An alternative approach to normalization and evaluation for gait patterns: Procrustes analysis applied to the cyclograms of sprinters and middle-distance runners

In order to compare gait patterns, a common procedure is to normalize strides both in time and magnitude. The stride duration is usually normalized to a time percentage before averaging curves. As the timing of event occurrences may shift across strides, the shape of the averaged curves is distorted and therefore the standard deviation is overvalued. Stride magnitude normalization is performed by means of dimensionless numbers. However, there is little agreement on which body size correction methods should be used. The Procrustes method describes curve shape and shape change in a mathematical and statistical framework, independently of time and size factors. The present study aims to explore how this technique may be used for time- and magnitude-stride normalization to reflect individual and group mean responses. The Procrustes method, which combines quantitative and visual features, is applied to the shape of the ankle and knee cyclograms. Superimposition of 25 cyclograms (10 for sprinters (SP) and 15 for middle-distance runners (MDR)) was supplemented by statistical procedures (principal component analysis, discriminant function) to extract the main key events, which vary according to the athletic specialities. In comparison with the MDR (poulaine-shaped cyclogram), the ovoid cyclogram of SP reveals the following gait indicators: a short braking phase, a rapid initial lower limb swing in the forward direction, a fast upward movement of the knee and ankle, and an active foot contact. The Procrustes approach could be used to describe other quasi-periodic movements through relative motion plots (e.g., cyclograms, angle-angle diagrams, phase plane portraits).     

Detrended Fluctuation Analysis and Adaptive Fractal Analysis of Stride Time Data in Parkinson's Disease: Stitching Together Short Gait Trials

Variability indicates motor control disturbances and is suitable to identify gait pathologies. It can be quantified by linear parameters (amplitude estimators) and more sophisticated nonlinear methods (structural information). Detrended Fluctuation Analysis (DFA) is one method to measure structural information, e.g., from stride time series. Recently, an improved method, Adaptive Fractal Analysis (AFA), has been proposed. This method has not been applied to gait data before. Fractal scaling methods (FS) require long stride-to-stride data to obtain valid results. However, in clinical studies, it is not usual to measure a large number of strides (e.g., strides). Amongst others, clinical gait analysis is limited due to short walkways, thus, FS seem to be inapplicable. The purpose of the present study was to evaluate FS under clinical conditions. Stride time data of five self-paced walking trials ( strides each) of subjects with PD and a healthy control group (CG) was measured. To generate longer time series, stride time sequences were stitched together. The coefficient of variation (CV), fractal scaling exponents (DFA) and (AFA) were calculated. Two surrogate tests were performed: A) the whole time series was randomly shuffled; B) the single trials were randomly shuffled separately and afterwards stitched together. CV did not discriminate between PD and CG. However, significant differences between PD and CG were found concerning and . Surrogate version B yielded a higher mean squared error and empirical quantiles than version A. Hence, we conclude that the stitching procedure creates an artificial structure resulting in an overestimation of true . The method of stitching together sections of gait seems to be appropriate in order to distinguish between PD and CG with FS. It provides an approach to integrate FS as standard in clinical gait analysis and to overcome limitations such as short walkways.     

Non-linear changes of lower extremity kinetics prior to gait transition

IntroductionThe purpose of this study was to examine the changes of lower extremity kinetics during walk-to-run (WR) transition and if the changes would follow a non-linear trend within the five strides before WR transition using a constant acceleration protocol.MethodsFourteen participants performed gait transition on the instrumented treadmill at a constant acceleration. Peak, time to peak, and movement and power of hip, knee and ankle joints were recorded and analyzed in sagittal plane for five strides before gait transition. Three Two-way MANOVA were employed to examine the differences of kinetic measures among the five strides. Univariate analysis and Post-Hoc Tukey’s test would be applied if needed. Also, Post hoc polynomial trend analyses were used to examine the trend of the kinetic measures that significantly changed during the five strides.ResultsCompared to the first four strides, significant differences were observed for peaks moments, joint powers, and time to peaks in the last stride before running at ankle, knee, and hip joints respectively. In general, the changes of kinetic variables were following a quadratic trend during the five strides before running.ConclusionJoint kinetic measures actively change in non-linear patterns during the five strides before running to prepare for the gait transition, indicating that the gait transition is an active reorganization rather than a passive reaction.     

