1
|
Han SL, Cai ML, Pan MC. Inertial Measuring System to Evaluate Gait Parameters and Dynamic Alignments for Lower-Limb Amputation Subjects. SENSORS (BASEL, SWITZERLAND) 2024; 24:1519. [PMID: 38475055 DOI: 10.3390/s24051519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/14/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024]
Abstract
The study aims to construct an inertial measuring system for the application of amputee subjects wearing a prosthesis. A new computation scheme to process inertial data by installing seven wireless inertial sensors on the lower limbs was implemented and validated by comparing it with an optical motion capture system. We applied this system to amputees to verify its performance for gait analysis. The gait parameters are evaluated to objectively assess the amputees' prosthesis-wearing status. The Madgwick algorithm was used in the study to correct the angular velocity deviation using acceleration data and convert it to quaternion. Further, the zero-velocity update method was applied to reconstruct patients' walking trajectories. The combination of computed walking trajectory with pelvic and lower limb joint motion enables sketching the details of motion via a stickman that helps visualize and animate the walk and gait of a test subject. Five participants with above-knee (n = 2) and below-knee (n = 3) amputations were recruited for gait analysis. Kinematic parameters were evaluated during a walking test to assess joint alignment and overall gait characteristics. Our findings support the feasibility of employing simple algorithms to achieve accurate and precise joint angle estimation and gait parameters based on wireless inertial sensor data.
Collapse
Affiliation(s)
- Shao-Li Han
- Department of Mechanical Engineering, National Central University, Taoyuan 32001, Taiwan
- Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua 500209, Taiwan
| | - Meng-Lin Cai
- Department of Mechanical Engineering, National Central University, Taoyuan 32001, Taiwan
| | - Min-Chun Pan
- Department of Mechanical Engineering, National Central University, Taoyuan 32001, Taiwan
| |
Collapse
|
2
|
Naseri A, Lee IC, Huang H, Liu M. Investigating the Association of Quantitative Gait Stability Metrics With User Perception of Gait Interruption Due to Control Faults During Human-Prosthesis Interaction. IEEE Trans Neural Syst Rehabil Eng 2023; 31:4693-4702. [PMID: 37906490 DOI: 10.1109/tnsre.2023.3328877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
This study aims to compare the association of different gait stability metrics with the prosthesis users' perception of their own gait stability. Lack of perceived confidence on the device functionality can influence the gait pattern, level of daily activities, and overall quality of life for individuals with lower limb motor deficits. However, the perception of gait stability is subjective and difficult to acquire online. The quantitative gait stability metrics can be objectively measured and monitored using wearable sensors; however, objective measurements of gait stability associated with human's perception of their own gait stability has rarely been reported. By identifying quantitative measurements that associate with users' perceptions, we can gain a more accurate and comprehensive understanding of an individual's perceived functional outcomes of assistive devices such as prostheses. To achieve our research goal, experiments were conducted to artificially apply internal disturbances in the powered prosthesis while the prosthetic users performed level ground walking. We monitored and compared multiple gait stability metrics and a local measurement to the users' reported perception of their own gait stability. The results showed that the center of pressure progression in the sagittal plane and knee momentum (i.e., residual thigh and prosthesis shank angular momentum about prosthetic knee joint) can potentially estimate the users' perceptions of gait stability when experiencing disturbances. The findings of this study can help improve the development and evaluation of gait stability control algorithms in robotic prosthetic devices.
Collapse
|
3
|
Johansson R, Jensen L, Barnett CT, Rusaw DF. Quantitative methods used to evaluate balance, postural control, and the fear of falling in lower limb prosthesis users: A systematic review. Prosthet Orthot Int 2023; 47:586-598. [PMID: 37318276 DOI: 10.1097/pxr.0000000000000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 04/23/2023] [Indexed: 06/16/2023]
Abstract
Problems with balance, postural control, and fear of falling are highly prevalent in lower limb prosthesis users, with much research conducted to understand these issues. The variety of tools used to assess these concepts presents a challenge when interpreting research outcomes. This systematic review aimed to provide a synthesis of quantifiable methods used in the evaluation of balance, postural control, and fear of falling in lower limb prosthesis users with an amputation level at or proximal to the ankle joint. A systematic search was conducted in CINAHL, Medline, AMED, Cochrane, AgeLine, Scopus, Web of Science, Proquest, PsycINFO, PsycArticles, and PubPsych databases followed by additional manual searching via reference lists in the reviewed articles databases. Included articles used quantitative measure of balance or postural control as one of the dependent variables, lower limb prosthesis users as a sample group, and were published in a peer-reviewed journal in English. Relevant assessment questions were created by the investigators to rate the assessment methods used in the individual studies. Descriptive and summary statistics are used to synthesize the results. The search yielded (n = 187) articles assessing balance or postural control (n = 5487 persons in total) and (n = 66) articles assessing fear of falling or balance confidence (n = 7325 persons in total). The most used test to measure balance was the Berg Balance Scale and the most used test to measure fear of falling was the Activities-specific Balance Confidence scale. A large number of studies did not present if the chosen methods were valid and reliable for the lower limb prosthesis users. Among study limitations, small sample size was common.
