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Cicarello NDS, Bohrer RCD, Devetak GF, Rodacki ALF, Loureiro APC, Manffra EF. Control of center of mass during gait of stroke patients: Statistical parametric mapping analysis. Clin Biomech (Bristol, Avon) 2023; 107:106005. [PMID: 37302301 DOI: 10.1016/j.clinbiomech.2023.106005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/14/2023] [Accepted: 05/17/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND The control of the center of mass is essential for a stable and efficient gait. Post-stroke patients present several impairments, which may compromise the control of the center of mass during gait in the sagittal and frontal planes. This study aimed to identify changes in the vertical and mediolateral behavior of the center of mass during the single stance phase of post-stroke patients using the statistical parametric mapping analysis. It also aimed to identify alterations in the center of mass trajectories regarding the motor recovery stages. METHODS Seventeen stroke patients and 11 neurologically intact individuals were analyzed. The statistical parametric mapping approach was used to identify changes in the center of mass trajectories between stroke and healthy groups. The trajectories of the center of mass of post-stroke individuals were compared according to their motor recovery status. FINDINGS A near-flat vertical trajectory of the center of mass was indenfitifed in the stroke group compared to their healthy counterparts, especially on the paretic side. The center of mass trajectories in both directions (vertical and mediolateral) presented substantial alteration at the end of the single stance phase in the stroke group. The trajectory of the center of mass of the stroke group was symmetrical in the mediolateral direction between the sides. The trajectories of the center of mass presented similar pattern irrespective of the motor recovery status. INTERPRETATION The statistical parametric mapping approach showed to be suitable for determining gait changes in post-stroke individuals, irrespective of their motor recovery stage.
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Affiliation(s)
| | | | - Gisele F Devetak
- Pontifícia Universidade Católica do Paraná, Health Technology Graduate Program, Rua Imaculada Conceição, 1155, Curitiba, Brazil; Complexo Hospital de Clínicas da Universidade Federal do Paraná, filial da Empresa Brasileira de Serviços Hospitalares (CHC-UFPR/Ebserh), Curitiba, Brazil
| | | | - Ana Paula Cunha Loureiro
- Pontifícia Universidade Católica do Paraná, Department of Physical Therapy, School of Medicine and Life Sciences, Rua Imaculada Conceição, 1155, Curitiba, Brazil.
| | - Elisangela Ferretti Manffra
- Pontifícia Universidade Católica do Paraná, Health Technology Graduate Program, Rua Imaculada Conceição, 1155, Curitiba, Brazil
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A Statistical Parametric Mapping Analysis Approach for the Evaluation of a Passive Back Support Exoskeleton on Mechanical Loading During a Simulated Patient Transfer Task. J Appl Biomech 2023; 39:22-33. [PMID: 36649717 DOI: 10.1123/jab.2022-0126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/26/2022] [Accepted: 11/18/2022] [Indexed: 01/18/2023]
Abstract
This study assessed the effectiveness of a passive back support exoskeleton during a mechanical loading task. Fifteen healthy participants performed a simulated patient transfer task while wearing the Laevo (version 2.5) passive back support exoskeleton. Collected metrics encompassed L5-S1 joint moments, back and abdominal muscle activity, lower body and back kinematics, center of mass displacement, and movement smoothness. A statistical parametric mapping analysis approach was used to overcome limitations from discretization of continuous data. The exoskeleton reduced L5-S1 joint moments during trunk flexion, but wearing the device restricted L5-S1 joint flexion when flexing the trunk as well as hip and knee extension, preventing participants from standing fully upright. Moreover, wearing the device limited center of mass motion in the caudal direction and increased its motion in the anterior direction. Therefore, wearing the exoskeleton partly reduced lower back moments during the lowering phase of the patient transfer task, but there were some undesired effects such as altered joint kinematics and center of mass displacement. Statistical parametric mapping analysis was useful in determining the benefits and hindrances produced by wearing the exoskeleton while performing the simulated patient transfer task and should be utilized in further studies to inform design and appropriate usage.
