Reggio nell'Emilia, Italy
Reggio nell'Emilia, Italy

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Filippin N.T.,Federal University of São Carlos | Lobo da Costa P.H.,Movement Analysis Laboratory | Mattioli R.,Federal University of São Carlos
Revista Brasileira de Fisioterapia | Year: 2010

Background: Parkinson's disease (PD) causes motor and non-motor impairments that affect the subject's quality of life. Objective: To assess the effects of treadmill-walking training with additional body load on the quality of life and motor function of subjects with PD. Methods: Nine subjects with PD, Hoehn and Yahr stages 2-3, not demented and with capability to ambulate independently took part in this study. The training program was divided into three phases (A1-B-A2): treadmill training with additional body load (A1), control condition (conventional physical therapy group; B) and a second period of treadmill training with load (A2). Each phase lasted six weeks. Quality of life and motor function were assessed by the PDQ-39 and the motor score of the Unifi ed Parkinson's Disease Rating Scale (UPDRS), respectively. The evaluations and the training were performed during the on-phase of the medication cycle. Results: There was improvement in the total PDQ-39 score across the training period. The subscores mobility, activities of daily living and cognition subscores signifi cantly improved after the training period. The improvement in the total score was associated with motor and non-motor factors in all of the training phases. The UPDRS motor score also improved, however it did not present any association with the improvement in quality of life. Conclusions: The results showed that the treadmill-walking training with additional body load allowed an improvement in motor and non-motor aspects related to quality of life and motor function in subjects with PD.

Benedetti M.G.,Instituto Ortopedico Rizzoli | Merlo A.,Movement Analysis Laboratory | Leardini A.,Instituto Ortopedico Rizzoli
Gait and Posture | Year: 2013

The dissemination of gait analysis as a clinical assessment tool requires the results to be consistent, irrespective of the laboratory. In this work a baseline assessment of between site consistency of one healthy subject examined at 7 different laboratories is presented. Anthropometric and spatio-temporal parameters, pelvis and lower limb joint rotations, joint sagittal moments and powers, and ground reaction forces were compared. The consistency between laboratories for single parameters was assessed by the median absolute deviation and maximum difference, for curves by linear regression. Twenty-one lab-to-lab comparisons were performed and averaged. Large differences were found between the characteristics of the laboratories (i.e. motion capture systems and protocols). Different values for the anthropometric parameters were found, with the largest variability for a pelvis measurement. The spatio-temporal parameters were in general consistent. Segment and joint kinematics consistency was in general high (R2>0.90), except for hip and knee joint rotations. The main difference among curves was a vertical shift associated to the corresponding value in the static position. The consistency between joint sagittal moments ranged form R2=0.90 at the ankle to R2=0.66 at the hip, the latter was increasing when comparing separately laboratories using the same protocol. Pattern similarity was good for ankle power but not satisfactory for knee and hip power. The force was found the most consistent, as expected. The differences found were in general lower than the established minimum detectable changes for gait kinematics and kinetics for healthy adults. © 2013 Elsevier B.V.

Eils E.,Movement Analysis Laboratory | Eils E.,University of Munster | Schroter R.,Movement Analysis Laboratory | Schroderr M.,Movement Analysis Laboratory | And 2 more authors.
Medicine and Science in Sports and Exercise | Year: 2010

Purpose: To investigate the effectiveness of a multistation proprioceptive exercise program for the prevention of ankle injuries in basketball players using a prospective randomized controlled trial in combination with biomechanical tests of neuromuscular performance. Methods: A total of 232 players participated in the study and were randomly assigned to a training or control group following the CONSORT statement. The training group performed a multistation proprioceptive exercise program, and the control group continued with their normal workout routines. During one competitive basketball season, the number of ankle injuries was counted and related to the number of sports participation sessions using logistic regression. Additional biomechanical pre-post tests (angle reproduction and postural sway) were performed in both groups to investigate the effects on neuromuscular performance. Results: In the control group, 21 injuries occurred, whereas in the training group, 7 injuries occurred. The risk for sustaining an ankle injury was significantly reduced in the training group by approximately 35%. The corresponding number needed to treat was 7. Additional biomechanical tests revealed significant improvements in joint position sense and single-limb stance in the training group. Conclusions: The multistation proprioceptive exercise program effectively prevented ankle injuries in basketball players. Analysis of number needed to treat clearly showed the relatively low prevention effort that is necessary to avoid an ankle injury. Additional biomechanical tests confirmed the neuromuscular effect and confirmed a relationship between injury prevention and altered neuromuscular performance. With this knowledge, proprioceptive training may be optimized to specifically address the demands in various athletic activities. Copyright © 2010 by the American College of Sports Medicine.

