Gait Coordination Deteriorates in Independent Old-Old Adults

Gimmon, Yoav; Rashad, Hisham; Kurz, Ilan; Plotnik, Meir; Riemer, Raziel; Debi, Ronen; Shapiro, Amir; Melzer, Itshak

doi:10.1123/japa.2017-0120

Cited by 19 publications

(28 citation statements)

References 32 publications

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“…PCI values observed among participants from the severe MS group were similar to an elderly population. One study of healthy individuals in their eight decade of life demonstrated that their PCI was approximately 10%, comparable to the severe MS cohort PCI of 10.2% at a median age of 54 years 35 . This observation illustrates the high degree of impaired coordination of gait in ambulatory pwMS with severe clinical disability.…”

Section: Discussionmentioning

confidence: 91%

“…The literature lacks consensus with regards to the association between gait speed and GA, PCI or Gait Variability. Studies report conflicting findings regarding each association with the literature supporting positive, negative and no correlations between gait speed and GA 34 , gait speed and PCI 35 , 36 , and gait speed and gait variability 37 – 39 . Within subject effects were seen on PCI but not on GA when gait was deliberately slowed 40 .…”

Section: Discussionmentioning

confidence: 95%

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Gait asymmetry, and bilateral coordination of gait during a six-minute walk test in persons with multiple sclerosis

Plotnik

Wagner

Adusumilli

et al. 2020

Sci Rep

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Gait impairments in persons with multiple sclerosis (pwMS) leading to decreased ambulation and reduced walking endurance remain poorly understood. our objective was to assess gait asymmetry (GA) and bilateral coordination of gait (BCG), among pwMS during the six-minute walk test (6MWT), and determine their association with disease severity. We recruited 92 pwMS (age: 46.6 ± 7.9; 83% females) with a range of clinical disability, who completed the 6MWT wearing gait analysis system. GA was assessed by comparing left and right swing times, and BcG was assessed by the phase coordination index (pci). Several functional and subjective gait assessments were performed. Results show that gait is more asymmetric and less coordinated as the disease progresses (p < 0.0001). Participants with mild MS showed significantly better BCG as reflected by lower PCI values in comparison to the other two MS severity groups (severe: p = 0.001, moderate: p = 0.02). GA and PCI also deteriorated significantly each minute during the 6MWT (p < 0.0001). GA and PCI (i.e., BCG) show weaker associations with clinical MS status than associations observed between functional and subjective gait assessments and MS status. Similar to other neurological cohorts, GA and pci may be important parameters to assess and target in interventions among pwMS. Multiple sclerosis (MS) is a degenerative, progressive, autoimmune disease of the central nervous system, often resulting in a continuous deterioration of walking 1. Hence, gait parameters, e.g. cadence, step-length, step-time, are impaired as compared to those measured in abled bodied individuals 1-4. This gait deterioration has been demonstrated as a decline in the ability to walk long distances, based on the 6-min or 500-m walk tests 5,6. One critical component of walking impairment is gait variability. Gait variability tends to change throughout the MS disease course, with greater variability in the higher levels of disability 7,8. Furthermore, gait variability is associated with increased fall risk 9. Human gait requires a high degree of symmetry and coordination. Gait asymmetry is associated with reduced walking velocity 10-12 and increased energy expenditure 13. Spinal cord injury is frequent in persons with multiple sclerosis (pwMS), noted in 83% by MRI and up to 99% at autopsy 14,15. Spinal cord injury is associated with lower extremity sensorimotor deficits and impaired ambulation. It was previously reported that walking velocity in pwMS was reduced when in vivo diffusion tensor imaging (DTI) of the cervical spinal cord reveals myelin and tissue injury within posterior columns (PC) and lateral corticospinal tracts (CST) 16. Since CST injury in pwMS is asymmetric 17 , we hypothesize that MS will be associated with increased gait asymmetry, since asymmetric lesions in the spinal white matter lesions have been shown to correspond to asymmetric motor function 18. Gait coordination is the ability to maintain a consistent phase-dependent cyclical relationship between different body segments or joints in...

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 95%

Gait asymmetry, and bilateral coordination of gait during a six-minute walk test in persons with multiple sclerosis

Plotnik

Wagner

Adusumilli

et al. 2020

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…Each initial contact (heel strike) of one side of the leg was marked and calculated for the step count and a stride time was defined by the time between two consecutive heel strikes of the same foot [37].…”

Section: Methodsmentioning

confidence: 99%

Preliminary Clinical Application of Textile Insole Sensor for Hemiparetic Gait Pattern Analysis

