Full Body Gait Measures - Mobility Systems...Full Body Gait Measures Gait measures are detected,...

Full Body Gait MeasuresGait measures are detected, analyzed, and averaged over the extent of the walking duration of the subject. Measures can also be broken down on a stride-by-stride basis when exported to Excel. All measures are assessed for Asymmetry and Variability [5].

Measures Unit Description

Lower Limb GaitLower Limb GaitLower Limb Gait

Stride Velocity m/s Gait speed Normalized %Stature/s Average gait speed normalized for heightStride Length meters Distance between two consecutive heel strikes Normalized %Stature Stride distance normalized for heightGait Cycle Time (GCT) seconds Duration of a complete gait cycle Double Support % of GCT Percentage of a gait cycle that both feet are on the ground Swing % of GCT Percentage of a gait cycle that either foot is off the ground Stance % of GCT Percentage of a gait cycle that either foot is on the groundKnee Range of Motion degrees Range of motion of the kneeLeg Range of Motion degrees RoM of shanks; averaged of the left and right sides.

Upper Limb GaitUpper Limb GaitUpper Limb Gait

Arm Swing Velocity deg/s Peak (95%) angular velocity of arms. Arm Swing Range of Motion Degrees Range of motion of arms during arm-swing. Trunk Range of Motion Degrees Average range of motion of trunk (sternum) Sagittal RoM Degrees RoM of trunk in sagittal plane. Frontal RoM Degrees RoM of trunk in frontal plane. Horizontal RoM Degrees RoM of trunk in horizontal plane.

References[1] Arash Salarian, Heike Russmann, Franois J G Vingerhoets, Catherine Dehollain, Yves Blanc, Pierre R

Burkhard, and Kamiar Aminian, Gait assessment in parkinson’s disease: toward an ambulatory system for long-term monitoring., IEEE Trans Biomed Eng 51 (2004), no. 8, 1434–1443.

[2] Meir Plotnik, Nir Giladi, and Jeffrey M Hausdorff, Bilateral coordination of walking and freezing of gait in parkinson’s disease., Eur J Neurosci 27 (2008), no. 8, 1999–2006 (eng).

[3] Meir Plotnik and Jeffrey M Hausdorff, The role of gait rhythmicity and bilateral coordination of stepping in the pathophysiology of freezing of gait in parkinson’s disease., Mov Disord 23 Suppl 2 (2008), S444–S450 (eng).

[4] Arash Salarian, Fay B Horak, Cris Zampieri, Patricia Carlson-Kuhta, John G Nutt, and Kamiar Aminian, iTUG, a sensitive and reliable measure of mobility., IEEE Trans Neural Syst Rehabil Eng 18 (2010), no. 3, 303–310.

[5] A. Sant’Anna, A. Salarian, and N. Wickstrom, A new measure of movement symmetry in early parkinson’s disease patients using symbolic processing of inertial sensor data, IEEE Transactions on Biomedical Engineering 58 (2011), no. 7, 2127–2135.

APDM, Inc. ♦ 2828 SW Corbett Avenue ♦ Portland, OR 97201Phone: 888-988-APDM (2736) ♦ Fax: 888-371-8370 ♦ http://apdm.com ♦ [email protected]

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Postural Transition MeasuresPostural transitions are detected, analyzed, and averaged over the extent of the walking duration of the subject. These measures are segmented by gait cycle when exported to Excel.


TurningTurningTurning

Duration seconds Duration of a 180 degree turn Peak Turn Velocity deg/s Peak (95%) angular velocity of trunk during turning Number of Step number Total number of steps during 180 degree turn Step Time seconds Average step duration during turning Step Time Before Turn seconds The last step duration before entering a turn

Sit-to-Stand Sit-to-Stand Sit-to-Stand

Duration seconds Duration from seated position to standing Velocity deg/s Peak (95%) angular velocity of trunk in sagittal plane Range of Motion degrees Range of motion of trunk in sagittal plane

Turn-to-Sit Turn-to-Sit Turn-to-Sit

Duration seconds Duration of 180 degree turn and sit transition Velocity deg/s Peak (95%) angular velocity of trunk during transition Range of Motion degrees Range of motion of trunk in sagittal plane during transition

Anticipatory Postural Adjustment (APA)Anticipatory Postural Adjustment (APA)Anticipatory Postural Adjustment (APA)

Duration seconds Time of APA onset to heel strike Stepping Leg RoM Degrees Range of motion of the shank during the first step Amplitude accel (g) Peak acceleration of trunk in preparation of step (ML + AP) Latency seconds Time of APA onset (trunk begins to move) to toe off

References[1] A. Salarian, F. B. Horak, C. Zampieri et al., “ITUG, a sensitive and reliable measure of mobility,”

IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 18, no. 3, pp. 303-310, 2010.

[2] A. Salarian, H. Russmann, F. J. G. Vingerhoets et al., “Gait Assessment in Parkinson's Disease: Toward an Ambulatory System for Long-Term Monitoring,” IEEE Transactions on Biomedical Engineering, vol. 51, no. 8, pp. 1434-1443, Aug., 2004.

