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Sensors for Recognition, Analysis, Assistance, and Training of Gait in Neurologic Disorders

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A special issue of Sensors (ISSN 1424-8220). This special issue belongs to the section "Wearables".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 5262

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Dr. Emilie Hutin

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Laboratoire Analyse et Restauration du Mouvement, Hôpitaux Universitaires Henri Mondor, AP-HP, Créteil, France
Interests: post-stroke gait; motor coordination; spastic cocontraction; cueing in Parkinson’s disease; walking velocity; neurological rehabilitation

Special Issue Information

Dear Colleagues,

There are multiple sensors for walking recognition and analysis sensors, and new technical solutions are continually offered to clinicians. In the field of neurological rehabilitation, wearable devices that help to measure movement and give mechanical assistance or information to the patient for movement guidance are powerful therapeutic tools. Their assessment function allows motor disorders to be characterised, their causes to be identified, and their treatments to be targeted more effectively. In addition, some sensors could assist the movement (e.g., functional electrical stimulation, cueing, feedback, etc.), but also could be used as tools for the intensification of physical treatment, particularly for daily use at home, within the framework of self-rehabilitation in adjunction with the conventional treatment. This Special Issue will cover the methods used to characterize, assist, or train gait in people with neurological disorders.

Dr. Emilie Hutin
Guest Editor

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Keywords

gait
dynamic stability
3D gait analysis
dynamic electromyography
validity, reliability and feasibility
functional electrical stimulation
orthosis
cueing in Parkinson’s disease
gait disorders
fatigue recognition during gait
aging
spastic paresis
multiple sclerosis
cerebral palsy
diplegic gait
Parkinson’s disease
ataxias
choreiform gait
neuropathy
myopathy

Published Papers (5 papers)

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Research

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10 pages, 1151 KiB

Open AccessCommunication

Influence of a Three-Month Mixed Reality Training on Gait Speed and Cognitive Functions in Adults with Intellectual Disability: A Pilot Study

by Alexis Laly, Elisabeth Rosnet and Nicolas Houel

Sensors 2024, 24(6), 1821; https://doi.org/10.3390/s24061821 - 12 Mar 2024

Viewed by 543

Abstract

People with intellectual disability (ID) are often subject to motor impairments such as altered gait. As gait is a task involving motor and perceptive dimensions, perceptual-motor training is an efficient rehabilitation approach to reduce the risk of falls which grows with age. Virtual, augmented, and mixed reality are recent tools which enable interaction with 3D elements at different levels of immersion and interaction. In view of the countless possibilities that this opens, their use for therapeutic purposes is constantly increasing. Therefore, the aim of this study was to investigate the influence a mixed reality activity could have on motor and cognitive abilities in eighteen adults with intellectual disability. For three months, once a week, they had around 20 min to pop virtual balloons with a finger using a Microsoft HoloLens2^® head-mounted mixed-reality device. Motor skills were assessed through gait analysis and cognitive abilities were measured with the Montréal Cognitive Assessment. Both walking speed and cognitive score increased after training. In conclusion, this study demonstrates that mixed reality holds potential to get used for therapeutic purposes in adults with ID. Full article

(This article belongs to the Special Issue Sensors for Recognition, Analysis, Assistance, and Training of Gait in Neurologic Disorders)

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12 pages, 1557 KiB

Open AccessArticle

Serious Game with Electromyography Feedback and Physical Therapy in Young Children with Unilateral Spastic Cerebral Palsy and Equinus Gait: A Prospective Open-Label Study

by Christophe Boulay, Jean-Michel Gracies, Lauren Garcia, Guillaume Authier, Alexis Ulian, Maud Pradines, Taian Martins Vieira, Talita Pinto, Marco Gazzoni, Béatrice Desnous, Bernard Parratte and Sébastien Pesenti

