Name: clinical assessment of spatiotemporal gait parameters in patients and older adults
Uploaded: 2014-11-07T14:00:00
Description: Watch this Scientific Journal Video about Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults at JoVE.com

The protocol follows the guidelines of the local human Ethics Committee in Zurich (KEK Zurich).
1. Hardware Installation (Figure 1)
<ol>
	<li>Use two 10-m sets of floor-based bars and place them parallel to each other (and to the line of progression) to create a corridor with an inter-set distance of approximately 1 m. 
	NOTE: This distance can be increased up to 8 m. Each bar has a length of 1 m&#160;and consists of 96 light diodes.</li>
	<li>Make a distinction between light-transmitti...

<ol>
	<li>Chow, J. W., Yablon, S. A., Horn, T. S., Stokic, D. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Temporospatial+characteristics+of+gait+in+patients+with+lower+limb+muscle+hypertonia+after+traumatic+brain+injury.">Temporospatial characteristics of gait in patients with lower limb muscle hypertonia after traumatic brain injury.</a> Brain. Inj. 24, 1575-1584 (2010).</li><li>Esser, P., Dawes, H., Collett, J., Feltham, M. G., Howells, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+spatio-temporal+gait+parameters+using+inertial+measurement+units+in+neurological+populations.">Assessment of spatio-temporal gait parameters using inertial measurement units in neurological populations.</a> Gait Posture. 34, 558-560 (2011).</li><li>Maffiuletti, N. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Spatiotemporal+parameters+of+gait+after+total+hip+replacement:+anterior+versus+posterior+approach.">Spatiotemporal parameters of gait after total hip replacement: anterior versus posterior approach.</a> Orthop. Clin. North Am. 40, 407-415 (2009).</li><li>Webster, K. E., Wittwer, J. E., Feller, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+gait+analysis+after+medial+unicompartmental+knee+arthroplasty+for+osteoarthritis.">Quantitative gait analysis after medial unicompartmental knee arthroplasty for osteoarthritis.</a> J. Arthroplasty. 18, 751-759 (2003).</li><li>Chui, K. K., Lusardi, M. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Spatial+and+temporal+parameters+of+self-selected+and+fast+walking+speeds+in+healthy+community-living+adults+aged+72-98+years.">Spatial and temporal parameters of self-selected and fast walking speeds in healthy community-living adults aged 72-98 years.</a> J. Geriatr. Phys. Ther. 33, 173-183 (2010).</li><li>Hollman, J. H., McDade, E. M., Petersen, R. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Normative+spatiotemporal+gait+parameters+in+older+adults.">Normative spatiotemporal gait parameters in older adults.</a> Gait Posture. 34, 111-118 (2011).</li><li>Lienhard, K., Schneider, D., Maffiuletti, N. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Validity+of+the+Optogait+photoelectric+system+for+the+assessment+of+spatiotemporal+gait+parameters.">Validity of the Optogait photoelectric system for the assessment of spatiotemporal gait parameters.</a> Med. Eng. Phys. 35, 500-504 (2013).</li><li>Perry, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gait+analysis,+normal+and+pathological+function.">Gait analysis, normal and pathological function.</a> First edn, Slack Inc. , (1992).</li><li>Lee, M. M., Song, C. H., Lee, K. J., Jung, S. W., Shin, D. C., Shin, S. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Concurrent+validity+and+test-retest+reliability+of+the+OPTOGait+photoelectric+cell+system+for+the+assessment+of+spatio-temporal+parameters+of+the+gait+of+young+adults.">Concurrent validity and test-retest reliability of the OPTOGait photoelectric cell system for the assessment of spatio-temporal parameters of the gait of young adults.</a> J. Phys. Ther. Sci. 26, 81-85 (2014).</li><li>Item-Glatthorn, J. F., Casartelli, N. C., Petrich-Munzinger, J., Munzinger, U. K., Maffiuletti, N. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Validity+of+the+intelligent+device+for+energy+expenditure+and+activity+accelerometry+system+for+quantitative+gait+analysis+in+patients+with+hip+osteoarthritis.">Validity of the intelligent device for energy expenditure and activity accelerometry system for quantitative gait analysis in patients with hip osteoarthritis.</a> Arch. Phys. Med. Rehabil. 93, 2090-2093 (2012).</li><li>Maffiuletti, N. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Concurrent+validity+and+intrasession+reliability+of+the+IDEEA+accelerometry+system+for+the+quantification+of+spatiotemporal+gait+parameters.">Concurrent validity and intrasession reliability of the IDEEA accelerometry system for the quantification of spatiotemporal gait parameters.</a> Gait Posture. 27, 160-163 (2008).</li><li>Reed, L. F., Urry, S. R., Wearing, S. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reliability+of+spatiotemporal+and+kinetic+gait+parameters+determined+by+a+new+instrumented+treadmill+system.">Reliability of spatiotemporal and kinetic gait parameters determined by a new instrumented treadmill system.</a> BMC Musculoskelet. Disord. 14, 249 (2013).</li><li>Kressig, R. W., Beauchet, O. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Guidelines+for+clinical+applications+of+spatio-temporal+gait+analysis+in+older+adults.">Guidelines for clinical applications of spatio-temporal gait analysis in older adults.</a> Aging Clin. Exp. Res. 18, 174-176 (2006).</li><li>Dubost, V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Relationships+between+dual-task+related+changes+in+stride+velocity+and+stride+time+variability+in+healthy+older+adults.">Relationships between dual-task related changes in stride velocity and stride time variability in healthy older adults.</a> Hum. Mov. Sci. 25, 372-382 (2006).</li><li>Hausdorff, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gait+variability:+methods,+modeling+and+meaning.">Gait variability: methods, modeling and meaning.</a> J. Neuroeng. Rehabil. 2, (2005).</li><li>Blin, O., Ferrandez, A. M., Serratrice, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+analysis+of+gait+in+Parkinson+patients:+increased+variability+of+stride+length.">Quantitative analysis of gait in Parkinson patients: increased variability of stride length.</a> J. Neurol. Sci. 98, 91-97 (1990).</li><li>Webster, K. E., Merory, J. R., Wittwer, J. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gait+variability+in+community+dwelling+adults+with+Alzheimer+disease.">Gait variability in community dwelling adults with Alzheimer disease.</a> Alzheimer. Dis. Assoc. Disord. 20, 37-40 (2006).</li><li>Bejek, Z., Paroczai, R., Illyes, A., Kiss, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+influence+of+walking+speed+on+gait+parameters+in+healthy+people+and+in+patients+with+osteoarthritis.">The influence of walking speed on gait parameters in healthy people and in patients with osteoarthritis.</a> Knee Surg. Sports Traumatol. Arthrosc. 14, 612-622 (2006).</li></ol>

