Pub Date : 2023-09-01DOI: 10.1016/j.gaitpost.2023.07.264
Zhongzheng Wang, Francesco Cenni, Iida Laatikainen-Raussi, Taija Finni, Ruoli Wang
Skeletal muscle architecture provides valuable insights for individuals with neuromuscular diseases, such as cerebral palsy (CP) [1]. Yet, to have a comprehensive view of muscle remodelling and better-informed clinical treatments, muscle quality (i.e. intramuscular fat, collagen fibres, and mechanical properties) should also be explored [2]. This comprehensive view can be achieved in a non-invasive image-based manner by combing magnetic resonance imaging (MRI) and shear wave elastography (SWE). What is the relationship between intramuscular fat fraction or T2 relaxation time and muscle mechanical properties? One individual with CP (13 years, male, GMFCS I) and four typically developing (TD, 17.3±7.9 years, 4 females) peers were enrolled in the study. Medial gastrocnemius (MG), lateral gastrocnemius (LG), and soleus (SOL) were assessed in neutral position (middle position between maximal dorsiflexed and plantarflexed position; CP -15.0°, TD -16.3±6.3°), while participants were laying prone with knee extended. SWE (Aixplorer, Supersonic Imagine) was recorded for MG and LG at mid-muscle belly, for SOL distally below the LG muscle-tendon junction. Shear modulus was estimated by means of an open-source software (ELASTOGUI, University of Nantes). Fat fraction and T2 relaxation times were estimated from modified Dixon and T2 mapping sequence using a 3.0-Tesla MR scanner (Ingenia CX, Philips Healthcare) at the same ankle position as SWE measurements. The intramuscular fat fraction was calculated based on 2-point fat-water separation [3]. T2 relaxation time is a quantitative parameter indicating collagen fibres content [4]. The correlation between shear modulus and fat fraction / T2 relaxation time was evaluated using linear correlation coefficient. Overall, the individual with CP showed higher muscle shear moduli than TD peers (Figure A) in all three muscles. The individual with CP had a similar fat content in MG and LG but higher fat content in SOL than TD peers (Figure B&F). Regarding the collagen fibres, the average T2 relaxation time for all three muscles were similar in both groups (Figure C). Overall, the correlation between muscle shear modulus and fat fraction / T2 relaxation time was weak (R=0.24 for fat fraction, R=-0.10 for T2 relaxation time, Figure D&E). Figure. (A-C) Average shear modulus, fat fraction, and T2 relaxation time. (D-E) Correlation between shear modulus and fat fraction / T2 relaxation time. The scatter points mean the imaging parameter and related shear modulus for all subjects. (F-G) Sample fat fraction and T2 maps. Download : Download high-res image (178KB)Download : Download full-size image This study is a first attempt to comprehensively analyze muscle quality in CP by combining MRI and SWE. It confirms the increased muscle fat fraction in CP [5], whilst no difference for T2 relaxation time was observed. The correlation results suggested higher passive muscle stiffness with higher fat content. These preliminary results nee
骨骼肌结构为脑瘫(CP)等神经肌肉疾病患者提供了宝贵的见解[1]。然而,为了全面了解肌肉重塑和更好的临床治疗,还应该探索肌肉质量(即肌内脂肪、胶原纤维和力学性能)[2]。通过结合磁共振成像(MRI)和横波弹性成像(SWE),可以以一种无创的基于图像的方式获得这种全面的视图。肌内脂肪含量或T2松弛时间与肌肉力学性能有何关系?1例CP患者(13岁,男性,GMFCS I)和4例发育典型的TD患者(17.3±7.9岁,4例女性)被纳入研究。腓肠肌内侧(MG)、腓肠肌外侧(LG)和比目鱼肌(SOL)在中立位(最大背屈位和跖屈位之间的中间位置;CP -15.0°,TD -16.3±6.3°),受试者俯卧,膝关节伸直。在中肌腹部的MG和LG, LG肌-肌腱连接处远端以下的SOL记录了SWE (aiexplorer, Supersonic Imagine)。剪切模量通过开源软件(ELASTOGUI, University of Nantes)估算。使用3.0-Tesla MR扫描仪(Ingenia CX, Philips Healthcare)在与SWE测量相同的脚踝位置,根据改进的Dixon和T2制图序列估计脂肪分数和T2松弛时间。肌内脂肪分数采用2点脂水分离法计算[3]。T2松弛时间是反映胶原纤维含量的定量参数[4]。用线性相关系数评价剪切模量与脂肪分数/ T2松弛时间的相关性。总体而言,CP患者的三块肌肉剪切模量均高于TD患者(图A)。CP患者的MG和LG脂肪含量相似,但SOL脂肪含量高于TD患者(图B&F)。在胶原纤维方面,两组三种肌肉的平均T2松弛时间相似(图C)。总体而言,肌肉剪切模量与脂肪分数/ T2松弛时间之间的相关性较弱(脂肪分数R=0.24, T2松弛时间R=-0.10,图D&E)。数字(A-C)平均剪切模量、脂肪分数和T2松弛时间。(D-E)剪切模量与脂肪分数/ T2松弛时间的相关性。散点表示所有受试者的成像参数和相关剪切模量。(F-G)样品脂肪分数和T2图。下载:下载高分辨率图像(178KB)下载:下载全尺寸图像本研究首次尝试结合MRI和SWE对CP的肌肉质量进行综合分析。它证实了CP中肌肉脂肪含量的增加[5],而T2松弛时间没有观察到差异。相关结果表明,脂肪含量越高,被动肌肉僵硬度越高。一旦收集到更大的样本,这些初步结果需要得到证实。
{"title":"Muscle quality: Intramuscular fat, collagen fibres, and mechanical properties in the triceps surae","authors":"Zhongzheng Wang, Francesco Cenni, Iida Laatikainen-Raussi, Taija Finni, Ruoli Wang","doi":"10.1016/j.gaitpost.2023.07.264","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.264","url":null,"abstract":"Skeletal muscle architecture provides valuable insights for individuals with neuromuscular diseases, such as cerebral palsy (CP) [1]. Yet, to have a comprehensive view of muscle remodelling and better-informed clinical treatments, muscle quality (i.e. intramuscular fat, collagen fibres, and mechanical properties) should also be explored [2]. This comprehensive view can be achieved in a non-invasive image-based manner by combing magnetic resonance imaging (MRI) and shear wave elastography (SWE). What is the relationship between intramuscular fat fraction or T2 relaxation time and muscle mechanical properties? One individual with CP (13 years, male, GMFCS I) and four typically developing (TD, 17.3±7.9 years, 4 females) peers were enrolled in the study. Medial gastrocnemius (MG), lateral gastrocnemius (LG), and soleus (SOL) were assessed in neutral position (middle position between maximal dorsiflexed and plantarflexed position; CP -15.0°, TD -16.3±6.3°), while participants were laying prone with knee extended. SWE (Aixplorer, Supersonic Imagine) was recorded for MG and LG at mid-muscle belly, for SOL distally below the LG muscle-tendon junction. Shear modulus was estimated by means of an open-source software (ELASTOGUI, University of Nantes). Fat fraction and T2 relaxation times were estimated from modified Dixon and T2 mapping sequence using a 3.0-Tesla MR scanner (Ingenia CX, Philips Healthcare) at the same ankle position as SWE measurements. The intramuscular fat fraction was calculated based on 2-point fat-water separation [3]. T2 relaxation time is a quantitative parameter indicating collagen fibres content [4]. The correlation between shear modulus and fat fraction / T2 relaxation time was evaluated using linear correlation coefficient. Overall, the individual with CP showed higher muscle shear moduli than TD peers (Figure A) in all three muscles. The individual with CP had a similar fat content in MG and LG but higher fat content in SOL than TD peers (Figure B&F). Regarding the collagen fibres, the average T2 relaxation time for all three muscles were similar in both groups (Figure C). Overall, the correlation between muscle shear modulus and fat fraction / T2 relaxation time was weak (R=0.24 for fat fraction, R=-0.10 for T2 relaxation time, Figure D&E). Figure. (A-C) Average shear modulus, fat fraction, and T2 relaxation time. (D-E) Correlation between shear modulus and fat fraction / T2 relaxation time. The scatter points mean the imaging parameter and related shear modulus for all subjects. (F-G) Sample fat fraction and T2 maps. Download : Download high-res image (178KB)Download : Download full-size image This study is a first attempt to comprehensively analyze muscle quality in CP by combining MRI and SWE. It confirms the increased muscle fat fraction in CP [5], whilst no difference for T2 relaxation time was observed. The correlation results suggested higher passive muscle stiffness with higher fat content. These preliminary results nee","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"371 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.gaitpost.2023.07.188
