scholarly journals Gait Training in Orthopedic Rehabilitation after Joint Replacement - Back to Normal Gait with Sonification?

2019 ◽  
Vol 18 (2) ◽  
pp. 34-48 ◽  
Author(s):  
J. Pietschmann ◽  
F. Geu Flores ◽  
T. Jöllenbeck
Keyword(s):  
New Technologies ◽  
Gait Training ◽  
Gait Pattern ◽  
Contralateral Side ◽  
Angle Measurement ◽  
Gait Patterns ◽  
Normal Gait ◽  
Frequent Use ◽  
Orthopedic Rehabilitation ◽  
Post Test

Abstract Even several years after total hip (THR) and total knee replacement (TKR) surgery patients frequently show deficient gait patterns leading to overloads and relieving postures on the contralateral side or in the spine. Gait training is, in these cases, an essential part of rehabilitation. The aim of this study was to compare different feedback methods during gait training after THR and TKR focusing, in particular, on auditory feedback via sonification. A total of 240 patients after THR and TKR were tested in a pre-post-test design during a 3-week rehabilitation period. Even though sonification did not show, statistically, a clear advantage over other feedback methods, it was well accepted by the patients and seemed to significantly change gait pattern during training. A sudden absence of sonification during training led to a rapid relapse into previous movement patterns, which highlights its effectiveness in breaking highly automated gait patterns. A frequent use of sonification during and after rehabilitation could, hence, reduce overloading after THR and TKR. This may soon be viable, since new technologies, such as inertial measurement units, allow for wearable joint angle measurement devices. Back to normal gait with sonification seems possible.

Estimates of Gastrocnemius Muscle Length During Simulated Pathological Gait

2013 ◽  
Vol 29 (2) ◽  
pp. 127-134 ◽  
Author(s):  
Smita Rao ◽  
Fred Dietz ◽  
H. John Yack
Keyword(s):  
Gastrocnemius Muscle ◽  
Muscle Length ◽  
Gait Pattern ◽  
Line Model ◽  
Gait Patterns ◽  
Segmented Model ◽  
Normal Gait ◽  
Straight Line ◽  
Crouch Gait ◽  
Pathological Gait

The purpose of this study was to compare estimates of gastrocnemius muscle length (GML) obtained using a segmented versus straight-line model in children. Kinematic data were acquired on eleven typically developing children as they walked under the following conditions: normal gait, crouch gait, equinus gait, and crouch with equinus gait. Maximum and minimum GML, and GML change were calculated using two models: straight-line and segmented. A two-way RMANOVA was used to compare GML characteristics. Results indicated that maximum GML and GML change during simulated pathological gait patterns were influenced by model used to calculate gastrocnemius muscle length (interaction: P = .004 and P = .026). Maximum GML was lower in the simulated gait patterns compared with normal gait (P < .001). Maximum GML was higher with the segmented model compared with the straight-line model (P = .030). Using either model, GML change in equinus gait and crouch with equinus gait was lower compared with normal gait (P < .001). Overall, minimum GML estimated with the segmented model was higher compared with the straight-line model (P < .01). The key findings of our study indicate that GML is significantly affected by both gait pattern and method of estimation. The GML estimates tended to be lower with the straight-line model versus the segmented model.

EXPLOITING VISUAL CUES FOR LEARNING GAIT PATTERNS ASSOCIATED WITH NEUROLOGICAL DISORDERS

2017 ◽  
Vol 79 (3) ◽  
Author(s):  
Kuhelee Roy ◽  
Geelapaturu Subrahmanya Venkata Radha Krish Rao ◽  
Savarimuthu, Margret Anouncia
Keyword(s):  
Early Diagnosis ◽  
Real Time ◽  
Neurological Disorders ◽  
Visual Cues ◽  
Gait Pattern ◽  
Shape Features ◽  
Gait Patterns ◽  
Normal Gait ◽  
Abnormal Gait ◽  
Gait Abnormalities

Records of cases involving neurological disorders often exhibit abnormalities in the gait pattern of an individual. As mentioned in various articles, the causes of various gait disorders can be attributed to neurological disorders. Hence analysis of gait abnormalities can be a key to predict the type of neurological disorders as a part of early diagnosis. A number of sensor-based measurements have aided towards quantifying the degree of abnormalities in a gait pattern. A shape oriented motion based approach has been proposed in this paper to envisage the task of classifying an abnormal gait pattern into one of the five types of gait viz. Parkinsonian, Scissor, Spastic, Steppage and Normal gait. The motion and shape features for two cases viz. right-leg-front and left-leg-front will be taken into account. Experimental results of application on real-time videos suggest the reliability of the proposed method.

