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1
Content available Body balance a few years after total hip replacement
EN
These aim of the study was to conduct a long-term evaluation of whether total hip replacement permanently affects the dynamic body balance. Methods: Twenty-five patients after the unilateral total hip replacement (mean age: 69.9 ± 6.2) and 25 subjects without the total hip replacement (mean age: 68.4 ± 4.8) who matched the age and overall health participated in this study. The force platform and functional tests such as Timed Up and Go, 3m walk test, Functional Reach Test, 30s Chair Stand Test, Step Test and Berg Balance Scale were used to assess dynamic balance. The results obtained in individual trials were compared using the Student’s t-test for independent variables, the Welch test or the non-parametric Mann–Whitney U-test. Results: Subjects from the THR group exhibited significantly increased time and distance in the tests performed on the force platform, compared to the control group. We also observed worse balance and functional test scores in the THR group: Timed Up and Go test ( p < 0.001), 3 m walk test ( p < 0.001), Functional Reach Test ( p < 0.001), 30 s Chair Stand Test ( p = 0.001) and Step Test (operated leg: p < 0.001, non-operated leg: p < 0.001). The results obtained in the Berg Balance Scale tests were not significantly different between the groups ( p = 0.218). Conclusions: We observed significant differences in postural stability and dynamic balance between patients after THR and subjects in the same age without endoprosthesis. Our research shows that total hip replacement permanently impairs patients’ dynamic balance and their functionality in certain lower-extremity activities.
2
EN
The aim of the work was to show that the fatigue load of bone tissue causes permanent structural changes in it. Methods: On the basis of the movie recording of gait, the time courses of angular changes in the joints of the lower limb were determined. Using the method of transforming Denavit–Hartenberg coordinate systems, the course of force loading the hip joint and, after that, the course of normal contact reaction of the femoral head of the knee joint during gait for the support phase were determined. On the basis of the Hertz formula, the course of contact stresses in the femoral joint head and the damage coefficient were determined according to the Palmgren–Miner damage accumulation hypothesis. Results: A calculation example was made using own software. The course of the obtained damage factor was compared to the image fixed in the X-ray image after its appropriate processing. The thesis of the work has been confirmed to a satisfactory degree. Conclusions: The nature of the lesions is similar to the image of structural changes in the head of the joint. It should be assumed that the image fixed in the bone is the result of the stored history of loads. Analysis of the obtained image can be used to determine the state of bone strength.
EN
The objective of this study was to compare the ground reaction forces (GRFs) and the multi-segment foot motion between individuals with plantar fasciitis (PF) and healthy controls. Methods: Twenty-one individuals with PF and 21 matched-case healthy controls who passed the criteria participated in the study. Gait data were assessed during their self-selected comfortable speeds by the 3D motion analysis system. The multi-segment foot motions were determined by the Oxford Foot Model. Outcome measures included the vertical and antero-posterior ground reaction forces (GRFs) and the multi-segment foot motions [the dorsiflexion (DF), plantarflexion (PF), inversion (Inv), eversion (Eve), adduction (Add), and abduction (Abd) peak angles for the forefoot with respect to hindfoot (FFHF) and the DF, PF, Inv, Eve, internal rotation (IR), and external rotation (ER) peak angles for the hindfoot with respect to tibia (HFTB) as well as their ranges (R)]. Results: Comparisons between individuals with PF and healthy controls showed no significant differences in any of the GRFs. Significant reductions were found in the FFHF-DF, FFHF-DF-R, FFHF-Inv, and HFTB-Inv/Eve-R in individuals with PF. In addition, there were tendencies of the increased angles of the FFHF-PF, HFTB-DF, HFTB-Inv, and HFTB-ER, but not significantly for individuals with PF, compared to healthy controls. Conclusions: Adaptations of the intra-foot motion showed the reduction of some angles but no change for the GRFs in individuals with PF compared to the healthy controls when both groups walked at a similar gait speed.
EN
An important issue in the case of people with physical disabilities is total or partial restoration of independent movement. The aim of the work was to determine the loads of the musculoskeletal system of the upper limb while walking with crutches. The methodology of the work consisted of carrying out studies of kinematics and ground reactions when walking with crutches. The next stage of the work was to perform simulations in the AnyBody environment. The results obtained during the simulation are values of forces occurring in the joints of the upper limb.
