No description available.

No description available.

There is a need for standardized clinically accessible measurements that would enable detection of the primary underlying deficit and a patient’s rehabilitation capacity after stroke. While a multitude of measures of neuromotor control exist, there is not a unified perspective on their complementarity versus redundancy for identifying the stroke-related impairments. This dissertation evaluates four measures of neuromotor control: the lower extremity portion of the Fugl-Meyer Assessment (FM-LE), plantarflexor central drive, the number of muscle synergies, and the dynamic motor control index. The first aim was to assess if the dynamic motor control index, which has not previously been used in a post-stroke population, could identify stroke-related impairments in neuromotor control, and how it compared to the number of muscle synergies. The second aim evaluated which measure(s) of neuromotor control were most indicative of biomechanics and functional outcomes. Twenty-two individuals post-stroke (60 ± 8 years old, chronicity 6 ± 4 years, 16 male, 10 right paretic) completed clinical assessments of the FM-LE and six-minute walk test, 90 seconds of fast treadmill walking during which force and muscle activity data were collection, and three burst-superimposition tests on the paretic limb for the calculation of central drive. The results of the first study concluded the dynamic motor control index was able to identify stroke-related impairments and may do so better than the discrete number of muscle synergies. The second study determined that the FM-LE, paretic central drive, and paretic dynamic motor control index are individually the best neuromotor indicator of propulsion asymmetry, endurance, and step time asymmetry, respectively, suggesting these measures are complementary for explaining post-stroke deficits. A multi-modal evaluation approach that combines these measures of neuromotor control with clinical and biomechanical evaluations provides the best opportunity to understand post-stroke walking impairment. Future work should focus on developing a single measure of neuromotor control that fully explains locomotor compensations and the primary underlying impairment, further enabling clinical accessibility and standardized assessments. / 2024-09-08T00:00:00Z

Evaluating side-to-side symmetry in the lower extremity has been significant in assessing injury risk and the success of rehabilitation programs. Considering limb dominance in the lower limbs is also important as limb dominance could influence symmetry measures. There is a need to assess symmetry, particularly in healthy populations, in tasks other than walking and running and establish how the dominant limb can impact symmetry. By evaluating symmetry in healthy adults, how the limbs function with respect to one another can be determined. Therefore, the first purpose of this study was to investigate the impact of lower limb dominance on walking and sitting-to-standing. Data was collected from 49 healthy older adults, aged 50-89 years old. Using loadsol® sensors (Novel, St. Paul, MN, USA), plantar loading data such as peak impact force and loading rate was calculated. Participants completed one sit-to-stand trial and three 10-meter walking trials, as these serve as prime examples of daily activities. The secondary purpose of this study was to assess the impact of lower limb dominance on athletic tasks like running and agility. The pedar-X® pressure insoles (Novel, St. Paul, MN, USA) were used to collect plantar loading data such as peak force, contact area, and contact time, from 10 athletes. Participants completed five t-drill trials and five agility ladder drill trials. The acceleration phase of the t-drill served as standard running. A mixed effects model was used to test if differences existed in various plantar loading outcome measures based on limb dominance. Non-parametric tests were used for non-normally distributed data. The statistical analysis determined that no significant differences existed between the dominant limb and non-dominant limb for the 10-meter walking trials peak impact force (p=0.245) or average loading rate (p=0.943). During the sit-to-stand trial, no significant differences existed in peak impact force (p=0.317) or average loading rate (p=0.943). For the agility ladder drill, the maximum force (p=0.427), contact area (p=0.517), or contact time (p=0.734) showed no significant differences. In the T-drill, the maximum force (p=0.385), contact area (p=0.571), or contact time (p=0.571) had no significant differences. These drive the conclusion that limb dominance does not need to be considered when assessing side-to-side symmetry. / Master of Science / Understanding how the left and right lower limbs of the body compare is important to preventing injuries and measuring if rehabilitation interventions are beneficial. A factor in that is knowing how the dominant limb can affect how the lower limbs compare to one another. Through symmetry, especially in healthy adults, a greater comprehension for over limb functionality can be better understood. There is need to assess the lower limb symmetry in healthy populations in tasks aside from walking and running as well as establish how the dominant limb is impacting that symmetry. The first purpose of this study was to observe how lower limb dominance affects walking and standing from a seated position. Data was collected from 49 healthy older adults, aged 50-89 years old. Insoles were placed in participants' shoes to collect plantar loading data. Each participant did two tasks: one trial of the sit-to-stand and three trials of 10-meter walking. The second purpose of this study was to observe how lower limb dominance affects athletic tasks such as running and agility. Loading insoles were used to collect data from 10 current or previous athletes. Each participant did five t-drill trials and five agility ladder trials. Statistical analyses established no significant differences were shown between the dominant and non-dominant limbs peak impact force for the 10-meter walking trials (p=0.245) nor for the average loading rate (p=0.943). For the sit-to-stand trial, no significant differences were seen in peak impact force (p=0.317) or average loading rate (p=0.943). In the agility ladder drill, no significant differences were shown for the maximum force (p=0.427), contact area (p=0.517), or contact time (p=0.734). In the agility ladder drill, no significant differences existed for the maximum force (p=0.385), contact area (p=0.571), or contact time (p=0.571). These findings suggested that the dominant limb does not impact lower limb comparisons.

No description available.

No description available.

