Investigation of the Dynamic Gait Index in children: a pilot study.
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ABSTRACT:
SUBMITTER: Lubetzky-Vilnai A
PROVIDER: S-EPMC3154737 | biostudies-literature | 2011 Fall
REPOSITORIES: biostudies-literature
Publications
Investigation of the Dynamic Gait Index in children: a pilot study.
Lubetzky-Vilnai Anat A Jirikowic Tracy L TL McCoy Sarah Westcott SW
Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association 20110901 3
<h4>Purpose</h4>We investigated the feasibility and construct validity of the Dynamic Gait Index (DGI) in children and explored interrater and test-retest reliability.<h4>Methods</h4>DGI performance of 10 children with fetal alcohol spectrum disorder (FASD), aged 8 to 15 years, was compared with that of 10 age- and sex-matched children with typical development (TD). Interrater reliability was evaluated for 16 children (10 TD, 6 FASD); 11 children returned for a retest (5 TD, 6 FASD).<h4>Results< ...[more]
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Project description:Introduction: In our previous study, we demonstrated that acupuncture improved gait disturbances, such as hypometric gait, in patients with Parkinson’s disease (PD). To investigate specific genes that indicate a therapeutic response to acupuncture, we analyzed transcriptome alterations following acupuncture using blood samples collected in our previous clinical trial. Methods: We reanalyzed the clinical data of patients and selected a representative patient with PD for transcriptomic analysis following acupuncture. We examined the expression changes of PD biomarker genes known to be consistently dysregulated in both the brain and blood in patients with PD. We validated these gene expression changes using quantitative real-time polymerase chain reaction (qPCR) in the blood of five other patients with PD who received acupuncture treatment. Results: After acupuncture treatment, the transcriptomic alterations in the representative patient were similar to those induced by dopaminergic therapy. Among PD biomarkers, ankyrin repeat domain 22 (ANKRD22), which is upregulated after dopaminergic therapy, and synapsin 1 (SYN1), which is the common gene to indicate synaptic dysfunction in PD, were upregulated following acupuncture. These alterations correlated with changes of gait parameters in patients with PD.alterations following acupuncture using blood samples collected in our previous clinical trial. Conclusion: This is the first report on gene expression changes and improvement of gait disturbance in patients with PD following acupuncture. Our data suggest that ANKRD22 and SYN1 can be used as biomarkers for therapeutic response to acupuncture in patients with PD, especially those with gait disturbance.alterations following acupuncture using blood samples collected in our previous clinical trial.
2021-06-19 | GSE178470 | GEO
Project description:UNLABELLED:Common variations at the loci harboring the fat mass and obesity gene (FTO), MC4R, and TMEM18 are consistently reported as being associated with obesity and body mass index (BMI) especially in adult population. In order to confirm this effect in pediatric population five European ancestry cohorts from pediatric eMERGE-II network (CCHMC-BCH) were evaluated. METHOD:Data on 5049 samples of European ancestry were obtained from the Electronic Medical Records (EMRs) of two large academic centers in five different genotyped cohorts. For all available samples, gender, age, height, and weight were collected and BMI was calculated. To account for age and sex differences in BMI, BMI z-scores were generated using 2000 Centers of Disease Control and Prevention (CDC) growth charts. A Genome-wide association study (GWAS) was performed with BMI z-score. After removing missing data and outliers based on principal components (PC) analyses, 2860 samples were used for the GWAS study. The association between each single nucleotide polymorphism (SNP) and BMI was tested using linear regression adjusting for age, gender, and PC by cohort. The effects of SNPs were modeled assuming additive, recessive, and dominant effects of the minor allele. Meta-analysis was conducted using a weighted z-score approach. RESULTS:The mean age of subjects was 9.8 years (range 2-19). The proportion of male subjects was 56%. In these cohorts, 14% of samples had a BMI ?95 and 28 ? 