Physical Therapy
Presenter(s): Lexi Nehls, Nate Addonizio, Michael Shiraishi, Christopher Hoang
Advisor(s): Dr. Rahul Soangra, Dr. Marybeth Grant-Beuttler
In healthy walkers, the gait cycle begins with a heel strike and ends with the toe leaving the ground on that same foot. Idiopathic toe walking (ITW) is characterized by little to no heel strike during the gait cycle. Studies have found that issues with gait, specifically toe walking, may be neurological as opposed to just being at the level of the foot and ankle (Williams et al., 2013). When testing the gait parameters of normal versus ITW, inertial measurement units (IMU’s) are often used to examine angular velocities and body segment accelerations in order to quantify human movement (Williams et al., 2013). When comparing the IMUs between a healthy walker and an ITW, children with ITW tend to have poorer motor proficiency, poorer balance, standing, and walking (Williams et al., 2013). In healthy walkers, bilateral coordination and gait asymmetry improved at faster walking speeds and deteriorated during slower speeds (Han et al., 2019). Our preliminary observations indicated that ITWs with high gait velocities in combination with longer stride lengths tend to be more stable; however, if both gait parameters are not met then dynamic stability during walking decreases. In this study, we introduce an intervention to ITW using smart shoes embedded with sensors. These shoes use machine learning algorithms to differentiate between toe walking and normal walking - when consecutive toe walk steps are recorded, a vibration is triggered to remind the walker to walk with their heel down. The shoes are intended to supplement treatment by filling in periods when a physical therapist is not available, increasing opportunities for correction of ITW. We want to examine the long term effects of this intervention by using the IMU data to quantify variations in gait parameters. It would be expected that when analyzing the IMUs of idiopathic toe walkers versus normal walkers, gait speed, limb asymmetry, postural sway, energy expenditure, and other gait parameters would be less proficient than of a healthy walker.