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Richard Baker - One of the best experts on this subject based on the ideXlab platform.
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Gait Analysis: clinical facts
European journal of physical and rehabilitation medicine, 2016Co-Authors: Richard Baker, Alberto Esquenazi, Maria Grazia Benedetti, Kaat DesloovereAbstract:Gait Analysis is a well-established tool for the quantitative assessment of Gait disturbances providing functional diagnosis, assessment for treatment planning, and monitoring of disease progress. There is a large volume of literature on the research use of Gait Analysis, but evidence on its clinical routine use supports a favorable cost-benefit ratio in a limited number of conditions. Initially Gait Analysis was introduced to clinical practice to improve the management of children with cerebral palsy. However, there is good evidence to extend its use to patients with various upper motor neuron diseases, and to lower limb amputation. Thereby, the methodology for properly conducting and interpreting the exam is of paramount relevance. Appropriateness of Gait Analysis prescription and reliability of data obtained are required in the clinical environment. This paper provides an overview on guidelines for managing a clinical Gait Analysis service and on the principal clinical domains of its application: cerebral palsy, stroke, traumatic brain injury and lower limb amputation.
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Gait Analysis methods in rehabilitation
Journal of NeuroEngineering and Rehabilitation, 2006Co-Authors: Richard BakerAbstract:Introduction Brand's four reasons for clinical tests and his Analysis of the characteristics of valid biomechanical tests for use in orthopaedics are taken as a basis for determining what methodologies are required for Gait Analysis in a clinical rehabilitation context. Measurement methods in clinical Gait Analysis The state of the art of optical systems capable of measuring the positions of retro-reflective markers placed on the skin is sufficiently advanced that they are probably no longer a significant source of error in clinical Gait Analysis. Determining the anthropometry of the subject and compensating for soft tissue movement in relation to the under-lying bones are now the principal problems. Techniques for using functional tests to determine joint centres and axes of rotation are starting to be used successfully. Probably the last great challenge for optical systems is in using computational techniques to compensate for soft tissue measurements. In the long term future it is possible that direct imaging of bones and joints in three dimensions (using MRI or fluoroscopy) may replace marker based systems. Methods for interpreting Gait Analysis data There is still not an accepted general theory of why we walk the way we do. In the absence of this, many explanations of walking address the mechanisms by which specific movements are achieved by particular muscles. A whole new methodology is developing to determine the functions of individual muscles. This needs further development and validation. A particular requirement is for subject specific models incorporating 3-dimensional imaging data of the musculo-skeletal anatomy with kinematic and kinetic data. Methods for understanding the effects of intervention Clinical Gait Analysis is extremely limited if it does not allow clinicians to choose between alternative possible interventions or to predict outcomes. This can be achieved either by rigorously planned clinical trials or using theoretical models. The evidence base is generally poor partly because of the limited number of prospective clinical trials that have been completed and more such studies are essential. Very recent work has started to show the potential of using models of the mechanisms by which people with pathology walk in order to simulate different potential interventions. The development of these models offers considerable promise for new clinical applications of Gait Analysis.
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Gait Analysis methods in rehabilitation.
