Cyclogram-Based Joint Symmetry Assessment After Utilization of a Foot Drop Stimulator During Post-stroke Hemiplegic Gait

Pilkar, Rakesh; Ramanujam, Arvind; Chervin, Kathleen; Forrest, Gail; Nolan, Karen J.

doi:10.1115/1.4040774

Cited by 11 publications

(9 citation statements)

References 26 publications

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“…Moreover, interpretation of the parameters they provide is not so straightforward as occurs with classic symmetry indexes. However, several studies carried out in the last decade on individuals affected by neurologic (neuropathies, stroke, Parkinson's disease [25][26][27]) and orthopedic conditions [28][29][30] demonstrated that such an approach is versatile and allows a more accurate and thorough analysis of gait symmetry, thus proving to be of great relevance in all conditions characterized by subtle, not easily detectable alteration of gait with the conventional discrete indices.…”

Section: Waveform-based Methods To Assess Interlimb Symmetry During Gaitmentioning

confidence: 99%

Kinematic Analysis of Lower Limb Joint Asymmetry During Gait in People with Multiple Sclerosis

et al. 2021

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The majority of people with Multiple Sclerosis (pwMS), report lower limb motor dysfunctions, which may relevantly affect postural control, gait and a wide range of activities of daily living. While it is quite common to observe a different impact of the disease on the two limbs (i.e., one of them is more affected), less clear are the effects of such asymmetry on gait performance. The present retrospective cross-sectional study aimed to characterize the magnitude of interlimb asymmetry in pwMS, particularly as regards the joint kinematics, using parameters derived from angle-angle diagrams. To this end, we analyzed gait patterns of 101 pwMS (55 women, 46 men, mean age 46.3, average Expanded Disability Status Scale (EDSS) score 3.5, range 1–6.5) and 81 unaffected individuals age- and sex-matched who underwent 3D computerized gait analysis carried out using an eight-camera motion capture system. Spatio-temporal parameters and kinematics in the sagittal plane at hip, knee and ankle joints were considered for the analysis. The angular trends of left and right sides were processed to build synchronized angle–angle diagrams (cyclograms) for each joint, and symmetry was assessed by computing several geometrical features such as area, orientation and Trend Symmetry. Based on cyclogram orientation and Trend Symmetry, the results show that pwMS exhibit significantly greater asymmetry in all three joints with respect to unaffected individuals. In particular, orientation values were as follows: 5.1 of pwMS vs. 1.6 of unaffected individuals at hip joint, 7.0 vs. 1.5 at knee and 6.4 vs. 3.0 at ankle (p < 0.001 in all cases), while for Trend Symmetry we obtained at hip 1.7 of pwMS vs. 0.3 of unaffected individuals, 4.2 vs. 0.5 at knee and 8.5 vs. 1.5 at ankle (p < 0.001 in all cases). Moreover, the same parameters were sensitive enough to discriminate individuals of different disability levels. With few exceptions, all the calculated symmetry parameters were found significantly correlated with the main spatio-temporal parameters of gait and the EDSS score. In particular, large correlations were detected between Trend Symmetry and gait speed (with rho values in the range of –0.58 to –0.63 depending on the considered joint, p < 0.001) and between Trend Symmetry and EDSS score (rho = 0.62 to 0.69, p < 0.001). Such results suggest not only that MS is associated with significantly marked interlimb asymmetry during gait but also that such asymmetry worsens as the disease progresses and that it has a relevant impact on gait performances.

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Section: Waveform-based Methods To Assess Interlimb Symmetry During Gaitmentioning

confidence: 99%

Kinematic Analysis of Lower Limb Joint Asymmetry During Gait in People with Multiple Sclerosis

et al. 2021

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“…Waveform-based methods exploit the whole kinematic data associated with a certain lower limb joint angle with time throughout the whole gait cycle and thus enrich the information content useful to quantify symmetry. This approach was successfully applied in the last decade to investigate inter-limb coordination in several pathologic populations affected by both neurologic (neuropathies, stroke, Parkinson's disease, and multiple sclerosis) [28][29][30][31][32] and orthopaedic conditions [33][34][35]. In most cases, the use of waveform-based methods resulted more effective in detecting subtle alterations of gait with respect to discrete symmetry indices.…”

Section: Introductionmentioning

confidence: 99%

Synchronized Cyclograms to Assess Inter-Limb Symmetry during Gait in Women with Anorexia and Bulimia: A Retrospective Study

