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1.
Sensors (Basel) ; 21(6)2021 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-33805794

RESUMEN

This paper examines the current state of the art of commercially available outdoor footfall sensor technologies and defines individually tailored solutions for the walking trails involved in an ongoing research project. Effective implementation of footfall sensors can facilitate quantitative analysis of user patterns, inform maintenance schedules and assist in achieving management objectives, such as identifying future user trends like cyclo-tourism. This paper is informed by primary research conducted for the EU funded project TrailGazersBid (hereafter referred to as TrailGazers), led by Donegal County Council, and has Sligo County Council and Causeway Coast and Glens Council (NI) among the 10 project partners. The project involves three trails in Ireland and five other trails from Europe for comparison. It incorporates the footfall capture and management experiences of trail management within the EU Atlantic area and desk-based research on current footfall technologies and data capture strategies. We have examined 6 individual types of sensor and discuss the advantages and disadvantages of each. We provide key learnings and insights that can help to inform trail managers on sensor options, along with a decision-making tool based on the key factors of the power source and mounting method. The research findings can also be applied to other outdoor footfall monitoring scenarios.


Asunto(s)
Conservación de los Recursos Naturales , Turismo , Caminata , Europa (Continente) , Irlanda
2.
Artículo en Inglés | MEDLINE | ID: mdl-33800159

RESUMEN

Physical activity would bring in plenty of health benefits, especially recreational physical activity (RPA). Previous studies have suggested that built environment would affect older people's recreational walking (RW) and RPA, but how the effects exist in a small-scale Chinese city remains unclear. Two hundred and fifty-two older participants were recruited in the city of Yiwu using cross-sectional survey of random samples in 2019. RW and RPA level of participants and perceived scores of built environments were collected using the International Physical Activity Questionnaire and Neighborhood Environment Walkability Scale, respectively. Linear regression analysis was conducted to investigate the association of built environment with older people's RW and RPA. The results showed that two main factors affecting older people's RW and RPA were residential density and aesthetics. Additionally, access to services was related to RW, and street connectivity was correlated with RPA. The associations of RW with built environment varied slightly with demographic variables included in the regression model. All the results suggested that lower residential density, better aesthetics environment, and higher street connectivity would motivate older people to engage more in RW and RPA. The better access to services encourages only RW, not RPA, in older people. These findings would be helpful for policy decision makers in the urban construction process in Yiwu. More studies are needed to enlarge the scientific evidence base about small-scale cities in China.


Asunto(s)
Entorno Construido , Caminata , Anciano , Anciano de 80 o más Años , China , Ciudades , Estudios Transversales , Planificación Ambiental , Ejercicio Físico , Humanos , Características de la Residencia
3.
Artículo en Inglés | MEDLINE | ID: mdl-33802511

RESUMEN

Pedestrian Priority Street (PPS) project, launched to encourage safer and more convenient walking by improving the inferior pedestrian environment on narrow streets without sidewalks, is based on Monderman's shared space concept. Similar to the shared space approach, PPS aims for mutual consideration between pedestrians and drivers and strives to create a pedestrian-friendly environment, but the project relies on a unique road surface design. Considering the two main goals of the PPS project, this study investigated how subjective safety and pedestrians' movements differed by design types. To analyze safety perception, ordered Logit regression and post-hoc interviews were conducted with visual assessment survey using recorded VR (virtual reality) videos. Next, trace mapping and analysis were performed based on the video recordings to measure the degree of free walking. The results found that pedestrians perceived higher safety level in PPSs than in general back road. Further, the pedestrians moved more freely in the street with an integrated design. In other types, which suggested a pedestrian zone at the roadside, there was not much difference in behavior from the general back roads. Thus, the design principle of PPS, which does not set a boundary between pedestrian and vehicle area, should be observed to lead to behavioral changes in pedestrians.


