Back stress and assistance exercises in extreme weightlifting

The purpose or this study was to test the suitability or selected assistance exercises to strengthen the low back for the Olympic lilts in elite weightlifters. Four subjects were filmed by a five-camera Motion Analysis system operating at 120Hz. The subjects completed both or the Olympic lifts (Snatch and Clean) at a near one repetition maximum and four assistance exercises (Bent-over Row, Clean Pull Deadlift, Romanian Deadlift, and Good Morning) at an intensity typically performed at a routine training session. Peak moments, compressive and shear forces about the L5/S1 intervertebral joint were calculated via a top-down inverse dynamics model. Comparisons were made between the lifts using a one way ANOVA with repeated measures and post-hoc differences between the means were calculated via Least Squared Differences. Significant differences (

A methodology for the Lower Limb Robotic Rehabilitation system

The overall goal of this thesis is to develop a new functional lower limb robot-assisted rehabilitation system for people with a paretic lower limb. A unilateral rehabilitation method is investigated, where the robot acts as an assistive device to provide the impaired leg therapeutic training through simulating the kinematics and dynamics of the ankle and lower leg movements. Foot trajectories of healthy subjects and post-stroke patients were recorded by a dedicated optical motion tracking system in a clinical gait measurement laboratory. A prototype 6 degrees of freedom parallel robot was initially built in order to verify capability of achieving singularity-free foot trajectories of healthy subjects in various exercises. This was then followed by building and testing another larger parallel robot to investigate the real-sized foot trajectories of patients. The overall results verify the designed robot’s capability in successfully tracking foot trajectories during different exercises. The thesis finally proposes a system of bilateral rehabilitation based on the concept of self-learning, where a passive parallel mechanism follows and records motion signatures of the patient’s healthy leg, and an active parallel mechanism provides motion for the impaired leg based on the kinematic mapping of the motion produced by the passive mechanism

Biomechanical Evaluation of an Optical System for Quantitative Human Motion Analysis

An eight-camera Optitrack motion capture system was evaluated by performing static, linear dynamic, and angular dynamic calibrations using marker distances associated with upper and lower extremity gait and wheelchair models. Data were analyzed to determine accuracy and resolution within a defined capture volume using a standard Cartesian reference system. Two additional cameras along with AMASS and Visual3D (C-Motion, Inc., Germantown, MD) biomechanical modeling software were used to determine joint kinematics at the pelvis, hip, knee, and ankle of ten control subjects (mean age 21.5 ± 1.65 years). The same data were processed through Nexus (Vicon Motion Systems, Oxford, England) modeling software. The joint angle data was statistically compared between the two systems using a variance components model which determined the variability between maximum, minimum, and range values. Static accuracy ranged from 99.31% to 99.90%. Static resolution ranged from 0.04 ± 0.15 mm to 0.63 ± 0.15 mm at the 0.05 level of significance. The dynamic accuracy ranged from 94.82% to 99.77 %, and dynamic resolution ranged from 0.09 ± 0.26 mm to 0.61 ± 0.31 mm at the 0.05 level of significance. These values are comparable to those reported for a standard Vicon 524 (Vicon Motion Systems, Oxford, England) motion analysis system. Gait cycle maximum, minimum, and range values showed no significant difference when comparing Visual3D and Nexus at the pelvis, hip, and knee. Significant differences were seen at the tibia (rotation) and foot due to foot model variations between the two systems. The results support application of the lower cost Optitrack cameras and Visual3D software for 3D kinematic assessment of lower extremity motion during gait. Additional potential applications supported by these findings include other lower extremity models, assisted ambulation, and wheelchair mobility

Sagittal knee kinematics in relation with the posterior tibia slope during jump landing after an anterior cruciate ligament reconstruction

