Download or read book Understanding the Effects of Wearing a Quantitatively Prescribed Passive dynamic Ankle foot Orthosis on the Mechanical Cost of transport and Gait Velocity in Individuals Post stroke written by Corey A. Koller and published by . This book was released on 2022 with total page 136 pages. Available in PDF, EPUB and Kindle. Book excerpt: Individuals post-stroke are commonly prescribed passive-dynamic ankle-foot orthoses (PD-AFOs) to aid in the control of shank forward rotation during mid-to- terminal stance due to plantar flexor weakness. PD-AFO bending stiffness is a key orthotic characteristic that can assist the plantar flexor muscles by providing the resistance needed to control shank forward rotation. Controlling shank forward rotation can store and return mechanical energy that can potentially increase gait velocity and decrease total mechanical cost-of-transport (COT). We developed a prescription model that can quantitatively prescribe PD-AFO bending stiffness based on an individual's level of plantar flexor function deficit. The overall purpose of this dissertation was to quantify and compare post-stroke COT and gait velocity along with underlying joint-level mechanisms through a range of conditions over time while the participant wears their quantitatively prescribed PD-AFO and examine the relationships between COT and common clinical assessments. Ten individuals with chronic stroke (> six months post-stroke) participated and underwent five visits. A clinical evaluation and the data needed to prescribe and manufacture the PD-AFOs were captured at the first visit. The PD-AFOs were manufactured in carbon fiber material and then fitted to the participants. Data was collected as the participants walked on an instrumented treadmill while wearing the PD-AFO and then returned two weeks and four weeks later to complete the same analyses. Simulation modeling analysis was conducted to statistically test Aims 1-3. Results showed that the quantitatively prescribed PD-AFOs significantly decreased total mechanical COT and increased gait velocity, by at least one MDC, compared to not wearing an orthosis. When comparing wearing the PD-AFO to wearing the SOC AFO, seven out of the nine participants significantly decreased total mechanical COT and although all participants increased gait velocity, only two increased by at least one MDC. Despite these improvements, inconsistent results were seen in the joint-level parameters across the three orthoses conditions. While wearing the PD-AFO across a range of gait velocities, changes in total mechanical COT were seen. While wearing the PD-AFO over time, minimal to no changes were seen in the global and joint-level parameters. Lastly, three of the clinical assessments (Fugl-Meyer assessment, dorsiflexion ROM with the knee flexed to 90℗ʻ, and gait velocity) showed potential relationships to changes in total mechanical COT magnitudes while wearing the PD-AFO. In general, these results improved our understanding of how quantitatively prescribing PD-AFO bending stiffness effected gait biomechanics and energetics over a range of conditions.
Download or read book Effect of Quantitatively Matched Passive dynamic Ankle foot Orthoses on Post stroke Gait written by Corey A. Koller and published by . This book was released on 2018 with total page 77 pages. Available in PDF, EPUB and Kindle. Book excerpt: The plantar flexors play a critical role in moving the body forward during gait by eccentrically contracting to control shank rotation. Insufficient control of shank rotation due to plantar flexor weakness, a common post-stroke impairment, may result in gait dysfunctions. Plantar flexor function during gait, or lack thereof, can be quantified by the peak plantar flexor moment. Passive-dynamic ankle-foot orthoses (PD-AFOs) can be prescribed to improve post-stroke gait. PD-AFO bending stiffness is a key orthosis characteristic that can replicate many functions of the plantar flexors. However, outcomes with ankle-foot orthoses (AFOs) are variable, likely because of the orthosis characteristics not being properly matched to each individual’s needs. We have developed a novel design and prescription process that quantitatively matches PD-AFOs based on each individual’s level of plantar flexor weakness. However, preliminary data collected by our lab showed that individuals post-stroke were unable to fully use the quantitatively matched PD-AFOs. We hypothesized that providing the individuals with real-time biofeedback on how to properly use the PD-AFO would help acclimate them to PD-AFO use and help them reap full benefits from the orthosis. Thus, the purpose of this study was to first evaluate if the quantitatively matched PD-AFOs improved gait biomechanics (peak plantar flexion moment) better than the originally prescribed AFO. Then, we