Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 17.578
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-36078206

RESUMO

Identifying potential gait deviations in patellofemoral instability (PI) can help with the development of effective rehabilitation strategies. The purpose of this systematic review was to examine whether there are specific gait alterations in subjects with PI. The present review followed the PRISMA guidelines and was initially registered at PROSPERO (CRD42021236765). The literature search was carried out in the databases of PubMed, the Cochrane library, Web of Science, ClinicalTrials.gov, and Medline. The search strategy resulted in the identification of seven relevant publications. Subjects with PI show decreased walking speed, stride length, and cadence. Some studies reported changes not only in knee kinematics and kinetics but also in hip and ankle kinematics and kinetics. There is evidence that most subjects with PI walk with a quadriceps avoidance gait and show increased genu valgum posture, but there is still great variability in the coping responses within individuals with PI. The discrepancy among the study results might underpin the fact that PI is a multifactorial problem, and subjects cope with the different underlying morphological as well as functional deficits using a variety of gait strategies, which makes the interpretation and understanding of the gait of subjects with PI a clinically challenging task.


Assuntos
Marcha , Velocidade de Caminhada , Articulação do Tornozelo , Fenômenos Biomecânicos/fisiologia , Marcha/fisiologia , Humanos , Articulação do Joelho , Caminhada/fisiologia , Velocidade de Caminhada/fisiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-36078509

RESUMO

This study aimed to determine the role of cognitive and affective responses to music cues in modulating the effects of familiarity with music on stride length and stride-to-stride variability in people with Parkinson's disease (PD). Using multilevel modeling, people with PD's spatiotemporal gait parameters and self-reported ratings of familiarity, enjoyment, cognitive and physical demand, beats salience of music cues after each walking trial, as well as music reward, were analyzed. Our findings indicate that (1) condition-varying perceived enjoyment and beat salience are positively associated with increased stride length; (2) participants with a greater music reward for mood regulation and emotion evocation show greater stride length changes compared with those with less music reward; (3) condition-varying perceived enjoyment is positively associated with decreases in stride-to-stride variability; and (4) participants with lower cognitive demand of walking with music cues and higher beat salience show lower stride-to-stride variability compared with those with higher cognitive demand and lower beat salience. These results provide behavioral evidence of independent and interactive influences of cognitive and affective responses to music cues on spatiotemporal gait parameters in people with PD.


Assuntos
Música , Doença de Parkinson , Estimulação Acústica/métodos , Sinais (Psicologia) , Marcha/fisiologia , Humanos , Caminhada/fisiologia
3.
J Foot Ankle Res ; 15(1): 66, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36071465

RESUMO

BACKGROUND: Achilles tendinopathy (AT) may affect ground reaction force (GRF) and muscle synergy (MS) during walking due to pain, biological integrity changes in the tendon and neuroplastic adaptations. The objective of this study was to compare GRF asymmetries and MS attributes between symptomatic and asymptomatic lower limbs (LL) during walking at natural and fast speeds in adults with unilateral AT. METHODS: A convenience sample consisting of twenty-eight participants walked on an instrumented treadmill at natural (1.3 m/s) and fast (1.6 m/s) speeds. Peak GRF were measured in mediolateral, anteroposterior and vertical directions. Individualized electromyography (EMG) activation profiles were time- and amplitude-normalized for three consecutive gait cycles and MS were extracted using non-negative matrix factorization algorithms. MS were characterized by the number, composition (i.e., weighting of each muscle) and temporal profiles (i.e., duration and amplitude) of the MS extracted during walking. Paired Student's t-tests assessed peak GRF and MS muscle weighting differences between sides whereas Pearson correlation coefficients characterized the similarities of the individualized EMG and MS activation temporal profiles within sides. RESULTS: AT had limited effects on peak GRF asymmetries and the number, composition and temporal profiles of MS between symptomatic and asymptomatic LL while walking on a level treadmill at natural and fast speeds. In most participants, four MS with a specific set of predominantly activated muscles were extracted across natural (71 and 61%) and fast (54 and 50%) walking speeds for the symptomatic and asymptomatic side respectively. Individualized EMG activation profiles were relatively similar between sides (r = 0.970 to 0.999). As for MS attributes, relatively similar temporal activation profiles (r = 0.988 to 0.998) and muscle weightings (p < 0.05) were found between sides for all four MS and the most solicited muscles. Although the faster walking speed increased the number of merged MS for both sides, it did not significantly alter MS symmetry. CONCLUSION: Faster walking speed increased peak GRF values but had limited effects on GRF symmetries and MS attribute differences between the LL. Corticospinal neuroplastic adaptations associated with chronic unilateral AT may explain the preserved quasi-symmetric LL motor control strategy observed during natural and fast walking among adults with chronic unilateral AT.


