The Experts below are selected from a list of 1005 Experts worldwide ranked by ideXlab platform
Robert Riener - One of the best experts on this subject based on the ideXlab platform.
-
MMVR - Virtual Gait training for children with cerebral palsy using the Lokomat Gait Orthosis.
Studies in health technology and informatics, 2020Co-Authors: Alexander Koenig, M Wellner, Susan Koneke, Lars Lunenburger, Andreas Meyer-heim, Robert RienerAbstract:The Lokomat Gait Orthosis was developed in the Spinal Cord Injury Center at the University Hospital Balgrist Zurich and provides automatic Gait training for patients with neurological Gait impairments, such as Cerebral Palsy (CP). Each patient undergoes a task-oriented Lokomat rehabilitation training program via a virtual reality setup. In four virtual scenarios, the patient is able to exercise tasks such as wading through water, playing soccer, overstepping obstacles or training in a street scenario, each task offering varying levels of difficulty. Patients provided positive feedback in reference to the utilized haptic method, specifically addressing the sufficient degree of realism. In a single case study, we verified the task difficulty.
-
virtual Gait training for children with cerebral palsy using the lokomat Gait Orthosis
Medicine Meets Virtual Reality, 2008Co-Authors: Alexander Koenig, M Wellner, Susan Koneke, Andreas Meyerheim, Lars Lunenburger, Robert RienerAbstract:The Lokomat Gait Orthosis was developed in the Spinal Cord Injury Center at the University Hospital Balgrist Zurich and provides automatic Gait training for patients with neurological Gait impairments, such as Cerebral Palsy (CP). Each patient undergoes a task-oriented Lokomat rehabilitation training program via a virtual reality setup. In four virtual scenarios, the patient is able to exercise tasks such as wading through water, playing soccer, overstepping obstacles or training in a street scenario, each task offering varying levels of difficulty. Patients provided positive feedback in reference to the utilized haptic method, specifically addressing the sufficient degree of realism. In a single case study, we verified the task difficulty.
-
Using a Robotic Gait Orthosis as Haptic Display - A Perception-Based Optimization Approach
2007 IEEE 10th International Conference on Rehabilitation Robotics, 2007Co-Authors: Mathias Wellner, Joachim Von Zitzewitz, Marco Guidali, Robert RienerAbstract:The actuated Gait Orthosis Lokomat has been developed at University Hospital Balgrist for patients with impairments due to neurological or orthopedic lesions. To enhance rehabilitation with the Lokomat, patient-cooperative techniques have been developed. Patient-cooperative means that the technical system considers the patient intention and efforts rather than imposing any predefined movement or inflexible strategy. It is hypothesized that patient-cooperative techniques have the potential to improve the therapeutic outcome compared to classical rehabilitation strategies. One example for patient-cooperative techniques are immersive, multi-modal scenarios. They can provide task-specific feedback and are expected to increase patient's motivation to contribute. One interaction possibility is haptic feedback which can be provided by the Gait Orthosis to simulate interaction with solid objects. The work described here investigated the potential of the Lokomat to provide haptic feedback. Frequency response measurements under closed-loop conditions were conducted to determine the force and position bandwidths. The final goal was to develop an approach for haptic rendering and optimize its parameters with experiments. Optimization criteria were object hardness and stability during object contact. Results of the bandwidth measurements show that the angle bandwidth is 3 Hz (excitation angle amplitude: 3deg) and the force bandwidth 8 Hz (excitation force amplitude: 10 N). The implemented haptic approach combines an impulsive force component, a penalty force component, and a component for lateral friction force. Best results were achieved for a combination of sine shape impulse, spring constant K with 2000 N/m, and modified damping coefficient B with 300 Ns/m2.
