Gait & posture最新文献_第6页

Investigation on the effects of mental fatigue on drop landing motion control in individuals with functional Ankle instability: A biomechanical perspective 从生物力学角度研究精神疲劳对功能性踝关节不稳患者落体运动控制的影响。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-01 DOI: 10.1016/j.gaitpost.2025.110027

Zilong Wang , Xiangdong Wang , Mengya Lu , Hedi Yang , Lingyu Kong , Tao Liu , Qiuxia Zhang

Objective

This study examined mental fatigue (MF)’s biomechanical effects on stable/unstable lower extremities in unilateral functional ankle instability (FAI) during single-leg landings.

Methods

Eighteen unilateral FAI individuals (9 males/9 females) met International Ankle Consortium criteria (CAIT ≤24, anterior drawer test). Kinematic/kinetic data were collected via Vicon motion capture and Kistler force plates during pre-/post-MF single-leg landings (stable/unstable sides). A 2 × 2 repeated-measures analysis of variance (ANOVA) was employed for data analysis.

Results

1) At the time of initial contact, a main effect of side was observed for hip flexion angle, with significantly smaller values on the unstable side compared to the stable side (p = 0.002). At the time of peak vertical ground reaction force (vGRF), a main effect of MF was identified for hip flexion angle, showing a significant reduction post-MF intervention (p = 0.012). 2) At the time of initial contact, a main effect of MF was detected for ankle plantarflexion angle, which significantly decreased after MF induction (p < 0.001). At the time of peak vGRF, a main effect of MF was observed for ankle inversion angle, with a significant reduction following MF intervention (p = 0.041). 3) The time to stabilization (TTS) was significantly prolonged after MF exposure (p = 0.036). 4) No interaction effects between MF and side were observed (p > 0.05).

Conclusion

MF impaired FAI individuals’ hip/ankle biomechanics (reduced flexion/plantarflexion/inversion, prolonged stabilization), suggesting compromised motor control and elevated reinjury risks via biomechanical overload. Absent MF-side interactions imply MF’s effects are limb-independent. Rehabilitation should address bilateral cognitive load impacts to enhance stability and injury prevention.

目的：研究精神疲劳（MF）对单侧功能性踝关节不稳定（FAI）单腿着地时稳定/不稳定下肢的生物力学影响。方法：18例单侧FAI患者（男9女9）符合国际踝关节协会标准（CAIT≤24，前抽屉试验）。在mf前/后单腿着陆（稳定/不稳定侧）期间，通过Vicon运动捕捉和Kistler力板收集运动学/动力学数据。采用2 × 2重复测量方差分析（ANOVA）进行数据分析。结果：1)初次接触时，侧位对髋屈曲角有主要影响，不稳定侧的屈曲角值明显小于稳定侧（p = 0.002）。在垂直地面反力（vGRF）达到峰值时，MF对髋屈曲角的主要影响是确定的，MF干预后髋屈曲角显著降低（p = 0.012）。2)初次接触时，MF对踝关节跖屈角有主要影响，诱导后踝关节跖屈角显著降低（p  0.05）。结论：MF损害了FAI个体的髋关节/踝关节生物力学（屈曲/跖屈曲/内翻减少，稳定时间延长），表明运动控制受损，生物力学负荷增加了再损伤风险。缺乏MF侧相互作用意味着MF的作用与肢体无关。康复应解决双侧认知负荷影响，以增强稳定性和损伤预防。

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引用次数: 0

Who takes a recovery step? Predictors of step execution after tripping in individuals with stroke 谁迈出了恢复的一步？中风患者绊倒后台阶执行的预测因子。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-01 DOI: 10.1016/j.gaitpost.2025.110031

Yuji Osada , Yosuke Kobayashi , Tomo Osuka , Sumiko Yamamoto

Background

A recovery step is a crucial balance reaction that prevents falls in individuals with stroke. However, the characteristics of this response after tripping remain unclear, particularly regarding which limb is used for stepping and the factors associated with whether a step is taken.

Research question

This study aimed to identify the factors associated with whether a recovery step was taken following a trip to support the development of effective fall prevention strategies for individuals with stroke.

Methods

A large-scale motion capture database comprising 41,943 gait trials was analyzed to identify near-falls caused by paretic toe tripping in 42 patients with subacute stroke. Logistic regression analysis was conducted to examine the influence of physical function, walking-aid use, and near-fall velocity during tripping on step execution.

Results

Recovery steps were observed in 48 % of the participants, and 95 % of these steps were initiated with the non-paretic limb. The key factors associated with the occurrence of recovery steps included right-sided hemiparesis (p = 0.085), nonuse of a cane (p = 0.028), and higher fall velocity (p = 0.007). The full logistic regression model demonstrated good predictive ability, with an area under the curve of 0.850.

Conclusions

Individuals with stroke predominantly rely on the non-paretic limb for recovery stepping. The side of hemiparesis, cane use, and near-fall velocity were identified as key factors associated with step occurrence. These findings support the facilitation of recovery stepping through individualized training with rapid disturbances during independent walking in individuals with stroke.

