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Reliability of a Gait Analysis System

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ClinicalTrials.gov Identifier: NCT05538221
Recruitment Status : Completed
First Posted : September 13, 2022
Last Update Posted : November 8, 2022
Sponsor:
Collaborators:
Fundación Favaloro
Institut Guttmann
Information provided by (Responsible Party):
Bernardo Centeno, Centro Integral de Neurologia y Especialidades Afines, Argentina

Brief Summary:
Gait disturbances can be observed in all age groups, and may be due to different conditions, such as advanced age, stroke, head trauma, spinal cord injury, cerebral palsy, myelomeningocele, among others. The aforementioned gait disorders are associated with an increased risk of falls (which can cause major fractures or head trauma), decreased mobility, loss of independence, cardiovascular pathology, and decreased quality of life. In order to improve a given abnormal gait pattern, an objective assessment of gait is necessary. There are several methods to carry out gait evaluations, like Instrumented Gait Analysis (High cost, time-consuming, qualified professionals needed) and the ones based on observation (limited reliability and validity). An alternative, is the use of video-based systems. SILEMA (Computer System for Gait Study Laboratories in Argentina) is a video-based low-cost gait analysis system that measures temporo-spatial (speed, step length, cadence, stance and swing times) and joint kinematic (Hip, Knee, Ankle) parameters. Its reliability has not been reported yet; thus the primary aim of this study is to determine both the "intra-evaluator" (same evaluator, different sessions) and "inter-evaluator" (same session, different evaluators) reliability.

Condition or disease Intervention/treatment
Gait Analysis Diagnostic Test: SILEMA

Detailed Description:

Gait disturbances can be observed in all age groups, and may be due to different conditions, such as advanced age, stroke, head trauma, spinal cord injury, cerebral palsy, myelomeningocele, among others. The aforementioned gait disorders are associated with an increased risk of falls (which can cause major fractures or head trauma), decreased mobility, loss of independence, cardiovascular pathology, and decreased quality of life.

One of the main objectives of rehabilitation is the improvement of the gait pattern, for which a correct evaluation of it is a necessary condition. Gait analysis is the systematic study of human locomotion, with joint kinematics (description of movement in different planes) and temporo-spatial parameters (speed, cadence, step length, stance and swing times) being variables usually valued and reported. There are several methods for conducting gait assessments. One of them consists of the administration of scales based on observation, which are accessible and simple to execute, but exhibit limited reliability and validity, depending in addition to the previous experience of the observer. The method considered "Gold standard" is the Instrumented Gait Analysis (IGA), from which parameters of kinematics (through optoelectronic cameras and reflective markers), kinetics (through the use of force platforms) and muscle activity (using electromyography) can be obtained.Unfortunately, these systems are not available in most rehabilitation centers, due to the high cost they represent, the need to have highly trained professionals for their use and the long time needed for calibration and post-processing, difficulties that are continuously mentioned in the literature. An alternative to IGA is the use of video-based systems that allow the quantification of temporo-spatial parameters and joint kinematics. One of these systems is SILEMA(Computer System for Gait Study Laboratories in Argentina) which is based on the technique of digital videography. This system exhibits the advantages of being portable, easy to implement and use, and low cost.The purpose of the clinical analysis of gait is usually to differentiate between normal and abnormal patterns, and to assess the change over time or due to an intervention (surgery, orthosis, botulinum toxin, physical therapy, etc.), being necessary in the latter case to make repeated measurements. Usually, to carry out gait evaluations, the patient is asked to perform several "passes", each of them consisting of a free gait through a walkway, at a "self-selected" speed, during a session in which the corresponding information is collected. In healthy subjects, there is usually a variability between repeated measurements (both intra-subject and inter-subject), which occurs at the expense of intrinsic factors (age, height, gait speed, etc.) or extrinsic, caused by methodological errors (experimental error), such as those related to the placement of markers (task carried out by an evaluator, usually a Therapist, or with the processing of a video made by the operator of the software. The consistency or repeatability of the measurements is what is known as reliability. In other words, reliability is a measure of the variability that exists between repeated measurements, and is usually estimated, as recommended, using the intraclass correlation coefficient "ICC" (Relative Reliability) and the standard error of the measure "SEM" (Absolute Reliability). Its determination is very important, since in daily practice it could give information on whether the observed change in a certain parameter of the gait is due to the intervention / evolution of the pathology or to the variability of the measurements. In the context of gait analysis, reliability is typically evaluated "inter-pass" (between several passes of the same subject, in the same session), "intra-operator" (same video evaluated by the same operator at two different times), "interoperator" (same video, different operators), "intra-evaluator" (same evaluator, different sessions) and "inter-evaluator" (same session, different evaluators). To the best of our knowledge, the reliability of SILEMA has not been reported, being the objective of the present study, to determine this metric, with the intention of expanding its use, both for the clinic and for research.

