Acute vestibular syndrome (AVS), defined by sudden onset of dizziness, nausea, impaired balance and gait instability, severely affects normal daily activities. Vestibular rehabilitation alleviates the condition and facilitates the return to normal activities. This study assessed the rehabilitation process of 30 participants with AVS using Inertial Measurement Unit (IMU)-based gait analysis during timed 25-ft walk tests (T25FW) conducted at onset, after a 6-week rehabilitation program, and at a 12-week follow-up. 54 healthy controls also performed the T25FW on one occasion. Gait variables based on either five lower body sensors or only the pelvis sensor were investigated. Clinical variables: walking speed and Vertigo Symptom Scale–Short Form (VSS–SF) vertigo-balance subscale (VSS–V) were also recorded. Significant successive improvements in VSS–V were observed between all timepoints. Furthermore, walking speed, Gait Profile Score (GPS), pelvis GPS, and cadence decreased from onset to the end of the rehabilitation period, after which changes were not significant. Walking speed was slower for the AVS group at baseline (0.65 m/s, p < 0.0001) and at 12 weeks (1.13 m/s, p < 0.05) compared to controls (1.26 m/s). GPS, pelvis GPS, GPS asymmetry, and cadence were significantly greater compared to controls at baseline (6.8° vs. 4.4°, 3.6° vs. 2.6°, and 87 steps/min vs. 118 steps/min, respectively, p < 0.0001). GPS asymmetry was also higher at baseline compared to controls (1.40 steps/min vs. 0.80 steps/min, p < 0.05).In conclusion, gait improvement was captured via IMU-based gait analysis, even when using a single sensor, supporting the clinical feasibility of using both single- and multi-sensor wearable systems for rehabilitation assessment.
Introduction Stair walking challenges balance and coordination in older people. Bench-stepping training improves stair climbing speed in healthy older women. This study assessed whether bench-stepping also improves dynamic balance and movement complexity during stair walking. Methods Secondary analyses of stair walking data from a previous study involving 45 healthy older women (69 y ± 4) that assessed the effects of a 12-week bench-stepping intervention. Centre-of-mass acceleration was measured during stair ascent and descent. Linear dynamics included time, acceleration magnitude, and harmonic ratios (HR; indicating symmetry). Movement complexity was quantified using nonlinear dynamics including sample entropy (SampEn), recurrence quantification analysis (RQA), and fractal dimension (FD). Results For stair ascent, increased speed (p = 0.018, R²partial =0.093,) was accompanied by proportional increases in acceleration magnitudes (p ≤ 0.039, R²partial = 0.078–0.101). SampEn decreased more in the intervention group (p ≤ 0.012, R²partial = 0.049–0.101), indicating more predictable dynamics. In contrast, for stair descent, no changes in speed or acceleration magnitudes were observed. However, SampEn (p = 0.001, R²partial =0.082) and maximum RQA line length (p = 0.008, R²partial =0.057) of vertical acceleration increased significantly compared to controls, indicating lower predictability and more persistent recurring patterns. No significant changes were found for other outcomes. Exploratory factor analysis revealed distinct differences in motor behaviour between stair ascent and descent. Conclusion Bench-stepping training induced measurable changes in stair walking dynamics. Specifically, sample entropy shows potential as a sensitive marker of altered motor complexity, particularly of vertical accelerations. Interestingly, the direction of changes in unpredictability differed between stair ascent and descent, suggesting different underlying control strategies.
Background Medial knee osteoarthritis is associated with increased medial compartment loading during gait. Valgus unloader knee orthotics are commonly used to reduce medial knee loading, but the biomechanical responses associated with semi-rigid designs remain unclear. Research question After six weeks of use, what effect does the orthotic condition have on first-peak knee adduction moment (KAM), second-peak KAM, and knee adduction angular impulse (KAAI) during constant-speed and self-selected-speed walking compared with baseline in individuals with medial knee osteoarthritis? Methods Twenty-four participants with Kellgren-Lawrence grade 2–4 completed a within-participant pretest–posttest study. Gait was assessed without the orthotic at baseline and while wearing it after six weeks of use (mean 5.13 h/day), at a constant speed of 1.39 m/s and self-selected speed. In OpenSim, first-peak KAM, second-peak KAM, and KAAI were calculated. GRF variables were secondary, exploratory outcomes. Conditions were compared using paired t-tests or Wilcoxon signed-rank tests. Holm-Bonferroni adjustment was applied to the three KAM-related outcomes within each walking condition. Results During constant-speed walking, first-peak KAM, second-peak KAM, and KAAI were lower with the orthotic by 6.9% , (r = 0.44), 6.8% (r = 0.47), and 15.8% (r = 0.51), respectively (Holm-adjusted p = 0.045 for each). Vertical GRF variables did not differ, whereas the braking-peak magnitude and braking and propulsive impulses increased. During self-selected-speed, participants walked 15.5% faster in the orthotic condition (p < 0.001). First- and second-peak KAM did not differ significantly from baseline, whereas KAAI was lower (−0.030 N·m·kg⁻¹·s, 95% CI −0.050 to −0.010; Holm-adjusted p = 0.014). The first vertical, braking, and propulsive GRF peaks increased, while vertical impulse decreased. Significance Semi-rigid orthotic use was associated with lower KAM-related loading during constant-speed walking and faster self-selected walking without higher peak KAM. The semi-rigid orthotic may be considered a possible adjunct to individualized, multicomponent care for individuals with medial knee osteoarthritis.
