Differences in Motor Development between Preterm Infants and Full-Term Preschool Children.

Although advances in obstetric and neonatal care have improved the survival of preterm infants, many studies document the increased risk of motor and sensory neurodevelopmental abnormalities that can hinder school progress. The aim of this study was to analyze the differences in gross and fine motor development in children born preterm and full term aged 3 to 6 years using the Peabody Developmental Motor Scales 2 (PDMS-II). Fifteen preterm and fifteen term children, matched for age and sex, participated in this study. They were evaluated with the PDMS-II scale. The scores obtained in the PDMS-II scale showed statistically significant differences (p < 0.05) in all subscales except for the "grasping" subscale. No dissimilarities were found between children who attended an early intervention program and those who did not participate, nor was there any correlation between week of gestation and birth weight and motor development in preschool. The results obtained show that differences are found with respect to motor development, with lower scores for those born preterm compared to children born at term. No statistically significant difference was found between preterm children who attended early intervention and those who did not. No correlation was found between motor development at preschool age and birth weight and gestational age.

Use of low-cost virtual reality in the treatment of the upper extremity in chronic stroke: a randomized clinical trial.

BACKGROUND: Chronicity and lack of motivation often go together during the upper limb rehabilitation process in stroke. Virtual reality is a useful tool in this context, providing safe, intensive, individualised treatments in a playful environment. B-cost, easy-to-use devices with personalised and motivating games for a specific population seem to be the most effective option in the treatment of the upper limbs. METHODS: A randomised clinical study with follow-up was carried out to assess the effectiveness of the Leap Motion Controller® device in improving the functionality of the upper limb in patients with chronic stroke. Patients (n = 36) were randomised into a control group that performed conventional therapy and an experimental group that combined the virtual reality protocol with conventional therapy. The outcome measures used were grip strength; the Block and Box Test; the Action Research Arm Test; the Disabilities of the Arm, Shoulder and Hand; as well as a Technology Satisfaction Questionnaire and adherence to treatment. RESULTS: Inter-group statistical analysis showed no significant differences except in subsection D of the Action Research Arm Test. Intra-group analysis showed significant differences in both groups, but the experimental group reached significance in all long-term variables. Satisfaction and adherence levels were very high. CONCLUSIONS: The Leap Motion Controller® system, as a complementary tool, produces improvements in grip strength, dexterity and motor function in patients with chronic stroke. It is perceived as a safe, motivating, and easy-to-use device. CLINICAL REGISTRATION: NCT04166617 Clinical Trials.

The efficacy of transcranial direct current stimulation on upper extremity motor function after stroke: A systematic review and comparative meta-analysis of different stimulation polarities.

BACKGROUND: The efficacy of transcranial direct current stimulation (tDCS) has been studied extensively. The cathodic (c-tDCS), anodic (a-tDCS), and bihemispheric stimulation have demonstrated efficacy in the management of the paretic upper extremity (UE) after stroke, but it has not been determined which stimulation polarity has, so far, shown the best results. OBJECTIVE: To evaluate the available evidence to determine which tDCS polarity has the best results in improving UE motor function after stroke. METHODS: PubMed, PEDro, Web of Science, EMBASE, and SCOPUS databases were searched. Different Medical Subject Headings (MeSH) terms were combined for the search strategy, to cover all studies that performed a comparison between different tDCS configurations focused on UE motor rehabilitation in people with lived experience of stroke. RESULTS: Fifteen studies remained for qualitative analysis and 12 for quantitative analysis. Non-significant differences with a 95% confidence interval (CI) were obtained for c-tDCS versus a-tDCS (g = 0.10, 95% CI = -0.13; 0.33, p = .39, N = 292), for a-tDCS versus bihemispheric (g = 0.02, 95% CI = -0.46; 0.42, p = .93, N = 81), and for c-tDCS versus bihemispheric (g = 0.09, 95% CI = -0.84; .66, p = .73, N = 100). No significant differences between the subgroups of the meta-analysis were found. CONCLUSIONS: The results of the present meta-analysis showed no evidence that a stimulation polarity is superior to the others in the rehabilitation of UE motor function after stroke. A non-significant improvement trend was observed toward c-tDCS compared to a-tDCS.

