scholarly journals Assessment of an Assistive Control Approach Applied in an Active Knee Orthosis Plus Walker for Post-Stroke Gait Rehabilitation

Sensors ◽  
2020 ◽  
Vol 20 (9) ◽  
pp. 2452
Author(s):  
Ana Cecilia Villa-Parra ◽  
Jessica Lima ◽  
Denis Delisle-Rodriguez ◽  
Laura Vargas-Valencia ◽  
Anselmo Frizera-Neto ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Muscle Activation ◽  
Inertial Sensors ◽  
Lower Limbs ◽  
Trunk Muscles ◽  
Control Group ◽  
Gait Rehabilitation ◽  
Control Approach ◽  
Post Stroke ◽  
Knee Orthosis

The goal of this study is the assessment of an assistive control approach applied to an active knee orthosis plus a walker for gait rehabilitation. The study evaluates post-stroke patients and healthy subjects (control group) in terms of kinematics, kinetics, and muscle activity. Muscle and gait information of interest were acquired from their lower limbs and trunk, and a comparison was conducted between patients and control group. Signals from plantar pressure, gait phase, and knee angle and torque were acquired during gait, which allowed us to verify that the stance control strategy proposed here was efficient at improving the patients’ gaits (comparing their results to the control group), without the necessity of imposing a fixed knee trajectory. An innovative evaluation of trunk muscles related to the maintenance of dynamic postural equilibrium during gait assisted by our active knee orthosis plus walker was also conducted through inertial sensors. An increase in gait cycle (stance phase) was also observed when comparing the results of this study to our previous work. Regarding the kinematics, the maximum knee torque was lower for patients when compared to the control group, which implies that our orthosis did not demand from the patients a knee torque greater than that for healthy subjects. Through surface electromyography (sEMG) analysis, a significant reduction in trunk muscle activation and fatigability, before and during the use of our orthosis by patients, was also observed. This suggest that our orthosis, together with the assistive control approach proposed here, is promising and could be considered to complement post-stroke patient gait rehabilitation.

scholarly journals Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ross M. Neuman ◽  
Staci M. Shearin ◽  
Karen J. McCain ◽  
Nicholas P. Fey
Keyword(s):  
Multiple Sclerosis ◽  
Muscle Activity ◽  
Healthy Subjects ◽  
Muscle Activation ◽  
Assistive Technologies ◽  
Lower Limbs ◽  
Biomechanical Analysis ◽  
Foot Drop ◽  
Plantar Flexors ◽  
Hip Flexion

Abstract Background Gait impairment is a common complication of multiple sclerosis (MS). Gait limitations such as limited hip flexion, foot drop, and knee hyperextension often require external devices like crutches, canes, and orthoses. The effects of mobility-assistive technologies (MATs) prescribed to people with MS are not well understood, and current devices do not cater to the specific needs of these individuals. To address this, a passive unilateral hip flexion-assisting orthosis (HFO) was developed that uses resistance bands spanning the hip joint to redirect energy in the gait cycle. The purpose of this study was to investigate the short-term effects of the HFO on gait mechanics and muscle activation for people with and without MS. We hypothesized that (1) hip flexion would increase in the limb wearing the device, and (2) that muscle activity would increase in hip extensors, and decrease in hip flexors and plantar flexors. Methods Five healthy subjects and five subjects with MS walked for minute-long sessions with the device using three different levels of band stiffness. We analyzed peak hip flexion and extension angles, lower limb joint work, and muscle activity in eight muscles on the lower limbs and trunk. Single-subjects analysis was used due to inter-subject variability. Results For subjects with MS, the HFO caused an increase in peak hip flexion angle and a decrease in peak hip extension angle, confirming our first hypothesis. Healthy subjects showed less pronounced kinematic changes when using the device. Power generated at the hip was increased in most subjects while using the HFO. The second hypothesis was not confirmed, as muscle activity showed inconsistent results, however several subjects demonstrated increased hip extensor and trunk muscle activity with the HFO. Conclusions This exploratory study showed that the HFO was well-tolerated by healthy subjects and subjects with MS, and that it promoted more normative kinematics at the hip for those with MS. Future studies with longer exposure to the HFO and personalized assistance parameters are needed to understand the efficacy of the HFO for mobility assistance and rehabilitation for people with MS.

