skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.


Title: Motion Analysis of Balance Pre and Post Sensorimotor Exercises to Enhance Elderly Mobility: A Case Study
Quantitative assessment of movement using motion capture provides insights on mobility which are not evident from clinical evaluation. Here, in older individuals that were healthy or had suffered a stroke, we aimed to investigate their balance in terms of changes in body kinematics and muscle activity. Our research question involved determining the effects on post- compared to pre-sensorimotor training exercises on maintaining or improving balance. Our research hypothesis was that training would improve the gait and balance by increasing joint angles and extensor muscle activities in lower extremities and spatiotemporal measures of stroke and elderly people. This manuscript describes a motion capture-based evaluation protocol to assess joint angles and spatiotemporal parameters (cadence, step length and walking speed), as well as major extensor and flexor muscle activities. We also conducted a case study on a healthy older participant (male, age, 65) and an older participant with chronic stroke (female, age, 55). Both participants performed a walking task along a path with a rectangular shape which included tandem walking forward, right side stepping, tandem walking backward, left side stepping to the starting location. For the stroke participant, the training improved the task completion time by 19 s. Her impaired left leg had improved step length (by 0.197 m) and cadence (by 10 steps/min) when walking forward, and cadence (by 12 steps/min) when walking backward. The non-impaired right leg improved cadence when walking forward (by 15 steps/min) and backward (by 27 steps/min). The joint range of motion (ROM) did not change in most cases. However, the ROM of the hip joint increased significantly by 5.8 degrees (p = 0.019) on the left leg side whereas the ROMs of hip joint and knee joint increased significantly by 4.1 degrees (p = 0.046) and 8.1 degrees (p = 0.007) on the right leg side during backward walking. For the healthy participant, the significant changes were only found in his right knee joint ROM having increased by 4.2 degrees (p = 0.031) and in his left ankle joint ROM having increased by 5.5 degrees (p = 0.006) during the left side stepping.  more » « less
Award ID(s):
1700219 1654474 1533479
PAR ID:
10403997
Author(s) / Creator(s):
; ;
Date Published:
Journal Name:
Applied Sciences
Volume:
13
Issue:
2
ISSN:
2076-3417
Page Range / eLocation ID:
889
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. Walking is the most common form of how animals move on land. The model organismDrosophila melanogasterhas become increasingly popular for studying how the nervous system controls behavior in general and walking in particular. Despite recent advances in tracking and modeling leg movements of walkingDrosophilain 3D, there are still gaps in knowledge about the biomechanics of leg joints due to the tiny size of fruit flies. For instance, the natural alignment of joint rotational axes was largely neglected in previous kinematic analyses. In this study, we therefore present a detailed kinematic leg model in which not only the segment lengths but also the main rotational axes of the joints were derived from anatomical landmarks, namely, the joint condyles. Our model with natural oblique joint axes is able to adapt to the 3D leg postures of straight and forward walking fruit flies with high accuracy. When we compared our model to an orthogonalized version, we observed that our model showed a smaller error as well as differences in the used range of motion (ROM), highlighting the advantages of modeling natural rotational axes alignment for the study of joint kinematics. We further found that the kinematic profiles of front, middle, and hind legs differed in the number of required degrees of freedom as well as their contributions to stepping, time courses of joint angles, and ROM. Our findings provide deeper insights into the joint kinematics of walking inDrosophila, and, additionally, will help to develop dynamical, musculoskeletal, and neuromechanical simulations. 
    more » « less
  2. Abstract Background To compare the performance (as determined by lower extremity kinematics) of knee exercises in healthy middle-aged and older individuals immediately after instruction and one week later. Methods This is a cross-sectional study in a laboratory setting. Nineteen healthy volunteers (age [y] 63.1 ± 8.6, mass [kg] 76.3 ± 14.7, height [m] 1.7 ± 0.1) participated in this study. High speed video and reflective markers were used to track motion during four exercises. The exercises were knee flexion, straight leg raise, and “V “in supine position, and hip abduction in side lying position. All participants received verbal and tactile cues during the training phase and the therapist observed and, if necessary, corrected the exercises. Upon return a week later the participants performed the same exercises without any further instructions. Knee and hip sagittal and rotational angles were extracted from the motion capture. A repeated measures t-test was used to compare the motions between two visits. Results Participants demonstrated more knee flexion during straight leg raise and “V in” exercises at the 2nd visit compared to the 1st visit (both p  <  0.05). During the “V out” exercise, they performed more external rotation ( p  <  0.05) while they showed more internal rotation during the “V in” exercise at the 2nd visit compared to the 1st visit. Conclusions Exercise performance declined significantly in healthy middle-aged and older individuals one week after instruction. This decline occurred despite an instructional exercise sheet being given to every participant. Other approaches designed to help individuals retain the ability to perform rehabilitative exercises correctly need to be explored. 
