Abstract: Elastic compression stockings (ECSs) have been widely applied in prophylaxis and treatment of chronic venous insufficiency of lower extremities. The medical function of ECS is to improve venous return and increase muscular pumping action to facilitate blood circulation, which is largely determined by the complex interaction between the ECS and lower limb tissues. Understanding the mechanical transmission of ECS along the skin surface, deeper tissues, and vascular system is essential to assess the effectiveness of the ECSs. In this study, a three-dimensional (3D) finite element (FE) model of the leg-ECS system integrated with a 3D fluid-solid interaction (FSI) model of the leg-vein system was constructed to analyze the biomechanical properties of veins and soft tissues under different ECS compression. The Magnetic Resonance Imaging (MRI) of the human leg was divided into three regions, including soft tissues, bones (tibia and fibula) and veins (peroneal vein, great saphenous vein, and small saphenous vein). The ECSs with pressure ranges from 15 to 26 mmHg (Classes I and II) were adopted in the developed FE-FSI model. The soft tissue was assumed as a Neo-Hookean hyperelastic model with the fixed bones, and the ECSs were regarded as an orthotropic elastic shell. The interfacial pressure and stress transmission were simulated by the FE model, and venous hemodynamics properties were simulated by the FSI model. The experimental validation indicated that the simulated interfacial pressure distributions were in accordance with the pressure measurement results. The developed model can be used to predict interfacial pressure, stress transmission, and venous hemodynamics exerted by ECSs and optimize the structure and materials properties of ECSs design, thus improving the efficiency of compression therapy.
Abstract: The number of people suffering from hemiplegia is growing each year. This lower limb disability affects all the aspects of their lives by taking away their autonomy. This implicates their close relatives, as well as the health system to provide the necessary care they need. The integration of exoskeletons in the medical field became a promising solution to resolve this issue. This paper presents an exoskeleton designed to help hemiplegic people get back the sensation and ability of normal walking. For this purpose, three step models have been created. The first step allows a simple forward movement of the leg. The second method is designed to overcome some obstacles in the patient path, and finally the third step model gives the patient total control over the device. Each of the control methods was designed to offer a solution to the challenges that the patients may face during the walking process.
Abstract: Wearable robotics is a potential solution in aiding gait rehabilitation of lower limbs dyskinesia patients, such as knee osteoarthritis or stroke afflicted patients. Many wearable robots have been developed in the form of rigid exoskeletons, but their bulk devices, high cost and control complexity hinder their popularity in the field of gait rehabilitation. Thus, the development of a portable, compliant and low-cost wearable robot for gait rehabilitation is necessary. Inspired by Chinese traditional folding fans and balloon inflators, the authors present an inflatable, foldable and variable stiffness knee exosuit (IFVSKE) in this paper. The pneumatic actuator of IFVSKE was fabricated in the shape of folding fans by using thermoplastic polyurethane (TPU) fabric materials. The geometric and mechanical properties of IFVSKE were characterized with experimental methods. To assist the knee joint smartly, an intelligent control profile for IFVSKE was proposed based on the concept of full-cycle energy management of the biomechanical energy during human movement. The biomechanical energy of knee joints in a walking gait cycle of patients could be collected and released to assist the joint motion just by adjusting the inner pressure of IFVSKE. Finally, a healthy subject was involved to walk with and without the IFVSKE to evaluate the assisting effects.
Abstract: Musculoskeletal problems in the hotel sector have been little studied. The aim of this study was to examine relationships of musculoskeletal pain and work characteristics with presenteeism, i.e., feeling sick but going to work anyway. Data of a self-reported questionnaire were collected from 1,101 employees, who joined the study on a voluntary basis from four hotels in northern Taiwan. The results showed that respondents who were female, were younger, had a higher educational level, and worked in the real-service department had higher presenteeism. There were significant positive associations between presenteeism and heavy loads, frequent beatings or hits of hard objects, improper bench height, employees’ lower limb and lower back pain. Our study results imply that knowledge of work characteristics and employees' musculoskeletal problems could be advantageously used to reduce presenteeism in the workplace.
