Objective To evaluate the clinical efficacy of ultrasound-guided acupuncture at myofascial trigger points(MTrPs)on treating post-stroke foot drop.Methods Sixty patients with post-stroke foot drop were randomly assigne...Objective To evaluate the clinical efficacy of ultrasound-guided acupuncture at myofascial trigger points(MTrPs)on treating post-stroke foot drop.Methods Sixty patients with post-stroke foot drop were randomly assigned to an observation group 1(20 cases,1 case dropped out),an observation group 2(20 cases,2 casses dropped out),and a control group(20 cases).The control group received conventional acupuncture at Yanglingquan(GB34),Jiexi(ST41),Taichong(LR3),Zusanli(ST36),Xuanzhong(GB39),and Qiuxu(GB40)on the affected side,once daily.In addition to the treatment of the control group,the observation group 1 received acupuncture at the tibialis anterior and gastrocnemius MTrPs,once every other day,while the observation group 2 received ultrasound-guided acupuncture at the tibialis anterior and gastrocnemius MTrPs,once every other day.All groups were treated for twooweeks.Three-dimensional gaitanalysis was performed using an infrared motion capture system,and the Holden walking scale was used to evaluate walking ability before and after treatment in the three groups.Results Compared before treatment,the patients in the observation groups 1 and 2 showed increased walking speed(P<0.05,P<0.01),and improved Holden walking scale grades(P<0.05,P<0.01)after treatment;the patients in the observation group 2 also showed increased ankle dorsiflexion angles(P<0.05).The walking speeds of the observation groups 1 and 2 were faster than those of the control group after treatment(P<0.05),the Holden walking scale grade in the observation group 2 was superior to that in the control group(P<0.05).Conclusion The ultrasound-guided acupuncture at MTrPs could effectively improve gait function in post-stroke foot drop patients.展开更多
The three-phase Enriched Environment(EE)paradigm has been shown to promote post-stroke functional improvement,but the neuronal mechanisms are still unclear.In this study,we applied a multimodal neuroimaging protocol c...The three-phase Enriched Environment(EE)paradigm has been shown to promote post-stroke functional improvement,but the neuronal mechanisms are still unclear.In this study,we applied a multimodal neuroimaging protocol combining magnetic resonance imaging(MRI)and positron emission tomography(PET)to examine the effects of post-ischemic EE treatment on structural and functional neuroplasticity in the bilateral sensorimotor cortex.Rats were subjected to permanent middle cerebral artery occlusion.The motor function of the rats was examined using the DigiGait test.MRI was applied to investigate the EE-induced structural modifications of the bilateral sensorimotor cortex.[^(18)F]-fluorodeoxyglucose PET was used to detect glucose metabolism.Blood oxygen level-dependent(BOLD)-functional MRI(fMRI)was used to identify the regional brain activity and functional connectivity(FC).In addition,the expression of neuroplasticity-related signaling pathways including neurotrophic factors(BDNF/CREB),axonal guidance proteins(Robo1/Slit2),and axonal growth-inhibitory proteins(NogoA/NgR)as well as downstream proteins(RhoA/ROCK)in the bilateral sensorimotor cortex were measured by Western blots.Our results showed the three-phase EE improved the walking ability.Structural T2 mapping imaging and diffusion tensor imaging demonstrated that EE benefited structure integrity in the bilateral sensorimotor cortex.PET-MRI fused images showed improved glucose metabolism in the corresponding regions after EE intervention.Specifically,the BOLD-based amplitude of low-frequency fluctuations showed that EE increased spontaneous activity in the bilateral motor cortex and ipsilateral sensory cortex.In addition,FC results showed increased sensorimotor connectivity in the ipsilateral hemisphere and increased interhemispheric motor cortical connectivity and motor cortical-thalamic connectivity following EE intervention.In addition,a strong correlation was found between increased functional connectivity and improved motor performance of limbs.Specifically,EE regulated the expression of neuroplasticity-related signaling,involving BDNF/CREB,Slit2/Robo1,as well as the axonal growth–inhibitory pathways Nogo-A/Nogo receptor and RhoA/ROCK in the bilateral sensorimotor cortex.Our results indicated that the three-phase enriched environment paradigm enhances neuronal plasticity of the bilateral sensorimotor cortex and consequently ameliorates post-stroke gait deficits.These findings might provide some new clues for the development of EE and thus facilitate the clinical translation of EE.展开更多
Purpose: This study focused on maintaining and improving the walking function of late-stage older individuals while longitudinally tracking the effects of regular exercise programs in a day-care service specialized fo...Purpose: This study focused on maintaining and improving the walking function of late-stage older individuals while longitudinally tracking the effects of regular exercise programs in a day-care service specialized for preventive care over 5 years, using detailed gait function measurements with an accelerometer-based system. Methods: Seventy individuals (17 male and 53 female) of a daycare service in Tokyo participated in a weekly exercise program, meeting 1 - 2 times. The average age of the participants at the start of the program was 81.4 years. Gait function, including gait speed, stride length, root mean square (RMS) of acceleration, gait cycle time and its standard deviation, and left-right difference in stance time, was evaluated every 6 months. Results: Gait speed and stride length improved considerably within six months of starting the exercise program, confirming an initial improvement in gait function. This suggests that regular exercise programs can maintain or improve gait function even age groups that predictably have a gradual decline in gait ability due to enhanced age. In the long term, many indicators tended to approach baseline values. However, the exercise program seemingly counteracts age-related changes in gait function and maintains a certain level of function. Conclusions: While a decline in gait ability with aging is inevitable, establishing appropriate exercise habits in late-stage older individuals may contribute to long-term maintenance of gait function.展开更多