scholarly journals The Effects of Abdominal Hypopressive Training on Postural Control and Deep Trunk Muscle Activation: A Randomized Controlled Trial

2021 ◽  
Vol 18 (5) ◽  
pp. 2741
Author(s):  
María del Mar Moreno-Muñoz ◽  
Fidel Hita-Contreras ◽  
María Dolores Estudillo-Martínez ◽  
Agustín Aibar-Almazán ◽  
Yolanda Castellote-Caballero ◽  
...  
Keyword(s):  
Postural Control ◽  
Muscle Activation ◽  
Center Of Pressure ◽  
Controlled Trial ◽  
Trunk Muscle ◽  
Posture Control ◽  
Trunk Muscles ◽  
Control Group ◽  
Female Population ◽  
Imaging Results

Background: Abdominal Hypopressive Training (AHT) provides postural improvement, and enhances deep trunk muscle activation. However, until recently, there was a lack of scientific literature supporting these statements. The major purpose of this study was to investigate the effect of AHT on posture control and deep trunk muscle function. Methods: 125 female participants aged 18–60 were randomly allocated to the Experimental Group (EG), consisting of two sessions of 30 min per week for 8 weeks of AHT, or the Control Group (CG), who did not receive any treatment. Postural control was measured with a stabilometric platform to assess the static balance and the activation of deep trunk muscles (specifically the Transverse Abdominal muscle (TrA)), which was measured by real-time ultrasound imaging. Results: The groups were homogeneous at baseline. Statistical differences were identified between both groups after intervention in the Surface of the Center of Pressure (CoP) Open-Eyes (S-OE) (p = 0.001, Cohen’s d = 0.60) and the Velocity of CoP under both conditions; Open-Eyes (V-OE) (p = 0.001, Cohen´s d = 0.63) and Close-Eyes (V-CE) (p = 0.016, Cohen´s d = 0.016), with the EG achieving substantial improvements. Likewise, there were statistically significant differences between measurements over time for the EG on S-OE (p < 0.001, Cohen´s d = 0.99); V-OE (p = 0.038, Cohen´s d = 0.27); V-CE (p = 0.006, Cohen´s d = 0.39), anteroposterior movements of CoP with Open-Eyes (RMSY-OE) (p = 0.038, Cohen´s d = 0.60) and activity of TrA under contraction conditions (p < 0.001, Cohen´s d = 0.53). Conclusions: The application of eight weeks of AHT leads to positive outcomes in posture control, as well as an improvement in the deep trunk muscle contraction in the female population.

scholarly journals Sequential muscle activation in the hemiparetic arm

2004 ◽  
Vol 60 (2) ◽  
Author(s):  
C. Mucha
Keyword(s):  
Patient Group ◽  
Healthy Subjects ◽  
Muscle Activation ◽  
Deltoid Muscle ◽  
Middle Part ◽  
Control Group ◽  
Biceps Muscle ◽  
Significant Prolongation ◽  
Healthy Control ◽  
Simultaneous Activation

