Asymmetry in gait pattern following tibial shaft fractures – a prospective one-year follow-up study of 49 patients

Larsen, Peter; Læssøe, Uffe; Rasmussen, Sten; Graven‐Nielsen, Thomas; Eriksen, Christian Berre; Elsøe, Rasmus

doi:10.1016/j.gaitpost.2016.09.027

Cited by 14 publications

(20 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…GA was assessed by comparing the swing times performed by one leg with respect to the swing times performed by the other, according to the following formula: GA = 100 × | ln(SSWT/LSWT) | , where SSWT and LSWT were the mean values of the swing times for the legs with the shortest and longest mean swing times, respectively 9 , 10 . We calculated the GA using this method, as it has commonly been used in previous studies 45 , 46 . Using this definition, a value of 0.0 reflected perfect symmetry, and higher values reflected greater degrees of asymmetry 9 .…”

Section: Methodsmentioning

confidence: 99%

The effect of levodopa on bilateral coordination and gait asymmetry in Parkinson’s disease using inertial sensor

Son¹,

Han

Lyoo

et al. 2021

npj Parkinsons Dis.

View full text Add to dashboard Cite

This study aimed to evaluate the effect of levodopa on the phase coordination index (PCI) and gait asymmetry (GA) of patients with Parkinson’s disease (PD) and to investigate correlations between the severity of motor symptoms and gait parameters measured using an inertial sensor. Twenty-six patients with mild-to-moderate-stage PD who were taking levodopa participated in this study. The Unified Parkinson’s Disease Rating Scale part III (UPDRS III) was used to assess the severity of motor impairment. The Postural Instability and Gait Difficulty (PIGD) subscore was calculated from UPDRS III. Patients were assessed while walking a 20-m corridor in both “OFF” and “ON” levodopa medication states, and gait analysis was performed using inertial sensors. We investigated the changes in gait parameters after taking levodopa and the correlations between UPDRS III, PIGD, and gait parameters. There was a significant improvement in PCI after taking levodopa. No significant effect of levodopa on GA was found. In “OFF” state, PCI and GA were not correlated with UPDRS III and PIGD. However, in “ON” state, PCI was the only gait parameter correlating with UPDRS III, and it was also highly correlated with PIGD compared to other gait parameters. Significant improvement in bilateral-phase coordination was identified in patients with PD after taking levodopa, without significant change in gait symmetricity. Considering the high correlation with UDPRS III and PIGD in “ON” states, PCI may be a useful and quantitative parameter to measure the severity of motor symptoms in PD patients who are on medication.

show abstract

Section: Methodsmentioning

confidence: 99%

The effect of levodopa on bilateral coordination and gait asymmetry in Parkinson’s disease using inertial sensor

Son¹,

Han

Lyoo

et al. 2021

npj Parkinsons Dis.

View full text Add to dashboard Cite

show abstract

“…GA was assessed by comparing the swing times performed by one leg with respect to those performed by the other, following the formula: GA = 100 x | ln(SSWT/LSWT) | where SSWT and LSWT were the mean values of the swing times for the leg with the short and long mean swing time, respectively[2,7]. We calculated the GA using this method because this has been commonly used in previous literature [4,5]. With this definition, values of 0.0 reflect perfect symmetry and high values reflect greater degrees of asymmetry [3].…”

Section: Methodsmentioning

confidence: 99%

“…This metric was used to quantify the ability of subjects to coordinate left-right stepping on level ground [7]. GA and PCI have been used as an indicator of different orthopedic diseases or status after surgery [4–6].…”

Section: Introductionmentioning

confidence: 99%

Quantitative analysis of the bilateral coordination and gait asymmetry using inertial measurement unit-based gait analysis