Collapse
Affiliation(s)
- Robin Johansson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Louise Jensen
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Southern Älvsborg Hospital, Borås, Sweden
| | - Cleveland T Barnett
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - David F Rusaw
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| |
Collapse
|
4
|
Fanous A, Botros M, Gholizadeh H, Baddour N, Lemaire ED. Design and evaluation of a hip prosthesis simulator: A technical note. Prosthet Orthot Int 2023; 47:443-446. [PMID: 36723415 DOI: 10.1097/pxr.0000000000000208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 11/21/2022] [Indexed: 02/02/2023]
Abstract
People with a limb loss at the level of the hip or pelvis have the most difficulty returning to walking compared with those with a lower amputation. This is because their prosthesis must replace the hip, knee, and ankle joints. An adjustable hip-disarticulation/hemipelvectomy prosthesis simulator that allows able-bodied individuals to wear and assess a prosthesis can help researchers and manufacturers when designing new prosthetic components (ie, hip joints). SolidWorks computer-aided design software was used to design and simulate an adapter that can connect prosthetic components to an off-the-shelf hip abduction orthosis. The adapter was made of 1020 stainless steel and aluminium 6061-T3 with a yield strength of 276 MPa. To confirm that this adapter is strong and safe for ambulation, mechanical testing was performed using an INSTRON machine. The maximum loads generated in any activity were chosen according to the International Organization for Standardization 15032:2000 standard for hip disarticulation external prostheses. The designed adapter allowed frontal, lateral, or distal mounting of different prosthetic hip joints. Mechanical testing confirmed that the new adapter can withstand forces and moments experienced during ambulation. The hip disarticulation/hemipelvectomy prosthesis simulator is easy to use and adjustable based on each person's height and pelvic width. Furthermore, this simulator would assist rehabilitation practitioners in experiencing the use of hip-level prostheses and give them a better understanding of people using such technologies. The next step in this project is to evaluate able-bodied participant gait while using this hip simulator prosthesis with different hip joints.
Collapse
Affiliation(s)
- Amir Fanous
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada
| | - Michael Botros
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada
| | - Hossein Gholizadeh
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada
- The Ottawa Hospital Rehabilitation Centre, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Natalie Baddour
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada
| | - Edward D Lemaire
- The Ottawa Hospital Rehabilitation Centre, Ottawa Hospital Research Institute, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| |
Collapse
|
5
|
Darter BJ, Syrett ED, Foreman KB, Kubiak E, Sinclair S. Changes in frontal plane kinematics over 12-months in individuals with the Percutaneous Osseointegrated Prosthesis (POP). PLoS One 2023; 18:e0281339. [PMID: 36812173 PMCID: PMC9946262 DOI: 10.1371/journal.pone.0281339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 01/13/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND A bone-anchored prosthesis (BAP) eliminates the need for a conventional socket by attaching a prosthesis directly to the user's skeleton. Currently, limited research addresses changes in gait mechanics post BAP implantation. OBJECTIVE Examine changes in frontal plane movement patterns after BAP implantation. METHODS Participants were individuals with unilateral transfemoral amputation (TFA) enrolled in the US Food and Drug Administration (FDA) Early Feasibility Study examining the Percutaneous Osseointegrated Prosthesis (POP). The participants completed overground gait assessments using their conventional socket and at 6-weeks, 12-weeks, 6-months, and 12-months following POP implantation. Statistical parameter mapping techniques were used in examining changes in frontal plane kinematics over the 12-months and differences with reference values for individuals without limb loss. RESULTS Statistically significant deviations were found pre-implantation compared to reference values for hip and trunk angles during prosthetic limb stance phase, and for pelvis and trunk relative to the pelvis angles during prosthetic limb swing. At 6-weeks post-implantation, only the trunk angle demonstrated a statistically significant reduction in the percent of gait cycle with deviations relative to reference values. At 12-months post-implantation, results revealed frontal plane movements were no longer statistically different across the gait cycle for the trunk angle compared to reference values, and less of the gait cycle was statistically different compared to reference values for all other frontal plane patterns analyzed. No statistically significant within-participant differences were found for frontal plane movement patterns between pre-implantation and 6-weeks or 12-months post-implantation. CONCLUSIONS Deviations from reference values displayed prior to device implantation were reduced or eliminated 12-months post-implantation in all frontal plane patterns analyzed, while within-participant changes over the 12-month period did not reach statistical significance. Overall, the results suggest the transition to a BAP aided in normalizing gait patterns in a sample of relatively high functioning individuals with TFA.
