Trajectory of Walking Function in Late-Stage Older Individuals Managed with a Regular Exercise Program: A 5-Year Longitudinal Tracking with an IoT Gait Analysis System Using Accelerometers

Purpose: This study focused on maintaining and improving the walking function of late-stage older individuals while longitudinally tracking the effects of regular exercise programs in a day-care service specialized for preventive care over 5 years, using detailed gait function measurements with an accelerometer-based system. Methods: Seventy individuals (17 male and 53 female) of a daycare service in Tokyo participated in a weekly exercise program, meeting 1 - 2 times. The average age of the participants at the start of the program was 81.4 years. Gait function, including gait speed, stride length, root mean square (RMS) of acceleration, gait cycle time and its standard deviation, and left-right difference in stance time, was evaluated every 6 months. Results: Gait speed and stride length improved considerably within six months of starting the exercise program, confirming an initial improvement in gait function. This suggests that regular exercise programs can maintain or improve gait function even age groups that predictably have a gradual decline in gait ability due to enhanced age. In the long term, many indicators tended to approach baseline values. However, the exercise program seemingly counteracts age-related changes in gait function and maintains a certain level of function. Conclusions: While a decline in gait ability with aging is inevitable, establishing appropriate exercise habits in late-stage older individuals may contribute to long-term maintenance of gait function.

The Immediate Analgesic Effect and Impact on Gait Function of Transcutaneous Electrical Nerve Stimulation in Late-Stage Elderly Individuals with Knee Pain: Examination of Gait Function Using an IoT-Based Gait Analysis Device

Purpose: This study verified the effects of transcutaneous electrical nerve stimulation (TENS), which can be worn during walking and exercise, in elderly individuals with late-stage knee pain who exercise regularly. Methods: Thirty-two late-stage elderly individuals were evaluated for knee pain during rest, walking, and program exercises, with and without TENS. Gait analysis was performed using an IoT-based gait analysis device to examine the effects of TENS-induced analgesia on gait. Results: TENS significantly reduced knee pain during rest, walking, and programmed exercises, with the greatest analgesic effect observed during walking. The greater the knee pain without TENS, the more significant the analgesic effect of TENS. A comparison of gait parameters revealed a significant difference only in the gait cycle time, with a trend towards faster walking with TENS;however, the effect was limited. Conclusion: TENS effectively relieves knee pain in late-stage elderly individuals and can be safely applied during exercise. Pain management using TENS provides important insights into the implementation of exercise therapy in this age group.

Assessment of hindlimb motor recovery affer severe thoracic spinal cord injury in rats: classification of CatWalk XT■ gait analysis parameters

Assessment of locomotion recovery in preclinical studies of experimental spinal cord injury remains challenging. We studied the CatWalk XT■gait analysis for evaluating hindlimb functional recovery in a widely used and clinically relevant thoracic contusion/compression spinal cord injury model in rats. Rats were randomly assigned to either a T9 spinal cord injury or sham laminectomy. Locomotion recovery was assessed using the Basso, Beattie, and Bresnahan open field rating scale and the CatWalk XT■gait analysis. To determine the potential bias from weight changes, corrected hindlimb(H) values(divided by the unaffected forelimb(F) values) were calculated. Six weeks after injury, cyst formation, astrogliosis, and the deposition of chondroitin sulfate glycosaminoglycans were assessed by immunohistochemistry staining. Compared with the baseline, a significant spontaneous recovery could be observed in the CatWalk XT■parameters max intensity, mean intensity, max intensity at%, and max contact mean intensity from 4 weeks after injury onwards. Of note, corrected values(H/F) of CatWalk XT■parameters showed a significantly less vulnerability to the weight changes than absolute values, specifically in static parameters. The corrected CatWalk XT■parameters were positively correlated with the Basso, Beattie, and Bresnahan rating scale scores, cyst formation, the immunointensity of astrogliosis and chondroitin sulfate glycosaminoglycan deposition. The CatWalk XT■gait analysis and especially its static parameters, therefore, seem to be highly useful in assessing spontaneous recovery of hindlimb function after severe thoracic spinal cord injury. Because many CatWalk XT■parameters of the hindlimbs seem to be affected by body weight changes, using their corrected values might be a valuable option to improve this dependency.