[3] M. Mancini, C. Zampieri, P. Carlson-Kuhta, L. Chiari, F.B. Horak. “Anticipatory postural adjustments prior to step initiation are hypometric in untreated Parkinson’s disease: An accelerometer-based approach,” European Journal of the Neurology 16(9):1028-34, Epub Apr 16, 2009.

[4] A. Salarian, C. Zampieri, F. B. Horak, P. Carlson-Kuhta, J. G. Nutt, and K. Aminian, “Analyzing 180° turns using an inertial system reveals early signs of progression of parkinson’s disease,” EMBC 2009. Annual International Conference of the IEEE, pp. 224-227, 2009.




Postural Sway MeasuresAll postural sway measures are assessed using the Opal™ movement monitor placed on a subject’s lumbar. All measures are reported in both medio-lateral (ML) and antero-posterior (AP) directions.

37 additional measures of balance can be exported to Excel separated into three categories: Jerkiness, Time-Domain, and Frequency-Domain. All details are in Mancini M. et al. [1].


Sway Area % of Normal Total sway area over the duration of the testSway Range % of Normal Range of postural sway in both ML and AP directions. Sway Velocity % of Normal Average trunk velocity Jerk % of Normal Smoothness of trunk swayVisual Dependence % of Normal Postural sway eyes open vs eyes closedProprioceptive Dependence % of Normal Postural sway hard surface vs foam surface

References[1] Mancini M, Salarian A, Carlson-Kuhta P, Zampieri C, King L, Chiari L, Horak FB, “ISway: a sensitive,

valid and reliable measure of postural control,” J Neuroeng Rehabil. 2012 August.

[2] Mancini, M., Horak, F.B., Carlson-Kuhta, P., Chiari, L. “Accelerometers provide a sensitive measure of postural abnormalities in untreated Parkinson’s disease.” Parkinsonism and Related Disorders 2011 Aug;17(7): 557-62.

[3] Mancini M, Carlson-Kuhta P, Zampieri C, Nutt JG, Chiari L, Horak FB. “Postural sway as a marker of progression in Parkinson's disease: a pilot longitudinal study.” Gait Posture. 2012 Jul;36(3): 471-6.




Sensor Configuration Measures

Postural Sway Only Postural Sway, Lower Limb Gait, Turning, APA

Postural Sway, Lower Limb Gait, Upper Limb Gait,

Turning, APA, Sit and Stand

Measures 1 Opal System 3 Opal System 6 Opal System

BalanceBalanceBalanceBalance

Sway Area

Sway Range

Sway Velocity

Jerk

Sway Range

Lower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait Measures

Stride Velocity

Stride Length

Gait Cycle Time

Double Support

Swing

Stance

Knee Range of Motion

Leg Range of Motion




Lower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait Measures

Arm Swing Velocity

Arm Swing Range of Motion

Trunk Range of Motion

TurningTurningTurningTurning

Duration

Peak Turn Velocity

Number of Step

Step Time

Step Time Before Turn

Sit-to-Stand MeasuresSit-to-Stand MeasuresSit-to-Stand MeasuresSit-to-Stand Measures

Duration

Velocity

Range of Motion

Turn-to-Sit MeasuresTurn-to-Sit MeasuresTurn-to-Sit MeasuresTurn-to-Sit Measures

Duration

Velocity

Range of Motion

Anticipatory Postural Adjustment (APA)Anticipatory Postural Adjustment (APA)Anticipatory Postural Adjustment (APA)Anticipatory Postural Adjustment (APA)

Duration

Stepping Leg RoM

Amplitude

Latency




Mobility Lab Protocol MeasuresMeasures iSway iCTSIB iWALK iTUG iSAW

BalanceBalanceBalanceBalanceBalanceBalance

Sway Area

Sway Range

Sway Velocity

Jerk

Sway Range

Lower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait Measures

Stride Velocity

Stride Length

Gait Cycle Time

Double Support

Swing

Stance

Knee Range of Motion

Leg Range of Motion

Lower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait MeasuresLower Limb Gait Measures

Arm Swing Velocity

Arm Swing Range of Motion

Trunk Range of Motion

TurningTurningTurningTurningTurningTurning

Duration

Peak Turn Velocity

Number of Step

Step Time

Step Time Before Turn

Sit-to-Stand MeasuresSit-to-Stand MeasuresSit-to-Stand MeasuresSit-to-Stand MeasuresSit-to-Stand MeasuresSit-to-Stand Measures

Duration

Velocity

Range of Motion




Turn-to-Sit MeasuresTurn-to-Sit MeasuresTurn-to-Sit MeasuresTurn-to-Sit MeasuresTurn-to-Sit MeasuresTurn-to-Sit Measures

Duration

Velocity

Range of Motion

Anticipatory Postural Adjustment (APA)Anticipatory Postural Adjustment (APA)Anticipatory Postural Adjustment (APA)Anticipatory Postural Adjustment (APA)Anticipatory Postural Adjustment (APA)Anticipatory Postural Adjustment (APA)

Duration

Stepping Leg RoM

Amplitude

Latency




Instrumented Walk TestThe Instrumented Walk (IWalk) is the most comprehensive test to measure a patient’s gait, We recommend that your patient walks for at least 2 minutes in order to collect a sufficient amount of gait cycles to accurately measure variability and asymmetry.

