L’analyse 3D du mouvement humain repose généralement sur un ensemble d’hypothèses permettant de modéliser et d’approcher la complexité du corps humain. Le but de ce travail de thèse est de s’affranchir des hypothèses les plus classiques (liaisons simples et parfaites de type rotule ou pivot) dans les calculs de cinématique et de dynamique inverse allant jusqu'à l'estimation des forces musculo-tendineuses. La première partie de la thèse traite de la cinématique articulaire du genou à l’aide de modèles cinématiques « géométriques » représentant les structures anatomiques par des éléments simples (sphère, plan, barre). Ces modèles apparaissent sous la forme de contraintes lors des calculs de cinématique (effectués notamment par optimisation multi-segmentaire). Le travail réalisé a consisté à introduire des ligaments déformables par l’utilisation de méthodes de pénalités pour la gestion de cescontraintes. Il a été montré que ces méthodes, utilisées avec un modèle géométrique générique, permettaient une amélioration de l’estimation de la cinématique du genou in-vivo basée sur des marqueurs cutanés (par rapport aux autres méthodes classiques) en introduisant des couplages articulaires physiologiques. La flexibilité des méthodes permet également d’envisager lapersonnalisation des modèles. La seconde partie se penche sur la dynamique du membre inférieur en étudiant l’influence des actionspassives des structures péri-articulaires durant la marche. Le travail a consisté en une étude locale et une étude globale de ces actions. L’étude locale a montré que l’influence des moments passifs ligamentaires reste limitée sur les forces musculo-tendineuses et les forces de contact articulaire. L’étude globale a montré que les moments passifs de l’ensemble des structures péri-articulaires ontune contribution substantielle aux moments moteurs durant la marche et que les modèles de moments passifs ligamentaires disponibles dans la littérature ne sont pas fiables. L’ensemble de ces développements cherche, à terme, à permettre une approche multi-échelle de la modélisation du membre inférieur. Dans cette optique, la modélisation articulaire proposée (avec desliaisons qui ne sont plus ni simples ni parfaites) permet un couplage plus adapté entre les différentes modélisations (de type multi-corps rigides articulés et éléments finis). / The main objective of this work is to overcome the most classical hypotheses used in kinematics (lower pair mechanical joints) and inverse dynamics computation (joints without resistance) including the estimation of muscular forces. Kinematics is addressed in the first part of the thesis by using “geometric” kinematic models consisting in simple elements (sphere, plane, shaft) modeling the anatomical structures. These models correspond to constraints in the kinematic computation (especially in multi-body optimization). The work consisted in introducing deformable ligaments by using a penalty-based method. It has beenshowed that this method used with a generic geometric model improved the estimation of the knee kinematics from the skin markers, when compared to more classical methods, and introduce physiological couplings between the degrees of freedom. Model personalization is also considered thanks to the flexibility of the method. The influence of the passive structure actions during gait is studied in the second part of the thesis. The work consisted in a local and a global study of those actions. The local study showed that the influence on the joint contact and musculo-tendon forces of the ligament passive moments is limited. The global study showed that the passive moments of the whole peri-articular structures contribute to the motor moments during gait and that the passive ligament moments available in the literature are not appropriate. The long term objective of those studies is to develop a multi-scale approach of the lower limb modeling. The proposed articular modeling (with more complex joints) allows a better interaction between the different scales of modeling (rigid multi-body vs. finite elements).

Traditional prosthetic socket fabrication is a laborious and time consuming process that involves physical measurements, plaster wrapping of the stump, plaster casting for positive mold preparation, and a thermoforming process. During the mold preparation stage, significant modifications are performed subjectively based on the prosthetist's experience to transmit an optimum load to the residual limb through the socket. Rapid Prototyping techniques have advanced rapidly during the recent decades emerging as a computer aided socket design alternative which promises a potential reduction in the fabrication time, and a more systematic design approach. In addition, 3-D scanning provides accurate and fast virtual replica of the stump which can be imported in CAD environments. Within 3-D CAD software, prosthetists are able to perform modifications precisely and store files indefinitely. This work examines the potential use of ZCorp 3-D printers to directly manufacture the thermoforming mold required for prosthetic socket manufacture. This work analyses the performance of Rapid Tooling molds for thermoformed socket based on three main parameters: pneumatic permeability, flexural strength and wear rate. The traditional material for mold casting, Plaster of Paris, is compared to materials used for three dimensional printing by Zcorp printers: zp130 and zp140 untreated as well as using them with custom and novel post treatments. To obtain the flexural strength of the different materials, three point bend tests were performed in a universal test machine using ASTM Standard D790-03 requirements. In addition, pneumatic permeability tests were performed to cylindrical specimens of the different materials following ASTM Standard D6539-00. Thermoforming tests confirm that Zcorp 3-D printed parts can serve as effective molds for thermoforming of prosthetic socket.