背景：恢复步骤是防止中风患者跌倒的关键平衡反应。然而，绊倒后这种反应的特征尚不清楚，特别是关于哪条肢体用于行走以及是否采取行动的相关因素。研究问题：本研究旨在确定与旅行后是否采取恢复步骤相关的因素，以支持中风患者有效预防跌倒策略的发展。方法：对42例亚急性脑卒中患者中41943例步态试验组成的大规模动作捕捉数据库进行分析，以确定由麻痹性脚趾绊倒引起的近跌倒。采用Logistic回归分析来检验身体功能、助行器使用和跳闸时近坠落速度对台阶执行的影响。结果：在48 %的参与者中观察到恢复步骤，其中95 %的这些步骤是由非麻痹肢体开始的。与恢复步骤发生相关的关键因素包括右侧偏瘫（p = 0.085）、不使用手杖（p = 0.028）和较高的坠落速度（p = 0.007）。全逻辑回归模型具有较好的预测能力，曲线下面积为0.850。结论：脑卒中患者主要依靠非麻痹肢体行走恢复。偏瘫的侧边、手杖的使用和接近坠落的速度被确定为与台阶发生相关的关键因素。这些发现支持通过个体化训练促进中风患者独立行走时的快速干扰。

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引用次数: 0

Effects of running technique characteristics on the patellofemoral joint load: A systematic review and meta-analysis 跑步技术特征对髌股关节负荷的影响：系统回顾和荟萃分析

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-10-31 DOI: 10.1016/j.gaitpost.2025.110025

Shiqi Yu , Peng Yuan , Yilin Xu , Yuwen Shangguan , Xuefeng Wang , Zhongmei Wang , Mingze Zhuang , Yawei Song

Background

Recent studies have shown that gait retraining can significantly affect the biomechanical load on the patellofemoral joint. It is of great significance to understand the effects of these running technique characteristics on patellofemoral joint load for developing effective prevention and rehabilitation strategies for injury.

Methods

A systematic review was conducted on the relevant studies from PubMed, Web of Science, EBSCO, CNKI, and Wanfang database, and the data were synthesized. Data including patellofemoral joint contact force (PFCF) and patellofemoral joint stress (PFJS) were extracted and pooled for analysis.

Results

A total of 2102 studies were retrieved, and 32 studies were finally included after applying the inclusion and exclusion criteria. According to subgroup analysis results, some running technique characteristics notably decreased PFCF (SMD = − 0.60; 95 % CI: − 0.71, − 0.49; z = 10.98, p = 0.000), including forefoot strike (FFS), decreased step length, increased step rate, decreased speed, trunk forward lean, backward running, and running softer; whereas some characteristics significantly increased PFCF (SMD = 0.46; 95 % CI: 0.29, 0.62; z = 5.47, p = 0.000), including increased step length, decreased step rate, increased speed, and trunk backward lean. Additionally, some characteristics remarkably decreased PFJS (SMD = − 0.59; 95 % CI: − 0.72, − 0.47; z = 9.02, p = 0.000), including FFS, decreased step length, increased step rate, decreased speed, and trunk forward lean; whereas some characteristics significantly increased PFJS (SMD = 0.43; 95 % CI: 0.24, 0.62; z = 4.39, p = 0.000), such as increased step length, decreased step rate, and trunk backward lean.

Conclusion

Some specific running technique characteristics can significantly influence patellofemoral joint load. Technique characteristics, such as FFS, decreased step length, increased step rate, decreased speed, trunk forward lean, backward running, and running softer, can effectively decrease the load. Conversely, increased step length, decreased step rate, increased speed, and trunk backward lean tended to increase the load.

最近的研究表明，步态再训练可以显著影响髌股关节的生物力学负荷。了解这些跑步技术特点对髌股关节负荷的影响，对于制定有效的损伤预防和康复策略具有重要意义。方法对PubMed、Web of Science、EBSCO、中国知网（CNKI）、万方数据库的相关研究进行系统综述，并对数据进行综合分析。提取髌骨股骨关节接触力（PFCF）和髌骨股骨关节应力（PFJS）数据进行汇总分析。结果共检索到2102篇研究，应用纳入和排除标准，最终纳入32篇研究。亚组分析结果显示，一些跑步技术特征显著降低了PFCF (SMD =−0.60;95 % CI:−0.71,−0.49;z = 10.98,p = 0.000)，包括前掌着地（FFS）、步长减少、步速增加、速度降低、躯干前倾、后跑、跑软；而一些特征显著增加了PFCF (SMD = 0.46; 95 % CI: 0.29, 0.62; z = 5.47,p = 0.000)，包括步长增加，步速降低，速度增加，躯干向后倾斜。此外，一些特征显著降低了PFJS (SMD = - 0.59; 95 % CI: - 0.72, - 0.47; z = 9.02,p = 0.000)，包括FFS、步长减少、步率增加、速度降低和躯干前倾；而一些特征显著增加了PFJS (SMD = 0.43; 95 % CI: 0.24, 0.62; z = 4.39,p = 0.000)，如步长增加，步速减少，躯干向后倾斜。结论某些特定的跑步技术特点对髌股关节负荷有显著影响。FFS、缩短步长、提高步速、降低速度、躯干前倾、后跑、跑软等技术特点，可以有效减轻负荷。相反，增加步长、降低步速、增加速度和躯干向后倾斜倾向于增加负荷。

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引用次数: 0

Investigating the effect of foot orthotics on dynamic stability in females with pes planus foot posture 探讨足部矫形器对女性平足足姿势动态稳定性的影响

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-20 DOI: 10.1016/j.gaitpost.2025.110057

Kelly A. Robb , Rachel Tameer, Patrick Crowley, Stephen D. Perry

Background

Foot orthotics, a device which can modify the mechanical interaction between foot and the external environment, are commonly prescribed for individuals with pes planus foot postures. The purpose of this study was to investigate the role of foot orthotics on controlling dynamic stability when females with pes planus foot posture experience a modified foot placement orientation during walking.