Design and Development of Assistive Leg for Lower Limb Rehabilitation

2014 ◽  
Vol 984-985 ◽  
pp. 1235-1244
Author(s):  
C.A. Sribalaji ◽  
S. Abhishek ◽  
S.P. Harisubramanyabalaji ◽  
Anjan Kumar Dash
Keyword(s):  
Lower Limb ◽  
Gait Pattern ◽  
Angle Measurement ◽  
Design And Development ◽  
Normal Gait ◽  
Reflex Action ◽  
Leg Movement ◽  
Limb Rehabilitation ◽  
Lower Limb Rehabilitation ◽  
Walking Aid

The main objective of this paper is to design and develop an assistive leg for the paralyzed patients, which supports them, by changing their paralyzed gait pattern to normal gait pattern. The normal gait pattern is achieved by reflex action. Two angle measurement sensors are mounted in the normal leg and two servo motors are mounted in the paralytic leg-at the hip and ankle. The principle is that as the person takes a step in his normal leg, the sensors detect the amount of leg movement and sent the data to microcontroller. Then the servo motors in the paralytic leg are actuated based on the commands from the microcontroller depending on the type of gait suitable for the person. It is observed in such patients that they follow three kinds of gait. Depending on the amount of normal leg movement the gait pattern is decided and the servo motors rotate to move the paralytic leg. During all these, the person still takes the help from the walking aid.

scholarly journals Three-Dimensional Human Gait Pattern: Reference Data for Young, Active Women Walking with Low, Preferred, and High Speeds

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Slawomir Winiarski ◽  
Jadwiga Pietraszewska ◽  
Bogdan Pietraszewski
Keyword(s):  
Reference Data ◽  
Three Dimensional ◽  
Gait Pattern ◽  
Human Gait ◽  
Specific Population ◽  
Gait Patterns ◽  
Normative Database ◽  
High Speeds ◽  
Normal Gait ◽  
Adjustment Of Parameters

Normal gait pattern is the key component in the investigation of pathological gait patterns. In computer motion analysis there is a need to include data from participants with different somatic structures to develop a normative database or to limit the database results to a specific population. The aim of this study was to determine kinematic gait patterns for young, active women walking with low, preferred, and self-selected speeds with regard to their somatic characteristics. Laboratory-based gait analysis was performed on 1320 gait cycles taken from 20 young, active women walking with three different speeds. Comprehensive anthropometric measurements and descriptive statistics were used to describe spatiotemporal and angular variables at each walking condition. The results demonstrated some significant differences in young, active women walking between different speeds and compared to the literature. This suggests that there is a need to include data from participants with different somatic structures to develop a normative database or limit the database results to a specific population. Detailed linear and angular kinematic variables allow for proper adjustment of parameters depending on the gait speed of people with locomotion disorders.

scholarly journals Acoustic Feedback in Gait Rehabilitation—Pre-Post Effects in Patients With Unilateral Hip Arthroplasty

2021 ◽  
Vol 3 ◽  
Author(s):  
Julia Reh ◽  
Gerd Schmitz ◽  
Tong-Hun Hwang ◽  
Alfred O. Effenberg
Keyword(s):  
Hip Arthroplasty ◽  
Inertial Sensor ◽  
Step Length ◽  
Gait Training ◽  
Gait Pattern ◽  
Control Group ◽  
Clinical Trial Registration ◽  
Acoustic Feedback ◽  
Post Test ◽  
Analysis System

It is known that patients after unilateral hip arthroplasty still suffer from a deficient gait pattern compared to healthy individuals one year after surgery. Through the method of gait sonification, it may be possible to achieve a more efficient training and a more physiological gait pattern. Increased loads on the musculoskeletal system could thus be reduced and rehabilitation times shortened. In a previous investigation with this patient group, we found immediate gait pattern changes during training with dual mode acoustic feedback [real-time feedback (RTF) and instructive model sequences (IMS)]. To determine whether an effect persists without the immediate use of acoustic feedback, we analyze data from four times of testing. Following unilateral hip arthroplasty 22 patients participated in an intervention of ten gait training sessions of 20 min each. During gait training the sonification group (SG) (n = 11) received an acoustic feedback consisting of RTF and IMS compared to a control group (CG) (n = 11). Pre-test, intermediate test, post-test, and re-test were conducted using an inertial sensor-based motion analysis system. We found significant effects (α = 0.05) regarding step length and range of motion (RoM) of the hip joint. Step length of the affected leg increased in the SG from intermediate test to post-test but decreased in the CG [intermediate test: (SG) 0.63 m ± 0.12 m, (CG) 0.63 m ± 0.09 m; post-test: (SG) 0.66 m ± 0.11 m, (CG) 0.60 m ± 0.09 m]. However, from the post-test to the re-test a reverse development was observed [re-test: (SG) 0.63 m ± 0.10 m, (CG) 0.65 m ± 0.09 m]. Also, from post-test to re-test a decrease in the RoM of the unaffected hip for the SG but an increase for the CG could be observed [post-test: (SG) 44.10° ± 7.86°, (CG) 37.05° ± 7.21°; re-test: (SG) 41.73° ± 7.38°, (CG) 40.85° ± 9.28°]. Regarding further parameters, significant interactions in step duration as well as increases in stride length, gait speed, cadence, and a decrease in ground contact time from pre-test to re-test were observed for both groups.Clinical Trial Registration:https://www.drks.de/drks_web/, identifier DRKS00022570.