Journal of neuroengineering and rehabilitation, 2006Co-Authors: Richard BakerAbstract:Brand's four reasons for clinical tests and his Analysis of the characteristics of valid biomechanical tests for use in orthopaedics are taken as a basis for determining what methodologies are required for Gait Analysis in a clinical rehabilitation context. The state of the art of optical systems capable of measuring the positions of retro-reflective markers placed on the skin is sufficiently advanced that they are probably no longer a significant source of error in clinical Gait Analysis. Determining the anthropometry of the subject and compensating for soft tissue movement in relation to the under-lying bones are now the principal problems. Techniques for using functional tests to determine joint centres and axes of rotation are starting to be used successfully. Probably the last great challenge for optical systems is in using computational techniques to compensate for soft tissue measurements. In the long term future it is possible that direct imaging of bones and joints in three dimensions (using MRI or fluoroscopy) may replace marker based systems. There is still not an accepted general theory of why we walk the way we do. In the absence of this, many explanations of walking address the mechanisms by which specific movements are achieved by particular muscles. A whole new methodology is developing to determine the functions of individual muscles. This needs further development and validation. A particular requirement is for subject specific models incorporating 3-dimensional imaging data of the musculo-skeletal anatomy with kinematic and kinetic data. Clinical Gait Analysis is extremely limited if it does not allow clinicians to choose between alternative possible interventions or to predict outcomes. This can be achieved either by rigorously planned clinical trials or using theoretical models. The evidence base is generally poor partly because of the limited number of prospective clinical trials that have been completed and more such studies are essential. Very recent work has started to show the potential of using models of the mechanisms by which people with pathology walk in order to simulate different potential interventions. The development of these models offers considerable promise for new clinical applications of Gait Analysis.
Kyle D. Allen - One of the best experts on this subject based on the ideXlab platform.
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The Open Source GaitOR Suite for Rodent Gait Analysis
Scientific reports, 2018Co-Authors: Brittany Y. Jacobs, Emily H. Lakes, Alex J. Reiter, Spencer P. Lake, Trevor R. Ham, Nic D. Leipzig, Stacy Porvasnik, Christine E. Schmidt, Rebecca A. Wachs, Kyle D. AllenAbstract:Locomotive changes are often associated with disease or injury, and these changes can be quantified through Gait Analysis. Gait Analysis has been applied to preclinical studies, providing quantitative behavioural assessment with a reasonable clinical analogue. However, available Gait Analysis technology for small animals is somewhat limited. Furthermore, technological and analytical challenges can limit the effectiveness of preclinical Gait Analysis. The Gait Analysis Instrumentation and Technology Optimized for Rodents (GaitOR) Suite is designed to increase the accessibility of preclinical Gait Analysis to researchers, facilitating hardware and software customization for broad applications. Here, the GaitOR Suite's utility is demonstrated in 4 models: a monoiodoacetate (MIA) injection model of joint pain, a sciatic nerve injury model, an elbow joint contracture model, and a spinal cord injury model. The GaitOR Suite identified unique compensatory Gait patterns in each model, demonstrating the software's utility for detecting Gait changes in rodent models of highly disparate injuries and diseases. Robust Gait Analysis may improve preclinical model selection, disease sequelae assessment, and evaluation of potential therapeutics. Our group has provided the GaitOR Suite as an open resource to the research community at www.GaitOR.org , aiming to promote and improve the implementation of Gait Analysis in preclinical rodent models.
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Gait Analysis methods for rodent models of arthritic disorders: reviews and recommendations.
Osteoarthritis and cartilage, 2016Co-Authors: E.h. Lakes, Kyle D. AllenAbstract:Gait Analysis is a useful tool to understand behavioral changes in preclinical arthritis models. While observational scoring and spatiotemporal Gait parameters are the most widely performed Gait analyses in rodents, commercially available systems can now provide quantitative assessments of spatiotemporal patterns. However, inconsistencies remain between testing platforms, and laboratories often select different Gait pattern descriptors to report in the literature. Rodent Gait can also be described through kinetic and kinematic analyses, but systems to analyze rodent kinetics and kinematics are typically custom made and often require sensitive, custom equipment. While the use of rodent Gait Analysis rapidly expands, it is important to remember that, while rodent Gait Analysis is a relatively modern behavioral assay, the study of quadrupedal Gait is not new. Nearly all Gait parameters are correlated, and a collection of Gait parameters is needed to understand a compensatory Gait pattern used by the animal. As such, a change in a single Gait parameter is unlikely to tell the full biomechanical story; and to effectively use Gait Analysis, one must consider how multiple different parameters contribute to an altered Gait pattern. The goal of this article is to review rodent Gait Analysis techniques and provide recommendations on how to use these technologies in rodent arthritis models, including discussions on the strengths and limitations of observational scoring, spatiotemporal, kinetic, and kinematic measures. Recognizing rodent Gait Analysis is an evolving tool, we also provide technical recommendations we hope will improve the utility of these analyses in the future.