Asunto(s)
Peatones , Realidad Virtual , Accidentes de Tránsito/prevención & control , Humanos , República de Corea , Seguridad , Seúl , Caminata
4.
Artículo en Inglés | MEDLINE | ID: mdl-33802516

RESUMEN

The main objectives of this study were: to compare the barriers to active commuting to and from school (ACS) between children and their parents separately for children and adolescents; and to analyze the association between ACS and the children's and parents' barriers. A total of 401 child-parent pairs, from Granada, Jaén, Toledo and Valencia, self-reported, separately, their mode of commuting to school and work, respectively, and the children's barriers to ACS. T-tests and chi-square tests were used to analyze the differences by age for continuous and categorical variables, respectively. Binary logistic regressions were performed to study the association between ACS barriers of children and parents and ACS. Both children and adolescents perceived higher physical and motivational barriers and social support barriers towards ACS than their parents (all p < 0.05). Additionally, the parents perceived higher distance, traffic safety, convenience, built environment, crime-related safety and weather as barriers towards ACS, than their children (all p < 0.05). Moreover, a higher perception of barriers was related to lower ACS. The results of our study showed the necessity of attenuating the perceptions of children and their parents in order to increase ACS. This is relevant to develop interventions in the specific contexts of each barrier and involving both populations.


Asunto(s)
Transportes , Caminata , Adolescente , Entorno Construido , Niño , Estudios Transversales , Humanos , Motivación , Características de la Residencia , Instituciones Académicas
5.
Artículo en Inglés | MEDLINE | ID: mdl-33804374

RESUMEN

This study determines the effect of walking backward on a treadmill on balance, speed of walking and cardiopulmonary fitness for patients with chronic stroke. Subjects with chronic stroke for more than six months, whose level of Brunnstrom stage is greater than IV and who are able to walk more than eleven meters with or without assistive devices were recruited. After grouping for a single-blind clinical randomized controlled trial, the subjects were divided into two groups: eight in the control group and eight in the experimental group. All subjects were subjected to 30 min traditional physical therapy, three times a week for four weeks. The experimental group was subjected to an additional 30 min of walking backward on a treadmill. The Berg Balance Scale (BBS) and the Timed Up and Go test (TUG) were used to determine the functional balance and walking ability. The walking speed was evaluated using a timed 10-Meter Walk Test (10MWT), and the cardiopulmonary fitness was determined using a 6-Minute Walk Test (6MWT) and a pulmonary function test (PFT). All assessments were made at baseline before training commenced (pre-training) and at the end of the four-week training period (post-training). A paired t-test and an independent t-test were used to determine the effect on balance, speed of walking and cardiopulmonary fitness before and after training. The level of significance α was 0.05. After four weeks of training, the experimental group showed significant differences (p < 0.05) on TUG, BBS, 10MWT, 6MWT, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). This pilot study shows that the 30 min of walking backward on a treadmill three times a week for four weeks increased balance, speed of walking and cardiopulmonary fitness. Trial registration: Current Controlled Trials NCT02619110.


Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Terapia por Ejercicio , Humanos , Proyectos Piloto , Equilibrio Postural , Método Simple Ciego , Estudios de Tiempo y Movimiento , Resultado del Tratamiento , Caminata
6.
Artículo en Inglés | MEDLINE | ID: mdl-33807611

RESUMEN

The six-minute walk test (6MWT) is a widely used test for the indirect measurement of cardiorespiratory fitness in various cancer populations. Although the 6MWT is a simple test, there are no normative values for breast cancer survivors (BCS) or comparisons of results with healthy counterparts. A systematic review with a meta-analysis was carried out, which included studies from 2007 to 2020. Ninety-one studies were found, 21 of which were included in the quantitative synthesis. Among them were 9 randomized controlled trials (RCT), 8 prospective cohort studies and 4 cross-sectional studies. A total of 1084 BCS were included. Our results revealed that healthy subjects (n = 878) covered a significantly greater distance than BCS during the 6MWT (589.9 m vs. 477.4 m, p < 0.001), and the results of the meta-regression analysis showed that the 6MWD was predicted by the participants' BMI (p < 0.001), but not by their age (p = 0.070). After adjustment for BMI, the healthy subjects also covered greater distances than the BCS (103 m; p < 0.001). The normative values of 6MWT were presented for BCS. Besides, 6MWT distances distinguish between their healthy counterparts, therefore, the 6MWT distance is a relevant parameter for the assessment and monitoring of cardiorespiratory fitness in medical and exercise interventions for BCS.


