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The purpose of this study was to evaluate the prevalence of foot involvement in psoriatic arthritis and to describe its different clinical and radiological features. We conducted a cross sectional study including 40 patients with psoriatic arthritis over a period of 12 months. Anamnesis, clinical examination of feet, podoscopic examination, X-rays of feet and heels, and ultrasound in B mode and power Doppler mode were done for each patient. Foot involvement was found in 95% of cases. It was symptomatic in 70% and inaugural of the disease in 20% of cases. The hindfoot and the forefoot were the sites most affected (77.5% and 47.5% respectively). The involvement of the midfoot was rarer (25%). Dactylitis was found in 17.5% and deformities of forefoot were found in 22.5% of cases. Antalgic gait was noted in 17.5% and static disorders of foot at podoscopic examination were identified in 35% of cases. Feet dermatological manifestations were found in 45% of cases. Diagnosis of different rheumatological manifestations was based on clinical findings and caracteristic radiological images on X-rays. We demonstrate he sensitivity of ultrasound in the detection and the diagnosis of different foot lesions including enthesitis, synovitis and tenosynovitis, dactylitis, bone erosions and psoriatic nail dystrophy. [ABSTRACT FROM AUTHOR]

The role of strengthening the lower limbs to optimize the biomechanics of the hip, knee and ankle during walking in patients with knee osteoarthritis, is still unclear. This study aimed to analyse the walking biomechanics of individuals with symptomatic mild to moderate knee osteoarthritis before and after a simplified lower limb resistance training protocol, focused on knee joint exercises with individualized load. Forty-one patients with symptomatic and radiographic mild to moderate knee osteoarthritis underwent 3D gait analysis pre-post 8 weeks lower limb resistance training protocol performed 3 times a week. Parameters investigated were spatiotemporal, sagittal range of motion, flexion and extension minimum and maximum values, power and moment of hip, knee and ankle, as well as self-reported pain and physical function by the Western Ontario MacMaster University Osteoarthritis Index. Paired t test, Wilcoxon, Spearman's correlation and a logistic model were used for statistical analysis, with p < 0.05. Pain improvement more than 2 points was considered clinically relevant. The effect size (ES) was calculated using Cohen's d. Post protocol walking speed increased 6.7% (ES: 0.711), cadence 3.7% (ES: 0.655), stride length 2.6% (ES: 0.542), and double support time reduced 6.9% (ES:0.459). It was also observed a significant increase in one maximum repetition test for legpress 46%, knee extension 23% and knee flexion chair 27% (p < 0.001). Patients reported a 62.5% reduction in pain (ES:1.518) and 64.9% improvement in physical function (ES:1.376). 82% of the patients presented more than 2 points improvement in pain. No evidence of strong correlations between pain, strength gains and gait parameters were found. There was a significant and clinical improvement of spatiotemporal gait parameters, pain, physical function, and strength after 8-week lower limb resistance training protocol. Patients who had a clinically relevant pain improvement presented better gait performance. [ABSTRACT FROM AUTHOR]

Foot deformities (e.g. planovalgus and cavovarus) are very common in children with spastic cerebral palsy (CP), with the midfoot often being involved. Dynamic foot function can be assessed with 3D gait analysis including a multi-segment foot model. Incorporating a midfoot segment in such a model, allows quantification of separate Chopart and Lisfranc joint kinematics. Yet, midfoot kinematics have not previously been reported in CP. What is the difference in multi-segment kinematics including midfoot joints between common foot deformities in CP and typically-developing feet? 103 feet of 57 children with spastic CP and related conditions were retrospectively included and compared with 15 typically-developing children. All children underwent clinical gait analysis with the Amsterdam Foot Model marker set. Multi-segment foot kinematics were calculated for three strides per foot and averaged. A k-means cluster analysis was performed to identify foot deformity groups that were present within CP data. The deformity type represented by each cluster was based on the foot posture index. Kinematic output of the clusters was compared to typically-developing data for a static standing trial and for the range of motion and kinematic waveforms during walking, using regular and SPM independent t-tests respectively. A neutral, planovalgus and varus cluster were identified. Neutral feet showed mostly similar kinematics as typically-developing data. Planovalgus feet showed increased ankle valgus and Chopart dorsiflexion, eversion and abduction. Varus feet showed increased ankle varus and Chopart inversion and adduction. This study is the first to describe Chopart and Lisfranc joint kinematics in different foot deformities of children with CP. It shows that adding a midfoot segment can provide additional clinical and kinematic information. It highlights joint angles that are more distinctive between deformities, which could be helpful to optimize the use of multi-segment foot kinematics in the clinical decision making process. • Neutral, planovalgus and varus feet are objectively classified in children with CP. • Kinematics including midfoot joint angles are described for each foot type. • Planovalgus feet in CP show increased Chopart dorsiflexion, eversion and abduction. • Varus feet in CP show increased ankle varus and Chopart inversion and adduction. • A midfoot segment in a foot model adds clinical insight in foot deformities in CP. [ABSTRACT FROM AUTHOR]

Gait and cognition are closely associated in Parkinson's disease (PD), with specific cognitive domains being associated with different motor symptoms. By identifying gait parameters affected by cognition, clinicians can develop targeted interventions that address cognitive impairment, improve gait, and reduce the risk of injury in PD patients. What gait parameters are affected by cognition in PD patients during dual-task walking, and how are these parameters related to cognitive function as measured by the Montreal Cognitive Assessment (MoCA)? 36 patients with available gait data and cognitive assessments were enrolled. Gait data of usual and dual-task walking sessions were recorded using lightweight wireless wearable sensors attached to trunk, lower, and upper extremities. Dual-task costs were calculated from usual and dual-task measures. Statistical analysis included non-parametric tests, Wilcoxon signed-rank test, Spearman's correlation, and stepwise linear regression models. Walking speed, cadence, asymmetry in arm swing (ASA), between arms' amplitude symmetry (BAS), average stride time, and jerk of the acceleration movement of the legs were found to be affected during the dual-task walking session (P<0.05). Spearman's correlation showed significant correlations between MoCA scores and ASA (ρ=-0.469, P =0.036) and BAS (ρ=-0.448, P =0.036) costs. Stepwise linear regression models found that MoCA scores were significant predictors of BAS and ASA costs (P<0.05). This study found a significant association between global cognitive ability and several gait parameters costs under cognitive load caused by dual-task walking in PD patients. The study identified the gait parameters that were affected by cognitive load and found that MoCA scores were significant predictors of those gait parameters. Identifying gait parameters affected by cognition can lead to more targeted interventions for improving gait and reducing injury risk in PD patients. • Gait is affected by cognitive load during dual-task walking in Parkinson's disease. • Dual-task costs of upper limb parameters were correlated with MoCA scores. • The MoCA score was a significant predictor of dual-task costs in upper limbs. • Interventions can be targeted at gait measures with significant dual-task costs. [ABSTRACT FROM AUTHOR]

Gait retraining using haptic biofeedback medially shifts the center of pressure (COP) while walking in orthopedic populations. However, the ideal sensor location needed to effectively shift COP medially has not been identified in people with chronic ankle instability (CAI). Can a heel sensor location feasibly be employed in people with CAI without negatively altering kinematics? Does a heel sensor placement relative to the 5th metatarsal head (5MH) impact COP location while walking in people with CAI? In this exploratory crossover study, 10 participants with CAI walked on a treadmill with vibration feedback for 10 minutes with a plantar pressure sensor under the heel and 5MH. Separate 2×2 repeated measures analyses of covariances (rmANCOVAs) were used to compare the averaged COP location and 3-D lower extremity kinematics from the first 10% of stance before and after training and between sensor locations. Baseline measures served as covariates to adjust for baseline differences. Feedback triggered by a heel sensor resulted in 40% of participants avoiding a heel strike. There were no significant main effects or interactions between time and sensor location on COP location when controlling for baseline COP (p>0.05). However, with the 5MH placement, participants displayed less ankle internal rotation(IR) (5MH/Heel: −4.12±0.00º/ −6.43±0.62º), less forefoot abduction (-4.29±0.00º/ −5.14±1.01º), more knee flexion (3.40±0.32º/ 0.14±0.57º), less knee external rotation (-10.95±0.00º/-11.24±1.48º), less hip extension (-0.20±0.00º/-1.42±1.05º), and less hip external rotation (3.12±0.00º/3.75±1.98º). A 5MH location may be more feasible based on difficulties maintaining heel strike when the sensor was under the heel. While no sensor location was statistically better at changing the COP, the 5MH location decreased proximal transverse plane motions making participants' gait more like controls. Individual response variations support comprehensive lower extremity assessments and the need to identify responder profiles using sensory feedback in people with CAI. • A forefoot sensor to control stimuli is more feasible for gait retraining in CAI. • A forefoot sensor may alter kinematics to be more like controls. • A heel sensor for gait retraining causes unanticipated gait deviations. [ABSTRACT FROM AUTHOR]

Although changes in the gait biomechanics during pregnancy are known to occur, it is unclear whether they return to their original state after childbirth. The objective of the current systematic review is to summarize existing literature reporting the biomechanical characteristics of gait in postpartum women and to identify knowledge gaps that calls for future investigations in this population. Relevant articles were selected using MEDLINE (PubMed), Scopus (Elsevier), Embase (Elsevier), and Web of Science (Clarivate Analytics). Articles were included if they met the following criteria: They must (1) include postpartum women, (2) report measures related to three-dimensional (3D) kinematics and/or kinetics, (3) have been published after 1990, and (4) have been published in English. The current systematic review included a total of 14 articles, five of which compare the data from postpartum women with nulliparous women or pre-pregnancy data. We observed that gait biomechanics changes of postpartum women could persist for more than 5 years after the childbirth. This review provides novel viewpoints on the biomechanics of postpartum women's gait and recommendations for future studies to fully understand these changes and improve postpartum women's physical and mental wellbeing. • Gait biomechanics differ between postpartum and nulliparous women. • Postpartum women experience persistent alterations in gait even after 5 years. • Smaller gluteus maximus activity is seen in postpartum women. • Postpartum women show greater hip peak adduction moment. [ABSTRACT FROM AUTHOR]

