Biomedical Engineering and Bioengineering Commons^™

Visual Oscillation Effects On Dynamic Balance Control In People With Multiple Sclerosis, Lara I. Riem, Scott A. Beardsley, Ahmed Z. Obeidat, Brian Schmit

Biomedical Engineering Faculty Research and Publications

Background: People with multiple sclerosis (PwMS) have balance deficits while ambulating through environments that contain moving objects or visual manipulations to perceived self-motion. However, their ability to parse object from self-movement has not been explored. The purpose of this research was to examine the effect of medial-lateral oscillations of the visual field and of objects within the scene on gait in PwMS and healthy age-matched controls using virtual reality (VR).

Methods: Fourteen PwMS (mean age 49 ± 11 years) and eleven healthy controls (mean age: 53 ± 12 years) participated in this study. Dynamic balance control was assessed while participants …

Task-Specific Versus Impairment-Based Training On Locomotor Performance In Individuals With Chronic Spinal Cord Injury: A Randomized Crossover Study, Jennifer K. Lotter, Christopher E. Henderson, Abby Plawecki, Molly E. Holthus, Emily H. Lucas, Marzieh M. Ardestani, Brian Schmit, George Hornby

Biomedical Engineering Faculty Research and Publications

Background. Many research studies attempting to improve locomotor function following motor incomplete spinal cord injury (iSCI) focus on providing stepping practice. However, observational studies of physical therapy strategies suggest the amount of stepping practice during clinical rehabilitation is limited; rather, many interventions focus on mitigating impairments underlying walking dysfunction. Objective. The purpose of this blinded-assessor randomized trial was to evaluate the effects of task-specific versus impairment-based interventions on walking outcomes in individuals with iSCI. Methods. Using a crossover design, ambulatory participants with iSCI >1-year duration performed either task-specific (upright stepping) or impairment-based training for up to 20 sessions over ≤6 …

Kinematic Foot Types In Youth With Pes Planovalgus Secondary To Cerebral Palsy, Juliet Amene, Joseph J. Krzak, Karen M. Kruger, Logan Killen, Haluk Altiok, Peter A. Smith, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

Background

Kinematic variability of the foot and ankle segments exists during ambulation among individuals with pes planovalgus (PPV) secondary to cerebral palsy (CP). Clinicians have previously recognized such variability through classification schemes to identify subgroups of individuals, but have been unable to identify kinematic foot types.

Research question

The purpose of this work was to identify kinematic foot types among children with PPV secondary to CP using 3-dimensional multi-segment foot and ankle kinematics during gait as inputs for principal component analysis (PCA) and K-means cluster analysis.

Methods

In a single assessment session, multi-segment foot and ankle kinematics using the …

Effects Of Spinal Fusion For Idiopathic Scoliosis On Lower Body Kinematics During Gait, Karen M. Kruger, Christina R. Garman, Joseph J. Krzak, Adam Graf, Sahar Hassani, Sergey Tarima, Peter F. Sturm, Kim W. Hammerberg, Purnendu Gupta, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

Objectives

The purpose of this study was to compare gait among patients with scoliosis undergoing posterior spinal fusion and instrumentation (PSFI) to typically developing subjects and determine if the location of the lowest instrumented vertebra impacted results.

Summary of Background Data

PSFI is the standard of care for correcting spine deformities, allowing the preservation of body equilibrium while maintaining as many mobile spinal segments as possible. The effect of surgery on joint motion distal to the spine must also be considered. Very few studies have addressed the effect of PSFI on activities such as walking and even fewer address …

Biplane Fluoroscopy For Hindfoot Motion Analysis During Gait: A Model-Based Evaluation, Janelle A. Cross, Ben Mchenry, Robert C. Molthen, Emily Exten, Taly Gilat-Schmidt, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

