Force Gait Research Articles

Time Orient Acceleration Gait Pattern Based FOG Prediction on Parkinson Patients Using Deep Learning and Wearable Sensors

The problem of predicting Freeze of Gait (FoG) on Parkinson diseased patients has been well studied. There exists number of approaches in predicting FoG, which uses sensory features, EEG data and so on. However, the methods suffer to achieve higher performance. To handle this issue, an efficient Time Orient Acceleration Gait pattern based FoG prediction model (TOAGP-FoG) is presented in this paper. The model designed to attach accelerometer sensors at different ankle and joints of the body. The sensor signals are recorded at different gait movement in long term. The sensory signals are passed to the central data server which tracks the movement signals. With the time variant signals stored by the model, the method generates Acceleration Gait Pattern with number of features. At each movement, the method analyses the patterns to compute FOG Risk Support (FoGRS) towards various gait movement. The FoG Risk Support is measured according to the movement forces produced by the patient for various gait movement in different time stamp and computes minimum gait force to be produced. Based on the FoGRS value, the method performs FoG prediction. The proposed method improves the performance of FoG prediction with higher accuracy. Other notable aspects of the suggested model include comparable performance, resiliency, real-time prediction capabilities, FOG-specific integration of data, and advanced deep learning methodologies for accurate prediction. The Special Features of TOAGP-FoG include the Multi-Sensor Configuration, Temporal Analysis, Adaptive Thresholding, Dynamic FoG Risk Support (FoGRS), and Enriched Feature Extraction. The TOAGP-FoG model offers an important breakthrough in the predictive modelling of Parkinson's disease since it integrates several features such as temporal flexibility, dynamic FoGRS computation, adaptive thresholding, enriched feature extraction, and multi-sensor configurations.

Effect of intramedullary nail stiffness on load-sharing in tibiotalocalcaneal arthrodesis: A patient-specific finite element study.

Tibiotalocalcaneal (TTC) arthrodesis is a procedure to treat severe ankle and subtalar arthropathy by providing pain free and stable fusion using IM nails. These nails can be manufactured with multiple materials and some feature the ability to dynamize the arthrodesis construct. However, the impact of IM nail material and nail dynamization on load-sharing and in the setting of bone resorption have not been quantified. This work utilized a patient-specific finite element analysis model of TTC arthrodesis to investigate IM nails with differing material moduli and the impact of nail dynamization on load-sharing and intersegmental compression in the setting of bone resorption. Each nail was virtually inserted into a patient-specific model of a hindfoot, which was segmented into the three bones of the TTC complex and assigned material properties based on the densitometry of the bone. Compression, amount of load-sharing, and stress distributions after simulated bone resorption were quantified and compared between the varying IM nails. Simulations revealed that bone segments were only subjected to 17% and 22% of dynamic gait forces in the titanium and carbon fiber nail constructs, whereas the pseudoelastic NiTi nail constructs allowed for 67% of the same. The titanium and carbon fiber nails lost all initial compression in less than 0.13mm of bone resorption, whereas the NiTi nail maintained compression through all simulated values of bone resorption. These data highlight the poor load-sharing of static nail TTC arthrodesis constructs and the ability of a pseudoelastic IM nail construct to maintain intersegmental compression when challenged with bone resorption.

Investigation of the relationship between steps required to stop and propulsive force using simple walking models

To prevent falls in the elderly, it is essential to evaluate their gait stability and identify factors that negatively affect it. Although one of the probable factors is a decrease in propulsive force of walking, the relationship between the force and the gait stability has not been fully clarified. To this end, two simple walking models were used to investigate the relationship between the propulsive force and the number of steps required to stop, denoted N. N was calculated as the number of steps required for the rimless wheel to stop and was treated as a variable which is an indirect indicator of stability. A lower N corresponds to the gait being closer to a stopped state. The propulsive force was calculated using the push-off impulse applied to the simplest walking model during the step-to-step transition. To account for the effects of the double support phase in human walking, the gravitational impulse, which is the integral of the body weight (gravitational force) over the double support time, was applied to the step-to-step transition equation of the models. The models revealed that the propulsive force is reduced by two factors: the reduction in step length and the reduction in walking speed. In the former, N increases; in the latter, N decreases. The former is consistent with previous experimental results on human gait, whereas the latter has not been experimentally investigated. These results may provide important insights in clarifying the relationship between the stability and the propulsive force in human gait.