To examine whether immersive virtual reality (VR) can improve balance, gait, mobility and fear of falling in older people. MEDLINE, EMBASE, CINAHL, PsycINFO, ProQuest Central (Engineering and Computer Science) and reference lists of included articles. Randomised controlled trials that administered immersive VR training and assessed balance, gait and mobility outcomes in older adults without neurological disorders (mean age ≥ 65). Primary outcomes were standing balance (e.g. postural sway), multi-item balance scales (e.g. Berg Balance Scale), gait (e.g. gait speed) and mobility (e.g. Timed Up and Go test). Secondary outcomes comprised measures of enjoyment, fear of falling, adherence (e.g. dropout rate), feasibility/usability and adverse effects (e.g. motion sickness). Meta-analyses showed that immersive VR training significantly improved standing balance (SMD: 0.51, 95% CI:.15, 0.86, p = 0.005, I2 = 28% - 3 studies, n = 79) and performance on the Berg Balance Scale (MD: 2.36, 95% CI: 1.17, 3.56, p=0.0001, I2=0% - 4 studies, n = 190). No significant improvement in gait, mobility or fear of falling was found. Subgroup analyses revealed higher training doses (≥4.5 total hours) and VR interventions using non-head mounted displays were more likely to improve standing balance. No meta-analyses were conducted for enjoyment, adherence, feasibility/usability and adverse events. The findings indicate immersive VR has beneficial effects on balance, but not gait, mobility or fear of falling. Further research is required to examine these outcomes in trials that also include quantitative measurements of enjoyment, adherence, clinical feasibility, usability and adverse effects. • Immersive virtual reality (VR) can improve balance in older people. • At least 4.5 hours of total training dose was necessary to improve balance. • Immersive VR without a head-mounted display may be more effective. • Effects of VR training on gait, mobility and fear of falling were not clear. • More research is needed for enjoyment, adherence, usability and side effects. [ABSTRACT FROM AUTHOR]

Increased spatiotemporal gait variability is considered a clinical biomarker of ageing and pathology, and a predictor of future falls. Nevertheless, it is unclear whether the increased spatiotemporal variability observed in persons with stroke is directly related to the pathology or simply reflects their choice of walking velocity. Does increased spatiotemporal gait variability directly relate to motor coordination deficits after stroke? Forty persons with stroke participated in this cross-sectional study. Participants performed the lower-extremity motor coordination test (LEMOCOT) on an electronic mat equipped with force sensors. Then, participants walked for 120 s on a computerized treadmill at their comfortable walking velocity. For the LEMOCOT we used the traditional score of in-target touch count and computed the absolute and variable error around the targets. For gait variability, we extracted the standard deviation of step time, step length, step velocity, and step width. Using linear modeling, we tested the correlations of gait variability with the outcome measures from the LEMOCOT, after controlling for walking velocity. The variability in step time, step length and step width correlated with walking velocity, while the variability in step velocity did not. After controlling for walking velocity, we observed that the LEMOCOT score correlated with the variance in step time, and the variable error in the LEMOCOT correlated with the variance in step length, in step width, and in step velocity. No significant correlation with any of the velocity-controlled step parameters was found for the absolute error in the LEMOCOT. Decreased performance in the LEMOCOT was associated with increased spatiotemporal variability in persons with stroke, regardless of their walking velocity. Our results demonstrate the connection between lower-extremity coordination impairments and deficits in gait function. • Regardless of walking velocity, spatiotemporal variability is related to intralimb coordination deficits following stroke. • Spatiotemporal variability is exponentially related to walking velocity in persons with stroke. • Some step parameters demonstrated a U-shaped relationship with walking velocity. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of functional improvement in the upper extremity on gait and balance in children with upper extremity affected. What are the effects of functional improvement in the upper extremity on gait and balance in children with upper extremity affected? Eighteen children with a diagnosis of rheumatologic diseases and 15 healthy children were evaluated with Shriners Hospital Upper Extremity Assessment, Jebsen-Taylor Hand Function Test, Abilhand Rheumatoid Arthritis Scale, 10-meter walk test and Childhood Health Assessment Questionnaire. For static balance assessment, the Biodex Balance was used. Ground reaction forces (peak forces (heel strike and push-off) and minimum force (loading response), single-limb support duration, Center-of-Force displacement and walking speed were evaluated with the Sensor Medica. Arm swing was evaluated with the Kinovea 2D motion analysis. Before treatment, single-limb support duration and push-off force was higher and center-of-force displacement was lower on affected side compared to unaffected side in rheumatologic group. After the 6-week rehabilitation program, upper extremity function, quality of life and functional gait score improved. Single-limb support duration decreased on affected side and increased on unaffected side. On affected side, push-off force decreased. The arm swing parameters were similar before and after treatment. Improving upper extremity function can help with gait balance by decreasing the difference in walking and balance parameters between the affected and unaffected sides and providing for more symmetrical weight transfer. • Improving upper extremity function can promote balance and gait. • Increased upper extremity function provides symmetrical weight transfer. • To enhance gait and balance, upper extremity therapies should be added to treatment. [ABSTRACT FROM AUTHOR]

In patients with medial knee osteoarthritis (OA), medial meniscus extrusion during gait is aggravated by mechanical stress, such as knee adduction moment (KAM). Conversely, the decrease in the range of knee rotation during stance phase is also one of the important issues in early knee OA, whereas the correlation between medial meniscus extrusion and knee rotation during gait are unclear. To investigate the correlation between increase in medial meniscus extrusion and range of knee rotation during gait in patients with early- and late-stage of knee OA. Forty patients with medial knee OA were enrolled and divided into early- and late-OA group by Kellgren-Lawrence grading scale. During gait tasks, the extent of medial meniscus extrusion was measured using ultrasonography and kinetic/kinematic data were measured using three-dimensional motion analysis system. The correlation between medial meniscus extrusion and the range of knee rotation or KAM were evaluated in the overall, early-, and late- OA groups. A significant negative correlation was observed between an increase in medial meniscus extrusion and range of knee rotation angle in early-OA group only. However, an increase in medial meniscus extrusion significantly correlated with the second KAM peak in the overall and early-OA groups. The decrease in range of knee rotation during stance phase may be associated with the increase in medial meniscus extrusion during gait in patients with early knee OA. • Assessed correlation of medial meniscus extrusion with knee rotation during gait. • Meniscus extrusion aggravated with restriction of knee rotation in early knee OA. • Meniscus extrusion was not correlated with knee rotation in late knee OA. • Meniscus extrusion correlated with knee adduction moment peak in knee OA. [ABSTRACT FROM AUTHOR]

GTP-cyclohydrolase 1-deficient dopa-responsive dystonia (GTPCH1-deficient DRD) typically presents in childhood with dystonic posture of the lower extremities, gait impairment, and a significant response to levodopa. We performed three-dimensional gait analysis (3DGA) to quantitatively assess the gait characteristics and changes associated with levodopa treatment in patients with GTPCH1-deficient DRD. Three levodopa-treated patients with GTPCH1-deficient DRD underwent 3DGA twice, longitudinally. Changes were evaluated for cadence; gait speed; step length; gait deviation index; kinematic data of the pelvis, hip, knee, and ankle joints; and foot progression angle. Levodopa treatment increased the cadence and gait speed in one of three patients and increased the gait deviation index in two of three patients. The kinematic data for each joint exhibited different characteristics, with some improvement observed in each of the three patients. There was consistent marked improvement in the abnormal foot progression angle; one patient had excessive external rotation of one foot, another had excessive bilateral internal rotation, and the other had excessive internal rotation of one foot and excessive external rotation of the opposite foot, all of which improved. The 3DGA findings demonstrate that the gait pathology and recovery process in GTPCH1-deficient DRD vary from case to case. Changes in the foot progression angle and gait deviation index can enable the effects of treatment to be more easily evaluated. [ABSTRACT FROM AUTHOR]

Walking is the most affected motor function in children with cerebral palsy (CP). Orthopaedic surgery is regularly used to improve ambulation in children with CP. Selective Percutaneous Myofascial Lengthening (SPML) is considered the state-of-the art technique for surgical lengthening of spastic/contracted muscles in CP. The purpose of this study was to investigate the effect of combined SPML surgery and postoperative functional physiotherapy on gait function and characteristics of children with spastic cerebral palsy (CP). Twenty-six children with spastic CP, aged 5–7 years, Gross Motor Function Classification System (GMFCS) levels II (n = 6), III (n = 12) and IV (n = 8) participated in a quasi-experimental one-group pretest-posttest study with a 9-month follow-up. The Global Motion Graph Deviation Index (MGDI) (including MGDI sub-indices of each joint in each plane of motion) and spatiotemporal parameters of a three-dimensional kinematic gait analysis were used to assess the gait function and characteristics, respectively. Nine months following SPML and functional physiotherapy, statistically significant improvements (p < 0.05) were noted in the Global MGDI, the MGDIs of sagittal plane knee and ankle motion analysis graphs, and the four most common spatiotemporal measures of gait: walking velocity, stride length, step length, and cadence. Children with spastic CP seem to gain better overall gait function following SPML procedure and functional physiotherapy, by achieving higher walking velocity, longer stride length and step length, and faster cadence. Further studies with control group and longer follow-up three-dimensional gait analyses are warranted to validate these positive results. [ABSTRACT FROM AUTHOR]

