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1.
Appl Ergon ; 98: 103587, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34547577

RESUMO

Anterior load carriage is common in occupational work and daily activities. Our primary purpose was to systematically review previous work concerning the biomechanics of walking with anterior load carriage. A secondary goal was to conduct a meta-analysis on common gait parameters relevant to front load carriage. An electronic database search yielded eight qualified articles. Meta-analyses were performed for four gait variables: stride length, heel contact velocity, required coefficient of friction, double support time. When possible, subgroup analyses by age were conducted. Results suggest that walking with front load carriage may shorten the stride length, particularly among young adults, but has small effects on the other three variables. Findings should be interpreted with caution given the limited number of studies included and small sample size per study. Future work investigating these four variables and others is needed to further our understanding of the impact of front load carriage on gait.


Assuntos
Marcha , Caminhada , Fenômenos Biomecânicos , Fricção , Humanos , Suporte de Carga , Adulto Jovem
2.
Appl Ergon ; 98: 103593, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34600306

RESUMO

Exoskeletons have the potential to assist users and augment physical ability. To achieve these goals across users, individual variation in muscle activation patterns when using an exoskeleton need to be evaluated. This study examined individual muscle activation patterns during walking with a powered ankle exoskeleton. 60% of the participants were observed to reduce medial gastrocnemius activation with exoskeleton powered and increase with the exoskeleton unpowered during stance. 80% of the participants showed a significant increase in tibialis anterior activation upon power addition, with inconsistent changes upon power removal during swing. 60% of the participants that were able to adapt to the system, did not de-adapt after 5 min. Muscle activity patterns differ between individuals in response to the exoskeleton power state, and affected the antagonist muscle behavior during this early adaptation. It is important to understand these different individual behaviors to inform the design of exoskeleton controllers and training protocols.


Assuntos
Exoesqueleto Energizado , Robótica , Tornozelo , Articulação do Tornozelo , Fenômenos Biomecânicos , Eletromiografia , Marcha , Humanos , Músculo Esquelético , Caminhada
3.
Clin Podiatr Med Surg ; 39(1): 37-55, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34809794

RESUMO

Children with cerebral palsy (CP) are at a high risk of developing foot and ankle deformities that can impact function, brace/shoe fit, and seating. The 3 commonly observed foot and ankle segmental malalignment patterns include equinus, planovalgus, and equinovarus. Assessment of foot deformities is multifaceted, requiring the collection and integration of data from a combination of sources that include the clinical history, standardized physical examination, observational and quantitative gait analysis, GMFCS classification, and radiographic findings. Surgical procedures are determined by identifying all segmental malalignments and assessing the contribution of dynamic or flexible soft-tissue imbalance, fixed soft-tissue imbalance, and skeletal deformities.


Assuntos
Paralisia Cerebral , Pé Torto Equinovaro , Tornozelo , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/cirurgia , Paralisia Cerebral/complicações , Criança , Marcha , Humanos , Exame Físico
4.
Appl Ergon ; 99: 103635, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34740071

RESUMO

The objective of the present study was to investigate the roles of lower-limb joint proprioception in postural control during gait. Seventy-two healthy adults including 36 younger and 36 older adults participated in two experimental sessions, i.e., lower-limb joint proprioception assessment session and gait assessment session. Lower-limb joint proprioception was assessed by joint position sense errors measured at the ankle, knee and hip of the dominant side. Postural control during gait was characterized by step length, step width and local dynamic stability. Results showed that hip proprioception contributed the most to postural control during gait among the lower-limb joint proprioception components, and that mechanisms for the hip proprioception effects were different between age groups. These findings highlighted the importance of incorporating hip proprioception enhancement exercises in postural control training programs, and the necessity of considering age-related differences in the effects of hip proprioception when designing these exercises.


