Gait

The locomotor pattern, generated by the central pattern generator, is under the dependence of descending and peripheral pathways. The afferent feedback from peripheral receptors allows the animal to correct for disturbances that occur during walking, while supraspinal structures are important for locomotion in demanding situations such as ladder walking. Such walking, by regards to the control needed for accuracy of movements, is now widely used for description of consequences of nervous system dysfunction on motor performance. It is important to have a good knowledge of the changes in kinematic parameters according to walking conditions, since it might reflect different neural mechanisms. The aim of this work was to perform a 3D kinematic analysis of both hind-and forelimb during overground and ladder walking, to study qualitative and quantitative locomotor characteristics in different modes of locomotion. The analysis was performed on 5 rats. Movements of the right hind-and forelimb were evaluated using a 3D optical analyser, and EMG of the soleus and tibialis anterior muscles was synchronously recorded. Results indicate that kinematic and electromyographic characteristics of locomotion are dependent on the type of support. Changes were more obvious for hindlimb than for forelimb. Velocity, stride length and tibialis anterior burst duration were lower on ladder than on runway. In addition, during ladder walking, a protraction was noticed, rats bring their feet more rostral at the end of the swing phase. All these changes constitute an adaptive strategy to allow a better tactile activity with forelimbs and to avoid foot misplacement.

The metacarpophalangeal (MCP) joint and its supporting soft tissues are common sites of injury in athletic horses. Equine gait analysis has focused on 2D analysis in the sagittal plane and little information is available which describes 3D motions of the MCP joint and their possible role in the development of injuries. The aim was to characterize the 3D rotations of the equine MCP joint during walking and trotting. Three-dimensional trajectories of marker triads fixed rigidly to the third metacarpus and proximal phalanx of the right forelimb of healthy horses were recorded at walk (n = 4) and trot (n = 6) at 120 Hz using eight infra-red cameras. Kinematics of the MCP joint were calculated in terms of helical angles between the two segments using singular-value decomposition and spatial attitude methods. The ranges of motion were: flexion/extension: 62 +/- 7 degrees at walk, 77 +/- 5 degrees at trot; adduction/abduction: 13 +/- 7 degrees at walk, 18 +/- 7 degrees at trot; and axial r...

Control of the head during locomotion has been suggested as a means of facilitating overall postural control of the body. The control of online steering is challenging, as it requires the central nervous system (CNS) to simultaneously control body reorientation in a new direction while modifying the ongoing step cycle. Stable body posture during steering is maintained via appropriately organized postural responses to error signals detected by the visual, vestibular, and/or proprioceptive systems. Modifications to the gait cycle include stepwidth regulation and movement of body center of mass (COM) in the direction of travel, and may be preceded by independent control of head orientation to see where one is going. The purpose of this investigation was to examine how the ability to successfully steer is influenced by unexpected head perturbations and how various body segments are coordinated and controlled to successfully steer along different pathways. Body kinematics were monitored as participants changed their direction of travel by varying amounts when visually cued one stride before the turn. Perturbations to the head were applied to either assist or oppose the change in direction one step prior to initiation of the turn. Analyses focused on the timing of the changes in head yaw, trunk yaw, and COM trajectories in the mediolateral plane. Results indicate that the order of control over the body segments was head and trunk reorientation in the direction of travel and finally movement of the COM in the intended direction. Thus gaze, inferred from head movement, preceded changes in COM trajectory. This suggests that looking where you are going is critical for steering. When steering is potentially compromised by unexpected head movements, the CNS delays committing movement of the COM until it has a chance to look at the new travel path.

