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To evaluate test-retest reliability of trunk kinematics relative to the pelvis during gait in two groups (males and females) of patients with non-specific chronic low back pain (NCLBP) using three-dimensional motion capture system.
A convenience sample of 40 NCLBP participants (20 males and 20 females) was evaluated in two sessions. Participants were asked to walk with self-selected speed and kinematics of thorax and lumbar spine were captured using a 6-infrared-cameras motion-analyzer system. Peak amplitude of displacement and its measurement errors and minimal detectable change (MDC) were then calculated.
Intraclass correlation coefficients (ICCs) were relatively constant but small for certain variables (lower lumbar peak flexion in female: inter-session ICC=0.51 and intra-session ICC=0.68; peak extension in male: inter-session ICC=0.67 and intra-session ICC=0.66). The measurement error remained constant and standard error of measurement (SEM) difference was large between males (generally ≤4.8°) and females (generally ≤5.3°). Standard deviation (SD) was higher in females. In most segments, females exhibited higher MDCs except for lower lumbar sagittal movements.
Although ICCs were sufficiently reliable and constant in both genders during gait, there was difference in SEM due to difference in SD between genders caused by different gait disturbance in chronic low back pain. Due to the increasing tendency of measurement error in other areas of men and women, attention is needed when measuring lumbar motion using the method described in this study.
Citations
Method: Three dimensional gait analysis was performed in 19 unilateral below-knee amputees and 20 controls. Measured gait parameters were temporal parameters and kinematic and kinetic parameters at hip, knee and ankle joints. Gait parameters obtained from amputated limbs were compared with those of sound limbs and control group.
Results: There were no significant differences in temporal parameters among 3 limbs. In amputated limbs, degree of knee flexion and knee extension moment in stance phase were less than sound limbs and control group. In addition, timing of peak knee extension moment occurred later. Also, timing of ankle plantar flexion in loading response and preswing phase occured later, and degree of ankle plantar flexion in preswing phase were less in amputated limbs compared to other limbs. Peak plantar flexion moment in amputated limbs were less than sound limbs, but not than control group.
Conclusion: This study suggested that most significant gait abnormalities in unilateral below-knee amputees were observed at the knee and ankle joint in amputated limbs. (J Korean Acad Rehab Med 2003; 27: 958-963)
Method: Eighteen children with spastic diplegic cerebral palsy participated in this study. Gait patterns on sagittal plane were studied before and at average 3.5 years after SPR. Kinematic and temporospatial data were obtained by the VICON 370 system.
Results: The spasticity of hip adductor and ankle plantarflexor were improved significantly after SPR. The maximal angle of pelvic tilt, ankle dorsiflexion angle at initial contact, peak ankle dorsiflexion angle during stance phase, at toe-off and during swing phase, mid-range point of flexion-extension motion on ankle were significantly improved after SPR. The temporospatial data tended to improve after SPR at long-term follow up.
Conclusion: The SPR reduced spasticity and the gait patterns were improved in children with spastic diplegic cerebral palsy at long-term follow up. (J Korean Acad Rehab Med 2003; 27: 855-861)
Method: Nine patients participated with PWB harness on the treadmill, and nine patients with traditional exercise. In harness group, the gait training with 30% weight reduction was offered on treadmill, they were treated daily and gait training was done for 20 minutes. In no-harness group, traditional gait training was done by physical therapists. Variables were gait parameters assessed by VICON 370 Gait Analyzer, other function tested by Motricity Index and Functional Ambulatory Category.
Results: In linear parameter, the harness group had faster gait speed, longer stride length, and more decreased double support time compared to the no-harness group. In kinematic parameters, the maximal flexion of knee was significantly increased in harness group, but no significant differences was in hip and ankle motion. In kinetic parameters, hip flexion moment of normal side was increased in harness group at heel strike phase, knee flexion moment of normal side was decreased in harness group at heel strike phase.
Conclusion: The gait training with partial weight bearing harness was more effective in acute stroke patients than traditional therapy, and was influenced in gait pattern, functional ability.
Objectives: To evaluate changes of the gait pattern and the clinical improvement in patients with degenerative arthritis of the knee after total knee arthroplasty (TKA).
Method: Gait analysis was performed in 64 patients with degenerative arthritis of the knee at pre- and post-surgery 1 year, also Hospital for Special Surgery (HSS) knee score and Visual analogue scale (VAS) for clinical assessment were investigated.
Results: 1) In the HSS knee score and VAS, there were statistically significant improvement after surgery (p＜0.05). 2) In the postoperative gait analysis, all the linear parameters except single limb support period were significantly improved (p＜0.05). Single limb support period was improved, but statistically insignificant. All the kinematic and kinetic parameters also were significantly improved (p＜0.05).
