Gait is a term used to describe the way an individual walks. Gait performance is used to interpret and indicate whether a person is at high risk of falls. Walk With Path has developed an insole called ‘Path Feel’, which is entirely designed to improve balance in people at risk of falls. Step-synchronised vibration applied to the feet of people with Parkinson's disease has been found to be effective in improving gait patterns. In a proof of concept study, a vibratory insole showed a significantly improved balance. And this is exactly what Path Feel does. It is an insole that provides vibrational feedback to the soles of people at risk of falls. It was designed for people with peripheral neuropathy, who are unable to feel the ground properly due to sensory deficit. It also serves people with general balance issues.
By amplifying the feet’s sense of touch, Path Feel enables users to identify accurately when their feet touch the ground. This reduces the sense of imbalance, as well as incidence of falls.
The White Paper summarized in this article, will detail the definition of the various gait parameters monitored by Path Feel insoles and the Path Insight dashboard. It will also show how each parameter provides insight into the wearer’s balance and fall risk.
Speed, variability, and symmetry, are 3 general parameters providing information about a person’s gait performance during a gait test, allowing its interpretation.
Speed and the indications of slow gait
Speed is the sixth vital medical sign - right after body temperature, respiration rate, blood pressure, and pulse rate. It is an important sign for physicians to identify a slow gait, which can mean reduced physical activity and damaged health. It is usually a warning for complex internal health problems that can lead to reduced survival in older age.
The following table gives typical figures related to gait speed:
Variability and how it is interpreted
To be able to assess a person’s Parkinson’s disease progression, and to predict the risk of falls for elderly patients, it is useful to look at the measure of variation between the duration of the gait cycle of each foot. Low variability is interpreted as “rigidity”, while higher variability can be seen as “instability”. To get a clear interpretation of gait variability, it should be measured when the patient walks freely for a duration of more than 20 cycles.
Symmetry and what it indicates
Gait symmetry indicates the degree of gait control. It is the ratio of swing times comparing how long each foot is in the air. Natural gait is marked by almost symmetric movement patterns of the lower extremities.
Swing time ratio is the most significant parameter to study symmetry of gait, as reduced swing time ratios have been associated with reduced balance in stroke and Parkinson’s patients.
Apart from speed, variability, and symmetry, which are important in assessing gait and determining various factors, there are temporal and spatial gait parameters that can help in the development of solutions to make an individual with risk of falls’ life easier.
These are the parameters that use time as a main indicator of gait. They represent the initial contact and final contact of the foot with the ground. The most used temporal gait parameters are:
- Loading phase
- Foot-flat phase
- Pushing phase
- Cycle time
- Cycle duration
- Double support time
- Stride Velocity
- Maximal Swing Speed
These are the parameters that use space as a main indicator of gait. Spatial parameters reflect the antero-posterior and medio-lateral movements of the feet during walking.The most used spatial gait parameters are:
- Stride Length
- Step length
- Turning Angle
- Strike Angle
- Lift-off Angle
- Swing Width
- 3D Path Length
- Full walking distance
- Base of support
Pressure and other forces acting on the foot
In addition to the above parameters, it is important to measure pressure on a person’s feet and how it is distributed over time. Depending on the individual’s activities, pressure loads across the foot can vary. Compared to people with normal gaits, a person with stumbling gaits has different patterns of plantar pressures. This distribution of pressure can indicate foot deformities, thus leading us to identify risk of falls.
- Peak pressure
- Horizontal shear
- Centre of Pressure (COP)
- Rotational force (Torque)
- Ground reaction force (GRF)
- Postural sway
Download the general gait parameters white paper
Path Feel insoles measure parameters that lead to fall risk in elderly patients. By providing insight on gait, it plays a large role in the prevention and decrease of falls.
Complete the form below to download the General Gait Parameters white paper.