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Measurement of mechanical properties of the skin in lower limb chronic venous disease compared to established non-invasive methods of assessmentFarrah, John Alfred January 1998 (has links)
Chronic venous disease (CVD) of the lower limbs is a major problem in the western world with 1% of the adult population estimated to be affected at any one time. The clinical sequelae of CVD of the lower limbs range from oedema, haemosiderosis and pigmentation, to gross lipodermatosclerosis (LDS) and venous ulceration. The site most commonly affected is the gaiter area of the lower limb. The extent and severity of venous disease can be assessed by clinical and physiological methods which include duplex ultrasonography and plethysmography. Tissue oedema can be assessed by volumetric or circumferential measurements and venous ulcers may be quantified by area measurements and response to treatment in ulcer healing studies. In the vast majority of patients a spectrum of skin changes precedes venous ulceration. At present, there is no standardised objective method of assessing the degree of skin change in these patients, so that the response to treatment can be objectively monitored. I have developed a tissue tonometer and standardised the methodology for the objective assessment and quantification of the skin changes seen in patients. The tissue tonometer is a simple non-invasive instrument which uses a sensing device that detects the movements of a loaded plunger placed on the skin. The movement of the plunger is dependent on the mechanical properties of the skin and subcutaneous tissue. The instrument is positioned on the gaiter region of the leg with the subject in the supine position. The movement of the plunger into the tissues is recorded and analysed by a computer. The data obtained from the tonometer were analysed as distance and rate constant parameters. A simple mathematical model using spring and dashpot constants was also applied to see if it fitted the data. Skin compliance was investigated in normal control subjects and patients with varying severity of skin changes due to CVD, clinically classified according to the CEAP (Clinical, (A)Etiological, Anatomical and Pathophysiological) method. There was a significant reduction in skin compliance in patients with clinically severe LDS as compared to normal controls and patients with pigmentation alone or oedema without any clinical evidence of skin change. I further investigated the correlation between the recently introduced CEAP method of classification and scoring of chronic venous disease of the lower limbs with the tissue tonometry findings and parameters obtained with duplex ultrasonography, air plethysmography and photoplethysmography. Tissue tonometry provides a standardised objective means of assessing the severity of skin change in CVD which may prove to be useful in evaluating response to a particular treatment and comparing data from different centres. The deterioration of the venous physiology shown by blood flow measuring techniques correlates poorly with the clinical sequelae of venous disease, whether assessed by a trained observer or measured by the tonometer. Patients show a wide range of sensitivity to venous valvular incompetence, suggesting that factors related to the tissue response to venous hypertension are crucial in determining which patients develop venous ulceration.
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Srovnání reakce kardiovaskulárních parametrů na zátěž jednou a oběma dolními končetinami na bicyklovém ergometru / Camparsion of crdiovascular responses to stress by one and both lower limbs on a bicycle ergometer.Baxová, Dana January 2014 (has links)
This thesis deals with the stress on a bicycle ergometer. This theoretical part is a summary of findings on the response of the cardiovascular parameters, one-leg ergometry, description of Borg RPE scale and laterality of the lower limbs. The practical part is a comparison of the measured values of cardiovascular parameters. Furthermore was evaluating the subjective perception of the intensity of workload and compares the workload between the left and right limbs. Methodology and data processing: data collection for statistical processing was carried out from December 2013 to early April 2014. Research group included 16 probands. The results were statistically analyzed and described. Results and conclusions: There are differences in the values of cardivascular parameters at maximum workload between the two and one leg. At submaximal workload are not significant differences Keywords: cardiovascular parameters, one-legged ergometry, laterality, Borg RPE scale
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Péče o dolní končetiny v dospělosti a ve stáří / Care about lower limbs in adulthood and in old age.VOJČOVÁ, Lucie January 2019 (has links)
Introduction: Lower limbs are ones of the most strained body parts to which people do not pay much attention. Conscientious care is absolutely vital for their right functioning. Main aims of the thesis: This thesis is focused on gathering the knowledge and skills in care of lower limbs with people at their adult and old age; and on describing how the care is being performed with the target group of people. The next aim is to describe the health care from the podiatry nurse´s point of view. Methodology: A qualitative research by means of half-structured interviews was chosen as the main method of the survey. People at their adult and old age from České Budějovice were interviewed, as well as a nurse working in the centre of podiatry. Results of the thesis: The research proves some level of knowledge in the field of care of lower limbs both with the adult and elderly citizens. Both these groups of people take care of their lower limbs. The results show conscientiousness with washing their feet and drying them especially in the spaces between their toes. On the one hand, the interviewed people take care of their feet by means of using lotions and by means of pedicure. However, they do not go to see specialists in pedicure. On the other hand, the results show that this kind of skin care is not very regular. The care devoted to nails seems to be problematic, it is necessary to add some information about a more appropriate way of cutting them. The results of choosing shoes; when the choice is based mainly on a fashionable look of shoes; show a bigger need of repeated and more accurate education in this field. The impacts of improperly chosen shoes, irregular care of the lower limbs and also underestimating of prophylactic medical checks were all evident on our informants´ feet. The outputs gained in practice: The intermediate results of this thesis were presented at the Students Scientific Conference. The results of the research were used as the basis for a workshop intended for people at the adult and old age. A suggested educational mental map can be used as a practical tool.