Research Question

Can foot orthotics control dynamic stability when females with pes planus foot posture experience a modified foot placement orientation during walking?

Methods

Kinematic data were collected from eighteen healthy young females (21.8 ± 3.2years) walking in prefabricated foot orthotics under three different stepping orientations (level, inversion, eversion). Outcome measures included gait parameters (step length, width, velocity) and dynamic stability (center of mass–base of support (COM-BOS), medio-lateral center of pressure (ML-COP) and antero-posterior COP (AP-COP)). Results were statistically evaluated with a repeated-measures ANOVA by within-subject factors of foot orthotic and step orientation. The relationship between foot posture index and dynamic stability was evaluated with spearman correlations.

Results

Results suggest that changing the orientation of the foot significantly challenges the balance control system, as evidenced by a reduction in step length, increased step width, and increased AP-COP maximums. In orthotics, inverting the foot significantly reduced the COM-BOS range (27.9 mm ± 17.8 mm) and AP COM-COP maximum (265.3 mm ± 26.7 mm), whereas everting the foot increased the AP COM-COP maximum (277.0 mm ± 27.3 mm).

Significance

As the foot becomes more flexible (higher FPI score), the reduction in COM-BOS range suggests an increased balance control resolution when walking in foot orthotics.

足部矫形器是一种可以改变足部与外部环境之间机械相互作用的装置，通常用于患有平足症足部姿势的个体。本研究旨在探讨足部矫形器在女性足部平足姿势改变时对动态稳定性的影响。研究问题：足部矫形器是否能控制女性平足足姿势在行走过程中改变足部放置方向时的动态稳定性？方法收集18名健康年轻女性（21.8 ± 3.2岁）在三种不同的踏步方向（水平、倒置、外翻）下使用预制足矫形器行走的皮肤数据。结果测量包括步态参数（步长、宽度、速度）和动态稳定性（质量中心-基础支撑（COM-BOS）、中外侧压力中心（ML-COP）和前后侧压力中心（AP-COP））。结果采用重复测量方差分析（repeated-measures ANOVA）对受试者内足部矫形和步向因素进行统计评价。用spearman相关法评价足部姿态指数与动态稳定性之间的关系。结果表明，改变足部方向会显著影响平衡控制系统，如步长减少、步宽增加和AP-COP最大值增加。在矫形器中，倒置足可显著降低COM-BOS范围（27.9 mm±17.8 mm）和AP COM-COP最大值（265.3 mm±26.7 mm），而翻足可增加AP COM-COP最大值（277.0 mm±27.3 mm）。随着足部变得更灵活（FPI评分更高），COM-BOS范围的降低表明在使用足部矫形器行走时平衡控制分辨率增加。

{"title":"Investigating the effect of foot orthotics on dynamic stability in females with pes planus foot posture","authors":"Kelly A. Robb , Rachel Tameer, Patrick Crowley, Stephen D. Perry","doi":"10.1016/j.gaitpost.2025.110057","DOIUrl":"10.1016/j.gaitpost.2025.110057","url":null,"abstract":"<div><h3>Background</h3><div>Foot orthotics, a device which can modify the mechanical interaction between foot and the external environment, are commonly prescribed for individuals with pes planus foot postures. The purpose of this study was to investigate the role of foot orthotics on controlling dynamic stability when females with pes planus foot posture experience a modified foot placement orientation during walking.</div></div><div><h3>Research Question</h3><div>Can foot orthotics control dynamic stability when females with pes planus foot posture experience a modified foot placement orientation during walking?</div></div><div><h3>Methods</h3><div>Kinematic data were collected from eighteen healthy young females (21.8 ± 3.2years) walking in prefabricated foot orthotics under three different stepping orientations (level, inversion, eversion). Outcome measures included gait parameters (step length, width, velocity) and dynamic stability (center of mass–base of support (COM-BOS), medio-lateral center of pressure (ML-COP) and antero-posterior COP (AP-COP)). Results were statistically evaluated with a repeated-measures ANOVA by within-subject factors of foot orthotic and step orientation. The relationship between foot posture index and dynamic stability was evaluated with spearman correlations.</div></div><div><h3>Results</h3><div>Results suggest that changing the orientation of the foot significantly challenges the balance control system, as evidenced by a reduction in step length, increased step width, and increased AP-COP maximums. In orthotics, inverting the foot significantly reduced the COM-BOS range (27.9 mm ± 17.8 mm) and AP COM-COP maximum (265.3 mm ± 26.7 mm), whereas everting the foot increased the AP COM-COP maximum (277.0 mm ± 27.3 mm).</div></div><div><h3>Significance</h3><div>As the foot becomes more flexible (higher FPI score), the reduction in COM-BOS range suggests an increased balance control resolution when walking in foot orthotics.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110057"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robot-assisted gait training for lower limb motor recovery in cerebral palsy: A meta-analysis of combined and standalone approaches 机器人辅助步态训练用于脑瘫患者下肢运动恢复：联合和独立方法的荟萃分析。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-12 DOI: 10.1016/j.gaitpost.2025.110052

HongJie Chen , GuoJun Yun , JingGang Wang , YanPing Fan , WeiDong Zhao , YuJun Zhan , Shuo Sun , YaTing Wang

Background

Cerebral palsy (CP), a leading cause of childhood motor disability, severely impacts lower limb function. Conventional gait training (CGT) faces challenges in standardization, while robot-assisted gait training (RAGT) offers biomechanical consistency but conflicting efficacy evidence. This meta-analysis evaluates RAGT monotherapy versus combined RAGT+CGT, therapeutic dose, and exoskeleton treadmill versus wearable robotic systems.

