Tag: gait analysis

Influence of exoskeleton therapy on gait parameters in patients with cerebral palsy

Adam Trzyna, Anna Brachman, Tomasz Łosień, Grzegorz Sobota


Adam Trzyna, Anna Brachman, Tomasz Łosień, Grzegorz Sobota – Influence of exoskeleton therapy on gait parameters in patients with cerebral palsy. Fizjoterapia Polska 2022; 22(2); 194-201

Abstract
Objective. The study presents the results of research aimed at assessing the influence of exoskeleton therapy on the basic spatiotemporal and kinetic parameters of gait in patients with cerebral palsy (CP).
Material and methods. Seventeen patients with CP (II GMFCS) participated in the study. The training program lasted 8 weeks with a two-week break in the middle of the entire cycle (3 weeks – 2 weeks off – 3 weeks). The training session lasted 90 minutes. The patients trained wearing an exoskeleton (Ekso GT) under the supervision of a qualified physiotherapist. The gait analysis was performed on the Zebris FDM-TDL treadmill for the preferred and maximum tolerated velocity, before and after the entire training program.
Results. When walking at maximum tolerated velocity, participants improved velocity, step rate, step length, gait cycle length, and gait cycle time. Contact times have significantly changed for the forefoot, midfoot, and heel areas. The stance phase time for the left and right sides decreased significantly. The above-mentioned parameters for the preferred velocity did not change statistically significantly.
Conclusions. Positive changes were observed for conditions more difficult than the preferred gait. More research is needed in different configurations of intensity, volume and duration of the entire rehabilitation cycle to optimize the rehabilitation program and maximize outcomes.
Key words:
exoskeleton, cerebral palsy (CP), gait analysis, gait re-education
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The assessment of gait deviations in patients with knee arthritis using the ground reaction forces analysis

Grzegorz Konieczny, Katarzyna Leżoń, Zdzisława Wrzosek, Michał Sokołowski

Grzegorz Konieczny, Katarzyna Leżoń, Zdzisława Wrzosek, Michał Sokołowski – The assessment of gait deviations in patients with knee arthritis using the ground reaction forces analysis. Fizjoterapia Polska 2006; 6(4); 317-321

Abstract
Background. The purpose of this study is to analyze the objective gait parameters for the subjects with knee arthritis using ground reaction forces analysis. Material and methods. The gait analysis was performed on 31 subjects with unilateral knee arthritis with use of Pressure Distribution Measurement System (PDM-S) force-plate. The first peak force, the second peak force, the loading rate, the push-off rate, the stance time, and the distribution of pressure across the foot were analyzed. The VAS score was also obtained. Results. The obtained results were compared with outcomes of gait analysis of healthy population presented by J. L. McCrory. The first and the second peak force were lower for the limb with arthritic knee. The stance time for the limb with arthritic knee was lower. The pressure measured at the heel, and rate of loading were also lower for the limb with arthritic knee. Conclusion. The osteoarthritis of knee leads to substantial alterations in gait. Gait deviations contribute mainly to pain associated with osteoarthritis of knee joint. The gait analysis with use of ground reaction force-plates is valuable method in functional assessment of knee arthritis.

Key words:
gait analysis, arthritis, knee

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Assessment of kinematics of pathological gait after articular cartilage 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 cartilage surgery. Fizjoterapia Polska 2006; 6(4); 304-309

Abstract
Background. This paper presents a biomechanical assessment of changes in the kinematics of gait of patients following selected types of articular cartilage surgery of the knee joint, examined with a 3D motion analysis system (SIMI Reality Motion Systems GmbH, Germany). Material and methods. The gait of thirty-two patients after articular cartilage surgery of the knee joint was analyzed in the course of 2 out of 4 stages of our original physiotherapy treatment. Monitoring the progress of the rehabilitation programme involved recording of spatial kinematic data of the gait and angle-time characteristics. The first measurement was taken between the 2nd and 3rd week postoperatively, the second was taken between the 6th and 8th postoperative week. The last measurement was taken between the 10th and 14th week postoperatively, when the patient’s gait was fully restored and being improved. Results. Satisfactory individual results in patients undergoing our rehabilitation programme were obtained in test patients compared to the control group between the 10th and 14th postoperative week. The spatial gait parameters: step and stride lengths were significantly increased and the stance-to-swing ratio decreased for the affected limb compared to the first measurement. Gait velocity was also found to have doubled. In addition the range of motion in the joints was increased and the angle characteristics were similar in the test patients and the control group. Conclusions. The extensive surgical and physiotherapeutic management improved gait parameters between the 10th and 14th postoperative week in all patients.

