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Cette thèse s’adresse à la problématique de contrôle/commande et d'observation des exosquelettes du membre supérieur pour l’assistance à la mobilité des personnes qui souffrent d'un déficit moteur, caractérisé par une perte totale ou partielle des capacités motrices. Le robot utilisé pour les validations est conçu par RB3D dans le but des travaux de recherches sur les lois de commandes pour la rééducation du membre supérieur au sien du Laboratoire LISSI (Laboratoire Images, Signaux et Systèmes Intelligents) de l’UPEC, appelé ULEL (Upper Limb Exoskeleton of LISSI).Deux approches de commande d'exosquelettes pour la rééducation fonctionnelle du membre supérieur ont été proposées. La première commande est conçue sur la base d’un estimateur en-ligne des paramètres dynamiques. Cette méthode d'adaptation permet d'améliorer les performances de contrôle de ce système, et de compenser les erreurs paramétriques dues au couplage de l'exosquelette avec le membre humain.La deuxième contribution consiste en une stratégie de commande robuste basée sur les modes glissants. Cette stratégie non-linéaire, garantie la convergence des erreurs de poursuite vers zéro en temps fini lorsque le régime de glissement est atteint. Ce type de commande est connu par sa robustesse vis-à-vis les variations paramétriques et les perturbations externes. L'efficacité de la méthode proposée est démontrée expérimentalement pour le mode de rééducation passif.Dans la dernière partie de la thèse, un observateur en mode glissant d'ordre supérieur est proposé pour estimer les couples d'interactions homme-exosquelette. L'observateur proposé est capable d'estimer les efforts au niveau de l'interface d'interaction entre l'exosquelette et le membre humain, en utilisant les mesures de position et l'entrée de commande. Les résultats obtenus montrent l’efficacité des solutions proposées sur l’exosquelette ULEL. / This thesis addresses the problem of control of an upper limb exoskeleton for mobility assistance of people who suffer from a motor deficit, characterized by a total or partial loss of motor skills. The robot used is designed by RB3D for the purpose of research work on the control laws for the rehabilitation of the upper limb at LISSI Laboratory (Laboratory Images, Signals and Intelligent Systems) of the UPEC university; this exoskeleton is called ULEL (Upper Limb Exoskeleton of LISSI).Two approaches to control exoskeletons for functional rehabilitation of the upper limb have been proposed. The first control is based on an online estimator of dynamic parameters. This adaptation method makes it possible to improve the control performance of this system, and to compensate for parametric errors due to coupling the exoskeleton with the human limb.The second contribution consists of a robust control strategy based on sliding modes. This nonlinear strategy guarantees the convergence of tracking errors to zero in finite time when the sliding mode is reached. This type of control is known by its robustness with respect to parametric variations and external disturbances. The effectiveness of the proposed method is experimentally demonstrated for the passive rehabilitation mode.Finally, in the last part of this thesis, a higher order sliding mode observer is proposed to estimate interactions torques of the human-exoskeleton system. The proposed observer is able to estimate the forces at the interaction interface between the exoskeleton and the human limb, using the position measurements and the control input. The obtained results show the effectiveness of the proposed solutions using the exoskeleton ULEL.

