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Sensors ◽  
2022 ◽  
Vol 22 (1) ◽  
pp. 385
Author(s):  
Masoud Abdollahi ◽  
Pranav Madhav Kuber ◽  
Michael Shiraishi ◽  
Rahul Soangra ◽  
Ehsan Rashedi

Background: A stroke often bequeaths surviving patients with impaired neuromusculoskeletal systems subjecting them to increased risk of injury (e.g., due to falls) even during activities of daily living. The risk of injuries to such individuals can be related to alterations in their movement. Using inertial sensors to record the digital biomarkers during turning could reveal the relevant turning alterations. Objectives: In this study, movement alterations in stroke survivors (SS) were studied and compared to healthy individuals (HI) in the entire turning task due to its requirement of synergistic application of multiple bodily systems. Methods: The motion of 28 participants (14 SS, 14 HI) during turning was captured using a set of four Inertial Measurement Units, placed on their sternum, sacrum, and both shanks. The motion signals were segmented using the temporal and spatial segmentation of the data from the leading and trailing shanks. Several kinematic parameters, including the range of motion and angular velocity of the four body segments, turning time, the number of cycles involved in the turning task, and portion of the stance phase while turning, were extracted for each participant. Results: The results of temporal processing of the data and comparison between the SS and HI showed that SS had more cycles involved in turning, turn duration, stance phase, range of motion in flexion–extension, and lateral bending for sternum and sacrum (p-value < 0.035). However, HI exhibited larger angular velocity in flexion–extension for all four segments. The results of the spatial processing, in agreement with the prior method, showed no difference between the range of motion in flexion–extension of both shanks (p-value > 0.08). However, it revealed that the angular velocity of the shanks of leading and trailing legs in the direction of turn was more extensive in the HI (p-value < 0.01). Conclusions: The changes in upper/lower body segments of SS could be adequately identified and quantified by IMU sensors. The identified kinematic changes in SS, such as the lower flexion–extension angular velocity of the four body segments and larger lateral bending range of motion in sternum and sacrum compared to HI in turning, could be due to the lack of proper core stability and effect of turning on vestibular system of the participants. This research could facilitate the development of a targeted and efficient rehabilitation program focusing on the affected aspects of turning movement for the stroke community.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261187
Author(s):  
Laura-Isabela Del Carpio ◽  
Yvan Petit ◽  
Lucien Diotalevi ◽  
Elisabeth Laroche ◽  
Annie Levasseur ◽  
...  

The impact of surgical correction of cranial cruciate ligament rupture (CCLR) on 3D kinematics has not been thoroughly evaluated in dogs. The success of current techniques remains limited, as illustrated by suboptimal weightbearing and progression of osteoarthritis. The inability to restore the stifle’s 3D kinematics might be a key element in understanding these suboptimal outcomes. The objective of this study was to evaluate the impact of lateral suture stabilization (LSS) on the 3D kinematics of the canine stifle joint. We hypothesized that LSS would not restore 3D kinematics in our model. Ten cadaveric pelvic limbs collected from large dogs (25–40 kg) were tested using a previously validated apparatus that simulates gait. Three experimental conditions were compared: (a) intact stifle; (b) unstable stifle following cranial cruciate ligament transection (CCLt) and (c) CCLt stabilized by LSS. Three-dimensional kinematics were collected through 5 loading cycles simulating the stance phase of gait and curves were analyzed using a Wilcoxon signed-rank test. LSS restored baseline kinematics for the entire stance phase for cranial and lateromedial translation, flexion, and abduction. It restored distraction over 90% of the stance phase. Internal rotation was limited, but not restored. This in vitro study had limitations, as it used a simplified model of stifle motion and weight-bearing. The results of this study report that LSS can restore physiologic 3D kinematics largely comparable to those of healthy stifles. Suboptimal outcome in patients following CCLR stabilization by LSS may therefore result from causes other than immediate postoperative abnormal 3D kinematics.


Author(s):  
Luisa de Roy ◽  
Daniela Warnecke ◽  
Steffen Paul Hacker ◽  
Ulrich Simon ◽  
Lutz Dürselen ◽  
...  

