81 ± 3.45 kg/m²). Before and after the interventions, gait speed (m/s) was assessed using a 10-minute walking test, and relative maximal force (Relative F max, N/kg) was evaluated during maximal voluntary isometric con-traction of the plantar flexors. From the force-time curve, early (0 – 50 ms) and late (100 – 200 ms) rates of force development (RFD) were extracted from the linear slopes (Δ force / Δ time). Results: Gait speed significantly improved in both groups (p < 0.05). However, the improvement was more pronounced in the GHS compared to the GLS (p < 0.05). Relative Fmax showed a more significant increase in the GLS than in the GHS (p < 0.05). Moreover, a significant 10% increase in early RFD in the GLS and a 20.1% increase in the GHS were observed (p < 0.05). The improvement in early RFD was greater in the GHS (p < 0.05). Additionally, late RFD improved significantly only in the GHS (+20.4%, p < 0.05). Conclusion: High-velocity resistance training appears particularly effective in improving the ability to rapidly generate force, which is essential for many daily activities re-quiring explosive movements and quick responses.

Background: Gait analysis systems are crucial for rehabilitation but are often time-consuming and less accessible in low and middle-income countries like Brazil. GAITWell^® was developed to address these challenges with its modular and portable design for automated gait data extraction and analysis. This study evaluates its methodological properties. Methods: GAITWell^® uses discrete binary sensors on interconnected plates to collect gait data, analyzed via the DBSCAN algorithm. Each plate measures 44 cm x 37 cm and features an 11 x 7 discrete sensor array with 4 cm spacing. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC), standard error of the mean (SEM), and Bland-Altman plots. Concurrent validity was evaluated by comparing the GAITWell^® measurements with those obtained from the Qualisys Pro-Reflex through correlations. Results: Participated 38 healthy young adults, including 18 females (47.4%). The sample had an average age of 33.2 years (SD 13.0) and an average BMI of 26.6 kg/m² (SD 5.4). Correlations between GAITWell^® and Qualisys ranged from moderate to very high for most gait variables, except stride length (r = .360, p < .05). ICC_2,1 showed moderate to good agreement for most variables, except for double support times, cadence, and base of support. Preliminary analysis suggests that increasing the sensor resolution to 1.2 cm x 1.2 cm could potentially decrease the measurement error from 2 cm to 0.6 cm, representing a theoretical reduction of 70%. Conclusions: While low resolution affected GAITWell^® reliability, it remains a promising tool. Future research should focus on enhancing sensor accuracy to improve reliability.

Exoskeleton technology has been shown to be useful for individuals with spinal cord injury (SCI), potentially facilitating their recovery of motor function and social reintegration. However, studies on the safety and usability of exoskeletons are limited. This study aimed to design a powered exoskeleton for SCI and evaluate its safety and usability. Ten healthy adults participated in this study. The prototype exoskeleton featured an adjustable frame, computer-controlled hip and knee joint actuators, and a gait-trigger sensor. The experimental actions included walking, standing, and sitting, with and without the prototype. Safety outcomes included adverse events, vital signs, numerical rating scale (NRS) scores for pain, discomfort, and fatigue, and prototype-human body clearance. Usability outcomes included donning and doffing times, subjective ratings, gait speed, stride length, and kinematic parameters of hip and knee joint angles. Safety outcomes showed no serious adverse events, stable vital signs, minimal NRS scores, and acceptable clearance. Usability outcomes showed high efficiency and received positive ratings. Kinematic parameters showed significant positive correlations between normal walking and walking with the prototype for both hip and knee joint angles, confirming its effectiveness in assisting walking. However, further device improvements and gait parameter tuning are necessary for future clinical application.

This review delves into the growing field of flexible and stretchable strain sensors utilized in human gait analysis, focusing on determining knee bending angle and muscle activities when a human subject walks. Recent advancements have enabled these sensors to accurately capture biomechanical parameters while accommodating the body's natural movements. We examine the principles underlying these sensors' design and fabrication techniques, emphasizing their flexibility, stretchability, and biocompatibility for seamless integration into wearable systems. Through critical evaluation of existing methodologies, we assess the reliability and validity of these sensors in quantifying gait parameters. Furthermore, we discuss this technology's clinical and research implications, highlighting its potential in personalized rehabilitation and sports performance optimization. We provide an overview of flexible strain sensors and their application for analyzing human walking gait, especially for observing walking gait in rehabilitation programs. First, we present the basic working principles of various flexible strain sensors. Second, by the application of flexible strain sensors as walking gait monitoring. Finally, current challenges and future opportunities in this research area are discussed. By synthesizing current knowledge and outlining future directions, this review aims to provide insights for researchers and practitioners seeking to leverage flexible and stretchable strain sensors for comprehensive human gait analysis.

Gait variability (GV) is a crucial measure of inconsistency of muscular activities or body seg-mental movements during repeated tasks. Hence, GV might serve as a relevant and sensitive measure to quantify adjustments of walking control. However, has not been clarified whether GV is associated with walking speed to exploit effective better coordination level. Fourteen male stu-dents (age 22.4 ± 2.7 years, body mass 74.9 ± 6.8 kg, body height 1.78 ± 0.05 m) took part in this study. After three days of walking 1 km each day at a self-selected speed (SS) on asphalt with Apple Watch S. 7 (AppleTM), the participants were randomly evaluated on a treadmill at three different walking speed intensities for 10 minutes each one, at SS-20% / SS+20% of SS, with 5 minutes of passive recovery in-between. Heart rate (HR) was monitored beat-to beat and nor-malized as HR%MAX, while the rate of perceived exertion (RPE) (CR-10) was asked after each trial. Kinematic analysis was performed assessing the Contact Time (CT), Swing Time (ST), Stride Length (SL), Stride Cycle (SC) and Gait Variability as Phase Coordination Index (PCI). RPE and HR increased with higher walking speed (P = 0.005 and P = 0.035, respectively). CT and SC decreased as the speed increased (P = 0.0001 and P = 0.013, respectively), while ST remained un-changed (P = 0.277). SL increased with higher walking speed (P = 0.0001). Conversely, PCI was 3.81 ± 0.88 % (high variability) at 3.96 ± 0.47 km·h-1, 2.64 ± 0.75 % (low variability) at SS (4.94 ± 0.58 km·h-1), 3.36 ± 1.09 % (high variability) at 5.94 ± 0.70 km·h-1 (P = 0.001). These results indi-cate that while the metabolic demand and kinematics variables changing linearly with increasing speed, the most effective GV was observed at SS. Therefore, SS could be a new methodological approach to choose the individual walking speed, normalize the speed intensity, and avoid a gait pattern alteration.

Background: The aim of this study was to compare energy expenditure (EE) predicted by accelerometery (EEAcc) with indirect calorimetry (EEMETA) in individuals with hemiparesis. Methods: Twenty-four participants (12 with stroke and 12 healthy controls) performed a six-minute walk test (6MWT) during which EEMETA was measured using a portable indirect calorimetry system and EEACC was calculated using Bouten’s equation (1993) with data from a 3-axis accelerometer positioned between L3 and L4. Results: Median EEMETA was 9.85 [8.18;11.89] W·kg-1 in the stroke group, and 5.0 [4.56;5.46] W·kg-1 in the control group. Median EEACC was 8.57 [7.86;11.24] W·kg-1 in the control group and 8.2 [7.05;9.56] W·kg-1 in the stroke group. EEACC and EEMETA were not significantly correlated in either the control (p=0.8) or the stroke groups (p=0.06). The Bland-Altman method showed a mean difference of 1.77±3.65 W·kg-1 between EEACC and EEMETA in the stroke group and -2.08±1.59 W·kg-1 in the controls. Conclusions: The accuracy of the predicted EE, based on the accelerometer and the equations proposed by Bouten et al, is low in individuals with hemiparesis and impaired gait. This combination (sensor and Bouten's equation) is not yet suitable for use as a stand-alone measure in clinical practice for the evaluation of hemiparetic patients.

