Publication date: Available online 20 February 2017
Source:Gait & Posture
Author(s): Paul Vasilyev, Sean Pearson, Mahmoud El-Gohary, Mateo Aboy, James McNames
Wearable devices with embedded kinematic sensors including triaxial accelerometers, gyroscopes, and magnetometers are becoming widely used in applications for tracking human movement in domains that include sports, motion gaming, medicine, and wellness. The kinematic sensors can be used to estimate orientation, but can only estimate changes in position over short periods of time. We developed a prototype sensor that includes ultra wideband ranging sensors and kinematic sensors to determine the feasibility of fusing the two sensor technologies to estimate both orientation and position. We used a state space model and applied the unscented Kalman filter to fuse the sensor information. Our results demonstrate that it is possible to estimate orientation and position with less error than is possible with either sensor technology alone. In our experiment we obtained a position root mean square error of 5.2cm and orientation error of 4.8° over a 15 minute recording.
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Τρίτη 21 Φεβρουαρίου 2017
Transfer effects of step training on stepping performance in untrained directions in older adults: A randomised controlled trial
Publication date: Available online 21 February 2017
Source:Gait & Posture
Author(s): Yoshiro Okubo, Jasmine Menant, Manasa Udyavar, Matthew A Brodie, Benjamin K Barry, Stephen R Lord, Daina Sturnieks
BackgroundAlthough step training improves the ability of quick stepping, some home-based step training systems train limited stepping directions and may cause harm by reducing stepping performance in untrained directions. This study examines the possible transfer effects of step training on stepping performance in untrained directions in older people.MethodsFifty four older adults were randomized into: forward step training (FT); lateral plus forward step training (FLT); or no training (NT) groups. FT and FLT participants undertook a 15-minute training session involving 200 step repetitions. Prior to and post training, choice stepping reaction time and stepping kinematics in untrained, diagonal and lateral directions were assessed.ResultsSignificant interactions of group and time (pre/post-assessment) were evident for the first step after training indicating negative (delayed response time) and positive (faster peak stepping speed) transfer effects in the diagonal direction in the FT group. However, when the second to the fifth steps after training were included in the analysis, there were no significant interactions of group and time for measures in the diagonal stepping direction.ConclusionsStep training only in the forward direction improved stepping speed but may acutely slow response times in the untrained diagonal direction. However, this acute effect appears to dissipate after a few repeated step trials. Step training in both forward and lateral directions appears to induce no negative transfer effects in diagonal stepping. These findings suggest home-based step training systems present low risk of harm through negative transfer effects in untrained stepping directions.Trial registration: ANZCTR 369066.
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Source:Gait & Posture
Author(s): Yoshiro Okubo, Jasmine Menant, Manasa Udyavar, Matthew A Brodie, Benjamin K Barry, Stephen R Lord, Daina Sturnieks
BackgroundAlthough step training improves the ability of quick stepping, some home-based step training systems train limited stepping directions and may cause harm by reducing stepping performance in untrained directions. This study examines the possible transfer effects of step training on stepping performance in untrained directions in older people.MethodsFifty four older adults were randomized into: forward step training (FT); lateral plus forward step training (FLT); or no training (NT) groups. FT and FLT participants undertook a 15-minute training session involving 200 step repetitions. Prior to and post training, choice stepping reaction time and stepping kinematics in untrained, diagonal and lateral directions were assessed.ResultsSignificant interactions of group and time (pre/post-assessment) were evident for the first step after training indicating negative (delayed response time) and positive (faster peak stepping speed) transfer effects in the diagonal direction in the FT group. However, when the second to the fifth steps after training were included in the analysis, there were no significant interactions of group and time for measures in the diagonal stepping direction.ConclusionsStep training only in the forward direction improved stepping speed but may acutely slow response times in the untrained diagonal direction. However, this acute effect appears to dissipate after a few repeated step trials. Step training in both forward and lateral directions appears to induce no negative transfer effects in diagonal stepping. These findings suggest home-based step training systems present low risk of harm through negative transfer effects in untrained stepping directions.Trial registration: ANZCTR 369066.
