The effect of limited sensory information on exoskeleton performance in people with complete spinal cord injury.

Despite the absence of somatosensory information from the lower extremities, people with complete spinal cord injury (SCI) can maintain postural stability in an exoskeleton. This is partly because humans are able to reweigh the relative dependence on each of the senses. However, when the sensory environment is changed, people with complete SCI are limited in their ability to reweigh their sensory organization towards more dependence on somatosensory information. The aim of this study was to investigate the effect of limited visual and/or auditory information on exoskeleton performance in people with complete SCI. Three experienced exoskeleton users performed twelve walking trials in the ReWalk exoskeleton. In each trial, the presence or absence of visual and/or auditory information was varied. Exoskeleton performance was operationalized as the walking distance covered and the amount of crutch loading. In one participant, the distance covered decreased when visual information was limited. The other two participants did not show substantial differences in distance covered between sensory conditions. Two participants decreased crutch loading when visual information was restricted, and one participant decreased crutch loading when auditory information was limited. The current study suggests a limited influence of the presence or absence of visual and auditory information on the distance covered in people with complete SCI walking in an exoskeleton. Interestingly, crutch loading seemed to decrease rather than increase when visual or auditory information was limited.

Immediate after-effects of robot-assisted gait with pelvic support or pelvic constraint on overground walking in healthy subjects.

BACKGROUND: Recovery of walking is a primary rehabilitation goal of most stroke survivors. Control of pelvic movements is one of the essential determinants of gait, yet surprisingly, conventional robot-assisted gait trainers constrain pelvic movements. Novel robot-assisted gait trainers, such as LOPES II, are able to support pelvic movements during gait. The aim of this cross-over study was to investigate the immediate after-effects of pelvic support (PS) or pelvic constraint (PC) gait training with LOPES II on overground walking in healthy subjects. METHODS: Thirteen able-bodied subjects (22.8 ± 2.1 years) participated in two 20-min gait training sessions with LOPES II; one with PS and one with PC. During the PS-training, the LOPES II actively guided the lateral displacement of the pelvis, while pelvic rotations were free. During the PC-condition, both lateral displacement and pelvic rotations were constrained and reduced to a minimum. The training sessions were separated by a 30-min resting period. Lateral displacement of the pelvis, hip and knee kinematics, and spatiotemporal parameters during overground walking were determined at baseline and immediately following the training using 3D gait analysis. RESULTS: During the PS-condition in LOPES II the lateral pelvic displacement was significantly greater (105.6 ± 0 .5 mm) than during the PC-condition (10.8 ± 0 .7 mm; p < 0.001). Analysis of the first five steps of overground walking immediately following PC-condition showed significantly smaller lateral displacements of the pelvis (32.3 ± 12.0 mm) compared to PS-condition (40.1 ± 9 .8 mm; p < 0.01). During the first five steps, step width was significantly smaller after PC-condition (0.17 ± 0. 04 m) compared to PS-condition (0.20 ± 0.04 m; p = 0.01) and baseline (0.19 ± 0. 03 m; p = 0.01). Lateral displacement of the pelvis and step width post training returned to baseline levels within 10 steps. PC- nor PS-condition affected kinematics, gait velocity, cadence, stride length or stance time. CONCLUSIONS: In healthy subjects, robot-assisted gait training with pelvic constraint had immediate negative after-effects on the overground walking pattern, as compared to robot-assisted gait training with pelvic support. Gait training including support of the lateral displacement of the pelvis better resembles the natural gait pattern. It remains to be identified whether pelvic support during robot-assisted gait training is superior to pelvic constraint to promote gait recovery in individuals with neurological disorders.

Estimating severity of sideways fall using a generic multi linear regression model based on kinematic input variables.

