An investigation into the utility of wearable sensor derived biofeedback on the motor control of the lumbar spine

Lower back pain (LBP) is a disability that affects a large proportion of the population and treatment for this has been shifting towards a more individualized, patient-centered approach. There has been a recent uptake in the utilization and implementation of wearable sensors that can administer biofeedback in various industrial, clinical, and performance-based settings. The overall aim of this Master’s thesis was to investigate how wearable sensors can be used in a sensorimotor (re)training approach, including how sensory biofeedback from wearable sensors can be used to improve measures of spinal motor control and proprioception. Two complementary research studies were completed to address this overall aim. As a systematic review, Study #1 focused on addressing the lack of consensus surrounding wearable sensor derived biofeedback and spine motor control. The results of this review suggest that haptic/vibrotactile feedback is the most common and that it is administered in an instantaneous real-time manner within most experimental paradigms. Further, study #1 identified clear gaps within the research literature. Specifically, future research would benefit from more clarity regarding study design, and movement instructions, and explicit definitions of biofeedback parameters to enhance reproducibility. The aim of Study #2 was to assess the acute effects of wearable sensor-derived auditory biofeedback on gross lumbar proprioception. To assess this, participants completed a target repositioning protocol, followed by a training period where they were provided with auditory feedback for two of four targets based on a percentage of their lumbar ROM. Results suggest that mid-range targets benefitted most from the acute auditory feedback training. Further, individuals with poorer repositioning abilities in the pre-training assessment showed the greatest improvements from the auditory feedback training. This suggests that auditory biofeedback training may be an effective tool to improve proprioception in those with proprioceptive deficits. Collectively these complimentary research studies will improve the understanding surrounding the ecological utility of wearable sensor derived biofeedback in industrial, clinical, and performance settings to enhance to sensorimotor control of the lumbar region

The short-term effects of a sports stacking intervention on the cognitive and perceptual motor functioning in geriatrics.

Masters Degree. University of KwaZulu-Natal, Durban.Introduction: Sport stacking has been shown to improve cognitive and motor functioning, such as reaction time and hand eye coordination, through studies conducted on children in grades two and three but limited research exists to suggest these improvements in other populations. Due to the decline in cognitive and motor functioning resulting from aging and the correlation of falls occurred with decreased cognitive functioning, improvements in these aspects may promote an improvement in brain functioning and quality of life in geriatrics. Aim: The aim of this study was to determine the effects of sport stacking on geriatric motor and cognitive functioning. Methods: This quasi-experimental design with a pre- and post-intervention selected a purposive sample of 60 geriatric participants in a retirement home located in the eThekwini region, KwaZulu-Natal. Participants were between 60-90 years old; had no physical disabilities; had no sports stacking experience; had no medical conditions including Alzheimer’s or Parkinson's disease or medication for Vertigo, hand eye coordination or memory, had no orthopedic complications, and were sedentary. All participants’ Body Mass Index were measured using the Nagata BW- 1222 W. Performance on Hand eye coordination was tested by using the plate tapping test, Reaction Time was tested by using the Position Speed Test, Memory was tested by using the SOMCT questionnaire, and Balance was tested by using the Sharpened Romberg Test. The quality of life assessment was measured by using the Lawton’s Instrumental Activities of Daily Living Questionnaire. Thirty participants were exposed to an eight week intervention twice a week for 60 minutes while the control group (n=30) continued with activities as per norm. Pre- and post-intervention results were analysed using the statistical programme SPSS Version 19. Means and Standard Deviations, and paired t-test statistics were used to test significant differences pre- and post- intervention. Results: The intervention group showed improvements in their reaction time (x̅ - 4.464)(σ 3.986) and plate tapping (x̅ 2.629)(σ 2.468) times. However, the control group also had an increase in reaction time (x̅ -1.933)(σ 4.849) and plate tapping (x̅ 1.538)(σ 3.255) times. The improvements found in the control group were not as significant as what was found in the intervention group. Overall, there were no changes in the balance results pre- and post-intervention. There were no significant results found in their memory, quality of life and hand eye coordination tests. However, the intervention groups’ sports stacking times improved over the eight week intervention and this could possibly be due to an improvement in skill level. Conclusion: It was apparent that the sports stacking intervention proved to be beneficial in improving motor functioning in geriatrics

