Introduction Practicality of implementation and dosing of supplemental gait training in an acute ... more Introduction Practicality of implementation and dosing of supplemental gait training in an acute stroke inpatient rehabilitation setting are not well studied but can have positive impact on outcomes. Objectives To determine the feasibility of early, intense supplemental gait training in inpatient stroke rehabilitation, compare functional outcomes and the specific mode of delivery. Design and setting Assessor blinded, randomized controlled trial in a tertiary Inpatient Rehabilitation Facility. Participants Thirty acute post-stroke patients with unilateral hemiparesis (≥ 18 years of age with a lower limb MAS ≤ 3). Intervention Lokomat® or conventional gait training (CGT) in addition to standard mandated therapy time. Main outcome measures Number of therapy sessions; adverse events; functional independence measure (FIM motor); functional ambulation category (FAC); passive range of motion (PROM); modified Ashworth scale (MAS); 5 times sit-to-stand (5x-STS); 10-m walk test (10MWT); 2-min...
In the current study, preliminary testing has indicated that a suitably processed electr omyograp... more In the current study, preliminary testing has indicated that a suitably processed electr omyography (EMG) signal is sensitive enough to display changes in muscle activity in a normal population due to changes in oithotic alignment Anterior and posterior motion stops were used to vary alignments (range of motion) of an ankle foot orthosis with which the subjects walked Iritegrated values of linear enveloped EMG profiles (as a measure of total muscle a.ctivity) of five gait related muscles influenced by the orthosis were statistically compared for various alignments In four of the five muscles, these pr ofiles wer e found to differ in the same consistent marmer for each of the four subjects Changes in muscle activity were justified by biomechanical changes in gait More specifically, mechanically restricted joint motion changes demands placed on gait muscles, and may also alter their activation onset and duration As a simple example, during early stance the tibia otates over the foot a...
... Christopher Bigelow¹, Kimberly Edginton¹, Mukul Talaty², and Necip Berme³ ¹ Bertec Corporatio... more ... Christopher Bigelow¹, Kimberly Edginton¹, Mukul Talaty², and Necip Berme³ ¹ Bertec Corporation, Columbus, Ohio, USA; ² Gait & Motion Analysis ... TM Cook and BA Cozzens worked for Moss Rehabilitation in Pennsylvania while RE Major, GK Rose, and JH Tait designed a ...
ABSTRACT Objective techniques for determining proper configuration (alignment) of lower limb pros... more ABSTRACT Objective techniques for determining proper configuration (alignment) of lower limb prostheses can help standardize and improve the functional outcomes for amputees. We propose that a dynamic forceline visualization system can assist in the development of such techniques. The forceline is a tool that allows the visualization of the ground reaction force in real time and in a spatially accurate manner relative to the image of the person as he/she walks. We evaluated a simplified version of an alignment protocol based on the forceline and using three novice clinicians and four amputee test subjects. The goal was to determine how easily the novice clinicians could learn the technique and how well they could apply it. All three clinicians were given a group training lasting about 1.5 hrs in which they were familiarized with the forceline visualization tool and were shown how to use it for determining prosthetic alignment on subjects with lower limb amputation. Then, each clinician evaluated the same four amputees both with and without the use of the forceline. The clinicians were able to learn and incorporate the simple alignment methodology using the forceline easily—each demonstrating basic understanding and skill in applying the method on the first amputee that each one evaluated. In 36% of the cases, using the line helped to standardize the clinicians’ alignments to the target alignment (the laboratory “nominal”). In 14% of the cases, using the forceline actually moved the clinicians away from the laboratory nominal. The alignment technique presented can assist clinical thinking by removing some of the guesswork and uncertainty involved during the alignment process. No objective or widely accepted standard exists for the definition of an optimal prosthetic alignment. A technique, such as that presented here, may help in defining and also subsequently in obtaining an optimal alignment.
The objectives of this research were: 1) to determine how the use of upper extremities to assist ... more The objectives of this research were: 1) to determine how the use of upper extremities to assist during a chair rise task affects lower extremity loading; 2) to examine how task difficulty affects performance when weakness is present; and 3) to compare the compensation strategies utilized by individuals with chronic weakness to those used by patients with acute weakness. Twelve polio survivors with predominant unilateral weakness of the knee extensors and six adults with no history of polio who had recently undergone unilateral knee surgery participated in this study. The sit-stand task was performed under four different conditions that varied by chair height and/or use of armrests. The results showed that the compensation strategies utilized by the polio survivors and surgery patients were similar, although the polio survivors showed a higher degree of asymmetric weight bearing, especially in the most difficult condition. These results may be helpful in predicting sites for future ...