Submitted by Jamile Barbosa da Cruz (jamile.cruz@ucsal.br) on 2016-10-06T18:28:03Z No. of bitstreams: 1 SANTOS SVB-2015.pdf: 925571 bytes, checksum: 2a8b3d6d4eff07f138a5ab08185e914d (MD5) / Approved for entry into archive by Maria Emília Carvalho Ribeiro (maria.ribeiro@ucsal.br) on 2016-11-29T19:10:53Z (GMT) No. of bitstreams: 1 SANTOS SVB-2015.pdf: 925571 bytes, checksum: 2a8b3d6d4eff07f138a5ab08185e914d (MD5) / Made available in DSpace on 2016-11-29T19:10:53Z (GMT). No. of bitstreams: 1 SANTOS SVB-2015.pdf: 925571 bytes, checksum: 2a8b3d6d4eff07f138a5ab08185e914d (MD5) Previous issue date: 2015-03-27 / A readaptação funcional é a volta do trabalhador ao seu posto de trabalho em funções compatíveis com as limitações que eventualmente tenha adquirido em seu labor. No serviço público é a investidura do servidor em cargo de atribuições e responsabilidades compatíveis com a limitação que tenha sofrido em sua capacidade física ou mental, em síntese um direito social. O presente trabalho, aborda o estudo do real alcance da readaptação, assim como, sua funcionalidade e eventuais óbices a sua aplicação, diante da singularidade do ofício policial, incluindo noções de risco, sofrimento e meio ambiente de trabalho e aqui representada pela categoria dos policiais federais. Apesar de um direito estatutário consolidado em lei, a operacionalidade deste instituto (readaptação funcional), quando aplicada a estes servidores, acusam limites e dificuldades que ainda não foram totalmente transpostas. Para confirmar esta afirmação, esta pesquisa analisou as abordagens literárias sobre a readaptação funcional, compreendendo a sua origem e evolução na legislação brasileira, cotejando-a com o entendimento do ofício policial e algumas particularidades que tocam o tema. Para isto realizou um estudo de caso de abordagem qualitativa. Estas análises partiram basicamente de dados coletados em documentos: bibliografias, bases de dados de órgãos públicos, processos administrativos e judiciais e demais pareceres de órgãos de controle interno. Ao final esta pesquisa identificou importantes marcos legais que proporcionam um cenário favorável a readaptação funcional aplicada aos servidores desta carreira, o que, infelizmente também não impediu de constatar a existência de uma dubiedade interpretativa, uma espécie de inabilidade dos gestores responsáveis em apropriar-se da atual noção e importância da readaptação funcional como forma de valorização profissional e de inclusão social no trabalho. A relevância desta pesquisa, portanto, está na peculiaridade do tema proposto, no chamamento e alerta à saúde destes profissionais e na possibilidade de uma nova percepção e abordagem sobre a readaptação funcional como direito estatutário amplo e irrestrito a toda categoria profissional, para tal desiderato, este estudo focou-se nos servidores da segurança pública no âmbito federal. / Functional rehabilitation is the return of the worker to his job in compatible with the constraints which it may have suffered in their work roles. In public service is vested in the office of server roles and responsibilities consistent with the limitation that has suffered in his physical or mental ability, in short a social right. The present work deals with the study of the actual scope of rehabilitation, as well as their functionality and possible obstacles to its implementation on the uniqueness of the police office, here represented by the category of the federal police. Although a consolidated statutory right by law, the operation of this institute (functional adaptation), when applied to these servers, accuse limits and difficulties that have not yet fully transposed. To confirm this assertion, this paper analyzed the literary approaches to functional adaptation, including its origin and evolution of Brazilian legislation, comparing it with the understanding of the police office, and some particulars touching the subject. For this case study conducted a qualitative approach. These analyzes basically left data collected from documents, bibliographies, databases of public institutions, administrative and judicial opinions, and other organs of internal control. At the end of this research identified important legal frameworks that provide a favorable environment to functional adaptation applied to this career servers, which unfortunately did not prevent him from establishing the existence of an interpretive ambiguity, a sort of inability of managers responsible for appropriating current notion and importance of functional adaptation as a form of social inclusion at work. The relevance of this research, therefore, is the peculiarity of the proposed topic, the call and warning to health professionals and those in the possibility of a new perception and approach on functional rehabilitation as broad and unfettered statutory right the entire profession, to this aim, this study focused on public safety servants at the federal level.