Sensors 2024, 24(5), 1513; https://doi.org/10.3390/s24051513 - 26 Feb 2024

Viewed by 595

Abstract

The clinical effects of a serious game with electromyography feedback (EMGs_SG) and physical therapy (PT) was investigated prospectively in children with unilateral spastic cerebral palsy (USCP). An additional aim was to better understand the influence of muscle shortening on function. Thirty children with USCP (age 7.6 ± 2.1 years) received four weeks of EMGs_SG sessions 2×/week including repetitive, active alternating training of dorsi- and plantar flexors in a seated position. In addition, each child received usual PT treatment ≤ 2×/week, involving plantar flexor stretching and command strengthening on dorsi- and plantar flexors. Five-Step Assessment parameters, including preferred gait velocity (normalized by height); plantar flexor extensibility (XV1); angle of catch (XV3); maximal active ankle dorsiflexion (XA); and derived coefficients of shortening, spasticity, and weakness for both soleus and gastrosoleus complex (GSC) were compared pre and post treatment (t-tests). Correlations were explored between the various coefficients and gait velocities at baseline. After four weeks of EMGs_SG + PT, there was an increase in normalized gait velocity from 0.72 ± 0.13 to 0.77 ± 0.13 m/s (p = 0.025, d = 0.43), a decrease in coefficients of shortening (soleus, 0.10 ± 0.07 pre vs. 0.07 ± 0.08 post, p = 0.004, d = 0.57; GSC 0.16 ± 0.08 vs. 0.13 ± 0.08, p = 0.003, d = 0.58), spasticity (soleus 0.14 ± 0.06 vs. 0.12 ± 0.07, p = 0.02, d = 0.46), and weakness (soleus 0.14 ± 0.07 vs. 0.11 ± 0.07, p = 0.005, d = 0.55). At baseline, normalized gait velocity correlated with the coefficient of GSC shortening (R = −0.43, p = 0.02). Four weeks of EMGs_SG and PT were associated with improved gait velocity and decreased plantar flexor shortening. A randomized controlled trial comparing EMGs_SG and conventional PT is needed. Full article

(This article belongs to the Special Issue Sensors for Recognition, Analysis, Assistance, and Training of Gait in Neurologic Disorders)

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11 pages, 1293 KiB

Open AccessArticle

Vertical Ground Reaction Forces in Parkinson’s Disease: A Speed-Matched Comparative Analysis with Healthy Subjects

by Marica Giardini, Anna Maria Turcato, Ilaria Arcolin, Stefano Corna and Marco Godi

Sensors 2024, 24(1), 179; https://doi.org/10.3390/s24010179 - 28 Dec 2023

Viewed by 603

Abstract

This study aimed to investigate and compare the vertical Ground Reaction Forces (vGRFs) of patients with Parkinson’s Disease (PwPD) and healthy subjects (HS) when the confounding effect of walking speed was absent. Therefore, eighteen PwPD and eighteen age- and linear walking speed-matched HS were recruited. Using plantar pressure insoles, participants walked along linear and curvilinear paths at self-selected speeds. Interestingly, PwPD exhibited similar walking speed to HS during curvilinear trajectories (p = 0.48) and similar vGRF during both linear and curvilinear paths. In both groups, vGRF at initial contact and terminal stance was higher during linear walking, while vGRF at mid-stance was higher in curvilinear trajectories. Similarly, the time to peak vGRF at each phase showed no significant group differences. The vGRF timing variability was different between the two groups, particularly at terminal stance (p < 0.001). In conclusion, PwPD and HS showed similar modifications in vGRF and a similar reduction in gait speed during curvilinear paths when matched for linear walking speed. This emphasized the importance of considering walking speed when assessing gait dynamics in PwPD. This study also suggests the possibility of the variability of specific temporal measures in differentiating the gait patterns of PwPD versus those of HS, even in the early stages of the disease. Full article

(This article belongs to the Special Issue Sensors for Recognition, Analysis, Assistance, and Training of Gait in Neurologic Disorders)

