| 1. |
- Agustsson, A., et al.
(author)
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Validity and reliability of an iPad with a three-dimensional camera for posture imaging
- 2019
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In: Gait and Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 68, s. 357-362
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Journal article (peer-reviewed)abstract
- Background: It is important to quantify a static posture to evaluate the need for and effectiveness of interventions such as physical management, physiotherapy, spinal orthosis or surgical treatment on the alignment of body segments. Motion analysis systems can be used for this purpose, but they are expensive, require a high degree of technical experience and are not easily accessible. A simpler method is needed to quantify static posture. Research objective: Assess validity and inter and intra rater reliability using an iPad with a 3-D camera to evaluate posture and postural deformity. Method: A 3-D model of a lying posture, created using an iPad with a 3-D camera, was compared to a Qualisys motion analysis system of the same lying posture, the latter used as the gold standard. Markers on the trunk and the leg were captured by both systems, and results from distance and angle measurements were compared. Results: All intra-class correlation coefficient values were above 0.98, the highest systematic error was 4.3 mm for length measurements and 0.2° for angle measurements. Significance: A 3-D model of a person, with markers on anatomical landmarks, created with an iPad with a 3-D camera, is a valid and reliable method of quantifying static posture. Conclusion: An iPad with a 3-D camera is a relatively inexpensive, valid and reliable method to quantify static posture in a clinical environment.
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| 2. |
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| 3. |
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| 4. |
- Bartonek, Asa, et al.
(author)
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A new carbon fibre spring orthosis for children with plantarflexor weakness
- 2007
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 25:4, s. 652-656
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Journal article (peer-reviewed)abstract
- We tested a new orthosis with a carbon fiber spring constructed to enable energy storing during increasing dorsiflexion in mid-stance, and to use the energy at the end of stance phase to aid push-off. The orthosis was tested on children with plantarflexor weakness due to motor disorders. All subjects were tested with 3D gait analysis with both the new orthosis and with their regularly used orthosis. In this technical note, the results of three individuals are reported. The preliminary findings show increased dorsiflexion, altered knee kinematics and improved kinetic and temporo-spatial parameters. Although the carbon spring orthosis influenced the subjects' gait in different ways, we conclude that the tested subjects with plantarflexion weakness benefit from the carbon fiber spring orthoses during walking. The parents' and children's subjective impressions as acquired from a questionnaire were also positive.
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| 5. |
- Bartonek, Asa, et al.
(author)
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Influence of heel lifts during standing in children with motor disorders
- 2011
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 34:3, s. 426-431
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Journal article (peer-reviewed)abstract
- Heel wedges may influence standing posture but how and to what extent are unknown. Thirty-two children with motor disorders - 16 with arthrogryposis multiplex congenita (AMC) and 16 with cerebral palsy (CP) - and 19 control children underwent a three-dimensional motion analysis. Unassisted standing during 20s with shoes only and with heel lifts of 10,20 and 30 mm heights was recorded in a randomized order. The more weight-bearing limb or the right limb was chosen for analysis. In both the AMC and CP groups, significant changes were seen between various heel lifts in ankle, knee and pelvis, and in the control group in the ankle only. Between orthosis and non-orthosis users significant differences were seen between different heel lift conditions in ankle, knee and trunk in the AMC group and in the ankle in the CP group. Pelvis position changed toward less anterior tilt with increasing heel height, but led to increasing knee flexion in most of the children, except for the AMC Non-Ort group. Children with AMC and CP represent different motor disorders, but the heel wedges had a similar influence on pelvis, hip and knee positions in all children with CP and in the AMC orthosis users. A challenge is to apply heel heights adequate to each individual's orthopaedic and neurologic conditions to improve biomechanical alignment with respect to all body segments.
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| 6. |
- Bartonek, A., et al.
(author)
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The influence of spasticity in the lower limb muscles on gait pattern in children with sacral to mid-lumbar myelomeningocele : a gait analysis study
- 2005
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 22:1, s. 10-25
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Journal article (peer-reviewed)abstract
- Gait analysis and recording of standing position were performed in 38 ambulatory children with myelomeningocele. Thirty-four were independent ambulators and four required a walking aid. All subjects were assigned one of four muscle function groups based on muscle strength. They were also divided into subgroups based on the distinction between flaccid and spastic paresis in the lower limb joints. A comparison was made between the gait pattern of the children with spasticity and that of the children with flaccid paresis in each muscle function group. Spasticity in only the ankle joint muscles influenced the subject's gait and standing position compared to the subgroups with a flaccid paresis. Even larger deviations in gait and standing position were observed when spasticity occurred in muscles at the knee and hip joints. When setting ambulatory goals the presence of additional neurological symptoms such as spasticity and inadequate balance should be taken into consideration.
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| 7. |
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| 8. |
- Bendt, Martina, et al.
(author)
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Gait and dynamic balance in adults with spina bifida
- 2022
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 96, s. 343-350
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Journal article (peer-reviewed)abstract
- BACKGROUND: Spina bifida (SB) is a complex congenital malformation, often causing impaired gait performance depending on the level and extent of malformation. Research regarding gait and balance performance in adults with SB, has not been sufficiently described yet.RESEARCH QUESTION: What are the characteristics of spatiotemporal gait parameters and balance performance in adults with SB? Further, do persons with muscle function (MF) level 3 differ regarding gait and balance performance from those with MF level 1-2?METHODS: Cross-sectional observational study at an outpatient clinic. 41 adults with SB (18-65 years), who walked regularly. Spatiotemporal parameters of gait was assessed with the APDM system and balance performance with the Mini Balance Evaluation Systems Test (Mini-BESTest). Muscle strength in the legs was assessed with 0-5 manual muscle test, and participants were classified according to level of MF into groups MF1, MF2, and MF3. Two-sided t-test was used for parametric independent variables, and Cohen's d was used for effect sizes. The Mann-Whitney U test was used for non-parametric independent data and effect size was calculated by the z value (r = z/√n).RESULTS: Mean gait speed was 0.96 (SD 0.20) m/s and mean stride length 1.08 m (SD 0.17), individuals with MF3 showed significantly slower gaitspeed and shorter stride length (p < 0.05). Lumbar rotation was 21° (SD 11), and thoracic lateral sway 15° (IQR 15) with significantley difference (p < 0.001 and p < 0.05) for individuals in MF3. Mini-BESTest showed a mean score of 11.3 (SD 6.9), and individuals with MF3 showed significantly lower scores (p ≤ 0.001).SIGNIFICANCE: Gait and balance performance was reduced compared to normative data in almost all parameters, especially in persons with less muscle function. Increased knowledge from advanced gait analysis may help healthcare professionals to design rehabilitation programmes, in order to achieve and maintain a sustainable gait and balance performance.
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| 9. |
- Benoit, Daniel L, et al.
(author)
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Effect of skin movement artifact on knee kinematics during gait and cutting motions measured in vivo
- 2006
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In: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; 24:2, s. 152-164
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Journal article (peer-reviewed)abstract
- Eight healthy male subjects had intra-cortical bone-pins inserted into the proximal tibia and distal femur. Three reflective markers were attached to each bone-pin and four reflective markers were mounted on the skin of the tibia and thigh, respectively. Roentgen-stereophotogrammetric analysis (RSA) was used to determine the anatomical reference frame of the tibia and femur. Knee joint motion was recorded during walking and cutting using infrared cameras sampling at 120Hz. The kinematics derived from the bone-pin markers were compared with that of the skin-markers. Average rotational errors of up to 4.4 degrees and 13.1 degrees and translational errors of up to 13.0 and 16.1mm were noted for the walk and cut, respectively. Although skin-marker derived kinematics could provide repeatable results this was not representative of the motion of the underlying bones. A standard error of measurement is proposed for the reporting of 3D knee joint kinematics.