Assuntos
Equilíbrio Postural , Propriocepção , Idoso , Articulação do Tornozelo , Marcha , Humanos , Articulação do Joelho
5.
Int J Rehabil Res ; 44(4): 350-357, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34739006

RESUMO

Acquired brain injury (ABI) is defined as a damage to the brain that occurs after birth. Subjects post-ABI frequently suffer from dynamic balance impairments that persist years after the injury. This study aimed to investigate the effect of a perturbation method using mechatronic shoes that introduce unexpected balance perturbations on the recovery of dynamic balance and gait velocity in chronic ABI participants. In an intervention trial, 35 chronic ABI participants (stroke and traumatic brain injury) participated in 22 sessions of perturbation training, twice a week for 3 months. Dynamic balance was assessed pre- and post-training using Community Balance and Mobility Scale (CB&M). Gait velocity was also assessed in the stroke participants using the 10 Meter Walking Test (10MWT). Dynamic balance improved significantly post-training (P = 0.001). This improvement was greater than the improvement that was observed in a sub-group that was tested twice before training (P = 0.04). Sixteen participants (45.7%) out of 35 met or exceeded minimal detectable change (MDC) of the CB&M Scale. Self-paced velocity also improved significantly (P = 0.02) but only two participants (9.5%) out of 21 exceeded the MDC of 10MWT post-stroke. Our results suggest that unexpected balance perturbation training using mechatronic shoes leads to an improvement in dynamic balance and gait velocity in chronic ABI participants. The advantage of perturbation training using mechatronic shoes with respect to conventional balance training should be further examined.


Assuntos
Dano Encefálico Crônico , Lesões Encefálicas , Acidente Vascular Cerebral , Marcha , Humanos , Equilíbrio Postural
6.
Neurol India ; 69(5): 1165-1175, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34747780

RESUMO

Background: Patients with Parkinson's disease (PD) commonly use complementary and alternative medications. Yoga is a mind-body intervention that is being increasingly explored as a tool in the therapeutic armamentarium of PD. Objective: To critically evaluate the studies and summarize the utility of Yoga in PD. Material and Methods: We performed a systematic literature search in the Medline and Cochrane databases and included randomized controlled trials (RCT) of Yoga in PD. The studies were evaluated for internal validity and the relevant data were extracted. Results: A total of seven studies were included in the analysis. We collated the data on the changes in motor function, gait and balance parameters, anxiety, depression and quality of life scores observed after intervention (Yoga) in patients with PD and highlighted the limitations of these studies. Conclusion: Anxiety, depression, and balance issues in PD may benefit from Yoga. Yoga has potential as an add-on therapy in PD.


Assuntos
Doença de Parkinson , Ioga , Ansiedade , Marcha , Humanos , Doença de Parkinson/terapia , Qualidade de Vida
7.
Stud Health Technol Inform ; 285: 199-204, 2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34734874

RESUMO

Gait analysis has evolved significantly during last years due to the great development of the Medical Internet of Things (MIoT) platforms that allow an easy integration of sensors (inertial, magnetic and pressure in our case) to the complex analytics required to compute, not only relevant parameters, but also meaningful indexes. In this paper, we extend a previous development based on a fully wireless pair of insoles by implementing an updated version with more reliable and user-friendly devices, smartphone app and web front-end and back-end. We also extend previous work focused on fall analysis (with the corresponding fall risk index or FRI) with the proposal of a new surgery recovery index (SRI) to account for the individual speed recovery speed that can be measured either at clinical facilities or at home in a telemedicine environment or while doing daily life activities. This new index can be personalized for different types of surgeries that affect gait such as hip, knee, etc. This paper presents the case of hip recovery and is built on top of the clinical standard SPPB test and allows obtaining quantitative parameters directly from the sensors.


