Gait Assessment

The study will be a single-centered, crossover, randomized control trial which will aim to determine which foot condition, barefoot or shod, allows for best performance of the SEBT. The dependent variable is reach distance. The independent variable is the differing foot conditions, barefoot versus shod. The SEBT will produce continuous, ratio data measured in centimeters. A quantitative primary research approach will be used as quantitative measurements allow for statistical comparison between variables, which will allow the hypothesis to be accepted or rejected (Barker et al., 2016). 1:1 block randomization will be used in this study, with participant being randomly assigned to either barefoot or shod first groups of equal sizes using the crossover design. Randomization

A clinician, respectively, should produce the patient’s clinical history and results, as well as the measurement properties of the index, this well better format and put in place short- and long-term goals based on an individual-report functional scale like the LEFS (1). The intention of this research was to assess the reliability, construct validity, and sensitivity to change the Lower Extremity Functional Scale. This test was given to 107 patients with lower-extremity musculoskeletal dysfunction referred to twelve outpatient PT clinics. This index was dispensed during the patient’s initial assessment, 24 to 48 hours following the initial assessment, and then at weekly intervals for four weeks (1). A patient with an initial LEFS score of 56/80, an example of lower extremity functional scale is to create functional level, set goals, and track progress and outcome, based on the error at any specific position in time for the LEFS of five points, the therapist can be highly confident that the actual scale score is between 51 and 61 (1). The leeway, or error, associated with an assumed measure on the LEFS is about plus or minus five scale points (90% confident intervals). A clinician, ergo, can be moderately confident that an observed score within the parameter of five points of the patient’s “true” outcome (1). The short-form 36-health survey (SF-36) is a 36-item, patient-delivered

Because the administration of the BESTest takes from 45 to 60 minutes, which may not be practical in all clinical settings, a condensed shorter version of the BESTest (Mini-BESTest) was created. Through the basis of rash analysis, unnecessary items and 2 sections of the BESTest, biomechanical constrains and stability limits/vertically, were removed to yield the assessment of dynamic balance. The Mini-BESTest contains 14 items of the original 36 items from the BESTest. The items on the Mini-BESTest are scored on a 3 point scale ranging from (0) to (2). A score of (0) indicates the lowest level of function and a score of (2) indicates the highest level of function, leading to a possible total score of 28 points (Yingyongyudha et al., 2015).

The FGA compared closely with these other assessments from moderate to strong compatibility (.57 to .85). The comparative values of the FGA with the BBS, FAC, fast walking speed, ABC, Modified Hoehn and Yahr scale, BI, and MDS-UPDRS-03 ranged from .85,.78, .73, .72, .70, .69, .and 66. These correlations show a positive trend for the FGA being a reliable assessment for balance and gait of PD patients. The TUG and FGA did not correlate as closely with a .57, but this difference is assumed to be due to the fact that TUG measures one characteristic while the FGA measures provides more in depth views of gait and balance. Overall, the FGA concurrent validity still resulted as an efficient assessment to use.

The Ankle Foot Orthosis at the University of Delaware (AFOUD) contains 2-DOF (inversion/eversion and dorsiflexion/plantarflexion motion) using an actuator, a spring and a damper to steadily maintain appropriate foot position of patient \cite{agrawal2005}. The Knee-Ankle-Foot-Orthosis (KAFO) uses artificial pneumatic muscles being a powered orthosis in walking step \cite{sawicki2009}. The study of gait rehabilitation, human motor adaptation and locomotion energetics were previously done by their work of ankle-foot orthosis (AFO). The Robotic Gait Trainer (RGT) (Figure \ref{fig:rgt}) from the Arizona State University presented a walking device using a tripod mechanism

The primary innovative aspect of the project is to develop an evidence-based holistic and functional post-operative rehabilitation program for foot and ankle (F&A) pathologies treated surgically (novelty), by integrating valid and reliable functional field tests (FFT) of the foot and of the lower limb measured with inexpensive, widespread available, portable motion sensor devices (MSD) (novelty) in order to diagnose and to treat mal-adaptive motor control and movement impairments (MMCMI) which are not currently detectable in a clinical setting. This may in turn result in improved rehabilitation, less risk for post-operative complications, earlier discharge and quicker resumption of normal activities of the daily living, which would make foot and ankle surgery more cost-efficient

Gait analysis has been used previously as a diagnostic tool in relation to musculoskeletal diseases. More recently, it has been accepted as helpful in the clinical setting when defining rehabilitation and preventative practices. The purpose of gait analysis is to determine the cause or area of injury, to find the “incorrect movement.”