Key words:
gait analysis, pathological gait, articular cartilage, rehabilitation

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Use of quantitative, objective gait analysis for assessment of selection quality of afos in CP children (gait analysis in afos selection in CP)

Małgorzata Syczewska, Anna Święcicka, Małgorzata Kalinowska, Krzysztof Graff

Małgorzata Syczewska, Anna Święcicka, Małgorzata Kalinowska, Krzysztof Graff – Use of quantitative, objective gait analysis for assessment of selection quality of afos in CP children (gait analysis in afos selection in CP). Fizjoterapia Polska 2006; 6(4); 298-303

Abstract
Background. The main aims of clinical gait analysis are to measure and to assess the parameters which characterize the patient’s locomotion in order to identify the primary pathologies and compensatory mechanisms. The aim of this paper is to present 6 patients with CP, in whose case the gait analysis was used to assess the influence of the AFOs on the gait. Material and methods. Six children with cerebral palsy, aged 6 to 14 years old, were recruited into the study. They all were treated in the Dept. Paediatric Rehabilitation CMHI. They underwent the objective gait analysis (using movement analysis system VICON 460) two times: barefoot, and in shoes with AFOs. Results. In four cases AFOs considerably improved the gait pattern, in two patients caused the gait deterioration. Conclusions. The aim of the AFOs is to improve gait (through improved ankle joint stability, and assistance to the weak calf muscles) and to correct pathological deviations, such as knee hyperextension. The improper choice of the AFO type, or bad fitting could result in no improvement, but in more severe cases even in gait deterioration. The results of this paper indicate that the quantitative gait analysis proved to be the efficient tool in assessing the selection quality of AFOs.

Key words:
gait analysis, AFO, CP

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Differences in knee movement while walking in children with cerebral palsy (CP)

Alicja Dziuba, Krystyna Kobel-Buys

Alicja Dziuba, Krystyna Kobel-Buys – Differences in knee movement while walking in children with cerebral palsy (CP). Fizjoterapia Polska 2007; 7(4); 447-454

Abstract
Background. Cerebral palsy (CP) affects many children, with about 50,000 CP patients living currently in Poland. The most frequent manifestation of CP is a gait disorder attributable to both neurological and developmental factors. The aim of this study is to analyze children’s walking abilities using basic gait parameters and trace changes of these parameters during rehabilitation.Material and methods. This paper presents the results of two-dimensional gait analysis using two cameras positioned perpendicular to the direction of the child’s walk and recording at 50 Hz the movement of the right and left side of the body in the sagittal plane. The paper describes the walking skills of three CP boys born in 2000 (3/JK/02, 8/SA/02 and 20/BM/03) who were able to walk with help. The locomotion analysis was based on change over time of angular displacements in the right and left knee in the support and swing phases of gait. Results. The analysis showed that child 3/JK/02 had the best knee movement pattern, as suggested by the approximation of mean angular displacements in selected points in the swing and stance phases to those established for normal children. Child 8/SA/02 displayed greater deterioration of the gait pattern, as the knee movement pattern differed more considerably from that of a healthy child. The knee movement of child 20/MB/03 improved very little. Conclusion. The type of kinematic analysis conducted in this study is of diagnostic significance, helping to identify an improvement or deterioration of gait in children undergoing rehabilitation, and can aid the physician or physiotherapist in selecting exercises addressing specific elements of the gait pattern in order to effect lasting improvements.
Key words:
cerebral palsy, gait analysis, knee movement
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Assessment of the impact of prosthetic foot support flexibility on gait in a patient after lower limb amputation at thigh level

Mateusz Curyło, Agnieszka Ciukszo, Marcin Zaczyk, Damian Szubski, Łukasz Strzępek, Bolesław Karwat, Jan W. Raczkowski

Mateusz Curyło, Agnieszka Ciukszo, Marcin Zaczyk, Damian Szubski, Łukasz Strzępek, Bolesław Karwat, Jan W. Raczkowski – Assessment of the impact of prosthetic foot support flexibility on gait in a patient after lower limb amputation at thigh level. Fizjoterapia Polska 2021; 21(2); 56-63