-
Stepping Over Virtual Obstacles with an Actuated Gait Orthosis
2007 IEEE Virtual Reality Conference, 2007Co-Authors: Mathias Wellner, Alexander Duschau-wicke, Joachim Von Zitzewitz, Robert RienerAbstract:The rehabilitation robot LOKOMAT has been developed at University Hospital Balgrist to automate treadmill training of spinal cord injury and stroke patients. Current rehabilitation training on that robot consists of moving the patient's legs on predefined trajectories. However, this kind of training is not challenging, as patients are moved regardless of their efforts and do not see their advancement. To enhance rehabilitation training with the LOKOMAT, a virtual reality setup was installed. It consists of a passive stereo projection system (screen size 3 m times 2 m), a Dolby 5.1 sound system and an electric fan. With that setup an obstacle crossing scenario was implemented. The patients can see their advancement on the screen, as an animated figurine (avatar) moves along a path simultaneously with their own movements. Additionally they can hear sounds (e.g. environmental sounds, steps), feel the wind, and experience force feedback, provided by the Orthosis, when hitting obstacles. The objective of a first study on visual feedback was to investigate which feedback suits best to perceive the obstacle distances and heights correctly. To answer this question, 14 healthy subjects walked in the actuated Gait Orthosis, received visual feedback and tried to avoid collisions with obstacles. Subjects could move freely within the Gait Orthosis and determine their own speed and step length. They had to cross the obstacles independently, with haptic feedback, indicating obstacle hits. Results show that the side view results in least obstacle hits and that 2D excels 3D display in this respect
Stephen W Hutchins - One of the best experts on this subject based on the ideXlab platform.
-
The effect of trunk extension on physiological cost index in spinal cord injury patients when using the advanced reciprocating Gait Orthosis: A pilot study.
Prosthetics and Orthotics International, 2015Co-Authors: Mokhtar Arazpour, Monireh Ahmadi Bani, Stephen W Hutchins, Mohammad Samadian, Mahmood Bahramizadeh, Masoud Gharib, Seyyed Ali Hosseini, Mohammad Ali MardaniAbstract:BACKGROUND: People with spinal cord injury walk with a flexed trunk when using reciprocating Gait orthoses for walking. Reduction in trunk flexion during ambulation has been shown to improve Gait parameters for reciprocating Gait Orthosis users. OBJECTIVE: The aim of this study was to investigate the effect on energy expenditure when spinal cord injury patients ambulate with an advanced reciprocating Gait Orthosis while wearing a thoracolumbosacral Orthosis to provide trunk extension. STUDY DESIGN: Quasi experimental study. METHODS: Four patients with spinal cord injury were fitted with an advanced reciprocating Gait Orthosis after completing a specific Gait training program. Patients walked along a flat walkway using the advanced reciprocating Gait Orthosis as a control condition and also while additionally wearing a thoracolumbosacral Orthosis at their self-selected walking speed. A stopwatch and a polar heart rate monitor were used to measure walking speed and heart rate. RESULTS: Walking speed, the distance walked, and the physiological cost index all improved when walking with the advanced reciprocating Gait Orthosis/thoracolumbosacral Orthosis test condition compared to walking with no thoracolumbosacral Orthosis in situ. CONCLUSION: Spinal cord injury patients can improve their walking speed, walking distance, and physiological cost index when wearing a thoracolumbosacral Orthosis in conjunction with an advanced reciprocating Gait Orthosis, which may be attributed to the trunk extension provided by the thoracolumbosacral Orthosis. CLINICAL RELEVANCE: It is concluded that wearing thoracolumbosacral Orthosis in association with an advanced reciprocating Gait Orthosis could be an effective alternative in rehabilitation for thoracic level of paraplegic patients to promote their health and well-being.