This study was performed to test the hypothesis that reducing the horizontal distance between the trailing foot (foot crossing the obstacle last) and obstacle, during stance just prior to stepping over the obstacle, would reduce flexion of the hip, knee, and ankle joints of the trailing limb when the toe is over the obstacle to reduce the vertical toe-obstacle clearance and increase the risk of tripping. Fourteen healthy young adults stepped over an obstacle of 51, 102, 153, and 204 mm height in a self-selected manner (i.e., toe-obstacle distance was not controlled) and for toe-obstacle distance targets of 10, 20, 30, and 40% of their step lengths measured during unobstructed gait. The reductions in toe-obstacle distance resulted in linear decreases in flexion of the hip, knee, and ankle when the toe was over the obstacle. Toe-obstacle clearance of the trailing limb decreased significantly as toe-obstacle distance decreased. The reductions in toe-obstacle distance led to contact of the trailing (but not the leading) foot with the obstacle, the closer the obstacle the greater the number of contacts. The reductions also resulted in linear decreases in swing time of the trailing limb from toe-off to when the toe was over the obstacle. The height of the hip was not affected by toe-obstacle distance. Angular velocity of knee flexion was found to increase linearly as toe-obstacle distance decreased and appears to be of primary importance in avoiding obstacle contact.

We studied the familiarisation time required for reliable sagittal-plane knee kinematics and temporal-distance gait measurements to be obtained from treadmill walking. We also studied whether knee kinematics and temporal-distance gait measurements obtained from familiarised treadmill walking can be generalised to overground walking. Sixteen subjects without pathology walked on a level overground walkway and on a treadmill. A motion measurement system was used to measure sagittal plane knee movements and temporal-distance gait parameters during overground and treadmill walking. Highly reliable knee kinematics and temporal-distance gait measurements [intraclass correlation coefficient (ICC)(2,1) ] 0.93] were found after 6 min of treadmill walking. These measurements, obtained after 6 min of treadmill walking, were highly correlated with and not significantly different to those of overground walking. Reliable measurements that can be generalised to overground walking, can be obtained from the treadmill within a familiarisation time of 6 min.

Different head-and-neck positions (HNPs) are discussed in relation to potential welfare issues. To evaluate the effect on welfare, seven Royal Dutch Sport horses were studied in five predetermined HNPs: (1) unrestrained (HNP1); (2) neck raised, bridge of nose around the vertical (HNP2); (3) neck lowered and considerably flexed, bridge of nose pointing towards the chest (HNP4); (4) neck raised and extended, bridge of nose in front of the vertical (HNP5), and (5) neck lowered and flexed, bridge of nose pointing towards the carpus (HNP7). A standardised exercise test (SET) of 34 min consisted of trot, canter and walk. Behaviour was recorded with a pre-defined ethogram and R-R intervals measured using telemetry. Cortisol concentrations were taken at the start, 5 and 30 min after the SET. Behaviour around the SET was scored separately. Conflict behaviours increased significantly during HNP2 when compared with HNP1, HNP4 and HNP7 during the SET, and there was significant negative anticipa...

Prosthetic manufacturers have marketed shockabsorbing pylons (SAPs) for attenuation of injurious loads from foot-ground contact. In this study, we compared a commonly prescribed SAP with a conventional rigid pylon, using a withinsubject design (n = 15 unilateral transtibial amputees), to assess effect on gait mechanics, measure transmitted accelerations in situ, and determine functional outcomes using step counts and questionnaires. No differences were found across pylons for self-selected walking speed, prosthetic-side step length, prosthetic-side loading rate and decelerative peak of the vertical ground reaction force, peak pylon acceleration, step count per week, or questionnaire results that examined pylon performance and subjects' pain and fatigue levels. The only statistically significant finding was for the prosthetic-side knee angle at initial contact, where subjects displayed an average of 2.6 degrees more flexion with the rigid pylon than the SAP while walking at a controlled speed (p = 0.004); this result indicates that transtibial amputees are able to modulate the effective stiffness of their residual limb in response to changes in prosthetic component stiffness. The results from the laboratory, field, and subjective outcome measurements suggest that the SAP in this study is as effective as a rigid pylon for unilateral transtibial amputees.

Previous studies examining the influence of gait analysis on surgical decision-making have been limited by the lack of a control group. The aim of this study was to use data from a randomized controlled trial to determine the effects of gait analysis on surgical decision-making in children with cerebral palsy (CP). 178 ambulatory children with CP (110 male; age 10.3±3.8

During diving, marine mammals must rely on the efficient utilization of a limited oxygen reserve sequestered in the lungs, blood and muscles. To determine the effects of exercise and apnea on the use of these reserves, we examined the physiological responses of adult bottlenose dolphins (Tursiops truncatus) trained to breath-hold on the water surface or to dive to submerged targets at depths between 60 and 210 m. Changes in blood lactate levels, in partial pressures of oxygen and carbon dioxide and in heart rate were assessed while the dolphins performed sedentary breath-holds. The effects of exercise on breath-hold capacity were examined by measuring heart rate and post-dive respiration rate and blood lactate concentration for dolphins diving in Kaneohe Bay, Oahu, Hawaii. Ascent and descent rates, stroke frequency and swimming patterns were monitored during the dives. The results showed that lactate concentration was 1.1+/-0.1 mmol l(-1) at rest and increased non-linearly with the ...