developed and evaluated if a real-time biofeedback tool helped individuals post-stroke more effectively use the PD-AFO while walking. Eleven individuals with chronic stroke (> six months post-stroke) underwent an instrumented gait analysis to gather baseline data. Using our design and prescription process, a carbon fiber PD-AFO was then quantitatively matched for each subject. Once the PD-AFOs were manufactured, seven of the subjects visited the lab for one evaluation visit and underwent an instrumented gait analysis using his/her Original AFO and the quantitatively matched PD-AFO. The other four subjects visited the lab for two evaluation visits and underwent an instrumented gait analysis with his/her Original AFO and the quantitatively matched PD-AFO and used the biofeedback tool. A one-way repeated measures ANOVA was performed on the subject’s mean peak plantar flexion moment between his/her Original AFO and the quantitatively matched PD-AFO. If a significant difference was observed, simulation modeling analysis (SMA) was then performed to determine which subjects achieved a significant difference between the two conditions. The subject’s mean peak dorsiflexion angle was compared to the range assigned to each individual post-stroke to determine if the subject was able to reach that targeted dorsiflexion range. A one-way repeated measure ANOVA was performed on the subject’s mean peak plantar flexion moment between pre-biofeedback and post-biofeedback for both evaluation visits. SMA was also performed to determine if a significant increase in mean peak plantar flexion moment was achieved pre- and post-biofeedback for each subject individually for both evaluation visits. The subject’s change in mean step length (pre- vs. post-biofeedback) while walking with the quantitatively matched bending stiffness PD-AFO was compared to the pre-feedback step length variability for both visits. Results showed that 9 out of the 11 subjects had a significant increase in mean peak plantar flexion moment from the Original AFO to the quantitatively matched PD-AFO. Furthermore, two of the four subjects, on the second evaluation visit, were able to reach their targeted dorsiflexion range post-biofeedback. However, the individual post-stroke’s mean peak plantar flexion moment and mean step length did not improve from pre- to post-biofeedback for either evaluation visit. This study’s findings begin to lay the foundation of a novel quantitative prescription process to improve the gait of individuals post-stroke.
Download or read book The Mechanical Response of a Passive dynamic Ankle foot Orthosis and Its Interaction with the Lower Limb During Gait written by Kirstie Edwards and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Prescription of a Passive dynamic Additive manufactured Ankle foot Orthosis on a Patient with a Severe Trimalleolar Fracture written by Luke Nigro and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The purposes of this study are to better understand the gait mechanics of a patient with an ankle fracture, and to provide a prescription for a rehabilitative device, known as a passive-dynamic ankle-foot orthosis (PD-AFO) in order to restore functional gait. One 58-year-old female subject recovering from a trimalleolar fracture (three fractures across both the medial and lateral malleoli) sustained from high-impact trauma was recruited for this study. Gait kinematics and ground reaction forces of the subject walking at a slow and fast pace were captured by a passive-marker camera-based motion analysis system and a floor-mounted force plate, respectively. An 8-segment biomechanical model was built based on several of the subjects anatomical landmarks and used to compute joint moments about the ankle, knee, and hip of both legs. Based on these kinetic metrics and the anatomy of the subject, a PD-AFO was designed in computer-aided design (CAD) software and verified through finite element analysis (FEA) to assist the subject by adding passive stiffness about the ankle, were it to be constructed. Results show that the subject utilized much less range of motion, and produced a much lower peak moment about the mediolateral axis in the injured ankle than the uninjured ankle at both walking speeds. Frequency and time-frequency analysis of the joint kinematics show slight differences in coordination between joints of the injured and uninjured legs at different frequencies. Residuals of joint angles, after being fit with a Fourier series, had generally higher standard deviations during slow walking, showing that the subject had less consistent joint angle ranges, perhaps due to a lack of stability. Finite element testing of the PD-AFO load showed the design is resolute enough to withstand normal loading during walking for the subject and can act as an additional stiffness component.
