Center of mass movement estimation using an ambulatory measurement system

Human body movement analysis is done in so-called 'gait-laboratories' where several gait variables are estimated by measurement systems such as optical position measurement systems, EMG or force plates. The accuracy of the ambulatory system is verified by comparing it to an optical reference system based on the semental kinematics method

Influence of gravity compensation training on synergistic movement patterns of the upper extremity after stroke, a pilot study

Background\ud \ud The majority of stroke patients have to cope with impaired arm function. Gravity compensation of the arm instantaneously affects abnormal synergistic movement patterns. The goal of the present study is to examine whether gravity compensated training improves unsupported arm function. \ud \ud Methods\ud \ud Seven chronic stroke patients received 18 half-hour sessions of gravity compensated reach training, in a period of six weeks. During training a motivating computer game was played. Before and after training arm function was assessed with the Fugl-Meyer assessment and a standardized, unsupported circle drawing task. Synergistic movement patterns were identified based on concurrent changes in shoulder elevation and elbow flexion/extension angles. \ud \ud Results\ud \ud Median increase of Fugl-Meyer scores was 3 points after training. The training led to significantly increased work area of the hemiparetic arm, as indicated by the normalized circle area. Roundness of the drawn circles and the occurrence of synergistic movement patterns remained similar after the training. \ud \ud Conclusions\ud \ud A decreased strength of involuntary coupling might contribute to the increased arm function after training. More research is needed to study working mechanisms involved in post stroke rehabilitation training. The used training setup is simple and affordable and is therefore suitable to use in clinical setting

Foot and ankle kinematics in rheumatoid arthritis: influence of foot and ankle joint and leg tendon pathologies

Objective From early onset of the disease, patients with rheumatoid arthritis (RA) experience walking impairments. Pathologic effects of RA on foot and ankle structures have been studied clinically, but little is known as to how they relate to kinematic changes during gait. The aim of this study was to explore the relationship between clinically observed pathologies of foot and ankle joints and leg tendons and the corresponding gait kinematics. Methods The gait of 25 subjects with varying stages of RA was recorded and foot and ankle kinematics were assessed. Magnetic resonance imaging was performed for each subject: first metatarsophalangeal (MTP) joint, midfoot, and hindfoot synovitis, erosion scores, and leg tendon involvement were determined. The joint alignment and motion score represented daily clinical assessment. The 95% confidence intervals of the Spearman's correlation coefficient tests were used to explore the relationships between the clinical and kinematic parameters. Results Maximum first MTP joint dorsiflexion at preswing was related to reduced first MTP joint passive motion, first MTP joint synovitis and erosion, midfoot synovitis and erosion, and hindfoot erosion. Midfoot pronation range of motion during single stance was related to subtalar alignment and Achilles tendon involvement. Hindfoot eversion range of motion during single stance was related to subtalar alignment and peroneus longus tendon involvement. Involvement of the tibialis posterior tendon could not be identified as an independent factor influencing foot or ankle kinematics. Conclusion Our findings suggest moderate to strong relationships between foot and ankle gait kinematics and structural pathologies

Improving walking capacity by surgical correction of equinovarus foot deformity in adult patients with stroke or traumatic brain injury: a systematic review.

Contains fulltext : 108285.pdf (publisher's version ) (Open Access)OBJECTIVE: Equinovarus foot deformity following stroke or traumatic brain injury compromises walking capacity, interfering with activities of daily living. In soft-tissue surgery the imbalanced muscles responsible for the deviant position of the ankle and foot are lengthened, released and/or transferred. However, knowledge about the effectiveness of surgical correction is limited. The aim of the present study was to carry out a systematic review of the literature to assess the effects of surgical correction of equinovarus foot deformity in patients with stroke or traumatic brain injury. METHODS: A systematic search of full-length articles in the English, German or Dutch languages published from 1965 to March 2011 was performed in PubMed, EMBASE, CINAHL, Cochrane and CIRRIE. The identified studies were analysed following the International Classification of Functioning, Disability and Health criteria. RESULTS: A total of 15 case series, case control and historically controlled studies (CEBM level 4) were identified, suggesting that surgical correction of equinovarus foot deformity is a safe procedure that is effective in terms of re-obtaining a balanced foot position, improving walking capacity and diminishing the need for orthotic use. DISCUSSION: Further validation of surgical correction of equinovarus foot deformity following stroke or traumatic brain injury is required, using higher level study designs with validated assessment tools. Comparing surgical techniques with other interventions is necessary to generate evidence upon which treatment algorithms could be based.1 juli 201

Application of arm support training in sub-acute stroke rehabilitation: First results on effectiveness and user experiences

A multi-center randomized clinical trial was performed in 7 Dutch rehabilitation centers, in the context of an implementation project (ROBAR), to compare the effect of an arm support (AS) training device to equally intensive conventional reach training (CON) on recovery of arm-hand function in sub-acute stroke. The Fugl-Meyer assessment (FM) and user experiences of therapists and patients were examined in both groups. An improvement of 10 and 8 points on the FM was found for respectively the CON and AS group. Both therapists and patients reported positive experiences on several aspects of user acceptance. These findings indicate that a low-tech system for arm support results in similar gains in arm function as conventional reach training in equal intensity, and is suitable for application in clinical practice

The effect of walking aids on muscle activation patterns during walking in stroke patients

The purpose of this study was to investigate changes in muscle activation patterns with respect to timing and amplitude that occur when subjects with stroke walk with and without a walking aid. This knowledge could help therapists in deciding whether or not patients should use a cane or quad stick while walking.\ud Thirteen patients suffering from a first unilateral ischemic stroke participated in the study. Surface electromyography (SEMG) of the erector spinae, gluteus maximus, gluteus medius, vastus lateralis, semitendinosus, gastrocnemius and tibialis anterior of the affected side were measured during three different conditions: (1) walking without a walking aid, (2) walking with a cane and (3) walking with a quad stick. Timing and amplitude parameters of the activation patterns were quantified using an objective burst detection algorithm and statistically evaluated.\ud Results showed a statistically significant and clinically relevant decrease in burst duration of both erector spinae and tibialis anterior when walking with a cane. The amplitude of the vastus lateralis and tibialis anterior dropped when patients walked with a cane and quad stick.\ud The use of a cane should be considered when therapy is given to stroke patients to achieve normal muscle activation patterns