One-year retention of gait speed improvement in stroke survivors after treatment with a wearable home-use gait device.

Background: Gait impairments after stroke are associated with numerous physical and psychological consequences. Treatment with the iStride gait device has been shown to facilitate improvements to gait function, including gait speed, for chronic stroke survivors with hemiparesis. This study examines the long-term gait speed changes up to 12 months after treatment with the gait device.

Gait Device Treatment Using Telehealth for Individuals With Stroke During the COVID-19 Pandemic: Nonrandomized Pilot Feasibility Study.

Background: During the COVID-19 pandemic, rehabilitation providers and consumers adopted telehealth practices at unprecedented rates. Multiple prepandemic studies demonstrate the feasibility and comparable efficacy between in-clinic and remote treatment for certain impairments caused by stroke, such as upper extremity weakness and impaired motor function. However, less guidance has been available regarding gait assessment and treatment.

Can mHealth Technology Help Mitigate the Effects of the COVID-19 Pandemic?

The aim of the study herein reported was to review mobile health (mHealth) technologies and explore their use to monitor and mitigate the effects of the COVID-19 pandemic. A Task Force was assembled by recruiting individuals with expertise in electronic Patient-Reported Outcomes (ePRO), wearable sensors, and digital contact tracing technologies. Its members collected and discussed available information and summarized it in a series of reports.

Center of pressure in a walking boot shifts posteriorly in patients following lower leg fracture.

Background: Studies have shown that the ambulatory behavior and amount of weight bearing performed by lower leg fracture patients, increases over time. It is likely that gait features, such as center of pressure (CoP), also change over time.

Research Question: The purpose of this study was to characterize changes in CoP exhibited by lower leg fracture patients wearing a walking boot during the recovery period.

Evaluating How Post-Bronchodilator Vital Capacities Affect the Diagnosis of Obstruction in Pulmonary Function Tests.

Background: Although the ratio of FEV to the vital capacity (VC) is universally accepted as the cornerstone of pulmonary function test (PFT) interpretation, FVC remains in common use. We sought to determine what the differences in PFT interpretation were when the largest measured vital capacity (VC) was used instead of the FVC.

Methods: We included 12,238 consecutive PFTs obtained for routine clinical care.

Using a pilot study to establish experimental methods for inexpensive instrumented insoles used in dynamic skiing analysis.

Loss of balance leads to increased likelihood of falling for human locomotion. Determining the likelihood of falling for skiing locomotion is challenging because, unlike walking, normal locomotion is not clearly defined. One of the first learned styles of skiing is wedge style (WS).

Durability evaluation of biopolymer coating on titanium alloy substrate.

For this study, a commercially available phosphorylcholine (PC) polymer was applied to Ti6Al4V ELI. A multivariate approach to design a statistically significant array of experiments was employed to evaluate and estimate optimization of PC-immobilization process factors. The seven process factors analyzed were (1) power level for RFGD plasma treatment, (2) duration of plasma treatment, (3) concentration of PC solution used to coat samples, (4) rate at which samples were dipped in/out of the solution, (5) temperature for curing, (6) relative humidity level during curing, and (7) duration of curing.

Potential to fall of bipeds using foot kinematics.

This research compares normal to unexpected slipping gaits of healthy adults to detect potential to fall. Using various x, y, and z position analyses, including a Root Mean Squared Error (RMSE), significant differences are shown between normal and unexpected slipping gaits. Our results show that after heel strike of the slipping foot, the recovery foot rapidly changes position to restore balance and lower falling potential.

Forward kinematics using IMU on-body sensor network for mobile analysis of human kinematics.

The feasibility of large network inertial measurement units (IMUs) are evaluated for purposes requiring feedback. A series of wireless IMUs were attached to a human lower-limb laboratory model outfitted with joint angle encoders. The goal was to discover if large networks of wireless IMUs can give realtime joint orientation data while still maintaining an acceptable degree of accuracy.

Kinetic Gait Analysis Using a Low-Cost Insole.

Abnormal gait caused by stroke or other pathological reasons can greatly impact the life of an individual. Being able to measure and analyze that gait is often critical for rehabilitation. Motion analysis labs and many current methods of gait analysis are expensive and inaccessible to most individuals.

A laboratory insole for analysis of sensor placement to determine ground reaction force and ankle moment in patients with stroke.

An insole system was constructed with 32 sensors inside a size 10 men's shoe. This system allows evaluation of the contributions of individual sensors spread throughout the surface area of the insole. The kinetic variables of interest in this initial study are ground reaction force and anterior-posterior ankle moment.

A feasibility study of an upper limb rehabilitation system using Kinect and computer games.