Title: The impact of technical exercise - alternating circling of the upper extremities - to technical part and performance of swimming style crawl, observed in Charles' University students of the Faculty of Physical Education and Sport Objectives: The aim of this thesis is to determine whether the exercise alternating circling of the upper extremities in standing applied during the swimming lessons has impact on improving technically swimming style crawl. Methods: The research involved 28 probands of the 1st degree of Faculty of Physical Education of Sport Charles University who have never taken part in swimming training. During the research was used only non-invasive methods. The measurement of height of body, upper extremity range and body composition on TANITA device. Testing was carried out in the laboratories of sports motorics at Faculty of Physical Education of Sport in Charles' University. Than testing in swimming pool was attended a swimming test at the distance of 25 and 50 m. Probands were testing in time and it was calculated number of strokes in a swimming test at the distance of 25 to 50 m. Results: Based on testing, we can say that intervention of the exercise alternating circling the upper extremities in probands of intervention group had a statistically significant reduction in...

Post stroke rehabilitation is effective when a large number of motor repetitions are provided to patients. However, conventional physical therapy or traditional desktop-size robot aided rehabilitation do not provide sufficient number of repetitions due to cost and logistical barriers. Our vision is to realize a wearable and functional hand orthosis that could be used outside of controlled, clinical settings, thus allowing for more training repetitions. Furthermore, if such a device can prove effective for Activities of Daily Living (ADLs) while actively worn, this can incentivize patients to increase its use, further enhancing rehabilitative effects. However, in order to provide such clinical benefits, the device must be completely wearable without obtrusive features, and intuitive to control even for non-experts. In this thesis, we thus focus on wearability, functionality, and intuitive intent detection technology for a novel hand robot, and assess its performance when used both as a rehabilitative device and an assistive tool. A fully wearable device must deliver meaningful manipulation capability in small and lightweight package. In this context, we investigate the capability of single-actuator devices to assist whole hand movement patterns through a network of exotendons. Our prototypes combine a single linear actuator (mounted on a forearm splint) with a network of exotendons (routed on the surface of a soft glove). We investigate two possible tendon network configurations: one that produces full finger extension (overcoming flexor spasticity) and one that combines proximal flexion with distal extension at each finger. In experiments with stroke survivors, we measure the force levels needed to overcome various levels of spasticity and to open the hand for grasping using the first of these configurations, and qualitatively demonstrate the ability to execute fingertip grasps using the second. Our results support the feasibility of developing future wearable devices able to assist a range of manipulation tasks. In order to further improve the wearability of the device, we propose two designs that provide effective force transmission by increasing moment arms around finger joints. We evaluate the designs with geometric models and experiment using a 3D-printed artificial finger to find force and joint angle characteristics of the suggested structures. We also perform clinical tests with stroke patients to demonstrate the feasibility of the designs. The testing supports the hypothesis that the proposed designs efficiently elicit extension of the digits in patients with spasticity as compared to existing baselines. With the suggested transmission designs, the device can deliver sufficient extension force even when the users have increased muscle tone due to fatigue. The vision of an orthotic device used for ADLs can only be realized if the patients are able to operate the device themselves. However, the field is generally lacking effective methods by which the user can operate the device: such controls must be effective, intuitive, and robust to the wide range of possible impairment patterns. The variety of encountered upper limb impairment patterns in stroke patients means that a single sensing modality, such as electromyography, might not be sufficient to enable controls for a broad range of users. To address this significant gap, we introduce a multimodal sensing and interaction paradigm for an active hand orthosis. In our proof-of-concept implementation, EMG is complemented by other sensing modalities, such as finger bend and contact pressure sensors. We propose multimodal interaction methods that utilize this sensory data as input, and show they can enable tasks for stroke survivors who exhibit different impairment patterns. We then assess the performance of the robotic orthosis for two possible roles: as a therapeutic tool that facilitates device mediated hand exercises to recover neuromuscular function, or as an assistive device for use in everyday activities to aid functional use of the hand. 11 chronic stroke (> 2 years) patients with moderate muscle tone (Modified Ashworth Scale ≤ 2 in upper extremity) engage in a month-long training protocol using the orthosis. Individuals are evaluated using standardized outcome measures, both with and without orthosis assistance. The results highlight the potential for wearable and user-driven robotic hand orthoses to extend the use and training of the affected upper limb after stroke. The advances proposed in this thesis have the potential to enable robotic based hand rehabilitation during daily activities (as opposed to isolated hand exercises with limited upper limb engagement) and over extended periods of time, even in a patient’s home environment. Numerous challenges must still be overcome in order to achieve this vision, related to design (compact devices with easier donning/doffing), control (robust yet intuitive intent inferral), and effectiveness (improved functionality in a wider range of metrics). However, if these challenges can be addressed, wearable robotic devices have the potential to greatly extend the use and training of the affected upper limb after stroke, and help improve the quality of life for a large patient population.

