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  • 1. Eek, M. N.
    et al.
    Zügner, Roland
    Stefansdottir, I.
    Tranberg, Roy
    Gothenburg University, Institute of Clinical Sciences, Section for Anesthesiology, Biomaterials and Orthopaedics, Department of Orthopaedics.
    Kinematic gait pattern in children with cerebral palsy and leg length discrepancy: Effects of an extra sole2017In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 55, p. 150-156Article in journal (Refereed)
    Abstract [en]

    The gait pattern in children with cerebral palsy (CP) often differs from normal, with slow velocity, problem with foot clearance and increased stress on joints. Several factors, such as muscle tone, impaired motor control, muscle contractures, skeletal deformities and leg length discrepancy affect gait. Leg length discrepancy can be treated surgically or with elevation of the shoe on the short leg. The purpose of this study was to examine whether compensating for leg length discrepancy, with elevation of the sole, leads to a change in movement pattern during walking in children with spastic CP. Results: Ten children with spastic CP, able to walk without aids, and 10 typically developing (TD) children aged between seven and 14 years were assessed with 3D gait analysis: 1) barefoot, 2) with shoes and 3) with an extra sole beneath the shoe for the shorter leg. All children with CP had a leg length discrepancy of more than or equal to 1.0 cm. In the barefoot condition, the velocity was slower and the stride length was shorter, in children with CP compared with TD. The stride length and gait velocity increased in children with CP with shoes and shoe + sole and the stance time became more symmetrical. Among children with CP, there was more flexion in the longer leg relative to the short leg during barefoot walking. Differences in the kinematic pattern between the long and the short leg decreased with the extra sole. 

  • 2.
    Elhadi, Mustafa M. O.
    et al.
    Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong.
    Ma, Christina Zong-Hao
    Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong.
    Lam, Wing K.
    Li Ning Sports Science Research Center, Li Ning (China) Sports Goods, Co. Ltd., Beijing, China.
    Lee, Winson C.-C.
    School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, Australia.
    Biomechanical approach in facilitating long-distance walking of elderly people using footwear modifications2018In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 64, p. 101-107Article in journal (Refereed)
    Abstract [en]

    Background: Long-distance walking is a convenient way for prompting physical activity of elderly people. However, walking ability declines with aging.

    Research question: This study assessed if silicone insoles with heel lifts (named here the prescribed insoles) could facilitate long-distance walking of older adults.

    Methods: Fifteen adults aged over 65, who did not have obvious lower-limb problems, walked on a treadmill for totally 60 min in two separate walking sessions: 1) with the prescribed insoles, and 2) with original insoles of the standardized shoes. Gait tests using force plates and a motion analysis system, and subjective evaluation using visual analog and Borg's CR10 scales were conducted at different time points of the treadmill walking.

    Results: Objective gait anaylsis showed that without using the prescribed insoles, there were significant reductions (p < 0.05) in stance time, vertical ground reaction force, ankle dorsiflexion angle and ankle power generation of the dominant leg after the 60-minute treadmill walk. Such significant reductions were not observed in the same group of subjects upon using the prescribed insoles. Meanwhile, significant improvements in subjective perception of physical exertion, pain and fatigue were observed.

    Significance: Heel lifts and silicone insoles are generally used to relieve plantar pain and reduce strain of plantar flexors in patients. This study showed they might also be solutions to facilitate long-distance walking of older adults, an approach which could prompt their physical activity. 

  • 3. Laughton, Carrie A
    et al.
    Slavin, Mary
    Katdare, Kunal
    Nolan, Lee
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Prosthetics and Orthotics.
    Bean, Jonathan F
    Kerrigan, D Casey
    Phillips, Edward
    Lipsitz, Lewis A
    Collins, James J
    Aging, muscle activity, and balance control: physiologic changes associated with balance impairment.2003In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 18, no 2, p. 101-108Article in journal (Other academic)
  • 4.
    Nilsson, Kjell-Åke
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    Detecting post-operative change in gait function using principal component analysis in subjects with cerebral palsy2006In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 24, p. 152-153Article in journal (Other academic)
    Abstract [en]

    Principal components analysis is a multivariate statistical method that has been used in gait analysis. One example of use of the method is the production of The Gillette Gait Index. This index, indicating normality in gait function, has been presented and validated by previous authors. According to suggestions made by these authors, the index could potentially be used to evaluate change in gait function after surgical intervention in subjects with cerebral palsy. The Gillette Gait Index was calculated using principal components analysis for nineteen individuals with cerebral palsy (5 hemiplegics, 13 diplegics and 1 quadriplegic; mean age 16 years, range 10-31 years) in a retrospective study. The change in index value per individual from the pre- to the postoperative situations was compared to the evaluation of change made by an experienced clinician. Agreement was evaluated using Cohen´s kappa ( k ), resulting in a value of k=0.406, which is usually considered to be a fair to moderate level of agreement.