Impact of reflex locomotion and the Bobath concept on clinical and biomolecular parameters in people with multiple sclerosis: study protocol for a randomized controlled trial.

Introduction: Multiple sclerosis (MS) is a progressive disease with a fluctuating and unpredictable course that has no curative treatment at present. One of its main characteristics is the variety of signs and symptoms that produce a high percentage of patients who present alterations in balance and gait during the development of the disease, decreased muscle strength, spasticity, or decreased pimax. Rehabilitative therapy, especially physiotherapy, is the main course of the treatment of these alterations using reflex locomotion and the Bobath concept as a form of kinesitherapy that activates the preorganized circuits of the central nervous system. Objective: The objective of this study is to evaluate the reflex locomotion and Bobath concept effects on balance, spasticity, reaction time, respiratory parameters, and lacrimal biomolecular markers. Methods and analysis: This is a randomized controlled trial on the effectiveness of two neurorehabilitation techniques in patients with multiple sclerosis conducted at the University of Salamanca. The research will take place at the Faculty of Nursing and Physiotherapy, University of Salamanca. The study will be conducted from June 2023 to June 2024. The reflex locomotion group will receive individual sessions of therapy (n = 27), and the Bobath concept group (n = 27) will receive the same number of sessions. Both groups will receive two sessions per week for 12 months. The measurement variables will be the Berg Balance Scale, the Tardieu Scale, the Cognitfit Program, Maximum Inspiratory Pressure, and Lacrimal Biomarkers. Ethics and dissemination: This study has been approved by the Ethics Committee of the University of Salamanca on March 2023 (ref: 896). Limitations: The main limitations of this study are the selection and number of patients, the delay in implementing the therapy within the initially scheduled period, inadequate sample collection, and inadequate sample processing. Trial registration number: ClinicalTrials.gov; identifier: NCT05558683.

A Novel Active Device for Shoulder Rotation Based on Force Control.

This article describes a one-degree-of-freedom haptic device that can be applied to perform three different exercises for shoulder rehabilitation. The device is based on a force control architecture and an adaptive speed PI controller. It is a portable equipment that is easy to use for any patient, and was optimized for rehabilitating external rotation movements of the shoulder in patients in whom this was limited by muscle-skeletal injuries. The sample consisted of 12 shoulder rehabilitation sessions with different shoulder pathologies that limited their range of shoulder mobility. The mean and standard deviations of the external rotation of shoulder were 42.91 ± 4.53° for the pre-intervention measurements and 53.88 ± 4.26° for the post-intervention measurement. In addition, patients reported high levels of acceptance of the device. Scores on the SUS questionnaire ranged from 65 to 97.5, with an average score of 82.70 ± 9.21, indicating a high degree of acceptance. The preliminary results suggest that the use of this device and the incorporation of such equipment into rehabilitation services could be of great help for patients in their rehabilitation process and for physiotherapists in applying their therapies.

Reliability and Validity of the 10-Meter Walk Test (10MWT) in Adolescents and Young Adults with Down Syndrome.

People with Down syndrome (DS) have gait deficits because motor milestones are usually reached later. Decreased gait speed or reduced stride length are some of the main deficits. The main objective of the present work was to assess the reliability of the 10-Meter Walk Test (10MWT) in adolescents and young adults with DS. The objective has been to analyze the construct validity of the 10MWT with the Timed up and go (TUG) test. A total of 33 participants with DS were included. Reliability was verified by intraclass correlation coefficient (ICC). The agreement was analyzed by the Bland-Altman method. Finally, construct validity was evaluated through Pearson correlation coefficient. The 10MWT intra-rater and inter-rater reliability were good (ICC between 0.76 until 0.9) and excellent (ICC > 0.9), respectively. The minimal detectable change for intra-rater reliability was 0.188 m/s. Also, it has demonstrated moderate construct validity (r > 0.5) considering the TUG test. The 10MWT has shown high intra- and inter-rater reliability and validity in adolescent and adults with SD and a moderate construct validity between TUG test and 10MWT.