Stroke survivors often present with abnormal gait, movement training can improve the walking performance post-stroke, and functional MRI can objectively evaluate the brain functions before and after movement training....Stroke survivors often present with abnormal gait, movement training can improve the walking performance post-stroke, and functional MRI can objectively evaluate the brain functions before and after movement training. This paper analyzes the functional MRI changes in patients with ischemic stroke after treadmill training with voluntary and passive ankle dorsiflexion. Functional MRI showed that there are some changes in some regions of patients with ischemic stroke including primary sensorimotor cortex, supplementary motor area and cingulate motor area after treadmill training. These findings suggest that treadmill training likely improves ischemic stroke patients＇ lower limb functions and gait performance and promotes stroke recovery by changing patients＇ brain plasticity; meanwhile, the novel treadmill training methods can better training effects.展开更多
<strong><span style="font-family:Verdana;">INTRODUCTION</span></strong><span><span><span style="font-family:;" "=""><span style="fon...<strong><span style="font-family:Verdana;">INTRODUCTION</span></strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> Gait asymmetry can become very pronounced in patie</span></span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">nts who have suffered a stroke. The impairment of trunk function in some stroke patients can restrict thorax mobility and cause respiratory muscle weakness. Trunk and neck dysfunction are believed to affect the gait in stroke patients. </span><b><span style="font-family:Verdana;">OBJECTIVE</span></b><span style="font-family:Verdana;">: This study aimed to investigate the relationship between gait asymmetry and respiratory function in stroke patients by measuring the step time and trunk acceleration. </span><b><span style="font-family:Verdana;">METHODS</span></b><span style="font-family:Verdana;">: This study employed a cross-sec</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">- </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">tional design. Thirty stroke patients participated in this study. The symmetry index (SI) and Lissajous index (LI) were used to evaluate asymmetry during walking. The respiratory function and respiratory muscle strength were eva</span><span style="font-family:Verdana;">luated by spirometry. We examined the relation between SI or LI and the res</span><span style="font-family:Verdana;">piratory function/respiratory muscle strength in patients with stroke. </span><b><span style="font-family:Verdana;">RE</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">- </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">SULTS</span></b></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">: The results of our analysis demonstrated that the SI was significantly correlated with the inspiratory and expiratory muscle strength and the </span><span><span style="font-family:Verdana;">LI was significantly correlated with the percentage of the predicted vital capacity (respectively, r = <span style="white-space:nowrap;">﹣</span>0.386, r = <span style="white-space:nowrap;">﹣</span>0.392, r = <span style="white-space:nowrap;">﹣</span>0.446;p < 0.05). </span><b><span style="font-family:Verdana;">CONCLUSION</span></b><span style="font-family:Verdana;">: </span></span><span style="font-family:Verdana;">The present study is the first to indicate a relationship between gait asymmetry and respiratory function in stroke patients.</span></span></span></span>展开更多
BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with ...BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. There is no report for DG in FMDs caused by an abnormal pattern in the ankle muscle recruitment strategy during gait.CASE SUMMARY A 52-year-old male patient presented with persistent limping gait. When we requested him to do dorsiflexion and plantar flexion of his ankle in the standing and seating positions, we didn’t see any abnormality. However, we could see the DG during the gait. There were no evidences of common peroneal neuropathy and L5 radiculopathy in the electrodiagnostic study. Magnetic resonance imaging of the lumbar spine, lower leg, and brain had no definite finding. No specific finding was seen in the neurologic examination. For further evaluation, a wireless surface electromyography(EMG) was performed. During the gait, EMG amplitude of left medial and lateral gastrocnemius(GCM) muscles was larger than right medial and lateral GCM muscles. When we analyzed EMG signals for each muscle, there were EMG bursts of double-contraction in the left medial and lateral GCM muscles, while EMG analysis of right medial and lateral GCM muscles noted regular bursts of single contraction. We could find a cause of DG in FMDs.CONCLUSION We report an importance of a wireless surface EMG, in which other examination didn’t reveal the cause of DG in FMDs.展开更多
