scholarly journals Effects of Tendon Release Surgery on Inter-Limb Leg Stiffness Control in Children with Spastic Diplegic Cerebral Palsy during Gait

2021 ◽  
Vol 11 (10) ◽  
pp. 4562
Author(s):  
Chien-Chung Kuo ◽  
Hsing-Po Huang ◽  
Hsuan-Yu Lu ◽  
Tsan-Yang Chen ◽  
Ting-Ming Wang ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Stance Phase ◽  
Reaction Force ◽  
Bilateral Symmetry ◽  
Healthy Controls ◽  
Leg Stiffness ◽  
Characteristic Features ◽  
Total Leg ◽  
Analysis System ◽  
Single Limb Support

Impaired motor control and musculotendon tightness in the lower extremities are characteristic features of patients with diplegic cerebral palsy (CP). Tendon release surgery (TRS) helps improve joint and leg stiffness, but the effects of TRS on inter-limb coordination in terms of the total leg stiffness, and the bilateral symmetry in leg stiffness during gait, remain unknown. Ten children with spastic diplegic CP scheduled for TRS and ten healthy controls participated in this study. The inter-limb sharing of total leg stiffness during double-limb support phase and bilateral leg stiffness symmetry during stance phase of gait were calculated using the kinematic and ground reaction force data measured by a motion analysis system. Before TRS, the patients with diplegic CP walked with a decreased share of total leg stiffness during weight-acceptance (p < 0.05) and with increased bilateral leg stiffness asymmetry during single-limb support and weight-transfer during gait (p < 0.05) when compared to healthy controls. After TRS, the bilateral leg stiffness asymmetry was significantly reduced in the CP group, especially in the terminal stance phase, with inter-limb sharing of total leg stiffness becoming similar to that in controls (p > 0.05). The surgery seemed to improve the lower limb control and increased the bilateral limb symmetry during gait.

A Comparison of Computation Methods for Leg Stiffness During Hopping

2014 ◽  
Vol 30 (1) ◽  
pp. 154-159 ◽  
Author(s):  
Hiroaki Hobara ◽  
Koh Inoue ◽  
Yoshiyuki Kobayashi ◽  
Toru Ogata
Keyword(s):  
Ground Reaction Force ◽  
Stance Phase ◽  
Center Of Mass ◽  
Reaction Force ◽  
Sine Wave ◽  
Phase Method ◽  
Leg Stiffness ◽  
Mass Displacement ◽  
Male Subjects ◽  
Oscillation Method

Despite the presence of several different calculations of leg stiffness during hopping, little is known about how the methodologies produce differences in the leg stiffness. The purpose of this study was to directly compareKlegduring hopping as calculated from three previously published computation methods. Ten male subjects hopped in place on two legs, at four frequencies (2.2, 2.6, 3.0, and 3.4 Hz). In this article, leg stiffness was calculated from the natural frequency of oscillation (method A), the ratio of maximal ground reaction force (GRF) to peak center of mass displacement at the middle of the stance phase (method B), and an approximation based on sine-wave GRF modeling (method C). We found that leg stiffness in all methods increased with an increase in hopping frequency, butKlegvalues using methods A and B were significantly higher than when using method C at all hopping frequencies. Therefore, care should be taken when comparing leg stiffness obtained by method C with those calculated by other methods.

scholarly journals A comparison of the free moment pattern between normal and hyper-pronated aligned feet in female subjects during the stance phase of gait

2018 ◽  
Author(s):  
F Yazdani ◽  
M Razeghi ◽  
S Ebrahimi
Keyword(s):  
Lower Extremity ◽  
Stance Phase ◽  
Reaction Force ◽  
Force Plate ◽  
Camera Motion ◽  
Lower Extremity Injuries ◽  
Single Force ◽  
Analysis System ◽  
Extremity Injuries ◽  
Free Moment

Background: Excessive range of adductory free moment of the ground reaction force may potentially increase the risk of lower extremity injuries by applying a higher torsional load transmitted to the proximal parts.Objective: It was hypothesized that the free moment pattern might be different between hyper-pronated and normal feet subjects. Moreover, a correlation would exist between peak adduction free moment and peak ankle-foot complex abduction at the stance phase of walking.Methods: Thirty female participants were divided into two groups of asymptomatic hyper-pronated and normal feet. Kinetic and kinematic data were collected using a single force plate and a six-camera motion analysis system during three successful free speed walking trials. Ensemble average curves were extracted from the time normalized individual trials of the stance phase for both free moment and peak ankle-foot complex abduction parameters.Results: Significant differences in peak adductory free moment, peak ankle-foot complex eversion and peak ankle-foot complex abduction were found between normal and hyper-pronated groups (4.90±0.97Vs. 5.94±0.88, P < 0.01), (3.30±0.95Vs. 6.28±1.47, P < 0.01) and (4.52±1.16Vs. 8.23±2.52, P < 0.01, respectively).A significant positive correlation was found between the peak adduction free moment and peak ankle-foot complex abduction in both groups, which was more strongly positive in hyper-pronated group (r = 0.745, p < 0.01, normal group, r = 0.900, p < 0.01, hyper-pronated group).Conclusion: As a good measure of torque which is transmitted to the lower extremity, may free moment be a useful biomechanical indicator for both clinical and research purposes.