This study investigated the chronological activation sequence of multiple joint movements of the hemiparetic arm in patients with central hemiparesis compared to healthy test subjects.Twelve patients with central hemiparesis and eight healthy control subjects were studied. First, in rapid abduction movement of the upper limb, the electromyographic activities of the middle part of the deltoid muscle, the brachial biceps muscle and the extensor muscles of the fingers, were registered. Second, in rapid flexion of the arm, the electromyographic activities of the ventral part of the deltoid muscle, the brachial biceps muscle and the superficial flexor muscles of the fingers, were measured. From the EMG data registered, activation duration, activation latency and the innervation sequence were determined and compared between the patient group and the control group. In the patient group, a significant prolongation of the activation duration was shown only in abduction. However, the activation latency was significantly prolonged in both movements compared to healthy test subjects. In the innervation sequences, a simultaneous activation was most frequently shown in healthy subjects. In healthy subjects, the deltoid muscle also usually functioned as leading muscle, whereas there was sometimes a shift distally to the brachial biceps muscle in the hemiparetic patients. The speed of rapid multiple joint movements in hemiparetic extremities seems to be unaffected in certain movements (anteversion), in others (abduction) it seems to be significantly reduced. This, as well as the fact that the activation latency is significantly longer in the hemiparetic limbs should be taken into consideration when choosing rehabilitation exercises.

scholarly journals Effect of real-time ultrasound imaging for biofeedback on trunk muscle contraction in healthy subjects: a preliminary study

2020 ◽  
Author(s):  
Shanshan Lin ◽  
Bo Zhu ◽  
Yiyi Zheng ◽  
Guozhi Huang ◽  
Qing Zeng ◽  
...  
Keyword(s):  
Muscle Contraction ◽  
Real Time ◽  
Ultrasound Imaging ◽  
Healthy Subjects ◽  
Transversus Abdominis ◽  
Trunk Muscles ◽  
Control Group ◽  
Visual Biofeedback ◽  
Preliminary Study ◽  
Experimental Group

Abstract Background: Real-time ultrasound imaging (RUSI) has been increasingly used as a form of biofeedback when instructing and re-training muscle contraction. However, the effectiveness of the RUSI on a single sustained contraction of the lumbar multifidus (LM) and transversus abdominis (TrA) has rarely been reported. This preliminary study aimed to determine if the use of RUSI, as visual biofeedback, could enhance the ability of activation and continuous contraction of the trunk muscles including LM and TrA.Methods: Forty healthy individuals were included and randomly assigned into the experimental group and control group. All subjects performed a preferential activation of the LM and/or TrA (maintained the constraction of LM and/or TrA for 30 seconds and then relaxed for two minutes), while those in the experimental group also received visual feedback provided by RUSI. The thickness of LM and/or TrA at rest and during contraction (Tc-max, T15s, and T30s) were extracted and recorded. The experiment was repeated three times.Results: No significant differences were found in the thickness of LM at rest (P > 0.999), Tc-max (P > 0.999), and T15s (P = 0.414) between the two groups. However, the ability to recruit LM muscle contraction differed between groups at T30s (P = 0.006), with subjects in the experimental group that received visual ultrasound biofeedback maintaining a relative maximum contraction. Besides, no significant differences were found in the TrA muscle thickness at rest (P > 0.999) and Tc-max (P > 0.999) between the two groups. However, significant differences of contraction thickness were found at T15s (P = 0.031) and T30s (P = 0.010) between the two groups during the Abdominal Drawing-in Maneuver (ADIM), with greater TrA muscle contraction thickness in the experimental group.Conclusions: RUSI can be used to provide visual biofeedback, which can promote continuous contraction, and improve the ability to activate the LM and TrA muscles in healthy subjects.

scholarly journals Prediction of Myoelectric Biomarkers in Post-Stroke Gait

Sensors ◽  
2021 ◽  
Vol 21 (16) ◽  
pp. 5334
Author(s):  
Iqram Hussain ◽  
Se-Jin Park
Keyword(s):  
Muscular Activity ◽  
Classification Performance ◽  
Lower Limbs ◽  
Training Dataset ◽  
Control Group ◽  
Mean Power ◽  
Predictive Tool ◽  
Post Stroke ◽  
Healthy Elderly ◽  
Power Frequency