Cette thèse porte sur le traitement de données multi-capteurs liées à la locomotion humaine.Son objectif est de concevoir des outils pour la segmentation de la locomotion à partir d'un réseau de capteurs embarqués et appliquée à deux domaines différents: le sport avec l'ultra-marathon et la déficience causée par un symptome de la maladie de Parkinson. Pour ces deux applications, le travail peut atteindre cet objectif concerné. d'une part, les contraintes matérielles liées au réseau de capteurs, et d'autre part, les algorithmes de traitement des données. Dans un premier temps, nous avons recueilli des données multi-capteurs sur un coureur du Marathon des Sables. Le réseau des capteurs étant confronté à des conditions extrêmes, il a fallu s'adapter à des problèmes techniques avant de pouvoir proposer un outil pour segmenter et classer ces grandes quantités de données. Dans un second temps, nous avons travaillé en collaboration avec un médecin, pour comprendre au mieux le ''freezing" (symptôme perturbant la marche de certains malades atteints de la maladie de Parkinson) afin de proposer une nouvelle méthode de détection pour ce symptôme. / This thesis focuses on the treatment of multi-sensor related data locomotion humaine.Son goal is to develop tools for segmentation of locomotion from a network of embedded and applied to two different domains sensors : sport with ultra -marathon and disability caused by a symptom of Parkinson's disease . For both applications, the work can achieve this question. one hand , the physical constraints of the network sensors , and secondly , the data processing algorithms . At first , we collected multi-sensor data on a runner Marathon des Sables. The network of sensors being confronted with extreme conditions, it was necessary to adapt to technical before proposing a tool to segment and classify these large amounts of data problems. In a second step , we worked with a doctor, to understand better the '' freezing " (symptom disrupting the progress of some patients with Parkinson's disease ) to propose a new detection method for this symptom.

La rééducation fonctionnelle classique comprend des séances thérapeutiques, des exercices à domicile et des mouvements avec ou sans l'aide de thérapeutes. Cette approche classique souffre de nombreuses limitations, en raison de l’incapacité de l’expert à suivre les séances à domicile du patient et du manque de motivation du patient pour répéter les exercices sans retour. Les jeux sérieux ont été présentés comme une solution à ces problèmes. Premièrement, des exergames ont été développés à l’aide d’une méthodologie de codesign, où patients, experts et développeurs ont pris part aux procédures de conception. Le capteur Kinect a été utilisé pour capturer la cinématique en temps réel au cours de l’exercice. Ensuite, une fusion de données a été étudier entre le capteur Kinect et les unités de mesure inertielles, afin d’augmenter la précision de l’estimation de l’angle des articulations, à l’aide d’une approche système de systèmes. Le système a été évalué par des patients avec différentes pathologies au cours de multiples campagnes d'évaluation. Les résultats obtenus montrent que les jeux sérieux peuvent être une solution pour des pathologies spécifiques. En outre, les experts ont été convaincus de la pertinence clinique de ce dispositif et ont estimé que les données proposées étaient suffisantes pour évaluer la situation du patient. La mise en place de tels systèmes maximiserait l’efficacité du programme de réadaptation. D'autre part, ce système permettrait également de réduire les limitations actuellement présentes dans les programmes de rééducation classiques, permettant aux patients de visualiser leurs mouvements et aux experts de suivre l'exécution de l'exercice à domicile. / Conventional musculoskeletal rehabilitation consists of therapeutic sessions, home exercise assignment, and movement execution with or without the assistance of therapists. This classical approach suffers from many limitations, due to the expert’s inability to follow the patient’s home sessions, and the patient’s lack of motivation to repeat the same exercises without feedback. Serious games have been presented as a possible solution for these problems. This thesis was carried out in the eBioMed experimental platform of the Université de technologie de Compiège, and in the framework of the Labex MS2T. The aim of this thesis is to develop a real-time, serious gaming system for home-based musculoskeletal rehabilitation. First, exergames were developed, using a codesign methodology, where the patients, experts and developers took part in the design and implementation procedures. The Kinect sensor was used to capture real-time kinematics during each exercise. Next, data fusion was implemented between the Kinect sensor and inertial measurement units, to increase the accuracy of joint angle estimation, using a system of systems approach. In addition, graphical user interfaces were developed, for experts and patients, to suit the needs of different end-users, based on the results of an end-user acceptability study. The system was evaluated by patients with different pathologies through multiple evaluation campaigns. Obtained results showed that serious games can be a good solution for specific types of pathologies. Moreover, experts were convinced of the clinical relevance of this device, and found that the estimated data was more than enough to assess the patient’s situation during their home-based exercise sessions. Finally, during these three years, we have set the base for a home-based rehabilitation system that can be deployed at home or in a clinical environment. The implementation of such systems would maximize the efficiency of rehabilitation program, while saving the patient’s and expert’s time and money. On the other hand, this system would also reduce the limitation that are currently present in classical rehabilitation programs, allowing the patients to visualize their movements, and the experts to follow the home exercise execution.