The protocol presented here can be used to evaluate spatial and temporal gait parameters of patients (orthopedic, neurological, cardiorespiratory, etc.) and healthy older adults with a recently-introduced photoelectric system. The total length and width of the system can be modulated depending on the available space and budget. The estimated cost (in Europe) is approximately 2,800 USD per meter for a 10-meter&#160;system and the minimum recommended length is 3 meter&#160;for floor-based gait analysis. A new feature of th...

Walking is one of the most important physical activities in everyday life, and is a main determinant of the quality of life for elderly and patient populations who may present with gait deteriorations. Clinical evaluation of gait function is therefore important to reveal potential alterations induced by aging and/or neurological/orthopedic pathologies, but also to prove the functional benefits of a treatment. Different instruments have been developed for the quantitative assessment of gait parameters, e.g., force plates, video-based 3D motion analysis, body-mounted accelerometers10,11, and instrumented walkway mats or treadmills12. However, these systems are mainly used for research studies rather than for clinical purposes because they are complex to operate, have low accessibility, and fragile sensors.
A floor-based photoelectric system has recently been introduced, which is able to provide a valid calculation of temporal features and 1D spatial coordinates of walking steps. This measuring instrument has several advantages compared to pre-existing systems: it is easy to handle, data are collected very quickly, it is simple to create a detailed report and it is a modular system which means that the length of the system can be changed. Thus, it can be used with confidence to measure within-group changes in longitudinal assessments and between-group differences in cross-sectional comparisons. The goals of the described protocol are to focus on the equipment and its installation, and to objectively and straightforwardly describe the assessment procedures for evaluating spatiotemporal gait parameters in elderly and patient populations.

<table border="0" cellpadding="0" cellspacing="0" width="846">
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">Name of Equipment</td>
			<td style="width:169px;">Company</td>
			<td style="width:119px;">Catalog Number</td>
			<td style="width:233px;">Comments/Description</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:325px;">-Optogait system (10 meters)</td>
			<td style="width:169px;">Microgate, Bolzano, Italy</td>
			<td style="width:119px;"></td>
			<td><a href="http://www.optogait.com/">www.optogait.com</a></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">-Optogait software</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td>www.optogait.com/Support/Downloads</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">-Laptop</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;"></td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:325px;">The Optogait system contains the following equipment:</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:325px;">-10 light-transmitting (T) bars (1 as a first meter)</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">-10 light-receiving (R) bars (1 as a first meter)</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:325px;">-18 caps to connect the bars within a set (9 for T and 9 for R bars) and 2 special caps for the last T and R bar</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">-1 camera with its tripod</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:22px;width:325px;">-1 cable for connecting the Optogait to the laptop</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:325px;">-1 cable for connecting the camera to the laptop</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">-2 power supplies (one for each set of bars)</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
	</tbody>
</table>

clinical assessment of spatiotemporal gait parameters in patients and older adults

Spatial and temporal characteristics of human walking are frequently evaluated to identify possible gait impairments, mainly in orthopedic and neurological patients1-4, but also in healthy older adults5,6. The quantitative gait analysis described in this protocol is performed with a recently-introduced photoelectric system (see&#160;Materials table) which has the potential to be used in the clinic because it is portable, easy to set up (no subject preparation is required before a test), and does not require maintenance and sensor calibration. The photoelectric system consists of series of high-density floor-based photoelectric cells with light-emitting and light-receiving diodes that are placed parallel to each other to create a corridor, and are oriented perpendicular to the line of progression7. The system simply detects interruptions in light signal, for instance due to the presence of feet within the recording area. Temporal gait parameters and 1D spatial coordinates of consecutive steps are subsequently calculated to provide common gait parameters such as step length, single limb support and walking velocity8, whose validity against a criterion instrument has recently been demonstrated7,9. The measurement procedures are very straightforward; a single patient can be tested in less than 5 min&#160;and a comprehensive report can be generated in less than 1&#160;min.

A recent study demonstrated the validity of the photoelectric system against a criterion instrument (a validated electronic walkway) for the assessment of spatiotemporal gait parameters in orthopedic patients and healthy elderly controls7. The same between-group differences in gait variables were detected by the two systems. Although concurrent validity was excellent, with intraclass correlation coefficients ranging between 0.933 and 0.999 (p &#60; 0.001), a systematic bias (p &#60; 0.001) was observed between...

Watch this Scientific Journal Video about Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults at JoVE.com

Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults

This protocol is used to evaluate spatial and temporal gait variables of neurological/orthopedic patients and older persons by means of a recently-introduced floor-based photocell system.

Spatial and temporal characteristics of human walking are frequently evaluated to identify possible gait impairments, mainly in orthopedic and ...

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