1st Joint ESMAC-GCMAS Meeting - Análise de Marcha

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(Fig. 1). Three markers on the acromion and medial and lateral epicondyles tracked motion of the humerus. Coordinates for these segments were formed consistent with ISB recommendations [2]. A static (anatomic) pose is captured with the elbow fully extended, the arm at neutral abduction and flexion, and the palm facing the subject’s thigh. The local (humeral) coordinate system (HCS) is transformed into the clinical flexion/extensionab/adduction coordinate system (CCS) for both the static and dynamic (activity) trials. The CCS is comprised of the previously defined humeral ZH, and transformed x’- and y’-axes that are defined as follows: (1) the x’-axis is taken to be the intersection of the humeral XHYH plane and the thoracic XTZT plane, which is, by definition, perpendicular to the humeral z-axis; (2) the y’-axis is the cross product of the humeral z- and x’- axes. Relative rotations are calculated between the Thoracic and CCS, and helical-axis decomposition is used to decompose the rotation matrices as described previously [3]. The components of the helical axis in the CCS x’-, y’-, and z-axes will represent, respectively, the amount of clinical abduction, flexion, and internal rotation for a given shoulder motion. Results Results of an able-bodied subject performing five shoulder flexion/extension cycles are shown (Fig. 2). Decomposition of the angles in the HCS revealed 75 degrees of peak rotation about the HCS XH-axis and 115 degrees of peak rotation about the HCS YH-axis. Alternatively, the measures of maximal abduction were found to be around 42 degrees, while there was a maximum 144 degrees of shoulder flexion. The second approach more closely represents the motion observed clinically. While there was still some amount of ab/adduction, this is due to the fact that the subject was not constrained in their chosen path during flexion/extension trials. Discussion While use of decomposition of the relative rotations of shoulder motion generated using the HCS yields correct and useful information for the purposes of generating biomechanical models, this data does not represent the motion in terms that are always meaningful in the clinical setting. Use of the proposed CCS for decomposing shoulder motion transforms relative motions from those occurring about humerus-fixed axes to axes that relate to the thorax are more clinically relevant. Additionally, since this method uses helical-axis decomposition, there is no need to alter rotation orders to compensate for the possibility of gimbal-lock due to either prescribed motions or unanticipated compensations. While this method is presented using relative motion of the humerus with respect to the trunk, it can easily be applied to examination of glenohumeral motion as well. References [1] An, Kai-Nan, (1991), Journal of Orthopaedic Research, 9, 143-9. [2] Wu, GE, (2005), Journal of Biomechanics, 38, 981-992. [3] Morrow, DA, (2003), Gait & Posture, 18, S35-S36. Figure 2. Kinematics from a subject performing shoulder flexion trials for helicalaxis decomposition of the motions in (A) the HCS, and (B) the CCS. - 105 - A B
O-27 OBJECTIVE IDENTIFCATION OF GAIT ABNORMALITIES Stebbins, Julie 1 , Pitt, Timothy 2 , Theologis, Tim 1 1 Oxford Gait Laboratory, Oxford, UK 2 Vaquita Software, Zaragoza, Spain Summary/conclusions Objective identification of kinematic gait abnormalities was implemented on six consecutive patients at the Oxford Gait Laboratory. This was found to be a useful method for improving consistency of interpreting gait reports and has potential to enhance reliability of treatment recommendations. Introduction The repeatability of treatment recommendations based on clinical gait analysis has recently been questioned [1]. An element of this variability may be attributed to lack of consistency in identifying gait abnormalities. A method to automatically generate a list of gait deviations is proposed here and implemented in six individual case studies. Statement of clinical significance Automatic identfication of gait abnormaliteis aids repeatability of interpreting gait reports and has potential to produce more consistent treatment recommendations. Methods Five sets of kinematic graphs obtained from clinical patients following three-dimensional gait analysis (Vicon) were reviewed during a routine interpretation session by a consultant orthopaedic surgeon, a physiotherapist, a bioengineer, an orthotist and a clinical technologist. Visual identification of abnormality was performed through a systematic process and results were recorded in a table. The same five sets of graphs