Collapse
Affiliation(s)
- Benjamin J. Darter
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, United States of America
- Physical Medicine and Rehabilitation Service, Central Virginia Veterans Health Care System, Richmond, VA, United States of America
- * E-mail:
| | - E. Daniel Syrett
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, United States of America
| | - K. Bo Foreman
- Department of Physical Therapy, University of Utah, Salt Lake City, UT, United States of America
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States of America
- Research Service, Salt Lake City Health Care System, Salt Lake City, UT, United States of America
| | - Erik Kubiak
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States of America
- Research Service, Salt Lake City Health Care System, Salt Lake City, UT, United States of America
- Department of Orthopedic Surgery, University of Nevada Las Vegas, Las Vegas, NV, United States of America
| | - Sarina Sinclair
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, United States of America
- Research Service, Salt Lake City Health Care System, Salt Lake City, UT, United States of America
| |
Collapse
|
6
|
Fylstra BL, Lee IC, Li M, Lewek MD, Huang H. Human-prosthesis cooperation: combining adaptive prosthesis control with visual feedback guided gait. J Neuroeng Rehabil 2022; 19:140. [PMID: 36517814 PMCID: PMC9753428 DOI: 10.1186/s12984-022-01118-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Personalizing prosthesis control is often structured as human-in-the-loop optimization. However, gait performance is influenced by both human control and intelligent prosthesis control. Hence, we need to consider both human and prosthesis control, and their cooperation, to achieve desired gait patterns. In this study, we developed a novel paradigm that engages human gait control via user-fed visual feedback (FB) of stance time to cooperate with automatic prosthesis control tuning. Three initial questions were studied: (1) does user control of gait timing (via visual FB) help the prosthesis tuning algorithm to converge faster? (2) in turn, does the prosthesis control influence the user's ability to reach and maintain the target stance time defined by the feedback? and (3) does the prosthesis control parameters tuned with extended stance time on prosthesis side allow the user to maintain this potentially beneficial behavior even after feedback is removed (short- and long-term retention)? METHODS A reinforcement learning algorithm was used to achieve prosthesis control to meet normative knee kinematics in walking. A visual FB system cued the user to control prosthesis-side stance time to facilitate the prosthesis tuning goal. Seven individuals without amputation (AB) and four individuals with transfemoral amputation (TFA) walked with a powered knee prosthesis on a treadmill. Participants completed prosthesis auto-tuning with three visual feedback conditions: no FB, self-selected stance time FB (SS FB), and increased stance time FB (Inc FB). The retention of FB effects was studied by comparing the gait performance across three different prosthesis controls, tuned with different visual FB. RESULTS (1) Human control of gait timing reduced the tuning duration in individuals without amputation, but not for individuals with TFA. (2) The change of prosthesis control did not influence users' ability to reach and maintain the visual FB goal. (3) All participants increased their prosthesis-side stance time with the feedback and maintain it right after feedback was removed. However, in the post-test, the prosthesis control parameters tuned with visual FB only supported a few participants with longer stance time and better stance time symmetry. CONCLUSIONS The study provides novel insights on human-prosthesis interaction when cooperating in walking, which may guide the future successful adoption of this paradigm in prosthesis control personalization or human-in-the-loop optimization to improve the prosthesis user's gait performance.