PL
Istotną sprawą w przypadku osób z niepełnosprawnością ruchową jest całkowite lub częściowe przywrócenie możliwości samodzielnego poruszania się. Jednym z podstawowych narzędzi używanym w celach reedukacyjnych są kule, balkony oraz rollatory do chodzenia [4]. Metodyka pracy składała się z przeprowadzenia badań kinematyki oraz reakcji podłoża podczas chodu z kulami. Badania te wykonane zostały z wykorzystaniem kombinezonu MVN Biomech oraz platform dynamometrycznych firmy AMTI. Następnie zsynchronizowane ze sobą zostały wyniki kinematyki oraz reakcji podłoża i wybrana została chwila czasowa, dla której reakcja podłoża była największa. Kolejnym etapem pracy było wykonanie symulacji w środowisku AnyBody. Wyniki uzyskane podczas symulacji to wartości sił występujących w stawach kończyny górnej.
EN
The effect of age on structural foot characteristics as well as on the plantar pressure distribution has been shown previously. However, the number of studies focused also on gender gait differences of elderly is lacking. The purpose of this study was to compare dynamic gait characteristic in younger and older elderly and to investigate the gender differences as the life-long load and footwear choice differ in males and females. Methods: 61 healthy elderly participants were divided by age and gender into four groups: males 60–69, males 70–79, females 60–69 and females 70–79 years old. Plantar pressures were recorded during barefoot walking at naturally chosen speed using Emed-at (Novel GmbH, Germany). Three steps of the left foot of each participant were used for further analysis, furthermore, hallux angle, foot progression angle, and arch index were calculated by the Emed software from obtained footprints. To compare the differences between the analyzed groups, effect size obtained by Cohen’s d was used. Results: Comparing the two age male groups, higher mean pressure was found in the 70–79 age group in region MH4, MH5 and mid-foot, suggesting a greater lateral load and decreased longitudinal arch of the foot. Comparing female groups, the higher mean pressure was found in the older age group in region MH1. In all other regions, the mean pressures were reduced in the older groups. Conclusions: The results suggest that the effect of aging on plantar pressure distribution during the gait is affected by gender and should be considered when evaluating the gait of elderly.
EN
The aim of this study was to compare gait stability and variability between walking conditions and age groups. Methods: Twenty-six healthy younger and older females participated. Trunk acceleration in the vertical (V), medial-lateral (ML) and anteriorposterior (AP) directions during 5 minutes walking overground and 3 minutes walking on the treadmill at self-selected speed were recorded. Root mean square and standard deviations of acceleration, stride time and its variability, Lyapunov exponents (LE), multiscale entropy (MSE) and harmonic ratios (HR) were computed. Results: Both age groups showed significantly higher stride time variability and short-term LE in all directions during overground walking. For the older group, overground walking showed higher V and AP standard deviation. Significantly lower values for overground walking were observed for long-term LE (V and ML for the younger group, ML for the older group), HR (ML for the older group) and MSE (V for the older group). Significant age-related differences were found for V long-term LE for overground walking. Conclusions: The present findings suggest that both linear and advanced computational techniques for gait stability and variability assessment in older adults are sensitive to walking conditions.
EN
Many pregnant women suffer from pelvic girdle pain (PGP) during pregnancy. Etiologies are multifactorial and affect the joint stability of the sacroiliac joint. Pelvic belts could restore stability and reduce pain during gait. The center of pressure (COP) is a reliable parameter to assess gait and balance. The objectives of this study were to analyze the COP during gait in pregnant women with PGP, to evaluate the effect of pelvic belts and to compare two types of belts on COP parameters. Materials and Methods: 46 pregnant women with PGP, 58 healthy pregnant women and 23 non-pregnant women participated in the study. The motor task consisted of three gait trials at different velocities on an electronic walkway. Two pelvic belts for pregnant women were used. An analysis of variance was performed to determine the effects of the progression of the pregnancy, gait speed, presence of pregnancy and occurrence of pain on the COP parameters. Results: Compared to the control group, pregnant women with PGP had a higher stance time, but COP displacement and velocity were lower. The COP parameters varied between pregnant women with and without pelvic girdle pain, the use of a belt during pregnancy decreased the walking velocity. No difference was found according to the type of belt. Conclusions: Differences in COP parameters during gait between pregnant women with or without PGP were minimal. Pelvic girdle pain did not affect the center of pressure. Wearing a belt during pregnancy modified the center of pressure velocity during gait in pregnant women with PGP.