Development of Neuro-Degenerative Diseases’ Gait Classification Algorithm Using Convolutional Neural Network and Wavelet Coherence Spectrogram of Gait Synchronization

Objective: A neurodegenerative disease (NDD) detection algorithm using a convolutional neural network (CNN) and wavelet coherence spectrogram of gait synchronization was developed to classify NDD based on gait force signals. The main purpose of this research was to help physicians with screening for NDD for early diagnosis, efficient treatment planning, and monitoring of disease progression. Methods: The NDD detection algorithm was evaluated using the existing online database from Physionet by Hausdorff <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">et al.</i> , called gait in neurodegenerative disease database, comprised of windowing, feature transformation, and classification processes. Force pattern variations among healthy control (HC) and patients with ALS, HD, and PD were distinctly observed from feature-extracted wavelet coherence spectrogram images. Results: HC was balanced because their left and right feet supported each other when walking. In patients with ALS, the left-right foot correlation was weaker than that in HC. In patients with HD, walking velocity varied, which indicated that only one foot (right or left) was dominant and sustained the entire body’s balance during movement. The left and right feet of patients with PD were correlated and coordinated in terms of supporting lower-body movements. The right foot was always on the ground to support the entire body when walking. Conclusion: The proposed NDD detection algorithm effectively differentiates gait patterns on the basis of a time-frequency spectrogram of gait force signals between HC and NDD patients with an overall sensitivity of 94.34%, specificity of 96.98%, accuracy of 96.37%, and AUC value of 0.97 using 5-fold cross-validation.

TN HYDROGELS AS A POTENTIAL ANTI-INFLAMMATORY DRUG DELIVERY SYSTEM TARGETED TO OSTEOARTHRITIC KNEES

Arthritis affects 26.3% of adults and approximately 50,000 children in the United States [1]. Hydrogel drug-delivery systems have been considered as a viable option for drug delivery to arthritic articular cartilage in the knee. To determine physiologically relevant loading, a Qualisys motion capture system was used to analyze the gait of college-aged females as they took several steps on a flat surface, then stepped onto a force plate. The motion capture and force plate data was used to determine maximum force exerted on the knee during normal gait. Three different alginate-based hydrogels, where the superior one had a triple interpenetrating graphene oxide network (TN hydrogels), were investigated for use as an antiinflammatory drug delivery system in a human knee joint. Physiologically relevant cyclic loading was performed to ensure that the TN hydrogel could withstand the force exerted in the knee. The TN hydrogel experienced a change in energy of 50% after cyclic loading (10.6 ± 15.0 Pa) and survived high stresses of 4 kPa, which is 80 magnitudes larger than observable gait forces as measured in this study. From a mechanical perspective, TN hydrogel appears to be mechanically viable for arthritis drug delivery. In addition, based on calculations and Flory-Rehner equations, the pore size of the TN hydrogel is adequate for encapsulating most NSAIDs, which have a molecule size ≤ 5μm.

Development of a Neurodegenerative Disease Gait Classification Algorithm Using Multiscale Sample Entropy and Machine Learning Classifiers.

The prevalence of neurodegenerative diseases (NDD) has grown rapidly in recent years and NDD screening receives much attention. NDD could cause gait abnormalities so that to screen NDD using gait signal is feasible. The research aim of this study is to develop an NDD classification algorithm via gait force (GF) using multiscale sample entropy (MSE) and machine learning models. The Physionet NDD gait database is utilized to validate the proposed algorithm. In the preprocessing stage of the proposed algorithm, new signals were generated by taking one and two times of differential on GF and are divided into various time windows (10/20/30/60-sec). In feature extraction, the GF signal is used to calculate statistical and MSE values. Owing to the imbalanced nature of the Physionet NDD gait database, the synthetic minority oversampling technique (SMOTE) was used to rebalance data of each class. Support vector machine (SVM) and k-nearest neighbors (KNN) were used as the classifiers. The best classification accuracies for the healthy controls (HC) vs. Parkinson’s disease (PD), HC vs. Huntington’s disease (HD), HC vs. amyotrophic lateral sclerosis (ALS), PD vs. HD, PD vs. ALS, HD vs. ALS, HC vs. PD vs. HD vs. ALS, were 99.90%, 99.80%, 100%, 99.75%, 99.90%, 99.55%, and 99.68% under 10-sec time window with KNN. This study successfully developed an NDD gait classification based on MSE and machine learning classifiers.

