LPcomS: Towards a Low Power Wireless Smart-Shoe System for Gait Analysis in People with Disabilities

Gait analysis using smart sensor technology is an important medical diagnostic process and has many applications in rehabilitation, therapy and exercise training. In this thesis, we present a low power wireless smart-shoe system (LPcomS) to analyze different functional postures and characteristics of gait while walking. We have designed and implemented a smart-shoe with a Bluetooth communication module to unobtrusively collect data using smartphone in any environment. With the design of a shoe insole equipped with four pressure sensors, the foot pressure is been collected, and those data are used to obtain accurate gait pattern of a patient. With our proposed portable sensing system and effective low power communication algorithm, the smart-shoe system enables detailed gait analysis. Experimentation and verification is conducted on multiple subjects with different gait including free gait. The sensor outputs, with gait analysis acquired from the experiment, are presented in this thesis

Use of stance control knee-ankle-foot orthoses : a review of the literature

The use of stance control orthotic knee joints are becoming increasingly popular as unlike locked knee-ankle-foot orthoses, these joints allow the limb to swing freely in swing phase while providing stance phase stability, thus aiming to promote a more physiological and energy efficient gait. It is of paramount importance that all aspects of this technology is monitored and evaluated as the demand for evidence based practice and cost effective rehabilitation increases. A robust and thorough literature review was conducted to retrieve all articles which evaluated the use of stance control orthotic knee joints. All relevant databases were searched, including The Knowledge Network, ProQuest, Web of Knowledge, RECAL Legacy, PubMed and Engineering Village. Papers were selected for review if they addressed the use and effectiveness of commercially available stance control orthotic knee joints and included participant(s) trialling the SCKAFO. A total of 11 publications were reviewed and the following questions were developed and answered according to the best available evidence: 1. The effect SCKAFO (stance control knee-ankle-foot orthoses) systems have on kinetic and kinematic gait parameters 2. The effect SCKAFO systems have on the temporal and spatial parameters of gait 3. The effect SCKAFO systems have on the cardiopulmonary and metabolic cost of walking. 4. The effect SCKAFO systems have on muscle power/generation 5. Patient’s perceptions/ compliance of SCKAFO systems Although current research is limited and lacks in methodological quality the evidence available does, on a whole, indicate a positive benefit in the use of SCKAFOs. This is with respect to increased knee flexion during swing phase resulting in sufficient ground clearance, decreased compensatory movements to facilitate swing phase clearance and improved temporal and spatial gait parameters. With the right methodological approach, the benefits of using a SCKAFO system can be evidenced and the research more effectively converted into clinical practice

The effect of prefabricated wrist-hand orthoses on performing activities of daily living

Wrist-hand orthoses (WHOs) are commonly prescribed to manage the functional deficit associated with the wrist as a result of rheumatoid changes. The common presentation of the wrist is one of flexion and radial deviation with ulnar deviation of the fingers. This wrist position Results in altered biomechanics compromising hand function during activities of daily living (ADL). A paucity of evidence exists which suggests that improvements in ADL with WHO use are very task specific. Using normal subjects, and thus in the absence of pain as a limiting factor, the impact of ten WHOs on performing five ADLs tasks was investigated. The tasks were selected to represent common grip patterns and tests were performed with and without WHOs by right-handed, females, aged 20-50 years over a ten week period. The time taken to complete each task was recorded and a wrist goniometer, elbow goniometer and a forearm torsiometer were used to measure joint motion. Results show that, although orthoses may restrict the motion required to perform a task, participants do not use the full range of motion which the orthoses permit. The altered wrist position measured may be attributable to a modified method of performing the task or to a necessary change in grip pattern, resulting in an increased time in task performance. The effect of WHO use on ADL is task specific and may initially impede function. This could have an effect on WHO compliance if there appears to be no immediate benefits. This orthotic effect may be related to restriction of wrist motion or an inability to achieve the necessary grip patterns due to the designs of the orthoses

The effect of prefabricated wrist-hand orthoses on grip strength

Prefabricated wrist-hand orthoses (WHOs) are commonly prescribed to manage the functional deficit and compromised grip strength as a result of rheumatoid changes. It is thought that an orthosis which improves wrist extension, reduces synovitis and increases the mechanical advantage of the flexor muscles will improve hand function. Previous studies report an initial reduction in grip strength with WHO use which may increase following prolonged use. Using normal subjects, and thus in the absence of pain as a limiting factor, the impact of ten WHOs on grip strength was measured using a Jamar dynamometer. Tests were performed with and without WHOs by right-handed, female subjects, aged 20-50 years over a ten week period. During each test, a wrist goniometer and a forearm torsiometer were used to measure wrist joint position when maximum grip strength was achieved. The majority of participants achieved maximum grip strength with no orthosis at 30° extension. All the orthoses reduced initial grip strength but surprisingly the restriction of wrist extension did not appear to contribute in a significant way to this. Reduction in grip must therefore also be attributable to WHO design characteristics or the quality of fit. The authors recognize the need for research into the long term effect of WHOs on grip strength. However if grip is initially adversely affected, patients may be unlikely to persevere with treatment thereby negating all therapeutic benefits. In studies investigating patient opinions on WHO use, it was a stable wrist rather than a stronger grip reported to have facilitated task performance. This may explain why orthoses that interfere with maximum grip strength can improve functional task performance. Therefore while it is important to measure grip strength, it is only one factor to be considered when evaluating the efficacy of WHOs