EN
Background: Proper, early, and exact identification of gait impairments and their causes is regarded as a prerequisite for specific therapy and a useful control tool to assess efficacy of rehabilitation. There is a need for simple tools allowing for quickly detecting general tendencies. Objective: The aim of this paper is to present the outcomes of traditional and fuzzy-based analysis of the outcomes of post-stroke gait reeducation using the NeuroDevelopmental Treatment-Bobath (NDT-Bobath) method. Materials and methods: The research was conducted among 40 adult people: 20 of them after ischemic stroke constituted the study group, and 20 healthy people constituted the reference group. Study group members were treated through 2 weeks (10 therapeutic sessions) using the NDT-Bobath method. Spatio-temporal gait parameters were assessed before and after therapy and compared using novel fuzzy-based assessment tool. Results: Achieved results of rehabilitation, observed as changes of gait parameters, were statistically relevant and reflected recovery. One-number outcomes from the proposed fuzzy-based estimator proved moderate to high consistency with the results of the traditional gait assessment. Conclusions: Observed statistically significant and favorable changes in the health status of patients, described by gait parameters, were reflected also in outcomes of fuzzy-based analysis. Proposed fuzzy-based measure increases possibility of the clinical gait assessment toward more objective clinical reasoning based on common use of the mHealth solutions.
PL
Ciąża jest stanem fizjologicznym, podczas którego zachodzi wiele przemian biochemicznych oraz biomechanicznych. Zmiany te znacząco wpływają na kondycję fizyczną kobiety ciężarnej. Powiększający się brzuch oraz zmiany temu towarzyszące znacząco wpływają na komfort poruszania się kobiety. Fizjologiczne zmiany zachodzące w czasie ciąży mogą być przyczyną nieprawidłowego ustawiania stopy, co może powodować bóle pleców i kończyn dolnych. Celem niniejszej pracy jest ocena rozkładu obciążeń stóp kobiet ciężarnych na podłoże podczas chodu.
EN
Pregnancy is a very special period in women's life. Anatomical, biomechanical and hormonal changes are characteristic for this period and may have impact on incorrect posture or affect musculoskeletal balance. Twenty-one pregnant women were recruited in three semesters pregnancy. Measurements included in-shoe plantar pressure distribution. Results suggest higher plantar pressure magnitude in all trimesters pregnancy. Especially, in the third trimester the changes in magnitude of pressure distribution were observe under the forefoot, medial arch and heel (p<0,05).
EN
Physical and hormonal modifications occuring during the pregnancy, can lead to an increase in postural instability and to a higher risk of falls during gait. The first objective was to describe the center of pressure (COP) during late pregnancy at different gait velocity. Comparison of nulliparous women with postpartum women were conducted in order to investigate the effects of pregnancy. The second objective was to analyse COP variability between pregnant and non-pregnant women in order to investigate the effects of regnancy on gait variability. Methods: Fifty-eight pregnant women in the last four months of pregnancy, nine postpartum women and twenty-three healthy non-pregnant women performed gait trials at three different speeds: preferred, slow and fast. Results: In the last four months of pregnancy gait velocity decreased. During the pregnancy, gait velocity decreased by 22%, stopover time increased by 6–12%, COP excursion XY decreased by 5% and COP velocity decreased by 16% and 20% along the anteroposterior and transverse axes, respectively. After delivery, gait velocity increased by 3% but remained a lower compared to non-pregnant women (–12%). Intra-individual variability was greater for non-pregnant than pregnant women. Conclusions: COP parameters were influenced by pregnancy. This suggests that pregnant women establish very specific and individual strategies with the aim of maintaining stability during gait.