The Dual-Tasking Texting Effect of Cell Phone Technology on Walking

Dual-tasking is the simultaneous performance of two tasks causing a divided allocation of attentional resources. Dual-tasking is apparent in our society in the form of cell phone use while walking, which alters gait characteristics, resulting in an increased risk of injuries due to falls and collisions. This study explored the effect of cell phone texting on walking and validated the use of accelerometer technology to measure gait characteristics. Twelve young adult participants walked three times across electronic force platforms during regular walking (control), walking while reading a text (reading), walking while typing a text (texting). The results indicated that gait force patterns differed from control during texting. The results also indicated a significant correlation between measures of force and acceleration across walking conditions. The outcome of this study adds to existing literature regarding the effects of cell phone use on walking patterns and highlights the use of accelerometer technology to assess gait characteristics.

Music therapy on gait disturbance and gait analysis for Parkinson's disease using a portable gait rhythmogram

Gait disturbance is one of the most frequent and intractable motor symptoms in Parkinson’s disease (PD). The aim of this study is to develop the application of music therapy and a new method of gait analyses in PD. The subjects of this study were 20 outpatients with PD with gait disturbance. We examined whether music therapy is effective as rehabilitation for gait disturbance in PD, by using a portable gait rhythmogram. PD gait speed was significantly slow, the steps were small, the cadence was also slower compared as that of normal control. By the addition of 3-dimensional acceleration measurement, the strength of PD gait was weak compared as normal control. The regression line indicates that gait force is an essential factor for gait speed. We checked a trajectory of the accelerometer, which indicates that PD patients have a large amplitude of the mediolateral direction. The patients carried out common walking training tasks carrying a portable gait rhythmogram. The walking training eight tasks were walking 5 meters in a straight line at subjects’ usual walking speeds, fast walking, walking with hand clapping, walking in step with music of 90 BPM (beat per minute), 100 BPM, 110 BPM, and 120 BPM, and fast walking without music. We recognized an effect of the music therapy by comparing walking before and after accompanied by stimulation with music. Significant improvements were observed in stride, gait speed, cadence, acceleration, and trajectory, suggesting music therapy is effective at reducing gait disturbance in PD.

Terapia manual na recuperação funcional pós-entorse lateral de tornozelo: revisão sistemática

INTRODUÇÃO: O tornozelo é considerado uma das regiões do corpo mais propensa às lesões esportivas, sendo 70% dessas lesões entorses de tornozelo. A recidiva de entorses pode provocar um prejuízo crônico na função proprioceptiva e sensório-motora. Não existe um tratamento específico para as entorses, sendo utilizados protocolos como o PRICE, abordagem passiva, imobilização da articulação e terapia manual. OBJETIVO: Trazer informações mais consistentes que elucidem os efeitos da terapia manual na recuperação da funcionalidade do paciente. MATERIAIS E MÉTODOS: Trata-se de uma revisão sistemática baseada no PRISMA, com buscas realizadas nas bases de dados: PubMed, SciELO, LILACS e PEDro. Foram pesquisados apenas ensaios clínicos randomizados, com avaliação maior ou igual a 5/10 na escala PEDro, nos idioma português e inglês. Os estudos deveriam incluir população com idade entre 18 e 60 anos utilizando técnicas de terapia manual como: Mulligan, Maitland, mobilização neural, massoterapia, liberação miofascial, pompage e alongamento passivo. RESULTADOS: Foram incluídos 7 artigos com um total de 300 indivíduos. Os estudos incluídos investigaram a recuperação da funcionalidade de pacientes submetidos à terapia manual. Limitações: heterogeneidade no tempo de lesão. CONCLUSÃO: Os resultados evidenciaram melhora na capacidade física para correr, saltar, pousar e realizar movimentos de corte e laterais, melhora da cinemática, marcha, distribuição de descarga de peso e função global.