The Stance Phase of Walking During Late Pregnancy

2005 ◽  
Vol 95 (3) ◽  
pp. 247-253 ◽  
Author(s):  
Janelle K. Lymbery ◽  
Wendy Gilleard
Keyword(s):  
Ground Reaction Force ◽  
Stance Phase ◽  
Center Of Pressure ◽  
Reaction Force ◽  
Late Pregnancy ◽  
Camera Motion ◽  
Motion Analysis System ◽  
Step Width ◽  
Analysis System ◽  
Camera Motion Analysis

The purpose of this study was to investigate temporospatial and ground reaction force variables in the stance phase of walking during late pregnancy. An eight-camera motion-analysis system was used to record 13 pregnant women at 38 weeks’ gestation and again 8 weeks after birth. In late pregnancy, there was a wider step width, and mediolateral ground reaction force tended to be increased in a medial direction. The center of pressure moved more medially initially and less anteriorly at 100% of stance in late pregnancy. The differences suggest that women may adapt their gait to maximize stability in the stance phase of walking and to control mediolateral motion. (J Am Podiatr Med Assoc 95(3): 247–253, 2005)

scholarly journals Tendon release reduced joint stiffness with unaltered leg stiffness during gait in spastic diplegic cerebral palsy

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245616
Author(s):  
Chien-Chung Kuo ◽  
Hsing-Po Huang ◽  
Ting-Ming Wang ◽  
Shih-Wun Hong ◽  
Li-Wei Hung ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Gait Analysis ◽  
Lower Limb ◽  
Stance Phase ◽  
Joint Stiffness ◽  
Locomotor System ◽  
Leg Stiffness ◽  
Before And After ◽  
Stiffness Control ◽  
Clinical Gait Analysis

Biomechanical deviations at individual joints are often identified by gait analysis of patients with cerebral palsy (CP). Analysis of the control of joint and leg stiffness of the locomotor system during gait in children with spastic diplegic CP has been used to reveal their control strategy, but the differences between before and after surgery remain unknown. The current study aimed to bridge the gap by comparing the leg stiffness—both skeletal and muscular components—and associated joint stiffness during gait in 12 healthy controls and 12 children with spastic diplegic CP before and after tendon release surgery (TRS). Each subject walked at a self-selected pace on a 10-meter walkway while their kinematic and forceplate data were measured to calculate the stiffness-related variables during loading response, mid-stance, terminal stance, and pre-swing. The CP group altered the stiffness of the lower limb joints and decreased the demand on the muscular components while maintaining an unaltered leg stiffness during stance phase after the TRS. The TRS surgery improved the joint and leg stiffness control during gait, although residual deficits and associated deviations still remained. It is suggested that the stiffness-related variables be included in future clinical gait analysis for a more complete assessment of gait in children with CP.

An acoustic myography functional assessment of cerebral palsy subjects compared to healthy controls during physical exercise

2019 ◽  
Vol 40 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Jessica Pingel ◽  
Ida Torp Andersen ◽  
Rikke Broholm ◽  
Anja Harder ◽  
Else Marie Bartels ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Physical Exercise ◽  
Functional Assessment ◽  
Healthy Controls ◽  
Acoustic Myography

scholarly journals A comparative study: use of a Brain-computer Interface (BCI) device by people with cerebral palsy in interaction with computers

2015 ◽  
Vol 87 (4) ◽  
pp. 1929-1937 ◽  
Author(s):  
Regina O. Heidrich ◽  
Emely Jensen ◽  
Francisco Rebelo ◽  
Tiago Oliveira
Keyword(s):  
Cerebral Palsy ◽  
Comparative Study ◽  
Case Studies ◽  
Brain Computer Interface ◽  
Product Evaluation ◽  
Computer Interface ◽  
Healthy Controls ◽  
The Brain