EN
Purpose: The aim of this paper is to provide the methods for automatic detection of the difference in gait features depending on a footwear. Methods: Artificial neural networks were applied in the study. The gait data were recorded during the walk with different footwear for testing and validation of the proposed method. The gait properties were analyzed considering EMG (electromyography) signals and using two types of artificial neural networks: the learning vector quantization (LVQ) classifying network, and the clustering competitive network. Results: Obtained classification and clustering results were discussed. For comparative studies, velocities of the leg joint trajectories, and accelerations were used. The features indicated by neural networks were compared with the conclusions formulated analyzing the above mentioned trajectories for ankle and knee joints. Conclusions: The matching between experimentally recorded joint trajectories and the results given by neural networks was studied. It was indicated what muscles are most influenced by the footwear, the relation between the footwear type and the muscles work was concluded.
EN
Purpose: The kinematic analysis of gait during pregnancy provides more information about the anatomical changes and contributes to exercise and rehabilitation prescription. The purposes were to describe and quantify the spatial, temporal and kinematic parameters in the joints of the lower limb during gait at the end of the first, second and third trimesters of pregnancy and in the postpartum period. Methods: A three-dimensional analysis was performed in eleven pregnant women. Repeated measures ANOVA was performed for comparisons between periods. Results: The longitudinal effect of pregnancy was not observed in spatial and temporal parameters. In joint kinematics the effect of pregnancy was observed in all joints for the three planes of motion. The hip joint and pelvis are the structures with more changes, and the results point to an increase in the anterior tilt of the pelvis as the pregnancy progresses, as well as a decrease of the amplitudes of the hip joint. The results suggested that pregnant women need to maintain the stability of the body, and become more efficient in locomotion. Conclusions: In general, the results retrieve the values from the beginning of pregnancy, indicating that the body was self-organized in order to overcome the morphological and physiological changes which women suffer during pregnancy, indicating that they have the ability to adapt depending on the demands, and after the effect of pregnancy is over, they return to values similar to those found in early pregnancy
EN
Purpose: Spastic diplegia is the most common form of cerebral palsy. It presents with symmetric involvement of the lower limbs and upper limbs. Children with spastic diplegia frequently experience problems with motor control, spasticity, and balance which lead to gait abnormalities. The aim of this study is twofold. Firstly, to determine the differences in spatial-temporal gait parameters and magnitude of plantar pressure distribution between children with spastic diplegia (CP) and typical children. Secondly, to compare and evaluate main changes of plantar pressure and spatial-temporal gait parameters instead of data between spastic diplegia children with prescribed ankle – solid foot orthosis (AFOs) and without using AFOs. Methods: The evaluation was carried out on 20 spastic diplegia children and 10 agematched children as a control group aged 6–15 years. Twenty children with spastic diplegia CP were divided into two groups: ten subjects with prescribed AFOs and ten subjects without use of assistive device. Patients used the AFOs orthosis for one year. Measurements included in-shoe plantar pressure distribution and spatial-temporal gait parameters. Results: Spatial-temporal gait parameters showed meaningful difference between study groups in velocity, stride length, step length and cadence ( p < 0.05). However no significant differences between patients with and without AFOs were found ( p > 0.05). Significant differences between typical and spastic diplegia children with AFOs were observed in the magnitude of plantar pressure under the toes, the metatarsal heads, the medial arch, and the heel ( p < 0.05). For typical subjects, the highest pressure amplitudes were found under the heel and the metatarsal heads, while the lowest pressure distribution was under the medial arch. In CP patients the lateral arch was strongly unloaded. The peak pressure under heel was shifted inside. Conclusions: Collected data and calculated scores present a state of the gait in test groups, showed the difference and could be valuable for physicians in decision making by choosing qualitative therapy. Furthermore, it allows predicting probability of further possible changes in gait of spastic diplegia patients with AFOs and without it. In conclusion, our current results showed that the use of AFOs, prescribed on a clinical basis by doctors improves gait patterns and gait stability in children with spastic cerebral palsy.