PURPOSE: An increased posterior tibia plateau angle is associated with increased risk for anterior cruciate ligament injury and re-rupture after reconstruction. The aims of this study were to determine whether the tibia plateau angle correlates with dynamic anterior tibia translation (ATT) after an anterior cruciate ligament reconstruction and whether the tibia plateau angle correlates with aspects of knee kinematics and kinetics during jump landing. METHODS: Thirty-seven patients after anterior cruciate ligament reconstruction with autograft hamstring tendon were included. Knee flexion angle and knee extension moment during single leg hops for distance were determined using a motion capture system and the dynamic ATT with its embedded method. The medial and lateral posterior tibia plateau angle were measured using MRI. Moreover, passive ATT was measured using the KT-1000 arthrometer. RESULTS: A weak negative correlation was found between the maximal dynamic ATT and the medial tibia plateau angle (p = 0.028, r = - 0.36) and between the maximal knee flexion angle and the lateral tibia plateau angle (p = 0.025, r = - 0.37) during landing. Patients with a smaller lateral tibia plateau angle show larger maximal knee flexion angle during landing than the patients with larger lateral tibia plateau angle. Also, the lateral tibia plateau angle is associated the amount of with muscle activity. CONCLUSION: The posterior medical tibia plateau angle is associated with dynamic ATT. The maximal knee flexion angle and muscle activity are associated with the posterior lateral tibia plateau angle. LEVEL OF EVIDENCE: III

Accuracy and repeatability of quantitative fluoroscopy for the measurement of sagittal plane translation and finite centre of rotation in the lumbar spine

Quantitative fluoroscopy (QF) was developed to measure intervertebral mechanics in vivo and has been found to have high repeatability and accuracy for the measurement of intervertebral rotations. However, sagittal plane translation and finite centre of rotation (FCR) are potential measures of stability but have not yet been fully validated for current QF. This study investigated the repeatability and accuracy of QF for measuring these variables. Repeatability was assessed from L2-S1 in 20 human volunteers. Accuracy was investigated using 10 consecutive measurements from each of two pairs of linked and instrumented dry human vertebrae as reference; one which tilted without translation and one which translated without tilt. The results found intra- and inter-observer repeatability for translation to be 1.1mm or less (SEM) with fair to substantial reliability (ICC 0.533-0.998). Intra-observer repeatability of FCR location for inter-vertebral rotations of 5o and above ranged from 1.5mm to 1.8mm (SEM) with moderate to substantial reliability (ICC 0.626-0.988). Inter-observer repeatability for FCR ranged from 1.2mm to 5.7mm, also with moderate to substantial reliability (ICC 0.621-0.878). Reliability was substantial (ICC>0.81) for 10/16 measures for translation and 5/8 for FCR location. Accuracy for translation was 0.1mm (fixed centre) and 2.2mm (moveable centre), with an FCR error of 0.3mm(x) and 0.4mm(y) (fixed centre). This technology was found to have a high level of accuracy and with a few exceptions, moderate to substantial repeatability for the measurement of translation and FCR from fluoroscopic motion sequences

Characterizing the Effects of High-intensity Exercise on Balance and Gait under Dual-task Conditions in Parkinson’s Disease

Parkinson’s disease (PD) is a neurodegenerative disorder, characterized by four cardinal motor symptoms including bradykinesia, tremor, rigidity, and postural instability, and non-motor symptoms including cognitive impairment. Daily activities, such as walking and maintaining balance, are impacted due to impairments in motor function, and are further exacerbated with the addition of cognitive loading, or dual-tasking (DT). High-intensity exercise has demonstrated centrally-mediated improvements of PD symptoms, with additional positive effects on overall health. The goal of this project was to identify changes in dynamic balance recovery and gait function under conditions with and without increased cognitive load after a high-intensity exercise intervention in a PD population. Participants included people with PD who completed an eight-week cycling intervention (PDE), people with Parkinson’s disease who did not complete the intervention (PDC), and healthy age-matched controls (HC), with 14 subjects per group. In Aim 1, while participants underwent a series of destabilizing balance tests, the time taken to regain balance and the center of pressure movement during balance recovery were measured. The PDE group demonstrated greater improvement in balance recovery after exercise compared with the PDC group. In Aim 2, participants completed a series of gait and cognitive tasks, both separately and concurrently. Outcome measures included spatiotemporal and kinematic gait parameters of the lower and upper extremities. The PDE group demonstrated significant improvement in gait measures and DT abilities compared to PDC, while no changes were found in cognitive function for any group. The standard clinical methods of measuring motor function can be subjective, and may not capture subtle motor characteristics. Force plate and motion-capture technologies can provide detailed, objective outcome data, therefore improving the understanding of how exercise affects motor symptoms of Parkinson’s disease. The Motek Computer Assisted Rehabilitation Environment (CAREN) system at the Cleveland Clinic was used to create the testing environment and for data collection. These results of this project suggest global changes in motor function demonstrated by changes in balance recovery and lower and upper extremity gait function. Quantitative gait analysis has shown to be an important metric in assessing effectiveness of an exercise intervention in PD