An ongoing EU Horizon 2020 Project called BionicVEST is investigating the effect of constant electrical stimulation (ES) of the inferior vestibular nerve in patients with bilateral vestibular dysfunction (BVD)[1]. The evidence is that constant ES results in improved postural stability and gait performance and so the question of central importance is how could constant ES of mainly saccular afferents in these BVD patients cause this improved performance? We suggest that the constant ES is substituting for the absent saccular neural input to the vestibular nuclei and the cerebellum in these BVD patients and indirectly via these structures to other structures which have been of great recent interest in motor control. One target area, the anterior midline cerebellum (the uvula) has recently been targeted as a location for deep brain stimulation in human patients to improve postural stability and gait. There are projections from midline cerebellum to basal ganglia including the striatum, structures involved in the initiation of gait. It may be that the effect of this activation of peripheral saccular afferent neurons is analogous to the effect of deep brain stimulation (DBS) by electrodes in basal ganglia acting to help alleviate the symptoms of patients with Parkinson's disease.

It is unclear whether military shoes (combat boots and sports shoes) attenuate loading rate or affect force transfer during walking. Therefore, this study compared ground reaction forces (GRF) related to impact and force transfer between combat boots, military sports shoes and running shoes. Ten army recruits walked over a walkway with two force plates embedded. GRF were measured when walking barefoot (for data normalization) and with combat boots, military sports shoes and running shoes. Loading rate, first and second peak forces and push-off rate of force were computed along with temporal analysis of waveforms. Reduced loading rate was observed for the running shoe compared to the combat boot (p = 0.02 and d = 0.98) and to the military sports shoe (p = 0.04 and d = 0.92). The running shoe elicited a smaller second peak force than the combat boot (p < 0.01 and d = 0.83). Walking with military shoes and combat boots led to larger force transfer then running shoes potentially due to harder material used in midsole composition (i.e. styrene-butadiene rubber). These results could lead to a potentially larger risk of injuries while long duration walking in military shoes and boots compared to traditional running shoes.

Gait is a basic cognitive propositive action that has been shown to be altered in late stages of neurodegenerative dementias. Nevertheless, alterations are less clear in mild forms of dementia, and the potential use of gait analysis as a biomarker of initial cognitive decline has hitherto mostly been neglected. We here report the results of a study of gait kinematic time series for two groups of patients (Mild Cognitive Impairment and mild Alzheimer's disease) and a group of matched control subjects. Two metrics based on permutation patterns are considered, respectively measuring the complexity and irreversibility of the time series. Results indicate that kinematic disorganisation is present at early phases of cognitive impairment; in addition, they depict a rich scenario, in which some joint movements display an increased complexity and irreversibility, while others a marked decrease. Beyond their potential use as biomarkers, complexity and irreversibility metrics can open a new door towards the understanding of the role of the nervous system in gait, as well as its adaptation and compensatory mechanisms.

Cognitive impairment and sarcopenia may share common risk factors and pathophysiological pathways. This study was performed to examine the association between impairments in specific cognitive domains and sarcopenia (and its defining components) in a large group of community-dwelling older adults. Cross-sectional analysis was performed on the baseline data of 3,014 adults aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study (KFACS). The final analysis included 1,887 adults underwent dual-energy X-ray absorptiometry and cognitive function assessments. Those with disability in activities of daily living, dementia, severe cognitive impairment, Parkinson’s disease, musculoskeletal complaints, neurological disorders, or who were illiterate were excluded. Cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet, the Frontal Assessment Battery. For sarcopenia, we used the diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of sarcopenia was 9.6% for men and 7.6% for women. Sarcopenia (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.04–2.99) and slow gait speed (OR 2.58, 95% CI 1.34–4.99) were associated with cognitive impairment in men. Only slow gait speed (OR 1.88, 95% CI 1.05–3.36) was associated with cognitive impairment in women. Sarcopenia is associated with cognitive impairment mainly due to slow gait speed. Our results suggested that cognitive impairment domains, such as processing speed and executive function, are associated with sarcopenia-related slow gait speed.

Prosthetic device is designed to function as a replacement for a missing limb and typically consists of suspension, liner, socket, pylon and foot components. The objectives of this research are to design a pylon component of a transtibial prosthetics by implementing auxetic metamaterial and to also validate performance of the designed pylon under quasi-static and dynamic conditions. The design and analysis processes are conducted using the finite element analysis and its effectiveness is validated by experimental testing of the prototype pylon sample. In the design process, the pylon structure is formulated by rearranging 2D re-entrant hexagon model into 3D model. It is identified from the design evaluation that the pylon exhibits the stiffness of the value of 79.24, 2371.6, and 13344 kN/m for the ligament thickness variation of 0.3 mm, 1 mm, and 2 mm, respectively. This directly indicates a capability of the stiffness tuning of the pylon by changing the ligament thickness. It is evaluated that the pylon with the ligament thickness of 0.3 mm causes the deformation of 0.53 cm during a single period of gait cycle, while the ligament thickness of the 1 mm causes the deformation of 0.4 cm. The deformation physically indicates the energy absorption of the pylon structure and hence the thinner ligament, the higher energy absorption provides. It is also found from the deformation transition of the primary and secondary bends, the negative Poisson’s ratio is occurred in 3D model transformed from 2D re-entrant hexagon.

This study aimed to analyze the responsiveness of the 5STS test among stroke patients and to estimate the MCIDs for different severity levels of community ambulation and stages of recovery. The 5STS and comparator instruments [gait speed and Functional Ambulatory Category (FAC)] were evaluated at baseline. These measures were repeated at 4 (Stage 1) and 8 weeks (Stage 2), together with the Global Rating of Change (GROC). The MCIDs were calculated with two anchor-based methods using the GROC as the external criterion. Responsiveness to change for the 5STS was estimated analyzing the correlation with changes in the two comparator instruments and their capacity to discriminate improvement. For the 5STS test, while the MCIDs of the limited community ambulators were similar in the two stages (around 3 s), those of the household ambulators decreased from 1.9 s to 0.72 s. Spearman's rho coefficients showed an acceptable correlation between changes in 5STS and changes for both the FAC and gait speed changes in both stages of recovery. Our study revealed that the 5STS is responsive to functional changes in patients with stroke and that their degree of severity and stage of recovery influence the MCID values of the 5STS.

Understanding the motor patterns underlying the movement of people with Parkinson's disease (PD) is fundamental to the effective targeting of non-pharmacological therapies. This study aims to analyze the gait pattern in relation to the evolutionary stage between I-II and III-IV according to the Hoehn and Yahr scale (H&amp;Y) in people affected by PD. The study was conducted with the participation of 37 PD patients, with a mean age of 70.09±9.53 years, and of whom 48.64% were women. The inclusion criteria were: 1. To be diagnosed with PD; 2. To be in an evolutionary stage of the disease of between I and IV and; 3. To be able to walk independently and without any assistance. Kinematic and spatial-temporal parameters of the gait were analyzed. The results show differences in speed of movement, cadence, stride length, support duration, swing duration, step width, walking cycle duration and double support time between the stages analyzed. These results confirm the differences in PD gait pattern between stages I-II and III-IV. Different behaviors of the same variable were recorded depending on whether the right or left sides were affected by PD.