Atsuo Takanishi - One of the best experts on this subject based on the ideXlab platform.
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Walking stabilization based on Gait Analysis for biped humanoid robot
Advanced Robotics, 2013Co-Authors: Kenji Hashimoto, Yuki Takezaki, Hun-ok Lim, Atsuo TakanishiAbstract:This study describes a biped walking stabilization based on Gait Analysis for a humanoid robot. So far, we have developed a humanoid robot as a human motion simulator which can quantitatively evaluate welfare and rehabilitation instruments instead of human subjects. However, the walking motion of the robot looked like human’s in our past researches, but a walking stabilization control was not based on Gait Analysis. To use a humanoid robot as a human motion simulator, not only mechanisms but also a stabilizer should be designed based on human beings. Of course, there are many studies on Gait Analysis in the field of neuroscience, but most of them are not modeled enough to be implemented on humanoid robots. Therefore, first, we conducted Gait Analysis in this study, and we obtained following two findings: (i) a foot-landing point exists on the line joining the stance leg and the projected point of center of mass on the ground, and (ii) the distance between steps is modified to keep mechanical energy at the...
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ICRA - Biped walking stabilization based on Gait Analysis
2012 IEEE International Conference on Robotics and Automation, 2012Co-Authors: Kenji Hashimoto, Yuki Takezaki, Hiromitsu Motohashi, Takuya Otani, Tatsuhiro Kishi, Hun-ok Lim, Atsuo TakanishiAbstract:This paper describes a walking stabilization control based on Gait Analysis for a biped humanoid robot. We have developed a human-like foot mechanism mimicking the medial longitudinal arch to clarify the function of the foot arch structure. To evaluate the arch function through walking experiments using a robot, a walking stabilization control should also be designed based on Gait Analysis. Physiologists suggest the ankle, hip and stepping strategies, but these strategies are proposed by measuring human beings who are not “walking” but “standing” against force disturbances. Therefore, first we conducted Gait Analysis in this study, and we modeled human walking strategy enough to be implemented on humanoid robots. We obtained following two findings from Gait Analysis: i) a foot-landing point exists on the line joining the stance leg and the projected point of CoM on the ground, and ii) the distance between steps is modified to keep mechanical energy at the landing within a certain value. A walking stabilization control is designed based on the Gait Analysis. Verification of the proposed control is conducted through experiments with a human-sized humanoid robot WABIAN-2R. The experimental videos are supplemented.
Tishya A. L. Wren - One of the best experts on this subject based on the ideXlab platform.
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Impact of Gait Analysis on pathology identification and surgical recommendations in children with spina bifida.
Gait & posture, 2018Co-Authors: Nicole M. Mueske, Sylvia Õunpuu, Deirdre D. Ryan, Bitte S. Healy, Jeffrey D. Thomson, Paul D. Choi, Tishya A. L. WrenAbstract:Abstract Background Gait Analysis provides quantitative data that can be used to supplement standard clinical evaluation in identifying and understanding Gait problems. It has been established that Gait Analysis changes treatment decision making for children with cerebral palsy, but this has not yet been studied in other diagnoses such as spina bifida. Research question To determine the effects of Gait Analysis data on pathology identification and surgical recommendations in children with spina bifida. Methods Two pediatric orthopaedic surgeons and two therapists with >10 years of experience in Gait Analysis reviewed clinical, video, and Gait Analysis data from 43 ambulatory children with spina bifida (25 male; mean age 11.7 years, SD 3.8; 25 sacral, 18 lumbar). Primary Gait pathologies were identified by each assessor both before and after consideration of the Gait Analysis data. Surgical recommendations were also recorded by the surgeons before and after consideration of the Gait Analysis data. Frequencies of pathology and surgery identification with and without Gait Analysis were compared using Fisher’s exact test, and percent change in pathology and surgery identification was calculated. Results Pathology identification often changed for common Gait problems including crouch (28% of cases), tibial rotation (35%), pes valgus (18%), excessive hip flexion (70%), and abnormal femur rotation (75%). Recognition of excessive hip flexion and abnormal femur rotation increased significantly after consideration of Gait Analysis data (p st metatarsal osteotomy (60%), and femoral derotation osteotomy (89%). At the patient level, consideration of Gait Analysis data altered surgical recommendations for 44% of patients. Significance Since Gait Analysis data often changes pathology identification and surgical recommendations, treatment decision making may be improved by including Gait Analysis in the patient care process.