Collapse
Affiliation(s)
- Bretta L. Fylstra
- grid.40803.3f0000 0001 2173 6074Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695 USA ,grid.10698.360000000122483208Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - I-Chieh Lee
- grid.40803.3f0000 0001 2173 6074Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695 USA ,grid.10698.360000000122483208Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Minhan Li
- grid.40803.3f0000 0001 2173 6074Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695 USA ,grid.10698.360000000122483208Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Michael D. Lewek
- grid.10698.360000000122483208Division of Physical Therapy, UNC Chapel Hill, Chapel Hill, NC 27599 USA
| | - He Huang
- grid.40803.3f0000 0001 2173 6074Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC 27695 USA ,grid.10698.360000000122483208Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| |
Collapse
|
7
|
Wong CK, Vandervort EE, Moran KM, Adler CM, Chihuri ST, Youdan GA. Walking asymmetry and its relation to patient-reported and performance-based outcome measures in individuals with unilateral lower limb loss. Int Biomech 2022; 9:33-41. [PMID: 36414237 PMCID: PMC9704090 DOI: 10.1080/23335432.2022.2142160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Gait asymmetry persists for most people after lower limb amputation and is associated with slower walking speeds. However, the relationship between gait asymmetry and patient-reported function remains unclear because they are not commonly assessed together. The purpose of this study was to determine relationships between gait asymmetries in people with lower limb loss and (1) patient-reported outcomes and (2) performance-based prosthetic functional measures. This cross-sectional analysis included nine people with unilateral limb loss aged 48.2 ± 13.1 years of mixed amputation etiology. Patient-reported outcomes included the Prosthetic Evaluation Questionnaire mobility subscale and Activities-specific Balance Confidence scale. Performance outcomes included the Berg Balance Scale and the 30-second sit-to-stand test. Walking performance measures included the 2-Minute Walk Test, during which APDM Opal sensors recorded spatiotemporal gait parameters, and daily step-counts from StepWatch4 activity monitors. The study found that the most asymmetric gait symmetry ratios (prosthetic-limb divided by intact-limb) could be attributed to prosthetic foot dorsiflexion-plantarflexion and rotation motion limitations: prosthetic-limb trailing double support (0.789 ± 0.052), toe-off (0.760 ± 0.068) and toe-out angle (0.653 ± 0.256). Single limb stance, and stance and swing phase durations were most strongly associated with balance and walking performance measures. Notably, no symmetry ratio was significantly associated with patient-reported prosthetic function (unadjusted Pearson correlation coefficients r < 0.50, P > 0.05). More gait symmetry was associated with better balance and walking performance but had no significant relationship with patient-reported function. Although achieving gait symmetry after lower limb loss is a common walking goal, symmetry was unrelated to the perception of functional mobility for people with lower limb loss.
Collapse
Affiliation(s)
- Christopher K. Wong
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA,CONTACT Christopher K. Wong Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, 617 West 168th St, Georgian-311, New York, NY10032, USA
| | | | - Kayla M. Moran
- Program in Physical Therapy, Columbia University, New York, NY, USA
| | - Carly M. Adler
- Program in Physical Therapy, Columbia University, New York, NY, USA
| | - Stanford T. Chihuri
- School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
| | | |
Collapse
|
8
|
Galindo Leon SA, Hassan M, Suzuki K. A Passive Three Degree of Freedom Transtibial Prosthesis With Adjustable Coronal Compliance and Independent Toe Joint. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:4330-4333. [PMID: 36086623 DOI: 10.1109/embc48229.2022.9871467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The effects of including lateral compliance or a toe joint in transtibial prostheses have been studied independently, showing the potential to improve the gait biomechanics in terms of stability, walking speed, and metabolic cost. However, both of these features are not commonly found in commercial prostheses despite their importance in human gait. In this work, we present a multi-axis passive transtibial prosthesis with three degrees of freedom (DOF). The prosthesis includes a compliant and adjustable coronal articulation using beam springs, an independent 3D-printed flexible forefoot as a toe joint, and sagittal dorsiflexion-plantarflexion stiffness using a helicoidal spring. We mechanically characterize each degree of freedom in terms of the provided stiffness. The measured stiffness values were 3.26Nm/deg, 4.94, or 5.63 Nm/deg in the sagittal plane (with different springs), and 2.54 Nm/deg, 2.79 Nm/deg, 2.94 Nm/deg, or 3.72 Nm/deg in the coronal plane (by adjusting the mechanism). Finally, the effect of different types of infill and infill levels for the 3D printed toes were explored, showing stiffness varying from 2.05 N/mm to 350 N/mm. The obtained sagittal stiffness is beneath the ones found in able-bodied persons; in contrast, the lateral stiffness values are comparatively higher than that of the able-bodied persons. However, the current design is simple to rearrange and modify the stiffness values. Lastly, the wide range of stiffness achievable in the 3D printed toes can be useful to achieve proper torque requirements in the forefoot for a broad range of users.