Methods

A systematic search across seven databases identified 19 randomized controlled trials (n = 1129). Outcomes included Gross Motor Function Measure-88 (GMFM-88) domains D/E, Berg Balance Scale (BBS), 6-minute walk test (6MWT), walking speed, and Modified Ashworth Scale (MAS). Subgroup analyses assessed therapeutic dose and robot type. Random- and fixed-effects models were applied.

Results

Combined RAGT+CGT significantly outperformed RAGT alone and CGT in GMFM-D [MD= 8.39,95 %CI(5.56,11.23) vs. 5.11,95 %CI(1.22,9.00),P < 0.00001], BBS [MD= 6.15,95 %CI(4.81,7.48) vs. 2.45,95 %CI(0.94,3.96),P < 0.00001], 6MWT [MD= 41.35,95 %CI(17.65,65.06) vs. 21.50,95 %CI(12.67,30.33),P = 0.0006],Walking speed [MD= 5.69,95 %CI(0.75,10.63) vs. 0.98,95 %CI(-0.78,2.75),P = 0.02] and MAS [MD= -0.37,95 %CI(-0.63,-0.12) vs. 0.19,95 %CI(-0.27,0.65),P = 0.004]. Low-to-medium dose interventions (1000–4000 min) achieved superior gains in GMFM-D/E compared to long-term protocols. Exoskeleton treadmills (e.g., Lokomat) outperformed wearable devices in GMFM-D/E improvements. Heterogeneity was moderate-to-high (I²=69–88 %), but sensitivity analyses confirmed robustness.

Conclusions

Combined RAGT and conventional rehabilitation significantly enhances lower limb motor function, balance, walking endurance/speed, and reduces spasticity in children with CP compared to RAGT alone (excluding GMFM-E). Medium-term interventions (8 weeks;dose:1000–4000 min) using exoskeleton treadmills yield superior outcomes to both extended protocols (>8 weeks;>4000 min) and wearable devices. Standardized assessments are needed to clarify GMFM-E improvements.

背景：脑瘫（CP）是儿童运动障碍的主要原因，严重影响下肢功能。传统的步态训练（CGT）在标准化方面面临挑战，而机器人辅助步态训练（RAGT）在生物力学方面具有一致性，但疗效证据相互矛盾。这项荟萃分析评估了RAGT单药治疗与RAGT+CGT联合治疗、治疗剂量、外骨骼跑步机与可穿戴机器人系统。方法：系统检索7个数据库，确定19个随机对照试验（n = 1129）。结果包括大运动功能测量-88 (GMFM-88) D/E域、Berg平衡量表（BBS）、6分钟步行测试（6MWT）、步行速度和改良Ashworth量表（MAS）。亚组分析评估治疗剂量和机器人类型。采用随机效应和固定效应模型。结果：RAGT+CGT联合治疗在gmmf - d方面的疗效显著优于RAGT单独治疗和CGT治疗[MD= 8.39,95 %CI(5.56,11.23) vs. 5.11,95 %CI(1.22,9.00)，P 结论：与RAGT单独治疗相比，RAGT联合常规康复治疗可显著增强CP患儿下肢运动功能、平衡、步行耐力/速度，并减少痉挛（不包括gmmf - e）。使用外骨骼跑步机的中期干预（8周；剂量：1000-4000 min）比扩展方案（>8周；>4000 min）和可穿戴设备的效果都要好。需要进行标准化评估，以明确转基因食品- e的改进。