Reliability and agreement of the timed up and go test in children and teenagers with autism spectrum disorder.

ASD patients include a variety of motor deficits; however, these issues have received less scientific attention than other ASD symptoms. Due to understanding and behavioral difficulties, it might be difficult to administer motor assessment measures to children and adolescents with ASD. To evaluate motor challenges in this population, including gait and dynamic balance issues, the timed up and go test (TUG) may be a simple, easy to apply, quick, and inexpensive tool. This test measures in seconds the time it takes for an individual to get up from a standard chair walk 3 m, turn around, walk back to the chair, and sit down again. The study purpose was to evaluate the inter- and intra-rater reliability of TUG test in children and teenagers with ASD. A total of 50 children and teenagers with ASD (43 boys and 7 girls) between 6 and 18 years were included. Reliability was verified by the intraclass correlation coefficient, standard error of measurement, and minimum detectable change. The agreement was analyzed by the Bland-Altman method. A good intra-rater reliability (ICC = 0.88; 95% CI = 0.79-0.93) and an excellent inter-rater reliability (ICC = 0,99; 95% CI = 0.98 to 0.99) were observed. Additionally, Bland-Altman plots demonstrated that there was no evidence of bias in either the replicates or between examiners. Furthermore, the limits of agreement (LOAs) between the testers and test replicates were close, indicating that there was little variation between measurements.       Conclusions: The test TUG showed strong intra- and inter-rater reliability values, low proportion of measurement errors, and lack of significant bias based on by test repetition in children and teenagers with ASD. These results could be clinically useful for assessing balance and the risk of falls in children and teenagers with ASD. However, the present study is not free of limitations, such as the use of a non-probabilistic sampling. What is Known: • People with ASD have a variety of motor deficits that have a prevalence rate almost as common as intellectual disability. In our knowledge, there are no studies that provide data on the reliability of the use of scales or assessment tests in children and adolescents with ASD to measure motor difficulties, such as gait and dynamic balance, in children and teenagers with ASD. • Timed up and go test (TUG) could be a possible tool to measure this motor skills. What is New: • The reliability and agreement of the Timed up and go test in 50 children and teenagers with autism spectrum disorder showed strong intra- and inter-rater reliability values, low proportion of measurement errors, and lack of significant bias based on by test repetition.

The influence between gestational age and postural control, a systematic review.

The central nervous system (CNS) of preterm infants might have some peculiarities which distinguish it from that of full term infants. The difficulties associated with prematurity are the main cause of deaths all over the world during the new-born period after community-acquired pneumonia, and the second cause of deaths worldwide in children under five years old. Early recognition of signs indicating fragile postural control in premature infants can support understanding and help prevent and early intervention on possible future neuromotor dysfunctions in these subjects. The purpose of this paper is to determine if there is a qualitatively different development of postural control in premature infants without neurological involvement and infants born at term. We conducted a systematic review of longitudinal and cross-sectional case-control studies published between 2010 and March 2020 on this topic. The evaluation of parameters related to postural control was also included. The methodological quality of the selected works was evaluated using the CASPe critical reading programme for cases and controls. PRISMA guidelines for systematic reviews were followed for prematurity and postural control. 16 articles were included. The total sample amounted to 3,460 participants, of which 1,860 in the preterm group, and 1,600 in the control group. All the studies found show a poorer postural control by the group of children born preterm compared to the group of children born at term and one study indicating more limited postural control with higher prematurity. Regarding the methodological quality according to CASPe, those studies exceeding half of the total score were considered of adequate quality.

The Use of Portable Devices for the Instrumental Assessment of Balance in Patients with Chronic Stroke: A Systematic Review.