Percentage Contribution of Lower Limb Moments to Vertical Ground Reaction Force in Normal Gait

ObjectiveThe purpose of this study was to investigate how the hip, knee, and ankle moments in the sagittal plane contribute to the vertical ground reaction force (GRF) in healthy participants during normal speed of walking. MethodsForty healthy male individuals volunteered to participate in this study. They were filmed using 6 high-speed (120 Hz) Pro-Reflex infrared cameras (Qualisys) while walking on an Advanced Mechanical Technology Incorporation force platform. The data collected were the percentage contribution of the moments of the hip, knee, and ankle joints in the sagittal plane at the instant of occurrence of the first peak, second peak, and trough of the vertical GRF. ResultsThe results revealed that at the first peak of the GRF (loading response), the highest contribution was generated from the knee extension moment followed by the hip extension moment. Knee flexion and ankle plantar flexion moments produced a high contribution to the trough of the GRF (midstance) with approximately equal values. The second peak of the GRF was mainly produced by the ankle plantar flexion moment. ConclusionThe role of hip extension moment is secondary to knee extension moment in the first peak of GRF. Knee flexion moment is secondary to ankle plantar flexion moment in the second peak of GRF. Both knee flexion and ankle plantar flexion moments have equal contribution during midstance.

Diagnosis of Parkinson’s disease using Gait Dynamics and Images

Abstract Parkinson’s disease is a neuro-degenerative disorder in which dopamine producing neurons in the brain structure called substantia nigra has damaged entire over time. PD leads to number of modal problems and mental disabilities. This paper presents a gait dynamic technology for the early stage prediction of Parkinson’s disease and a discussion on the Image processing technologies related to PD diagnosis. The analysis of gait in Parkinson’s disease helps to understand the behaviour of the neural system and so the early detection of Parkinson’s disease is possible. This can help neurologists to improve their treatment and to give guidance in reintegrate programs. This paper introduces an efficient multi-sensor data analysis of gait force in PD with respect to healthy subjects using PARAFAC model. Tensor decomposition is proposed in the work for the analysis of multi-sensors data. The data are collected from PhysioNet gait database consist of multichannel recording from force sensors of 93 patients with PD and 73 healthy subjects.

Recurrence Quantification Analysis at work: Quasi-periodicity based interpretation of gait force profiles for patients with Parkinson disease

In this letter, making use of real gait force profiles of healthy and patient groups with Parkinson disease which have different disease severity in terms of Hoehn-Yahr stage, we calculate various heuristic complexity measures of the recurrence quantification analysis (RQA). Using this technique, we are able to evince that entropy, determinism and average diagonal line length (divergence) measures decrease (increases) with increasing disease severity. We also explain these tendencies using a theoretical model (based on the sine-circle map), so that we clearly relate them to decreasing degree of irrationality of the system as a course of gait’s nature. This enables us to interpret the dynamics of normal/pathological gait and is expected to increase further applications of this technique on gait timings, gait force profiles and combinations of them with various physiological signals.

Lower limb muscle co-contraction and joint loading of flip-flops walking in male wearers.

Flip-flops may change walking gait pattern, increase muscle activity and joint loading, and predispose wearers to foot problems, despite that quantitative evidence is scarce. The purpose of this study was to examine the lower limb muscle co-contraction and joint contact force in flip-flops gait, and compare with those of barefoot and sports shoes walking. Ten healthy males were instructed to perform over-ground walking at self-selected speed under three footwear conditions: 1) barefoot, 2) sports shoes, and 3) thong-type flip-flops. Kinematic, kinetic and EMG data were collected and input to a musculoskeletal model to estimate muscle force and joint force. One-way repeated measures ANOVA was conducted to compare footwear conditions. It was hypothesized that flip-flops would induce muscle co-contraction and produce different gait kinematics and kinetics. Our results demonstrated that the musculoskeletal model estimation had a good temporal consistency with the measured EMG. Flip-flops produced significantly lower walking speed, higher ankle and subtalar joint range of motion, and higher shear ankle joint contact force than sports shoes (p < 0.05). There were no significant differences between flip-flops and barefoot conditions in terms of muscle co-contraction index, joint kinematics, and joint loading of the knee and ankle complex (p > 0.05). The variance in walking speed and footwear design may be the two major factors that resulted in the comparable joint biomechanics in flip-flops and barefoot walking. From this point of view, whether flip-flops gait is potentially harmful to foot health remains unclear. Given that shod walking is more common than barefoot walking on a daily basis, sports shoes with close-toe design may be a better footwear option than flip-flops for injury prevention due to its constraint on joint motion and loading.