This longitudinal study investigated the long-term effect of different treadmill interventions on the development of gait patterns in infants with Down syndrome (DS). Thirty infants with DS (mean age 10.0 months, S.D. 1.9 months) were randomly assigned to either a ''low intensity-generalized'' (LG) training group, or a ''high intensity-individualized'' (HI) training group. Treadmill intervention was conducted in infants' homes until they walked three steps independently. Twenty-five participants completed a 1-year gait follow-up after the treadmill intervention. Six basic gait parameters were examined: normalized velocity, cadence, step length, step width, double support percentage, and dynamic base. Principal component analysis (PCA) conducted for the set of the six basic gait parameters demonstrated that the first principal component (PC1) accounted for 83.8% of the variance. A two-way ANOVA with repeated measures conducted with PC1 scores revealed a significant visit effect and group difference; both groups significantly increased PC1 scores over time, and the HI group produced significantly higher PC1 scores than the LG group. Specifically, the HI group produced significantly higher normalized velocity and cadence, and lower double support percentage than the LG group. In addition, both groups significantly reduced foot rotation asymmetry over time although no difference was found between the two groups. We concluded that the HI treadmill intervention provided a better long-term effect on the development of basic gait parameters than the LG training, and the reduction of foot rotation asymmetry over time was not differentially affected by the different training protocols. #

We tested the hypothesis that vibratory thresholds in the elderly are related to mobility. In all, 629 older persons without dementia underwent testing including 11 lower extremity performance measures and modified United Parkinson's Disease Rating Scale (UPDRS), summarized as composite mobility and global parkinsonian signs. Vibratory thresholds were measured at the ankle and toes bilaterally using the graduated Rydel–Seiffer tuning fork. In linear regression models adjusted for age, sex, and education, vibratory threshold was associated with composite mobility (estimate, 0.047, SE = 0.011, P < 0.001) and global parkinsonian signs score (estimate, −0.252, SE = 0.126, P = 0.047). These findings were primarily due to the association of vibratory threshold with gait and balance components of composite mobility and parkinsonian gait. These results were unchanged when we controlled for body mass index, physical activity, cognition, depression, vascular risk factors, vascular disease burden, joint pain, and falls. Vibratory thresholds are associated with mobility, supporting the link between peripheral sensory nerve function and mobility in the elderly. Muscle Nerve, 2009

Study Design: Case series describing the outcomes of individual patients with hip osteoarthritis treated with manual physical therapy and exercise. Case Description: Seven patients referred to physical therapy with hip osteoarthritis and/or hip pain were included in this case series. All patients were treated with manual physical therapy followed by exercises to maximize strength and range of motion. Six of 7 patients completed a Harris Hip Score at initial examination and discharge from physical therapy, and 1 patient completed a Global Rating of Change Scale at discharge. Outcomes: Three males and 4 females with a median age of 62 years (range, 52-80 years) and median duration of symptoms of 9 months (range, 2-60 months) participated in this case series. The median number of physical therapy sessions attended was 5 (range, 4-12). The median increase in total passive range of motion of the hip was 82°(range, 70°-86°). The median improvement on the Harris Hip Score was 25 points (range, 15-38 points). The single patient who completed the Global Rating of Change Scale at discharge reported being ''a great deal better.'' Numeric pain rating scores decreased by a mean of 5 points (range, 2-7 points) on 0-to-10-point scale. Discussion: All patients exhibited reductions in pain and increases in passive range of motion, as well as a clinically meaningful improvement in function. Although we cannot infer a cause and effect relationship from a case series, the outcomes with these patients are similar to others reported in the literature that have demonstrated superior clinical outcomes associated with manual physical therapy and exercise for hip osteoarthritis compared to exercise alone.