Collapse
|
9
|
Zwierzchowska A, Gawel E, Celebanska D, Rosolek B. Musculoskeletal pain as the effect of internal compensatory mechanisms on structural and functional changes in body build and posture in elite Polish sitting volleyball players. BMC Sports Sci Med Rehabil 2022; 14:49. [PMID: 35346336 PMCID: PMC8962485 DOI: 10.1186/s13102-022-00439-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 03/17/2022] [Indexed: 02/04/2023]
Abstract
Background With the dynamic development of professional Paralympic sport, the prevalence of musculoskeletal pain and structural and/or functional disturbances in Para athletes constantly increases. The aim of the study was to evaluate the impact of internal compensatory mechanisms on selected aspects of body structure and function in elite sitting volleyball players. Methods The study included eighteen elite sitting volleyball players (male; n = 12, female; n = 6, age; 36.0 ± 6.1, body mass; 76.6 ± 16.1, body height; 179.3 ± 0.1) from the Polish national team. Retrospective and direct participatory observation methods were used in the study. NMQ-7 was used to assess the current prevalence and location of musculoskeletal pain. The evaluation of spinal curvature and pelvic inclination was performed using a non-invasive Medi Mouse method (Idiag M360) in three different trunk positions. All statistical analyses were performed using Statistica 13.3 software package. Results Lumbar hypolordosis was a predominant sagittal deviation of spinal curvature (n = 15;83%). Low back pain (LBP) and neck pain were the most frequent complaints (50%). Statistically significant differences in the values of thoracic kyphosis angle, pelvic inclination, and spine length (SL) in sagittal standing flexion and extension were found. However, there was no statistically significant difference in sagittal standing flexion for the lumbar lordosis angle with a simultaneous significant change in pelvic inclination (66.9°). Moreover, a tendency to interpenetration of relationships between variables that characterize (a) body structure and (b) function of the spine and musculoskeletal pain were observed. Shoulder pain correlated with SL (R = 0.6; p < 0.05) and body height (R = 0.5; p < 0.05). Pelvic inclination correlated with shoulder pain, LBP (R = 0.5; p < 0.05/R = 0.6; p < 0.01), and body trunk fat mass (R = − 0.6; p < 0.05). Conclusions Trunk fat mass induces internal compensatory mechanisms to maintain optimal pelvic inclination and sagittal spinal balance. Furthermore, the level of pelvic mobility may determine musculoskeletal pain in Para athletes with lower limb impairment.
Collapse
Affiliation(s)
- Anna Zwierzchowska
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72A, 40-065, Katowice, Poland
| | - Eliza Gawel
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72A, 40-065, Katowice, Poland.
| | - Diana Celebanska
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72A, 40-065, Katowice, Poland
| | - Barbara Rosolek
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Mikołowska 72A, 40-065, Katowice, Poland
| |
Collapse
|
10
|
The Impact of Internal Compensatory Mechanisms on Musculoskeletal Pain in Elite Polish Sitting Volleyball Players – A Preliminary Study. J Hum Kinet 2022; 81:277-288. [PMID: 35291641 PMCID: PMC8884867 DOI: 10.2478/hukin-2022-0023] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
The purpose of the study was to evaluate the impact of (1) maximal muscular strength of the upper body and (2) fat mass on musculoskeletal pain and sagittal spinal curvature deviations in elite Polish sitting volleyball players. The study examined twelve players (age = 35.4 ± 6.9 years). The assessments were performed based on objective (anthropometric examinations, Medi Mouse, 1RM test) and subjective (NMQ = 7) measurements. All statistical analyses were performed using the SPSS. The lower back, the upper back and the neck were the most frequent painful areas. Statistical analyses showed a significant relationship between lumbar lordosis (LL) sagittal standing extension (r = 0.62; p = 0.03) and thoracic kyphosis (TK) sagittal standing flexion (r = -0.63; p = 0.28) with the 1RM. Furthermore, correlations between a body adiposity index and TK sagittal standing flexion and extension (r = -0.65; p = 0.05, r = - 0.58; p = 0.0.05) as well as LL sagittal standing flexion (r = 0.61; p = 0.05) were found. The body mass index correlated with wrist pain, whereas a very high relationship was found between pain in the wrists and knee joints. Neck pain positively correlated with TK and LL sagittal standing. Low back pain correlated with LL sagittal standing flexion and TK sagittal standing extension. Fat mass impacts the depth of anteroposterior spinal curvatures, what may cause pain in the neck and the lower back. The 1 RM bench press may influence the prevalence and location of musculoskeletal pain, whereas its values might be predicted by the depth of TK. A lower 1RM in the bench press may impact sagittal spinal curvature deviations. Deepen TK and LL significantly contribute to the prevalence of the neck pain.