Asunto(s)
Neoplasias de la Mama , Supervivientes de Cáncer , Capacidad Cardiovascular , Prueba de Esfuerzo , Humanos , Sobrevivientes , Prueba de Paso , Caminata
7.
Artículo en Inglés | MEDLINE | ID: mdl-33808014

RESUMEN

In order to develop tailored interventions aiming to encourage active transport among older adults, it is important to gain insights into the modifiable moderators affecting active transport behavior considering the neighborhood in which one lives. Therefore, this study aimed to determine which objective physical environmental factors have an impact on the active transport behavior of Belgian older adults (≥65 years old) and which psychosocial and social environmental moderators influence those relationships. Data from 503 independent living older adults who participated the Belgian Environmental Physical Activity Study in Seniors were included. Multilevel negative binominal regression models (participants nested in neighborhoods) with log link function were fitted for the analyses. Our resulted indicated that older adults living in an environment with higher residential density, higher park density, lower public transport density, and more entropy index had higher active transport levels. Furthermore, different types of neighborhood in which older adults live can lead to different moderators that are decisive for increasing older adults' active transport behavior. Therefore, based on our results some recommendations towards tailored interventions could be given to increase older adults' active transport behavior depending on the environment in which one lives.


Asunto(s)
Transportes , Caminata , Anciano , Bélgica , Planificación Ambiental , Ejercicio Físico , Humanos , Características de la Residencia
8.
BMC Geriatr ; 21(1): 221, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33794786

RESUMEN

BACKGROUND: People with Parkinson's disease (PD) have described their walking difficulties as linked to activity avoidance, social isolation, reduced independence and quality of life. There is a knowledge gap regarding predictive factors of perceived walking difficulties in people with PD. Such knowledge could be useful when designing intervention studies. This study aimed to investigate how perceived walking difficulties evolve over a 3-year period in people with PD. A specific aim was to identify predictive factors of perceived walking difficulties. METHODS: One hundred forty-eight people with PD (mean age 67.9 years) completed the Generic Walk-12 (Walk-12G) questionnaire (which assesses perceived walking difficulties) at both baseline and the 3-year follow-up. Paired samples t-test was used for comparing baseline and follow-up mean scores. Multivariable linear regression analyses were used to identify predictive factors of perceived walking difficulties. RESULTS: Perceived walking difficulties increased after 3 years: mean Walk-12G score 14.8 versus 18.7, p < 0.001. Concerns about falling was the strongest predictor (ß = 0.445) of perceived walking difficulties, followed by perceived balance problems while dual tasking (ß = 0.268) and pain (ß = 0.153). Perceived balance problems while dual tasking was the strongest predictor (ß = 0.180) of a change in perceived walking difficulties, followed by global cognitive functioning (ß = - 0.107). CONCLUSIONS: Perceived walking difficulties increase over time in people with PD. Both personal factors (i.e. concerns about falling) and motor aspects (i.e. balance problems while dual tasking) seem to have a predictive role. Importantly, our study indicates that also non-motor symptoms (e.g. pain and cognitive functioning) seem to be of importance for future perceived walking difficulties. Future intervention studies that address these factors need to confirm their preventative effect on perceived walking difficulties.


Asunto(s)
Enfermedad de Parkinson , Caminata , Accidentes por Caídas , Anciano , Humanos , Limitación de la Movilidad , Enfermedad de Parkinson/diagnóstico , Calidad de Vida
9.
Angiol Sosud Khir ; 27(1): 7-16, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33825723

RESUMEN

AIM: This study was aimed at assessing tolerability, safety and therapeutic efficacy of Pletax® (cilostazol) compared with Trental® (pentoxifylline) in patients with moderate-to-severe intermittent claudication. PATIENTS AND METHODS: The study included a total of one hundred 40-to-65-year-old patients presenting with confirmed diagnosis of moderate-to-severe intermittent claudication. Depending on the therapeutic regimen, the patients were divided into two groups. Group 1: 50 patients orally took Pletax® (cilostazol) at a dose of 100 mg twice daily 30 minutes before meals or 2 hours after meals together with conventional therapy. Group 2: 50 patients took oral Trental® (pentoxifylline) in a dose of 400 mg 3 times daily 30 minutes before meals or 2 hours after meals along with conventional therapy. The duration of the follow up period amounted to 24 weeks for both groups. The treadmill test was carried out at room temperature, with the running track tilt angle of 0° at a speed of 3 km/h. The primary parameters of efficacy were as follows: the dynamics of the minimal walking distance (a distance walked by the patient until the appearance of pain in the extremity) and dynamics of the maximal walking distance (a distance walked by the patients until full stop due to pain in the extremity). RESULTS: Analysing efficacy demonstrated higher results of Pletax® compared with Trental®. The obtained findings suggested that Pletax® showed a significant clinical effect as soon as at 2 weeks, followed by advantage during the whole period of follow up. Analysing the parameters of the minimal and maximal walking distances in the group of patients taking Pletax® demonstrated clear superiority over the Trental® group as soon as by week 2 of administration, which preserved during the whole follow-up period. The minimal pain-free walking distance in the Pletax group at baseline amounted to 92.9±83.4 m (Trental group - 92.3±78.4; p=0.3), followed by an increase at week 8 to 126±115 m (Trental group - 116±96.3; p=0.51), at week 16 to 136±116 m (Trental group - 118±95.5; p=0.04), at week 24 to 149±126 b (Trental group - 127±98.9; p=0.01). At the same time, the effect of Pletax® and Trental® on the secondary parameter of efficacy, i.e., the ankle-brachial index was comparable: at baseline - 0.472 and 0.482 (p=0.28), at 2 weeks - 0.48 and 0.483 (p=031), at 8 weeks - 0.49 and 0.485 (p=0.74), at 16 weeks - 0.494 and 0.492 (p=0.2), at 24 weeks - 0.501 and 0.496 (p=0.45). CONCLUSION: The obtained findings demonstrated advantages of Pletax® over Trental®, manifesting themselves in the achievement of the highest parameters by such criteria as the minimal and maximal walking distance. High safety and efficacy of Pletax® were confirmed by low frequency of unfavourable events during therapy.