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Desenvolvimento de um jogo para reabilitação de pessoas que sofreram AVC, baseado no exame de cognição ACE-R / Game development for rehabilitation of people who suffered strokes, based on cognition exam ACE-RPasqual, Thales Bueno 14 March 2018 (has links)
O Acidente Vascular Cerebral (AVC) é uma das maiores preocupações da saúde no mundo, sendo a segunda maior causa de morte no mundo e a terceira maior de incapacitação. Sendo a cognição uma das capacidades que são afetadas pelo AVC, é comum o uso de exames para verificar em que nível de estado mental o paciente se encontra. Os pacientes que apresentam incapacidades passam por um longo e complexo programa de reabilitação. Esses indivíduos tornam-se limitados na realização das Atividades de Vida Diárias (AVDs), como caminhar, devido a problemas envolvendo alterações da motricidade em um lado do corpo. O tornozelo é uma articulação importante pois está diretamente ligada à capacidade de caminhar e se manter em pé. Existem diversos exames cognitivos e motores para avaliar o dano causado aos indivíduos, bem como sua melhora ao longo da terapia, porém a área da saúde carece de ferramentas que possam unir a avaliação com os recursos de reabilitação. Portanto, este projeto tem como objetivo o desenvolvimento de um jogo voltado para reabilitação motora para o membro inferior e cognitiva para pessoas que sofreram AVC baseado em um exame de análise cognitiva e interface com temática familiar, utilizando um mecanismo projetado especificamente para reabilitação de tornozelo. O principal objetivo deste projeto é desenvolver um jogo que o desempenho do jogador se correlacione com o desempenho do mesmo no Addenbrooke\'s Cognitive Examination Revised (ACE-R). Pensando no público de maior incidência do AVC, o jogo tem uma temática de familiaridade visando a fácil identificação e imersão do indivíduo no processo de reabilitação, para esse fim foi desenvolvido um jogo baseado em cartas de baralho. Dessa forma o projeto focou em três frentes principais: a articulação a ser reabilitada, a patologia e o perfil de usuário. Este trabalho seguiu uma metodologia para seu desenvolvimento desde a fase de estratégia, especificações e planejamento, concepção e homologação. Os resultados se mostraram satisfatórios dentro dos objetivos estabelecidos dando abertura para diversas frentes de estudo em relação a desenvolvimento de jogos, imersão e desempenho de indivíduos em jogos virtuais, cinemática do tornozelo e níveis cognitivos. Este trabalho também pode ser utilizado como guia para novos desenvolvimentos de jogos sérios integrado com mecanismos robóticos para reabilitação. / The Cerebrovascular Accident (CVA) or Stroke is one of the greatest health concerns in the world, being the second largest cause of death in the world and the third largest cause of disability. Since cognition is one of the capacities that are affected by stroke, it is common to use tests to find out what level of the patient\'s mental state is. Patients with disabilities experiences need a long and complex rehabilitation program. They become limited in performing Daily Life Activities (DLA), such as walking, due to problems involving the movement alterations in one body\'s side. The ankle is directly linked to to walk and stand ability. There are several cognitive and motor tests to evaluate the damage caused to subjects, as well as their improvement throughout therapy, but the health care area lacks tools that can integrate the evaluation with the rehabilitation tools. Therefore, this project aims to develop an ankle rehabilitation game for people who have suffered from stroke, based on a cognitive analysis examination that has interface with family thematic, using a mechanism designed specifically for ankle rehabilitation. The main goal of this project is to develop a specifically game that correlates with Addenbrookes Cognitive Examination (ACE-R). Thinking about the audience of higher incidence of CVA, the game will have a familiar theme for the easy identification and immersion of the individual in the rehabilitation process, for this purpose a game based on playing cards was developed. In this way the project was focused on three main fronts: the articulation, the pathology and the user\'s profile. This work followed a methodology to be developed since its strategy, specifications and planning, conception, testing and homologation. The results proved to be satisfactory within the stated objectives, opening up several study fronts in relation to game development, immersion and performance of individuals in virtual games, ankle kinematics and cognitive levels. This work also can be used as a guide for new serious game development integrated with robotic mechanisms for rehabilitation.
