Comparison of gait strategy in subjects with hereditary spastic paraplegia to subjects with spastic diplegia using gait analysis

Cimolin, Verônica; Piccinini, Luigi; Turconi, Anna Carla; Berti, Matteo; Crivellini, Marcello; Albertini, G.; Galli, Manuela

doi:10.1016/j.gaitpost.2006.09.038

Cited by 6 publications

(14 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Using stationary approaches, altered ranges of motion in hip, knee, and ankle joints were observed for HSP when compared with controls and, in part, also with patients with cerebral palsy. 7,8,21,22 In addition, 3D motion capture studies also characterized altered trunk movement patterns during gait in HSP. 23,24 Moreover, different subtypes of gait impairments in HSP have been proposed, according to the severity and clinical phenotype of proximal vs distal spasticity and paresis of the legs.…”

Section: Discussionmentioning

confidence: 99%

Inertial Gait Sensors to Measure Mobility and Functioning in Hereditary Spastic Paraplegia

et al. 2022

View full text Add to dashboard Cite

Background and objectives:Hereditary spastic paraplegia (HSP) causes progressive spasticity and weakness of the lower limbs. As neurological examination and the clinical Spastic Paraplegia Rating Scale (SPRS) are subject to potential patient- and clinician-dependent bias, instrumented gait analysis bears the potential to objectively quantify impaired gait. The aim of the present study was to investigate gait cyclicity parameters by application of a mobile gait analysis system in a cross sectional cohort of HSP patients and a longitudinal fast progressing subcohort.Methods:Using wearable sensors attached to the shoes, HSP patients and controls performed a 4x10 meters walking test during regular visits in three outpatient centers. Patients were also rated according to the SPRS and in a subset, questionnaires on quality of life and fear of falling were obtained. An unsupervised segmentation algorithm was employed to extract stride parameters and respective coefficients of variation.Results:Mobile gait analysis was performed in a total of 112 ambulatory HSP patients and 112 age and gender matched controls. While swing time was unchanged compared to controls, there were significant increases in the duration of the total stride phase and the duration of the stance phase, both regarding absolute values and coefficients of variation values. While stride parameters did not correlate to age, weight or height of the patients, there were significant associations of absolute stride parameters to single SPRS items reflecting impaired mobility (|r| > 0.50), to patients’ quality of life (|r| > 0.44), and notably to disease duration (|r| > 0.27). Sensor-derived coefficients of variation, on the other hand, were associated with patient-reported fear of falling (|r| > 0.41) and cognitive impairment (|r| > 0.40). In a small 1-year follow-up analysis of patients with complicated HSP and fast progression, absolute values of mobile gait parameters had significantly worsened compared to baseline.Discussion:The presented wearable sensor system provides parameters of stride characteristics which appear clinically valid to reflect gait impairment in HSP. Due to the feasibility with regard to time, space and costs, the present study forms the basis for larger scale longitudinal and interventional studies in HSP.

show abstract

Section: Discussionmentioning

confidence: 99%

Inertial Gait Sensors to Measure Mobility and Functioning in Hereditary Spastic Paraplegia

et al. 2022

View full text Add to dashboard Cite

show abstract

“…32 , 85 , 135 , 154 , 155 , [159][160][161][162][163][164][165][166] Finally, 3D-IGA has identified unique characteristics that differentiate between 2 pediatric populations that walk with similar gait deviations and atypical patterns, including children with CP versus children with idiopathic toe walking, 31,124,167 and spastic versus dyskinetic 168 or hereditary spastic paraparesis. [169][170][171][172][173] While 3D-IGA can identify unique characteristics in different pediatric populations, it does not exclusively provide a differential diagnosis.…”

Section: Supporting Evidence and Clinical Interpretationmentioning

confidence: 99%

Three-Dimensional Instrumented Gait Analysis for Children With Cerebral Palsy: An Evidence-Based Clinical Practice Guideline

States,

Salem,

Krzak

et al. 2024

Pediatric Physical Therapy

View full text Add to dashboard Cite

Background: Children with cerebral palsy (CP) who walk have complex gait patterns and deviations often requiring physical therapy (PT)/medical/surgical interventions. Walking in children with CP can be assessed with 3-dimensional instrumented gait analysis (3D-IGA) providing kinematics (joint angles), kinetics (joint moments/powers), and muscle activity. Purpose: This clinical practice guideline provides PTs, physicians, and associated clinicians involved in the care of children with CP, with 7 action statements on when and how 3D-IGA can inform clinical assessments and potential interventions. It links the action statement grades with specific levels of evidence based on a critical appraisal of the literature. Conclusions: This clinical practice guideline addresses 3D-IGA’s utility to inform surgical and non-surgical interventions, to identify gait deviations among segments/joints and planes and to evaluate the effectiveness of interventions. Best practice statements provide guidance for clinicians about the preferred characteristics of 3D-IGA laboratories including instrumentation, staffing, and reporting practices. Video Abstract: Supplemental digital content available at http://links.lww.com/PPT/A524.