Assuntos
Análise da Marcha , Marcha , Acidentes por Quedas , Articulação do Joelho , Sapatos
8.
Artigo em Inglês | MEDLINE | ID: mdl-34770057

RESUMO

Falls are a complex problem, given their multifactorial nature, the comorbidities involved, and due to the dependency of older persons living in nursing homes. Risk, fear of falling, falls themselves, and their recurrence are the main factors behind fragility fractures, lack of independence, and increases in pain prevalence, and other comorbidities in older populations. The objectives of the present quantitative and longitudinal study were: (a) to characterize the cognitive state and fall frequency of older persons living in nursing homes; (b) to analyze the relationship between cognitive status and some fall risk factors; and (c) to associate cognitive decline, gait ability, and muscle strength of the examined institutionalized older persons with fall occurrence and recurrence over 12 months. The participants were 204 older persons who lived in Portuguese nursing homes, and data were collected from January 2019 to February 2020 by consulting medical records and applying the following instruments: the Mini-Mental State Examination, Timed Up and Go Test, and Medical Research Council Manual Muscle Testing Scale. Fall prevalence, assessed in two periods, 12 months apart, was similar in both samples (with and without cognitive decline) and close to 42%, and the annual recurrence rate was 38.3%. Older persons with no cognitive decline showed an association between gait speed and occurrence of first fall and recurrent fall (p < 0.05). Muscle strength and use of gait aid devices were not related to falls and their recurrence, regardless of mental state.


Assuntos
Acidentes por Quedas , Disfunção Cognitiva , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/epidemiologia , Medo , Marcha , Humanos , Estudos Longitudinais , Força Muscular , Equilíbrio Postural , Estudos de Tempo e Movimento
9.
Sensors (Basel) ; 21(21)2021 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-34770283

RESUMO

We present the use of a single inertial measurement unit (IMU) worn on the thigh to produce stride-by-stride estimates of walking speed and its spatiotemporal determinants (i.e., stride time and stride length). Ten healthy and eight post-stroke individuals completed a 6-min walk test with an 18-camera motion capture system used for ground truth measurements. Subject-specific estimation models were trained to estimate walking speed using the polar radius extracted from phase portraits produced from the IMU-measured thigh angular position and velocity. Consecutive flexion peaks in the thigh angular position data were used to define each stride and compute stride times. Stride-by-stride estimates of walking speed and stride time were then used to compute stride length. In both the healthy and post-stroke cohorts, low error and high consistency were observed for the IMU estimates of walking speed (MAE < 0.035 m/s; ICC > 0.98), stride time (MAE < 30 ms; ICC > 0.97), and stride length (MAE < 0.037 m; ICC > 0.96). This study advances the use of a single wearable sensor to accurately estimate walking speed and its spatiotemporal determinants during both healthy and hemiparetic walking.


Assuntos
Velocidade de Caminhada , Caminhada , Fenômenos Biomecânicos , Marcha , Humanos , Movimento (Física) , Coxa da Perna
10.
Sensors (Basel) ; 21(21)2021 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-34770340

RESUMO

Parkinson's disease (PD) is the second most common neurodegenerative disorder affecting over 6 million people globally. Although there are symptomatic treatments that can increase the survivability of the disease, there are no curative treatments. The prevalence of PD and disability-adjusted life years continue to increase steadily, leading to a growing burden on patients, their families, society and the economy. Dopaminergic medications can significantly slow down the progression of PD when applied during the early stages. However, these treatments often become less effective with the disease progression. Early diagnosis of PD is crucial for immediate interventions so that the patients can remain self-sufficient for the longest period of time possible. Unfortunately, diagnoses are often late, due to factors such as a global shortage of neurologists skilled in early PD diagnosis. Computer-aided diagnostic (CAD) tools, based on artificial intelligence methods, that can perform automated diagnosis of PD, are gaining attention from healthcare services. In this review, we have identified 63 studies published between January 2011 and July 2021, that proposed deep learning models for an automated diagnosis of PD, using various types of modalities like brain analysis (SPECT, PET, MRI and EEG), and motion symptoms (gait, handwriting, speech and EMG). From these studies, we identify the best performing deep learning model reported for each modality and highlight the current limitations that are hindering the adoption of such CAD tools in healthcare. Finally, we propose new directions to further the studies on deep learning in the automated detection of PD, in the hopes of improving the utility, applicability and impact of such tools to improve early detection of PD globally.


