Neurochemistry International xxx (2016) 1e6

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Neurochemistry International
journal homepage: www.elsevier.com/locate/nci

Does acupuncture ameliorate motor impairment after stroke? An

assessment using the CatWalk gait system
Yan Cao a, Ning Sun b, Jing-Wen Yang a, Yang Zheng a, Wen Zhu a, Zhen-Hua Zhang a,
Xue-Rui Wang a, Guang-Xia Shi a, Cun-Zhi Liu a, *
a
b

Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine afliated to Capital Medical University, Beijing, China
Shandong University of Traditional Chinese Medicine, Jinan, China

a r t i c l e i n f o

a b s t r a c t

Article history:
Received 1 August 2016
Received in revised form
26 September 2016
Accepted 27 October 2016
Available online xxx

The effect of acupuncture on gait decits after stroke is uncertain. This animal study was designed to
determine whether acupuncture improves gait impairment following experimentally induced ischemic
stroke. Ischemic stroke was induced by permanent middle cerebral artery occlusion (MCAO) in rats. After
7 days' of acupuncture treatment, assessment of gait changes using the CatWalk automated gait analysis
system was performed. Comparison of the CatWalk gait parameters among the groups showed that gait
function was impaired after ischemic stroke and acupuncture treatment was effective in improving a
variety of gait parameters including intensity, stance and swing time, swing speed and stride length at
postoperative day 8. This study demonstrates a benecial effect of acupuncture on gait impairment in
rats following ischemic stroke. Further studies aimed to investigate the effects of acupuncture at different
stages during stroke using the CatWalk system are required.
2016 Elsevier Ltd. All rights reserved.

Keywords:
Ischemic stroke
Acupuncture
Gait decits
Stroke rehabilitation

1. Introduction
Stroke remains one of the devastating of all neurological diseases, often causing death or substantial physical impairment and
disability. It is one of the most common cause of death worldwide,
as well as the third contributor to the worldwide burden of
disability (GBD 2013 DALYs and HALE Collaborators, 2015; GBD
2013 Mortality and Causes of Death Collaborators, 2015). Post
stroke gait decits are common cause of disability in stroke patients. It is characterized by temporal asymmetry, reduced walking
velocity, and reduced stride length that noticeably impact on a
patient's ability to live independently. Impaired gait function not
only reduces ambulation but also leads to imbalance and falls,
especially in elderly patients experiencing stroke, which may result
in a secondary injuries. Nevertheless, medicine has developed few
effective interventions to promote recovery of post stroke gait
decits.
Acupuncture has been used for stroke recovery in Asia for

* Corresponding author. Acupuncture and Moxibustion Department, Beijing

Hospital of Traditional Chinese Medicine afliated to Capital Medical University, 23
Meishuguanhou Street, Dongcheng District, Beijing 100010, China.
E-mail address: lcz623780@126.com (C.-Z. Liu).

centuries and physicians and patients in Western countries have

also begun to accept acupuncture as an alternative strategies
against stroke (Pandian et al., 2011; Shah et al., 2008). But several
studies including randomized controlled trials (Zhang et al., 2015),
meta-analyses (Sze et al., 2002) and systematic reviews (Zhang
et al., 2014a) have reported that there were no signicant positive
effects of acupuncture on motor recovery in stroke patients. The
purpose of the present study was to investigate the efcacy of
acupuncture on improving gait decits after cerebral ischemia using the CatWalk automated gait analysis system.
The CatWalk automated gait analysis system is a highly sensitive
tool to assess the gait and locomotion. When a rat traverses a glass
plate voluntarily towards a goal box, its footprints are captured.
Then the system visualizes the footprints and calculates statistics
related to spatial and temporal parameters of the footprints. This
system is more objective than other traditional assessment tools to
quantify footprints and gait in animals. The CatWalk automated gait
analysis has been validated in many kinds of neurological disorders,
including spinal cord injury (Hamers et al., 2006), neuropathic pain
(Huehnchen et al., 2013), arthritis (Parvathy and Masocha, 2013),
Parkinson's (Zhou et al., 2015) and stroke (Liu et al., 2013). Therefore, we choose the CatWalk automated gait analysis as the method
to assess gait in this experiment.

http://dx.doi.org/10.1016/j.neuint.2016.10.014
0197-0186/ 2016 Elsevier Ltd. All rights reserved.