Download or read book The Influence of Ankle foot Orthosis Stiffness on Gait Performance in Patients with Lower Limb Neuromuscular and Musculoskeletal Impairments written by Nicole Lynn Guckert and published by . This book was released on 2012 with total page 86 pages. Available in PDF, EPUB and Kindle. Book excerpt: Individuals with various lower-limb neuromuscular and musculoskeletal impairments are often prescribed passive-dynamic ankle-foot orthoses (PD-AFOs) to compensate for impaired ankle muscle weakness. Several studies have demonstrated the beneficial effects of PD-AFOs on pathological gait, but few studies have examined the influence of the AFO stiffness characteristics on gait performance. One challenge to performing such studies is the difficulty of manufacturing custom AFOs with a wide range of controlled stiffness levels. However, selective laser sintering (SLS) is a well-suited additive manufacturing technique for generating subject-specific PD-AFOs of varied stiffness. Therefore, the overall goal of this study was to use SLS manufactured PD-AFOs to identify the relationships between AFO stiffness and gait performance in patients with various lower-limb neuromuscular and musculoskeletal impairments. Six subjects with unilateral impairments were enrolled in this study. For each subject, one subject-specific PD-AFO equivalent to the subject's clinically prescribed carbon fiber PD-AFO (nominal), one 20% more compliant and one 20% more stiff were manufactured using SLS. Three-dimensional kinematic and kinetic data were collected from each subject while ambulating with each PD-AFO at two different speeds to allow a comprehensive biomechanical analysis to assess the influence of PD-AFO stiffness on gait performance. The results showed that in the compliant AFO condition, the AFO limb vertical ground reaction force (GRF) impulse during loading and the non-AFO limb medial GRF impulse during push-off decreased. In addition, the AFO limb braking GRF impulse during loading and the non-AFO limb braking GRF impulse in early single-limb stance decreased. Furthermore, in the compliant AFO condition, negative knee work during early single-limb stance increased while positive hip work in early swing decreased in the AFO limb. Overall, as AFO stiffness decreased, the AFO limb contributed less to body support and braking. In addition, a decreased medial GRF impulse coupled with an increased vertical GRF impulse during non-AFO single-limb stance suggests that walking stability may be compromised as AFO stiffness decreases. Thus, a tradeoff may exist between preserving stability and increasing net propulsion, which should be considered when assessing the mobility needs of individuals prescribed PD-AFOs as a result of various neuromuscular and musculoskeletal impairments.
Download or read book The Biomechanics and Motor Control of Human Gait written by David A. Winter and published by . This book was released on 1991 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Gait Analysis written by Jacquelin Perry and published by CRC Press. This book was released on 2024-06-01 with total page 570 pages. Available in PDF, EPUB and Kindle. Book excerpt: The extensive and ground-breaking work of Dr. Jacquelin Perry is encompassed and detailed in the world renowned text, Gait Analysis: Normal and Pathological Function. The medical, healthcare, and rehabilitation professions key text for over 18 years on gait.... Now available in a much anticipated New Second Edition Dr. Jacquelin Perry is joined by Dr. Judith Burnfield to present today's latest research findings on human gait. Gait Analysis, Second Edition has been updated and expanded to focus on current research, more sophisticated methods, and the latest equipment available to analyze gait. What is New: • A new chapter covering running • Synergy of motion between the two limbs • A new chapter covering pediatrics • A new chapter covering stair negotiation • New and updated clinical examples • A section on power inside each chapter covering normal gait • New methods and equipment to analyze gait This Second Edition to Gait Analysis offers a re-organization of the chapters and presentation of material in a more user-friendly, yet comprehensive format. Essential information is provided describing gait functions, and clinical examples to identify and interpret gait deviations. Learning is further reinforced with images and photographs. Features: • Six sections cover the fundamentals, normal gait, pathological gait, clinical considerations, advanced locomotor functions, and gait analysis systems • Clinical significance of the most common pathological gait patterns • Over 470 illustrations and photographs, as well as 40 tables • Patient examples to illustrate elements of normal and pathological gait Tens of thousands of orthopedic, orthotic and prosthetic, physical therapy, and other rehabilitation professionals have kept a copy of Gait Analysis by their side for over 18 years...join the thousands more who will bring the Second Edition into their clinics, classrooms, and personal collections.