-
Comparison of Gait between healthy participants and persons with spinal cord injury when using the advanced reciprocating Gait Orthosis
Prosthetics and Orthotics International, 2015Co-Authors: Mokhtar Arazpour, Monireh Ahmadi Bani, Mohammad Ebrahim Mousavi, Stephen W Hutchins, Mahmood Bahramizadeh, Mahmoud Joghtaei, Sarah Curran, Guive Sharifi, Mohammad Ali MardaniAbstract:Background: The advanced reciprocating Gait Orthosis (ARGO) has a rigid structure which provides restricted movement at the hip, knee, and ankle joints and incorporates a pelvic section with an extended section in the lumbar region. Healthy subjects, when walking with an RGO in situ, could feasibly demonstrate the level of limitation in movement imposed by ARGO-assisted ambulation. Objective: The aim of this study was to compare the function of the advanced reciprocating Gait Orthosis when fitted with the dorsiflexion-assist ankle–foot orthoses on temporal–spatial parameters and kinematics of walking in both able-bodied people and those with spinal cord injury. Study design: Quasi experimental design. Methods: Data were acquired from six able-bodied and four spinal cord injury subjects who used an advanced reciprocating Gait Orthosis which incorporated dorsiflexion-assist ankle–foot orthoses. Kinematics and temporal–spatial parameters were calculated and compared. Results: All able-bodied individuals walked with speeds which were only approximately one-third that of when walking without an Orthosis. The mean step length and cadence were both reduced by 48% and 6%, respectively. There were significant differences in hip, knee, and ankle joint range of motions between normal walking and walking with the advanced reciprocating Gait Orthosis both in able-bodied subjects and patients with spinal cord injury. There were also significant differences in the speed of walking, cadence, step length, hip range of motion, and ankle range of motion when using the advanced reciprocating Gait Orthosis between the two groups. Conclusion: Temporal–spatial parameters and lower limb sagittal plane kinematics of walking were altered compared to normal walking, especially when spinal cord injury subjects walked with the advanced reciprocating Gait Orthosis compared to the able-bodied subjects. Clinical relevance To produce an improvement in RGO function, an increase in walking performance should involve attention to improvement of hip, knee, and ankle joint kinematics, which differs significantly from normal walking.
-
The influence of trunk extension in using advanced reciprocating Gait Orthosis on walking in spinal cord injury patients: A pilot study:
Prosthetics and Orthotics International, 2014Co-Authors: Mokhtar Arazpour, Monireh Ahmadi Bani, Mohammad Ebrahim Mousavi, Stephen W Hutchins, Masoud Gharib, Sarah Curran, Hooshang SaberiAbstract:Background:Spinal cord injury patients walk with a flexed trunk when using reciprocating Gait orthoses. Reduction of trunk flexion during ambulation may produce an improvement in Gait parameters for reciprocating Gait Orthosis users.Objectives:To investigate the effect on kinematics and temporal–spatial parameters when spinal cord injury patients ambulate with an advanced reciprocating Gait Orthosis while wearing a thoracolumbosacral Orthosis to provide trunk extension.Study design:Comparative study between before and after use o thoracolumbosacral Orthosis with the advanced reciprocating Gait orthoses.Methods:Four patients with spinal cord injury were fitted with an advanced reciprocating Gait Orthosis and also wore a thoracolumbosacral Orthosis. Patients walked along a flat walkway either with or without the thoracolumbosacral Orthosis at their self-selected walking speed. Temporal–spatial parameters and lower limb kinematics were analyzed.Results:Mean walking speed, step length, and cadence all improve...
-
Comparison of Gait between healthy participants and persons with spinal cord injury when using a powered Gait Orthosis-a pilot study
Spinal Cord, 2013Co-Authors: Mokhtar Arazpour, Monireh Ahmadi Bani, Stephen W Hutchins, Mahmood Bahramizadeh, S R Mehrpour, Mehdi RahgozarAbstract:Comparison of Gait between healthy participants and persons with spinal cord injury when using a powered Gait Orthosis-a pilot study
-
The influence of a rocker sole adaptation on Gait parameters in spinal cord injury patients ambulating with the advanced reciprocating Gait Orthosis – a pilot study
Disability and Rehabilitation: Assistive Technology, 2013Co-Authors: Mokhtar Arazpour, Monireh Ahmadi Bani, Stephen W Hutchins, Mahmood Bahramizadeh, Sarah Curran, Hooshang Saberi, Mohammad Ali MardaniAbstract:AbstractObjective: When walking with an advanced reciprocating Gait Orthosis (ARGO), ankle and knee joint motion is restricted which causes an un-cosmetic Gait compared to normal walking. The purpose of this study was to develop and evaluate a rocker modification for use with the ARGO in order to improve hip joint kinematics, walking speed, step length and cadence. Method: Spinal cord injury patients (n = 4) with thoracic-level injury participated in this study, and walked with a standard ARGO and one which was also adapted with a rocker sole in a randomized order. Results: Mean walking speed and step length were both significantly increased by volunteer SCI subjects when ambulating using the ARGO adapted with a rocker sole compared to the standard ARGO. Cadence was not significantly affected, but swing time was significantly reduced and mean hip flexion and extension were both significantly increased when walking with the adapted ARGO. Conclusion: The rocker sole modification produced an increase in walk...