Please cite this article in press as: Cao, Y., et al., Does acupuncture ameliorate motor impairment after stroke? An assessment using the CatWalk
gait system, Neurochemistry International (2016), http://dx.doi.org/10.1016/j.neuint.2016.10.014

Y. Cao et al. / Neurochemistry International xxx (2016) 1e6

3 moderate decit (failing to the left), score 4 severe decit (no

spontaneous walk), and score 5 death. All rats were evaluated by
the same trained person.

2. Experimental procedures
2.1. Experimental design
The experimental protocol is shown in Fig. 1. All rats were given
adaptation training for the CatWalk System one week prior to the
surgery for 7 days. Rats were considered to be qualied when they
went cross the glass plate at a constant speed without hesitation
during 3 trials. Then the qualied rats were randomly assigned to
the MCAO operated group (n 30) and sham operated group
(SHAM, n 10). Neurological deciency was evaluated 24 h after
surgery using the Zea Longa 5 point scoring scale. 20 rats scoring 1
to 3 were chosen and randomly assigned to 2 groups: the group
treated with acupuncture (MCAO Acu, n 10), and the group
without acupuncture (MCAO, n 10). Rats from MCAO Acu group
were treated with acupuncture beginning 48 h after MCAO and this
was continued for 7 days. 8 days after MCAO, all the rats from 3
groups performed the CatWalk test.

2.5. Acupuncture intervention

The acupoints JiaJi (EX-B2) are shown in Fig. 2. Acupoints A C
and acupoints B D were used alternately for 7 days. One-off
sterile acupuncture needles (Huatuo, Suzhou Medical Instruments
Factory, Suzhou, China), with a length of 13 mm and diameter of
0.14 mm, were used in this experiment. After sterilization with
iodine, needles were inserted horizontally 2/3 mm into acupoints,
and rotated 2/3 times per second clockwise for 30 s respectively.
Rats in the SHAM and MCAO groups were grasped in the same
manner only without interventions as the same periods as
MCAO Acu group.
2.6. Gait analysis

2.2. Animals
A total of 40 Male SD rats, weighting 270e300 g, were obtained
from Vital River Laboratories (Beijing, China) and housed in cages
with ad libitum access to food and water under controlled temperature (23 1  C) and light (12 h light-dark cycle) conditions. All
experiments were performed in accordance with the Guidelines for
the Care and Use of Mammals in Neuroscience and Behavioral
Research and were approved by the Committee of Ethics on Animal
Experiments at the local institution.
2.3. Experimental models
Rats were anesthetized by the intraperitoneal injection of 3.5%
chloral hydrate (1 ml/100 g). Through a ventral neck midline incision, the right common carotid artery (CCA), internal carotid artery
(ICA) and external carotid artery (ECA) were exposed. A nylon
monolament of 0.34/0.36 0.02 mm in diameter (Shandong
Biological Technology Co, Ltd.) was inserted into the right CCA, and
then advanced through the ICA until it closed the origin of the MCA,
approximately 17/18 mm beyond the CCA bifurcation. Then the
monolament was cut and left inside in the vessels. Rectal temperature of the rats were monitored and maintained at 37 0.5  C
throughout the surgery using a heating pad. Rats in the shamoperated group received the same surgical procedures as above
only without inserting a lament. Rats that underwent surgery for
longer than 15 min were excluded to avoid as much operational
interference as possible.

Gait analysis was performed with CatWalk Analysis System

(Noldus Information Technology, Wageningen, The Netherlands) 8
days after surgery. The animals were evaluated the gait testing by
an investigator who was unaware to animal grouping. Briey, the
equipment was located in a dark and silent room. Rats were made
to travel through the 1.5 m long enclosed glass plate, and food was
used as a bait at the end of the walkway. The rats passed a high
speed camera underneath the glass plate that captured the
constantly changing paw image and the CatWalk Analysis software
analyzed the results of gait parameters. Gait parameters were
automatically labeled as right forepaw (RF), right hind paw (RH),
left forepaw (LF) and left hind paw (LH). Gait parameters were
detailed in Table 1.
Three spatiotemporal parameters (V), including swing time,
stance time and stride length were each used in the following two
equations (Kim and Eng, 2003; Vassalo et al., 2015):
1. Symmetry ratio (ratio): ratio Vparetic/Vnon-paretic
2. Symmetry index (SI): SI [(Vparetic-Vnon-paretic)/
0.5(Vparetic Vnon-paretic)]*100
Where Vparetic is a gait variable recorded for the paretic limb
and Vnon-paretic is the corresponding variable for the nonparetic
limb. The magnitude of SI (expressed in absolute values) represents
the degree of asymmetry and the sign indicates the pattern of
asymmetry. A SI value of zero represents perfect symmetry.
2.7. Statistical analysis