{"title":"Robot-assisted gait training for lower limb motor recovery in cerebral palsy: A meta-analysis of combined and standalone approaches","authors":"HongJie Chen , GuoJun Yun , JingGang Wang , YanPing Fan , WeiDong Zhao , YuJun Zhan , Shuo Sun , YaTing Wang","doi":"10.1016/j.gaitpost.2025.110052","DOIUrl":"10.1016/j.gaitpost.2025.110052","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral palsy (CP), a leading cause of childhood motor disability, severely impacts lower limb function. Conventional gait training (CGT) faces challenges in standardization, while robot-assisted gait training (RAGT) offers biomechanical consistency but conflicting efficacy evidence. This meta-analysis evaluates RAGT monotherapy versus combined RAGT+CGT, therapeutic dose, and exoskeleton treadmill versus wearable robotic systems.</div></div><div><h3>Methods</h3><div>A systematic search across seven databases identified 19 randomized controlled trials (n = 1129). Outcomes included Gross Motor Function Measure-88 (GMFM-88) domains D/E, Berg Balance Scale (BBS), 6-minute walk test (6MWT), walking speed, and Modified Ashworth Scale (MAS). Subgroup analyses assessed therapeutic dose and robot type. Random- and fixed-effects models were applied.</div></div><div><h3>Results</h3><div>Combined RAGT+CGT significantly outperformed RAGT alone and CGT in GMFM-D [MD= 8.39,95 %CI(5.56,11.23) vs. 5.11,95 %CI(1.22,9.00),P < 0.00001], BBS [MD= 6.15,95 %CI(4.81,7.48) vs. 2.45,95 %CI(0.94,3.96),P < 0.00001], 6MWT [MD= 41.35,95 %CI(17.65,65.06) vs. 21.50,95 %CI(12.67,30.33),P = 0.0006],Walking speed [MD= 5.69,95 %CI(0.75,10.63) vs. 0.98,95 %CI(-0.78,2.75),P = 0.02] and MAS [MD= -0.37,95 %CI(-0.63,-0.12) vs. 0.19,95 %CI(-0.27,0.65),P = 0.004]. Low-to-medium dose interventions (1000–4000 min) achieved superior gains in GMFM-D/E compared to long-term protocols. Exoskeleton treadmills (e.g., Lokomat) outperformed wearable devices in GMFM-D/E improvements. Heterogeneity was moderate-to-high (I²=69–88 %), but sensitivity analyses confirmed robustness.</div></div><div><h3>Conclusions</h3><div>Combined RAGT and conventional rehabilitation significantly enhances lower limb motor function, balance, walking endurance/speed, and reduces spasticity in children with CP compared to RAGT alone (excluding GMFM-E). Medium-term interventions (8 weeks;dose:1000–4000 min) using exoskeleton treadmills yield superior outcomes to both extended protocols (>8 weeks;>4000 min) and wearable devices. Standardized assessments are needed to clarify GMFM-E improvements.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110052"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Same patients, different professionals: A comparative study of Edinburgh Visual Gait Scorring accuracy and agreement in cerebral palsy 相同的患者，不同的专业人员：脑瘫患者爱丁堡视觉步态评分准确性和一致性的比较研究

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-12 DOI: 10.1016/j.gaitpost.2025.110051

Sema Ertan Birsel , Meltem Celik , Osman Dogan , Elif Demirci , Onur Oto , Recep Abdullah Erten , Muharrem Inan

Background

Accurate gait assessment in cerebral palsy (CP) is essential for determining treatment strategies. The Edinburgh Visual Gait Score (EVGS) provides a standardized framework for assessing gait deviations visually. However, inter-observer variability between surgeons and physiotherapists may impact the agreement in assessment and decision-making in CP.

Research question

Do pediatric orthopedic surgeons and physiotherapists differ in their scoring accuracy and inter-rater reliability when using the Edinburgh Visual Gait Score to assess gait in children with cerebral palsy?

Methods

This study was conducted among physiotherapists and pediatric orthopedic surgeons who had the same gait assessment training. The gait data of 10 children and the standardized EVGS scoring form were shared with professionals via email. The collected data were analyzed to evaluate both inter-professional agreement between the groups and intragroup consistency within each group and the accuracy level for each group.

Results

21 physiotherapists and 15 pediatric orthopedic surgeons participated in this study. The overall accuracy of the total EVGS was 55.5 % for pediatric orthopedic surgeons, and 48.3 % for physiotherapists. Pediatric orthopedic surgeons exhibited high-moderate agreement (Krippendorff’s Alpha coefficients over 0.70) for parameters of distal segments (foot and knee). However, intragroup reliability for pelvic and hip parameters showed lower agreement with Krippendorff’s Alpha coefficients below 0.70. Physiotherapists demonstrated "low agreement" for all items and the total score, with Krippendorff’s Alpha values below 0.67.

Significance

Current study findings reinforce the importance of continued education and practice in maximizing the clinical and research potential of the EVGS. While variability persists between professional groups, the EVGS remains a valid and valuable tool for evaluating gait in CP.

背景：脑瘫患者准确的步态评估对于确定治疗策略至关重要。爱丁堡视觉步态评分（EVGS）为视觉评估步态偏差提供了一个标准化的框架。然而，外科医生和物理治疗师之间的观察者间差异可能会影响cp评估和决策的一致性。研究问题：在使用爱丁堡视觉步态评分评估脑瘫儿童的步态时，儿科骨科医生和物理治疗师在评分准确性和评估者间可靠性方面存在差异吗？方法本研究在接受过相同步态评估训练的物理治疗师和儿科骨科医生中进行。10名儿童的步态数据和标准化EVGS计分表通过电子邮件与专业人员共享。对收集到的数据进行分析，以评估各组之间的专业间一致性和各组内部一致性以及各组的准确性水平。结果21名物理治疗师和15名儿科骨科医生参与了本研究。儿童骨科医生EVGS的总体准确率为55.5% %，物理治疗师为48.3% %。小儿骨科医生对远端节段（足和膝关节）的参数表现出中高一致性（Krippendorff 's Alpha系数大于0.70）。然而，骨盆和髋关节参数的组内信度与Krippendorff Alpha系数低于0.70的一致性较低。物理治疗师对所有项目和总分表现出“低一致性”，Krippendorff的Alpha值低于0.67。目前的研究结果强调了继续教育和实践在最大限度地发挥EVGS临床和研究潜力方面的重要性。虽然专业组之间存在差异，但EVGS仍然是评估CP步态的有效和有价值的工具。

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引用次数: 0

Gait quality improves after unilateral subthalamic nucleus deep brain stimulation in Parkinson's disease patients 帕金森病患者单侧丘脑下核深部脑刺激后步态质量改善

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-20 DOI: 10.1016/j.gaitpost.2025.110059

Brandon M. Peoples , Harrison C. Walker , Kenneth D. Harrison , Keven G. Santamaria-Guzman , Silvia E. Campos-Vargas , Damaris C. Cifuentes , Natasha Brooks , Christopher P. Hurt , Jaimie A. Roper

Background

While deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a standard therapy for motor symptoms of Parkinson's disease (PD), its effect on gait is not well established.