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Differences in implementation of Gait Analysis recommendations based on affiliation with a Gait laboratory
Gait & posture, 2012Co-Authors: Tishya A. L. Wren, Susan A. Rethlefsen, Koorosh J. Elihu, Shaun Mansour, Deirdre D. Ryan, Michelle L. Smith, Robert M. KayAbstract:A B S T R A C T This study examined the extent to which Gait Analysis recommendations are followed by orthopedic surgeons with varying degrees of affiliation with the Gait laboratory. Surgical data were retrospectively examined for 95 patients with cerebral palsy who underwent lower extremity orthopedic surgery following Gait Analysis. Thirty-three patients were referred by two surgeons directly affiliated with the Gait laboratory (direct affiliation), 44 were referred by five surgeons from the same institution but not directly affiliated with the Gait laboratory (institutional affiliation), and 18 were referred by 10 surgeons from other institutions (no affiliation). Data on specific surgeries were collected from the Gait Analysis referral, Gait Analysis report, and operative notes. Adherence to the Gait Analysis recommendations was calculated by dividing the number of procedures where the surgery followed the Gait Analysis recommendation (numerator) by the total number of procedures initially planned, recommended by Gait Analysis, or done (denominator). Adherence with the Gait Analysis recommendations was 97%, 94%, and 77% for the direct, institutional, and no affiliation groups, respectively. Procedures recommended for additions to the surgical plan were added 98%, 87%, and 77% of the time. Procedures recommended for elimination were dropped 100%, 89%, and 88% of the time. Of 81 patients who had specific surgical plans prior to Gait Analysis, changes were implemented in 84% (68/81) following Gait Analysis recommendations. Gait Analysis influences the treatment decisions of surgeons regardless of affiliation with the Gait laboratory, although the influence is stronger for surgeons who practice within the same institution as the Gait laboratory.
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Efficacy of clinical Gait Analysis: A systematic review
Gait & posture, 2011Co-Authors: Tishya A. L. Wren, George E. Gorton, Sylvia Õunpuu, Carole A. TuckerAbstract:The aim of this systematic review was to evaluate and summarize the current evidence base related to the clinical efficacy of Gait Analysis. A literature review was conducted to identify references related to human Gait Analysis published between January 2000 and September 2009 plus relevant older references. The references were assessed independently by four reviewers using a hierarchical model of efficacy adapted for Gait Analysis, and final scores were agreed upon by at least three of the four reviewers. 1528 references were identified relating to human instrumented Gait Analysis. Of these, 116 original articles addressed technical accuracy efficacy, 89 addressed diagnostic accuracy efficacy, 11 addressed diagnostic thinking and treatment efficacy, seven addressed patient outcomes efficacy, and one addressed societal efficacy, with some of the articles addressing multiple levels of efficacy. This body of literature provides strong evidence for the technical, diagnostic accuracy, diagnostic thinking and treatment efficacy of Gait Analysis. The existing evidence also indicates efficacy at the higher levels of patient outcomes and societal cost-effectiveness, but this evidence is more sparse and does not include any randomized controlled trials. Thus, the current evidence supports the clinical efficacy of Gait Analysis, particularly at the lower levels of efficacy, but additional research is needed to strengthen the evidence base at the higher levels of efficacy.