Gait analysis in swine,sheep,and goats after neurologic injury:a literature review

Medical research on neurologic ailments requires representative animal models to validate treatments before they are translated to human clinical trials.Rodents are the predominant animal model used in neurological research despite limited anatomic and physiologic similarities to humans.As a result,functional testing designed to assess locomotor recovery after neurologic impairment is well established in rodent models.Comparatively,large r,more clinically relevant models have not been as well studied.To achieve similar locomotor testing standardization in larger animals,the models must be accessible to a wide array of researchers.Non-human primates are the most relevant animal model fo r translational research,however ethical and financial barriers limit their accessibility.This review focuses on swine,sheep,and goats as large animal alternatives for transitional studies between rodents and non-human primates.The objective of this review is to compare motor testing and data collection methods used in swine,sheep,and goats to encourage testing standardization in these larger animal models.The PubMed database was analyzed by searching combinations of swine,sheep,and goats,neurologic injuries,and functional assessments.Findings were categorized by animal model,data collection method,and assessment design.Swine and sheep were used in the majority of the studies,while only two studies were found using goats.The functional assessments included open pen analysis,treadmill walking,and guided free walking.Data collection methods included subjective behavioral rating scales and objective tools such as pressure-sensitive mats and image-based analysis software.Overall,swine and sheep were well-suited for a variety of assessment designs,with treadmill walking and guided free walking offering the most consistency across multiple trials.Data collection methods varied,but image-based gait analysis software provided the most robust analysis.Future studies should be conducted to standardize functional testing methods after neurologic impairment in large animals.

Efficient Gait Analysis Using Deep Learning Techniques

Human Activity Recognition(HAR)has always been a difficult task to tackle.It is mainly used in security surveillance,human-computer interaction,and health care as an assistive or diagnostic technology in combination with other technologies such as the Internet of Things(IoT).Human Activity Recognition data can be recorded with the help of sensors,images,or smartphones.Recognizing daily routine-based human activities such as walking,standing,sitting,etc.,could be a difficult statistical task to classify into categories and hence 2-dimensional Convolutional Neural Network(2D CNN)MODEL,Long Short Term Memory(LSTM)Model,Bidirectional long short-term memory(Bi-LSTM)are used for the classification.It has been demonstrated that recognizing the daily routine-based on human activities can be extremely accurate,with almost all activities accurately getting recognized over 90%of the time.Furthermore,because all the examples are generated from only 20 s of data,these actions can be recognised fast.Apart from classification,the work extended to verify and investigate the need for wearable sensing devices in individually walking patients with Cerebral Palsy(CP)for the evaluation of chosen Spatio-temporal features based on 3D foot trajectory.Case-control research was conducted with 35 persons with CP ranging in weight from 25 to 65 kg.Optical Motion Capture(OMC)equipment was used as the referral method to assess the functionality and quality of the foot-worn device.The average accuracy±precision for stride length,cadence,and step length was 3.5±4.3,4.1±3.8,and 0.6±2.7 cm respectively.For cadence,stride length,swing,and step length,people with CP had considerably high inter-stride variables.Foot-worn sensing devices made it easier to examine Gait Spatio-temporal data even without a laboratory set up with high accuracy and precision about gait abnormalities in people who have CP during linear walking.

Sensor-Based Gait Analysis for Parkinson’s Disease Prediction

Parkinson’s disease is identified as one of the key neurodegenerative disorders occurring due to the damages present in the central nervous system.The cause of such brain damage seems to be fully explained in many research studies,but the understanding of its functionality remains to be impractical.Specifically,the development of a quantitative disease prediction model has evolved in recent decades.Moreover,accelerometer sensor-based gait analysis is accepted as an important tool for recognizing the walking behavior of the patients during the early prediction and diagnosis of Parkinson’s disease.This type of minimal infrastructure equipment helps in analyzing the Parkinson’s gait properties without affecting the common behavioral patterns during the clinical practices.Therefore,the Accelerometer Sensor-based Parkinson’s Disease Identi-fication System(ASPDIS)is introduced with a kernel-based support vector machine classifier model to make an early prediction of the disease.consequently,the proposed classifier can easily predict various severity levels of Parkinson’s disease from the sensor data.The performance of the proposed classifier is com-pared against the existing models such as random forest,decision tree,and k-near-est neighbor classifiers respectively.As per the experimental observation,the proposed classifier has more capability to differentiate Parkinson’s from non-Parkinson patients depending upon the severity levels.Also,it is found that the model has outperformed the existing classifiers concerning prediction time and accuracy respectively.