Assuntos
Tendão do Calcâneo , Doenças Musculoesqueléticas , Tendinopatia , Adulto , Fenômenos Biomecânicos , Humanos , Extremidade Inferior/fisiologia , Músculo Esquelético/fisiologia , Caminhada/fisiologia
4.
J Foot Ankle Res ; 15(1): 68, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36071489

RESUMO

BACKGROUND: Different multi-segment foot models have been used to explore the effect of foot orthoses. Previous studies have compared the kinematic output of different multi-segment foot models, however, no study has explored if different multi-segment foot models detect similar kinematic changes when wearing a foot orthoses. The aim of this study was to compare the ability of two different multi-segment foot models to detect kinematic changes at the hindfoot and forefoot during the single and double support phases of gait when wearing a foot orthosis. METHODS: Foot kinematics were collected during walking from a sample of 32 individuals with and without a foot orthosis with a medial heel bar using an eight-camera motion capture system. The Oxford Foot Model (OFM) and a multi-segment foot model using the Calibrated Anatomical System Technique (CAST) were applied simultaneously. Vector field statistical analysis was used to explore the kinematic effects of a medial heel bar using the two models, and the ability of the models to detect any changes in kinematics was compared. RESULTS: For the hindfoot, both models showed very good agreement of the effect of the foot orthosis across all three anatomical planes during the single and double support phases. However, for the forefoot, the level of agreement between the models varied with both models showing good agreement of the effect in the coronal plane but poorer agreement in the transverse and sagittal planes. CONCLUSIONS: This study showed that while consistency exists across both models for the hindfoot and forefoot in the coronal plane, the forefoot in the transverse and sagittal planes showed inconsistent responses to the foot orthoses. This should be considered when interpreting the efficacy of different interventions which aim to change foot biomechanics.


Assuntos
Órtoses do Pé , Fenômenos Biomecânicos/fisiologia , Pé/fisiologia , Marcha/fisiologia , Humanos , Caminhada/fisiologia
5.
Sensors (Basel) ; 22(17)2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36081055

RESUMO

The ankle joint is one of the important joints of the human body to maintain the ability to walk. Diseases such as stroke and ankle osteoarthritis could weaken the body's ability to control joints, causing people's gait to be out of balance. Ankle-foot orthoses can assist users with neuro/muscular or ankle injuries to restore their natural gait. Currently, passive ankle-foot orthoses are mostly designed to fix the ankle joint and provide support for walking. With the development of materials, sensing, and control science, semi-active orthoses that release mechanical energy to assist walking when needed and can store the energy generated by body movement in elastic units, as well as active ankle-foot orthoses that use external energy to transmit enhanced torque to the ankle, have received increasing attention. This article reviews the development process of ankle-foot orthoses and proposes that the integration of new ankle-foot orthoses with rehabilitation technologies such as monitoring or myoelectric stimulation will play an important role in reducing the walking energy consumption of patients in the study of human-in-the-loop models and promoting neuro/muscular rehabilitation.


Assuntos
Órtoses do Pé , Tornozelo , Articulação do Tornozelo , Fenômenos Biomecânicos , Marcha/fisiologia , Humanos , Pesquisa , Caminhada/fisiologia
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2332-2335, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086198

