O protocolo segue as orientações do Comitê de Ética local, humano, em Zurique (KEK Zurique). 1. Instalação de Hardware (Figura 1) <ol><li> Usar dois conjuntos de 10 m de barras à base de piso e colocá-las paralelas umas às outras (e para a linha de progressão) para criar um intervalo com uma distância inter-conjunto de aproximadamente 1 m. NOTA: Esta distância pode ser aumentada até 8 m. Cada bar tem um comprimento de 1 m e consiste de 96 diodos emissores de luz. </li><li> Faça uma distinção entre a luz-transmissor (T) e unidades de recepção de luz (R) para a instalação das barras, colocando o (T) unidades no lado direito e as unidades de recepção de luz (R) à esquerda de luz de transmissão lado com respeito à direcção de passeio. NOTA: Os primeiros bares metros (tanto T e R) têm tambores de prata. As barras de T e R dispostos sobre os restantes 9 m são todos iguais e intermutáveis. </li><li> Ligue todas as barras de uma linha com tampas (sem fio). Utilize 2 power suprimentos: um para cada conjunto de barras (T e R). </li><li> Conecte-se a primeira barra de R para o laptop com um cabo USB. </li><li> Posicione a câmera ao lado do primeiro bar para verificações off-line (por exemplo, o pé de partida), e conectá-lo ao computador portátil com um cabo USB. </li><li> Coloque uma marca de 2 m antes e depois do início e do fim da pista. </li><li> Ligue o dispositivo fotoelétrico utilizando o interruptor on-off do primeiro R e T bar. </li><li> Verifique se os LEDs de controle localizados em todos os bares R são verdes. NOTA: Se assim for, o sistema está na posição correcta e pode iniciar o teste; No entanto, se um ou mais dos LEDs de controlo são vermelhos do sistema não está correctamente posicionado e / ou ligado. Controlar todas as tampas, verificando se eles estão completamente clicado no lugar e, em seguida, desligue o sistema e ligue novamente. </li></ol><img alt="A Figura 1" src="/files/ftp_upload/51878/51878fig1.jpg" /> Figura 1. O photoelectric sistema consiste de luz-transmissor (T) e de recepção de luz (R) unidades que são colocados paralelamente uns aos outros com uma distância de cerca de 1 m. A câmara está instalada perto da área de início para fins de controlo. O laptop é conectado com cabos USB para o primeiro bar R e para a câmera. <a href="https://www.jove.com/files/ftp_upload/51878/51878fig1highres.jpg" target="_blank">Por favor clique aqui para ver uma versão maior desta figura.</a> 2. Instalação e Preparação de um Teste de Software <ol><li> Carregue o software que opera o sistema fotoelétrico de www.optogait.com/Support/Downloads. Nota: Este protocolo é descrito usando a versão 1.8.1. </li><li> Se o software é usado pela primeira vez para análise da marcha criar um novo ensaio do seguinte modo (em contrário avançar para o passo 2.3): <ol><li> Selecione Teste em seguida, clique em Definir / Modificar testes. Agora clique em prova da Marcha e selecione Duplicate teste.Clique em Confirmar na janela pop-up para que o teste é repetido. </li><li> Clique duas vezes no teste duplicado para modificar o nome (por exemplo, teste de caminhada de 10 bars) e selecionar 10 para o número de barras. Use os parâmetros padrão para o teste de marcha, que são apresentados na Figura 2. Por fim, selecione Salvar para salvar todas as modificações. </li></ol></li><li> Adicionar um novo paciente para o banco de dados. Selecione pacientes, clique em Inserir / Modificar paciente, e em seguida, clique em New paciente para inserir os dados. Em seguida, salvar os dados. </li></ol><img alt="A Figura 2" src="/files/ftp_upload/51878/51878fig2.jpg" /> Figura 2. configurações padrão para um teste de marcha com 10 bares, tal como descrito no presente protocolo. Estes ajustes têm de ser definido quando o sistema fotoeléctrica é usado pela primeira vez. Neste protocolo o pé partida não está definido.O sistema começa a medir quando o paciente entra na área de gravação e pára medir quando o paciente deixa as unidades de medição. <a href="https://www.jove.com/files/ftp_upload/51878/51878fig2highres.jpg" target="_blank">Por favor clique aqui para ver uma versão maior desta figura.