scholarly journals The effects of ground-irregularity-cancelling prosthesis control on balance over uneven surfaces

2021 ◽  
Vol 8 (1) ◽  
pp. 201235
Author(s):  
Vincent L. Chiu ◽  
Alexandra S. Voloshina ◽  
Steven H. Collins
Keyword(s):  
Sagittal Plane ◽  
Frontal Plane ◽  
Step Length ◽  
Limb Amputation ◽  
Mass Motion ◽  
Movement Variability ◽  
Trunk Movement ◽  
Uneven Terrain ◽  
Ankle Torque ◽  
Prosthesis Control

Over half of individuals with a lower-limb amputation are unable to walk on uneven terrain. Using a prosthesis emulator system, we developed an irregularity-cancelling controller intended to reduce the effect of disturbances resulting from uneven surfaces. This controller functions by changing the neutral angles of two forefoot digits in response to local terrain heights. To isolate the effects of the controller, we also programmed a spring-like controller that maintained fixed neutral angles. Five participants with transtibial amputation walked on a treadmill with an uneven walking surface. Compared with the spring-like controller, the irregularity-cancelling controller reduced ankle torque variability by 41% in the sagittal plane and 64% in the frontal plane. However, user outcomes associated with balance were mostly unaffected; only trunk movement variability was reduced, whereas metabolic rate, mediolateral centre of mass motion, and variabilities in step width, step length and step time were unchanged. We conclude that reducing ankle torque variability of the affected limb is not sufficient for reducing the overall effect of disturbances due to uneven terrain. It is possible that other factors, such as changes in step height or disturbances to the intact limb, play a larger role in difficulty balancing while walking over uneven surfaces.

scholarly journals Using Biofeedback to Reduce Step Length Asymmetry Impairs Dynamic Balance in People Poststroke

2021 ◽  
pp. 154596832110193
Author(s):  
Sungwoo Park ◽  
Chang Liu ◽  
Natalia Sánchez ◽  
Julie K. Tilson ◽  
Sara J. Mulroy ◽  
...  
Keyword(s):  
Angular Momentum ◽  
Sagittal Plane ◽  
Dynamic Balance ◽  
Objective Measure ◽  
Frontal Plane ◽  
Step Length ◽  
Berg Balance Scale ◽  
Whole Body ◽  
Functional Gait ◽  
Full Body

Background People poststroke often walk with a spatiotemporally asymmetric gait, due in part to sensorimotor impairments in the paretic lower extremity. Although reducing asymmetry is a common objective of rehabilitation, the effects of improving symmetry on balance are yet to be determined. Objective We established the concurrent validity of whole-body angular momentum as a measure of balance, and we determined if reducing step length asymmetry would improve balance by decreasing whole-body angular momentum. Methods We performed clinical balance assessments and measured whole-body angular momentum during walking using a full-body marker set in a sample of 36 people with chronic stroke. We then used a biofeedback-based approach to modify step length asymmetry in a subset of 15 of these individuals who had marked asymmetry and we measured the resulting changes in whole-body angular momentum. Results When participants walked without biofeedback, whole-body angular momentum in the sagittal and frontal plane was negatively correlated with scores on the Berg Balance Scale and Functional Gait Assessment supporting the validity of whole-body angular momentum as an objective measure of dynamic balance. We also observed that when participants walked more symmetrically, their whole-body angular momentum in the sagittal plane increased rather than decreased. Conclusions Voluntary reductions of step length asymmetry in people poststroke resulted in reduced measures of dynamic balance. This is consistent with the idea that after stroke, individuals might have an implicit preference not to deviate from their natural asymmetry while walking because it could compromise their balance. Clinical Trials Number: NCT03916562.

scholarly journals 3D kinematic analysis of patients’ gait before and after unilateral total hip replacement

2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Kateřina Kolářová ◽  
Tomáš Vodička ◽  
Michal Bozděch ◽  
Martin Repko
Keyword(s):  
Range Of Motion ◽  
Total Hip Replacement ◽  
Kinematic Analysis ◽  
Hip Replacement ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Step Length ◽  
Total Hip ◽  
Before And After ◽  
Analysis System