RESUMO

This exploratory study used EEG as mobile imaging method to study cortico-muscular connectivity (CMC) during walking in able-bodied individuals (AB) and individuals with spinal cord injury (iSCI), while walking with and without exoskeleton walking robot (EWR) assistance. We also explored change in CMC after intensive training using EWR assistance in iSCI. Results showed no different in CMC within the AB group during walking with and without robot assistance. However, before training the iSCI subjects showed lower CMC during walking with robot assistance. The intensive 40 hours of walking training with EWR improved the walking function in iSCI participants allowing them to walk with robot assistance set to lower assistance level. This decrease in assistance level and improvement in walking function correlated with increase in CMC, reducing the difference in CMC during walking with and without EWR assistance. The findings suggest that high level of robot assistance and low walking function in iSCI correlates with weaker connectivity between primary motor cortices and lower extremity muscles. Further research is needed to better understand the importance of intention and cortical involvement in training of walking function using EWRs. Clinical Relevance - This study provides innovative data on CMC during walking and how it changes with EWR assistance and with training. This research is important to the clinical field to provide recommendations of how training of walking function can be delivered to maximize cortical engagement and improve rehabilitation outcomes.


Assuntos
Exoesqueleto Energizado , Traumatismos da Medula Espinal , Terapia por Exercício/métodos , Humanos , Traumatismos da Medula Espinal/reabilitação , Caminhada/fisiologia
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 1809-1813, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086362

RESUMO

In operational settings, lower-limb active exoskeletons may experience errors, where an actuation that should be present is missed. These missed actuations may impact users' trust in the system and the adapted human-exoskeleton coordination strategies. In this study, we introduced pseudorandom catch trials, in which an assistive exoskeleton torque was not applied, to understand the immediate responses to missed actuations and how users' internal models to an exoskeleton adapt upon repeated exposure to missed actuations. Participants (N = 15) were instructed to complete a stepping task while wearing a bilateral powered ankle exoskeleton. Human-exoskeleton coordination and trust were inferred from task performance (step accuracy), step characteristics (step length and width), and joint kinematics at selected peak locations of the lower limb. Step characteristics and task accuracy were not impacted by the loss of exoskeleton torque as hip flexion was modulated to support completing the stepping task during catch trials, which supports an impacted human-exoskeleton coordination. Reductions in ankle plantarflexion during catch trials suggest user adaptation to the exoskeleton. Trust was not impacted by catch trials, as there were no significant differences in task performance or gait characteristics between earlier and later strides. Understanding the interactions between human-exoskeleton coordination, task accuracy, and step characteristics will support development of exoskeleton controllers for non-ideal operational settings.


Assuntos
Exoesqueleto Energizado , Tornozelo/fisiologia , Fenômenos Biomecânicos/fisiologia , Marcha/fisiologia , Humanos , Caminhada/fisiologia
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 3640-3644, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086565

RESUMO

Human gait is a complex system affected by many other processes of human physiology. It has multiple inputs and multiple outputs. Due to its complex nature, signals obtained from this system also exhibit complexity and variability. It has been analyzed in many ways to extract the information inhabited by these signals. Entropy based methods showed a significant impact on analysis of gait signals. Threshold based symbolic entropy analysis is one of the entropy based method applied to human gait signals. In this method Normalized Corrected Shannon Entropy (NCSE) is calculated to compare the spontaneous output of the human locomotors system during different walking conditions. Selection of the threshold values is an important task and sometimes it depends upon the type and size of the data. Results are dependent on the proper selection of the threshold. In this paper, different threshold selection methods are discussed and their impact on the results are presented. It was observed that, variation in stride interval has performed better as a threshold value as compare to the other methods. It provided maximum separation among different groups of gait data used in this study. We concluded with the recommendations for the proper selection of the threshold values to apply symbolic entropy methods on human gait signals. Clinical relevance Various gait related problems are common in older adults that increase with age and are associated with reduced gait speed increased fall risk and other impairments. Consequently objective gait assessment in the clinics depending upon the size of the available data has become increasingly important for the classification of gait. It was found that while applying symbolic entropy method proper selection of threshold result into improved classification of different types of gait data which will help the clinician for better decision-making regarding treatment.