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| 10. |
- Blomqvist, Sven, 1964-, et al.
(author)
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Postural muscle responses and adaptations to backward platform perturbations in young people with and without intellectual disability
- 2014
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 39:3, s. 904-908
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Journal article (peer-reviewed)abstract
- This study examines postural muscle responses to backward perturbations in young people (16-20 years) with and without intellectual disability (ID). The study included 56 young people with ID and 43 age-matched without ID volunteers. The subjects stood on a platform that was moved backwards in a surface translation. Lower and upper leg muscles and lower back spine muscles were recorded with surface electromyography (EMG). Muscle onset latency, time to peak amplitude (EMG), adaptation of muscle responses to repeated perturbations (using integrated EMG (IEMG) for epochs), and synergies and strategies were assessed. The result showed no differences between the two groups in muscle onset latency, synergies, and strategies. Young people with ID reduced their time to peak amplitude in investigated muscles, a response that was different from the group without ID. Also, young people with ID tended to adapt their IEMG less compared to the controls. These findings suggest that young people with ID have limited ability to use somatosensory information and adapt their postural muscle responses to repeated external perturbations.
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| 11. |
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| 12. |
- Bäcklund, Tomas, et al.
(author)
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Trunk sway in idiopathic normal pressure hydrocephalus : quantitative assessment in clinical practice
- 2017
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In: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; , s. 62-70
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Journal article (peer-reviewed)abstract
- Background: In diagnosis and treatment of patients with idiopathic normal pressure hydrocephalus (iNPH), there is need for clinically applicable, quantitative assessment of balance and gait. Using a body worn gyroscopic system, the aim of this study was to assess postural stability of iNPH patients in standing, walking and during sensory deprivation before and after cerebrospinal fluid (CSF) drainage and surgery. A comparison was performed between healthy elderly (HE) and patients with various types of hydrocephalus (ventriculomegaly (VM)).Methods: Trunk sway was measured in 31 iNPH patients, 22 VM patients and 58 HE. Measurements were performed at baseline in all subjects, after CSF drainage in both patient groups and after shunt surgery in the iNPH group.Results: Preoperatively, the iNPH patients had significantly higher trunk sway compared to HE, specifically for the standing tasks (p < 0.001). Compared to VM, iNPH patients had significantly lower sway velocity during gait in three of four cases on firm support (p < 0.05). Sway velocity improved after CSF drainage and in forward-backward direction after surgery (p < 0.01). Compared to HE both patient groups demonstrated less reliance on visual input to maintain stable posture.Conclusions: INPH patients had reduced postural stability compared to HE, particularly during standing, and for differentiation between iNPH and VM patients sway velocity during gait is a promising parameter. A reversible reduction of visual incorporation during standing was also seen. Thus, the gyroscopic system quantitatively assessed postural deficits in iNPH, making it a potentially useful tool for aiding in future diagnoses, choices of treatment and clinical follow-up.
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| 13. |
- Cedervall, Ylva, et al.
(author)
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A longitudinal study of gait function and characteristics of gait disturbances in individuals with Alzheimer's disease
- 2014
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 39:4, s. 1022-1027
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Journal article (peer-reviewed)abstract
- Walking in daily life places high demands on the interplay between cognitive and motor functions. A well-functioning dual-tasking ability is thus essential for walking safely. The aims were to study longitudinal changes in gait function during single- and dual-tasking over a period of two years among people with initially mild AD (n = 21). Data were collected on three occasions, twelve months apart. An optical motion capture system was used for three-dimensional gait analysis. Gait parameters were examined at comfortable gait speed during single-tasking, dual-tasking naming names, and naming animals. The dual-task cost for gait speed was pronounced at baseline (names 26%, animals 35%), and remained so during the study period. A significant (p < 0.05) longitudinal decline in gait speed and step length during single- and dual-tasking was observed, whereas double support time, step width and step height showed inconsistent results. Systematic visual examination of the motion capture files revealed that dual-tasking frequently resulted in gait disturbances. Three main characteristics of such disturbances were identified: Temporal disturbance, Spatial disturbance and Instability in single stance. These aberrant gait performances may affect gait stability and increase the risk of falling. Furthermore, the observed gait disturbances can contribute to understanding and explaining previous reported gait variability among individuals with AD. However, the role that dual-task testing and aberrant dual-task gait performance play in the identification of individuals with early signs of cognitive impairment and in predicting fall risk in AD remains to be studied.
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| 14. |
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| 15. |
- Coury, H. J. C. G., et al.
(author)
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Change in knee kinematics during gait after eccentric isokinetic training for quadriceps in subjects submitted to anterior cruciate ligament reconstruction
- 2006
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In: Gait & Posture. - : Elsevier BV. - 1879-2219 .- 0966-6362. ; 24:3, s. 370-374
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Journal article (peer-reviewed)abstract
- Knee kinematics after anterior cruciate ligament (ACL) reconstruction is of interest in studies evaluating the effect of training programs. Many studies have addressed knee flexion/extension but not valgus/varus movements. Considering that joint stability is a major concern in ACL reconstruction surgery, movements occurring in the frontal plane of the knee also deserve attention. Knee extensor torque was analyzed by an isokinetic dynamometer and the angular amplitudes and velocities of flexion/extension and valgus/varus movements were analyzed by goniometry during gait 9 months after ACL reconstruction. The analysis was repeated after 3 months of eccentric isokinefic training of the quadriceps in five patients. The gait pattern was also recorded for 10 healthy controls. The knee extensor torque and flexion/extension range of movement during gait increased significantly after training. However, an unexpectedly increased valgus, most pronounced during the swing phase, which may imply adverse effects on the knee, was also observed in the ACL reconstructed knee. The recorded valgus angles may however be overestimated due to crosstalk. Thus, the extent of the increased valgus, as well as the mechanisms involved and the functional and clinical implications, need clarification before eccentric training after ACL reconstruction can be generally recommended. (C) 2005 Elsevier B.V. All rights reserved.
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| 16. |
- Crommert, Martin Eriksson, et al.
(author)
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Activation of transversus abdominis varies with postural demand in standing
- 2011
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In: Gait & Posture. - Amsterdam : Elsevier. - 0966-6362 .- 1879-2219. ; 33:3, s. 473-477
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Journal article (peer-reviewed)abstract
- Transversus abdominis (TrA) is a multifunctional muscle, being involved in pressure regulation within the abdominal cavity and thereby in direction independent stabilization of the spine and resistance to imposed trunk flexion moments. Indirect evidence suggests a role of TrA also in postural control of the erect human trunk. The main purpose here was to investigate if the magnitude of TrA activation is related to postural demand. Eleven healthy males performed seven different symmetrical static bilateral arm positions holding 3kg in each hand. The arm positions were selected to systematically vary the height of the centre of mass (COM) keeping imposed moments constant and vice versa. EMG was recorded bilaterally with fine-wire intramuscular electrodes from TrA and obliquus internus (OI) and with surface electrodes from rectus abdominis (RA) and erector spinae (ES). Intra-abdominal pressure (IAP) was measured via a pressure transducer in the gastric ventricle. TrA was the only muscle that displayed activation co-varying with the vertical position of the COM. Further, TrA activation increased, together with IAP and ES activation, with imposed flexion moment, i.e. with arms extended horizontally forward. In contrast to OI, RA and ES, TrA activation was independent of the direction of the imposed moment (arms held inclined forward or backward). In conclusion, TrA activation level is uniquely associated with increased postural demand caused by elevated COM. Also, TrA appears to assist in counteracting trunk flexion via increased IAP, and contribute to general spine stabilization when the trunk is exposed to moderate flexion and extension moments.