Assuntos
Aprendizado Profundo , Doença de Parkinson , Inteligência Artificial , Marcha , Humanos , Doença de Parkinson/diagnóstico , Fala
11.
Sensors (Basel) ; 21(21)2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34770421

RESUMO

The purpose of this retrospective study was to quantify the three-dimensional knee and ankle joint kinematics and kinetics during walking in young participants with different degrees of obesity and to identify the associated effects by stratifying the obese participants according to their BMI. Thirty-two young obese individuals (mean age 30.32 years) and 16 normal-weight age-matched individuals were tested using 3D gait analysis. Analysis of kinematic and kinetic data revealed significant differences in mechanics at knee and ankle joints in all the evaluated planes of movement. Compared to the healthy-weight participants, obese adults demonstrated less knee flexion, greater knee ab-adduction angle during the entire gait cycle and abnormalities at the knee flex-extension moment. At the ankle joint, reduced range of motion was observed together with a lower peak of ankle plantarflexor moment and power during terminal stance. These results provide insight into a potential pathway by which obesity predisposes a healthy adult for increased risk of osteoarthritis.


Assuntos
Articulação do Tornozelo , Caminhada , Adulto , Tornozelo , Fenômenos Biomecânicos , Marcha , Humanos , Articulação do Joelho , Obesidade , Amplitude de Movimento Articular , Estudos Retrospectivos
12.
Sensors (Basel) ; 21(21)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34770468

RESUMO

The position calibration of inertial measurement units (IMUs) is an important part of human motion capture, especially in wearable systems. In realistic applications, static calibration is quickly invalid during the motions for IMUs loosely mounted on the body. In this paper, we propose a dynamic position calibration algorithm for IMUs mounted on the waist, upper leg, lower leg, and foot based on joint constraints. To solve the problem of IMUs' position displacement, we introduce the Gauss-Newton (GN) method based on the Jacobian matrix, the dynamic weight particle swarm optimization (DWPSO), and the grey wolf optimizer (GWO) to realize IMUs' position calibration. Furthermore, we establish the coordinate system of human lower limbs to estimate each joint angle and use the fusion algorithm in the field of quaternions to improve the attitude calibration performance of a single IMU. The performances of these three algorithms are analyzed and evaluated by gait tests on the human body and comparisons with a high-precision IMU-Mocap reference device. The simulation results show that the three algorithms can effectively calibrate the IMU's position for human lower limbs. Additionally, when the degree of freedom (DOF) of a certain dimension is limited, the performances of the DWPSO and GWO may be better than GN, when the joint changes sufficiently, the performances of the three are close. The results confirm that the dynamic calibration algorithm based on joint constraints can effectively reduce the position offset errors of IMUs on upper or lower limbs in practical applications.


Assuntos
Marcha , Extremidade Inferior , Fenômenos Biomecânicos , Calibragem , Organotiofosfatos
13.
Sensors (Basel) ; 21(21)2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34770493

RESUMO

Gait analysis applications in clinics are still uncommon, for three main reasons: (1) the considerable time needed to prepare the subject for the examination; (2) the lack of user-independent tools; (3) the large variability of muscle activation patterns observed in healthy and pathological subjects. Numerical indices quantifying the muscle coordination of a subject could enable clinicians to identify patterns that deviate from those of a reference population and to follow the progress of the subject after surgery or completing a rehabilitation program. In this work, we present two user-independent indices. First, a muscle-specific index (MFI) that quantifies the similarity of the activation pattern of a muscle of a specific subject with that of a reference population. Second, a global index (GFI) that provides a score of the overall activation of a muscle set. These two indices were tested on two groups of healthy and pathological children with encouraging results. Hence, the two indices will allow clinicians to assess the muscle activation, identifying muscles showing an abnormal activation pattern, and associate a functional score to every single muscle as well as to the entire muscle set. These opportunities could contribute to facilitating the diffusion of surface EMG analysis in clinics.