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Heterogeneidade metabólica muscular associada à assimetria funcional. / Muscle metabolic heterogeneity associated with functional asymmetry.Semiatzh, Marcelo 09 October 2018 (has links)
No contexto da atividade física, é aceito que a maioria das pessoas apresenta membros inferiores (MI) assimétricos, um deles atuando como lado dominante (DM), enquanto o outro é considerado não dominante (ND). Existe heterogeneidade da resposta dos MI de acordo com a função (DM / ND) em face de estímulos, como caminhada, manutenção da postura e exercício. O objetivo deste estudo foi avaliar a heterogeneidade metabólica e biomecânica entre os MI, comparando biópsias de ambos os músculos gastrocnêmios mediais em indivíduos ativos (AT) e muito ativos (MA). A expressão gênica da proteína de ligação aos ácidos graxos (FABP) no músculo gastrocnêmio medial(GM) mostrou diferença significativa (p <0,05) apenas no membro ND, com maior expressão no AT, enquanto a citrato sintase (CS) mostrou diferenças (p <0,05) no membro DM, com maior expressão em MA. Para os indivíduos MA, houve diferença significativa (p <0,05) entre os MI para FABP e CS que foram mais expressas no membro DM. Em relação aos impulsos horizontal de frenagem da marcha, a lateralidade causou diferença significativa (p <0,05) entre os indivíduos no grupo AT, com maior frenagem em ND. Quanto ao esforço, a diferença significativa para o impulso horizontal de frenagem da marcha(p <0,05) ocorreu somente no membro ND, sendo maior frenagem no grupo AT. Na propulsão, a diferença (p <0,05) ocorreu para o impulso de propulsão horizontal da marcha com interferência lateral no esforço somente no membro DM, sendo o maior no grupo MA. Para o impulso vertical de propulsão da marcha, independente do esforço, DM apresenta menor impulso. Nossos dados apontaram para a existência de diferenças metabólicas e biomecânicas entre os hemisférios opostos que podem ser exacerbados pelo exercício contínuo e especializado. Os resultados do fator lateralidade nos membros de DM e ND mostram diferentes adaptações entre os grupos, que podem ser consideradas na pesquisa e na clínica. / In the context of physical activity, most people present asymmetric lower limbs (LL), one of them acting as the dominant (DM) side, while the other is considered non-dominant (ND). There is heterogeneity of LL response according to function (DM/ND) in the face of stimuli such as walking, posture maintenance and exercise. The aim of this study was to evaluate metabolic and biomechanical heterogeneity between the LL, comparing muscle biopsies of active (AC) and very active (VA) individuals. Gene expression of fatty acid binding protein (FABP) in the gastrocnemius medial muscle showed a significant difference (p <0.05) only for ND, with higher expression in the AC, while citrate synthase (CS) expression was different (p <0.05) in DM limb, with higher expression in VA. For VA, there was significant difference (p <0.05) between the limbs, as FABP and CS expression was higher in DM. There was significant difference (p <0.05) regarding impulses in braking, considering laterality in the AC group, with higher braking capacity in ND. In concern to effort, a significant difference (p <0.05) was found for ND, as the parameters were higher in AC. In the case of propulsion, the difference (p <0.05) occurred with laterality interfering in the effort degree in the DM, with horizontal impulse propulsion being superior in VA. For the vertical impulse of gait propulsion, regardless of the effort, DM presents less impulse. Our data point out to the existence of metabolic and biomechanical differences between the opposite body hemispheres that may be exacerbated by continued exercise and specialization. The laterality factor results in the DM and ND limbs showing different adaptations between groups and are of relevance for exercise prescription and study.