Collapse
|
11
|
Michelini A, Sivasambu H, Andrysek J. The Short-Term Effects of Rhythmic Vibrotactile and Auditory Biofeedback on the Gait of Individuals After Weight-Induced Asymmetry. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 2022; 5:36223. [PMID: 37614474 PMCID: PMC10443516 DOI: 10.33137/cpoj.v5i1.36223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 01/22/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Biofeedback (BFB), the practice of providing real-time sensory feedback has been shown to improve gait rehabilitation outcomes. BFB training through rhythmic stimulation has the potential to improve spatiotemporal gait asymmetries while minimizing cognitive load by encouraging a synchronization between the user's gait cycle and an external rhythm. OBJECTIVE The purpose of this work was to evaluate if rhythmic stimulation can improve the stance time symmetry ratio (STSR) and to compare vibrotactile to auditory stimulation. Gait parameters including velocity, cadence, stride length, double support time, and step length symmetry, were also examined. METHODOLOGY An experimental rhythmic stimulation system was developed, and twelve healthy adults (5 males), age 28.42 ± 10.93 years, were recruited to participate in walking trials. A unilateral ankle weight was used to induce a gait asymmetry to simulate asymmetry as commonly exhibited by individuals with lower limb amputation and other clinical disorders. Four conditions were evaluated: 1) No ankle weight baseline, 2) ankle weight without rhythmic stimulation, 3) ankle weight + rhythmic vibrotactile stimulation (RVS) using alternating motors and 4) ankle weight + rhythmic auditory stimulation (RAS) using a singletone metronome at the participant's self-selected cadence. FINDINGS As expected the STSR became significantly more asymmetrical with the ankle weight (i.e. induced asymmetry condition). STSR improved significantly with RVS and RAS when compared to the ankle weight without rhythmic stimulation. Cadence also significantly improved with RVS and RAS compared to ankle weight without rhythmic stimulation. With the exception of double support time, the other gait parameters were unchanged from the ankle weight condition. There were no statistically significant differences between RVS and RAS. CONCLUSION This study found that rhythmic stimulation can improve the STSR when an asymmetry is induced. Moreover, RVS is at least as effective as auditory stimulation in improving STSR in healthy adults with an induced gait asymmetry. Future work should be extended to populations with mobility impairments and outside of laboratory settings.
Collapse
Affiliation(s)
- A. Michelini
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - H. Sivasambu
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - J. Andrysek
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| |
Collapse
|
12
|
Basla C, Chee L, Valle G, Raspopovic S. A non-invasive wearable sensory leg neuroprosthesis: mechanical, electrical and functional validation. J Neural Eng 2021; 19. [PMID: 34915454 DOI: 10.1088/1741-2552/ac43f8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/16/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Lower limb amputees suffer from a variety of functional deficits related to the absence of sensory communication between the central nervous system and the lost extremity. Indeed, they experience high risk of falls, asymmetric walking and balance, and low prosthesis embodiment, that significantly decrease their quality of life. Presently, there are no commercially available devices able to provide sensory feedback to leg amputees. Recently, some invasive solutions (i.e. requiring a surgery) have been proposed by different research groups, however a non-invasive effective alternative exploitable in everyday life is still missing. APPROACH To address this need we developed and tested a lightweight, non-invasive, wearable technology (NeuroLegs) providing sensory (i.e. knee angle joint and tactile) feedback to the users through electro-cutaneous stimulation. A user-friendly GUI and mobile App have been developed to easily calibrate and control the system. Standard mechanical and electrical tests were performed to assess the safety and reliability of the technology. MAIN RESULTS No mechanical failures, stable communication among system parts and a long-lasting battery (>23h) were demonstrated. The NeuroLegs system was then verified in terms of accuracy in measuring relevant gait parameters in healthy participants. A high temporal reliability was found when detecting stride features (important for the real-time configuration) with a correct match to the walking cadence, in all assessed walking conditions. The effectiveness of the NeuroLegs system at improving walking of three transfemoral amputees was then verified in movement laboratory tests. Increased temporal gait symmetry and augmented confidence were found. Stepping outside from the lab, Neurolegs was successfully exploited by a transfemoral amputee in CYBATHLON Global Edition 2020 in several challenging situations related to daily-living activities. SIGNIFICANCE Our results demonstrate that the NeuroLegs system provides the user with useful sensory information that can be successfully exploited in different walking conditions of daily life.