Assuntos
Marcha , Caminhada , Acidentes por Quedas , Idoso , Entropia , Marcha/fisiologia , Humanos , Caminhada/fisiologia , Velocidade de Caminhada/fisiologia
9.
Trials ; 23(1): 729, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36056399

RESUMO

BACKGROUND: High-intensity repetitive task-specific practice might be the most effective strategy to promote motor recovery after stroke, and electromechanical-assisted gait training represents one of the treatment options. However, there is still difficulty in clarifying the difference between conventional gait training and electromechanically assisted gait training. METHODS: The study is a multicenter, randomized, parallel-group clinical trial for stroke patients. Three clinical research centers in Korea (Dongguk University Ilsan Hospital, Chungnam National University Hospital, and Seoul National University Bundang Hospital) will participate in the clinical trial and 144 stroke patients will be registered. Enrolled patients are assigned to two groups, an experimental group and a control group, according to a randomization table. In addition, patients are treated for half an hour (one session) five times a week for 4 weeks. Both groups carry out basic rehabilitation (central nervous system development therapy and strength exercise) and the experimental group executes robotic walking rehabilitation treatment, and the control group executes conventional gait rehabilitation treatment. The primary endpoint variable is the Functional Ambulation Category (FAC) that determines the degree of independent walking and is measured before, after, and after 4 weeks of treatment. Secondary endpoint variables are 11 variables that take into account motor function and range, measured at the same time as the primary endpoint variable. DISCUSSION: There are still insufficient data on the effectiveness of electromechanical-assisted gait training for stroke patients and large-scale research is lacking. Thus, the research described here is a large-scale study of stroke patients that can supplement the limitations mentioned in other previous studies. In addition, the clinical studies described here include physical epidemiological analysis parameters that can determine walking ability. The results of this study can lead to prove the generalizable effectiveness and safety of electromechanical-assisted gait training with EXOWALK®. TRIAL REGISTRATION: Clinical Research Information Service (CRIS), Republic of Korea KCT0003411, Registered on 30 October 2018.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Terapia por Exercício/métodos , Marcha/fisiologia , Humanos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Resultado do Tratamento , Caminhada/fisiologia
10.
Brain Nerve ; 74(9): 1101-1109, 2022 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-36065671

RESUMO

Recent studies have reported the neural mechanisms underlying gait and motor function recovery; neurorehabilitation involves application of these findings to clinical rehabilitation. This article focuses on post-stroke gait disorders. Gait disorder in patients with hemiplegic stroke is characterized by reduced walking speed, which is attributable to merged muscle synergies and a decreased trail limb angle. This paper describes the aforementioned factors and recent clinical research that confirms the role of the volume of gait as the most important factor, as well as evidence of various intervention methods. Furthermore, it is necessary to experience walking in various contexts and environments to achieve adaptive gait.


Assuntos
Transtornos Neurológicos da Marcha , Reabilitação Neurológica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Marcha/fisiologia , Humanos , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/métodos , Caminhada/fisiologia
11.
J Foot Ankle Res ; 15(1): 70, 2022 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-36089598

RESUMO

BACKGROUND: Idiopathic toe walking (ITW) is an exclusionary diagnosis. There has been limited exploration of lower limb active range of motion and strength measures in children with ITW. This researched aimed to determine any differences in lower limb muscle active range of motion and strength in children who have ITW, compared to normative data collected from children who displayed typical gait. METHODS: Children were recruited with had a diagnosis of ITW, aged between 4 and 10 years, and no recent treatment. Data collected included parent reported data such as time spent toe walking, percentage of time spent toe walking, and clinician collected data such as age, height and weight. Joint ranges of motion and strength measures were collected by an experience clinician. Active and weight bearing joint ranges of motion were evaluated with a goniometer or digital inclinometer. Lower limb muscle strength measures were evaluated with a hand-held dynamometer. Published normative data sets were used for comparison. Measures were analysed with regression analyses to determine differences between groups in different measures, considering measures known to impact range and strength. Odds ratios (OR), 95% confidence intervals (CI) and p values were reported. RESULTS: Twenty-six children with ITW participated. Reduced weight bearing ankle range of motion, when measured with the knee bent, was associated with being in the ITW group (p = 0.009), being older (p < 0.001) and weighing less (p < 0.001). Reduced ankle plantar flexion range was only associated with being in the ITW group (p = 0.015). For all lower limb strength measures, excluding hip external rotation, children who displayed greater strength, did not toe walk (p < 0.002), were older (p < 0.001) and weighed more (p < 0.014). with ITW. CONCLUSION: Children with ITW displayed reduced overall plantar and dorsiflexion at the ankle, compared to non-toe walking children. Reduced plantarflexion is children with ITW has not been described before, however reduced dorsiflexion is commonly reported. Children with ITW were weaker in many lower limb measures, even when age and weight were considered. This should lead clinicians and researchers to pay greater attention to lower limb strength measures in this population.


