scholarly journals Robot-assisted weight-bearing exercise for stroke patients with limited mobility

2018 ◽  
Vol 38 (2) ◽  
pp. 879-892 ◽  
Author(s):  
Guo Shanshan ◽  
Yulong Wang ◽  
Kun Wang ◽  
Jianjun Long ◽  
Xing Lv ◽  
...  

Weight-bearing exercise is a well-accepted physiotherapy to prevent osteoporosis for stroke patients. But the immobility of stroke patients limits the types and intensity of conventional interventions. Recent advances in robot-assisted therapeutic device provide an innovative way which could potentially overcome the above-mentioned limitations. However, the effects of robot-assisted physiotherapy on osteoporosis prevention have not been fully understood. The purpose of the present study is to develop an innovative theoretical framework to investigate the effects of static robot-assisted walking exercise on bone health. Through conducting a series of studies using a robot, force insoles and CT-image-based computational modeling, our results show that robot-assisted walking can significantly reduce the osteoporosis risk for stroke patients. However, the vertical peak ground reaction forces generated from static robot walking is generally lower than that from treadmill walking due to the fact that there are no heel strike and push-off effects in static robotic walking.

Medicine ◽  
2018 ◽  
Vol 97 (22) ◽  
pp. e10960
Author(s):  
Gabriel Gijon-Nogueron ◽  
Inmaculada Palomo-Toucedo ◽  
Alejandro Gil-Tinoco ◽  
Ana Belen Ortega-Avila ◽  
Pedro Vicente Munuera-Martínez

2020 ◽  
Vol 10 (5) ◽  
pp. 1575 ◽  
Author(s):  
Marek Pańtak

Building structures carrying pedestrian traffic, e.g., footbridges, long-span floors and long cantilevered platforms projecting outwards from the walls (long balconies), can be susceptible to the dynamic influence of its users. One type of dynamic action that can occur on these structures is the dynamic action of people running. The main aim of this paper is to present the results of the harmonic analyses and mathematical models of two types of ground reaction forces (GRFs) generated by people applying different running techniques, i.e., forefoot- and heel-strike (rearfoot) running technique. The analyses of the GRFs were performed on the basis of the results of laboratory tests of running people and concern the vertical component of the ground reaction forces (VGRFs) generated by runners. The harmonic analyses were performed using Fourier transform. The results of the study show the main features and differences between forces generated by forefoot- and heel-strike runners. Data obtained for various running styles allowed the development of a load model proposal for the VGRFs generated by heel-strike runners. The results of the VGRF parameterization and the proposed new VGRF model allow the VGRFs generated by forefoot and heel-strike runners to be accurately estimated in the case of normal running pace (recreational running). The application of the presented results allows improvements to the accuracy of determining the dynamic response of structures induced by runners.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Anabèle Brière ◽  
Sylvie Nadeau ◽  
Séléna Lauzière ◽  
Denis Gravel

Background. The weight-bearing (WB) and effort distributions during the five-repetition sit-to-stand test (5R-STS) were assessed in healthy and hemiparetic subjects and were compared to the distributions obtained for a single STS task (1-STS). Methods. Eighteen hemiparetic subjects and 12 controls were included. The WB distribution and time were computed using the vertical ground reaction forces. The knee muscles' effort distribution was quantified with the electromyographic (EMG) data of the STS transfers expressed relatively to the EMG values of maximal strength assessments. Results. In both groups, the time, WB, and effort distributions did not differ between repetitions of the 5R-STS test. The WB and effort distributions of the first repetition were more asymmetrical than those for the 1-STS for the hemiparetic subjects only. Conclusions. Since no changes were found between repetitions, the 5R-STS test might not be demanding enough. The hemiparetic subjects adopt different WB and effort distribution strategies according to the number of STSs to complete.


2011 ◽  
Vol 133 (12) ◽  
Author(s):  
Jeff A. Nessler ◽  
Moustafa Moustafa-Bayoumi ◽  
Dalziel Soto ◽  
Jessica Duhon ◽  
Ryan Schmitt

Robotic locomotor training devices have gained popularity in recent years, yet little has been reported regarding contact forces experienced by the subject performing automated locomotor training, particularly in animal models of neurological injury. The purpose of this study was to develop a means for acquiring contact forces between a robotic device and a rodent model of spinal cord injury through instrumentation of a robotic gait training device (the rat stepper) with miniature force/torque sensors. Sensors were placed at each interface between the robot arm and animal’s hindlimb and underneath the stepping surface of both hindpaws (four sensors total). Twenty four female, Sprague-Dawley rats received mid-thoracic spinal cord transections as neonates and were included in the study. Of these 24 animals, training began for 18 animals at 21 days of age and continued for four weeks at five min/day, five days/week. The remaining six animals were untrained. Animal-robot contact forces were acquired for trained animals weekly and untrained animals every two weeks while stepping in the robotic device with both 60 and 90% of their body weight supported (BWS). Animals that received training significantly increased the number of weight supported steps over the four week training period. Analysis of raw contact forces revealed significant increases in forward swing and ground reaction forces during this time, and multiple aspects of animal-robot contact forces were significantly correlated with weight bearing stepping. However, when contact forces were normalized to animal body weight, these increasing trends were no longer present. Comparison of trained and untrained animals revealed significant differences in normalized ground reaction forces (both horizontal and vertical) and normalized forward swing force. Finally, both forward swing and ground reaction forces were significantly reduced at 90% BWS when compared to the 60% condition. These results suggest that measurement of animal-robot contact forces using the instrumented rat stepper can provide a sensitive and reliable measure of hindlimb locomotor strength and control of flexor and extensor muscle activity in neurologically impaired animals. Additionally, these measures may be useful as a means to quantify training intensity or dose-related functional outcomes of automated training.