The purpose of this study was to quantify the accuracy and precision of a biplane fluoroscopy system for model-based tracking of in vivo hindfoot motion during over-ground gait. Gait was simulated by manually manipulating a cadaver foot specimen through a biplane fluoroscopy system attached to a walkway. Three 1.6-mm diameter steel beads were implanted into the specimen to provide marker-based tracking measurements for comparison to model-based tracking. A CT scan was acquired to define a gold standard of implanted bead positions and to create 3D models for model-based tracking. Static and dynamic trials manipulating the specimen through the capture volume …

Segmental Kinematic Analysis Of Planovalgus Feet During Walking In Children With Cerebral Palsy, Karen M. Kruger, Katherine A. Konop, Joseph Krzak, Adam Graf, Haluk Altiok, Peter A. Smith, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

Pes planovalgus (flatfoot) is a common deformity among children with cerebral palsy. The Milwaukee Foot Model (MFM), a multi-segmental kinematic foot model, which uses radiography to align the underlying bony anatomy with reflective surface markers, was used to evaluate 20 pediatric participants (30 feet) with planovalgus secondary to cerebral palsy prior to surgery. Three-dimensional kinematics of the tibia, hindfoot, forefoot, and hallux segments are reported and compared to an age-matched control set of typically-developing children. Most results were consistent with known characteristics of the deformity and showed decreased plantar flexion of the forefoot relative to hindfoot, increased forefoot abduction, and …

Lpcoms: Towards A Low Power Wireless Smart-Shoe System For Gait Analysis In People With Disabilities, Ishmat Zerin

Master's Theses (2009 -)

Gait analysis using smart sensor technology is an important medical diagnostic process and has many applications in rehabilitation, therapy and exercise training. In this thesis, we present a low power wireless smart-shoe system (LPcomS) to analyze different functional postures and characteristics of gait while walking. We have designed and implemented a smart-shoe with a Bluetooth communication module to unobtrusively collect data using smartphone in any environment. With the design of a shoe insole equipped with four pressure sensors, the foot pressure is been collected, and those data are used to obtain accurate gait pattern of a patient. With our proposed …

Using Swing Resistance And Assistance To Improve Gait Symmetry In Individuals Post-Stroke, Sheng-Che Yen, Brian D. Schmit, Ming Wu

Biomedical Engineering Faculty Research and Publications

A major characteristic of hemiplegic gait observed in individuals post-stroke is spatial and temporal asymmetry, which may increase energy expenditure and the risk of falls. The purpose of this study was to examine the effects of swing resistance/assistance applied to the affected leg on gait symmetry in individuals post-stroke. We recruited 10 subjects with chronic stroke who demonstrated a shorter step length with their affected leg in comparison to the non-affected leg during walking. They participated in two test sessions for swing resistance and swing assistance, respectively. During the adaptation period, subjects counteracted the step length deviation caused by the …

Biplanar Fluoroscopic Analysis Of In Vivo Hindfoot Kinematics During Ambulation, Janelle Ann Cross

Dissertations (1934 -)

The overall goal of this project was to develop and validate a biplanar fluoroscopic system and integrated software to assess hindfoot kinematics. Understanding the motion of the foot and ankle joints may lead to improved treatment methods in persons with foot and ankle pathologies. During gait analysis, skin markers are placed on the lower extremities, which are defined as four rigid-body segments with three joints representing the hip, knee and ankle. This method introduces gross assumptions on the foot and severely limits the analysis of in depth foot mechanics. Multi-segmental models have been developed, but are susceptible to skin motion …

Kinematic Foot Types In Youth With Equinovarus Secondary To Hemiplegia, Joseph Krzak, Daniel M. Corcos, Diane L. Damiano, Adam Graf, Donald Hedeker, Peter A. Smith, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

Background

Elevated kinematic variability of the foot and ankle segments exists during gait among individuals with equinovarus secondary to hemiplegic cerebral palsy (CP). Clinicians have previously addressed such variability by developing classification schemes to identify subgroups of individuals based on their kinematics.

Objective

To identify kinematic subgroups among youth with equinovarus secondary to CP using 3-dimensional multi-segment foot and ankle kinematics during locomotion as inputs for principal component analysis (PCA), and K-means cluster analysis.

