title: Linking clinical measurements and kinematic gait patterns of toe-walking using fuzzy decision trees.
abstract: Toe-walking is one of the most prevalent gait deviations and has been linked to many diseases. Three major ankle kinematic patterns have been identified in toe-walkers, but the relationships between the causes of toe-walking and these patterns remain unknown. This study aims to identify these relationships. Clearly, such knowledge would increase our understanding of this gait deviation, and could help clinicians plan treatment. The large quantity of data provided by gait analysis often makes interpretation a difficult task. Artificial intelligence techniques were used in this study to facilitate interpretation as well as to decrease subjective interpretation. Of the 716 limbs evaluated, 240 showed signs of toe-walking and met inclusion criteria. The ankle kinematic pattern of the evaluated limbs during gait was assigned to one of three toe-walking pattern groups to build the training data set. Toe-walker clinical measurements (range of movement, muscle spasticity and muscle strength) were coded in fuzzy modalities, and fuzzy decision trees were induced to create intelligible rules allowing toe-walkers to be assigned to one of the three groups. A stratified 10-fold cross validation situated the classification accuracy at 81%. Twelve rules depicting the causes of toe-walking were selected, discussed and characterized using kinematic, kinetic and EMG charts. This study proposes an original approach to linking the possible causes of toe-walking with gait patterns.
authors.affiliation: Laboratoire d'Automatique, de Mécanique et d'Informatique industrielles et Humaines, Université de Valenciennes et du Hainaut-Cambrésis, Le Mont Houy, 59313 Valenciennes Cedex 9, France. Stephane.Armand@hcuge.ch
authors.forename: Stéphane
authors.initials: S
authors.lastname: Armand
authors.forename: Eric
authors.initials: E
authors.lastname: Watelain
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Roux
authors.forename: Moïse
authors.initials: M
authors.lastname: Mercier
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Lepoutre
mesh_terms: D001696:Biomechanical Phenomena; D002648:Child; D003663:Decision Trees; D004576:Electromyography; D017143:Fuzzy Logic; D020233:Gait Disorders, Neurologic / Q000145:classification / Q000503:physiopathology*; D006801:Humans; D007596:Joints / Q000503:physiopathology; D009119:Muscle Contraction / Q000502:physiology; D009128:Muscle Spasticity / Q000503:physiopathology; D053580:Muscle Strength / Q000502:physiology; D009140:Musculoskeletal Diseases / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014034:Toes; D016138:Walking / Q000502:physiology*