Tag: gait disorders

Assessment of kinematics of pathological gait after articular cartillage surgery

Andrzej Czamara, Sławomir Winiarski, Zbigniew Jethon, Andrzej Bugajski, Rafał Szafraniec, Andrzej Zaleski, Wiesław Tomaszewski

Andrzej Czamara, Sławomir Winiarski, Zbigniew Jethon, Andrzej Bugajski, Rafał Szafraniec, Andrzej Zaleski, Wiesław Tomaszewski – Assessment of kinematics of pathological gait after articular cartillage surgery. Fizjoterapia Polska 2007; 7(1); 1-9

Abstract

Background. Thirty two male patients with the full-thickness lesion of articular cartilage on the load-bearing surface of the knee joint (Outerbridge Grade III-IV) were involved in the study. The goal of this paper is the biomechanical assessment of changes in the kinematics of gait of patients after selected articular cartilage surgeries of knee joint examined by the 3D motion analysis system (SIMI Reality Motion Systems GmbH, Germany). Material and methods. Gait of thirty two patients with the articular cartilage surgery of knee joint was analyzed while they underwent 2 out of 4 stages of our original physiotherapy treatment. In order to test the progress of the rehabilitation program the spatial kinematic data of the gait was collected and the angle-time characteristics acquired. The first measurement was taken between the 2nd and 3rd week postoperatively, the second was taken between 6th and 8th week postop. The last measurement was taken between 10th and 14th week postoperatively, when the patient’s gait was fully restored and being improved. The values of step and stride lengths (meters), gait velocity (meters per sec.) and the step cadence (steps per sec.) were monitored as well as the stance and swing ratios (percent of the gait cycle) of the affected and unaffected limb. Range of motion in the knee joint was examined in dynamics and the angles at heel-strike and toe-off measured for both lower limbs. Results. As a consequence of our rehabilitation procedure satisfactory results were obtained individually between 10th and 14th week postop. in test patients with reference to the control group. The spatial gait parameters step and stride lengths have significantly increased and the stance to swing ratio have decreased for the affected limb compared to the first measurement. The gait velocity was found to be doubled. In addition an increase in range of motion in the joints was noticed and the angle characteristics was similar to the one of the control group. Conclusions. The extensive surgical and physiotherapeutic procedures applied in the treatment have improved gait parameters between 10th and 14th week postop in all tested patients.

Key words:
biomechanics, gait, gait disorders, articular cartilage, surgery, rehabilitation
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Gait pattern of people after fractures of proximal femoral epiphysis treated surgically. Preliminary report

Beata Kita, Tomasz Ridan, Tomasz Łosień, Katarzyna Kniaziew-Gomoluch, Joanna Szymańska

B. Kita, T. Ridan, T. Łosień, K. Kniaziew-Gomoluch, J. Szymańska – Gait pattern of people after fractures of proximal femoral epiphysis treated surgically. Preliminary report. Fizjoterapia Polska 2020; 20(3); 164-170

Abstract
Introduction. It is estimated that more than 50% of patients who functioned well before the proximal femoral fracture were unable to return to pre-injury activity. Moreover, mortality in this group of patients is estimated at over 21% within the first year of fracture, and in the next 5 years this number increases to 59%. The aim of the study is to analyze the impact of the fracture of the proximal part of femur treated surgically on selected gait parameters.
Material and methods. 51 people were examined, including 40 women and 11 men. The average age of the respondents was 73 years. The youngest person in the study group was 51 years old and the oldest 92 years old. The following research tools were used in the study: interview, analysis of medical documentation and gait assessment on the tensometric platform. Results. In the age group 50-64 years, the walking cycle time among the examined people was on average 1.51 sec in women and 1.35 sec in men. In the age group 65-80 years, among women and men is 1.37 sec. Conclusions. The gait pattern of people after a fracture of the proximal femur is changed and deviates from the norm. In the study group, the length of the walk cycle in both women and men in the age group 50 -64 years old, as well as 65-80 years old, is significantly shorter compared to the assumptions of the standard. The study did not show significant differences in step length on the operated and non-operated side in all age groups, both in women and men. Walking cycle times (stride time) in the 54-64 age group and 65-80 years of age among the surveyed men is within the upper limit of the norm. On the other hand, among the surveyed women in these age groups, the walking cycle time significantly exceeds the upper limit of the norm.
Key words:
gait pattern, proximal femur fractures, gait disorders, elderly people
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Diagnostics of Balance and Gait Disorders in Patients with Parkinson’s Disease

Maria Kłoda, Grażyna Brzuszkiewicz-Kuźmicka, Edyta Smolis-Bąk, Izabela Korabiewska, Monika Lewandowska, Dariusz Białoszewski

M. Kłoda, G. Brzuszkiewicz-Kuźmicka, E. Smolis-Bąk, I. Korabiewska, M. Lewandowska, D. Białoszewski – Diagnostics of Balance and Gait Disorders in Patients with Parkinson’s Disease. FP 2017; 17(2); 122-131

Abstract

Parkinson’s disease is a chronic, progressing affliction of the human central nervous system. It is one of degenerative diseases and affects mainly the extrapyramidal system, and in particular the substantia nigra of the midbrain.  Along with the axial symptoms of Parkinson’s disease, the other most important ones would include abnormalities of posture and gait. The improper posture has an impact on future problems with locomotion and self-service functions.
Prior to introducing any physiotherapy, there should be carried out a number of tests, which will allow both, quantitative and qualitative assessment the patient’s gait and his or her posture. These tests include among others: gait analysis performed on a treadmill of the ”Zebris” FDM-TDM type, which uses the WinFDM-T data base system, Vicon 460 system for the three-dimensional assessment of gait, Timed Up & Go, 10 MWT or Tinetti tests.
Demographic data indicate the increasing incidence of the Parkinson’s disease, which seems to be due to the gradual lengthening of a human life span. This makes it very important to properly rehabilitate and care for the patients.
As the disease progresses, patients begin to experience discomfort during their daily activities, and in locomotion, and thus their quality of life is being reduced. Here comes the great importance of implemented physiotherapy treatments, which are supposed to maintain, for as long as possible, the patients’ mobility at the level sufficient to enable their independent functioning. Introduced early enough physiotherapy procedures significantly improve gait parameters in patients with the Parkinson’s disease, thus delaying progression of the disease.

Key words:
diagnostics, Parkinson’s disease, balance disorders, gait disorders

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