The effect of branch diameter on primate gait sequence pattern

Most mammals use lateral sequence gaits during quadrupedal locomotion, a pattern characterized by the touchdown of a forelimb directly following the ipsilateral hind limb in a given stride cycle. Primates, however, tend to use diagonal sequence (DS) gaits, whereby it is the touchdown of a contralateral forelimb that follows that of a given hind limb most closely in time. A number of scenarios have been offered to explain why primates favor DS gaits, most of them relating to the use of the arboreal habitat and, in particular, the exploitation of a narrow branch niche. This experimental study explores the potential explanation for the use of DS gaits by examining the relationship between branch diameter and gait patterns in 360 strides collected from six species of quadrupedal strepsirrhine primates on broad and narrow diameter supports. Gait sequence is quantified using limb phase, or the percentage of time during a stride cycle that a forelimb touchdown follows an ipsilateral hind limb touchdown. Although Loris, Nycticebus and Eulemur rubriventer individuals in this study did exhibit significantly lower locomotor velocities on narrower supports (P<0.01 in all three species), analyses of covariance showed no significant differences in limb phase values between broad and narrow diameter supports. Hence, results indicate surprisingly little evidence to suggest that alterations in gait sequence pattern provide a specific advantage for negotiating narrow supports.     

Peripheral neuropathy does not alter the fractal dynamics of stride intervals of gait.

The purpose of this study was to determine the effect (if any) of significant sensory loss on the long-range correlations normally observed in the stride intervals of human gait. Fourteen patients with severe peripheral neuropathy and 12 gender-, age-, height-, and weight-matched nondiabetic controls participated. Subjects walked around an approximately 200-m open-level walkway for 10 min at their comfortable pace. Continuous knee joint kinematics were recorded and used to calculate a stride interval time series for each subject. Power spectral density and detrended fluctuation analyses were used to determine whether these stride intervals exhibited long-range correlations. If the loss of long-range correlations indicates deterioration of the central control of gait, then changes in peripheral sensation should have no effect. If instead the loss of long-range correlations is a consequence of a general inability to regulate gait cycle timing, then a similar loss should occur in patients with peripheral locomotor disorders. Both power spectral density analyses and detrended fluctuation analyses showed that temporal correlations in the stride times of neuropathic and control subjects were statistically identical (P = 0.954 and P = 0.974, respectively), despite slower gait speeds (P = 0.008) and increased stride time variability (P = 0.036) among the neuropathy patients. All subjects in both groups exhibited long-range correlations. These findings demonstrate that the normal long-range correlation structure of stride intervals is unaltered by significant peripheral sensory loss. This further supports the hypothesis that the central nervous system is involved in the regulation of long-range correlations.     

Paired nonlinear behavior of active and passive joint torques associated with preparation for walk-to-run gait transition

This study investigated the lower extremity torque's active and passive features during the walk-to-run gait transition with continuously increased walking speed. Fourteen volunteers participated in the experiment. Kinematic and kinetic data were collected synchronously. Five strides leading up the gait transition were examined. Peaks of the passive (e.g., contact) and active (e.g., generalized muscle torques), along with net joint torque, and time to peak torques exhibited significant differences at the last stride before gait transition, compared to the first four strides, at the ankle, knee, and hip joints, respectively. Selected peak joint active and passive torques showed significant and opposite trends at critical events within a stride cycle: such ankle joint right after heel-contact, knee joint during weight acceptance, and both hip and knee joints right before toe-off. The magnitude and the corresponding time to active and passive peak torque changed in a nonlinear pattern before the transition from walk to run. The lower extremity segment-interaction during gait transition appeared to be an active reorganization exemplified by the interaction between the lower extremity's active and passive torque components.     