Gait abnormalities are one of the distinguishing symptoms of patients with Parkinson's disease (PD) that contribute to fall risk. Our study compares the gait parameters of people with PD when they walk through a predefined course without assistance, with a conventional walker, and with a motorized walker under different speed cues. Six PD subjects were recruited at the New York Institute of Technology College of Osteopathic Medicine to participate in this study. Spatial posture and gait data of the test subjects were collected via a VICON motion capture system. We developed a framework to process and extract gait features and applied statistical analysis on these features to examine the significance of the findings. The results showed that motorized walkers with haptic cues significantly improved gait symmetry of PD subjects. Specifically, the asymmetry index of the gait cycle time was reduced from 6.7% when walking without assistance to 0.56% and below when using a walker. Furthermore, the double support time of a gait cycle was reduced by 4.88% compared to walking without assistance.

The purpose of this study was to investigate the effects of cognitive dual-tasking on gait initiation and sit-to-walk. Twenty-eight healthy young adults performed gait initiation and sit-to-walk under two conditions: while engaging in serial subtraction (dual-task) and without any additional task (single-task). Motion data were collected using a 10-camera optoelectronic motion capture system, synchronized with force plates and surface electromyography. We analyzed spatiotemporal parameters, center of mass displacement, center of pressure trajectory, and lower limb muscle activation patterns. We found that dual-task conditions significantly affected both gait initiation and sit-to-walk patterns, increasing the duration of transitions and mediolateral center of mass displacements, while reducing vertical center of mass displacements and forward propulsion. We also observed a more constrained and less efficient center of pressure path, with reduced posterior displacement during the weight shift phase. Muscle activation, particularly in the tibialis anterior and biceps femoris, decreased during dual-task conditions, indicating altered neuromuscular strategies. These findings suggest a shift in postural control demands and motor performance during dual-task transitions.

Background: Recent studies have found forward head posture (FHP) to be associated with altered physiology, however, there is a lack of research into whether FHP is associated with altered gait parameters when cognitively challenged. The current study was undertaken to investigate the changes in gait parameters in asymptomatic individuals with FHP when a cognitive dual task is introduced during walking. Methods: Ninety asymptomatic participants were recruited, 45 having FHP defined as having a craniovertebral angle (CVA) &lt; 50, and 45 sex and age-matched controls having normal head posture (NHP) defined as CVA &gt; 55. All participants walked along a 10 meter platform under a control condition (no cognitive load) with 3 consecutive trials while an optical motion-capture system consisting of 8 infrared cameras was used to assess gait kinematics. Secondly, participants were assessed under a dual task cognitive load condition (3 trials while performing simple addition, counting backwards, and answering yes or no questions) to identify the impact on gait kinematics compared to the control condition. Results: Under the single task condition, there were no significant differences for any gait parameter, however, under the dual task condition, 12/13 gait parameters were significantly altered for the FHP group compared to the NHP group (p &lt; .01). A calculation of dual task cost (DTC) percentage showed significant increases in all gait parameters in participants with FHP (p &lt; .02). Correlations between the CVA and gait parameters were not significant for the single task condition, but all gait parameters were correlated to CVA for the dual task condition (p &lt; .01). The correlation between CVA and DTC for all gait variables were also significant (p &lt; .04). Conclusions: This study demonstrates that FHP significantly increases the cognitive cost during walking, highlighting the importance of proper postural alignment for maintaining cognitive function under a dual task condition. Addressing FHP through targeted interventions could improve both physical and cognitive health, enhancing overall well-being and daily functioning.

While researchers have made notable progress in bio-inspired swimming robot development, a persistent challenge lies in creating propulsive gaits tailored to these robotic systems. The California sea lion achieves its robust swimming abilities through a careful coordination of foreflippers and body segments. In this paper, reinforcement learning (RL) was used to develop a novel sea lion foreflipper gait for a bio-robotic swimmer using a numerically modelled computational representation of the robot. This model integration enabled reinforcement learning to develop desired swimming gaits in the challenging underwater domain. The novel RL gait outperformed the characteristic sea lion foreflipper gait in the simulated underwater domain. When applied to the real-world robot, the RL constructed novel gait performed as well or better than the characteristic sea lion gait in many factors. This work shows the potential for using complimentary bio-robotic and numerical models with reinforcement learning to enable the development of effective gaits and maneuvers for underwater swimming vehicles.

In horses, quantitative assessment of gait parameters, as the use of inertial measurement units system (IMUs), might help in the decision-making process. However, it requires financial investment, is time-consuming, and lacks accuracy if displaced. An innovative Artificial Intelligence marker-less Motion Tracking System (AI-MTS) may overcome these limitations in the field. Our aim was to compare the level of agreement and accuracy between both systems and visual clinical assessment. Twenty horses underwent locomotion analysis by visual assessment, IMUs and AI- MTS systems, in the following conditions: straight hard (SH), straight soft (SS), left and right circle hard (LCH, RCH) and soft (LCS, RCS). A greater number of horses were considered sound by clinical examination, compared to those identified as symmetric by the two gait analysis systems. More limbs were considered asymmetric by the AI-MTS compared to IMUs, suggesting its greater sensitivity. The greatest agreement between the two systems was found for the difference between two minima in vertical head position in SH, while the lowest for the difference between two minima in vertical pelvis position in SS, reflecting the difficulties in assessing asymmetry of hindlimbs. Some degree of asymmetry may be clinically relevant, suggesting its regular use in training horses.

Introduction: The transcranial direct current stimulation (tDCS) is a promising technique for brain modulation after cerebrovascular accident (CVA). This treatment modality has been previously studied in the recovery of patients. The aim of this review is to analyze the evidence in the ap-plication of tDCS in the recovery of gait disturbance in stroke patients. Methods: This review was conducted according to the recommendations of the PRISMA statement. Three different elec-tronic databases were searched for relevant results: PubMed, Scopus, and Cochrane. We included reviews and meta-analyses that only considered randomized controlled trials (RCTs) that inves-tigated the effects of transcranial direct electrical stimulation, in combination or not with other physiotherapy treatment, on gait recovery. Results: Thirteen studies with a total of 195 RCTs were included. Data on population, outcome measures, protocols and outcomes were extracted. The Amstar-2 scale and the GRADE system of certainty of evidence were used. Only one study re-ceived high certainty of evidence, 5 received low certainty of evidence and 7 received critically low certainty of evidence. Conclusions: Although the tDCS produces positive changes in gait recovery in spatio-temporal parameters, mobility, endurance, strength and motor function, there is insuf-ficient evidence to recommend this treatment.

Accurately estimating a person's age is crucial for identity verification at all critical checkpoints, including airports, land borders, and seaports. Human gait may be used as a biometric identifier and indicator of age, among other things. This study aims to develop methods for estimating a person's age by observing their walk. In this paper, a novel technique for preprocessing the proposed gait dataset has been used by utilizing a combination of the gait energy image (GEI), the accumulated frame difference energy image (AFDEI), and the invariant moment of the image. The proposed technique outperformed state-of-the-art methods in terms of accuracy. The proposed method was tested and evaluated using a convolutional neural network (CNN), and it achieved an average accuracy of 90.35% across 14 different view angles within 5 K-Fold, the proposed method resulted in 94.68% and 94.54% in 30º and 75º view degree respectively. concluding that the approach is effective and promising for estimating age using human gait.

Robot-assisted gait training (RAGT) is a promising treatment for stroke rehabilitation. Although the coordination between the upper and lower limbs is important for locomotor training, commercially available robotics for gait training mainly focus on the restoration of lower limb function. We aimed to evaluate the feasibility and usability of complex upper and lower limb RAGT in stroke patients using the GTR-A®, end effector-type robotic device. Patients with subacute stroke (N=9) received 30-minute RAGT thrice a week for two weeks (six sessions). Functionally, the hand grip strength (HGS), Functional Ambulatory Categories, modified Barthel Index, muscle strength test sum score, Berg Balance Scale, Timed Up and Go test, and Short Physical Performance Battery were used. The heart rate and a structured questionnaire were used to evaluate cardiorespiratory fitness and the usability of RAGT. Among the nine patients, all functional parameters between the baseline and post-training were significantly improved after RAGT, except for HGS and the muscle strength test. The questionnaire’s mean scores for each domain were as follows: safety 4.40±0.35, effects 4.23±0.31, efficiency 4.22±0.77, and satisfaction 4.41±0.25. The GTR-A® is a feasible and safe robotic device for patients with gait impairment after stroke. It showed functional improvement with endurance training effects.