Gait analysis of children with spastic hemiplegic cerebral palsy

An experiment was carried out in the key laboratory for Technique Diagnosis and Function Assessment of Winter Sports of China to investigate the differences in gait characteristics between healthy children and children with spastic hemiplegic cerebral palsy. With permission of their parents, 200 healthy children aged 3 to 6 years in the kindergarten of Northeastern University were enrolled in this experiment. Twenty children aged 3 to 6 years with spastic hemiplegic cerebral palsy from Shengjing Hospital, China were also enrolled in this experiment. Standard data were collected by simultaneously recording gait information from two digital cameras. DVracker was used to analyze the standard data. The children with hemiplegic cerebra palsy had a longer gait cycle, slower walking speed, and longer support phase than did the healthy children. The support phase was longer than the swing phase in the children with hemiplegic cerebral palsy. There were significant differences in the angles of the hip, knee, and ankle joint between children with cerebral palsy and healthy children at the moment of touching the ground and buffering, and during pedal extension. Children with hemiplegic cerebral palsy had poor motor coordination during walking, which basically resulted in a short stride, high stride frequency to maintain speed, more obvious swing, and poor stability.

Spinal alignment evolution with age:A prospective gait analysis study

AIM To describe,using gait analysis,the development of spinal motion in the growing child.METHODS Thirty-six healthy children aged from 3 to 16 years old were included in this study for a gait analysis(9m-walk).Various kinematic parameters were recorded and analyzed such as thoracic angle(TA),lumbar angle(LA)and sagittal vertical axis(SVA).The kinetic parameters were the net reaction moments(N.m/kg)at the thoracolumbar and lumbosacral junctions.RESULTS TA and LA curves were not statistically correlated to the age(respectively,P=0.32 and P=0.41).SVA increased significantly with age(P<0.001).Moments in sagittal plane at the lumbosacral junction were statistically correlated to the age(P=0.003),underlining the fact that sagittal mechanical constraints at the lumbosacral junction increase with age.Moments in transversal plane at the thoracolumbar and lumbosacral junctions were statistically correlated to the age(P=0.0002and P=0.0006),revealing that transversal mechanical constraints decrease with age.CONCLUSION The kinetic analysis showed that during growth,a decrease of torsional constraint occurs while an increase of sagittal constraint is observed.These changes in spine biomechanics are related to the crucial role of the trunk for bipedalism acquisition,allowing stabilization despite lower limbs immaturity.With the acquisition of mature gait,the spine will mainly undergo constraints in the sagittal plane.

Effect of Motor Relearning Combined with t DCS on Motor Function of Lower Extremities and Gait in Patients with Cerebral Infarction and 3D Gait Analysis

[Objectives]To observe the effect of motor relearning combined with transcranial direct current stimulation on the motor function of lower extremities in patients with cerebral infarction,and to observe its effect on gait by 3D gait analysis.[Methods]60 patients with cerebral infarction who met the inclusion criteria were randomly divided into 3 groups according to the order of treatment(n=20).Group A received motor relearning treatment,group B received transcranial direct current stimulation treatment,group C received motor relearning combined with transcranial direct current stimulation,and the curative effect was observed after 5 courses of treatment.[Results]Before treatment,FMA,MBI,spatio-temporal parameters for 3D gait analysis(gait frequency,gait cycle,stride length,gait speed,stride length deviation,double support)and lower limb joint motion parameters(affected side stride length,maximum hip flexion,maximum hip extension,maximum knee flexion,maximum knee extension,stance phase,swing phase)were compared among the three groups.After treatment,the FMA and MBI of the three groups increased,and the spatio-temporal parameters for 3D gait analysis(gait frequency,gait cycle,gait speed,double support)and the lower limb joint motion parameters(affected side stride length,maximum hip flexion,maximum hip extension,maximum knee flexion,swing phase)were all improved,while the spatio-temporal parameters(stride length and stride length deviation)and the lower limb joint motion parameters(maximum knee extension and stance phase)decreased.Compared with those before treatment,there were significant differences among the three groups(P<0.05).Through the comparison between groups,it was found that the FMA,MBI,spatio-temporal parameters for 3D gait analysis(gait frequency,gait cycle,gait speed,double support)and lower limb joint motion parameters(affected side stride length,maximum hip flexion,maximum hip extension,maximum knee flexion,swing phase)in group C were significantly higher than those in group A and B,while the spatio-temporal parameters(stride length and stride length deviation)and lower limb joint motion parameters(maximum knee extension and stance phase)in group C were significantly lower than those in group A and group B,and the difference was statistically significant(P<0.05).[Conclusions]Motor relearning combined with transcranial direct current stimulation could increase MBI and FMA,improve gait spatio-temporal parameters and lower limb joint motion parameters,and correct abnormal gait in patients with cerebral infarction.