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| 17. |
- Dahlgren, Gunilla, et al.
(author)
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Test-retest reliability of step counts with the ActivPAL™ device in common daily activities.
- 2010
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In: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; 32:3, s. 386-90
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Journal article (peer-reviewed)abstract
- The ActivPAL device is a well-established physical activity monitor for assessment of physical activity. AIM: To investigate test-retest reliability of step counts and establish minimal detectable changes (MDC) in step count to account for intra device error over time in various physical activities. METHODS: Healthy participants (n=24, age range, 19-28 years) performed activities on two occasions, 1 week apart, in a laboratory setting; self-paced floor walking, treadmill walking at three different speeds (3.2 km/h, 4.5 km/h and 4.5 km/h with incline), treadmill jogging (8.0 km/h), stair walking and cycling on an exercise bike at three speeds (45 rpm, 60 rpm and 75 rpm). Relative reliability was calculated using intraclass correlation coefficient (ICC) and Spearman correlation. Absolute reliability was assessed using standard error of measurement (SEM) and coefficient of repeatability (CR). RESULTS: The ActivPAL showed high to very high relative reliability for treadmill walking at all speeds and stair walking, while self-paced normal floor walking showed moderate reliability. The absolute reliability was the best for treadmill walking activities, slightly increased for self-paced walking, followed by stair walking and jogging. The use of activity monitors during cycling has been questioned and our results confirm a low absolute and relative reliability. MDC values varied according to the type of activity e.g. treadmill walking 4.5 km/h (10 steps), walking on the floor (45 steps). Data loss in this study (10-13%) was higher than previously reported. CONCLUSIONS: The ActivPAL is reliable for treadmill walking, jogging and self-paced walking. MCD varies according to the activity and should be considered when establishing true change over time.
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| 18. |
- Dozza, Marco, 1978, et al.
(author)
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What is the most effective type of audio-biofeedback for postural motor learning?
- 2011
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In: Gait Posture. - : Elsevier BV. - 1879-2219 .- 0966-6362. ; 34:3, s. 313-9
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Journal article (peer-reviewed)abstract
- Biofeedback is known to improve postural control and reduce postural sway. However, the effects that different biofeedback modes (coding for more or less complex movement information) may have on postural control improvement are still poorly investigated. In addition, most studies do not take into account the effects of spontaneous motor learning from repetition of a task when investigating biofeedback-induced improvement in postural control. In this study, we compared the effects of four different modes of audio-biofeedback (ABF), including direction and/or magnitude of sway information or just a non-specific-direction alarm, on the postural sway of 13 young healthy adults standing on a continuously rotating surface. Compared to the non-specific-direction alarm, ABF of continuous postural sway direction and/or amplitude resulted in larger postural sway reduction in the beginning of the experiment. However, over time, spontaneous postural motor learning flattened the effects of the different modes of ABF so that the alarm was as effective as more complex information about body sway. Nevertheless, motor learning did not make ABF useless, since all modes of ABF further reduced postural sway, even after subjects learned the task. All modes of ABF resulted in improved multi-segmental control of posture and stabilized the trunk-in-space. Spontaneous motor learning also improved multi-segmental control of posture but not trunk-in-space stabilization as much as ABF. In conclusion, although practice standing on a perturbing surface improved postural stability, the more body sway information provided to subjects using ABF, the greater the additional improvement in postural stability.
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| 19. |
- Eek, Meta Nyström, et al.
(author)
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Kinematic gait pattern in children with cerebral palsy and leg length discrepancy: Effects of an extra sole
- 2017
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In: Gait and Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 55, s. 150-156
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Journal article (peer-reviewed)abstract
- The gait pattern in children with cerebral palsy (CP) often differs from normal, with slow velocity, problem with foot clearance and increased stress on joints. Several factors, such as muscle tone, impaired motor control, muscle contractures, skeletal deformities and leg length discrepancy affect gait. Leg length discrepancy can be treated surgically or with elevation of the shoe on the short leg. The purpose of this study was to examine whether compensating for leg length discrepancy, with elevation of the sole, leads to a change in movement pattern during walking in children with spastic CP. Results: Ten children with spastic CP, able to walk without aids, and 10 typically developing (TD) children aged between seven and 14 years were assessed with 3D gait analysis: 1) barefoot, 2) with shoes and 3) with an extra sole beneath the shoe for the shorter leg. All children with CP had a leg length discrepancy of more than or equal to 1.0 cm. In the barefoot condition, the velocity was slower and the stride length was shorter, in children with CP compared with TD. The stride length and gait velocity increased in children with CP with shoes and shoe + sole and the stance time became more symmetrical. Among children with CP, there was more flexion in the longer leg relative to the short leg during barefoot walking. Differences in the kinematic pattern between the long and the short leg decreased with the extra sole.
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| 20. |
- Eek, Meta Nyström, et al.
(author)
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Muscle strength and kinetic gait pattern in children with bilateral spastic CP.
- 2011
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In: Gait & posture. - : Elsevier BV. - 1879-2219 .- 0966-6362. ; 33:3, s. 333-7
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Journal article (peer-reviewed)abstract
- Cerebral palsy is often associated with an abnormal gait pattern. This study put focus on relation between muscle strength and kinetic gait pattern in children with bilateral spastic cerebral palsy and compares them with a reference group. In total 20 children with CP and 20 typically developing children participated. They were all assessed with measurement of muscle strength in eight muscle groups in the legs and a 3-dimensional gait analysis including force data. It was found that children with CP were not only significantly weaker in all muscle groups but also walked with slower velocity and shorter stride length when compared with the reference group. Gait moments differed at the ankle level with significantly lower moments in children with CP. Gait moments were closer to the maximal muscle strength in the group of children with CP. Furthermore a correlation between plantarflexing gait moment and muscle strength was observed in six of the eight muscle groups in children with CP, a relation not found in the reference group. A similar pattern was seen between muscle strength and generating ankle power with a rho=0.582-0.766. The results of this study state the importance of the relationship of the overall muscle strength pattern in the lower extremity, not only the plantarflexors.
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| 21. |
- Eek, Meta Nyström, et al.
