Rotational deformities are common lower extremity abnormalities in children. Rotational problems include in-toeing and out-toeing. In-toeing is caused by one of the three types of deformity: metatarsus adductus, internal tibial torsion, and increased femoral anteversion. Out-toeing is less common than intoeing, and its causes are similar but opposite to those of intoeing. These include femoral retroversion and external tibial torsion. An accurate diagnosis can be made with careful history and physical examination, which includes torsional profile (a four- component composite of measurements of the lower extremities). Charts of normal values and values with two standard deviations for each component of the torsional profile are available. In most cases, the abnormality improves with time. A careful physical examination, explanation of the natural history, and serial measurements are usually reassuring to the parents. Treatment is usually conservative. Special shoes, cast, or braces are rarely beneficial and have no proven efficacy. Surgery is reserved for older children with deformity from three to four standard deviations from the normal.

Objective This study aimed to design a “ Gait enhancer” and investigate its effect on standing ability and Gait speed of children with cerebral palsy spastic diplegia. Materials & Methods A new gate trainer was designed based on Theo Johnson mechanism. Johnson's two separate movement chains were placed on either side of the gate trainer body and attached to the lower limbs by a foot plate. To investigate the effect of the designed device, a single-item experimental study with baseline design, treatment and maintenance (ABA) was performed on four children with available spastic diplegia cerebral palsy. These children received routine occupational therapy sessions. Results The designed “ Gait enhancer” increased standing ability and Gait speed scores in all subjects. Non-overlapping measures also indicated the improvement in both variables. Measured by Cohen’ s d, the effect size for standing ability were 1. 95, 2. 29, 1. 83, and 2. 3 for the child No. 1, 2, 3, and 4, respectively. Regarding walking speed, the effect size for these children, No. 1 to 4, were 1. 13, 3. 37, 2. 15, and 2. 21, respectively. Cohen’ s d values were greater than 0. 8, indicating the considerable effect of the intervention. Hedges’ g was also calculated due to the small sample size, which was greater than 0. 8 for all subjects in standing ability and Gait speed. Conclusion Following the use of Gait Enhancer along with conventional occupational therapy, we observed an increase in the ability to stand and walk at children with cerebral palsy. Findings showed that the change in standing ability and walking speed occurred more during the period of using the designed device than other stages, which could be a consequence of using Gait Enhancer along with routine occupational therapy sessions at this stage of the study. However, it should be noted that this study was only a single case study and to prove the effectiveness of this tool in children with cerebral palsy, it is necessary to conduct clinical trial studies.

Parkinson's disease (PD) is a neurological disorder that mainly affects dopamineproducing neurons and motor system. The most obvious symptoms of PD are tremor, slow movement, stiffness and difficulty with walking. Walking in PD is slower than normal walking. In this paper, the Gait in patients with PD is modeled by a mathematical and computational method. This model includes structures which are involved in PD, such as basal ganglia, thalamus, cortex, supplementary motor area (SMA), muscle and joint-load dynamics. The output of the model is walking speed in PD. The output value is 0. 83 m/s, which is in the range reported by clinical results (0. 18-1. 21 m/s). Some methods which increase the Gait speed in PD are investigated too. These methods include deep brain stimulation, drug prescription and strengthening the muscles. The results show that each of these methods will improve the Gait speed, in fact, by using these methods, the value of output increases and approaches the walking speed range in healthy individuals (1. 36-1. 30 m/s). Moreover, the effect of rigidity on Gait speed is studied; it has been observed that the stiffness and speed of the Gait are inversely related. Finally a control method is offered which improve the Gait speed by increasing the magnitude response of the closed-loop system.

Background: Deficits in upper body movement have received little attention during Gait in cerebral palsy (CP) children with crouch Gait pattern (CGP). Objective: Purpose of this research is to describe the correlation of trunk movement with the excessive knee flexion and ankle kinematic in CP children with CGP. Material and Methods: Gait analysis data from 57 limbs of diplegic CP children with CGP and 26 limbs of normal children was gathered. Kinematic parameters of trunk in relation to the pelvis were extracted in the sagittal, transverse and coronal planes. CP limbs were clustered using K-means cluster analysis according to the knee flexion angle at initial contact and the mean position of ankle joint during the stance phase of Gait cycle, to three clusters. Pearson correlation coefficient between knee, ankle and trunk kinematic variables was assessed. Differences between clusters were analyzed with Kruskal– Wallis and post hoc tests. Results: The results revealed: 1) crouch clusters had more trunk obliquity and rotation mean position than normal; 2) the range of motions of the trunk obliquity and rotation exhibited significant differences between crouch and normal clusters; 3) the level of excessive knee flexion had positive correlation with the trunk mean position in all planes; 4) the ankle kinematic at stance phase was associated with the trunk mean position in all planes. Conclusion: The results revealed the trunk mean position is correlated with the excessive knee flexion severity and ankle joint kinematic in CP children with CGP.