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Quantification of Gait Stability During Incline and Decline Walking: The Responses of Required Coefficient of Friction and Dynamic Postural Index. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:7716821. [PMID: 36275397 PMCID: PMC9581656 DOI: 10.1155/2022/7716821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/13/2022] [Accepted: 09/29/2022] [Indexed: 11/04/2022]
Abstract
This study aims to investigate the gait stability response during incline and decline walking for various surface inclination angles in terms of the required coefficient of friction (RCOF), postural stability index (PSI), and center of pressure (COP)-center of mass (COM) distance. A customized platform with different surface inclinations (0°, 5°, 7.5°, and 10°) was designed. Twenty-three male volunteers participated by walking on an inclined platform for each inclination. The process was then repeated for declined platform as well. Qualysis motion capture system was used to capture and collect the trajectories motion of ten reflective markers that attached to the subjects before being exported to a visual three-dimensional (3D) software and executed in Matlab to obtain the RCOF, PSI, as well as dynamic PSI (DPSI) and COP-COM distance parameters. According to the result for incline walking, during initial contact, the RCOF was not affected to inclination. However, it was affected during peak ground reaction force (GRF) starting at 7.5° towards 10° for both walking conditions. The most affected PSI was found at anterior-posterior PSI (APSI) even as low as 5° inclination during both incline and decline walking. On the other hand, DPSI was not affected during both walking conditions. Furthermore, COP-COM distance was most affected during decline walking in anterior-posterior direction. The findings of this research indicate that in order to decrease the risk of falling and manage the inclination demand, a suitable walking strategy and improved safety measures should be applied during slope walking, particularly for decline and anterior-posterior orientations. This study also provides additional understanding on the best incline walking technique for secure and practical incline locomotion.
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Mahmood I, Raza A, Maqbool HF, Dehghani-Sanij AA. Evaluation of an ankle–foot orthosis effect on gait transitional stability during ramp ascent/descent. Med Biol Eng Comput 2022; 60:2119-2132. [DOI: 10.1007/s11517-022-02587-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
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Dickerson LC, Queen RM. Foot Posture and Plantar Loading With Ankle Bracing. J Athl Train 2021; 56:461-472. [PMID: 34000019 DOI: 10.4085/1062-6050-164-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Arch height is one important aspect of foot posture. An estimated 20% of the population has pes planus and 20% has pes cavus. These abnormal foot postures can alter lower extremity kinematics and plantar loading and contribute to injury risk. Ankle bracing is commonly used in sport to prevent these injuries, but no researchers have examined the effects of ankle bracing on plantar loading. OBJECTIVE To evaluate the effects of ankle braces on plantar loading during athletic tasks. DESIGN Cross-sectional study. SETTING Laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 36 participants (11 men, 25 women; age = 23.1 ± 2.5 years, height = 1.72 ± 0.09 m, mass = 66.3 ± 14.7 kg) were recruited for this study. INTERVENTION(S) Participants completed walking, running, and cutting tasks in 3 bracing conditions: no brace, lace-up ankle-support brace, and semirigid brace. MAIN OUTCOME MEASURE(S) We analyzed the plantar-loading variables of contact area, maximum force, and force-time integral for 2 midfoot and 3 forefoot regions and assessed the displacement of the center of pressure. A 3 × 3 mixed-model repeated-measures analysis of variance was used to determine the effects of brace and foot type (α = .05). RESULTS Foot type affected force measures in the middle (P range = .003-.047) and the medial side of the foot (P range = .004-.04) in all tasks. Brace type affected contact area in the medial midfoot during walking (P = .005) and cutting (P = .01) tasks, maximum force in the medial and lateral midfoot during all tasks (P < .001), and force-time integral in the medial midfoot during all tasks (P < .001). Portions of the center-of-pressure displacement were affected by brace wear in both the medial-lateral and anterior-posterior directions (P range = .001-.049). CONCLUSIONS Ankle braces can be worn to redistribute plantar loading. Additional research should be done to evaluate their effectiveness in injury prevention.
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Affiliation(s)
- Laura C Dickerson
- Kevin P. Granata Biomechanics Lab, Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg
| | - Robin M Queen
- Kevin P. Granata Biomechanics Lab, Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg
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Vieira MF, Rodrigues FB, de Oliveira Assis A, de Mendonça Mesquita E, Lemes TS, De Villa GAG, Baptista RR, de Oliveira Andrade A, Lobo da Costa PH. Effects of additional load at different heights on gait initiation: A statistical parametric mapping of center of pressure and center of mass behavior. PLoS One 2021; 16:e0242892. [PMID: 34115751 PMCID: PMC8195414 DOI: 10.1371/journal.pone.0242892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/23/2021] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to investigate the effects of different vertical positions of an asymmetrical load on the anticipatory postural adjustments phase of gait initiation. Sixty-eight college students (32 males, 36 females; age: 23.65 ± 3.21 years old; weight: 69.98 ± 8.15 kg; height: 1.74 ± 0.08 m) were enrolled in the study. Ground reaction forces and moments were collected using two force platforms. The participants completed three trials under each of the following random conditions: no-load (NL), waist uniformly distributed load (WUD), shoulder uniformly distributed load (SUD), waist stance foot load (WST), shoulder stance foot load (SST), waist swing foot load (WSW), and shoulder swing foot load (SSW). The paired Hotelling's T-square test was used to compare the experimental conditions. The center of pressure (COP) time series were significantly different for the SUD vs. NL, SST vs. NL, WST vs. NL, and WSW vs. NL comparisons. Significant differences in COP time series were observed for all comparisons between waist vs. shoulder conditions. Overall, these differences were greater when the load was positioned at the shoulders. For the center of mass (COM) time series, significant differences were found for the WUD vs. NL and WSW vs. NL conditions. However, no differences were observed with the load positioned at the shoulders. In conclusion, only asymmetrical loading at the waist produced significant differences, and the higher the extra load, the greater the effects on COP behavior. By contrast, only minor changes were observed in COM behavior, suggesting that the changes in COP (the controller) behavior are adjustments to maintain the COM (controlled object) unaltered.