Day-to-day reliability of gait characteristics in rats

The purpose of the present study was to determine the day-to-day reliability in stride characteristics in rats during treadmill walking obtained with two-dimensional (2D) motion capture. Kinematics were recorded from 26 adult rats during walking at 8 m/min, 12 m/min and 16 m/min on two separate days. Stride length, stride time, contact time, swing time and hip, knee and ankle joint range of motion were extracted from 15 strides. The relative reliability was assessed using intra-class correlation coefficients (ICC(1,1)) and (ICC(3,1)). The absolute reliability was determined using measurement error (ME). Across walking speeds, the relative reliability ranged from fair to good (ICCs between 0.4 and 0.75). The ME was below 91 mm for strides lengths, below 55 ms for the temporal stride variables and below 6.4° for the joint angle range of motion. In general, the results indicated an acceptable day-to-day reliability of the gait pattern parameters observed in rats during treadmill walking. The results of the present study may serve as a reference material that can help future intervention studies on rat gait characteristics both with respect to the selection of outcome measures and in the interpretation of the results.     

A hidden Markov model-based stride segmentation technique applied to equine inertial sensor trunk movement data

Inertial sensors are now sufficiently small and lightweight to be used for the collection of large datasets of both humans and animals. However, processing of these large datasets requires a certain degree of automation to achieve realistic workloads. Hidden Markov models (HMMs) are widely used stochastic pattern recognition tools and enable classification of non-stationary data. Here we apply HMMs to identify and segment into strides, data collected from a trunk-mounted six degrees of freedom inertial sensor in galloping Thoroughbred racehorses. A data set comprising mixed gait sequences from seven horses was subdivided into training, cross-validation and independent test set. Manual gallop stride segmentations were created and used for training as well as for evaluating cross-validation and test set performance. On the test set, 91% of the strides were accurately detected to lie within +/- 40 ms (< 10% stride time) of the manually segmented stride starts. While the automated system did not miss any of the strides, it identified additional gallop strides at the beginning of the trials. In the light of increasing use of inertial sensors for ambulatory measurements in clinical settings, automated processing techniques will be required for efficient data processing to enable instantaneous decision making from large amounts of data. In this context, automation is essential to gain optimal benefits from the potentially increased statistical power associated with large numbers of strides that can be collected in a relatively short period of time. We propose the use of HMM-based classifiers since they are easy to implement. In the present study, consistent results across cross-validation and test set were achieved with limited training data.     

Extended Timed Up & Go test: Is walking forward and returning back to the chair equivalent gait?

The Timed Up & Go test (TUG) is functional test and is a part of routine clinical examinations. The instrumented Timed Up & Go test enables its segmentation to sub-tasks: sit-to-stand, walking forward, turning, walking back, stand-to-sit, and consequently the computation of task-specific parameters and sub-tasks separately. However, there are no data on whether walking forward parameters differ from the walking back parameters. This study tested the differences between walking forward and walking back in the TUG extended to 10 m for 17 spatio-temporal gait parameters. All parameters were obtained from a GAITRite® pressure sensitive walkway (CIR Systems, Inc.). The differences were assessed for healthy controls and Parkinson's disease (PD) patients. None of investigated parameters exhibited a difference between both gait subtasks for healthy subjects group. Five parameters of interest, namely velocity, step length, stride length, stride velocity, and the proportion of the double support phase with respect to gait cycle duration, showed a statistically significant difference between gait for walking forward and walking back in PD patients. Therefore, we recommend a separate assessment for walking forward and walking back rather than averaging both gaits together.     

Artificial neural network model for the generation of muscle activation patterns for human locomotion.