DOI: https://doi.org/10.56984/8ZG0DDEF8

Abstract
Objective. The article presents the results of experimental studies, the main objective of which was to determine how the degree of flexibility of the lower limb prosthesis support system impacts the pattern of secondarily learned gait in a patient after amputation. Material and methods. The study was carried out on a patient (35-year-old man) after lower limb amputation at the level of 1/3 of the proximal femur, who followed a previously planned walking path. Inclusion criteria: gender F and M, amputation at 1/3 of the proximal femur, age below 40, traumatic amputation, average level of activity, use of a prosthesis for at least one year. Exclusion criteria: age over 40, amputations below 1/3 of the proximal femur, amputations for vascular reasons, activity level below average, use of a prosthesis for under one year. During the study, the patient was equipped with three support systems corresponding to three degrees of flexibility of the prosthetic foot (soft, medium, hard). Biomechanical data during gait was collected using FlexinFit by Sensor Medica for assessing the pressure between the foot and the inside of the shoe. Results. In the entire gait cycle, the support phase on the healthy limb was the longest. The hard support system generates the greatest asymmetry of the transferred loads between the limbs. In this support variant, the difference in load between the healthy limb and the amputated limb was 1,330 kg/m2, which represented an asymmetry of 21%. In terms of load distribution, the best support was medium support – medium support flexibility, for which the difference in load between the healthy limb and the amputated limb was 770 kg/m2, which was an asymmetry of 12%. Conclusions. When designing a prosthesis for people after lower limb amputation, it is crucial to correctly adjust its features to the individual needs of each patient (adjusting prosthesis kinematics, adjusting support system stiffness), so that gait is possibly closest to normal with low energy demand.
Key words:
lower limb amputation, gait analysis, prosthetic gait, prosthetic rehabilitation
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Robotic-assisted locomotor training in a 7-year-old child with hemiplegia. Case study

Ewelina Żak, Grzegorz Sobota, Jacek Durmała

Ewelina Żak, Grzegorz Sobota, Jacek Durmała – Robotic-assisted locomotor training in a 7-year-old child with hemiplegia. Case study. Fizjoterapia Polska 2012; 12(2); 159-168

Abstract
Background. The aim of the study was to assess the effectiveness and influence on gait parameters of a 4 – week automated training by a driven gait orthosis. Material and methods. Treadmill training with a driven gait orthosis was used for a 7 year with hemiplegia. Her disability represented 1 level in the GMFCS scale. The child received 18 sessions over 4-week period (5sessions/week, mean therapy duration was 45 minutes per session). Pre and post-training evaluations were performed on kinematics gait parameters using motion capture system (BTS-Smart). Results. After therapy were observed return or approximate value of the evaluated parameters to a normative level of control group. Conclusions. Even small changes in temporal and distance parameters of gait could improve comfort and quality of the patient’s gait. After therapy, there was noted improvement in most of the gait parameters pointing to positive impact of this form of therapy in patient with impaired gait described.
Key words:
Cerebral Palsy, gait analysis, locomotor training, three-dimensional motion analysis
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Analiza chodu chorych na przewlekłą obturacyjną chorobę płuc

Sebastian Rutkowski, Anna Rutkowska, Jacek Łuniewski,
Jan Szczegielniak

S. Rutkowski, A. Rutkowska, J. Łuniewski, J. Szczegielniak – Gait analysis of patients with chronic obstructive pulmonary disease. FP 2014; 14(4); 24-33

Streszczenie
Celem pracy była analiza chodu chorych na POChP. Podjęto próbę odpowiedzi na pytanie, czy zdiagnozowana przewlekła obturacyjna choroba płuc ma wpływ na parametry chodu w trakcie 6 minutowego testu marszowego.
W badaniu wzięło udział 33 chorych na POChP: 27 mężczyzn i 6 kobiet, którzy przebywali na leczeniu stacjonarnym w Szpitalu Specjalistycznym MSW w Głuchołazach, w okresie od lutego 2011 do maja 2011 roku, którzy stanowili grupę badaną. Grupę kontrolą stanowiło 48 osób: 35 kobiet i 9 mężczyzn.
Stwierdzono że średnia dystansu uzyskana w grupie badanej wyniosła 538,97m ±176,32 m, natomiast w grupie kontrolnej 546,7m ±85,7 m. Chorzy na POChP w trakcie testu poruszali się z mniejszą prędkością, stawiali krótsze kroki w dłuższym czasie
Analiza wyników wykazała, że chorzy na POChP prezentowali pogorszone wartości wskaźników opisujących parametry chodu w trakcie 6 minutowego testu marszowego.

Słowa kluczowe:
analiza chodu, POChP, 6MWT

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