Gait analysis in children affected by myelomeningocele: comparison of the various levels of lesion.

The aim of this study was to utilise the gait analysis (GA) methodology to characterise the walking act in children with different levels of myelomeningocele. To this end, we analysed 30 children (mean age 11 +/- 3 years, still able to walk without ortheses) grouped according to the site of their neurological lesion (localised from L4 down to S5); ten healthy children (mean age 9 +/- 2 years) were also analysed for comparison. Of the many kinematic and kinetic parameters provided by GA, we focused on those providing a good correlation with the level of lesion. In particular, the following parameters are presented and discussed: angle of flexion at the knee joint at the moment of contact of the foot with the ground, knee joint flexion-extension range of motion, flexion of the hip at the beginning of the stride, anterior pelvic tilt, range of rotation of the pelvis in the horizontal plane and ankle joint power. The higher the level of the neurological lesion, the more these parameters of gait were found to deviate from those measured in the control group. This study emphasises the relationship that exists between the site (level) of the neurological lesion and the individual aspects of the functional limitation associated with it.

Method for the analysis of posture and interface pressure of car drivers.

Biomechanical study of car driver posture is one of the most referenced aspects for the ergonomic design process of the whole vehicle. The aim of this work is to present a multi-factor method for the analysis of sitting posture and the resulting interactions of the car driver body with the cushion and the backrest. The proposed method, based on the combined use of an optoelectronic system for motion capture and suitable matrices of pressure sensors, has allowed the measurement of a large set of car driver posture parameters and the identification of specific sitting strategies characterising the driving posture, despite the different behaviours of the analysed subjects.

Three-dimensional easy morphological (3-DEMO) classification of scoliosis, part I.

BACKGROUND: While scoliosis has, for a long time, been defined as a three-dimensional (3D) deformity, morphological classifications are confined to the two dimensions of radiographic assessments. The actually existing 3-D classification proposals have been developed in research laboratories and appear difficult to be understood by clinicians. AIM OF THE STUDY: The aim of this study was to use the results of a 3D evaluation to obtain a simple and clinically oriented morphological classification (3-DEMO) that might make it possible to distinguish among different populations of scoliotic patients. METHOD: We used a large database of evaluations obtained through an optoelectronic system (AUSCAN) that gives a 3D reconstruction of the spine. The horizontal view was used, with a spinal reference system (Top View). An expert clinician evaluated the morphological reconstruction of 149 pathological spines in order to find parameters that could be used for classificatory ends. These were verified in a mathematical way and through computer simulations: some parameters had to be excluded. Pathological data were compared with those of 20 normal volunteers. RESULTS: We found three classificatory parameters, which are fully described and discussed in this paper: Direction, the angle between spinal pathological and normal AP axis; Shift, the co-ordinates of the barycentre of the Top View ; Phase, the parameter describing the spatial evolution of the curve. Using these parameters it was possible to distinguish normal and pathological spines, to classify our population and to differentiate scoliotic patients with identical AP classification but different 3D behaviors. CONCLUSION: The 3-DEMO classification offers a new and simple way of viewing the spine through an auxiliary plane using a spinal reference system. Further studies are currently under way to compare this new system with the existing 3-D classifications, to obtain it using everyday clinical and x-rays data, and to develop a triage for clinical use.