Yunus Ozdemir, Nazif Ekin Akalan, Yener Temelli
The Selective Motor Control Assessment of the Lower Extremity (SCALE) is a tool used to assess the quality of motor control of the lower extremity in cerebral palsy (CP). Selective motor control (SMC) is known to be associated with balance and some walking alterations, as well as a significant sign for gross motor function (1-3). It is well known that the single limb stance has a strong relationship with the stability in stance which is the main aim of physiotherapy for improving the quality of walking for CP (4). Therefore the aim of this study is to determine the relationship between SMC, single-limb standing (SLS) time and single support time (SST) of gait in CP. Is there any relationship between SMC with SLS time and SST of gait in individuals with CP? In this study, 10 individuals with spastic type diplegics CP (mean age: 12,7±5,86) were included and bilateral limbs (n:20) were evaluated. Inclusion criteria were GMFCS level I or II, walk 10 meters without assistive device. Patients who had undergone surgery or had botulinum toxin injections in the last 6 months were excluded. The Selective Control Assessment of the Lower Extremity (SCALE) was performed on the hip (S1), knee (S2), subtalar (S3), ankle (S4) and toes (S5) joint for SMC. In addition, the total foot score (TFS) was calculated by summing the subtalar, ankle and toe joint scores; and the total score (TS) is calculated by summing all joints. Independent SLS score of the Gross Motor Function Measure was applied (three point scale). The interested gait parameters of each individual were analyzed with a pedobarography (Win-track, Balma, France). The SST was normalized by dividing stance time. For each parameter, 3 averaged trials were included. Pearson and Spearman’s correlation with Cohen's classification were used for statistical analysis (5). S3, TFS and TS had a strongly positive correlation with SLS score. There was a moderate positive correlation between S5 and SST (Table 1). Download : Download high-res image (207KB)Download : Download full-size image Strong positive correlation of total foot and total scores on SCALE test with single limb stance may show that improving total SMC, especially on subtalar joints, may increase the time of independent standing on one leg. Although only SMC at toes has the moderate level correlation with SST which is also the parameter related with stability in stance phase (4). Therefore improving motor control on toe flex-extension may have a great potential on increasing stance phase stability for CP. It is worthwhile to design randomized control studies with a large number of participants to analyze the relationship of improving SMC and stability in the stance phase by 3D gait analysis in the future.
选择性下肢运动控制评估(Selective Motor Control Assessment of The Lower Extremity, SCALE)是一种用于评估脑瘫患者下肢运动控制质量的工具。选择性运动控制(SMC)已知与平衡和一些行走改变有关,也是大运动功能的重要标志(1-3)。众所周知,单肢站立与站立稳定性有很强的关系,而站立稳定性是CP物理治疗提高行走质量的主要目的(4)。因此,本研究的目的是确定SMC与CP中单肢站立(SLS)时间和步态单支撑时间(SST)之间的关系。在CP个体中,SMC与SLS时间和步态SST之间是否存在关系?本研究纳入10例痉挛性双瘫CP患者(平均年龄:12、7±5、86),对20例双侧肢体进行评估。纳入标准为GMFCS I级或II级,无辅助器具行走10米。排除在过去6个月内接受过手术或注射过肉毒杆菌毒素的患者。对髋关节(S1)、膝关节(S2)、距下关节(S3)、踝关节(S4)和脚趾关节(S5)进行下肢选择性控制评估(SCALE)。此外,将距下、踝关节和脚趾关节评分相加计算足部总评分(TFS);总得分(TS)由所有关节之和计算。采用大肌肉运动功能量表独立SLS评分(三分制)。对每个个体感兴趣的步态参数进行足部摄影分析(Win-track, Balma, France)。通过除以姿态时间对海表温度进行归一化。对于每个参数,包括3次平均试验。采用Pearson和Spearman与Cohen分类的相关性进行统计分析(5)。S3、TFS、TS与SLS评分呈强正相关。S5与SST之间存在中等正相关(表1)。下载:下载高分辨率图像(207KB)下载:下载全尺寸图像单肢站立时,全足与SCALE测试总分呈强正相关,可能表明改善全足SMC,特别是距下关节,可以增加单腿独立站立的时间。虽然只有趾部SMC与SST有中等程度的相关性,而SST也是与站立阶段稳定性相关的参数(4)。因此,改善趾部屈伸运动控制可能对提高CP的站立阶段稳定性有很大的潜力。未来值得设计大量参与者的随机对照研究,通过三维步态分析来分析改善SMC与站立阶段稳定性的关系。
{"title":"Selective motor control may be associated with the single support time of gait and single limb standing time in cerebral palsy","authors":"Yunus Ozdemir, Nazif Ekin Akalan, Yener Temelli","doi":"10.1016/j.gaitpost.2023.07.188","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.188","url":null,"abstract":"The Selective Motor Control Assessment of the Lower Extremity (SCALE) is a tool used to assess the quality of motor control of the lower extremity in cerebral palsy (CP). Selective motor control (SMC) is known to be associated with balance and some walking alterations, as well as a significant sign for gross motor function (1-3). It is well known that the single limb stance has a strong relationship with the stability in stance which is the main aim of physiotherapy for improving the quality of walking for CP (4). Therefore the aim of this study is to determine the relationship between SMC, single-limb standing (SLS) time and single support time (SST) of gait in CP. Is there any relationship between SMC with SLS time and SST of gait in individuals with CP? In this study, 10 individuals with spastic type diplegics CP (mean age: 12,7±5,86) were included and bilateral limbs (n:20) were evaluated. Inclusion criteria were GMFCS level I or II, walk 10 meters without assistive device. Patients who had undergone surgery or had botulinum toxin injections in the last 6 months were excluded. The Selective Control Assessment of the Lower Extremity (SCALE) was performed on the hip (S1), knee (S2), subtalar (S3), ankle (S4) and toes (S5) joint for SMC. In addition, the total foot score (TFS) was calculated by summing the subtalar, ankle and toe joint scores; and the total score (TS) is calculated by summing all joints. Independent SLS score of the Gross Motor Function Measure was applied (three point scale). The interested gait parameters of each individual were analyzed with a pedobarography (Win-track, Balma, France). The SST was normalized by dividing stance time. For each parameter, 3 averaged trials were included. Pearson and Spearman’s correlation with Cohen's classification were used for statistical analysis (5). S3, TFS and TS had a strongly positive correlation with SLS score. There was a moderate positive correlation between S5 and SST (Table 1). Download : Download high-res image (207KB)Download : Download full-size image Strong positive correlation of total foot and total scores on SCALE test with single limb stance may show that improving total SMC, especially on subtalar joints, may increase the time of independent standing on one leg. Although only SMC at toes has the moderate level correlation with SST which is also the parameter related with stability in stance phase (4). Therefore improving motor control on toe flex-extension may have a great potential on increasing stance phase stability for CP. It is worthwhile to design randomized control studies with a large number of participants to analyze the relationship of improving SMC and stability in the stance phase by 3D gait analysis in the future.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"2010 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
