PubMed HealthSearch

SEARCH · PubMed Health

Results for “gait”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

Gait patterns of the diseased knee joint.

Biomechanical gait analyses were carried out on 21 patients in whom 11 had bilateral and 10 unilateral disease of the knee joint. Similar studies, for use as controls were made on 7 normal volunteers. The data, on which the analyses were based, were obtained using a force plate, a xylophone plate, electromyography and electrogoniometry. The equipment and methods used are described. The results suggest that the locomotion mechanism in patients with disease of the knee joints is affected adversely by severity of pain and instability. Alterations observed in the gait characteristics of such patients comprise decreased sagittal plane knee motion during stance phase, increased electromyographic activities of the quadriceps and the hamstrings during stance phase and increase in the lateral component of ground reaction force. Functional requirements of the knee joint include stable support of body weight and a wide range of movement. These features make the knee particularly susceptible to the deleterious effects of traumatic injury, inflammatory and degenerative disease. The purposes of this study are to characterise the gait patterns of patients with such disease of the knee joints and to identify the mechanisms of these abnormal patterns. With these intentions, biomechanical analyses were carried out on information obtained from the use of force plates, electrogoniometry and electromyography.

Adult

Biomechanical gait analysis of the diseased knee joint.

Clinical and roentgenographic examinations do not provide objective information on the functional performance of a diseased knee joint. In the present study, biomechanical parameters of knee joint function for 95 patients (162 knees) with rheumatoid arthritis and degenerative joint disease were studied in a gait laboratory and compared with those for 29 normal subjects. Gait abnormalities of the patient groups were significant and were related more to the functional status of the knee than to patient age and sex or the specific diagnosis. Knee joint disease produced an inefficient gait that seemed to mitigate joint pain (by reducing poorly tolerated compressive forces on the joint) and to increase proprioceptive feedback (in order to increase dynamic muscular control of the unstable joint). Biomechanical parameters were statistically correlated with some clinical and roentgenographic features to allow standardization of functional assessment of the diseased knee joint.

Arthritis, Rheumatoid

Function of the triceps surae during gait. Compensatory mechanisms for unilateral loss.

We studied the gait of a woman who was normal except for surgical excision of the gastrocnemius and soleus muscles. She was able to compensate for nearly all of her abnormalites of gait by excessive lateral pelvic tilt and prolonged quadriceps activity. Her mild disability, as regards gait, consisted of inability to increase walking speeds beyond the normal pacing. However, despite uneven step lengths, she had uniform forward progression. She had excessive dorsiflexion of the ankle and diminished plantar flexion on the involved side even though the retained plantar flexors could provide 38 per cent of her normal plantar flexor strength.

Adult

The initiation of gait.

The initiation of gait was studied utilizing electromyography, force-plate data, measurements of walking velocities, and ranges of motion of joints, all of which demonstrated that gait is initiated by the body becoming unbalanced in such a way as to permit a subject to pick one foot the ground in order to take the first step. The subsequent transition of the body to the steady gait pattern occurs rapidly over a period of appproximately three steps. This transition involves rapid changes in the measured forces and activities of the muscles of the lower extremity and the motion of the joints reflects these changes.

Adult

Assessment of the quality of sitting and gait patterns in children with Down's syndrome.

Clinical work with children with Down's syndrome resulted in a suggestion of a relationship between the external rotation and abduction of their hips, their excessive hip mobility in sitting, and their wide-based gait. This relationship was examined using data from 104 questionnaires completed by the parents of children with Down's syndrome. The clinical and demographic findings consistently documented the unusual sitting patterns of these children. How children were placed in the sitting position significantly influenced subsequent come-to-sit patterns but did not appear to influence subsequent walking patterns. Longitudinal studies of sitting patterns, hip mobility and gait are recommended. Therapeutic implications are that body rotation should be incorporated into motor intervention programs for children with Down's syndrome.

Biomechanical Phenomena

[Normal gait and its changes after total arthroplasty of the lower extremity. Study on 200 subjects of the support phase of the step and its impulse].

The authors have studied the normal gait of 50 individuals using a dynamometric platform. Measurements have been made of the impulse at each step, the weight bearing phase and the forces transmitted by the foot to the floor. The results have been compared with those obtained from a study of the gait of 150 patients treated by total prostheses (133 hips, 10 knees, 7 ankles). This type of study leads to a better appreciation of operative results.

Aged

Improvement of gait following functional electrical stimulation. I. Investigations on changes in voluntary strength and proprioceptive reflexes.