The paper presents an innovative hexapod walking robot built with 3-UPU parallel mechanism. In the robot, the parallel mechanism is used as both an actuator to generate walking and also a connecting body to connect two groups of three legs, thus enables the robot to walk with simple gait by very few motors. In the paper, the forward and inverse kinematics solutions are obtained. The workspace of the parallel mechanism is analyzed using limit boundary search method. The walking stability of the robot is analyzed, which yields the robot’s maximum step length. The gait planning of the hexapod walking robot is studied for walking on both flat and uneven terrains. The new robot, combining the advantages of parallel robot and walking robot, has a large carrying capacity, strong passing ability, flexible turning ability, and simple gait control for its deployment for uneven terrain.

Abstract: This study evaluates the effect of paravertebral spinal injection (PSI), utilizing both subjective and objective assessments in chronic low back pain (LBP) associated with facet joint arthrosis over a one-month duration. Subjective questionnaires included the Visual Analogue Scale (VAS) for pain, Oswestry Disability Index, Health Survey SF-12, and the short Falls Efficacy Scale International (FES-I). Objective assessments included in-clinic gait and timed-up-and-go (TUG) tests using wearable sensors, as well as 48-hour daily physical activity (DPA) monitored using a chest-worn tri-axial accelerometer. Subjective and objective measures were performed prior to treatment, immediately after the treatment, and one-month afterthe treatment. Eight LBP patients were recruited for this study (mean age = 54±13 years, body mass index = 31.41±6.52 kg/m2, 50% males). Results show significant decrease in pain (~55%, p<0.05) and disability (Oswestry scores, ~21%, p<0.05). In-clinic gait and TUG were also significantly improved (~16% and ~18% faster walking and shorter TUG, p<0.05); however, DPA (including percentage of physical activities (walking and standing) and the number of steps) showed no significant change after PSI (p>0.25; effect size≤0.44). We hypothesize that DPA may continue to be truncated by conditioned fear-avoidance, a psychological state that may prevent increase in daily physical activity to avoid pain.

Running on a non-motorized, curved-deck treadmill is thought to improve gait mechanics. It is not known, though, if the change in gait carries over to running on a motorized treadmill or level ground. To determine the effect of running on a curved non-motorized treadmill (CNT) on gait characteristics measured during a subsequent bout of running on a traditional motorized treadmill (TMT). Sixteen healthy college-aged participants, age (mean±SD) 20.4±1.6 years volunteered to have their gait analyzed while running on a TMT and CNT. After familiarization and warm-up on both treadmills, each subject completed five, 4-minute bouts of running alternating between traditional motorized and curved non-motorized treadmills: TMT-1, CNT-1, TMT-2, CNT-2, and TMT-3. Variables of interest included step length (m), stride length (m), imbalance score (%), and step angle (°) and were measured using Optogait gait analysis equipment. Differences in gait char acteristics among TMT-1, TMT-2, and TMT-3 can be attributed to running on the CNT. The results show that running on a CNT resulted in significant changes in gait characteristics. These findings suggest that running on a CNT can significantly alter gait characteristics may result in improvements in running gait that persist to subsequent running on a TMT.

Background/Objectives: Stroke patients generally have balance and gait dysfunction due to decreased range of motion (ROM) and muscle strength of the ankle joint. A therapist can apply a floss band to enhance ROM, pain control, jumping performance, strength, myofascial release, and recovery from fatigue. This study compared the immediate effects of floss band application on ankle ROM, balance, and gait ability in stroke patients.; Methods: This study randomized 40 chronic stroke patients to either the floss (n = 20) or sham (n = 20) band group. Outcome measures were ankle ROM, weight bearing lunge test (WBLT) performance, standing balance, and gait ability. Outcome measures were assessed at baseline and immediately after applying the floss or placebo band.; Results: There were significant improvements in dorsiflexion (DF), WBLT, static balance, and foot strike in those who used the floss band compared to the sham group (all p &lt; 0.05).; Conclusions: The floss band improved ankle DF, balance, and gait, indicating that it is a feasible therapeutic method for improving ankle DF, balance, and gait in chronic stroke patients.

In this study, we developed a lightweight shoe sensor system equipped with four high-capacity, compact triaxial force sensors and an inertial measurement unit. Remarkably, this system enabled measurements of localized three-directional ground reaction forces (GRFs) at each sensor position (heel, first and fifth metatarsal heads, and toe) and estimations of stride length and toe clearance during walking. Compared to conventional optical motion analysis systems, the developed sensor system provided relatively accurate results for stride length and minimum toe clearance. To test the performance of the system, 15 older and eight young adults were instructed to walk along a straight-line while wearing the system. The results revealed that compared to the young adults, older adults exhibited lower localized GRF contributions from the heel and greater localized GRF contribution from the toe and fifth metatarsal locations. Furthermore, the older adults exhibited greater variability in their stride length and smaller toe clearance with greater variability compared to the young adults. These results underscore the effectiveness of the proposed gait analysis system in distinguishing the gait characteristics of young and older adults, potentially replacing traditional motion capture systems and force plates in gait analysis.

This study investigates the efficacy of an integrated rehabilitation program that combines vestibular and knee-focused therapies to improve proprioceptive function, balance, and motor control in patients suffering from both Benign Paroxysmal Positional Vertigo (BPPV) and knee joint conditions. The study involved 59 participants diagnosed with both vestibular dysfunction and knee impairments, who were enrolled in a comprehensive rehabilitation program. Vestibular interventions included specific maneuvers such as the Epley maneuver and Brandt-Daroff exercises, aimed at repositioning otoliths and reducing vertigo symptoms, while balance retraining exercises were implemented to enhance stability and prevent falls. Additionally, TECAR therapy was used for its deep tissue heating and regenerative benefits, and specific proprioceptive exercises targeting the knee joint were conducted to improve joint position sense and reduce the risk of falls. The intervention resulted in significant improvements in proprioceptive accuracy, as evidenced by enhanced joint position sense measurements and increased scores on the Dynamic Gait Index (DGI). These findings suggest that the dual-targeted rehabilitation approach not only addresses the individual impairments associated with vestibular dysfunction and knee pathology but also effectively improves overall functional outcomes by tackling the complex interplay between these conditions. The study further highlights the importance of a multidisciplinary approach in rehabilitation, where addressing vestibular and musculoskeletal dysfunctions simultaneously can lead to better patient outcomes. The integrated rehabilitation strategy presented in this study offers a comprehensive approach to managing complex clinical cases, ultimately contributing to improved quality of life and functional independence in patients affected by concurrent vestibular and knee joint issues.

