Measuring step kinematic variability on an instrumented treadmill: how many steps are enough?

Owings, Tammy M.; Grabiner, Mark D.

doi:10.1016/s0021-9290(03)00108-8

Cited by 154 publications

(117 citation statements)

References 11 publications

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“…Similarly, if measures of gait dynamics are going to find a home in clinical settings, work needs to be done to develop age-dependent norms and confidence intervals, to establish guidelines and procedures for standardization, and to identify practical ways of measuring gait fluctuations in clinical settings. As an example, to some degree, measures of variability depend on and become more robust as the length of the recording and the time series length increases (Owings & Grabiner, 2003). Yet, in studies reporting measures of gait variability, we find a wide range in the number of strides examined; some investigators base their measures on less than ten strides while others measure over hundreds of strides, even when quantifying the same aspects of the stride-to-stride fluctuations.…”

Section: Future Directions and Summarymentioning

confidence: 90%

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Hausdorff

2007

Human Movement Science

704

579

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Until recently, quantitative studies of walking have typically focused on properties of a typical or average stride, ignoring the stride-to-stride fluctuations and considering these fluctuations to be noise. Work over the past two decades has demonstrated, however, that the alleged noise actually conveys important information. The magnitude of the stride-to-stride fluctuations and their changes over time during a walk -gait dynamics -may be useful in understanding the physiology of gait, in quantifying age-related and pathologic alterations in the locomotor control system, and in augmenting objective measurement of mobility and functional status Indeed, alterations in gait dynamics may help to determine disease severity, medication utility, and fall risk, and to objectively document improvements in response to therapeutic interventions, above and beyond what can be gleaned from measures based on the average, typical stride. This review discusses support for the idea that gait dynamics has meaning and may be useful in providing insight into the neural control of locomtion and for enhancing functional assessment of aging, chronic disease, and their impact on mobility.

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Section: Future Directions and Summarymentioning

confidence: 90%

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Hausdorff

2007

Human Movement Science

704

579

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“…In addition, factors such as whether these gait cycles were collected continuously or not and using a treadmill or not, all influence the outcome in different ways. Although the use of a treadmill allows a considerable number of strides to be measured, a necessary requirement to gain reliable and precise estimates of linear [102] as well as nonlinear variability [38], walking over treadmill is known to differ from walking over ground [103,104]. Studies that incorporated pressure walkways often measured multiple runs to record sufficient strides in order to obtain precise and reliable estimates of variability, thus making these protocols non-continuous.…”

Section: Sources Of Heterogeneity Among Studiesmentioning

confidence: 99%

Kinematic measures for assessing gait stability in elderly individuals: a systematic review

Hamacher

Singh

Dieën

et al. 2011

J. R. Soc. Interface.

324

271

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Falls not only present a considerable health threat, but the resulting treatment and loss of working days also place a heavy economic burden on society. Gait instability is a major fall risk factor, particularly in geriatric patients, and walking is one of the most frequent dynamic activities of daily living. To allow preventive strategies to become effective, it is therefore imperative to identify individuals with an unstable gait. Assessment of dynamic stability and gait variability via biomechanical measures of foot kinematics provides a viable option for quantitative evaluation of gait stability, but the ability of these methods to predict falls has generally not been assessed. Although various methods for assessing gait stability exist, their sensitivity and applicability in a clinical setting, as well as their cost-effectiveness, need verification. The objective of this systematic review was therefore to evaluate the sensitivity of biomechanical measures that quantify gait stability among elderly individuals and to evaluate the cost of measurement instrumentation required for application in a clinical setting. To assess gait stability, a comparative effect size (Cohen's d ) analysis of variability and dynamic stability of foot trajectories during level walking was performed on 29 of an initial yield of 9889 articles from four electronic databases. The results of this survey demonstrate that linear variability of temporal measures of swing and stance was most capable of distinguishing between fallers and non-fallers, whereas step width and stride velocity prove more capable of discriminating between old versus young (OY) adults. In addition, while orbital stability measures (Floquet multipliers) applied to gait have been shown to distinguish between both elderly fallers and non-fallers as well as between young and old adults, local stability measures (ls) have been able to distinguish between young and old adults. Both linear and nonlinear measures of foot time series during gait seem to hold predictive ability in distinguishing healthy from fall-prone elderly adults. In conclusion, biomechanical measurements offer promise for identifying individuals at risk of falling and can be obtained with relatively low-cost tools. Incorporation of the most promising measures in combined retrospective and prospective studies for understanding fall risk and designing preventive strategies is warranted.

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“…For the long trial, the middle 200 strides were analyzed to attain adequate precision [16,17], and for the short bouts trial, the middle eight strides were analyzed to ensure steady state gait.…”

Section: Discussionmentioning

confidence: 99%

“…Both variability and local dynamic stability are sensitive to aging and appear to be affected in fallers [7,[9][10][11][12][13][14][15]. However, the relationship between these measures and fall risk has been established only under laboratory conditions, where continuous data series exceeding 200 strides are required for precise estimation [16,17]. For clinical use and ambulatory assessment, it is questionable whether it is feasible to collect datasets containing such large numbers of consecutive strides; hence their estimation based on short bouts of gait would be preferable.…”

Section: Introductionmentioning

confidence: 99%

Toward ambulatory balance assessment: Estimating variability and stability from short bouts of gait

et al. 2014

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Measuring step kinematic variability on an instrumented treadmill: how many steps are enough?

Cited by 154 publications

References 11 publications

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Gait dynamics, fractals and falls: Finding meaning in the stride-to-stride fluctuations of human walking

Kinematic measures for assessing gait stability in elderly individuals: a systematic review

Toward ambulatory balance assessment: Estimating variability and stability from short bouts of gait

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