EN
Purpose: One of the aims of the treatment in ambulant cerebral palsy (CP) patients is improvement of gait. Level of gait pathology is assessed by instrumented gait analysis, including surface electromyography. The aim of this study was to investigate the relation of the abnormality level of the gait and the co-contraction of the agonist-antagonist muscles, and relation between symmetry left /right leg in gait and symmetry of muscular activity. Methods: Fifty one patients with Cerebral Palsy underwent clinical assessment and instrumented gait analysis, including surface electromyography. Signals were bilaterally collected from rectus femoris, medial and lateral hamstrings, tibialis anterior, lateral gastrocnemius and gluteus maximus. In older children additionally signals from soleus and lateral vastus were recorded. Sixteen gait variables were selected to calculate Gillette Gait Index, separately for left and right leg. From the envelopes the series of cross-correlation coefficients were calculated. Results: Weak correlations were found between averaged agonist-antagonist correlation coefficient and Gillette Gait Index. Differences between hemiparetic less-involved legs, hemiparetic spastic legs, and diplegic legs were found for co-contraction of rectus femoris and biceps femoris and for averaged agonist-antagonist co-contraction. The differences between hemiparetic and diplegic groups were found for some muscle correlation coefficients. Conclusions: The results obtained in this study show, that the activity pattern of the leg muscles is specific for a given patient, and the dependence of the kinematics pathology on the abnormal activation pattern is not a direct one.
EN
Footwear is an important element of an attirement, which protects the human foot from injuries and negative effects of extraneous environmental conditions. Moreover shoes are necessary component of locomotor apparatus, cause human sole is not adapted to long - distances walking without protection. Modern shoe is equipped with stiffened midsole, hightened heel or arch supports, which has been changed the foot strike. Today a typically strike of human gait is rearfoot - which the point of the first contact the ground is heel. The specific rigid construction of shoes follows that natural barefoot strike has been changed on rearfoot. On the other side, set of materials which is used for shoe production like leather, woven or unwoven textiles or synthetics materials are an important factor to influence the quality of footwear and affects the comfort of use. Therefore innovative textiles and polymer materials are desirable to create new protective and functional properties of shoes.
Logistyka
|
2015
|
nr 4
7483--7490, CD2
PL
Ocena chodu i biegu ma istotne znaczenie przy identyfikacji chorób związanych z układem ruchu. W celu wyznaczenia określonych parametrów można wykorzystać specjalistyczne oprogramowanie jak BTS, SkillSpector oraz czujniki ProMove mini. Pacjent porusza się ze stałą prędkością na bieżni. Uzyskane wyniki są następnie przekształcane za pomocą funkcji trygonometrycznych dla prawej i lewej kończyny, przez co uzyskuje się kąty w odpowiednich stawach. Znormalizowanie danych na poszczególne kroki i podział na fazy w każdym kroku pozwala na wyznaczenie asymetrii podczas ruchu. Poprzez zastosowanie metod numerycznych, za pomocą szeregu trygonometrycznego Fouriera oraz sumy sinusów uzyskuje się parametry każdego ze stawów w poszczególnych fazach kroku. Można je wykorzystać do planowania trajektorii egzoszkieletu wspomagającego proces rehabilitacji. Dokładność dopasowania określa się za pomocą błędu średniokwadratowego.
EN
The identification of typical parameters of gait and running is very important in estimation of diseases associated with human motor system. In order to determine the specific parameters, the specialized software like BTS, SkillSpector an ProMove mini sensor can be used. The user is moved at a constant speed on a treadmill. The results obtained are then converted by using of trigonometric functions for right and lef leg, thereby forming angles in the respective joints. The data for each step are standardized, and phasing in every step to determine the asymmetry in the motion. Through the use of numerical methods (eg. Matlab package), trigonometric Fourier series and the sum of sines, parameters are obtained of each of the joints in the individual phases step. They can be used to plan the trajectory of the exoskeleton eg. supporting the rehabilitation process. The accuracy of the fit is determined by a mean square error.