While it is generally accepted that traumatic meniscus pathologies lead to degenerative articular cartilage changes in the mid-to long-term and consecutively to post-traumatic osteoarthritis (PTOA), very little is known about how such injuries initiate tribological changes within the knee and their possible impact on PTOA acceleration. Therefore, the aim of this study was to investigate the influence of three different medial meniscus states (intact, posterior root tear, total meniscectomy) on the initial whole knee joint friction. Six ovine knee joints were tested in a passive pendulum friction testing device under an axial load of 250 N and an initial deflection of 12°, representing swing phase conditions, and under an axial load of 1000 N and an initial deflection of 5°, simulating stance phase conditions. To additionally consider the influence of the time-dependent viscoelastic nature of the knee joint soft tissues on whole joint friction, the tests were performed twice, directly following load application and after 20 min creep loading of either 250 N or 1000 N axial load. On the basis of a three-dimensional joint kinematic analysis, the energy loss during the passive joint motion was analyzed, which allowed considerations on frictional and damping processes within the joint. The so-called “whole knee joint” friction was evaluated using the boundary friction model from Stanton and a viscous friction model from Crisco et al., both analyzing the passive joint flexion-extension motion in the sagittal plane. Significantly lower friction coefficients were observed in the simulated swing phase after meniscectomy (p &lt; 0.05) compared to the intact state. No initial whole joint friction differences between the three meniscus states (p &gt; 0.05) were found under stance phase conditions. Soft tissue creeping significantly increased all the determined friction coefficients (p &lt; 0.05) after resting under load for 20 min. The exponential decay function of the viscous friction model provided a better fit (R2∼0.99) to the decaying flexion-extension data than the linear decay function of the boundary friction model (R2∼0.60). In conclusion, this tribological in vitro study on ovine knee joints indicated that neither a simulated posterior medial meniscus root tear nor the removal of the medial meniscus resulted in an initially increased whole joint friction.


Symmetry ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2372
Author(s):  
Paul S. Sung ◽  
Moon Soo Park

Although the asymmetries of scoliotic gait in adolescent idiopathic scoliosis (AIS) groups have been extensively studied, recent studies indicated conflicting results regarding the ground reaction forces (GRFs) during gait in subjects with spinal deformity. The asymmetry during the stance phase might be clarified with three-dimensional (3D) compensations of GRFs between similar characteristics of subjects with and without AIS. The purpose of this study was to compare the normalized 3D GRF differences during the stance phase of gait while considering age, BMI, and Cobb angle between subjects with and without right AIS. There were 23 subjects with right convexity of thoracic idiopathic scoliosis and 22 age- and gender-matched control subjects. All subjects were right upper/lower limb dominant, and the outcome measures included the Cobb angles, normalized GRF, and KAI. The mediolateral (M/L) third peak force on the dominant limb decreased in the AIS group (t = 2.58, p = 0.01). Both groups demonstrated a significant interaction with the 3D indices (F = 5.41, p = 0.02). The post-hoc analysis identified that the M/L plane of asymmetry was significantly different between groups. The Cobb angles were negatively correlated with the vertical asymmetry index (r = −0.45, p = 0.03); however, there was no significant correlation with age (r = −0.10, p = 0.65) or body mass index (r = −0.28, p = 0.20). The AIS group demonstrated decreased GRF in the dominant limb M/L plane of the terminal stance phase. This compensatory motion was confirmed by a significant group difference on the M/L plane of the KAI. This KAI of vertical asymmetry correlated negatively with the Cobb angle. The asymmetric load transmission with compensatory vertical reactions was evident due to abnormal loading in the stance phase. These kinetic compensatory patterns need to be considered with asymmetry on the dominant limb when developing rehabilitation strategies for patients with AIS.


2021 ◽  
Author(s):  
Zhenhan Deng ◽  
Zijun Cai ◽  
Yusheng Li ◽  
Zhiqin Deng ◽  
Wei Lu ◽  
...  

Abstract Background This study aims to compare the kinematic characteristics of hindfoot joints of stage Ⅱ adult acquired flatfoot deformity (AAFD) and normal foot through two-dimension (2D) -three-dimension (3D) registration technology and a single fluoroscopic imaging system, thus to provide research basis to the pathogenesis, diagnosis and treatment of AAFD. Methods Then seven normal volunteers and eight volunteers with stage Ⅱ AAFD were recruited to take the CT scans for their bilateral feet in neutral positions, after that their lateral dynamic X-ray data during stance phase were collected including fourteen normal feet and ten flatfeet. A computer-aided simulated light source for 3D CT model was applied to obtain a virtual image, and it is matched with the dynamic X-ray images to make a registration in “Fluo” software, by which finally the spatial changes during the stance phase can be calculated. Results In the early stage of touching the ground and the middle stage of standing, the extension and external rotation valgus of the navicular bone of the flat foot was compared with that of the normal navicular bone, and there was no significant difference in the extension and external rotation valgus of the calcaneus between the cuboid phase and the normal navicular bone. In the late stance phase, the degree of varus relative to the distance of the navicular bone was smaller in the flat foot than in the normal foot but the degree of metatarsal flexion was not significantly different between the cuboid and the calcaneus, and the degree of varus was smaller in the calcaneus but the degree of metatarsal flexion was greater. Conclusion During the early and mid-stance phase, there are excessive motion in the subtalar and talonavicular joints in stage Ⅱ AAFD. During the late stance phase, the motion of subtalar and talonavicular joints are in the decompensated state. During the whole stance phase, the motion of calcaneocuboid joint has no significant difference in both normal foot and stage Ⅱ AAFD.