Mokhtar Arazpour - One of the best experts on this subject based on the ideXlab platform.
-
Influence of Reciprocating Link When Using an Isocentric Reciprocating Gait Orthosis (IRGO) on Walking in Patients with Spinal Cord Injury: A Pilot Study
Topics in Spinal Cord Injury Rehabilitation, 2017Co-Authors: Mokhtar Arazpour, Mahmood Bahramizadeh, Guive Sharifi, Milad Gholami, Monireh Ahmadi BaniAbstract:Background: Studies collectively imply that the reciprocal link has no effect on walking when using reciprocating Gait orthoses (RGOs). There may be differences between the 2 configurations of the RGO (eg, isocentric reciprocating Gait Orthosis [IRGO] and IRGO without reciprocating link), but the specific benefits and problems encountered in their use must be understood. Purpose: To highlight more evidence for the mechanical function of the reciprocal link in RGOs used for walking by individuals with spinal cord injury (SCI). Methods: Nine people with SCI participated in this study. Gait analysis was performed in 2 conditions (walking with IRGO and walking with IRGO without reciprocating link) in a random order. The Vicon digital capture system was used to obtain kinematic data. Results: There were significant differences between each orthotic configuration in terms of speed of walking (p = .029), step length (p = .048), hip joint range of motion (ROM) (p ≤ .001), and lateral and vertical compensatory mot...
-
Effect of Orthotic Gait Training with Isocentric Reciprocating Gait Orthosis on Walking in Children with Myelomeningocele
Topics in Spinal Cord Injury Rehabilitation, 2017Co-Authors: Mokhtar Arazpour, Monireh Ahmadi Bani, Masoud Gharib, Farin Soleimani, Firoozeh Sajedi, Roshanak Vameghi, Mohammad SamadianAbstract:Background: Mechanical orthoses are used to assist in standing and walking after neurological injury in children with myelomeningocele (MMC). Objectives: To evaluate the influence of orthotic Gait training with an isocentric reciprocating Gait Orthosis (IRGO) on the kinematics and temporal-spatial parameters of walking in children with MMC. Methods: Five children with MMC were fitted with an IRGO. They walked at their own comfortable cadence using the Orthosis. The hip joint angle, spatial temporal parameters, and compensatory motions were measured and analyzed. Results: Significant increases in walking speed and step length were demonstrated following orthotic Gait training during walking with the IRGO. The sagittal plane hip range of motion was also significantly increased; however, the vertical and horizontal compensatory motions were significantly decreased. Conclusion: This study evaluated the influence of Gait training with an IRGO on the kinematics and temporal spatial parameters in MMC children. The findings showed that orthotic Gait training improved hip joint range of motion, increased walking speed and step length, and decreased lateral and vertical compensatory motions during level-ground walking trials.
-
Comparison of new medial linkage reciprocating Gait Orthosis and isocentric reciprocating Gait Orthosis on energy consumption in paraplegic patients: a case series.