Many research groups have studied fall impact mechanics to understand how fall severity can be reduced to prevent hip fractures. Yet, direct impact force measurements with force plates are restricted to a very limited repertoire of experimental falls. The purpose of this study was to develop a generic model for estimating hip impact forces (i.e. fall severity) in in vivo sideways falls without the use of force plates. Twelve experienced judokas performed sideways Martial Arts (MA) and Block ('natural') falls on a force plate, both with and without a mat on top. Data were analyzed to determine the hip impact force and to derive 11 selected (subject-specific and kinematic) variables. Falls from kneeling height were used to perform a stepwise regression procedure to assess the effects of these input variables and build the model. The final model includes four input variables, involving one subject-specific measure and three kinematic variables: maximum upper body deceleration, body mass, shoulder angle at the instant of 'maximum impact' and maximum hip deceleration. The results showed that estimated and measured hip impact forces were linearly related (explained variances ranging from 46 to 63%). Hip impact forces of MA falls onto the mat from a standing position (3650±916N) estimated by the final model were comparable with measured values (3698±689N), even though these data were not used for training the model. In conclusion, a generic linear regression model was developed that enables the assessment of fall severity through kinematic measures of sideways falls, without using force plates.

Totally asymmetric simple exclusion process simulations of molecular motor transport on random networks with asymmetric exit rates.

Using the totally asymmetric simple-exclusion-process and mean-field transport theory, we investigate the transport in closed random networks with simple crossing topology-two incoming, two outgoing segments, as a model for molecular motor motion along biopolymer networks. Inspired by in vitro observation of molecular motor motion, we model the motor behavior at the intersections by introducing different exit rates for the two outgoing segments. Our simulations of this simple network reveal surprisingly rich behavior of the transport current with respect to the global density and exit rate ratio. For asymmetric exit rates, we find a broad current plateau at intermediate motor densities resulting from the competition of two subnetwork populations. This current plateau leads to stabilization of transport properties within such networks.

Incorporating in vivo fall assessments in the simulation of femoral fractures with finite element models.

Femoral fractures are a major health issue. Most experimental and finite element (FE) fracture studies use polymethylmethacrylate cups on the greater trochanter (GT) to simulate fall impact loads. However, in vivo fall studies showed that the femur is loaded distally from the GT. Our objective was to incorporate in vivo fall data in FE models to determine the effects of loading position and direction, and size of simulated impact site on the fracture load and fracture type for a healthy and an osteoporotic femur. Twelve sets of loading position and angles were applied through 'near point loads' on the models. Additional simulations were performed with 'cup loads' on the GT, similar to the literature. The results showed no significant difference between fracture loads from simulations with near point loads distally from the GT and those with cup loads on the GT. However, simulated fracture types differed, as near point loads distally from the GT generally resulted in various neck fractures, whilst cup load simulations predicted superior neck and trochanteric fractures only. This study showed that incorporating in vivo fall assessments in FE models by loading the models distally from the GT results in prediction of realistic fracture loads and fracture types.

Shear banding of colloidal glasses: observation of a dynamic first-order transition.

We demonstrate that application of an increasing shear field on a glass leads to an intriguing dynamic first-order transition in analogy with equilibrium transitions. By following the particle dynamics as a function of the driving field in a colloidal glass, we identify a critical shear rate upon which the diffusion time scale of the glass exhibits a sudden discontinuity. Using a new dynamic order parameter, we show that this discontinuity is analogous to a first-order transition, in which the applied stress acts as the conjugate field on the system's dynamic evolution. These results offer new perspectives to comprehend the generic shear-banding instability of a wide range of amorphous materials.

Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls.

Sideways falls onto the hip are a major cause of femoral fractures in the elderly. Martial arts (MA) fall techniques decrease hip impact forces in sideways falls. The femoral fracture risk, however, also depends on the femoral loading configuration (direction and point of application of the force). The purpose of this study was to determine the effect of fall techniques, landing surface and fall height on the impact force and the loading configuration in sideways falls. Twelve experienced judokas performed sideways MA and Block ('natural') falls on a force plate, both with and without a judo mat on top. Kinematic and force data were analysed to determine the hip impact force and the loading configuration. In falls from a kneeling position, the MA technique reduced the impact force by 27%, but did not change the loading configuration. The use of the mat did not change the loading configuration. Falling from a standing changed the force direction. In all conditions, the point of application was distal and posterior to the greater trochanter, but it was less distal and more posterior in falls from standing than from kneeling position. The present decrease in hip impact force with an unchanged loading configuration indicates the potential protective effect of the MA technique on the femoral fracture risk. The change in loading configuration with an increased fall height warrant further studies to examine the effect of MA techniques on fall severity under more natural fall circumstances.