Purpose: The purpose of the study was to describe changes in the kinematic parameters in the patients’ gait after total hip replacement. Methods: Research group of men in the end stage of osteoarthritis indicated to the THR (n = 10; age 54.1 ± 7.5 years; weight 92.2 ± 9.6 kg; height 179.7 ± 5.9 cm). All participants underwent a total of three measurements: before surgery, 3 and 6 months after the surgery. Using the 3D kinematic analysis system, the patients’ gait was recorded during each measurement session and kinematic analysis was carried out. The parameters that were monitored included the sagittal range of motion while walking in the ankle, the knee and the hip joints of the operated and the unoperated limb, and the range in the hip joint’s frontal plane, the rotation of pelvis in the frontal and transverse planes, as well as the speed of walking and the walking step length. Results: Significant increases were found in sagittal range of motion in the operated hip joint, sagittal range of motion in the ankle joint on the unoperated side and in the walking step length of the unoperated limb. Conclusions: During walking after a THR, the sagittal range of motion in the ankle of the unoperated limb increases. Also, the range of motion in the sagittal plane on the operated joint increases, which is related to the lengthening of the step of the unoperated lower limb.

Implications of Increased Lower Extremity Movement Variability on Fall Susceptibility at Increased Stride Lengths During Locomotion

2013 ◽  
Author(s):  
Andrew D. Nordin ◽  
Joshua P. Bailey ◽  
Janet S. Dufek
Keyword(s):  
Lower Extremity ◽  
Repeated Measures ◽  
Stride Length ◽  
Mixed Model ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Knee Joints ◽  
Lower Extremity Injury ◽  
Movement Variability ◽  
Heel Contact

The purpose of this examination was to explore the effects of stride length (SL) perturbations on walking gait, relative to preferred walking (PW) and running (PR), via lower extremity range of motion (ROM) variability. ROM variability at the hip, knee, and ankle joints, in the sagittal and frontal planes were used in evaluating motor control of gait, where increased gait variability has been previously implicated in fall susceptibly. Nine participants (5 male, 4 female; mean age 23.11±3.55 years, height 1.72±0.18m, mass 72.66±14.37kg) free from previous lower extremity injury were examined. Kinematic data were acquired using a 12-camera system (Vicon MX T40-S; 200Hz). Data filtering and interpolation included a low pass, 4th order, Butterworth filter (15Hz cutoff) and cubic spline. Five gait trials were completed for PW and PR, with subsequent SL manipulations computed as a percentage of leg length (LL). SL perturbations included 60%, 80%, 100%, 120%, and 140% of LL. Kinematic analysis involved one stride (two steps) during each gait trial, assessing ROM at the hip, knee, and ankle from heel contact to toe-off for each limb, in the sagittal and frontal planes. Variability was expressed using coefficient of variation (%). Comparisons were made using 3×7 (joint × stride condition) mixed model ANOVAs, with repeated measures on stride condition (α = 0.05), using SPSS 20.0. Differences in lower extremity ROM variability were detected among stride conditions in the frontal and sagittal planes (F[3.185,76.451] = 3.004, p = .033; F[4.595,110.279] = 2.834, p = .022, respectively). Greater ROM variability was observed at, and in excess of SLs of 100%LL relative to PW in the frontal plane (PW: 9.2±4.2%; 100%LL: 11.8±3.6%, p = .014; 120%LL: 13.5±5.8%, p = .046; 140%LL: 13.8±6.5%, p = .016), and between SLs of 80%LL and 120%LL in the sagittal plane (4.9±3.0%; 7.8±4.7%, p = .046, respectively). From this, PW appeared to occur within SLs of 60%LL to 80%LL, while SLs exceeding 100%LL resulted in increased lower extremity ROM variability. This may have consequences for fall susceptibility at increased stride lengths during walking. PR did not reveal significant variability differences (p>.05) compared to walking conditions in either the sagittal or frontal plane (7.5±5.0%; 12.8±7.7%, respectively), suggesting that running represents a separate, but stable gait pattern. In the sagittal plane, ROM variability was significantly lower at the hip (3.9±1.5%), relative to the ankle (8.4±1.6%, p<.001) and knee joints (7.4±2.6%, p = .001), suggesting that gait control may be more active at the ankle and knee joints. Future investigations should examine kinetic changes in gait when altering stride length.