Conception, réalisation et mise en oeuvre d’un calcul de risque de chute en temps réel dans un micro-logiciel embarqué dans une semelle intelligente

Mon projet de recherche consiste à développer, sur une semelle instrumenté, une reconnaissance de la marche et un calcul du risque lié à celle-ci qui soit fiable. Pour développer une reconnaissance fiable, il a fallu s’appuyer sur la littérature déjà existante mais aussi développer des moyens de vérifications des procédés mis en place. Pour cela, il a fallu créer un système embarqué que l’on peut diviser en plusieurs étapes : 1) définition d’une fenêtre d’analyse 2) extraction des signaux des capteurs. 3) détection de la marche 4) traitement des signaux pendant l’activité 5) calcul du risque lié à la marche 6) exportation des résultats obtenus pour en faire la vérification. Pour la première étape, il est important de délimiter une fenêtre pouvant contenir l’activité à détecter, la fenêtre d’analyse étant en corrélation avec le temps, il faut la définir suffisamment grande pour que le début et la fin de l’activité soit dans cette fenêtre mais il est aussi important de ne pas la prendre trop grande car, utilisant de la technologie embarqué, les ressources disponibles ne sont pas « infinies » comme sur un ordinateur. À la seconde étape, l’acquisition des signaux consiste à mesurer les mouvements de l’opérateur à l’aide d’un instrument de mesure non-invasif, non-intrusif capable de fonctionner dans son milieu de travail in-situ. La troisième étape consiste, à l’aide de la littérature, à définir ce qu’est un pas traduisant la marche en utilisant les capteurs présents dans la semelle. Ainsi on peut définir ce qu’est un pas et délimiter un segment de notre fenêtre sur lequel nous ferons l’analyse du risque. Une fois le segment de données extrait à l’aide de la détection de la marche, des caractéristiques sont extraites sur les signaux relevés afin de permettre de diminuer le nombre de données à traiter ainsi que de permettre de créer plus facilement une distinction entre la marche et les autres activités. En cinquième étape, nous calculons le risque à l’aide des caractéristiques extraites, ce modèle de calcul est calqué sur un modèle déjà existant très fiable et pourtant très simpliste basé sur un modèle statistique. Pour la dernière étape, les données obtenues sont transférés vers un ordinateur afin de faire un traitement sur Matlab des résultats obtenus, à la fois sur le calcul des caractéristiques mais aussi sur le calcul du risque. Une fois la comparaison effectuée, le calcul de la déviation de l’écart mesuré avec les valeurs attendues donne des résultats de l’ordre de 10−7% pour les résultats avec l’écart le plus grand. Dans les meilleurs cas, la précision atteinte est de 100%, tout particulièrement pour le calcul du risque qui est le résultat le plus intéressant à étudier. Ces résultats n’impliquent pas que le risque est reconnu dans 100% des situations mais plutôt que les résultats des calculs sont totalement fiables. Ainsi, la semelle mis en place dispose des meilleurs outils pour atteindre les résultats escomptés dans la détection des autres activités

The biomechanics of human locomotion

Includes bibliographical references. The thesis on CD-ROM includes Animate, GaitBib, GaitBook and GaitLab, four quick time movies which focus on the functional understanding of human gait. The CD-ROM is available at the Health Sciences Library

Proceedings XXIII Congresso SIAMOC 2023

Il congresso annuale della Società Italiana di Analisi del Movimento in Clinica (SIAMOC), giunto quest’anno alla sua ventitreesima edizione, approda nuovamente a Roma. Il congresso SIAMOC, come ogni anno, è l’occasione per tutti i professionisti che operano nell’ambito dell’analisi del movimento di incontrarsi, presentare i risultati delle proprie ricerche e rimanere aggiornati sulle più recenti innovazioni riguardanti le procedure e le tecnologie per l’analisi del movimento nella pratica clinica. Il congresso SIAMOC 2023 di Roma si propone l’obiettivo di fornire ulteriore impulso ad una già eccellente attività di ricerca italiana nel settore dell’analisi del movimento e di conferirle ulteriore respiro ed impatto internazionale. Oltre ai qualificanti temi tradizionali che riguardano la ricerca di base e applicata in ambito clinico e sportivo, il congresso SIAMOC 2023 intende approfondire ulteriori tematiche di particolare interesse scientifico e di impatto sulla società. Tra questi temi anche quello dell’inserimento lavorativo di persone affette da disabilità anche grazie alla diffusione esponenziale in ambito clinico-occupazionale delle tecnologie robotiche collaborative e quello della protesica innovativa a supporto delle persone con amputazione. Verrà infine affrontato il tema dei nuovi algoritmi di intelligenza artificiale per l’ottimizzazione della classificazione in tempo reale dei pattern motori nei vari campi di applicazione