Application of 2D Gait Analysis for the Assessment of Gait Disturbance in Patients with Spastic Tetraparesis

Abstract

The aim of the study was to explore the use of 2D gait analysis for assessing gait abnormalities in patients with spastic tetraparesis associated with spinal cord injury and other lesions of the cervical spinal cord. Materials and Methods The study included 12 patients with tetraparesis of various etiologies. Gait assessment was performed by video analysis using reflective markers (1.5 cm) and a special walking platform. The spatial coordinates of the markers were determined by capturing the reflected light with infrared LEDs located around the lenses of video cameras. Results Using 2D gait analysis, numerical indicators of gait disturbance in spastic tetraparesis were obtained. We found a prolongation of the stand phase with a shortening of the swing phase (from 81.9 [76.1; 89.2] to 85.3 [74.4; 90.2]%; p=0.97) and the period of the double step (from 0.50 [0.45; 0.96] to 0.40 [0.34; 0.66]; p=0.4) in comparison with the target (normal) values (60% — for the stand phase; 1.41 — for the double-step period). The movements in the hip, knee, and ankle joints are described using numerical values. We then compared the data obtained from the left and right sides of the patient’s body: there were no statistically significant differences between the two sets of data. We also compared the gait characteristics before and after treatment (in 4 patients). Statistically significant differences in values were obtained for the stand and swing phases (p=0.035), the range of motion in the hip joint (p=0.01), and gait velocity (p=0.046). Kendall’s analysis revealed no significant correlation between the data obtained by video gait analysis and the gait changes by the Modified Ashworth Scale (р>0.05). Conclusion 2D gait analysis is a promising method for quantifying gait disturbance in patients with spastic tetraparesis. It allows one to identify characteristic gait patterns, in particular, an increase in the stand phase with a shortening of the swing phase and the double step period, as well as a decrease in the range of motion in the hip joints with an increase in the knee and ankle ones.