Duchenne muscular dystrophy (DMD) is a genetic disorder linked to chromosome Xp21, due to absence of dystrophin production. It is clinically characterized by progressive muscle weakness, fatigue, and development of jo...Duchenne muscular dystrophy (DMD) is a genetic disorder linked to chromosome Xp21, due to absence of dystrophin production. It is clinically characterized by progressive muscle weakness, fatigue, and development of joint contractures that compromise general motor functionality, mainly the gait. Objective: To characterize the motor function and decrease gait in children with DMD using the Portuguese version of the Motor Function Measure scale (MFM-P). Methods: A review of medical records including chronological age and scores from MFM-P of children with a DMD who attended at the Neuromuscular Diseases Clinic at Campinas State University (UNICAMP), Brazil was performed in this study. A total of 36 medical records of male patients with confirmed clinical diagnosis of DMD, ambulatory or not, regardless of age;excluding those with other associated diseases or other types of muscular dystrophies were selected. Data were analyzed using Kolmogorov-Smirnov and Spearman correlation statistical tests. Results: Analysis of all data collected showed that 75% of our sample had D1 scores lower than 41.02%. There was a linear relationship between the scores of D2 and D3, but no association between D2 and D1 scores was noted. D1 score was between 40% and 80% in those patients presenting D2 scores between 80% and 100%. In all cases patients with low total score presented a greater risk for loss of gait and their functionality. Conclusion: The standing posture and the postural transfers were the worst activities observed in children with DMD, with positive correlation between proximal and distal motor function. Even with high scores according MFM-P in proximal function, the children showed strong predictors for loss of gait.展开更多
Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. How...Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.展开更多
The corticoreticular tract （CRT） is known to be involved in walking and postural control. Using diffusion tensor tractography （DTT）, we investigated the relationship between the CRT and gait dysfunction, includ- i...The corticoreticular tract （CRT） is known to be involved in walking and postural control. Using diffusion tensor tractography （DTT）, we investigated the relationship between the CRT and gait dysfunction, includ- ing trunk instability, in pediatric patients. Thirty patients with delayed development and 15 age-matched, typically-developed （TD） children were recruited. Fifteen patients with gait dysfunction （bilateral trunk instability） were included in the group A, and the other 15 patients with gait dysfunction （unilateral trunk instability） were included in the group B. The Growth Motor Function Classification System, Functional Ambulation Category scale, and Functional Ambulation Category scale were used for measurement of functional state. Fractional anisotropy, apparent diffusion coefficient, fiber number, and tract integrity of the CRT and corticospinal tract were measured. Diffusion parameters or integrity of corticospinal tract were not significantly different in the three study groups. However, CRT results revealed that both CRTs were disrupted in the group A, whereas CRT disruption in the hemispheres contralateral to clinical mani- festations was observed in the group B. Fractional anisotropy values and fiber numbers in both CRTs were decreased in the group A than in the group TD. The extents of decreases of fractional anisotropy values and fiber numbers on the ipsilateral side relative to those on the contralateral side were greater in the group B than in the group TD. Functional evaluation data and clinical manifestations were found to show strong correlations with CRT status, rather than with corticospinal tract status. These findings suggest that CRT status appears to be clinically important for gait function and trunk stability in pediatric patients and DTT can help assess CRT status in pediatric patients with gait dysfunction.展开更多
目的:研究表明,重复经颅磁刺激和经颅直流电刺激对改善脑瘫患儿粗大运动功能具有积极作用。采用网状Meta分析方法评价重复经颅磁刺激和经颅直流电刺激对脑瘫患儿下肢运动功能及步态改善的临床疗效。方法:检索中国知网、万方、维普、Sino...目的:研究表明,重复经颅磁刺激和经颅直流电刺激对改善脑瘫患儿粗大运动功能具有积极作用。采用网状Meta分析方法评价重复经颅磁刺激和经颅直流电刺激对脑瘫患儿下肢运动功能及步态改善的临床疗效。方法:检索中国知网、万方、维普、SinoMed、PubMed、Web of Science、Medline数据库,搜索关于重复经颅磁刺激与经颅直流电刺激改善脑瘫患儿下肢运动功能及步态的随机对照试验,检索时限均为数据库建库至2024-10-05。筛选文献、提取资料并评价纳入研究的偏倚风险,采用Stata 15.0软件进行网状Meta分析,使用GRADE证据分级系统进行质量评价。结果:最终纳入19篇研究,涉及常规治疗、高频重复经颅磁刺激、低频重复经颅磁刺激、阳极经颅直流电刺激4种治疗方案。网状Meta分析结果显示,与常规治疗相比,低频重复经颅磁刺激改善脑瘫患儿粗大运动功能方面的疗效最佳[MD=9.48,95%CI(6.61,12.34),P<0.05],在缓解痉挛方面,高频重复经颅磁刺激的疗效最佳[MD=-0.63,95%CI(-1.72,0.45),P<0.05],经颅直流电刺激改善脑瘫患儿踝关节活动度和步速方面的疗效最佳[MD=2.27,95%CI(1.37,3.17),P<0.05;MD=0.11,95%CI(0.05,0.17),P<0.05]。结论:现有临床证据表明,对于脑瘫患儿,在改善下肢粗大运动功能方面,低频重复经颅磁刺激展现出最佳疗效;对于降低肌痉挛程度,高频重复经颅磁刺激的效果更为显著;在步态改善方面,经颅直流电刺激则表现出明显优势。展开更多
目的:通过网状Meta分析整合直接与间接证据,比较不同非侵入性脑刺激技术及参数对帕金森病患者步态和平衡功能的影响,并排序最佳干预方案。方法:检索CNKI、万方、维普、CBM、PubMed、Cochrane图书馆、EMbase和Web of Science数据库,筛选...目的:通过网状Meta分析整合直接与间接证据,比较不同非侵入性脑刺激技术及参数对帕金森病患者步态和平衡功能的影响,并排序最佳干预方案。方法:检索CNKI、万方、维普、CBM、PubMed、Cochrane图书馆、EMbase和Web of Science数据库,筛选有关非侵入性脑刺激改善帕金森病患者步态和平衡障碍的随机对照试验,检索时限截止到2025-06-16。对纳入的研究进行数据提取,采用RevMan 5.4.1软件和Stata 17.0软件进行统计学处理。结果:①纳入47篇研究,共2767例患者,试验组1399例、对照组1368例;②传统Meta分析结果显示,高频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分(UPDRSⅢ)评分、冻结步态问卷(FOG-Q)评分,缩短起立-行走计时试验(TUGT)时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);经颅直流电刺激可以降低冻结步态问卷评分、缩短起立-行走计时试验时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);低频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分评分,与常规治疗比较有显著性差异(P<0.05);3种脑刺激方法对于步频的改善均无统计学意义(P>0.05),受限于研究数量少,需进一步验证;③网状Meta分析结果显示(以下排序均基于间接比较),在降低统一帕金森评定量表第三部分评分方面:高频重复经颅磁刺激选择初级运动皮质区(M1)+背外侧前额叶皮质区(DLPFC)双侧靶点联合刺激的累积概率排序最高(95.2%),在初级运动皮质区上刺激排序次之(72.5%);在缩短起立-行走计时试验时间方面:高频重复经颅磁刺激在背外侧前额叶皮质区刺激的累积概率排序最高(85.5%),在初级运动皮质区上刺激排序次之(69.0%);在改善步速方面:高频重复经颅磁刺激在背外侧前额叶皮质区的累积概率排序最高(92.5%),在初级运动皮质区上刺激排序次之(76.7%);在提高Berg平衡量表评分方面:高频重复经颅磁刺激在初级运动皮质区上刺激的累积概率排序最高(79.9%),经颅直流电刺激在小脑上刺激排序次之(79.8%);④GRADE证据质量评价结果显示,统一帕金森评定量表第三部分、冻结步态问卷评分、起立-行走计时试验、步长证据等级为中级,步速、步频、Berg平衡量表评分为低级。结论:不同类型非侵入性脑刺激都可以改善帕金森病患者的步态和平衡功能。背外侧前额叶皮质区靶向的高频重复经颅磁刺激对步态功能的改善优于初级运动皮质(中等证据),而初级运动皮质靶向的高频重复经颅磁刺激对平衡功能的改善优于小脑靶向的经颅直流电刺激(低级证据)。展开更多