Electromyography (EMG) is sensitive to neuromuscular changes resulting from ischemic stroke and is considered a potential predictive tool of post-stroke gait and rehabilitation management. This study aimed to evaluate the potential myoelectric biomarkers for the classification of stroke-impaired muscular activity of the stroke patient group and the muscular activity of the control healthy adult group. We also proposed an EMG-based gait monitoring system consisting of a portable EMG device, cloud-based data processing, data analytics, and a health advisor service. This system was investigated with 48 stroke patients (mean age 70.6 years, 65% male) admitted into the emergency unit of a hospital and 75 healthy elderly volunteers (mean age 76.3 years, 32% male). EMG was recorded during walking using the portable device at two muscle positions: the bicep femoris muscle and the lateral gastrocnemius muscle of both lower limbs. The statistical result showed that the mean power frequency (MNF), median power frequency (MDF), peak power frequency (PKF), and mean power (MNP) of the stroke group differed significantly from those of the healthy control group. In the machine learning analysis, the neural network model showed the highest classification performance (precision: 88%, specificity: 89%, accuracy: 80%) using the training dataset and highest classification performance (precision: 72%, specificity: 74%, accuracy: 65%) using the testing dataset. This study will be helpful to understand stroke-impaired gait changes and decide post-stroke rehabilitation.

scholarly journals Neuromuscular Mechanosensitivity in Subjects with Chronic Ankle Sprain: A Cross-Sectional Study

Pain Medicine ◽  
2019 ◽  
Vol 21 (9) ◽  
pp. 1991-1998 ◽  
Author(s):  
Cristina Lorenzo-Sánchez-Aguilera ◽  
David Rodríguez-Sanz ◽  
Tomás Gallego-Izquierdo ◽  
Irene Lázaro-Navas ◽  
Josue Plaza-Rodríguez ◽  
...  
Keyword(s):  
Ankle Sprain ◽  
Healthy Subjects ◽  
Ankle Instability ◽  
Pressure Pain Threshold ◽  
Neuromuscular Control ◽  
Lower Limbs ◽  
Control Group ◽  
Case Group ◽  
Strong Positive Correlation ◽  
Cross Sectional

Abstract Background Ankle sprain is one of the most common musculoskeletal injuries in sports, at work, and at home. Subjects who suffer from this injury may develop ankle instability. Functional instability has been associated with a high rate of resprain and impaired neuromuscular control in patients with ankle instability. Objective Measurement of neural and muscular mechanosensitivity after ankle sprain injury and establishment of the relationship between these variables. Methods A cross-sectional case-control study was performed with a sample of 58 students from Alcalá de Henares University (21 males and 37 females, mean age ± SD = 21 ± 3.7 years). Subjects were divided into two groups: a case group (N = 29, subjects with unstable ankle) and a control group (N = 29, healthy subjects). The pressure pain threshold (PPT) of the tibialis anterior, peroneus longus, and peroneus brevis muscles and mechanosensitivity of the common peroneus and tibial nerves were evaluated in all subjects through a manual mechanical algometer. Results Neuromuscular PPTs showed significant differences (P &lt; 0.05) between both groups, such that, compared with the control group, the case group exhibited significantly lower PPT levels. In the case group, a strong positive correlation was observed between neural and muscular homolateral mechanosensitivity in both lower limbs. Conclusions Participants with chronic ankle instability showed higher neuromuscular mechanosensitivity in muscles and nerves surrounding the ankle joint than healthy subjects. These findings indicate that low PPT values may be associated with symptoms that characterize this disease.

Development of a Six Bar Mechanism Based Active Knee Orthosis for Post-Stroke Gait Rehabilitation

2021 ◽  
Author(s):  
Hosu Lee ◽  
Amre Eizad ◽  
Sanghun Pyo ◽  
Hoyoung Kim ◽  
Junyeoung Lee ◽  
...  
Keyword(s):  
Gait Rehabilitation ◽  
Post Stroke ◽  
Knee Orthosis

scholarly journals Work and power reduced in L-dopa naïve patients in the early-stages of Parkinson’s disease

