RESUMO
A modular methodology for automated gait data evaluation: The aim of Instrumented Gait Analysis is to measure data such as joint kinematics or kinetics during gait in a quantitative way. The data evaluation for clinical purposes is often performed by experienced physicians (diagnosis of specific motion dysfunction, planning and validation of therapy). Due to subjective evaluation and complexity of the pathologies, there exists no objective, standardized data analysis method for these tasks. This article covers the development of a modular, computer-based methodology to quantify the degree of pathological gait in comparison to normal behavior, as well as to automatically search for interpretable gait abnormalities and to visualize the results. The outcomes are demonstrated with two different patient groups.
Assuntos
Paralisia Cerebral/fisiopatologia , Marcha/fisiologia , Processamento de Imagem Assistida por Computador/instrumentação , Paraplegia/fisiopatologia , Traumatismos da Medula Espinal/fisiopatologia , Fenômenos Biomecânicos , Paralisia Cerebral/diagnóstico , Paralisia Cerebral/reabilitação , Humanos , Articulações/fisiopatologia , Paraplegia/diagnóstico , Paraplegia/reabilitação , Valores de Referência , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/reabilitaçãoAssuntos
Teste de Esforço/instrumentação , Marcha/fisiologia , Processamento de Imagem Assistida por Computador/instrumentação , Gravação em Vídeo/instrumentação , Eletromiografia/instrumentação , Desenho de Equipamento , Humanos , Processamento de Sinais Assistido por Computador/instrumentação , SoftwareRESUMO
STUDY DESIGN: A prospective study was performed to evaluate the gait training of seven consecutive spinal cord injured patients and 10 controls on a treadmill using instrumented gait analysis and video documentation. OBJECTIVES: To determine whether it is possible to maintain gait motion within physiological limits during treadmill training. SETTING: Primary and secondary care unit for spinal cord injury, Heidelberg, Germany. METHODS: Treadmill training was instituted as early as possible. Gait analysis was performed when the patients were stable enough to walk without manual aid from therapists and enough endurance to allow measurements. A control group of healthy volunteers were examined as well. Video documentation and a camera system using passive markers were employed. RESULTS: Treadmill training started with weight reduction of 25% of bodyweight (18 (0-35) kg), maximum walking speed 0.28 (0.15-0.7) m/s and maximum walking duration 4.7 (3-7) min. At the end of the training, weight reduction decreased to 9.3 (0-20) kg, maximum walking speed increased to 0.67 (0.23-1.1) ms with a maximum walking duration of 11 (8-15) min. 3-D motion analysis of hip, knee and ankle demonstrated joint excursions almost entirely within the limits of normal gait. Exceptions were due to fixed contractures. CONCLUSIONS: Our data suggests that it is possible to perform early gait training on a treadmill with no supportive orthoses within the physiologic range of joint motion. The risk for repetitive stress injuries or other negative effects is low.