One of the main parts of body that play key role in tennis matches is shoulder complex [1,2]. There are many joints and muscles caused shoulder to be complex [2–5]. Evaluation of the muscle activities is necessary to improve safety and performance [5]. The fundamental challenge for evaluation of muscle activity is measuring by EMG due to limitation of equipment, expensiveness, and inaccessibility to deep muscles [6–8]. Therefore, it is important to use musculoskeletal modeling to evaluate muscle activation [9–12]. On the other hand, there have been different musculoskeletal models with different joint definitions and the DOF [13,14]. Thus, the goal of this study was to validate the muscle activation output from different model by EMG data for the TFOS. How does muscle activity from experimental and modeling valuations change during the tennis forehand overhead smash (TFOS)? Twenty-five professional tennis athletes (Mass: 69.3±7.5 kg, Heights: 178±9.3 cm, Age: 29.5±7.5 years). The kinematics of markers were recorded by a 12 high-speed motion captures (Vicon, Oxford, UK, 100 Hz). The shoulder model of Holzbaur et al. [15–17] selected as base model and three version of models extracted based on the DOF: (5 DOF) a model with only three rotational DOF between humerus and trunk Glenohumeral joint, (11 DOF) a model with three rotational DOF for Scapulothoracic joint, Acromioclavicular joint, and Glenohumeral joint, (Stanford) a model with coupled motions for scapula, clavicle, and humerus. All models include two DOF for radio-ulna and elbow joints. After scaling the models, the inverse kinematics, inverse dynamics, and static optimization tools were applied to compute kinematics, kinetics, and muscle activity variables. The EMG activity in selective muscles was measured by the Myon wireless EMG system with a sampling frequency of 1000 Hz [18]. The average RMS of differences between each model and EMG (RMSE) over the muscles were 0.27±0.10, 0.29±0.12, and 0.22±0.10 for 5DOF, Stanford, and 11DOF models, respectively. Furthermore, the average Pearson's correlation coefficient over the muscles were 0.89±0.08, 0.88±0.09, and 0.93±0.60 for 5DOF, Stanford, and 11DOF models, respectively. The minimum RMS error (0.22±0.10) and maximum Pearson's correlation coefficient (0.93±0.60) were observed for 11 DOF model. Table 1: Muscle activity comparison between musculoskeletal simulation outputs (from three different models) and experimental data (EMG) including the RMSE, and Pearson's correlation coefficient for the TFOS movement.Download : Download high-res image (181KB)Download : Download full-size image According to the results, the 11 DOF model are more similar to the experimental (EMG) based on both RMSE and Pearson's correlation coefficient. Although the simulation results of some muscles were significantly different from the experimental results. Therefore, the alternative method to quantify muscle activation is musculoskeletal modeling. Moreover, the best mode
{"title":"Muscle activity of upper extremity during the is tennis forehand overhead smash: Experimental VS musculoskeletal modeling","authors":"Sheida Shourabadi Takabi, Meroeh Mohammadi, Reza Najarpour","doi":"10.1016/j.gaitpost.2023.07.162","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.162","url":null,"abstract":"One of the main parts of body that play key role in tennis matches is shoulder complex [1,2]. There are many joints and muscles caused shoulder to be complex [2–5]. Evaluation of the muscle activities is necessary to improve safety and performance [5]. The fundamental challenge for evaluation of muscle activity is measuring by EMG due to limitation of equipment, expensiveness, and inaccessibility to deep muscles [6–8]. Therefore, it is important to use musculoskeletal modeling to evaluate muscle activation [9–12]. On the other hand, there have been different musculoskeletal models with different joint definitions and the DOF [13,14]. Thus, the goal of this study was to validate the muscle activation output from different model by EMG data for the TFOS. How does muscle activity from experimental and modeling valuations change during the tennis forehand overhead smash (TFOS)? Twenty-five professional tennis athletes (Mass: 69.3±7.5 kg, Heights: 178±9.3 cm, Age: 29.5±7.5 years). The kinematics of markers were recorded by a 12 high-speed motion captures (Vicon, Oxford, UK, 100 Hz). The shoulder model of Holzbaur et al. [15–17] selected as base model and three version of models extracted based on the DOF: (5 DOF) a model with only three rotational DOF between humerus and trunk Glenohumeral joint, (11 DOF) a model with three rotational DOF for Scapulothoracic joint, Acromioclavicular joint, and Glenohumeral joint, (Stanford) a model with coupled motions for scapula, clavicle, and humerus. All models include two DOF for radio-ulna and elbow joints. After scaling the models, the inverse kinematics, inverse dynamics, and static optimization tools were applied to compute kinematics, kinetics, and muscle activity variables. The EMG activity in selective muscles was measured by the Myon wireless EMG system with a sampling frequency of 1000 Hz [18]. The average RMS of differences between each model and EMG (RMSE) over the muscles were 0.27±0.10, 0.29±0.12, and 0.22±0.10 for 5DOF, Stanford, and 11DOF models, respectively. Furthermore, the average Pearson's correlation coefficient over the muscles were 0.89±0.08, 0.88±0.09, and 0.93±0.60 for 5DOF, Stanford, and 11DOF models, respectively. The minimum RMS error (0.22±0.10) and maximum Pearson's correlation coefficient (0.93±0.60) were observed for 11 DOF model. Table 1: Muscle activity comparison between musculoskeletal simulation outputs (from three different models) and experimental data (EMG) including the RMSE, and Pearson's correlation coefficient for the TFOS movement.Download : Download high-res image (181KB)Download : Download full-size image According to the results, the 11 DOF model are more similar to the experimental (EMG) based on both RMSE and Pearson's correlation coefficient. Although the simulation results of some muscles were significantly different from the experimental results. Therefore, the alternative method to quantify muscle activation is musculoskeletal modeling. Moreover, the best mode","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.gaitpost.2023.07.216
Maria B. Sánchez, Andy Sanderson, Emma Hodson-Tole
The trunk represents almost 50% of the total mass of a person [1] and, because it comprises multiple segments, has a large range of motion [2]. Trunk posture and movement are important in the execution of activities of daily living (ADL), especially for those related with arm function [3]. However, in movement analysis, the trunk is usually defined as a single rigid, cylindrical segment between the shoulders and pelvis. This oversimplification ignores the large movement potential the trunk has [2], and therefore does not enable a complete evaluation of trunk movement. Does a single segment trunk model adequately reveal trunk movements for a simple reaching and grasping movement? The University Ethics Committee (ref:47565) approved the project. Eleven people (7 male; (mean ±SD) age: 27.82 ±3.18years, height: 1.74 ±0.11 m; weight: 75.0 ±12.7 kg) participated after signing the consent form. An upper-body marker-set was used: left/right acromion, iliac-crest, ASIS; manubrium, S1; five inverted “L” clusters of 3 markers: two 2.5 cm lateral of C7, T3, T7, T11 and L3, with the third marker on the long end of the “L” with the length adjusted based on the participant’ s size. These defined a single-segment-trunk (acromia to iliac-crests), and upper-, mid- and lower-thoracic, and upper- and lower-lumbar segments (multi-segment-trunk). Participants were asked to stand from a hight-adjustable bench, walk to a low table and lean to collect a mug before returning to the bench. Motion capture data were recorded (100 Hz), tracked, and processed. Segmental angles (in relation to the absolute coordinate system) were estimated for the “leaning to collect” section of each trial. The