Spinal cord series and cases, 2015Co-Authors: M Ahmadi Bani, Mokhtar Arazpour, Reza Vahab Kashani, F Farahmand, M E Mousavi, S W HutchinsAbstract:OBJECTIVES: As energy consumption during orthotics walking has main role in rehabilitation of walking in individuals with spinal cord injury (SCI), the aim of this study was comparison between new medial linkage Orthosis (new MLO) and isocentric reciprocating Gait Orthosis (IRGO) on energy consumption in paraplegic patients. METHODS: Four people with motor incomplete SCI (mean age 34.5 years, mass 73 kg and height 175 cm with injury levels ranging from T8-T12) participated in this study. Gait evaluation was performed using new MLO compared with using conventional IRGO. Walking speed and heart rate were measured to calculate the physiological cost index (PCI) to estimate metabolic energy consumption. RESULTS: Reductions in energy consumption were observed using new MLO compared with using IRGO, but the difference was not statistically significant. However, walking distance and walking speed also improved, but not significantly. CONCLUSION: All subjects had faster speeds of walking, walked longer distances and had lower PCI when using new MLO compared to walking with IRGO. Consequently, this Orthosis should be examined and considered with larger sample size.
-
The effect of trunk extension on physiological cost index in spinal cord injury patients when using the advanced reciprocating Gait Orthosis: A pilot study.
Prosthetics and Orthotics International, 2015Co-Authors: Mokhtar Arazpour, Monireh Ahmadi Bani, Stephen W Hutchins, Mohammad Samadian, Mahmood Bahramizadeh, Masoud Gharib, Seyyed Ali Hosseini, Mohammad Ali MardaniAbstract:BACKGROUND: People with spinal cord injury walk with a flexed trunk when using reciprocating Gait orthoses for walking. Reduction in trunk flexion during ambulation has been shown to improve Gait parameters for reciprocating Gait Orthosis users. OBJECTIVE: The aim of this study was to investigate the effect on energy expenditure when spinal cord injury patients ambulate with an advanced reciprocating Gait Orthosis while wearing a thoracolumbosacral Orthosis to provide trunk extension. STUDY DESIGN: Quasi experimental study. METHODS: Four patients with spinal cord injury were fitted with an advanced reciprocating Gait Orthosis after completing a specific Gait training program. Patients walked along a flat walkway using the advanced reciprocating Gait Orthosis as a control condition and also while additionally wearing a thoracolumbosacral Orthosis at their self-selected walking speed. A stopwatch and a polar heart rate monitor were used to measure walking speed and heart rate. RESULTS: Walking speed, the distance walked, and the physiological cost index all improved when walking with the advanced reciprocating Gait Orthosis/thoracolumbosacral Orthosis test condition compared to walking with no thoracolumbosacral Orthosis in situ. CONCLUSION: Spinal cord injury patients can improve their walking speed, walking distance, and physiological cost index when wearing a thoracolumbosacral Orthosis in conjunction with an advanced reciprocating Gait Orthosis, which may be attributed to the trunk extension provided by the thoracolumbosacral Orthosis. CLINICAL RELEVANCE: It is concluded that wearing thoracolumbosacral Orthosis in association with an advanced reciprocating Gait Orthosis could be an effective alternative in rehabilitation for thoracic level of paraplegic patients to promote their health and well-being.
-
The influence of orthotic Gait training with an isocentric reciprocating Gait Orthosis on the walking ability of paraplegic patients: a pilot study.
Spinal Cord, 2015Co-Authors: Mohammad Samadian, Mokhtar Arazpour, Mahmood Bahramizadeh, M Ahmadi Bani, A Pouyan, S W HutchinsAbstract:The influence of orthotic Gait training with an isocentric reciprocating Gait Orthosis on the walking ability of paraplegic patients: a pilot study
Monireh Ahmadi Bani - One of the best experts on this subject based on the ideXlab platform.
