Balance Control and Lower Limb Joint Work in Children with Bilateral Genu Valgum During Level Walking

Author(s):  
Kuan-Wen Wu ◽  
Wei-Chun Lee ◽  
Ya-Ting Ho ◽  
Ting-Ming Wang ◽  
Ken N. Kuo ◽  
...  
2018 ◽  
Vol 43 (3) ◽  
pp. 257-265 ◽  
Author(s):  
Saffran Möller ◽  
David Rusaw ◽  
Kerstin Hagberg ◽  
Nerrolyn Ramstrand

Background: Individuals using a lower-limb prosthesis indicate that they need to concentrate on every step they take. Despite self-reports of increased cognitive demand, there is limited understanding of the link between cognitive processes and walking when using a lower-limb prosthesis. Objective: The objective was to assess cortical brain activity during level walking in individuals using different prosthetic knee components and compare them to healthy controls. It was hypothesized that the least activity would be observed in the healthy control group, followed by individuals using a microprocessor-controlled prosthetic knee and finally individuals using a non-microprocessor-controlled prosthetic knee. Study design: Cross-sectional study. Methods: An optical brain imaging system was used to measure relative changes in concentration of oxygenated and de-oxygenated haemoglobin in the frontal and motor cortices during level walking. The number of steps and time to walk 10 m was also recorded. The 6-min walk test was assessed as a measure of functional capacity. Results: Individuals with a transfemoral or knee-disarticulation amputation, using non-microprocessor-controlled prosthetic knee ( n = 14) or microprocessor-controlled prosthetic knee ( n = 15) joints and healthy controls ( n = 16) participated in the study. A significant increase was observed in cortical brain activity of individuals walking with a non-microprocessor-controlled prosthetic knee when compared to healthy controls ( p < 0.05) and individuals walking with an microprocessor-controlled prosthetic knee joint ( p < 0.05). Conclusion: Individuals walking with a non-microprocessor-controlled prosthetic knee demonstrated an increase in cortical brain activity compared to healthy individuals. Use of a microprocessor-controlled prosthetic knee was associated with less cortical brain activity than use of a non-microprocessor-controlled prosthetic knee. Clinical relevance Increased understanding of cognitive processes underlying walking when using different types of prosthetic knees can help to optimize selection of prosthetic components and provide an opportunity to enhance functioning with a prosthesis.


2008 ◽  
Vol 28 (2) ◽  
pp. 222-228 ◽  
Author(s):  
A.H. Vrieling ◽  
H.G. van Keeken ◽  
T. Schoppen ◽  
E. Otten ◽  
A.L. Hof ◽  
...  

Author(s):  
Jang-Ho Park ◽  
Sunwook Kim ◽  
Maury A. Nussbaum ◽  
Divya Srinivasan*

Sensors ◽  
2020 ◽  
Vol 20 (24) ◽  
pp. 7216
Author(s):  
Wei Yang ◽  
Jiyu Zhang ◽  
Sheng Zhang ◽  
Canjun Yang

With the help of wearable robotics, the lower limb exoskeleton becomes a promising solution for spinal cord injury (SCI) patients to recover lower body locomotion ability. However, fewer exoskeleton gait planning methods can meet the needs of patient in real time, e.g., stride length or step width, etc., which may lead to human-machine incoordination, limit comfort, and increase the risk of falling. This work presents a human-exoskeleton-crutch system with the center of pressure (CoP)-based gait planning method to enable the balance control during the exoskeleton-assisted walking with crutches. The CoP generated by crutches and human-machine feet makes it possible to obtain the overall stability conditions of the system in the process of exoskeleton-assisted quasi-static walking, and therefore, to determine the next stride length and ensure the balance of the next step. Thus, the exoskeleton gait is planned with the guidance of stride length. It is worth emphasizing that the nominal reference gait is adopted as a reference to ensure that the trajectory of the swing ankle mimics the reference one well. This gait planning method enables the patient to adaptively interact with the exoskeleton gait. The online gait planning walking tests with five healthy volunteers proved the method’s feasibility. Experimental results indicate that the algorithm can deal with the sensed signals and plan the landing point of the swing leg to ensure balanced and smooth walking. The results suggest that the method is an effective means to improve human–machine interaction. Additionally, it is meaningful for the further training of independent walking stability control in exoskeletons for SCI patients with less assistance of crutches.


2020 ◽  
Vol 142 (12) ◽  
Author(s):  
Nicole G. Harper ◽  
Jason M. Wilken ◽  
Richard R. Neptune

Abstract Dynamic balance is controlled by lower-limb muscles and is more difficult to maintain during stair ascent compared to level walking. As a result, individuals with lower-limb amputations often have difficulty ascending stairs and are more susceptible to falls. The purpose of this study was to identify the biomechanical mechanisms used by individuals with and without amputation to control dynamic balance during stair ascent. Three-dimensional muscle-actuated forward dynamics simulations of amputee and nonamputee stair ascent were developed and contributions of individual muscles, the passive prosthesis, and gravity to the time rate of change of angular momentum were determined. The prosthesis replicated the role of nonamputee plantarflexors in the sagittal plane by contributing to forward angular momentum. The prosthesis largely replicated the role of nonamputee plantarflexors in the transverse plane but resulted in a greater change of angular momentum. In the frontal plane, the prosthesis and nonamputee plantarflexors contributed oppositely during the first half of stance while during the second half of stance, the prosthesis contributed to a much smaller extent. This resulted in altered contributions from the intact leg plantarflexors, vastii and hamstrings, and the intact and residual leg hip abductors. Therefore, prosthetic devices with altered contributions to frontal-plane angular momentum could improve balance control during amputee stair ascent and minimize necessary muscle compensations. In addition, targeted training could improve the force production magnitude and timing of muscles that regulate angular momentum to improve balance control.


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