Background: Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis(OA), little is known about its potential benefits on gait characteristics among older ...Background: Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis(OA), little is known about its potential benefits on gait characteristics among older Chinese women who have a high prevalence of both radiographic and symptomatic knee OA. This study aims to assess the efficacy of a tailored Tai Ji Quan intervention on gait kinematics for older Chinese women with knee OA.Methods: A randomized controlled trial involving 46 older women in Shanghai, China, with clinically diagnosed knee OA. Randomized(1:1)participants received either a 60 min Tai Ji Quan session(n = 23) 3 times weekly or a 60 min bi-weekly educational session(n = 23) for 24 weeks.Primary outcomes were changes in gait kinematic measures from baseline to 24 weeks. Secondary outcomes included changes in scores on the Western Ontario and Mc Master University Osteoarthritis Index(WOMAC) and Short Physical Performance Battery(SPPB).Results: After 24 weeks the Tai Ji Quan group demonstrated better performance in gait velocity(mean difference, 8.40 cm/s, p = 0.01), step length(mean difference, 3.52 cm, p = 0.004), initial contact angle(mean difference, 2.19°, p = 0.01), and maximal angle(mean difference, 2.61°,p = 0.003) of flexed knees during stance phase compared to the control group. In addition, the Tai Ji Quan group showed significant improvement in WOMAC scores(p < 0.01)(mean difference,-4.22 points in pain, p = 0.002;-2.41 points in stiffness, p < 0.001;-11.04 points in physical function, p = 0.006) and SPPB scores(mean difference, 1.22 points, p < 0.001).Conclusion: Among older Chinese women with knee OA, a tailored Tai Ji Quan intervention improved gait outcomes. The intervention also improved overall function as indexed by the WOMAC and SPPB. These results support the use of Tai Ji Quan for older Chinese adults with knee OA to both improve their functional mobility and reduce pain symptomatology.展开更多
In this paper, the ensemble empirical mode decomposition （EEMD） is applied to analyse accelerometer signals collected during normal human walking. First, the self-adaptive feature of EEMD is utilised to decompose th...In this paper, the ensemble empirical mode decomposition （EEMD） is applied to analyse accelerometer signals collected during normal human walking. First, the self-adaptive feature of EEMD is utilised to decompose the ac- celerometer signals, thus sifting out several intrinsic mode functions （IMFs） at disparate scales. Then, gait series can be extracted through peak detection from the eigen IMF that best represents gait rhythmicity. Compared with the method based on the empirical mode decomposition （EMD）, the EEMD-based method has the following advantages： it remarkably improves the detection rate of peak values hidden in the original accelerometer signal, even when the signal is severely contaminated by the intermittent noises; this method effectively prevents the phenomenon of mode mixing found in the process of EMD. And a reasonable selection of parameters for the stop-filtering criteria can improve the calculation speed of the EEMD-based method. Meanwhile, the endpoint effect can be suppressed by using the auto regressive and moving average model to extend a short-time series in dual directions. The results suggest that EEMD is a powerful tool for extraction of gait rhythmicity and it also provides valuable clues for extracting eigen rhythm of other physiological signals.展开更多
Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes...Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes. However, a functional integrative rehabilitative approach addressing lumbo-pelvic misalignment in the sagittal (anteriorly tilted pelvis) and frontal (Trendelenburg gait) planes has not been presented. The aforementioned patho-biomechanical conditions and their management are often discussed estranged from each other rather than functionally integrated. This paper serves as a short communication which discusses the lumbo-pelvic anatomy, identifies the anatomical and biomechanical associations between the anteriorly tilted pelvic and Trendelenburg gait. Through an analysis of relevant literature, recommendations were made on the improvement of flexibility of the hip flexors, taut iliofemoral and pubofemoral ligaments to resolve the primary abnormal force-couple, with improved flexibility of the erector spinae and quadratus lumborum to resolve the secondary abnormal force-couple. In addition, improved flexibility of the hip flexors should coincide with closed-kinetic chain concentric strengthening of the ipsi-lateral hip abductors and contralateral external obliques. Patient education is also needed for self-re-alignment of the lower extremity to a neutral position and neutral foot stance. Biokineticists/exercise therapists should also review the patient’s gait biomechanics to determine whether sartorius synergistic dominance is in play. In conclusion, the association between an anteriorly tilted pelvis and Trendelenburg gait, is in regard to taut anterior acetabulofemoral ligaments and femoral retroversion torsion angle that is both preceded and followed by the biomechanical influence of various anatomical structures. These anatomical and biomechanical factors must be evaluated by the biokineticists/exercise therapists before prescribing a rehabilitative programme to ensure successful rehabilitation of lumbo-pelvic hip complex.展开更多
AIM:To develop a subset of simple outcome measures to quantify prosthetic gait deviation without needing three-dimensional gait analysis(3DGA).METHODS:Eight unilateral,transfemoral amputees and 12 unilateral,transtibi...AIM:To develop a subset of simple outcome measures to quantify prosthetic gait deviation without needing three-dimensional gait analysis(3DGA).METHODS:Eight unilateral,transfemoral amputees and 12 unilateral,transtibial amputees were recruited.Twenty-eight able-bodied controls were recruited.All participants underwent 3DGA,the timed-up-and-go test and the six-minute walk test(6MWT).The lowerlimb amputees also completed the Prosthesis Evaluation Questionnaire.Results from 3DGA were summarised using the gait deviation index(GDI),which was subsequently regressed,using stepwise regression,against the other measures.RESULTS:Step-length(SL),self-selected walking speed(SSWS) and the distance walked during the 6MWT(6MWD) were significantly correlated with GDI.The 6MWD was the strongest,single predictor of the GDI,followed by SL and SSWS.The predictive ability of the regression equations were improved following inclusion of self-report data related to mobility and prosthetic utility.CONCLUSION:This study offers a practicable alternative to quantifying kinematic deviation without the need to conduct complete 3DGA.展开更多