THE EFFECT OF TRANSIENT LOADING ON A FOOT-ORTHOTIC USING TEMPORAL PARAMETERS OF GAIT

This study describes a method for performing transient finite element analysis (FEA) of an assistive device using experimental parameters obtained from gait analysis. A subject displaying pathologic gait, owing to lower limb deformity, was chosen for gait study. Using CAD tools, a remedial orthotic device was designed, which is expected to improve the gait of the subject. The orthotic model was subjected to static and transient loading conditions obtained from gait study, using an FEA tool. The stress ‘hot’ zones between the two modes of analysis are studied. In addition, the experimental gait data of a healthy control group were recorded to perform univariate regression studies for predicting the peak values of the normal forces, and validated by comparing with those available in the literature. The values thus obtained may be used for static behavioral analysis of assistive devices. From the FEA results, it can be conclusively said that the orthotic model is capable of sustaining gait cycle loading. The regression studies suggest the possibility of using anthropometric data to predict gait forces and subsequently perform static and transient loading analysis of assistive devices.

A finite element study on the mechanical response of the head-neck interface of hip implants under realistic forces and moments of daily activities: Part 1, level walking.

This paper investigates the mechanical response of a modular head-neck interface of hip joint implants under realistic loads of level walking. The realistic loads of the walking activity consist of three dimensional gait forces and the associated frictional moments. These forces and moments were extracted for a 32mm metal-on-metal bearing couple. A previously reported geometry of a modular CoCr/CoCr head-neck interface with a proximal contact was used for this investigation. An explicit finite element analysis was performed to investigate the interface mechanical responses. To study the level of contribution and also the effect of superposition of the load components, three different scenarios of loading were studied: gait forces only, frictional moments only, and combined gait forces and frictional moments. Stress field, micro-motions, shear stresses and fretting work at the contacting nodes of the interface were analysed. Gait forces only were found to significantly influence the mechanical environment of the head-neck interface by temporarily extending the contacting area (8.43% of initially non-contacting surface nodes temporarily came into contact), and therefore changing the stress field and resultant micro-motions during the gait cycle. The frictional moments only did not cause considerable changes in the mechanical response of the interface (only 0.27% of the non-contacting surface nodes temporarily came into contact). However, when superposed with the gait forces, the mechanical response of the interface, particularly micro-motions and fretting work, changed compared to the forces only case. The normal contact stresses and micro-motions obtained from this realistic load-controlled study were typically in the range of 0-275MPa and 0-38µm, respectively. These ranges were found comparable to previous experimental displacement-controlled pin/cylinder-on-disk fretting corrosion studies.

Quantification of the role of tibial posterior slope in knee joint mechanics and ACL force in simulated gait

The anterior cruciate ligament (ACL) rupture is a common knee joint injury with higher prevalence in female athletes. In search of contributing mechanisms, clinical imaging studies of ACL-injured individuals versus controls have found greater medial–lateral posterior tibial slope (PTS) in injured population irrespective of the sex and in females compared to males, with stronger evidence on the lateral plateau slope. To quantify these effects, we use a lower extremity musculoskeletal model including a detailed finite element (FE) model of the knee joint to compute the role of changes in medial and/or lateral PTS by ±5° and ±10° on knee joint biomechanics, in general, and ACL force, in particular, throughout the stance phase of gait. The model is driven by reported kinematics/kinetics of gait in asymptomatic subjects. Our predictions showed, at all stance periods, a substantial increase in the anterior tibial translation (ATT) and ACL force as PTS increased with reverse trends as PTS decreased. At mid-stance, for example, ACL force increased from 181N to 317N and 460N as PTS increased by 5° and 10°, respectively, while dropped to 102N and 0N as PTS changed by –5° and –10°, respectively. These effects are caused primarily by change in PTS at the tibial plateau that carries a larger portion of joint contact force. Steeper PTS is a major risk factor, especially under activities with large compression, in markedly increasing ACL force and its vulnerability to injury. Rehabilitation and ACL injury prevention programs could benefit from these findings.