Introduction: Low back pain (LBP) is the leading cause of lost productivity, absenteeism, disability, and early retirement worldwide. LBP treatment should be comprehensive, including prevention, education, diagnosis, and various treatment methods. Treatment can be divided into pharmacological and non-pharmacological. The role of physiotherapy in the comprehensive treatment of LBP is very important. Elastic therapeutic tape, also called kinesiology tape or therapeutic kinesiology tape, has been used for about 50 years. Purpose: The aim of this study was to evaluate the effectiveness of Kinesio taping in patients suffering from (LBP) and its possible effect on the swing of the center of pressure (COP), balance, gait, improvement of coordination, and pain reduction. Material and methods: A total of 60 patients aged 20 to 83 years (54% women) were examined, all of whom met the inclusion and exclusion criteria. In the experimental group, in addition to comprehensive rehabilitation, kinesiotaping of the L1-L5 spine was used. The control group underwent balance control training. The research tools used included the Bohannon single-leg standing test, the FAC scale - Functional Ambulatory Category, the Podsiadlo and Richardson Standing and Walking Test - Timed Up and Go (TUG), lumbar spine mobility assessment, Lasegue's sign and examination of neurological deficit symptoms. and self-assessment of pain using the Visual Analogue Scale (VAS). Results: Kinesio taping has a statistically significant effect on postural control, balance, gait, coordination, and pain. The main parameter with a statistically significant effect on the effects of Kinesio taping was age (below 55 years), which was also observed in the control group. Conclusions: Kinesio taping is an effective method in the treatment of LBP. It improves postural control, balance, gait, coordination, and pain.

Background: Alzheimer's disease causes great changes, with the prefrontal cortex be-ing frequently damaged zones, affecting physical and cognitive behavioural and compromising autonomy and quality of life. Objective: To evaluate the effectiveness of feedback-based tech-nology on the improvement of physical-cognitive capacities in Alzheimer. Methods: Forty pa-tients with Alzheimer were recruited from the Santa Elena Alzheimer's Association, Seville, of which 15 ended up being pilot participants, divided randomly into controls (8) and experi-mental (7). They were evaluated with: Cognitive Mini-Examination Scale, Oddball Test and At-tention Network, Berg Scale, Tinetti, Timed up and Go and Geriatric Deterioration Scale. The experimental group was treated with feedback-based technology under the supervision of physiotherapists, during 16 thirty-minute sessions, twice a week. The control group performed their usual care. Result: A significant improvement was observed in the experimental group (Cognitive Mini-Examination and Tinetti). In the group of control, a worsening of physical and motor skills was evidenced because of the degenerative disease. Discussion/Conclusion: This treatment could be a strategy to keep the patient in early stages for longer, and improve quali-ty of life delaying dependency. It creates intergenerational bonds and use at home to promote treatment adherence.

We present the design and overall development of an eight degrees of freedom (DOF) based Bioinspired Quadruped Robot (BiQR). The robot is designed with a skeleton made of cedar wood. The wooden skeleton is based on exploring the potential of cedar wood to be a choice for legged robots’ design. With a total weight of 1.19 kg, the robot uses eight servo motors that run the position control. Relying on the inverse kinematics, the control design enables the robot to perform the walk gait-based locomotion in a controlled environment. The robot has two main aspects: 1) the initial wooden skeleton development of the robot showing it to be an acceptable choice for robot design, 2) the robot’s applicability as a low-cost legged platform to test the locomotion in a laboratory or a classroom setting.

The healthy function of the vestibular system (VS) is of vital importance for individuals to carry out their daily activities independently and safely. This study carries out Tsallis entropy (TE)-based analysis on insole force sensor data in order to extract features to differentiate between healthy and VS-diseased individuals. Using a specifically developed algorithm, we detrend the acquired data to examine the fluctuation around the trend curve in order to consider the individual’s walking habit and thus increase the accuracy in diagnosis. It is observed that the TE-value increases for diseased people as an indicator of the problem of maintaining balance. As one of the main contributions of this study, in contrast to studies in the literature that focus on gait dynamics requiring extensive walking time, we directly process the instantaneous pressure values, enabling to reduce the data acquisition period significantly. The extracted feature set is then inputted into fundamental classification algorithms, with the Support-Vector-Machine (SVM) demonstrating the highest performance, achieving an average accuracy of 95%. This study constitutes a significant step of a large project aiming to identify specific VS disease together with its stage. The performance achieved in this study provides a strong motivation to further explore this topic.

Background and Aims. Most research on Parkinson's disease (PD) focuses on describing symp-toms and movement characteristics. Studies rarely focus on the early detection of PD and the search for suitable markers of a prodromal stage. Early detection is important, so treatments that may potentially change the course of the disease can be attempted early on. While gait disturb-ances are less pronounced in the early stages of the disease, the prevalence, and severity increase with disease progression. Therefore, postural instability and gait difficulties could be identified as sensitive biomarkers. The aim was to evaluate the discriminatory power of the Trail-Walking Test (Schott, 2015) as a potential diagnostic instrument to improve the predictive power of the clinical evaluation concerning the severity of the disease and record the different aspects of walking. Methods. 20 older healthy (M = 72.4 years, SD = 5.53) adults and 46 older adults with PD and the motor phenotypes postural instability/gait difficulty (PIGD; M = 69.7 years, SD = 8.68) and tremor dominant (TD; M = 68.2 years, SD = 8.94) participated in the study. The participants performed a motor-cognitive dual task (DT) of increasing cognitive difficulty in which they had to walk a given path (condition 1), walk to numbers in ascending order (condition 2), and walk to numbers and letters alternately and in ascending order (condition 3). Results. With an increase in the cognitive load, the time to complete the tasks (seconds) become longer in all groups, F(1.23, 73.5) = 121, p < .001, ɳ2p = .670. PD-PIGD shows the longest times in all conditions of the TWT, F(2, 60) = 8.15, p < .001, ɳ2p = .214. Mutual interferences in the cognitive and motor domain can be observed. How-ever, clear group-specific patterns cannot be identified. A differentiation between the motor phenotypes of PD is especially feasible with the purely motor condition (TWT-M; AUC = . 685, p = 0.44). Conclusions. PD patients with PIGD must be identified by valid, well-evaluated clinical tests that allow a precise assessment of the disease's individual fall risk, the severity of the dis-ease, and the prognosis of progression. The TWT covers various aspects of mobility, examines the relationship between cognitive functions and walking, and enables differentiation of the motor phenotypes of PD.

The deterioration of gait can be used as a biomarker for ageing and neurological diseases. Continuous gait monitoring and analysis are essential for early deficit detection and personalized rehabilitation. The use of mobile and wearable inertial sensor systems for gait monitoring and analysis have been well explored with promising results in the literature. However, most of these studies focus on the technologies for gait characteristic assessment, few of them have considered the data acquisition bandwidth of the sensing system. Inadequate sampling frequency will sacrifice signal fidelity, thus leading to an inaccurate estimation especially for spatial gait parameters. In this work, we developed an inertial sensor based in-shoe gait analysis system for real-time gait monitoring and investigated the optimal sampling frequency to capture all the information on walking patterns. An exploratory validation study was performed using an optical motion capture system on four healthy adult subjects, where each person underwent five walking sessions, giving a total of 20 sessions. Percentage mean absolute errors (MAE%) obtained in stride time, stride length, stride velocity, and cadence while walking were 1.19%, 1.68%, 2.08%, and 1.23%, respectively. In addition, an eigen-analysis based graphical descriptor from raw gait cycle signals was proposed as a new gait metric that can be quantified by principal component analysis to differentiate gait patterns, which has great potential to be used as a powerful analytical tool for gait disorder diagnostics.

Autism Spectrum Disorder (ASD) is a neuro-developmental disorder that limits social interactions, cognitive skills, and abilities. Since ASD can last during an affected person's entire life cycle, the diagnosis at the early onset can yield a significant positive impact. The current medical diagnostic systems (e.g., DSM-5/ICD-10) are somewhat subjective; rely purely on the behavioral observation of symptoms, and hence, some individuals often go misdiagnosed or late-diagnosed. Therefore, researchers have focused on developing data-driven automated diagnosis systems with less screening time, low cost, and improved accuracy while significantly reducing professional intervention. Human Activity Analysis (HAA) is considered one of the most promising niches in computer vision research. This paper aims to analyze its potentialities in the automated detection of autism by tracking the exclusive characteristics of autistic individuals such as repetitive behavior, atypical walking style, and unusual visual saliency. This review provides a detailed inspection of HAA-based autism detection literature published in 2011 on-wards depicting core approaches, challenges, probable solutions, available resources, and scopes of future exploration in this arena. According to our study, deep learning outperforms machine learning in ASD detection with a classification accuracy of 76\% to 95\% on different datasets comprise of video, image, or skeleton data that recorded participants performing a large number of actions. However, machine learning provides satisfactory results on datasets with a small number of action classes and has a range of 60\% to 93\% accuracy among numerous studies. We hope this extensive review will provide a comprehensive guideline for researchers in this field.