-
Influence of Reciprocating Link When Using an Isocentric Reciprocating Gait Orthosis (IRGO) on Walking in Patients with Spinal Cord Injury: A Pilot Study
Topics in Spinal Cord Injury Rehabilitation, 2017Co-Authors: Mokhtar Arazpour, Mahmood Bahramizadeh, Guive Sharifi, Milad Gholami, Monireh Ahmadi BaniAbstract:Background: Studies collectively imply that the reciprocal link has no effect on walking when using reciprocating Gait orthoses (RGOs). There may be differences between the 2 configurations of the RGO (eg, isocentric reciprocating Gait Orthosis [IRGO] and IRGO without reciprocating link), but the specific benefits and problems encountered in their use must be understood. Purpose: To highlight more evidence for the mechanical function of the reciprocal link in RGOs used for walking by individuals with spinal cord injury (SCI). Methods: Nine people with SCI participated in this study. Gait analysis was performed in 2 conditions (walking with IRGO and walking with IRGO without reciprocating link) in a random order. The Vicon digital capture system was used to obtain kinematic data. Results: There were significant differences between each orthotic configuration in terms of speed of walking (p = .029), step length (p = .048), hip joint range of motion (ROM) (p ≤ .001), and lateral and vertical compensatory mot...
-
Effect of Orthotic Gait Training with Isocentric Reciprocating Gait Orthosis on Walking in Children with Myelomeningocele
Topics in Spinal Cord Injury Rehabilitation, 2017Co-Authors: Mokhtar Arazpour, Monireh Ahmadi Bani, Masoud Gharib, Farin Soleimani, Firoozeh Sajedi, Roshanak Vameghi, Mohammad SamadianAbstract:Background: Mechanical orthoses are used to assist in standing and walking after neurological injury in children with myelomeningocele (MMC). Objectives: To evaluate the influence of orthotic Gait training with an isocentric reciprocating Gait Orthosis (IRGO) on the kinematics and temporal-spatial parameters of walking in children with MMC. Methods: Five children with MMC were fitted with an IRGO. They walked at their own comfortable cadence using the Orthosis. The hip joint angle, spatial temporal parameters, and compensatory motions were measured and analyzed. Results: Significant increases in walking speed and step length were demonstrated following orthotic Gait training during walking with the IRGO. The sagittal plane hip range of motion was also significantly increased; however, the vertical and horizontal compensatory motions were significantly decreased. Conclusion: This study evaluated the influence of Gait training with an IRGO on the kinematics and temporal spatial parameters in MMC children. The findings showed that orthotic Gait training improved hip joint range of motion, increased walking speed and step length, and decreased lateral and vertical compensatory motions during level-ground walking trials.
-
The effect of trunk extension on physiological cost index in spinal cord injury patients when using the advanced reciprocating Gait Orthosis: A pilot study.
Prosthetics and Orthotics International, 2015Co-Authors: Mokhtar Arazpour, Monireh Ahmadi Bani, Stephen W Hutchins, Mohammad Samadian, Mahmood Bahramizadeh, Masoud Gharib, Seyyed Ali Hosseini, Mohammad Ali MardaniAbstract:BACKGROUND: People with spinal cord injury walk with a flexed trunk when using reciprocating Gait orthoses for walking. Reduction in trunk flexion during ambulation has been shown to improve Gait parameters for reciprocating Gait Orthosis users. OBJECTIVE: The aim of this study was to investigate the effect on energy expenditure when spinal cord injury patients ambulate with an advanced reciprocating Gait Orthosis while wearing a thoracolumbosacral Orthosis to provide trunk extension. STUDY DESIGN: Quasi experimental study. METHODS: Four patients with spinal cord injury were fitted with an advanced reciprocating Gait Orthosis after completing a specific Gait training program. Patients walked along a flat walkway using the advanced reciprocating Gait Orthosis as a control condition and also while additionally wearing a thoracolumbosacral Orthosis at their self-selected walking speed. A stopwatch and a polar heart rate monitor were used to measure walking speed and heart rate. RESULTS: Walking speed, the distance walked, and the physiological cost index all improved when walking with the advanced reciprocating Gait Orthosis/thoracolumbosacral Orthosis test condition compared to walking with no thoracolumbosacral Orthosis in situ. CONCLUSION: Spinal cord injury patients can improve their walking speed, walking distance, and physiological cost index when wearing a thoracolumbosacral Orthosis in conjunction with an advanced reciprocating Gait Orthosis, which may be attributed to the trunk extension provided by the thoracolumbosacral Orthosis. CLINICAL RELEVANCE: It is concluded that wearing thoracolumbosacral Orthosis in association with an advanced reciprocating Gait Orthosis could be an effective alternative in rehabilitation for thoracic level of paraplegic patients to promote their health and well-being.
