title: Gaitography applied to prosthetic walking.
abstract: During walking on an instrumented treadmill with an embedded force platform or grid of pressure sensors, center-of-pressure (COP) trajectories exhibit a characteristic butterfly-like shape, reflecting the medio-lateral and anterior-posterior weight shifts associated with alternating steps. We define "gaitography" as the analysis of such COP trajectories during walking (the "gaitograms"). It is currently unknown, however, if gaitography can be employed to characterize pathological gait, such as lateralized gait impairments. We therefore registered gaitograms for a heterogeneous sample of persons with a trans-femoral and trans-tibial amputation during treadmill walking at a self-selected comfortable speed. We found that gaitograms directly visualize between-person differences in prosthetic gait in terms of step width and the relative duration of prosthetic and non-prosthetic single-support stance phases. We further demonstrated that one should not only focus on the gaitogram's shape but also on the time evolution along that shape, given that the COP evolves much slower in the single-support phase than in the double-support phase. Finally, commonly used temporal and spatial prosthetic gait characteristics were derived, revealing both individual and systematic differences in prosthetic and non-prosthetic step lengths, step times, swing times, and double-support durations. Because gaitograms can be rapidly collected in an unobtrusive and markerless manner over multiple gait cycles without constraining foot placement, clinical application of gaitography seems both expedient and appealing. Studies examining the repeatability of gaitograms and evaluating gaitography-based gait characteristics against a gold standard with known validity and reliability are required before gaitography can be clinically applied.
authors.affiliation: Faculty of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam, Van der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands. m.roerdink@vu.nl.
authors.forename: Melvyn
authors.initials: M
authors.lastname: Roerdink
authors.affiliation: INAIL Centro Protesi, Budrio, Italy.
authors.forename: Andrea G
authors.initials: AG
authors.lastname: Cutti
authors.affiliation: INAIL Centro Protesi, Budrio, Italy.
authors.forename: Aurora
authors.initials: A
authors.lastname: Summa
authors.affiliation: INAIL Centro Protesi, Budrio, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Monari
authors.affiliation: INAIL Centro Protesi, Budrio, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Veronesi
authors.affiliation: Faculty of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam, Van der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands.|Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands.
authors.forename: Mariëlle W
authors.initials: MW
authors.lastname: van Ooijen
authors.affiliation: Faculty of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam, Van der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands.|School of Sport and Education, Brunel University, London, UK.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Beek
mesh_terms: D000328:Adult; D000368:Aged; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D001696:Biomechanical Phenomena / Q000502:physiology; D005080:Exercise Test; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007866:Leg / Q000502:physiology; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D016138:Walking / Q000502:physiology*