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Andrzej Szopa - One of the best experts on this subject based on the ideXlab platform.
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Gait Pattern Differences Among Children With Bilateral Cerebral Palsy.
Frontiers in neurology, 2019Co-Authors: Małgorzata Domagalska-szopa, Andrzej SzopaAbstract:Background: The positive findings from our previous studies, which revealed the link between postural and Gait Patterns in children with unilateral cerebral palsy (CP) were very encouraging for recognition this relationship in children with bilateral cerebral palsy (CP). Therefore, the objective of this study was to evaluate whether different Gait Patterns corresponding to postural Patterns in children with bilateral CP could be statistically significant according to a cluster analysis. Methods: Fifty-eight participants with bilateral CP and 45 matched children with typical growth and development. The participants walked barefoot along a treadmill at their own pace. Three-dimensional kinematic data were collected using the Measuring System for Motion Analysis. To characterize Gait Patterns, the Gillette Gait Index (GGI) and its 16 distinct Gait parameters were used. The participants were divided into four subgroups according to their postural Patterns. Results: A cluster analysis revealed 4 Gait Patterns corresponding to postural Patterns: (1) normal Gait Pattern corresponded to neutral posture; (2) balanced Gait Pattern corresponded to balanced posture; (3) lordotic Gait Pattern corresponded to lordotic postural Pattern; (4) swayback Gait Pattern corresponded to backward-leaning posture. There were significant differences in mean GGI and various clusters in the 8 GGI Gait parameters: cadence, mean pelvic tilt; mean pelvic rotation, minimum hip flexion, peak hip abduction in swing; knee flexion at initial contact, and peak dorsiflexion in stance. Conclusion: Our results showed that Gait discrepancies among children with bilateral CP were not simply a result of lower limb kinematic deviations in the sagittal plane. Information on different Gait Patterns could improve early therapy in children with bilateral CP before abnormal Gait Patterns are fully established.
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Gait Pattern differences between children with mild scoliosis and children with unilateral cerebral palsy.
PloS one, 2014Co-Authors: Małgorzata Domagalska-szopa, Andrzej SzopaAbstract:This study was conducted to investigate the effects of asymmetrical body posture alone, i.e., the effects seen in children with mild scoliosis, vs. the effects of body posture control impairment, i.e., those seen in children with unilateral cerebral palsy on Gait Patterns. Three-dimensional instrumented Gait analysis (3DGA) was conducted in 45 children with hemiplegia and 51 children with mild scoliosis. All the children were able to walk without assistance devices. A set of 35 selected spatiotemporal Gait and kinematics parameters were evaluated when subjects walked on a treadmill. A cluster analysis revealed 3 different Gait Patterns: a scoliotic Gait Pattern and 2 different hemiplegic Gait Patterns. The results showed that the discrepancy in Gait Patterns was not simply a lower limb kinematic deviation in the sagittal plane, as expected. Additional altered kinematics, such as pelvic misorientation in the coronal plane in both the stance and swing phases and inadequate stance phase hip ad/abduction, which resulted from postural Pattern features, were distinguished between the 3 Gait Patterns. Our study provides evidence for a strong correlation between postural and Gait Patterns in children with unilateral cerebral palsy. Information on differences in Gait Patterns may be used to improve the guidelines for early therapy for children with hemiplegia before abnormal Gait Patterns are fully established. The Gait pathology characteristic of scoliotic children is a potential new direction for treating scoliosis that complements the standard posture and walking control therapy exercises with the use of biofeedback.
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Gait Pattern differences in children with unilateral cerebral palsy.
Research in developmental disabilities, 2014Co-Authors: Andrzej Szopa, Małgorzata Domagalska-szopa, Andrzej CzamaraAbstract:Abstract Children with cerebral palsy (CP) often have atypical body posture Patterns and abnormal Gait Patterns resulting from functional strategies to compensate for primary anomalies that are directly attributable to damage to the central nervous system. Our previous study revealed two different postural Patterns in children with unilateral CP: (1) a Pattern with overloading of the affected body side and (2) a Pattern with under-loading of the affected side. The purpose of present study was to test whether different Gait Patterns dependent on weight distribution between the affected and unaffected body sides could be detected in these children. The study included 45 outpatients with unilateral CP and 51 children with mild scoliosis (reference group). The examination consisted of two inter-related parts: paedobarographic measurements of the body mass distribution between the body sides and three-dimensional instrumented Gait analysis. Using cluster analysis based on the Gillette Gait Index (GGI) values, three Gait Patterns were described: a scoliotic Gait Pattern and two hemiplegic Gait Patterns, corresponding to overloading/under-loading of the hemi-side, which are the pro-gravitational Gait Pattern (PGP) and the anti-gravitational Gait Pattern (AGP), respectively. The results of this study showed that subjects with AGP presented a higher degree of deviation from the normal Gait than children with PGP. This proof that there are differences in the GGI between the AGP and PGP could be a starting point to identify kinematic differences between these Gaits in a follow-up study.