Assuntos
Marcha , Músculo Esquelético , Criança , Eletromiografia , Humanos
14.
Sensors (Basel) ; 21(21)2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34770512

RESUMO

In the current study, our research group proposed an asymmetric lower extremity exoskeleton to enable above-knee amputees to walk with a load. Due to the absence of shank and foot, the knee and ankle joint at the amputation side of the exoskeleton lack tracking targets, so it is difficult to realize the function of assisted walking when going up and downstairs. Currently, the use of lower-limb electromyography to predict the angles of lower limb joints has achieved remarkable results. However, the prediction effect was poor when only using electromyography from the thigh. Therefore, this paper introduces hip-angle and plantar pressure signals for improving prediction effect and puts forward a joint prediction method of knee- and ankle-joint angles by electromyography of the thigh, hip-joint angle, and plantar pressure signals. The generalized regression neural network optimized by the golden section method is used to predict the joint angles. Finally, the parameters (the maximum error, the Root-Mean-Square error (RMSE), and correlation coefficient (γ)) were calculated to verify the feasibility of the prediction method.


Assuntos
Amputados , Fenômenos Biomecânicos , Marcha , Humanos , Articulação do Joelho/cirurgia , Redes Neurais de Computação
15.
Sensors (Basel) ; 21(21)2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34770524

RESUMO

Walking function disorders are typical for patients after cerebral stroke. Biofeedback technology (BFB) is currently considered effective and promising for training walking function, including in patients after cerebral stroke. Most studies recognize that BFB training is a promising tool for improving walking function; however, the data on the use of highly selective walking parameters for BFB training are very limited. The aim of our study was to investigate the feasibility of using BFB training targeting one of the basic parameters of gait symmetry-stance phase duration-in cerebral stroke patients in the early recovery period. The study included 20 hemiparetic patients in the early recovery period after the first hemispheric ischemic stroke. The control group included 20 healthy subjects. The BFB training and biomechanical analysis of walking (before and after all BFB sessions) were done using an inertial system. The mean number of BFB sessions was nine (from 8 to 11) during the three weeks in clinic. There was not a single negative response to BFB training among the study patients, either during the sessions or later. The spatiotemporal parameters of walking showed the whole syndrome complex of slow walking and typical asymmetry of temporal walking parameters, and did not change significantly as a result of the study therapy. The changes were more significant for the functioning of hip and knee joints. The contralateral hip amplitude returned to the normal range. For the knee joint, the amplitude of the first flexion increased and the value of the amplitude of hyperextension decreased in the middle of the stance phase. Concerning muscle function, the observed significant decrease in the function of m. Gastrocnemius and the hamstring muscles on the paretic side remained without change at the end of the treatment course. We obtained positive dynamics of the biomechanical parameters of walking in patients after the BFB training course. The feasibility and efficacy of their use for targeted correction need further research.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Biorretroalimentação Psicológica , Fenômenos Biomecânicos , Marcha , Humanos , Acidente Vascular Cerebral/terapia , Caminhada
16.
Sensors (Basel) ; 21(21)2021 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-34770686

RESUMO

Spinal cord injury (SCI) patients suffer from diverse gait deficits depending on the severity of their injury. Gait assessments can objectively track the progress during rehabilitation and support clinical decision making, but a comprehensive gait analysis requires far more complex setups and time-consuming protocols that are not feasible in the daily clinical routine. As using inertial sensors for mobile gait analysis has started to gain ground, this work aimed to develop a sensor-based gait analysis for the specific population of SCI patients that measures the spatio-temporal parameters of typical gait laboratories for day-to-day clinical applications. The proposed algorithm uses shank-mounted inertial sensors and personalized thresholds to detect steps and gait events according to the individual gait profiles. The method was validated in nine SCI patients and 17 healthy controls walking on an instrumented treadmill while wearing reflective markers for motion capture used as a gold standard. The sensor-based algorithm (i) performed similarly well for the two cohorts and (ii) is robust enough to cover the diverse gait deficits of SCI patients, from slow (0.3 m/s) to preferred walking speeds.


