An Embedded Gait Analysis System for CNS Injury Patients

Clinical evaluation of CNS injury patients before and after treatment is an essential step in gait rehabilitation. Medical care of gait disturbance for stroke patients is based on different treatments based on clinical and functional evaluations. Evaluation of gait aims at characterizing the motor performance to provide clinicians with information on the patient’s organizational or performance status and to allow them to consider the most appropriate treatment options. A 3D instrumented gait analysis system allows quantification of several parameters at each instant of walking but does not represent gait in daily life conditions. The absence of devices usable in daily life situation constitutes a lack pointed out by clinical practitioners and is at the origin of this work. In the following are described the design and implementation of a wireless embedded system for the collection of spatiotemporal parameters of pathological gait in everyday life. Algorithms estimate joint angles, step length, and gait events and automatically partition data into gait cycles. Experiments have been carried out to accurately evaluate the joint angles, the precision of sensor synchronization, the precision of gait event detection, and the robustness in the case of pathological walk. Comparisons with references given by the 3D instrumented gait analysis system are detailed

Modélisation numérique de l'assise médicale spécifique à la formation d'escarres de pression (S13)

Cet article, propose un modèle éléments finis 3D d'un fessier humain en contact avec un coussin en nid d'abeille à base de thermoplastique polyuréthane (TPU). L'objectif est d'étudier la pression à l'interface fessier/coussin, afin d'améliorer le confort du patient se déplaçant en fauteuil roulant, en particulier dans le cadre de la prévention d'escarres. Pour différents cas de figures de coussins disponibles sur le marché, les résultats numériques démontrent que le coussin à base de TPU est un des coussins les plus approprié et adapté pour réduire la formation d'escarres

Étude pilote de l'impact d'orthèses plantaires thermoformées sur la douleur chez les hockeyeurs sur gazon souffrant d'aponévrosite plantaire

International audiencePlantar fasciitis is the most common diagnosis for pain in the underside of the heel in athletes. While many studies have focused on running, none has focused on field hockey. The foot functional index is used to assess pain at the time of foot orthotics delivery and at one month. After one month of treatment, the heel of all players was significantly less painful. Like many sports that place intensive demands on the foot, the use of plantar orthoses can be a relevant therapeutic solution that complements other treatments such as foot muscle strengthening

Effet des matériaux de recouvrement d'orthèses plantaires sur la température intérieure de chaussures de course à pied sur un parcours de 10 km à allure modérée

International audienceDuring running, heat production in the footwear can be responsible for various pathologies such as phlyctenes. The sole that interposes between the foot and the shoe seems to be decisive. The comparison of the temperature recorded inside the footwear equipped with two different soles (ortholeage sole with an EVA coating and latex sole) out of 16 participants during a 10-km-race shows, on the one hand, that the temperature may rise up to six degrees and then holds steady at kilometre 6, and, on the other hand, that there are no differences between the two soles. These results can comfort professionals in the choice of EVA recovery

Caractéristiques de la propulsion du fauteuil roulant lors de sprints répétés chez des handibasketteurs

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Handrim forces during wheelies performance in able-bodied and SCI subjects

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Quotation of upper limb risk musculoskeletal disorders by fuzzy logic: Particular case of manual wheelchair propulsion and curb ascent

Introduction. For manual wheel chair users, the capacity to ascend a curb is essential for autonomy, however may contribute to the development or exacerbation of musculoskeletal disorders (MD). The objective of this study was to use fuzzy logic to quantify the risk of MD during curb ascent. Materials and Methods. Seventeen patients with SCI (> 6 months) were included. Kinematics and kinetics were recorded using a motion capture system and instrumented wheels on the manual wheelchair. Three trials were recorded for each subject. Results. The risk of MD was 15% greater during curb ascent than propulsion, mainly because of increases in kinetic risk. The kinetic risk was greatest at the wrist during curb ascent (50%). Discussion and conclusion. Quantification of the risk of MD using fuzzy logic is useful to highlight at-risk situations and to identify the parameters responsible

Does Accelerometry at the Centre of Mass Accurately Predict the Gait Energy Expenditure in Patients with Hemiparesis?

International audienceBackground: The aim of this study was to compare energy expenditure (EE) predicted by accelerometery (EEAcc) with indirect calorimetry (EEMETA) in individuals with hemiparesis. Methods: Twenty-four participants (12 with stroke and 12 healthy controls) performed a six-minute walk test (6MWT) during which EEMETA was measured using a portable indirect calorimetry system and EEACC was calculated using Bouten’s equation (1993) with data from a three-axis accelerometer positioned between L3 and L4. Results: The median EEMETA was 9.85 [8.18;11.89] W·kg−1 in the stroke group and 5.0 [4.56;5.46] W·kg−1 in the control group. The median EEACC was 8.57 [7.86;11.24] W·kg−1 in the control group and 8.2 [7.05;9.56] W·kg−1 in the stroke group. The EEACC and EEMETA were not significantly correlated in either the control (p = 0.8) or the stroke groups (p = 0.06). The Bland–Altman method showed a mean difference of 1.77 ± 3.65 W·kg−1 between the EEACC and EEMETA in the stroke group and −2.08 ± 1.59 W·kg−1 in the controls. Conclusions: The accuracy of the predicted EE, based on the accelerometer and the equations proposed by Bouten et al., was low in individuals with hemiparesis and impaired gait. This combination (sensor and Bouten’s equation) is not yet suitable for use as a stand-alone measure in clinical practice for the evaluation of hemiparetic patients

Effect of power-assistance on upper limb biomechanical and physiological variables during a 6-minute, manual wheelchair propulsion test: a randomised, cross-over study

Purpose Use of a power-assistance wheelchair could reduce the risk of musculoskeletal disorders (MSDs), however, a comprehensive biomechanical evaluation of these systems has not been carried out. This study aimed to evaluate and compare biomechanical UL propulsion variables, and physiological exercise-related variables during the use of a wheelchair with rear drive power assist device (RD-PAD) and a standard manual wheelchair (MW). Materials and methods Twenty-two adults with spinal cord injury were recruited. RD-PAD (SmartDrive system) was fitted to their own MW. An instrumented wheel was used to measure handrim forces, and gas exchange and heart rate were monitored. Participants performed repeated out and back runs for 6 min on a straight outdoor course. Results Distance covered was significantly greater with the RD-PAD (538 ± 104 m versus 470 ± 124 m). Peak mechanical effort during the propulsion phase was significantly lower with the RD-PAD (p < 0.001). Heart rate, metabolic equivalent of task (MET), tidal volume, minute volume, oxygen consumption, and peak oxygen consumption were all significantly lower with the RD-PAD (p < 0.001). Conclusions The results showed that use of RD-PAD increased the distance covered by MW users and reduced the energy costs of propulsion. The biomechanical results indirectly suggest that RD-PAD may reduce the risk of MSD. • Implications for Rehabilitation • Using the SmartDrive system as propulsion assistance increases the travel autonomy. • The SmartDrive system reduces the biomechanical constraints propelling the wheelchair on a slope and low slope. • SmartDrive the system reduces the physiological solicitation related to the propulsion of wheelchair