Real-Time Gait Cycle Parameter Recognition Using a Wearable Accelerometry System

This paper presents the development of a wearable accelerometry system for real-time gait cycle parameter recognition. Using a tri-axial accelerometer, the wearable motion detector is a single waist-mounted device to measure trunk accelerations during walking. Several gait cycle parameters, including cadence, step regularity, stride regularity and step symmetry can be estimated in real-time by using autocorrelation procedure. For validation purposes, five Parkinson’s disease (PD) patients and five young healthy adults were recruited in an experiment. The gait cycle parameters among the two subject groups of different mobility can be quantified and distinguished by the system. Practical considerations and limitations for implementing the autocorrelation procedure in such a real-time system are also discussed. This study can be extended to the future attempts in real-time detection of disabling gaits, such as festinating or freezing of gait in PD patients. Ambulatory rehabilitation, gait assessment and personal telecare for people with gait disorders are also possible applications

Accuracy and repeatability of a semi-quantitative barefoot pressure measurement method for clinical use:The Derks Calculation Method

Background: This study was designed to assess the accuracy and repeatability of the Derks Calculation Method in the normal foot during walking.Methods: Measurements were taken from 25 healthy subjects (age 32.0 ± 12.4), 23 females and 2 males, on five separate occasions at seven days, three weeks, three months, and nine months apart by means of a mid-gait method. Values were calculated for internal rotation (IR) and external rotation of the heel (ER), heel valgus/varus (HV), heel length (HL), heel width (HW), width of the midfoot (WM) and the forefoot (WF), and the length of the foot (LF).Results: For all five separate occasions and in 87.5% of the parameters investigated, the coefficient of repeatability (CR, expressed as a percentage of the mean) was less than 5%. One parameter showed a high CR - heel valgus/varus (HV) was extremely high (&gt;800%). The maximum 95% Confidence Interval (CI) for the five different occasions was no higher than 0.2 cm for IR, ER and HV with a standard error (SE) of 0.01 and &gt;0.01 respectively. The maximum 95% CI for WF was 0.4 cm (SE 0.1), and for HW, WM and LF the maximum 95% CI was 0.7 cm (SE 0.1 or 0.2). HL showed the highest 95% CI (0.9 cm) with an SE of 0.2.Conclusion: The Derks Calculation Method was found to be accurate and repeatable if HV was excluded, which renders this method a viable clinical tool in settings where sophisticated computerised systems are still unavailable.</p

Extraarticular Subtalar Arthrodesis for Pes Planovalgus: An Interim Result of 50 Feet in Patients with Spastic Diplegia

BACKGROUND: There are no reports of the pressure changes across the foot after extraarticular subtalar arthrodesis for a planovalgus foot deformity in cerebral palsy. This paper reviews our results of extraarticular subtalar arthrodesis using a cannulated screw and cancellous bone graft. METHODS: Fifty planovalgus feet in 30 patients with spastic diplegia were included. The mean age at the time of surgery was 9 years, and the mean follow-up period was 3 years. The radiographic, gait, and dynamic foot pressure changes after surgery were investigated. RESULTS: All patients showed union and no recurrence of the deformity. Correction of the abduction of the forefoot, subluxation of the talonavicular joint, and the hindfoot valgus was confirmed radiographically. However, the calcaneal pitch was not improved significantly after surgery. Peak dorsiflexion of the ankle during the stance phase was increased after surgery, and the peak plantarflexion at push off was decreased. The peak ankle plantar flexion moment and power were also decreased. Postoperative elevation of the medial longitudinal arch was expressed as a decreased relative vertical impulse of the medial midfoot and an increased relative vertical impulse (RVI) of the lateral midfoot. However, the lower than normal RVI of the 1st and 2nd metatarsal head after surgery suggested uncorrected forefoot supination. The anteroposterior and lateral paths of the center of pressure were improved postoperatively. CONCLUSIONS: Our experience suggests that the index operation reliably corrects the hindfoot valgus in patients with spastic diplegia. Although the operation corrects the plantar flexion of the talus, it does not necessarily correct the plantarflexed calcaneus and forefoot supination. However, these findings are short-term and longer term observations will be needed.ope

A real time plantar pressure feedback device for foot unloading

The design and development of a plantar pressure control device, adapted to correct plantar pressure distribution patterns, is described. This device is based on the artificial return of information in real time to instantaneously reveal to subject certain events, of which he was unaware and which are difficult to quantify, such as the pressure variation generated by foot-ground contact. An acoustic alarm and visual signals, adjusted to a specific pressure load, alert the user in the case of excessive plantar pressure. So, our feedback device is designed to substitute for loss of feeling in patients who have peripheral neuropathy secondary to diabetes mellitus. The ultimate aim of this project is to prevent the development of neuropathic foot ulceration by providing both visual and auditory extrinsic sensory feedback to compensate for the malfunctioning peripheral nerves and to transmit information to the patient about dangerous conditions on the plantar surface of the feet. A trial of the device in a healthy subject is presented to evaluate whether a new gait pattern can emerge thanks to feedback from plantar pressure measurements

Développement et validation d'un dispositif de bouclage bio-rétroactif baropodométrique (application à la démarche du pied)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF

Step-to-step reproducibility and asymmetry to study gait auto-optimization in healthy and cerebral palsied subjects

AbstractObjectiveThe purpose of our study was to compare plantar pressure asymmetry and step-to-step reproducibility in both able-bodied persons and two groups of hemiplegics. The relevance of the research was to determine the efficiency of asymmetry and reproducibility as indexes for diagnosis and rehabilitation processes.Material and methodThis study comprised 31 healthy young subjects and 20 young subjects suffering from cerebral palsy hemiplegia assigned to two groups of 10 subjects according to the severity of their musculoskeletal disorders. The peaks of plantar pressure and the time to peak pressure were recorded with an in-shoe measurement system. The intra-individual coefficient of variability was calculated to indicate the consistency of plantar pressure during walking and to define gait stability. The effect size was computed to quantify the asymmetry and measurements were conducted at eight footprint locations.ResultsResults indicated few differences in step-to-step reproducibility between the healthy group and the less spastic group while the most affected group showed a more asymmetrical and unstable gait.ConclusionFrom the concept of self-optimisation and depending on the neuromotor disorders the organism could make priorities based on pain, mobility, stability or energy expenditure to develop the best gait auto-optimisation