1. 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)