BACKGROUND: Gait adaptability, including the ability to avoid obstacles and to take visually guided steps, is essential for safe movement through a cluttered world. This aspect of walking ability is important for regaining independent mobility but is difficult to assess in clinical practice. OBJECTIVE: The objective of this study was to investigate the validity of an instrumented treadmill with obstacles and stepping targets projected on the belt's surface for assessing prosthetic gait adaptability. DESIGN: This was an observational study. METHODS: A control group of people who were able bodied (n=12) and groups of people with transtibial (n=12) and transfemoral (n=12) amputations participated. Participants walked at a self-selected speed on an instrumented treadmill with projected visual obstacles and stepping targets. Gait adaptability was evaluated in terms of anticipatory and reactive obstacle avoidance performance (for obstacles presented 4 steps and 1 step ahead, respectively) and accuracy of stepping on regular and irregular patterns of stepping targets. In addition, several clinical tests were administered, including timed walking tests and reports of incidence of falls and fear of falling. RESULTS: Obstacle avoidance performance and stepping accuracy were significantly lower in the groups with amputations than in the control group. Anticipatory obstacle avoidance performance was moderately correlated with timed walking test scores. Reactive obstacle avoidance performance and stepping accuracy performance were not related to timed walking tests. Gait adaptability scores did not differ in groups stratified by incidence of falls or fear of falling. LIMITATIONS: Because gait adaptability was affected by walking speed, differences in self-selected walking speed may have diminished differences in gait adaptability between groups. CONCLUSIONS: Gait adaptability can be validly assessed by use of an instrumented treadmill with a projected visual context. When walking speed is taken into account, this assessment provides unique, quantitative information about walking ability in people with a lower-limb amputation.
BACKGROUND: Gait adaptability, including the ability to avoid obstacles and to take visually guided steps, is essential for safe movement through a cluttered world. This aspect of walking ability is important for regaining independent mobility but is difficult to assess in clinical practice. OBJECTIVE: The objective of this study was to investigate the validity of an instrumented treadmill with obstacles and stepping targets projected on the belt's surface for assessing prosthetic gait adaptability. DESIGN: This was an observational study. METHODS: A control group of people who were able bodied (n=12) and groups of people with transtibial (n=12) and transfemoral (n=12) amputations participated. Participants walked at a self-selected speed on an instrumented treadmill with projected visual obstacles and stepping targets. Gait adaptability was evaluated in terms of anticipatory and reactive obstacle avoidance performance (for obstacles presented 4 steps and 1 step ahead, respectively) and accuracy of stepping on regular and irregular patterns of stepping targets. In addition, several clinical tests were administered, including timed walking tests and reports of incidence of falls and fear of falling. RESULTS: Obstacle avoidance performance and stepping accuracy were significantly lower in the groups with amputations than in the control group. Anticipatory obstacle avoidance performance was moderately correlated with timed walking test scores. Reactive obstacle avoidance performance and stepping accuracy performance were not related to timed walking tests. Gait adaptability scores did not differ in groups stratified by incidence of falls or fear of falling. LIMITATIONS: Because gait adaptability was affected by walking speed, differences in self-selected walking speed may have diminished differences in gait adaptability between groups. CONCLUSIONS: Gait adaptability can be validly assessed by use of an instrumented treadmill with a projected visual context. When walking speed is taken into account, this assessment provides unique, quantitative information about walking ability in people with a lower-limb amputation.
Authors: Mariëlle W van Ooijen; Anita Heeren; Katrijn Smulders; Alexander C H Geurts; Thomas W J Janssen; Peter J Beek; Vivian Weerdesteyn; Melvyn Roerdink Journal: Exp Brain Res Date: 2014-12-24 Impact factor: 1.972
Authors: Adeel Aqil; Roshan Drabu; Jeroen H Bergmann; Milad Masjedi; Victoria Manning; Barry Andrews; Sarah K Muirhead-Allwood; Justin P Cobb Journal: Int Orthop Date: 2013-02-27 Impact factor: 3.075
Authors: Melvyn Roerdink; Andrea G Cutti; Aurora Summa; Davide Monari; Davide Veronesi; Mariëlle W van Ooijen; Peter J Beek Journal: Med Biol Eng Comput Date: 2014-09-24 Impact factor: 2.602
Authors: Rosanne B van Dijsseldonk; Lysanne A F de Jong; Brenda E Groen; Marije Vos-van der Hulst; Alexander C H Geurts; Noel L W Keijsers Journal: Front Neurol Date: 2018-11-20 Impact factor: 4.003
Authors: Mariëlle W van Ooijen; Melvyn Roerdink; Marga Trekop; Jan Visschedijk; Thomas W Janssen; Peter J Beek Journal: BMC Geriatr Date: 2013-04-16 Impact factor: 3.921
Authors: Celine Timmermans; Melvyn Roerdink; Marielle W van Ooijen; Carel G Meskers; Thomas W Janssen; Peter J Beek Journal: Trials Date: 2016-08-26 Impact factor: 2.279