Leardini A.,Instituto Ortopedico Rizzoli | Biagi F.,Instituto Ortopedico Rizzoli | Merlo A.,Movement Analysis Laboratory | Belvedere C.,Instituto Ortopedico Rizzoli | Benedetti M.G.,Instituto Ortopedico Rizzoli
Clinical Biomechanics | Year: 2011

Background: Motion of human trunk segments in healthy subjects during activities of daily living has been described either with oversimplified models or with cumbersome techniques of isolated anatomical complex. This study describes multi-segmental trunk motion based on a new technique which is a compromise between technical limitations, implied with the experiments, and clinical relevance. Methods: The thorax segment was tracked by the optimal spatial matching of four thoracic markers. The separate bi-dimensional shoulder line rotations and translations with respect to the thorax were calculated by markers on the two acromions. Spine motion was characterised by a 5-link-segment model from additional four skin markers, in the anatomical reference frame based on four pelvic spine markers. These 14 markers were tracked in 10 healthy subjects and one clinical case during static upright posture, chair rising-sitting, step up-and-down and level walking, and also during elementary flexion and extension, lateral bending, and axial rotation movements of the entire trunk. Findings: Intra-subject repeatability over ten repetitions was found to be high for most of the measurements, with average standard deviations of less than 1.8° for all planar rotations at the spine, and less smaller than 1 mm for shoulder translations. Large motion, albeit with different patterns, was found in all subjects, also revealing interesting couplings over the three anatomical planes. Interpretation: Considerable subject-specific motion occurs at each of these different trunk segments in all three anatomical planes, in simple exercises and in motor tasks of daily living. Measurements taken with the present new trunk model in pathological subjects shall reveal corresponding patterns and ranges of motion in abnormal conditions. © 2011 Elsevier Ltd. All rights reserved.

Bugane F.,Movement Analysis Laboratory | Bugane F.,LorAn Engineering Srl | Benedetti M.G.,Movement Analysis Laboratory | Casadio G.,LorAn Engineering Srl | And 4 more authors.
Computer Methods and Programs in Biomedicine | Year: 2012

This paper investigates the ability of a single wireless inertial sensing device stuck on the lower trunk to provide spatial-temporal parameters during level walking. The 3-axial acceleration signals were filtered and the timing of the main gait events identified. Twenty-two healthy subjects were analyzed with this system for validation, and the estimated parameters were compared with those obtained with state-of-the-art gait analysis, i.e. stereophotogrammetry and dynamometry. For each side, from four to six gait cycles were measured with the device, of which two were validated by gait analysis. The new acquisition system is easy to use and does not interfere with regular walking. No statistically significant differences were found between the acceleration-based measurements and the corresponding ones from gait analysis for most of the spatial-temporal parameters, i.e. stride length, stride duration, cadence and speed, etc.; significant differences were found for the gait cycle phases, i.e. single and double support duration, etc. The system therefore shows promise also for a future routine clinical use. © 2012 Elsevier Ireland Ltd.

Benedetti M.G.,Instituto Ortopedico Rizzoli | Manca M.,Movement Analysis Laboratory | Ferraresi G.,Movement Analysis Laboratory | Boschi M.,Instituto Ortopedico Rizzoli | Leardini A.,Instituto Ortopedico Rizzoli
Clinical Biomechanics | Year: 2011

Background: The aim of this study is to assess the clinical value of a recently introduced original protocol for full three dimensional analysis of ankle rotations in patients with equinovarus foot. Methods: A preliminary study merging the Total3Dgait protocol and the conventional Vicon® Plug-in-Gait marker-sets on five patients with foot deformity was performed to compare the output exactly over the same gait cycles. In the second study, 15 patients with equinus varus foot were assessed retrospectively by means of the Total3Dgait protocol before and after surgery. Data on ankle kinematics were compared to those of a control group. The Functional Ambulation Categories scale and other goals such as orthosis/aids removal, decrease in foot pain, healing of calluses and sores were considered as measures of clinical outcome. Findings: The Total3Dgait protocol provides additional joint motion, in the coronal and transverse planes. Kinematics in the three anatomical planes improved significantly although no changes in time-distance parameters were evident. Improvement in clinical outcome measures was also achieved. Interpretation: The new protocol provides valuable additional data in measuring full three dimensional kinematics of the foot during gait. Whereas the speed of walking was unchanged after surgery for most of patients, the kinematic changes in the three anatomical planes, as measured by the new protocol, were the only measures able to demonstrate motion changes induced by surgery at the foot and to explain subject-specific gains as improvement in stability during walking, relief of pain, calluses and sores, and removal or modification of foot orthosis and aids. © 2011 Elsevier Ltd. All rights reserved.

