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Yan Y, Gong R, Cao M, Han B, Li H, Liu G. The effect of different mechanism combinations on sliding between brace and lower limb during walking and leg-raising. Proc Inst Mech Eng H 2024; 238:500-507. [PMID: 38534031 DOI: 10.1177/09544119241241440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Knee braces are commonly used to support the knee joint and improve function. However, brace sliding caused by the misalignment between brace and knee during motion is a common problem, which reduces the therapeutic effect and leads to brace abandonment. To investigate the effect of mechanism combinations on sliding, an experimental brace was designed to isolate the mechanism as the sole variable. Ten healthy participants were recruited, each of whom worn four combinations of lateral/medial mechanisms: lateral and medial single-axis (SA), lateral super gear (SG) and medial non-circular gear (NCG), lateral four-bar linkage (FL) and medial SG, and lateral FL and medial NCG. The knee flexion angle was collected using inertial measurement units, and brace sliding was measured by 3D motion capture system. All combinations had significant changes in peak sliding of thigh and shank compared to the SA combination (p < 0.05), but lateral FL and medial NCG combination had the lowest peak and final sliding during walking and leg-raising, with significant reductions of 40.7 and 85.3% in peak sliding of thigh, and significant reductions of 56.3 and 72.0% in peak sliding of shank, respectively (p < 0.05). Moreover, the mechanism combination did not significantly impact the knee range of motion (p > 0.05). The mechanism combination that fit the instantaneous center of rotation of lateral/medial condyle of knee joint demonstrates a significant reduction in brace sliding. Additionally, the peak sliding during motion is significantly higher than the final sliding.
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Affiliation(s)
- Yuzhou Yan
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, Shaanxi, P.R. China
| | - Ruitao Gong
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, Shaanxi, P.R. China
| | - Mengzhao Cao
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, Shaanxi, P.R. China
| | - Bing Han
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, Shaanxi, P.R. China
| | - Hui Li
- Joint Surgery Department, Xi'an Hong-hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P.R. China
| | - Geng Liu
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, Shaanxi, P.R. China
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Walker J, Thomas A, Stolycia ML, Wilkins RA, Lunn DE. Acute biomechanical responses to wearing a controlled ankle motion (CAM) Walker boot during walking. Gait Posture 2024; 108:208-214. [PMID: 38118224 DOI: 10.1016/j.gaitpost.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/09/2023] [Accepted: 12/14/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND Controlled ankle motion (CAM) boots are often prescribed during the rehabilitation of lower limb injuries and pathologies to reduce foot and ankle movement and loading whilst allowing the patient to maintain normal daily function. RESEARCH QUESTION The aim of this study was to quantify the compensatory biomechanical mechanisms undergone by the ipsilateral hip and knee joints during walking. In addition, the compensatory mechanisms displayed by the contralateral limb were also considered. METHODS Twelve healthy participants walked on an instrumented treadmill at their preferred walking speed. They underwent kinematic and kinetic analysis during four footwear conditions: normal shoes (NORM), a Malleo Immobil Air Walker on the right leg (OTTO), a Rebound® Air Walker on the right leg with (EVEN) and without (OSS) an Evenup Shoelift™ on the contralateral leg. RESULTS CAM boot wear increased the relative joint contribution to total mechanical work from the ipsilateral hip and knee joints (p < 0.05), which was characterised by increased hip and knee abduction during the swing phase of the gait cycle. EVEN increased the absolute work done and relative contribution of the contralateral limb. CAM boot wear reduced walking speed (p < 0.05), which was partially compensated for during EVEN. SIGNIFICANCE The increased hip abduction in the ipsilateral leg was likely caused by the increase in effective leg length and limb mass, which could lead to secondary site complications following prolonged CAM boot wear. Although prescribing an even-up walker partially mitigates these compensatory mechanisms, adverse effects to contralateral limb kinematics and kinetics (e.g., elevated knee joint work) should be considered.
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Affiliation(s)
- Josh Walker
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom.