Abstract: The gait pattern in people that present motor limitations foment the demand for auxiliary locomotion devices. These artifacts for movement assistance vary according to its shape, size and functional features, following the clinical applications desired. Among the ortheses of lower limbs, the ankle-foot orthesis aims to improve the ability to walk in people with different neuromuscular limitations, although they do not always answer patients' expectations for their aesthetic and functional characteristics. The purpose of this study is to explore the possibility of using new design in additive manufacturer to reproduce the shape and functional features of a ankle-foot orthesis in an efficient and modern way. Therefore, this work presents a study about the performance of the mechanical forces through the analysis of finite elements in an ankle-foot orthesis. It will be demonstrated a study of distribution of the stress on the orthopedic device in orthostatism and during the movement in the course of patient's walk.
Abstract: The purpose of study was to investigate the effect of varying pole weights on energy expenditure, upper limb and lower limb muscle activity as Electromyogram during Nordic walking (NW). Four healthy men [age = 22.5 (±1.0) years, body mass = 61.4 (±3.6) kg, height = 170.3 (±4.3) cm] and three healthy women [age = 22.7 (±2.9) years, body mass = 53.0 (±1.7) kg, height = 156.7 (±4.5) cm] participated in the experiments after informed consent. Seven healthy subjects were tested on the treadmill, walking, walking (W) with Nordic Poles (NW) and walking with 1kg weight Nordic Poles (NW+1). Walking speed was 6 km per hours in all trials. Eight EMG activities were recorded by bipolar surface methods in biceps brachii, triceps brachii, trapezius, deltoideus, tibialis anterior, medial gastrocnemius, rectus femoris and biceps femoris muscles. And heart rate (HR), oxygen uptake (VO2), and rate of perceived exertion (RPE) were measured. The level of significance was set at a = 0.05, with p < 0.05 regarded as statistically significant. Our results confirmed that use of NW poles increased HR at a given upper arm muscle activity but decreased lower limb EMGs in comparison with W. Moreover NW was able to increase more step lengths with hip joint extension during NW rather than W. Also, EMG revealed higher activation of upper limb for almost all NW and 1kgNW tests plus added masses compared to W (p < 0.05). Therefore, it was thought either of NW and 1kgNW were to have benefit as a physical exercise for safe, feasible, and readily training for a wide range of aged people in the quality of daily life. However, there was no significant effected in leg muscles activity by using 1kgNW except for upper arm muscle activity during Nordic pole walking.
Abstract: The purpose of this research paper is to study and develop a system that is able to help identify problems and improve human rehabilitation after traumatic injuries. Traumatic injuries in human’s lower limbs can occur over a life time and can have serious side effects if they are not treated correctly. In this paper, we developed an intelligent cane (IntelliCane) so as to help individuals in their rehabilitation process and provide feedback to the users. The first stage of the paper involves an analysis of the existing systems on the market and what can be improved. The second stage presents the design of the system. The third part, which is still under development is the validation of the system in real world setups with people in need. This paper presents mainly stages one and two.
Abstract: Surface electromyographic (sEMG) signal has the potential to identify the human activities and intention. This potential is further exploited to control the artificial limbs using the sEMG signal from residual limbs of amputees. The paper deals with the development of multichannel cost efficient sEMG signal interface for research application, along with evaluation of proposed class dependent statistical approach of the feature selection method. The sEMG signal acquisition interface was developed using ADS1298 of Texas Instruments, which is a front-end interface integrated circuit for ECG application. Further, the sEMG signal is recorded from two lower limb muscles for three locomotions namely: Plane Walk (PW), Stair Ascending (SA), Stair Descending (SD). A class dependent statistical approach is proposed for feature selection and also its performance is compared with 12 preexisting feature vectors. To make the study more extensive, performance of five different types of classifiers are compared. The outcome of the current piece of work proves the suitability of the proposed feature selection algorithm for locomotion recognition, as compared to other existing feature vectors. The SVM Classifier is found as the outperformed classifier among compared classifiers with an average recognition accuracy of 97.40%. Feature vector selection emerges as the most dominant factor affecting the classification performance as it holds 51.51% of the total variance in classification accuracy. The results demonstrate the potentials of the developed sEMG signal acquisition interface along with the proposed feature selection algorithm.