The Wnt family of secreted proteins consists of 19 family members (in the mouse) and is known to signal through multiple pathways that regulate crucial processes in the development of almost all tissues. Dissecting the roles of individual Wnts has been hampered due to functional redundancy that exists between family members. We made use of a conditional allele of the acyltransferase, Porcupine (Porcn), that is required for the secretion of all Wnt ligands, and the Msx2Cre deleter to eliminate the secretion of all Wnt ligands from the ventral limb ectoderm, ventral abdominal ectoderm, and urogenital ectoderm. Phenotypically the limbs of these mice have several similarities with En1 mutant mice which have a double-dorsal phenotype. however, we show that appropriate dorsoventral limb pattern is maintained at the molecular level and that the observed defects are due to a failure to appropriately execute ventral pattern. Additionally, newborn mice lack ventral digital tendons and the most superficial musculature in the regions of strongest and earliest deletion. Molecular analysis indicates that tendons are lost downstream of the absent musculature and are initially patterned correctly. Thus we show a role for ectodermal Wnts in the development of underlying musculature. We additionally examine the role of limb mesenchymal Wnts in the development of deeper limb musculature utilizing the Prx1Cre deleter. The deep musculature of the autopod and zeugopod is reduced or absent in mutants and the development of superficial musculature appears to proceed normally. Hence we show that superficial muscles require only ectodermal Wnts and deeper muscles require only mesenchymal Wnts.

No / High compression therapy, whether with bandage systems or hosiery, is the accepted treatment of lower limb venous ulceration. Compression has not only been shown to improve healing, it has been demonstrated to reduce oedema and improve tissue oxygen levels (Stacey et al, 1990), reversing some of the changes associated with chronic venous insufficiency (Vandongen and Stacey, 2000). The introduction of multilayer high compression bandage systems in the late 1980s, and subsequent improvements in bandage textiles and design, have undoubtedly improved outcomes for many patients. However, compression alone does not address the underlying pathology of venous ulceration, chronic venous insufficiency (CVI), and without treatment CVI continues to cause skin damage and increases the risk of recurrent ulceration. In 1999, Nelzen emphasised that compression treatment has been used since the days of Hippocrates and yet has not solved the problem of leg ulceration (Nelzen, 1999).

Title: Use of fitness center to affect the strength of the lower limbs for football players. Objectives: The aim of thesis is to create an overview for strengthening the lower limbs of football players from lower categories in fitness center. Find information about the strengthening of the lower limbs of football players from performance category and compared with men who go strengthen to the fitness centers. Methods: The paper has been used the literature analysis and carrying out survey which was conducted using interviews. 50 football players of performance category were target group. Results: In this work it was found that 72% football players dedicated strengthening the lower limbs especially in a comprehensive way and not just in fitness centers, as well ass at home and in training. The lower limbs of football players are overwhelmingly strengthened, but at lower categories the quidance of trained coach is missing. The number of reps and sets in training for the lower limbs are rather lower. 60% of footballers train in one set under 10 reps and 84% footballers do under 16 sets in strength training of the lower limbs. Keywords: Lower limbs - football - strength abilities - methodology of the strengthening - exercises application.

Title: Use of fitness center to affect the strength of the lower limbs for football players. Objectives: The aim of thesis is to create an overview for strengthening the lower limbs of football players in fitness center. Methods: The paper has been used the literature analysis and carrying out survey which was conducted using interviews. 50 football players were target group performance categories. Results: In this work it was found that football players dedicated strengthening the lower limbs especially in a comprehensive way and not just in fitness centers, as well ass at home and in training. The lower limbs of football players are overwhelmingly strengthened at least in some way. Keywords: Lower limbs - football - strength abilities - methodology of the strengthening - exercises application.