Sensitivity of the OLGA and VCM models to erroneous marker placement: effects on 3D-gait kinematics.

Gait data need to be reliable to be valuable for clinical decision-making. To reduce the impact of marker placement errors, the Optimized Lower Limb Gait Analysis (OLGA) model was developed. The purpose of this study was to assess the sensitivity of the kinematic gait data to a standard marker displacement of the OLGA model compared with the standard Vicon Clinical Manager (VCM) model and to determine whether OLGA reduces the errors due to the most critical marker displacements. Healthy adults performed six gait sessions. The first session was a standard gait session. For the following sessions, 10mm marker displacements were applied. Kinematic data were collected for both models. The root mean squares of the differences (RMS) were calculated for the kinematics of the displacement sessions with respect to the first session. The results showed that the RMS values were generally larger than the stride-to-stride variation except for the pelvic kinematics. For the ankle, knee and hip kinematics, OLGA significantly reduced the averaged RMS values for most planes. The shank, knee and thigh anterior-posterior marker displacements resulted in RMS values exceeding 10°. OLGA reduced the errors due to the knee and thigh marker displacements, but not the errors due to the ankle marker displacements. In conclusion, OLGA reduces the effect of erroneous marker placement, but does not fully compensate all effects, indicating that accurate marker placement remains of crucial importance for adequate 3D-gait analysis and subsequent clinical decision-making.

Feasibility of measuring event related desynchronization with electroencephalography during walking.

Brain Computer Interfaces could be useful in rehabilitation of movement, perhaps also for gait. Until recently, research on movement related brain signals has not included measuring electroencephalography (EEG) during walking, because of the potential artifacts. We investigated if it is possible to measure the event Related Desynchronization (ERD) and event related spectral perturbations (ERSP) during walking. Six subjects walked on a treadmill with a slow speed, while EEG, electromyography (EMG) of the neck muscles and step cycle were measured. A Canonical Correlation Analysis (CCA) was used to remove EMG artifacts from the EEG signals. It was shown that this method correctly deleted EMG components. A strong ERD in the mu band and a somewhat less strong ERD in the beta band were found during walking compared to a baseline period. Furthermore, lateralized ERSPs were found, depending on the phase in the step cycle. It is concluded that this is a promising method to use in BCI research on walking. These results therefore pave the way for using brain signals related to walking in a BCI context.

Criticality in dynamic arrest: correspondence between glasses and traffic.

Dynamic arrest is a general phenomenon across a wide range of dynamic systems including glasses, traffic flow, and dynamics in cells, but the universality of dynamic arrest phenomena remains unclear. We connect the emergence of traffic jams in a simple traffic flow model directly to the dynamic slowing down in kinetically constrained models for glasses. In kinetically constrained models, the formation of glass becomes a true (singular) phase transition in the limit T→0. Similarly, using the Nagel-Schreckenberg model to simulate traffic flow, we show that the emergence of jammed traffic acquires the signature of a sharp transition in the deterministic limit p→1, corresponding to overcautious driving. We identify a true dynamic critical point marking the onset of coexistence between free flowing and jammed traffic, and demonstrate its analogy to the kinetically constrained glass models. We find diverging correlations analogous to those at a critical point of thermodynamic phase transitions.

A new method to normalize plantar pressure measurements for foot size and foot progression angle.

