1. Gait phenotypes in paediatric hereditary spastic paraplegia revealed by dynamic time warping analysis and random forests
- Author
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Pulido-Valdeolivas, Irene, Gómez-Andrés, David, Martín-Gonzalo, Juan Andrés, Rodríguez-Andonaegui, Irene, López-López, Javier, Pascual-Pascual, Samuel Ignacio, Rausell, Estrella, Universitat Autònoma de Barcelona, UAM. Departamento de Anatomía, Histología y Neurociencia, UAM. Departamento de Pediatría, and Instituto de Investigación Sanitaria Hospital Universitario de La Paz (IdiPAZ)
- Subjects
Pelvic tilt ,Male ,Kinematics ,Knee Joint ,Physiology ,Knees ,lcsh:Medicine ,Walking ,Pediatrics ,Corpus Callosum ,0302 clinical medicine ,Medicine and Health Sciences ,Cluster Analysis ,Public and Occupational Health ,Range of Motion, Articular ,Child ,lcsh:Science ,Musculoskeletal System ,Gait ,Neurologic Examination ,Multidisciplinary ,Physics ,Child Health ,Classical Mechanics ,Brain ,Biomechanical Phenomena ,Phenotypes ,medicine.anatomical_structure ,Child, Preschool ,Physical Sciences ,Legs ,Female ,Anatomy ,Gait Analysis ,Research Article ,musculoskeletal diseases ,Dynamic time warping ,medicine.medical_specialty ,Adolescent ,Hereditary spastic paraplegia ,Medicina ,Sensitivity and Specificity ,Pelvis ,Hereditary Spastic Paraplegias (HSP) ,03 medical and health sciences ,Physical medicine and rehabilitation ,Gait analysis (IGA) ,medicine ,Humans ,Hip ,business.industry ,Biological Locomotion ,Spastic Paraplegia, Hereditary ,Limbs (Anatomy) ,lcsh:R ,Ankles ,Biology and Life Sciences ,030229 sport sciences ,Random forests ,medicine.disease ,Sagittal plane ,Preferred walking speed ,Gait analysis ,lcsh:Q ,Ankle ,business ,human activities ,030217 neurology & neurosurgery - Abstract
The Hereditary Spastic Paraplegias (HSP) are a group of heterogeneous disorders with a wide spectrum of underlying neural pathology, and hence HSP patients express a variety of gait abnormalities. Classification of these phenotypes May help in monitoring disease progression and personalizing therapies. This is currently managed by measuring values of some kinematic and spatio-temporal parameters at certain moments during the gait cycle, either in the doctor´s surgery room or after very precise measurements produced by instrumental gait analysis (IGA). These methods, however, do not provide information about the whole structure of the gait cycle. Classification of the similarities among time series of IGA measured values of sagittal joint positions throughout the whole gait cycle can be achieved by hierarchical clustering analysis based on multivariate dynamic time warping (DTW). Random forests can estimate which are the most important isolated parameters to predict the classification revealed by DTW, since clinicians need to refer to them in their daily practice. We acquired time series of pelvic, hip, knee, ankle and forefoot sagittal angular positions from 26 HSP and 33 healthy children with an optokinetic IGA system. DTW revealed six gait patterns with different degrees of impairment of walking speed, cadence and gait cycle distribution and related with patient’s age, sex, GMFCS stage, concurrence of polyneuropathy and abnormal visual evoked potentials or corpus callosum. The most important parameters to differentiate patterns were mean pelvic tilt and hip flexion at initial contact. Longer time of support, decreased values of hip extension and increased knee flexion at initial contact can differentiate the mildest, near to normal HSP gait phenotype and the normal healthy one. Increased values of knee flexion at initial contact and delayed peak of knee flexion are important factors to distinguish GMFCS stages I from II- III and concurrence of polyneuropathy, DGA was in receipt of a grant from Sociedad Española de Neurología Pediátrica (SENEP). Publication fee was supported by EUF-ONCE-UAM and Asociación Española de Paraparesia Espástica Familiar (AEPEF).
- Published
- 2018