Abstract: Electromyography (EMG) is one of the important indicators during exercise, as it is closely related to the level of muscle activations. This work quantifies the muscle conditions of the lower limbs in a constant workload exercise. Surface EMG signals of the vastus laterals (VL), vastus medialis (VM), rectus femoris (RF), gastrocnemius medianus (GM), gastrocnemius lateral (GL) and Soleus (SOL) were recorded from fourteen healthy males. The EMG signals were segmented in two phases: activation segment (AS) and relaxation segment (RS). Period entropy (PE), peak count (PC), zero crossing (ZC), wave length (WL), mean power frequency (MPF), median frequency (MDF) and root mean square (RMS) are calculated to provide the quantitative information of the measured EMG segments. The outcomes reveal that the PE, PC, ZC and RMS have significantly changed (p
Abstract: The paper describes conceptual design, control strategies, and partial simulation for a new fully autonomous lower limb wearable exoskeleton system for human motion enhancement that can support its weight and increase strength and endurance. Various problems still remain to be solved where the most important is the creation of a power and cost efficient system that will allow an exoskeleton to operate for extended period without batteries being frequently recharged. The designed exoskeleton is enabling to decouple the weight/mass carrying function of the system from the forward motion function which reduces the power and size of propulsion motors and thus the overall weight, cost of the system. The decoupling takes place by blocking the motion at knee joint by placing passive air cylinder across the joint. The cylinder is actuated when the knee angle has reached the minimum allowed value to bend. The value of the minimum bending angle depends on usual walk style of the subject. The mechanism of the exoskeleton features a seat to rest the subject’s body weight at the moment of blocking the knee joint motion. The mechanical structure of each leg has six degrees of freedom: four at the hip, one at the knee, and one at the ankle. Exoskeleton legs are attached to subject legs by using flexible cuffs. The operation of all actuators depends on the amount of pressure felt by the feet pressure sensors and knee angle sensor. The sensor readings depend on actual posture of the subject and can be classified in three distinct cases: subject stands on one leg, subject stands still on both legs and subject stands on both legs but transit its weight from one leg to other. This exoskeleton is power efficient because electrical motors are smaller in size and did not participate in supporting the weight like in all other existing exoskeleton designs.
Abstract: This paper addresses attention to a research regarding the design of a knee orthosis in a modular form used on children walking rehabilitation. This research is focused on the human lower limb kinematic analysis which will be used as input data on virtual simulations and prototype validation. From this analysis, important data will be obtained and used as input for virtual simulations of the knee modular orthosis. Thus, a knee orthosis concept was obtained and validated through virtual simulations by using MSC Adams software. Based on the obtained results, the modular orthosis prototype will be manufactured and presented in this article.
Abstract: This paper investigates and presents a cable-driven
robot to lower limb rehabilitation use in sagittal plane. The presented
rehabilitation robot is used for a trajectory tracking in joint space.
The paper covers kinematic and dynamic analysis, which reveals
the tensionability of the used cables as being the actuating source
to provide a rehabilitation exercises of the human leg. The desired
trajectory is generated to be used in the control system design in joint
space. The obtained simulation results is showed to be efficient in
this kind of application.
Abstract: Human soft tissue is loaded and deformed by any
activity, an effect known as a stress-strain relationship, and is often
described by a load and tissue elongation curve. Several advances
have been made in the fields of biology and mechanics of soft human
tissue. However, there is limited information available on in vivo
tissue mechanical characteristics and behavior. Confident mechanical
properties of human soft tissue cannot be extrapolated from e.g.
animal testing. Thus, there is need for non invasive methods to
analyze mechanical characteristics of soft human tissue. In the present
study, the internal mechanical conditions of the lower limb, which
is subject to an external load, is studied by use of the finite element
method. A detailed finite element model of the lower limb is made
possible by use of MRI scans. Skin, fat, bones, fascia and muscles
are represented separately and the material properties for them are
obtained from literature. Previous studies have been shown to address
macroscopic deformation features, e.g. indentation depth, to a large
extent. However, the detail in which the internal anatomical features
have been modeled does not reveal the critical internal strains that
may induce hypoxia and/or eventual tissue damage. The results of the
present study reveals that lumped material models, i.e. averaging of
the material properties for the different constituents, does not capture
regions of critical strains in contrast to more detailed models.