BACKGROUND: Improving balance remains a challenge in stroke rehabilitation. The technological development has allowed the design of more accessible and user-friendly systems for assessing postural control. OBJECTIVES: The aim of this review was to analyze portable devices for the instrumental assessment of balance in patients with chronic stroke. METHODS: PRISMA guidelines were used to carry out the systematic review. The literature search was restricted to articles written in English or Spanish published from 2013 to December 2022 in Pubmed, Web of Science, Scopus, PEDro, and CINAHL. Of the 309 search results, 229 unique references were reviewed after duplicates were removed. The PEDro scale was applied to evaluate the methodological quality of the included papers, and the degree of evidence and level of recommendation were determined through the Oxford Centre for Evidence-Based Medicine. RESULTS: A total of seven articles reporting on five different balance testing devices were included in this systematic review; they regarded BIORescue, a smartphone application, and the Biodex-BioSway Balance System for the evaluation of standing balance, and SwayStar Balance and Xsens ForceShoes™ for the evaluation of dynamic balance during walking. CONCLUSIONS: The use of portable devices that assess balance in adult patients with chronic stroke is scarce.

Arm-swing kinematics in Parkinson's disease: A systematic review and meta-analysis.

BACKGROUND: Parkinson's disease (PD) causes postural instability and gait abnormalities that may be associated with an arm swing reduction. OBJECTIVE: To conduct systematic review and meta-analysis to determine the kinematic patterns of arm-swing during gait in people with PD METHODS: A computer literature search of the PubMed, EMBASE, WOS, PEDro, SCOPUS and SciELO databases was conducted. Terms related to PD and arm-swing were combined to find studies that performed a free walking evaluation of the arm-swing of PD patients on or off medication compared to healthy controls. After a standardized evaluation by three examiners, fifteen articles met inclusion criteria. Random effects meta-analysis models were utilized to quantify (1) the arm-swing range of motion (RoM); (2) the arm-swing amplitude; (3) the arm-swing velocity; and (4) the arm-swing asymmetry. RESULTS: On average, arm-swing RoM (7.07°), amplitude (0.8 cm), and velocity (0.31 m/s) were significantly decreased in PD compared to healthy controls. Healthy subjects had significantly more symmetrical arm-swing (8.16%) than people with PD. Effect sizes were moderate-large. CONCLUSIONS: People with PD have significant differences in RoM, amplitude, velocity, and asymmetry of arm-swing during gait compared to the healthy control group. Medication phase does not significantly influence arm-swing characteristics. Further studies will be needed to determine whether different disease characteristics influence the biomechanics of arm-swing during gait.

Nintendo Switch Joy-Cons' Infrared Motion Camera Sensor for Training Manual Dexterity in People with Multiple Sclerosis: A Randomized Controlled Trial.

BACKGROUND: The Nintendo Switch® (NS) is the ninth video game console developed by Nintendo®. Joy-Cons® are the primary game controllers for the NS® video game console, and they have an infrared motion camera sensor that allows capturing the patient's hands without the need to place sensors or devices on the body. The primary aim of the present study was to evaluate the effects of the NS®, combined with a conventional intervention, for improving upper limb (UL) grip muscle strength, coordination, speed of movements, fine and gross dexterity, functionality, quality of life, and executive function in multiple sclerosis (MS) patients. Furthermore, we sought to assess satisfaction and compliance levels. METHODS: A single-blinded, randomized clinical trial was conducted. The sample was randomized into two groups: an experimental group who received treatment based on Dr Kawashima's Brain Training® for the NS® (20 min) plus conventional rehabilitation (40 min), and a control group who received the same conventional rehabilitation (60 min) for the ULs. Both groups received two 60 min sessions per week over an eight-week period. Grip strength, the Box and Blocks Test (BBT), the Nine Hole Peg Test (NHPT), the QuickDASH, the Multiple Sclerosis Impact Scale (MSIS-29), the Trail Making Test (TMT), and the Stroop Color and Word Test (SCWT) were used pre- and post-treatment. Side effects and attendance rates were also recorded. RESULTS: Intragroup analysis showed significant improvements for the experimental group in the post-treatment assessments for grip strength in the more affected side (p = 0.033), the BBT for the more (p = 0.030) and the less affected side (p = 0.022), the TMT (A section) (p = 0.012), and the QuickDASH (p = 0.017). No differences were observed for the control group in intragroup analysis, but they were observed in the NHPT for the more affected side (p = 0.012). The intergroup analysis did not show differences between both groups. CONCLUSIONS: Our results show that an eight-week experimental protocol, after using Dr Kawashima's Brain Training® and the right-side Joy-Con controller for the NS®, combined with a conventional intervention, showed improvements in grip strength, coordination, fine and gross motor function, executive functions, and upper limb functionality in the experimental group. However, no differences were observed when both groups were compared in the intergroup analysis. The addition of Brain Training® for the NS® for the upper limb rehabilitation did not show side effects and was rated with a high satisfaction and excellent compliance in people with MS. TRIAL REGISTRATION: This randomized controlled trial has been registered at ClinicalTrials Identifier: NCT04171908, November 2019.