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Avaliação do efeito da meia elástica na hemodinâmica venosa dos membros inferiores de corredores / Evaluation of the effect of compression stockings in venous hemodynamic of the lower limbs of runnersCastilho Junior, Oswaldo Teno 02 October 2015 (has links)
RESUMO Castilho Junior, O T. Avaliaço do efeito da meia elástica na hemodinâmica venosa dos membros inferiores de corredores. 2015. 71f. Dissertação (Mestrado) - Faculdade de Medicina Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto - SP. Introdução: A literatura médica a respeito da eficácia e dos benefícios do uso de meias elásticas de compressão graduada (MECG) na corrida é controversa e inconclusiva. Objetivo: O objetivo foi verificar as alterações da hemodinâmica venosa dos MMII pela pletismografia a ar (PGA) , do lactato sanguíneo e da resposta clínica provocadas pela corrida em atletas amadores saudáveis sem e com o uso de MECG. População e Método: Dez atletas (4 homens e 6 mulheres), corredores voluntários, com idade média 40,3 anos, índice de massa corporal (IMC) médio de 21,88, foram submetidos a avaliações de parâmetros hemodinâmicos venosos por meio da PGA (IEV-índice de enchimento venoso; FE-fraço de ejeção e FVR-fração de volume residual), dosagem de lactato capilar e avaliação clínica (frequência cardíaca, dor e conforto nos MMII) em 3 situações: em repouso (antes da corrida); logo depois de uma corrida de 10 km em esteira com inclinação de 1% sem o uso de MECG e uma semana após com o uso de MECG. Todas as variáveis foram analisadas estatisticamente e considerou-se 5% o nível de significância. Resultado: Após a corrida houve elevação significativa dos valores de IEV dos MMII no grupo sem em relação ao grupo com MECG e em repouso. Houve queda significativa da FVR do membro inferior direito no grupo com MECG em relação aos grupos em repouso e sem meia elástica, o que não ocorreu no membro inferior esquerdo. A FE foi semelhante em todas as situações. O lactato elevou-se no final da corrida no grupo sem MECG e notou-se tendência a elevação no grupo com MECG, mas a diferença inicial e final do lactato nas duas situações permaneceu semelhante. As manifestações clínicas (frequência cardíaca , dor, conforto e lesões) foram semelhantes em todas as situações após a corrida sem e com MECG. Conclusão: Apesar de inalteradas as manifestações clínicas ( frequência cardíaca, dor e desconforto) e dos níveis de lactato de corredores amadores, sadios, após a corrida de 10km com inclinação de 1%, o uso de MECG teve efeitos positivos na hemodinâmica venosa dos MMII, aferidos pela PGA e caracterizados pela redução do IEV em ambos os membros e pela queda da FVR, pelo menos no membro inferior direito. / Background: The literature about the efficacy and the benefits of wearing compression stockings (CS) in running is controverse and inconclusive. Objective: The objective was to verify the changes of venous hemodynamic parameters of the lower limbs measured by air pletismography (APG), of the capillary lactate and of some clinical aspects promoted by running in normal healthy runners wearing or not compression stockings. Methods: Ten volunteer runners (4 men, 6 women), mean age 40,3 years, mean corporal mass index of 21,88, were submitted to evaluation the hemodynamic parameters measured by APG (venous filling index VFI; ejection fraction EF and residual venous fraction - RVF), measurement of capillary lactate and clinical aspects (cardiac frequency, pain, comfort and lesions) in 3 situations: at rest (before running); after a 10 Km running on a treadmill with 1% inclination degree without CS and a week later, after the same running wearing compression stockings. All variables were statistically analised and it was considered 5% as the significance level. Results: After running there was significant elevation of the VFI in the group without CS compared to the groups at rest and with CS. There was also a meaning descent of the RVF levels of the right lower limb of the volunteers wearing CS compared to those without CS and at rest, but this was not noticed on the left lower limb. The EF was the same in all situations. The lactate levels increased after running without CS and there was a tendency of elevation with the use of CS, but the initial and final differences in both situations remained the same. The clinical aspects (cardiac frequency, pain, comfort and lesions) were similar after running with or without CS. Conclusion: Although there were no changes of the clinical aspects (cardiac frequency, pain, comfort and lesions) and the lactate levels of healthy amateur runners after a 10 Km running on a treadmill with a 1% elevation degree, APG showed that the use of CS promoted beneficial effects on venous hemodynamics of the lower limbs, featured by the fall of the VFI levels on both lower limbs and the fall of the RVF levels on the right lower limbs.