</a> 3. Procedimentos de teste <ol><li> Sempre dar as mesmas instruções para o paciente 13. <ol><li> Instrua o paciente a andar com sapatos de sola plana ao longo da de 10 m passarela em duas velocidades diferentes: normal (&quot;andar em um ritmo que seja confortável para você&quot;), e mais rápido do que o normal (&quot;andar em um ritmo que é mais rápido que que normalmente a pé &quot;). </li><li> Peça ao paciente para olhar para a frente durante os ensaios de locomoção. </li><li> Peça ao paciente para iniciar a primeira etapa com o mesmo pé para melhor padronização das condições de teste. </li><li> Peça para o paciente começar a andar 2 m antes da primeira barra fotoelétrico e concluir cada trial 2 m após a última barra, a fim de manter a velocidade da marcha constante 13. </li></ol></li><li> Demonstrar um ensaio com velocidade normal ao paciente. </li><li> Solicite o paciente a realizar três ensaios de familiarização seguidas de um ensaio experimental em cada velocidade. Sempre ensaios de velocidade normais completos primeiros. </li><li> Para se preparar com o software, clique em Testar e, em seguida, em Executar para iniciar as medições com o teste criado. <ol><li> Selecione o paciente clicando em Select, a escolha do paciente e, em seguida, clique em Confirmar. </li><li> Selecione o teste clicando em Select, e escolhendo a exemplo de teste, teste de caminhada de 10 bares. Verifique se apenas este teste for selecionado para a medição. </li><li> Coloque a câmera de modo que ele pode gravar toda a caminhada. Mude a posição da câmera enquanto verifica a imagem ao vivo na tela de seu laptop. </li><li> Por fim, clique em Executarnovamente. NOTA: Agora, o software está pronto para medir. Assim que o paciente entra as barras, o sistema começa a medir e uma janela pop-up aparece pedindo ao pé inicial. </li></ol></li><li> Clique com o pé apropriado de modo que os parâmetros da marcha será calculado correctamente. NOTA: A câmera grava automaticamente uma vez que o teste é iniciado. </li><li> Salve o teste. </li></ol> Análise 4. Dados <ol><li> Clique em Resultados para exibir os ensaios completos. Em seguida, clique na seta ao lado do teste de interesse para transferir o teste a partir da lista de teste para a seção de análise de teste. Agora clique em Exibir para exibir o teste selecionado. Consulte a seção de resultados em todos os testes realizados neste estudo. NOTA: Uma janela com todos os dados de teste é exibida (Figura 3). No lado esquerdo da janela há alguns botões de comando para ativar várias funções. A outra parte da janela apresenta 4 types de informação sobre o teste atual. Cada conjunto de informações pode ser mostrado / escondido usando os comandos de configuração. De cima para baixo os itens são os seguintes: vídeo, gráficos exibindo os resultados, tabela com dados numéricos, e bares fotoelétricos. </li><li> Clique em dados da marcha para apresentar um relatório de marcha (Figura 3). </li><li> Clique em Imprimir (a janela com o relatório aparece) para imprimir o relatório. NOTA: O relatório pode ser impresso como é ou pode ser modificado. Para os diferentes parâmetros espaço-temporais, os seguintes resultados são apresentados no relatório: valores médios ± desvio padrão (SD) de lado a esquerda e para a direita, os coeficientes de variação (CV) expressando marcha Variabilidade 14,15, e a percentagem de diferença entre o lado esquerdo eo do lado direito (assimetria). <ol><li> Se necessário, modificar o relatório da seguinte forma: abrir o relatório como descrito acima (passo 4.3). Clique nos botões Mostrar ou Ocultar no sid esquerdae da tela para adaptar os dados apresentados e gráficos do relatório. </li><li> Para mudar o logotipo e / ou o rodapé do relatório, clique no botão respectivo (Alterar logotipo ou alterar rodapé) para modificar esses parâmetros. </li></ol></li><li> Para comparar dois ou mais testes realizados em diferentes ocasiões, por exemplo, antes e depois de uma intervenção, selecione os diferentes testes na seção de resultados, clicando na seta ao lado para os testes e, em seguida, clique no botão Comparar. NOTA: Um relatório com a comparação direta de todos os parâmetros dos diferentes testes é exibido. </li></ol><img alt="A Figura 3" src="/files/ftp_upload/51878/51878fig3.jpg" /> Figura 3. tela de todos os dados de teste. Os botões de comando aparecer no lado esquerdo da janela (por exemplo, clicando em Imprimir um relatório é gerado, que pode ser eventualmente alterada). A outraparte da janela apresenta as seguintes informações sobre o teste atual, de cima para baixo: vídeo, gráficos mostrando os resultados, a tabela com dados numéricos, e bares fotoelétricos. Esses detalhes podem ser mostrados / oculto utilizando o botão Configurar no lado direito. A visão real dos dados pode ser alterado clicando-se em dados da marcha ou marcha relatório, respectivamente. <a href="https://www.jove.com/files/ftp_upload/51878/51878fig3highres.jpg" target="_blank">Por favor clique aqui para ver uma versão maior desta figura.</a>