Wang

Kim

Shin

et al. 2019

Sensors

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Post-stroke gait dysfunction occurs at a very high prevalence. A practical method to quantitatively analyze the characteristics of hemiparetic gait is needed in both clinical and community settings. This study developed a 10-channeled textile capacitive pressure sensing insole (TCPSI) with a real-time monitoring system and tested its performance through hemiparetic gait pattern analysis. Thirty-five subjects (18 hemiparetic, 17 healthy) walked down a 40-m long corridor at a comfortable speed while wearing TCPSI inside the shoe. For gait analysis, the percentage of the plantar pressure difference (PPD), the step count, the stride time, the coefficient of variation, and the phase coordination index (PCI) were used. The results of the stroke patients showed a threefold higher PPD, a higher step count (41.61 ± 10.7), a longer average stride time on the affected side, a lower mean plantar pressure on the affected side, higher plantar pressure in the toe area and the lateral side of the foot, and a threefold higher PCI (hemi: 19.50 ± 13.86%, healthy: 5.62 ± 5.05%) compared to healthy subjects. This study confirmed that TCPSI is a promising tool for distinguishing hemiparetic gait patterns and thus may be used as a wearable gait function evaluation tool, the external feedback gait training device, and a simple gait pattern analyzer for both hemiparetic patients and healthy individuals.

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“…1 PCI values observed among participants from the severe MS group were similar to an elderly population. One study of able-bodied individuals in their eight decade of life demonstrated that their PCI was approximately 10%, quite comparable to the severe MS cohort PCI of 10.2% at a median age of 54 years 37 . This observation illustrates the high degree of impaired coordination of gait in ambulatory pwMS with severe clinical disability.…”

Section: Relation To Previous Findingsmentioning

confidence: 86%

Gait asymmetry, and bilateral coordination of gait during a six-minute walk test in persons with multiple sclerosis

Plotnik

Wagner

Adusumilli

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Gait impairments in persons with multiple sclerosis (pwMS) underlying reduced walking endurance are still poorly understood. Thus, our objective was to assessed gait asymmetry (GA) and bilateral coordination of gait (BCG), among pwMS during the sixminute walk test (6MWT) and their association with disease severity. For this aim, we recruited ninety-two pwMS (age: 46.6 ± 7.9; 83% females) with a broad range of clinical disability who completed the 6MWT wearing gait analysis system. GA was assessed by comparing left and right swing times, and BCG by using the phase coordination index (PCI). Several functional and subjective gait assessments were performed. Results show that gait is more asymmetric and less coordinated as the disease progresses (p<.0001).Participants with mild MS showed significant better BCG as reflected by lower PCI values in comparison to the other two MS severity groups (severe: p =.001, moderate: p=.02). GA and PCI also deteriorated significantly with time during the 6MWT (p<.0001). GA and PCI (i.e., BCG) show somewhat weaker associations with clinical MS status than associations observed between functional and subjective gait assessments and MS status. Similar to other neurological cohorts, GA and PCI are important parameters to assess and to target in interventions among pwMS. BackgroundMultiple sclerosis (MS) is a degenerative, progressive, autoimmune disease of the central nervous system, often resulting in a continuous deterioration of walking 1 .Hence, gait parameters, e.g. cadence, step-length, step-time, are impaired as compared to those measured in abled bodied individuals 1-4 . This gait deterioration has been demonstrated as a decline in the ability to walk long distances, based on the 6-minute or 500-meter walk tests 5,6 . One critical component of walking impairment is gait variability.Gait variability tends to change throughout the MS disease course, with greater variability in the higher levels of disability 7,8 . Furthermore, gait variability is associated with increased fall risk 9 . Potential association between MS pathology and difficulties in gait symmetry and bilateral coordination of gait (BCG)Human gait requires a high degree of symmetry and coordination. Gait asymmetry is associated with reduced walking velocity 10-12 and increased energy expenditure 13 .Spinal cord injury is frequent in persons with multiple sclerosis (pwMS), noted in 83% by MRI and up to 99% at autopsy 14,15 . Spinal cord injury is associated with lower extremity sensorimotor deficits and impaired ambulation. It was previously reported that walking velocity in pwMS was reduced when in vivo diffusion tensor imaging (DTI) of the cervical spinal cord reveals myelin and tissue injury within posterior columns (PC) and lateral corticospinal tracts (CST) 16 . Since CST injury in pwMS is asymmetric 17 , we hypothesize that MS will be associated with increased gait asymmetry, since asymmetric lesions in the spinal white matter lesions correspond to asymmetric motor function 18 .Gait coordination is the abilit...

show abstract

Gait Coordination Deteriorates in Independent Old-Old Adults

Cited by 19 publications

References 32 publications

Gait asymmetry, and bilateral coordination of gait during a six-minute walk test in persons with multiple sclerosis

Gait asymmetry, and bilateral coordination of gait during a six-minute walk test in persons with multiple sclerosis

Preliminary Clinical Application of Textile Insole Sensor for Hemiparetic Gait Pattern Analysis

Gait asymmetry, and bilateral coordination of gait during a six-minute walk test in persons with multiple sclerosis

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