Plantar pressure measurement provides important information about the structure and function of the foot and is a helpful tool to evaluate patients with foot complaints. In general, average and maximum plantar pressure of 6-11 areas under the foot are used to compare groups of subjects. However, masking the foot means a loss of important information about the plantar pressure distribution pattern. Therefore, the purpose of this study was to develop and test a simple method that normalizes the plantar pressure pattern for foot size, foot progression angle, and total plantar pressure. Moreover, scaling the plantar pressure to a standard foot opens the door for more sophisticated analysis techniques such as pattern recognition and machine learning. Twelve subjects walked at preferred and half of the preferred walking speed over a pressure plate. To test the method, subjects walked in a straight line and in an approaching angle of approximately 40 degrees . To calculate the normalized foot, the plantar pressure pattern was rotated over the foot progression angle and normalized for foot size. After normalization, the mean shortest distance between the contour lines of straight walking and walking at an angle had a mean of 0.22 cm (SD: 0.06 cm) for the forefoot and 0.14 cm (SD: 0.06 cm) for the heel. In addition, the contour lines of normalized feet for the various subjects were almost identical. The proposed method appeared to be successful in aligning plantar pressure of various feet without losing information.

Older women strongly prefer stride lengthening to shortening in avoiding obstacles.

In the present study the obstacle avoidance strategy during treadmill walking was investigated in ten young (aged 19-32) and ten older females (aged 65-78). Minimisation of displacement of the foot from its original landing position has been proposed to be the main criterion for the selection of alternate foot placement. Each participant performed 60 obstacle avoidance trials. Foot-obstacle configurations were varied in order to obtain both lengthening and shortening avoidance reactions. For each trial it was calculated how much lengthening and how much shortening of the stride was required minimally for successful avoidance. The difference between required lengthening and required shortening was expressed as a percentage of the control stride length and was used as a measure of minimal displacement. The behavior of young females was in agreement with the minimal displacement criterion. The older females, however, exhibited a strong preference for stride lengthening, even in situations in which stride shortening would be highly favorable. The explanation for the long step strategy preference of the older females is discussed in terms of age-related changes in decision-making, differences between young and older persons in the unobstructed gait pattern, and safety considerations.

Gait adjustments in response to an obstacle are faster than voluntary reactions.

It has been reported that obstacle avoidance reactions during gait have very short latencies. This raises the question whether the cortex can be involved, as it is in voluntary reactions. In this study, latencies of obstacle avoidance (OA) reactions were determined and related to latencies of voluntary stride modifications and simple reaction times (SRT) of hand and foot. Twenty-five healthy young adults participated in this study. While they were walking on the treadmill, an obstacle suddenly fell in front of their left leg. The first reaction to the obstacle was the moment at which the differentiated acceleration curve of the foot deviated from the control signal. Latencies of OA reactions were 122 ms (SD 14 ms) on average. Two very different avoidance reactions (lengthening and shortening of the stride) were noticed, but there was no avoidance strategy effect on OA latencies. OA latencies were significantly shorter as compared to latencies of voluntary stride modifications and simple reaction times of hand and foot. The short OA latencies could not only be explained from the dynamic nature of the task. It is suggested that subcortical pathways might be involved in obstacle avoidance.

Adaptations in arm movements for added mass to wrist or ankle during walking.

The aim of the present study was to answer the question whether adaptations to local perturbations are restricted to the perturbed limb or whether they induce a reorganization of all co-moving limbs. Specifically, we studied the adaptations in arm movements to mass perturbations in seven healthy adults during walking on a treadmill. Four different perturbation conditions were employed in random order (no perturbation, mass added to both wrists, to the right wrist, and to the right ankle). During each experimental condition ten different belt speeds (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, 5.0 km/h) were successively offered, while the arm movements and the electromyographic activity of the musculus deltoid posterior and anterior were measured. The results indicated that cadence was not affected by adding mass to the wrist or ankle. However, adding mass to a wrist not only resulted in an increase in muscle activity and a decrease of movement amplitude of the perturbed arm, but also in alterations in the non-perturbed arm. Notably, adding mass to one ankle induced adaptive changes in both arms, in that both muscle activity and arm movement increased. The present results indicate that during walking the loading of one of the limbs induces a general reorganization, involving all participating bodily segments, presumably to maintain balance while providing rhythm constancy.