    more » « less
  3. Healthy human locomotion functions with good gait symmetry depend on rhythmic coordination of the left and right legs, which can be deteriorated by neurological disorders like stroke and spinal cord injury. Powered exoskeletons are promising devices to improve impaired people's locomotion functions, like gait symmetry. However, given higher uncertainties and the time-varying nature of human-robot interaction, providing personalized robotic assistance from exoskeletons to achieve the best gait symmetry is challenging, especially for people with neurological disorders. In this paper, we propose a hierarchical control framework for a bilateral hip exoskeleton to provide the adaptive optimal hip joint assistance with a control objective of imposing the desired gait symmetry during walking. Three control levels are included in the hierarchical framework, including the high-level control to tune three control parameters based on a policy iteration reinforcement learning approach, the middle-level control to define the desired assistive torque profile based on a delayed output feedback control method, and the low-level control to achieve a good torque trajectory tracking performance. To evaluate the feasibility of the proposed control framework, five healthy young participants are recruited for treadmill walking experiments, where an artificial gait asymmetry is imitated as the hemiparesis post-stroke, and only the ‘paretic’ hip joint is controlled with the proposed framework. The pilot experimental studies demonstrate that the hierarchical control framework for the hip exoskeleton successfully (asymmetry index from 8.8% to − 0.5%) and efficiently (less than 4 minutes) achieved the desired gait symmetry by providing adaptive optimal assistance on the ‘paretic’ hip joint. 
    more » « less
  4. Proportional myoelectric controller (PMC) has been one of the most common assistance strategies for robotic exoskeletons due to its ability to modulate assistance level directly based on the user's muscle activation. However, existing PMC strategies (static or user-adaptive) scale torque linearly with muscle activation level and fail to address complex and non-linear mapping between muscle activation and joint torque. Furthermore, previously presented adaptive PMC strategies do not allow for environmental changes (such as changes in ground slopes) and modulate the system's assistance level over many steps. In this work, we designed a novel user- and environment-adaptive PMC for a knee exoskeleton that modulates the peak assistance level based on the slope level during locomotion. We recruited nine able-bodied adults to test and compare the effects of three different PMC strategies (static, user-adaptive, and user- and environment-adaptive) on the user's metabolic cost and the knee extensor muscle activation level during load-carriage walking (6.8 kg) in three inclination settings (0°, 4.5°, and 8.5°). The results showed that only the user- and environment-adaptive PMC was effective in significantly reducing user's metabolic cost (5.8% reduction) and the knee extensor muscle activation (19% reduction) during 8.5° incline walking compared to the unpowered condition while other PMCs did not have as large of an effect. This control framework highlights the viability of implementing an assistance paradigm that can dynamically adjust to the user's biological demand, allowing for a more personalized assistance paradigm. 
    more » « less
  5. Many control methods have been proposed for powered prosthetic legs, ranging from finite state machines that switch between discrete phases of gait to unified controllers that have a continuous sense of phase. In particular, recent work has shown that a mechanical phase variable can parameterize the entire gait cycle for controlling a prosthetic leg during steady rhythmic locomotion. However, the unified approach does not provide voluntary control over non-rhythmic motions like stepping forward and back. In this paper we present a phasing algorithm that uses the amputee’s hip angle to control both rhythmic and non-rhythmic motion through two modes: 1) a piecewise (PW) function that provides users voluntary control over stance and swing in a piecewise manner, and 2) a unified function that continuously synchronizes the motion of the prosthetic leg with the amputee user at different walking speeds. The two phase variable approaches are compared in experiments with a powered knee-ankle prosthesis used by an above-knee amputee subject. 
    more » « less