Assuntos
Transtornos dos Movimentos , Dedos do Pé , Estudos de Casos e Controles , Criança , Pré-Escolar , Marcha/fisiologia , Humanos , Extremidade Inferior , Transtornos dos Movimentos/diagnóstico , Dedos do Pé/fisiologia , Caminhada/fisiologia
12.
PLoS Comput Biol ; 18(9): e1010466, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36084139

RESUMO

Hemiparesis, defined as unilateral muscle weakness, often occurs in people post-stroke or people with cerebral palsy, however it is difficult to understand how this hemiparesis affects movement patterns as it often presents alongside a variety of other neuromuscular impairments. Predictive musculoskeletal modeling presents an opportunity to investigate how impairments affect gait performance assuming a particular cost function. Here, we use predictive simulation to quantify the spatiotemporal asymmetries and changes to metabolic cost that emerge when muscle strength is unilaterally reduced and how reducing spatiotemporal symmetry affects metabolic cost. We modified a 2-D musculoskeletal model by uniformly reducing the peak isometric muscle force unilaterally. We then solved optimal control simulations of walking across a range of speeds by minimizing the sum of the cubed muscle excitations. Lastly, we ran additional optimizations to test if reducing spatiotemporal asymmetry would result in an increase in metabolic cost. Our results showed that the magnitude and direction of effort-optimal spatiotemporal asymmetries depends on both the gait speed and level of weakness. Also, the optimal speed was 1.25 m/s for the symmetrical and 20% weakness models but slower (1.00 m/s) for the 40% and 60% weakness models, suggesting that hemiparesis can account for a portion of the slower gait speed seen in people with hemiparesis. Modifying the cost function to minimize spatiotemporal asymmetry resulted in small increases (~4%) in metabolic cost. Overall, our results indicate that spatiotemporal asymmetry may be optimal for people with hemiparesis. Additionally, the effect of speed and the level of weakness on spatiotemporal asymmetry may help explain the well-known heterogenous distribution of spatiotemporal asymmetries observed in the clinic. Future work could extend our results by testing the effects of other neuromuscular impairments on optimal gait strategies, and therefore build a more comprehensive understanding of the gait patterns observed in clinical populations.


Assuntos
Marcha , Acidente Vascular Cerebral , Simulação por Computador , Marcha/fisiologia , Humanos , Paresia , Caminhada/fisiologia
13.
J Neural Eng ; 19(4)2022 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-35944515

RESUMO

Objective.Lower-limb amputees suffer from a variety of health problems, including higher metabolic consumption and low mobility. These conditions are linked to the lack of a natural sensory feedback (SF) from their prosthetic device, which forces them to adopt compensatory walking strategies that increase fatigue. Recently, both invasive (i.e. requiring a surgery) and non-invasive approaches have been able to provide artificial sensations via neurostimulation, inducing multiple functional and cognitive benefits. Implants helped to improve patient mobility and significantly reduce their metabolic consumption. A wearable, non-invasive alterative that provides similar useful health benefits, would eliminate the surgery related risks and costs thereby increasing the accessibility and the spreading of such neurotechnologies.Approach.Here, we present a non-invasive SF system exploiting an optimally-calibrated (just noticeable difference-based) electro-cutaneous stimulation to encode intensity-modulated foot-ground and knee angle information personalized to the user's just noticeable perceptual threshold. This device was holistically evaluated in three transfemoral amputees by examination of metabolic consumption while walking outdoors, walking over different inclinations on a treadmill indoors, and balance maintenance in reaction to unexpected perturbation on a treadmill indoors. We then collected spatio-temporal parameters (i.e. gait dynamic and kinematics), and self-reported prosthesis confidence while the patients were walking with and without the SF.Main results.This non-invasive SF system, encoding different distinctly perceived levels of tactile and knee flexion information, successfully enabled subjects to decrease metabolic consumption while walking and increase prosthesis confidence. Remarkably, more physiological walking strategies and increased stability in response to external perturbations were observed while walking with the SF.Significance.The health benefits observed with the use of this non-invasive device, previously only observed exploiting invasive technologies, takes an important step towards the development of a practical, non-invasive alternative to restoring SF in leg amputees.


