Rocker profiles are one of the most commonly prescribed footwear modifications provided to individuals with impaired rollover. Impaired rollover is caused due to loss of neuromuscular function (i.e. stoke) or orthotic ankle constraint. When rollover is impaired, continued forward progression is interrupted and walking gait becomes less efficient (i.e. increased energy expenditure). Rocker profile footwear modifications are designed to mimic the functions of the anatomical ankle-foot rockers and provide its users with a smooth and efficient rollover. However, while there is theory governing the design of a rocker profile and subjective descriptions of rocker profile function, the extent to which a rocker profile footwear provides rollover has not yet been quantified. The aim of this study was to quantify effective and ineffective rollover and test whether our rocker profile provides effective rollover. We hypothesized that healthy subjects (n=4) walking with orthotic ankle constraint and the rocker profile (STOP) would have no change in rollover and energy expenditure outputs compared to walking with orthotic ankle free and rocker profile (FREE); but that healthy subjects (n=4) walking in STOP would have a change in rollover and energy expenditure outputs compared to walking with orthotic ankle constraint and no rocker profile (STOP-NR). To test this hypothesis, rollover was quantified as stance phase duration, cadence and radius of curvature and energy expenditure was quantified as heart rate and rating of perceived exertion. In addition to these outputs, we analyzed the ground reaction forces and duration of stance in early, middle and late stance period to determine the effects of the rocker profile footwear components. Through the rollover and energy expenditure outputs of the STOP, FREE and STOP-NR conditions, we quantified effective rollover as 0.29 (0.01) radius of curvature with a heart rate of 110.5(6.7) bpm and ineffective rollover as 0.69(0.12) radius of curvature with a heart rate of 131.5 (8.1) bpm. By creating this scale, we were able to determine that our rocker profile provided effective rollover (0.34[0.04] radius of curvature with a heart rate of 111.3[8.3] bpm). However, a future study with a greater sample size is needed to confirm these results.

Disregard for patient-specific joint-level variability may be related to decreased functional ability, poor implant longevity and dissatisfaction post-TKA. The purpose of this study was to, 1) compare pre and post-implant intraoperative passive knee adduction angle kinematic patterns and characterize the effect of surgical intervention on each pattern, 2) examine the association between passive pre and post-implant knee kinematics measured intraoperatively and dynamic knee kinematics and kinetics pre and post-TKA measured during gait, and 3) compare dynamic post-TKA kinematic and kinetic patterns between patient-specific knee recipients and traditional TKA recipient. Patients received a TKA using the Stryker Precision Knee navigation system capturing pre/post-implant kinematics through a passive range of flexion. One-week prior and 1-year post-TKA patients underwent three-dimensional gait analysis. Knee joint waveforms were calculated according to the joint coordinate system. Principal component analysis (PCA) was applied to frontal plane gait angles, moments and navigation angles. Paired two- tailed t-tests were used to compare principal component (PC) scores between pre and post-implant patterns, and a one-way ANOVA was used to test if post-implant patterns were significantly different from zero. Two-tailed Pearson correlation coefficients tested for associations between navigation and gait PCscores, and an un-paired two-tailed t-test was used to compare PCscores between patient-specific and traditional TKA groups. Six different passive kinematic phenotypes were captured pre-implant. Although some waveform patterns persisted at small magnitudes post-implant (PC1 and PC3: p<0.001), curves remained within the clinically acceptable alignment range through passive motion. A positive correlation was found between navigation adduction angle PC1 and gait adduction moment PC1 pre and post-TKA (p<0.001, r=0.79; p<0.01 r=0.67), and a negative correlation between navigation adduction angle PC1 and gait adduction angle PC1 post-TKA (p=0.03, r=-0.53). The patient-specific group showed significantly lower PC2 scores than the traditional TKA group (p=0.03), describing a lower flexion moment magnitude during early stance phase, possibly representing a functional limitation or non- confidence during gait. These results were an important first step to assess patient- specific approaches to TKA, suggesting possible applications for patient-specific intraoperative kinematics to aid in surgical decision-making and influence functional outcomes.