Gait Image Classification Using Deep Learning Models for Medical Diagnosis

Gait refers to a person’s particular movements and stance while moving around.Although each person’s gait is unique and made up of a variety of tiny limb orientations and body positions,they all have common characteristics that help to define normalcy.Swiftly identifying such characteristics that are difficult to spot by the naked eye,can help in monitoring the elderly who require constant care and support.Analyzing silhouettes is the easiest way to assess and make any necessary adjustments for a smooth gait.It also becomes an important aspect of decision-making while analyzing and monitoring the progress of a patient during medical diagnosis.Gait images made publicly available by the Chinese Academy of Sciences(CASIA)Gait Database was used in this study.After evaluating using the CASIA B and C datasets,this paper proposes a Convolutional Neural Network(CNN)and a CNN Long Short-TermMemory Network(CNN-LSTM)model for classifying the gait silhouette images.Transfer learningmodels such as MobileNetV2,InceptionV3,Visual Geometry Group(VGG)networks such as VGG16 and VGG19,Residual Networks(ResNet)like the ResNet9 and ResNet50,were used to compare the efficacy of the proposed models.CNN proved to be the best by achieving the highest accuracy of 94.29%.This was followed by ResNet9 and CNN-LSTM,which arrived at 93.30%and 87.25%accuracy,respectively.

Reference values of gait parameters in healthy Chinese university students: A cross-sectional observational study

BACKGROUND Gait is influenced by race,age,and diseases type.Reference values for gait are closely related to numerous health outcomes.To gain a comprehensive understanding of gait patterns,particularly in relation to race-related pathologies and disorders,it is crucial to establish reference values for gait in daily life considering sex and age.Therefore,our objective was to present sex and age-based reference values for gait in daily life,providing a valuable foundation for further research and clinical applications.AIM To establish reference values for lower extremity joint kinematics and kinetics during gait in asymptomatic adult women and men.METHODS Spatiotemporal,kinematics and kinetics parameters were measured in 171 healthy adults(70 males and 101 females)using the computer-aided soft tissue foot model.Full curve statistical parametric mapping was performed using independent and paired-samples t-tests.RESULTS Compared with females,males required more time(cycle time,double-limb support time,stance time,swing time,and stride time),and the differences were statistically significant.In addition,the step and stride lengths of males were longer.Compared to males,female cadence was faster,and statures-per-second and stride-per-minute were higher.There were no statistical differences in speed and stride width between the two groups.After adjusting for height,it was observed that women walked significantly faster than men,and they also had a higher cadence.However,in terms of step length,stride length,and stride width,both genders exhibited similarities.CONCLUSION We established reference values for gait speed and spatiotemporal gait parameters in Chinese university students.This contributes to a valuable database for gait assessment and evaluation of preventive or rehabilitative programs.

Performance of the walking trail making test in older adults with white matter hyperintensities