Assessment and exercise for Freezing of Gait in Parkinson’s Disease

Parkinson's disease (PD) is a neurodegenerative disorder characterized through multiple motor- and non-motor symptoms. Gait disorders and balance deficits are very common in people with PD and often cannot be fully alleviated by standard therapy. The mentioned deficits not only lower the quality of life but also increase the risk for falls. Especially people with PD who experience Freezing of Gait (FOG), an episodic gait disturbance, are at risk and need individualized therapy options. Therefore, exercise and physical therapy have become increasingly important in the rehabilitation of PD. This work aims to investigate the validity and reliability for assessment methods for FOG and check their potential as outcome measures for clinical trials. Furthermore, it explores feasibility and treatment options of the Split-belt treadmill (SBT) as a tool modulate gait asymmetry in people with PD as well as the short-term effects on gait. Study 1 focused on the validity of the German version of the New Freezing of Gait-Questionnaire. It found that the translated version was a valid instrument to assess the severity of FOG in the German-speaking PD population. Study 2 investigated the within-session reliability of the assessment of anticipatory postural adjustment in PD+FOG and found a high variability in the reliability scores, depending on the outcome of interest. Study 3 summarized the current literature on SBT walking in people with PD and showed that people with PD can successfully adapt their gait to the split belts. The final study investigated the short-term effects of one SBT training session and found that SBT with changing conditions was most useful to improve gait adaptation in PD+FOG. This thesis provides some important findings regarding the assessment of FOG and highlights opportunities for suitable outcome measures for clinical studies in this field. Furthermore, it highlights the potential of SBT training for the rehabilitation of PD by showing that it is feasible, safe and above all has positive effects on gait adaptation in people with PD. Those findings give important implications for the selection of outcome measure and the design of training interventions for PD+FOG in future studies

Effectiveness of intensive physiotherapy for gait improvement in stroke: systematic review

Introduction: Stroke is one of the leading causes of functional disability worldwide. Approximately 80% of post-stroke subjects have motor changes. Improvement of gait pattern is one of the main objectives of physiotherapists intervention in these cases. The real challenge in the recovery of gait after stroke is to understand how the remaining neural networks can be modified, to be able to provide response strategies that compensate for the function of the affected structures. There is evidence that intensive training, including physiotherapy, positively influences neuroplasticity, improving mobility, pattern and gait velocity in post-stroke recovery. Objectives: Review and analyze in a systematic way the experimental studies (RCT) that evaluate the effects of Intensive Physiotherapy on gait improvement in poststroke subjects. Methodology: Were only included all RCT performed in humans, without any specific age, that had a clinical diagnosis of stroke at any stage of evolution, with sensorimotor deficits and functional gait changes. The databases used were: Pubmed, PEDro (Physiotherapy Evidence Database) and CENTRAL (Cochrane Center Register of Controlled Trials). Results: After the application of the criteria, there were 4 final studies that were included in the systematic review. 3 of the studies obtained a score of 8 on the PEDro scale and 1 obtained a score of 4. The fact that there is clinical and methodological heterogeneity in the studies evaluated, supports the realization of the current systematic narrative review, without meta-analysis. Discussion: Although the results obtained in the 4 studies are promising, it is important to note that the significant improvements that have been found, should be carefully considered since pilot studies with small samples, such as these, are not designed to test differences between groups, in terms of the effectiveness of the intervention applied. Conclusion: Intensive Physiotherapy seems to be safe and applicable in post-stroke subjects and there are indications that it is effective in improving gait, namely speed, travelled distance and spatiotemporal parameters. However, there is a need to develop more RCTs with larger samples and that evaluate the longterm resultsN/