Asunto(s)
Claudicación Intermitente , Pentoxifilina , Adulto , Anciano , Cilostazol , Prueba de Esfuerzo , Humanos , Claudicación Intermitente/diagnóstico , Claudicación Intermitente/tratamiento farmacológico , Persona de Mediana Edad , Caminata
10.
Artículo en Inglés | MEDLINE | ID: mdl-33801189

RESUMEN

Nordic walking (NW) is a popular form of rehabilitation. NW improves psychophysical condition in breast cancer (BC) survivors. This study aimed to analyze the effects of NW on functional and postural changes of the trunk in women of different ages after BC. We hypothesized that an age relationship would be found. BC survivors (n = 39) were stratified by age as "middle- aged" (45-59 years) or "older" (60-75 years), then randomly allocated to the training intervention. A study group (SG, n = 19) participated in NW and a control group (CG, n = 20) performed general gymnastics. The sagittal spinal curvatures and isokinetic trunk muscle endurance were recorded at two time points, pre- and post-training intervention. Significant within NW group changes (p < 0.05) were found for the total work (TW) and average power (AP) of trunk flexors and extensors and the upper thoracic angle in middle-aged women. In older Nordic walkers, significant increases in TW and AP of the trunk flexor muscles were observed, with a negative increase in the trunk inclination angle. In CG, no significant functional or postural changes were observed in response to general gymnastics. NW improved both functional and postural changes in middle-aged women. This study identified the limitations of NW training in older women.


Asunto(s)
Neoplasias de la Mama , Curvaturas de la Columna Vertebral , Factores de Edad , Anciano , Neoplasias de la Mama/terapia , Femenino , Humanos , Persona de Mediana Edad , Torso , Caminata
11.
Artículo en Inglés | MEDLINE | ID: mdl-33805167

RESUMEN

Road safety has become a worldwide public health concern. Although many factors contribute to collisions, pedestrian behaviors can strongly influence road safety outcomes. This paper presents results of a survey investigating the effects of age, gender, attitudes towards road safety, fatalistic beliefs and risk perceptions on self-reported pedestrian behaviors in a Chinese example. The study was carried out on 543 participants (229 men and 314 women) from 20 provinces across China. Pedestrian behaviors were assessed by four factors: errors, violations, aggressions, and lapses. Younger people reported performing riskier pedestrian behaviors compared to older people. Gender was not an influential factor. Of the factors explored, attitudes towards road safety explained the most amount of variance in self-reported behaviors. Significant additional variance in risky pedestrian behaviors was explained by the addition of fatalistic beliefs. The differences among the effects, and the implications for road safety intervention design, are discussed. In particular, traffic managers can provide road safety education and related training activities to influence pedestrian behaviors positively.