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Porovnání procenta tělesného tuku dolních končetin u studentů učitelství prvního stupně ZŠ s šetřením z roku 2005 pomocí bioelektrické impedance / Comparison body fat at student's elementary school teaching with survey from the 2005 year by the help of bioelectrical impedance of lower extremitiesJAREŠOVÁ, Petra January 2012 (has links)
No description available.
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Antropometria das extremidades dos membros inferiores de obesos: parâmetros para o desing ergonômico de calçadosMenin, Mariana [UNESP] 21 August 2009 (has links) (PDF)
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menin_m_me_bauru.pdf: 2582375 bytes, checksum: 9ac80bce611d113caf77acd4193372ba (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O homem moderno faz uso de calçados por aproximadamente 8 horas/dia e, quando este produto é inadequado aos aspectos biomecânicos e antropométricos das extremidades dos membros inferiores (EMI's), podem ocorrer desconfortos ou lesões. Alguns estudos têm sido desenvolvidos no Brasil sobre ergonomia e usabilidade no design de calçados, entretanto, entre os vários aspectos a serem explorados, destaca-se a necessidade de adequação antropométrica deste produto. Os calçados devem ter dimensões e formatos próprios para a realidade das diferentes categorias populacionais como, por exemplo, a qual apresenta uma maior carga física nas EMI's e, portanto, está mais propensa ao surgimento ou agravamento de doenças nesta região. São poucas as pesquisas sobre a antropometria de obesos e inexistem aquelas que tratam especificamente de dados referentes às dimensões das EMI's desses indivíduos. É importante ressaltar que esta faixa populacional vem crescendo em todo o mundo nos últimos anos, o que demanda o desenvolvimento de produtos especializados, a partir de critérios ergonômicos mais precisos. Portanto, este estudo tem como objetivo realizar um levantamento antropométrico das EMI's de indivíduos obesos e não obesos, utilizando-se para isso de procedimentos metodológicos sistematizados, permitindo analisar as diferenças entre estes indivíduos. Foram coletados dados de percepção de conforto no uso de calçados e 30 variáveis antropométricas das EMI's de 84 sujeitos adultos, sendo 42 obesos e 42 não obesos de ambos os gêneros. Os resultados afirmam que as duas faixas populacionais aqui comparadas encontram dificuldades em adquirir calçados e, também, que ambas sentem desconforto ao utilizá-los. Quanto às variáveis antropométricas, 17 apresentaram diferença estatisticamente significativa, particularmente nas dimensões relacionadas às circunferências... / The modern man uses shoes for about 8 hours per day, and when this product is inappropriate to anthropometric and biomechanical aspects of the lower limbs extremities, discomfort and/or diseases can happen. Some studies about usability and, however, among the various aspects to be explored, there is the need anthropometric adaptation for this product. The shoes must have own size and own shape to reality of ergonomic in shoes designing have been developed in Brazil different population categories, such as the population of obese people, which has a greater physical burden on lower limbs extremities and therefore it's more prone to the occurence or worsening of diseases in this region. The are few researches about anthropometry of obesity and there are no ones that specifically deal data related to the size of these individuals' lower limbs extremities. It's important to not that this population is growing up in the whole whole world last years, which demands the development of specialized products, from more accurate ergonomic criterion. Therefore, this stufy aims to achieve an anthropometric survey of non-obese and obese individual's lower limbs extremities, using systematic methodological procedures, allowing analyzing the differences between these individuals. Data on perceptions of comfort was collected using shoes and 30 anthropometric variables of 84 adult people'lower limbs extremities, divided into 42 obese and 42 non-obese patients of both genders. The results affirm that both compared population have difficulties to bye shoes, and also that they fell uncomfortable to use them. About anthropometric variables, 17 showed statistically significant difference, particularly in the dimensions related to circles. Thus it demonstrates the real need of the application of ergonomic design and anthropometric data of obese people in the modeling and desegning shoes.