BACKGROUND Several studies have reported that the walking trail making test(WTMT)completion time is significantly higher in patients with developmental coordination disorders and mild cognitive impairments.We hypothesized that WTMT performance would be altered in older adults with white matter hyperintensities(WMH).AIM To explore the performance in the WTMT in older people with WMH.METHODS In this single-center,observational study,25 elderly WMH patients admitted to our hospital from June 2019 to June 2020 served as the WMH group and 20 participants matched for age,gender,and educational level who were undergoing physical examination in our hospital during the same period served as the control group.The participants completed the WTMT-A and WTMT-B to obtain their gait parameters,including WTMT-A completion time,WTMT-B completion time,speed,step length,cadence,and stance phase percent.White matter lesions were scored according to the Fazekas scale.Multiple neuropsychological assessments were carried out to assess cognitive function.The relationships between WTMT performance and cognition and motion in elderly patients with WMH were analyzed by partial Pearson correlation analysis.RESULTS Patients with WMH performed significantly worse on the choice reaction test(CRT)(0.51±0.09 s vs 0.44±0.06 s,P=0.007),verbal fluency test(VFT,14.2±2.75 vs 16.65±3.54,P=0.012),and digit symbol substitution test(16.00±2.75 vs 18.40±3.27,P=0.010)than participants in the control group.The WMH group also required significantly more time to complete the WTMT-A(93.00±10.76 s vs 70.55±11.28 s,P<0.001)and WTMT-B(109.72±12.26 s vs 82.85±7.90 s,P<0.001).WTMT-A completion time was positively correlated with CRT time(r=0.460,P=0.001),while WTMT-B completion time was negatively correlated with VFT(r=-0.391,P=0.008).On the WTMT-A,only speed was found to statistically differ between the WMH and control groups(0.803±0.096 vs 0.975±0.050 m/s,P<0.001),whereas on the WTMT-B,the WMH group exhibited a significantly lower speed(0.778±0.111 vs 0.970±0.053 m/s,P<0.001)and cadence(82.600±4.140 vs 85.500±5.020 steps/m,P=0.039),as well as a higher stance phase percentage(65.061±1.813%vs 63.513±2.465%,P=0.019)relative to controls.CONCLUSION Older adults with WMH showed obviously poorer WTMT performance.WTMT could be a potential indicator for cognitive and motor deficits in patients with WMH.

A Clinical Randomized Controlled Study of Low-Frequency rTMS Therapy on Lower Limb Motor Dysfunction after Stroke

Objective:To investigate the efficacy and safety of low-frequency repetitive transcranial magnetic stimulation(rTMS)for the treatment of lower limb motor dysfunction after stroke.Methods:A total of 96 patients with stroke and lower limb motor dysfunction were enrolled in this study,and were randomly divided into the experimental group and the sham stimulation group using the method of calculator-generated random numbers.Both groups received conventional medication and rehabilitation therapy.The experimental group received 4 weeks of 1 Hz rTMS treatment in the primary cortical motor area(M1)of the healthy side,with the treatment coil tangent to the skull surface;the sham stimulation group underwent the same procedures as the experimental group,but the treatment coil was perpendicular to the skull surface instead.Lower-extremity subscale of the Fugl-Meyer Assessment(FMA-LE),Berg Balance Scale(BBS),gait analysis,and lower-extremity surface electromyography(LESEM)were performed in both groups before and after rTMS treatment.Results:All 96 patients completed the test with no shedding and no adverse reactions.After treatment,the FMA-LE score and BBS score of the 2 groups of patients were significantly improved as compared with the pre-treatment(P<0.05),and the TUG test time was reduced as compared with the pre-treatment(P<0.05).The true stimulation group had greater improvement in all assessment indexes than that of the sham stimulation group(P<0.05).After treatment,the electromyographic activity of the tibialis anterior and rectus femoris muscles in the true simulation group improved significantly.The step length,step speed,and step frequency were also significantly improved in both groups after treatment,and the symmetrical ratio of step length and support time was reduced(P<0.05).Comparison between the groups revealed that the true simulation group significantly improved after rTMS treatment as compared to the sham stimulation group(P<0.05).Conclusion:1Hz rTMS treatment safely and effectively improved motor and balance function in patients with post-stroke lower limb motor dysfunction.

Tracking of Thigh Flexion Angle during Gait Cycles in an Ambulatory Activity Monitoring Sensor Network

An accelerometry-based gait analysis approach via the platform of sensor network is reported in this paper. The hardware units of the sensor network are wearable accelerometers that are attached at the limbs of human body. For the specific task of gait analysis, flexion angles of the thighs during gait cycles are computed. A Kalman filter is designed to estimate the flexion-extension angle, angular velocity of the thigh using the output of the wearable accelerometers. The proposed approach has been applied to four subjects and the performance is compared with video-based approach. Comparative results indicate that with the proposed Kalman filter, the sensor network is able to track the movement of the thighs during gait cycles with good accuracy and simultaneously detect major gait event of foot contact from the waveform of the angular velocity.