A new low-cost system for rehabilitation of the impaired upper limb for stroke survivors is presented. A computer game was developed specifically for this purpose and the user's impaired upper extremity is tracked using a downward-pointed Kinect, an inexpensive motion capture system commercially available from Microsoft. A Kalman filter was implemented to reduce data jittering.

Flow characteristics of continuous-flow left ventricular assist devices in a novel open-loop system.

Fluid-pumping technology is a mature engineering subject area with a well-documented knowledge base. However, the pump design optimization techniques accepted in industry are geared toward steady-state constant-flow conditions. In contrast, the implantation of a continuous-flow pump to aid the output of the human left ventricle subjects the device to perpetual variation.

The effect of partial weight bearing in a walking boot on plantar pressure distribution and center of pressure.

Physicians routinely prescribe partial weight bearing in a walking boot following fractures of the lower limbs in order to produce the needed mechanical environment to facilitate healing. Plantar pressure measurements can provide key information regarding the mechanical environment experienced by lower limb bones. The effect of walking boots on plantar pressure distribution has been well reported, however, the combined effects of partial weight bearing and walking boots on plantar pressure distribution and center of pressure is unknown.

Liquid cooling system for the vibro-tactile threshold device.

Vibrotactile threshold testing has been used to investigate activation of human somatosensory pathways. A portable vibrotactile threshold testing device called the Vibrotactile Threshold Evaluator for the Workplace (VTEW) was designed for screening of carpal tunnel syndrome in the workplace, and initially contained a small fan for cooling. During subject testing, the device is operated intermittently, which causes the linear actuator to warm the tactile probe.

Instrumented insole vs. force plate: a comparison of center of plantar pressure.

Instrumented insoles allow analysis of gait outside of the confines of a motion analysis lab and capture motion data on every step. This study assesses the concurrent validity of center of plantar pressure (COPP) measurements during walking, and shows that our custom instrumented insoles compare favorably to an Advanced Mechanical Technology Inc. (AMTI) force plate in a clinical motion laboratory, particularly when the large difference in price is considered (an insole is nearly two orders of magnitude less expensive than a force plate).

A wireless sensory feedback system for real-time gait modification.

Current rehabilitation technology and techniques have proven effective at modifying and correcting gait abnormalities. They are however limited to laboratory and clinical settings, under the supervision of a specialist. Conventional techniques for quantifying gait asymmetries can be combined with sensory feedback methods to provide an intuitive and inexpensive feedback system for extra-clinical rehabilitation.

Progress in vibrotactile threshold evaluation techniques: a review.

Vibrotactile threshold (VT) testing has been used for nearly a century to investigate activation of human somatosensory pathways. This use of vibrotactile stimuli provides a versatile tool for detecting peripheral neuropathies, and has been broadly used for investigation of carpal tunnel syndrome. New applications include investigation of drug-induced neuropathies and diabetes-related neuropathies.

Just enough measurement: a proposed paradigm for designing medical instrumentation.

Our research group hypothesizes that one way to provide low-cost healthcare delivery efficiently is through the use of a large number of inexpensive sensors that can provide meaningful medical data. Typical development of medical instrumentation pursues increased resolution and higher accuracy - accompanied by a corresponding increase in cost; it is no secret that high costs impose a heavy burden on healthcare. We seek to invert the adage that quality is more important than quantity by extracting high quality biomedical information from a large quantity of low-cost measurements, and to demonstrate this using measurement instrumentation developed in our lab for extra-clinical assessment and rehabilitation tools.

Insole sensor system for real-time detection of biped slip.

The study of bipedal gait is important for two primary reasons: biomimetic robotics and human gait rehabilitation. Both fields have numerous models describing bipedal locomotion that require a no-slip interaction with the ground for accuracy. This paper presents a low cost wearable sensor system capable of identifying slip in real time, which could afford rehabilitative analysts important information on the nature of patient falls, and provide robot designers a feedback ability with which to implement an active traction control system.

Gait analysis using a shoe-integrated wireless sensor system.

We describe a wireless wearable system that was developed to provide quantitative gait analysis outside the confines of the traditional motion laboratory. The sensor suite includes three orthogonal accelerometers, three orthogonal gyroscopes, four force sensors, two bidirectional bend sensors, two dynamic pressure sensors, as well as electric field height sensors. The "GaitShoe" was built to be worn in any shoe, without interfering with gait and was designed to collect data unobtrusively, in any environment, and over long periods.

Development of a quantitative in-shoe measurement system for assessing balance: sixteen-sensor insoles.

This work presents the first phase in the development of an in-shoe sensor system designed to evaluate balance. Sixteen force-sensitive resistors were strategically mounted to a removable insole, and the bilateral outputs were recorded. The initial results indicate that these sensors are capable of detecting subtle changes in weight distribution, corresponding to the subject's ability to balance.