In this work, we present a system that detects Freezing of Gait Detection (FOG) that uses of a single wearable inertial sensor to automatically evaluate a Parkinson's patient's gait instability and detect FOG in real-time. A wearable vibrator is our cueing system which is triggered by the FOG detection whenever a FOG episode takes place. The vibration impulses help the patient to prevent FOG by switching to voluntarily movement execution. Sensor data were collected from nine patients with Parkinson's disease performing Unified Parkinson's Disease Rating Scale (UPDRS) test under the supervision of a clinical expert. Along with data recording, a video was taken from patient's parkour. The data were labeled through the recorded video of the patient's tests and FOG and non-FOG data were assigned. A machine learning model using a deep Long-Short-Term-Memory (LSTM) employ the accelerometer data from the sensor and the inference leads to a FOG or non-FOG classification. The FOG detection model is pruned, quantized and used for real-time inference on Google Coral board worn on the patient' body. The model deployed on a Google coral board sends a trigger to the cuing device right after the FOG detection and the patient get alert for the happening FOG. The individualized model for one-second windows applied in this work performed an average of 91.5% of sensitivity and 86.5% specificity for models running on PC and 91.7% of sensitivity and 86.7% of specificity for the models tested on Google coral with the latency of 50 millisecond on real-time testing. [ABSTRACT FROM AUTHOR]

• Design and train 55-layer CNN model on the CIFAR-100 dataset. • Build two-stream network to extract spatial and temporal features from the images. • Feature optimization is performed using a Genetic algorithm. Human Gait Recognition (HGR) is referred to as a biometric tactic that is broadly used for the recognition of an individual by using the pattern of walking. There are some key factors such as angle variation, clothing variation, foot shadows, and carrying conditions that affect the human gait. In this work, a new approach is proposed for the HGR that contains five major steps. In the first step, the video data is converted into image frames. In the second step, RGB to GRAY conversion is carried out. After that, a two-stream network is designed by using a 55-layer CNN model called CNN-55 trained on CIFAR-100. The CNN-55 is designed from scratch and trained on the CIFAR-100 dataset by selecting hyperparameters. This pre-trained CNN-55 is used to build a two-stream network. In Stream-1 the optical flow frames are obtained by Horn and Schunk algorithm. These frames are fed into a CNN-55 to extract temporal features. In Stream-2 the GRAY frames are fed to the CNN-55 model for extraction of spatial features. After that, both vectors are serially fused. In the fourth step, the fused feature vector is fed into the Genetic Algorithm for optimization. Finally, the feature vector is fed into the One-Versus-All SVM classifier for recognition. The system is tested on all CASIA-B angles such as 000, 180, 360, 540, 720, 900, 1080, 1260, 1440, 1620, and 1800 which provides accuracy of 97.10%, 96.80%, 94.60%, 98.0%, 98.30%, 96.80%, 97.60, 96.90%, 99.60%, 96.80%, and 97.60%, respectively. The proposed method produces better outcomes compared to recent techniques. [ABSTRACT FROM AUTHOR]

We searched to quantify the influence of sagittal vertical axis (SVA) on the improvement of spatiotemporal gait parameters using a gait motion analysis (GMA) before and after decompression surgery in patients suffering from lumbar spinal stenosis (LSS). Thirty-nine patients with severe LisSS planned for lumbar decompression underwent a full-body biplanar radiographs (EOS) to quantify the SVA and have benefited from a 3-dimensional GMA 1 month before surgery (M0) and 6 month (M6) after surgery. The first step of this study was to confirm the validation of 3-dimensional sagittal vertical axis (3D SVA) for posture analysis. An analysis of modification of the 3D SVA and spatiotemporal gait parameters was then carried out in order to identify any correlation. Decompression surgery did not significantly improve 3D SVA between M0 and M6 (respectively 49.1 [50.3] vs. 49.84 [19.02], P = 0.42). Concerning spatiotemporal parameters, we found significant difference for all parameters between M0 and M6. A strong correlation (R2 > 0.65) between static SVA (EOS) and 3D SVA was demonstrated using a statistical regression equation. There was also a statistically significant correlation between SVA (static and 3-dimension) and improvement in spatiotemporal gait parameters after decompression surgery. This study analyses the relationship between postural change (SVA) and improvement in gait parameters measured during GMA before and after decompression surgery for LSS. This specific analysis of gait parameters may represent a prognostic assessment tool for the recovery of patients undergoing surgery for a LSS. [ABSTRACT FROM AUTHOR]

Leg length discrepancy (LLD) is common in youth and is cause by several conditions. Long leg X-rays is the gold standard technique of measuring LLD. It is highly accurate and reliable compared to clinical method, but expose the subject to radiation. Instrumented Gait Analysis (IGA) serves not only as a means to measure joint kinematics during gait but also as a valuable tool for assessing Leg Length Discrepancy (LLD) while standing. Research Question. The purpose of this study was to compare different methods of determining the LLD in paediatric population. We hypothesize that IGA using joint centres is more accurate and precise than the tape measurement. Thirty-one patients with mean age 12.3 (SD=2.4) years were retrospectively included in the study. Their LLD varied between 0 and 36 mm. Three methods for determining LLD were compared to radiography using Bland-Altman analysis: 1. Tape measurement, 2. IGA, summarizing the distance from the spina iliaca anterior superior to the medial malleolus marker via the medial knee condyle marker. 3. IGA, summarizing distances between ankle, knee, and hip joints centres where the latter is calculated with different equations. The IGA joints method performed better than the tape measurement or IGA markers method. The equations of Davis calculating the hip joint centre had the highest accuracy with mean difference to radiography of 0.7 mm (SD=6.3). The simple Harrington method resulted in a slightly reduced accuracy but higher precision 0.9 mm (SD=6.2). The Harrington method with leg length as input was less accurate 1.0 mm (SD=6.7), but was still considerably better than the tape measurement 1.8 mm (SD=7.0) or IGA markers method 1.1 mm (SD=11.5). Significance. Determining LLD with IGA using the distances between ankle, knee and hip joints centres is a feasible method that can be applied in clinical practice to calculate LLD. • Leg length difference can be accurately determined by 3D motion capturing. • It is more accurate and precise than using tape measurements. • It is not accurate and precise for determining femur and tibia length. • Different calculation methods of the hip joint center do not affect the accuracy. [ABSTRACT FROM AUTHOR]

Gait classification is a clinically helpful task performed after a stroke in order to guide rehabilitation therapy. Gait disorders are commonly identified using observational gait analysis in clinical settings, but this approach is limited due to low reliability and accuracy. Data-driven gait classification can quantify gait deviations and categorise gait patterns automatically possibly improving reliability and accuracy; however, the development and clinical utility of current data driven systems has not been reviewed previously. The purpose of this systematic review is to evaluate the literature surrounding the methodology used to develop automatic gait classification systems, and their potential effectiveness in the clinical management of stroke-affected gait. The database search included PubMed, IEEE Xplore, and Scopus. Twenty-one studies were identified through inclusion and exclusion criteria from 407 available studies published between 2015 and 2022. Development methodology, classification performance, and clinical utility information were extracted for review. Most of gait classification systems reported a classification accuracy between 80%–100%. However, collated studies presented methodological errors in machine learning (ML) model development. Further, many studies neglected model components such as clinical utility (e.g., predictions don't assist clinicians or therapists in making decisions, interpretability, and generalisability). We provided recommendations to guide development of future post-stroke automatic gait classification systems to better assist clinicians and therapists. Future automatic gait classification systems should emphasise the clinical significance and adopt a standardised development methodology of ML model. • Gait classification systems achieved mixed results regarding performance. • Methodological errors were present in development of gait classification systems. • The scarcity of clinical utility limit application in clinical settings. • Recommendations can guide development and clinical utility of models. [ABSTRACT FROM AUTHOR]

Gait adaptability training programs to prevent falls in healthy older adults can be proposed in virtual reality. The development of training programs requires the characterization of the target population. Before proposing an innovative training program to develop gait adaptability behavior of healthy older adults in fully immersive virtual reality, we had to compare gait adaptability behavior between healthy older adults and young adults in virtual reality. Twenty healthy older adults (with no fall history) and twenty young adults performed a goal-directed locomotion task in a totally secure virtual reality set-up. Gait adaptability behavior was investigated via a set of measures taking into account gait speed, pointing accuracy, and the evolution of the relationship between the participant and the environment through both inter-trial and trial-by-trial analyses. Mann-Whitney tests and linear regressions were performed to determine potential age differences. The results reveal some common and specific strategies in gait adaptability behavior between healthy older and young adults. In both populations, successive gait adjustments depend on the state of the agent-environment system. However, older adults walked more slowly than young adults (p <.001) with a greater coupling at the end of the target approach (p =.003). In the context of fall prevention in healthy older adults, fully immersive VR appears as a relevant tool to propose relevant gait training programs to improve gait adjustments. • Older adults initiated their gait adjustments earlier in comparison to young adults. • Gait adaptability behavior depends on the current state of the agent-environment system. • Virtual reality appears as a relevant tool to propose relevant training programs in older adults. [ABSTRACT FROM AUTHOR]