scholarly journals MOVEMENT VARIABILITY IN PRE-TEEN AND TEENAGE ATHLETES DURING SPORTS RELATED TASKS

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0015
Author(s):  
Bianca Edison ◽  
Bridget O’Callahan ◽  
Nicole M. Mueske ◽  
Adriana Conrad-Forrest ◽  
Mia J. Katzel ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Frontal Plane ◽  
Individual Variability ◽  
Transverse Plane ◽  
Drop Jump ◽  
Movement Variability ◽  
Case Scenario ◽  
Worst Case ◽  
Subject Variability ◽  
Within Subject Variability

Background: Movement variability may affect injury assessment and may change as athletes mature. Hypothesis/Purpose: We hypothesized that pre-teen athletes would exhibit greater variability than teenage athletes when performing drop jump, heel touch, and single leg hop motions. Methods: 55 uninjured pediatric athletes were divided into pre-teen (age 7-12 years; n=29; 11 female) and teenage (age 13-15 years; n=26; 13 female) groups of similar size. All participants performed 2-3 repetitions per side of three sports related tasks: drop jump (41 cm), heel touch (single-leg squat from 15 cm or 23 cm step, depending on whether subject height <155 cm), and single leg hop for distance. 3D kinematics were recorded using motion capture during the loading phase of each task. To assess intra-individual variability, we examined the standard deviation (SD) and range (maximum-minimum) of key metrics among the multiple repetitions of each task performed by each participant. Variability was compared between age groups using 2-sided t-tests. Results: In the drop jump and heel touch, the younger group was more variable than the older group (Figure 1.1 left). The median within-subject SD of repeat measurements varied from 1-6° in the sagittal plane, 1-3° in the frontal plane, and 1-4° in the transverse plane over both groups (Table 1.2), while the within-subject range of measurements varied from 2-11° in the sagittal, 2-5° in the frontal, and 2-7° in the transverse planes (Table 1.3). Representing a worst-case scenario, the 95th percentile for range of measurements was >15° for many sagittal plane variables and >10° for many frontal and transverse plane variables in the younger group. In the singl- leg hop, the older group was much more variable than the younger group in the sagittal plane, particularly at the trunk, pelvis, and ankle (Figure 1.1 right). The younger group was still more variable than the older group at the trunk and pelvis in the transverse plane. Median within-subject variability ranged from 2-9° for SD and 3-17° for range of repeat measurements. Conclusion: There was substantial within-subject variability in performing sports related tasks for pediatric athletes of all ages. Variability was generally lower for older athletes, but was particularly high in the older group for sagittal plane trunk and pelvis motion during single-leg hop landing, which may reflect the need to adjust for less constrained positioning of a larger proximal mass. The high variability in performing sports tasks suggests that multiple trials should be analyzed for a more complete and representative evaluation. [Figure: see text][Table: see text][Table: see text]

scholarly journals Trunk, head and pelvis interactions in healthy children when performing seated daily arm tasks

2018 ◽  
Vol 236 (7) ◽  
pp. 2023-2036 ◽  
Author(s):  
L. H. C. Peeters ◽  
I. Kingma ◽  
G. S. Faber ◽  
J. H. van Dieën ◽  
I. J. M. de Groot
Keyword(s):  
Head Movement ◽  
Sagittal Plane ◽  
Neuromuscular Disorders ◽  
Frontal Plane ◽  
Upper Body ◽  
Movement Direction ◽  
Healthy Children ◽  
Trunk Movement ◽  
Trunk Motion ◽  
Trunk Segments