Prediction of Communicative Disorders Linked to Autistic Spectrum Disorder Based on Early Psychomotor Analysis.

This systematic review evaluated psychomotor differences between children with and without siblings who have autism spectrum disorder (ASD), as well as the most reliable psychomotor skills that can help predict ASD and its associated language disorders. Literature from 2005 to 2020 was searched using the following databases: PubMed, Trip Medical Database, Cochrane, Web of Science, Science Direct, and Brain. A total 11 papers were included. Fine motor skills and joint attention displayed reliable results in order to predict ASD and its associated language disorders. The period between the first and the second year of life was considered the most appropriate one for the assessment of psychomotor skills. The best period to predict language disorders and ASD diagnosis is around 36 months old.

Feasibility and Efficacy of a Virtual Reality Game-Based Upper Extremity Motor Function Rehabilitation Therapy in Patients with Chronic Stroke: A Pilot Study.

BACKGROUND: The objective of the present study was to develop a virtual reality protocol based on activities of daily living and conventional rehabilitation, using Leap Motion Controller to improve motor function in upper extremity rehabilitation in stroke patients. At the same time, the purpose was to explore its efficacy in the recovery of upper extremity motor function in chronic stroke survivors, and to determine feasibility, satisfaction and attendance rate; Methods: A prospective pilot experimental clinical trial was conducted. The outcome measures used were the grip strength, the Action Research Arm Test (ARAT), the Block and Box Test (BBT), the Short Form Health Survey-36 Questionnaire, a satisfaction questionnaire and attendance rate; Results: Our results showed statistically significant changes in the variables grip strength, BBT and ARAT as well as high levels of satisfaction and attendance; Conclusions: This virtual reality platform represents an effective tool in aspects of upper extremity functionality rehabilitation in patients with chronic stroke, demonstrating feasibility and high levels of attendance and satisfaction.

Reflex Locomotion Therapy for Balance, Gait, and Fatigue Rehabilitation in Subjects with Multiple Sclerosis.

This study evaluates the effects of a rehabilitation program based on reflex locomotion therapy (RLT) on balance, gait, and fatigue in patients with multiple sclerosis (MS). Twenty-three patients diagnosed with MS participated in this study. Reversal design was carried out. The assessment tools included the Berg Balance Scale (BBS), the Performance Oriented Mobility Assessment (POMA), the Fatigue Severity Scale (FSS) and the instrumental analysis of the gait recorded by Vicon Motion System®. We analyzed spatio-temporal parameters and kinematic variables of the hip, knee, and ankle joints. Additionally, the Client Satisfaction Questionnaire (CSQ-8) was administrated. We did find a significant improvement in balance and gait tools after the RLT period. Regarding instrumental analysis, the statistical analysis of spatio-temporal parameters showed a significant improvement in stride length, double support, and velocity after the RLT period. Concerning kinematic parameters, the analysis showed improvements in hip and knee range of motion (ROM) after RLT period. RLT could improve gait and balance in patients with MS. The patients reported a high level of satisfaction with the therapy received.