Developing, Testing and Optimising a Mouse Hindlimb Musculoskeletal Model

Stability during locomotion arises from many complex interactions which are not yet fully understood. Studies into how sensory feedback from muscle spindles contributes to this have used neuromechanical simulations, however their accuracy is limited due to the lack of available physiological data. This presentation outlines the methods used to develop a musculoskeletal model of the mouse hindlimb, which will be used to predict responses to perturbations which occur with or without sensory feedback.The 3D musculoskeletal model, which represents bones, joints and 39 muscles of the mouse hindlimb, was created using SIMM (Musculographics, USA) through a combination of muscle architecture data and I2KI enhanced microCT scanning. Architecture data, such as muscle mass, pennation angle and fibre length were gathered from microdissections, while muscle geometry was determined using I2KI microCT scanning, a non‐destructive method of determining muscle paths and attachment points. Muscle moment arms predicted by the model were found to agree with measured data from previous studies.In future work, in vivo optogenetics will be used to characterise changes in gait and muscle forces which occur in free running mice in response to induced neural and mechanical perturbations with or without sensory feedback from hindlimb muscles. These physiological data will be used to update and refine the musculoskeletal model.

Steeper posterior tibial slope markedly increases ACL force in both active gait and passive knee joint under compression

The role of the posterior tibial slope (PTS) in anterior cruciate ligament (ACL) risk of injury has been supported by many imaging studies but refuted by some in vitro works. The current investigation was carried out to compute the effect of ±5o change in PTS on knee joint biomechanics in general and ACL force/strain in particular. Two validated finite element (FE) models of the knee joint were employed; one active lower extremity musculoskeletal model including a complex FE model of the knee joint driven by in vivo kinematics/kinetics collected in gait of asymptomatic subjects, and the other its isolated unconstrained passive tibiofemoral (TF) joint considered under 1400N compression at four different knee flexion angles (0°–45°). In the TF model, the compression force was applied at the joint mechanical balance point causing no rotations in sagittal and frontal planes.Changes in PTS moderately affected muscle forces and joint contact forces at mid-stance period. Both active (at mid-stance) and passive (at all flexion angles) models showed a substantial increase in the anterior tibial translation and ACL force as PTS increased with reverse trends as PTS decreased. In the active model of gait at mid-stance, ACL force increased by 75% (from 181N to 317N) in steeper PTS but decreased by 44% (to 102N) in flatter PTS. The posterolateral bundle of ACL carried the load at smaller flexion angles with a shift to its anteromedial bundle as flexion increased. In accordance with earlier imaging studies, greater PTS is a major risk factor for ACL rupture especially in activities involving large compression forces.

ACCELEROMETRY-BASED LONG-TERM MONITORING OF MOVEMENT DISORDERS: FROM DIURNAL GAIT BEHAVIOR TO NOCTURNAL BED MOBILITY

Accelerometry-based motion analysis is widely recognized as a promising tool in health care and medical settings since it is unobtrusive, inexpensive, and capable of providing useful information on human movement disorders. Patients suffering from neurological diseases such as Parkinson's disease (PD) often exhibit a combination of multiple motion symptoms during everyday activities. Thus, there is a need in clinical practice to capture as many types of abnormal movements as possible with minimal instrumentation that does not interfere with the subject's usual behavioral patterns. This paper presents the prospect of total health monitoring with a single accelerometer-based technique. The behavior of a PD patient was continuously recorded for a period of 36 h using a portable device with a triaxial accelerometer worn on the waist. Data were analyzed by newly developed computer programs to extract relevant movement parameters that might underlie pathological motor performance. We found that the state of the disease could be quantified in terms of distinctive aspects such as gait force, synchronization between both legs, and falls during diurnal walking, and turnover and respiration during nocturnal sleep. Our method may be a useful and practical tool that enables refined clinical assessment of the overall health status of patients with motion disorders.

2A2-A07 下肢への振動呈示による歩行サポートに関する研究 : 第1報:歩行時における下肢伝搬振動の計測・再生装置の開発(触覚と力覚(2))

2A2-A07 下肢への振動呈示による歩行サポートに関する研究 : 第1報:歩行時における下肢伝搬振動の計測・再生装置の開発(触覚と力覚(2))