PubMed | Movement Analysis Laboratory and Instituto Ortopedico Rizzoli
Type: | Journal: BioMed research international | Year: 2014

Equinus deformity of the foot is a common feature of hemiplegia, which impairs the gait pattern of patients. The aim of the present study was to explore the role of ankle-foot deformity in gait impairment. A hierarchical cluster analysis was used to classify the gait patterns of 49 chronic hemiplegic patients with equinus deformity of the foot, based on temporal-distance parameters and joint kinematic measures obtained by an innovative protocol for motion assessment in the sagittal, frontal, and transverse planes, synthesized by parametrical analysis. Cluster analysis identified five subgroups of patients with homogenous levels of dysfunction during gait. Specific joint kinematic abnormalities were found, according to the speed of progression in each cluster. Patients with faster walking were those with less ankle-foot complex impairment or with reduced range of motion of ankle-foot complex, that is with a stiff ankle-foot complex. Slow walking was typical of patients with ankle-foot complex instability (i.e., larger motion in all the planes), severe equinus and hip internal rotation pattern, and patients with hip external rotation pattern. Clustering of gait patterns in these patients is helpful for a better understanding of dysfunction during gait and delivering more targeted treatment.

PubMed | University of Tübingen, Thomas College, Catholic University of Leuven and Movement Analysis Laboratory
Type: Journal Article | Journal: Journal of biomechanics | Year: 2014

Multi-segmental foot kinematics have been analyzed by means of optical marker-sets or by means of inertial sensors, but never by markerless dynamic 3D scanning (D3DScanning). The use of D3DScans implies a radically different approach for the construction of the multi-segment foot model: the foot anatomy is identified via the surface shape instead of distinct landmark points. We propose a 4-segment foot model consisting of the shank (Sha), calcaneus (Cal), metatarsus (Met) and hallux (Hal). These segments are manually selected on a static scan. To track the segments in the dynamic scan, the segments of the static scan are matched on each frame of the dynamic scan using the iterative closest point (ICP) fitting algorithm. Joint rotations are calculated between Sha-Cal, Cal-Met, and Met-Hal. Due to the lower quality scans at heel strike and toe off, the first and last 10% of the stance phase is excluded. The application of the method to 5 healthy subjects, 6 trials each, shows a good repeatability (intra-subject standard deviations between 1 and 2.5) for Sha-Cal and Cal-Met joints, and inferior results for the Met-Hal joint (>3). The repeatability seems to be subject-dependent. For the validation, a qualitative comparison with joint kinematics from a corresponding established marker-based multi-segment foot model is made. This shows very consistent patterns of rotation. The ease of subject preparation and also the effective and easy to interpret visual output, make the present technique very attractive for functional analysis of the foot, enhancing usability in clinical practice.

PubMed | Movement Analysis Laboratory
Type: Comparative Study | Journal: Disability and rehabilitation | Year: 2014

In the management of adults with cerebral palsy (CP), one of the goals is to monitor and prevent spasticity-related deteriorations in gait. Botulinum Toxin Injections (BTI) are commonly used to treat this spasticity in these patients. The purpose of this study was to evaluate (i) the effect of multi-site BTI on gait patterns in adults with CP and (ii) to determine if these modifications could be detected by the Gait Deviation Index (GDI).Spontaneous-velocity gait was recorded using 3D gait analysis before and 1 month after multi-site BTI in lower limb muscles. Spatiotemporal parameters (STP), kinematic parameters (KP) and the GDI were computed.Post BTI, stride length, peak hip flexion and peak knee flexion during Swing Phase (SW) were significantly increased while the GDI was not significantly modified.A single multi-site BTI improved STP and KP of adults with CP but the GDI was not sensitive enough to detect these changes. Implications for Rehabilitation Only few study on adults with cerebral palsy BTI approach on the gait patterns are largely unknown. BTI session induced only some smaller improvement of KP and STP. This improvement did not modify the GDI. We cannot determine if GDI is a relevant tool to evaluate changes following BTI or other types of treatment.

PubMed | Shriners Hospital for Children SHC, Motion Analysis Laboratory, Medical Staff Research, Movement Analysis Laboratory and 2 more.
Type: Journal Article | Journal: Developmental medicine and child neurology | Year: 2015

The aim of this study was to examine differences in gait kinematics and spatiotemporal parameters in ambulatory children and adolescents with bilateral spastic cerebral palsy (BSCP) among Gross Motor Function Classification System (GMFCS) levels I-III.A retrospective review was conducted of individuals with BSCP who had three-dimensional motion analysis (3DGA) at one of seven pediatric hospitals. Means and standard deviations of each gait parameter were stratified by GMFCS levels (I-III) and for a typically developing comparison group.Data from 292 children and adolescents with BSCP (189 males, 103 females; mean age 13 y) were compared to a typically developing comparison group (24 male, 26 female; mean age 10 y 6 mo). Gait patterns differed from typically developing in all GMFCS levels, with increasing deviation as GMFCS level increased in 21 out of 28 parameters. Despite significant differences in selected mean kinematic parameters among GMFCS levels such as knee angle at initial contact of 24, 29, and 41 in GMFCS levels I, II and III respectively, there was also substantial overlap among GMFCS levels.GMFCS levels cannot be identified using specific gait kinematics. Treatment decisions should be guided by comprehensive 3DGA that allows measurement of gait impairments at the joint level for each individual.

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