Małgorzata Domagalska-szopa - One of the best experts on this subject based on the ideXlab platform.
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Gait Pattern Differences Among Children With Bilateral Cerebral Palsy.
Frontiers in neurology, 2019Co-Authors: Małgorzata Domagalska-szopa, Andrzej SzopaAbstract:Background: The positive findings from our previous studies, which revealed the link between postural and Gait Patterns in children with unilateral cerebral palsy (CP) were very encouraging for recognition this relationship in children with bilateral cerebral palsy (CP). Therefore, the objective of this study was to evaluate whether different Gait Patterns corresponding to postural Patterns in children with bilateral CP could be statistically significant according to a cluster analysis. Methods: Fifty-eight participants with bilateral CP and 45 matched children with typical growth and development. The participants walked barefoot along a treadmill at their own pace. Three-dimensional kinematic data were collected using the Measuring System for Motion Analysis. To characterize Gait Patterns, the Gillette Gait Index (GGI) and its 16 distinct Gait parameters were used. The participants were divided into four subgroups according to their postural Patterns. Results: A cluster analysis revealed 4 Gait Patterns corresponding to postural Patterns: (1) normal Gait Pattern corresponded to neutral posture; (2) balanced Gait Pattern corresponded to balanced posture; (3) lordotic Gait Pattern corresponded to lordotic postural Pattern; (4) swayback Gait Pattern corresponded to backward-leaning posture. There were significant differences in mean GGI and various clusters in the 8 GGI Gait parameters: cadence, mean pelvic tilt; mean pelvic rotation, minimum hip flexion, peak hip abduction in swing; knee flexion at initial contact, and peak dorsiflexion in stance. Conclusion: Our results showed that Gait discrepancies among children with bilateral CP were not simply a result of lower limb kinematic deviations in the sagittal plane. Information on different Gait Patterns could improve early therapy in children with bilateral CP before abnormal Gait Patterns are fully established.
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Gait Pattern differences between children with mild scoliosis and children with unilateral cerebral palsy.
PloS one, 2014Co-Authors: Małgorzata Domagalska-szopa, Andrzej SzopaAbstract:This study was conducted to investigate the effects of asymmetrical body posture alone, i.e., the effects seen in children with mild scoliosis, vs. the effects of body posture control impairment, i.e., those seen in children with unilateral cerebral palsy on Gait Patterns. Three-dimensional instrumented Gait analysis (3DGA) was conducted in 45 children with hemiplegia and 51 children with mild scoliosis. All the children were able to walk without assistance devices. A set of 35 selected spatiotemporal Gait and kinematics parameters were evaluated when subjects walked on a treadmill. A cluster analysis revealed 3 different Gait Patterns: a scoliotic Gait Pattern and 2 different hemiplegic Gait Patterns. The results showed that the discrepancy in Gait Patterns was not simply a lower limb kinematic deviation in the sagittal plane, as expected. Additional altered kinematics, such as pelvic misorientation in the coronal plane in both the stance and swing phases and inadequate stance phase hip ad/abduction, which resulted from postural Pattern features, were distinguished between the 3 Gait Patterns. Our study provides evidence for a strong correlation between postural and Gait Patterns in children with unilateral cerebral palsy. Information on differences in Gait Patterns may be used to improve the guidelines for early therapy for children with hemiplegia before abnormal Gait Patterns are fully established. The Gait pathology characteristic of scoliotic children is a potential new direction for treating scoliosis that complements the standard posture and walking control therapy exercises with the use of biofeedback.
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Gait Pattern differences in children with unilateral cerebral palsy.