Methods

In a single assessment session, multi-segment foot and ankle kinematics using the Milwaukee Foot Model (MFM) were collected in 24 children/adolescents with equinovarus and …

Robotic Resistance/Assistance Training Improves Locomotor Function In Individuals Poststroke: A Randomized Controlled Study, Ming Wu, Jill M. Landry, Janis Kim, Brian D. Schmit, Sheng-Che Yen, Jillian Macdonald

Biomedical Engineering Faculty Research and Publications

Objective

To determine whether providing a controlled resistance versus assistance to the paretic leg at the ankle during treadmill training will improve walking function in individuals poststroke.

Design

Repeated assessment of the same patients with parallel design and randomized controlled study between 2 groups.

Setting

Research units of rehabilitation hospitals.

Participants

Patients (N=30) with chronic stroke.

Intervention

Subjects were stratified based on self-selected walking speed and were randomly assigned to the resistance or assistance training group. For the resistance group, a controlled resistance load was applied to the paretic leg at the ankle to resist leg swing during treadmill walking. …

Effect Of Tilt Sensor Versus Heel Loading On Neuroprosthesis Stimulation Reliability And Timing For Individuals Post-Stroke During Level And Non- Level Treadmill Walking, M. Barbara Silver-Thorn

Biomedical Engineering Faculty Research and Publications

Study background: Non-level walking may adversely affect stimulation of neuroprostheses as initial programming is performed during level walking. The objectives of this study were to assess stimulation reliability of tilt and heel sensor-based neuroprosthesis stimulation during level and non-level walking, examine stimulation initiation and termination timing during level and non-level walking, and determine whether heel or tilt sensor-based stimulation control is more robust for non-level ambulation. Methods: Eight post-stroke individuals with drop foot who were able to actively ambulate within the community were selected for participation. Each subject acclimated to the neuroprosthesis and walked on a treadmill randomly positioned in …

Dynamic Balance Control During Treadmill Walking In Chronic Stroke Survivors, Eric Richard Walker

Dissertations (1934 -)

Maintaining dynamic balance is an important component of walking function that is likely impaired in chronic stroke survivors, evidenced by an increased prevalence of falls. Dynamic balance control requires maintaining the center of mass (COM) within the base of support during movement. During walking, dynamic balance control is achieved largely by modifying foot placement to adjust the base of support. However, chronic stroke survivors have difficulty with both precision control of foot placement, as well as reduced control of COM movement. The objective of this dissertation was to characterize dynamic balance control strategies during walking in chronic stroke survivors. Additionally, …

Multisegmental Foot And Ankle Motion Analysis After Hallux Valgus Surgery, Karl Canseco, Jason T. Long, Thomas Smedberg, Sergey Tarima, Richard Marks, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

Background: Gait changes in patients with hallux valgus, including altered kinematic and temporal-spatial parameters, have been documented in the literature. Although operative treatment can yield favorable clinical and radiographic results, restoration of normal gait in this population remains unclear. Segmental kinematic changes within the foot and ankle during ambulation after operative correction of hallux valgus have not been reported. The aim of this study was to analyze changes in multisegmental foot and ankle kinematics in patients who underwent operative correction of hallux valgus. Methods: A 15-camera Vicon Motion Analysis System was used to evaluate 24 feet in 19 patients with …

Comparison Of An Ankle-Foot-Orthosis And Neuroprosthesis During Level And Non-Level Walking For Individuals Post-Stroke, Michelle Beverly Gallagher

Master's Theses (2009 -)

This study used gait analysis to compare the efficacy of the two foot drop treatments (ankle-foot-orthosis and neuroprosthesis) and to contrast the stimulation control of the two different neuroprosthesis sensors during level and non-level ambulation of post-stroke individuals.

