Tag: gait analysis

外骨骼治疗对脑瘫患者步态参数的影响

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

DOI: https://doi.org/10.56984/8ZG0DE7jJ

摘要
目的。 本研究旨在评估外骨骼治疗对脑瘫（CP）患者基本时空和动力学步态参数的影响。

材料和方法。 研究共纳入 17 名 CP 患者（II GMFCS）。训练计划持续 8 周，中间有 2 周的休息期（3 周训练 – 2 周休息 – 3 周训练）。每次训练持续 90 分钟。患者在合格的物理治疗师监督下，穿戴 Ekso GT 外骨骼进行训练。步态分析采用 Zebris FDM-TDL 跑步机，在患者可接受的最优速度和最大耐受速度下进行测试，测试时间分别为整个训练计划前后。

结果。 在最大耐受速度下行走时，患者的步速、步频、步长、步态周期长度和步态周期时间均有所改善。前足、中足和后跟区域的接触时间发生了显著变化。左侧和右侧的支撑相时间显著减少。在首选速度下，上述参数的变化在统计学上无显著意义。

结论。 在比首选步态更困难的条件下观察到了积极的变化。需要进一步研究不同强度、训练量和整个康复周期持续时间的配置，以优化康复方案并最大化治疗效果。

关键词：
外骨骼, 脑瘫（CP）, 步态分析, 步态再训练
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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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Gait analysis of patients with chronic obstructive pulmonary disease

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

Abstract

The aim of the study was the analysis of gait parameters of patients with COPD. It was decided to examine whether the diagnosed chronic obstructive pulmonary disease affects the gait parameters during a 6-minute walk test.
The research material consisted of 33 COPD in patients (27 males, 6 females) of MIAA Specialistic Hospital in Głuchołazy, who were treated there from February 2011 to May 2011. Control group consisted of 48 healthy (9 males, 35 females).
It was found that the average distance reached in the test group was 538,97m ±176,32m, while in the control group 546,7m ± 85,7m. Patients with COPD during the test were moving at a slower speed, achieved shorter steps during longer step time
Analysis of the results showed that COPD patients presented deteriorated the value of indicators describing the gait parameters during the 6-minute walk test

Key words:
gait analysis, COPD, 6MWT

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