85%. Meta analyses produced a signal at 16q12 genomic region with the best result of p = 1.43 × 10(-) (7) [p (rec) = 7.34 × 10(-) (8)) for the SNP rs8050136 at the first intron of FTO gene (z = 5.26) and with no heterogeneity between cohorts (p = 0.77). Under a recessive model, another published SNP at this locus, rs1421085, generates the best result [z = 5.782, p (rec) = 8.21 × 10(-) (9)]. Imputation in this region using dense 1000-Genome and Hapmap CEU samples revealed 71 SNPs with p < 10(-) (6), all at the first intron of FTO locus. When hetero-geneity was permitted between cohorts, signals were also obtained in other previously identified loci, including MC4R (rs12964056, p = 6.87 × 10(-) (7), z = -4.98), cholecystokinin CCK (rs8192472, p = 1.33 × 10(-) (6), z = -4.85), Interleukin 15 (rs2099884, p = 1.27 × 10(-) (5), z = 4.34), low density lipoprotein receptor-related protein 1B [LRP1B (rs7583748, p = 0.00013, z = -3.81)] and near transmembrane protein 18 (TMEM18) (rs7561317, p = 0.001, z = -3.17). We also detected a novel locus at chromosome 3 at COL6A5 [best SNP = rs1542829, minor allele frequency (MAF) of 5% p = 4.35 × 10(-) (9), z = 5.89]. CONCLUSION:An EMR linked cohort study demonstrates that the BMI-Z measurements can be successfully extracted and linked to genomic data with meaningful confirmatory results. We verified the high prevalence of childhood rate of overweight and obesity in our cohort (28%). In addition, our data indicate that genetic variants in the first intron of FTO, a known adult genetic risk factor for BMI, are also robustly associated with BMI in pediatric population.
| S-EPMC3847941 | biostudies-literature
Project description:Children with cerebral palsy (CP) have motor impairments that make it challenging for them to participate in standard physical activity (PA) interventions. There is a need to evaluate adapted PA interventions for this population. Dance can promote coordination, posture, muscle strength, motor learning, and executive functioning. This pilot study evaluated the feasibility and the effects of a new therapeutic ballet intervention specifically designed for children with CP. Methods: Eight children with CP (9-14 y/o; 75% female) participated in a 6-week therapeutic ballet intervention. Outcomes were measured in multiple domains, including body composition (DXA), muscle strength (hand-grip dynamometer), habitual physical activity, gait and selective motor control functions, and executive functioning. Follow-up assessments of habitual physical activity, gait, and executive functioning were completed 4 to 5 weeks post-intervention. Results: Five of the eight participants were overfat or obese based on DXA percentage of body fat. All participants were below the 50th percentile for their age and gender for bone density. Four participants showed a trend to improve hand-grip strength in one hand only, while one improved in both hands. There were significant improvements in gait across time points (pre, post, and follow-up), specifically in time of ambulation (X pre = 4.36, X post = 4.22, X follow-up = 3.72, d = 0.056, p = 0.02), and in step length (cm) on the right: X pre = 48.29, X post = 50.77, X follow-up = 52.11, d = 0.22, p = 0.027, and left stride: X pre = 96.29, X post = 102.20, X follow-up = 104.20, d = 0.30, p = 0.027, indicating gait changes in bilateral lower extremities. There was improvement in inhibitory control (d = 0.78; 95% Confidence Limit = ±0.71, p < 0.05) with large individual responses primarily among those above the mean at baseline. Conclusions: Therapeutic ballet may prove to be a useful intervention to promote physiological and cognitive functions in children with CP. Results demonstrated feasibility of the physical, physiological, and cognitive assessments and suggested improvements in participants' gait and inhibitory control with large individual responses. Modifications to personalize the intervention may be needed to optimize positive outcomes. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT03681171.
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Project description:BACKGROUND:While physical frailty and malnutrition/obesity (parameters easily measured by a nurse) are not the same, older persons who are malnourished/obese are more likely to be frail and there is a potential overlap between these conditions. The objective was to examine the relationship between gait speed (GS) and body mass index (BMI) in men and women aged 75 years and older. DESIGN:Cross-sectional analysis. SETTING, PARTICIPANTS:Data from the Aging Multidisciplinary Investigation (AMI), a French prospective cohort study with participants randomly selected from the farmer Health Insurance rolls. MEASUREMENTS:Usual GS was measured over a 4 meters-track. BMI was categorized using clinical cut-points for European populations: (e.g, <20.0 kg/m2; 20.0-24.9 kg/m2; 25.0-29.9 kg/m2; 30.0-34.9 kg/m2; ?35.0 kg/m2). RESULTS:The current analyses were performed in 449 participants. Mean age was 81 years. Being malnourished/obese was significantly associated with slow GS. Unadjusted and age-adjusted models showed that underweight, overweight and obesity statuses were significantly associated with slow GS for both women (0.83m/s [0.61; 1.04], 0.87m/s [0.72; 1.02], 0.70 m/s [0.41; 0.98], respectively) and men (0.83m/s [0.61; 1.04], 1.11m/s [1.03; 1.20], 0.97m/s [0.75; 1.19], respectively). CONCLUSION:Malnourished/obese are associated with slow GS in older persons. These variables could be contributed at comprehensively and complementarily assessing the older person.