<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>

Os autores não têm nada a revelar.

O protocolo apresentado aqui pode ser usado para avaliar os parâmetros espaciais e temporais da marcha de pacientes (ortopédicas, neurológicas, cardiorrespiratórias, etc.) e idosos saudáveis ​​com um sistema fotoelétrico recém-introduzido. A largura e comprimento total do sistema pode ser modulado consoante o espaço e orçamento disponível. O custo estimado (na Europa) é de aproximadamente 2.800 dólares por metro para um sistema de 10 metros e um comprimento mínimo recomendado é de 3 metros para anális...

Caminhar é uma das atividades físicas mais importantes na vida cotidiana, e é um elemento determinante da qualidade de vida das populações idosas e doentes que apresentem deteriorações da marcha. A avaliação clínica da função de marcha, é importante para revelar potenciais alterações induzidas pelo envelhecimento e / ou patologias neurológicas / ortopédicos, mas também para provar os benefícios funcionais de um tratamento. Diferentes instrumentos têm sido desenvolvidos para a avaliação quantitativa dos parâmetros da marcha, por exemplo, plataformas de força, análise de movimento 3D baseado em vídeo, acelerômetros montados em corpo 10,11, e instrumentados tapetes de passarela ou esteiras 12. No entanto, estes sistemas são utilizados principalmente para estudos de investigação, e não para fins clínicos, porque eles são complexos de operar, têm baixa acessibilidade, e sensores frágeis. Um sistema fotoeléctrica à base de piso foi recentemente introduzido, que é capaz de proporcionar uma cal válidoculação de características temporais e 1D coordenadas espaciais de pé passos. Este instrumento de medição tem várias vantagens em comparação com os sistemas de pré-existentes: é fácil de manusear, os dados são recolhidos muito rapidamente, é simples para criar um relatório pormenorizado e é um sistema modular, o que significa que o comprimento do sistema pode ser alterada . Assim, ele pode ser usado com confiança para medir dentro do grupo mudanças nas avaliações longitudinais e diferenças entre os grupos em comparações transversais. As metas do protocolo descrito estão a concentrar-se sobre o equipamento e sua instalação, e para descrever de forma objetiva e direta os procedimentos de avaliação de avaliação dos parâmetros espaço-temporais da marcha em populações idosas e doentes.