We present a nonlinear dynamical model of the human gait control system in a variety of gait regimes. The stride-interval time series in normal human gait is characterized by slightly multifractal fluctuations. The fractal nature of the fluctuations becomes more pronounced under both an increase and decrease in the average gait. Moreover, the long-range memory in these fluctuations is lost when the gait is keyed on a metronome. Human locomotion is controlled by a network of neurons capable of producing a correlated syncopated output. The central nervous system is coupled to the motocontrol system, and together they control the locomotion of the gait cycle itself. The metronomic gait is simulated by a forced nonlinear oscillator with a periodic external force associated with the conscious act of walking in a particular way.

Horseback riding is the most fundamental use of domestic horses and has had a huge influence on the development of human societies for millennia. Over time, riding techniques and the style of riding improved. Therefore, horses with the ability to perform comfortable gaits (e.g. ambling or pacing), so-called &#39;gaited&#39; horses, have been highly valued by humans, especially for long distance travel. Recently, the causative mutation for gaitedness in horses has been linked to a substitution causing a premature stop codon in the DMRT3 gene (DMRT3_Ser301STOP) [1]. In mice, Dmrt3 is expressed in spinal cord interneurons and plays an important role in the development of limb movement coordination [1]. Genotyping the position in 4396 modern horses from 141 breeds revealed that nowadays the mutated allele is distributed worldwide with an especially high frequency in gaited horses and breeds used for harness racing [2]. Here, we examine historic horse remains for the DMRT3 SNP, tracking ...

Restoring mobility and rehabilitation of gait are high priorities for post-stroke rehabilitation. Cueing using metronomic rhythmic sensory stimulation has been shown to improve gait, but most versions of this approach have used auditory and visual cues. In contrast, we developed a prototype wearable system for rhythmic cueing based on haptics, which was shown to be highly effective in an early pilot study. In this paper we describe a follow-up study with four stroke survivors to inform design, and to identify issues and requirements for such devices to be used in home-based or outdoor settings. To this end, we present a blended user-centred design study of a wearable haptic gait rehabilitation system. This study draws on the combined views of physiotherapists, nurses, interaction designers and stroke survivors. Many of the findings were unanticipated, identifying issues outside the scope of initial designs, with important implications for future design and appropriate use.

Older subjects after hip fracture walk more slowly than age-matched peers. The extent to which they walk more slowly is difficult to define because the standard error of the measure (SEM), sensitivity to change, and clinically important change have not been reported for gait speed. The purposes of this study were to quantify the SEM for habitual and fast gait speeds among older subjects after hip fracture, to define the minimal detectable change (MDC), and to estimate the minimal clinically important difference (MCID) for habitual gait speed. A sample of 92 subjects after hip fracture was drawn from 3 studies that collected gait speed data. An estimate of the MDC was determined by use of the SEM. The MCID was determined from expert opinion and from a receiver operating characteristic (ROC) curve. The SEM and the MDC were 0.08 m/s and 0.10 m/s for habitual speed and fast speed, respectively. Both methods of MCID estimation identified 0.10 m/s as a meaningful change in habitual gait s...

Changes in stride frequency and length with speed are key parameters in animal locomotion research. They are commonly measured in a laboratory on a treadmill or by filming trained captive animals. Here, we show that a clustering approach can be used to extract these variables from data collected by a tracking collar containing a GPS module and tri-axis accelerometers and gyroscopes. The method enables stride parameters to be measured during free-ranging locomotion in natural habitats. As it does not require labelled data, it is particularly suitable for use with difficult to observe animals. The method was tested on large data sets collected from collars on free-ranging lions and African wild dogs and validated using a domestic dog.