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15 pages, 1496 KiB

Open AccessArticle

A Velocity Stretch Reflex Threshold Based on Muscle–Tendon Unit Peak Acceleration to Detect Possible Occurrences of Spasticity during Gait in Children with Cerebral Palsy

by Axel Koussou, Raphaël Dumas and Eric Desailly

Sensors 2024, 24(1), 41; https://doi.org/10.3390/s24010041 - 20 Dec 2023

Viewed by 943

Abstract

Spasticity might affect gait in children with cerebral palsy. Quantifying its occurrence during locomotion is challenging. One approach is to determine kinematic stretch reflex thresholds, usually on the velocity, during passive assessment and to search for their exceedance during gait. These thresholds are determined through EMG-Onset detection algorithms, which are variable in performance and sensitive to noisy data, and can therefore lack consistency. This study aimed to evaluate the feasibility of determining the velocity stretch reflex threshold from maximal musculotendon acceleration. Eighteen children with CP were recruited and underwent clinical gait analysis and a full instrumented assessment of their soleus, gastrocnemius lateralis, semitendinosus, and rectus femoris spasticity, with EMG, kinematics, and applied forces being measured simultaneously. Using a subject-scaled musculoskeletal model, the acceleration-based stretch reflex velocity thresholds were determined and compared to those based on EMG-Onset determination. Their consistencies according to physiological criteria, i.e., if the timing of the threshold was between the beginning of the stretch and the spastic catch, were evaluated. Finally, two parameters designed to evaluate the occurrence of spasticity during gait, i.e., the proportion of the gait trial time with a gait velocity above the velocity threshold and the number of times the threshold was exceeded, were compared. The proposed method produces velocity stretch reflex thresholds close to the EMG-based ones. For all muscles, no statistical difference was found between the two parameters designed to evaluate the occurrence of spasticity during gait. Contrarily to the EMG-based methods, the proposed method always provides physiologically consistent values, with median electromechanical delays of between 50 and 130 ms. For all subjects, the semitendinosus velocity during gait usually exceeded its stretch reflex threshold, while it was less frequent for the three other muscles. We conclude that a velocity stretch reflex threshold, based on musculotendon acceleration, is a reliable substitute for EMG-based ones. Full article

(This article belongs to the Special Issue Sensors for Recognition, Analysis, Assistance, and Training of Gait in Neurologic Disorders)

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Review

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13 pages, 619 KiB

Open AccessReview

Effects of Manual Therapy on Parkinson’s Gait: A Systematic Review

by Arnaud Delafontaine, Thomas Vialleron, Gaëtan Barbier, Arnaud Lardon, Mélodie Barrière, María García-Escudero, Laurent Fabeck and Martin Descarreaux

Sensors 2024, 24(2), 354; https://doi.org/10.3390/s24020354 - 07 Jan 2024

Viewed by 1567

Abstract

Manual therapy (MT) is commonly used in rehabilitation to deal with motor impairments in Parkinson’s disease (PD). However, is MT an efficient method to improve gait in PD? To answer the question, a systematic review of clinical controlled trials was conducted. Estimates of effect sizes (reported as standard mean difference (SMD)) with their respective 95% confidence interval (95% CI) were reported for each outcome when sufficient data were available. If data were lacking, p values were reported. The PEDro scale was used for the quality assessment. Three studies were included in the review. MT improved Dynamic Gait Index (SMD = 1.47; 95% CI: 0.62, 2.32; PEDro score: 5/10, moderate level of evidence). MT also improved gait performances in terms of stride length, velocity of arm movements, linear velocities of the shoulder and the hip (p < 0.05; PEDro score: 2/10, limited level of evidence). There was no significant difference between groups after MT for any joint’s range of motion during gait (p > 0.05; PEDro score: 6/10, moderate level of evidence). There is no strong level of evidence supporting the beneficial effect of MT to improve gait in PD. Further randomized controlled trials are needed to understand the impact of MT on gait in PD. Full article

(This article belongs to the Special Issue Sensors for Recognition, Analysis, Assistance, and Training of Gait in Neurologic Disorders)

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