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Affiliation(s)
- Marcus Fraga Vieira
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Fábio Barbosa Rodrigues
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Goiás, Brazil
- State University of Goiás – Unidade Trindade-GO, Brazil
| | | | | | - Thiago Santana Lemes
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | | | - Adriano de Oliveira Andrade
- Centre for Innovation and Technology Assessment in Health (NIATS), Federal University of Uberlândia, Uberlândia, Brazil
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Mani H, Miyagishima S, Kozuka N, Takeda K, Taneda K, Inoue T, Sato Y, Asaka T. Development of temporal and spatial characteristics of anticipatory postural adjustments during gait initiation in children aged 3-10 years. Hum Mov Sci 2020; 75:102736. [PMID: 33310381 DOI: 10.1016/j.humov.2020.102736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 10/30/2020] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Abstract
This study aimed to analyze the development of direction specificities of temporal and spatial control and the coordination pattern of anticipatory postural adjustment (APA) along the anteroposterior (AP) and mediolateral (ML) directions during gait initiation (GI) in children aged 3-10 years. This study included 72 healthy children aged 3-10 years and 14 young adults. The child population was divided into four groups by age: 3-4, 5-6, 7-8, and 9-10 years. The GI task included GI using the dominant limb. The peak center of feet pressure (COP) shifts during APAs (APApeak), initiation time of COP shifts (APAonset), and the COP vectors in the horizontal plane were calculated to evaluate the direction specificity of spatial, temporal, and coordination control, respectively. A difference in direction specificity development was found for the APApeak. The APApeak in the mediolateral axis, but not in the anteroposterior axis, was significantly higher in the 7-8 years age group than in other groups. Although APAonset was not found for direction specificity, a significant difference between the adult and children groups (5-6 years, 7-8 years, and 9-10 years) was observed in the direction of the COP vector. In conclusion, the developmental process of the spatial, temporal, and coordination control of APAs during GI varied with age. Furthermore, the spatial control and coordination pattern of APAs was found to be direction specific. All components of APAs, namely temporal and spatial control, coordination pattern, and direction specificities, should be analyzed to capture the developmental process of anticipatory postural control.
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Affiliation(s)
- Hiroki Mani
- Faculty of Health Sciences, Hokkaido University, Sapporo, Kita 12 Nishi 5, Kita-Ku, Sapporo, Hokkaido 060-0812, Japan.
| | - Saori Miyagishima
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo Medical University, Minami 1 Nishi 16, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan.
| | - Naoki Kozuka
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Minami 1 Nishi 17, Chuo-Ku, Sapporo, Hokkaido 060-8556, Japan.
| | - Kenta Takeda
- Department of Rehabilitation for the Movement Functions, Research Institute of National Center for Persons with Disabilities, Namiki 4-1, Tokorozawa, Saitama 359-8555, Japan
| | - Kenji Taneda
- Graduate School of Health Sciences, Hokkaido University, Kita 12 Nishi 5, Kita-Ku, Sapporo, Hokkaido 060-0812, Japan
| | - Takahiro Inoue
- Graduate School of Health Sciences, Hokkaido University, Kita 12 Nishi 5, Kita-Ku, Sapporo, Hokkaido 060-0812, Japan
| | - Yui Sato
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo Medical University, Minami 1 Nishi 16, Chuo-Ku, Sapporo, Hokkaido 060-8543, Japan.
| | - Tadayoshi Asaka
- Faculty of Health Sciences, Hokkaido University, Sapporo, Kita 12 Nishi 5, Kita-Ku, Sapporo, Hokkaido 060-0812, Japan.
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Bernardelli RS, Scheeren EM, Fuentes Filho AR, Pereira PA, Gariba MA, Moser ADDL, Bichinho GL. Effects of Kinesio Taping on postural balance in patients with low back pain, a randomized controlled trial. J Bodyw Mov Ther 2019; 23:508-514. [DOI: 10.1016/j.jbmt.2019.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 01/15/2019] [Indexed: 11/15/2022]
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