Background: Idiopathic Toe Walking (ITW) is the persistence of a forefoot strike pattern at initial contact while walking beyond the age of three years, in the absence of other justifiable causes. This review aims to consolidate the current knowledge on the subject and to highlight recent advancements in literature. Methods: We conducted an electronic search in the following databases up to June 2023: Ovid MEDLINE, EBSCO, Embase, CINAHL Plus, and PubMed. The PICO framework was employed to define search terms. Results: Despite considerable methodological heterogeneity among studies, we found a stronger inclination toward investigating etiological and prognostic factors. There is a trend for a higher prevalence in boys with a positive family history. Novel classifications have been proposed to improve differential diagnosis. Among conservative treatment options, there is stronger evidence for gait improvement with the use of serial casting followed by orthoses. Severe cases may benefit from surgical Zone III gastrocsoleus lengthening. Conclusion: Further studies with standardized methodologies are required to clarify questions about the etiology, classification, and treatment of this condition. Nonetheless, there is a higher level of evidence supporting conservative treatments with serial casting and orthoses, as well as gastrocsoleus Zone III surgical lengthening for severe cases in the second decade of life.

Human footprint is having a unique set of ridges unmatched by any other human being, and therefore it can be used in different identity documents for example birth certificate, Indian biometric identification system AADHAR card, driving license, PAN card, and passport. There are many instances of the crime scene where an accused must walk around and left the footwear impressions as well as barefoot prints and therefore it is very crucial to recovering the footprints to identify the criminals. Footprint-based biometric is a considerably newer technique for personal identification. Fingerprints, retina, iris and face recognition are the methods most useful for attendance record of the person. This time world is facing the problem of global terrorism. It is challenging to identify the terrorist because they are living as regular as the citizens do. Their soft target includes the industries of special interests such as defense, silicon and nanotechnology chip manufacturing units, pharmacy sectors. They pretend themselves as religious persons, so temples and other holy places, even in markets is in their targets. These are the places where one can obtain their footprints easily. The gait itself is sufficient to predict the behaviour of the suspects. The present research is driven to identify the usefulness of footprint and gait as an alternative to personal identification.

Mobile health technologies enable continuous, quantitative assessment of mobility and gait in real-world environments, facilitating early diagnosis of gait disorders, disease progression monitoring, and prediction of adverse events like falls. Traditionally, mobile gait assessment predominantly relied on body-fixed sensors positioned at the feet or lower trunk. Here, we investigate the potential of an algorithm utilizing an ear-worn motion sensor for spatiotemporal segmentation of gait patterns. We collected 3D acceleration profiles from the ear-worn sensor during varied walking speeds in 53 healthy adults. Temporal convolutional networks were trained to detect stepping sequences and predict spatial relations between steps. The resulting algorithm, mEar, accurately detects initial and final ground contacts (F1 score of 99% and 91%, respectively). It enables determination of temporal and spatial gait cycle characteristics (among others stride time and stride length) with good to excellent validity at a precision sufficient to monitor clinically relevant changes in walking speed, stride-to-stride variability, and side asymmetry. This study highlights the ear as a viable site for monitoring gait and proposes its potential integration with in-ear vital sign monitoring. Such integration offers a practical approach to comprehensive health monitoring and telemedical applications, by integrating multiple sensors in a single anatomical location.

State-of-the-art augmented-reality (AR) glasses record their position and orientation in space, enabling measurements and analyses of clinical gait-and-balance tests. This study’s objective was to evaluate concurrent validity and test-retest reliability for common clinical gait-and-balance tests in people with Parkinson’s disease: the Five Times Sit-To-Stand (FTSTS) and Timed Up-and-Go (TUG) tests. Position and orientation data was collected in 22 participants with Parkinson's disease using HoloLens 2 and Magic Leap 2 AR glasses, from which test-completion durations and durations of distinct sub-parts (e.g., sit-to-stand, turning) were derived and compared to reference systems and over test repetitions. Regarding concurrent validity, for both tests an excellent between-systems agreement was found for position and orientation time series and test-completion durations. Between-systems agreement for FTSTS (sub-)durations were all excellent, while TUG turning sub-durations were excellent (turn 1) and moderate (turn 2). Regarding test-retest reliability, the within-system test-retest variation in test-completion times and sub-durations was always much greater than the between-systems variation, implying that these (sub-)durations may be derived interchangeably from AR and reference-system data. In conclusion, AR data are of sufficient quality to evaluate gait and balance in people with Parkinson's disease, with valid quantification of test-completion durations and sub-durations of distinct FTSTS and TUG sub-parts.

Chronic obstructive pulmonary disease (COPD) is increasingly being recognized as a systemic disease rather than a mere disorder of the lungs. Central (respiratory) and peripheral (limb) muscle weakness are among the main pronounced systemic effects of COPD. While the disease primarily affects the lower limb muscles and contributes to gait impairment, COPD is also associated with an increasing risk of falls in patients (COPDp). Previous studies have reported higher rates of falls among COPDp (1.17 to 1.20 falls/person-year), amounting to four times higher than an age-matched healthy group. Potential fall risk factors include muscle weakness, impaired daily activities, cognitive dysfunction, and gait and balance impairment. Although COPDp often manifest many of these risk factors, there remains a gap in literature regarding falls during walking in this population. This study aimed to 1. analyze the literature to identify the risk factors of falling in COPDp, and 2. investigate the underlying mechanisms by which these risk factors can lead to increased prevalence of falling. The results suggest that in addition to the known risk factors of falling, low back pain and mental fatigue should also be considered as relevant risk factors in the treatment process of these patients. Moreover, respiratory problems, which are common in this population, have demonstrated pronounced effects on energy expenditure, gait, and other types of activities of daily living (ADLs), leading to reduced intensity, disrupted coordination of the trunk-pelvic structure with the lower limbs during gait, and altered motor control performance due to activation of muscles in an inefficient synergic manner. These problems potentially lead to the increased vulnerability of these patients to external disturbances and higher incidence risk of falls and injuries. Cognitive problems, which are typically due to reduced oxygen received by the brain, as well as general inflammation caused by COPD, also play a significant role in gait disruption and balance. Future research is warranted to determine the prevalence of falls in COPDp by examining the response of these patients to Medio-Lateral (ML) and Anterior-Posterior (AP) disturbances during gait in association with traditional and recommended fall risk factors.

Freezing of Gait (FOG) is an impairment that affects the majority of patients in the advanced stages of Parkinson’s Disease (PD). FOG can lead to sudden falls and injuries, negatively impacting the quality of life for the patients and their families. Rhythmic Auditory Stimulation (RAS) can be used to help patients recover from FOG and resume normal gait. RAS might be ineffective due to the latency between the start of a FOG event, it’s detection and initialization of RAS. We propose a system capable of both FOG prediction and detection using signals from tri-axial accelerometer sensors that will be useful in initializing RAS with minimal latency. We compared the performance of several time frequency analysis techniques, including moving windows extracted from the signals, handcrafted features, Recurrence Plots (RP), Short Time Fourier Transform (STFT), Discreet Wavelet Transform (DWT) and Pseudo Wigner Ville Distribution (PWVD) with Deep Learning (DL) based Long Short Term Memory (LSTM) and Convolutional Neural Networks (CNN). We also propose three Ensemble Network Architectures that combine all the time frequency representations and DL architectures. Experimental results show that our ensemble architectures significantly improve the performance compared with existing techniques. We also present the results of applying our method trained on publicly available dataset to data collected from patients using wearable sensors in collaboration with A.T. Still University.