Reliability and agreement of the Nine Hole Peg Test in patients with unilateral spastic cerebral palsy.

Upper extremity involvement is one of the most common motor impairments in children with unilateral spastic cerebral palsy (CP). One tool for the assessment of manual function in CP is the Nine Hole Peg Test (NHPT). However, the reliability of the NHPT in patients with unilateral CP is unknown. This study aimed to analyze the intra-rater inter-session reliability of the NHPT in unilateral spastic CP, for its use in clinical practice and research. A total of 27 participants with spastic unilateral CP were included. Reliability was verified by the intraclass correlation coefficient (ICC), standard error of measurement, and minimum detectable change. The agreement was analyzed by the Bland-Altman method. An excellent intra-rater reliability was observed for the non-affected side (ICC = 0.94) and the affected side (ICC = 0.96). The minimal detectable change was 4 and 12 s for the non-affected and affected side, respectively. There were no significant biases between repetitions.   Conclusions: The NHPT showed excellent intra-rater inter-session reliability in patients with spastic unilateral CP. In addition, the test shows adequate agreement and proportionally small errors to assess manual dexterity. What is Known: • The Nine Hole Peg Test (NHPT) is widely used to assess dexterity in patients with neurological conditions. • The NHPT has demonstrated appropriate measurement properties in healthy children and adults with neurological conditions. What is New: • The NHPT presents excellent reliability, small measurement errors, and adequate agreement for the assessment of patients with cerebral palsy. • The measurement error of the NHPT in unilateral cerebral palsy may be up to 13% of the total time to perform it.

Use of the Leap Motion Controller® System in the Rehabilitation of the Upper Limb in Stroke. A Systematic Review.

OBJECTIVES: Upper limb impairment is the most common motor impairment in stroke survivors. The use of new technologies in the field of rehabilitation aims to reduce the impact of functional problems. Our objective is to evaluate the effectiveness of using the Leap Motion Controller® virtual reality system in the treatment of upper limb functionality in people with stroke. MATERIALS AND METHODS: PRISMA guidelines were used to carry out the systematic review. The literature search was restricted to articles written in English or Spanish published from 2012 to December 2020 in Pubmed, Web of Science, Scopus, PEDro and Science Direct. Of the 309 search results, 230 unique references were reviewed after duplicates were removed. The Downs and Black and CONSORT scales were applied to evaluate the methodological quality of the included papers and the degree of evidence and level of recommendation were determined through the Oxford Centre for Evidence-Based Medicine. RESULTS: Six papers with a total of 144 participants were included in this review, with heterogeneity of the sample, assessment measures, protocols, number of sessions and diversity of games applied. The main results of the studies show favourable data after using the Leap Motion Controller® system in the improvement of upper limb functionality in people with stroke. CONCLUSIONS: There is a growing trend in the use of the Leap Motion Controller® device as a tool in the treatment of the upper limb in people with stroke. Nevertheless, the limitations encountered suggest the need for future research protocols with greater scientific rigor.

Validation of a Hybrid Exoskeleton for Upper Limb Rehabilitation. A Preliminary Study.

Recovery of therapeutic or functional ambulatory capacity in patients with rotator cuff injury is a primary goal of rehabilitation. Wearable powered exoskeletons allow patients to perform repetitive practice with large movements to maximize recovery, even immediately after the acute event. The aim of this paper is to describe the usability, acceptability and acceptance of a hybrid exoskeleton for upper-limb passive rehabilitation using the System Usability Scale (SUS) questionnaire. This equipment, called ExoFlex, is defined as a hybrid exoskeleton since it is made up of rigid and soft components. The exoskeleton mechanical description is presented along with its control system and the way motion is structured in rehabilitation sessions. Seven patients (six women and one man) have participated in the evaluation of this equipment, which are in the range of 50 to 79 years old. Preliminary evidence of the acceptance and usability by both patients and clinicians are very promising, obtaining an average score of 80.71 in the SUS test, as well as good results in a questionnaire that evaluates the clinicians' perceived usability of ExoFlex.