2016 ◽  
Vol 74 (4) ◽  
pp. 287-292
Author(s):  
Lidiane Oliveira Lima ◽  
Francisco Cardoso ◽  
Luci Fuscaldi Teixeira-Salmela ◽  
Fátima Rodrigues-de-Paula
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Healthy Subjects ◽  
Lower Limbs ◽  
Control Group ◽  
Isokinetic Dynamometer ◽  
Muscular Performance ◽  
Early Stages ◽  
Rehabilitation Strategies

ABSTRACT Studies which have investigated muscular performance during the initial stages of Parkinson´s disease (PD) without L-dopa treatments were not found. Objective to assess whether muscular performance, work and power, of the trunk and lower limbs in L-dopa naïve patients in the early stages of PD was lower than those of healthy subjects and to compare muscular performance between the lower limbs. Method Ten subjects with PD, Hoehn and Yahr (HY) I-II, L-dopa naïve and 10 subjects in the control group were assessed with the isokinetic dynamometer. Results ANOVAs revealed that work and power measures of the trunk, hip, knee, and ankle muscular groups were lower in PD compared with the control group (p < 0.05). There were no significant differences in muscular performance between the lower limbs. Conclusion The results suggested the use of specific exercises, as rehabilitation strategies, to improve the ability to produce work and power with this population.

scholarly journals Automatic pairing of inertial sensors to lower limb segments – a plug-and-play approach

2016 ◽  
Vol 2 (1) ◽  
pp. 715-718 ◽  
Author(s):  
David Graurock ◽  
Thomas Schauer ◽  
Thomas Seel
Keyword(s):  
Sensor Networks ◽  
Lower Limb ◽  
Healthy Subjects ◽  
Inertial Sensors ◽  
Inertial Sensor ◽  
Lower Limbs ◽  
Inertial Measurement Units ◽  
Inertial Measurement ◽  
Correct Pairing ◽  
Measurement Units

AbstractInertial sensor networks enable realtime gait analysis for a multitude of applications. The usability of inertial measurement units (IMUs), however, is limited by several restrictions, e.g. a fixed and known sensor placement. To enhance the usability of inertial sensor networks in every-day live, we propose a method that automatically determines which sensor is attached to which segment of the lower limbs. The presented method exhibits a low computational workload, and it uses only the raw IMU data of 3 s of walking. Analyzing data from over 500 trials with healthy subjects and Parkinson’s patients yields a correct-pairing success rate of 99.8% after 3 s and 100% after 5 s.

scholarly journals Use of hippotherapy in gait training for hemiparetic post-stroke

2010 ◽  
Vol 68 (6) ◽  
pp. 908-913 ◽  
Author(s):  
Fernanda Beinotti ◽  
Nilzete Correia ◽  
Gustavo Christofoletti ◽  
Guilherme Borges
Keyword(s):  
Conventional Treatment ◽  
Motor Impairment ◽  
Gait Training ◽  
Berg Balance Scale ◽  
Positive Influence ◽  
Lower Limbs ◽  
Control Group ◽  
Post Stroke ◽  
Group B ◽  
In The Beginning

OBJECTIVE: To evaluate the hippotherapy influence on gait training in post-stroke hemiparetic individuals. METHOD: The study was constituted of 20 individuals divided into two groups. Group A performed the conventional treatment while group B the conventional treatment along with hippotherapy during 16 weeks. The patients were evaluated by using the Functional Ambulation Category Scale, Fugl-Meyer Scale, only the lower limbs and balance sub items, Berg Balance Scale, and functional assessment of gait (cadence) in the beginning and end of the treatment. RESULTS: Significant improvements were observed in the experimental group including motor impairment in lower limbs (p=0.004), balance, over time (p=0.007) but a significant trend between groups (p=0.056). The gait independence, cadence and speed were not significantly in both groups (p=0.93, 0.69 and 0.44). CONCLUSION: Hippotherapy associated with conventional physical therapy demonstrates a positive influence in gait training, besides bringing the patients' gait standard closer to normality than the control group.

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