1st Joint ESMAC-GCMAS Meeting - Análise de Marcha

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A distinct trend to increased peak vertical joint reaction forces with increased NSA was found. As a result, the inclination angle of the resultant reaction force in the frontal plane decreased substantially with decreasing NSA, introducing a more vertical alignment of the reaction force at peak loading (Figure 2). Although, the sagittal plane angle showed variations in the individual model, no clear relation with the changes in NSA could be established. When halving the abductor muscle force generating capacity, all components of the reaction forces decreased. However, the previously described relations of the joint reaction forces with NSA were unchanged. Peak Anterior - Posterior component Peak Vertical component Peak Medio - Lateral component Peak Total Reaction Force Figure 1. Changes in peak joint reaction forces during stance with increasing NSA. UM is the reference undeformed model. Angle in frontal plane Angle in sagittal plane Figure 2. Changes in inclination angle associated with peak joint reaction forces during stance with increasing NSA. UM is the reference undeformed model. Angle (°) 30 25 20 15 10 5 0 Reaction Force / Body Weight 9 8 7 6 5 4 3 2 1 0 Peak Joint Reaction Forces during Stance UM Inclination angle of Joint Reaction Forces during Stance UM Discussion The interaction between hip geometry, muscle moment generating capacity and hip loading can be analyzed using inverse dynamics based on personalized musculoskeletal modeling. Our results show an important interaction between NSA and medio-lateral reaction forces, causing a more vertical inclination angle in the frontal plane during gait. This therefore will result in a more vertical loading of the implant when peak reaction forces are applied during gait. Although we did not analyze the interaction between NSA, NL and PW, our findings do suggest that a minimal NSA angle needs to be preserved in order to limit the medio-lateral force component and limit the resulting bending stress in the femoral shaft. The calculation of individual hip loading by use of musculoskeletal modeling and inverse analysis may contribute to understanding the effect of hip joint loading on bone remodeling and implant load shearing. References [1] Lenaerts G, Jonkers I, Spaepen A, 2005, Gait & Posture, 22 (1), S19: [2] Stansfield BW, Nicol AC, 2002, Clin Biomech, 17:130-139 - 135 -
O-38 BIOMECHANICAL AND METABOLIC PERFORMANCE OF A NEW ORTHOTIC KNEE JOINT PRINCIPLE FOR STANCE PHASE SAFETY Schmalz, T., PhD 1 , Blumentritt, S., PhD 1 , Drewitz, H., CPO 2 1 Department of Research, Otto Bock Health Care, Duderstadt, Germany 2 Orthopaedic Workshop, Rehabilitation Centre, Göttingen, Germany Summary Recently developed orthotic knee joints that are integrated into a knee-ankle-foot-orthosis (KAFO) stabilize the paralyzed knee in stance phase while permitting natural flexion and extension at the knee during swing phase. The functional advantages for these patients can be documented by metabolic and biomechanical parameters. Introduction For many patients with lower limb weakness or paralysis, functional mobility is achieved by means of a KAFO. In traditional orthoses, the knee joint is locked throughout the complete gait cycle (knee completely locked – KTL) to guarantee safety during stance phase. Over the last few years, 5 new orthotic systems ([1]) have been developed worldwide which stabilize the knee joint during stance phase without interfering with knee flexion in swing (knee locked during stance – KLDS). In the present study, KAFOs utilizing KTL and KLDS principles are compared based on metabolic and biomechanical parameters. Statement of clinical significance This study investigates and documents the functional advantages that patients with lower limb weakness or paralysis can anticipate from orthoses utilizing the new KLDS principles. Methods 6 patients (5 male patients and 1 female patient, aged 48±14y, height 177±9cm, body mass 83 ±14kg) with paresis of the m.quadr. fem. who had been fitted with a KAFO (Free Walk, Otto Bock, Germany) were examined. The knee joint in this orthosis can be used in either KTL and KLDS settings. Metabolic energy consumption was measured while walking on a treadmill (velocities between 0.6 and 0.95m/s) using the CPX system (MedGraphics, USA). Kinematic and kinetic parameters determined while walking on level ground at each subject’s selfselected comfortable speed (VICON 460, Oxford Metrics, GB; Kistler Force Plates, Kistler AG, Switzerland). A similar gait analysis on level ground was conducted with a group of healthy people (n=30, age 28±5y, height 175±6cm, body mass 71±9kg) for comparison. Results Using the KLDS principle on a treadmill, a significant reduction of oxygen consumption averaging 12% was demonstrated. Average heart rate also dropped significantly by 7% (table 1). Biomechanical gait parameters demonstrated that the abnormal pelvic obliquity, necessary to clear the foot when the KAFO was in the KTL mode, is eliminated in the KLDS mode. (Figure1, left). Furthermore, the distinct overload on the joints of the contralateral leg, which was present in KTL mode, is significantly reduced in the KLDS situation. (reduction of strong external extension moments in knee and hip joint, figure 1, right). - 136 -
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
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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 and 52: O-26 CLINICALLY SIGNIFICANT SHOULDE
Page 53 and 54: O-27 OBJECTIVE IDENTIFCATION OF GAI
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: O-37 SUBJECT SPECIFIC HIP GEOMETRY
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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