<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

Características espaciais e temporais do andar humano são freqüentemente avaliados para identificar possíveis deficiências da marcha, principalmente em pacientes ortopédicos e neurológicos 1-4, mas também em idosos saudáveis ​​5,6. A análise quantitativa da marcha descrito no presente protocolo é realizada com um sistema recentemente fotoeléctrica-introduzido (ver tabela Materiais), que tem o potencial para ser utilizado na clínica, porque ele é portátil, fácil de montar (nenhuma preparação sujeito é necessária antes de um teste ), e não requer manutenção e calibração do sensor. O sistema consiste de fotoeléctrica série de células fotoeléctricas baseados no piso de alta densidade com diodos emissores de luz e de recepção de luz que são colocados paralelamente uns aos outros para criar um corredor, e estão orientadas perpendicularmente à linha de progressão 7. O sistema simplesmente detecta interrupções no sinal de luz, por exemplo devido à presença de pé dentro da área de gravação. Temporalparâmetros da marcha e 1D coordenadas espaciais de etapas consecutivas são posteriormente calculado para fornecer parâmetros de marcha comuns, tais como comprimento do passo, suporte único membro e curta velocidade 8, cuja validade contra um instrumento critério foi recentemente demonstrado 7,9. Os procedimentos de medição são muito simples; um único paciente pode ser testado em menos de 5 minutos e um relatório global pode ser gerado em menos de 1 min.

Um estudo recente demonstrou a validade do sistema fotoelétrico contra um instrumento critério (uma passarela eletrônico validado) para a avaliação dos parâmetros espaço-temporais da marcha em pacientes ortopédicos e idosos saudáveis ​​controles 7. As mesmas diferenças entre os grupos em variáveis ​​da marcha foram detectados pelos dois sistemas. Apesar de validade concorrente foi excelente, com coeficientes de correlação intraclasse variando entre 0,933 e 0,999 (p &lt;0,001), um viés si...

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.

Avaliação Clínica de espaço-temporal parâmetros da marcha em pacientes mais velhas e adultos

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

clinical-assessment-spatiotemporal-gait-parameters-patients-older

Research

JoVE Journal

Medicine

13.7K visualizações.  Schulthess Clinic. 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.

Vídeo: Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults

Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers

Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations.

We demonstrate: (1) procedures for collection of salivary samples in cognitive impaired older adults by family caregivers in the home setting, (2) procedures for measuring stress activity via salivary cortisol and alpha amylase, and (3) representative profiles. Protocols that allow researchers to study stress-linked processes advance our understanding of biological sensitivity and susceptibility.

Salivary measures have emerged in bio-behavioral research  that are easy-to-collect, minimally invasive, and relatively inexpensive  biologic markers of ...

Medicina

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this is only partially explained by traditional CVD risk factors. Vascular dysfunction is an important non-traditional risk factor, characterized by vascular endothelial dysfunction (most commonly assessed as impaired endothelium-dependent dilation [EDD]) and stiffening of the large elastic arteries. While various techniques exist to assess EDD and large elastic artery stiffness, the most commonly used are brachial artery flow-mediated dilation (FMDBA) and aortic pulse-wave velocity (aPWV), respectively. Both of these noninvasive measures of vascular dysfunction are independent predictors of future cardiovascular events in patients with and without kidney disease. Patients with CKD demonstrate both impaired FMDBA, and increased aPWV. While the exact mechanisms by which vascular dysfunction develops in CKD are incompletely understood, increased oxidative stress and a subsequent reduction in nitric oxide (NO) bioavailability are important contributors. Cellular changes in oxidative stress can be assessed by collecting vascular endothelial cells from the antecubital vein and measuring protein expression of markers of oxidative stress using immunofluorescence. We provide here a discussion of these methods to measure FMDBA, aPWV, and vascular endothelial cell protein expression.

The degree of vascular dysfunction and contributing physiological mechanisms can be assessed in patients with chronic kidney disease by measuring brachial artery flow-mediated dilation, aortic pulse-wave velocity, and vascular endothelial cell protein expression.

Avaliação da função vascular em pacientes com doença renal crônica

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this ...