Gait disturbances such as slow walking speed and step-to-step variability have been reported among people with mild Alzheimer’s disease (AD) and as risk factors for functional decline, dependency, and falls. Additionally, AD-related emotional reactions and decreased initiative can lead to physical inactivity. The aims of this thesis, therefore, were to explore how the ability to be physically active is affected in the early years of AD, and how people with mild AD and their cohabitants reason about physical activity as part of their everyday life. To meet the aims, an approach inspired by mixed methods research was used, covering measurements, observations and subjective experiences. Data were collected from different sources in parallel. Participants with mild AD were recruited at the Memory Clinic, Uppsala University Hospital. In Study I, a case study with two couples in which one member had AD, in-depth interviews and participating interviews were performed. Physical activity such as walking was viewed as a meaningful routine improving well-being. Participants were positive about making adjustments to enable physical activity. In Study II, the 25 participants with AD showed a significant lower walking capacity (10 m comfortable walk test, 6-minute walk test, Timed-up-and-Go test) at baseline compared to controls. The decline continued during the subsequent two years. The influence of a cognitive task on walking was distinct, despite this, participants maintained a health-promoting level of physical activity during the two-year study-period. In Study III, gait testing in the motor laboratory of 21 participants with AD showed a marked impact on gait parameters (e.g. slowed speed, decreased step length) by a cognitive task. Additionally, specific dual-task gait disturbances were frequent. In Study IV, in-depth interviews with 14 participants with AD indicated that physical activity was viewed as a meaningful activity, used as a means to maintain well-being and selfhood, and contributed to continuity in life. In conclusion, walking capacity deteriorates and declines in the early stages of AD. A simple cognitive task can have a substantially negative impact on walking already in mild AD. In contrast, people with AD can also gain “self-promoting benefits” from physical activity beyond the common health-promoting benefits.

The purpose of this thesis was to study the outcome of Single Event Multilevel Surgery (SEMLS) on the gait pattern known as crouch gait in children with spastic diplegic cerebral palsy. The term “crouch gait” in the literature has been defined by many authors to mean a flexed knee coupled with many different combinations of posture at the ankle. Consequently it was necessary to provide a robust definition of crouch gait before the outcome study could proceed. Crouch gait was defined in the context of a classification of sagittal gait patterns in spastic diplegia. In the cross-sectional study on the classification of sagittal gait patterns, 187 children with spastic diplegia were categorised according to visual recognition of their gait pattern and sagittal plane kinematic data. Six gait patterns in spastic diplegia were identified, one of which was crouch gait. A pattern of increasing age, severity and biomechanical incompetency in maintaining an extended posture was seen across the gait patterns and crouch gait appeared to be the “end” gait pattern. A longitudinal study documented how the identified gait patterns evolved over time. Thirty-four children were followed for more than one year and the results indicated that the stability of the gait pattern was variable. The reliability of the classification was found to be acceptable. (For complete abstract open document)

A fisioterapia motora vem sendo empregada como terapia de suporte para as distrofias musculares, porém, seu efeito no músculo distrófico e na função motora global precisa ser melhor compreendida para direcionar os tratamentos. Esta pesquisa objetiva elucidar o papel da fisioterapia motora na deposição de colágeno muscular, bem como em alguns parâmetros cinemáticos e dinâmicos da marcha do modelo Golden Retriever Muscular Dystrophy (GRMD). Fragmentos do músculo bíceps femoralis foram coletados por biópsia de cinco animais GRMD de mesma idade para análises por microscopia de luz e imuno-histoquímica. A marcha dos animais foi registrada por câmeras de vídeo e as Forças de Reação do Solo (FRS) nos sentidos vertical (Fy), craniocaudal (Fx) e mediolateral (Fz) coletadas utilizando uma plataforma de força Kistler AG (9287A/100Hz) com os valores normalizados pelo peso corporal. Dois animais (tratados: TD) participaram do