Assuntos
Amputados , Membros Artificiais , Fenômenos Biomecânicos , Retroalimentação , Marcha/fisiologia , Humanos , Desenho de Prótese , Caminhada/fisiologia
14.
PLoS One ; 17(8): e0273794, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36040986

RESUMO

BACKGROUND AND OBJECTIVES: The 6-minute walk test (6MWT) is a field test commonly used to predict peak oxygen consumption (VO2peak) in people after stroke. Inclusion of cardiodynamic variables measured by impedance cardiography (ICG) during a 6MWT has been shown to improve prediction of VO2peak in healthy adults but these data have not been considered in people after stroke. This study investigates whether the prediction of VO2peak can be improved by the inclusion of cardiovascular indices derived by impedance cardiography (ICG) during the 6MWT in people after stroke. METHODS: This was a cross-sectional study. Patients diagnosed with stroke underwent in random order, a maximal cardiopulmonary exercise test (CPET) and 6MWT in separate dates. Heart rate (HR), stroke volume (SV) and cardiac output (CO) were measured by ICG during all tests. Oxygen consumption was recorded by a metabolic cart during the CPET. Recorded data were subjected to multiple regression analyses to generate VO2peak prediction equations. RESULTS: Fifty-nine patients, mean age 50.0±11.7 years were included in the analysis. The mean distance covered in the 6MWT (6MWD) was 294±13 m, VO2peak was 19.2±3.2 ml/min/kg. Mean peak HR, SV and CO recorded during 6MWT were 109±6 bpm, 86.3±8.8 ml, 9.4±1.2 L/min and during CPET were 135±14 bpm, 86.6±9 ml, 11.7±2 L/min respectively. The prediction equation with inclusion of cardiodynamic variables: 16.855 + (-0.060 x age) + (0.196 x BMI) + (0.01 x 6MWD) + (-0.416 x SV6MWT) + (3.587 x CO 6MWT) has a higher squared multiple correlation (R2) and a lower standard error of estimate (SEE) and SEE% compared to the equation using 6MWD as the only predictor. CONCLUSION: Inclusion of SV and CO measured during the 6MWT in stroke patients further improved the VO2peak prediction power compared to using 6MWD as a lone predictor.


Assuntos
Teste de Esforço , Acidente Vascular Cerebral , Adulto , Débito Cardíaco , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Oxigênio , Consumo de Oxigênio/fisiologia , Volume Sistólico , Teste de Caminhada , Caminhada/fisiologia
15.
Sensors (Basel) ; 22(16)2022 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-36015700

RESUMO

This study investigates the potential of passive monitoring of gait and turning in daily life in people with multiple sclerosis (PwMS) to identify those at future risk of falls. Seven days of passive monitoring of gait and turning were carried out in a pilot study of 26 PwMS in home settings using wearable inertial sensors. The retrospective fall history was collected at the baseline. After gait and turning data collection in daily life, PwMS were followed biweekly for a year and were classified as fallers if they experienced >1 fall. The ability of short-term passive monitoring of gait and turning, as well as retrospective fall history to predict future falls were compared using receiver operator curves and regression analysis. The history of retrospective falls was not identified as a significant predictor of future falls in this cohort (AUC = 0.62, p = 0.32). Among quantitative monitoring measures of gait and turning, the pitch at toe-off was the best predictor of falls (AUC = 0.86, p < 0.01). Fallers had a smaller pitch of their feet at toe-off, reflecting less plantarflexion during the push-off phase of walking, which can impact forward propulsion and swing initiation and can result in poor foot clearance and an increased metabolic cost of walking. In conclusion, our cohort of PwMS showed that objective monitoring of gait and turning in daily life can identify those at future risk of falls, and the pitch at toe-off was the single most influential predictor of future falls. Therefore, interventions aimed at improving the strength of plantarflexion muscles, range of motion, and increased proprioceptive input may benefit PwMS at future fall risk.