A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients

Intracranial pressure (ICP) monitoring is now widely used in neurosurgical critical patients. Besides mean ICP value, the ICP derived parameters such as ICP waveform, amplitude of pulse (AMP), the correlation of ICP amplitude and ICP mean (RAP), pressure reactivity index (PRx), ICP and arterial blood pressure (ABP) wave amplitude correlation (IAAC), and so on, can reflect intracranial status, predict prognosis, and can also be used as guidance of proper treatment. However, most of the clinicians focus only on the mean ICP value while ignoring these parameters because of the limitations of the current devices. We have recently developed a multimodality monitoring system to address these drawbacks. This portable, user-friendly system will use a data collecting and storing device to continuously acquire patients&#39; physiological parameters first, i.e., ABP, ICP, and oxygen saturation, and then analyze these physiological parameters. We hope that the multimodality monitoring system will be accepted as a key measure to monitor physiological parameters, to analyze the current clinical status, and to predict the prognosis of the neurosurgical critical patients.

Recently, we have developed a portable multimodality monitoring system for the monitoring of various physiological parameters in neurosurgical critical patients. Detailed protocols on how to use this multimodality monitoring system are presented here.

Um protocolo detalhado para parâmetros fisiológicos aquisição e análise em pacientes críticos neurocirúrgicos

Intracranial pressure (ICP) monitoring is now widely used in neurosurgical critical patients. Besides mean ICP value, the ICP derived parameters such as ...

Severe Burn Injury in a Swine Model for Clinical Dressing Assessment

Wound healing is a dynamic repair process and is the most complex biological process in human life. In response to burn injury, alterations in biological pathways impair the inflammation response, resulting in delayed wound healing. Impaired wound healing frequently occurs in patients with diabetes leading to unfavorable outcomes such as amputation. Hence, dressings having beneficial effect in promoting burn wound repair are needed. However, studies on burn wound treatment are limited due to lack of proper animal models. Our previous study demonstrated wound-healing performance in rat and swine models using a minimally invasive surgical technique. This study aimed to demonstrate a swine model of severe burn injury that eliminates wound contraction and more closely approximates the human processes of re-epithelialization and new tissue formation. This protocol provides a detailed procedure for creating consistent burn wounds and examining the wound-healing performance under the treatment of an experimental dressing in a swine model. Six burn wounds were created symmetrically on the dorsum, which were covered with a clinical dressing composed of four layers: an inner contact layer of experimental materials, an inner intermediate layer of waterproof film, an outer intermediate layer of gauze, and an outer layer of adhesive plaster. Upon the completion of experiments, wound closure, wound area, and Vancouver Scar Scale score were examined. The samples of skin resected from each animal post-sacrifice were histologically prepared and stained using hematoxylin and eosin staining. Antibacterial activity of each dressing in the context of wound healing was also examined. The application of the clinical dressing to the wounds in swine model mimics the biological processes of human wound healing with respect to the processes of epithelialization, cellular proliferation, and angiogenesis. Therefore, this swine model provides an easy-to-learn, cost-effective, and robust method to assess the effect of clinical dressings in severe burn injury.

To closely mimic the mode of burn injuries requires the interplay between clinical observation and studies in animal models. In this study, a swine model of severe burn injury was established to assess an experimental dressing in physiological and pathophysiological settings.

Queimadura grave lesão em um modelo de suíno para avaliação clínica de vestir

Wound healing is a dynamic repair process and is the most complex biological process in human life. In response to burn injury, alterations in biological ...

Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy

While the number of new treatment options tested in patients with Duchenne muscular dystrophy (DMD) is increasing, there is still no defining of the most reliable assessments regarding therapeutic efficacy. We present clinical and radiological outcome measures used in ambulatory patients participating in our trial &#34;Treatment with L-citrulline and metformin in Duchenne muscular dystrophy&#34;. The motor function measure is a validated test in patients with neuromuscular disorders that consists of 32 items and assesses all three dimensions of motor performance including standing and transfer (D1 subscore), axial and proximal motor function (D2 subscore), and distal motor function (D3 subscore). The test shows high intra- and inter-rater variability but only when strictly following guidelines of the materials, examination steps, and calculation of scores. The 6-minute walk test, timed 10-meter walk/run test, and supine-up time are commonly used timed functional tests that also sufficiently monitor changes in muscle function; however, they strongly depend on patient collaboration. Quantitative MRI is an objective and sensitive biomarker to detect subclinical changes, though the examination costs may be a reason for its limited use. In this study, a high correlation between all clinical assessments and quantitative MRI scans was found. The combinational use of these methods provides a better understanding about disease progression; however, longitudinal studies are needed to validate their reliability.