Methods

This study investigated gait quality in 28 patients with PD undergoing unilateral STN DBS. Gait assessments were performed preoperatively (OFF and ON levodopa) and at two and four months postoperatively using either conventional ring or directional stimulation (OFF levodopa). The primary outcome was the Enhanced Gait Variability Index (EGVI), a measure of gait quality. Patients were stratified into two subgroups based on their baseline OFF-medication EGVI scores: elevated (n = 12) and normative (n = 16). Statistical analysis utilized 2 × 4 repeated measures ANOVA and Pearson correlations.

Results

A significant group-by-visit interaction was observed for EGVI at both comfortable (p < .001) and maximal (p = .014) walking speeds. The elevated variability group demonstrated significant improvement in gait quality from baseline with levodopa and with both ring and directional stimulation. The normative variability group showed no significant change across conditions. No statistically significant difference was found between ring and directional stimulation. Baseline EGVI was strongly correlated with Timed Up and Go performance (r = .75), PIGD score (r = .74), freezing of gait (r = .60), and balance confidence (r = -.55).

Conclusion

Unilateral STN DBS improves gait quality in PD patients with high baseline gait variability and preserves function in those with normal variability. These findings suggest that quantitative gait analysis may aid in patient selection and set therapeutic expectations for DBS.

虽然丘脑底核深部脑刺激（DBS）是帕金森病（PD）运动症状的标准治疗方法，但其对步态的影响尚未得到很好的证实。方法对28例PD患者行单侧STN DBS的步态质量进行研究。术前（OFF和ON左旋多巴）和术后2个月和4个月分别使用常规环形或定向刺激（OFF左旋多巴）进行步态评估。主要结果是增强步态变异性指数（EGVI），一种步态质量的测量方法。根据基线OFF-medication EGVI评分将患者分为两个亚组：升高（n = 12）和正常（n = 16）。统计分析采用2 × 4重复测量方差分析和Pearson相关。结果在舒适步行速度（p <； .001）和最大步行速度（p = .014）下，EGVI均存在显著的组访交互作用。高变异性组在左旋多巴和环形和定向刺激的基础上显示出步态质量的显著改善。标准变异性组在不同条件下没有显着变化。环形增产与定向增产之间无统计学差异。基线EGVI与Timed Up和Go表现密切相关（r = ）。75)， PIGD评分（r = ）。74)、步态冻结（r = ）。60)，平衡置信度（r = - 0.55）。结论单侧STN DBS改善了基线步态变异性高的PD患者的步态质量，保留了基线步态变异性正常的PD患者的功能。这些发现表明，定量步态分析可能有助于患者选择和设定DBS的治疗预期。

{"title":"Gait quality improves after unilateral subthalamic nucleus deep brain stimulation in Parkinson's disease patients","authors":"Brandon M. Peoples , Harrison C. Walker , Kenneth D. Harrison , Keven G. Santamaria-Guzman , Silvia E. Campos-Vargas , Damaris C. Cifuentes , Natasha Brooks , Christopher P. Hurt , Jaimie A. Roper","doi":"10.1016/j.gaitpost.2025.110059","DOIUrl":"10.1016/j.gaitpost.2025.110059","url":null,"abstract":"<div><h3>Background</h3><div>While deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a standard therapy for motor symptoms of Parkinson's disease (PD), its effect on gait is not well established.</div></div><div><h3>Methods</h3><div>This study investigated gait quality in 28 patients with PD undergoing unilateral STN DBS. Gait assessments were performed preoperatively (OFF and ON levodopa) and at two and four months postoperatively using either conventional ring or directional stimulation (OFF levodopa). The primary outcome was the Enhanced Gait Variability Index (EGVI), a measure of gait quality. Patients were stratified into two subgroups based on their baseline OFF-medication EGVI scores: elevated (n = 12) and normative (n = 16). Statistical analysis utilized 2 × 4 repeated measures ANOVA and Pearson correlations.</div></div><div><h3>Results</h3><div>A significant group-by-visit interaction was observed for EGVI at both comfortable (p < .001) and maximal (p = .014) walking speeds. The elevated variability group demonstrated significant improvement in gait quality from baseline with levodopa and with both ring and directional stimulation. The normative variability group showed no significant change across conditions. No statistically significant difference was found between ring and directional stimulation. Baseline EGVI was strongly correlated with Timed Up and Go performance (r = .75), PIGD score (r = .74), freezing of gait (r = .60), and balance confidence (r = -.55).</div></div><div><h3>Conclusion</h3><div>Unilateral STN DBS improves gait quality in PD patients with high baseline gait variability and preserves function in those with normal variability. These findings suggest that quantitative gait analysis may aid in patient selection and set therapeutic expectations for DBS.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110059"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Coordination index – A method for the assessment of the inter-joint coordination during gait 协调指数。一种评估步态中关节间协调的方法。

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-01 DOI: 10.1016/j.gaitpost.2025.110030

Małgorzata Syczewska, Ewa Szczerbik, Małgorzata Kalinowska, Anna Święcicka

Background

The gait analysis is a relatively commonly used tool for evaluating the functional deficits of various groups of patients, regardless of the origin of these deficits, but is especially common in patients with neurological deficits. One of the problems they encounter is disrupted coordination. One of the methods to asses it is cyclogram, or angle-angle plot.

