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1.
Biosensors (Basel) ; 11(7)2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34208947

RESUMO

Wearable robotic devices have been proved to considerably reduce the energy expenditure of human walking. It is not only suitable for healthy people, but also for some patients who require rehabilitation exercises. However, in many cases, the weight of soft exosuits are relatively large, which makes it difficult for the assistant effect of the system to offset the metabolic consumption caused by the extra weight, and the heavy weight will make people uncomfortable. Therefore, reducing the weight of the whole system as much as possible and keeping the soft exosuit output power unchanged, may improve the comfort of users and further reduce the metabolic consumption. In this paper, we show that a novel lightweight soft exosuit which is currently the lightest among all known powered exoskeletons, which assists hip flexion. Indicated from the result of experiment, the novel lightweight soft exosuit reduces the metabolic consumption rate of wearers when walking on the treadmill at 5 km per hour by 11.52% compared with locomotion without the exosuit. Additionally, it can reduce more metabolic consumption than the hip extension assisted (HEA) and hip flexion assisted (HFA) soft exosuit which our team designed previously, which has a large weight. The muscle fatigue experiments show that using the lightweight soft exosuit can also reduce muscle fatigue by about 10.7%, 40.5% and 5.9% for rectus femoris, vastus lateralis and gastrocnemius respectively compared with locomotion without the exosuit. It is demonstrated that decreasing the weight of soft exosuit while maintaining the output almost unchanged can further reduce metabolic consumption and muscle fatigue, and appropriately improve the users' comfort.


Assuntos
Exoesqueleto Energizado , Fenômenos Biomecânicos , Metabolismo Energético , Terapia por Exercício , Marcha/fisiologia , Humanos , Fadiga Muscular/fisiologia , Robótica/instrumentação , Caminhada/fisiologia , Dispositivos Eletrônicos Vestíveis
2.
J Back Musculoskelet Rehabil ; 34(4): 707-714, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34092596

RESUMO

BACKGROUND: Kinematic analysis has been a dominant tool for addressing the neuromuscular and proprioceptive alterations that occur in Low Back Pain (LBP) patients. Movement variability is a crucial component of this analysis. In the recent years application of non-linear indices seems to be showing the way. OBJECTIVE: The aim of the study was to compare movement variability, as expressed mainly by non-linear indices, at the pelvis and lumbar spine between LBP patients and healthy participants during gait. METHODS: Sixteen (16) LBP patients and thirteen (13) healthy control subjects (non-athletes) participated in the study. Participants walked on a treadmill at different walking conditions while recorded by a 6-infrared camera optoelectronic system. Kinematic variability of pelvic and lumbar movement was analyzed using linear (standard deviation - SD) and non-linear indices (Maximal Lyapunov Exponent - LyE and Approximate Entropy - ApEn). RESULTS: Healthy subjects were found to have significantly greater mean values than LBP patients at seven pelvic and lumbar components in LyE, ApEn and SD. Specifically, the calculated LyE at the pelvis during normal gait was proven to have a sensitivity of 92.3% and a specificity of 90% in the discrimination of healthy subjects from LBP patients. Female subjects presented with higher variability in gait measures than males. CONCLUSION: Healthy participants presented with higher movement variability in their kinematic behavior in comparison to LBP patients. Lower variability values may be partly explained by the attempt of LBP patients to avoid painful end of range of motion positions. In this perspective non-linear indices seem to relate to qualitive characteristics of movement that need to be taken into consideration during rehabilitation.


Assuntos
Marcha/fisiologia , Dor Lombar/fisiopatologia , Caminhada/fisiologia , Adulto , Fenômenos Biomecânicos/fisiologia , Teste de Esforço , Feminino , Humanos , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Movimento/fisiologia , Pelve/fisiopatologia , Amplitude de Movimento Articular/fisiologia
3.
J Clin Neurosci ; 89: 211-215, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34119269