Skilled locomotor behaviour requires information from various levels within the central nervous system (CNS). Mathematical models have permitted researchers to simulate various mechanisms in order to understand the organization of the locomotor control system. While it is difficult to adequately characterize the numerous inputs to the locomotor control system, an alternative strategy may be to use a kinematic movement plan to represent the complex inputs to the locomotor control system based on the possibility that the CNS may plan movements at a kinematic level. We propose the use of artificial neural network (ANN) models to represent the transformation of a kinematic plan into the necessary motor patterns. Essentially, kinematic representation of the actual limb movement was used as the input to an ANN model which generated the EMG activity of 8 muscles of the lower limb and trunk. Data from a wide variety of gait conditions was necessary to develop a robust model that could accommodate various environmental conditions encountered during everyday activity. A total of 120 walking strides representing normal walking and ten conditions where the normal gait was modified in terms of cadence, stride length, stance width or required foot clearance. The final network was assessed on its ability to predict the EMG activity on individual walking trials as well as its ability to represent the general activation pattern of a particular gait condition. The predicted EMG patterns closely matched those recorded experimentally, exhibiting the appropriate magnitude and temporal phasing required for each modification. Only 2 of the 96 muscle/gait conditions had RMS errors above 0.10, only 5 muscle/gait conditions exhibited correlations below 0.80 (most were above 0.90) and only 25 muscle/gait conditions deviated outside the normal range of muscle activity for more than 25% of the gait cycle. These results indicate the ability of single network ANNs to represent the transformation between a kinematic movement plan and the necessary muscle activations for normal steady state locomotion but they were also able to generate muscle activation patterns for conditions requiring changes in walking speed, foot placement and foot clearance. The abilities of this type of network have implications towards both the fundamental understanding of the control of locomotion and practical realizations of artificial control systems for use in rehabilitation medicine.     

Step-to-Step Variability in Treadmill Walking: Influence of Rhythmic Auditory Cueing

While walking, human beings continuously adjust step length (SpL), step time (SpT), step speed (SpS = SpL/SpT) and step width (SpW) by integrating both feedforward and feedback mechanisms. These motor control processes result in correlations of gait parameters between consecutive strides (statistical persistence). Constraining gait with a speed cue (treadmill) and/or a rhythmic auditory cue (metronome), modifies the statistical persistence to anti-persistence. The objective was to analyze whether the combined effect of treadmill and rhythmic auditory cueing (RAC) modified not only statistical persistence, but also fluctuation magnitude (standard deviation, SD), and stationarity of SpL, SpT, SpS and SpW. Twenty healthy subjects performed 6×5 min. walking tests at various imposed speeds on a treadmill instrumented with foot-pressure sensors. Freely-chosen walking cadences were assessed during the first three trials, and then imposed accordingly in the last trials with a metronome. Fluctuation magnitude (SD) of SpT, SpL, SpS and SpW was assessed, as well as NonStationarity Index (NSI), which estimates the dispersion of local means in the times series (SD of 20 local means over 10 steps). No effect of RAC on fluctuation magnitude (SD) was observed. SpW was not modified by RAC, what is likely the evidence that lateral foot placement is separately regulated. Stationarity (NSI) was modified by RAC in the same manner as persistent pattern: Treadmill induced low NSI in the time series of SpS, and high NSI in SpT and SpL. On the contrary, SpT, SpL and SpS exhibited low NSI under RAC condition. We used relatively short sample of consecutive strides (100) as compared to the usual number of strides required to analyze fluctuation dynamics (200 to 1000 strides). Therefore, the responsiveness of stationarity measure (NSI) to cued walking opens the perspective to perform short walking tests that would be adapted to patients with a reduced gait perimeter.     

Overcoming the limitations of the Harmonic Ratio for the reliable assessment of gait symmetry