文摘Objective To evaluate the clinical efficacy of ultrasound-guided acupuncture at myofascial trigger points(MTrPs)on treating post-stroke foot drop.Methods Sixty patients with post-stroke foot drop were randomly assigned to an observation group 1(20 cases,1 case dropped out),an observation group 2(20 cases,2 casses dropped out),and a control group(20 cases).The control group received conventional acupuncture at Yanglingquan(GB34),Jiexi(ST41),Taichong(LR3),Zusanli(ST36),Xuanzhong(GB39),and Qiuxu(GB40)on the affected side,once daily.In addition to the treatment of the control group,the observation group 1 received acupuncture at the tibialis anterior and gastrocnemius MTrPs,once every other day,while the observation group 2 received ultrasound-guided acupuncture at the tibialis anterior and gastrocnemius MTrPs,once every other day.All groups were treated for twooweeks.Three-dimensional gaitanalysis was performed using an infrared motion capture system,and the Holden walking scale was used to evaluate walking ability before and after treatment in the three groups.Results Compared before treatment,the patients in the observation groups 1 and 2 showed increased walking speed(P<0.05,P<0.01),and improved Holden walking scale grades(P<0.05,P<0.01)after treatment;the patients in the observation group 2 also showed increased ankle dorsiflexion angles(P<0.05).The walking speeds of the observation groups 1 and 2 were faster than those of the control group after treatment(P<0.05),the Holden walking scale grade in the observation group 2 was superior to that in the control group(P<0.05).Conclusion The ultrasound-guided acupuncture at MTrPs could effectively improve gait function in post-stroke foot drop patients.
基金supported by the National Natural Science Foundation of China(82174471).
文摘The three-phase Enriched Environment(EE)paradigm has been shown to promote post-stroke functional improvement,but the neuronal mechanisms are still unclear.In this study,we applied a multimodal neuroimaging protocol combining magnetic resonance imaging(MRI)and positron emission tomography(PET)to examine the effects of post-ischemic EE treatment on structural and functional neuroplasticity in the bilateral sensorimotor cortex.Rats were subjected to permanent middle cerebral artery occlusion.The motor function of the rats was examined using the DigiGait test.MRI was applied to investigate the EE-induced structural modifications of the bilateral sensorimotor cortex.[^(18)F]-fluorodeoxyglucose PET was used to detect glucose metabolism.Blood oxygen level-dependent(BOLD)-functional MRI(fMRI)was used to identify the regional brain activity and functional connectivity(FC).In addition,the expression of neuroplasticity-related signaling pathways including neurotrophic factors(BDNF/CREB),axonal guidance proteins(Robo1/Slit2),and axonal growth-inhibitory proteins(NogoA/NgR)as well as downstream proteins(RhoA/ROCK)in the bilateral sensorimotor cortex were measured by Western blots.Our results showed the three-phase EE improved the walking ability.Structural T2 mapping imaging and diffusion tensor imaging demonstrated that EE benefited structure integrity in the bilateral sensorimotor cortex.PET-MRI fused images showed improved glucose metabolism in the corresponding regions after EE intervention.Specifically,the BOLD-based amplitude of low-frequency fluctuations showed that EE increased spontaneous activity in the bilateral motor cortex and ipsilateral sensory cortex.In addition,FC results showed increased sensorimotor connectivity in the ipsilateral hemisphere and increased interhemispheric motor cortical connectivity and motor cortical-thalamic connectivity following EE intervention.In addition,a strong correlation was found between increased functional connectivity and improved motor performance of limbs.Specifically,EE regulated the expression of neuroplasticity-related signaling,involving BDNF/CREB,Slit2/Robo1,as well as the axonal growth–inhibitory pathways Nogo-A/Nogo receptor and RhoA/ROCK in the bilateral sensorimotor cortex.Our results indicated that the three-phase enriched environment paradigm enhances neuronal plasticity of the bilateral sensorimotor cortex and consequently ameliorates post-stroke gait deficits.These findings might provide some new clues for the development of EE and thus facilitate the clinical translation of EE.
文摘Purpose: This study focused on maintaining and improving the walking function of late-stage older individuals while longitudinally tracking the effects of regular exercise programs in a day-care service specialized for preventive care over 5 years, using detailed gait function measurements with an accelerometer-based system. Methods: Seventy individuals (17 male and 53 female) of a daycare service in Tokyo participated in a weekly exercise program, meeting 1 - 2 times. The average age of the participants at the start of the program was 81.4 years. Gait function, including gait speed, stride length, root mean square (RMS) of acceleration, gait cycle time and its standard deviation, and left-right difference in stance time, was evaluated every 6 months. Results: Gait speed and stride length improved considerably within six months of starting the exercise program, confirming an initial improvement in gait function. This suggests that regular exercise programs can maintain or improve gait function even age groups that predictably have a gradual decline in gait ability due to enhanced age. In the long term, many indicators tended to approach baseline values. However, the exercise program seemingly counteracts age-related changes in gait function and maintains a certain level of function. Conclusions: While a decline in gait ability with aging is inevitable, establishing appropriate exercise habits in late-stage older individuals may contribute to long-term maintenance of gait function.