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Predictors for anterior pelvic tilt following surgical correction of flexed knee gait including patellar tendon shortening in children with cerebral palsy
Publication date: Available online 21 February 2017
Source:Gait & Posture
Author(s): Harald Böhm, Matthias Hösl, Leonhard Döderlein
IntroductionPatellar tendon shortening procedure within single event multilevel surgeries was shown to improve crouch gait in Cerebral Palsy (CP) patients. However, one of the drawbacks associated to the correction of flexed knee gait may be increased pelvic anterior tilt with compensatory lumbar lordosis.Research questionWhich CP patients are at risk for excessive anterior pelvic tilt following correction of flexed knee gait including patellar tendon shortening?Methods32 patients with CP between 8-18 years GMFCS I&II were included. They received patellar tendon shortenings within multilevel surgery. Patients with concomitant knee flexor lengthening were excluded. Gait analysis and clinical testing was performed pre- and 24.1 (SD=1.9)months postoperatively. Patients were subdivided into more/less than 5° increase in anterior pelvic tilt. Preoperative measures indicating m. rectus and m. psoas shortness, knee flexor over-length, hip extensor and abdominal muscle weakness and equinus gait were compared between groups. Stepwise multilinear regression of the response value increase in pelvic tilt during stance phase was performed from parameters that were significantly different between groups.Results34% of patients showed more than 5° increased pelvic anterior tilt postoperatively. Best predictors for anterior pelvic tilt from preoperative measures were increased m. rectus tone and reduced hip extension during walking that explained together 39% of the variance in increase of anterior pelvic tilt.Discussionevery third patient showed considerable increased pelvic tilt following surgery of flexed knee gait. In particular patients with preoperative higher muscle tone in m. rectus and lower hip extension during walking were at risk and both features need to be addressed in the therapy.
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Source:Gait & Posture
Author(s): Harald Böhm, Matthias Hösl, Leonhard Döderlein
IntroductionPatellar tendon shortening procedure within single event multilevel surgeries was shown to improve crouch gait in Cerebral Palsy (CP) patients. However, one of the drawbacks associated to the correction of flexed knee gait may be increased pelvic anterior tilt with compensatory lumbar lordosis.Research questionWhich CP patients are at risk for excessive anterior pelvic tilt following correction of flexed knee gait including patellar tendon shortening?Methods32 patients with CP between 8-18 years GMFCS I&II were included. They received patellar tendon shortenings within multilevel surgery. Patients with concomitant knee flexor lengthening were excluded. Gait analysis and clinical testing was performed pre- and 24.1 (SD=1.9)months postoperatively. Patients were subdivided into more/less than 5° increase in anterior pelvic tilt. Preoperative measures indicating m. rectus and m. psoas shortness, knee flexor over-length, hip extensor and abdominal muscle weakness and equinus gait were compared between groups. Stepwise multilinear regression of the response value increase in pelvic tilt during stance phase was performed from parameters that were significantly different between groups.Results34% of patients showed more than 5° increased pelvic anterior tilt postoperatively. Best predictors for anterior pelvic tilt from preoperative measures were increased m. rectus tone and reduced hip extension during walking that explained together 39% of the variance in increase of anterior pelvic tilt.Discussionevery third patient showed considerable increased pelvic tilt following surgery of flexed knee gait. In particular patients with preoperative higher muscle tone in m. rectus and lower hip extension during walking were at risk and both features need to be addressed in the therapy.
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Uphill walking: Biomechanical demand on the lower extremities of obese adolescents
Publication date: Available online 20 February 2017
Source:Gait & Posture
Author(s): Gerda Strutzenberger, Nathalie Alexander, Dominik Bamboschek, Elisabeth Class, Helmut Langhof, Hermann Schwameder
The number of obesity prevalence in adolescents is still increasing. Obesity treatment programs typically include physical activity with walking being recommended as appropriate activity, but limited information exists on the demand uphill walking places on the joint loading and power of obese adolescents. Therefore, the purpose of this study was to investigate the effect of different inclinations on step characteristics, sagittal and frontal joint angles, joint moments and joint power of obese adolescents in comparison to their normal-weight peers. Eleven obese (14.5 ± 1.41 years, BMI: 31.1 ± 3.5 kg/m2) and eleven normal-weight adolescents (14.3 ± 1.86 years, BMI: 19.0 ± 1.7 kg/m2) walked with 1.11 m/s on a ramp with two imbedded force plates (AMTI, 1000 Hz) at three inclinations (level, 6°, 12°). Kinematic data were collected via an infrared-camera motion system (Vicon, 250Hz). The two-way (inclination, group) ANOVA indicated a significant effect of inclination on almost all variables analysed, with the hip joint being the most affected by inclination, followed by the knee and ankle joint. The obese participants additionally spent less time in swing phase, walked with an increased knee flexion and valgus angle and an increased peak hip flexion and adduction moment. Hip joint power of obese adolescents was especially in the steepest inclination significantly increased compared to their normal-weight peers. Obese adolescents demonstrate increased joint loading compared to their normal-weight peers and in combination with a musculoskeletal malalignment they might be prone to an increased overuse injury risk.