RESUMO

Robot-assisted gait training using a voluntary-driven wearable cyborg, Hybrid Assistive Limb (HAL), has been shown to improve the mobility of patients with neurological disorders; however, its effect on the quality of life (QOL) of patients is not clear. The aim of this study was to assess the effects of HAL-assisted gait training on QOL and mobility in patients with neuromuscular diseases (NMDs). Ten patients with NMDs (seven men and three women, mean age: 57 ± 11 years), with impairment in mobility but could walk alone with aids underwent two courses of gait training with HAL over 6 months, and the single course consisted of nine sessions of training for 4 weeks. We compared the findings of the 2 min walk test, 10 m walk test, the Short Form-36 (SF-36) questionnaire, and the Hospital Anxiety and Depression Scale at baseline, after the 1st training, before the 2nd training, and after the 2nd training using the Friedman test. A significant improvement was observed in the 2 min walking distance from baseline (93 ± 50 m) to after the 2nd training (115 ± 48 m, P = 0.034), as well as in the domains of vitality (P = 0.019) and mental component summary score (P = 0.019) of SF-36. The improvement in 10 m walking speed was significantly correlated with that in the physical functioning (R = 0.831, P = 0.003) and role physical (R = 0.697, P = 0.025) domains in the SF-36. Our findings suggest that HAL-assisted gait training is effective in improving QOL associated with mental health as well as gait ability in selected patients with NMDs.


Assuntos
Terapia por Exercício/métodos , Exoesqueleto Energizado , Marcha/fisiologia , Doenças Neuromusculares/terapia , Robótica/métodos , Caminhada/fisiologia , Adulto , Idoso , Terapia por Exercício/instrumentação , Terapia por Exercício/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neuromusculares/psicologia , Qualidade de Vida/psicologia , Robótica/instrumentação , Caminhada/psicologia
4.
Medicine (Baltimore) ; 100(24): e26275, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34128859

RESUMO

ABSTRACT: This study was conducted to investigate the effects of the degree of dual-task (DT) interference on gait, dual-task cost (DTC), cognitive ability, balance, and fall efficacy in people with stroke.In this cross-sectional study, people with chronic stroke (N = 36) performed a DT gait assessment (gait and cognitive task). During the evaluation, DT interference in motor and cognition was evaluated simultaneously. Thus, the group with severe interference in both tasks (mutual interference) was compared with the group with mild interference in either.The main effects for the degree of motor interference were observed on gait performance, DTC in motor, time up and go, and trail-making test B. In the cognitive interference, the main effects were observed on correct response rate, DTC in cognition, time up and go, and trail-making test B. An interaction effect was observed in the trail-making test B.The degree of motor interference affected gait, balance ability, and executive function (EF), and the degree of cognitive interference influenced the correct response rate in the DT condition, balance ability, and EF. Furthermore, mutual interference led to a significant reduction in EF in people with stroke.


Assuntos
Cognição/fisiologia , Marcha/fisiologia , Equilíbrio Postural/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Acidentes por Quedas , Idoso , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Desempenho Psicomotor/fisiologia , Reabilitação do Acidente Vascular Cerebral , Análise e Desempenho de Tarefas
5.
Medicine (Baltimore) ; 100(19): e25789, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-34106614

RESUMO

INTRODUCTION: Patellofemoral pain (PFP) is highly prevalent in runners. Physical therapies were proved to be effective in the treatment of PFP. Gait retraining is an important method of physical therapy, but its effectiveness and safety for PFP remained controversial. Previous review suggests gait retraining in the treatment of PFP warrants consideration. However, recent publications of randomized controlled studies and case series studies indicated the positive effect of gait retraining in clinical and functional outcomes, which re-raise the focus of gait retraining. This paper will systematically review the available evidence, assessing the safety and effectiveness for the use of gait retraining for runners with PEP. METHOD AND ANALYSIS: A systematic review of relevant studies in Pubmed, Embase, SCOPUS, and Cochrane Library were synthesized. Inclusion criteria are studies evaluating clinical outcomes (i.e., changes to pain and/or function) following running retraining interventions in symptomatic running populations; Studies with less than 10 participants in total or in the running retraining intervention group were excluded. The primary outcomes measured will be pain score, Lower extremity functional scale and training related injuries or complications. Review Manager (Revman Version 5.3) software will be used for data synthesis, sensitivity analysis, meta regression, subgroup analysis and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias and Begg and Egger tests will be used to assess funnel plot symmetries. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence. ETHICS AND DISSEMINATION: Our aim is to publish this systematic review in a peer-reviewed journal. Our findings will provide information about the safety of gait retraining and their effect on reliving pain and improving function of lower limb on runners with PEP. This review will not require ethical approval as there are no issues about participant privacy.