基金supported by the Natural Science Foundation of China,No.30973165
文摘Stroke survivors often present with abnormal gait, movement training can improve the walking performance post-stroke, and functional MRI can objectively evaluate the brain functions before and after movement training. This paper analyzes the functional MRI changes in patients with ischemic stroke after treadmill training with voluntary and passive ankle dorsiflexion. Functional MRI showed that there are some changes in some regions of patients with ischemic stroke including primary sensorimotor cortex, supplementary motor area and cingulate motor area after treadmill training. These findings suggest that treadmill training likely improves ischemic stroke patients＇ lower limb functions and gait performance and promotes stroke recovery by changing patients＇ brain plasticity; meanwhile, the novel treadmill training methods can better training effects.
文摘<strong><span style="font-family:Verdana;">INTRODUCTION</span></strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> Gait asymmetry can become very pronounced in patie</span></span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">nts who have suffered a stroke. The impairment of trunk function in some stroke patients can restrict thorax mobility and cause respiratory muscle weakness. Trunk and neck dysfunction are believed to affect the gait in stroke patients. </span><b><span style="font-family:Verdana;">OBJECTIVE</span></b><span style="font-family:Verdana;">: This study aimed to investigate the relationship between gait asymmetry and respiratory function in stroke patients by measuring the step time and trunk acceleration. </span><b><span style="font-family:Verdana;">METHODS</span></b><span style="font-family:Verdana;">: This study employed a cross-sec</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">- </span></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">tional design. Thirty stroke patients participated in this study. The symmetry index (SI) and Lissajous index (LI) were used to evaluate asymmetry during walking. The respiratory function and respiratory muscle strength were eva</span><span style="font-family:Verdana;">luated by spirometry. We examined the relation between SI or LI and the res</span><span style="font-family:Verdana;">piratory function/respiratory muscle strength in patients with stroke. </span><b><span style="font-family:Verdana;">RE</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">- </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">SULTS</span></b></span></span><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">: The results of our analysis demonstrated that the SI was significantly correlated with the inspiratory and expiratory muscle strength and the </span><span><span style="font-family:Verdana;">LI was significantly correlated with the percentage of the predicted vital capacity (respectively, r = <span style="white-space:nowrap;">﹣</span>0.386, r = <span style="white-space:nowrap;">﹣</span>0.392, r = <span style="white-space:nowrap;">﹣</span>0.446;p < 0.05). </span><b><span style="font-family:Verdana;">CONCLUSION</span></b><span style="font-family:Verdana;">: </span></span><span style="font-family:Verdana;">The present study is the first to indicate a relationship between gait asymmetry and respiratory function in stroke patients.</span></span></span></span>
文摘BACKGROUND Dystonic gait(DG) is one of clinical symptoms associated with functional dystonia in the functional movement disorders(FMDs). Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation. There is no report for DG in FMDs caused by an abnormal pattern in the ankle muscle recruitment strategy during gait.CASE SUMMARY A 52-year-old male patient presented with persistent limping gait. When we requested him to do dorsiflexion and plantar flexion of his ankle in the standing and seating positions, we didn’t see any abnormality. However, we could see the DG during the gait. There were no evidences of common peroneal neuropathy and L5 radiculopathy in the electrodiagnostic study. Magnetic resonance imaging of the lumbar spine, lower leg, and brain had no definite finding. No specific finding was seen in the neurologic examination. For further evaluation, a wireless surface electromyography(EMG) was performed. During the gait, EMG amplitude of left medial and lateral gastrocnemius(GCM) muscles was larger than right medial and lateral GCM muscles. When we analyzed EMG signals for each muscle, there were EMG bursts of double-contraction in the left medial and lateral GCM muscles, while EMG analysis of right medial and lateral GCM muscles noted regular bursts of single contraction. We could find a cause of DG in FMDs.CONCLUSION We report an importance of a wireless surface EMG, in which other examination didn’t reveal the cause of DG in FMDs.
文摘Duchenne muscular dystrophy (DMD) is a genetic disorder linked to chromosome Xp21, due to absence of dystrophin production. It is clinically characterized by progressive muscle weakness, fatigue, and development of joint contractures that compromise general motor functionality, mainly the gait. Objective: To characterize the motor function and decrease gait in children with DMD using the Portuguese version of the Motor Function Measure scale (MFM-P). Methods: A review of medical records including chronological age and scores from MFM-P of children with a DMD who attended at the Neuromuscular Diseases Clinic at Campinas State University (UNICAMP), Brazil was performed in this study. A total of 36 medical records of male patients with confirmed clinical diagnosis of DMD, ambulatory or not, regardless of age;excluding those with other associated diseases or other types of muscular dystrophies were selected. Data were analyzed using Kolmogorov-Smirnov and Spearman correlation statistical tests. Results: Analysis of all data collected showed that 75% of our sample had D1 scores lower than 41.02%. There was a linear relationship between the scores of D2 and D3, but no association between D2 and D1 scores was noted. D1 score was between 40% and 80% in those patients presenting D2 scores between 80% and 100%. In all cases patients with low total score presented a greater risk for loss of gait and their functionality. Conclusion: The standing posture and the postural transfers were the worst activities observed in children with DMD, with positive correlation between proximal and distal motor function. Even with high scores according MFM-P in proximal function, the children showed strong predictors for loss of gait.