Made available in DSpace on 2014-07-29T15:08:18Z (GMT). No. of bitstreams: 1 dissertacaoRenatoGomide.pdf: 2296595 bytes, checksum: 2dddc092b65cb82c20f3e729fd541225 (MD5) Previous issue date: 2012-05-02 / The use of computing devices used in virtual reality has been exploited to provide solutions in healthcare, specifically in functional rehabilitation. There are studies that indicate that immersion caused by the use of virtual environments in rehabilitation presents positive results on the evolution of a patient in therapy. From this information, there was motivation for this study, which aims at developing a low cost solution consisting in a virtual environment for upper limbs rehabilitation. This work describes the internal elements of the computing device and also the development of the virtual environment. The user interacts with the virtual environment through computer vision techniques, having a webcam as a data input device. Acquired images by the webcam are processed so that an object of interest may be in evidence by algorithms of image segmentation. There were analyzed five techniques of image segmentation in RGB and HSV color spaces. By the results obtained in the development environment, it wasn't possible to classify the best method of segmentation, and the performance of the methods varies according to the color of the object of interest and lighting of the external environment. The virtual environment was modeled after technical visits made in rehabilitation center supported by physiotherapists and occupational therapists. The virtual environment was tested only in research environment. Therefore it is necessary to employ the system in rehabilitation clinic in partnership with health professionals so that there is a validation of the virtual environment developed in this project in the area of rehabilitation. / A utilização da computação em dispositivos de realidade virtual tem sido explorada para prover soluções na área da saúde, mais especificamente em recuperação funcional. Há estudos que indicam que a imersão causada pela utilização de ambientes virtuais em reabilitação apresenta resultados positivos sobre a evolução do quadro de um paciente em terapia motora. A partir desta informação, houve motivação para este estudo, que tem como objetivo principal desenvolver um ambiente virtual de baixo custo para recuperação funcional de membros superiores. O ambiente virtual foi modelado a partir de visitas técnicas realizadas em centro de reabilitação com o apoio de fisioterapeutas e terapeutas ocupacionais. Além disso, este trabalho descreve quais elementos internos do dispositivo computacional e também qual ambiente virtual foram desenvolvidos. O usuário interage com o ambiente virtual por meio de técnicas de visão computacional, tendo uma webcam como dispositivo de entrada de dados. As imagens adquiridas pela webcam são processadas de modo que um objeto de interesse fique em evidência por meio de segmentação da imagem. Foram analisadas cinco técnicas de segmentação de imagem nos espaços de cores RGB e HSV. Por meio dos resultados obtidos no ambiente de desenvolvimento, não foi possível classificar o melhor método de segmentação, pois o desempenho de cada um varia de acordo com a cor do objeto de interesse e da iluminação do ambiente externo. O ambiente virtual foi testado apenas em laboratório e em ambiente de desenvolvimento. Portanto, em parceria com profissionais da saúde, é necessário empregar o sistema em clínica de reabilitação para que haja a validação do ambiente virtual desenvolvido neste projeto.

Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2014-10-15T21:29:54Z No. of bitstreams: 2 Dissertacao - Fabrício Leonardo Leopoldino - 2013.pdf: 15282157 bytes, checksum: d2e674ff7b57f0a88c10f3ee9a9b248d (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2014-10-16T17:22:45Z (GMT) No. of bitstreams: 2 Dissertacao - Fabrício Leonardo Leopoldino - 2013.pdf: 15282157 bytes, checksum: d2e674ff7b57f0a88c10f3ee9a9b248d (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-10-16T17:22:45Z (GMT). No. of bitstreams: 2 Dissertacao - Fabrício Leonardo Leopoldino - 2013.pdf: 15282157 bytes, checksum: d2e674ff7b57f0a88c10f3ee9a9b248d (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-09-18 / This study proposes a Virtual Environment to support the functional rehabilitation of the upper limbs, using the Microsoft Kinect sensor motion capture. It is organized in five chapters: 1) Use of Virtual Environments in the process of functional rehabilitation of people affected by an Encephalic Vascular Accident; 2) Technologies used, 3) AVARFMS development; 4) Discussion; 5) Conclusions. Sequelae of Encephalic Vascular Accident impair the development of the Activities of Daily Living. Rehabilitation does not consist in a process that seeks only the adaptation of the patient, but in a real effort with the goal of promoting the development of people creative and inclusive functionality. With the emergence of Virtual Environments and greater integration between the areas of rehabilitation medicine and information systems as well as the appearance of low cost motion sensors (Microsoft Kinect, for example), a new paradigm begins to be postulated between researchers in these two areas: the study and development of virtual environments to assist in the rehabilitation process. With the goal of providing a fun tool to patients who have been affected by an encephalic vascular accident and offering therapists ways to measure (qualitatively and quantitatively) the evolution of the patient treatment, it is proposed a virtual environment that uses the motion sensor Kinect, created by Microsoft. The findings presented in this study show that the proposed objectives were achieved. / O presente trabalho propõe um ambiente virtual de apoio à reabilitação funcional de membros superiores, utilizando o sensor de captura de movimento da Microsoft, Kinect. Está dividido em cinco capítulos: 1) Utilização de Ambientes Virtuais no Processo de Reabilitação Funcional de Pessoas Acometidas por um Acidente Vascular Encefálico; 2) Tecnologias Utilizadas; 3) Desenvolvimento do AVARFMS; 4) Discussão e 5) Conclusões. O Acidente Vascular Encefálico (AVE) deixa sequelas que comprometem o desenvolvimento das Atividades de Vida Diária. A reabilitação não consiste em um processo que busca apenas a adaptação do paciente, mas em um esforço concreto, com o objetivo de promover o desenvolvimento máximo da funcionalidade criadora e inclusiva das pessoas. Com o surgimento dos Ambientes Virtuais (AVs) e a maior integração entre as áreas da medicina de reabilitação e sistemas de informação, bem como o aparecimento de Sensores de Movimento (Microsoft Kinect, por exemplo) de baixo custo, um novo paradigma começa a ser postulado entre pesquisadores destas duas áreas: o estudo e desenvolvimento de AVs para auxiliar no processo de reabilitação. Com o objetivo de fornecer uma ferramenta divertida aos pacientes que foram acometidos por um AVE e oferecer aos terapeutas maneiras de medir (qualitativamente e quantitativamente) a evolução do tratamento de um paciente, é proposto um Ambiente Virtual que utiliza o sensor de movimentos Kinect, criado pela Microsoft. As conclusões apresentadas neste trabalho mostram que os objetivos propostos pelo ambiente foram atingidos