The aim of this thesis was to evaluate the Vojta method therapy impact to the muscles function of the upper limbs of patients with tetraplegia. This is a pilot study, which was attended by five probands. To objectify the results, the method of surface electromyography was adopted. EMG activity of 14 muscles of the upper limbs and shoulder girdle during selected movements before and after therapy was recorded. The choice of therapeutic positions and activation zones was individual. Although a few muscles show significant changes, statistically considerable influence of the therapy cannot be confirmed from the obtained results. But from the point of view of clinical observation and patients 'subjective feelings an obvious difference can be seen. Therefore, it may be in the future advantageous to monitor the impact of Vojta method to locomotor system through clinical methods such as functional tests, tests of independence, range of motion or kinematic analysis.

O ambiente aquático é um recurso bastante utilizado na prática de atividade física, reabiltação e lazer. No entanto, apesar de seu amplo uso, pouco se sabe sobre a demanda mecânica a que nosso corpo está sujeito durante a atividade física neste ambiente. O conhecimento das cargas sobre o corpo durante exercícios em água poderá permitir uma melhor compreensão das adaptações realizadas pelo ser humano para se movimentar neste ambiente e, ainda, auxiliar na prescrição correta de atividades físicas. O objetivo deste trabalho foi, portanto, estimar as forças e torques articulares sobre o tornozelo, joelho e quadril de adultos jovens, saudáveis, durante o andar em ambiente terrestre e aquático (água rasa). Para tanto, conduzimos um experimento no qual 10 indivíduos caminharam com velocidade auto-selecionada nos dois ambientes. Durante o andar medimos as componentes da força de reação do solo, usando uma plataforma de força, e filmamos os movimentos, com auxílio de um de sistema de aquisição de imagens. As forças e torques internos foram determinadas através da técnica da dinâmica inversa e de estimativas das forças de arrasto e respectivos torques, realizadas a partir da teoria das faixas (\"strip theory\"). Os resultados referentes à cinemática articular e descritiva e às forças de reação do solo foram, no geral, semelhantes aos resultados apresentados em estudos anteriores, indicando que não há mudanças na coordenação dos movimentos articulares nem re- organização temporal da passada durante o andar em água. Entretanto, foi possível perceber mudanças nos sentidos dos torques articulares durante o ciclo para o joelho e o quadril, sugerindo que, para manter a mesma coordenação articular sob a ação do empuxo e do arrasto, é necessário promover mudanças nos padrões dos torques internos nestas articulações. Com relação à articulação do tornozelo, os resultados mostram que há diminuição nos torques articulares necessários para gerar a flexão plantar durante o apoio. A estimativa das forças de arrasto se mostrou adequada para descrever a situação experimental, o que indica que os valores apresentados neste estudo são adequados para descrever a carga mecânica no aparelho locomotor durante o andar em piscina com água rasa. / The aquatic environment is a resource often used for the practice of physical activity, rehabilitation, and leisure. However, despite its extensive use, little is known about the mechanical demand that our body is subjected during physical activity in this environment. The knowledge of the load on the human body during water exercise will give us a greater understanding of the adaptations of the human being in water and assist the health professional to the correct prescription for physical activities. The goal of this work was, therefore, to estimate the internal joint forces and moments on the ankle, knee, and hip joints of young healthy adults during walking in the terrestrial and aquatic (shallow water) environments. For that, we conducted an experiment in which 10 subjects walked with self-selected speed in both environments. During the experiment, we measured the components of ground reaction forces, with a force plate, and recorded the subject\'s movements with a video analysis system. To find the forces and moments we used the inverse dynamics procedure and the calculation of drag forces and moments were based on the strip theory. The results concerning the joints and descriptive kinematics and the ground reaction forces were, in general, similar to the results presented in previous studies, indicating that there aren\'t changes in the coordination of joint movements or a re-organization of the stride during walking in water. Meanwhile, we were able to see changes in the directions of joint moments during the gait cycle for the knee and hip joints, suggesting that to keep the same joint coordination under the action of drag and buoyancy, it is necessary to promote changes in the patterns of internal moments in these joints. As for the ankle, the results showed that there is a decrease in joint moments necessary to generate the plantar flexion during the support phase. The estimation of the drag forces was adequate to describe the experimental situation, which suggests that the values presented here can describe correctly the mechanical load on the locomotor system during walking in shallow water.