protocolo de fisioterapia que consistiu de atividade de marcha com velocidade controlada em área de 288 metros, 3 vezes/semana durante 12 semanas. Os animais controles (CD) mantiveram sua rotina de atividades diárias. A coleta I foi considerada como tempo zero (t0) com n=5 e o tempo após a fisioterapia (t1) como coleta II. As análises estatísticas consideraram p<.01. Foi realizada Imuno-histoquímica anti-colágenos tipo I, III (Calbiochem®) e IV (Bioreagents®). As características histopatológicas foram observadas no t0. Os CD apresentaram fibras hipercontraídas no t1, não observadas nos TD. Os colágenos do tipo I e III foram os mais presentes e aumentados. No t1, feixes espessos de colágeno do tipo I foram observados no endomísio dos TD, comparado ao t0. Os animais GRMD apresentaram velocidade lenta de marcha no t0 (0.64 m.s-1) com diminuição da mesma no t1 para os TD (0.45 m.s-1). No t1, os TD apresentaram diminuição da ADM do quadril (p<.0001), bem como do ombro (p<.05). O joelho e carpo dos animais foram as articulações com maiores ADM durante a marcha. Houve aumento da força vertical (Fy) dos membros torácicos e pélvicos dos TD e CD no t1 comparada ao t0. Os CD mostraram aumento do tempo de suporte dos membros torácicos no t1. A força propulsiva (Fx-) dos animais GRMD estava diminuída no t0, não mostrando sofrer influência da fisioterapia. A força medial (Fz+) do membro torácico dos TD mostrou aumento no t1 quando comparada aos CD p<.0001). Os animais tratados apresentam diminuição da flexibilidade e menor regeneração do tecido muscular em comparação aos animais não tratados. Funcionalmente, a fraqueza muscular dos animais distróficos reflete em uma marcha lenta, com característica de sobrecarga e dificuldade de avançar com o corpo. Além destas características, os TD apresentam menor amplitude de movimento articular proximal quando comparado ao t0. A fisioterapia motora aplicada acelera as alterações morfológicas no músculo distrófico sem interferir na progressão das disfunções de marcha no modelo canino da distrofia muscular. / Physiotherapy has been widely used as support treatment for muscular dystrophies. Its effect on dystrophic muscle and global function should be better understood to guide treatments. This study aims to understand the role of motor physical therapy on muscular collagen deposition and some kinematics and dynamical parameters of gait of the Golden Retriever Muscular Dystrophy (GRMD) model. Five GRMD dogs with the same age had fragments of biceps femoralis collected by biopsy for light microscopy and Immunohistochemistry analysis. Gait of the dogs were video recording for kinematics analysis and Ground Reaction Forces (GRF) in vertical (Fy), craniocaudal (Fx) and mediolateral (Fz) direction were collect using a Force Plate Kistler AG (9287A/100Hz) and normalized for body weight. Two animals (therapy dogs: TD) underwent a protocol which consisted of velocity controlled walking activity in an area of 288 meters total length, 3 times/week per 12 weeks. Control dogs (CD) maintained their daily routine. Zero time (t0) is considered at collect I (n=5) and time after therapy (t1) - collect II. Statistical analysis considered p<.01. Immunohistochemistry anticollagen types I, III (Calbiochem®) and IV (Bioreagents®) were performed. Histopathology features were observed at t0. CD presented hypercontracted fibers that were not observed on TD at t1. Collagen types I and III were the most increased ones. At t1, thicker tracts of collagen type I were observed at the endomysium of TD compared to t0. GRMD dogs presented slow velocity of gait (0.64 m.s-1) at t0 and there were a decrease of this velocity of TD at t1 (0.45 m.s-1). Hip ROM was decrease at t1 (p<.0001), as well as the shoulder ROM (p<.05) for TD. Stifle and Carpal ROM presented the highest active ROM during gait of dystrophic dogs. Fy of thoracic and pelvic limbs at t1 of TD and CD was higher than t0. CD presented increase of support time of thoracic limbs at t1 (49 to 53%). Propulsive force (Fx-) of GRMD dogs were decrease at t0, with no effect of physical therapy. Medial force (Fz+) of TD thoracic limbs were higher at t1 when compared to CD (p<.0001). TD presents less muscular flexibility and regeneration when compared to CD. Functionally, the muscular weakness of dystrophic dogs reflects a gait with slow velocity, overloaded and difficulty to goes forward. Moreover, TD presented lower range of motion of the proximal joints when compared to t0. The applied motor physical therapy accelerates the morphological alterations on dystrophic muscle without stop the gait disorders of the canine model of Duchenne muscular dystrophy.