2.4. Neurological deciency evaluation

The neurological deciency was evaluated using Zea Longa 5
scoring scale, which was described as following: score 0 no
neurologic decit, score 1 mild decit (failure to fully extend the
left forepaw), score 2 moderate decit (circling to the left), score

Statistical analysis was carried out using SPSS 13.0 software

(SPSS Inc., Chicago, IL, USA). Statistical signicance was evaluated
using one-way analyses of variance followed by post hoc paired
comparisons using the Turkey tests when appropriate. A value of
P < 0.01 was considered statistically signicant difference.

Fig. 1. The experimental protocol of the study. MCAO, middle cerebral artery occlusion.

Please cite this article in press as: Cao, Y., et al., Does acupuncture ameliorate motor impairment after stroke? An assessment using the CatWalk
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Y. Cao et al. / Neurochemistry International xxx (2016) 1e6

paw pressure decit during the acupuncture treatment was

detected in all four paws (p < 0.01) (Fig. 3).
3.2. Ischemia affected the swing speed and stride length of all paws
and acupuncture improved those of left limbs
3.2.1. Swing speed
There was signicant difference in all paws between MCAO and
sham rats in swing speed (P < 0.01). Only did the left hindpaw show
signicant recovery over time after acupuncture. There was no
signicant difference in MCAO group and MCAO Acu group in the
forepaws and right hindpaw (p > 0.01) (Fig. 4A).
3.2.2. Stride length
Similarly to the nding in swing speed, MCAO induced a signicant decrease in both right and left limbs in the distance between successive placements of the same paw during maximal
contact, known as stride length (P < 0.01). However, acupuncture
was only benecial for the diagonal limbs of ischemic rats (P < 0.01)
(Fig. 4B).
3.3. Ischemia affected the stance and swing time of left limbs and
right forepaw and acupuncture improved those of left limbs
3.3.1. Stance
The duration of the stance increased signicantly for forepaws
and diagonal hindpaw in the MCAO rats and there was a signicant
improvement in those rats treated with acupuncture (P < 0.001)
(Fig. 5A).
3.3.2. Swing
The results of swing were globally similar to those of stance at
16 days after ischemia. The swing phase of right forepaw and left
limbs in MCAO rats were signicantly higher than those of sham
rats, especially in the affected left side (P < 0.01). One week of
acupuncture treatment was signicantly in decreasing the swing
times in left limbs (P < 0.01) (Fig. 5B).
3.4. Ischemia and acupuncture had little effects on max contact
area
The size of the print area at maximal contact of forepaws and
ipsilateral hindpaw of MCAO rats during oor contact was similar
with that of sham group (p > 0.01). Animals subjected to MCAO
displayed a decrease in maximal contact in the affected left hindpaw only which varied with sham operated animals (P < 0.01).
However, the max contact area did not change signicantly for
either forepaws or hindpaws in the MCAO Acu group (p > 0.01)
(Fig. 6).
3.5. Ischemia resulted in the gait asymmetry and acupuncture had
little effects on it
Fig. 2. Location of acupoints. A: Two points in pair, bilateral, 4 mm horizontally away
from the 2th thoracic vertebra. B: Two points in pair, bilateral, 4 mm horizontally away
from the 6th thoracic vertebra. C: Two points in pair, bilateral, 4 mm horizontally away
from the 10th thoracic vertebra. D: Two points in two pair, bilateral, 4 mm horizontally
away from the 2th lumbar vertebra.

