Gait Analysis in Neurorehabilitation: From Research to Clinical Practice

Abstract

When brain damage occurs, gait and balance are often impaired. Evaluation of the gait cycle, therefore, has a pivotal role during the rehabilitation path of subjects who suffer from neurological disorders. Gait analysis can be performed through laboratory systems, non-wearable sensors (NWS), and/or wearable sensors (WS). Using these tools, physiotherapists and neurologists have more objective measures of motion function and can plan tailored and specific gait and balance training early to achieve better outcomes and improve patients’ quality of life. However, most of these innovative tools are used for research purposes (especially the laboratory systems and NWS), although they deserve more attention in the rehabilitation field, considering their potential in improving clinical practice. In this narrative review, we aimed to summarize the most used gait analysis systems in neurological patients, shedding some light on their clinical value and implications for neurorehabilitation practice.

Can Robotic Gait Training with End Effectors Improve Lower-Limb Functions in Patients Affected by Multiple Sclerosis? Results from a Retrospective Case–Control Study

“…Our findings are likely influenced by the suitability of end-effector devices for patients who had residual locomotor function, indicating a sufficient activation of proximal joints and muscles [ 30 ]. Most MS patients manifest a hemiparetic gait due to spasticity and stiffness localized at the knee and ankle [ 6 , 31 ]. This could lead to reduced ankle dorsiflexion during initial contact and insufficient plantarflexion during the pre-swing phase of the gait [ 31 ].…”

“…Symptoms are varied and heterogeneous since they depend on the localization of demyelination plaques throughout the brain [ 5 ]. Regarding mobility, patients with MS can experience fatigue, changes in gait due to ataxia, muscle weakness, spasticity, and sensory and proprioceptive deficits [ 6 ]. In addition, spasticity in the quadriceps, weakness of the hamstrings, and gastrocnemius tend to reduce hip extension during the stance phase of gait, as well as knee flexion during the swing phase [ 6 , 7 ].…”

“…Regarding mobility, patients with MS can experience fatigue, changes in gait due to ataxia, muscle weakness, spasticity, and sensory and proprioceptive deficits [ 6 ]. In addition, spasticity in the quadriceps, weakness of the hamstrings, and gastrocnemius tend to reduce hip extension during the stance phase of gait, as well as knee flexion during the swing phase [ 6 , 7 ]. These biomechanical alterations of gait are more pronounced when MS patients manifest spasticity.…”

Smart Textiles: A Review and Bibliometric Mapping

“…Smart textiles for gait analysis include smart socks, smart shoes and shoe insoles, smart trousers, exosuits, knee pads, skin-mounted textile sensors, and whole-body networks [120,144,[221][222][223][224][225][226][227][228]. Gait analysis is essential in medicine (medical diagnostics, rehabilitation or prevention in orthopaedics, physiotherapy, neurology, psychiatry, gerontology), sports (performance improvement, rehabilitation after injuries), biometrics (identification, authentication, surveillance of persons, criminal investigation), and virtual reality and game controllers [144,222,225,226,229].…”

Treadmill Training Plus Semi-Immersive Virtual Reality in Parkinson’s Disease: Results from a Pilot Study

“…PD patients were excluded if they had (1) cognitive, visual, or auditory deficits that impair the comprehension and/or execution of the proposed exercises; (2) presence of comorbidities that prevent upright posture and walking (hypotension); and (3) refusal or impossibility to provide informed consent. Indeed, we excluded for the technological instrumentation issues (related to the C-Mill), PD patients with (1) weight > 135 kg and (2) Height > 200 cm; (3) open lesions or bandages whether in contact with the harness. All experiments were conducted according to the ethical policies and procedures approved by the local ethics committee (IRCCS-ME 37/21).…”