Assuntos
Marcha , Síndrome da Dor Patelofemoral/terapia , Modalidades de Fisioterapia , Corrida , Protocolos Clínicos , Marcha/fisiologia , Humanos , Síndrome da Dor Patelofemoral/etiologia , Síndrome da Dor Patelofemoral/fisiopatologia , Corrida/fisiologia , Resultado do Tratamento
6.
Clin Podiatr Med Surg ; 38(3): 291-302, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34053645

RESUMO

Pes cavus is a complicated, multiplanar deformity that requires a thorough understanding in order to provide the appropriate level of care. The foot and ankle surgeon should perform a comprehensive examination, including a neurologic evaluation, in the workup of this patient population. Understanding the cause of the patient's deformity is a critical step in predicting the disease course as well as the most acceptable form of treatment. The surgical correlation with the patient's pathologic anatomy requires an in-depth clinical evaluation, in addition to the radiographic findings, as the radiographic findings do not necessarily correlate with the patient's discomfort.


Assuntos
Pé Cavo/fisiopatologia , Pé Cavo/cirurgia , Articulação do Tornozelo/fisiopatologia , Contratura/fisiopatologia , Fáscia/fisiopatologia , Fasciíte Plantar/fisiopatologia , Ossos do Pé/fisiopatologia , Marcha/fisiologia , Humanos , Músculo Esquelético/fisiopatologia , Procedimentos Ortopédicos , Pé Cavo/etiologia , Dedos do Pé/fisiopatologia
7.
BMC Neurol ; 21(1): 201, 2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34006233

RESUMO

BACKGROUND: Characterization of prediagnostic Parkinson's Disease (PD) and early prediction of subsequent development are critical for preventive interventions, risk stratification and understanding of disease pathology. This study aims to characterize the role of the prediagnostic period in PD and, using selected features from this period as novel interception points, construct a prediction model to accelerate the diagnosis in a real-world setting. METHODS: We constructed two sets of machine learning models: a retrospective approach highlighting exposures up to 5 years prior to PD diagnosis, and an alternative model that prospectively predicted future PD diagnosis from all individuals at their first diagnosis of a gait or tremor disorder, these being features that appeared to represent the initiation of a differential diagnostic window. RESULTS: We found many novel features captured by the retrospective models; however, the high accuracy was primarily driven from surrogate diagnoses for PD, such as gait and tremor disorders, suggesting the presence of a distinctive differential diagnostic period when the clinician already suspected PD. The model utilizing a gait/tremor diagnosis as the interception point, achieved a validation AUC of 0.874 with potential time compression to a future PD diagnosis of more than 300 days. Comparisons of predictive diagnoses between the prospective and prediagnostic cohorts suggest the presence of distinctive trajectories of PD progression based on comorbidity profiles. CONCLUSIONS: Overall, our machine learning approach allows for both guiding clinical decisions such as the initiation of neuroprotective interventions and importantly, the possibility of earlier diagnosis for clinical trials for disease modifying therapies.


Assuntos
Doença de Parkinson/diagnóstico , Marcha/fisiologia , Análise da Marcha , Humanos , Aprendizado de Máquina , Estudos Retrospectivos , Medição de Risco , Tremor
8.
Health Qual Life Outcomes ; 19(1): 139, 2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-33952260

RESUMO

BACKGROUND: To develop a priority-based patient/parent reported outcome measure for children with lower-limb differences (LD) by adapting the Gait Outcomes Assessment List (GOAL) questionnaire. METHODS: Guided by a conceptual framework of patient priorities, the GOAL questionnaire was iteratively modified and its sensibility evaluated by field-testing it on children with LD, and their parents. Cognitive interviews were conducted with a subgroup of these children, and an e-survey administered to a multidisciplinary group of health care professionals with expertise in paediatric LD. Findings were integrated to create the final version of the GOAL-LD. RESULTS: Twenty-five children (9-18 years), 20 parents, and 31 healthcare professionals evaluated the content and sensibility of the GOAL, with an emphasis on the relevance and importance of the items to patients' health related quality of life (HRQL). This resulted in the retention of 26 of the original 50 items, elimination of 12, modification of 12, and addition of seven new items. The new 45-item GOAL-LD questionnaire was shown to be sensible, and its content deemed important. CONCLUSIONS: The GOAL-LD questionnaire has a high level of face and content validity, and sensibility. It comprehensively captures the HRQL goals and outcomes that matter to children with LD and their parents. Following further psychometric evaluation, the GOAL-LD may serve as a much needed patient and parent reported outcome measure for this population.