Pau,

Cerfoglio,

Capodaglio

et al. 2023

Symmetry

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Anorexia nervosa (AN) and bulimia nervosa (BN) are eating diseases characterized by extreme eating behaviours impacting both mental and physical health. Aberrant musculoskeletal adaptations due to malnutrition affect motor abilities such as postural control and gait. To date, limited data is available with regards to gait symmetry in AN and BN. The aim of this study was to characterize inter-limb asymmetry during gait in two cohorts affected by AN and BN, respectively, using the synchronized cyclograms and to compare it with a healthy weight group. A total of 14 AN, 17 BN, and 11 healthy-weight females were assessed via 3D gait analysis. Gait spatio-temporal parameters were computed together with angle–angle diagrams, which were characterized in terms of their geometric features. Individuals with AN and BN were characterized by reduced speed and cadence and an abnormal increase in the duration of the double support phase with respect to the healthy controls. With respect to inter-limb symmetry, asymmetries were detected in both groups, with individuals with BN exhibiting significantly larger cyclogram areas at the hip joint with respect to the other groups (323.43 degrees2 vs. 253.74 degrees2 vs. 136.37 degrees2) and significantly higher orientation angle and Trend Symmetry at both knee and ankle joint. The cyclogram analysis suggests the presence of an altered gait symmetry in individuals with BN. In the AN group, it is possible to observe a similar trend; however, this is not statistically significant. Overall, the findings of this study may provide a novel perspective on the motor control dysfunction linked to eating disorders and aid clinicians in selecting a suitable rehabilitation scheme targeted at enhancing motor stability and control.

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“…13 Mechanisms of walking after ABI are often characterized by reduced speed, kinematic, temporospatial, and neuromuscular asymmetry, and postural instability. [14][15][16][17] Therefore, one of the major rehabilitation goals for individuals after ABI is to improve mobility and regain functional independence in the community. 18 Numerous interventions are being developed based on exercise, physical therapy, functional electrical stimulation, and robotic exoskeletons.…”

Section: Introductionmentioning

confidence: 99%

“…Hemiparesis, which persists even into the chronic phase of stroke, affects balance and reduces a person's ability to walk 13 . Mechanisms of walking after ABI are often characterized by reduced speed, kinematic, temporospatial, and neuromuscular asymmetry, and postural instability 14‐17 . Therefore, one of the major rehabilitation goals for individuals after ABI is to improve mobility and regain functional independence in the community 18 .…”

Section: Introductionmentioning

confidence: 99%

Wearable devices for tracking physical activity in the community after an acquired brain injury: A systematic review

Veerubhotla

Krantz

Ibironke

et al. 2021

PM&R

Self Cite

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Objective The application of wearable devices in individuals with acquired brain injury (ABI) resulting from stroke or traumatic brain injury (TBI) for monitoring physical activity (PA) has been relatively recent. The current systematic review aims to provide insights into the adaption of these devices, the outcome metrics, and their transition from the laboratory to the community for PA monitoring of individuals with ABI. Literature Survey The PubMed and Google Scholar databases were systematically reviewed using appropriate search terms. A total of 20 articles were reviewed from the last 15 years. Methodology Articles were classified into three categories: PA measurement studies, PA classification studies, and validation studies. The quality of studies was assessed using a quality appraisal checklist. Synthesis It was found that the transition of wearable devices from in‐lab to community‐based studies in individuals with stroke has started but is not widespread. The transition of wearable devices in the community has not yet started for individuals with TBI. Accelerometer‐based devices were more frequently chosen than pedometers and inertial measurement units. No consensus on a preferred wearable device (make or model) or wear location could be identified, although step count was the most common outcome metric. The accuracy and validity of most outcome metrics used in the community were not reported for many studies. Conclusions To facilitate future studies using wearable devices for PA measurement in the community, we recommend that researchers provide details on the accuracy and validity of the outcome metrics specific to the study environment. Once the accuracy and validity are established for a specific population, wearable devices and their derived outcomes can provide objective information on mobility impairment as well as the effect of rehabilitation in the community.

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Cyclogram-Based Joint Symmetry Assessment After Utilization of a Foot Drop Stimulator During Post-stroke Hemiplegic Gait

Cited by 11 publications

References 26 publications

Kinematic Analysis of Lower Limb Joint Asymmetry During Gait in People with Multiple Sclerosis

Kinematic Analysis of Lower Limb Joint Asymmetry During Gait in People with Multiple Sclerosis

Synchronized Cyclograms to Assess Inter-Limb Symmetry during Gait in Women with Anorexia and Bulimia: A Retrospective Study

Wearable devices for tracking physical activity in the community after an acquired brain injury: A systematic review

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