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Study Type : Observational
Actual Enrollment : 18 participants
Observational Model: Other
Time Perspective: Cross-Sectional
Official Title: Reliability of a Low-cost Video-based Gait Analysis System
Actual Study Start Date : October 20, 2022
Actual Primary Completion Date : November 4, 2022
Actual Study Completion Date : November 4, 2022

Intervention Details:
  • Diagnostic Test: SILEMA
    SILEMA consists of a webcam connected to a laptop, a LED reflector, and a software. To carry out gait analysis with SILEMA, an Evaluator must place six yellow auto-adhesive markers over certain anatomical landmarks in the lower limbs, namely, greater trochanter, external femoral condyle, head of the fibula, lateral malleolus and base and head of the fifth metatarsal. The patient is asked to walk barefoot through an eight meter walkway at a self-selected speed, while a webcam connected to a laptop records a video. Then, an Operator, making use of the software, processes the video, obtaining spatio-temporal and joint kinematic parameters.


Primary Outcome Measures :
  1. Step Length [ Time Frame: One Week ]
    Distance between the initial contact of one foot, and the next initial contact of the other foot, expressed in meters. Kinematic parameter to define reliability

  2. Speed [ Time Frame: One Week ]
    Distance travelled in the unit of time, expressed in meters/seconds .Kinematic parameter to define reliability

  3. Cadence [ Time Frame: One Week ]
    Number of steps performed on the unit of time. Kinematic parameter to define reliability

  4. Stance Time [ Time Frame: One Week ]
    Time elapsed between the initial contact of one foot and the take-off of the toes of the same foot, expressed in seconds.Kinematic parameter to define reliability

  5. Swing Time [ Time Frame: One Week ]
    Time elapsed between take-off of the toes and the next initial contact of the same foot, expressed in seconds. Kinematic parameter to define reliability

  6. Hip Range of Motion [ Time Frame: One Week ]
    In Degrees. Kinematic parameter to define reliability

  7. Knee Range of Motion [ Time Frame: One Week ]
    In Degrees. Kinematic parameter to define reliability

  8. Ankle Range of Motion [ Time Frame: One Week ]
    In Degrees. Kinematic parameter to define reliability

  9. Minimum Hip angle [ Time Frame: One Week ]
    In Degrees. Kinematic parameter to define reliability

  10. Minimum Knee angle [ Time Frame: One Week ]
    In Degrees. Kinematic parameter to define reliability

  11. Minimum Ankle angle [ Time Frame: One Week ]
    In Degrees. Kinematic parameter to define reliability

  12. Maximum Hip angle [ Time Frame: One Week ]
    In Degrees. Kinematic parameter to define reliability

  13. Maximum Knee angle [ Time Frame: One Week ]
    In Degrees. Kinematic parameter to define reliability

  14. Maximum Ankle angle [ Time Frame: One Week ]
    In Degrees. Kinematic parameter to define reliability



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Probability Sample
Study Population
Healthy adult volunteers
Criteria

Inclusion Criteria:

  • Age between 18 and 60 years

Exclusion Criteria:

  • History of any condition (neuromuscular, cardiovascular and/or musculoskeletal) that could generate an atypical gait pattern
  • Pregnancy
  • Known hypersensitivity to adhesive tape

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05538221


Locations
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Argentina
CINEA
San Miguel De Tucumán, Tucumám, Argentina, 4000
Sponsors and Collaborators
Centro Integral de Neurologia y Especialidades Afines, Argentina
Fundación Favaloro
Institut Guttmann
Investigators
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Principal Investigator: Bernardo Centeno Centro Integral de Neurologia y Especialidades Afines, Argentina
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Responsible Party: Bernardo Centeno, Medical Doctor, Centro Integral de Neurologia y Especialidades Afines, Argentina
ClinicalTrials.gov Identifier: NCT05538221    
Obsolete Identifiers: NCT05305755
Other Study ID Numbers: ConfSilema
First Posted: September 13, 2022    Key Record Dates
Last Update Posted: November 8, 2022
Last Verified: November 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Bernardo Centeno, Centro Integral de Neurologia y Especialidades Afines, Argentina:
Gait
Reliability
Video
Kinematics
Temporo Spatial Parameters