The Harmonic Ratio (HR) is an index based on the spectral analysis of lower trunk accelerations that is commonly used to assess the quality of gait. However, it presents several issues concerning reliability and interpretability. As a consequence, the literature provides very different values albeit corresponding to the same populations. In the present work, an improved harmonic ratio (iHR) was defined, relating the power of the intrinsic harmonics (i.e. associated with the symmetric component of gait) to the total power of the signal for each stride, leading to a normalised index ranging from 0 to 100%. The effect of the considered number of harmonics and strides on the estimate of both HR and iHR was assessed. The gait of three groups of volunteers was investigated: young healthy adults, elderly women and male trans-femoral amputees. Both HR and iHR were able to discriminate gait deviations from the gait of young healthy adults. Moreover, iHR proved to be more robust with respect to the number of considered harmonics and strides, and to exhibit a lower inter-stride variability. Additionally, using a normalised index as iHR led to a more straightforward interpretation and improved comparability. The importance of standardised conditions for the index evaluation was unveiled, and, in order to enhance the future comparability of the index, the following guidelines were presented: considering at least 20 harmonics and 20 strides; expressing the acceleration components in a repeatable, anatomical, local system of reference; and evaluating the iHR index, rather than the traditional HR.     

Gait variability magnitude but not structure is altered in essential tremor

Essential tremor (ET) is a common tremor disorder affecting postural/action tremor of the upper extremities and midline. Recent research revealed a cerebellar-like deficit during tandem gait in persons with ET, though spatiotemporal variability during normal gait in ET has been relatively ignored. The first purpose of this study was to investigate gait variability magnitude and structure in ET as compared to healthy older adults (HOA). To address this issue, 11 ET and 11 age-matched HOAs walked on a treadmill for 5 min at preferred walking speeds. HOAs walked for an additional minute while speed-matched to an ET participant. The second purpose was to describe the clinical correlates of gait variability in this population. To address this aim, 31 persons with ET walked on a treadmill for 5 min and completed the Fahn–Tolosa–Marin Tremor Rating Scale. Gait variability magnitude was derived by calculating coefficients of variation in stride length, stride time, step length, step time, and step width. Gait variability structure was derived using a detrended fluctuation analysis technique. At preferred walking speeds, ET participants walked significantly slower with significantly increased variability magnitude in all five spatiotemporal gait parameters. At speed-matched walking, ET participants exhibited significantly higher step width variability. Gait variability structure was not different between groups. We also observed that gait variability magnitude was predicted by severity of upper extremity and midline tremors. This study revealed that self-selected gait in ET is characterized by high variability that is associated with tremor severity in the upper extremity and midline.     

The effects of resisted sprint training on acceleration performance and kinematics in soccer, rugby union, and Australian football players

Acceleration is a significant feature of game-deciding situations in the various codes of football. However little is known about the acceleration characteristics of football players, the effects of acceleration training, or the effectiveness of different training modalities. This study examined the effects of resisted sprint (RS) training (weighted sled towing) on acceleration performance (0-15 m), leg power (countermovement jump [CMJ], 5-bound test [5BT], and 50-cm drop jump [50DJ]), gait (foot contact time, stride length, stride frequency, step length, and flight time), and joint (shoulder, elbow, hip, and knee) kinematics in men (N = 30) currently playing soccer, rugby union, or Australian football. Gait and kinematic measurements were derived from the first and second strides of an acceleration effort. Participants were randomly assigned to 1 of 3 treatment conditions: (a) 8-week sprint training of two 1-h sessions x wk(-1) plus RS training (RS group, n = 10), (b) 8-week nonresisted sprint training program of two 1-h sessions x wk(-1) (NRS group, n = 10), or (c) control (n = 10). The results indicated that an 8-week RS training program (a) significantly improves acceleration and leg power (CMJ and 5BT) performance but is no more effective than an 8-week NRS training program, (b) significantly improves reactive strength (50DJ), and (c) has minimal impact on gait and upper- and lower-body kinematics during acceleration performance compared to an 8-week NRS training program. These findings suggest that RS training will not adversely affect acceleration kinematics and gait. Although apparently no more effective than NRS training, this training modality provides an overload stimulus to acceleration mechanics and recruitment of the hip and knee extensors, resulting in greater application of horizontal power.     