Abstract: Introduction: Whole-Body Vibration (WBV) uses
high frequency mechanical stimuli generated by a vibration plate and
transmitted through bone, muscle and connective tissues to the whole
body. Research has shown that long-term vibration-plate training
improves neuromuscular facilitation, especially in afferent neural
pathways, responsible for the conduction of vibration and
proprioceptive stimuli, muscle function, balance and proprioception.
Some researchers suggest that the vibration stimulus briefly inhibits
the conduction of afferent signals from proprioceptors and can
interfere with the maintenance of body balance. The aim of this study
was to evaluate the influence of a single set of exercises associated
with whole-body vibration on the joint position sense and body
balance. Material and methods: The study enrolled 55 people aged
19-24 years. These individuals were randomly divided into a test
group (30 persons) and a control group (25 persons). Both groups
performed the same set of exercises on a vibration plate. The
following vibration parameters: frequency of 20Hz and amplitude of
3mm, were used in the test group. The control group performed
exercises on the vibration plate while it was off. All participants were
instructed to perform six dynamic exercises lasting 30 seconds each
with a 60-second period of rest between them. The exercises involved
large muscle groups of the trunk, pelvis and lower limbs.
Measurements were carried out before and immediately after
exercise. Joint position sense (JPS) was measured in the knee joint
for the starting position at 45° in an open kinematic chain. JPS error
was measured using a digital inclinometer. Balance was assessed in a
standing position with both feet on the ground with the eyes open and
closed (each test lasting 30 sec). Balance was assessed using Matscan
with FootMat 7.0 SAM software. The surface of the ellipse of
confidence and front-back as well as right-left swing were measured
to assess balance. Statistical analysis was performed using Statistica
10.0 PL software. Results: There were no significant differences
between the groups, both before and after the exercise (p> 0.05). JPS
did not change in both the test (10.7° vs. 8.4°) and control groups
(9.0° vs. 8.4°). No significant differences were shown in any of the
test parameters during balance tests with the eyes open or closed in
both the test and control groups (p> 0.05). Conclusions: 1.
Deterioration in proprioception or balance was not observed
immediately after the vibration stimulus. This suggests that vibrationinduced
blockage of proprioceptive stimuli conduction can have only
a short-lasting effect that occurs only as long as a vibration stimulus
is present. 2. Short-term use of vibration in treatment does not impair
proprioception and seems to be safe for patients with proprioceptive
impairment. 3. These results need to be supplemented with an
assessment of proprioception during the application of vibration
stimuli. Additionally, the impact of vibration parameters used in the
exercises should be evaluated.
Abstract: Background: Diabetic sensorimotor polyneuropathy
(DSP) is one of the most common microvascular complications of
type 2 diabetes. Loss of sensation is thought to contribute to a lack of
static and dynamic stability and increased risk of falling. Purpose:
The purpose of this study was to compare the effects of low-level
laser (LLL) and monochromatic near-infrared photo energy (MIRE)
on pain, cutaneous sensation, static stability, and index of lower limb
blood flow in diabetic patients with peripheral neuropathy. Methods:
Forty diabetic patients with peripheral neuropathy were recruited for
participation in this study. They were divided into two groups: The
MIRE group, which contained 20 patients, and the LLL group, which
contained 20 patients. All patients who participated in the study had
been subjected to various physical assessment procedures, including
pain, cutaneous sensation, Doppler flow meter, and static stability
assessments. The baseline measurements were followed by treatment
sessions that were conducted twice a week for six successive weeks.
Results: The statistical analysis of the data revealed significant
improvement of pain in both groups, with significant improvement in
cutaneous sensation and static balance in the MIRE group compared
to the LLL group; on the other hand, the results showed no
significant differences in lower limb blood flow between the groups.
