Identification of gait events in children with spastic cerebral palsy: comparison between the force plate and algorithms

Gonçalves, Rejane Vale; Fonseca, Sérgio T.; Araújo, Priscila Albuquerque de; Araújo, Vanessa Lara; Barboza, Tais Martins; Martins, Gabriela Andrade; Mancini, Marisa Cotta

doi:10.1016/j.bjpt.2019.05.007

Cited by 13 publications

(25 citation statements)

References 11 publications

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“…Among the included studies, the majority were cohort in design (13 retrospective and 1 prospective cohort studies), followed by case series (4 studies), case control (1 study), single-armed clinical trial (1 study), cross-sectional (1 study), and randomized controlled trial (1 study). The overall number of included patients with CP in our study is 3595 patients and 4814 limbs/feet, ranging from 7 patients in the study of Goncalves et al [ 22 ] to 1147 patients in the study of Naidu et al [ 28 ]. Most of the included studies reported the data of patients with the spastic type of CP (15 studies) [ 6 , 7 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…The overall number of included patients with CP in our study is 3595 patients and 4814 limbs/feet, ranging from 7 patients in the study of Goncalves et al [ 22 ] to 1147 patients in the study of Naidu et al [ 28 ]. Most of the included studies reported the data of patients with the spastic type of CP (15 studies) [ 6 , 7 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 35 ]. The age of CP patients among included studies ranged from a mean of 3.8 years (with SD of 2) in the study of Boulay et al [ 17 ] to 18.2 years (with SD of 9.9) in the study of Horsch et al [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Quality assessment of the included studies was conducted by the NIH quality assessment tool for each distinctive study design. A total of 16 studies were of fair quality (moderate risk of bias) [ 6 , 7 , 17 , 20 , 22 , 24 , 25 , 28 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ], 4 studies were of poor quality (high risk of bias) [ 18 , 19 , 21 , 29 ], and 2 studies were of good quality (low risk of bias) [ 23 , 26 ].…”

Section: Prevalence Of Equinus Footmentioning

confidence: 99%

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Is the Prevalence of Equinus Foot in Cerebral Palsy Overestimated? Results from a Meta-Analysis of 4814 Feet

Horsch

Klotz²,

Platzer

et al. 2021

JCM

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Background: Equinus is a common foot deformity in patients with cerebral palsy (CP). However, its prevalence is scarcely reported in the literature. Therefore, we conducted this review to estimate the prevalence of equinus foot in CP. Methods: Eight databases were searched. Our primary outcome was the prevalence of equinus foot in CP patients. Subgroup analysis was conducted based on study design, the laterality of CP, and whether equinus foot was defined or not. Results: The prevalence of equinus foot in CP was 93% (95% CI: 71–99). The prevalence was 99% (95% CI: 55–100), 96% (95% CI: 57–100), and 65% (95% CI: 37–86) in unilateral, both, and bilateral CP, respectively. Based on study design, equinus foot prevalence was 92% (95% CI: 34–100) in case series and 62% (95% CI: 47–74) in cohort studies. Four studies reported definition criteria for equinus foot, with a pooled prevalence rate of equinus foot of 99% (95% CI: 36–100) compared to a rate of 89% (95% CI: 59–98) among studies that lacked a definition criterion. Conclusions: This is the first meta-analysis to address the prevalence of equinus foot in CP patients. Although its prevalence is very high, our findings should be interpreted with caution due to the presence of multiple limitations, such as the lack of standardized definition criteria for equinus foot, the inappropriate study design, the wide confidence interval of equinus foot rate, and the small number of studies investigating it as a primary outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Prevalence Of Equinus Footmentioning

confidence: 99%

See 1 more Smart Citation

Is the Prevalence of Equinus Foot in Cerebral Palsy Overestimated? Results from a Meta-Analysis of 4814 Feet

Horsch

Klotz²,

Platzer

et al. 2021

JCM

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“…Multiple methods exist for calculating spatiotemporal gait parameters, whether based on force plates or reflective marker systems [ 22 , 23 , 24 ]. However, these techniques require expensive equipment and are only applicable in a gait laboratory.…”