Download or read book Stroke Recovery and Rehabilitation written by Richard L. Harvey, MD and published by Demos Medical Publishing. This book was released on 2008-11-20 with total page 817 pages. Available in PDF, EPUB and Kindle. Book excerpt: A Doody's Core Title 2012 Stroke Recovery and Rehabilitation is the new gold standard comprehensive guide to the management of stroke patients. Beginning with detailed information on risk factors, epidemiology, prevention, and neurophysiology, the book details the acute and long-term treatment of all stroke-related impairments and complications. Additional sections discuss psychological issues, outcomes, community reintegration, and new research. Written by dozens of acknowledged leaders in the field, and containing hundreds of tables, graphs, and photographic images, Stroke Recovery and Rehabilitation features: The first full-length discussion of the most commonly-encountered component of neurorehabilitation Multi-specialty coverage of issues in rehabilitation, neurology, PT, OT, speech therapy, and nursing Focus on therapeutic management of stroke related impairments and complications An international perspective from dozens of foremost authorities on stroke Cutting edge, practical information on new developments and research trends Stroke Recovery and Rehabilitation is a valuable reference for clinicians and academics in rehabilitation and neurology, and professionals in all disciplines who serve the needs of stroke survivors.
Download or read book Clinical Pathways in Stroke Rehabilitation written by Thomas Platz and published by Springer Nature. This book was released on 2021-01-14 with total page 284 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book focuses on practical clinical problems that are frequently encountered in stroke rehabilitation. Consequences of diseases, e.g. impairments and activity limitations, are addressed in rehabilitation with the overall goal to reduce disability and promote participation. Based on the available best external evidence, clinical pathways are described for stroke rehabilitation bridging the gap between clinical evidence and clinical decision-making. The clinical pathways answer the questions which rehabilitation treatment options are beneficial to overcome specific impairment constellations and activity limitations and are well acceptable to stroke survivors, as well as when and in which settings to provide rehabilitation over the course of recovery post stroke. Each chapter starts with a description of the clinical problem encountered. This is followed by a systematic, but concise review of the evidence (RCTs, systematic reviews and meta-analyses) that is relevant for clinical decision-making, and comments on assessment, therapy (training, technology, medication), and the use of technical aids as appropriate. Based on these summaries, clinical algorithms / pathways are provided and the main clinical-decision situations are portrayed. The book is invaluable for all neurorehabilitation team members, clinicians, nurses, and therapists in neurology, physical medicine and rehabilitation, and related fields. It is a World Federation for NeuroRehabilitation (WFNR) educational initiative, bridging the gap between the rapidly expanding clinical research in stroke rehabilitation and clinical practice across societies and continents. It can be used for both clinical decision-making for individuals and as well as clinical background knowledge for stroke rehabilitation service development initiatives.
Download or read book Kinesiology written by Carol A. Oatis and published by . This book was released on 2009 with total page 968 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Second Edition of Kinesiology: The Mechanics and Pathomechanics of Human Movement relates the most current understanding of anatomy and mechanics with clinical practice concerns. Featuring seven chapters devoted to biomechanics, straightforward writing, and over 900 beautiful illustrations, the text provides you with detailed coverage of the structure, function, and kinesiology of each body region. You will gain an in-depth understanding of the relationship between the quality of movement and overall human health. Special features include: New DVD containing about 150 videos provides dynamic examples of clinical demonstrations, principle illustrations, and lab activities. This powerful resource explores patient function, dysfunction, and injury for greater comprehension. Clinical Relevance Boxes reinforce the relationship of biomechanical principles to patient care through real-life case studies. Muscle Attachment Boxes provide easily accessed anatomical information and tips on muscle palpation Examining the Forces Boxes highlight the advanced mathematical concepts used to determine forces on joint structure. Evidence-based presentations deliver the most current literature and essential classic studies for your understanding of musculoskeletal structure and function. Whether you are a student or practitioner in the field of physical therapy, occupational therapy, or exercise science, this comprehensive book serves as an excellent resource for best practice techniques.
Download or read book Gait Analysis written by Rebecca Craik and published by . This book was released on 1995 with total page 504 pages. Available in PDF, EPUB and Kindle. Book excerpt: . Diversity and the commonalities of gait analysis. . Limitations and problems of the present technology. . Part one begins with a case study; Part two is a thorough discussion of the conceptual frameworks; Part three is primary approaches to gait analysis; the final part is applications of these assessment approaches. . Key terms, study questions and introductory page for each section.
Download or read book Recent Advances in Physiotherapy written by Cecily Partridge and published by John Wiley & Sons. This book was released on 2007-04-04 with total page 268 pages. Available in PDF, EPUB and Kindle. Book excerpt: Like Partridge: Neurological Physiotherapy: Bases of Evidence for Practice, each chapter in Recent Advances in Physiotherapy features a case report provided by a team of clinicians based on details from a real patient. This book of recent advances provides readers with a way of keeping up-to-date with recent work in the discipline of physiotherapy, based on the evidence for current practice.