Nordic Walking Improves Postural Alignment and Leads to a More Normal Gait Pattern Following Weeks of Training: A Pilot Study

2016 ◽  
Vol 24 (4) ◽  
pp. 575-582 ◽  
Author(s):  
Christopher Dalton ◽  
Julie Nantel
Keyword(s):  
Power Generation ◽  
Older Adult ◽  
Gait Pattern ◽  
Normal Pattern ◽  
Nordic Walking ◽  
Gait Patterns ◽  
Healthy Older Adults ◽  
Postural Alignment ◽  
Normal Gait ◽  
The Impact

The aim of this study was to investigate the impact of an 8-week Nordic walking (NW) intervention on older adult gait patterns and postural alignment. Twelve healthy older adults aged 60–80 years (8 female, 4 male) participated, all performing two 6-min walk tests (one with poles [WP], one without poles [NP]) and six 5-m walk trials (3 WP, 3 NP) at pre- and posttesting. Gait and postural variables were compared between poling conditions (i.e., WP to NP) as well as before and following the intervention. Following training, pole use resulted in various gait changes including: longer stride, faster gait, and increased power generation at the hip (H3) and power absorption at the knee (K1 and K4). We conclude that an initial 8-week training period is necessary for novice NW to perfect technique and to restore gait to a more natural, normal pattern following training.

scholarly journals Efficiency and Stability of Step-To Gait in Slow Walking

2022 ◽  
Vol 15 ◽  
Author(s):  
Kento Hirayama ◽  
Yohei Otaka ◽  
Taichi Kurayama ◽  
Toru Takahashi ◽  
Yutaka Tomita ◽  
...  
Keyword(s):  
High Risk ◽  
Muscle Weakness ◽  
Lateral Displacement ◽  
Gait Pattern ◽  
Motor Deficit ◽  
Risk Of Falling ◽  
Gait Patterns ◽  
Normal Gait ◽  
Percent Recovery ◽  
Low Speeds

As humans, we constantly change our movement strategies to adapt to changes in physical functions and the external environment. We have to walk very slowly in situations with a high risk of falling, such as walking on slippery ice, carrying an overflowing cup of water, or muscle weakness owing to aging or motor deficit. However, previous studies have shown that a normal gait pattern at low speeds results in reduced efficiency and stability in comparison with those at a normal speed. Another possible strategy is to change the gait pattern from normal to step-to gait, in which the other foot is aligned with the first swing foot. However, the efficiency and stability of the step-to gait pattern at low speeds have not been investigated yet. Therefore, in this study, we compared the efficiency and stability of the normal and step-to gait patterns at intermediate, low, and very low speeds. Eleven healthy participants were asked to walk with a normal gait and step-to gait on a treadmill at five different speeds (i.e., 10, 20, 30, 40, and 60 m/min), ranging from very low to normal walking speed. The efficiency parameters (percent recovery and walk ratio) and stability parameters (center of mass lateral displacement) were analyzed from the motion capture data and then compared for the two gait patterns. The results suggested that step-to gait had a more efficient gait pattern at very low speeds of 10–30 m/min, with a larger percent recovery, and was more stable at 10–60 m/min in comparison with a normal gait. However, the efficiency of the normal gait was better than that of the step-to gait pattern at 60 m/min. Therefore, step-to gait is effective in improving gait efficiency and stability when faced with situations that force us to walk slowly or hinder quick walking because of muscle weakness owing to aging or motor deficit along with a high risk of falling.