Assuntos
Marcha/fisiologia , Pessoal de Saúde/psicologia , Extremidade Inferior/fisiologia , Pais/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Avaliação de Sintomas/normas , Adolescente , Adulto , Criança , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Psicometria/normas , Psicometria/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Avaliação de Sintomas/estatística & dados numéricos , Adulto Jovem
9.
Knee ; 30: 305-313, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34015587

RESUMO

BACKGROUND: Varus alignment of the knee is a risk factor for developing knee osteoarthritis. Recently, voluntary shifting the plantar pressure distribution medially (medial foot loading) during gait has been found to reduce knee adduction angle during stance, which may lower the joint load. However, it is not yet known whether such effect would persist after long-term self-practice. This study aimed to determine whether medial foot loading can be an effective self-care protocol for reducing the knee adduction angle. METHODS: Eight subjects with asymptomatic varus knee alignment were trained on medial foot loading once in a laboratory, then carried out as self-practice for 8 weeks outside the laboratory. Spatiotemporal gait parameters and lower limb joint kinematics data were collected during natural walking prior to the training (baseline walking), during the practice session immediately after the initial training (trained walking), and during natural walking after the self-practice period (post-practice walking). RESULTS: Participants walked significantly faster after the self-practice period with longer step length compared with the baseline. The knee adduction angle at initial contact, maximum angle during stance, and mean angle during a gait cycle were significantly decreased during both the trained and post-practice walking compared with baseline. The 8-week self-practice caused larger decrements in the three angles than the single training, but no significant differences were found between the two conditions. CONCLUSIONS: Self-practice of medial foot loading walking could be an effective gait strategy to reduce the knee adduction angle. The effect could be sustained for individuals with asymptomatic varus knee alignment.


Assuntos
Marcha/fisiologia , Joelho/fisiopatologia , Caminhada/fisiologia , Fenômenos Biomecânicos , Feminino , Pé/fisiologia , Humanos , Joelho/fisiologia , Extremidade Inferior/fisiologia , Masculino , Osteoartrite do Joelho/etiologia , Modalidades de Fisioterapia , Autocuidado , Adulto Jovem
10.
Hum Mov Sci ; 77: 102798, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33857702

RESUMO

Humans readily entrain their movements to a beat, including matching their gait to a prescribed tempo. Rhythmic auditory cueing tasks have been used to enhance stepping behavior in a variety of clinical populations. However, there is limited understanding of how temporal accuracy of gait changes over practice in healthy young adults. In this study, we examined how inter-step interval and cadence deviated from slow, medium, and fast tempos across steps within trials, across trials within blocks, and across two blocks that bookended a period of practice of walking to each tempo. Participants were accurate in matching the tempo at the slow and medium tempos, while they tended to lag behind the beat at the fast tempo. We also found that participants showed no substantial improvement across steps and trials, nor across blocks, suggesting that participants had a robust ability to entrain their gait to the specified metronome tempo. However, we did find that participants habituated to the prescribed tempo, showing self-paced gait that was faster than self-paced baseline gait after the fast tempo, and slower than self-paced baseline gait after the slow tempo. These findings might represent an "after-effect" in the temporal domain, akin to after-effects consistently shown in other sensorimotor tasks. This knowledge of how healthy participants entrain their gait to temporal cues may have important implications in understanding how clinical populations acquire and modify their gait in rhythmic auditory cueing tasks.


Assuntos
Estimulação Acústica , Marcha/fisiologia , Caminhada/fisiologia , Adulto , Antropometria , Sistema Nervoso Central/fisiologia , Sinais (Psicologia) , Nível de Saúde , Voluntários Saudáveis , Audição , Humanos , Masculino , Prática Psicológica , Reprodutibilidade dos Testes , Adulto Jovem
11.
Hum Mov Sci ; 77: 102800, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33906002