-
Comparison of Gait between healthy participants and persons with spinal cord injury when using the advanced reciprocating Gait Orthosis
Prosthetics and Orthotics International, 2015Co-Authors: Mokhtar Arazpour, Monireh Ahmadi Bani, Mohammad Ebrahim Mousavi, Stephen W Hutchins, Mahmood Bahramizadeh, Mahmoud Joghtaei, Sarah Curran, Guive Sharifi, Mohammad Ali MardaniAbstract:Background: The advanced reciprocating Gait Orthosis (ARGO) has a rigid structure which provides restricted movement at the hip, knee, and ankle joints and incorporates a pelvic section with an extended section in the lumbar region. Healthy subjects, when walking with an RGO in situ, could feasibly demonstrate the level of limitation in movement imposed by ARGO-assisted ambulation. Objective: The aim of this study was to compare the function of the advanced reciprocating Gait Orthosis when fitted with the dorsiflexion-assist ankle–foot orthoses on temporal–spatial parameters and kinematics of walking in both able-bodied people and those with spinal cord injury. Study design: Quasi experimental design. Methods: Data were acquired from six able-bodied and four spinal cord injury subjects who used an advanced reciprocating Gait Orthosis which incorporated dorsiflexion-assist ankle–foot orthoses. Kinematics and temporal–spatial parameters were calculated and compared. Results: All able-bodied individuals walked with speeds which were only approximately one-third that of when walking without an Orthosis. The mean step length and cadence were both reduced by 48% and 6%, respectively. There were significant differences in hip, knee, and ankle joint range of motions between normal walking and walking with the advanced reciprocating Gait Orthosis both in able-bodied subjects and patients with spinal cord injury. There were also significant differences in the speed of walking, cadence, step length, hip range of motion, and ankle range of motion when using the advanced reciprocating Gait Orthosis between the two groups. Conclusion: Temporal–spatial parameters and lower limb sagittal plane kinematics of walking were altered compared to normal walking, especially when spinal cord injury subjects walked with the advanced reciprocating Gait Orthosis compared to the able-bodied subjects. Clinical relevance To produce an improvement in RGO function, an increase in walking performance should involve attention to improvement of hip, knee, and ankle joint kinematics, which differs significantly from normal walking.
-
The influence of trunk extension in using advanced reciprocating Gait Orthosis on walking in spinal cord injury patients: A pilot study:
Prosthetics and Orthotics International, 2014Co-Authors: Mokhtar Arazpour, Monireh Ahmadi Bani, Mohammad Ebrahim Mousavi, Stephen W Hutchins, Masoud Gharib, Sarah Curran, Hooshang SaberiAbstract:Background:Spinal cord injury patients walk with a flexed trunk when using reciprocating Gait orthoses. Reduction of trunk flexion during ambulation may produce an improvement in Gait parameters for reciprocating Gait Orthosis users.Objectives:To investigate the effect on kinematics and temporal–spatial parameters when spinal cord injury patients ambulate with an advanced reciprocating Gait Orthosis while wearing a thoracolumbosacral Orthosis to provide trunk extension.Study design:Comparative study between before and after use o thoracolumbosacral Orthosis with the advanced reciprocating Gait orthoses.Methods:Four patients with spinal cord injury were fitted with an advanced reciprocating Gait Orthosis and also wore a thoracolumbosacral Orthosis. Patients walked along a flat walkway either with or without the thoracolumbosacral Orthosis at their self-selected walking speed. Temporal–spatial parameters and lower limb kinematics were analyzed.Results:Mean walking speed, step length, and cadence all improve...
Ronald J Triolo - One of the best experts on this subject based on the ideXlab platform.