     

  • 5.
    Nolan, Lee
    et al.
    Jönköping University. Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Prosthetics and Orthotics.
    Kerrigan, D Casey
    Postural control: toe-standing versus heel-toe standing.2004In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 19, no 1, p. 11-15Article in journal (Refereed)
  • 6.
    Nolan, Lee
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Prosthetics and Orthotics.
    Wit, Andrzej
    Dudziñski, Krzysztof
    Lees, Adrian
    Lake, Mark
    Wychowañski, Michał
    Adjustments in gait symmetry with walking speed in trans-femoral and trans-tibial amputees2003In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 17, no 2, p. 142-151Article in journal (Other academic)
  • 7.
    Riad, Jacques
    et al.
    Department of Orthopedics, Skaraborgs Hospital, Skövde, Sweden.
    Coleman, Scott
    Motion and Sports Lab, Baylor University Medical Center, Dallas, TX, United States.
    Lundh, Dan
    Högskolan Skövde, Skövde, Sweden.
    Brostrom, Eva
    Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
    Arm posture score and arm movement during walking: A comprehensive assessment in spastic hemiplegic cerebral palsy2011In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 33, no 1, p. 48-53Article in journal (Refereed)
    Abstract [en]

    Patients with hemiplegic cerebral palsy often have noticeably deviant arm posture and decreased arm movement. Here we develop a comprehensive assessment method for the upper extremity during walking. Arm posture score (APS), deviation of shoulder flexion/extension, shoulder abduction/adduction, elbow flexion/extension and wrist flexion/extension were calculated from three-dimensional gait analysis. The APS is the root mean square deviation from normal, similar to Baker's Gait Profile Score (GPS) [1]. The total range of motion (ROM) was defined as the difference between the maximum and minimum position in the gait cycle for each variable. The arm symmetry, arm posture index (API) was calculated by dividing the APS on the hemiplegic side by that on the non-involved side, and the range of motion index (ROMI) by dividing the ROM on the hemiplegic side by that on the non-involved side. Using the APS, two groups were defined. Group 1 had minor deviations, with an APS under 9.0 and a mean of 6.0(95% CI 5.0-7.0). Group 2 had more pronounced deviations, with an APS over 9.0 and a mean of 13.1 (CI 10.8-15.5) (p = 0.000). Total ROM was 60.6 in group 1 and 46.2 in group 2 (p = 0.031). API was 0.89 in group 1 and 1.70 in group 2 (p < 0.001). ROMI was 1.15 in group 1 and 0.69 in group 2 (p = 0.003). APS describes the amount of deviation, ROM provides additional information on movement pattern and the indices the symmetry. These comprehensive objective and dynamic measurements of upper extremity abnormality can be useful in following natural progression, evaluating treatment and making prognoses in several categories of patients. 

  • 8.
    Rusaw, David
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Rudholmer, Elin
    Jönköping University, School of Health and Welfare.
    Barnett, Cleveland T.
    School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom.
    Development of a limits of stability protocol for use in transtibial prosthesis users: Learning effects and reliability of outcome variables2017In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 58, p. 539-545Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to empirically quantify reliability and learning effects of a Limits of Stability protocol for transtibial prosthesis users. Outcome variables from center of pressure and center of mass were tested on: 1) multiple test repetitions within a single test occasion; and 2) between multiple test occasions. Trantibial prosthesis users (n=7) and matched controls (n=7) executed five trials of the Limits of Stability protocol on two occasions per day, on two consecutive days. Inter-trial learning effects and reliability of outcomes extracted via center of mass and center of pressure were evaluated utilizing standard biomechanics laboratory equipment. Reliability was good to excellent except the reaction time variable which was poor (Pooled 95%CI of ICC=0.248-0.484). An inter-trial learning effect was present in directional control for prosthesis users when the first trial was included in analysis (center of mass: 95%CI of r=0.065-0.239; center of pressure: 95%CI of r=0.076-0.249). The use of standard biomechanics lab equipment can produce reliable results for the Limits of Stability protocol. Researchers should be aware of low reliability of reaction time variable in the protocol assessed and should execute at least one practice trial prior to that which is used in subsequent analysis.

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