Patients with central spastic paresis and equipped with peroneal stimulators sometimes experience an improvement in their gait, even when the stimulator has been switched off. The object of the present investigation was to reach a better understanding of the mechanisms operating in such cases. 7 patients were investigated on repeated occasions. It was found that some of these patients got a clear increase in isometric strength of foot dorsiflexion following 10 min of peroneal stimulation. In other cases the increase was only slight. There was an inverse relation between the increase and the strength before stimulation. The increase of strength was due, at least partly, to an increased ability to activate the foot dorsiflectors, since there was a simultaneous increase in the EMG from the anterior tibial muscle. Evidence was also obtained suggesting that the increase in strength involved not only foot dorsiflexion but also plantarflexion of the foot end extension of the knee. Following peroneal stimulation there was also a decrease of the achilles reflex and in some cases possibly also the patellar reflex. There was an inverse relation between the decrease in the achilles reflex and its strength before stimulation. It is probable that the changes in voluntary strength and reflex activity reflect conditions which can be of importance in explaining the gait improvement which is sometimes observed in patients equippped with peroneal stimulators.

Achilles Tendon

[Biomechanical gait analysis in infantile cerebral palsy (author's transl)].

The gait pattern is recorded by use of a high-speed camera, whilst x/y coordinates of the joints are registered by a Vanguard Motion Analyzer and stored on punched tape for processing, using specially-developed computer programmes. The results are mainly plotted as stick diagrams, chronograms, angle-time diagrams and angle-angle diagrams, allowing an immediate assessment of the gait pattern. Furthermore, the data are stored for statistical analysis in regard to evaluation of the efficacy of physiotherapeutic and orthopaedic measures.

Age Factors

The pedynograph: a clinical tool for force measurement and gait analysis in lower extremity amputees.

The pedynograph is a simple, inexpensive piece of equipment which can be used in the clinical setting to monitor amputee gait. Strain gauges applied to the pylon of a modular prosthesis and incorporated in an appropriate electrical circuit provide measurements of axial load which are displayed on an oscilloscope during ambulation. Preliminary experience with the described equipment has shown that it is of value in monitoring and regulating weight bearing in patients with healing or maturing stumps or impairment of stump sensation. Gait and prosthetic problems can be analyzed, their correction documented and a permanent record of amputee performance provided.

Adult

Occult fractures in the production of gait disturbance in childhood.

Trauma to the lower extremities is the principal cause of gait disturbance in early childhood. Three cases are presented to emphasize the relative frequency of children hospitalized for diagnostic evaluation of altered gait who have occult fractures. The cases may refresh the primary physician of the variables that serve as obstacles to accurate diagnosis.

Child

Clinical study of total ankle replacement with gait analysis. A preliminary report.

Twenty-one ankle replacements in nineteen patients after an average follow-up of 14.7 months were analyzed with respect to their history, physical and roentgenographic findings, and gait analysis. The relief of pain and functional improvement after operation were disappointing compared with the results of prosthetic replacement in other joints and were not related to early complications, age, diagnosis, or the prosthesis used. Muscle weakness about the ankle, especially of the plantar flexors, was a prominent finding and appeared to cause abnormal patterns of gait and of ankle motion. The frequency of progressively increasing radiolucent lines was 88 per cent and of late loosening, 10 per cent. These results suggest a need for more emphasis on postoperative rehabilitation and on the uncertainty of this procedure at its present stage of development.

Activities of Daily Living

[Gait analysis in children with cerebral movement disorders].

The study comprises the results of gait analyses that were carried out by means of three-dimensional motion films. The gaits were recorded by two synchronized film-cameras from different angles. Enlarged on a screen a frame to frame analysis was possible. Various statements were obtained on the kind and severeness of the handicap. By computerizing the data the results were proved to be of statistical significance. The research finally included studies on electromyographic activities of several muscles in the lower extremities.

Adolescent

Role of the posterior calf muscles in normal gait.

The role of the calf muscles during the single-limb stance phase of gait was assessed in fifteen normal subjects and in seven with either an amputation or a neuromuscular deficit. Normal activity of the muscles, paralysis by nerve blocks, and stability versus instability of the ankle were studied. Pelvic displacement and velocity, step length, and step time were evaluated for each limb during the gait cycle, and the contribution of activity of calf muscles to each was determined. Limb-segment position, lower-limb joint angles, over-all cadence, velocity, and stride length were measured to reveal compensatory mechanisms in the absence of muscle strength in the calf. The results indicate that the force produced by activity of calf muscles is used to restrain the body's own forward momentum and not used to propel it further. Absence of the calf muscle causes an immediate compensatory reaction directed toward maintaining over-all stability rather than speed.

Adolescent

Effectiveness of passive vs. assistive robotic gait training on functional recovery and neuroplasticity post-stroke: A randomized controlled trial.