Orientador: Rita Moura Fortes / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Civil, Arquitetura e Urbanismo / Made available in DSpace on 2018-08-05T20:06:15Z (GMT). No. of bitstreams: 1 Reis_Marcusdos_M.pdf: 5198803 bytes, checksum: 2ebe7ace919af514d5ddb6cb2fc7b863 (MD5) Previous issue date: 2005 / Resumo: Revestimentos de cimento asfáltico de petróleo são utilizados como pavimentos de vias, as quais necessitam de manutenção preventiva e corretiva. Neste último contexto surgiu o microrrevestimento asfáltico a frio, que tem sido aplicado com sucesso como sistema corretivo de deficiências funcionais do pavimento. Como a mistura é composta por aproximadamente 75% de agregados, estes passam a ter um papel relevante. Esta pesquisa apresenta um estudo da influência da granulometria dos agregados no desempenho do microrrevestimento asfáltico a frio no ensaio de deslocamento lateral e vertical. Esta avaliação foi realizada com auxílio do Simulador de Tráfego, conhecido como L WT - Load Wheel Tester, tendo sido desenvolvido um estudo para verificação da repetitividade deste equipamento e dos ensaios. Na moldagem foram empregadas composições de agregados especificadas pelas faixas granulométricas das normas usuais. Deste modo, este estudo apresenta diretrizes para a escolha adequada da granulometria quando da elaboração de projetos de microrrevestimento asfáltico a frio / Abstract: Surface layer are used as asphalt pavements, which need preventive and corrective maintenance. In this last context the cold micro surfacing appeared, that has been applied with success as system corrective of pavement functional deficiencies. As the mixture is composed for approximately 75% of aggregate these theme is very important. This research presents a study of the influence of the aggregate gradations in the cold micro surfacing performance in the lateral and vertical displacement. This evaluation was accomplished using Traffic Simulator, called LWT - Load Wheel Tester. Also it was developed a study repeatability of this equipment and the proceedings. This research used the usual aggregate gradations presented in the respective standards. Finally, this study presents guidelines for the appropriate choice of gradation to use in design of cold micro surfacing / Mestrado / Transportes / Mestre em Engenharia Civil

Abstract Achilles tendon rupture (ATR) conservative treatment result usually good clinical outcome, but despite the treatment method calf muscle strength deficit persist. Recent evidence suggests that surgery might surpass conservative treatment in restoring strength after ATR, but structural explanations for surgery-related improved strength remain uncertain. The purposes of this thesis were to compare calf muscle isokinetic strength recovery, calf muscle volume, fatty degeneration and AT elongation after conservative treatment or after open surgical repair of ATR. An additional aim was to assess the role of fascial augmentation in terms of calf muscle isokinetic strength recovery, AT elongation, calf muscle volume atrophy and fatty degeneration, and their relationship with calf muscle isokinetic strength in long-term follow-up after ATR surgery. Surgery resulted in 10% to 18% greater plantar flexion strength (P = 0.037) compared to conservative treatment. The mean differences between affected and healthy soleus muscle volumes were -18% after surgery and -25% after conservative treatment (P = 0.042). At 18 months, AT were, on average 19 mm longer in patients treated conservatively compared to surgery (P < 0.001). At 18 months, patients with greater (2–3) fatty degeneration had lower soleus muscle volumes and plantar flexion strength in the healthy leg. In long term, augmentation did not affect any of the strength variables, but the injured side showed 12% to 18% strength deficit compared with the healthy side (P < 0.001). The AT was, on average, 12 mm longer in the affected leg than in the healthy