Conclusion: LLL and MIRE can improve painful symptoms in
patients with diabetic neuropathy. On the other hand, MIRE is also
useful in improving cutaneous sensation and static stability in
patients with diabetic neuropathy.
Abstract: The efficiency of the actuation system of exoskeletons
and active orthoses for lower limbs is a significant aspect of the
design of such devices because it affects their efficacy. The F-IVT is
an innovative actuation system to power artificial knee joint with
energy recovery capabilities. Its key and non-conventional elements
are a flywheel that acts as a mechanical energy storage system, and
an Infinitely Variable Transmission (IVT). The design of the F-IVT
can be optimized for a certain walking condition, resulting in a heavy
reduction of both the electric energy consumption and of the electric
peak power. In this work, by means of simulations of level ground
walking at different speeds, it is demonstrated that the F-IVT is still
an advantageous actuator which permits to save energy consumption
and to downsize the electric motor even when it does not work in
nominal conditions.
Abstract: VACTERL association is a rare disorder with various
congenital malformations. The aetiology remains unknown.
Combination of at least three congenital anomalies of the following
criteria is required for diagnosis: vertebral defects, anal atresia,
cardiac anomalies, tracheo-esophageal fistula, renal anomalies, and
limb defects. The first case was 1-day old male neonate with multiple
congenital anomalies was bore from 28 years old mother. The mother
had history of pregnancy with lymphocyte therapy. His anomalies
included: defects in thoracic and lumbar vertebral, anal atresia,
bilateral hydronephrosis, atrial septal defect, and lower limb
abnormality. Other anomalies were cryptorchidism and nasal canal
narrowing. The second case was born with 32 weeks gestational age
from mother with history of pregnancy with lymphocyte therapy. He
had thoracic vertebral defect, cardiac anomalies and renal defect.
diagnosis based on clinical finding is VACTERL association. Early
diagnosis is very important to investigation and treatment of other
coexistence anomalies. VACTERL association in mothers with
history of pregnancy with lymphocyte therapy has suggested possibly
of relationship between VACTERL association and this method of
pregnancy.
Abstract: This paper investigates the activity of the rectus
femoris (RF) and biceps femoris (BF) in healthy subjects during salat
(prostration) and specific exercise (squat exercise) using
electromyography (EMG). A group of undergraduates aged between
19 to 25 years voluntarily participated in this study. The myoelectric
activity of the muscles were recorded and analyzed. The finding
indicated that there were contractions of the muscles during the salat
and exercise with almost same EMG’s level. From the result,
Wilcoxon’s Rank Sum test showed significant difference between
prostration and squat exercise (p
Abstract: Kinematic data wisely correlate vector quantities in
space to scalar parameters in time to assess the degree of symmetry
between the intact limb and the amputated limb with respect to a
normal model derived from the gait of control group participants.
Furthermore, these particular data allow a doctor to preliminarily
evaluate the usefulness of a certain rehabilitation therapy.
Kinetic curves allow the analysis of ground reaction forces (GRFs)
to assess the appropriateness of human motion.
Electromyography (EMG) allows the analysis of the fundamental
lower limb force contributions to quantify the level of gait
asymmetry. However, the use of this technological tool is expensive
and requires patient’s hospitalization. This research work suggests
overcoming the above limitations by applying artificial neural
networks.
Abstract: Estimation of stature is an important step in developing a biological profile for human identification. It may provide a valuable indicator for unknown individual in a population. The aim of this study was to analyses the relationship between stature and lower limb dimensions in the Malaysian population. The sample comprised 100 corpses, which included 69 males and 31 females between age ranges of 20 to 90 years old. The parameters measured were stature, thigh length, lower leg length, leg length, foot length, foot height and foot breadth. Results showed that mean values in males were significantly higher than those in females (P < 0.05). There were significant correlations between lower limb dimensions and stature. Cross-validation of the equation on 100 individuals showed close approximation between known stature and estimated stature. It was concluded that lower limb dimensions were useful for estimation of stature, which should be validated in future studies.