Introduction Practicality of implementation and dosing of supplemental gait training in an acute ... more Introduction Practicality of implementation and dosing of supplemental gait training in an acute stroke inpatient rehabilitation setting are not well studied but can have positive impact on outcomes. Objectives To determine the feasibility of early, intense supplemental gait training in inpatient stroke rehabilitation, compare functional outcomes and the specific mode of delivery. Design and setting Assessor blinded, randomized controlled trial in a tertiary Inpatient Rehabilitation Facility. Participants Thirty acute post-stroke patients with unilateral hemiparesis (≥ 18 years of age with a lower limb MAS ≤ 3). Intervention Lokomat® or conventional gait training (CGT) in addition to standard mandated therapy time. Main outcome measures Number of therapy sessions; adverse events; functional independence measure (FIM motor); functional ambulation category (FAC); passive range of motion (PROM); modified Ashworth scale (MAS); 5 times sit-to-stand (5x-STS); 10-m walk test (10MWT); 2-min...
In the current study, preliminary testing has indicated that a suitably processed electr omyograp... more In the current study, preliminary testing has indicated that a suitably processed electr omyography (EMG) signal is sensitive enough to display changes in muscle activity in a normal population due to changes in oithotic alignment Anterior and posterior motion stops were used to vary alignments (range of motion) of an ankle foot orthosis with which the subjects walked Iritegrated values of linear enveloped EMG profiles (as a measure of total muscle a.ctivity) of five gait related muscles influenced by the orthosis were statistically compared for various alignments In four of the five muscles, these pr ofiles wer e found to differ in the same consistent marmer for each of the four subjects Changes in muscle activity were justified by biomechanical changes in gait More specifically, mechanically restricted joint motion changes demands placed on gait muscles, and may also alter their activation onset and duration As a simple example, during early stance the tibia otates over the foot a...
... Christopher Bigelow¹, Kimberly Edginton¹, Mukul Talaty², and Necip Berme³ ¹ Bertec Corporatio... more ... Christopher Bigelow¹, Kimberly Edginton¹, Mukul Talaty², and Necip Berme³ ¹ Bertec Corporation, Columbus, Ohio, USA; ² Gait & Motion Analysis ... TM Cook and BA Cozzens worked for Moss Rehabilitation in Pennsylvania while RE Major, GK Rose, and JH Tait designed a ...
ABSTRACT Objective techniques for determining proper configuration (alignment) of lower limb pros... more ABSTRACT Objective techniques for determining proper configuration (alignment) of lower limb prostheses can help standardize and improve the functional outcomes for amputees. We propose that a dynamic forceline visualization system can assist in the development of such techniques. The forceline is a tool that allows the visualization of the ground reaction force in real time and in a spatially accurate manner relative to the image of the person as he/she walks. We evaluated a simplified version of an alignment protocol based on the forceline and using three novice clinicians and four amputee test subjects. The goal was to determine how easily the novice clinicians could learn the technique and how well they could apply it. All three clinicians were given a group training lasting about 1.5 hrs in which they were familiarized with the forceline visualization tool and were shown how to use it for determining prosthetic alignment on subjects with lower limb amputation. Then, each clinician evaluated the same four amputees both with and without the use of the forceline. The clinicians were able to learn and incorporate the simple alignment methodology using the forceline easily—each demonstrating basic understanding and skill in applying the method on the first amputee that each one evaluated. In 36% of the cases, using the line helped to standardize the clinicians’ alignments to the target alignment (the laboratory “nominal”). In 14% of the cases, using the forceline actually moved the clinicians away from the laboratory nominal. The alignment technique presented can assist clinical thinking by removing some of the guesswork and uncertainty involved during the alignment process. No objective or widely accepted standard exists for the definition of an optimal prosthetic alignment. A technique, such as that presented here, may help in defining and also subsequently in obtaining an optimal alignment.
The objectives of this research were: 1) to determine how the use of upper extremities to assist ... more The objectives of this research were: 1) to determine how the use of upper extremities to assist during a chair rise task affects lower extremity loading; 2) to examine how task difficulty affects performance when weakness is present; and 3) to compare the compensation strategies utilized by individuals with chronic weakness to those used by patients with acute weakness. Twelve polio survivors with predominant unilateral weakness of the knee extensors and six adults with no history of polio who had recently undergone unilateral knee surgery participated in this study. The sit-stand task was performed under four different conditions that varied by chair height and/or use of armrests. The results showed that the compensation strategies utilized by the polio survivors and surgery patients were similar, although the polio survivors showed a higher degree of asymmetric weight bearing, especially in the most difficult condition. These results may be helpful in predicting sites for future ...
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