Research in developmental disabilities, 2014Co-Authors: Andrzej Szopa, Małgorzata Domagalska-szopa, Andrzej CzamaraAbstract:Abstract Children with cerebral palsy (CP) often have atypical body posture Patterns and abnormal Gait Patterns resulting from functional strategies to compensate for primary anomalies that are directly attributable to damage to the central nervous system. Our previous study revealed two different postural Patterns in children with unilateral CP: (1) a Pattern with overloading of the affected body side and (2) a Pattern with under-loading of the affected side. The purpose of present study was to test whether different Gait Patterns dependent on weight distribution between the affected and unaffected body sides could be detected in these children. The study included 45 outpatients with unilateral CP and 51 children with mild scoliosis (reference group). The examination consisted of two inter-related parts: paedobarographic measurements of the body mass distribution between the body sides and three-dimensional instrumented Gait analysis. Using cluster analysis based on the Gillette Gait Index (GGI) values, three Gait Patterns were described: a scoliotic Gait Pattern and two hemiplegic Gait Patterns, corresponding to overloading/under-loading of the hemi-side, which are the pro-gravitational Gait Pattern (PGP) and the anti-gravitational Gait Pattern (AGP), respectively. The results of this study showed that subjects with AGP presented a higher degree of deviation from the normal Gait than children with PGP. This proof that there are differences in the GGI between the AGP and PGP could be a starting point to identify kinematic differences between these Gaits in a follow-up study.
Andrzej Czamara - One of the best experts on this subject based on the ideXlab platform.
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Gait Pattern differences in children with unilateral cerebral palsy.
Research in developmental disabilities, 2014Co-Authors: Andrzej Szopa, Małgorzata Domagalska-szopa, Andrzej CzamaraAbstract:Abstract Children with cerebral palsy (CP) often have atypical body posture Patterns and abnormal Gait Patterns resulting from functional strategies to compensate for primary anomalies that are directly attributable to damage to the central nervous system. Our previous study revealed two different postural Patterns in children with unilateral CP: (1) a Pattern with overloading of the affected body side and (2) a Pattern with under-loading of the affected side. The purpose of present study was to test whether different Gait Patterns dependent on weight distribution between the affected and unaffected body sides could be detected in these children. The study included 45 outpatients with unilateral CP and 51 children with mild scoliosis (reference group). The examination consisted of two inter-related parts: paedobarographic measurements of the body mass distribution between the body sides and three-dimensional instrumented Gait analysis. Using cluster analysis based on the Gillette Gait Index (GGI) values, three Gait Patterns were described: a scoliotic Gait Pattern and two hemiplegic Gait Patterns, corresponding to overloading/under-loading of the hemi-side, which are the pro-gravitational Gait Pattern (PGP) and the anti-gravitational Gait Pattern (AGP), respectively. The results of this study showed that subjects with AGP presented a higher degree of deviation from the normal Gait than children with PGP. This proof that there are differences in the GGI between the AGP and PGP could be a starting point to identify kinematic differences between these Gaits in a follow-up study.
Manuela Galli - One of the best experts on this subject based on the ideXlab platform.
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Use of the Gait Profile Score for the Quantification of Gait Pattern in Down Syndrome
Journal of Developmental and Physical Disabilities, 2015Co-Authors: Manuela Galli, Veronica Cimolin, Chiara Rigoldi, Ana Kleiner, Claudia Condoluci, Giorgio AlbertiniAbstract:Gait Analysis can characterize alterations in walking Patterns, but results in a considerable amount of data that requires complex interpretation. The literature proposes some global indexes that represent the deviation of pathological Gait from healthy Gait Pattern. In this study, the Gait Profile Score (GPS) and the Gait Variable Scores (GVSs) were selected among the summary indexes for describing Gait Pattern of individuals with Down Syndrome (DS). Twenty-four participants with DS and 15 healthy individuals took part in this study. From their Gait analysis data, the GPS and the GVSs were computed. The Mann-Whitney U test compared data of DS group and control group ( p
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effects of obesity on Gait Pattern in young individuals with down syndrome