The number of strides required for treadmill running gait analysis is unaffected by either speed or run duration

Participation in running events has increased recently, with a concomitant increase in the rate of running related injuries (RRI). Mechanical overload is thought to be a primary cause of RRI, it is often detected using motion analysis to examine running mechanics during either overground or treadmill running. In treadmill running, no clear consensus for the number of strides required to establish stable kinematic data exists. The aim of this study was to establish the number of strides needed for stable data when analysing gait kinematics in the stance phase of treadmill running. Twenty healthy, masters age group, club runners completed a high intensity interval training run (HIIT) and an energy-expenditure matched medium intensity continuous run (MICR). Thirty consecutive strides at start and end of each run were identified. Sequential averaging was employed to determine the number of strides required to establish a stable value. No significant differences existed in the number of strides required to achieve stable values. Twenty consecutive strides are required to be 95% confident stable values exist for maximum angle, angle at initial foot contact, and range of motion at the ankle, knee, and hip joints variables at the ankle, knee, and hip joints, in all three planes of motion, and spatiotemporal regardless of running speed and time of capture.     

Spatio-temporal gait characteristics of the hind-limb cycles during voluntary bipedal and quadrupedal walking in bonobos (Pan paniscus)

Spatio-temporal gait characteristics (step and stride length, stride frequency, duty factor) were determined for the hind-limb cycles of nine bonobos (Pan paniscus) walking quadrupedally and bipedally at a range of speeds. The data were recalculated to dimensionless quantities according to the principle of dynamic similarity. Lower leg length was used as the reference length. Interindividual variability in speed modulation strategy of bonobos appears to be low. Compared to quadrupedal walking, bipedal bonobos use smaller steps to attain a given speed (differences increase with speed), resulting in shorter strides at a higher frequency. In the context of the ("hybrid") dynamic pattern approach to locomotion (Latach, 1998) we argue that, despite these absolute differences, intended walking speed is the basic control variable which elicits both quadrupedal and bipedal walking kinematics in a similar way. Differences in the initial status of the dynamic system may be responsible for the differences in step length between both gaits. Comparison with data deduced from the literature shows that the effects of walking speed on stride length and frequency are similar in bonobos, common chimpanzees, and humans. This suggests that (at least) within extant homininae, spatio-temporal gait characteristics are highly comparable, and this in spite of obvious differences in mass distribution and bipedal posture.     

Torque around the center of mass: dynamic stability during quadrupedal arboreal locomotion in the Siberian chipmunk (Tamias sibiricus)

When animals travel on tree branches, avoiding falls is of paramount importance. Animals swiftly running on a narrow branch must rely on movement to create stability rather than on static methods. We examined how Siberian chipmunks (Tamias sibiricus) remain stable while running on a narrow tree branch trackway. We examined the pitch, yaw, and rolling torques around the center of mass, and hypothesized that within a stride, any angular impulse (torque during step time) acting on the center of mass would be canceled out by an equal and opposite angular impulse. Three chipmunks were videotaped while running on a 2 cm diameter branch trackway. We digitized the videos to estimate center of mass and center of pressure positions throughout the stride. A short region of the trackway was instrumented to measure components of the substrate reaction force. We found that positive and negative pitch angular impulse was by far the greatest in magnitude. The anterior body was pushed dorsally (upward) when the forelimbs landed simultaneously, and then the body pitched in the opposite direction as both hindlimbs simultaneously made contact. There was no considerable difference between yaw and rolling angular impulses, both of which were small and equal between fore- and hindlimbs. Net angular impulses around all three axes were usually greater than or less than zero (not balanced). We conclude that the chipmunks may balance out the torques acting on the center of mass over the course of two or more strides, rather than one stride as we hypothesized.     

Energy cost of walking and gait instability in healthy 65- and 80-yr-olds.

This study tested whether the lower economy of walking in healthy elderly subjects is due to greater gait instability. We compared the energy cost of walking and gait instability (assessed by stride to stride changes in the stride time) in octogenarians (G80, n = 10), 65-yr-olds (G65, n = 10), and young controls (G25, n = 10) walking on a treadmill at six different speeds. The energy cost of walking was higher for G80 than for G25 across the different walking speeds (P < 0.05). Stride time variability at preferred walking speed was significantly greater in G80 (2.31 +/- 0.68%) and G65 (1.93 +/- 0.39%) compared with G25 (1.40 +/- 0.30%; P < 0.05). There was no significant correlation between gait instability and energy cost of walking at preferred walking speed. These findings demonstrated greater energy expenditure in healthy elderly subjects while walking and increased gait instability. However, no relationship was noted between these two variables. The increase in energy cost is probably multifactorial, and our results suggest that gait instability is probably not the main contributing factor in this population. We thus concluded that other mechanisms, such as the energy expenditure associated with walking movements and related to mechanical work, or neuromuscular factors, are more likely involved in the higher cost of walking in elderly people.     

