Evaluation of a novel biomechanics-informed walking frame, developed through a Knowledge Transfer Partnership between biomechanists and design engineers.

Background: Walking aids such as walking frames offer support during walking, yet paradoxically, people who self-report using them remain more likely to fall than people who do not. Lifting of walking frames when crossing door thresholds or when turning has shown to reduce stability, and certain design features drive the need to lift (e.g.

An investigation of the effects of walking frame height and width on walking stability.

Background: Walking aids are designed for structural support during walking, however, surprisingly self-reported use of a walking aid ("Yes, I use one.") has been identified as a risk factor for falling. Adjustment and design of walking aids may affect their usefulness in facilitating a stable walking pattern.

Are older people putting themselves at risk when using their walking frames?

Background: Walking aids are issued to older adults to prevent falls, however, paradoxically their use has been identified as a risk factor for falling. To prevent falls, walking aids must be used in a stable manner, but it remains unknown to what extent associated clinical guidance is adhered to at home, and whether following guidance facilitates a stable walking pattern. It was the aim of this study to investigate adherence to guidance on walking frame use, and to quantify user stability whilst using walking frames.

Objective measures of rollator user stability and device loading during different walking scenarios.

Walking aids are widely used by older adults, however, alarmingly, their use has been linked to increased falls-risk, yet clinicians have no objective way of assessing user stability. This work aims to demonstrate the application of a novel methodology to investigate how the type of walking task, the amount of body weight supported by the device (i.e.

Methods for the Real-World Evaluation of Fall Detection Technology: A Scoping Review.

Falls in older adults present a major growing healthcare challenge and reliable detection of falls is crucial to minimise their consequences. The majority of development and testing has used laboratory simulations. As simulations do not cover the wide range of real-world scenarios performance is poor when retested using real-world data.

Skill assessment in upper limb myoelectric prosthesis users: Validation of a clinically feasible method for characterising upper limb temporal and amplitude variability during the performance of functional tasks.

Upper limb myoelectric prostheses remain challenging to use and are often abandoned. A proficient user must be able to plan/execute arm movements while activating the residual muscle(s), accounting for delays and unpredictability in prosthesis response. There is no validated, low cost measure of skill in performing such actions.

Characterisation of rollator use using inertial sensors.

The use of walking aids is prevalent among older people and people with mobility impairment. Rollators are designed to support outdoor mobility and require the user to negotiate curbs and slopes in the urban environment. Despite the prevalence of rollators, analysis of their use outside of controlled environments has received relatively little attention.

Feasibility study of a take-home array-based functional electrical stimulation system with automated setup for current functional electrical stimulation users with foot-drop.

Objective: To investigate the feasibility of unsupervised community use of an array-based automated setup functional electrical stimulator for current foot-drop functional electrical stimulation (FES) users.

Design: Feasibility study.

Setting: Gait laboratory and community use.

Visuomotor behaviours when using a myoelectric prosthesis.

Background: A recent study showed that the gaze patterns of amputee users of myoelectric prostheses differ markedly from those seen in anatomically intact subjects. Gaze behaviour is a promising outcome measures for prosthesis designers, as it appears to reflect the strategies adopted by amputees to compensate for the absence of proprioceptive feedback and uncertainty/delays in the control system, factors believed to be central to the difficulty in using prostheses. The primary aim of our study was to characterise visuomotor behaviours over learning to use a trans-radial myoelectric prosthesis.

Automated detection of instantaneous gait events using time frequency analysis and manifold embedding.

Accelerometry is a widely used sensing modality in human biomechanics due to its portability, non-invasiveness, and accuracy. However, difficulties lie in signal variability and interpretation in relation to biomechanical events. In walking, heel strike and toe off are primary gait events where robust and accurate detection is essential for gait-related applications.

Simulating acceleration from stereophotogrammetry for medical device design.

When designing a medical device based on lightweight accelerometers, the designer is faced with a number of questions in order to maximize performance while minimizing cost and complexity: Where should the inertial unit be located? How many units are required? How is performance affected if the unit is not correctly located during donning? One way to answer these questions is to use position data from a single trial, captured with a nonportable measurement system (e.g., stereophotogrammetry) to simulate measurements from multiple accelerometers at different locations on the body.