Context: Most of the patients suffering from any neurological disorder pose ambulatory disturbance at any stage of disease which may result in falling without showing any warning sign and every patient is different from another. So there is a need to develop a mechanism to detect shaky motion. Objectives: The major objectives are: (i) To check different gait parameters in walking disorders using Shimmer platform (R). (ii) Wearing SHIMMER wireless sensors on hip, waist and chest, to check which one is the most suitable. (iii) To draw effective conclusion/results based on calibrated data in real time and offline processing in EyesWeb/Matlab.To develop an effective mechanism/algorithm for security warning and activating alarm systems. Methods: Our thesis project is related to analyze real-time gait of the patient suffering from Parkinson&apos;s disease for actively responding to the shaky movements. Based on real world data, we have developed a mechanism to monitor a real time gait analysis algorithm to detect any gait deviation. This algorithm is efficient, sensitive to detect miner deviation and not hard coded i.e. user can set Sampling Rate &amp; Threshold values to analyze motion. Researchers can directly use this algorithm in their study without need to implement themselves. It works on pre-calculated threshold values while initial sampling rate is set to 100MHz. Results: Accelerometers putting on the chest shows high unnecessary acceleration during fall, suggest putting on waist position. Also, if a patient initiates steps with energy, his/her gait may become more stable as shown in the conscious gait. Results show that after DBS surgical procedure, the patient still experiences postural instability with fall. So it is evident to show that such patients may have reduced cognition even after surgery. Another finding is that such patients may lean left or right during turning. Conclusions: We have presented a real time gait analysis algorithm, capable of detecting the motion of the patient with PD to actively respond to the shakier motion setting threshold values. Our proposed algorithm is easy to implement, reusable and can affectively generate healthcare alarms. Additionally, this system might be used by other researchers without the need to implement by themselves. The proposed method is sensitive to detect fall therefore objectively can be used for fall risk assessment as well .The same algorithm with minor modifications can be used for seizure detection in other disorders mainly epileptic seizers to alert health providers for emergency. / Any malfunctioning of neurons in the nervous system is called Neurological disorder. Over 100 neurological disorders have been discovered throughout the world. In our study, we have chosen one disorder: Falling in Parkinson’s disease. Experiments can be performed on different gait parameters like body velocity, time ratio, ground slope, stance/swing, body gestures and gait patterns. Sensors can be put on hips, knees, thighs, limbs, neck, head, chest or any other suitable body part to capture motion data for further pre-and post-processing. Pre-processing is real time gait analysis through time domain and frequency domain to trigger various security steps and messages for patient care. Post -processing is offline analysis of motion data in different tools such as EyesWeb, BioMOBIUS and Matlab for calculations, analysis and plotting of motion to take decisions to formulate a mechanism for patient activity detection and monitoring. The area which we choose is pretty interesting, pertaining to rehabilitation, wellness and healthcare for older people. Other related keywords may include keywords may be helpful using one or combination of more than one. WSN, BAN or WBAN, biosensors, neurological disorders, gait analysis, fall detection, fall avoidance, Parkinson’s disease, wireless accelerometer, ambulatory monitoring, freezing of gait and fall risk assessment. Most of the patients suffering from any neurological disorder in later stages of disease pose