Asunto(s)
Peatones , Accidentes de Tránsito , Anciano , Anciano de 80 o más Años , Actitud , China , Femenino , Humanos , Masculino , Percepción , Seguridad , Caminata
12.
Sensors (Basel) ; 21(7)2021 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-33805520

RESUMEN

In recent years the increased rate of the aging population has become more serious. With aging, the elderly sometimes inevitably faces many problems which lead to slow walking, unstable or weak limbs and even fall-related injuries. So, it is very important to develop an assistive aid device. In this study, a fuzzy controller-based smart walker with a distributed robot operating system (ROS) framework is designed to assist in independent walking. The combination of Raspberry Pi and PIC microcontroller acts as the control kernel of the proposed device. In addition, the environmental information and user postures can be recognized with the integration of sensors. The sensing data include the road slope, velocity of the walker, and user's grip forces, etc. According to the sensing data, the fuzzy controller can produce an assistive force to make the walker moving more smoothly and safely. Apart from this, a mobile application (App) is designed that allows the user's guardian to view the current status of the smart walker as well as to track the user's location.


Asunto(s)
Dispositivos de Autoayuda , Caminata , Anciano , Humanos , Postura , Programas Informáticos
13.
Sensors (Basel) ; 21(7)2021 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-33805914

RESUMEN

Current research on Parkinson's disease (PD) is increasingly concerned with the identification of objective and specific markers to make reliable statements about the effect of therapy and disease progression. Parameters from inertial measurement units (IMUs) are objective and accurate, and thus an interesting option to be included in the regular assessment of these patients. In this study, 68 patients with PD (PwP) in Hoehn and Yahr (H&Y) stages 1-4 were assessed with two gait tasks-20 m straight walk and circular walk-using IMUs. In an ANCOVA model, we found a significant and large effect of the H&Y scores on step length in both tasks, and only a minor effect on step time. This study provides evidence that from the two potentially most important gait parameters currently accessible with wearable technology under supervised assessment strategies, step length changes substantially over the course of PD, while step time shows surprisingly little change in the progression of PD. These results show the importance of carefully evaluating quantitative gait parameters to make assumptions about disease progression, and the potential of the granular evaluation of symptoms such as gait deficits when monitoring chronic progressive diseases such as PD.


Asunto(s)
Trastornos Neurológicos de la Marcha , Enfermedad de Parkinson , Dispositivos Electrónicos Vestibles , Marcha , Humanos , Enfermedad de Parkinson/diagnóstico , Caminata
14.
Sensors (Basel) ; 21(5)2021 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-33806449

RESUMEN

Flatfoot is a common musculoskeletal deformity. One of the most effective treatments is to wear individually customized plantar pressure-based insoles to help users change the abnormally distributed pressure on the pelma. However, most previous studies were divided only into several plantar areas without detailed plantar characteristic analysis. In this study, a new insole is designed which redistributes pressure following the analysis of characteristic points of plantar pressure, and practical evaluation during walking of subjects while wearing the insole. In total, 10 subjects with flexible flatfeet have participated in the performance of gait experiments by wearing flat insoles, orthotic insoles, and plantar pressure redistribution insoles (PPRI). The results showed that the stance time of PPRI was significantly lower than that of the flat insoles under slow gait. PPRI in the second to third metatarsal and medial heel area showed better unloading capabilities than orthotic insoles. In the metatarsal and heel area, the PPRI also had its advantage in percentage of contact area compared to flat insole and orthotic insole. The results prove that PPRI improves the plantar pressure distribution and gait efficiency of adults with flexible flatfeet, and can be applied into clinical application.


Asunto(s)
Pie Plano , Ortesis del Pié , Adulto , Diseño de Equipo , Pie Plano/terapia , Pie , Humanos , Presión , Zapatos , Caminata
15.
Sensors (Basel) ; 21(5)2021 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-33806525

RESUMEN

Sarcopenia can cause various senile diseases and is a major factor associated with the quality of life in old age. To diagnose, assess, and monitor muscle loss in daily life, 10 sarcopenia and 10 normal subjects were selected using lean mass index and grip strength, and their gait signals obtained from inertial sensor-based gait devices were analyzed. Given that the inertial sensor can measure the acceleration and angular velocity, it is highly useful in the kinematic analysis of walking. This study detected spatial-temporal parameters used in clinical practice and descriptive statistical parameters for all seven gait phases for detailed analyses. To increase the accuracy of sarcopenia identification, we used Shapley Additive explanations to select important parameters that facilitated high classification accuracy. Support vector machines (SVM), random forest, and multilayer perceptron are classification methods that require traditional feature extraction, whereas deep learning methods use raw data as input to identify sarcopenia. As a result, the input that used the descriptive statistical parameters for the seven gait phases obtained higher accuracy. The knowledge-based gait parameter detection was more accurate in identifying sarcopenia than automatic feature selection using deep learning. The highest accuracy of 95% was achieved using an SVM model with 20 descriptive statistical parameters. Our results indicate that sarcopenia can be monitored with a wearable device in daily life.