A common gait retraining goal for runners is reducing vertical ground reaction force (GRF) loading rates (LRs), which have been associated with injury. Many gait retraining programs prioritize an internal focus of attention, despite evidence supporting an external focus of attention when a specific outcome is desired (e.g., LR reduction). Does an external focus of attention (using cues for quiet, soft landings) result in comparable reductions in LRs to those achieved using a common internal focus (forefoot striking while barefoot)? This observational study included 37 injured runners (18 male; mean age 36 (14) years) at the OMITTED Running Center. Runners wore inertial measurement units over the distal-medial tibia while running on an instrumented treadmill at a self-selected speed. Data were collected for three conditions: 1) Shod-Control (wearing shoes, without cues); 2) Shod-Quiet (wearing shoes, cues for quiet, soft landings); and 3) Barefoot-FFS (barefoot, cues for forefoot strike (FFS)). Within-subject variables were compared across conditions: vertical instantaneous loading rate (LR, primary outcome); vertical stiffness during initial loading; peak vertical GRF; peak vertical tibial acceleration (TA); and cadence. Vertical LR, stiffness, and TA were lower in the Shod-Quiet compared to Shod-Control p < 0.001). Peak vertical GRF and cadence were not different between Shod-Quiet and Shod-Control. Reductions in stiffness and LR were similar between Shod-Quiet and Barefoot-FFS, and GRF in Barefoot-FFS remained similar to both shod conditions. However, runners demonstrated additional reductions in TA and increased cadence when transitioning from Shod-Quiet to the Barefoot-FFS condition (p < 0.05). These results suggests that a focus on quiet, soft landings may be an effective gait retraining method for future research. • Cues for quiet, soft landings resulted in acute reductions in loading rates in runners. • Loading rate reductions were similar to a barefoot, forefoot strike condition. • Strategies used to achieve quiet, soft landings were varied between runners. [ABSTRACT FROM AUTHOR]

Studies have shown good reliability for gait analysis interpretation among surgeons from the same institution. However, reliability among surgeons from different institutions remains to be determined. Is gait analysis interpretation by surgeons from different institutions as reliable as it is for surgeons from the same institution? Gait analysis data for 67 patients with cerebral palsy (CP) were reviewed prospectively by two orthopedic surgeons from different institutions in the same state, each with > 10 years' experience interpreting gait analysis data. The surgeons identified gait problems and made treatment recommendations for each patient using a rating form. Percent agreement between raters was calculated for each problem and treatment, and compared to expected agreement based on chance using Cohen's kappa. For problem identification, the greatest agreement was seen for equinus (85% agreement), calcaneus (88%), in-toeing (89%), and out-toeing (90%). Agreement for the remaining problems ranged between 66–78%. Percent agreement was significantly higher than expected due to chance for all issues (p ≤ 0.01) with modest kappa values ranging from 0.12 to 0.51. Agreement between surgeons for treatment recommendations was highest for triceps surae lengthening (89% agreement), tibial derotation osteotomy (90%), and foot osteotomy (87%). Agreement for the remaining treatments ranged between 72–78%. Percent agreement for all treatments was significantly higher than the expected values (p ≤ 0.002) with modest kappa values ranging from 0.22 to 0.52. Previous research established that computerized gait analysis data interpretation is reliable for surgeons within a single institution. The current study demonstrates that gait analysis interpretation can also be reliable among surgeons from different institutions. Future research should examine reliability among physicians from more institutions to confirm these results. • Excellent agreement was seen for surgeons from different institutions. • Agreement for treatment reflects differing intervention thresholds. • Larger multicenter research is needed to confirm these results. [ABSTRACT FROM AUTHOR]

Children with hypermobility spectrum disorder/hypermobile Ehlers-Danlos syndrome (HSD/hEDS) have a high prevalence of chronic pain, which may influence gait dynamics. However, little is known about pain outcomes and their association with gait spatiotemporal parameters in children with HSD/hEDS. Does pain correlate with gait spatiotemporal parameters in children with HSD/hEDS? Eighteen children with HSD/hEDS and eighteen typically developing (TD) children participated in the study. The current level of pain (0–10 on the numeric rating scale), modified Brief Pain Inventory, and Pain Catastrophizing Scale-Child version were implemented to assess pain in children with HSD/hEDS. All children completed a gait analysis at a self-selected speed. Mean and variability (measured using the coefficient of variation) of gait spatiotemporal parameters were analyzed. Gait parameters included stride length, stride time, gait speed, percent stance time, and step width. A Mann-Whitney U-test was used to compare the gait parameters between children with HSD/hEDS and TD children. Spearman correlations were used to examine the relationships between pain and gait spatiotemporal parameters in children with HSD/hEDS. Children with HSD/hEDS had a longer percent stance time compared to TD children (p = 0.03). Lower pain interference in relationships with other people was significantly associated with faster gait speeds (ρ = −0.55, p = 0.03). Children with HSD/hEDS also had greater pain interference during mobility (ρ = 0.5, p = 0.05) and going to school (ρ = 0.65, p = 0.01), which were significantly correlated with greater stride length variability. Greater pain interference during enjoyment of life was significantly associated with greater percent stance time variability (ρ = 0.5, p = 0.05). Greater pain catastrophizing was correlated with decreased step width variability in children with HSD/hEDS (ρ = −0.49, p = 0.05). Pain interference and catastrophe were significantly associated with gait spatiotemporal variability. Our findings suggest that assessing pain-associated gait alterations may help understand the clinical features and gait kinematics of children with HSD/hEDS. • The percent stance time was different between HSD/hEDS and typically developing children. • There is no difference in gait variability between HSD/hEDS and typically developing children. • Faster gait speeds were associated with lower pain outcomes in children with HSD/hEDS. • Stride length, percent stance time, and step width variability were associated with pain. [ABSTRACT FROM AUTHOR]

Femoroacetabular impingement (FAI) is a condition where the femoral head-neck junction collides with the acetabulum. Open or arthroscopic treatment of FAI aims to increase hip motion while reducing impingement during passive or dynamic movements. What are the biomechanical characteristics of the hip and pelvis in adolescents and young adults diagnosed with FAI syndrome 1) pre-operatively compared to controls and 2) pre- to post-operatively? 43 patients with FAI and 43 controls were included in the study. All patients with FAI had cam deformities and underwent unilateral hip preservation surgery (either open or arthroscopic). Pre- and post-operative imaging, patient-reported outcomes, and gait analysis were performed. Joint angles and internal joint moments were evaluated with an emphasis on the pelvis and hip. A comparative analysis was conducted to evaluate the gait patterns before and after surgical treatment, as well as to compare pre-operative gait patterns to a control group. 43 patients with FAI (28 female, 16.5 ± 1.5 yrs) and 43 controls (28 female, 16.0 ± 1.5 yrs) were included. Pre-operative patients with FAI had decreased stride length and walking speed compared to controls, with no significant change following surgery. There were no differences in sagittal and coronal plane hip and pelvis kinematics comparing pre- to post-operative and pre-operative to controls. Pre-operatively, differences in internal hip rotation angle (pre: 3.3˚, post: 3.9˚, controls: 7.7˚) and hip extensor moment (pre: 0.121, post: 0.090, controls: 0.334 Nm/kg) were observed compared to controls with no significant changes observed following surgery. Compensatory movement strategies in pelvic and hip motion are evident during gait in patients with FAI, particularly in the sagittal and transverse planes. These strategies remained consistent two years post-surgery. While surgery improved radiographic measures and patient-reported outcomes, gait did not elicit biomechanical changes following surgical treatment. • Biomechanical outcomes following surgery for femoroacetabular impingement is varied • Pelvis and hip kinematics during gait did not change following surgical treatment • Joint kinetic differences evident pre-operatively did not improve post-operatively [ABSTRACT FROM AUTHOR]

Abnormal gait characteristics have been observed in people with diabetic neuropathy, but it is unclear if subtle changes in gait occur in prediabetic people with impaired fasting glucose (IFG). The aims of this study were: (1) to investigate if digital gait measures discriminate people with prediabetes from healthy control participants (HC) and (2) to investigate the relationship between gait measures and clinical scores (concurrent validity). 108 people with prediabetes (71.20 ± 5.11 years) and 63 HC subjects (70.40 ± 6.25 years) wore 6 inertial sensors (Opals by APDM, Clario) while performing the 400-meter fast walk test. Fifty-five measures across 5 domains of gait (Lower Body, Upper Body, Turning, and Variability) were averaged. Analysis of Covariance was used to investigate the group differences, with body mass index as a covariate. Pearson's correlation coefficient assessed the association between the gait measures and the Short Physical Performance Battery (SPPB) score. Nine gait measures were significantly different (p < 10–4) between IFG and HC groups. Step duration, cadence, and turn velocity were the most discriminative measures. In contrast, traditional stop-watch time was not significantly different between groups (p = 0.13), after controlling for BMI. Cadence (r = −0.37, p < 0.001), step duration (r = −0.39, p < 0.001), and turn velocity (r = 0.47, p < 0.001) showed a significant correlation with the SPPB score. Body-worn inertial sensors detected gait impairments in people with prediabetes that related to clinical balance test performance, even when the traditional stop-watch time was not prolonged for the 400-meter walk test. • 108 people with prediabeties and 63 healthy subjects participated in this study. • Objective gait measures from 400-meter walk test were compared between groups. • Step duration, cadence, and turn velocity were the most discriminative measures. • Traditional stop-watch time from 400-meter walk test was not different between groups. • Digital gait measures show a potential to be used in prediabetic clinical trials. [ABSTRACT FROM AUTHOR]

