The process of learning to walk is ongoing throughout childhood. The Gait Variability Index (GVI; A. Gouelle et al., 2013) has been proposed to quantify the variability of spatiotemporal parameters (STP) during gait. The authors' aim was to evaluate the GVI and STP of healthy children and teenagers to (a) determine changes in the GVI with age and to derive normal values in children and (b) to evaluate the influence of STP on the GVI. A total of 140 typically developing children from 1 to 17 years old were categorized into 7 groups of 20 based on age. Spatiotemporal gait parameters were recorded using an electronic walkway. GVI increased and STP changed with age. In the children-teenagers group, the GVI was positively related to step length, speed, and negatively to cadence. Following normalization by lower limb length, correlations were no longer significant. In contrast, raw base of support was not correlated with the GVI but normalized base of support was. A multiple linear regression showed that only age had a direct impact on the GVI, indicating that gait continues to change after 6-7 years. These changes were only demonstrated by the GVI, highlighting its usefulness for the evaluation of gait in young populations.
Prior research has established the Gait Variability Index (GVI) as a composite measure of gait variability, based on spatiotemporal parameters, that is associated with functional outcomes. However, under certain circumstances the magnitude and directional specificity of the GVI is adversely affected by shortcomings in the calculation method. Here we present an enhanced gait variability index (EGVI) that addresses those shortcomings and improves the utility of the measure. The EGVI was further enhanced by removing some input spatiotemporal variables that captured overlapping/redundant information. The EGVI was used to reanalyze data from four previously published studies that used the original GVI. After removing data affected by the GVI’s prior shortcomings, the association between EGVI and GVI values was stronger for the pooled dataset (r2 = 0.95) and for the individual studies (r2 = 0.88–0.98). The EGVI also revealed stronger associations between the index value and functional outcomes for some studies. The EGVI successfully addresses shortcomings in the GVI calculation that affected magnitude and directional specificity of the index. We have confirmed the validity of prior published work that used the original GVI, while also demonstrating even stronger results when these prior data were re-analyzed with the EGVI. We recommend that future research should use the EGVI as a composite measure of gait variability.
The present case study fell within the framework of the "absolute approach of expertise" because it assesses a "truly exceptional individual" (Chi, MTH, Cambridge Handbook of Expertise and Expert Performance, London, United Kingdom: Cambridge University Press, 2006, pp. 121-130). This technique analysis examined the movement-production strategy used by a professional tennis player performing serve-return strokes. This research enabled us to establish the relation between tennis serve-return technique and successful performance. An optoelectronic system was used to capture and analyze the expert player's stroke production in a live situation to determine the temporal trajectory of the serve-return initiation movement. Some differences between the serve-return shots were observed concerning the occurrence time of the lateral racquet displacement, the amplitude of the racquet movement, and the average latency time. No difference was observed for the gravity center (GC) movements. Backhand, forehand, and reprogramming strokes were executed with a general constancy of occurrence and average times of the GC and racquet movements. This expert player used a predictive movement-production strategy specified by a high level of reproducibility of the movement with nevertheless adaptive skills during reprogramming strokes. This adaptation supported either the development of highly consistent motor programs or the use of a more flexible strategy based on the perception-action coupling.
Background Children with spastic diplegia frequently show excessive knee extension (stiff-knee gait) throughout swing phase, which may interfere with foot clearance. Abnormal rectus femoris activity is commonly associated with a stiff-knee gait. Rectus femoris transfer has been recommended to enhance knee flexion during swing. However, recent studies suggest the transfer does not generate a knee flexor moment but diminishes knee extension moment in swing and MRI studies show the transferred tendons can be constrained by scarring to underlying muscles. Thus, it is possible knee flexion would be improved by distal rectus release rather than transfer since it would not be adherent to the underlying muscles. Questions/purposes We therefore determined whether rectus femoris distal tendon resection improves knee ROM and kinematic characteristics of stiff-knee gait in patients with spastic diplegia.
Patients and MethodsWe studied 45 patients who underwent rectus femoris distal tendon resection as a part of multilevel surgery. Rectus femoris procedures were indicated based on kinematic characteristics of stiff-knee gait. All patients were walkers and had a mean age at surgery of 13 years (range, 6-22 years). We obtained gait analyses before surgery and at mean 2-year followup. We based postoperative assessment on clinical evaluation and gait analysis data. Results At followup, rectus femoris distal tendon resection was associated with improved knee ROM and timing of peak knee flexion in swing, and the absolute values of peak knee flexion became normal for those patients who showed abnormal preoperative values.
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