total displacement in each plane and a combined 3D movement (sum of the three planes) of the single-segment-trunk and of the multi-segment-trunk compared with a paired sample t-test. Table 1 shows the difference in the combined 3D movement for the single-segment-trunk when compared to the multi-segment-trunk (t = 27.95, p<.01) and for each of the planes of movement (t = 18.21, 11.19, 14.15, p<.01, for sagittal, frontal and horizontal). The standardised mean difference was considered very large (8.07 ±8.06).Download : Download high-res image (82KB)Download : Download full-size image This simplified approach identified the scale of additional information that could be gained from a multi-segment-trunk. Further exploration should focus on understanding if the amount of movement in a multi-segment-trunk vs single-segment-trunk is of a very different magnitude; it should also look specifically at where are the more important differences. Additional development might focus on understanding the best representation of the trunk movement when assessing ADL in clinical populations. I would say this phrasing is better, calling your approach very simple is an insult to your work, calling it simplified indicates that you’re just presenting in a simple way for them.
{"title":"Does a single segment trunk model adequately reveal trunk movements for a simple reaching and grasping movement?","authors":"Maria B. Sánchez, Andy Sanderson, Emma Hodson-Tole","doi":"10.1016/j.gaitpost.2023.07.216","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.216","url":null,"abstract":"The trunk represents almost 50% of the total mass of a person [1] and, because it comprises multiple segments, has a large range of motion [2]. Trunk posture and movement are important in the execution of activities of daily living (ADL), especially for those related with arm function [3]. However, in movement analysis, the trunk is usually defined as a single rigid, cylindrical segment between the shoulders and pelvis. This oversimplification ignores the large movement potential the trunk has [2], and therefore does not enable a complete evaluation of trunk movement. Does a single segment trunk model adequately reveal trunk movements for a simple reaching and grasping movement? The University Ethics Committee (ref:47565) approved the project. Eleven people (7 male; (mean ±SD) age: 27.82 ±3.18years, height: 1.74 ±0.11 m; weight: 75.0 ±12.7 kg) participated after signing the consent form. An upper-body marker-set was used: left/right acromion, iliac-crest, ASIS; manubrium, S1; five inverted “L” clusters of 3 markers: two 2.5 cm lateral of C7, T3, T7, T11 and L3, with the third marker on the long end of the “L” with the length adjusted based on the participant’ s size. These defined a single-segment-trunk (acromia to iliac-crests), and upper-, mid- and lower-thoracic, and upper- and lower-lumbar segments (multi-segment-trunk). Participants were asked to stand from a hight-adjustable bench, walk to a low table and lean to collect a mug before returning to the bench. Motion capture data were recorded (100 Hz), tracked, and processed. Segmental angles (in relation to the absolute coordinate system) were estimated for the “leaning to collect” section of each trial. The total displacement in each plane and a combined 3D movement (sum of the three planes) of the single-segment-trunk and of the multi-segment-trunk compared with a paired sample t-test. Table 1 shows the difference in the combined 3D movement for the single-segment-trunk when compared to the multi-segment-trunk (t = 27.95, p<.01) and for each of the planes of movement (t = 18.21, 11.19, 14.15, p<.01, for sagittal, frontal and horizontal). The standardised mean difference was considered very large (8.07 ±8.06).Download : Download high-res image (82KB)Download : Download full-size image This simplified approach identified the scale of additional information that could be gained from a multi-segment-trunk. Further exploration should focus on understanding if the amount of movement in a multi-segment-trunk vs single-segment-trunk is of a very different magnitude; it should also look specifically at where are the more important differences. Additional development might focus on understanding the best representation of the trunk movement when assessing ADL in clinical populations. I would say this phrasing is better, calling your approach very simple is an insult to your work, calling it simplified indicates that you’re just presenting in a simple way for them.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.gaitpost.2023.07.276
Yihong Zhao, Shiyang Yan, Ruoyi Li, Luming Yang, Bi Shi
Obesity will cause changes in foot structure and plantar pressure distribution, increasing the risk of foot pain and injury [1]. Functional footwear (outsole) is an essential way to distribute the local plantar pressure for children with obesity. However, the traditional design and research of outsoles need to go through the whole process of design, molding, production, fitting experiments, and so on, which is a long time and high-cost consumption. How to obtain the optimal design scheme of cushioned footwear for children with obesity through finite element analysis? Based on the database of foot morphology of children with obesity, a 3D outsole model was established, and the arch height of the outsole was set as 30%, 60%, and 100% of the arch height of children with obesity. Based on the anthropometric data, biomechanical data, and CT imaging data of children with obesity, a biomechanical simulation model of the lower limb musculoskeletal system and a finite element model of the foot were established. To verify the validity of the finite element model, the simulation results of the maximum principal stress of children with obesity during walking were compared with the actual measured data.The structure of the outsole is preliminarily constructed in Solidworks. The arch height (30%, 60%, and 100%) of the outsole was set to simulate the support at the arch. The foot-outsole-ground structure was assembled, and the pressure on the foot-shoe interface was simulated in ANSYS Workbench, to explore the dispersion effect of different arch heights. After obtaining the best design scheme, the actual relief effect of the outsoles was tested through the try-on trials. The simulation results showed that the 60% arch height support could effectively achieve the dispersion of plantar pressure in the plantar toe area and heel area. The try-on results showed that, when wearing the cushioned footwear, the peak pressure in the central forefoot and heel were relieved by 36.8% and 43.8%, respectively, from176.5 kPa and 310.9 kPa to 111.6 kPa and 174.7 kPa. Fig. 1 (a) 3D model of coushioned outsole. (b) Finite element analysis and verfication results. (c) Construction and assembly of the outsole structure. (d) The finite element analysis results between foot and outsole with the 60% arch height. (e) The cushioned footwear. (f) The cushioned effects of the outsole in the try-on experiments.Download : Download high-res image (244KB)Download : Download full-size image Through finite element analysis and fitting verification test, we found that when the arch height of the outsole is 60% of the arch height of the children with obesity, the decompression function is the best, which can transfer the pressure of the front palm and heel to the arch and toe. Finite element analysis makes functional shoe development process more efficient.
