www.ntu.edu.sg

School of Chemical and Biomedical Engineering

Investigation Of Gait Characteristics In The Elderly Population

In Singapore For Diagnosis Of Sarcopenia And Related

Observations In Knee MRI

Supervisor: Asst. Professor POH CHUEH LOO

Co-Supervisor: Dr. BARRY P PEREIRA (National University of Singapore)

Research Associate: SUBHASIS BANERJI (National University of Singapore) Student: SINGH GAUTAM

Sarcopenia is defined as the loss of muscle mass, strength and function with

age. It is characterized by a lower skeletal muscle quantity, higher fat

accumulation in the muscle, lower muscle strength, and lower physical

performance.

Problems

•Disability, Injuries

•Risk of Falls (Frailty)

•Lack of appropriate metrics to measure frailty markers to identify the onset of

sarcopenia

To investigate gait characteristic parameters using motion analysis for the

diagnosis of sarcopenia and related muscle changes seen in MRI images of

the Knee.

To investigate various frailty markers such as grip strength, kinematics and

muscle volume that can identify ‘First Clinical Signatures of Frailty’ in elderly

population by analyzing their clinical measures and gait parameters along with

their magnetic resonance imaging of knee and thus to predict the

commencement of sarcopenia.

INTRODUCTION

PROPOSED SOLUTION

OBJECTIVES

APPROACH

i. Sixty subjects were considered, all males and

their age was divided into three categories -

young (20-30 years), middle-aged (40-50 years)

and elderly (60-80 years)

ii. The elderly group was further sub-categorized

based on CSHA (Canadian Study of Health and

Ageing) scale. CSHA=1 represented healthy

elderly, CSHA=3 represented apparently

vulnerable and CSHA=4 represented frail elderly.

iii. Grip strength, Time Up and Go, and One leg

stand were performed to measure clinical

parameters.

iv. Motion analysis was done to measure Temporal

parameters (cadence, walking speed, foot off

etc.) and Kinematics (hip, knee rotation, foot

progression etc.) of the elderly subjects.

v. Magnetic Resonance Imaging was done for

twenty five subjects to measure muscle volume

change in hamstrings, gastrocnemius and

quadriceps of knee.

vi. Finally, a correlation was done between motion

analysis parameters and magnetic imaging of

knee in order to diagnose sarcopenia in elderly

population of Singapore.

RESULTS Hip Rotation

- 20

- 10

0

10

20

30

40

50

0 20 40 60 80 100

Knee Rotation

- 35

- 30

- 25

- 20

- 15

- 10

- 5

0

5

10

0 20 40 60 80 100

Knee Valgus/Varus

- 5

0

5

10

15

20

25

30

35

40

45

0 20 40 60 80 100

Foot Progression

- 30

- 20

- 10

0

10

20

0 20 40 60 80 100

CONCLUSIONS

‘First Signatures of Frailty’

•Motion Analysis:

Cadence: < 75 steps/min

Walking Speed: < 0.7 m/sec

•Magnetic Resonance Imaging:

Hamstrings: Lower Volume

Gastrocnemius: Lower Volume

TRANSITION TO FRAILTY/ONSET OF SARCOPENIA

Decreased in Hip Rotation, Increased Varus and Internal Rotation of

Knee and Foot Progression are indicative of transition to frailty which

may be Age Independent.

*This study was supported by NRF-CRP (Singapore) Funding Scheme (2008) and was conducted at National University Hospital, Singapore

Fig. A: Plug in Gait Markers on

subject

Fig. B: Static Calibration of subject

using Vicon Nexus software

(A)

(B)