Proceedings XXI Congresso SIAMOC 2021

XXI Congresso Annuale della SIAMOC, modalità telematica il 30 settembre e il 1° ottobre 2021. Come da tradizione, il congresso vuole essere un’occasione di arricchimento e mutuo scambio, dal punto di vista scientifico e umano. Verranno toccati i temi classici dell’analisi del movimento, come lo sviluppo e l’applicazione di metodi per lo studio del movimento nel contesto clinico, e temi invece estremamente attuali, come la teleriabilitazione e il telemonitoraggio

Proceedings SIAMOC 2019

Il congresso annuale della Società Italiana di Analisi del Movimento in Clinica, giunto quest'anno alla sua ventesima edizione, ritorna a Bologna, che già ospitò il terzo congresso nazionale nel 2002. Il legame tra Bologna e l'analisi del movimento è forte e radicato, e trova ampia linfa sia nel contesto accademico che nel ricco panorama di centri clinici d'eccellenza. Il congresso SIAMOC, come ogni anno, è l’occasione per tutti i professionisti dell’ambito clinico, metodologico ed industriale di incontrarsi, presentare le proprie ricerche e rimanere aggiornati sulle più recenti innovazioni nell’ambito dell’applicazione clinica dei metodi di analisi del movimento. Questo ha contribuito, in questi venti anni, a fare avanzare sensibilmente la ricerca italiana nel settore, conferendole un respiro ed un impatto internazionale, e a diffonderne l'applicazione clinica per migliorare la valutazione dei disordini motori, aumentare l'efficacia dei trattamenti attraverso l'analisi quantitativa dei dati e una più focalizzata pianificazione dei trattamenti, ed inoltre per quantificare i risultati delle terapie correnti

Proceedings SIAMOC 2019

Il congresso annuale della Società Italiana di Analisi del Movimento in Clinica, giunto quest'anno alla sua ventesima edizione, ritorna a Bologna, che già ospitò il terzo congresso nazionale nel 2002. Il legame tra Bologna e l'analisi del movimento è forte e radicato, e trova ampia linfa sia nel contesto accademico che nel ricco panorama di centri clinici d'eccellenza. Il congresso SIAMOC, come ogni anno, è l’occasione per tutti i professionisti dell’ambito clinico, metodologico ed industriale di incontrarsi, presentare le proprie ricerche e rimanere aggiornati sulle più recenti innovazioni nell’ambito dell’applicazione clinica dei metodi di analisi del movimento. Questo ha contribuito, in questi venti anni, a fare avanzare sensibilmente la ricerca italiana nel settore, conferendole un respiro ed un impatto internazionale, e a diffonderne l'applicazione clinica per migliorare la valutazione dei disordini motori, aumentare l'efficacia dei trattamenti attraverso l'analisi quantitativa dei dati e una più focalizzata pianificazione dei trattamenti, ed inoltre per quantificare i risultati delle terapie correnti

Motor patterns evaluation of people with neuromuscular disorders for biomechanical risk management and job integration/reintegration

Neurological diseases are now the most common pathological condition and the leading cause of disability, progressively worsening the quality of life of those affected. Because of their high prevalence, they are also a social issue, burdening both the national health service and the working environment. It is therefore crucial to be able to characterize altered motor patterns in order to develop appropriate rehabilitation treatments with the primary goal of restoring patients' daily lives and optimizing their working abilities. In this thesis, I present a collection of published scientific articles I co-authored as well as two in progress in which we looked for appropriate indices for characterizing motor patterns of people with neuromuscular disorders that could be used to plan rehabilitation and job accommodation programs. We used instrumentation for motion analysis and wearable inertial sensors to compute kinematic, kinetic and electromyographic indices. These indices proved to be a useful tool for not only developing and validating a clinical and ergonomic rehabilitation pathway, but also for designing more ergonomic prosthetic and orthotic devices and controlling collaborative robots