3. Results
3.1. Ischemia led to a persistent reduction in paw intensity and
acupuncture improved this reduction
Animals subjected to MCAO applied signicantly less paw
pressure, as measured by the intensity of the footprint during
locomotion on all four paws (p < 0.01). A gradual recovery of the

The gait symmetry is important clinically since it may be associated with a number of negative consequences such as inefciency
and challenges to balance control (Lin et al., 2006; Patterson et al.,
2008). Therefore we further analyzed the gait symmetry values
calculated from spatiotemporal values. Most measures in the MCAO
group reected a skewed distribution indicating the presence of
asymmetry compared to the sham (P < 0.01) (Table 2). The distributions also highlighted that the asymmetry of fore limbs were
more severe than that of the hind limbs. Although acupuncture had
signicant improvements in spatiotemporal values including stride
length, and stance and swing time, only swing asymmetry did
ameliorate by acupuncture (P < 0.01).

Please cite this article in press as: Cao, Y., et al., Does acupuncture ameliorate motor impairment after stroke? An assessment using the CatWalk
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Y. Cao et al. / Neurochemistry International xxx (2016) 1e6

Table 1
CatWalk gait parameter denitions.
Parameters

Denitions

Spatial parameters
Max contact area (cm2)
Intensity (a.u.)
Kinetic parameters
Stance (secs)
Swing (secs)
Swing speed (cm/secs)
Stride length (cm)

The size of the print area at maximal contact with the glass plate during a stance phase
Average light intensity of the print at the moment of maximal contact expressed as arbitrary unit (a.u.)
Duration of the paw contact with the glass plate in a step cycle
Duration of the paw of no contact with the glass plate in a step cycle
Speed of a paw during swing phase, i.e. stride length/swing
Distance between consecutive steps of the same paw

Table 2
Effects of ischemic stroke and acupuncture on gait symmetry.
Parameters

Spatial
Stance ratio
Swing ratio
SI stance
SI swing
Semporal
Stride length ratio
SI stride length

Sham mean (SD)

MCAO Acu

MCAO

Fore limbs

Hind limbs

All limbs

Fore limbs

Hind limbs

All limbs

Fore limbs

Hind limbs

All limbs

1.04(0.05)
0.98(0.05)
4.68(3.85)
4.57(1.90)

1.00(0.06)
1.04(0.06)
4.46(2.90)
5.43(3.43)

1.01(0.04)
1.01(0.05)
4.02(3.16)
3.63(2.57)

0.87(0.08)*
1.32(0.31)
16.26(7.92)*
37.65(16.79)*

0.96(0.03)
1.09(0.05)
7.82(4.79)
16.13(4.82)*

0.96(0.07)
1.15(0.12)
8.28(2.75)
24.30(7.91)*

0.94(0.02)
1.17(0.11)
10.06(6.63)
16.41(8.01)#

1.00(0.04)
1.01(0.19)
6.13(2.93)
10.78(3.27)

0.98(0.09)
1.13(0.09)
6.01(2.94)
19.96(10.44)

1.02(0.05)
4.25(3.09)

0.99(0.02)
1.37(0.89)

1.01(0.03)
3.58(2.47)

0.97(0.08)
20.47(8.49)*

0.85(0.10)
16.23(8.01)*

0.98(0.01)
12.59(6.52)

0.95(0.11)
17.87(3.16)

0.92(0.19)
9.24(5.74)

0.97(0.05)
10.71(9.28)

All SI values entered in absolute values. Mean (SD) values measures for the sham rats (n 10), MCAO rats (n 10) and MCAO Acupuncture rats (n 10) calculated with two
equations: ratio and SI using three spatiotemporal gait parameters: stance time, swing time and stride length. For ANOVA, *p < 0.01 VS Sham group; #p < 0.01 VS MCAO group.
MCAO, middle cerebral artery occlusion; Acu, acupuncture; SI, symmetry index.

Fig. 3. Effects of ischemic stroke and acupuncture on intensity. For ANOVA, *p < 0.01
VS Sham group; #p < 0.01 VS MCAO group. The data are expressed as means SEM,
n 10 in each group. MCAO, middle cerebral artery occlusion; Acu, acupuncture; RF,
right forepaw; RH, right hindpaw; LF, left forepaw; LH, left hindpaw.