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Desenvolvimento de sistema de rastreamento da posição de membros inferiores / Development of a lower limbs position tracking systemPentiado, Thiago Rodrigues 07 February 2018 (has links)
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Previous issue date: 2018-02-07 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Sistemas de rastreamento de movimento são amplamente utilizados em diversas áreas de conhecimento, como por exemplo, para aplicações de realidade aumentada, ciência do esporte e reabilitação de pacientes. Atualmente, diversas tecnologias existem no mercado para a captura e análise de movimento, entretanto, os altos custos envolvendo tais tecnologias são proibitivos. Isso impede que hospitais, clínicas e grupos de pesquisa tenham acesso a esse tipo de tecnologia. Nesse sentido, é apresentado neste trabalho um sistema de baixo custo de rastreamento do movimento de membros inferiores. O sistema proposto consiste de uma IMU (inertial measurement unit) com três giroscópios e três acelerômetros para as medições, e o algoritmo de filtro de Kalman para reduzir os erros de estimação. Os resultados obtidos mostram que o equipamento, além de dimensões reduzidas de peso e volume, apresenta alto desempenho, com valores de correlação maiores que 99% com o dispositivo de referência, sendo uma alternativa a sistemas comerciais utilizados. / Motion tracking systems are widely used in many areas of knowledge, such as augmented reality applications, sports science and patient rehabilitation. Currently, there are several technologies for motion capture and analysis available in the market, however, the high costs of such technologies prevents hospitals, clinics and research groups from having access to this type of system. In this sense, a low-cost tracking system for lower limb movement is presented in this work. The system consists of an IMU (inertial measurement unit) with three gyroscopes and three accelerometers for the measurements, and the Kalman filter algorithm to reduce estimation errors. The results show that the equipment, in addition to reduced dimensions of weight and volume, presents high performance, with correlation values higher than 99% with the reference device, being an alternative to the reference system used.
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Desenvolvimento de sistema de rastreamento da posição de membros inferiores /Pentiado, Thiago Rodrigues. January 2018 (has links)
Orientador: Aparecido Augusto de Carvalho / Resumo: Sistemas de rastreamento de movimento são amplamente utilizados em diversas áreas de conhecimento, como por exemplo, para aplicações de realidade aumentada, ciência do esporte e reabilitação de pacientes. Atualmente, diversas tecnologias existem no mercado para a captura e análise de movimento, entretanto, os altos custos envolvendo tais tecnologias são proibitivos. Isso impede que hospitais, clínicas e grupos de pesquisa tenham acesso a esse tipo de tecnologia. Nesse sentido, é apresentado neste trabalho um sistema de baixo custo de rastreamento do movimento de membros inferiores. O sistema proposto consiste de uma IMU (inertial measurement unit) com três giroscópios e três acelerômetros para as medições, e o algoritmo de filtro de Kalman para reduzir os erros de estimação. Os resultados obtidos mostram que o equipamento, além de dimensões reduzidas de peso e volume, apresenta alto desempenho, com valores de correlação maiores que 99% com o dispositivo de referência, sendo uma alternativa a sistemas comerciais utilizados. / Abstract: Motion tracking systems are widely used in many areas of knowledge, such as augmented reality applications, sports science and patient rehabilitation. Currently, there are several technologies for motion capture and analysis available in the market, however, the high costs of such technologies prevents hospitals, clinics and research groups from having access to this type of system. In this sense, a low-cost tracking system for lower limb movement is presented in this work. The system consists of an IMU (inertial measurement unit) with three gyroscopes and three accelerometers for the measurements, and the Kalman filter algorithm to reduce estimation errors. The results show that the equipment, in addition to reduced dimensions of weight and volume, presents high performance, with correlation values higher than 99% with the reference device, being an alternative to the reference system used. / Mestre
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