Kinematic analysis quantifies gait abnormalities associated with lameness in broiler chickens and identifies evolutionary gait differences

This is the first time that gait characteristics of broiler (meat) chickens have been compared with their progenitor, jungle fowl, and the first kinematic study to report a link between broiler gait parameters and defined lameness scores. A commercial motion-capturing system recorded three-dimensional temporospatial information during walking. The hypothesis was that the gait characteristics of non-lame broilers (n = 10) would be intermediate to those of lame broilers (n = 12) and jungle fowl (n = 10, tested at two ages: immature and adult). Data analysed using multi-level models, to define an extensive range of baseline gait parameters, revealed inter-group similarities and differences. Natural selection is likely to have made jungle fowl walking gait highly efficient. Modern broiler chickens possess an unbalanced body conformation due to intense genetic selection for additional breast muscle (pectoral hypertrophy) and whole body mass. Together with rapid growth, this promotes compensatory gait adaptations to minimise energy expenditure and triggers high lameness prevalence within commercial flocks; lameness creating further disruption to the gait cycle and being an important welfare issue. Clear differences were observed between the two lines (short stance phase, little double-support, low leg lift, and little back displacement in adult jungle fowl; much double-support, high leg lift, and substantial vertical back movement in sound broilers) presumably related to mass and body conformation. Similarities included stride length and duration. Additional modifications were also identified in lame broilers (short stride length and duration, substantial lateral back movement, reduced velocity) presumably linked to musculo-skeletal abnormalities. Reduced walking velocity suggests an attempt to minimise skeletal stress and/or discomfort, while a shorter stride length and time, together with longer stance and double-support phases, are associated with instability. We envisage a key future role for this highly quantitative methodology in pain assessment (associated with broiler lameness) including experimental examination of therapeutic agent efficacy.     

Gait in Very Preterm School-Aged Children in Dual-Task Paradigms

Objective

The control of gait requires executive and attentional functions. As preterm children show executive and attentional deficits compared to full-term children, performing concurrent tasks that impose additional cognitive load may lead to poorer walking performance in preterm compared to full-term children. Knowledge regarding gait in preterm children after early childhood is scarce. We examined straight walking and if it is more affected in very preterm than in full-term children in dual-task paradigms.

Study design

Twenty preterm children with very low birth-weight (≤ 1500 g), 24 preterm children with birth-weight > 1500 g, and 44 full-term children, born between 2001 and 2006, were investigated. Gait was assessed using an electronic walkway system (GAITRite) while walking without a concurrent task (single-task) and while performing one concurrent (dual-task) or two concurrent (triple-task) tasks. Spatio-temporal gait parameters (gait velocity, cadence, stride length, single support time, double support time), normalized gait parameters (normalized velocity, normalized cadence, normalized stride length) and gait variability parameters (stride velocity variability, stride length variability) were analyzed.

Results

In dual- and triple-task conditions children showed decreased gait velocity, cadence, stride length, as well as increased single support time, double support time and gait variability compared to single-task walking. Further, results showed systematic decreases in stride velocity variability from preterm children with very low birth weight (≤ 1500 g) to preterm children with birth weight > 1500 g to full-term children. There were no significant interactions between walking conditions and prematurity status.

Conclusions

Dual and triple tasking affects gait of preterm and full-term children, confirming previous results that walking requires executive and attentional functions. Birth-weight dependent systematic changes in stride velocity variability indicate poorer walking performance in preterm children who were less mature at birth.