| | - Aaron Thomas
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - Mason L Stolycia
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom
| | - Richard A Wilkins
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom; Podiatry Department, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - David E Lunn
- Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
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Fernández-Vázquez D, Calvo-Malón G, Molina-Rueda F, López-González R, Carratalá-Tejada M, Navarro-López V, Miangolarra-Page JC. Kinematic Gait Analysis in People with Mild-Disability Multiple Sclerosis Using Statistical Parametric Mapping: A Cross-Sectional Study. SENSORS (BASEL, SWITZERLAND) 2023; 23:7671. [PMID: 37765727 PMCID: PMC10535645 DOI: 10.3390/s23187671] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/30/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023]
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system. Gait abnormalities, such as altered joint kinematics, are common in people with MS (pwMS). Traditional clinical gait assessments may not detect subtle kinematic alterations, but advances in motion capture technology and analysis methods, such as statistical parametric mapping (SPM), offer more detailed assessments. The aim of this study was to compare the lower-limb joint kinematics during gait between pwMS and healthy controls using SPM analysis. Methods: A cross-sectional study was conducted involving pwMS and healthy controls. A three-dimensional motion capture system was used to obtain the kinematic parameters of the more affected lower limb (MALL) and less affected lower limb (LALL), which were compared using the SPM analysis. Results: The study included 10 pwMS with mild disability (EDSS ≤ 3) and 10 healthy controls. The results showed no differences in spatiotemporal parameters. However, significant differences were observed in the kinematics of the lower-limb joints using SPM. In pwMS, compared to healthy controls, there was a higher anterior pelvis tilt (MALL, p = 0.047), reduced pelvis elevation (MALL, p = 0.024; LALL, p = 0.044), reduced pelvis descent (MALL, p = 0.033; LALL, p = 0.022), reduced hip extension during pre-swing (MALL, p = 0.049), increased hip flexion during terminal swing (MALL, p = 0.046), reduced knee flexion (MALL, p = 0.04; LALL, p < 0.001), and reduced range of motion in ankle plantarflexion (MALL, p = 0.048). Conclusions: pwMS with mild disability exhibit specific kinematic abnormalities during gait. SPM analysis can detect alterations in the kinematic parameters of gait in pwMS with mild disability.
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Affiliation(s)
- Diego Fernández-Vázquez
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; (D.F.-V.); (F.M.-R.); (M.C.-T.); (J.C.M.-P.)
- Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Gabriela Calvo-Malón
- School of Official Master’s Degrees, Universidad Rey Juan Carlos, 28922 Madrid, Spain;
| | - Francisco Molina-Rueda
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; (D.F.-V.); (F.M.-R.); (M.C.-T.); (J.C.M.-P.)
- Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Raúl López-González
- Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - María Carratalá-Tejada
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; (D.F.-V.); (F.M.-R.); (M.C.-T.); (J.C.M.-P.)
- Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Víctor Navarro-López
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; (D.F.-V.); (F.M.-R.); (M.C.-T.); (J.C.M.-P.)
- Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Juan Carlos Miangolarra-Page
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; (D.F.-V.); (F.M.-R.); (M.C.-T.); (J.C.M.-P.)
- Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
- Physical Medicine and Rehabilitation Department, University Hospital of Fuenlabrada, 28942 Madrid, Spain
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Fang S, Vijayan V, Reissman ME, Kinney AL, Reissman T. Effects of Walking Speed and Added Mass on Hip Joint Quasi-Stiffness in Healthy Young and Middle-Aged Adults. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094517. [PMID: 37177721 PMCID: PMC10181717 DOI: 10.3390/s23094517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
Joint quasi-stiffness has been often used to inform exoskeleton design. Further understanding of hip quasi-stiffness is needed to design hip exoskeletons. Of interest are wearer responses to walking speed changes with added mass of the exoskeleton. This study analyzed hip quasi-stiffness at 3 walking speed levels and 9 added mass distributions among 13 young and 16 middle-aged adults during mid-stance hip extension and late-stance hip flexion. Compared to young adults, middle-aged adults maintained a higher quasi-stiffness with a smaller range. For a faster walking speed, both age groups increased extension and flexion quasi-stiffness. With mass evenly distributed on the pelvis and thighs or biased to the pelvis, both groups maintained or increased extension quasi-stiffness. With mass biased to the thighs, middle-aged adults maintained or decreased extension quasi-stiffness while young adults increased it. Young adults decreased flexion quasi-stiffness with added mass but not in any generalizable pattern with mass amounts or distributions. Conversely, middle-aged adults maintained or decreased flexion quasi-stiffness with even distribution on the pelvis and thighs or biased to the pelvis, while no change occurred if biased to the thighs. In conclusion, these results can guide the design of a hip exoskeleton's size and mass distribution according to the intended user's age.
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Affiliation(s)
- Shanpu Fang
- Department of Mechanical and Aerospace Engineering, University of Dayton, Dayton, OH 45469, USA
| | - Vinayak Vijayan
- Department of Mechanical and Aerospace Engineering, University of Dayton, Dayton, OH 45469, USA
| | - Megan E Reissman
- Department of Mechanical and Aerospace Engineering, University of Dayton, Dayton, OH 45469, USA
| | - Allison L Kinney
- Department of Mechanical and Aerospace Engineering, University of Dayton, Dayton, OH 45469, USA
| | - Timothy Reissman
- Department of Mechanical and Aerospace Engineering, University of Dayton, Dayton, OH 45469, USA
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