Abstract Development of trunk and head supportive devices for children with neuromuscular disorders requires detailed information about pelvis, trunk and head movement in interaction with upper extremity movement, as these are crucial for daily activities when seated in a wheelchair. Twenty-five healthy subjects (6–20 years old) were included to obtain insight in the physiological interactions between these segments and to assess maturation effects. Subjects performed a maximum range of trunk and head movement tasks and several daily tasks, including forward and lateral reaching. Movements of the arms, head, pelvis, and sub-sections of the trunk were recorded with an optical motion capture system. The range of motion of each segment was calculated. Contributions of individual trunk segments to the range of trunk motion varied with movement direction and therefore with the task performed. Movement of pelvis and all trunk segments in the sagittal plane increased significantly with reaching height, distance and object weight when reaching forward and lateral. Trunk movement in reaching decreased with age. Head movement was opposite to trunk movement in the sagittal (> 50% of the subjects) and transverse planes (> 75% of the subjects) and was variable in the frontal plane in most tasks. Both trunk and head movement onsets were earlier compared to arm movement onset. These results provide insight in the role of the upper body in arm tasks in young subjects and can be used for the design of trunk and head supportive devices for children with neuromuscular disorders.

EFFECTS OF KNEE OSTEOARTHRITIS ON BODY'S CENTER OF MASS MOTION IN OLDER ADULTS DURING LEVEL WALKING

2010 ◽  
Vol 22 (03) ◽  
pp. 205-212 ◽  
Author(s):  
Ting-Ming Wang ◽  
Wei-Chun Hsu ◽  
Chu-Fen Chang ◽  
Chih-Chung Hu ◽  
Tung-Wu Lu
Keyword(s):  
Knee Osteoarthritis ◽  
Dynamic Stability ◽  
Sagittal Plane ◽  
Center Of Pressure ◽  
Center Of Mass ◽  
Frontal Plane ◽  
Mass Motion ◽  
Knee Oa ◽  
Level Walking ◽  
Normal Controls

Knowledge of the control of the body's dynamic stability in patients with knee osteoarthritis (OA) is helpful for the management of these patients and for the evaluation of treatment outcomes. The purpose of the current study was to investigate the dynamic stability of patients with knee OA during level walking using variables describing the motion of the body's center of mass (COM) and its relationship to the center of pressure (COP). Kinematic and kinetic data during level walking were obtained from 10 patients with bilateral knee OA and 10 normal controls using a motion analysis system and two forceplates. Compared to the normal controls, patients with knee OA exhibited normal COM positions and velocities at key instances of gait but with significant changes in COM accelerations. In the sagittal plane, adjustments to the anterioposterior acceleration of the COM throughout the complete gait cycle were needed for better control of the COM during the more challenging latter half of single leg stance. Diminished A/P COM–COP separation was also used to maintain body stability with reduced joint loadings. In the frontal plane, this was achieved by increasing the acceleration of the body's COM towards the stance leg. The more jerky motion of the body's COM observed may be a result of reduced ability associated with knee OA in the control of the motion of the COM. Strengthening of the muscles of the lower extremities, as well as training of the control of the COM through a dynamic balance training program, are equally important for the dynamic stability of patients with knee OA.

scholarly journals Effectiveness of an ankle–foot orthosis on walking in patients with stroke: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoo Jin Choo ◽  
Min Cheol Chang
Keyword(s):  
Stride Length ◽  
Walking Speed ◽  
Sagittal Plane ◽  
Meta Analysis ◽  
Step Length ◽  
Stride Time ◽  
Plane Angle ◽  
Ankle Foot Orthosis ◽  
Biomechanical Parameters ◽  
Foot Orthosis