Mature locomotion in humans is characterized by an anti-phase coordination (moving in opposite directions) between the pelvic and the scapular girdles. This pattern involves a specific relationship between the arm and leg motion is deemed to be most flexible and dynamically efficient. Still, when the arms are involved in another task, like a field player running with a ball in the hands, locomotion is still possible. In order to probe the flexibility of the locomotor synergy, the present study aimed to determine the persistence and the strength of the coordination patterns between the pelvic and scapular girdles when no arm swing was allowed during walking and running. Relative phase, the time difference between the girdle rotations, measured the ongoing inter-girdle coordination of eight healthy participants asked to walk and run with or without arm swing. Results showed that an absence of arm swing led to a change from an anti-phase to in-phase pattern (girdles moving in the same direction) and that an increase in velocity strengthened the adopted pattern. Moreover, the frequency distribution of relative phase for all gait patterns with arm swing proved to be bimodal, indicating that the prevailing anti-phase pattern was always mixed with a noticeable proportion of in-phase coordination. The presence of the in-phase pattern in the easy, natural locomotion with arm swing manifests its persistence and its stability, perhaps pertaining to its prevalence in earlier times in ontogeny or evolution.

With age, loss of skeletal muscle mass (sarcopenia) results in decreased muscle strength and power. Decreased strength and power, in turn, are closely linked with declines in physical function. Preferred walking speed, a marker of physical function, is slower in older adults compared to young adults. Research suggests that older adults may walk slower as a consequence of decreased plantarflexor power at pushoff. In this study, we hypothesized that providing additional plantarflexion (PF) power during push-off would (1) increase preferred walking speed, and (2) reduce metabolic cost of transport (MCOT), in young and older adults. PF power was augmented using powered ankle-foot orthoses (PAFOs). The PAFOs, which use pneumatic actuators to provide an additional PF moment, were based on a design by Ferris et al. [Ferris DP, Czerniecki JM, Hannaford B. An ankle-foot orthosis powered by artificial pneumatic muscles. J Appl Biomech 2005;21:189-97.].

We measured the forces produced at the cat's hindpaw by microstimulation of the lumbar spinal cord and the movements resulting from those forces. We also measured the forces and movements produced by co-and sequential activation of two intraspinal sites. Isometric force responses were measured at nine limb configurations with the paw attached to a force transducer. The active forces elicited at different limb configurations were summarized as patterns representing the sagittal plane component of the forces produced at the paw throughout the workspace. The force patterns divided into the same distinct types found with the femur fixed. The responses during simultaneous activation of two spinal sites always resembled the response for activation of one of the two sites, i.e., winner-take-all, and we did not observe vectorial summation of the forces produced by activation of each site individually as reported in chronic spinal animals. The movements produced by activation of each of the sites were consistent with the force orientations, and different movements could be created by varying the sequence of activation of individual sites. Our results highlight the absence of a vectorial summation phenomenon during intraspinal microstimulation in decerebrate animals, and the preservation during movement of the orientation of isometric forces.

Hypotonia, ligament laxity and motor alterations are characteristic for patients with Down syndrome (DS). The purpose of this study was the evaluation of typical gait pattern of subjects with Down syndrome and the quantification of their joint stiffness, connected with ligament laxity and hypotonia, as a possible compensation. 98 children with DS (mean age: 11.7 years; range: 6-15 years) and 30 healthy children (control group (CG); mean age: 11 years; range: 5-13 years) underwent full 3D gait analysis at self-selected speed.

Fifty patients with spastic diplegic cerebral palsy were included in this retrospective study which compared visual assessment of gait to three-dimensional (3D) gait analysis. Inter-observer variability was evaluated as well. Inclusion criteria comprehended independent ambulation (i.e. without assistive devices or orthoses). All subjects went through 3D gait analysis at the Gait Analysis Laboratory of the AACD Hospital. Four observers, viewing videotaped gait cycles, evaluated 10 specific points of interest of the cycle: hip flexion at terminal stance; knee flexion at initial contact; knee extension at terminal stance; knee flexion at initial swing; ankle dorsiflexion at initial contact; pelvic obliquity at mid stance; hip adduction at loading response; pelvic rotation; hip rotation at mid stance and foot progression angle, in relation to the lower limb, at mid stance. Their evaluation was then compared to the 3D kinematics data. A statistical analysis of the results was performed using kappa and McNemar's test in order to determine inter-observer and visual/3D analysis agreement. Results showed that inter-observer agreement was high but on the other hand, only two points of the gait cycle (knee flexion at initial contact and pelvic obliquity) were shown to have been similarly evaluated visually and with the 3D analysis. In conclusion, this study indicates that only knee flexion at initial contact and pelvic obliquity appear to be reliably evaluated on a visual basis alone. Visual observation is therefore inadequate for the evaluation of the other eight selected points of the gait cycle which require some form of quantitative assessment. #

