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.

Muscle Contributions to Balance Control During Amputee and Nonamputee Stair Ascent

2020 ◽  
Vol 142 (12) ◽  
Author(s):  
Nicole G. Harper ◽  
Jason M. Wilken ◽  
Richard R. Neptune
Keyword(s):  
Angular Momentum ◽  
Lower Limb ◽  
Sagittal Plane ◽  
Balance Control ◽  
Dynamic Balance ◽  
Frontal Plane ◽  
Rate Of Change ◽  
Prosthetic Devices ◽  
Stair Ascent

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.

scholarly journals Manual stabilization reveals a transient role for balance control during locomotor adaptation

2019 ◽  
Author(s):  
Sungwoo Park ◽  
James M. Finley
Keyword(s):  
Angular Momentum ◽  
Balance Control ◽  
Dynamic Balance ◽  
Step Length ◽  
Bipedal Walking ◽  
Whole Body ◽  
Arm Swing ◽  
Angular Momenta ◽  
After Effect ◽  
Potential Factor

AbstractA fundamental feature of human locomotor control is the need to adapt our walking pattern in response to changes in the environment. For example, when people walk on a split-belt treadmill which has belts that move at different speeds, they adapt to the asymmetric speed constraints by reducing their spatiotemporal asymmetry. Here, we aim to understand the role of stability as a potential factor driving this adaptation process. We recruited 24 healthy, young adults to adapt to walking on a split-belt treadmill while either holding on to a handrail or walking with free arm swing. We measured whole-body angular momentum and step length asymmetry as measures of dynamic balance and spatiotemporal asymmetry, respectively. To understand how changes in intersegmental coordination influenced measures of dynamic balance, we also measured segmental angular momenta and the coefficient of limb cancellation. When participants were initially exposed to the asymmetry in belt speeds, we observed an increase in whole-body angular momentum that was due to both an increase in the momentum of individual limb segments and a reduction in limb cancellation. Holding on to a handrail reduced the perturbation to asymmetry during the early phase of adaptation and resulted in a smaller after-effect during post-adaptation. In addition, the stabilization provided by holding on to a handrail led to reductions in the coupling between angular momentum and asymmetry. These results suggest that regulation of dynamic balance is most important during the initial, transient phase of adaptation to walking on a split-belt treadmill.Summary StatementRegulation of balance exhibits a transient effect on adaptation to imposed asymmetries during bipedal walking. External stabilization attenuates initial deviations in spatiotemporal asymmetry but has no effect on subsequent adaptation.

scholarly journals Effects of application of texture insoles on the balance of subjects with Multiple Sclerosis

2017 ◽  
Vol 16 (1) ◽  
pp. 9-16
Author(s):  
Wildja De Lima Gomes ◽  
Thais Botossi Scalha ◽  
Lucas Brino Mota ◽  
Viviane Almeida Kuroda ◽  
Juliana Cintra Garrafa ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Dynamic Balance ◽  
Step Length ◽  
Berg Balance Scale ◽  
Measuring Instruments ◽  
Balance Scale ◽  
Functional Gait ◽  
Dynamic Gait Index ◽  
Dynamic Gait ◽  
Gait Index

Objective: The aim of this study was to evaluate the effects on static and dynamic balance after the use of textured insoles. Method: Fifteen subjects with multiple sclerosis were evaluated before using the insoles, after using them for 1 month, and after 2 months without using, them using the following measuring instruments: the Berg Balance Scale, Dynamic Gait Index, and 10-meter Walk Test, a means of functional gait assessment. Results: Improvement was observed in the Berg Balance Scale and Dynamic Gait Index scores, walking time, number of steps and step length after using the insoles for 1 month. The improvement in Berg Balance Scale score remained after two months without the insoles and there were no changes in gait speed. Conclusion: The use of textured insoles was effective as an intervention to improve static and dynamic balance in patients with multiple sclerosis.

scholarly journals Validation of a Laser Ranged Scanner-Based Detection of Spatio-Temporal Gait Parameters Using the aTUG Chair

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1343
Author(s):  
Sebastian Fudickar ◽  
Jörn Kiselev ◽  
Christian Stolle ◽  
Thomas Frenken ◽  
Elisabeth Steinhagen-Thiessen ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Measurement Accuracy ◽  
Dynamic Balance ◽  
Step Length ◽  
Berg Balance Scale ◽  
Walking Ability ◽  
Functional Requirements ◽  
Balance Confidence ◽  
Gait Parameters ◽  
Abc Scale