RESUMO

Understanding how individuals navigate challenging accuracy demands required to register a legal jump is important in furthering knowledge of competitive long jumping. Identification of co-ordination tendencies unique to each individual emphasises the need to examine the presence of unique movement solutions and presents important information for individualisation of training environments. In this study, key measures of gait were recorded during the long jump run-ups of 8 athletes at 8 national level competitions in the 2015 and 2016 Australian track and field seasons. These gait measures were examined to identify whether different visual regulation strategies emerged for legal and foul jumps for each competitor. Emergence of different footfall variability data curves, illustrating how step adjustments were distributed across the run-up for each athlete, suggests that athletes interacted differently with features of the competition environment. This observation highlights the importance of movement adaptability as constraints change and emerge across each performance trial. Results provided further support in conceptualising the run-up as a continuous interceptive action task consisting of a series of interconnected events (i.e., individual step lengths) influencing the regulation of gait towards the take-off board. This information can be used by coaches and practitioners in designing training environments that promote athlete adaptation of more functional movement solutions closely matched to the dynamics of competition environments. Results suggest that training designs that help athletes to search, explore and exploit key sources of information from the competition environment will enhance the fit between the individual and the environment and the development of rich, adaptable movement solutions for competitive performance.


Assuntos
Atletas , Marcha/fisiologia , Movimento , Corrida/fisiologia , Atletismo , Adaptação Fisiológica , Adulto , Austrália , Feminino , Humanos , Conhecimento , Masculino , Prática Psicológica , Adulto Jovem
12.
J Neuroeng Rehabil ; 18(1): 67, 2021 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-33882948

RESUMO

BACKGROUND: Extremity weakness, fatigue, and postural instability often contribute to mobility deficits in persons after stroke. Wearable technologies are increasingly being utilized to track many health-related parameters across different patient populations. The purpose of this systematic review was to identify how wearable technologies have been used over the past decade to assess gait and mobility in persons with stroke. METHODS: We performed a systematic search of Ovid MEDLINE, CINAHL, and Cochrane databases using select keywords. We identified a total of 354 articles, and 13 met inclusion/exclusion criteria. Included studies were quality assessed and data extracted included participant demographics, type of wearable technology utilized, gait parameters assessed, and reliability and validity metrics. RESULTS: The majority of studies were performed in either hospital-based or inpatient settings. Accelerometers, activity monitors, and pressure sensors were the most commonly used wearable technologies to assess gait and mobility post-stroke. Among these devices, spatiotemporal parameters of gait that were most widely assessed were gait speed and cadence, and the most common mobility measures included step count and duration of activity. Only 4 studies reported on wearable technology validity and reliability metrics, with mixed results. CONCLUSION: The use of various wearable technologies has enabled researchers and clinicians to monitor patients' activity in a multitude of settings post-stroke. Using data from wearables may provide clinicians with insights into their patients' lived-experiences and enrich their evaluations and plans of care. However, more studies are needed to examine the impact of stroke on community mobility and to improve the accuracy of these devices for gait and mobility assessments amongst persons with altered gait post-stroke.


Assuntos
Marcha/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Dispositivos Eletrônicos Vestíveis , Humanos , Reprodutibilidade dos Testes
13.
J Rehabil Med ; 53(5): jrm00194, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-33880570

RESUMO

Gait impairments in people with Charcot Marie Tooths disease are the combined result of ankle-foot deformities, muscle weakness, and somatosensory impairments. People with Charcot-Marie-Tooth disease often experience pain and difficulties when walking, especially barefoot. They also trip and fall frequently and have a lower than normal gait speed and distance. Because these gait impairments and related complaints are disabling, clinical management aimed at improving gait is important. Management involves both conservative and surgical treatment options, each with limited scientific evidence. However, a treatment algorithm that describes both conservative and surgical treatment options is currently lacking. This study sets out a step-wise treatment algorithm, based on evidence, if available, and otherwise reflecting practice-based experience. The treatment algorithm will be of value in daily clinical practice, and will serve as a template for future research.