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)

The intent of the following research is to utilize task-specific, constraint-induced therapies and apply towards dynamic training for symmetrical balance. Modifications to an elliptical trainer were made to both measure weight distributions during dynamic stance as well as provide kinetic biofeedback through a man-machine interface. Following a review of the background, which includes research from several decades that are seminal to current studies, a design review is discussed to cover the design of the modified elliptical (Chapter 2). An initial study was conducted in a healthy sample population in order to determine the best visual biofeedback representation by comparing different man-machine interfaces (Chapter 3). Index of gait symmetry measures indicated that one display interface optimized participant performance during activity with the modified elliptical trainer. A second study was designed to determine the effects of manipulating the gain of the signal to encourage increased distribution towards the non-dominant weight bearing limb. The purpose of the second study was to better understand the threshold value of gain manipulation in a healthy sample set. Results analyzing percentage error as a measure of performance show that a range between 5-10% allows for a suitable threshold value to be applied for participants who have suffered a stroke. A final study was conducted to apply results/knowledge from the previous two studies to a stroke cohort to determine short-term carryover following training with the modified elliptical trainer. Data taken from force measurements on the elliptical trainer suggest that there was carryover with decreased error from pre to post training. For one participant GaitRite® data show a significant difference from pre to post measurements in single limb support. The results of the research suggest that visual biofeedback can improve symmetrical performance during dynamic patterns. For a better understanding of visual biofeedback delivery, one display representation proved to be beneficial compared to the others which resulted in improved performance. Results show that healthy human participants can minimize error with visual biofeedback and continue minimizing error until a threshold value of 10%. Finally, results have shown promise towards applying such a system for kinetic gait rehabilitation.

Cheung Chi-Kin. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 53-60). / Text in English; abstracts in English and Chinese. / Cheung Chi-Kin. / Acknowledgement --- p.i / Abstract --- p.ii / Table of Contents --- p.v / List of Figures --- p.viii / List of Tables --- p.ix / Introduction --- p.1 / Statement of Problem --- p.3 / Research Questions --- p.4 / Significance of the Study --- p.4 / Theoretical contribution --- p.4 / Practical contribution --- p.5 / Review of Literature --- p.6 / Physiological Studies regarding Load Carriage --- p.6 / Energy expenditure --- p.7 / Heart rate --- p.7 / Comparison between physiological studies and biomechanical studies regarding load carrying --- p.8 / Motor Control during Load Carrying --- p.10 / Gait Pattern --- p.11 / Gait pattern under load carrying --- p.11 / Walking velocity --- p.13 / Treadmill vs. overground walking --- p.13 / Trunk Posture --- p.15 / Electromyographic Activity --- p.16 / EMG and muscle force --- p.17 / EMG and fatigue --- p.18 / EMG during load carrying --- p.19 / Load Carrying Studies in Children --- p.21 / Methodology --- p.24 / Design --- p.24 / Subject --- p.24 / Instrumentation --- p.25 / Motion analysis --- p.25 / Electromyography --- p.25 / Heart rate measurement --- p.26 / School bag --- p.26 / Experimental Set-up --- p.27 / Procedures --- p.27 / Data Reduction --- p.29 / Gait parameters --- p.29 / Trunk posture --- p.31 / Electromyographic analysis --- p.32 / Heart rate --- p.34 / Data Analysis --- p.34 / Results --- p.35 / Gait Pattern --- p.35 / Trunk Posture --- p.36 / Electromyographic Activity --- p.37 / Channel 1 --- p.37 / Channel 2 --- p.37 / Channel 3 --- p.38 / Heart Rate --- p.38 / Summary --- p.39 / Discussion --- p.40 / Gait Pattern during Load Carriage --- p.40 / Stride parameters --- p.40 / Temporal parameters --- p.42 / Trunk Posture --- p.43 / Electromyographic Activity --- p.44 / Erector spinea --- p.45 / Upper trapezius --- p.45 / Risk factor from EMG measurement --- p.47 / Heart Rate --- p.47 / Maximum Permissible Backpack Weight for Children --- p.48 / Limitations of the Study --- p.49 / Further Direction --- p.50 / Conclusion --- p.52 / References --- p.53 / Appendix / Appendix A - Subject Information & Consent form --- p.61 / Appendix B - Experiment Set-up --- p.66 / Appendix C - Measurement of Skinfold --- p.67 / Appendix D - Standardized Isometric Maximum Voluntary Contraction --- p.68 / Appendix D - Figures and Tables --- p.69

This thesis investigates walking patterns in healthy young people and in people with an increased risk of falling, and determines the physiological contributions to walking stability. First, a review of the relevant literature on techniques for assessing walking stability, age-related changes in balance and gait, and the contributions of vision, vestibular function, peripheral sensation and strength was undertaken. In response to a critical analysis of these findings, a new technique and protocol for the assessment of walking stability was developed. This involved measuring and analysing head and pelvis accelerations while subjects walked on a level surface and an irregular surface. Gait patterns were studied in 30 young healthy subjects and two groups known to be at increased risk of falling - 100 subjects over the age of 75, and 30 subjects with diabetic peripheral neuropathy. A series of vision, sensation, strength, reaction time and balance tests were also undertaken to identify subjects??? physiological abilities and risk of falls. Acceleration patterns of the head and pelvis differed according to physiological risk of falling, particularly when walking on the irregular surface. Those with a high risk of falling walked with a reduced velocity, cadence and step length, and exhibited less rhythmic acceleration patterns at the head and pelvis. Gait patterns were significantly associated with leg strength, peripheral sensation and reaction time. It is concluded that subjects with a high physiological risk of falling exhibit characteristic patterns of walking that indicate an impaired ability to control the movement of the pelvis and head, which may predispose to loss of balance.