To study the body posture characteristics when walking with trolley case, and to explore the effects of different usage methods and weights of trolley case on body posture characteristics. Fifteen subjects pushed and pulled(Condition 1 and 2) the case with three load weights of 10 %, 20 % and 30 % of their own body weight with 0 % no load as baseline for both conditions. The basic gait parameters, kinematic and kinetic data were collected using the VICON infrared motion capture system and a 3D force platform. Two repeated measures factor (condition×weight) analysis of variance was used for statistical analysis of the gait temporal and spatial parameters, as well as trunk angle, kinetic ground reaction force, shoulder joint force, and trunk moment. Significant condition*weight interactions were detected in DLST (Double Limb Stance Time) (F=5.341，P = 0.006), GRF (Ground Reaction Force) in frontal plane (F=10.507, p < 0.001) and vertical plane (F=3.751, p = 0.021), shoulder joint force in sagittal plane (F=21.129, p < 0.001), and flexion-extension angle of the trunk in the sagittal plane (F=4.888, p < 0.010). Significant main effects were detected in walking speed (F=35.842, p < 0.001), right support time (F=12.156, p < 0.001), left swing time (F=8.506, p < 0.001), left support time (F=1.122, p < 0.001), right step length (F=33.900, p < 0.001), and left step length (F=14.960, p < 0.001) under different weights. A significant main effect was detected in sagittal GRF (F=11.77, p < 0.001), trunk rotation angle (F=4.124, p = 0.016), amplitude of COM (F=2.993, p = 0.046), under different weights. When the weight of the case exceeds 20 % of the body weight, from the perspective of energy efficiency, the push method is more advantageous than the pull method. When walking with luggage, people tend to maintain the stability of their trunk posture by adjusting the force on their arms more often. • To explore the effects of Trolley Case on body posture characteristics. • Adopt two methods and three kinds of weight control trolley. • VICON and three-dimensional dynamometer measure the basic parameters. • Changes in body posture parameters vary across different Trolley Case usage methods. • It is recommended to use the side push mode and 20 % body weight control trolley. [ABSTRACT FROM AUTHOR]

Persons who undergo unilateral transtibial amputation are at an increased risk of secondary musculoskeletal joint pain and degeneration, which has been linked to excessive loading rates of the intact-side limb. Tibial axial acceleration, a feasible measure of loading rates with wearable sensors, would be clinically useful to relate to joint pain in persons with unilateral transtibial amputation. What is the relationship between peak tibial axial accelerations and intact-side joint pain in persons with unilateral transtibial amputation during walking? Persons with unilateral transtibial amputation (n = 51) were separated into two groups based on the presence of intact-side limb pain (with pain: n = 16; without pain: n = 35). Tibial axial accelerations were measured with bilateral shank-mounted IMUs while participants completed three 10-meter walk tests. Peak tibial axial accelerations for each limb and between-limb symmetry were compared between groups using analysis of co-variance; significance was set at 0.05. Between persons with vs. without intact-side limb pain, peak tibial axial accelerations were smaller on the prosthetic side (0.64 vs. 0.81 g; p = 0.04), similar on the intact side (0.82 vs. 0.79 g; p = 0.53), and more asymmetrical between sides (intact > prosthetic) (0.81 vs. 1.03 g; p = 0.01). Symmetry in peak tibial axial acceleration can assist with identifying preferential limb loading during walking and, with future research, could serve as a useful clinical target for intact-side limb unloading strategies to help mitigate secondary musculoskeletal pain in persons with unilateral transtibial amputation. • Tibial acceleration via wearable sensors is a pragmatic measure of limb loading • Prosthetic side tibial acceleration is reduced in amputees with intact limb pain • Tibial acceleration symmetry may identify preferential loading strategies [ABSTRACT FROM AUTHOR]

Previous research on the accuracy of mobile measurement systems has focused on parameters related to the whole gait cycle. Specifically, bilateral gait characteristics were primarily used as outcome measures. How accurate are unilateral gait characteristics detected using a mobile system at various fixed walking speeds? Gait analysis during treadmill walking at velocities (VEL) of 2.5 (v1), 4.5 (v2) and 6.5 km/h (v3) was performed in a population of 47 healthy young adults, consisting of 27 females (age: 23 ± 2 years, BMI: 21.4 ± 2.2 kg/m²) and 20 males (age: 22 ± 1 years, BMI: 23.3 ± 3.4 kg/m²). Spatiotemporal gait data were simultaneously determined using an instrumented treadmill (gaitway 3D) and a mobile gait analysis system (RehaGait). Besides VEL, bilateral (stride length [SL], cadence [CAD]) and unilateral (contact duration [CON], single [SS] and double support duration [DS]) outcomes were validated. Across the three VEL investigated, the correlations between both measurement systems were almost perfect in SL and CAD (r > 0.97). In addition, SL significantly differed (p < 0.01) with moderate to large effects, whereby the root mean squared error (RMSE) did not exceed 1.8 cm. RMSE in CAD was not higher than 0.33 spm and statistically significant differences were only present at v1 (d = 0.63). DS was the most erroneous unilateral parameter with values for %RMSE ranging from 9% at v1 to 14% at v3. In CON and SS %RMSE was in a magnitude of 2–4% across all VEL. Furthermore, VEL affected measurement accuracy in unilateral outcomes with moderate to large effects (F (2, 45) > 6.0, p < 0.01, η p 2 > 0.11) with consistently higher differences at lower velocities. Based on the results presented the validity of the mobile gait analysis system investigated to detect gait asymmetries must be questioned. • The device investigated provides accurate results for cadence and stride length. • The estimation of walking speed was also accurate. • Unilateral parameters were revealed to be less accurate than bilateral outcomes. • Double support duration detection showed the lowest level of accuracy. • The accuracy in contact time detection improved with walking speed. [ABSTRACT FROM AUTHOR]

Veering occurs during blind walking, which causes individuals to deviate from crosswalks or fall off platforms. Despite being linked to static postural control, the relationship between veering and gait function (gait variability and plantar pressure), which is presumed to be related to dynamic postural control, has yet to be fully understood. How do gait variability and plantar pressure affect veering? This experiment involved a walking task in which 11 blind adults were instructed to walk along a straight path using a white cane. We measured the veering values and analyzed the relationship between gait variability and plantar pressure. One participant with a particularly severe veering tendency was excluded from the analysis. Based on the veering characteristics of the participants, the walking trajectories were classified as veering to the left (14 trials) or the right (14 trials) sides. Correlation analysis showed no significant correlation between the veering value and gait variability (vertical, lateral, and anterior-posterior). Plantar pressure (the ball of the fifth toe and the total) was significantly negatively correlate with the veering value. In contrast, the plantar pressure results for the participant who was excluded showed a different characteristic. We hypothesized that blind individuals would exhibit dynamic postural control to stay on a straight path by increasing the plantar pressure on the ball of the fifth toe and the total pressure on the opposite foot when veering occurs. However, this adaptation was not observed in a blind individual with severe veering tendencies. • Gait variability is not associated with veering. • Plantar pressure showed a significant negative correlation with veering. • Blind individuals face difficulty with dynamic postural control, causing veering. [ABSTRACT FROM AUTHOR]

In-toeing gait is defined as the internal rotation of the long axis of the foot to the line of progression. Although most of the time it is corrected spontaneously but sometimes causes torsional misalignment syndrome and maybe patellofemoral instability and arthritis of the knee. What is the effect of gait plate insoles and lateral sole wedged shoes on foot progression angle (FPA) in children with in-toeing? In this study, a randomized control trial was conducted with 11 participants (18 feet) who were girls aged between seven and ten years old. They were randomly assigned to either the gait plate group (6 girls, 11 feet) or the lateral sole wedge group (5 girls, 11 feet). The foot progression angle was measured using the RS scanner pressure platform before and after four weeks of intervention, both with and without interventions. The interaction effects of time and group on outcomes were analyzed using Mixed ANOVA and post-hoc complementary tests with a confidence interval of 95%. It was observed that none of the interventions had an immediate impact on the FPA (P > 0.05). However, after four weeks, the FPA increased by 9.96 degrees with the lateral sole wedge and by 3.51 degrees with the gate plate insole. During the immediate and short-term evaluation, no significant difference was noticed between the two groups (P > 0.05). However, there was a large effect size (eta square = 0.269) observed in the time group interaction between the two groups (P = 0.028). Conservative methods like using a gait plate insole or modifying shoes with a lateral sole wedge can improve the foot progression angle in children with in-toeing gait. However, longer studies with larger sample sizes are needed to reach a conclusion. • Neither the gate plate insole nor the lateral sole wedge had an immediate effect on the foot progressive angle. • Four weeks of using the gate plate insole and lateral sole wedge increased the foot's progressive angle. • The process of correcting the foot progressive angle was more in the wedge group than in the gate plate group. [ABSTRACT FROM AUTHOR]

Conventional balance and gait assessments for fall risk screening are often conducted under unperturbed conditions. However, older adults can allocate their attention to motor tasks (balance or walking) without revealing performance deficiencies, posing a challenge in identifying those with compromised gait and balance. Do community-dwelling older adults exhibit greater changes in cognitive and/or walking performance under balance-challenging conditions compared to typical dual-task walking conditions? Twenty-nine healthy, community-dwelling older adults performed four cognitive tasks (visual and auditory Stroop tasks, Clock task, and Paced Auditory Serial Addition Test) while walking with and without lateral treadmill sways (Perturbed vs. Unperturbed) and during standing. We calculated dual-task costs (DTC) and walking perturbation effects (WPE) as the percentage of change in cognitive and walking performance between dual and single-task conditions and between Perturbed and Unperturbed conditions, respectively. Older adults exhibited similar DTC and WPE on cognitive task performance. However, in walking performance, they demonstrated significantly greater WPE than DTC across all gait and stability measures (p < 0.01), including the mean and variability of stride and margins of stability (MOS) measures, the variability of trunk movement and lower-limb joint angles, and the local stability measures. Older adults took shorter but wider steps, exhibited shorter MOS AP but greater MOS ML , and experienced increased movement variability and walking instability to a greater extent than during dual-task walking. Overall, changes in variability and stability measures were more pronounced than those in mean gait measures. Introducing destabilizing perturbations to increase the task demands of balance and gait assessments is a more effective method to challenge older adults compared to simply adding a concurrent cognitive task. Fall screening assessments for community-dwelling older adults should incorporate balance-challenging conditions, such as introducing gait perturbations. • DTC and WPE during cognitive and destabilizing walking challenges were assessed. • Older adults exhibited similar DTC and WPE on cognitive task performance. • They showed significantly greater WPE than DTC in all gait and stability measures. • Pronounced changes in variability and stability exceed those in mean gait measures. • Comprehensive fall screening should include challenging gait-perturbing conditions. [ABSTRACT FROM AUTHOR]

