Gait & posture
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A child's natural gait pattern may be affected by the gait laboratory environment. Wearable devices using body-worn sensors have been developed for gait analysis. The purpose of this study was to validate and explore the use of foot-worn inertial sensors for the measurement of selected spatio-temporal parameters, based on the 3D foot trajectory, in independently walking children with cerebral palsy (CP). ⋯ Children with cerebral palsy showed significantly higher inter-stride variability (measured by their coefficient of variation) for speed, stride length, swing and stance. During turning trajectories speed and stride length decreased significantly (p<0.01) for both groups, whereas stance increased significantly (p<0.01) in CP children only. Foot-worn inertial sensors allowed us to analyze gait spatiotemporal data outside a laboratory environment with good accuracy and precision and congruent results with what is known of gait variations during linear walking in children with CP.
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Recent research in motor control shows the interactive role of cognitive factors in postural control. However, there is little understanding in how children with autism spectrum disorder (ASD) develop their postural behaviors. This study compares the interference of visual or auditory tasks on postural control in children with ASD. ⋯ Results showed that children with ASD indicated higher postural sway scores in visual task vs. auditory task; as root mean square (p=0.04), mean velocity (p=0.01) and sway area (p=0.02) but TD children scores remained unchanged. Children with ASD also showed significantly higher sway scores than TD children in all parameters. We conclude that in addition to primary differences in patterns of postural control of children with ASD compared to TD children, visual and auditory tasks may differently influence the postural control in this population.
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Midfoot break (MFB) is a foot deformity that can occur when ankle dorsiflexion is restricted due to muscle spasticity or contractures, causing abnormal increased motion through the midfoot. MFB has been previously described in terms of forefoot (FF) and hindfoot (HF) motion in the sagittal plane. The purpose of this study was to further classify MFB by describing FF and HF motion in the coronal and transverse planes along with plantar pressures, with the goal of optimizing treatment of this deformity. ⋯ The Supinated MFB group had increased lateral midfoot pressures, increased forefoot supination, and increased internal forefoot rotation (forefoot adductus). In the Flat Foot MFB group, midfoot pressures were increased and distributed uniformly between the medial and lateral sides, forefoot pronation was increased, and internal forefoot rotation was present. By combining this new information with previously reported methods of measuring sagittal plane kinematics of MFB, it is now possible to characterize midfoot break in terms of severity and foot-floor contact pattern.
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Clinical Trial
Higher step length variability indicates lower gray matter integrity of selected regions in older adults.
Step length variability (SLV) increases with age in those without overt neurologic disease, is higher in neurologic patients, is associated with falls, and predicts dementia. Whether higher SLV in older adults without neurologic disease indicates presence of neurologic abnormalities is unknown. Our objective was to identify whether SLV in older adults without overt disease is associated with findings from multimodal neuroimaging. ⋯ Our results highlighted the hippocampus and anterior cingulate gyrus, regions involved in memory and executive function. These findings support previous research indicating a role for cognitive function in motor control. Higher SLV may indicate focal neuropathology in those without diagnosed neurologic disease.
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Controlled Clinical Trial
Test-retest reliability of sensor-based sit-to-stand measures in young and older adults.
This study investigated test-retest reliability of sensor-based sit-to-stand (STS) peak power and other STS measures in young and older adults. In addition, test-retest reliability of the sensor method was compared to test-retest reliability of the Timed Up and Go Test (TUGT) and Five-Times-Sit-to-Stand Test (FTSST) in older adults. Ten healthy young female adults (20-23 years) and 31 older adults (21 females; 73-94 years) participated in two assessment sessions separated by 3-8 days. ⋯ The average sensor-based STS peak power of the normal STS trials and the average sensor-based STS peak power of the fast STS trials showed excellent test-retest reliability in young adults (intra-class correlation (ICC)≥0.90; zero in 95% confidence interval of mean difference between test and retest (95%CI of D); standard error of measurement (SEM)≤6.7% of mean peak power) and older adults (ICC≥0.91; zero in 95%CI of D; SEM≤9.9%). Test-retest reliability of sensor-based STS peak power and TUGT (ICC=0.98; zero in 95%CI of D; SEM=8.5%) was comparable in older adults, test-retest reliability of the FTSST was lower (ICC=0.73; zero outside 95%CI of D; SEM=14.4%). Sensor-based STS peak power demonstrated excellent test-retest reliability and may therefore be useful for clinical assessment of functional status and fall risk.