The effects of different factors—such as age, sex, performance level, and athletic shoe features—on postural balance in athletes remain unclear. The main objective of our study is to identify the features of postural stability in athletes of different age, sex, performance level, and using different types of athletic shoes. This study assessed postural stability in athletes (n = 936, 6–47 years) in a normal bipedal stance with eyes open (EO) and eyes closed (EC). Postural stability was evaluated based on the center of pressure (COP), sway area (AS), and velocity (VCP) while standing on a stabiloplatform. Children (6–12 years) and teen athletes (13–17 years) showed reduced AS-EO (p < 0.01) and VCP-EO (p < 0.01) compared to control (n = 225, 7–30 years). In male and female athletes aged 18+, only VCP-EC was lower versus control. In females (13–17 and 18+), VCP-EO and EC were lower than in males (p < 0.05). Only in the Shooting group, the athletes’ performance levels had an effect on VCP-EO (p = 0.020). Long use of rigid athletic shoes with stiff ankle support was associated with reduced posture stability. Postural stability in athletes was mostly influenced by the athlete‘s age, and, to a lesser extent, by their sex, performance level, and athlete shoe features.
Background/Objectives: Gait dysfunction occurs in 80% of stroke survivors. It increases the risk of falls, reduces functional independence, and thus affects the quality of life. Therefore, it is very important to restore the gait function in post-stroke survivors. The purpose of this study was to investigate the functional changes of gait biomechanics in patients with hemiplegia in the subacute stage of ischemic stroke based on spatiotemporal, kinematic, and EMG parameters. Methods: Initial biomechanical gait analyses of 31 patients and 34 controls were selected. The obtained parameters were assessed and compared within and across the study groups (post-stroke hemiparetic patients and healthy controls) to determine the pathognomonic features of the hemiplegic gait. Results: The gait function asymmetry was characterized by reciprocal changes, i.e., harmonic sequences of gait cycles. The most significant changes were in the kinematics of the knee joint and the EMG activity in the anterior tibialis, gastrocnemius, and hamstring muscles on the paretic side. The movements in the lower extremity joints ranged from a typical amplitude decrease to an almost complete lack of movement or involuntary excessive movement, as can occur in the ankle joint. The knee joint showed two distinct patterns: a slight flexion throughout the entire gait cycle and knee hyperextension during the middle stance phase. Conclusions: The gait function asymmetry is characterized by reciprocal changes (in temporal gait parameters). The most significant changes included decreased amplitude in the knee joint and decreased amplitude of EMG of all muscles under study, except for the m. quadriceps femoris.
Walking function disorders are typical for patients after cerebral stroke. Biofeedback technology (BFB) is currently considered effective and promising for training walking function, including in patients after cerebral stroke. Most studies recognize that BFB training is a promising tool for improving walking function; however, the data on the use of highly selective walking parameters for BFB training are very limited. The aim of our study was to investigate the feasibility of using BFB training targeting one of the basic parameters of gait symmetry—stance phase duration—in cerebral stroke patients in the early recovery period. The study included 20 hemiparetic patients in the early recovery period after the first hemispheric ischemic stroke. The control group included 20 healthy subjects. The BFB training and biomechanical analysis of walking (before and after all BFB sessions) were done using an inertial system. The mean number of BFB sessions was nine (from 8 to 11) during the three weeks in clinic. There was not a single negative response to BFB training among the study patients, either during the sessions or later. The spatiotemporal parameters of walking showed the whole syndrome complex of slow walking and typical asymmetry of temporal walking parameters, and did not change significantly as a result of the study therapy. The changes were more significant for the functioning of hip and knee joints. The contralateral hip amplitude returned to the normal range. For the knee joint, the amplitude of the first flexion increased and the value of the amplitude of hyperextension decreased in the middle of the stance phase. Concerning muscle function, the observed significant decrease in the function of m. Gastrocnemius and the hamstring muscles on the paretic side remained without change at the end of the treatment course. We obtained positive dynamics of the biomechanical parameters of walking in patients after the BFB training course. The feasibility and efficacy of their use for targeted correction need further research.
The objective of the study was to evaluate the clinical, functional, and biomechanical symptoms in patients with anterior cruciate ligament (ACL) rupture before and after ACL reconstruction. The study enrolled 20 patients and 20 healthy subjects as controls. Walking biomechanics was assessed at three time points: before surgery and three months and a year or more after surgical reconstruction. Impact loads on both sides differed significantly from the respective values before surgery (p<0.05). Walking cycle duration decreased with time after surgery. On both sides (affected and unaffected), hip movement amplitudes were significantly smaller than in control (p<0.05). They remained so in the follow-up periods after the reconstruction. Before ACL reconstruction, the amplitude of the main flexion of the knee was significantly reduced both on the affected and unaffected sides. The amplitude gradually increased after the reconstruction, and a year post-surgery, it reached, on the operated side, the same values as in the control group. Complete functional recovery of the knee joint was not achieved within a year after the ACL surgical reconstruction. The remaining changes, however, were not clinically pronounced and could only be detected by instrumental gait analysis. The compensatory processes developed bilaterally, in both the hip and knee joints.
A foot placement of inertial sensors is commonly used for heel‐strike (HS) and toe‐off (TO) event detection. However, in clinical practice, such sensor placement may be difficult or even impossible due to the deformity of patients’ feet. The first contribution of this paper is a new algorithm for HS and TO event detection for cases when the sensors are placed on the lateral malleolus. Such sensor placement allows gait analysis in patients with foot deformities. In addition, the placement of the sensor directly on the wide bone surface of the lateral malleolus ensures secure fixation of the sensor during walking. The proposed algorithm is based on deep neural networks, which can be easily adapted (by retraining the neural networks) for analysis of various pathological gait patterns. It is especially important in clinical practice when the number of possible pathological gait patterns is very large. The algorithm proposed in this paper was implemented in a new wearable system for the clinical gait analysis. The second contribution is a validation of this new wearable system. The performance of both proposed algorithm and gait analysis system was evaluated against a reference treadmill system where a capacitance–based pressure platform was used. A total of 117 healthy volunteers participated in the comparison (62 males and 55 females, age 24–55 years, height 162–183 cm). They were asked to perform 2 min walking trials with different speed. Mean accuracy ± precision was –0.021 ± 0.091 s for gait cycle, 0.589 ± 1.144 steps/min for cadence, –0.051 ± 0.544% for stance phase, –0.37 ± 0.649% for single support, 0.296 ± 0.711% for double support, 0.132 ± 0.561% for load response, and 0.106 ± 0.661% for preswing. Limitations of the proposed algorithm and its compassion with state‐of‐the‐art algorithms were discussed.