Gerald F. Harris - One of the best experts on this subject based on the ideXlab platform.
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Gait Analysis in children and adolescents with spinal cord injuries.
The journal of spinal cord medicine, 2004Co-Authors: Peter A Smith, Sahar Hassani, Kathyrn Reiners, Lawrence C Vogel, Gerald F. HarrisAbstract:Improving ambulation in patients with spinal cord injuries (SCIs) is a major challenge for the clinician. Physical examination can be supplemented with biomechanic information from the Gait laboratory to comprehensively evaluate and improve walking. Gait Analysis is an effective method to evaluate 3-dimensional dynamic joint range of motion (kinematics) and forces (kinetics) occurring at the hip, knee, and ankle/foot. Clinical Gait Analysis has proved to be essential for surgical and rehabilitative planning and posttreatment assessment in many neuromuscular disorders. Benefits of Gait Analysis also may apply to walking patients with SCIs. The goal of this study was to demonstrate the utility of Gait Analysis in children and adolescents with SCIs. Motion Analysis evaluations and physical examinations were performed on 33 children and adolescents with SCIs (16 males, 17 females). Mean age at time of Gait Analysis was 11.7 years, with an age range of 2.5 to 21 years. Abnormal kinematic patterns, which were repeatable over several years, were demonstrated in the patients with SCI. Gait Analysis was beneficial in making educated treatment decisions about orthotic prescription, surgery, postsurgical evaluation, prescription of new therapy, evaluation of spasticity medications, and experimental treatments. Another advantage of Gait Analysis is recording and reviewing changes in Gait over time. In our study, 22 of the 33 patients received a 1-year follow-up Gait Analysis. Patients followed over multiyear intervals have demonstrated characteristic changes in mobility patterns, resulting in changes in prescription of mobility aids. The benefits of Gait Analysis are demonstrated by case presentation. Improved ambulation for patients with SCI can be accomplished with physical therapy, orthotics, spasticity management, and surgery. These treatments, as well as innovative new areas such as functional electrical stimulation and robotic-assisted therapy, rely on Gait Analysis to provide a template of normal walking patterns and to measure function and document improvements.
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Gait Analysis in rehabilitation medicine: a brief report.
American journal of physical medicine & rehabilitation, 1999Co-Authors: Rory A. Cooper, Miller F, Esquenazi A, Gerald F. HarrisAbstract:Gait Analysis can be a powerful tool for rehabilitation research and clinical practice. However, there has been little coordinated effort to set goals for the application of Gait Analysis in rehabilitation. Therefore, a priority setting process was engaged to obtain the opinions of a diverse pool of experts related to human motion Analysis. The primary goal of this process was to develop priorities for future research, development, and standardization in Gait Analysis. A multistep approach was used that included expert testimony, group discussions, individually developed priorities, and a ranking process. Several important priorities emerged from this activity. The highest priority was assigned to research on the efficacy, outcomes, and cost-effectiveness of Gait Analysis.
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Procedures for Gait Analysis
Archives of physical medicine and rehabilitation, 1994Co-Authors: Gerald F. Harris, Jacqueline J. WertschAbstract:Observational Gait Analysis is clinically useful with videotape slow-motion replay and freeze-frame, offering significant improvement over unaided visual observation. Any form of observational Gait Analysis, however, has limited precision and is more descriptive than quantitative. This article reviews procedures that are available for Gait Analysis. Gait Analysis systems have evolved from cine with manual digitization, electrogoniometry, and video technology to sophisticated automated tracking systems. When used in conjunction with biomechanical models, these systems allow quantitative Analysis of many specific Gait characteristics such as joint moments and powers (kinetic Analysis), joint angles, angular velocities, and angular accelerations (kinematic Analysis). Analysis of dynamic electromyographic activity and energy consumption adds useful clinical information to Gait Analysis. The combination of a careful clinical assessment and Gait Analysis can be a powerful tool for the clinician.