Conclusion: This study suggests that gait analysis can be used for quantitative evaluation of the effects of total knee arthroplasty in patients with degenerative arthritis of the knee. (J Korean Acad Rehab Med 2002; 26: 581-586)
Objective: The aims of this study were to investigate the characteristics of stair climbing through the comparison between the stair climbing and level walking, and to present the standard values of stair climbing.
Method: Twenty healthy young adults were recruited. The kinematic and kinetic data of level walking and stair climbing on the specially designed stair were obtained through 3 dimensional motion analyzer (Vicon 370 system) with the force plate.
Results: The sagittal range of motion of all examined joints at stair climbing was significantly increased compared as at level walking (p＜0.05). The maximal flexion angle at swing phase of all examined joints were significantly increased at stair climbing compared than at level walking (p＜0.05). At loading response, the kinetic data showed the significant differences between stair climbing and level walking. The time when the maximal extensor moment of knee developed was significantly earlier than when that of hip developed (p＜0.05).
Conclusion: As a results, we found that stair climbing was different from level walking and had the unique pattern in the kinematic and kinetic aspect. The motion analysis of stair climbing may be useful to the further studies.
Objective: The aim of this study was to speculate the role of arm swing during gait through the comparison of energy consumption and kinematic data between the arm restriction and free arm swing
Method: 20 healthy male adults were recruited as subjects. The kinematic data including upper trunk and oxygen consumption were compared at three different walking speeds (2 km/hr, 4 km/hr, 6 km/hr) between with and without arm restriction.
Results: The oxygen consumption rate with arm restriction was significantly increased at fast speed walking (6 km/hr) comparing that without arm restriction. We found the significant difference of anterior-tilt angle, range of motion (ROM) in the coronal and transverse plane of upper trunk, anterior pelvic tilting angle, ROM of pelvis in coronal and transverse plane, maximal flexion angle of hip, ROM of hip in the coronal plane, and the external rotation angle at single support time in the transverse plane of hip between with and without arm restriction at fast walking speed (p＜0.05).
Conclusion: These results revealed that arm restriction while walking resulted in the minimal, significant changes of energy consumption, and kinematic data. Therefore, arm swing on gait was considered to have roles on energy conservation at fast walking, and on getting better limb advancement and stability.
Objective: To investigate a biomechanism of pelvic pain in pregnancy by use of motion analyzer.
Method: Ten pregnant women in the early third trimester and 10 healthy women as control were enrolled. A gait analysis by a Vicon 370 motion analyzer system was performed to investigate the dynamic lumbo-pelvic motion of pregnancy in biomechanical aspects.
Results: The mean maximal surface lordotic angle of pregnant women was 24.42⁑3.98 degrees, the mean minimal surface lordotic angle 20.64⁑4.27 degrees, and the mean maximal surface lordotic angle of controls was 21.61⁑2.43 degrees, the mean minimal surface lordotic angle 18.38⁑2.29 degrees (p＞0.05). The mean maximal anterior pelvic tilt of pregnant women was 21.11⁑5.91 degrees, and the mean maximal anterior pelvic tilt of controls was 15.28⁑4.94 degrees (p＜0.05).
Conclusion: The angle of lumbar lordosis was within normal ranges but the anterior pelvic tilt was increased significantly in pregnancy. This can place mechanical stress on lumbo-pelvic region. This dynamic sagittal imbalance of the spine may be a considerable cause for low back and pelvic pain in pregnancy as indicated by the results of this study.
Objective: The purpose of this study is to evaluate gait characteristics using kinematic analysis in children with hemiplegic spastic cerebral palsy.
Method: Fifty-seven non-operated spastic hemiplegic children who were able to walk independently without any walking aid were recruited as subjects. Three-dimensional kinematic gait analysis using a motion analyzer (Vicon 370 M. A. with 6 infrared cameras) were performed in all patients. Changes in joint angle of hip, knee and ankle in sagittal plane were evaluated to classify gait pattern and also the temporospatial values were measured to determine any differences between groups.
Results: Gait patterns were able to be classified into 6 groups. Group I had a minimal gait disturbance, a drop foot pattern. Group II showed hip and knee flexed, with normal ankle range. Group III showed hip, knee, and ankle flexed. Group IV showed genu recurvatum with tibia progression, Group V showed genu recurvatum with tibia arrest. Group VI showed stiff crouch gait. However, the temporospatial values between groups were not significantly different.
Conclusion: This classification system would be useful for converting the vast quantitative information of gait analysis into descriptive and clinically relevant patterns. Therefore, it would be helpful for the clinician to understand underlying pathology and plan appropriate treatment.
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