Han

Kim

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

Inertial measurement unit (IMU)-based gait analysis can be used to quantitatively analyze the bilateral coordination and gait asymmetry (GA). The purpose of this study was to investigate changes in bilateral coordination and GA due to gait speed using an IMU based gait analysis and identify spatiotemporal factors affecting bilateral coordination and GA. Eighty healthy adults (40 men and 40 women) participated in the study. The mean age was 26.2 years, and the mean body mass index was 22.8 kg/m2. Three different walking speeds (80%, 100%, and 120% of preferred walking speed) on a treadmill were applied for 1 min of continuous level walking using a shoe-type IMU-based gait analysis system. The phase coordination index (PCI) and GA were calculated on three different walking speeds. Several variables (gait speed, height, body mass index, cadence, and step length) were analyzed as possible factors affecting the PCI and GA. Bilateral coordination and GA improved during fast walking (p = 0.005 and p = 0.019, respectively) and deteriorated during slow walking (p<0.001 and p = 0.008, respectively), compared with the participants’ preferred walking speeds. The correlation analysis revealed that PCI was negatively correlated with step length at each walking condition and lower gait speed was negatively correlated with PCI and GA during slow walking. Both bilateral coordination and GA had a negative linear relationship with gait speed, showing an improvement in the fast walking condition and deterioration in the slow walking condition. Step length was the factor associated with the change in the bilateral coordination.

show abstract

“…They had patients walk over a pressure‐sensitive mat which uses temporal‐spatial parameters to describe gait and found asymmetries within the fractured leg at 6 months with 12.8% shorter single support, 12.8% longer swing time, 11.9% shorter step length, and 32.3% increased foot rotation. By the end of 12 months, the observed gait asymmetries were almost corrected 5 . While the results of the study by Larsen et al produced good results at 12 months follow‐up, other functional outcome studies have shown that 44%–86% of patients continue to experience anterior knee pain even after their fractures are fully healed 11–20 .…”

Section: Introductionmentioning

confidence: 94%

“…Tibial diaphyseal fractures are most commonly surgically repaired with intramedullary nailing (IMN). While there are a number of studies using gait analysis to assess fracture outcomes, 2–4 literature evaluating functional ability and gait patterns following IMN of tibial shaft fractures is scarce 5 . Three‐dimensional motion analysis describes segmental gait patterns of the whole lower extremity using temporal‐spatial, kinematic, and kinetic parameters.…”

Section: Introductionmentioning

confidence: 99%

Gait and strength assessment following surgical repair by intramedullary nailing of isolated tibial shaft fracture

Canseco,

Becker,

Muscott

et al. 2023

Journal Orthopaedic Research

View full text Add to dashboard Cite

The objective of the study was to evaluate the long‐term strength and gait outcomes after intramedullary nailing of isolated tibial diaphyseal fractures. This retrospective cohort study was conducted at an academic Level I trauma center. Fifteen participants with isolated tibial diaphyseal fractures (OTA/AO 42) at least 2 years postoperative from intramedullary nailing (IMN) provided informed consent. The average age was 40 ± 14 (range, 24‐69); there were nine men and six women. Knee flexion‐extension strength data were collected. Temporal spatial, kinematic and kinetic gait parameters were measured and compared to historic control data. Participants completed the SF‐36 and sMFA questionnaires. The mean length of follow‐up between surgery and gait analysis was 6 ± 2 years. The fractured limb demonstrated deficits in quadriceps strength between 9.8‐23.4% compared to the unaffected limb. Temporal spatial parameters revealed slower walking speed, shorter stride length, decreased cadence, and shorter single limb support time in the fractured limb. Altered kinematic and kinetic findings included a knee extension shift during stance, with an increased knee flexor moment demand and decreased total knee power during loading and midstance. These findings represent deficits in concentric and eccentric knee extensor activity. Additionally, the fractured limb demonstrated decreased ankle dorsiflexion during stance and diminished ankle push‐off power. Long‐term outcomes after IMN of tibial diaphyseal fractures demonstrate decreased quadriceps strength and altered gait parameters that may have implications to the high incidence of knee and ankle pain in the fractured limb.This article is protected by copyright. All rights reserved.

show abstract

Asymmetry in gait pattern following tibial shaft fractures – a prospective one-year follow-up study of 49 patients

Abstract: In patients treated by intramedullary nailing following a tibial shaft fracture, gait asymmetry accompanied with slower speed and cadence are common during the first 6 months and become normalized compared with a healthy reference population between 6 and 12 months post-operatively.

Cited by 14 publications

References 25 publications

The effect of levodopa on bilateral coordination and gait asymmetry in Parkinson’s disease using inertial sensor

The effect of levodopa on bilateral coordination and gait asymmetry in Parkinson’s disease using inertial sensor

Quantitative analysis of the bilateral coordination and gait asymmetry using inertial measurement unit-based gait analysis

Gait and strength assessment following surgical repair by intramedullary nailing of isolated tibial shaft fracture

Contact Info

Product

Resources

About