Collapse
Affiliation(s)
- Chiara Basla
- ETH Zurich, Tannenstrasse 1, Zurich, Zürich, 8092, SWITZERLAND
| | - Lauren Chee
- ETH Zurich, Tannenstrasse 1, Zurich, Zürich, 8092, SWITZERLAND
| | - Giacomo Valle
- ETH Zürich, Tannenstrasse 1, Zurich, 8092, SWITZERLAND
| | | |
Collapse
|
13
|
Huang H(H, Si J, Brandt A, Li M. Taking Both Sides: Seeking Symbiosis Between Intelligent Prostheses and Human Motor Control during Locomotion. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2021; 20:100314. [PMID: 34458654 PMCID: PMC8388605 DOI: 10.1016/j.cobme.2021.100314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Robotic lower-limb prostheses aim to replicate the power-generating capability of biological joints during locomotion to empower individuals with lower-limb loss. However, recent clinical trials have not demonstrated clear advantages of these devices over traditional passive devices. We believe this is partly because the current designs of robotic prothesis controllers and clinical methods for fitting and training individuals to use them do not ensure good coordination between the prosthesis and user. Accordingly, we advocate for new holistic approaches in which human motor control and intelligent prosthesis control function as one system (defined as human-prosthesis symbiosis). We hope engineers and clinicians will work closely to achieve this symbiosis, thereby improving the functionality and acceptance of robotic prostheses and users' quality of life.
Collapse
Affiliation(s)
- He (Helen) Huang
- NC State/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA, 27695
- NC State/UNC Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, 27514
| | - Jennie Si
- Department of Electrical, Computer, and Energy Engineering, Arizona State University, Tempe, Arizona, USA, 85281
| | - Andrea Brandt
- NC State/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA, 27695
- NC State/UNC Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, 27514
| | - Minhan Li
- NC State/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA, 27695
- NC State/UNC Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, 27514
| |
Collapse
|
14
|
Nalam V, Huang HH. Empowering prosthesis users with a hip exoskeleton. Nat Med 2021; 27:1677-1678. [PMID: 34635853 DOI: 10.1038/s41591-021-01529-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Varun Nalam
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA.,Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - He Helen Huang
- Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, USA. .,Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| |
Collapse
|
15
|
Gholizadeh H, Baddour N, Botros M, Brannen K, Golshan F, Lemaire ED. Hip disarticulation and hemipelvectomy prostheses: A review of the literature. Prosthet Orthot Int 2021; 45:434-439. [PMID: 34524261 DOI: 10.1097/pxr.0000000000000029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/27/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although the global population of people with a hip disarticulation (HD) or hemipelvectomy (HP) amputation is small, the degree of disability is high, affecting function and independence. A comprehensive literature review is needed to examine the evidence for prostheses in these amputation levels. METHOD A scoping literature review was conducted to examine related research documents from 1950 to September 2020, found using Scopus, Web of Science, PubMed, and Google Scholar databases. Studies evaluated (retrospectively or prospectively) HD or HP prostheses and were written in English. Study design and protocol, research instrument, sample size, and outcome measures were reviewed. RESULTS In the past 70 years, 53 articles that evaluated HD or HP prostheses were published. Most research was conducted in the United States (24 articles) and Japan (nine articles). In 42 articles, authors prospectively evaluated the effects of prostheses in these amputation levels. On average, prospective studies had four (SD = 5) participants. Since 1950, only five prospective studies evaluated HD or HP prostheses with 10 or more participants. Moreover, sufficient information was often unavailable for research replication. CONCLUSION More evidence is needed regarding the effects of HD or HP prosthetic components (i.e. hip, knee, ankle, socket type, and suspension system) on gait, patient satisfaction, prosthetic use, interface pressure, and energy expenditure. Articles mostly have small sample sizes that reduce confidence in the reliability of their findings and limit generalizability. Future investigations are needed with vigorous methodology and larger sample sizes to provide strong statistical conclusions.