Characterizing the Effects of High-intensity Exercise on Balance and Gait under Dual-task Conditions in Parkinson’s Disease

Parkinson’s disease (PD) is a neurodegenerative disorder, characterized by four cardinal motor symptoms including bradykinesia, tremor, rigidity, and postural instability, and non-motor symptoms including cognitive impairment. Daily activities, such as walking and maintaining balance, are impacted due to impairments in motor function, and are further exacerbated with the addition of cognitive loading, or dual-tasking (DT). High-intensity exercise has demonstrated centrally-mediated improvements of PD symptoms, with additional positive effects on overall health. The goal of this project was to identify changes in dynamic balance recovery and gait function under conditions with and without increased cognitive load after a high-intensity exercise intervention in a PD population. Participants included people with PD who completed an eight-week cycling intervention (PDE), people with Parkinson’s disease who did not complete the intervention (PDC), and healthy age-matched controls (HC), with 14 subjects per group. In Aim 1, while participants underwent a series of destabilizing balance tests, the time taken to regain balance and the center of pressure movement during balance recovery were measured. The PDE group demonstrated greater improvement in balance recovery after exercise compared with the PDC group. In Aim 2, participants completed a series of gait and cognitive tasks, both separately and concurrently. Outcome measures included spatiotemporal and kinematic gait parameters of the lower and upper extremities. The PDE group demonstrated significant improvement in gait measures and DT abilities compared to PDC, while no changes were found in cognitive function for any group. The standard clinical methods of measuring motor function can be subjective, and may not capture subtle motor characteristics. Force plate and motion-capture technologies can provide detailed, objective outcome data, therefore improving the understanding of how exercise affects motor symptoms of Parkinson’s disease. The Motek Computer Assisted Rehabilitation Environment (CAREN) system at the Cleveland Clinic was used to create the testing environment and for data collection. These results of this project suggest global changes in motor function demonstrated by changes in balance recovery and lower and upper extremity gait function. Quantitative gait analysis has shown to be an important metric in assessing effectiveness of an exercise intervention in PD

The Development and Application of a Forearm Simulator to Investigate Radial Head Biomechanics

The forearm is a complex articular unit, with poorly understood biomechanics. A novel forearm simulator to facilitate physiologic testing of cadavers for multiple clinical scenarios was designed, manufactured and validated. A number of outcome measurements were potentiated including the forearm’s resistance to rotation, radiocapitellar contact pressure and area as well as IOM loads. Testing of changes to forearm biomechanics due to radial head excision and variations of radial head arthroplasty dimensions was conducted. Radial head arthroplasty using the correct radial head length and diameter recreated the biomechanics of an intact forearm. Radial head excision as well an implant of non-anatomic length or diameter created abnormal radiocapitellar joint properties and load transfer within the forearm. The simulator had good repeatability and reproducibility. If radial head arthroplasty is clinically required, an implant that is similar in dimensions to the native radial head maintains native forearm biomechanics

Advances in Human-Robot Interaction

Rapid advances in the field of robotics have made it possible to use robots not just in industrial automation but also in entertainment, rehabilitation, and home service. Since robots will likely affect many aspects of human existence, fundamental questions of human-robot interaction must be formulated and, if at all possible, resolved. Some of these questions are addressed in this collection of papers by leading HRI researchers

Rehabilitation Engineering

Population ageing has major consequences and implications in all areas of our daily life as well as other important aspects, such as economic growth, savings, investment and consumption, labour markets, pensions, property and care from one generation to another. Additionally, health and related care, family composition and life-style, housing and migration are also affected. Given the rapid increase in the aging of the population and the further increase that is expected in the coming years, an important problem that has to be faced is the corresponding increase in chronic illness, disabilities, and loss of functional independence endemic to the elderly (WHO 2008). For this reason, novel methods of rehabilitation and care management are urgently needed. This book covers many rehabilitation support systems and robots developed for upper limbs, lower limbs as well as visually impaired condition. Other than upper limbs, the lower limb research works are also discussed like motorized foot rest for electric powered wheelchair and standing assistance device