Motion analysis for the evaluation of dynamic spasticity during walking: A systematic scoping review

Background: Three-dimensional (3D) gait analysis has the potential to assess dynamic spasticity (DS). However, little is known about which parameters can be utilized for assessment.

Objective: To evaluate the application of 3D gait analysis in assessing DS during walking and to identify the most relevant parameters for clinical practice.

Methods: A systematic scoping review was conducted by a multidisciplinary team of researchers and clinicians. A literature search of the PubMed, Web of Science and Cochrane Library databases was conducted using the following inclusion criteria: (i) clinical trial study; (ii) focused on the relationship between spasticity and gait analysis indicators during walking. The risk of bias was assessed using the Mixed Methods Appraisal Tool. Data were analyzed using content analysis and quantification techniques.

Results: Four key parameters in 3D gait analysis-spatiotemporal parameters, kinematics, kinetics, and myoelectric signals-are utilized to evaluate alterations in DS during walking. Among the spatiotemporal parameters, the most frequently used metrics are speed, stride length, and cadence. In kinematics, the ankle and knee joint angles are the most commonly measured indicators. For kinetics, the ankle joint moment and plantar pressure are the primary focus. For myoelectric signals, the most utilized metrics include the patterns and duration of muscle co-contraction.

Conclusions: 3D gait analysis is feasible for precisely evaluating DS during walking. However, to obtain a comprehensive evaluation, it is essential to integrate multiple metrics. High-quality research is urgently needed to provide more precise assessment protocols by analyzing changes in gait parameters before and after spasticity interventions.