The effect of whole body vibration on gait dynamics after chronic stroke in Pakistan; A Randomized Controlled Clinical Trial

Objective: To determine the effect of whole body vibration (WBV) therapy on gait dynamics in chronic stroke patients in a tertiary care hospital. Methods: The present study was randomized, assessor-blinded, parallel-group, clinical trial conducted at Physiotherapy Department, Lahore General Hospital, Lahore, Pakistan, from November 2017 to April 2019. After taking written informed consent, 64 chronic stroke patients were randomly allocated (1:1) to routine physiotherapy (RP) group (n=32) and whole-body vibration (WBV) group (n=32) by computer random number generator method. Twelve sessions of vibration therapy were given to WBV group with an amplitude of 3 mm and frequency of 20Hz. Sessions comprises of 5 bouts of 120 seconds with 60 seconds rest intervals for 6 days/week x 2 weeks in erect standing position. The outcome measure was score of Timed Up and Go test (TUG test) and 10 Meter Walk test (10MWT) before and after intervention. Mann Whitney U Test and Wilcoxon Signed Rank test were used to analyze data. Results: After 2-week intervention, significant difference was seen in TUG, 10 Meter Walk test Slow Speed (10MWTSS), 10 Meter Walk test fast speed (10MWTFS) score for both treatment groups (p-value<0.05). However patients in WBV group had better improvement as compared to patients in the RP group. Conclusions: Initiation of walk and Walking Speed improved with Whole-body vibration therapy in chronic stroke survivors in Pakistan. Clinical Trial Number: IRCT20190328043131N1 Key Words: Stroke, Whole body Vibration, Rehabilitation, Walk Initiation, Walking Speed, Continuous...

Parkinson’s Disease Rating Scale Using Synchronization Analysis of Gait Dynamics

Analysis of gait dynamics is a noninvasive and totally painless test, and it can be an ideal method for the diagnosis of neurodegenerative diseases. In this study, based on the strength of synchronization between dynamics of strides, we have suggested a rating scale method for Parkinson’s disease (PD). Methods. The sample included 15 persons with PD (age: 66.8 ± 10.9 years) and 16 healthy persons (age: 39.3 ± 18.5 years) which were recruited from the Neurology Outpatient Clinic at Massachusetts General Hospital and were instructed to walk a 77 m long, straight hallway. The time interval of strides and subphases of strides were measured. Using the Hilbert transformation method, we obtained the data phase and used mean absolute error (MAE) to calculate the synchronization strength of the data phase. Results. In order to check the accuracy of our method, we measured the correlation between our numerical results (MAE) and values of the Hoehn-Yahr scale. Spearman’s rank correlation coefficients ( r ) and the P values were calculated. MAE of left and right stride intervals (LRSI) significantly correlates with the Hoehn-Yahr scale for the subjects with PD (with r = 0.60 and P = 0.025 < 0.05 ). Conclusion. We have revealed that the synchronization weakness of LRSI shows the severity of PD. This method seems to be well suited as a rating scale for people with PD.

Quantifying the Dynamic Stability of Gait Patterns in People with Hallux Valgus

Hallux valgus (HV), which is mainly caused by the wearing of narrow-width and high-heeled shoes, disrupts gait behavior because it deforms lower limb joints. There is limited information regarding the relationship between the foot disease HV and lower limb joints. Previous studies evaluating abnormal gait patterns caused by deformity used spatiotemporal parameters; however, they failed to characterize the overall gait dynamics. To address this issue, this study is aimed at characterizing the gait stability of patients with HV and examining the joints that are critically affected by HV. To assess complex gait dynamics, we quantified the potential changes in gait stability by using the maximum Lyapunov exponent (MLE). Angular displacements of the ankle, knee, and hip in the sagittal plane during walking were investigated to calculate the MLE for gait stability based on foot conditions (i.e., barefoot, flat shoes, and high heels). During walking, a large MLE ( P < 0.05 ) was noted for the knee joints of subjects with HV, relative to the other lower limb joints. HV appears to have the most critical effect on the knee joints during walking. Ankle movement exhibited higher dynamic stability than the other joint movements of the lower limb ( P < 0.05 ). The type of shoe used in the experiment showed no significant dependence with gait stability and joint movement ( P > 0.05 ). Quantitative assessments of dynamic stability using the MLE may help clinicians assess the overall gait dynamics of HV patients and other people suffering from gait disturbances.

A Case Study Demonstrating the Utility of Surveillance Video in Assessing Gait Dynamics and Behavior During a Slip and Fall

As the use of surveillance video at commercial properties becomes more prevalent, it is more likely an incident involving a personal injury will be captured on film. This provides a unique opportunity for Human Factors practitioners involved in forensic investigations to analyze the behavior of the individual prior to, during, and after the event in question. It also provides an opportunity to gather unique and objective data. The present work describes a case study of a slip and fall where surveillance video and onsite measurements were combined and analyzed to quantify a plaintiff’s gait pattern. Using this type of analysis, we were able to determine that the plaintiff was likely aware that the floor was slippery and adjusted her gait and behavior prior to the slip and fall incident.