(author)
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Single-leg vertical jumping in young adults with spastic cerebral palsy
- 2023
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In: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; 103, s. 1-5
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Journal article (peer-reviewed)abstract
- Background: Maximum-strength tests are commonly used to detect muscle weakness in persons with cerebral palsy (CP). Tests of explosive strength (power) in the lower extremities, such as vertical jump tests, are more uncommon but might supplement maximum-strength testing by providing additional information about motor function. Research question: Is it feasible and useful to measure single-leg vertical jumping in young adults with CP? Methods: Eleven persons with spastic CP (18-30 years), able to walk without support, were compared with a reference group. Jump height and power generation in jumping were measured using a 3D motion-analysis system and force plates. Maximum strength in plantarflexors was measured on the same occasion. Data were analysed using non-parametric statistics. Results: Jump height was significantly greater in the reference group than in the group with CP, both relative to the less-involved leg of the participants with CP (p = .007) and relative to their more-involved leg (p < .001). In the group with CP, jump height was twice as great for the less-involved leg than for the more-involved leg (p = .008). Power generation at the hip joint was similar between the groups but differed for the knee and ankle joints (p = .001-.033). In the reference group, most of the power was generated at the ankle joint, while the hip was the dominant power generator for the more-involved leg in the group with CP. Muscle strength in the group with CP showed a high correlation with jump height (rho = .745, p < .001) and power generation at the ankle (rho = .780, p = .001). Significance: The single-leg vertical jump test proved capable of measuring jump height and power generation in participants with CP. It also identified explosive muscle weakness both relative to a reference group and between legs. Hence the jump test may provide information additional to common tests of maximal muscle strength in persons with CP.
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| 22. |
- Elhadi, Mustafa M. O., et al.
(author)
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Biomechanical approach in facilitating long-distance walking of elderly people using footwear modifications
- 2018
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In: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; 64, s. 101-107
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Journal article (peer-reviewed)abstract
- Background: Long-distance walking is a convenient way for prompting physical activity of elderly people. However, walking ability declines with aging.Research question: This study assessed if silicone insoles with heel lifts (named here the prescribed insoles) could facilitate long-distance walking of older adults.Methods: Fifteen adults aged over 65, who did not have obvious lower-limb problems, walked on a treadmill for totally 60 min in two separate walking sessions: 1) with the prescribed insoles, and 2) with original insoles of the standardized shoes. Gait tests using force plates and a motion analysis system, and subjective evaluation using visual analog and Borg's CR10 scales were conducted at different time points of the treadmill walking.Results: Objective gait anaylsis showed that without using the prescribed insoles, there were significant reductions (p < 0.05) in stance time, vertical ground reaction force, ankle dorsiflexion angle and ankle power generation of the dominant leg after the 60-minute treadmill walk. Such significant reductions were not observed in the same group of subjects upon using the prescribed insoles. Meanwhile, significant improvements in subjective perception of physical exertion, pain and fatigue were observed.Significance: Heel lifts and silicone insoles are generally used to relieve plantar pain and reduce strain of plantar flexors in patients. This study showed they might also be solutions to facilitate long-distance walking of older adults, an approach which could prompt their physical activity.
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| 23. |
- Elmgren Frykberg, Gunilla, 1957-, et al.
(author)
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Impact of stroke on anterior-posterior force generation prior to seat-off during sit-to-walk
- 2012
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 35:1, s. 56-60
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Journal article (peer-reviewed)abstract
- Force generation during sit-to-walk (STW) post-stroke is a poorly studied area, although STW is a common daily transfer giving rise to a risk of falling in persons with disability. The purpose of this study was to describe and compare strategies for anterior-posterior (AP) force generation prior to seat-off during the STW transfer in both subjects with stroke and in matched controls. During STW at self-selected speed, AP force data were collected by 4 force plates, beneath the buttocks and feet from eight subjects with stroke '(>6 months after onset) and 8 matched controls. Subjects with post-stroke hemiparesis and matched controls generated a similar magnitude of total AP force impulses (F-1.71 = 0.67; p = 0.42) beneath buttocks and feet prior to seat-off during STW. However, there were significant group differences in AP force impulse generation beneath the stance buttock (i.e. the non-paretic buttock in the stroke group), with longer duration (F-1.71 = 8.78; p <0.005), larger net AP impulse (F-1.71 = 6.76; p < 0.05) and larger braking impulse (F-1.71 = 7.24; p <0.05) in the stroke group. The total braking impulse beneath buttocks and feet was about 4.5 times larger in the stroke group than in the control group (F-1.71 = 8.84; p < 0.005). An intra-and inter-limb dys-coordination with substantial use of braking impulses was demonstrated in the stroke group. This motor strategy differed markedly from the smooth force interaction in the control group. These results might be important in the development of treatment models related to locomotion post-stroke.
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| 24. |
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| 25. |
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| 26. |
- Fransson, Per-Anders, et al.
(author)
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Methods for Evaluation of Postural Control Adaptation
- 2000
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In: Gait & Posture. - 1879-2219. ; 12:1, s. 14-24
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Journal article (peer-reviewed)abstract
- New methods were developed to determine the dynamic changes of postural control during the initial exposure to large perturbances of stance. The adjustments of postural control over time in measured anteroposterior torque, were investigated in ten normal subjects. Perturbations of stance were evoked by two high intensity vibrators applying pseudorandom stimulation either to the calf muscles or the paravertebral muscles of the neck. The new methods use a system identification approach, which distinguishes between feedback control, adaptation of postural responses and adaptation to stimulus. This approach makes it possible to quantify motion dynamics and complexity, stimulus impact and adjustments of postural control. Quantification of the different adaptive responses could be useful for diagnostic purposes, in evaluating treatment efficacy and patient progress in rehabilitation programs.
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| 27. |
- Fredrik, Öhberg, et al.
(author)
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Gait analysis using a portable motion sensor system : measurements in subjects with hip implant as compared with healthy controls
- 2013
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 38:suppl 1, s. 99-100
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Journal article (peer-reviewed)abstract
- Introduction: There is an increase of age related diseases such as hip joint arthritis, something that is often treated with hip replacement surgery. The aim of this study was to quantify movement function and its effect on quality of life in persons treated with hip implant, in comparison to matched asymptomatic controls.Patients/Materials and Methods: This is an ongoing study, and so far, 2 asymptomatic subjects (CTRL, age 50 ± 13 years, BMI 23 ± 2), and 4 subjects with hip implant (HIP, age 51 ± 15 years, BMI 25 ± 3), have been analyzed. The HIP group received their implant 2.6 ± 1.1 years ago and finished their rehabilitation 1.6 ± 1.1 years ago. Hip dysfunction and Osteoarthritis Outcome Score (HOOS) was used to assess the subject's hip function and its associated problems. A functional calibration (flexion/abduction movements) was done and each subject then performed 5 repetitions of gait (approx. 25 left/right gait cycles). Movement was registered with a custom-developed portable motion sensor system, where each sensor consisted of a tri-axial accelerometer and gyroscope. Sensors were placed on pelvis and each thigh and shank. Further calculations were done in MATLAB (v7.12 R2011a, Mathworks). Cosine rotation matrices were extracted by functional sensor-to- segment-calibration and sensor fusion [1], and hip and knee angles were obtained as Euler angles.Results: Preliminary results indicated larger range in hip rotation and smaller range of knee flexion during gait in HIP group than in the CTRL group (Fig. 1). HOOS profile (Fig. 2) indicated that hip function during sports (SP) and the general quality of life (QOL) were lower in the HIP group.Fig. 1. Mean and SD of hip and knee angle over 15 gait cycles in one HIP subject (blue) as compared with the CTRL group (black). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)Figure optionsFig. 2. HOOS profiles in HIP (blue square) and CTRL group (black). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)Figure optionsDiscussion and conclusions: Motion patterns during gait seemed to be negatively affected in subjects with hip implant, even after the rehabilitation program was completed and even though the HOOS profiles indicated a relative good hip function.Reference[1]J. Favre, B.M. Jolles, O. Siegrist, K. AminianQuaternion-based fusion of gyroscopes and accelerometers to improve 3D angle measurement
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| 28. |
- Frossard, L., et al.