The Long-Term Maintenance of Upper Limb Motor Improvements Following Transcranial Direct Current Stimulation Combined with Rehabilitation in People with Stroke: A Systematic Review of Randomized Sham-Controlled Trials.

BACKGROUND: The effectiveness of transcranial direct current stimulation (tDCS) in the upper limb (UL) motor rehabilitation of stroke has been widely studied. However, the long-term maintenance of its improvements has not yet been proven. METHODS: A systematic search was conducted in MEDLINE/Pubmed, Web of Science, PEDRo, and Scopus databases from inception to April 2021. Randomized controlled trials were included if they performed a tDCS intervention combined with UL rehabilitation in stroke patients, performed several sessions (five or more), and assessed long-term results (at least three-month follow-up). Risk of bias and methodological quality were evaluated with the Cochrane RoB-2 and the Oxford quality scoring system. RESULTS: Nine studies were included, showing a high methodological quality. Findings regarding UL were categorized into (1) functionality, (2) strength, (3) spasticity. All the studies that showed significant improvements retained them in the long term. Baseline functionality may be a limiting factor in achieving motor improvements, but not in sustaining them over the long term. CONCLUSION: It seems that the improvements achieved during the application of tDCS combined with UL motor rehabilitation in stroke were preserved until the follow-up time (from 3 months to 1 year). Further studies are needed to clarify the long-term effects of tDCS.

Gait Pattern in People with Multiple Sclerosis: A Systematic Review.

The aim of the present systematic review was to describe the gait pattern in people with multiple sclerosis (MS) by compiling the main findings obtained from studies using three-dimensional capture systems of human movement. The search was carried out in PubMed, Web of Science, Physiotherapy Evidence Database (PEDro), and the Cumulative Index to Nursing and Allied Health (CINAHL) databases. Studies that used three-dimensional gait analysis systems and that analyzed spatiotemporal, kinematic, kinetic, or electromyographic parameters, were included. The quality of the studies was assessed using the Critical Review Form-Quantitative Studies scale. 12 articles were included with 523 (342 women and 181 men) people with a diagnosis of MS. The present work suggests that people with MS have a decrease in speed and stride length, as well as an increase in double-stance intervals during gait. Likewise, it is common to observe a decrease in hip extension during the stance period, a decrease in knee flexion in the swing period, a decrease in ankle dorsiflexion in the initial contact and a decrease in ankle plantar flexion during the pre-swing phase. The subjects with MS decrease the hip extensor moment and the ankle power during the stance period of walking.

Test-Retest Reliability of a Conventional Gait Model for Registering Joint Angles during Initial Contact and Toe-Off in Healthy Subjects.

The aim of this study was to evaluate the test-retest reliability of a conventional gait model (CGM), the Plug-in Gait model, to calculate the angles of the hip, knee, and ankle during initial contact (IC) and toe-off (TO). Gait analysis was performed using the Vicon Motion System® (Oxford Metrics, Oxford, UK). The study group consisted of 50 healthy subjects. To evaluate the test-retest reliability, the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the minimal detectable change (MDC), and the Bland-Altman analysis with 95% limits of agreement were calculated. The ICC for the joint angles of the hip, knee, and ankle was higher than 0.80. However, the ankle angle at IC had an ICC lower than 0.80. The SEM was <5° for all parameters. The MDC was large (>5°) for the hip angle at IC. The Bland-Altman analysis indicated that the magnitude of divergence was between ±5° and ±9° at IC and around ±7° at TO. In conclusion, the ICC for the plug-in gait model was good for the hip, knee, and ankle angles during IC and TO. The plots revealed a disagreement between measurements that should be considered in patients' clinical assessments.