This article covers the suitability to measure gait-parameters via a Laser Range Scanner (LRS) that was placed below a chair during the walking phase of the Timed Up&Go Test in a cohort of 92 older adults (mean age 73.5). The results of our study demonstrated a high concordance of gait measurements using a LRS in comparison to the reference GAITRite walkway. Most of aTUG’s gait parameters demonstrate a strong correlation coefficient with the GAITRite, indicating high measurement accuracy for the spatial gait parameters. Measurements of velocity had a correlation coefficient of 99%, which can be interpreted as an excellent measurement accuracy. Cadence showed a slightly lower correlation coefficient of 96%, which is still an exceptionally good result, while step length demonstrated a correlation coefficient of 98% per leg and stride length with an accuracy of 99% per leg. In addition to confirming the technical validation of the aTUG regarding its ability to measure gait parameters, we compared results from the GAITRite and the aTUG for several parameters (cadence, velocity, and step length) with results from the Berg Balance Scale (BBS) and the Activities-Specific Balance Confidence-(ABC)-Scale assessments. With confidence coefficients for BBS and velocity, cadence and step length ranging from 0.595 to 0.798 and for ABC ranging from 0.395 to 0.541, both scales demonstrated only a medium-sized correlation. Thus, we found an association of better walking ability (represented by the measured gait parameters) with better balance (BBC) and balance confidence (ABC) overall scores via linear regression. This results from the fact that the BBS incorporates both static and dynamic balance measures and thus, only partly reflects functional requirements for walking. For the ABC score, this effect was even more pronounced. As this is to our best knowledge the first evaluation of the association between gait parameters and these balance scores, we will further investigate this phenomenon and aim to integrate further measures into the aTUG to achieve an increased sensitivity for balance ability.

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.

RUNNING PATTERN GENERATION OF HUMANOID BIPED WITH A FIXED POINT AND ITS REALIZATION

2009 ◽  
Vol 06 (04) ◽  
pp. 631-656 ◽  
Author(s):  
BAEK-KYU CHO ◽  
ILL-WOO PARK ◽  
JUN-HO OH
Keyword(s):  
Fixed Point ◽  
Angular Momentum ◽  
Sagittal Plane ◽  
Center Of Mass ◽  
Maximum Velocity ◽  
Frontal Plane ◽  
Numerical Approach ◽  
Pattern Generation ◽  
Upper Body ◽  
Running Pattern

This paper discusses the generation of a running pattern for a humanoid biped and verifies the validity of the proposed method of running pattern generation via experiments. Two running patterns are generated independently in the sagittal plane and in the frontal plane and the two patterns are then combined. When a running pattern is created with resolved momentum control in the sagittal plane, the angular momentum of the robot about the Center of Mass (COM) is set to zero, as the angular momentum causes the robot to rotate. However, this also induces unnatural motion of the upper body of the robot. To solve this problem, the biped was set as a virtual under-actuated robot with a free joint at its support ankle, and a fixed point for a virtual under-actuated system was determined. Following this, a periodic running pattern in the sagittal plane was formulated using the fixed point. The fixed point is easily determined in a numerical approach. In this way, a running pattern in the frontal plane was also generated. In an experiment, a humanoid biped known as KHR-2 ran forward using the proposed running pattern generation method. Its maximum velocity was 2.88 km/h.

The Effect of the TayCo External Ankle Brace on Multidirectional Reach Distance, Balance, and Motion in Collegiate Athletes

2020 ◽  
Vol 25 (6) ◽  
pp. 323-327
Author(s):  
Steven J. Smith ◽  
Cameron J. Powden
Keyword(s):  
Range Of Motion ◽  
Sagittal Plane ◽  
Dynamic Balance ◽  
Plantar Flexion ◽  
Collegiate Athletes ◽  
Frontal Plane ◽  
Plane Motion ◽  
Lower Extremity Function ◽  
Physically Active ◽  
Ankle Brace

Ensuring ankle stability while allowing for functional movement is important when returning patients to physical activity and attempting to prevent injury. The purpose of this study was to examine the effectiveness of the TayCo external and a lace-up ankle brace on lower extremity function, dynamic balance, and motion in 18 physically active participants. Significantly greater range of motion was demonstrated for the TayCo brace compared with the lace-up brace for dorsiflexion and plantar flexion, as well as less range of motion for the TayCo brace compared to the lace-up brace for inversion and eversion. The TayCo brace provided restricted frontal plane motion while allowing increased sagittal plane motion without impacting performance measures.