were then submitted to an automated assessment of abnormality, using the Parameter Check PlugIn (Vaquita Software). An initial list of kinematic variables was chosen for analysis and compared to the visual assessment of kinematic graphs. This list was further refined based on initial results to reflect clinical relevance. Mean and standard deviation values were determined from the kinematic graphs of 36 healthy children. If the difference between recorded value and the healthy mean was greater than one standard deviation, then the variable was deemed to be abnormal and recorded as such. The percentage agreement between the visual observation and automatic list of abnormalities was calculated. In addition, the kinematic graphs obtained from one patient were visually reviewed on two separate occasions, to determine percentage of agreement between visual identification of abnormality on different days. Results An example of kinematic graphs from a child (age 10 years, 11 months) with spastic diplegic cerebral palsy is shown in figure 1. The abnormalities which were identified automatically were ordered according to the magnitude of the difference from normal and are listed below: 1. Increased knee flexion at initial contact (no. of SDs) 2. Reduced maximum knee extension in stance 3. Reduced maximum hip extension 4. Exaggerated hip flexion in swing 5. Increased average foot external progression 6. Exaggerated peak knee flexion in swing 7. Pelvic obliquity with the right side down 8. Reduced range of dorsiflexion - 108 -
Page 1 and 2: O-01 KNEE EXTENSION AT TERMINAL SWI
Page 3 and 4: O-02 THE MODIFIED TARDIEU IN STANDI
Page 5 and 6: O-03 COORDINATION BETWEEN PELVIS, T
Page 7 and 8: O-04 CAN GAIT ANALYSIS GUIDE MANAGE
Page 9 and 10: O-05 DISTAL FEMORAL EXTENTSION OSTE
Page 11 and 12: O-06 THE EFFECT OF SHOES ON GAIT IN
Page 13 and 14: O-07 CORRELATIONS BETWEEN CLINICAL
Page 15 and 16: O-08 DOUBLE CALIBRATION VS GLOBAL O
Page 17 and 18: O-09 THE SYMMETRICAL AXIS OF ROTATI
Page 19 and 20: O-10 FEASIBILITY OF A NEW -JOINT CO
Page 21 and 22: O-11 A SINGLE GAIT CYCLE AS MEASURE
Page 23 and 24: O-12 IMPROVED TRACKING OF HIP ROTAT
Page 25 and 26: O-13 PROTOCOL CHANGES CAN IMPROVE T
Page 27 and 28: O-14 ALTERNATIVE METHODS FOR MEASUR
Page 29 and 30: O-15 OVERLAY PROJECTION OF 3D GAIT
Page 31 and 32: O-16 RELATIONSHIP BETWEEN THE ANTHR
Page 33 and 34: O-17 COMPARING THE RELIABILITY OF V
Page 35 and 36: O-18 3D HIP AND PELVIC GAIT PATTERN
Page 37 and 38: O-19 RELIABILITY AND VALIDITY OF AN
Page 39 and 40: O-20 HOW ACCURATE IS THE ESTIMATION
Page 41 and 42: O-21 IMPACT OF WHEELCHAIR PROPULSIO
Page 43 and 44: O-22 TOWARDS A NEW PROTOCOL FOR MOT
Page 45 and 46: O-23 KINEMATIC ANALYSIS OF UPPER LI
Page 47 and 48: O-24 KINEMATIC UPPER LIMB ANALYSIS
Page 49 and 50: O-25 3D KINEMATICS OF UPPER EXTREMI
Page 51: O-26 CLINICALLY SIGNIFICANT SHOULDE
Page 55 and 56: - 110 - O-28 NORMALCY GAIT INDEX AN
Page 57 and 58: O-29 GILLETTE GAIT INDEX IS CONSIST
Page 59 and 60: O-30 GAITABASE: NEW APPROACH TO CLI
Page 61 and 62: O-31 A MODIFIED GAIT CLASSIFICATION
Page 63 and 64: O-32 QUANTIFICATION OF KINEMATIC ME
Page 65 and 66: O-33 EXTRINSIC AND INTRINSIC VARIAT
Page 67 and 68: O-34 PAIRED OUTCOME ASSESSMENT OF A
Page 69 and 70: O-35 ENERGY EXPENDITURE DURING OVER
Page 71 and 72: O-36 HIGH FAILURE RATES WHEN AVOIDI
Page 73 and 74: O-37 SUBJECT SPECIFIC HIP GEOMETRY
Page 75 and 76: O-38 BIOMECHANICAL AND METABOLIC PE
Page 77 and 78: O-39 BIOMECHANICS OF GAIT IN CHARCO
Page 79 and 80: O-40 SAGITTAL PLANE LOWER EXTREMITY
Page 81 and 82: O-41 AN EXPLORATION OF THE FUNCTION
Page 83 and 84: O-42 DYNAMIC SIMULATIONS OF SLOW, F
Page 85 and 86: O-43 AUTOMATIC IDENTIFICATION OF MU
Page 87 and 88: O-44 DYNAMIC MEASUREMENT OF GASTROC
Page 89 and 90: O-45 ASSESSING THE REGULATORY ACTIV
Page 91 and 92: O-46 ABNORMAL EMG-ACTIVITY IN PATHO
Page 93 and 94: O-47 AVERAGED EMG PROFILES IN RUNNI
Page 95 and 96: O-48 TRACKING DYNAMIC FOOT PRESSURE
Page 97 and 98: O-49 THE INFLUENCE OF FOOTWEAR SOLE
Page 99 and 100: O-50 GAIT ANALYSIS IN CHILDREN TREA
Page 101 and 102: O-51 A COMPARISON OF METHODS FOR US
Page 103 and 104:
O-52 BIOMECHANICAL OPTIMIZATION OF
Page 105 and 106:
O-53 EFFECT OF SENSORY-THRESHOLD EL
Page 107 and 108:
O-54 THE IMPACT OF SINGLE EVENT MUL
Page 109 and 110:
O-55 COMPREHENSIVE GAIT ANALYSIS OU
Page 111 and 112:
O-56 THE EFFECT OF INCLUDING S2 ROO
Page 113 and 114:
O-57 DYNAMIC FUNCTION AFTER ANTERIO
Page 115 and 116:
O-58 RECOVERY OF MUSCLE STRENGTH FO
Page 117 and 118:
O-59 AUDITORY-PACED WALKING FOLLOWI
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1st Joint ESMAC-GCMAS Meeting - Análise de Marcha

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