Movement variability in stroke patients and controls performing two upper limb functional tasks: a new assessment methodology.

Background: In the evaluation of upper limb impairment post stroke there remains a gap between detailed kinematic analyses with expensive motion capturing systems and common clinical assessment tests. In particular, although many clinical tests evaluate the performance of functional tasks, metrics to characterise upper limb kinematics are generally not applicable to such tasks and very limited in scope. This paper reports on a novel, user-friendly methodology that allows for the assessment of both signal magnitude and timing variability in upper limb movement trajectories during functional task performance.

An instance-based algorithm with auxiliary similarity information for the estimation of gait kinematics from wearable sensors.

Wearable human movement measurement systems are increasingly popular as a means of capturing human movement data in real-world situations. Previous work has attempted to estimate segment kinematics during walking from foot acceleration and angular velocity data. In this paper, we propose a novel neural network [GRNN with Auxiliary Similarity Information (GASI)] that estimates joint kinematics by taking account of proximity and gait trajectory slope information through adaptive weighting.

Falls and gait characteristics among older persons with peripheral neuropathy.

Objective: To prospectively determine the frequency and circumstances of falls in older persons with peripheral neuropathy and to identify gait characteristics on smooth and irregular surfaces associated with falls in this same population.

Design: This was a descriptive and observational study of a prospective group cohort. Spatial and temporal gait measures on smooth and irregular surfaces, as well as basic demographic and clinical data, were obtained in 20 older persons with peripheral neuropathy.

What causes a crossover step when walking on uneven ground? A study in healthy young women.

We hypothesized that, during gait, the perturbation caused by stepping on a 1.2-cm high protuberance with the medial forefoot would not only alter stance foot kinematics and kinetics, but also alter subsequent step location and timing, even to the point of causing a crossover step. Twelve healthy young women performed at least three flat surface and three perturbation trials while walking along a level walkway.

Gait analysis in a challenging environment differentiates between fallers and nonfallers among older patients with peripheral neuropathy.

Objective: To identify differences in gait based on fall history among a group of older subjects with peripheral neuropathy (PN) in 2 environments: standard (SE) (smooth surface, normal lighting) and challenging (CE) (irregular surface, low lighting).

Design: Observational, case-control study of PN subjects with and without a history of falling in the previous year.

Setting: A biomechanical laboratory.

Influence of an irregular surface and low light on the step variability of patients with peripheral neuropathy during level gait.

Patients with peripheral neuropathy (PN) report greater difficulty walking on irregular surfaces with low light (IL) than on flat surfaces with regular lighting (FR). We tested the primary hypothesis that older PN patients would demonstrate greater step width and step width variability under IL conditions than under FR conditions. Forty-two subjects (22 male, 20 female: mean +/- S.

Effects of surface irregularity and lighting on step variability during gait: a study in healthy young and older women.

Relatively few studies have examined how uneven surfaces affect human gait. To study this, along with the effects of advancing age and low light conditions, we measured step width and step time variability, as well as comfortable gait speed, in 12 healthy young women (YW) and 12 healthy older women (OW) as they walked at a comfortable speed along a 10-m walkway. Ten trials were completed for each cell of a 2 x 2 factorial design: (1) flat surface with regular lighting; (2) flat surface with low lighting; (3) irregular surface with regular lighting; and (4) irregular surface with low lighting.

A comparison of gait characteristics between older women with and without peripheral neuropathy in standard and challenging environments.

Objectives: To compare gait patterns in older women with and without peripheral neuropathy (PN) in standard (smooth surface, normal lighting) and challenging environments (CE) (irregular surface, low lighting).

Design: Observational, controlled study of 24 subjects.

Setting: Biomechanical research laboratory.

Interventions improve gait regularity in patients with peripheral neuropathy while walking on an irregular surface under low light.

Objectives: To determine which, if any, of three inexpensive interventions improve gait regularity in patients with peripheral neuropathy (PN) while walking on an irregular surface under low-light conditions.

Design: Observational.

Setting: University of Michigan Biomechanics Research Laboratory.