The ankle dorsiflexion range of motion (ADF-ROM) during single support phase allows elastic energy storage in the calcaneal tendon, contributing to advance the body forward. Reduced ADF-ROM may influence lower limb kinetics and stiffness. What is the influence of reduced passive ADF-ROM on lower limb internal moments and stiffness during gait? Thirty-two participants, classified into two groups according to passive ADF-ROM (smaller than 10° and greater than 15°), were submitted to gait assessment at self-selected speed with a force platform and a three-dimensional motion analysis system. Statistical parametrical mapping (SPM) analyses were used to compare the lower limbs' internal moments between groups. Independent t-tests analyzed the differences between groups on lower limb stiffness during gait. The lower ADF-ROM group had greater knee flexor moment (terminal stance and push-off), greater ankle abductor (i.e., shank internal rotator) moment in terminal stance and greater knee internal rotator moment in mid to terminal stance. The lower ADF-ROM group also had higher lower limb stiffness during gait. Individuals with reduced passive ADF-ROM had greater lower limb stiffness and adopted a gait pattern with increased knee and ankle moments, suggesting increased loading at these joints. • The lower ankle dorsiflexion group demonstrated an increase of joint moments. • The lower ankle dorsiflexion group had greater lower limb stiffness. • The lower ankle dorsiflexion group presented increase knee flexor moment. • The lower ankle dorsiflexion group presented greater ankle abductor moment. • The lower ankle dorsiflexion group presented greater knee internal rotator moment. [ABSTRACT FROM AUTHOR]

Ankle-foot orthoses (AFOs) are orthopaedic devices often prescribed to treat foot drop. For patients who are not satisfied with off-the-shelf solutions, custom AFOs personalized to the patient's lower limb anatomy are required. Dynamic AFOs provide stability while allowing for physiological ankle mobility in the stance phase of walking. Can a morphology-based dynamic custom AFO made of fiberglass-reinforced polyamide restore a quasi-normal gait pattern and improve comfort in patients with foot drop? In this pilot study, the legs and feet of ten foot drop patients (age=64.9 ± 11.4 years; BMI=26.2 ± 2.1 kg/m2) were scanned using a Kinect-based 3D scanner. A custom AFO was designed and produced for each patient using a fiberglass-reinforced polyamide through selective laser sintering. To assess kinematics, skin markers were placed on relevant bony landmarks according to a validated protocol. Each patient was instructed to walk at a self-selected comfortable speed under three conditions: wearing the custom AFO, wearing an off-the-shelf orthosis (Codivilla spring), and without any AFO (shod condition). Muscle activation in the tibialis anterior, gastrocnemius, rectus femoris and biceps femoris muscles in both legs was recorded using wireless sEMG sensors. The comfort and of each AFO was evaluated using a Visual Analogue Scale. The custom AFO resulted in significant increase of stride length and walking speed compared to the shod condition. Except for the hip joint, which exhibited greater maximum flexion and reduced range of motion, the kinematic parameters of all other joints were similar to those observed in a healthy control population. Furthermore, the custom AFO received significantly higher comfort scores compared to the Codivilla spring. This study has provided evidence supporting the effectiveness of custom orthotic solutions in restoring lower limb kinematics and improving the perceived comfort in foot drop patients compared to off-the-shelf solutions. • A novel passive dynamic custom Ankle-Foot-Orthosis has been proposed. • The functional outcome of the custom AFO was investigated in foot drop patients. • The custom AFO was scored more comfortable than a standard orthosis. • The custom AFO resulted in better kinematic and spatiotemporal parameters than shod. [ABSTRACT FROM AUTHOR]

Biomechanics significantly impacts sports performance and injury prevention. Traditional methods like discrete point analysis simplify continuous kinetic and kinematic data, while one-dimensional Statistical Parametric Mapping (spm1d) evaluates entire movement curves. Nevertheless, spm1d's application in sports and injury research is limited. As no systematic review exists, we conducted a scoping systematic review, synthesizing the current applications of spm1d across various populations, activities, and injuries. This review concludes by identifying gaps in the literature and suggesting areas for future research. What research exists using spm1d in sports biomechanics, focusing on the lower limbs, in what populations, and what are the current research gaps? We searched PubMed, Embase, Web of Science, and ProQuest databases for the following search string: "(((knee) OR (hip)) OR (ankle)) OR (foot) OR (feet) AND (statistical parametric mapping)". English peer-reviewed studies assessing lower limb kinetics or kinematics in different sports or sports-related injuries were included. Reviews, meta-analyses, conference abstracts, and grey literature were excluded. Our search yielded 165 papers published since 2012. Among these, 112 examined healthy individuals (67 %), and 53 focused on injured populations (33 %). Running (n = 45), cutting (n = 25), and jumping/landing (n = 18) were the most common activities. The predominant injuries were anterior cruciate ligament rupture (n = 21), chronic ankle instability (n = 18), and hip-related pain (n = 9). The main research gaps included the unbalanced populations, underrepresentation of common sports and sport-related injuries, gender inequality, a lack of studies in non-laboratory settings, a lack of studies on varied sports gear, and a lack of reporting standardization. This review spotlights crucial gaps in spm1d research within sports biomechanics. Key issues include a lack of studies beyond laboratory settings, underrepresentation of various sports and injuries, and gender disparities in research populations. Addressing these gaps can significantly enhance the application of spm1d in sports performance, injury analysis, and rehabilitation. • There is increasing use of statistical parametric mapping for biomechanics. • Running, cutting, and jumping are the most studied activities found in this review. • The main injuries studied are ACL rupture, ankle instability, and hip pain. • Primary gaps: underrepresented populations, small samples, and non-lab studies. [ABSTRACT FROM AUTHOR]

Stress is a critical risk factor for various health issues, but an objective, non-intrusive and effective measurement approach for stress has not yet been established. Gait, the pattern of movements in human locomotion, has been proven to be a valid behavioral indicator for recognizing various mental states in a convenient manner. This study aims to identify the severity of stress by assessing human gait recorded through an objective, non-intrusive measurement approach. One hundred and fifty-two participants with an average age of 23 years old (SD = 1.07) were recruited. The Chinese version of the Perceived Stress Scale with 10 items (PSS-10) was used to assess participants' stress levels. The participants were then required to walk naturally while being recorded with a regular camera. A total of 1320 time-domain and 1152 frequency-domain gait features were extracted from the videos. The top 40 contributing features, confirmed by dimensionality reduction, were input into models consisting of four machine-learning regression algorithms (i.e., Gaussian Process Regressor, Linear Regression, Random Forest Regressor, and Support Vector regression), to assess stress levels. The models that combined time- and frequency-domain features performed best, with the lowest RMSE (4.972) and highest validation (r = 0.533). The Gaussian Process Regressor and Linear Regression outperformed the others. The greatest contribution to model performance was derived from gait features of the waist, hands, and legs. The severity of stress can be accurately detected by machine learning models using two-dimensional (2D) video-based gait data. The machine learning models used for assessing perceived stress were reliable. Waist, hand, and leg movements were found to be critical indicator in detecting stress. • Stress severity can be identified using time- and frequency- domain gait features. • The machine learning models used for assessing perceived stress were reliable. • Waist, hand, and leg movements are critical for detecting stress in young adults. [ABSTRACT FROM AUTHOR]

Gait changes with aging have been investigated, but few studies have examined a wide range of gait parameters across the adult lifespan. This study aimed to investigate gait differences across age groups stratified by sex. This cross-sectional study included 629 healthy, normal-weight (i.e., BMI < 30 kg/m2) participants from Switzerland of the COmPLETE cohort study, aged 20 to over 90 years. Gait metrics were assessed using an inertial measurement unit (IMU)-based gait analysis system, including speed, cycle duration variability, asymmetry, stride length, cycle duration, cadence, double support, stance (time foot is on the ground during a gait cycle), swing (time foot is in the air during a gait cycle), loading (early part of the stance phase), foot-flat (mid-stance phase when foot is flat), and pushing (late stance phase leading to toe-off) phases. Percentile curves were calculated using generalized additive models for location, scale, and shape. Gait data from 545 participants (273 men and 272 women) were analyzed. Participants were equally distributed across the seven age decades, with an average of 40 men and 40 women representing every decade. Both men and women showed a reduction in gait speed and stride length, and an increase in cycle duration variability and asymmetry with aging. Gait speed and stride length declined across the age groups, with a significant difference found in participants aged 80 to 91 compared to younger age groups. Age-related changes in gait parameters were seen in both men and women. These may be attributed to the typical decline in muscle strength, balance, coordination, and neuromuscular function. The results of this study contribute to the understanding of gait changes throughout the lifespan and can be used for comparison with other populations and as reference values for individual patients. • First paper providing norm values for gait parameters in a European population. • Large sample of healthy adults across the life span (20 to over 90 years of age). • Comprehensive overview of gait parameters across age groups, stratified by sex. • Both men and women displayed lower gait speed and stride length with age. • Gait variability and asymmetry was higher from around 60 years of age. [ABSTRACT FROM AUTHOR]