International Journal of Rehabilitation Research, 2015Co-Authors: Manuela Galli, Veronica Cimolin, Chiara Rigoldi, Claudia Condoluci, Giorgio AlbertiniAbstract:In individuals with Down syndrome (DS), the prevalence of obesity is widespread; despite this, there are no experimental studies on the effect of obesity on Gait strategy in DS individuals. The aim of this study is to assess the clinical Gait analysis of a group of obese individuals with DS and a group of nonobese individuals with DS to determine whether obesity produces a different Gait Pattern in these participants. In addition, although females and males share a similar mass, they are characterized by different fat distribution and/or accumulation; thus, the presence of differences between females and males within the two DS groups was investigated. Gait analysis data of a group of 78 young individuals with DS and 20 normal-weight participants in the 5-18-year age range were considered. Among DS individuals, 40 were classified as obese (obese DS group), whereas 38 were classified as normal weight (nonobese groups). A three-dimensional Gait analysis was carried out using an optoelectronic system, force platforms and video recording. Spatiotemporal, kinematic and kinetic parameters were identified and calculated for each participant. Our results show that most of the parameters were similar in the two groups of DS participants; the only differences were in terms of stance duration, longer in the obese DS group and dorsiflexion ability during the swing phase, which was limited in the obese DS group. The two DS groups were significantly different in terms of ankle stiffness (Ka index): both groups were characterized by reduced values compared with the control group, but the obese group presented lower values with respect to nonobese participants. The data showed that females were characterized by significant modifications of Gait Pattern compared with males in both groups, in particular, at proximal levels, such as the hip and the pelvis. Our findings indicate that the presence of obesity exerts effects on Gait Pattern in DS individuals and in particular on ankle joint stiffness. These results may have special clinical relevance; the biomechanical comparison of Gait in young obese and nonobese DS individuals may provide a basis for developing either specific or common rehabilitative strategies.
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relationship between flat foot condition and Gait Pattern alterations in children with down syndrome
Journal of Intellectual Disability Research, 2014Co-Authors: Manuela Galli, Veronica Cimolin, Massimiliano Pau, Pier Francesco Costici, Giorgio AlbertiniAbstract:Background In patients with Down syndrome (DS) one of the most common abnormalities is flat foot which can interfere significantly with normal daily activities, such as Gait. The aim of this study was to quantitatively assess the relationship between the flat foot and the Gait alterations in DS children. Method Twenty-nine patients with DS and 15 non-affected subjects were assessed using 3D Gait Analysis, using an optoelectronic system, force platforms and video recording. The degree of flat foot was assessed using the arch index and kinematic and kinetic parameters were identified and calculated from 3D Gait Analysis for each study participant. Results Data showed that ankle plantarflexion moment and ankle power during terminal stance were significant to differentiate the patients with and without flat feet: their peak values were significantly lower for the patients with flat foot. In addition, the research for correlation demonstrated that the higher the arch index value, the lower the peak of ankle moment and of the generated ankle power during terminal stance and the minimum of absorbed ankle power. Conclusions Children with flat foot displayed a less functional Gait Pattern in terms of ankle kinetics than children without flat foot, suggesting that the presence of flat foot may lead to a weaker efficient walking. Then, the increasing flat foot tended to result in lower push-off ability, leading a less functional walking.
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Gait Pattern in myotonic dystrophy steinert disease a kinematic kinetic and emg evaluation using 3d Gait analysis
Journal of the Neurological Sciences, 2012Co-Authors: Manuela Galli, Veronica Cimolin, V Crugnola, Lorenzo Priano, Francesco Menegoni, C Trotti, Eva Milano, Alessandro MauroAbstract:We investigated the Gait Pattern of 10 patients with myotonic dystrophy (Steinert disease; 4 females, 6 males; age: 41.5+7.6 years), compared to 20 healthy controls, through manual muscle test and Gait analysis, in terms of kinematic, kinetic and EMG data. In most of patients (80%) distal muscle groups were weaker than proximal ones. Weakness at lower limbs was in general moderate to severe and MRC values evidenced a significant correlation between tibialis anterior and gastrocnemius medialis (R=0.91). An overall observation of Gait Pattern in patients when compared to controls showed that most spatio-temporal parameters (velocity, step length and cadence) were significantly different. As concerns kinematics, patients' pelvic tilt was globally in a higher position than control group, with reduced hip extension ability in stance phase and limited range of motion; 60% of the limbs revealed knee hyperextension during midstance and ankle joints showed a quite physiological position at initial contact and higher dorsiflexion during stance phase if compared to healthy individuals. Kinetic plots evidenced higher hip power during loading response and lower ankle power generation in terminal stance. The main EMG abnormalities were seen in tibialis anterior and gastrocnemius medialis muscles. In this study Gait analysis gives objective and quantitative information about the Gait Pattern and the deviations due to the muscular situation of these patients; these results are important from a clinical point of view and suggest that rehabilitation programs for them should take these findings into account.