leg (P < 0.001). The mean soleus muscle volume was 13% lower in the affected leg than in the healthy leg (P < 0.001). The mean volumes of the medial- and lateral gastrocnemius muscles were 12% and 11% lower in the affected leg than in the healthy leg, respectively (P < 0.001). AT elongation correlated substantially with plantar strength deficit (ρ = 0.51, P < 0.001) and with both gastrocnemius (ρ = 0.46, P = 0.001) and soleus muscle atrophy (ρ = 0.42, P = 0.002). Calf muscle fatty degeneration was more common in the affected leg compared healthy leg (P ≤ 0.018). In conclusion, surgery of ATR restored calf muscle isokinetic strength earlier and more completely than conservative treatment. Conservative treatment resulted in greater soleus muscle atrophy and AT elongation compared surgery, which may partly explain the surgery related better strength results. Augmentation provided no long-term benefits compared with simple suturation, and a 12 to 18% plantar flexion strength deficit compared to the healthy side persisted. AT elongation may explain the smaller calf muscle volumes, greater fatty degeneration, and plantar flexion strength deficit observed in long-term follow-up after surgical repair of ATR. / Tiivistelmä Akillesjännerepeämän (ATR) konservatiivisella ja leikkaushoidolla hoidolla saavutetaan hyvät kliiniset tulokset. Viimeisimmät tutkimukset kuitenkin viittaavat leikkaushoidolla saavutettavan paremmat voimat kuin konservatiivisella hoidolla, mutta rakenteelliset selitykset leikkaushoidon paremmalle pohjelihaksen voimille ovat epäselviä. Työn tarkoituksena oli verrata pohjelihaksen isokineettisten voimien palautumista, pohjelihastilavuuksia, rasvadegeneraatiota ja akillesjänteen (AT) pidentymistä ATR:n konservatiivisen- ja leikkaushoidon jälkeen. Tarkoituksena oli arvioida lihaskalvovahvikkeen merkitystä pohjelihaksen isokineettisten voimien palautumisessa pitkäaikaisseurannassa. Lisäksi tutkimme AT pidentymisen, pohjelihastilavuuksien ja rasvadegeneraation suhdetta pohjelihaksen isokineettisiin voimiin ATR:n leikkaushoidon jälkeen 14 v seurannassa. Leikkaushoidolla saavutettiin 10–18 % paremmat pohjelihaksen voimat verrattuna konservatiiviseen hoitoon. Leikkaushoidon jälkeen soleuslihasten tilavuuksien puoliero terveen jalan hyväksi oli 18 % ja konservatiivisen hoidon jälkeen 25 %. 18 kk kohdalla konservatiivisesti hoidettujen AT oli 19 mm pidempi verrattuna leikkauksella hoidettuihin. 18 kk kohdalla potilaat, joilla vamma jalan soleuslihaksen rasva-degeneraatio oli korkea (2–3), kärsivät suuremmasta soleuslihaksen atrofiasta ja pohjelihaksen voima puolierosta. Voimat eivät muuttuneet 12 kk ja 14 v kontrollien välillä. Lihaskalvovahvikkeella ei ollut merkitystä voimien palautumisessa pelkkään suoraan ompeluun verrattuna, mutta vammapuoli jäi 10–18 % heikommaksi verrattuna terveeseen jalkaan. Vammajalan akillesjänne oli 12 mm pidempi terveeseen jalkaan verrattuna. Vammajalan kolmipäisen pohjelihaksen tilavuus oli 11–13 % pienempi verrattuna terveeseen jalkaan. Akillesjänteen pituus korreloi pohjelihaksen voimapuolieron sekä pohjelihasatrofian kanssa. Akillesjännerepeämän leikkaushoidolla pohjelihaksen isokineettiset voimat palautuvat nopeammin ja täydellisemmin kuin konservatiivisella hoidolla. Leikkaushoitoon verrattuna konservatiivinen hoito johtaa suurempaan soleuslihaksen atrofiaan ja akillesjänteen pidentymään, mikä selittää osittain leikkaushoidon paremmat voimatulokset. 14 v seurannassa lihaskalvovahvikkeesta ei ole etua akillesjännerepeämän leikkaushoidossa. Akillesjännerepeämän leikkaushoidosta huolimatta potilaalle jää terveeseen jalkaan verrattuna 10–18 % pohjelihasten voimapuoliero. Akillesjänteen pidentyminen mahdollisesti selittää pohjelihasten atrofian, rasvadegeneraation ja pysyvän pohjelihasten voimapuolieron akillesjännerepeämän leikkaushoidon jälkeen 14 v seurannassa.