Dynamic biomechanical effect of lower body positive pressure treadmill training for hemiplegic gait rehabilitation after stroke: A case report

BACKGROUND Lower body positive pressure(LBPP)treadmill has potential applications for improving the gait of patients after stroke,but the related mechanism remains unclear.CASE SUMMARY A 62-year-old male patient suffered from ischemic stroke with hemiplegic gait.He was referred to our hospital because of a complaint of left limb weakness for 2 years.The LBPP training was performed one session per day and six times per week for 2 wk.The dynamic plantar pressure analysis was taken every 2 d.Meanwhile,three-digital gait analysis and synchronous electromyography as well as clinical assessments were taken before and after LBPP intervention and at the 4-wk follow-up.During LBPP training,our patient not only improved his lower limb muscle strength and walking speed,but more importantly,the symmetry index of various biomechanical indicators improved.Moreover,the patient’s planter pressure transferring from the heel area to toe area among the LBPP training process and the symmetry of lower body biomechanical parameters improved.CONCLUSION In this study,we documented a dynamic improvement of gait performance in a stroke patient under LBPP training,which included lower limb muscle strength,walking speed,and symmetry of lower limb biomechanics.Our study provides some crucial clues about the potential dynamic mechanism for LBPP training on gait and balance improvement,which is related to rebuilding foot pressure distribution and remodeling symmetry of biomechanics of the lower limb.

Technological advancements in the analysis of human motion and posture management through digital devices

Technological development of motion and posture analyses is rapidly progressing,especially in rehabilitation settings and sport biomechanics.Consequently,clear discrimination among different measurement systems is required to diversify their use as needed.This review aims to resume the currently used motion and posture analysis systems,clarify and suggest the appropriate approaches suitable for specific cases or contexts.The currently gold standard systems of motion analysis,widely used in clinical settings,present several limitations related to marker placement or long procedure time.Fully automated and markerless systems are overcoming these drawbacks for conducting biomechanical studies,especially outside laboratories.Similarly,new posture analysis techniques are emerging,often driven by the need for fast and non-invasive methods to obtain high-precision results.These new technologies have also become effective for children or adolescents with non-specific back pain and postural insufficiencies.The evolutions of these methods aim to standardize measurements and provide manageable tools in clinical practice for the early diagnosis of musculoskeletal pathologies and to monitor daily improvements of each patient.Herein,these devices and their uses are described,providing researchers,clinicians,orthopedics,physical therapists,and sports coaches an effective guide to use new technologies in their practice as instruments of diagnosis,therapy,and prevention.

A New Mixed Clustering-Based Method to Analyze the Gait of Children with Cerebral Palsy

Cerebral palsy is a group of persistent central movement and posturaldevelopmental disorders, and restricted activity syndromes. This syndrome iscaused by non-progressive brain damage to the developing fetus or infants. Cerebralpalsy assessment can determine whether the brain is behind or abnormal. If itexists, early intervention and rehabilitation can be carried out as soon as possibleto restore brain function to the greatest extent. The direct external manifestation ofcerebral palsy is abnormal gait. Accurately determining the muscle strengthrelatedreasons that cause this abnormal gait is the primary problem for treatment.In this paper, clustering methods were used to compare and analyze the differencesbetween the abnormal and normal gait parameters of children with andwithout cerebral palsy. Since the collected data contains overlapping data thatmay be mutated, while the centroids are also different, the expected result is stratified.To solve this problem, a mixed clustering method is proposed that combinesthe advantages of K-means and hierarchical clustering, meaning that eachset of data shows a similar trend to specific parameters. Experiment results showthat this method can detect cerebral palsy through the difference between theabnormal gait of children with cerebral palsy and that of normal children.

MOBILE PHONE AS PERVASIVE ELECTRONIC MEDIA TO RECORD AND EVALUATE HUMAN GAIT BEHAVIOR

Gait recognition has been of great importance for disease diagnosis,rehabilitation assessment,as well as personal identification.Conventional gait analysis generally has to rely heavily on complex,expensive data acquisition and computing apparatus.To significantly simplify the evaluation process the mobile phone,which is one of the most indispensable electronic media in human daily life,was adopted as a pervasive tool for gait study,by using its digital imaging recording and analysis function.The basic procedure to record and quantify the video of human gait was illustrated and demonstrated through conceptual experiments.Potential applications were discussed.Some fundamental and practical issues raised in such flexible technology were pointed out.This method is expected to be widely used in future human analysis.