2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Antti Alamäki ◽  
Elina Nevala ◽  
Juha Jalovaara ◽  
John Barton ◽  
Salvatore Tedesco ◽  
...  

Biomechanical analysis of gait is commonly used in physiotherapy. Ground reaction forces during phases of gait is one element of kinetic analysis. In this article, we analyze if the MoveSole® smart insole is valid and accurate equipment for measuring ground reaction forces in clinical physiotherapy. MoveSole® StepLab is a mobile measurement system for instant underfoot force measurements during gait. Unique electromagnetic film (EMFI) based sensor technology and printed electronics production technology is integrated in the MoveSole® StepLab measurement system. The MoveSole® StepLab measures plantar ground reaction force distribution over the sensors and provides an estimation of the maximum total ground reaction force. We developed a two phase validation process to extract relevant parameters and compared the results to a Kistler force plate using the BioWare® analyzing program as a reference method. Our results show that MoveSole® smart insoles reach the strong level of accuracy needed in clinical work concerning highest ground reaction forces during step (Pearson correlation .822 - .875). The correlation of the time when the maximum ground reaction force occurred was moderate, e.g. during heel strike or toe-off (Pearson correlation natural gait speed .351 - .462, maximum gait speed .430). Our conclusion is that MoveSole® smart insoles are a potential tool for analyzing and monitoring gait ground reaction forces during physiotherapy processes.


Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1542
Author(s):  
Zoe Mass Kokolevich ◽  
Erik Biros ◽  
Oren Tirosh ◽  
Jacqueline Elise Reznik

This case report study aims to identify the differences in the ground reaction forces (GRF) placed on the forefoot, hindfoot, and entire foot between the paretic and non-paretic legs in two stroke patients to identify potential targets for improved physiotherapy treatment. A digital gait analysis foot pressure insole was fitted inside the participants’ shoes to measure the percentage of body weight taken during the stance phase, and the vertical GRF of the two subjects are reported in this paper. Both patients presented noteworthy differences in gait parameters individually and between their paretic and non-paretic legs. The trend shows a decreased percentage of body weight on the paretic forefoot and hindfoot, although the percentage bodyweight placed on the entire foot remained similar in both feet. The gait patterns shown were highly individual and indicated that both legs were affected to some degree. These findings identify key motion targets for an improved physiotherapy treatment following a stroke, suggesting that physiotherapy treatment should be targeted and individually tailored and should include both extremities.


2000 ◽  
Vol 9 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Stephen J. Kinzey ◽  
Mitchell L. Cordova ◽  
Kevin J. Gallen ◽  
Jason C. Smith ◽  
Justin B. Moore

Objective:To determine whether a standard 20-min ice-bath (10°C) immersion of the leg alters vertical ground-reaction-force components during a 1 -legged vertical jump.Design:A 1 × 5 factorial repeated-measures model was used.Setting:The Applied Biomechanics Laboratory at The University of Mississippi.Participants:Fifteen healthy and physically active subjects (age = 22.3 ± 2.1 years, height = 177.3 ± 12.2 cm, mass = 76.3 ± 19.1 kg) participated.Intervention:Subjects performed 25 one-legged vertical jumps with their preferred extremity before (5 jumps) and after (20 jumps) a 20-min cold whirlpool to the leg. The 25 jumps were reduced into 5 sets of average trials.Main Outcome Measures:Normalized peak and average vertical ground-reaction forces, as well as vertical impulse obtained using an instrumented force platform.Results:Immediately after cryotherapy (sets 2 and 3), vertical impulse decreased (P= .01); peak vertical ground-reaction force increased (set 2) but then decreased toward baseline measures (P= .02). Average vertical ground-reaction force remained unchanged (P>.05).Conclusions:The authors advocate waiting approximately 15 min before engaging in activities that require the production of weight-bearing explosive strength or power.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ioannis D. Zoulias ◽  
Monica Armengol ◽  
Adrian Poulton ◽  
Brian Andrews ◽  
Robin Gibbons ◽  
...  

Abstract This paper describes a Functional Electrical Stimulation (FES) standing system for rehabilitation of bone mineral density (BMD) in people with Spinal Cord Injury (SCI). BMD recovery offers an increased quality of life for people with SCI by reducing their risk of fractures. The standing system developed comprises an instrumented frame equipped with force plates and load cells, a motion capture system, and a purpose built 16-channel FES unit. This system can simultaneously record and process a wide range of biomechanical data to produce muscle stimulation which enables users with SCI to safely stand and exercise. An exergame provides visual feedback to the user to assist with upper-body posture control during exercising. To validate the system an alternate weight-shift exercise was used; 3 participants with complete SCI exercised in the system for 1 hour twice-weekly for 6 months. We observed ground reaction forces over 70% of the full body-weight distributed to the supporting leg at each exercising cycle. Exercise performance improved for each participant by an increase of 13.88 percentage points of body-weight in the loading of the supporting leg during the six-month period. Importantly, the observed ground reaction forces are of higher magnitude than other studies which reported positive effects on BMD. This novel instrumentation aims to investigate weight bearing standing therapies aimed at determining the biomechanics of lower limb joint force actions and postural kinematics.


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