4. Discussion
The present study was aimed at providing an analysis of gait
function in rats after stroke and exploring the effects of acupuncture using the CatWalk automated gait analysis system. Most of the
spatial parameters and temporal parameters except maximum area
were altered in rats with focal ischemia. These gait impairments
were improved by two weeks of acupuncture treatment.
The right cerebral artery occlusion resulted in an infarct volume
in right brain, so we found that right brain ischemia led to a left
limbs' impairment in CatWalk parameters including max contact
area, intensity, stance and swing time, swing speed and stride
length. Among these CatWalk parameters, the max contact area
and intensity are both directly related to pressure, and indicates the
relative force exerted during locomotion. A decreased max contact
area and intensity may be an indicator of reduced propulsion and
weight bearing by paws. In our study, brain ischemia just led to a
reduction in maximal area of paw contact of left limbs, while

Fig. 4. Effects of ischemic stroke and acupuncture on swing speed (A) and stride
length(B). For ANOVA, *p < 0.01 VS Sham group; #p < 0.01 VS MCAO group. The data
are expressed as means SEM, n 10 in each group. MCAO, middle cerebral artery
occlusion; Acu, acupuncture; RF, right forepaw; RH, right hindpaw; LF, left forepaw; LH,
left hindpaw.

resulted in a reduction of intensity of all the paws. However, a

previous study indicated that the maximal area of contact was
signicantly decreased in all paws at 4 days after ischemia (Wang
et al., 2008). The difference of the analysis time may lead to this

Please cite this article in press as: Cao, Y., et al., Does acupuncture ameliorate motor impairment after stroke? An assessment using the CatWalk
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Y. Cao et al. / Neurochemistry International xxx (2016) 1e6

Fig. 5. Effects of ischemic stroke and acupuncture on stance time (A) and swing time
(B). For ANOVA, *p < 0.01 VS Sham group; #p < 0.01 VS MCAO group. The data are
expressed as means SEM, n 10 in each group. MCAO, middle cerebral artery occlusion; Acu, acupuncture; RF, right forepaw; RH, right hindpaw; LF, left forepaw; LH,
left hindpaw.

Fig. 6. Effects of ischemic stroke and acupuncture on max contact area. For ANOVA,
*p < 0.01 VS Sham group. The data are expressed as means SEM, n 10 in each
group. MCAO, middle cerebral artery occlusion; Acu, acupuncture; RF, right forepaw;
RH, right hindpaw; LF, left forepaw; LH, left hindpaw.

distinction. The reduced propulsion may lead to longer stance and

swing time for injured limbs and more weight bearing for uninjured paws. Our data have conrmed that the stance and swing
time of left limbs and right forepaw were increased (p < 0.01),
possibly because the forepaws play a more important role in supporting the body weight during walking for compensation. We also
observed a signicant decrease in the swing speed and stride
length for all four paws in MCAO group (p < 0.01). The previous
studies suggested that ischemia had little effects on these