OBJECTIVE: This study seeks to compare the impacts of various robotic gait training (RAGT) modes on lower limb motor function recovery in stroke patients while exploring the corresponding neural mechanisms. DESIGN: A single-blind, randomized controlled trial. SETTING: Inpatient Rehabilitation Facility. PARTICIPANTS: Forty-eight patients aged 18-80 who had experienced their first unilateral subacute stroke accompanied by walking impairments were included. INTERVENTIONS: Participants were randomly assigned to: (1) assistive mode training, (2) passive mode training, or (3) control group receiving only traditional rehabilitation. Clinical and neurological outcomes were assessed at pre-intervention (T0), and post-2-week intervention (T1). MAIN OUTCOME MEASURES: Outcomes were evaluated using the Fugl-Meyer Assessment for Lower Extremity, Berg Balance Scale, Modified Barthel Index, the Functional Ambulatory Category, and functional near-infrared spectroscopy. RESULTS: Among the 48 patients recruited, significant time effects were observed across all groups in FMA-LE scores (p&#x202f;<&#x202f;0.001). Notable improvements were detected in the conventional group (MD = 2.69, p&#xff1c;0.01) and the passive group (MD = 3.67, p&#x202f;<&#x202f;0.001), with the assistive mode also demonstrating a significant effect (MD = 1.79, p&#x202f;<&#x202f;0.05). BBS scores improved across all groups; however, no significant differences were noted between the groups (p&#x202f;=&#x202f;0.11). Similarly, MBI scores showed a significant time effect (p&#x202f;<&#x202f;0.001), without notable group differences (p&#x202f;=&#x202f;0.29). CONCLUSION: All training modalities effectively enhanced motor function, balance, and daily living skills in stroke patients. Distinct cortical activation and connectivity patterns were observed between training modalities, which may reflect different neuroplastic mechanisms. These preliminary neural differences may help inform personalized rehabilitation strategies, although no clinical superiority of one mode over another can be concluded from the present data.

Humans

De novo missense variants in ZBTB47 are associated with developmental delays, hypotonia, seizures, gait abnormalities, and variable movement abnormalities.

The collection of known genetic etiologies of neurodevelopmental disorders continues to increase, including several syndromes associated with defects in zinc finger protein transcription factors (ZNFs) that vary in clinical severity from mild learning disabilities and developmental delay to refractory seizures and severe autism spectrum disorder. Here we describe a new neurodevelopmental disorder associated with variants in ZBTB47 (also known as ZNF651), which encodes zinc finger and BTB domain-containing protein 47. Exome sequencing (ES) was performed for five unrelated patients with neurodevelopmental disorders. All five patients are heterozygous for a de novo missense variant in ZBTB47, with p.(Glu680Gly) (c.2039A>G) detected in one patient and p.(Glu477Lys) (c.1429G>A) identified in the other four patients. Both variants impact conserved amino acid residues. Bioinformatic analysis of each variant is consistent with pathogenicity. We present five unrelated patients with de novo missense variants in ZBTB47 and a phenotype characterized by developmental delay with intellectual disability, seizures, hypotonia, gait abnormalities, and variable movement abnormalities. We propose that these variants in ZBTB47 are the basis of a new neurodevelopmental disorder.

Child

A light-emitting diode system for the analysis of gait. A method and selected clinical examples.

The purpose of this study was to design, develop, and test a comprehensive and potentially clinically useful system for the objective evaluation of sagittal-plane motion and temporal and distance factors during gait. A light-emitting diode and a 35 mm single-frame color slide photographic technique were utilized. The method of data collection and reduction produced values that are similar to reports in previous literature. High reliability was shown both within and across investigators testing normal subjects. Across-investigator comparisons when taking angular measurements demonstrated lower reliability. Specific clinical examples are presented to demonstrate the applicability of the light-emitting diode system.

Gait

In-toeing gait in children.

Torsional deformities in the lower extremities, resulting from constrained intrauterine position, tend to spontaneously correct toward the adult configuration during growth. Internal tibial torsion, metatarsus adductus and femoral anteversion are clinically evident conditions that occur because of arrested normal postnatal development. An understanding of the dynamics of spontaneous correction permits assessment of the child with in-toeing gait as well as the selection of proper treatment.

Adult

Stiff-legged gait in hemiplegia: surgical correction.

Selective tenotomy of one or two heads of the quadriceps based on electromyographic criteria improved knee flexion in hemiplegic patients who walked with a unilateral stiff-legged gait. The improvement was greatest in eight patients in whom the rectus femoris was released, either with or without release of the vastus intermedius, with activity in pre-swing stance and initial swing confined to those heads of the quadriceps; in these patients knee flexion improved an average of 20 degrees. Knee flexion improved an average of only 8 degrees in five patients in who activity was present in one head of the quadriceps that was not surgically released. No improvement in knee flexion occurred in seven of eight patients in whom activity was present in two or more of the quadriceps heads that were not surgically released.

Electromyography