Assuntos
Doença de Charcot-Marie-Tooth/complicações , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/terapia , Marcha/fisiologia , Caminhada/fisiologia , Adolescente , Algoritmos , Doença de Charcot-Marie-Tooth/patologia , Criança , Feminino , Humanos , Masculino
14.
Medicine (Baltimore) ; 100(16): e25212, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879656

RESUMO

ABSTRACT: Gait rehabilitations have been abundantly performed for post-stroke patients, because gait is the most important factor for the return of post-stroke patients to daily life. However, conventional uniform gait rehabilitations tend to be tedious and reduce motivation. The aim of this study was to contribute to the development of personalized rehabilitation of gait by identifying differences in gait recovery pattern according to the paralyzed side of post-stroke patients.The gait analysis was performed on stroke patients who are right-handed and can walk independently. We retrospectively analyzed the results of pelvic movements and displacement of center of pressure (COP) during gait using corresponding equipments. To show the difference of gait recovery pattern according to the paralyzed side, we divided subjects into two groups, right (n = 19) and left (n = 20) hemiparesis group. The measured variables were as follows: tilt, obliquity, and rotation symmetries of pelvis; area, velocity, and lateral symmetry of COP.First, in the left hemiparesis group, obliquity (P < .01) and rotation (P < .01) symmetries of the movement of the pelvis were significantly improved in the follow-up compared to the initial gait analysis. In the right hemiparesis group, tilt (P < .001), obliquity (P < .001), and rotation (P < .05) symmetries were significantly improved in the follow-up compared to the initial gait analysis. Second, COP area and COP velocity values in the follow-up were significantly smaller than those in the initial gait analysis in the left (P < .001, P < .05) and right (P < .001, P < .01) hemiparesis groups. The positive value of lateral symmetry increased, although not a significant difference statistically, as walking ability improved in both groups. In the correlation analysis among variables obtained using Treadmill, there were significant positive linear relationships between the lateral symmetry and the COP area (P < .05), and between the COP velocity and the lateral symmetry (P < .001) of the follow-up gait analysis in the right hemiparesis group.It was confirmed that the gait recovery pattern differs according to the paralyzed side of post-stroke patients and the role of the intact side, such as moving the COP to the intact side, is important for the improvement of gait function in both groups.This study was registered with the Clinical Research Information Service (CRIS) of the Korea National Institute of Health (NIH), Republic of Korea (KCT0002984) and was approved by the Institutional Review Board (IRB) of the WKUGH (WKIRB [2018-25], November 28, 2018).


Assuntos
Transtornos Neurológicos da Marcha/reabilitação , Paresia/reabilitação , Recuperação de Função Fisiológica , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos , Acidente Vascular Cerebral/fisiopatologia , Idoso , Teste de Esforço , Feminino , Lateralidade Funcional , Marcha/fisiologia , Análise da Marcha , Transtornos Neurológicos da Marcha/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Movimento , Paresia/etiologia , Pelve/fisiopatologia , República da Coreia , Estudos Retrospectivos , Resultado do Tratamento
15.
Sci Data ; 8(1): 103, 2021 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-33846357

RESUMO

Understanding the lower limb kinematic, kinetic, and electromyography (EMG) data interrelation in controlled speeds is challenging for fully assessing human locomotion conditions. This paper provides a complete dataset with the above-mentioned raw and processed data simultaneously recorded for sixteen healthy participants walking on a 10 meter-flat surface at seven controlled speeds (1.0, 1.5, 2.0, 2.5, 3.0, 3.5, and 4.0 km/h). The raw data include 3D joint trajectories of 24 retro-reflective markers, ground reaction forces (GRF), force plate moments, center of pressures, and EMG signals from Tibialis Anterior, Gastrocnemius Lateralis, Biceps Femoris, and Vastus Lateralis. The processed data present gait cycle-normalized data including filtered EMG signals and their envelope, 3D GRF, joint angles, and torques. This study details the experimental setup and presents a brief validation of the data quality. The presented dataset may contribute to (i) validate and enhance human biomechanical gait models, and (ii) serve as a reference trajectory for personalized control of robotic assistive devices, aiming an adequate assistance level adjusted to the gait speed and user's anthropometry.


Assuntos
Eletromiografia , Marcha/fisiologia , Perna (Membro)/fisiologia , Músculo Esquelético/fisiologia , Caminhada , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Modelos Biológicos , Adulto Jovem
16.
Sensors (Basel) ; 21(6)2021 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-33799420