文摘Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education,Science and Technology(2012-013997)
文摘The corticoreticular tract （CRT） is known to be involved in walking and postural control. Using diffusion tensor tractography （DTT）, we investigated the relationship between the CRT and gait dysfunction, includ- ing trunk instability, in pediatric patients. Thirty patients with delayed development and 15 age-matched, typically-developed （TD） children were recruited. Fifteen patients with gait dysfunction （bilateral trunk instability） were included in the group A, and the other 15 patients with gait dysfunction （unilateral trunk instability） were included in the group B. The Growth Motor Function Classification System, Functional Ambulation Category scale, and Functional Ambulation Category scale were used for measurement of functional state. Fractional anisotropy, apparent diffusion coefficient, fiber number, and tract integrity of the CRT and corticospinal tract were measured. Diffusion parameters or integrity of corticospinal tract were not significantly different in the three study groups. However, CRT results revealed that both CRTs were disrupted in the group A, whereas CRT disruption in the hemispheres contralateral to clinical mani- festations was observed in the group B. Fractional anisotropy values and fiber numbers in both CRTs were decreased in the group A than in the group TD. The extents of decreases of fractional anisotropy values and fiber numbers on the ipsilateral side relative to those on the contralateral side were greater in the group B than in the group TD. Functional evaluation data and clinical manifestations were found to show strong correlations with CRT status, rather than with corticospinal tract status. These findings suggest that CRT status appears to be clinically important for gait function and trunk stability in pediatric patients and DTT can help assess CRT status in pediatric patients with gait dysfunction.
文摘目的:研究表明,重复经颅磁刺激和经颅直流电刺激对改善脑瘫患儿粗大运动功能具有积极作用。采用网状Meta分析方法评价重复经颅磁刺激和经颅直流电刺激对脑瘫患儿下肢运动功能及步态改善的临床疗效。方法:检索中国知网、万方、维普、SinoMed、PubMed、Web of Science、Medline数据库,搜索关于重复经颅磁刺激与经颅直流电刺激改善脑瘫患儿下肢运动功能及步态的随机对照试验,检索时限均为数据库建库至2024-10-05。筛选文献、提取资料并评价纳入研究的偏倚风险,采用Stata 15.0软件进行网状Meta分析,使用GRADE证据分级系统进行质量评价。结果:最终纳入19篇研究,涉及常规治疗、高频重复经颅磁刺激、低频重复经颅磁刺激、阳极经颅直流电刺激4种治疗方案。网状Meta分析结果显示,与常规治疗相比,低频重复经颅磁刺激改善脑瘫患儿粗大运动功能方面的疗效最佳[MD=9.48,95%CI(6.61,12.34),P<0.05],在缓解痉挛方面,高频重复经颅磁刺激的疗效最佳[MD=-0.63,95%CI(-1.72,0.45),P<0.05],经颅直流电刺激改善脑瘫患儿踝关节活动度和步速方面的疗效最佳[MD=2.27,95%CI(1.37,3.17),P<0.05;MD=0.11,95%CI(0.05,0.17),P<0.05]。结论:现有临床证据表明,对于脑瘫患儿,在改善下肢粗大运动功能方面,低频重复经颅磁刺激展现出最佳疗效;对于降低肌痉挛程度,高频重复经颅磁刺激的效果更为显著;在步态改善方面,经颅直流电刺激则表现出明显优势。
文摘目的:通过网状Meta分析整合直接与间接证据,比较不同非侵入性脑刺激技术及参数对帕金森病患者步态和平衡功能的影响,并排序最佳干预方案。方法:检索CNKI、万方、维普、CBM、PubMed、Cochrane图书馆、EMbase和Web of Science数据库,筛选有关非侵入性脑刺激改善帕金森病患者步态和平衡障碍的随机对照试验,检索时限截止到2025-06-16。对纳入的研究进行数据提取,采用RevMan 5.4.1软件和Stata 17.0软件进行统计学处理。结果:①纳入47篇研究,共2767例患者,试验组1399例、对照组1368例;②传统Meta分析结果显示,高频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分(UPDRSⅢ)评分、冻结步态问卷(FOG-Q)评分,缩短起立-行走计时试验(TUGT)时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);经颅直流电刺激可以降低冻结步态问卷评分、缩短起立-行走计时试验时间,增加步长,改善步速,提高Berg平衡量表评分,且均优于常规治疗(P<0.05);低频重复经颅磁刺激可以降低统一帕金森病评定量表第三部分评分,与常规治疗比较有显著性差异(P<0.05);3种脑刺激方法对于步频的改善均无统计学意义(P>0.05),受限于研究数量少,需进一步验证;③网状Meta分析结果显示(以下排序均基于间接比较),在降低统一帕金森评定量表第三部分评分方面:高频重复经颅磁刺激选择初级运动皮质区(M1)+背外侧前额叶皮质区(DLPFC)双侧靶点联合刺激的累积概率排序最高(95.2%),在初级运动皮质区上刺激排序次之(72.5%);在缩短起立-行走计时试验时间方面:高频重复经颅磁刺激在背外侧前额叶皮质区刺激的累积概率排序最高(85.5%),在初级运动皮质区上刺激排序次之(69.0%);在改善步速方面:高频重复经颅磁刺激在背外侧前额叶皮质区的累积概率排序最高(92.5%),在初级运动皮质区上刺激排序次之(76.7%);在提高Berg平衡量表评分方面:高频重复经颅磁刺激在初级运动皮质区上刺激的累积概率排序最高(79.9%),经颅直流电刺激在小脑上刺激排序次之(79.8%);④GRADE证据质量评价结果显示,统一帕金森评定量表第三部分、冻结步态问卷评分、起立-行走计时试验、步长证据等级为中级,步速、步频、Berg平衡量表评分为低级。结论:不同类型非侵入性脑刺激都可以改善帕金森病患者的步态和平衡功能。背外侧前额叶皮质区靶向的高频重复经颅磁刺激对步态功能的改善优于初级运动皮质(中等证据),而初级运动皮质靶向的高频重复经颅磁刺激对平衡功能的改善优于小脑靶向的经颅直流电刺激(低级证据)。
基金funded by the Shanghai City Committee of Science and Technology Key Project (No. 12490503200)the National Science Foundation for Distinguished Young Scholars of China (No. 81025022)
文摘Background: Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis(OA), little is known about its potential benefits on gait characteristics among older Chinese women who have a high prevalence of both radiographic and symptomatic knee OA. This study aims to assess the efficacy of a tailored Tai Ji Quan intervention on gait kinematics for older Chinese women with knee OA.Methods: A randomized controlled trial involving 46 older women in Shanghai, China, with clinically diagnosed knee OA. Randomized(1:1)participants received either a 60 min Tai Ji Quan session(n = 23) 3 times weekly or a 60 min bi-weekly educational session(n = 23) for 24 weeks.Primary outcomes were changes in gait kinematic measures from baseline to 24 weeks. Secondary outcomes included changes in scores on the Western Ontario and Mc Master University Osteoarthritis Index(WOMAC) and Short Physical Performance Battery(SPPB).Results: After 24 weeks the Tai Ji Quan group demonstrated better performance in gait velocity(mean difference, 8.40 cm/s, p = 0.01), step length(mean difference, 3.52 cm, p = 0.004), initial contact angle(mean difference, 2.19°, p = 0.01), and maximal angle(mean difference, 2.61°,p = 0.003) of flexed knees during stance phase compared to the control group. In addition, the Tai Ji Quan group showed significant improvement in WOMAC scores(p < 0.01)(mean difference,-4.22 points in pain, p = 0.002;-2.41 points in stiffness, p < 0.001;-11.04 points in physical function, p = 0.006) and SPPB scores(mean difference, 1.22 points, p < 0.001).Conclusion: Among older Chinese women with knee OA, a tailored Tai Ji Quan intervention improved gait outcomes. The intervention also improved overall function as indexed by the WOMAC and SPPB. These results support the use of Tai Ji Quan for older Chinese adults with knee OA to both improve their functional mobility and reduce pain symptomatology.