Effects of Water Weight-Loss Walking Training on Lower Limb Motor Function and Gait in Stroke Patients

Background: Water weight-loss walking training is an emerging physical therapy technique, which provides new ideas for improving the motor function of stroke patients and improving the quality of life of patients. However, the rehabilitation effect of water weight-loss training in stroke patients is currently unclear. Objective: To analyze the effect of water weight loss walking training in stroke patients. Methods: A total of 180 stroke patients admitted to our hospital from January 2019 to December 2021 were selected and randomly divided into two groups. The control group received routine walking training, and the research group performed weight loss walking training in water on this basis. The lower limb motor function, muscle tone grade, daily living ability, gait and balance ability were compared between the two groups before and after treatment. Results: Compared with the control group, the FMA-LE score (Fugl-Meyer motor assessment of Lower Extremity), MBI score (Modified Barthel Index) and BBS score (berg balance scale) of the study group were higher after treatment, and the muscle tone was lower (P Conclusion: Water weight loss walking training can enhance patients’ muscle tension, correct patients’ abnormal gait, improve patients’ balance and walking ability, and contribute to patients’ motor function recovery and self-care ability improvement.

Study on the correlation between early three-dimensional gait analysis and clinical efficacy after robot-assisted total knee arthroplasty

Purpose:Robot-assisted technology is a forefront of surgical innovation that improves the accuracy of total knee arthroplasty (TKA).But whether the accuracy of surgery can improve the clinical efficacy still needs further research.The purpose of this study is to perform three-dimensional (3D) analysis in the early postoperative period of patients who received robot-assisted total knee arthroplasty (RATKA),and to study the trend of changes in gait parameters after RATKA and the correlation with the early clinical efficacy.Methods:Patients who received RATKA in the Center of Joint Surgery,the First Hospital Affiliated to Army Military Medical University from October 2020 to January 2021 were included.The imaging parameters,i.e.,hip-knee-ankle angle,lateral distal femoral angle,medial proximal tibial angle,posterior condylar angle were measured 3 months post-TKA.The 3D gait analysis and clinical efficacy by Western Ontario Mac Master University Index (WOMAC) score were performed pre-TKA,3 and 6 months post-TKA.The differences in spatiotemporal parameters of gait,kinetic parameters,and kinematic parameters of the operated limb and the contralateral limb were compared.The correlation between gait parameters and WOMAC scores was analyzed.Paired samplet-test and Wilcoxon rank-sum test were used to analyze the difference between groups,and Spearman correlation coefficient was used to analyze the correlation.Results:There were 31 patients included in this study,and the imaging indexes showed that all of them returned to normal post-TKA.The WOMAC score at 3 months post-TKA was significantly lower than that pre-TKA,and there was no significant difference between at 3 and 6 months.The 3D gait analysis results showed that the double support time of the operated limb reduced at 3 and 6 months (allp < 0.05),the maximum extension and maximum external rotation of the knee joint increased at stance phase,and the maximum flexion angle,the range of motion and the maximum external rotation increased at swing phase.Compared with the preoperative data,there were significant improvements (allp < 0.05).Compared with the contralateral knee joint,the maximum external rotation of the knee joint at swing phase was smaller than that of the contralateral side,and the maximum flexion and extension moment was greater than that of the contralateral knee.The maximum external rotation moment of the joint was greater than that of the contralateral knee joint (p < 0.05).There was a negative correlation between the single support time pre-TKA and the WOMAC score at 3 months (p = 0.017),and the single support time at 3 months was negatively correlated with the WOMAC score at 6 months (p = 0.043).The cadence at 6 months was negatively correlated with the WOMAC score at 6 months (p = 0.031).The maximum knee extension at stance phase at 6 months was negatively correlated with the WOMAC score at 6 month (p = 0.048).The maximum external rotation at stance phase at 6 months was negatively correlated with the WOMAC score at 6 months (p = 0.024).Conclusion:The 3D gait analysis of RATKA patients is more sensitive than WOMAC score in evaluating the clinical efficacy.Trend of changes in gait parameters shows that the knee joint support,flexion and extension function,range of motion,external rotation and varus deformity moment of the patient were significantly improved at 3 months after surgery,and continued to 6 months after surgery.Compared with the contralateral knee,the gait parameters of the operated limb still has significant gaps in functionality,such as the external rotation and flexion and extension.The single support time,cadence,knee extension,and knee external rotation of the operated limb have a greater correlation with the postoperative WOMAC score.Postoperative rehabilitation exercises should be emphasized,which is of great value for improving the early efficacy of RATKA.