Degenerative cervical myelopathy (DCM) is the most common cause of cervical spinal cord dysfunction in adults and the result of chronic degenerative changes of the cervical spine. The compression of the spinal cord can lead to ischemia, inflammation, and neuronal apoptosis with a consequent impairment of the neurological function. Gait impairment is one of the most frequent signs of DCM. To investigate the changes in spatio-temporal gait parameters assessed using 3D gait analysis in patients affected by DCM compared with healthy controls and the effect of surgical decompression on these parameters. Systematic review and meta-analysis. The meta-analysis included 267 patients with DCM and 276 healthy controls. Spatio-temporal parameters of gait were assessed. The primary outcome was gait speed; the secondary outcomes were cadence, stride length, step width, stride time, single-limb support time, and double-limb support time. Studies reporting spatial and/or temporal gait parameters measured using 3D gait analysis in patients with DCM were included. Data sources were Embase, Medline, and the Core Collection of Web of Science. Meta-analyses were performed to investigate the influence of surgical decompression in patients measured before and after surgery as well as to compare gait parameters of patients with DCM with controls. Thirteen studies reporting on 267 patients with DCM and 276 healthy controls met the inclusion criteria. Seven studies compared patients with DCM with healthy controls, three studies compared gait in patients with DCM before and after surgical decompression, and three studies performed both comparisons. Compared with healthy controls, patients with DCM had slower gait speed (Standardized Mean Difference (SMD), −1.49; 95% confidence interval (CI) [−1.86; −1.13]; p<.001), lower cadence (SMD, −0.78; 95%CI [−1.00; −0.56]; p<.001), shorter stride length (SMD, −1.27; 95%CI [−1.53, −1.01]; p<.001), greater step width (SMD, 0.98; 95%CI [0.42, 1.54]; p=.003), longer stride time (SMD, 0.77; 95%CI [0.37, 1.16]; p=.009), single-limb support phase (SMD, -0.68; 95%CI [−1.06; −0.29]; p=.011), and double-limb support phase (SMD 0.84; 95%CI [0.35, 1.32]; p=.012). After surgical decompression, patients with DCM showed an improvement in gait speed (SMD, 0.57 (95%CI [0.29; 0.85]; p=.003) and no significant differences in other spatio-temporal parameters. Patients with DCM have clearly different spatio-temporal gait parameters than healthy controls. Gait speed is the only spatio-temporal gait parameter that improves significantly after surgical decompression suggesting that gait speed may be an important clinical outcome parameter in patients with DCM. [ABSTRACT FROM AUTHOR]

Wearable robotic exoskeletons and leg braces are desirable for gait rehabilitation because they can apply loads directly to an affected joint. Yet, they are not widely used in clinics because they are costly and complex to set up. Conversely, tethered devices, such as elastic resistance bands, are widely available in clinics, are low-cost, and are quick to set up. However, resistance bands will affect walking differently based on how they are configured to pull on the leg (e.g., pulling forward or backward). How can a resistance band be configured to alter muscle activation and gait biomechanics based on the segment it is attached to and the angle with which it attaches? We used an open-source musculoskeletal modeling platform to emulate several configurations of an elastic band pulling on the ankle, calf, and thigh at various angles during non-pathological walking. We evaluated gait biomechanics and simulated muscle activation using computed muscle control (CMC) and identified a subset of four configurations with potential applications for gait training. Eight non-pathological participants then walked on a treadmill under these configurations to verify how these configurations altered muscle activation. We found that muscle activity greatly varied based on the location where the elastic band is attached and the angle with which the elastic band pulls on the leg. Notably, specific angles can be used to pull on the legs to elicit an increase or decrease in muscle activation. This study provides insight into how tethered devices can be configured to provide assistance or resistance during gait training. This information can be applied when developing low-cost gait training solutions for addressing individuals' impairments. • Resistance band configuration affects muscle activation and gait biomechanics. • Certain angles cause specific responses in muscle activation and gait biomechanics. • Moving the band attachment proximally elicits less of a change in muscle activation. • Pulling backward on the ankle resists quadriceps and the plantar flexors. • These results can inform treatments that use resistance bands for gait training. [ABSTRACT FROM AUTHOR]

Instrumented gait analysis is an established procedure in biomechanical assessment, requiring specially-trained analysts to interpret the complex graphical output generated. Does a new method of visual representation of lower limb kinematic gait analysis data provide a reliable and valid method of interpretation of biomechanical data for healthcare professionals? An innovative system based on the Traffic Lights System (TLS) was developed. Simulated abnormal gait was captured using a 16-camera optoelectronic motion capture system, and the results were presented in both the Traditional Graphical System (TGS) format and the new TLS. An online form was filled by health professionals who attempted to interpret normal and abnormal motion in the joints presented in the 2 output formats. Out of 26 raters, 18 preferred the new system because of its user-friendliness and its ease of interpretation. 2 raters preferred the TGS, with one of these raters clarifying that the preference is due to colour blindness. For intra-rater reliability, 2 trained raters provided a second response for the TGS (Cronbach's Alpha ranging between 0.733 and 0.918), whilst the TLS resulted in Cronbach's Alpha between 0.817 and 1.00 amongst 3 untrained raters. The Fleiss Multi-rater Kappa Test demonstrated low inter-rater reliability amongst raters in the TGS, whereas the overall Fleiss Multi-rater Kappa values of the TLS surpassed the TGS in all 3 studies. This study showed that whilst trained health professionals have high intra-rater reliability in interpreting traditional gait analysis results, those professionals inexperienced in the system, do not always comprehend the complex graphs generated by the system when presenting gait analysis data. When these graphs are transformed into coloured outputs representing the extent of the movement, the TLS has demonstrated high validity and high intra- and inter-rater reliability, significantly exceeding those of the TGS, especially in untrained health professionals. • trained health professionals reliably interpret traditional gait analysis results. • inexperienced professionals do not comprehend complex graphs presenting gait analysis data. • TLS has demonstrated high validity and high intra- and inter-rater reliability. • reliability of TLS exceeded those of the TGS in untrained health professionals. [ABSTRACT FROM AUTHOR]

Balance perturbation studies during walking have improved our understanding of balance control in various destabilizing conditions. However, it is unknown to what extent balance recovery strategies can be generalized across different types of mediolateral balance perturbations. Do similar mediolateral perturbations (foot placement versus surface translation) have similar effects on balance control and corresponding balance response strategies? Kinetic and kinematic data were previously collected during two separate studies, each with 15 young, healthy participants walking on an instrumented treadmill. In both studies, medial and lateral balance perturbations were applied at 80% of the gait cycle either by a treadmill surface translation or a pneumatic force applied to the swing foot. Differences in balance control (frontal plane whole body angular momentum) and balance response strategies (hip abduction moment, ankle inversion moment, center of pressure excursion and frontal plane trunk moment) between perturbed and unperturbed gait cycles were evaluated using statistical parametric mapping. Balance disruptions after foot placement perturbations were larger and sustained longer compared to surface translations. Changes in joint moment responses were also larger for the foot placement perturbations compared to the surface translation perturbations. Lateral hip, ankle, and trunk strategies were used to maintain balance after medial foot placement perturbations, while a trunk strategy was primarily used after surface translations. Surface and foot placement perturbations influence balance control and corresponding response strategies differently. These results can help inform the development of perturbation-based balance training interventions aimed at reducing fall risk in clinical populations. • Surface and foot placement perturbations influence balance control. • Balance disruptions following foot placement perturbations are larger. • Balance response strategies are different between perturbations. • These results have implications for designing perturbation-based balance training. [ABSTRACT FROM AUTHOR]

Ankle–foot-complex mobility impairments, which can be assessed by the difference between the sitting and standing positions, are related to an increase in the load on the knee and hip joints during the stance phase of the gait. What is the relationship between the ankle–foot-complex mobility during static weight bearing and the mechanical stresses on the knee and hip joints throughout the stance phase? Ankle–foot-complex mobility and gait data were collected from 26 healthy adults. The complex mobility was established by comparing the foot indices, measured using a three-dimensional foot scanner, in sitting and standing positions. The gait data were acquired using eight cameras (recording at 100 Hz) and three force plates (recording at 1000 Hz). Stance phase data were collected via ground reaction forces. The stance phase was dissected into shock absorption and propulsion phases, during which the external knee and hip adduction moment impulses (KAMi, HAMi) were recorded. The correlation between the ankle–foot-complex mobility during static weight bearing and KAMi and HAMi during the stance phase was examined using Pearson's product–moment correlation coefficients. This study revealed that KAMi correlated with medial malleolus mobility (r = −0.44) throughout the stance phase. Furthermore, in the propulsive phase, KAMi correlated with calcaneus (r = 0.51) and navicular (r = −0.50) mobilities, whereas HAMi correlated with calcaneus mobility (r = −0.40). The study provides insights into the relationship between the static mobility of the ankle–foot complex in healthy individuals and mechanical stress during the stance phase. Calcaneus and navicular mobilities were related to efficient push-off in the propulsive phase. Medial malleolus mobility was related to the control of the lateral tilt of the lower limb and ankle dorsiflexion motion throughout the stance phase. • Hind- and mid-foot mobility contribute to knee and hip mechanical stress during gait. • Medial malleolus mobility linked to lateral tilt of lower limb and ankle dorsiflexion. • Maintaining calcaneus inversion and navicular mobility crucial for push-off propulsion. [ABSTRACT FROM AUTHOR]