| S-EPMC7064171 | biostudies-literature
Project description:ObjectivesThere has been controversy over whether ketamine affects intracranial pressure (ICP) in children. Transcranial Doppler ultrasound (TCD) is a validated technique used to assess ICP changes noninvasively. Gosling pulsatility index (PI) directly correlates with ICP changes. The objective of this study was to quantify PI changes as a surrogate marker for ICP changes in previously healthy children receiving intravenous ketamine for procedural sedation.MethodsWe performed a prospective, observational study of patients 5-18 years old who underwent sedation with intravenous ketamine as monotherapy. ICP changes were assessed by surrogate PI at baseline, immediately after ketamine administration, and every 5 minutes until completion of the procedure. The primary outcome measure was PI change after ketamine administration compared to baseline (denoted ΔPI).ResultsWe enrolled 15 participants. Mean age was 9.9 ± 3.4 years. Most participants underwent sedation for fracture reduction (87%). Mean initial ketamine dose was 1.4 ± 0.3 mg/kg. PI decreased at all time points after ketamine administration. Mean ΔPI at sedation onset was -0.23 (95% confidence interval [CI] = -0.30 to -0.15), at 5 minutes was -0.23 (95% CI = -0.28 to -0.18), at 10 minutes was -0.14 (95% CI = -0.21 to -0.08), at 15 minutes was -0.18 (95% CI = -0.25 to -0.12), and at 20 minutes was -0.19 (95% CI = -0.26 to -0.12). Using a clinically relevant threshold of ΔPI set at +1 (+8 cm H2O), no elevation in ICP, based on the PI surrogate marker, was demonstrated with 95% confidence at all time points after ketamine administration.ConclusionsKetamine did not significantly increase PI, which was used as a surrogate marker for ICP in this sample of previously healthy children. This pilot study demonstrates a model for evaluating ICP changes noninvasively in the emergency department.
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Project description:Background:Robotic wearable exoskeletons have been utilized as a gait training device in persons with spinal cord injury. This pilot study investigated the feasibility of offering exoskeleton-assisted gait training (EGT) on gait in individuals with incomplete spinal cord injury (iSCI) in preparation for a phase III RCT. The objective was to assess treatment reliability and potential efficacy of EGT and conventional physical therapy (CPT). Methods:Forty-four individuals were screened, and 13 were eligible to participate in the study. Nine participants consented and were randomly assigned to receive either EGT or CPT with focus on gait. Subjects received EGT or CPT, five sessions a week (1 h/session daily) for 3 weeks. American Spinal Injury Association (ASIA) Lower Extremity Motor Score (LEMS), 10-Meter Walk Test (10MWT), 6-Minute Walk Test (6MWT), Timed Up and Go (TUG) test, and gait characteristics including stride and step length, cadence and stance, and swing phase durations were assessed at the pre- and immediate post- training. Mean difference estimates with 95% confidence intervals were used to analyze the differences. Results:After training, improvement was observed in the 6MWT for the EGT group. The CPT group showed significant improvement in the TUG test. Both the EGT and the CPT groups showed significant increase in the right step length. EGT group also showed improvement in the stride length. Conclusion:EGT could be applied to individuals with iSCI to facilitate gait recovery. The subjects were able to tolerate the treatment; however, exoskeleton size range may be a limiting factor in recruiting larger cohort of patients. Future studies with larger sample size are needed to investigate the effectiveness and efficacy of exoskeleton-assisted gait training as single gait training and combined with other gait training strategies. Trial registration:Clinicaltrials.org, NCT03011099, retrospectively registered on January 3, 2017.