ambulatory disturbance especially falling. Such patients may fall without showing any warning sign and every patient is different from another. So there is a need to develop a mechanism to detect shaky motion to avoid such patients from falling. Therefore, a real time gait analysis algorithm is implemented to trigger security alarms. In order to assess &amp; evaluate gait analysis, accurate, reliable &amp; consistent measurement tools need to be utilized. Even slight deviation in the data monitoring through measurement tools is not encouraged to use [21]. Gait disturbance can be measured using 3 axis accelerometers like SHIMMER(R) for real time motion analysis. In the wireless sensor network, SHIMMER platform provides wireless Body Area Network (BAN) to capture motion data. This data can be saved in CSV (Comma Separated Version) file for post processing or a 2 GB MicroSD card can be used to capture data in the SHIMMER accelerometer itself. The use of accelerometer is more suitable due to the fact that we are 66 capturing data from postural instability. One two or combinations of accelerometers can be put on different body parts. SHIMMER Gyroscope is more suitable for jerky motion with disease such as epilepsy. Mostly accelerometers and gyroscopes are used for gait analysis [4]. Defining our research work, this study is carried out on the patient with Parkinson’s disease (PD), to study various gait parameters, test wireless accelerometers on different body parts, and implementing an algorithm to trigger a security alarm system by setting a threshold value. Criteria for setting threshold value are calculating standard deviation and employed by different researchers like [3]. The main motivation to perform this experimental research work is to avoid the patient with PD from falling during unstable shaky gait. Security alarms can be activated whenever a patient poses a shakier gait. Two types of alarms or sirens can be activated in the lgorithm. First, to activate Warning Alarms when the value from motion data exceeds maximum threshold value 1 and second to activate Emergency Alarms when the value from motion data exceeds maximum threshold value 2. Later on airbag can be put on the patient’s hip position to avoid him/her from injury and hip fracture. The results show the proposed system is fairly simple to implement in the real time environment, flexible to adjust to any necessary change in the future.The major advantage of this algorithm is its reusability. Algorithm is not hard coded because a user can set his own sampling rate or threshold value or both, and check results. This algorithm is further modifiable to trigger airbag, a security push button, SOS calls, messages, siren activation system, automatic email forwarding, health care alert, and many more. The same algorithm with minor modifications can be used for fall avoidance or health care assurance on other disorders mainly in epileptic seizers to alert health providers in case of emergency, can be used for other seizures and disorders such as epilepsy, etc. Overall, this report presents the analysis of an experiment to measure the usability of wireless accelerometer data to monitor the activity of the patient suffering from Parkinson disease. Our research and experimental work can be quoted toward fall risk assessment. / Inam-ul-Haq Lindblomsvagen 37233 Ronneby +46 760609660

In 3D and 2D animations walk cycles of characters appear very frequently and are an important way of expressing various aspects of the story told. However walk cycles are tedious and time consuming to animate. In this work an Autodesk MAYA plug-in has been developed, that aims at automating this process. The walk cycle plug-in can be highly beneficial for animators when creating convincing walk cycles in a fast and simple way. The plug-in calculates the right values for each phase in the walk cycle. The GUI of the plug-in makes it easy to provide the required input parameters. In addition, the plug-in allows the animation of a character to walk along a chosen path.

