Background: Postural stability and plantar pressure parameters can be assessed by baropodometry; nevertheless, they are often affected by low repeatability. The aim of the study was to test the accuracy and repeatability of a novel resistive sensor pressure plate and to establish the most reliable baropodometric parameters. Methods: Accuracy and repeatability of the FM12050 BTS-Bioengineering plate measurements were assessed by using different weights in static conditions across three sessions. Subsequently, 20 healthy subjects were assessed by 30-s stabilometric analysis in bipedal standing with open eyes across four trials in two sessions, morning and afternoon. Results: Pressure plate repeatability in measuring the static weights was very high, and plate measurements were correlated to the scale measurements (Pearson’s coefficient = 0.99). Percentage of load distribution between left and right foot and in rearfoot and forefoot regions showed the largest repeatability (coefficient of variation < 5%) across trials. Eventually, median and percentiles (25–75%) were reported for each parameter. Conclusions: This study helped to assess the accuracy and repeatability of a novel pressure plate in static conditions and to define the most reliable parameters for the assessment of postural stability and foot morphology. The present healthy-subject stabilometric dataset may be used as reference data in the evaluation of pathological populations.
Posture can be evaluated by clinical and instrumental methods. Three-dimensional motion analysis is the gold standard for the static and dynamic postural assessment. Conventional stereophotogrammetric protocols are used to assess the posture of pelvis, hip, knee, ankle, trunk (considered as a single segment) and rarely head and upper limbs during walking. A few studies also analyzed the multi-segmental trunk and whole-body kinematics. Aim of our study was to evaluate the sagittal spine and the whole-body during walking in healthy subjects by 3D motion analysis using a new marker set. Fourteen healthy subjects were assessed by 3D-Stereophotogrammetry using the DB-Total protocol. Excursion Range, Absolute Excursion Range, Average, intra-subject Coefficient of Variation (CV) and inter-subject Standard Deviation Average (SD Average) of eighteen new kinematic parameters related to sagittal spine and whole-body posture were calculated. The analysis of the DB-Total parameters showed a high intra-subject (CV < 50%) and a high inter-subject (SD Average < 1) repeatability for the most of them. Kinematic curves and new additional values were reported. The present study introduced new postural values characterizing the sagittal spinal and whole-body alignment of healthy subjects during walking. DB-Total parameters may be useful for understanding multi-segmental body biomechanics and as a benchmark for pathological patterns.
22 January 2024 in IEEE Journal of Translational Engineering in Health and Medicine
Background: Executive functions (EFs) are neurocognitive processes planning and regulating daily life actions. Performance of two simultaneous tasks, requiring the same cognitive resources, lead to a cognitive fatigue. Several studies investigated cognitive-motor task and the interference during walking, highlighting an increasing risk of falls especially in elderly and people with neurological diseases. A few studies instrumentally explored relationship between activation-no-activation of two EFs (working memory and inhibition) and spatial-temporal gait parameters. Aim of our study was to detect activation of inhibition and working memory during progressive difficulty levels of cognitive tasks and spontaneous walking using, respectively, wireless electroencephalography (EEG) and 3D-gait analysis. Methods: Thirteen healthy subjects were recruited. Two cognitive tasks were performed, activating inhibition (Go-NoGo) and working memory (N-back). EEG features (absolute and relative power in different bands) and kinematic parameters (7 spatial-temporal ones and Gait Variable Score for 9 range of motion of lower limbs) were analyzed. Results: A significant decrease of stride length and an increase of external-rotation of foot progression were found during dual task with Go-NoGo. Moreover, a significant correlation was found between the relative power in the delta band at channels Fz, C4 and progressive difficulty levels of Go-NoGo (activating inhibition) during walking, whereas working memory showed no correlation. Conclusions: This study reinforces the hypothesis of the prevalent involvement of inhibition with respect to working memory during dual task walking and reveals specific kinematic adaptations. The foundations for EEG-based monitoring of cognitive processes involved in gait are laid. Clinical and Translational Impact Statement: Clinical and instrumental evaluation and training of executive functions (as inhibition), during cognitive-motor task, could be useful for rehabilitation treatment of gait disorder in elderly and people with neurological disease.
This study is the first to quantitatively characterize the sagittal spine and whole body posture of patients with late-onset Pompe disease during walking, showing a pathological kinematic pattern defined “man falling backwards.” 3-D-motion analysis, with a specific marker set (DB-total protocol) introducing new whole body kinematic parameters, may be useful for accurate functional evaluation and monitoring this rare disease.
Foot position affects postural stability during upright standing; however, conflicting indications have been reported for the ideal foot placement during stabilometric exams. The aims of this study were to evaluate (1) the correlation between anthropometric measurements (AMs) and between-feet measurements (BFMs) in self-selected comfortable foot position (SCFP) and (2) the effect of comfortable and standardized foot position (SFP) on plantar pressure and stabilometric parameters. Stabilometry was conducted on twenty healthy subjects in terms of SCFP and SFP. Correlation between AMs and BFMs in SCFP was investigated via Pearson’s analysis. Data variability was assessed using the coefficient of variation, and statistical differences between SCFP and SFP were evaluated via the Wilcoxon test. No correlation was found between AMs and BFMs. Subjects placed their feet nearly parallel in SCFP with a wider inter-heel distance. The variability of plantar pressure parameters was greater in SFP. A lower foot contact area on the right side and higher plantar pressures in the left midfoot region (p-value < 0.05) were found in SFP as compensatory foot adaptations. According to the present study, a comfortable foot position allows for the reduction in postural stability and plantar pressure parameter variability. This position may help improve statistical power when investigating statistical differences between conditions in stabilometry.
Postural abnormalities in the sagittal plane are common in Parkinson’s disease (PD) and increase the risk of falls. Previous studies have reported short-term benefit of corrective corsets in PD patients assessed by clinical and instrumental methods, while long-term effects on sagittal posture in upright standing and during walking remain unexplored. Fifteen PD patients with postural abnormalities on the sagittal plane, evaluated via the NeuroPostureApp, and ten healthy subjects matched for age and BMI were assessed by 3D motion analysis in upright posture. Then, the PD patients were evaluated with and without the K1 Posture Keeper during standing and walking at baseline (T0) and after three months of use (T1). The results showed an anteriorization of the head–cervical region with respect to the trunk and a whole-body misalignment in PD patients compared to healthy controls. The use of the K1 Posture Keeper induced a back shift of the nasion with a better alignment of the head with respect to the trunk, pelvis, and feet in upright standing and during walking, underlining an improvement in the sagittal alignment of the entire body in PD. These findings showed the therapeutical role of K1 Posture Keeper on sagittal posture in static and dynamic conditions, potentially due to proprioceptive reorganization.