(author)
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Apparatus for monitoring load bearing rehabilitation exercises of a transfemoral amputee fitted with an osseointegrated fixation: a proof-of-concept study
- 2010
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In: Gait & Posture. - : Elsevier BV. - 1879-2219 .- 0966-6362. ; 31:2, s. 223-228
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Journal article (peer-reviewed)abstract
- The purpose of this proof-of-concept study was to determine the relevance of direct measurements to monitor the load applied on the osseointegrated fixation of transfemoral amputees during static load bearing exercises. The objectives were (A) to introduce an apparatus using a three-dimensional load transducer, (B) to present a range of derived information relevant to clinicians, (C) to report on the outcomes of a pilot study and (D) to compare the measurements from the transducer with those from the current method using a weighing scale. One transfemoral amputee fitted with an osseointegrated implant was asked to apply 10 kg, 20 kg, 40 kg and 80 kg on the fixation, using self-monitoring with the weighing scale. The loading was directly measured with a portable kinetic system including a six-channel transducer, external interface circuitry and a laptop. As the load prescribed increased from 10 kg to 80 kg, the forces and moments applied on and around the antero-posterior axis increased by four-fold anteriorly and 14-fold medially, respectively. The forces and moments applied on and around the medio-lateral axis increased by nine-fold laterally and 16-fold from anterior to posterior, respectively. The long axis of the fixation was overloaded and underloaded in 17% and 83% of the trials, respectively, by up to + or - 10%. This proof-of-concept study presents an apparatus that can be used by clinicians facing the challenge of improving basic knowledge on osseointegration, for the design of equipment for load bearing exercises and for rehabilitation programs.
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| 29. |
- Frykberg E, Gunilla, 1957-, et al.
(author)
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The Arm Posture Score for assessing arm swing during gait : An evaluation of adding rotational components and the effect of different gait speeds
- 2014
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 40:1, s. 64-69
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Journal article (peer-reviewed)abstract
- In 3D gait analysis, quantification of leg movements is well established, whereas ameasure of armswing has been lacking. Recently, the Arm Posture Score (APS) was introduced to characterize arm movements in children with cerebral palsy, including information from four variables (APS(4)) in the sagittal and frontal planes. A potential limitation of the APS is that it does not include rotational movements and has not yet been evaluated with regard to gait speed. The aims of this study were (i) to investigate the effect on APS of adding two components of arm rotation (APS(6)) and (ii) to determine the influence of gait speed on the APS measures, when applied to non-disabled adults. Forty-two subjects walked 10 m at a selfselected speed (1.34 m/s), and in addition a subgroup of 28 subjects walked at a slowspeed (0.66 m/s) set by a metronome. Data were collected from markers in a whole-body set up and by eight optoelectronic cameras. The results demonstrated significantly higher APS(6) than APS(4) values for both arms, irrespective of gait speed. Speed condition, whether self-selected or slow, had a significant effect on both APS measures. The two additional arm components are suggested to provide relevant information about arm swing during walking. However, APS(6) needs to be implemented in gait analysis of individuals with gait arm pathologies in order to further examine its utility. Werecommend that gait speed should to be taken into account when using APS measures to quantify arm swing during gait. (C) 2014 Elsevier B. V. All rights reserved.
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| 30. |
- Gomez, S., et al.
(author)
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Differences between body movement adaptation to calf and neck muscle vibratory proprioceptive stimulation
- 2009
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In: Gait & Posture. - : Elsevier BV. - 1879-2219 .- 0966-6362. ; 30:1, s. 93-99
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Journal article (peer-reviewed)abstract
- Adaptation is essential in maintaining stability during balance-challenging situations. We studied, ill standing subjects with eyes open and closed, adaptive responses of the anteroposterior head, shoulder, hip and knee movements: gastrocnemius and tibialis anterior EMG activity and anteroposterior body Posture when proprioceptive information from the neck or calf muscles underwent vibratory perturbations. After 30 s of quiet stance, vibratory stimuli were applied repeatedly for 200 s, and adaption to stimulation was analyzed in four successive 50 s periods. Repeated neck and calf vibration significantly increased linear body movement variance at all recorded sites (p < 0.001, except neck stimulation with eyes closed, EC-neck), increased tibialis anterior (p < 0.001, except EC-neck) and gastrocnemious muscle activity (p < 0.001). Most body movement variances and tibialis anterior EMG activity decreased significantly over time (most p-values < 0.01 or lower) and overall, the body leaning forward increased from 5.5 degrees to 6.5 degrees (p < 0.01). The characteristics of the responses were influenced by vision and site of vibration, e.g., neck vibration affected body Posture more rapidly than calf vibration. Our findings support the notion that proprioceptive perturbations have different effects in terms of nature, degree and adaptive response depending on site of vibratory proprioceptive stimulation, a factor that needs consideration in clinical investigations and design of rehabilitation programs. (C) 2009 Elsevier B.V. All rights reserved.
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| 31. |
- Grip, Helena, et al.
(author)
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Three dimensional kinematic analyses of finger movement control and association to brain activity responses : A pilot study on healthy individuals
- 2017
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 57, s. 355-
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Journal article (peer-reviewed)abstract
- Introduction: An increased knowledge of how the brain control finger movements give us keys to understand the recovery of motor function after a brain injury. This knowledge is crucial for the development of reliable and valid assessment methods in the clinical evaluation of hand function.Research question: How are individual finger movements represented in the brain? Investigating the associations between kinematics and brain activity responses in healthy individuals.Methods: Keeping the others still. Finger movements were performed lying in the MR scanner in order to register brain activity response during the task. Optoelectronic cameras simultaneously monitored the positions of reflective markers affixed to each finger. The marker position data were used to calculate each finger's movement frequency (MF), movement independence (“Individuation Index”, II), stationary ability (Stationarity Index, SI)[1][1]. fMRI data was analyzed by contrasting the finger movements against its active rest.Results: Preliminary analyses showed that (1) the finger movements primarily activate sensorimotor areas in the contralateral hemisphere (Fig. 1A), (2) that use of kinematic parameters in the fMRI analyses improved spatial specificity and (3) II engage a number of cortical areas, while MF engage fewer areas (Fig. 1B–D). Further analyses will further explore activations maps for each individual finger.Discussion: The inclusion of movement parameters in the fMRI analyses improves the specificity in the derived activation map, increasing the interpretability of the neural correlates of movement control. This advancement carries the promise for the development of better assessment methods of the recovery of function post-stroke with usability in rehabilitation practices.
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| 32. |
- Gullstrand, Lennart, et al.