RESUMO

Parkinson's disease (PD) is a chronic movement disorder that produces a variety of characteristic movement abnormalities. The ubiquity of wrist-worn accelerometry suggests a possible sensor modality for early detection of PD symptoms and subsequent tracking of PD symptom severity. As an initial proof of concept for this technological approach, we analyzed the U.K. Biobank data set, consisting of one week of wrist-worn accelerometry from a population with a PD primary diagnosis and an age-matched healthy control population. Measures of movement dispersion were extracted from automatically segmented gait data, and measures of movement dimensionality were extracted from automatically segmented low-movement data. Using machine learning classifiers applied to one week of data, PD was detected with an area under the curve (AUC) of 0.69 on gait data, AUC = 0.84 on low-movement data, and AUC = 0.85 on a fusion of both activities. It was also found that classification accuracy steadily improved across the one-week data collection, suggesting that higher accuracy could be achievable from a longer data collection. These results suggest the viability of using a low-cost and easy-to-use activity sensor for detecting movement abnormalities due to PD and motivate further research on early PD detection and tracking of PD symptom severity.


Assuntos
Acelerometria/instrumentação , Doença de Parkinson/diagnóstico , Tremor/diagnóstico , Dispositivos Eletrônicos Vestíveis , Acelerometria/métodos , Adulto , Idoso , Bancos de Espécimes Biológicos , Marcha/fisiologia , Humanos , Aprendizado de Máquina , Pessoa de Meia-Idade , Monitorização Fisiológica , Doença de Parkinson/fisiopatologia , Punho
17.
J Neuroeng Rehabil ; 18(1): 58, 2021 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-33827607

RESUMO

BACKGROUND: Recent evidence suggests that disinhibition and/or hyperexcitation of the brainstem descending pathways and intraspinal motor network diffuse spastic synergistic activation patterns after stroke. This results in simplified or merged muscle sets (i.e., muscle modules or synergies) compared to non-impaired individuals and this leads to poor walking performance. However, the relations of how these neuromuscular deficits influence gait quality (e.g., symmetry or natural walking patterns) are still unclear. The objective of this exploratory study was to investigate the relations of modular neuromuscular framework and gait quality measures in chronic stroke individuals. METHODS: Sixteen chronic post-stroke individuals participated in this study. Full lower body three-dimensional kinematics and electromyography (EMG) were concurrently measured during overground walking at a comfortable speed. We first examined changes in gait quality measures across the number of muscle modules using linear regression model. Then, a stepwise multiple regression was used to investigate the optimal combination of the neuromuscular parameters that associates with gait quality measures. RESULTS: We observed that subjects who had a lower number of muscle modules revealed reduced function (i.e., speed) and greater asymmetry in the kinematic parameters including limb length, footpath area, knee flexion/extension, and hip abduction/adduction (all p < 0.05). We also found that the combination of input variables from the modular neuromuscular control framework significantly associated with gait quality measures (average [Formula: see text]). Those variables included variability accounted for ([Formula: see text]) information from the muscle modules and area under the EMG envelope curves of the quadriceps (i.e., rectus femoris and vastus lateralis) and tibialis anterior muscles. CONCLUSIONS: The results suggest that there exists a significant correlation between the neuromuscular control framework and the gait quality measures. This study helps to understand the underlying mechanism of disturbances in gait quality and provides insight for a more comprehensive outcome measure to assess gait impairment after stroke.


Assuntos
Transtornos Neurológicos da Marcha/etiologia , Marcha/fisiologia , Músculo Esquelético/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Caminhada/fisiologia , Adulto , Idoso , Área Sob a Curva , Fenômenos Biomecânicos , Eletromiografia , Feminino , , Transtornos Neurológicos da Marcha/fisiopatologia , Articulação do Quadril/fisiopatologia , Humanos , Articulação do Joelho/fisiopatologia , Perna (Membro) , Masculino , Pessoa de Meia-Idade
18.
Medicine (Baltimore) ; 100(9): e24931, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655958