Design of a 6-DOF Robotic Gait Training System With Closed-Chain Foot Initiated Kinematics Control

2015 ◽  
Author(s):  
Wei Liu ◽  
John Kovaleski ◽  
Marcus Hollis
Keyword(s):  
Three Dimensional ◽  
Computer Software ◽  
Gait Training ◽  
Gait Pattern ◽  
Training System ◽  
Normal Walking ◽  
Robot Assisted ◽  
Walking Gait ◽  
The Right ◽  
Joint Motions

Robotic assisted rehabilitation, taking advantage of neuroplasticity, has been shown to be helpful in regaining some degree of gait performance. Robot-applied movement along with voluntary efferent motor commands coordinated with the robot allows optimization of motion training. We present the design and characteristics of a novel foot-based 6-degree-of-freedom (DOF) robot-assisted gait training system where the limb trajectory mirrored the normal walking gait. The goal of this study was to compare robot-assisted gait to normal walking gait, where the limb moved independently without robotics. Motion analysis was used to record the three-dimensional kinematics of the right lower extremity. Walking motion data were determined and transferred to the robotic motion application software for inclusion in the robotic trials where the robot computer software was programmed to produce a gait pattern in the foot equivalent to the gait pattern recorded from the normal walking gait trial. Results demonstrated that ankle; knee and hip joint motions produced by the robot are consistent with the joint motions in walking gait. We believe that this control algorithm provides a rationale for use in future rehabilitation, targeting robot-assisted training in people with neuromuscular disabilities such as stroke.

COMMON ORTHOPEDIC PROBLEMS IN CHILDREN

PEDIATRICS ◽  
1956 ◽  
Vol 17 (5) ◽  
pp. 786-791
Author(s):  
C. B. Larson
Keyword(s):  
Weight Bearing ◽  
Gait Pattern ◽  
Normal Range ◽  
Spring Ligament ◽  
Normal Gait ◽  
Longitudinal Arch ◽  
Foot Problems ◽  
Bearing Stress ◽  
Shoe Soles ◽  
Shape And Size

Foot Problems NORMALLY the foot functions differently in stance than it does in motion. During stance, static stresses are most important. The foot may be divided at the midtarsal joints into the hindfoot which receives 60 per cent of the weight-bearing stress and the forefoot which receives 40 per cent of the stress. The spring ligament normally transmits the stresses from hindfoot to forefoot. All degrees of foot shape and size may be natural for a particular individual. Similarly, the gait pattern of a child varies considerably within the normal range. The child should be allowed to establish his own normal gait pattern. During the toddling stages the child's shoe soles should be flexible enough to bend at the toe. One should avoid the use of rigid shoes. Some of the conditions which may alter normal stance or gait follow. Simple Foot Strain Long arch strain is due to abnormal stress on the longitudinal ligament. Inflammatory repair of the ligament produces pain which can be demonstrated by finding an area tender to palpation. Some patients have a depressed longitudinal arch or long spring ligament without foot symptoms. A diagnosis of long arch strain cannot be made unless tenderness is present. A tight heel cord may produce foot strain. The foot accommodates to a tight heel cord by pronation of the forefoot. To correct a tight heel cord, the child should stand away from the wall (while facing it) with the heels flat, then lean forward count to 3. Repeat 5 times twice daily. Pronation

Dynamic and Reactive Walking for Humanoid Robots Based on Foot Placement Control

2016 ◽  
Vol 13 (02) ◽  
pp. 1550041 ◽  
Author(s):  
Juan Alejandro Castano ◽  
Zhibin Li ◽  
Chengxu Zhou ◽  
Nikos Tsagarakis ◽  
Darwin Caldwell
Keyword(s):  
Center Of Mass ◽  
Humanoid Robots ◽  
Gait Pattern ◽  
Gait Patterns ◽  
Foot Placement ◽  
Inverted Pendulum Model ◽  
Gait Parameters ◽  
Pendulum Model ◽  
Single Mass ◽  
Walking Velocity

This paper presents a novel online walking control that replans the gait pattern based on our proposed foot placement control using the actual center of mass (COM) state feedback. The analytic solution of foot placement is formulated based on the linear inverted pendulum model (LIPM) to recover the walking velocity and to reject external disturbances. The foot placement control predicts where and when to place the foothold in order to modulate the gait given the desired gait parameters. The zero moment point (ZMP) references and foot trajectories are replanned online according to the updated foothold prediction. Hence, only desired gait parameters are required instead of predefined or fixed gait patterns. Given the new ZMP references, the extended prediction self-adaptive control (EPSAC) approach to model predictive control (MPC) is used to minimize the ZMP response errors considering the acceleration constraints. Furthermore, to ensure smooth gait transitions, the conditions for the gait initiation and termination are also presented. The effectiveness of the presented gait control is validated by extensive disturbance rejection studies ranging from single mass simulation to a full body humanoid robot COMAN in a physics based simulator. The versatility is demonstrated by the control of reactive gaits as well as reactive stepping from standing posture. We present the data of the applied disturbances, the prediction of sagittal/lateral foot placements, the replanning of the foot/ZMP trajectories, and the COM responses.

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