(author)
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Measurements of vertical displacement in running, a methodological comparison
- 2009
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 30:1, s. 71-75
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Journal article (peer-reviewed)abstract
- The aim was (1) to evaluate measurements of vertical displacements (V-disp) of a single point on sacrum as an estimate of the whole body centre of mass (CoM) V-disp during treadmill running and (2) to compare three methods for measuring this single point. These methods were based on a position transducer(PT), accelerometers (AMs) and an optoelectronic motion capture system. Criterion method was V-disp of the whole body CoM measured with the motion capture system. Thirteen subjects ran at 10, 12, 14, 16. 18, 20 and 22 km h(-1) with synchronous recordings with the three methods. Four measurements of the (V-disp) were derived: (1) V-disp of CoM calculated from a segment model consisting of 13 segments tracked with 36 reflective markets, (2) V-disp of the sacrum recorded with the PT, (3) V-disp of the sacrum Calculated from the AM, and (4) V-disp of the sacrum calculated as the mid point of two reflective markets (sacrum marker, SM) attached at the level of the sacral bone. The systematic discrepancy between the Measurements of sacrum V-disp and CoM V-disp varied between 0 and 1.5 mm and decreased with increasing running velocity and decreasing step duration. PT and SM measurements showed strong correlation, whereas the AM showed a variability increasing with velocity. The random discrepancy within each Subject was 7 mm for all three methods. In conclusion single-point recordings of the sacrum V-disp may be used to monitor changes in V-disp of CoM during treadmill running.
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| 33. |
- Gutierrez, Elena M, 1973-, et al.
(author)
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Kinetics of compensatory gait in persons with myelomeningocele
- 2005
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 21:1, s. 12-23
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Journal article (peer-reviewed)abstract
- This study investigated the kinetic strategy and compensatory mechanisms during self-ambulatory gait in children with lumbo-sacral myelomeningocele. Thirty-one children with mid-lumbar to low-sacral myelomeningocele who walked without aids and 21 control children were evaluated by three-dimensional gait analysis. Joint moments in all planes at the hip and knee and sagittal moments at the ankle, as well as joint power and work done at all three joints, were analyzed. Joint moment capacity lost due to plantarflexor and dorsiflexor weakness was provided instead by orthotic support, but other joints were loaded more to compensate for the weakness at the ankles and restricted ankle motion. Subjects with total plantarflexor and dorsiflexor paresis and strength in the hip abductors had more knee extensor loading due to plantarflexor weakness and dorsiflexion angle of the orthotic, ankle joint. The subjects with orthoses also generated more power at the hip to supplement the power generation lost to plantarflexor weakness and fixed ankles. The most determinant muscle whose paresis changes gait kinetics was the hip abductor. Hip abductor weakness resulted in a characteristic pattern where the hips displayed an eccentric adduction moment, mediating energy transfer into the lower limbs, and the hips replaced the knees as power absorbers in early stance. Joint moment, power and work analyses complement a kinematic analysis to provide a complete picture of how children who have muscle paresis recruit stronger muscle groups to compensate for weaker ones.
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| 34. |
- Gutierrez-Farewik, Elena M., et al.
(author)
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Centre of mass motion during gait in persons with myelomeningocele
- 2003
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In: Gait & Posture. - 0966-6362 .- 1879-2219. ; 18:2, s. 37-46
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Journal article (peer-reviewed)abstract
- The movement of the centre of mass in the vertical and lateral directions during gait in children with myelomeningocele was analyzed. The children were classified into five groups depending on the successive paresis of lower limb muscle groups and compared to a control group. In the groups with. dorsi- and plantarflexor weakness, the excursions increased and an anterior trend in the centre of mass was observed. In the groups with additional abductor paresis, the lateral excursion was highest and the vertical excursion low due to increased transverse and frontal motion and reduced sagittal motion. With further paresis of the hip extensors, the centre of mass was more posteriorly positioned due to compensatory trunk extension. Improved understanding of individual children's solutions to their muscle paresis can be obtained by visualizing the centre of mass relative to the pelvis. Centre of mass analyses in myelomeningocele offer an important complement to standard gait analysis.
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| 35. |
- Gutierrez-Farewik, Elena M., et al.
(author)
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Characteristic gait kinematics in persons with lumbosacral myelomeningocele
- 2003
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In: Gait & Posture. - 0966-6362 .- 1879-2219. ; 18:3, s. 170-177
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Journal article (peer-reviewed)abstract
- Thirty self-ambulatory children with mid-lumbar to low-sacral myelomeningocele who walked without aids and 21 control children were evaluated by three-dimensional gait analysis. Characteristic kinematic patterns and parameters in the trunk, pelvis, hip, knee and ankle were analyzed with respect to groups with successive weakness of the ankle plantarflexor, ankle dorsiflexor, hip abductor, hip extensor and knee flexor muscles. Extensive weakness of the plantarflexors resulted in kinematic alterations in the trunk, pelvis, hip and knee and in all three planes seen as knee flexion, anterior pelvic tilt and trunk and pelvic rotation. Additional extensive weakness of the dorsiflexors made little difference in the walking strategy. Large kinematic alterations in all planes were observed where there was a large extent of additional weakness of the hip abductor but strength remaining in the hip extensors. In this group, gait was characterized by large lateral sway of the trunk, rotation of the trunk and pelvis, pelvic hike and increased extension of the knees. In the group with total poresis hip extensors but yet some knee flexion, gait was similar to the previous group but there was less sagittal plane movement greates and posterior trunk tilt. Gait analysis provides an understanding of the compensatory strategies employed in these patients. Clinical management can be directed towards stabilizing the lower extremities and accommodating large upper body motion to preserve this method of self-ambulation even in children who have considerable hip extensor and abductor weakness.
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| 36. |
- Halvorsen, Kjartan, et al.
(author)
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Minimal marker set for center of mass estimation in running
- 2009
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 30:4, s. 552-555
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Journal article (peer-reviewed)abstract
- The purpose was to study the validity of a recently proposed method [Forsell C, Halvorsen K. A method for determining minimal sets of markers for the estimation of center of mass, linear and angular momentum. journal of Biomechanics 2009;42(3):361-5] for estimating the trajectory of the whole-body center of mass (CoM) in the case of running at: velocities ranging from 10 to 22 km h(-1). The method gives an approximation to the CoM using the position of fewer markers on the body than the standard method of tracking each segment of the body. Fourteen male athletes participated. A standard method for determining the CoM from a model of 13 segments and using the position of 36 markers was used as reference method. Leave-one-out cross-validation revealed errors that decreased with increasing number of markers used in the approximative method. Starting from four markers, the error in absolute position of the CoM decreased from 15 mm to 3 mm in each direction. For the velocity of the CoM the estimation bias was neglectable, and the random error decreased from 0.15 to 0.05 m s(-1). The inter-subject and intra-subject variability in the estimated model parameters increased with increasing number of markers. The method worked well also when applied to running at velocities outside the range of velocities in the data used to determine the model parameters. The results indicate that a model using 10 markers represents a good trade-off between simplicity and accuracy, but users must take into account requirements of their specific applications.
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| 37. |
- Harringe, M L, et al.
(author)
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Postural control measured as the center of pressure excursion in young female gymnasts with low back pain or lower extremity injury.