Individuals with Parkinson’s Disease (PD) are at an increased risk of falls due to associated motor symptoms and impaired postural control. Gait dysfunction, observed soon after diagnosis, leads to disability with disease progression. The purpose of this study was to determine if there were differences in dynamic postural control during self-paced walking and obstacle-crossing between persons with mild to moderate PD and healthy controls. Participants included nine individuals with mild to moderate PD (PD cohort) and nine age- and gender-matched controls (CON cohort). Anatomical marker trajectories and ground reaction forces were collected as participants walked along the pathway. Three successful representative right and left gait cycles were analyzed using Visual3D biomechanical software. Analyses, involving a mixed model ANOVA using R Statistical Software, examined spatiotemporal (ST) gait parameters for strides involving the leading and trailing limbs and dynamic balance variables, including COM - COP inclination angle, and the COP - COM M/L, COP - XCOM M/L, UMAX - XCOM M/L distances, at distinct points from the stance limb related to the leading and trailing legs. There were no differences between CON and PD for all ST gait parameters during obstacle crossing, except for a significantly reduced step length (p = 0.00489) for the PD group related to the trailing limb. However, there were significant main effects of Step and Condition interacting with Step for swing time, stance time, and step length. For both CON and PD groups the COP - COM , COP - XCOM , UMAX - XCOM metrics demonstrated that the COM was medial to the BOS from first double support, generally moving more medially through second double support for the stance limb during motion of the leading and trailing limbs. Event and Event interacting with Condition were significant for the COP - COM and COP - XCOM variables, while UMAX – XCOM was significant only for Event (p < 0.001). The PD group demonstrated significantly larger mean values for COP – COM M/L at first double support (p = 0.00435) and COP - XCOM M/L at second double support (p = 0.0158) for the second step. Our results suggest that the margin of stability may be useful in discerning dynamic postural control adaptations during walking and obstacle negotiation in persons with mild PD.

The shape of the knee is a chain-like structure of an ellipsoid. This suggests that, in the latest study, in addition to rolling, there is slippage in the motion of the knee. This paper selects a mechanical braking model for cattle based on two mechanical structures in different directions at the joints. The experimental results show that the modified dynamical system has strong chaotic properties. This can be one of the basis for judging various health states.

Motor functions are deteriorated by aging. Some conditions may magnify this deterioration. To examine whether hemodialysis (HD) process would negatively impact gait and balance beyond diabetes condition among mid-age adults (48-64 years) and older adults (65+ years). One hundred and ninety-six subjects (age=66.2±9.1 years, body-mass-index=30.1±6.4 kg/m², female=56%) in 5 groups were recruited: mid-age adults with diabetes undergoing HD (Mid-age HD+, n=38) and without HD (Mid-age HD-, n=40); older adults with diabetes undergoing HD (Older HD+, n=36) and without HD (Older HD-, n=37); and non-diabetic older adults (Older DM-, n=45). Gait parameters (stride velocity, stride length, gait cycle time, and double support) and balance parameters (ankle, hip, and center of mass sways) were quantified using validated wearable platforms. Groups with diabetes had overall poorer gait and balance compared to the non-diabetic group (p<0.050). Among people with diabetes, the HD+ had significantly worsened gait and balance when comparing to the HD- (Cohen’s effect size d=0.63-2.32, p<0.050). Between-group difference was more pronounced among older adults with the largest effect size observed for stride length (d=2.32, p<0.001). Results suggested that deterioration in gait speed among the HD+ was correlated with age (r=-0.440, p<0.001), while this correlation was diminished among the HD-. Interestingly, results also suggested that poor gait in the Older HD- related to poor balance, while no correlation was observed between poor balance and poor gait among the Older HD+. Using objective assessments, results confirmed that the presence of diabetes can deteriorate gait and balance, and this deterioration can be magnified by HD process. Among non-HD people with diabetes, poor static balance described poor gait. However, among people with diabetes undergoing HD, age was a dominate factor describing poor gait irrespective of static balance. Results also suggested feasibility of using wearable platforms to quantify motor performance during routine dialysis clinic visits. These objective assessments may assist in identifying early deterioration in motor function, which in turn may promote timely intervention.

Predicting ground reaction forces (GRFs) and ground reaction moments (GRMs) through a biomechanical model-based approach offers advantages for biomechanical analysis, particularly in situations where the application of a statistical model is limited by insufficient training data. However, the current prediction method is unsuitable for clinical applications due to its long computational time. The present study developed a new optical motion capture (OMC)-based method to predict GRFs, GRMs, and joint torques. The proposed approach performed the estimation process by distributing external forces, as determined by the equation of motion, between the left and right feet based on foot deformations, thereby predicting the GRFs and GRMs without relying on machine learning or optimization techniques. We investigated the prediction accuracy during walking by comparing a conventional analysis using a force plate with the OMC results. The comparison revealed excellent or strong correlations between the prediction and measurement for all GRFs, GRMs, and lower limb joint torques. The proposed method, which provides practical estimation with low computational cost, facilitates efficient biomechanical analysis and rapid feedback of analysis results, thereby increasing its applicability for kinetics estimation in clinical settings.

Low-intensity noisy galvanic vestibular stimulation (nGVS) can improve static and dynamic postural deficits in patients with bilateral vestibular loss (BVL). In this study, we aimed to explore the neurophysiological and neuroanatomical substrates underlying nGVS treatment effects in a rat model of BVL. Regional brain activation patterns and behavioral responses to repeated 30-min nGVS treatment in comparison to sham stimulation were investigated by serial whole-brain [18F]-FDG-PET measurements and quantitative locomotor assessments before and at 9 consecutive time points up to 60 days after chemical bilateral labyrinthectomy (BL). [18F]-FDG-PET revealed a broad nGVS-induced modulation on regional brain activation patterns encompassing biologically plausible brain networks in the brainstem, cerebellum, multisensory cortex and basal ganglia during the entire observation period post-BL. nGVS broadly reversed brain activity adaptions occurring in the natural course post-BL. Parallel behavioral locomotor assessment demonstrated a beneficial treatment effect of nGVS on sensory-ataxic gait alterations, particularly in the early stage of post-BL recovery. Stimulation-induced locomotor improvements were finally linked to nGVS brain activity responses in the brainstem, hemispheric motor and limbic networks. In conclusion, combined [18F]-FDG-PET and locomotor analysis discloses the potential neurophysiological and neuroanatomical substrates that mediate previously observed therapeutic nGVS effects on postural deficits in patients with BVL.

Tracking the kinematics of human movement usually requires the use of equipment that constrains the user within a room (e.g., optical motion capture systems), or requires the use of a conspicuous body-worn measurement system (e.g., inertial measurement units (IMUs) attached to each body segment). This paper presents a novel Lie group constrained extended Kalman filter to estimate lower limb kinematics using IMU and inter-IMU distance measurements in a reduced sensor count configuration. The algorithm iterates through the prediction (kinematic equations), measurement (pelvis height assumption/inter-IMU distance measurements, zero velocity update for feet/ankles, flat-floor assumption for feet/ankles, and covariance limiter), and constraint update (formulation of hinged knee joints and ball-and-socket hip joints). The knee and hip joint angle root-mean-square errors in the sagittal plane for straight walking were 7.6±2.6∘ and 6.6±2.7∘, respectively, while the correlation coefficients were 0.95±0.03 and 0.87±0.16, respectively. Furthermore, experiments using simulated inter-IMU distance measurements show that performance improved substantially for dynamic movements, even at large noise levels (σ=0.2 m). However, further validation is recommended with actual distance measurement sensors, such as ultra-wideband ranging sensors.