Research Question

Could cyclogram index, based on cyclograms for lower limbs contribute to understanding of the disrupted coordination in neurological patients?

Methods

This paper presents the coordination index, which is based on the perimeters of four cyclograms: hip/pelvis, knee/hip and ankle/knee in the sagittal plane and hip/pelvis in the frontal plane. Data extracted from retrospective gait analyses of patients with spastic diplegia cerebral palsy, dystrophy and Guillain-Barre syndrome were used to calculate cyclograms, coordination index and gait indices: Gillette Gait Index (GGI), Gait Deviation Index (GDI) and Gait Profile Score (GPS).

Results

The main finding of this paper is the independence of the new coordination index from commonly used indices: GGI, GDI and GPS. A discriminant analysis, in which the grouping variable was the name of the disease, revealed that cyclogram perimeters and coordination index were statistically significant predictors.

Significance

Coordination index could be used as additional measure assessing the disrupted coordination in patients.

Conclusion

This paper shows the potential usefulness of the proposed method in clinical application, especially in the long-term changes induced by the various treatment methods.

背景：步态分析是一种相对常用的评估各种患者功能缺陷的工具，无论这些缺陷的来源如何，但在神经功能缺陷患者中尤其常见。他们遇到的问题之一是协调中断。评估它的方法之一是环图，或角-角图。研究问题：基于下肢环图的环图指数是否有助于了解神经系统患者的协调性紊乱？方法：提出以矢状面髋/骨盆、膝关节/髋关节、踝关节/膝关节、额面髋/骨盆四个环的周长为基础的协调性指数。采用痉挛性双瘫脑瘫、营养不良和格林-巴利综合征患者回顾性步态分析数据，计算环图、协调指数和步态指标：吉列步态指数（GGI）、步态偏差指数（GDI）和步态轮廓评分（GPS）。结果：本文的主要发现是新的协调指标与常用指标GGI、GDI和GPS的独立性。以疾病名称为分组变量的判别分析显示，环图周长和配位指数是具有统计学意义的预测因子。意义：协调指数可作为评价患者协调障碍的附加指标。结论：所提出的方法在临床应用中具有潜在的实用性，特别是在各种治疗方法引起的长期变化中。

{"title":"Coordination index – A method for the assessment of the inter-joint coordination during gait","authors":"Małgorzata Syczewska, Ewa Szczerbik, Małgorzata Kalinowska, Anna Święcicka","doi":"10.1016/j.gaitpost.2025.110030","DOIUrl":"10.1016/j.gaitpost.2025.110030","url":null,"abstract":"<div><h3>Background</h3><div>The gait analysis is a relatively commonly used tool for evaluating the functional deficits of various groups of patients, regardless of the origin of these deficits, but is especially common in patients with neurological deficits. One of the problems they encounter is disrupted coordination. One of the methods to asses it is cyclogram, or angle-angle plot.</div></div><div><h3>Research Question</h3><div>Could cyclogram index, based on cyclograms for lower limbs contribute to understanding of the disrupted coordination in neurological patients?</div></div><div><h3>Methods</h3><div>This paper presents the coordination index, which is based on the perimeters of four cyclograms: hip/pelvis, knee/hip and ankle/knee in the sagittal plane and hip/pelvis in the frontal plane. Data extracted from retrospective gait analyses of patients with spastic diplegia cerebral palsy, dystrophy and Guillain-Barre syndrome were used to calculate cyclograms, coordination index and gait indices: Gillette Gait Index (GGI), Gait Deviation Index (GDI) and Gait Profile Score (GPS).</div></div><div><h3>Results</h3><div>The main finding of this paper is the independence of the new coordination index from commonly used indices: GGI, GDI and GPS. A discriminant analysis, in which the grouping variable was the name of the disease, revealed that cyclogram perimeters and coordination index were statistically significant predictors.</div></div><div><h3>Significance</h3><div>Coordination index could be used as additional measure assessing the disrupted coordination in patients.</div></div><div><h3>Conclusion</h3><div>This paper shows the potential usefulness of the proposed method in clinical application, especially in the long-term changes induced by the various treatment methods.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"124 ","pages":"Article 110030"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intra- and interobserver reliability of femoral torsion measurement using ultrasound with inertial sensor in children aged 7–9 years 7-9岁儿童超声与惯性传感器股骨扭转测量的观察者内部和观察者之间的可靠性

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-07 DOI: 10.1016/j.gaitpost.2025.110046

Xavier Ruiz-Tarrazo , Andrea Coda , Carla Sánchez-Dueñas , Salomé Tárrega , Carles Escalona-Marfil

Background

Accurate assessment of femoral torsion in children is crucial for diagnosing and managing musculoskeletal conditions. Ultrasonography offers a non-invasive, cost-effective alternative to traditional imaging, but its reliability and validity remain underexplored.

Purpose

To evaluate the reliability of two ultrasonography-based methods—single- and dual-reference—for measuring femoral torsion in children aged 7–9 years, using an inertial sensor attached to the transducer. Additionally, the study examined inter-method differences, assessed biomechanical consistency via correlation with hip rotation, and evaluated children’s satisfaction with the procedure.