2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Xiaomeng Wu ◽  
Liying Zhao ◽  
Shuli Guo ◽  
Lintong Zhang

The foot-mounted pedestrian navigation system (PNS) that uses microelectromechanical systems (MEMS) inertial measurement units (IMUs) to track the person’s position. However errors accumulate over time during inertial navigation solutions, which affects the positioning precision. In this paper, a multicondition zero velocity detector is used to detect the stance phase of gait. Then the errors are corrected in the stance phase and the swing phase, respectively, through the Kalman filter. When pedestrians are going up and down the stairs, the divergence of height will reduce the accuracy of three-dimensional positioning. In this paper, an accelerometer and a barometer are used to obtain altitude variation, and after that the stair condition detection (SCD) algorithm is proposed to correct the height of Kalman filter output and detect the walking state of pedestrians. Through theoretical research and field experiments, these algorithms are studied carefully. The results of the experiment show that the algorithm proposed in this paper can effectively eliminate errors and achieve more accurate positioning.


Author(s):  
Choonghyun Son ◽  
Anna Lee ◽  
Junkyung Lee ◽  
DaeEun Kim ◽  
Seung-Jong Kim ◽  
...  

Abstract Background Aging societies lead to higher demand for gait rehabilitation as age-related neurological disorders such as stroke and spinal cord injury increase. Since conventional methods for gait rehabilitation are physically and economically burdensome, robotic gait training systems have been studied and commercialized, many of which provided movements confined in the sagittal plane. For better outcomes of gait rehabilitation with more natural gait patterns, however, it is desirable to provide pelvic movements in the transverse plane. In this study, a robotic gait training system capable of pelvic motions in the transverse plane was used to evaluate the effect of the pelvic motions on stroke patients. Method Healbot T, which is a robotic gait training system and capable of providing pelvic movements in the transverse plane as well as flexion/extension of the hip and knee joints and adduction/abduction of the hip joints, is introduced and used to evaluate the effect of the pelvic movement on gait training of stroke patients. Gait trainings in Healbot T with and without pelvic movements are carried out with stroke patients having hemiparesis. Experiment Twenty-four stroke patients with hemiparesis were randomly assigned into two groups and 23 of them successfully completed the experiment except one subject who had dropped out due to personal reasons. Pelvis-on group was provided with pelvic motions whereas no pelvic movement was allowed for pelvis-off group during 10 sessions of gait trainings in Healbot T. Electromyography (EMG) signals and interaction forces as well as the joint angles of the robot were measured. Gait parameters such as stride length, cadence, and walking speed were measured while walking on the ground without assistance of Healbot T after gait training on 1st, 5th, and 10th day. Result Stride length significantly increased in both groups. Furthermore, cadence and walking speed of the pelvis-on group were increased by 10.6% and 11.8%. Although interaction forces of both groups except the thighs showed no differences, EMG signals from gluteus medius of the pelvis-on group increased by 88.6% during stance phase. In addition, EMG signals of biceps femoris, gastrocnemius medial, and gastrocnemius lateral of the pelvis-on group increased whereas EMG signals of the pelvis-off group except gastrocnemius lateral showed no difference after gait trainings. Conclusion Gait training using a robotic gait training system with pelvic movements was conducted to investigate the effects of lateral and rotational pelvic movements in gait training of stroke patients. The pelvic movements affected to increase voluntary muscle activation during the stance phase as well as cadence and walking speed. Clinical trial registration KCT0003762, 2018-1254, Registered 28 October 2018, https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=14310&ltype=&rtype=


Biology ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1187
Author(s):  
Jie Wang ◽  
Lei Qiao ◽  
Long Yu ◽  
Yanmin Wang ◽  
Redha Taiar ◽  
...  

Background: Insoles have been widely applied to many diseases, but stroke involves complex problems and there is a paucity of research on the application of insoles in stroke patients. Aim: To evaluate the effect of customized insoles on gait in patients with hemiplegia. Design: A randomized controlled trial. Setting: Rehabilitation department of a hospital. Population: A total of 50 stroke patients were randomized into an experimental group (n = 25) or a control group (n = 25). Methods: Both groups received conventional gait training, which was conducted five times a week, every 40 min for four weeks and patients in the experimental group were required to wear customized insoles for at least 1 h per day for four weeks. The primary outcome measure was the Tinetti Gait Scale (TGS) and the secondary outcome measures were the plantar pressure test, 6-min walking test (6MWT), lower extremity Fugl–Meyer assessment (FMA-LE), Berg Balance Scale (BBS), and the modified Barthel index (MBI). Results: Compared to the control group, there were significant increases in the experimental group after four weeks (p = 0.014) and at the four week follow-up (p = 0.001) in the change in TGS, weight-bearing on the involved side (p = 0.012) or forefoot (p = 0.028) when standing, weight-bearing on the involved side (p = 0.01 6) or forefoot (p = 0.043) when walking, early stance phase (p = 0.023) and mid stance phase (p = 0.013) on the involved side, FMA-LE (p = 0.029), BBS (p = 0.005), and MBI (p = 0.009), but there were no differences in the late stance phase (p = 0.472) on the involved side when walking or in the 6MWT (p = 0.069). Conclusions: Customized insoles had great efficacy in enhancing gait performance in stroke patients.


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.


2021 ◽  
pp. 165-183
Author(s):  
N A Abu Osman ◽  
P X Ku
Keyword(s):  

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