Assuntos
Esclerose Múltipla , Marcha/fisiologia , Humanos , Projetos Piloto , Equilíbrio Postural , Estudos Retrospectivos , Caminhada/fisiologia
16.
Sensors (Basel) ; 22(16)2022 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-36015888

RESUMO

An FDA-approved soft wearable robot, the Myosuit, which was designed to provide hip and knee extension torque has recently been commercialized. While studies have reported reductions in metabolic costs, increased gait speeds, and improvements in clinical test scores, a comprehensive analysis of electromyography (EMG) signals and joint kinematics is warranted because the recruitment of appropriate muscle groups during physiological movement patterns facilitates effective motor learning. Here, we compared the lower limb joint kinematics and EMG patterns while wearing the Myosuit with that of unassisted conditions when performing level overground and incline treadmill gait. The level overground gait sessions (seven healthy subjects) were performed at self-selected speeds and the incline treadmill gait sessions (four healthy subjects) were performed at 2, 3, 4, and 5 km/h. In order to evaluate how the user is assisted, we conducted a biomechanical analysis according to the three major gait tasks: weight acceptance (WA), single-limb support, and limb advancement. The results from the gait sessions suggest that Myosuit not only well preserves the users' natural patterns, but more importantly reduce knee extensor demand during the WA phase for both level and incline gait.


Assuntos
Marcha , Articulação do Joelho , Fenômenos Biomecânicos , Marcha/fisiologia , Humanos , Joelho , Articulação do Joelho/fisiologia , Extremidade Inferior/fisiologia , Caminhada/fisiologia
17.
Sensors (Basel) ; 22(16)2022 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-36015914

RESUMO

To improve exoskeleton designs, it is crucial to understand the effects of the placement of such added mass on a broad spectrum of users. Most prior studies on the effects of added mass on gait have analyzed young adults using discrete point analysis. This study quantifies the changes in gait characteristics of young and middle-aged adults in response to added mass across the whole gait cycle using statistical parametric mapping. Fourteen middle-aged and fourteen younger adults walked during 60 s treadmill trials under nine different loading conditions. The conditions represented full-factorial combinations of low (+3.6 lb), medium (+5.4 lb), and high (+10.8 lb) mass amounts at the thighs and pelvis. Joint kinematics, kinetics and muscle activations were evaluated. The young and middle-aged adults had different responses to added mass. Under pelvis loading, middle-aged adults did not adopt the same kinematic responses as younger adults. With thigh loading, middle-aged adults generally increased knee joint muscle activity around heel strike, which could have a negative impact on joint loading. Overall, as age may impact the user's response to an exoskeleton, designers should aim to include sensors to directly monitor user response and adaptive control approaches that account for these differences.


Assuntos
Exoesqueleto Energizado , Marcha , Fenômenos Biomecânicos/fisiologia , Marcha/fisiologia , Humanos , Articulação do Joelho/fisiologia , Pessoa de Meia-Idade , Caminhada/fisiologia , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-35954652

RESUMO

BACKGROUND: This study aimed to analyze the prevalence of sarcopenia in elderly people from Northern Brazil according to muscle weakness or walking slowness. METHODS: The sample consisted of 312 elderly people (72.6 ± 7.8 years). For walking slowness, a gait speed ≤ 0.8 m/s was used as a cut-off value, and for muscle weakness the following handgrip strength criteria were used for men and women, respectively: CI: <27.0/16.0 kg; CII: <35.5/20.0 kg; CIII: grip strength corrected for body mass index (BMI) < 1.05/0.79; CIV: grip strength corrected for total fat mass: <1.66/0.65; CV: grip strength corrected for body mass: <0.45/0.34. RESULTS: Walking speed was reduced in 27.0% of women and 15.2% of men (p < 0.05). According to grip strength criteria, 28.5% of women and 30.4% of men (CI), 58.0% of women and 75.0% of men (CII), 66.0% of women and 39.3% of men (CIII), 28.8% of women and 19.6% of men (CIV), and 56.5% of women and 50.0% of men (CV) were identified as having sarcopenia. CONCLUSIONS: Walking slowness is more prevalent in women and muscle weakness is more prevalent in men in Northern Brazil. Walking slowness proved to be more concordant with muscle weakness in both sexes when the CI for handgrip strength was adopted.