Asunto(s)
Sarcopenia , Dispositivos Electrónicos Vestibles , Marcha , Humanos , Calidad de Vida , Sarcopenia/diagnóstico , Caminata
16.
Sensors (Basel) ; 21(6)2021 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-33806984

RESUMEN

Freezing of gait (FOG) is a sudden and highly disruptive gait dysfunction that appears in mid to late-stage Parkinson's disease (PD) and can lead to falling and injury. A system that predicts freezing before it occurs or detects freezing immediately after onset would generate an opportunity for FOG prevention or mitigation and thus enhance safe mobility and quality of life. This research used accelerometer, gyroscope, and plantar pressure sensors to extract 861 features from walking data collected from 11 people with FOG. Minimum-redundancy maximum-relevance and Relief-F feature selection were performed prior to training boosted ensembles of decision trees. The binary classification models identified Total-FOG or No FOG states, wherein the Total-FOG class included data windows from 2 s before the FOG onset until the end of the FOG episode. Three feature sets were compared: plantar pressure, inertial measurement unit (IMU), and both plantar pressure and IMU features. The plantar-pressure-only model had the greatest sensitivity and the IMU-only model had the greatest specificity. The best overall model used the combination of plantar pressure and IMU features, achieving 76.4% sensitivity and 86.2% specificity. Next, the Total-FOG class components were evaluated individually (i.e., Pre-FOG windows, Freeze windows, transition windows between Pre-FOG and Freeze). The best model detected windows that contained both Pre-FOG and FOG data with 85.2% sensitivity, which is equivalent to detecting FOG less than 1 s after the freeze began. Windows of FOG data were detected with 93.4% sensitivity. The IMU and plantar pressure feature-based model slightly outperformed models that used data from a single sensor type. The model achieved early detection by identifying the transition from Pre-FOG to FOG while maintaining excellent FOG detection performance (93.4% sensitivity). Therefore, if used as part of an intelligent, real-time FOG identification and cueing system, even if the Pre-FOG state were missed, the model would perform well as a freeze detection and cueing system that could improve the mobility and independence of people with PD during their daily activities.


Asunto(s)
Trastornos Neurológicos de la Marcha , Enfermedad de Parkinson , Marcha , Humanos , Calidad de Vida , Caminata
17.
Sensors (Basel) ; 21(5)2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33807832

RESUMEN

This study aims to explore the possibility of estimating a multitude of kinematic and dynamic quantities using subject-specific musculoskeletal models in real-time. The framework was designed to operate with marker-based and inertial measurement units enabling extensions far beyond dedicated motion capture laboratories. We present the technical details for calculating the kinematics, generalized forces, muscle forces, joint reaction loads, and predicting ground reaction wrenches during walking. Emphasis was given to reduce computational latency while maintaining accuracy as compared to the offline counterpart. Notably, we highlight the influence of adequate filtering and differentiation under noisy conditions and its importance for consequent dynamic calculations. Real-time estimates of the joint moments, muscle forces, and reaction loads closely resemble OpenSim's offline analyses. Model-based estimation of ground reaction wrenches demonstrates that even a small error can negatively affect other estimated quantities. An application of the developed system is demonstrated in the context of rehabilitation and gait retraining. We expect that such a system will find numerous applications in laboratory settings and outdoor conditions with the advent of predicting or sensing environment interactions. Therefore, we hope that this open-source framework will be a significant milestone for solving this grand challenge.


Asunto(s)
Marcha , Caminata , Fenómenos Biomecánicos , Músculos
18.
Sensors (Basel) ; 21(7)2021 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-33808057