Walking comes naturally to us and appears to be simple. However, this is not so and it is known that walking requires high level neural control and muscle coordination. There is no single, unifying theory of bipedal walking. Models of walking are useful in various ways such as developing computational theories of neural control, understanding muscle coordination and to design and analyze lower extremity prostheses. This thesis deals with modeling and simulation of walking from a kinematics and dynamics view point. Three sagittal planar models with increasing levels of complexity are presented in this thesis. The first model is a simple two degrees of freedom (DoF) model representing the motion at the hip and the knee joint. The second model is a three DoF model where the ankle joint motion is also taken into account. Finally, the third model considers both the legs and has seven DoF. The kinematic and dynamic equations of the models are derived, and the inverse dynamic analysis and forward dynamic simulation of the models are performed. The simulation results are compared with experimental data available in literature.

BAKGRUND: Personer med amputation på transhumeral nivå har en asymmetrisk anatomi. Det är inte väl studerat hur denna asymmetri påverkar dessa personers stående och gång, och inte heller vilka besvär som detta skulle kunna orsaka. SYFTE: Att undersöka om någon skillnad i stillastående kropps-hållning och gångmönster uppstår då personer med transhumeral amputation använder respektive inte använder protes. Utöver det så är också syftet att undersöka om ryggbesvär förekommer hos personer med denna amputationsnivå. METOD: Två transhumeralt amputerade personer deltog i studien. Statisk undersökning och gånganalys genomfördes med och utan armprotes. En enkätundersökning gällande muskuloskeletala besvär genomfördes på deltagarna. RESULTAT: Inga större skillnader har hittats i bäckenets kinematik och bålens rörelse i sagittalplan då försökspersonerna går utan protes jämfört med när de går med protes. Däremot har vi funnit en thorakal lateralflexion mot den amputerade sidan under gång, som minskar då försökspersonerna använder protes. Då försökspersonerna är stillastående utan protes lutar de mot den amputerade sidan. När de använder protes minskar lutningen. Försökspersonerna led inte av ryggbesvär. SLUTSATS: Användande av armprotes för personer med transhumeral amputation verkar ge en rakare hållning under gång och stående. / BACKGROUND: People with transhumeral amputation have an asymmetrical anatomy. The influence of this asymmetry on gait and standing has not been well studied, neither has the potential problems that this could cause. OBJECTIVE: To investigate if any difference in standing posture and gait kinematics occur when people with transhumeral amputation use a prosthesis compared to when they don’t. Furthermore, the aim is to investigate if back problems are prevalent among people with this amputation level. METHODS: Two transhumeral amputees participated in this study. Static and gait analysis was conducted with and without prosthesis. The participants completed a survey regarding musculoskeletal problems. RESULTS: No major difference has been found in thorax tilt and pelvic kinematics when the subjects walk with compared to without prosthesis. However we have found a thorax obliquity towards the amputated side during walking, which is reduced when the subjects use their prosthesis. The subjects are leaning towards the amputated side when standing without prosthesis. When using the prosthesis the obliquity is reduced. The subjects do not suffer from any back problems. CONCLUSIONS: Use of an arm prosthesis seems to give people with transhumeral amputation a more upright posture during walking and standing.

Today gait analysis are performed in laboratories with expensive equipment and people must visit the labs to perform several supervised tests. The goal of this project is to develop a platform enables gait analysis with the accelerometer sensor in a mobile phone. This would allow more people to do gait analysis, as smart phones are widely available and cheap equipment compared to lab equipments. In order to solve this task a mobile application and a cloud server was created. The mobile application can gather data from the internal accelerometer sensor and a medical grade sensor simultaneously and send the data to the cloud server. When two sensors are used the symmetry between the left foot and the right foot can be measured, although the system works with only one sensor aswell. On the cloud server the accelerometer data is analysed and gait analysis is done on the data and visualized on a web page. The mobile application can collect data for 4 hours at a sampling rate of 120Hz and two sensors are used. When sending data collected from two sensors to the cloud at a sampling rate of 120 Hz the amount of data is approximately 21.96 Mb/h. The goal of the project was to create a proof-of-concept platform to do gait analysis and that goal was fullled and a fully functional platform was developed.