{"title":"Design of cushioned footwear for children with obesity based on gait dynamics and motion simulation","authors":"Yihong Zhao, Shiyang Yan, Ruoyi Li, Luming Yang, Bi Shi","doi":"10.1016/j.gaitpost.2023.07.276","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.276","url":null,"abstract":"Obesity will cause changes in foot structure and plantar pressure distribution, increasing the risk of foot pain and injury [1]. Functional footwear (outsole) is an essential way to distribute the local plantar pressure for children with obesity. However, the traditional design and research of outsoles need to go through the whole process of design, molding, production, fitting experiments, and so on, which is a long time and high-cost consumption. How to obtain the optimal design scheme of cushioned footwear for children with obesity through finite element analysis? Based on the database of foot morphology of children with obesity, a 3D outsole model was established, and the arch height of the outsole was set as 30%, 60%, and 100% of the arch height of children with obesity. Based on the anthropometric data, biomechanical data, and CT imaging data of children with obesity, a biomechanical simulation model of the lower limb musculoskeletal system and a finite element model of the foot were established. To verify the validity of the finite element model, the simulation results of the maximum principal stress of children with obesity during walking were compared with the actual measured data.The structure of the outsole is preliminarily constructed in Solidworks. The arch height (30%, 60%, and 100%) of the outsole was set to simulate the support at the arch. The foot-outsole-ground structure was assembled, and the pressure on the foot-shoe interface was simulated in ANSYS Workbench, to explore the dispersion effect of different arch heights. After obtaining the best design scheme, the actual relief effect of the outsoles was tested through the try-on trials. The simulation results showed that the 60% arch height support could effectively achieve the dispersion of plantar pressure in the plantar toe area and heel area. The try-on results showed that, when wearing the cushioned footwear, the peak pressure in the central forefoot and heel were relieved by 36.8% and 43.8%, respectively, from176.5 kPa and 310.9 kPa to 111.6 kPa and 174.7 kPa. Fig. 1 (a) 3D model of coushioned outsole. (b) Finite element analysis and verfication results. (c) Construction and assembly of the outsole structure. (d) The finite element analysis results between foot and outsole with the 60% arch height. (e) The cushioned footwear. (f) The cushioned effects of the outsole in the try-on experiments.Download : Download high-res image (244KB)Download : Download full-size image Through finite element analysis and fitting verification test, we found that when the arch height of the outsole is 60% of the arch height of the children with obesity, the decompression function is the best, which can transfer the pressure of the front palm and heel to the arch and toe. Finite element analysis makes functional shoe development process more efficient.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.gaitpost.2023.08.018
Gabor Barton, Jacob Beesley, Jasmine Milnes, Gabriela Czanner, Lynne Boddy
{"title":"There is life outside the gait lab: Effectiveness of a self-organising neural map for recognising 24/7 activities of daily living","authors":"Gabor Barton, Jacob Beesley, Jasmine Milnes, Gabriela Czanner, Lynne Boddy","doi":"10.1016/j.gaitpost.2023.08.018","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.08.018","url":null,"abstract":"","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.gaitpost.2023.07.171
Evelina Nilsson, Helena Grip, Catharina Österlund
The jaw and neck sensorimotor systems are functionally integrated during jaw functions1,2. The jaw border movements include maximum opening, laterotrusion to left and right, protrusion and retrusion3. Three-dimensional (3D) kinematic movement analysis provide data to distinguish natural movement patterns from those adapted to pain and dysfunction. Therefore, the reliability of kinematics is crucial to assess movement variability of integrated jaw-neck motor capacity. Can we ensure a high accuracy of the novel method intended to use for estimation of maximum jaw movements and geometric characterization (area and volume)? Is there a high test-retest reliability and intraindividual consistency for a group of healthy participants performing maximum jaw movements? 3D kinematic analysis was used for movement recognition. The first part included three glass beakers of different sizes, with known volumes and the cross-sectional area was estimated with a geometrical algorithm. The percentage deviation between target values and estimated values was calculated and to test the agreement a linear regression was made. The second part included 17 healthy participants (25.37 years ± 2.36). Maximum jaw movements were performed in a pre-determined movement pattern to track reflective marker positions of jaw and head segments. Movement amplitudes, magnitudes, areas, and volumes were analyzed. Intraclass correlation coefficient (ICC)4 estimates and Bland-Altman plots5 were used to assess test – retest reliability. Coefficient of variation (CV)6 tested the within session reliability. Preliminary results for the beakers showed a total percentage deviation from the target area and volume of 0.03 (SD 0.59) and 0.72 (SD 0.81), respectively. The linear regression showed a linear agreement between estimated and target value with R2=0.99. Preliminary results of test – retest reliability per movement outcome variable showed moderate to excellent reliability according to ICC-classification4. The limits of agreement between test and retest session presented with Bland-Altman plots showed good agreement between first and second measurement. The intra individual movement variability expressed as CV showed good repeatability. Jaw movements including the horizontal directions displayed widest ICC 95% confidence interval and highest CV values. (Fig. 1. Coefficient of variation - box plots).Download : Download high-res image (67KB)Download : Download full-size image This study addressed reliability of kinematic parameters of maximum jaw movements and its geometrics. The preliminary main findings indicate high accuracy of the novel method for estimations of volume and area. The agreement between sessions was considered good as well as consistency in repeated movements. Moreover, the more complex movement, the lower reliability and higher variability was seen. In future research of jaw-neck motor function the presented method is suggested to enables valid analysis of jaw movement perf