Achievement of normal gait patterns and speed is usually the main objective of gait training. Improvement of

Walking is the main form of locomotion in humans, being especially important in the independence of the elderly and their activities of daily living. Not only is it important for the elderly to maintain healthy gait, but gait difficulties have potential in affecting their psychological wellbeing and quality of life. This report will discuss the anatomy and biomechanics of normal gait, methods of gait analysis, and causes and biomechanics of abnormal gait - particularly in the elderly and post-fracture rehabilitation.

Gait speed is suitable for any patient for whom ambulation development is a objective which both comfortable (CGS) and fast gait speed (FGS). Therefore, should be tested comfortable gait speed is also called “habitual gait speed” in some studies have found that the ability in increase/decrease walking speed over or lower down a “comfortable” pace present normal, healthy walking and specify the likely to change to different environments (e.g. crowed hallways, crossing streets). Furthermore, many people with disablement have only one speed for mobility. However, Riley (2001) reports that propulsive alteration to speed changes occur firstly in the hip and secondarily at the ankle. So, in a study of what predicts gait variability in community-dwelling

A journal which discusses and characterises gait in terms of healthy and hemiparetic is “Characterization of gait pattern by 3D angular accelerations in hemiparetic and healthy gait”.

Gait means locomotion and evaluating locomotion by professionals is called gait analysis. Pattern of walking differ from one individual to another. A gait cycle consists of “the activities that occur from the point of initial contact of one lower extremity to the point at which the same extremity contacts the ground again”There are 2 phases of walking: stance phase ii. Swing phase. Stance phase covers from heels strike to toe. In this phase foot is on ground which acts as a shock absorber. Swing phase is non weight bearing phase in which weight is only on one foot during walking. Gait constitutes movement of whole body which involves biomechanical abnormalities like running, skipping, hopping etc. Gait analysis is performed by physiotherapist,

Gait is the manner in which somebody walks, we use gait analysis to study this. This can be done in a number of different ways, such as using sensors attached to the body. Gait analysis is important as it helps us to reduce somebody’s risk of falling which can be done by installing safety equipment such as grab bars in the home. In my experiment I used the digit span test to observe the affect dual tasking has on gait.

However lower limbs more relevant than upper limbs for estimation of gait and physical function, handgrip strength has been used and well correlated with the most relevant outcomes. But there is factors unrelated to muscle strength, e.g. motivation or cognition, may interfere the correct assessment of muscle strength (Cruz-Jentoft et al., 2010).

The correct APA sequence to prepare a step is to shift body weight laterally onto the initiation foot to get ready to the weight shifting from the stepping leg to the support leg. After that, body weight is shifted to the support leg and we can initiate with our stepping leg to make a step. However, at some situations, weight shift goes to the wrong direction and this must be corrected before initiation and mostly this happened among seniors and choice reaction task. APA is so important because it works to make sure we initiate our step safely, and errors in APA usually cause a loss of balance which may lead to a fall. Choice reaction task is widely used in gait and stepping experiment to trigger error APAs, and in our study we characterized four types of APA in CRT: Correct APA Trial which COP went directly to the stepping foot and then crossover to the support foot; Posterior Shift Trial which the COP neither tended to move right nor left, instead it chose a medial way to move backward; Error APA Trial which COP moved towards support foot first and then corrected itself after some time; Multiple Error APA Trial which COP pattern tended to have two or more correction turning curves (Fig.9) before it moved to the stepping leg. Most MET trials had two errors and only very few of the trials got three. As we have already known that, with one error happened, the person’s COP