Prevalence estimates of Parkinson’s disease (PD) – the fastest growing neurodegenerative disease – are underestimated due to issues surrounding diagnostic accuracy, symptomatic undiagnosed cases, suboptimal prodromal monitoring, and limited screening access. Remotely monitored wearable devices and sensors provide precise, objective, and frequent measures of motor and non-motor symptoms. Here, we used consumer-grade wearable device and sensor data from the WATCH-PD study to develop a PD screening tool aimed at eliminating gaps between patient symptoms and diagnosis. Early-stage PD (n=82) and age-matched comparison (n=50) participants completed a multidomain assessment battery during a one-year longitudinal multicenter study. Using disease- and behavior-relevant feature engineering and multivariate machine learning modeling of early-stage PD status, we developed a highly accurate (92.3%), sensitive (90.0%), and specific (100%) Random Forest classification model (AUC=0.92) that performed well across environmental contexts. These findings provide robust support for further exploring consumer-grade wearable devices and sensors for global population-wide PD screening and surveillance.

Background. The markerless motion capture system (MLS) is a new technology that uses deep learning to detect body segments from digital images. This study tested the agreement between the MLS and a force-plate based system (FPS, “gold standard”) to quantify stability control and motor performance (MP) during gait initiation (GI). Methods. Healthy adults (young and elderly) and patients with Parkinson’s disease (PD) performed GI series at spontaneous and maximal velocity on an FPS while being filmed by an MLS. Signals from both systems were used to compute the peak of forward center-of-mass velocity (indicator of MP) and the braking index (BI, indicator of stability control). Results. Descriptive statistics indicated that both systems detected between-groups differences and velocity effects similarly, while a Bland-Altman (BA) plot anal-ysis showed that BI and MP mean biases were virtually zero in all groups and conditions. Bayes factor 01 indicated strong (for BI) and moderate (for MP) evidence that both systems provided equivalent values. However, trial-by-trial analysis of BA plots revealed the possibility of differ-ences > 10% between the two systems. Conclusion. Although non-negligible differences do occur, MLS appears to be as efficient as FPS in detecting PD and velocity condition effects on BI and MP

Investigations reporting positive effects of Extracorporeal Shock Wave Therapy (ESWT) on nerve regeneration are limited to the rat sciatic nerve model. The effects of ESWT on muscle-in-vein conduits (MVCs) have also not been investigated yet. This study aimed to evaluate the effects of ESWT after repair of the rat median nerve with either autografts (ANGs) or MVCs. In male Lewis rats, a 7-mm segment of the right median nerve was reconstructed either with an ANG or MVC. For each reconstructive technique, one group of animals received one application of ESWT while the other rats served as controls. Animals were observed for 12 weeks and nerve regeneration was assessed via computerized gait analysis, the grasping test, electrophysiological evaluations and histological quantification of axons, blood vessels and lymphatic vasculature. Here we provide for the first time a comprehensive analysis of ESWT effects on nerve regeneration in a rat model of median nerve injury. Furthermore, this study is among the first reporting the quantification of lymphatic vessels following peripheral nerve injury and reconstruction in vivo. While we found no significant direct positive effects of ESWT on peripheral nerve regeneration, results following nerve repair with MVCs were significantly inferior to those after ANG repair.

This paper pioneers a novel exploration of environmental impacts in livestock farming, with a focus on pig farming's intersection with climate change and sustainability. It emphasizes the transformative potential of data-driven Artificial Intelligence (AI) methodologies, specifically the Internet of Things (IoT) and multimodal data analysis, in promoting equitable and sustainable food systems. The study observes five pigs, aged 86 to 108 days, using a tripartite sensor that records heart rate, respiration rate, and accelerometer data. The unique experimental design alternates between periods of isolation during feeding and subsequent pairing, enabling the investigation of stress-induced changes. Key inquiries include discerning patterns in heart rate data during isolation versus paired settings, fluctuations in respiration rates, and behavioral shifts induced by isolation or pairing. The study also explores potential detection of gait abnormalities, correlations between pigs' age and their gait or activity patterns, and the evolution of pigs' walking abilities with age. The paper scrutinizes accelerometer data to detect activity changes when pigs are paired, potentially indicating increased stress or aggression. It also examines the adaptation of pigs to alternating isolation and pairing over time, and how their heart rate, respiration rate, and activity data reflect this process. The study considers other significant variables, such as time of day and isolation duration, affecting the pigs' physiological parameters. Sensor data is further utilized to identify behavioral patterns during periods of feeding, isolation, or pairing. In conclusion, this study harnesses IoT and multimodal data analysis in a groundbreaking approach to pig welfare research. It underscores the compelling potential of technology to inform about overall pig welfare, particularly stress levels and gait quality, and the power of data-driven insights in fostering equitable, healthy, and environmentally conscious livestock production systems.

Ankle sprains are the most frequently occurring musculoskeletal injuries among recreational athletes. Ankle support through bandages following the initial orthotic treatment might be beneficial for rehabilitation purposes. Since hardly any study has investigated the impact of bandages in the acute phase of ankle sprains, our study examined the immediate effects of wearing an ankle bandage on fine coordination, proprioception, and motor performance in subjects five weeks after an acute ankle injury. In total, 70 subjects with acute unilateral supination trauma were tested. All subjects completed several rating questionnaires and biomechanical investigations, including a fine coordination and proprioception test, single leg stances, the Y-Balance test and gait analysis. All biomechanical investigations were conducted for the subject's injured leg with and without a bandage (MalleoTrain® Bauerfeind AG) and the healthy leg. Subjects reported moderate to strong improvements in ankle stability and pain when wearing the bandage. Wearing the bandage significantly normalized subjects’ single leg stance performance, as well as the stance phase duration, and the vertical ground reaction forces during walking. However, the bandage did not have a clear effect on fine coordination and proprioception. Wearing a bandage in the acute phase of an ankle sprain may immediately improve motor performance, including standing and walking.

Objective: To investigate whether impaired plantar cutaneous vibration perception contributes to axial motor symptoms in Parkinson’s disease (PD) and whether anti-parkinsonian medication and subthalamic nucleus deep brain stimulation (STN-DBS), show different effects. Methods: Three groups were tested: PD patients on medication (PD-MED), PD patients on medication and additional STN-DBS (PD-MED–DBS), and healthy subjects (HS) as reference. Motor performance was analyzed using a pressure distribution platform. Plantar cutaneous vibration perception thresholds (VPT) were investigated using a customized vibration exciter at 30 Hz. Results: Motor performance of PD-MED and PD-MED–DBS was characterized by greater postural sway, smaller limits of stability ranges, and slower gait, due to shorter strides, fewer steps per minute, and broader stride widths compared to HS. Comparing patient groups, PD-MED–DBS showed better overall motor performance than PD-MED, particularly for the functional limits of stability and gait. VPTs were significantly higher for PD-MED compared to HS, which suggests impaired plantar cutaneous vibration perception in PD. However, PD-MED–DBS showed less impaired cutaneous vibration perception than PD-MED. Conclusion: PD patients suffer from poor motor performance compared to healthy subjects. Anti-parkinsonian medication in conjunction with STN-DBS seems to be superior for normalizing axial motor symptoms compared to medication alone. Plantar cutaneous vibration perception is impaired in PD patients, whereas anti-parkinsonian medication together with STN-DBS is superior for normalizing tactile cutaneous perception compared to medication alone. Consequently, based on our results and the findings of the literature impaired plantar cutaneous vibration perception might contribute to axial motor symptoms in PD.