- 2008
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 28:1, s. 38-45
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Journal article (peer-reviewed)abstract
- Gymnasts are known to practice and compete although suffering from injuries and pain. Pain may change strategies for postural control. The primary aim of the present study was to investigate how center of pressure (COP) measurements are influenced by low back pain and lower extremity injury in top-level female gymnasts. A secondary aim was to study the reliability of these measurements using a test-retest design, and how this depends on the duration of the test. Fifty-seven top-level gymnasts were included in four groups: non-injured (NI, n=18), low back pain (LBP, n=11), lower extremity injury (LEI, n=17) and a multiple injury group (MI, n=11). COP excursion during quiet stance was measured on a force platform, during 120s: (1) hard surface/eyes open, (2) hard surface/eyes closed, (3) foam surface/eyes open and (4) foam surface/eyes closed. The COP excursion increased, for all groups, during the foam surface/eyes closed measurement compared to the other three tests. Furthermore, the LBP group showed a 49% (p=0.01) larger COP area compared to the LEI group in the foam surface/eyes closed condition. Measurements on foam surface were in general more reliable than tests on hard surface and tests with eyes closed were more reliable than tests with eyes open. Tests during 120s were in most cases more reliable than tests during 60s. In conclusion the COP excursion is influenced by injury location. Quiet stance measurements on foam surface with eyes closed seems to be reliable and sensitive in young female gymnasts.
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| 38. |
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| 39. |
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| 40. |
- Heintz, Sofia, et al.
(author)
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Static optimization of muscle forces during gait in comparison to EMG-to-force processing approach
- 2007
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 26:2, s. 279-288
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Journal article (peer-reviewed)abstract
- Individual muscle forces evaluated from experimental motion analysis may be useful in mathematical simulation, but require additional musculoskeletal and mathematical modelling. A numerical method of static optimization was used in this study to evaluate muscular forces during gait. The numerical algorithm used was built on the basis of traditional optimization techniques, i.e., constrained minimization technique using the Lagrange multiplier method to solve for constraints. Measuring exact muscle forces during gait analysis is not currently possible. The developed optimization method calculates optimal forces during gait, given a specific performance criterion, using kinematics and kinetics from gait analysis together with muscle architectural data. Experimental methods to validate mathematical methods to calculate forces are limited. Electromyography (EMG) is frequently used as a tool to determine muscle activation in experimental studies on human motion. A method of estimating force from the EMG signal, the EMG-to-force approach, was recently developed by Bogey et al. [Bogey RA, Perry J, Gitter AJ. An EMG-to-force processing approach for determining ankle muscle forcs during normal human gait. IEEE Trans Neural Syst Rehabil Eng 2005;13:302-10] and is based on normalization of activation during a maximum voluntary contraction to documented maximal muscle strength. This method was adapted in this study as a tool with which to compare static optimization during a gait cycle. Muscle forces from static optimization and from EMG-to-force muscle forces show reasonably good correlation in the plantarflexor and dorsiflexor muscles, but less correlation in the knee flexor and extensor muscles. Additional comparison of the mathematical muscle forces from static optimization to documented averaged EMG data reveals good overall correlation to patterns of evaluated muscular activation. This indicates that on an individual level, muscular force patterns from mathematical models can arguably be more accurate than from those obtained from surface EMG during gait, though magnitude must still be validated.
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| 41. |
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| 42. |
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| 43. |
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| 44. |
- Hodges, Paul W, et al.
(author)
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Intra-abdominal pressure response to multidirectional support-surface translation.
- 2004
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 20:2, s. 163-70
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Journal article (peer-reviewed)abstract
- A complex response of the trunk muscles occurs to restore equilibrium in response to movement of the support surface. Intra-abdominal pressure (IAP) is considered to contribute to control of the trunk. This study investigated the contribution of IAP to the postural response to multidirection support-surface translation. IAP was recorded with a thin-film pressure transducer inserted via the nose into the stomach and trunk motion was recorded with an optoelectronic system with markers over the spinous process of L1. A pattern of trunk movement was recorded in response to the support-surface translations that was consistent with a 'hip' strategy of postural control. The trunk moved in a manner appropriate to move the centre of gravity over the new base of support. IAP was increased with movement in each direction, but varied in timing and amplitude between translation directions. In general, the IAP was greater with translations in the sagittal plane compared to the frontal plane and was initiated earlier for translations in the backward direction. These data indicate that IAP contributes to the postural response associated with support-surface translation and suggest that this is consistent with stiffening the spine.
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| 45. |
- Houdijk, H., et al.
(author)
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Energy expenditure of stroke patients during postural control tasks
- 2010
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 32:3, s. 321-6
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Journal article (peer-reviewed)abstract
- Two common impairments in patients after stroke are loss of balance control and fatigue. We propose that both could be inter-related. The purpose of this study was to investigate the metabolic energy demand for balance control in patients after stroke during upright standing. Ten stroke patients and 12 able-bodied controls performed four 5-min upright standing tasks on a force plate; unperturbed (SU), blindfolded (SUB), on foam surface (SUF) and with feet parallel against each other (SUP). Metabolic energy expenditure, posturography measures and muscle activity (EMG) of lower leg muscles were measured. Patients required on average 125% (33Jkg(-1)s(-1)) more metabolic energy for upright standing under the various conditions than controls. In addition, balance manipulation significantly (p<0.05) affected energy expenditure (21% higher in SUB, 52% in SUF, 40% in SUP compared to SU). Although the increase in energy expenditure was on average twice as high in patients than controls no significant group by condition interaction effect was found. Overall correlations between posturography measures, EMG and energy expenditure (r=0.33-0.60) were significant (p<0.001). We conclude that impaired balance control puts an extra demand on the energy expenditure during motor activities in stroke patients. This should be considered when prescribing interventions aimed at reducing physiological strain.
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| 46. |
- Höglund, Anette, et al.
(author)
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Influence of dual tasks on sitting postural sway in children and adolescents with myelomeningocele
- 2009
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 30:4, s. 424-430
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Journal article (peer-reviewed)abstract
- Performing dual tasks, e.g. cognitive and motor tasks simultaneously, may be especially challenging to children with motor disorders. Changes in postural sway have been used to evaluate the effect of dual tasks. Increases in postural sway frequency and concurrent decrease in sway amplitude have been interpreted as tighter control of postural sway. The purpose of this study was to analyze postural sway under single and dual task conditions, while sitting. Thirteen children and adolescents with myelomeningocele and a matched control group were included in the study. The participants performed two single and two dual tasks each. The single task was a sitting still task. The dual tasks were one visual-spatial task and one executive task while simultaneously sitting still. Amplitude, velocity and frequency of center of pressure displacement of postural sway were analyzed between tasks and between groups. The results of the cognitive tasks were analyzed as well. The results revealed different patterns in the groups. During single tasks, the MMC group displayed significantly lower frequencies and velocities of center of pressure displacement compared to the control group. Adding the visual-spatial task influenced postural sway significantly in the control group, while adding the executive task influence the postural sway significantly in the MMC group. The myelomeningocele group confirmed our clinical experience by performing the cognitive tasks slowly but accurately. Further studies are needed to evaluate whether motor function, sensory function, structural anomalies in the brain or any other causes, separately or together, may explain the observed differences in the groups.
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| 47. |
- Iversen, Maura D., et al.