A prosthetic foot is a key element of a prosthetic leg, literally forming the basis for a stable and efficient amputee gait. We determined the roll-over characteristics of a broad range of prosthetic feet and examined the effect of a variety of shoes on these characteristics. The body weight of a person acting on a prosthetic foot during roll-over was emulated by means of an inverted pendulum-like apparatus. Parameters measured were the effective radius of curvature, the forward travel of the center of pressure, and the instantaneous radius of curvature of the prosthetic feet. Finally, we discuss how these parameters relate to amputee gait.

The primary purpose of this study was to investigate the effects of cognitive loading on movement kinematics and trajectory formation during goal-directed walking in a virtual reality (VR) environment. The secondary objective was to measure how participants corrected their trajectories for perturbed feedback and how participants' awareness of such perturbations changed under cognitive loading. We asked 14 healthy young adults to walk towards four different target locations in a VR environment while their movements were tracked and played back in real-time on a large projection screen. In 75% of all trials we introduced angular deviations of 65u to 630u between the veridical walking trajectory and the visual feedback. Participants performed a second experimental block under cognitive load (serial-7 subtraction, counterbalanced across participants). We measured walking kinematics (joint-angles, velocity profiles) and motor performance (end-point-compensation, trajectory-deviations). Motor awareness was determined by asking participants to rate the veracity of the feedback after every trial. In-line with previous findings in natural settings, participants displayed stereotypical walking trajectories in a VR environment. Our results extend these findings as they demonstrate that taxing cognitive resources did not affect trajectory formation and deviations although it interfered with the participants' movement kinematics, in particular walking velocity. Additionally, we report that motor awareness was selectively impaired by the secondary task in trials with high perceptual uncertainty. Compared with data on eye and arm movements our findings lend support to the hypothesis that the central nervous system (CNS) uses common mechanisms to govern goaldirected movements, including locomotion. We discuss our results with respect to the use of VR methods in gait control and rehabilitation.

Virtual reality (VR) can induce postural instability in standing and walking, as quantified with kinematic parameters. This study examines the effect of a VR environment on kinetic gait parameters. Ten healthy volunteers walked on an instrumented treadmill in a VR environment and a non-VR environment. In the VR environment, a corridor with colored vertical stripes comprising the walls was projected onto a concave screen placed in front of the treadmill. The speed of the moving image was perceptually equivalent to the speed of the treadmill, creating an illusion that subjects walked through the corridor. Vertical ground reaction forces were sampled. Kinetic parameters that reflect gait stability (weight acceptance peak force, weight acceptance rate, push-off peak force and push-off rate) were compared between the VR and non-VR environments. Subjects walked in the VR environment with increased magnitudes and rates of weight acceptance force and with increased rates of push-off force. Variability in weight acceptance rates and peak forces, and variability in push-off peak forces, were also increased in the VR environment. The gait deviations reflect a compensatory response to visual stimulation that occurs in the VR environment, suggesting that walking in a VR environment may induce gait instability in healthy subjects.

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Objective. The study aims to create a diagnostic support tool to indicate the likelihood of the presence of lumbar spinal stenosis (LSS) using a cluster of elements from the patient history and observational fi ndings. Design. The study is case based and case controlled. Setting. The study was performed in the tertiary care of a medical center. Subjects. There were a total of 1,448 patients who presented with a primary complaint of back pain with or without leg pain. Methods. All patients underwent a standardized clinical examination. The diagnosis of LSS was made by one of two experienced orthopaedic surgeons based on clinical fi ndings and imaging. Data from the patient history and observational fi ndings were then statistically analysed using bivariate analysis and contingency tables. Results. The most diagnostic combination included a cluster of: 1) bilateral symptoms; 2) leg pain more than back pain; 3) pain during walking/standing; 4) pain relief upon sitting; and 5) age >48 years. Failure to meet the condition of any one of fi ve positive examination fi ndings demonstrated a high sensitivity of 0.96 (95% CI = 0.94-0.97) and a low negative likelihood ratio (LR−) of 0.19 (95% CI = 0.12-0.29). Meeting the condition of four of fi ve examination fi ndings yielded a LR+ of 4.6 (95% CI = 2.4-8.9) and a post-test probability of 76%. Conclusion. The high sensitivity of the diagnostic support tool provides the potential to reduce the incidence of unnecessary imaging when the diagnosis of LSS is statistically unlikely. In patients where the condition of four of the fi ve fi ndings was present, the post-test probability of 76% suggests that imaging and further workup are indicated. This is an inexpensive but powerful tool, with a potential to increase diagnostic effi ciency and reduce cost by narrowing the indications for imaging.