TEST MEASURES: Full body gait (legs, arms, and trunk), asymmetry, variability and turning.

SETUP: 1. Walking corridor must be at least 7 meters in length.

PROTOCOL:1. Select IWalk in Sessions tab, and press start trial.

2. Patient should stand comfortably and wait for instruction to begin walking.

3. When the patient is ready, press record and instruct the patient to walk.

4. The patient can want to the end of the corridor and stop, or turn around, do laps, anything. Just make sure they walk in a straight path (or you will measure false asymmetry) and preform 180 degree turns when necessary.

5. Terminate the trial at any point.

NORMATIVE VALUES:Normative values were collected using a 2 minute walk in a corridor 7 meters or longer with 180 degree turns at both ends.




Instrumented Timed-Up and Go TestThe Instrumented Timed-Up and Go (ITUG) is a common test to assess a patient’s mobility, and APDM has made it more valuable by giving you the ability to precisely measure all of the components of mobility, rather than just duration.

TEST MEASURES: Full body gait (legs, arms, and trunk) and postural transitions (sit, stand, and turning).

SETUP: 1. Measure 7 meters, placing tape at the two ends.

2. Place a chair at the start end before the tape. 1. The chair should be armless

PROTOCOL:1. Select ITUG in Sessions tab, and press start trial.

2. Patient should sit comfortably in the chair with their arms on their legs, and back against the seat.

3. When the patient is ready, press record and the trial will begin to count down from 3 seconds.

4. The patient should rise from the chair without using their arms and begin walking.• If the patient is unable to rise from the chair with arms, reset the trial and allow them to

use their arms to stand.

5. After the patient walks passed the 7m end tape, they should turn 180 degrees and walk back.

6. Once they arrive at the chair they should turn 180 degrees, and sit down.

7. Terminate the trial when the patient rests their back against the back of the seat.

NORMATIVE VALUES:Normative values were collected using the protocol listed above.




Instrumented Stand and Walk TestThe Instrumented Stand and Walk (ISAW) is the most comprehensive test of balance control, measuring quiet stance, anticipatory postural control, gait, and turning. The test takes about a minute to administer and is perfect for fall risk assessment.

TEST MEASURES: Static balance, anticipatory postural control, full body gait (legs, arms, and trunk) and turning.

SETUP: 1. Measure 7 meters, placing tape at the two ends.

PROTOCOL:1. Select ISAW in Sessions tab, and press start trial.

2. Patient should stand comfortably behind the tape with their hands to their side or across their chest.

3. When the patient is ready, press record and the trial will begin to count up to 30 seconds.

4. At 30 seconds, instruct the patient to “walk”.

5. The patient should walk just past the other piece of tape, turn 180 degrees, walk back to the starting tape and stop without turning. They will be facing the opposite direction of how they started.

6. Terminate the trial when the patient stops completely.




Instrumented Postural SwayThe instrumented Postural Sway (ISway) test is a common test of quiet stance balance. It is a very simple test comprising of only 1 sensor around the waist. The test takes only 30 seconds to administer.

TEST MEASURES: Postural sway

SETUP: 1. Have the patient fit their feet around the foot template provided with the Mobility Lab system (to

normalize foot placement)

PROTOCOL:1. Select ISway test in Sessions tab, and press start trial.

2. Patient should stand comfortably with their hands at their side or across their chest.

3. Press start and wait for the test to count down from 30 seconds.

NORMATIVE VALUES:Normative values were collected with eyes open on a hard surface with arms crossed.




Instrumented CTSIBThe Instrumented modified Clinical Test of Sensory Organization and Balance (CTSIB) is a composite test to assess a patient’s balance under different test conditions.

TEST MEASURES: Postural sway, visual dependence, proprioceptive dependence, and vestibular loss

SETUP: 1. No setup required (no foot template)

PROTOCOL:1. Select ICTSIB test in Sessions tab, and press start trial.

2. Patient should stand comfortably with their feet together and hands at their side.

3. Follow the conditions outlined in the trial description.

4. Press start and wait for the test to count down from 30 seconds. Move on to the next test condition.

TEST CONDITIONS:

1. Eyes Open, Hard Surface.

2. Eyes Closed, Hard Surface.

3. Eyes Open, Foam Surface.

4. Eye Closed, Foam Surface.

NORMATIVE VALUES:Normative values were collected following the protocol listed above.




Full Body Gait Measures - Mobility Systems...Full Body Gait Measures Gait measures are detected,...

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