RESUMEN

Stooped posture, which is usually aggravated during walking, is one of the typical postural deformities in patients with parkinsonism. However, the degree of stooped posture is difficult to quantitatively measure during walking. Furthermore, continuous feedback on posture is also difficult to provide. The purpose of this study is to measure the degree of stooped posture during gait and to investigate whether vibration feedback from sensor modules can improve a patient's posture. Parkinsonian patients with stooped posture were recruited for this study. Two wearable sensors with three-axis accelerometers were attached, one at the upper neck and the other just below the C7 spinous process of the patients. After being calibrated in the most upright posture, the sensors continuously recorded the sagittal angles at 20 Hz and averaged the data at every second during a 6 min walk test. In the control session, the patients walked with the sensors as usual. In the vibration session, sensory feedback was provided through vibrations from the neck sensor module when the sagittal angle exceeded a programmable threshold value. Data were collected and analyzed successfully in a total of 10 patients. The neck flexion and back flexion were slightly aggravated during gait, although the average change was <10° in most patients in both measurement sessions. Therefore, it was difficult to evaluate the effect of sensory feedback through vibration. However, some patients showed immediate response to the feedback and corrected their posture during gait. In conclusion, this preliminary study suggests that stooped posture could be quantitatively measured during gait by using wearable sensors in patients with parkinsonism. Sensory feedback through vibration from sensor modules may help in correcting posture during gait in selected patients.


Asunto(s)
Trastornos Parkinsonianos , Dispositivos Electrónicos Vestibles , Marcha , Humanos , Postura , Caminata
19.
Sensors (Basel) ; 21(6)2021 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-33809581

RESUMEN

Step counts and oxygen consumption have yet to be reported during the 2-min walk test (2MWT) test in persons with lower-limb amputations (LLA). The purpose of this study was to determine step counts and oxygen consumption during the 2MWT in LLA. Thirty-five men and women walked for two minutes as quickly as possible while wearing activity monitors (ActiGraph Link on the wrist (LW) and ankle (LA), Garmin vivofit®3 on the wrist (VW) and ankle (VA), and a modus StepWatch on the ankle (SA), and a portable oxygen analyzer. The StepWatch on the ankle (SA) and the vivofit3 on the wrist (VW) had the least error and best accuracy of the activity monitors studied. While there were no significant differences in distance walked, oxygen consumption (VO2) or heart rate (HR) between sexes or level of amputation (p > 0.05), females took significantly more steps than males (p = 0.034), and those with unilateral transfemoral amputations took significantly fewer steps than those with unilateral transtibial amputations (p = 0.023). The VW and SA provided the most accurate step counts among the activity monitors and were not significantly different than hand counts. Oxygen consumption for all participants during the 2MWT was 8.9 ± 2.9 mL/kg/min, which is lower than moderate-intensity activity. While some may argue that steady-state activity has not yet been reached in the 2MWT, it may also be possible participants are not walking as fast as they can, thereby misclassifying their performance to a lower standard.


Asunto(s)
Amputación , Caminata , Femenino , Humanos , Extremidad Inferior/cirugía , Masculino , Consumo de Oxígeno , Tecnología , Prueba de Paso
20.
Sensors (Basel) ; 21(6)2021 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-33809758

RESUMEN

The untethered exoskeletal robot provides patients with the freest and realistic walking experience by assisting them based on their intended movement. However, few previous studies have reported the effect of robot-assisted gait training (RAGT) using wearable exoskeleton in children with cerebral palsy (CP). This pilot study evaluated the effect of overground RAGT using an untethered torque-assisted exoskeletal wearable robot for children with CP. Three children with bilateral spastic CP were recruited. The robot generates assistive torques according to gait phases automatically detected by force sensors: flexion torque during the swing phase and extension torque during the stance phase at hip and knee joints. The overground RAGT was conducted for 17~20 sessions (60 min per session) in each child. The evaluation was performed without wearing a robot before and after the training to measure (1) the motor functions using the gross motor function measure and the pediatric balance scale and (2) the gait performance using instrumented gait analysis, the 6-min walk test, and oxygen consumption measurement. All three participants showed improvement in gross motor function measure after training. Spatiotemporal parameters of gait analysis improved in participant P1 (9-year-old girl, GMFCS II) and participant P2 (13-year-old boy, GMFCS III). In addition, they walked faster and farther with lower oxygen consumption during the 6-min walk test after the training. Although participant P3 (16-year-old girl, GMFCS IV) needed the continuous help of a therapist for stepping at baseline, she was able to walk with the platform walker independently after the training. Overground RAGT using a torque-assisted exoskeletal wearable robot seems to be promising for improving gross motor function, walking speed, gait endurance, and gait efficiency in children with CP. In addition, it was safe and feasible even for children with severe motor impairment (GMFCS IV).


Asunto(s)
Parálisis Cerebral , Robótica , Parálisis Cerebral/diagnóstico , Niño , Preescolar , Femenino , Marcha , Humanos , Lactante , Masculino , Proyectos Piloto , Caminata
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