show abstract

“…Similar to DCP, HSP patients presented stiff knee gait with reduced knee and hip flexion in the swing phase, insufficient knee extension in terminal swing, and insufficient hip extension in stance (5, 39, 40). Nonetheless, longer knee hyperextension was often observed during midstance compared to DCP (5, 34,36,37). This may be interpreted as compensation to rectus femoris weakness/hypoactivation (quadriceps avoidance pattern) (34,36) to achieve a supportive reaction and avoid joint collapse during walking, rather than one manifestation of spasticity, as suggested by EMG pattern (36).…”

Section: Figurementioning

confidence: 99%

“…Nonetheless, longer knee hyperextension was often observed during midstance compared to DCP (5, 34,36,37). This may be interpreted as compensation to rectus femoris weakness/hypoactivation (quadriceps avoidance pattern) (34,36) to achieve a supportive reaction and avoid joint collapse during walking, rather than one manifestation of spasticity, as suggested by EMG pattern (36). While DCP subjects presented higher rectus femoris and hamstring activation, low activation of knee extensors was reported in HSP, with increased absorbed power and decreased generated power at the knee (34,36).…”

Section: Figurementioning

confidence: 99%

Gait analysis patterns and rehabilitative interventions to improve gait in persons with hereditary spastic paraplegia: a systematic review and meta-analysis

Faccioli,

Cavalagli,

Falocci

et al. 2023

Front. Neurol.

View full text Add to dashboard Cite

BackgroundHereditary spastic paraplegias (HSPs) are a group of inheritance diseases resulting in gait abnormalities, which may be detected using instrumented gait analysis. The aim of this systematic review was 2-fold: to identify specific gait analysis patterns and interventions improving gait in HSP subjects.MethodsA systematic review was conducted in PubMed, Cochrane Library, REHABDATA, and PEDro databases, in accordance with reporting guidelines of PRISMA statement and Cochrane's recommendation. The review protocol was recorded on the PROSPERO register. Patients with pure and complicated HSP of any age were included. All types of studies were included. Risk of bias, quality assessment, and meta-analysis were performed.ResultsForty-two studies were included: 19 were related to gait analysis patterns, and 24 were intervention studies. The latter ones were limited to adults. HSP gait patterns were similar to cerebral palsy in younger subjects and stroke in adults. Knee hyperextension, reduced range of motion at knee, ankle, and hip, reduced foot lift, and increased rapid trunk and arm movements were reported. Botulinum injections reduced spasticity but uncovered weakness and improved gait velocity at follow-up. Weak evidence supported intrathecal baclofen, active intensive physical therapy (i.e., robot-assisted gait training, functional exercises, and hydrotherapy), and functional electrical stimulation. Some improvements but adverse events were reported after transcranial magnetic stimulation, transcutaneous spinal direct current stimulation, and spinal cord stimulation implant.ConclusionKnee hyperextension, non-sagittal pelvic movements, and reduced ROM at the knee, ankle, and hip represent the most peculiar patterns in HSP, compared to diplegic cerebral palsy and stroke. Botulinum improved comfortable gait velocity after 2 months. Nonetheless, interventions reducing spasticity might result in ineffective functional outcomes unveiling weakness. Intensive active physical therapy and FES might improve gait velocity in the very short term.

show abstract

Comparison of gait strategy in subjects with hereditary spastic paraplegia to subjects with spastic diplegia using gait analysis

Cited by 6 publications

References 2 publications

Inertial Gait Sensors to Measure Mobility and Functioning in Hereditary Spastic Paraplegia

Inertial Gait Sensors to Measure Mobility and Functioning in Hereditary Spastic Paraplegia

Three-Dimensional Instrumented Gait Analysis for Children With Cerebral Palsy: An Evidence-Based Clinical Practice Guideline

Gait analysis patterns and rehabilitative interventions to improve gait in persons with hereditary spastic paraplegia: a systematic review and meta-analysis

Contact Info

Product

Resources

About