{"title":"Reliability of 3D kinematic recording of jaw and head movements","authors":"Evelina Nilsson, Helena Grip, Catharina Österlund","doi":"10.1016/j.gaitpost.2023.07.171","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.171","url":null,"abstract":"The jaw and neck sensorimotor systems are functionally integrated during jaw functions1,2. The jaw border movements include maximum opening, laterotrusion to left and right, protrusion and retrusion3. Three-dimensional (3D) kinematic movement analysis provide data to distinguish natural movement patterns from those adapted to pain and dysfunction. Therefore, the reliability of kinematics is crucial to assess movement variability of integrated jaw-neck motor capacity. Can we ensure a high accuracy of the novel method intended to use for estimation of maximum jaw movements and geometric characterization (area and volume)? Is there a high test-retest reliability and intraindividual consistency for a group of healthy participants performing maximum jaw movements? 3D kinematic analysis was used for movement recognition. The first part included three glass beakers of different sizes, with known volumes and the cross-sectional area was estimated with a geometrical algorithm. The percentage deviation between target values and estimated values was calculated and to test the agreement a linear regression was made. The second part included 17 healthy participants (25.37 years ± 2.36). Maximum jaw movements were performed in a pre-determined movement pattern to track reflective marker positions of jaw and head segments. Movement amplitudes, magnitudes, areas, and volumes were analyzed. Intraclass correlation coefficient (ICC)4 estimates and Bland-Altman plots5 were used to assess test – retest reliability. Coefficient of variation (CV)6 tested the within session reliability. Preliminary results for the beakers showed a total percentage deviation from the target area and volume of 0.03 (SD 0.59) and 0.72 (SD 0.81), respectively. The linear regression showed a linear agreement between estimated and target value with R2=0.99. Preliminary results of test – retest reliability per movement outcome variable showed moderate to excellent reliability according to ICC-classification4. The limits of agreement between test and retest session presented with Bland-Altman plots showed good agreement between first and second measurement. The intra individual movement variability expressed as CV showed good repeatability. Jaw movements including the horizontal directions displayed widest ICC 95% confidence interval and highest CV values. (Fig. 1. Coefficient of variation - box plots).Download : Download high-res image (67KB)Download : Download full-size image This study addressed reliability of kinematic parameters of maximum jaw movements and its geometrics. The preliminary main findings indicate high accuracy of the novel method for estimations of volume and area. The agreement between sessions was considered good as well as consistency in repeated movements. Moreover, the more complex movement, the lower reliability and higher variability was seen. In future research of jaw-neck motor function the presented method is suggested to enables valid analysis of jaw movement perf","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135299063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gait adaptation to perturbations is essential for safe interaction with the physical environment and therefore it is important to understand how people with lower-limb amputation adapt their gait to changing conditions (1). Previous studies tried to find some deviation patterns and understand the kinematic strategies of amputee's gait (2). However, there is limited information available on the hip kinematics of amputees during gait and there is no study has yet investigated the effect of the perturbation on the hip kinematics of amputees. How does unpredictable continuous perturbation during gait affect the hip kinematics of unilateral transtibial amputees? Individuals with unilateral trans-tibial amputations and using prostheses with an active vacuum plus carbon foot combination were included in to study. Kinematic data of the hip were collected from 11 amputees and 10 healthy controls during walking on two different ground conditions. Participants walked at least 512 steps at their preferred speed on a motorized treadmill’s (ReaxRun Pro) flat ground condition and then the gait analysis was repeated on a perturbed (5% unpredictable perturbation) ground condition. RehaGait- Pro system was used for evaluation of the kinematics of the hip(min-max hip angles and variability of the hip min-max angles) during gait. Negative values indicated hip hyperextension, positive values indicated hip flexion. The statistical analysis was performed by pairing the residual limbs of amputees with the non-dominant side of the healthy group (RL side), and the sound limbs with the dominant side of the healthy group (HL side). It was observed that the hip hyperextension angle on the sound limb side was bigger in the amputees than in the control group on flat (d=0.462; p=0.034) and perturbated ground (d=0.584; p=0.007). The effect size was larger on the perturbed ground. There was no difference in the maximum hip angles and variability of max-min hip angles between the groups in both ground conditions (p>0.05). The results showed in Table.Download : Download high-res image (142KB)Download : Download full-size image Amputation-related changes were observed in hip kinematics during walking under both ground conditions. However, this change was more prominent on the perturbated ground. The reason for the higher hip hyperextension values in amputees is thought to be due to their efforts to compensate for the ankle (exp. strong plantar flexion) movements. On the unpredictable perturbation ground, the limitation of ankle movements, which is one of the first adaptive mechanisms in adaptation to the ground (exp. subtalar rotations plus plantarflexion), may have made the situation more evident. Future studies may focus on the effect of gait training on perturbed surfaces on gait kinematics, which is an indicator of adaptation to variable conditions.
{"title":"The effect of perturbation on hip kinematics of transtibial amputees","authors":"Nimet Sermenli Aydın, İlke Kurt, Halit Selçuk, Sinem Salar, Sezer Ulukaya, Hilal Keklicek","doi":"10.1016/j.gaitpost.2023.07.229","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.229","url":null,"abstract":"Gait adaptation to perturbations is essential for safe interaction with the physical environment and therefore it is important to understand how people with lower-limb amputation adapt their gait to changing conditions (1). Previous studies tried to find some deviation patterns and understand the kinematic strategies of amputee's gait (2). However, there is limited information available on the hip kinematics of amputees during gait and there is no study has yet investigated the effect of the perturbation on the hip kinematics of amputees. How does unpredictable continuous perturbation during gait affect the hip kinematics of unilateral transtibial amputees? Individuals with unilateral trans-tibial amputations and using prostheses with an active vacuum plus carbon foot combination were included in to study. Kinematic data of the hip were collected from 11 amputees and 10 healthy controls during walking on two different ground conditions. Participants walked at least 512 steps at their preferred speed on a motorized treadmill’s (ReaxRun Pro) flat ground condition and then the gait analysis was repeated on a perturbed (5% unpredictable perturbation) ground condition. RehaGait- Pro system was used for evaluation of the kinematics of the hip(min-max hip angles and variability of the hip min-max angles) during gait. Negative values indicated hip hyperextension, positive values indicated hip flexion. The statistical analysis was performed by pairing the residual limbs of amputees with the non-dominant side of the healthy group (RL side), and the sound limbs with the dominant side of the healthy group (HL side). It was observed that the hip hyperextension angle on the sound limb side was bigger in the amputees than in the control group on flat (d=0.462; p=0.034) and perturbated ground (d=0.584; p=0.007). The effect size was larger on the perturbed ground. There was no difference in the maximum hip angles and variability of max-min hip angles between the groups in both ground conditions (p>0.05). The results showed in Table.Download : Download high-res image (142KB)Download : Download full-size image Amputation-related changes were observed in hip kinematics during walking under both ground conditions. However, this change was more prominent on the perturbated ground. The reason for the higher hip hyperextension values in amputees is thought to be due to their efforts to compensate for the ankle (exp. strong plantar flexion) movements. On the unpredictable perturbation ground, the limitation of ankle movements, which is one of the first adaptive mechanisms in adaptation to the ground (exp. subtalar rotations plus plantarflexion), may have made the situation more evident. Future studies may focus on the effect of gait training on perturbed surfaces on gait kinematics, which is an indicator of adaptation to variable conditions.","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.gaitpost.2023.07.149