Collapse
Affiliation(s)
- Hossein Gholizadeh
- Ottawa Hospital Research Institute, Centre for Rehabilitation Research and Development, Ottawa, Canada
| | - Natalie Baddour
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada
| | - Michael Botros
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada
| | - Kelly Brannen
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada
| | - Farshad Golshan
- Faculty of Engineering, Department of Mechanical Engineering, University of Ottawa, Ottawa, Canada
| | - Edward D Lemaire
- Ottawa Hospital Research Institute, Centre for Rehabilitation Research and Development, Ottawa, Canada
- Faculty of Medicine, University of Ottawa, Canada
| |
Collapse
|
16
|
Unilateral above-knee amputees achieve symmetric mediolateral ground reaction impulse in walking using an asymmetric gait strategy. J Biomech 2020; 115:110201. [PMID: 33388484 DOI: 10.1016/j.jbiomech.2020.110201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/26/2020] [Accepted: 12/11/2020] [Indexed: 11/20/2022]
Abstract
The ability to sustain steady straight-ahead walking is one goal of gait rehabilitation for individuals with unilateral above-knee (UAK) amputation. Despite the morphological and musculoskeletal asymmetry resulting from unilateral limb loss, the mediolateral ground-reaction-impulse (GRI) should be counterbalanced between the affected and unaffected limbs during straight-ahead walking. Therefore, we investigated the strategies of mediolateral ground-reaction-force (GRF) generation adopted by UAK prosthesis users walking along a straight path. GRFs of 15 participants with UAK amputation were measured during straight-ahead walking. Then, the mediolateral GRI, stance time, and mean mediolateral GRF during the stance phase of the affected and unaffected limbs were compared. To better understand the GRF generation strategy, statistical-parametric-mapping (SPM) was applied to assess the phase-dependent difference of the mediolateral GRFs between two limbs. The results showed that UAK prosthesis users can achieve symmetric mediolateral GRI during straight-ahead walking by adopting an asymmetric gait strategy: shorter stance time and higher mean mediolateral GRF over the stance phase for the affected than for the unaffected limb. In addition, the analysis using SPM revealed that the affected limb generates a higher mean medial GRF component than the unaffected limb, especially during the single-support phase. Thus, a higher medial GRF during the single-support phase of the affected limb may allow UAK prosthesis users to achieve mediolateral GRI that are similar to those of the unaffected limb. Further insights on these mechanics may serve as guidelines on the improved design of prosthetic devices and the rehabilitation needs of UAK prosthesis users.
Collapse
|
17
|
Harandi VJ, Ackland DC, Haddara R, Cofré Lizama LE, Graf M, Galea MP, Lee PVS. Individual muscle contributions to hip joint-contact forces during walking in unilateral transfemoral amputees with osseointegrated prostheses. Comput Methods Biomech Biomed Engin 2020; 23:1071-1081. [PMID: 32691622 DOI: 10.1080/10255842.2020.1786686] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Direct skeletal attachment of prostheses in transfemoral amputees circumvents skin-interface complications associated with conventional sockets; however, joint pain and musculoskeletal disease is known to occur postoperatively. This study quantified hip contact forces and the roles of individual muscles in producing hip contact forces during walking in transfemoral amputees with osseointegrated prostheses. Musculoskeletal models were developed for four transfemoral amputees. Gluteus maximus and gluteus medius were the major contributors to the hip contact forces, and the intact limb hip muscles demonstrated greater contributions to hip contact forces than those of the residual limb. The findings may be useful for mitigating walking asymmetry.
Collapse
Affiliation(s)
| | | | - Raneem Haddara
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Australia
| | - L Eduardo Cofré Lizama
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | - Mark Graf
- Department of Allied Health, Royal Melbourne Hospital, Melbourne, Australia
| | - Mary Pauline Galea
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | - Peter Vee Sin Lee
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Australia
| |
Collapse
|