Eight subjects completed two gait analysis sessions, once while using a study-provided articulated AFO and the other while using a WalkAide. After four weeks of acclimation to the device, each subject performed two minute walking trials on a level, inclined and declined treadmill. Kinematic and heart rate data were collected for all sessions. Plantar pressure and WalkAide tilt, heel loading, and stimulation …

Analysis Of Push-Off Power During Locomotion In Children With Type 1 Osteogenesis Imperfecta, Joseph Krzak, Adam Graf, Ann Flanagan, Angela Caudill, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

Background/Purpose

Children with type 1 osteogenesis imperfecta (OI) present with abnormal gait characteristics, including reduced power generation during pushoff. However, the exact biomechanical factors associated with reduced power generation are not clearly understood. The purpose of this study was to investigate the biomechanical factors associated with a reduction in ankle power generation in children with type 1 OI.

Methods

Twenty-four participants with type 1 OI (12.5 ± 3.6 years of age) and 24 typically developing children (12.4 ± 3.7 years of age) were evaluated. Three-dimensional gait analysis, isometric plantar flexion strength using dynamometry, and pedobarography were collected on each participant. …

Implications Of Arm Restraint On Lower Extremity Kinetics During Gait, Jason T. Long, John B. Groner, Dan C. Eastwood, Timothy R. Dillingham, Prateek Grover, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

Background

Literature indicates the importance of the upper extremities in providing stability and propulsion for the body during ambulation. However, the kinetic implications of upper extremity restraint during gait are not as well documented.

Aim

The objective of this study was to examine the effect of arm restraint (unilateral and bilateral) on lower extremity joint kinetics during walking.

Methods

Twenty-three healthy young participants were instrumented for three dimensional motion analysis, and tested in four randomly ordered upper extremity restraint conditions (unrestrained, bilateral restraint, right side restraint, and left side restraint). Temporal spatial parameters and gait/phase-specific lower extremity kinetics and kinematics …

Upper Extremity Kinetics During Lofstrand Crutch-Assisted Gait In Children, Neha Bhagchandani

Master's Theses (2009 -)

Complete biomechanical analysis helps evaluate the motion during various gait patterns for the upper and lower extremities. Extensive studies have been performed to evaluate unassisted gait patterns, but very little has been accomplished for studying assisted motion. Children with pathologies such as osteogenesis imperfecta, spinal cord injury, and cerebral palsy use assistive devices such as anterior and posterior walkers, canes, Lofstrand and axillary crutches for ambulation purposes.

Statistics show that there are currently about 566,000 crutch users in the United States. The long-term crutch users in this population can suffer various upper limb pathologies associated with extensive upper extremity (UE) …

Motion Of The Multisegmental Foot In Hallux Valgus, Karl Canseco, Leah Rankine, Jason T. Long, Thomas Smedberg, Richard Marks, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

Hallux valgus is a common condition characterized by lateral deviation of the large toe and medial deviation of the first metatarsal. While some gait analyses of patients with hallux valgus have been performed using plantar pressures, very little is known about the kinematics of gait in this population. The purpose of this study was to evaluate triplanar kinematics in patients with hallux valgus using a multisegmental foot model. Materials and Methods: A 15-camera Vicon Motion Analysis System was used to evaluate the gait of 38 feet in 33 patients with mild to severe hallux valgus. The Milwaukee foot model was …

Functional Stability Of Transfemoral Amputee Gait Using The 3r80 And Total Knee 2000 Prosthetic Knee Units, M. Barbara Silver-Thorn, Christine L. Glaister

Biomedical Engineering Faculty Research and Publications

Prosthetic knee designs have become extremely sophisticated compared to early constant friction single axis mechanisms. Today, prosthetists and physicians have a wide variety of components to choose from for their transfemoral amputee patients. Unfortunately, there are little quantitative data comparing the performance of different types of prosthetic components, and prosthetic prescription is often based on empirical knowledge and experience, rather than objective comparison of prosthetic designs. This study used gait analysis to objectively evaluate the stability characteristics of two types of prosthetic knee designs, the polycentric Total Knee 2000 (Ossur, Aliso Viejo, CA) and the single axis 3R80 stance control …