Materials and methods

A prospective study was conducted with 20 children (40 femora) between November 2023 and December 2024. The single-reference method assessed the proximal femur; the dual-reference also included the femoral condyles. Intra-observer reliability was tested with repeated measurements two weeks apart; inter-observer reliability was assessed between two independent raters. Intraclass correlation coefficients (ICC) and Spearman’s rho were used to evaluate reliability. Satisfaction was assessed via a five-level Faces Scale.

Results

Both the single-reference and dual-reference methods demonstrated excellent reliability, with intra-observer ICC_(2,1) values of 0.962 and 0.952, and inter-observer values of 0.915 and 0.914, respectively. The single-reference method consistently produced higher torsion values (mean differences: 9.21° and 8.45°), though results were strongly correlated. Correlations with hip rotation ranged from ρ = 0.666 to −0.676 (P < .001). Satisfaction was high: 95 % reported no or mild discomfort, 90 % found the procedure comfortable, and 75 % were willing to repeat it.

Conclusion

Ultrasonography combined with inertial sensors provides a reliable, non-invasive method for assessing femoral torsion in children, with good clinical feasibility and high acceptance.

背景：准确评估儿童股扭转对诊断和治疗肌肉骨骼疾病至关重要。超声检查提供了一种非侵入性的、低成本的传统影像学替代方法，但其可靠性和有效性仍有待进一步研究。目的评价单参考和双参考超声测量7-9岁儿童股骨扭力的可靠性，采用惯性传感器连接换能器。此外，该研究还检查了方法间的差异，通过与髋关节旋转的相关性评估了生物力学一致性，并评估了儿童对手术的满意度。材料与方法于2023年11月至2024年12月对20名儿童（40股骨）进行前瞻性研究。单参考法评估股骨近端；双参考还包括股骨髁。通过间隔两周的重复测量来测试观察者内部的信度；在两个独立的评价者之间评估观察者间的信度。用类内相关系数（ICC）和Spearman’s rho评价信度。满意度通过五级面部量表进行评估。结果单参考和双参考方法均具有良好的信度，观察者内ICC（2,1）值分别为0.962和0.952，观察者间ICC值分别为0.915和0.914。单参考方法始终产生更高的扭转值（平均差异：9.21°和8.45°），尽管结果强烈相关。与髋关节旋转相关的ρ = 0.666至- 0.676 （P <； .001）。满意度很高：95% %报告没有或轻微不适，90% %认为手术舒适，75% %愿意重复手术。结论超声联合惯性传感器是一种可靠、无创的评估儿童股扭转的方法，具有良好的临床可行性和较高的接受度。

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引用次数: 0

Acute effects of dynamic stretching on knee joint position sense and dynamic balance in recreational runners: A randomized controlled trial 动态拉伸对休闲跑步者膝关节位置感和动态平衡的急性影响：一项随机对照试验

IF 2.4 3区医学 Q3 NEUROSCIENCES

Gait & posture

Pub Date : 2026-02-01 Epub Date: 2025-11-10 DOI: 10.1016/j.gaitpost.2025.110049

Edgar Simões , Nuno Tavares , Marina Saraiva

Objectives

Proprioception and dynamic balance are crucial elements of neuromuscular control during running, supporting movement precision and postural adjustments. Dynamic stretching is commonly used in warm-ups to enhance muscle activation and sensorimotor readiness, but its acute effects on proprioception and balance remain unclear.

Design

Randomized controlled trial.

Participants

Sixty-two healthy recreational runners (25–45 years; ≥20 km/week), randomly assigned to a Dynamic Stretching group (n = 31) or a control group performing light walking (n = 31).

Main outcome measures

Joint position sense was assessed through active joint repositioning using 2D video analysis, with Absolute Angular Error, Relative Angular Error, and Variable Angular Error as outcomes. Balance was evaluated using the Y-Balance Test, including anterior, posteromedial, and posterolateral reach directions, as well as a composite score.

Results

The Dynamic Stretching group showed significant reductions in Absolute Angular Error (p < 0.05) and Variable Angular Error (p < 0.001), with a between-group difference in Relative Angular Error (p = 0.043). Both groups improved Y-Balance Test scores, but the Dynamic stretching group achieved significantly greater gains in posteromedial reach and Composite Score (p < 0.001).

Conclusions

Dynamic stretching acutely improves proprioceptive accuracy and dynamic balance in recreational runners, supporting its inclusion in warm-up routines.

目的本体感觉和动态平衡是跑步过程中神经肌肉控制的关键要素，支持运动精度和体位调节。动态拉伸通常用于热身，以增强肌肉激活和感觉运动准备，但其对本体感觉和平衡的急性影响尚不清楚。设计随机对照试验。参与者：62名健康的休闲跑步者（25-45岁，≥20 km/week），随机分为动态拉伸组（n = 31）和轻步行组（n = 31）。主要结果测量通过使用二维视频分析主动关节重新定位来评估关节位置感，以绝对角度误差、相对角度误差和可变角度误差作为结果。使用Y-Balance测试评估平衡，包括前、后内侧和后外侧到达方向，以及综合评分。结果动态拉伸组绝对角误差（p < 0.05）和可变角误差（p < 0.001）显著降低，相对角误差组间差异（p = 0.043）。两组均提高了Y-Balance测试分数，但动态拉伸组在内侧后伸和综合得分方面取得了显著更大的进步（p < 0.001）。结论动态拉伸可显著提高休闲跑步者本体感觉的准确性和动态平衡，支持将其纳入热身活动。

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引用次数: 0