Mario Martínez Zarzuela, David González-Ortega, Míriam Antón-Rodríguez, Francisco Javier Díaz-Pernas, Henning Müller, Cristina Simón-Martínez
The use of a wide range of computer vision solutions, and more recently high-end Inertial Measurement Units (IMU) have become increasingly popular for assessing human physical activity in clinical and research settings [1]. Nevertheless, to increase the feasibility of patient tracking in out-of-the-lab settings, it is necessary to use a reduced number of devices for movement acquisition. Promising solutions in this context are IMU-based wearables and single camera systems [2]. Additionally, the development of machine learning systems able to recognize and digest clinically relevant data in-the-wild is needed, and therefore determining the ideal input to those is crucial [3]. For upper-limb activity recognition out-of-the-lab, do wearables or single camera offer better performance? Recordings from 16 healthy subjects performing 8 upper-limb activities from the VIDIMU dataset [4] were used. For wearable recordings, the subjects wore 5 IMU-based wearables and adopted a neutral pose (N-pose) for calibration. Joint angles were estimated with inverse kinematics algorithms in OpenSense [5]. Single-camera video recordings occurred simultaneously. Joint angles were estimated with inverse kinematics algorithms in OpenSense. Single-camera video recordings occurred simultaneously, and the subject’s pose was estimated with DeepStream [6]. We compared various Deep Learning architectures (DNN, CNN, CNN-LSTM, LSTM-CNN, LSTM, LSTM-AE) for recognizing daily living activities. The input to the different neural architectures consisted in a 2-second time series containing the estimated joint angles and their 2D FFT. Every network was trained using 2 subjects for validation, a batch size of 20, Adam as the optimizer, and combining early stopping and other regularization techniques. Performance metrics were extracted from 4-fold cross-validation experiments. In all neural networks, performance was higher with IMU-based wearables data compared to video. The best network was an LSTM AutoEncoder (6 layers, 700 K parameters; wearable data accuracy:0.985, F1-score:0.936 (Fig. 1); video data accuracy:0.962, F1-score:0.842). Remarkably, when using video as input there were no significant differences in the performance metrics obtained among different architectures. On the contrary, the F1 scores using IMU data varied significantly (DNN: 0.849, CNN: 0.889, CNN-LSTM: 0.879, LSTM-CNN: 0.904, LSTM: 0.920, LSTM-AE: 0.936).Download : Download high-res image (108KB)Download : Download full-size image Wearables and video present advantages and disadvantages. While IMUs can provide accurate information about the orientation and acceleration of body parts, body-to-segment calibration and drift can affect data reliability. Similarly, a single camera can easily track the position of different body joints, but the recorded data does not yet reliably represent the movement with all degrees of freedom. Our experiments confirm that despite the current limitations of wearables, with a very si
{"title":"A comparative study on wearables and single-camera video for upper-limb out-of-the-lab activity recognition with different deep learning architectures","authors":"Mario Martínez Zarzuela, David González-Ortega, Míriam Antón-Rodríguez, Francisco Javier Díaz-Pernas, Henning Müller, Cristina Simón-Martínez","doi":"10.1016/j.gaitpost.2023.07.149","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.149","url":null,"abstract":"The use of a wide range of computer vision solutions, and more recently high-end Inertial Measurement Units (IMU) have become increasingly popular for assessing human physical activity in clinical and research settings [1]. Nevertheless, to increase the feasibility of patient tracking in out-of-the-lab settings, it is necessary to use a reduced number of devices for movement acquisition. Promising solutions in this context are IMU-based wearables and single camera systems [2]. Additionally, the development of machine learning systems able to recognize and digest clinically relevant data in-the-wild is needed, and therefore determining the ideal input to those is crucial [3]. For upper-limb activity recognition out-of-the-lab, do wearables or single camera offer better performance? Recordings from 16 healthy subjects performing 8 upper-limb activities from the VIDIMU dataset [4] were used. For wearable recordings, the subjects wore 5 IMU-based wearables and adopted a neutral pose (N-pose) for calibration. Joint angles were estimated with inverse kinematics algorithms in OpenSense [5]. Single-camera video recordings occurred simultaneously. Joint angles were estimated with inverse kinematics algorithms in OpenSense. Single-camera video recordings occurred simultaneously, and the subject’s pose was estimated with DeepStream [6]. We compared various Deep Learning architectures (DNN, CNN, CNN-LSTM, LSTM-CNN, LSTM, LSTM-AE) for recognizing daily living activities. The input to the different neural architectures consisted in a 2-second time series containing the estimated joint angles and their 2D FFT. Every network was trained using 2 subjects for validation, a batch size of 20, Adam as the optimizer, and combining early stopping and other regularization techniques. Performance metrics were extracted from 4-fold cross-validation experiments. In all neural networks, performance was higher with IMU-based wearables data compared to video. The best network was an LSTM AutoEncoder (6 layers, 700 K parameters; wearable data accuracy:0.985, F1-score:0.936 (Fig. 1); video data accuracy:0.962, F1-score:0.842). Remarkably, when using video as input there were no significant differences in the performance metrics obtained among different architectures. On the contrary, the F1 scores using IMU data varied significantly (DNN: 0.849, CNN: 0.889, CNN-LSTM: 0.879, LSTM-CNN: 0.904, LSTM: 0.920, LSTM-AE: 0.936).Download : Download high-res image (108KB)Download : Download full-size image Wearables and video present advantages and disadvantages. While IMUs can provide accurate information about the orientation and acceleration of body parts, body-to-segment calibration and drift can affect data reliability. Similarly, a single camera can easily track the position of different body joints, but the recorded data does not yet reliably represent the movement with all degrees of freedom. Our experiments confirm that despite the current limitations of wearables, with a very si","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.gaitpost.2023.07.193