The aim of this study is to present the most reliable clinical outcome measures and their correlations with quantitative muscle MRI in ambulant patients with Duchenne muscular dystrophy.

Medições da função motora e outros parâmetros de resultados clínicos em Ambulant crianças com Distrofia Muscular de Duchenne

While the number of new treatment options tested in patients with Duchenne muscular dystrophy (DMD) is increasing, there is still no defining of the most ...

Multi-Modal Home Sleep Monitoring in Older Adults

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and research participants. Home sleep testing has gained momentum in the field of sleep medicine due to its convenience and lower cost, as well as being more naturalistic. The accuracy and quality of home sleep testing, however, may be variable because studies are not monitored by sleep technologists. There has been some success in improving the accuracy of home sleep studies by having trained sleep technicians assist participants inside their homes with putting on the devices, but this can be intrusive and time-consuming for those involved. In this protocol, participants undergo at-home sleep monitoring with multiple devices: 1) a single-channel EEG device; 2) a home sleep test for sleep-disordered breathing and periodic limb movements; 3) actigraphy; and 4) sleep logs. A major challenge of this study is obtaining high-quality sleep monitoring data on the first attempt in order to minimize participant burden. This protocol describes the implementation of educational manuals with step-by-step instructions and photos. The goal is to improve the quality of home sleep testing.

Here, we present a protocol to improve the quality of data from home sleep testing by providing a method to enhance instructions through a structured participant visit. This protocol includes the implementation of a step-by-step educational manual with photos to ensure proper placement of equipment.

Multi-Modal casa sono monitoramento em adultos mais velhos

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and ...

Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis

This protocol provides guidance on how to perform high resolution video rasterstereography and treadmill gait analysis on patients after lumbar fusion surgery to obtain results about altered variables of gait and posture. These observed changes can then be correlated with the patient-reported outcome measure of pain relief. The rasterstereographic device projects lines of parallel light onto the surface of the tested subject&#39;s back. The deformation of these lines is recognized by the device. From these data, a special software then generates a 3-D profile based on the principle of triangulation. With an inaccuracy of only 0.2 mm it can measure changes in posture at very high precision. Gait and stance parameters are recorded using a treadmill equipped with an electric sensor mat that contains 10,200 miniature force sensors in the registering zone under the belt. Initial walking speed on the treadmill is 0.5 km/h. Speed is then gradually increased by increments of 0.1 km/h until each subject reaches his or her individual maximum well tolerable walking speed. At this speed, parameters are recorded during a 20 s measurement interval. Subjects are tested barefoot and without holding a handrail. Among various other parameters, stride width, step length, stance phase and foot rotation are measured. Both methods used reportedly have a high intra- and inter-observer reliability. The advantage of these highly accurate techniques is that they offer an objective and very detailed perspective on changes in the patient&#39;s posture and gait. Due to the amount of data generated, these techniques are, however, not so much suitable for everyday routine use, but rather interesting to scientifically evaluate long term alterations in posture and gait in patients like for example after lumbar fusion surgery.

Evaluation of Patients&#039; Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis

Here, we present a protocol to analyze the posture and the gait of patients after lumbar fusion surgery by means of high-resolution video rasterstereography and a treadmill equipped with an integrated sensor mat. Allowing critical functional postoperative evaluation on a less subjective level may enhance accuracy and reliability of indication for surgery.

Avaliação da postura e da marcha perfil depois da cirurgia de fusão lombar por vídeo Rasterstereography e análise de marcha de esteira dos pacientes

This protocol provides guidance on how to perform high resolution video rasterstereography and treadmill gait analysis on patients after lumbar fusion ...