Changes in the dynamic balance level of winter sports players, candidates for ZSMS Zakopane in the years 2007-2016

2019 ◽  
Vol 29 (88) ◽  
pp. 28-40
Author(s):  
Dariusz Tchórzewski ◽  
Janusz Brudecki ◽  
Janusz Jaworski ◽  
Przemysław Bujas
Keyword(s):  
High School ◽  
High School Students ◽  
Junior High ◽  
Sagittal Plane ◽  
Dynamic Balance ◽  
Frontal Plane ◽  
Difficulty Level ◽  
School Students ◽  
Winter Sports ◽  
Motor Fitness

Research aim. The objective of the work is to determine the changes in the level of ability to maintain balance in dynamic conditions among winter sports players, candidates for junior-high and high school of the Zakopane Sports Championship Team (ZSMS) over the last decade. The following research questions were formulated: 1. Have there been significant changes in the level of dynamic balance of winter sports candidates at ZSMS Zakopane in the last ten years? 2. Did any changes have a similar range in the subjects in both analysed tilt directions (anterior-posterior and lateral)? 3. Did the differences in the level of dynamic balance between 13- and 16-year-old candidates maintain at a similar level during the examined period? Materials and methods. The study included a 133 group of boys, junior-high candidates (age 13.32 ± 0.77) and a 198 group of high school students (age 16.02 ± 0.48). To determine the level of balance on an unstable surface, the Libra balance platform of the Italian company EasyTech was used. A sine wave with an amplitude of 5° and a frequency of 10 cycles/min were used as the path pattern. The balance curvature r=40 cm and the sixth difficulty level (deviation from the reference line by 5° in each direction) were applied. The following results were used for the analysis: stability index (SI), total area (TA) and index of balance precision (IBP). The tests were carried out separately for the frontal and sagittal planes. Before the measurements were taken, the basic somatic features of the subjects were measured. The diversity of the results of individual stability parameters was verified via the Kruskal-Wallis and the Mann-Whitney U tests. Results. Over the decade, in both 13- and 16-year-olds, significant improvement in the value of all tested parameters of stability in the frontal plane was noted. Among junior-high school students, these equalled: SI=40.5%; TA=30.0%; IBP=52.5%, whereas for high-school students, the values totalled: SI=32.1%; TA=23.6%; IBP=49.4%. However, the occurrence of such positive changes in the sagittal plane has not been confirmed. Similarly, 13-year-olds improved their results in the following range: SI=22.9%; TA=18.2%; IBP=33.5%, while for 16-year-olds, these were: SI=11.6%; TA=9.9%; IBP=16.8%. There was a gradual disappearance of differences in the level of balance between the junior- and high-school ZSMS candidates. Conclusions. Analysis of changes in the level of dynamic balance of winter sports players over the decade indicates that this ability has not yielded to trends characterising the nationwide population in the field of motor fitness. The presented results indicate either constant improvement in the stability of the subjects (frontal plane) or maintaining it at a good, stable level (sagittal plane). This is an optimistic conclusion, because many authors believe that the results obtained on balance platforms not only characterise the level of postural stability of subjects, but also that the speed of adaptation to the conditions of the unstable ground is a determinant of the level of coordination abilities of a subject.

Dynamic locomotion synchronization of bipedal robot and human operator via bilateral feedback teleoperation

2019 ◽  
Vol 4 (35) ◽  
pp. eaav4282 ◽  
Author(s):  
Joao Ramos ◽  
Sangbae Kim
Keyword(s):  
Sagittal Plane ◽  
Frontal Plane ◽  
Humanoid Robots ◽  
Human Locomotion ◽  
Human Motion ◽  
Body Motion ◽  
Human Operator ◽  
Whole Body ◽  
Physical Endurance ◽  
Bipedal Robot

Despite remarkable progress in artificial intelligence, autonomous humanoid robots are still far from matching human-level manipulation and locomotion proficiency in real applications. Proficient robots would be ideal first responders to dangerous scenarios such as natural or man-made disasters. When handling these situations, robots must be capable of navigating highly unstructured terrain and dexterously interacting with objects designed for human workers. To create humanoid machines with human-level motor skills, in this work, we use whole-body teleoperation to leverage human control intelligence to command the locomotion of a bipedal robot. The challenge of this strategy lies in properly mapping human body motion to the machine while simultaneously informing the operator how closely the robot is reproducing the movement. Therefore, we propose a solution for this bilateral feedback policy to control a bipedal robot to take steps, jump, and walk in synchrony with a human operator. Such dynamic synchronization was achieved by (i) scaling the core components of human locomotion data to robot proportions in real time and (ii) applying feedback forces to the operator that are proportional to the relative velocity between human and robot. Human motion was sped up to match a faster robot, or drag was generated to synchronize the operator with a slower robot. Here, we focused on the frontal plane dynamics and stabilized the robot in the sagittal plane using an external gantry. These results represent a fundamental solution to seamlessly combine human innate motor control proficiency with the physical endurance and strength of humanoid robots.

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