EN
Purpose: Medial longitudinal arch (MLA) strengthening has been considered an important part of successful flatfoot treatment. But, to date, the biomechanical loading behavior of the medial arch in flatfoot has not been evaluated. This study aimed to evaluate the MLA moment, MLA deformation angle, foot kinematics and ground reaction forces (GRF) in both normal foot and flatfoot groups. Methods: Each participant’s foot was classified according to arch type using foot prints and radiographs. Twenty-eight non-obese adults (13 flatfeet and 15 normal feet) were involved. The biomechanics data were collected in a 3D motion analysis laboratory. The MLA biomechanics were calculated. Hindfoot and forefoot kinematics were also analyzed. Results: The flatfoot group had a significantly greater peak eversion MLA moment ( p = 0.005) and a smaller peak MLA deformation angle ( p < 0.05) during specific subphases. The peak of hindfoot plantarflexion ( p < 0.05) and internal rotation ( p < 0.05) and the peak of forefoot abduction ( p < 0.05) in the specific subphases were greater in the flatfoot group. The flatfoot group also had significantly smaller peak vertical GRF ( p < 0.05) during late stance and larger peak medial GRF ( p < 0.05) during mid stance. Conclusions: This study found a significantly greater eversion deforming force acting at the MLA structure, greater hindfoot and forefoot motion, less MLA flexibility and abnormal GRF in a flatfoot group during walking, which reflected the deficit of foot function in a flatfoot group.
EN
Purpose: Children with cerebral palsy (CP) often use a crouch gait pattern that has disturbances in the knee joint kinematics. Although the length and rate of lengthening of the hamstring musculature have been speculated to be the reason that these disturbances are not adequately dissipated, this relationship has not been adequately explored. The purpose of this exploratory investigation was to use simulations of a musculoskeletal model and Floquet analysis to evaluate how the performance of hamstrings musculature during gait may be related to the knee joint instabilities seen in children with CP. Methods: Children with CP and typically developing (TD) children walked on a treadmill as a motion capture system assessed the knee joint kinematics. Floquet analysis was used to quantify the rate that disturbances present at the knee joint were dissipated, and simulations of a musculoskeletal model were used to estimate the in vivo length and velocity of the hamstrings. Pearson correlation coefficients were calculated to determine if there was a relationship between the rate that the disturbances were dissipated and the performance of the hamstring musculature. Results: The children with CP had hamstrings that lengthened more slowly than TD children, and required more strides to dissipate disturbances in the knee joint kinematics. There was negative correlation between the rate that the hamstrings lengthened and the rate that the knee joint disturbances were dissipated. Conclusions: Our results suggest that the ability of children with CP to dissipate the knee joint disturbances may be related to the inability to properly control the hamstring musculature.
19
Content available remote Modelowanie chodu robota ortotycznego przy różnych długościach kroku
PL
W artykule opisano problem doboru długości kroku i prędkości chodu robota ortotycznego ze względu na energetyczne zapotrzebowanie układów napędowych robota, który jest zasilany z przenośnego źródła energii elektrycznej. Przeprowadzono badania symulacyjne energii pobieranej przez układy napędowe biodra i kolana podczas jednego cyklu chodu oraz przy założeniu, że robot pokonuje stały dystans 100 m. Uzyskane wyniki stanowią podstawę do optymalizacji algorytmów sterowania robota.
EN
In the paper the effect of length of a step as well as gait velocity on energy demand of orthotic robot is discussed. The authors focused on studying the issue due to the fact that a portable energy supply was used. Simulation test of energy consumption of hip and knee actuators during one gait cycle and for an assumption that robot passes 100 meters were carried out .The results form the basis for the optimization of robot control algorithms.
PL
Celem pracy była analiza chodu osób z porażeniem połowiczym po udarze mózgu. Dokonano porównania wybranych parametrów lokomocji osób z porażeniem do chodu osób zdrowych, a także kończyny po stronie porażonej i nieporażonej. Analizie poddano 10 osób, w tym 4 kobiety i 6 mężczyzn. Wyniki badań przedstawiono na tle rezultatów chodu z naturalną prędkością młodych, zdrowych osób, stanowiących grupę porównawczą.
EN
The aim of this paper was to analyse the gait of people after stroke with hemiplegia and make comparision with the health people’s walk. Gait parameters obtained for paralyzed limb were compared with those obtainted for health one. Ten people after strokes with hemiplegia, including 4 women and 6 men, were taken into consederation. The results were presented on the background of the walk of the young, health people who were the reference group.
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