Assuntos
Sarcopenia , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Força da Mão/fisiologia , Humanos , Masculino , Força Muscular/fisiologia , Debilidade Muscular/epidemiologia , Paresia , Sarcopenia/epidemiologia , Caminhada/fisiologia , Velocidade de Caminhada/fisiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-35954684

RESUMO

Understanding the effects of sloped roads in the pedestrian environment on the body during ambulation with a walking frame can help design friendlier living environments for elderly individuals. A survey of the characteristics of walking frames used in different pedestrian environments was investigated in five communities, and a controlled study of the effects of a sloped road on a subject with different walking frames was carried out as foundational research in the laboratory. A synchronous acquisition system consisting of a wireless motion capture module and a physiological information recording module was applied to collect data on the motion of the shoulder joint and skin conductance response (SCR) of fingers in one participant. Force data were collected from sensors placed on the four legs of the walking frame. The experimental data obtained during different tasks were quantitatively analyzed. Compared to flat ground, the shoulder joint rotated in the opposite direction in horizontal and internal/external planes when using a wheeled walking frame on an uphill road, and the supportive force decreased on both uphill and downhill roads. The range of motion of the shoulder joint reduced and the direction of the shoulder joint motion changed when using a footed walking frame on both uphill and downhill roads. Additionally, the peak value of the supportive force on the uphill road appeared in the first 50% of the gait cycle, which was earlier than in the other cases. In addition, walking on the uphill road with a walking frame had a maximum SCR value, which means a greater impact of psychological arousal. Biomechanics of the shoulder joint and psychological arousal are closely related to the ease of walking on a sloped road with a walking frame. These findings are beneficial for designing more appropriate environments for elderly individuals who walk with aids.


Assuntos
Pedestres , Idoso , Fenômenos Biomecânicos , Marcha/fisiologia , Humanos , Extremidade Inferior/fisiologia , Caminhada/fisiologia
20.
Trials ; 23(1): 661, 2022 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-35974379

RESUMO

BACKGROUND: Stroke is the leading cause of acquired disability in France. While 90% of patients recover the ability to walk, it is often limited with a steady speed of approximately 0.7 m/s. This limitation of walking activity is partly related to a decrease in strength associated with more or less significant spasticity. In particular, it seems that the strength of the dorsiflexor muscles is directly related to walking speed. We hypothesise that a protocol based on gestural repetition targeted at the ankle during the subacute phase potentiates the recovery of motor control, improving walking activity, and participates in recovering better social participation. METHODS: An estimated total of 60 patients with subacute stroke will be recruited to participate in this multicentre, interventional, prospective, randomised controlled trial. All participants will benefit from conventional rehabilitation. In addition, the experimental group will take part in an ankle isokinetic rehabilitation programme for 6 weeks (at least 25 sessions). The control group will receive the same duration of conventional rehabilitation. The primary outcome measure will be a 10-m walking speed at post-intervention. Secondary outcomes will include social participation, walking spatio-temporal parameters, and dorsiflexor strength. Outcome measurements will be taken at baseline, immediately after treatment (6 weeks), then at 6 months and 1 year of follow-up. DISCUSSION: This study aims to provide scientific evidence that a protocol based on an early over-solicitation of the ankle dorsiflexor muscles to promote their "awakening" can serve to achieve a more effective walking activity, which in turn encourages social participation following discharge from the hospital. This protocol should also help optimise physical medicine and rehabilitation practices: the more systematic use of the isokinetic dynamometer as a technique associated with, and integrated into the conventional rehabilitation protocol would allow an objective evaluation of the rehabilitation benefits and should increase the rehabilitation gain in central nervous system disorders. TRIAL REGISTRATION: Limoges University Hospital is the sponsor of this research (Unique Protocol ID: 87RI18_0010) This research is supported by the French Ministry of Health (PHRC 2020-A03328-31) and is conducted with the support of DGOS (PHRC interregional - GIRCI SOHO). The study protocol was approved by the French Human Subjects Protection Review Board (Comité de Protection des Personnes Nord-Ouest III) on February 23, 2021. The trial was registered in the ClinicalTrials.gov registry ( NCT04800601 ) on March 16, 2021.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Tornozelo , Protocolos Clínicos , Terapia por Exercício/métodos , Hemiplegia , Humanos , Estudos Prospectivos , Recuperação de Função Fisiológica/fisiologia , Acidente Vascular Cerebral/diagnóstico , Resultado do Tratamento , Caminhada/fisiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...