Download or read book Gait Analysis in the Science of Rehabilitation written by Joel A. DeLisa and published by DIANE Publishing. This book was released on 1998 with total page 129 pages. Available in PDF, EPUB and Kindle. Book excerpt: Instrumented gait analysis systems offer objective evaluation of the effectiveness of the various rehabilitation treatments that are aimed at improving gait disabilities. There are four sections in this report: clinical observation; review of the instrumental gait analysis systems; the value of information resulting from instrumented gait analysis from the perspective of a psychiatrist, an orthopedic surgeon, & a physical therapist; & discussion of future trends for gait laboratories. The authors are experts from multiple rehabilitation specialties to give you an understanding of how gait analysis can be used to evaluate a person's walking abilities to maximize function & maintain or improve quality of life. Illustrations.
Download or read book Wearable Robots written by José L. Pons and published by John Wiley & Sons. This book was released on 2008-04-15 with total page 358 pages. Available in PDF, EPUB and Kindle. Book excerpt: A wearable robot is a mechatronic system that is designed around the shape and function of the human body, with segments and joints corresponding to those of the person it is externally coupled with. Teleoperation and power amplification were the first applications, but after recent technological advances the range of application fields has widened. Increasing recognition from the scientific community means that this technology is now employed in telemanipulation, man-amplification, neuromotor control research and rehabilitation, and to assist with impaired human motor control. Logical in structure and original in its global orientation, this volume gives a full overview of wearable robotics, providing the reader with a complete understanding of the key applications and technologies suitable for its development. The main topics are demonstrated through two detailed case studies; one on a lower limb active orthosis for a human leg, and one on a wearable robot that suppresses upper limb tremor. These examples highlight the difficulties and potentialities in this area of technology, illustrating how design decisions should be made based on these. As well as discussing the cognitive interaction between human and robot, this comprehensive text also covers: the mechanics of the wearable robot and it’s biomechanical interaction with the user, including state-of-the-art technologies that enable sensory and motor interaction between human (biological) and wearable artificial (mechatronic) systems; the basis for bioinspiration and biomimetism, general rules for the development of biologically-inspired designs, and how these could serve recursively as biological models to explain biological systems; the study on the development of networks for wearable robotics. Wearable Robotics: Biomechatronic Exoskeletons will appeal to lecturers, senior undergraduate students, postgraduates and other researchers of medical, electrical and bio engineering who are interested in the area of assistive robotics. Active system developers in this sector of the engineering industry will also find it an informative and welcome resource.
Download or read book Cerebral Palsy written by Freeman Miller and published by JHU Press. This book was released on 2006-05-08 with total page 537 pages. Available in PDF, EPUB and Kindle. Book excerpt: When a child has a health problem, parents want answers. But when a child has cerebral palsy, the answers don't come quickly. A diagnosis of this complex group of chronic conditions affecting movement and coordination is difficult to make and is typically delayed until the child is eighteen months old. Although the condition may be mild or severe, even general predictions about long-term prognosis seldom come before the child's second birthday. Written by a team of experts associated with the Cerebral Palsy Program at the Alfred I. duPont Hospital for Children, this authoritative resource provides parents and families with vital information that can help them cope with uncertainty. Thoroughly updated and revised to incorporate the latest medical advances, the second edition is a comprehensive guide to cerebral palsy. The book is organized into three parts. In the first, the authors describe specific patterns of involvement (hemiplegia, diplegia, quadriplegia), explain the medical and psychosocial implications of these conditions, and tell parents how to be effective advocates for their child. In the second part, the authors provide a wealth of practical advice about caregiving from nutrition to mobility. Part three features an extensive alphabetically arranged encyclopedia that defines and describes medical terms and diagnoses, medical and surgical procedures, and orthopedic and other assistive devices. Also included are lists of resources and recommended reading.
Download or read book The HELP Guide to Cerebral Palsy written by Nadire Berker and published by . This book was released on 2005-01-01 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Rehabilitation in Movement Disorders written by Robert Iansek and published by Cambridge University Press. This book was released on 2013-05-23 with total page 263 pages. Available in PDF, EPUB and Kindle. Book excerpt: Provides a broad overview of current rehabilitation approaches, emphasizing the need for interdisciplinary management and focussing on deliverable outcomes.