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Source:Gait & Posture
Author(s): Gerda Strutzenberger, Nathalie Alexander, Dominik Bamboschek, Elisabeth Class, Helmut Langhof, Hermann Schwameder
The number of obesity prevalence in adolescents is still increasing. Obesity treatment programs typically include physical activity with walking being recommended as appropriate activity, but limited information exists on the demand uphill walking places on the joint loading and power of obese adolescents. Therefore, the purpose of this study was to investigate the effect of different inclinations on step characteristics, sagittal and frontal joint angles, joint moments and joint power of obese adolescents in comparison to their normal-weight peers. Eleven obese (14.5 ± 1.41 years, BMI: 31.1 ± 3.5 kg/m2) and eleven normal-weight adolescents (14.3 ± 1.86 years, BMI: 19.0 ± 1.7 kg/m2) walked with 1.11 m/s on a ramp with two imbedded force plates (AMTI, 1000 Hz) at three inclinations (level, 6°, 12°). Kinematic data were collected via an infrared-camera motion system (Vicon, 250Hz). The two-way (inclination, group) ANOVA indicated a significant effect of inclination on almost all variables analysed, with the hip joint being the most affected by inclination, followed by the knee and ankle joint. The obese participants additionally spent less time in swing phase, walked with an increased knee flexion and valgus angle and an increased peak hip flexion and adduction moment. Hip joint power of obese adolescents was especially in the steepest inclination significantly increased compared to their normal-weight peers. Obese adolescents demonstrate increased joint loading compared to their normal-weight peers and in combination with a musculoskeletal malalignment they might be prone to an increased overuse injury risk.
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Relationship between ambulatory physical activity assessed by activity trackers and physical frailty among nursing home residents.
Publication date: Available online 20 February 2017
Source:Gait & Posture
Author(s): F. Buckinx, A. Mouton, J.Y. Reginster, J.L. Croisier, N. Dardenne, C. Beaudart, J. Nelis, E. Lambert, G. Appelboom, O. O Bruyère
BackgroundsThe aim of this study was to assess the relationship between the level of ambulatory physical activity, measured by physical activity tracker, and the clinical components of physical frailty, among nursing home residents.MethodsWe proceeded in 3 steps: (1) Validation of the physical activity tracker (i.e. the Pebble): 24 volunteer adults walked on a treadmill. The number of steps recorded by the Pebble worn by the subjects was compared with the number of steps counted by the investigators, by means of the Intra-class correlation coefficients (ICC). (2) Measurement of ambulatory physical activity, using the Pebble trackers, over a 7-day period. (3) Relationship between the results obtained with the Pebble trackers (step 2) and subjects’ clinical characteristics, linked to physical frailty.ResultsICC data, showed that the reliability of the Pebble was better when it was worn at the foot level (ICC ranged from 0.60 to 0.93 depending on the tested speed). Gait speed is also an important determinant of the reliability, which is better for low gait speed. On average, the 27 nursing home residents included in the second step of this study walked 1678.4±1621 (median=1300) steps per day. Most physical components of frailty measured in this study were significantly different between subjects who walked less than 1300 steps per day and those who were more active.ConclusionThis study showed that nursing home residents have a poor ambulatory physical activity, assessed using a physical activity tracker, which is associated with poorer physical performances and higher disability.
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Source:Gait & Posture
Author(s): F. Buckinx, A. Mouton, J.Y. Reginster, J.L. Croisier, N. Dardenne, C. Beaudart, J. Nelis, E. Lambert, G. Appelboom, O. O Bruyère
BackgroundsThe aim of this study was to assess the relationship between the level of ambulatory physical activity, measured by physical activity tracker, and the clinical components of physical frailty, among nursing home residents.MethodsWe proceeded in 3 steps: (1) Validation of the physical activity tracker (i.e. the Pebble): 24 volunteer adults walked on a treadmill. The number of steps recorded by the Pebble worn by the subjects was compared with the number of steps counted by the investigators, by means of the Intra-class correlation coefficients (ICC). (2) Measurement of ambulatory physical activity, using the Pebble trackers, over a 7-day period. (3) Relationship between the results obtained with the Pebble trackers (step 2) and subjects’ clinical characteristics, linked to physical frailty.ResultsICC data, showed that the reliability of the Pebble was better when it was worn at the foot level (ICC ranged from 0.60 to 0.93 depending on the tested speed). Gait speed is also an important determinant of the reliability, which is better for low gait speed. On average, the 27 nursing home residents included in the second step of this study walked 1678.4±1621 (median=1300) steps per day. Most physical components of frailty measured in this study were significantly different between subjects who walked less than 1300 steps per day and those who were more active.ConclusionThis study showed that nursing home residents have a poor ambulatory physical activity, assessed using a physical activity tracker, which is associated with poorer physical performances and higher disability.
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Second cause of hidden hearing loss identified
Patients who complain they can't hear their friends at a noisy restaurant, but pass a hearing test in their doctor's office, may be describing hidden hearing loss.
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Second cause of hidden hearing loss identified
Patients who complain they can't hear their friends at a noisy restaurant, but pass a hearing test in their doctor's office, may be describing hidden hearing loss.
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