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joint stiffness and Gait Pattern evaluation in children with down syndrome
Gait & Posture, 2008Co-Authors: Manuela Galli, Chiara Rigoldi, Reinald Brunner, Naznin Virjibabul, Albertini GiorgioAbstract:Hypotonia, ligament laxity and motor alterations are characteristic for patients with Down syndrome (DS). The purpose of this study was the evaluation of typical Gait Pattern of subjects with Down syndrome and the quantification of their joint stiffness, connected with ligament laxity and hypotonia, as a possible compensation. 98 children with DS (mean age: 11.7 years; range: 6-15 years) and 30 healthy children (control group (CG); mean age: 11 years; range: 5-13 years) underwent full 3D Gait analysis at self-selected speed. Subjects with DS walked with more hip flexion during the whole Gait cycle, knee flexion in stance phase, a limitation of the knee range of motion, and plantarflexion of the ankle at initial contact. Ankle power was limited as evident in terminal stance and pre-swing, represented by a low propulsive capacity at push-off, too. Hip joint stiffness was increased in general in patients with DS versus normal subjects while ankle joint stiffness revealed a lower value instead.
Alexander C H Geurts - One of the best experts on this subject based on the ideXlab platform.
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near normal Gait Pattern with peroneal electrical stimulation as a neuroprosthesis in the chronic phase of stroke a case report
Archives of Physical Medicine and Rehabilitation, 2011Co-Authors: Roos Van Swigchem, Vivian Weerdesteyn, Hanneke J R Van Duijnhoven, Jasper Den J Boer, Tjemme Beems, Alexander C H GeurtsAbstract:Abstract van Swigchem R, Weerdesteyn V, van Duijnhoven HJ, den Boer J, Beems T, Geurts AC. Near-normal Gait Pattern with peroneal electrical stimulation as a neuroprosthesis in the chronic phase of stroke: a case report. In recent years, the use of functional electrical stimulation (FES) of the peroneal nerve has increased as an alternative for an ankle-foot orthosis (AFO) to treat stroke-related drop foot. We present a chronic stroke patient demonstrating an almost normal Gait Pattern with peroneal FES as a neuroprosthesis. A 60-year-old survivor of a right hemisphere infarction 21 months ago, who regularly used a polypropylene AFO, was provided with a surface-based peroneal FES device for severe drop foot. In a second instance, he received an implanted FES system because of skin problems with the surface stimulator. With both FES devices, the patient achieved an adequate foot elevation. Moreover, his hip and knee flexion angles during walking increased to normal values and his ankle push-off power increased. His Gait Pattern became almost symmetrical and less variable than with the AFO. Furthermore, his ability to avoid a sudden obstacle improved to normal values with FES. Our patient showed benefits from peroneal FES beyond what can be attributed to improved foot lift alone. With regard to the potential working mechanisms underlying this response to FES, biomechanical benefits related to improved ankle push-off are suggested as the main mechanism.
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near normal Gait Pattern with peroneal electrical stimulation as a neuroprosthesis in the chronic phase of stroke a case report
Archives of Physical Medicine and Rehabilitation, 2011Co-Authors: Roos Van Swigchem, Vivian Weerdesteyn, Jasper Den J Boer, Tjemme Beems, Hanneke J R Van Duijnhoven, Alexander C H GeurtsAbstract:In recent years, the use of functional electrical stimulation (FES) of the peroneal nerve has increased as an alternative for an ankle-foot orthosis (AFO) to treat stroke-related drop foot. We present a chronic stroke patient demonstrating an almost normal Gait Pattern with peroneal FES as a neuroprosthesis. A 60-year-old survivor of a right hemisphere infarction 21 months ago, who regularly used a polypropylene AFO, was provided with a surface-based peroneal FES device for severe drop foot. In a second instance, he received an implanted FES system because of skin problems with the surface stimulator. With both FES devices, the patient achieved an adequate foot elevation. Moreover, his hip and knee flexion angles during walking increased to normal values and his ankle push-off power increased. His Gait Pattern became almost symmetrical and less variable than with the AFO. Furthermore, his ability to avoid a sudden obstacle improved to normal values with FES. Our patient showed benefits from peroneal FES beyond what can be attributed to improved foot lift alone. With regard to the potential working mechanisms underlying this response to FES, biomechanical benefits related to improved ankle push-off are suggested as the main mechanism.