Celastrus paniculatus Wild. (Celasteraceae) (CP) is a well-known Ayurvedic &#39;Medhya Rasayana&#39; (nervine tonic), used extensively as a neuro-protective and memory enhancer, and in different central nervous system disorders. To evaluate the effect of CP against 3-nitropropionic acid (3-NP) induced Huntington&#39;s disease (HD) like symptoms in Wistar male rats. The ethanol extract of CP seeds (CPEE), prepared by maceration, was standardized on the basis of linoleic acid content (6.42%) using thin layer chromatography densitometric analysis. Protective effect of CPEE (100 and 200 mg/kg) and its various fractions, viz., petroleum ether (40 mg/kg), ethyl acetate (2.5 mg/kg), n-butanol (7 mg/kg) and aqueous (18 mg/kg), administered orally for 20 days, against 3-NP (10 mg/kg, i.p. for 14 days) was assessed by their effect on body weight, locomotor activity, grip strength, gait pattern and cognitive dysfunction and biochemical parameters for oxidative damage in the striatum and cortex...

Obturator nerve injury in obstetrics/gynecology and gynecologic oncology is thought to be infrequent. The reported consequences of this injury vary in severity and management options have not been well described. The functional anatomy, dual adductor muscle innervation, and inconstant accessory obturator nerve presence help explain variable outcome following neurotmesis. Intraoperative management centers around epineurial repair with surgical loupe magnification, With the assistance of postoperative physiotherapy this approach leads to satisfactory results.

Durable fixation of the components was a major concern in all of the total ankle designs (about 20) that were introduced during the 1970s and 1980s. This brought the method into disrepute and it was questioned whether the ankle joint could be replaced at all . During the last decade, however the interest in ankle replacement has been renewed and a few new designs seem to show promising results in inflammatory arthritis and in degenerative and posttraumatic osteoarthrosis . Although initial attempts at total ankle replacement largely failed, interest has recently renewed in the procedure. The main stimuli may derive from partial dissatisfaction with ankle arthrodesis and the success of total hip and knee arthroplasty [6 -8].

The aims of the present study were to quantify the impairment in ankle coactivation on the paretic and non-paretic sides of subjects with hemiparesis and to examine the relationship of ankle coactivation with postural instability, motor deficit of the paretic lower extremity and locomotor performance. Electromyography of the medial gastrocnemius (MG) and tibialis anterior (TA) muscles were recorded bilaterally during gait in 30 subjects (62.1±9.9 years) who had suffered a recent stroke (Ͻ6 months) as well as on one side of 17 healthy controls (59.3±9.1 years) walking at very slow speed. Ankle muscle coactivation was calculated by dividing the time of overlap between MG and TA signals (threshold of 20 µV) by the duration of the gait phases of interest: stance, swing, first and second double support sub-phases and single support sub-phase. The time spent in single support and the peak plantarflexor moment of force on the paretic side were used to measure, respectively, postural stability and dynamic strength of the paretic plantarflexors. The subjects with hemiparesis demonstrated less coactivation on the paretic side during the single support sub-phase (pϽ0.01) and more coactivation during first and second double support sub-phases on the non-paretic side (pϽ0.001) compared to control values. The patients with coactivation patterns that differed the most from controls were the patients with the more severe impairments and disabilities. While the reduced coactivation on the paretic side may contribute to poor postural stability and poor locomotor performance, the presence of excessive coactivation on the non-paretic side when both limbs were in ground contact may be an adaptation to help maintain postural stability during gait.