Some Gait Characteristics of Below-Knee Amputees and Their Reflection on the Ground Reaction Forces

Seliktar, R.; Mizrahi, J.

doi:10.1243/emed_jour_1986_015_009_02

Cited by 58 publications

(46 citation statements)

References 17 publications

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“…SRI was computed as the percentage ratio between two consecutive a min relevant to two consecutive steps, each one performed by one leg (i.e., the ratio was computed between the lower a min and the higher a min absolute values). It provided values lower than 100 percent or equal to 100 percent (if the two consecutive steps had two equal values of a min ), representing an indicator of asymmetries in decelerations [12,32]. Because the RMS of acceleration is strictly dependent on WS, we normalized the values of RMS-AP and RMS-LL with respect to those of RMS-CC by using the inverse of their percentage ratio as an indicator of stability.…”

Section: Protocolmentioning

confidence: 99%

Assessment of gait stability, harmony, and symmetry in subjects with lower-limb amputation evaluated by trunk accelerations

et al. 2014

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Abstract-Analysis of upper-body accelerations is a promising and simple technique for quantitatively assessing some general features of gait such as stability, harmony, and symmetry. Despite the growing literature on elderly healthy populations and neurological patients, few studies have used accelerometry to investigate these features in subjects with lower-limb amputation. We enrolled four groups of subjects: subjects with transfemoral amputation who walked with a locked knee prosthesis, subjects with transfemoral amputation who walked with an unlocked knee prosthesis, subjects with transtibial amputation, and age-matched nondisabled subjects. We found statistically significant differences for stability (p < 0.001), harmony (p < 0.001), and symmetry (p < 0.001) of walking, with general trends following the noted order of subjects, but with the lowest laterolateral harmony in subjects with transtibial amputation. This study is the first to investigate upper-body acceleration of subjects with unilateral lower-limb amputation during walking who were evaluated upon dismissal from a rehabilitation hospital; it is also the first study to differentiate the sample in terms of level of amputation and type of prosthesis used.

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Section: Protocolmentioning

confidence: 99%

Assessment of gait stability, harmony, and symmetry in subjects with lower-limb amputation evaluated by trunk accelerations

et al. 2014

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“…18,19 A symmetry ratio less than 1.0 thus indicates smaller values associated with the affected as compared to the unaffected lower limb.…”

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confidence: 99%

Infarct hemisphere and noninfarcted brain volumes affect locomotor performance following stroke

Chen

Novak

Manor³

2014

Neurology

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Objective: Brain damage within the right middle cerebral artery (MCA) territory is particularly disruptive to mediolateral postural stabilization. The objective of this cross-sectional study was to test the hypothesis that chronic right MCA infarcts (as compared to left) are associated with slower and more bilaterally asymmetrical gait. We further hypothesized that in those with chronic right MCA infarct, locomotor performance is more dependent on gray matter (GM) volumes within noninfarcted regions of the brain that are involved in motor control yet lie outside of the MCA territory.Methods: Gait speed was assessed in 19 subjects with right MCA infarct, 20 with left MCA infarct, and 108 controls. Bilateral plantar pressure and temporal symmetry ratios were calculated in a subset of the cohort. GM volumes within 5 regions outside of the MCA territory (superior parietal lobe, precuneus, caudate, putamen, and cerebellum) were quantified from anatomic MRIs.Results: Right and left infarct groups had similar poststroke duration (7.6 6 6.0 years), infarct size, and functional independence. The right infarct group demonstrated slower gait speed and greater asymmetry compared to the left infarct group and controls (p , 0.05). In the right infarct group only, those with larger GM volumes within the cerebellum (r 2 5 0.32, p 5 0.02) and caudate (r 2 5 0.56, p , 0.001) exhibited faster gait speed.Conclusion: Individuals with chronic lesions within the right MCA territory, as compared to the left MCA territory, exhibit slower, more asymmetrical gait. For these individuals, larger GM volumes within regions outside of the infarcted vascular territory may help preserve locomotor control. Although approximately two-thirds of stroke survivors regain the ability to walk, 1 many present with diminished locomotor performance characterized by slow walking speed and bilaterally asymmetrical walking patterns. 2,3 Lesions within the right hemisphere of the brain, as compared to the left, appear to be more disruptive to both gait and postural control.4-9 More specifically, lesions within the right middle cerebral artery (MCA) territory are particularly disturbing to both the sense of postural verticality and the ability to stabilize the body in the frontal plane. 8,[10][11][12][13] Recent studies, however, have also indicated that the complex motor control system can compensate for impairment to one or more elements of the system by placing increased reliance on remaining intact elements.14 As such, the extent of residual gait abnormality following an infarct may be dependent on not only infarct hemisphere but also on the integrity of noninfarcted brain regions.The objectives of the study were to investigate the effects of infarct hemisphere, as well as gray matter (GM) volumes within regions outside of the infarcted vascular territory, on locomotor performance in individuals with chronic MCA infarcts. We hypothesized that individuals with

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“…Because the aim of our study was to test a method to quantify asymmetry, we fixed p-values at 0.05, 0.01, and 0.001. We determined the SI proposed by Robinson et al [8], the IA defined by Vagenas and Hoshizaki [9], and the RI used by several authors [9][10][11] to quantify the bilateral differences. The equations are where PPP 1 = peak plantar pressure for the unaffected side within the group with hemiparesis and for the cushion side within the nondisabled group and PPP 2 = peak pressure for the affected side within the group with hemiparesis and for the propulsive side within the nondisabled group.…”

Section: Discussionmentioning

confidence: 99%

“…A ratio index (RI) has also been used to quantify asymmetry. With this method, the value for a given gait parameter obtained from the right limb is divided by the associated value of the left limb [10][11][12]. A ratio of 1 indicates a reciprocal gait pattern, while higher or lower values reflect asymmetries.…”

Section: Introductionmentioning

confidence: 99%

Using effect size to quantify plantar pressure asymmetry of gait of nondisabled adults and patients with hemiparesis

Potdevin¹,

Femery²,

Decatoire³

et al. 2007

JRRD

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Abstract-In the literature, numerous statistical analyses are used to quantify asymmetry in gait. This study tested the effect size (ES) statistic for quantifying asymmetry in nondisabled and pathological populations. The plantar pressure peaks on eight footprint locations of 27 nondisabled subjects and 18 patients with hemiparesis were bilaterally compared. Asymmetry quantifications were performed with ES and standard statistical tests (index of asymmetry, symmetry index, and ratio index). The results show an advantage in using ES to quantify asymmetry when confidence limits are also calculated. Conversely, traditional asymmetry indexes immediately implied asymmetry without statistical basis. These findings should be considered when one is attempting to diagnose pathological walking patterns or guide rehabilitation processes.

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Some Gait Characteristics of Below-Knee Amputees and Their Reflection on the Ground Reaction Forces

Cited by 58 publications

References 17 publications

Assessment of gait stability, harmony, and symmetry in subjects with lower-limb amputation evaluated by trunk accelerations

Assessment of gait stability, harmony, and symmetry in subjects with lower-limb amputation evaluated by trunk accelerations

Infarct hemisphere and noninfarcted brain volumes affect locomotor performance following stroke

Using effect size to quantify plantar pressure asymmetry of gait of nondisabled adults and patients with hemiparesis

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