Browsing by Author "Carnide, Filomena"
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- Construct validity of markerless three-dimensional gait biomechanics in healthy older adultsPublication . Carvalho, Andreia; Vanrenterghem, Jos; Cabral, Sílvia; d'Assunção, Ana M.; Carnide, Filomena; Veloso, António P.; Moniz-Pereira, VeraBackground and aim: Gait changes due to aging can result in functional limitations and a higher risk of falls, with older adults showing alterations in joint angles and moments. Marker-based gait analysis is not widely used in clinical settings due to its complexity and discomfort, especially in older adults. Recent advances in markerless motion capture, such as Theia3D, offer a promising alternative. This study aims to assess the construct validity of a markerless motion capture system for gait analysis in healthy older adults. Methods: A cross-sectional study included 30 healthy community-dwelling older adults. Gait data were collected using marker-based and markerless motion capture systems in randomized order, with participants wearing tight-fitting minimal clothes plus 46 reflective markers attached, or their usual clothes, respectively. Joint kinematics (including range of motion) and kinetics were analyzed, and correlations between methods (Rxy) were assessed. Bland-Altman analysis was used to measure agreement. Root-mean-square differences (RMSD) were computed. Acceptable thresholds were set at ≤ 5º for kinematics and at ≤ 10 % of signal amplitude for kinetics. Results: Strong correlations (Rxy≥0.7) were found between the systems for sagittal plane kinematics (except for the pelvis), particularly for knee and ankle joints. A low agreement was detected in sagittal plane hip and pelvis kinematics, along with RMSD exceeding 5º. Weaker correlations and poor agreement were observed for transverse and frontal plane motions. Overall, strong correlations were found for kinetics, except for the joint ankle inversion-eversion moment, and poor agreement for the frontal and transverse planes. Conclusion: Overall, markerless motion capture demonstrated good construct validity for measuring sagittal plane gait lower-limb gait kinematics (excluding pelvis) and kinetics in healthy older adults. However, considering the agreement between methods and the results for the other movement planes, further validation is required before markerless and marker-based systems can be used interchangeably in gait assessments.
- Effects of ankle foot orthoses on the gait patterns in children with spastic bilateral cerebral palsy: a scoping reviewPublication . Ricardo, Diogo; Raposo, Maria; Cruz, Eduardo; Oliveira, Raul; Carnide, Filomena; Veloso, António; João, FilipaBackground: Cerebral palsy (CP) is the most common cause of motor disability in children and can cause severe gait deviations. The sagittal gait patterns classification for children with bilateral CP is an important guideline for the planning of the rehabilitation process. Ankle foot orthoses should improve the biomechanical parameters of pathological gait in the sagittal plane. Methods: A systematic search of the literature was conducted to identify randomized controlled trials (RCT) and controlled clinical trials (CCT) which measured the effect of ankle-foot orthoses (AFO) on the gait of children with spastic bilateral CP, with kinetic, kinematic, and functional outcomes. Five databases (Pubmed, Scopus, ISI Web of SCIENCE, SciELO, and Cochrane Library) were searched before February 2020. The PEDro score was used to assess the methodological quality of the selected studies and alignment with the Cochrane approach was also reviewed. Prospero registration number: CRD42018102670. Results: We included 10 studies considering a total of 285 children with spastic bilateral CP. None of the studies had a PEDro score below 4/10, including five RCTs. We identified five different types of AFO (solid; dynamic; hinged; ground reaction; posterior leaf spring) used across all studies. Only two studies referred to a classification for gait patterns. Across the different outcomes, significant differences were found in walking speed, stride length and cadence, range of motion, ground force reaction and joint moments, as well as functional scores, while wearing AFO. Conclusions: Overall, the use of AFO in children with spastic bilateral CP minimizes the impact of pathological gait, consistently improving some kinematic, kinetic, and spatial-temporal parameters, and making their gait closer to that of typically developing children. Creating a standardized protocol for future studies involving AFO would facilitate the reporting of new scientific data and help clinicians use their clinical reasoning skills to recommend the best AFO for their patients.