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Project description:A large and increasing number of the work force in the population spend their work hours at the keyboard. There is evidence that repetitive high levels of static work, or extreme working postures involving the neck-shoulder muscles are an increased risk for chronic neck-shoulder pain. The aim of this study was to investigate the effect of dynamic computer working (DCW), using a mobile application to the desk surface, on pain characteristics and biomarkers in office workers. We included 10 female subjects. All subjects answered questionnaires about general health, pain intensity and characteristics. The pressure pain threshold (PPT), neck range and motion, neck and shoulder strength were measured. Microdialysis was conducted in trapezius muscle. Measurements were performed before and 4 weeks after DCW. Multivariate analysis, orthogonal partial least square discriminate analysis (OPLS-DA) and univariate analysis paired test, Wilcoxon, was performed. There was significant improvement in reported neck pain, quality of life, and psychological distress after 4 weeks DCW. The PPT and strength in neck and shoulder were significantly increased after DCW. A significant OPLS-DA model showed clear separation between the samples collected before and after 4 weeks DCW. In conclusion, these results show that keyboard work at a movable desk application might decrease the risk of repetitive strain injuries in the neck and shoulder muscles.
| S-EPMC7915059 | biostudies-literature
Project description:Background People with Parkinson’s disease (PD) are at a high risk of falls, with ~ 60% experiencing a fall each year. Greater mediolateral head and pelvis motion during gait are known to increase the risk of falling in PD, however the ability to modify these aspects of gait has not been examined. Thus, this study aimed to examine whether mediolateral trunk, head and pelvis motion during walking could be successfully decreased in people with PD using real-time biofeedback. Methods Participants were provided with real-time biofeedback regarding their mediolateral trunk lean via a visual projection whilst walking along an 8-m indoor walkway. Using the feedback provided, they were asked to reduce the magnitude of their mediolateral trunk lean. Gait was recorded for four conditions (i) Baseline, (ii) Intervention, (iii) immediately Post-Intervention, and (iv) 1-week Follow-Up. Biomechanical variables associated with falls risk were compared between conditions, including normalised mediolateral motion, gait velocity and stride length. Results A reduction in mediolateral trunk lean, step length and gait velocity from Baseline to the Intervention and Post-intervention conditions was observed. Contrary to this, increased normalised ML pelvis and trunk motion was observed between the Baseline and Intervention conditions, but returned to Baseline levels in the Post-Intervention condition. Conclusions Results from the current study suggest that real-time visual biofeedback may be effective at modifying specific gait characteristics that are associated with falls in PD. Further research is required to better understand the influence of this intervention approach on falls incidence. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12620000994987. Registered 10 June 2020 - Retrospectively registered, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380324 Supplementary Information The online version contains supplementary material available at 10.1186/s12984-022-01051-1.
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Project description:The medial longitudinal arch is considered as an essential feature which distinguishes humans from other primates. The longitudinal arch plays a supporting and buffering role in human daily physical activities. However, bad movement patterns could lead to deformation of arch morphology, resulting in foot injuries. The authors aimed to investigate any alterations in static and dynamic arch index following different weight bearings. A further aim was to analyze any changes in plantar pressure distribution characteristics on gait during walking and stopping, Twelve males were required to complete foot morphology scans and three types of gait tests with 0%, 10%, 20% and 30% of additional body weight. The dynamic gait tests included walking, planned and unplanned gait termination. Foot morphology details and plantar pressure data were collected from subjects using the Easy-Foot-Scan and Footscan pressure platform. No significant differences were observed in static arch index when adding low levels of additional body weight (10%). There were no significant changes observed in dynamic arch index when loads were added in the range of 20% to 30%, except in unplanned gait termination. Significant maximal pressure increases were observed in the rearfoot during walking and in both the forefoot and rearfoot during planned gait termination. In addition, significant maximum pressure increases were shown in the lateral forefoot and midfoot during unplanned gait termination when weight was increased. Findings from the study indicated that excessive weight bearing could lead to a collapse of the arch structure and, therefore, increases in plantar loading. This may result in foot injuries, especially during unplanned gait termination.
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