AbstractWe conducted a meta-analysis to investigate the effectiveness of ankle–foot orthosis (AFO) use in improving gait biomechanical parameters such as walking speed, mobility, and kinematics in patients with stroke with gait disturbance. We searched the MEDLINE (Medical Literature Analysis and Retrieval System Online), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, Embase, and Scopus databases and retrieved studies published until June 2021. Experimental and prospective studies were included that evaluated biomechanics or kinematic parameters with or without AFO in patients with stroke. We analyzed gait biomechanical parameters, including walking speed, mobility, balance, and kinematic variables, in studies involving patients with and without AFO use. The criteria of the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate the methodological quality of the studies, and the level of evidence was evaluated using the Research Pyramid model. Funnel plot analysis and Egger’s test were performed to confirm publication bias. A total of 19 studies including 434 participants that reported on the immediate or short-term effectiveness of AFO use were included in the analysis. Significant improvements in walking speed (standardized mean difference [SMD], 0.50; 95% CI 0.34–0.66; P < 0.00001; I2, 0%), cadence (SMD, 0.42; 95% CI 0.22–0.62; P < 0.0001; I2, 0%), step length (SMD, 0.41; 95% CI 0.18–0.63; P = 0.0003; I2, 2%), stride length (SMD, 0.43; 95% CI 0.15–0.71; P = 0.003; I2, 7%), Timed up-and-go test (SMD, − 0.30; 95% CI − 0.54 to − 0.07; P = 0.01; I2, 0%), functional ambulation category (FAC) score (SMD, 1.61; 95% CI 1.19–2.02; P < 0.00001; I2, 0%), ankle sagittal plane angle at initial contact (SMD, 0.66; 95% CI 0.34–0.98; P < 0.0001; I2, 0%), and knee sagittal plane angle at toe-off (SMD, 0.39; 95% CI 0.04–0.73; P = 0.03; I2, 46%) were observed when the patients wore AFOs. Stride time, body sway, and hip sagittal plane angle at toe-off were not significantly improved (p = 0.74, p = 0.07, p = 0.07, respectively). Among these results, the FAC score showed the most significant improvement, and stride time showed the lowest improvement. AFO improves walking speed, cadence, step length, and stride length, particularly in patients with stroke. AFO is considered beneficial in enhancing gait stability and ambulatory ability.

scholarly journals DOES BRAIN ACTIVATION DURING FUNCTIONAL MOVEMENT TASKS DIFFERENTIATE BETWEEN GOOD AND BAD MOVERS? AN INTEGRATED NEUROIMAGING ASSESSMENT OF MOTOR CONTROL IN YOUNG ATHLETES

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0013
Author(s):  
Manish Anand ◽  
Jed A. Diekfuss ◽  
Dustin R. Grooms ◽  
Alexis B. Slutsky-Ganesh ◽  
Scott Bonnette ◽  
...  
Keyword(s):  
Motor Control ◽  
Range Of Motion ◽  
Brain Function ◽  
Sagittal Plane ◽  
Brain Activity ◽  
Frontal Plane ◽  
Acl Injury ◽  
Timing Error ◽  
Lingual Gyrus ◽  
Increased Activity

Background: Aberrant frontal and sagittal plane knee motor control biomechanics contribute to increased anterior cruciate ligament (ACL) injury risk. Emergent data further indicates alterations in brain function may underlie ACL injury high risk biomechanics and primary injury. However, technical limitations have limited our ability to assess direct linkages between maladaptive biomechanics and brain function. Hypothesis/Purpose: (1) Increased frontal plane knee range of motion would associate with altered brain activity in regions important for sensorimotor control and (2) increased sagittal plane knee motor control timing error would associate with altered activity in sensorimotor control brain regions. Methods: Eighteen female high-school basketball and volleyball players (14.7 ± 1.4 years, 169.5 ± 7 cm, 65.8 ± 20.5 kg) underwent brain functional magnetic resonance imaging (fMRI) while performing a bilateral, combined hip, knee, and ankle flexion/extension movements against resistance (i.e., leg press) Figure 1(a). The participants completed this task to a reference beat of 1.2 Hz during four movement blocks of 30 seconds each interleaved in between 5 rest blocks of 30 seconds each. Concurrent frontal and sagittal plane range of motion (ROM) kinematics were measured using an MRI-compatible single camera motion capture system. Results: Increased frontal plane ROM was associated with increased brain activity in one cluster extending over the occipital fusiform gyrus and lingual gyrus ( p = .003, z > 3.1). Increased sagittal plane motor control timing error was associated with increased brain activity in multiple clusters extending over the occipital cortex (lingual gyrus), frontal cortex, and anterior cingulate cortex ( p < .001, z > 3.1); see Figure 1 (b). Conclusion: The associations of increased knee frontal plane ROM and sagittal plane timing error with increased activity in regions that integrate visuospatial information may be indicative of an increased propensity for knee injury biomechanics that are, in part, driven by reduced spatial awareness and an inability to adequately control knee abduction motion. Increased activation in these regions during movement tasks may underlie an impaired ability to control movements (i.e., less neural efficiency), leading to compromised knee positions during more complex sports scenarios. Increased activity in regions important for cognition/attention associating with motor control timing error further indicates a neurologically inefficient motor control strategy. [Figure: see text]