Assuntos
Análise da Marcha , Traumatismos da Medula Espinal , Algoritmos , Marcha , Humanos , Traumatismos da Medula Espinal/diagnóstico , Caminhada , Velocidade de Caminhada
17.
Artigo em Inglês | MEDLINE | ID: mdl-34769864

RESUMO

Gait and physical fitness are related to cognitive function. A decrease in motor function and physical fitness can serve as an indicator of declining global cognitive function in older adults. This study aims to use machine learning (ML) to identify important features of gait and physical fitness to predict a decline in global cognitive function in older adults. A total of three hundred and six participants aged seventy-five years or older were included in the study, and their gait performance at various speeds and physical fitness were evaluated. Eight ML models were applied to data ranked by the p-value (LP) of linear regression and the importance gain (XI) of XGboost. Five optimal features were selected using elastic net on the LP data for men, and twenty optimal features were selected using support vector machine on the XI data for women. Thus, the important features for predicting a potential decline in global cognitive function in older adults were successfully identified herein. The proposed ML approach could inspire future studies on the early detection and prevention of cognitive function decline in older adults.


Assuntos
Disfunção Cognitiva , Marcha , Idoso , Cognição , Disfunção Cognitiva/diagnóstico , Feminino , Humanos , Aprendizado de Máquina , Masculino , Aptidão Física
18.
J Pak Med Assoc ; 71(11): 2511-2514, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34783727

RESUMO

OBJECTIVE: To determine the effects of whole body vibration therapy on gait in chronic stroke patients. METHODS: The randomised, assessor-blinded, controlled clinical study was conducted at the Physiotherapy Department, Lahore General Hospital, Lahore, Pakistan, from November 2017 to April 2019, and comprised chronic stroke patients wh were randomly divided into two equal groups, with group A reciving routine physiotherapy and group B reciving whole-body vibration therapy. Both the groups received 12 sessions each. Vibration therapy was given with an amplitude of 3mm and frequency of 20Hz. Sessions comprised 5 bouts of 120 seconds with 60s rest intervals for 6 days/week for 2 weeks in erect standing position. The outcome measure was the score of timed up and go test and 10-meter walk test before and after intervention. Data was analysed using SPSS 21. RESULTS: Of the 64 patients, there were 32(50%) in each of the two groups. Significant difference was seen post-intervention in both the groups (p<0.05) although both groups were statistically same in terms of Timed Up and go Test, 10 Meter walk Test Slow Speed and 10 Meter walk Test Fast Speed (p>0.05). CONCLUSIONS: Walking speed improved with both treatments i.e. whole-body vibration therapy and routine physiotherapy in chronic stroke survivors. Clinical Trial Number: Identifier: IRCT20190328043131N1:https://www.irct.ir/user/trial/38832/view.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Terapia por Exercício , Marcha , Humanos , Equilíbrio Postural , Acidente Vascular Cerebral/terapia , Estudos de Tempo e Movimento , Vibração/uso terapêutico , Caminhada
19.
Hum Mov Sci ; 80: 102892, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34749196

RESUMO

The relative displacements of body segments during walking can be reduced to a small number of multi-joint kinematic patterns, pmk, through Principal Component Analysis (PCA). These patterns were extracted from two groups of children (n = 8, aged 6-9 years, 4 males, and n = 8, aged 10-13 years, 4 males) and 7 adults (21-29 years, 1 male), walking on a treadmill at various velocities, normalized to body stature (adimensional Froude number, Fr). The three-dimensional coordinates of body markers were captured by an optoelectronic system. Five components (pm1 to pm5) explained 99.1% of the original dataset variance. The relationship between the variance explained ("size") of each pmk and the Fr velocity varied across movement components and age groups. Only pm1 and pm2, which described kinematic patterns in the sagittal plane, showed significant differences (at p < 0.05) across pairs of age groups. The time course of the size of all the five components matched various mechanical events of the step cycle at the level of both body system and lower limb joints. Such movement components appeared clinically interpretable and lend themselves as potential markers of neural development of walking.


Assuntos
Marcha , Caminhada , Adulto , Fenômenos Biomecânicos , Criança , Humanos , Extremidade Inferior , Masculino , Análise de Componente Principal
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