Bethe ansatz solution of triangular trimers on the triangular lattice.

Recently, a model consisting of triangular trimers covering the triangular lattice was introduced and its exact free energy given. In this paper we present the complete calculation leading to this exact result. The solution involves a coordinate Bethe ansatz with two kinds of particles. It is similar to that of the square-triangle random tiling model by Widom and Kalugin. The connection of the trimer model with related solvable models is discussed.

Exact and numerical results for a dimerized coupled spin- 1/2 chain

We establish exact results for coupled spin-1/2 chains for special values of the four-spin interaction V and dimerization parameter delta. The first exact result is at delta = 1/2 and V = -2. Because we find a very small but finite gap in this dimerized chain, this can serve as a very strong test case for numerical and approximate analytical techniques. The second result is for the homogeneous chain with V = -4 and gives evidence that the system has a spontaneously dimerized ground state. Numerical diagonalization and bosonization techniques indicate that the interplay between dimerization and interaction could result in gapless phases in the regime 0

Exact stationary state for an asymmetric exclusion process with fully parallel dynamics.

The exact stationary state of an asymmetric exclusion process with fully parallel dynamics is obtained using the matrix product ansatz. We give a simple derivation for the deterministic case by a physical interpretation of the dimension of the matrices. We prove the stationarity via a cancellation mechanism, and by making use of an explicit representation of the matrix algebra we easily find closed expressions for the correlation functions in the general probabilistic case. Asymptotic expressions, obtained by making use of earlier results, allow us to derive the exact phase diagram.

Evidence against a three-phase point in a binary hard-core lattice model.

Using Monte Carlo simulation, Van Duijneveldt and Lekkerkerker [Phys. Rev. Lett. 71, 4264 (1993)] found gas-liquid-solid behavior in a simple two-dimensional lattice model with two types of hard particles. The same model is studied here by means of numerical transfer-matrix calculations, focusing on the finite-size scaling of the gaps between the largest few eigenvalues. No evidence for a gas-liquid transition is found. We discuss the relation of the model with a solvable restricted solid-on-solid model of which the states obey the same exclusion rules. Finally, a detailed analysis of the relation with the dilute three-state Potts model strongly supports the tricritical point rather than a three-phase point.

Clinical gait analysis in a rehabilitation context: some controversial issues.

OBJECTIVE: To determine the focus of clinical gait analysis in order to explain the observed mismatch between the available technology for movement analysis and the aims of clinical rehabilitation medicine. DESIGN: Literature search using two different interactive computerized search systems. OUTCOME MEASURES: The selected studies on clinical gait analysis were screened on the type of tasks they employed in the assessment of gait. The tasks were divided into impairment-orientated and disability-orientated. RESULTS: The results indicated a dominance of simple motor tasks focusing at the level of impairments. In only 15 out of the 96 reviewed articles were tasks used that were aimed at the level of disabilities. CONCLUSIONS: A gap exists between the conceptual frameworks used in clinical rehabilitation medicine and those used in clinical movement analysis.

Are older adults more dependent on visual information in regulating self-motion than younger adults?

Older adults look at the ground more while they are walking than younger adults do. In the present study, the effect of blocking that exproprioceptive visual information on the walking pattern of older adults was investigated. The first 0.75 m of the floor in front of healthy young adults (n = 10, mean age = 26.0 years) and 2 groups of older adults (n = 10, mean age 65.7 years; and n = 9, mean age = 75.9 years) was occluded. The dependent variables were step velocity, step length, and step frequency. The effect of the manipulation on those kinematic variables increased with age. The older adults had a significant increase in velocity and step length. The possible use of optic flow information from the ground to regulate the velocity of self-motion is discussed.