Section: Related Workmentioning

confidence: 99%

“…One of the essential components of such a system is the real-time tracking of the spatio-temporal gait parameters in people with gait disorders. Several methods exist that use full kinematic captures [ 22 , 23 , 24 ] or lighter inertial sensors [ 25 , 26 , 27 , 28 , 29 , 30 ]. Two recent works exploit an AR HMD but do not involve children with CP [ 31 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

Validity of Hololens Augmented Reality Head Mounted Display for Measuring Gait Parameters in Healthy Adults and Children with Cerebral Palsy

Guinet

Bouyer

Otmane

et al. 2021

Sensors

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Serious games are a promising approach to improve gait rehabilitation for people with gait disorders. Combined with wearable augmented reality headset, serious games for gait rehabilitation in a clinical setting can be envisaged, allowing to evolve in a real environment and provide fun and feedback to enhance patient’s motivation. This requires a method to obtain accurate information on the spatiotemporal gait parameters of the playing patient. To this end, we propose a new algorithm called HoloStep that computes spatiotemporal gait parameters using only the head pose provided by an augmented reality headset (Hololens). It is based on the detection of peaks associated to initial contact event, and uses a combination of locking distance, locking time, peak amplitude detection with custom thresholds for children with CP. The performance of HoloStep was compared during a walking session at comfortable speed to Zeni’s reference algorithm, which is based on kinematics and a full 3D motion capture system. Our study included 62 children with cerebral palsy (CP), classified according to Gross Motor Function Classification System (GMFCS) between levels I and III, and 13 healthy participants (HP). Metrics such as sensitivity, specificity, accuracy and precision for step detection with HoloStep were above 96%. The Intra-Class Coefficient between steps length calculated with HoloStep and the reference was 0.92 (GMFCS I), 0.86 (GMFCS II/III) and 0.78 (HP). HoloStep demonstrated good performance when applied to a wide range of gait patterns, including children with CP using walking aids. Findings provide important insights for future gait intervention using augmented reality games for children with CP.

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Gait event detection using kinematic data in children with bilateral spastic cerebral palsy

Gómez-Pérez

Martori

Puig-Diví

et al. 2021

Clinical Biomechanics

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Background: Ground reaction forces are the gold standard for detecting gait events, but they are not always applicable in cerebral palsy. Ghoussayni's algorithm is an event detection method based on the sagittal plane velocity of heel and toe markers. We aimed to evaluate whether Ghoussayni's algorithm, using two different thresholds, was a valid event detection method in children with bilateral spastic cerebral palsy. We also aimed to define a new adaptation of Ghoussayni's algorithm for detecting foot strike in cerebral palsy, and study the effect of event detection methods on spatiotemporal parameters. Methods: Synchronized kinematic and kinetic data were collected retrospectively from 16 children with bilateral spastic cerebral palsy (7 males and 9 females; age 8.9 ± 2.7 years) walking barefoot at self-selected speed. Gait events were detected using methods: 1) ground reaction forces, 2) Ghoussayni's algorithm with a threshold of 0.5 m/s, and 3) Ghoussayni's algorithm with a walking speed dependent threshold. The new adaptation distinguished how foot strikes were performed (heel and/or toe) comparing the timing when the foot markers velocities fell below the threshold. Differences between the three methods, and between spatiotemporal parameters calculated from the two Ghoussayni's thresholds were analyzed. Findings: There were statistically significant (P < 0.05) differences between methods 1 and 3, and between some spatiotemporal parameters calculated from methods 2 and 3. Ghoussayni's algorithm showed better performance for foot strike than for toe off. Interpretation: Ghoussayni's algorithm using 0.5 m/s is valid in children with bilateral spastic cerebral palsy. Event detection methods affect spatiotemporal parameters.

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Identification of gait events in children with spastic cerebral palsy: comparison between the force plate and algorithms

Cited by 13 publications

References 11 publications

Is the Prevalence of Equinus Foot in Cerebral Palsy Overestimated? Results from a Meta-Analysis of 4814 Feet

Is the Prevalence of Equinus Foot in Cerebral Palsy Overestimated? Results from a Meta-Analysis of 4814 Feet

Validity of Hololens Augmented Reality Head Mounted Display for Measuring Gait Parameters in Healthy Adults and Children with Cerebral Palsy

Gait event detection using kinematic data in children with bilateral spastic cerebral palsy

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