parameters; they tended to decrease as well, but not reaching a

statistically signicant difference (Wang et al., 2008). Our results in
gait alterations resembled those stroke patients who have
decreased cadence and increased of the duration of stand (Aruin
et al., 2000; Veerbeek et al., 2014). Weakness in the affected hip
exors and ankle plantar exors may contribute to swing speed and
step length decits (Milot et al., 2006). These data show us that
bipedal and quadrupedal gait impairment after stroke share some
similarities.
Acupuncture is an easily performed non-pharmaceutical recovery approach for stroke patients in China. Previous studies
showed that acupuncture stimulation on limbs may cause the
retraction reaction of the exor and extensor which impact gait
rehabilitation. Therefore the choice of the traditional acupoints
used on the limbs is debated. In the present study, we chose acupoins EX-B2 to evaluate the efcacy of acupuncture. Our data
suggest that the benecial effects of acupuncture on gait function
can be differentially analyzed by temporal and spatial parameters.
In our study, major parameters of left limbs, such as intensity,
stance, stride length, swing and swing asymmetry in acupuncture
group showed signicant improvement compared to those in
MCAO group. Acupuncture has also tended to increase maximal
area and swing speed, though not reaching a statistical difference.
The results are consistent with experiment research and clinical
observations. In MCAO rats from previous studies, motor functional
performance was improved by electro-acupuncture examined by
the foot fault test and parallel bar test analyses (Wang et al., 2003).
The motor behavior scoresGarcia's scores were also increased by
electro-acupuncture (Kim et al., 2009). The acupuncture treatment
time of these studies were similar to our research, approximately
two weeks. Acupuncture can increase the Fugle-Meyer motor
function score and Barthel index score of the patients with drop
foot and strephenopodia after stroke (Liu et al., 2012). Furthermore,
acupuncture could improve the hemiplegic gait cycle, stand time
and swing time of ischemic stroke patients (Li et al., 2014). These
observations indicate that acupuncture can mitigate the gait
dysfunction caused by ischemic stroke.
However, the cellular and molecular mechanisms underlying
the benecial effects of acupuncture on gait function remain unclear. Neural plasticity, which is responsible for recovery from brain
injury, can be induced by acupuncture. Acupuncture could upregulate nerve growth factor and brain-derived neurotropic growth
factor in many neurodegenerative disease (Manni et al., 2010;
Soligo et al., 2013). Indeed, acupuncture has been reported to increase dendritic spine density in MCAO rats; thus making promotion of acupuncture for neural plasticity a plausible mechanism for
recovery of gait function (Lu et al., 2016; Ren et al., 2008). Another
candidate mechanism may involve that acupuncture increased
gasoline, an actin-binding protein that helps controlling muscle
strength. It is suggested that acupuncture might also directly
strengthen the local muscle that leads to improved gait function
(Pan et al., 2011). Besides, gait is not only indicative of lower extremity motor function, but also reects cognitive function. Intact
cognition and attention processes are required to ensure proper
gait control. Acupuncture is reported to improve cognitive function
of patients with cognitive impairment after stroke and several
kinds of ischemia rat models (Liu et al., 2014; Shi et al., 2015; Wang
et al., 2015; Zhang et al., 2014b). Effects on antioxidant and antiinammatory signaling pathway may be the underlying mechanisms (Zeng et al., 2014). These positive effects of acupuncture for
cognition contribute to recovery of gait function.
A lot of methods have been developed to assess motor dysfunctions after stroke, like neuroscores, forepaw placing test, footfault tests, whisker-guided exploration, adhesive removal test,
corner test and staircase task test. However, these tests only

Please cite this article in press as: Cao, Y., et al., Does acupuncture ameliorate motor impairment after stroke? An assessment using the CatWalk
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Y. Cao et al. / Neurochemistry International xxx (2016) 1e6

measure a narrow spectrum of motor dysfunctions. For example,

the neuroscores cannot avoid articial disturbance. While forepaw
placing test, foot-fault tests and the others measure forelimbs only,
with the hind limbs neglected. In contrast, the CatWalk automated
gait analysis system, a computerized gait analysis tool, was applied
in our study to qualify objective gait parameters of all limbs.
Moreover, it can not only detect the static as well as dynamic aspects of gait as the human gait analysis systems, but also the spatial
and temporal aspects of interlimb coordination that are particularly
valuable for quadrupeds. The CatWalk automated gait analysis
system evaluated motivated movement so it is more objective and
similar to the actual human phenomenon. Although the CatWalk
method has been used in a variety of studies for assessing impaired
gait function after spinal cord injury, neuropathic pain, arthritis,
Parkinson's and stroke, it has not yet been used to explore the effects of acupuncture in experimental stroke. The present study is
rst to assess gait improvement in stroke rats after acupuncture
treatment using CatWalk automated gait analysis system. It can
provide more evidence on positive effects of acupuncture in gait
function status.
Our study has some limitations. First, the treatment and
assessment are within 8 days after MCAO surgery. It is possible that
long-term effects of acupuncture have not been determination
because the post assessment was too close in time to the treatment
completion. Moreover, the treatment period is shorter than that in
clinical studies. Therefore, a new study design with treatment and
assessment for more extended periods will be necessary.
In summary, our study demonstrated gait function was impaired
after ischemia stroke. 7 days of acupuncture treatment improved a
variety of gait impairments, reecting improvement in sensorimotor status of MCAO rats. Further studies aimed to investigate the
effects of acupuncture at different stage during stroke using the
CatWalk system are required.
Acknowledgments
The study was funded by the National Natural Science Foundation of China (Grant no. 81473501), Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special
Funding Support (ZYLX201412) and Financially supported by 973
Program under Grant No.2014CB543203.
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Please cite this article in press as: Cao, Y., et al., Does acupuncture ameliorate motor impairment after stroke? An assessment using the CatWalk
gait system, Neurochemistry International (2016), http://dx.doi.org/10.1016/j.neuint.2016.10.014