Push-off during the terminal stance phase has a major impact on forward progression during walking. During this phase, the ground reaction force is applied to a small area under the forefoot. A better understanding of how single forefoot areas contribute to push-off peak in healthy subjects is needed to develop biomimetic orthopedic devices for forefoot amputees. What is the contribution of different forefoot sole areas to push-off peak as a function of speed and slope? In this analytical study, 15 healthy subjects walked on a treadmill at different speeds (0.8 m/s; 1.2 m/s; 1.6 m/s; max. gait speed) without de-/inclination and on different slopes (−10°; −5°; 0°; 5°; 10°) with normal walking speed. The Novel Pedar-X System was used to measure vertical sole force. Push-off peak of the entire sole was determined and relative contributions of the areas under the hallux, first ray, and toes (I-V) were calculated and analyzed using separate repeated-measures ANOVA (α = 0.05). Push-off peak increases with faster walking speeds as well as with 10° inclination. Downhill walking is associated with a reduced push-off peak. The contribution of all forefoot areas increases with faster walking speeds and at a declination of −10°. Push-off contribution of the area under the hallux increases by about 64.6% at fast walking compared to slow walking and this increase is higher than that of the area under the first ray and toes (p < 0.05). These findings indicate the major role of the hallux in speed generation and the importance of the forefoot during downhill walking. The results show the need for an adequate assistive device even in hallux amputation cases to compensate for deficits in the push-off phase. • Subject-specific forefoot sole masks were created based on anatomical landmarks. • Relative push-off contributions were defined as percentage of the entire sole force. • Faster walking speeds are associated with a higher forefoot contribution. • Contribution of the hallux area increases most as a function of walking speed. • Higher forefoot contribution during −10° downhill walking. [ABSTRACT FROM AUTHOR]

Inertial Measurement Units (IMUs) offer a promising alternative to optoelectronic systems to obtain joint lower-limb kinematics during gait. However, the associated methodologies, such as sensor-to-segment (S2S) calibration and multibody optimization, have been developed mainly for, and tested on, asymptomatic subjects. This study proposes to evaluate two personalizations of the methodology used to obtain lower-body kinematics from IMUs with pathological subjects: S2S calibration and multibody optimization. Based on previous studies, two decision trees were developed to select the best (in terms of accuracy and repeatability) S2S methods to be performed by the patient given his/her abilities. The multibody optimization was personalized by limiting the kinematic chain range of motion to the results of the subject's clinical examination. These two propositions were tested on 12 patients with various gait deficits. The patients were equipped with IMUs and reflective markers tracked by an optoelectronic system. They had to perform the postures and movements selected by the decision trees then walk back and forth along a walkway. Gait kinematics obtained from the IMUs directly (referred to as Direct kinematics), and after multibody optimization performed via the OpenSim software using the generic range of motion (referred to as Generic Optimized kinematics), and using the personalized range of motion (referred to as Personalized Optimized kinematics) were compared to those obtained with the Conventional Gait Model through Root Mean Square Errors (RMSE), Correlation Coefficients (CC) and Range of Motion differences (ΔROM). The RMSEs were smaller than 8.1° in the sagittal plane but greater than 7.4° in the transverse plane. The CCs, between 0.71 and 0.99 in the sagittal plane, deteriorate sharply in the frontal and transverse planes where they only measured between 0.15 and 0.68. The ΔROMs were mostly below 8.3°. Optimized kinematics did not improve compared to Direct kinematics. The personalization of the proposed S2S calibration method showed encouraging results, whereas multibody optimization did not impact the resulting joint kinematics. • Decision trees were built to select the most appropriate S2S calibration. • The kinematic chain RoM was limited to the results of the clinical examination. • The results were similar to those obtain with asymptomatic subjects. • Multibody optimization personalization had no noticeable impact on the kinematics. [ABSTRACT FROM AUTHOR]

Quantitative gait analysis (QGA) has the potential to support clinician decision-making. However, it is not yet widely accepted in practice. Evidence for clinical efficacy (i.e., efficacy and effectiveness), as well as a users' perspective on using the technology in clinical practice (e.g., ease of use and usefulness) can help impact their widespread adoption. To synthesize the literature on the clinical efficacy and clinician perspectives on the use of gait analysis technologies in the clinical care of adult populations. This scoping review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. We included peer-reviewed and gray literature (i.e., conference abstracts). A search was conducted in MEDLINE (Ovid), CENTRAL (Ovid), EMBASE (Ovid), CINAHL (EBSCO) and SPORTDiscus (EBSCO). Included full-text studies were critically appraised using the JBI critical appraisal tools. A total of 15 full-text studies and two conference abstracts were included in this review. Results suggest that QGA technologies can influence decision-making with some evidence to suggest their role in improving patient outcomes. The main barrier to ease of use was a clinician's lack of data expertise, and main facilitator was receiving support from staff. Barriers to usefulness included challenges finding suitable reference data and data accuracy, while facilitators were enhancing patient care and supporting clinical decision-making. This review is the first step to understanding how QGA technologies can optimize clinical practice. Many gaps in the literature exist and reveal opportunities to improve the clinical adoption of gait analysis technologies. Further research is needed in two main areas: 1) examining the clinical efficacy of gait analysis technologies and 2) gathering clinician perspectives using a theoretical model like the Technology Acceptance Model to guide study design. Results will inform research aimed at evaluating, developing, or implementing these technologies. This work was supported by the Walter and Maria Schroeder Institute for Brain Innovation and Recovery and AGE-WELL Graduate Student Award in Technology and Aging [2021,2022]. • Quantitative gait analysis technologies can influence decision-making. • Some evidence suggests the role of gait technologies in improving patient outcomes. • A barrier to ease of use was a clinician's lack of data expertise and a facilitator was receiving support from staff. • A barrier to usefulness was challenges finding suitable reference data and a facilitator was enhancing patient care. [ABSTRACT FROM AUTHOR]

Midfoot osteoarthritis (OA) is a common condition, however its aetiology is not well understood. Understanding how plantar pressures differ between people with and without midfoot OA may provide insight into the aetiology and how best to manage this condition. To compare plantar pressures between people with and without symptomatic radiographic midfoot OA. This was a cross-sectional study of adults aged ≥ 50 years registered with four UK general practices who reported foot pain in the past year. Symptomatic radiographic midfoot OA was defined as midfoot pain in the last four weeks, combined with radiographic OA in one or more midfoot joints. Cases were matched 1:1 for sex and age (± 5 years) to controls. Peak plantar pressure and maximum force in 10 regions of the foot were determined using a pressure platform (RSscan International, Olen, Belgium) and compared between the groups using independent samples t -tests and effect sizes (Cohen's d). We included 61 midfoot OA cases (mean age 67.0, SD 8.1, 31 males, 30 females) and matched these to 61 controls (mean age 66.0, SD 7.9). Midfoot OA cases displayed greater force (d =0.79, medium effect size, p = <0.001) and pressure at the midfoot (d =0.70, me d ium effect size, p = <0.001), greater force at the fourth metatarsophalangeal (MTP) joint (d =0.28, small effect size, p = 0.13), and fifth MTP joint (d =0.37, small effect size, p = 0.10) and greater pressure at the fifth MTP joint (d =0.34, small effect size, p = 0.13). They also dis p layed lower force (d =0.40, small effect size, p = 0.02) and pressure at the hallux (d =0.50, medium effect size, p = <0.001) and lower force (d =0.54, medium effect size, p = <0.001) and pressure at the lesser toes (d =0.48, small effect size, p = <0.001) compare d with controls. Midfoot OA appears to be associated with lowering of the medial longitudinal arch, greater lateral push off and less propulsion at toe off. Longitudinal studies are needed to establish causal relationships. • People with midfoot OA displayed greater forces and pressures within the midfoot. • They had greater forces and pressures in the lateral forefoot and lower in the toes. • Midfoot OA appears associated with the lowering of the medial longitudinal arch. • It is also associated with greater lateral push off and less propulsion at toe off. • Future studies should assess interventions designed to normalise foot loading. [ABSTRACT FROM AUTHOR]

Children with unilateral spastic cerebral palsy (USCP) have muscle hypertonia, balance, and coordination defects that affect gross motor skills, especially walking. Understanding the gait characteristics and lower limb muscle activation patterns of USCP children can provide an objective and quantitative basis for patient assessment and treatment plan formulation. This study compared the gait and lower limb muscle activation characteristics of children with USCP and with typical development (TD) during walking. We recorded gait and sEMG data of 20 children with USCP, and 20 with typical development. sEMG signals were acquired from the bilateral tibialis anterior (TA) and lateral gastrocnemius muscles (LG) during walking. The root mean square (RMS) value, integrated electromyographic (iEMG) value and co-contraction ratio (CR) were used to evaluate muscle activity. Student's t Test and non-parametric rank sum Test were used to compare the differences between the data groups (significance level of 0.05). The stance time, step length, speed, single leg support time ratio, ground impact, pre-swing angle, and muscle strength of the affected side were significantly decreased compared to those of the unaffected side in children with USCP (P < 0.05), while the swing phase, muscle tonus of LG were significantly prolonged (P < 0.05). Compared with TD children, children with USCP exhibited reduced bilateral walking ability, particularly noticeable in their smaller pre-swing angle(P < 0.05), diminished muscle strength of the TA and LG, as well as LG spasms(P < 0.05). Children with USCP have decreased ambulatory gait stability. Step length, pull acceleration, pre-swing angle, and CR can be used as sensitive indicators for gait assessment. Strengthening the TA muscle and reducing ankle spasm may help improve gait and postural stability in children with USCP. • Gait analysis and SEMG are effective methods to evaluate children' motor ability. • co-contraction ratio can effectively reflect the degree of muscle tonus. • Training on the unaffected side will be an effective method of rehabilitation. [ABSTRACT FROM AUTHOR]