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Neurorehabilitation and Neural Repair
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Reliability and Validity of Bilateral Thigh and Foot Accelerometry Measures of Walking in Healthy and Hemiparetic Subjects

Kaveh Saremi, MD

Neurologic Rehabilitation and Research Program, Department of Neurology, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA

Jon Marehbian

Neurologic Rehabilitation and Research Program, Department of Neurology, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA

Xiaohong Yan

Department of Bio-mathematics, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA

Jean-Philippe Regnaux, PhD

Department of Rehabilitation, Hopital Raymond Poincare, Garches, France

Robert Elashoff, PhD

Department of Biomathematics, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA

Bernard Bussel, MD

Department of Rehabilitation, Hopital Raymond Poincare, Garches, France

Bruce H. Dobkin, MD

Neurologic Rehabilitation and Research Program, Department of Neurology, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, bdobkin{at}mednet.ucla.edu

Objective. Measures of walking ability in large clinical trials are usually limited to a timed short-distance walk and the distance walked in a fixed time. A new integrated system of 5 accelerometers was tested for reliability and compared to a footswitch system to determine if the accelerometers offered a practical option for the acquisition of spatiotemporal gait parameters. Methods. Leg accelerations and decelerations were defined in relation to simultaneous kinematic and electromyographic data acquired from a healthy subject. Eight healthy adults and 6 independent ambulators with hemiparetic stroke walked 15 m at 2 different speeds wearing both the accelerometers and footswitches. Twelve healthy subjects walked at 5 different speeds repeated 3 times on each of 2 days wearing the accelerometers. Walking speed, cadence, stride length, and single- and double-limb support, swing, and stance times were calculated. Results. No differences (t test, P > 0.2) were found between footswitch and accelerometer variables when comparing all left or right legs in healthy subjects and all paretic or unaffected legs in stroke subjects. A 2-way nested ANOVA model (speed, left and right legs, trial, and session) with the accelerometers at walking speeds from 0.5 to 1.8 m/s revealed high reproducibility of all measures. Conclusions. The accelerometry system provided reliable and valid spatiotemporal measures of gait for the upper range of speeds likely to be targeted for rehabilitation interventions in ambulatory subjects.

Key Words: Gait analysis • Accelerometry • Stroke rehabilitation • Locomotion • Walking

Neurorehabilitation and Neural Repair, Vol. 20, No. 2, 297-305 (2006)
DOI: 10.1177/1545968306287171


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