Invasive Hemodynamic Assessment for the Right Ventricular System and Hypoxia-Induced Pulmonary Arterial Hypertension in Mice

Pulmonary arterial hypertension (PAH) is a chronic and severe cardiopulmonary disorder. Mice are a popular animal model used to mimic this disease. However, the evaluation of right ventricular pressure (RVP) and pulmonary artery pressure (PAP) remains technically challenging in mice. RVP and PAP are more difficult to measure than left ventricular pressure because of the anatomical differences between the left and right heart systems. In this paper, we describe a stable right heart hemodynamic measurement method and its validation using healthy and PAH mice. This method is based on open-chest surgery and mechanical ventilation support. It is a complicated procedure compared to closed chest procedures. While a well-trained surgeon is required for this surgery, the advantage of this procedure is that it can generate both RVP and PAP parameters at the same time, so it is a preferable procedure for the evaluation of PAH models.

Here, we present a protocol to perform an invasive hemodynamic assessment of the right ventricle and pulmonary artery in mice using an open-chest surgery approach.

Avaliação Hemodinâmica Invasiva para o Sistema Ventricular Direito e hipertensão arterial pulmonar induzida por hipóxia em camundongos

Pulmonary arterial hypertension (PAH) is a chronic and severe cardiopulmonary disorder. Mice are a popular animal model used to mimic this disease. ...

A Training Program Using an Agility Ladder for Community-Dwelling Older Adults

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. The purpose of this study is to report the physical fitness benefits of a training program for independent community-dwelling older adults using an agility ladder. Each training session lasted approximately 30 minutes, and the benefits were achieved with two sessions per week for 14 weeks. Training was timed and involved four different drills and varying levels of difficulty through time. The exercises were performed at the School of Physical Education of the University of Campinas, S&#227;o Paulo state, Brazil. The study participants (n = 16; mean age of 66.9 &#177; 5.0 years) were instructed to perform the exercises as quickly as possible without making mistakes and were assisted by a physical trainer when they made mistakes. Assessments were performed both before and after training using five functional tests (i.e., Illinois agility, five times sit-to-stand, timed up-and-go, walking usual speed, and one-leg stand). Although the study sample was not compared with a control group, the results indicate that training protocols using an agility ladder are easy and practical and improve physical function performance in older adults.

The aim of this study is to present an agility training program for older people. The feasibility of this program is described, and the training protocol demonstrated by video imaging.

Um programa de treinamento usando uma escada de agilidade para idosos residentes na comunidade

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. ...

Oral Health Assessment by Lay Personnel for Older Adults

Oral health is an often-undervalued contributor to overall health. The literature, however, underscores the myriad of systemic diseases influenced by oral health, including type II diabetes, heart disease, and atherosclerosis. Thus, assessments of oral health, called oral screenings, have a significant role in assessing risk of disease, managing disease, and even improving disease by oral care. Here we present a method to assess oral health quickly and consistently across time. The protocol is simple enough for non-oral health professionals such as students, family, and caregivers. Useful for any age of patient, the method is particularly key for older individuals who are often at risk of inflammation and chronic disease. Components of the method include existing oral health assessment scales and inventories, which are combined to produce a comprehensive assessment of oral health. Thus, oral characteristics assessed include intraoral and extraoral structures, soft and hard tissues, natural and artificial teeth, plaque, oral functions such as swallowing, and the impact this oral health status has on the patient&#39;s quality of life. Advantages of this method include its inclusion of measures and perceptions of both the observer and patient, and its ability to track changes in oral health over time. Results acquired are quantitative totals of questionnaire and oral screening items, which can be summed for an oral health status score. The scores of successive oral screenings can be used to track the progression of oral health across time and guide recommendations for both oral and overall health care.

The goal of this protocol is to enable non-dental professionals to assess oral health status for research or health-screening purposes. Aspects assessed include lips, tongue, soft and hard tissues, natural and artificial teeth, oral cleanliness, plaque, swallowing, and impact of oral health on quality of life.

Avaliação em Saúde Bucal por Leigo para Idosos

Oral health is an often-undervalued contributor to overall health. The literature, however, underscores the myriad of systemic diseases influenced by oral ...