基金Project supported by the National Natural Science Foundation of China (Grant Nos. 60501003 and 60701002)
文摘In this paper, the ensemble empirical mode decomposition （EEMD） is applied to analyse accelerometer signals collected during normal human walking. First, the self-adaptive feature of EEMD is utilised to decompose the ac- celerometer signals, thus sifting out several intrinsic mode functions （IMFs） at disparate scales. Then, gait series can be extracted through peak detection from the eigen IMF that best represents gait rhythmicity. Compared with the method based on the empirical mode decomposition （EMD）, the EEMD-based method has the following advantages： it remarkably improves the detection rate of peak values hidden in the original accelerometer signal, even when the signal is severely contaminated by the intermittent noises; this method effectively prevents the phenomenon of mode mixing found in the process of EMD. And a reasonable selection of parameters for the stop-filtering criteria can improve the calculation speed of the EEMD-based method. Meanwhile, the endpoint effect can be suppressed by using the auto regressive and moving average model to extend a short-time series in dual directions. The results suggest that EEMD is a powerful tool for extraction of gait rhythmicity and it also provides valuable clues for extracting eigen rhythm of other physiological signals.
文摘Lower back pain (LBP) is a widespread, painful medical condition that has been plaguing society for many years. Present conservative rehabilitation focus is on lumbo-pelvic hip stability exercises in individual planes. However, a functional integrative rehabilitative approach addressing lumbo-pelvic misalignment in the sagittal (anteriorly tilted pelvis) and frontal (Trendelenburg gait) planes has not been presented. The aforementioned patho-biomechanical conditions and their management are often discussed estranged from each other rather than functionally integrated. This paper serves as a short communication which discusses the lumbo-pelvic anatomy, identifies the anatomical and biomechanical associations between the anteriorly tilted pelvic and Trendelenburg gait. Through an analysis of relevant literature, recommendations were made on the improvement of flexibility of the hip flexors, taut iliofemoral and pubofemoral ligaments to resolve the primary abnormal force-couple, with improved flexibility of the erector spinae and quadratus lumborum to resolve the secondary abnormal force-couple. In addition, improved flexibility of the hip flexors should coincide with closed-kinetic chain concentric strengthening of the ipsi-lateral hip abductors and contralateral external obliques. Patient education is also needed for self-re-alignment of the lower extremity to a neutral position and neutral foot stance. Biokineticists/exercise therapists should also review the patient’s gait biomechanics to determine whether sartorius synergistic dominance is in play. In conclusion, the association between an anteriorly tilted pelvis and Trendelenburg gait, is in regard to taut anterior acetabulofemoral ligaments and femoral retroversion torsion angle that is both preceded and followed by the biomechanical influence of various anatomical structures. These anatomical and biomechanical factors must be evaluated by the biokineticists/exercise therapists before prescribing a rehabilitative programme to ensure successful rehabilitation of lumbo-pelvic hip complex.
文摘AIM:To develop a subset of simple outcome measures to quantify prosthetic gait deviation without needing three-dimensional gait analysis(3DGA).METHODS:Eight unilateral,transfemoral amputees and 12 unilateral,transtibial amputees were recruited.Twenty-eight able-bodied controls were recruited.All participants underwent 3DGA,the timed-up-and-go test and the six-minute walk test(6MWT).The lowerlimb amputees also completed the Prosthesis Evaluation Questionnaire.Results from 3DGA were summarised using the gait deviation index(GDI),which was subsequently regressed,using stepwise regression,against the other measures.RESULTS:Step-length(SL),self-selected walking speed(SSWS) and the distance walked during the 6MWT(6MWD) were significantly correlated with GDI.The 6MWD was the strongest,single predictor of the GDI,followed by SL and SSWS.The predictive ability of the regression equations were improved following inclusion of self-report data related to mobility and prosthetic utility.CONCLUSION:This study offers a practicable alternative to quantifying kinematic deviation without the need to conduct complete 3DGA.