(author)
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Self-rated walking disability and dynamic ankle joint stiffness in children and adolescents with Juvenile Idiopathic Arthritis receiving intraarticular corticosteroid joint injections of the foot
- 2019
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In: Gait & Posture. - : ELSEVIER IRELAND LTD. - 0966-6362 .- 1879-2219. ; 67, s. 257-261
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Journal article (peer-reviewed)abstract
- Background: Children and adolescents with Juvenile Idiopathic Arthritis (JIA) exhibit deviations in ankle dynamic joint stiffness (DJS, or moment-angle relationship) compared to healthy peers, but the relationship between ankle DJS and self-reported walking impairments has not been studied. This secondary analysis aimed to investigate the relationship between ankle DJS and self-reported walking disability in juveniles with JIA, and to determine whether intraarticular corticosteroid foot injections (IACI) were associated with long term changes in ankle DJS. Research questions: Is ankle DJS altered in children with JIA reporting walking difficulties compared to children with JIA reporting no walking difficulties? Are IACIs associated with persistent alterations in ankle DJS? Methods: Gait dynamics (DJS), foot pain, and foot-related disability were assessed in 33 children with JIA before intraarticular corticoid foot injection (IACI), and three months after IACI. Using self-reported walking capacity scores, children were classified as either having no walking difficulties (ND) or having walking difficulties (WD). Inferential statistics were used to compare demographics, pain, impairment scores, and ankle DJS between the groups. Results: Before treatment, in the WD group, ankle DJS was significantly decreased both in the early rising phase (ERP = 0.03 +/- 0.02 vs. 0.05 +/- 0.02 Nm(kg*deg)(-1)) and late rising phase (LRP = 0.11 +0.06 vs. 0.24+0.22 Nm (kg*deg)(-1)) compared to the ND group. At three months, the ERP was still significantly decreased in the WD group (ERP = 0.03 +/- 0.01 vs. 0.05+0.03 Nm(kg*deg)(-1)). Significance: Among children and adolescents with JIA who reported walking difficulties prior to IACIs, alterations in DJS in early stance phase (decreased ERP) remained three months after IACI suggesting persistent gait adaptations, possibly related to pain. Pre-treatment gait analysis may aid in identifying children who will not have long term benefit from IACIs in terms of improved gait, and therefore, may be informed and have the choice to be spared the risk of side effects associated with this treatment.
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| 48. |
- Johansson, Anna-Maria, et al.
(author)
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Three dimensional kinematic analyses of movement control of individual fingers post-stroke
- 2015
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 42:Supplement 1, s. S33-S33
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Journal article (peer-reviewed)abstract
- Research question: Objectives of the present study are: (1) to quantify finger movements in a 3D context and (2) by this method investigate the ability to perform individualized finger movements, with and without vision of the hands, in persons with a chronic stroke diagnosis compared to able-bodied controls.Introduction: Increased knowledge of how fine movement control is affected by stroke is important for the understanding of recovery of function. This is crucial for the development of reliable and valid assessment methods for evaluation of rehabilitation of the upper limbs. This study is part of the MOST project (MOST-MOvement control in STroke) where both clinical tests and 3D movement assessments are performed.Materials and methods: At present, 18 persons post-stroke (M age = 67 years; 6 women) and 26 able-bodied controls (M age = 62 years, 11 women) have participated. The ability to perform uni-manual individualized finger movements and the effect of vison of the hands were evaluated. Participants were instructed to move a specific finger in cyclic extension–flexion movements at the metacarpophalangeal joint, keeping the rest of the finger straight and the other fingers still, at a self-paced speed during 10 s (2 test series for each hand; 8 test series in total). The task was performed seated. The wrists were extended about 10° and fixated to a wooden frame with forearm support. Reflective markers were affixed to each fingertip and movements were recorded by optoelectronic cameras. Based on the positional change of the fingers during task performance, two indices ranging from 0-1 were calculated: (1) Individuation index (II) where the independence of each finger movement is shown and where 1 indicate complete independence, (2) stationary index (SI) where 1 indicate that the finger remains still when the other fingers move [1].Results: Our results show that it is possible to quantify individual finger movements by use of 3D movement analysis addressing the quality of movement performance in stroke survivors: all but 3 persons post-stroke were able to perform the task. Preliminary analyses (based on a subsample constituted of 8 post-stroke and 8 controls) verify that the test discriminated between groups where participants post-stroke had lower values on II and SI as compared to the control persons, the lowest values were observed for the middle and ring fingers. Ongoing analyses will show if vision influences the outcomes.Discussion: A set-up has been tested where individual finger movements can be quantified in 3D, and that discriminates between persons post stroke compared to controls. This advancement carries a promise for development of better assessment methods for recovery of function post-stroke.Reference[1] C. Häger-Ross, M.H. Schieber Quantifying the independence of human finger movements: comparisons of digits, hands and movement frequencies.J Neurosci, 20 (2000), pp. 8542–8550
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| 49. |
- Johansson, Gudrun M., et al.
(author)
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Assessment of arm movements during gait in stroke : the Arm Posture Score
- 2014
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In: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 40:4, s. 549-555
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Journal article (peer-reviewed)abstract
- The purpose of the study was to apply the Arm Posture Score (APS) to a stroke population, since comprehensive measures to quantify arm swing in the affected and non-affected arms during gait are lacking. A further aim was to investigate how gait speed and upper limb function estimated by clinical measures are related to the APS in the stroke group. The APS is the summarized root mean square deviation (RMSD) from normal, based on kinematics. Four arm movements (sagittal and frontal planes) as well as six arm movements (incorporating transversal plane) were included in the calculation of APS, referred to as APS4 and APS6, respectively. The study population consisted of 25 persons with stroke and 25 age- and gender-matched controls. The APS measures were significantly different between the affected and non-affected arms, as well as between the affected arm and the non-dominant arm of the controls (p≤0.001). Spasticity significantly influenced both APS measures, while speed only had a significant effect on the APS4. The APS measures correlated significantly to clinical measures of upper limb function. Both APS measures seem to be useful indices to quantify and discriminate between impaired and normal arm swing during gait after stroke. The variability of rotational arm movements needs to be studied further before considering the additional value of the APS6 over the APS4. When interpreting the APS, complementary kinematics should be taken into account, as the single value of the APS gives no information about the direction of the deviation.
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- Johansson, Hanna, et al.
(author)
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Cognitive function and walking velocity in people with dementia : a comparison of backward and forward walking
- 2017
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In: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; 58, s. 481-486
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Journal article (peer-reviewed)abstract
- How forward and backward walking, both central to everyday life, relate to cognition are relatively unexplored in people with dementia. This study aimed to investigate if forward and backward walking velocity respectively, associated with global cognition and executive function in people with dementia, and whether the association differed according to walking aid use or dementia type. Using a cross-sectional design, 161 participants (77% women), a mean Mini-Mental State Examination (MMSE) score of 15, and mean age of 85.5 years and living in nursing homes were included. Self-paced forward walking (FW) and backward walking (BW) velocity over 2.4 m was measured. Global cognitive outcome measurements included MMSE and Alzheimer Disease Assessment Scale - Cognitive subscale (ADAS-Cog). Executive function was measured using Verbal Fluency (VF). In comprehensively adjusted multivariate linear regression analyses, FW was independently associated with VF (p = 0.001), but not MMSE (p = 0.126) or ADAS-Cog (p = 0.818). BW was independently associated with VF (p = 0.043) and MMSE (p = 0.022), but not ADAS-Cog (p = 0.519). Interaction analyses showed that the association between BW velocity and executive function were stronger in participants who walked without a walking aid. No associations differed according to dementia type. In conclusion, executive function appears important to walking velocity, both forward and backward, in people with dementia with mild to moderately severe cognitive impairment. Global cognitive function was associated with backward walking only, perhaps due to it being more challenging. The association between BW velocity and executive function differed according to use of walking aids, which appeared to attenuate the association.
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