scholarly journals Biologically Inspired Design and Development of a Variable Stiffness Powered Ankle-Foot Prosthesis

2019 ◽  
Vol 11 (4) ◽  
Author(s):  
Alexander Agboola-Dobson ◽  
Guowu Wei ◽  
Lei Ren
Keyword(s):  
Lower Limb ◽  
Degrees Of Freedom ◽  
Sagittal Plane ◽  
Frontal Plane ◽  
Variable Stiffness ◽  
Plane Motion ◽  
Biologically Inspired ◽  
Passive Rotation ◽  
Ground Conditions ◽  
Biologically Inspired Design

Recent advancements in powered lower limb prostheses have appeased several difficulties faced by lower limb amputees by using a series-elastic actuator (SEA) to provide powered sagittal plane flexion. Unfortunately, these devices are currently unable to provide both powered sagittal plane flexion and two degrees of freedom (2-DOF) at the ankle, removing the ankle’s capacity to invert/evert, thus severely limiting terrain adaption capabilities and user comfort. The developed 2-DOF ankle system in this paper allows both powered flexion in the sagittal plane and passive rotation in the frontal plane; an SEA emulates the biomechanics of the gastrocnemius and Achilles tendon for flexion while a novel universal-joint system provides the 2-DOF. Several studies were undertaken to thoroughly characterize the capabilities of the device. Under both level- and sloped-ground conditions, ankle torque and kinematic data were obtained by using force-plates and a motion capture system. The device was found to be fully capable of providing powered sagittal plane motion and torque very close to that of a biological ankle while simultaneously being able to adapt to sloped terrain by undergoing frontal plane motion, thus providing 2-DOF at the ankle. These findings demonstrate that the device presented in this paper poses radical improvements to powered prosthetic ankle-foot device (PAFD) design.

scholarly journals Habitual Physical Activity as a Determinant of the Effect of Moderate Physical Exercise on Postural Control in Older Men

2012 ◽  
Vol 7 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Rafał Stemplewski ◽  
Janusz Maciaszek ◽  
Maciej Tomczak ◽  
Robert Szeklicki ◽  
Dorota Sadowska ◽  
...  
Keyword(s):  
Physical Activity ◽  
Postural Control ◽  
Sagittal Plane ◽  
Center Of Pressure ◽  
Force Plate ◽  
Frontal Plane ◽  
Habitual Physical Activity ◽  
Similar Reaction ◽  
Mean Velocity ◽  
Ergometer Exercise

The aim of the study was to compare the effect of exercise on postural control (PC) among the elderly with lower or higher level of habitual physical activity (HPA). The study involved 17 elderly men (mean age 72.9 ± 4.79 years). Mean velocity of the center of pressure (COP) displacements was measured using a force plate both before and after cycle ergometer exercise. A significantly higher increase in mean velocity of COP displacements and its component in the sagittal plane were observed in the group with lower level of HPA in comparison with the group with higher HPA level. Simultaneously, a relatively similar reaction to the exercise in the frontal plane was observed in both groups, possibly connected to the specific type of used exercise, which mainly activated the sagittal muscles.

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