ABSTRACT This article presents a comparative study among people with cerebral palsy and healthy controls, of various ages, using a Brain-computer Interface (BCI) device. The research is qualitative in its approach. Researchers worked with Observational Case Studies. People with cerebral palsy and healthy controls were evaluated in Portugal and in Brazil. The study aimed to develop a study for product evaluation in order to perceive whether people with cerebral palsy could interact with the computer and compare whether their performance is similar to that of healthy controls when using the Brain-computer Interface. Ultimately, it was found that there are no significant differences between people with cerebral palsy in the two countries, as well as between populations without cerebral palsy (healthy controls).

scholarly journals Dynamic Balancing Responses in Unilateral Transtibial Amputees Following Outward-Directed Perturbations During Slow Treadmill Walking Differ Considerably for Amputated and Non-Amputated Side

2021 ◽  
Author(s):  
Andrej Olenšek ◽  
Matjaž Zadravec ◽  
Helena Burger ◽  
Zlatko Matjačić
Keyword(s):  
Stance Phase ◽  
Center Of Pressure ◽  
Center Of Mass ◽  
Reaction Force ◽  
Dynamic Balancing ◽  
Transtibial Amputation ◽  
Control Subjects ◽  
Foot Strike ◽  
Transtibial Amputees ◽  
Proprioceptive Function

Abstract BackgroundDue to disrupted motor and proprioceptive function lower limb amputation imposes considerable challenges associated with balance and greatly increases risk of falling in case of perturbations during walking. The aim of this study was to investigate dynamic balancing responses in unilateral transtibial amputees when they were subjected to perturbing pushes to the pelvis in outward direction at the time of foot strike on non-amputated and amputated side during slow walking.MethodsFourteen subjects with unilateral transtibial amputation and nine control subjects participated in the study. They were subjected to perturbations that were delivered to the pelvis at the time of foot strike of either the left or right leg. We recorded trajectories of center of pressure and center of mass, durations of in-stance and stepping periods as well as ground reaction forces. Statistical analysis was performed to determine significant differences in dynamic balancing responses between control subjects and subjects with amputation when subjected to outward-directed perturbation upon entering stance phases with non-amputated or amputated side.ResultsWhen outward-directed perturbations were delivered at the time of foot strike of the non-amputated leg, subjects with amputation were able to modulate center of pressure and ground reaction force similarly as control subjects which indicates application of in-stance balancing strategies. On the other hand, there was a complete lack of in-stance response when perturbations were delivered when the amputated leg entered the stance phase. Subjects with amputations instead used the stepping strategy and adjusted placement of the non-amputated leg in the ensuing stance phase to make a cross-step. Such response resulted in significantly higher displacement of center of mass. ConclusionsResults of this study suggest that due to the absence of the COP modulation mechanism, which is normally supplied by ankle motor function, people with unilateral transtibial amputation are compelled to choose the stepping strategy over in-stance strategy when they are subjected to outward-directed perturbation on the amputated side. However, the stepping response is less efficient than in-stance response. To improve their balancing responses to unexpected balance perturbation people fitted with passive transtibial prostheses should undergo perturbation-based balance training during clinical rehabilitation.

Effect of Hopping Frequency on Bilateral Differences in Leg Stiffness

2013 ◽  
Vol 29 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Hiroaki Hobara ◽  
Koh Inoue ◽  
Kazuyuki Kanosue
Keyword(s):  
Ground Reaction Force ◽  
Center Of Mass ◽  
Reaction Force ◽  
Human Movement ◽  
Vertical Ground Reaction Force ◽  
Mass Model ◽  
Lower Extremity Injuries ◽  
Leg Stiffness ◽  
Significant Difference ◽  
Bilateral Differences

Understanding the degree of leg stiffness during human movement would provide important information that may be used for injury prevention. In the current study, we investigated bilateral differences in leg stiffness during one-legged hopping. Ten male participants performed one-legged hopping in place, matching metronome beats at 1.5, 2.2, and 3.0 Hz. Based on a spring-mass model, we calculated leg stiffness, which is defined as the ratio of maximal ground reaction force to maximum center of mass displacement at the middle of the stance phase, measured from vertical ground reaction force. In all hopping frequency settings, there was no significant difference in leg stiffness between legs. Although not statistically significant, asymmetry was the greatest at 1.5 Hz, followed by 2.2 and 3.0 Hz for all dependent variables. Furthermore, the number of subjects with an asymmetry greater than the 10% criterion was larger at 1.5 Hz than those at 2.2 and 3.0 Hz. These results will assist in the formulation of treatment-specific training regimes and rehabilitation programs for lower extremity injuries.

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