Sofia Pastrouma, Filippos Kasiotis, Aikaterini - Evanthia Gkanatsiou, Natalia Kitsouli, Konstantinos Vassis, Zacharias Dimitriadis, Savvas Spanos, Ioannis Poulis
Decreased hip abductor strength has been associated with a range of knee pathologies. Hip abduction muscles play a critical role in providing pelvic stability and leg alignment during weight-bearing movements by eccentrically controlling hip adduction. Poor hip control can result in abnormal lower extremity motions, and studies have reported that lower limb problems such as patellofemoral pain (PFP),1 knee osteoarthritis (OA),2 and ACL injuries,3,4 are linked with altered lower limb kinematics, with a higher prevalence in females.5 A body of literature suggests that increased dynamic knee valgus is associated with hip abductor weakness.6 Moreover, several studies have shown that interventions such as neuromuscular training (NMT) programs can lower the incidence of lower extremity problems. An NMT program emphasizing optimal alignment of the trunk and lower limb joints relative to each other, along with quality movement performance while dynamically and functionally strengthening the lower limb muscles, may be better at enhancing hip muscle strength. Therefore, we performed a randomized controlled trial evaluating the effects of NMT in comparison to a progressive resistance training program (PRT) on muscle hip abductor strength. To investigate whether a 6-week NMT can improve the hip abductor muscle strength better than a PRT. The present study was a single-blind randomized controlled trial aiming to investigate the effects of two interventions on asymptomatic females, aged 18-35 years old. Sample size calculation revealed that 26 participants per group were required. Following a baseline assessment, 52 participants were randomly assigned to either a 6-week PRT or NMT intervention involving 3 sessions per week. The PRT intervention consisted of hip abductor exercises performed in an open kinetic chain, with three to four sets of ten repetitions at a target intensity of 6-8 RPE.7,8,9 The NMT intervention focused on improving functional stability, balance, proprioception, strength, agility, postural function, and orientation,10,11 consisting of weight-bearing positions. The participants were assessed after the 6-week intervention. Mean peak hip abduction, concentric and eccentric torque, were measured by a blinded assessor on a Biodex System 3 Pro isokinetic dynamometer at 60°/s. Dependent t-tests showed significant improvements in CON60, and ECC60 after both interventions (<0.05) (Table 1). Two-way mixed ANOVAs did not reveal statistically significant Group*Time interactions for the CON60 and ECC60. The results from the comparison of the effectiveness of each intervention are visually presented in Figs. 1 and 2. Download : Download high-res image (114KB)Download : Download full-size image Both PRT and NMT improved abductor strength. However, both groups had similar overall differences in strength before and after the intervention. Since no intervention is superior to the other, neuromuscular training might be clinically preferred as it combines dyn
髋关节外展肌力量下降与一系列膝关节病变有关。髋外展肌通过偏心控制髋内收,在负重运动中提供骨盆稳定性和腿部对齐方面发挥关键作用。髋关节控制不佳可导致下肢运动异常,研究报道,下肢问题,如髌股疼痛(PFP),1膝骨关节炎(OA),2和前交叉韧带损伤,3,4与下肢运动学改变有关,女性患病率更高5大量文献表明,动态膝外翻增加与髋外展肌无力有关此外,一些研究表明,神经肌肉训练(NMT)计划等干预措施可以降低下肢问题的发生率。NMT项目强调躯干和下肢关节相对于彼此的最佳对齐,以及在动态和功能性加强下肢肌肉的同时进行高质量的运动表现,可能会更好地增强髋关节肌肉力量。因此,我们进行了一项随机对照试验,评估NMT与进行性阻力训练计划(PRT)对肌肉髋关节外展肌力量的影响。研究6周的NMT是否能比PRT更好地改善髋关节外展肌力量。本研究是一项单盲随机对照试验,旨在探讨两种干预措施对18-35岁无症状女性的影响。样本量计算显示,每组需要26名参与者。在基线评估之后,52名参与者被随机分配到为期6周的PRT或NMT干预组,每周进行3次干预。PRT干预包括在开放的动力链中进行髋关节外展肌锻炼,每组重复3至4组,每组10次,目标强度为6- 8rpe 7,8,9。NMT干预侧重于改善功能稳定性、平衡、本体感觉、力量、敏捷性、姿势功能和定向10,11,包括负重姿势。干预6周后对参与者进行评估。平均峰值髋外展,同心和偏心扭矩,由盲法评估者在60°/s的Biodex System 3 Pro等速测力仪上测量。依赖t检验显示,两种干预措施后CON60和ECC60均有显著改善(<0.05)(表1)。双向混合方差分析未显示CON60和ECC60在组*时间的相互作用具有统计学意义。图1和图2直观地展示了各干预措施有效性比较的结果。下载:下载高分辨率图像(114KB)下载:下载全尺寸图像PRT和NMT均提高了外展肌力量。然而,两组在干预前后的力量总体差异相似。由于没有任何干预措施优于其他干预措施,神经肌肉训练可能是临床首选,因为它结合了个体的动态和功能强化。
{"title":"Comparison of neuromuscular and abductor strengthening exercises in the hip abductor muscle strength: A randomized controlled trial","authors":"Sofia Pastrouma, Filippos Kasiotis, Aikaterini - Evanthia Gkanatsiou, Natalia Kitsouli, Konstantinos Vassis, Zacharias Dimitriadis, Savvas Spanos, Ioannis Poulis","doi":"10.1016/j.gaitpost.2023.07.193","DOIUrl":"https://doi.org/10.1016/j.gaitpost.2023.07.193","url":null,"abstract":"Decreased hip abductor strength has been associated with a range of knee pathologies. Hip abduction muscles play a critical role in providing pelvic stability and leg alignment during weight-bearing movements by eccentrically controlling hip adduction. Poor hip control can result in abnormal lower extremity motions, and studies have reported that lower limb problems such as patellofemoral pain (PFP),1 knee osteoarthritis (OA),2 and ACL injuries,3,4 are linked with altered lower limb kinematics, with a higher prevalence in females.5 A body of literature suggests that increased dynamic knee valgus is associated with hip abductor weakness.6 Moreover, several studies have shown that interventions such as neuromuscular training (NMT) programs can lower the incidence of lower extremity problems. An NMT program emphasizing optimal alignment of the trunk and lower limb joints relative to each other, along with quality movement performance while dynamically and functionally strengthening the lower limb muscles, may be better at enhancing hip muscle strength. Therefore, we performed a randomized controlled trial evaluating the effects of NMT in comparison to a progressive resistance training program (PRT) on muscle hip abductor strength. To investigate whether a 6-week NMT can improve the hip abductor muscle strength better than a PRT. The present study was a single-blind randomized controlled trial aiming to investigate the effects of two interventions on asymptomatic females, aged 18-35 years old. Sample size calculation revealed that 26 participants per group were required. Following a baseline assessment, 52 participants were randomly assigned to either a 6-week PRT or NMT intervention involving 3 sessions per week. The PRT intervention consisted of hip abductor exercises performed in an open kinetic chain, with three to four sets of ten repetitions at a target intensity of 6-8 RPE.7,8,9 The NMT intervention focused on improving functional stability, balance, proprioception, strength, agility, postural function, and orientation,10,11 consisting of weight-bearing positions. The participants were assessed after the 6-week intervention. Mean peak hip abduction, concentric and eccentric torque, were measured by a blinded assessor on a Biodex System 3 Pro isokinetic dynamometer at 60°/s. Dependent t-tests showed significant improvements in CON60, and ECC60 after both interventions (<0.05) (Table 1). Two-way mixed ANOVAs did not reveal statistically significant Group*Time interactions for the CON60 and ECC60. The results from the comparison of the effectiveness of each intervention are visually presented in Figs. 1 and 2. Download : Download high-res image (114KB)Download : Download full-size image Both PRT and NMT improved abductor strength. However, both groups had similar overall differences in strength before and after the intervention. Since no intervention is superior to the other, neuromuscular training might be clinically preferred as it combines dyn","PeriodicalId":94018,"journal":{"name":"Gait & posture","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}