title: Identification and classification of toe-walkers based on ankle kinematics, using a data-mining method.
abstract: A database of 1,736 patients and 2,511 gait analyses was reviewed to identify for trials where the first rocker was absent. A fuzzy c-means algorithm was used to identify sagittal ankle kinematic patterns and three groups were identified. The first showed a progressive dorsiflexion during the stance phase, while the second had a short-lived dorsiflexion, followed by a progressive plantarflexion. The third group exhibited a double bump pattern, moving successively from a short-lived dorsiflexion to a short-lived plantarflexion and then returning to a further short-lived dorsiflexion before ending with plantarflexion until toe-off. The three patterns were linked to different neurological conditions. Myopathy, neuropathy and arthogryposis essentially revealed group 1 patterns, whereas idiopathic toe-walkers mainly displayed group 2 patterns. Cerebral palsy patients, however, were relatively homogeneously distributed amongst the three groups. Able-bodied subjects walking on their toes showed a high proportion of unclassifiable ankle patterns, due to a variable gait whilst toe walking. Despite the variety of neurological conditions included in this meta-analysis repeatable biomechanical patterns appeared that could influence therapeutic management.
authors.affiliation: Laboratoire d'Automatique, de Mécanique et d'Informatique Industrielles et Humaines, Université de Valenciennes et du Hainaut-Cambrésis, LAMIH, UMR CNRS 8530, France. stephane.armand@univ-valenciennes.fr
authors.forename: Stéphane
authors.initials: S
authors.lastname: Armand
authors.forename: Eric
authors.initials: E
authors.lastname: Watelain
authors.forename: Moïse
authors.initials: M
authors.lastname: Mercier
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Lensel
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Lepoutre
mesh_terms: D000293:Adolescent; D000465:Algorithms; D001696:Biomechanical Phenomena; D019992:Databases as Topic; D004576:Electromyography; D005260:Female; D017143:Fuzzy Logic; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D014034:Toes; D016138:Walking / Q000502:physiology*