RESUMO

ABSTRACT: Although the mutual relationship between ambulation and physical activity (PA) in people with multiple sclerosis (pwMS) has been described in several studies, there is still a lack of detailed information about the way in which specific aspects of the gait cycle are associated with amount and intensity of PA. This study aimed to verify the existence of possible relationships among PA parameters and the spatio-temporal parameters of gait when both are instrumentally assessed.Thirty-one pwMS (17F, 14 M, mean age 52.5, mean Expanded Disability Status Scale (EDSS) score 3.1) were requested to wear a tri-axial accelerometer 24 hours/day for 7 consecutive days and underwent an instrumental gait analysis, performed using an inertial sensor located on the low back, immediately before the PA assessment period. Main spatio-temporal parameters of gait (i.e., gait speed, stride length, cadence and duration of stance, swing, and double support phase) were extracted by processing trunk accelerations. PA was quantified using average number of daily steps and percentage of time spent at different PA intensity, the latter calculated using cut-point sets previously validated for MS. The existence of possible relationships between PA and gait parameters was assessed using Spearman rank correlation coefficient rho.Gait speed and stride length were the parameters with the highest number of significant correlations with PA features. In particular, they were found moderately to largely correlated with number of daily steps (rho 0.62, P< .001), percentage of sedentary activity (rho = -0.44, P < .001) and percentage of moderate-to-vigorous activity (rho = 0.48, P < .001). Small to moderate significant correlations were observed between PA intensity and duration of stance, swing and double support phases.The data obtained suggest that the most relevant determinants associated with higher and more intense levels of PA in free-living conditions are gait speed and stride length. The simultaneous quantitative assessment of gait parameters and PA levels might represent a useful support for physical therapists in tailoring optimized rehabilitative and training interventions.


Assuntos
Exercício Físico/fisiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Marcha/fisiologia , Esclerose Múltipla/complicações , Modalidades de Fisioterapia , Adolescente , Adulto , Idoso , Feminino , Seguimentos , Análise da Marcha , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/fisiopatologia , Esclerose Múltipla/reabilitação , Estudos Retrospectivos , Adulto Jovem
19.
Rev. neurol. (Ed. impr.) ; 72(5): 157-167, 1 mar., 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-202075

RESUMO

INTRODUCCIÓN: La esclerosis múltiple (EM) es una enfermedad inflamatoria desmielinizante del sistema nervioso central. Se ha propuesto la imagen motora (IM) como tratamiento para mejorar la marcha, la fatiga y la calidad de vida en esta patología. OBJETIVO: Evaluar la eficacia del abordaje mediante IM, terapia de observación de acciones (AOT) o terapia en espejo, en comparación con una modalidad diferente de rehabilitación o la no intervención en la EM. DESARROLLO: Se realizó una revisión sistemática de ensayos controlados aleatorizados. Se incluyeron estudios de los últimos 10 años que comparasen la IM frente a otras intervenciones o la no intervención en pacientes con EM. Se utilizó la escala PEDro para evaluar la calidad metodológica de los estudios incluidos. Ocho estudios cumplieron los criterios de elegibilidad. Para la fatiga, la IM y su combinación con la relajación parecen ser superiores en comparación con otros tratamientos o la no intervención. La IM combinada con música también mostró mejoras significativas en la marcha y en la calidad de vida. CONCLUSIONES: La IM combinada con ejercicios de relajación ha demostrado eficacia en el tratamiento de la fatiga, la marcha, el equilibrio, la depresión y la calidad de vida en personas con EM. La AOT resulta útil en la rehabilitación del miembro superior y en la mejora de la atención, el control ejecutivo y la activación de las redes sensoriomotoras. Son necesarios estudios de mayor calidad metodológica que respalden estos resultados y valoren su efectividad a largo plazo


INTRODUCTION: Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Motor imagery (MI) has been proposed as a treatment to improve gait, fatigue and quality of life in these dysfunctions. AIM: To assess the effectiveness of MI, action observation therapy or mirror therapy approaches compared to other rehabilitation modality or no intervention, in MS. DEVELOPMENT: A systematic review of randomized controlled trials was conducted. Studies published in the last ten years investigating MI versus other interventions or no intervention in patients with MS were included. PEDro scale was used to assess methodological quality of included studies. Eight studies met the eligibility criteria. For fatigue, the MI and its combination with relaxation seem to be superior compared with other types of interventions or no intervention. The MI combined with music also showed significant improvements in gait and quality of life (QoL). CONCLUSIONS: MI and its combination with relaxation exercises have been shown to be effective in the treatment of fatigue, gait, balance, depression and QoL in patients with MS. The action observation therapy is useful in upper limb rehabilitation and improvement in attention, executive control and activation of sensorimotor networks. Further research with high methodological quality is needed to support these findings and to evaluate their effectiveness in long term


Assuntos
Esclerose Múltipla/reabilitação , Imagens, Psicoterapia/métodos , Modalidades de Fisioterapia , Qualidade de Vida , Marcha/fisiologia , Fadiga/fisiopatologia , Equilíbrio Postural/fisiologia
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