-
Development Of A Hybrid Gait Orthosis: A Case Report
Journal of Spinal Cord Medicine, 2020Co-Authors: Rudi Kobetic, Byron E. Marsolais, Richard Gaudio, Dwight T. Davy, Ronald J Triolo, Scott TashmanAbstract:AbstractObjective: The purpose of this case study was to improve stability, posture, and speed of Gait in an individual with paraplegia through the application of a hybrid system including trunk-hip-knee-ankle-foot Orthosis (THKAFO) with lockable joints and multichannel functional electrical stimulation (FES) with implanted electrodes.Methods: Two hybrid orthoses were implemented and evaluated on a person with complete absence of motor function and sensation below the T-9 level spinal cord injury. The first hybrid was a modified isocentric reciprocal Gait Orthosis (IRGO) with the knees controlled by FES, the ankles fixed at neutral, and the hips coupled with a reciprocator. The second hybrid had a THKAFO instrumented with lockable joints using wrap-spring clutches at the hips and knees (THKAFO-LJ) that provided free extension and allowed for flexion only when disengaged by solenoids. A microprocessor-controlled stimulator provided muscle stimulation and activation signals for the solenoids. These two hybr...
-
Simulation of a functional neuromuscular stimulation powered mechanical Gait Orthosis with coordinated joint locking
IEEE Transactions on Neural Systems and Rehabilitation Engineering, 2005Co-Authors: C.s. To, Rudi Kobetic, R.f. Kirsch, Ronald J TrioloAbstract:The purpose of this study was to examine a hybrid Orthosis system (HOS) for walking after spinal-cord injury (SCI) that coordinates the mechanical locking and unlocking of knee and ankle joints of a reciprocating Gait Orthosis (RGO), while propulsive forces are injected and unlocked joints controlled with functional neuromuscular stimulation (FNS). The likely effectiveness of the HOS in terms of forward progression, stability, and posture of paraplegic Gait was determined in this simulation study. A three-dimensional computer model of a HOS combining FNS with an RGO incorporating feedback control of muscle activation and joint locking was developed. An anthropomorphic human model included passive joint moments and a foot-ground contact model adapted from other studies. A model of the RGO reciprocally coupled the hips and locked and unlocked the knee and ankle joints during stance and swing respectively. The actions of muscles under FNS activation were modeled via closed-loop control of joint torque inputs. A walking aid that mimicked canes and voluntary upper extremity actions maintained lateral stability by providing the necessary shoulder forces and moments. The simulated HOS achieved Gait speeds of 0.51/spl plusmn/0.03 m/s, stride lengths of 0.85/spl plusmn/0.04 m, and cadences of 72/spl plusmn/4 steps/min, exceeding the reported performance of other assistive Gait systems. Although minimal forward trunk tilt was found to be necessary during specific phases of Gait, posture, and stability were significantly improved over FNS-only systems.
-
The feasibility of a functional neuromuscular stimulation powered mechanical Gait Orthosis with coordinated joint locking
The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2004Co-Authors: C.s. To, Rudi Kobetic, R.f. Kirsch, Ronald J TrioloAbstract:The purpose of this study was to examine the feasibility of a hybrid Orthosis for walking after spinal cord injury (SCI) that coordinates the locking and unlocking of knee and ankle joints of a reciprocating Gait Orthosis (RGO), while injecting propulsive forces and controlling unlocked joints with functional neuromuscular stimulation (FNS). The effectiveness of the hybrid system relative to Gait stability and posture were determined in this simulation study. A three-dimensional computer model of a hybrid Orthosis system (HOS) combining FNS with a RGO incorporating feedback control of muscle activation and coordinated joint locking was developed in Working Model 3D. The simulated hybrid Orthosis system achieved Gait speeds, stride lengths, and cadences of 0.51 /spl plusmn/ 0.03 m/s, 0.85 /spl plusmn/ 0.04 m, and 72 /spl plusmn/ 4 steps/min respectively, exceeding the performance of other hybrid systems. Forward trunk tilt was found to be necessary during initial step from standing and pro-swing, but posture and stability were significantly improved over FNS-only systems. The results of the model shows that a HOS that coordinates knee and ankle joint locking with electrical stimulation to the paralyzed muscles holds significant advantages over brace- and FNS-only walking systems in terms of enhanced trunk stability and posture.
