QUANTITATIVE GAIT ANALYSIS FOR CLINICAL DECISION MAKING

用于临床决策的定量步态分析

• 批准号: 7378217
• 负责人: NICOLAS Eugene WALSH
• 金额: $ 1.11万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7378217
• 关键词: QUANTITATIVE; GAIT; ANALYSIS; CLINICAL; DECISION

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. OBJECTIVE: The overall purpose of this study is to develop an improved gait analysis system for the real time acquisition, calculation and interpretation of joint kinematic and kinetic information using linked segment body model animation to display and visually depict deviations from normal motion and joint function. Subjects will be studied using the standard protocol used for patient evaluations in the UTHSCSA / STVHCS Gait Analysis and Innovative Technologies Laboratory (GB013 VAH). RESEARCH PLAN: Continued development of quantitative gait analysis systems, software and usage require pilot data from patients with a spectrum of gait disorders as well as normative data. Subjects will be studied using the standard protocol used for patient evaluations in the Rehabilitation Medicine Human Motion Laboratory. The standard protocol includes the routine collection of kinematic data, kinetic data and, in selected cases, electromyography information. All collected raw data will ultimately be processed for relevant biomechanical parameters and utilized to build either a Normative Database or Non-Normative Database from which selected cases may be extracted for teaching purposes, pilot data or software development. The project is not designed to test specific hypotheses and as such statistical analyses are not planned. METHODS: The standard protocol includes the routine collection of kinematic data, kinetic data, foot pressure data and, in selected cases, electromyography information. All collected raw data will ultimately be processed for relevant biomechanical parameters and utilized to build either a Normative Database or Non-Normative Database from which selected cases maybe extracted for teaching purposes, pilot data or software development. The project is not designed to test specific hypothesis and as such statistical analysis are not planned. To acquire kinematics data, infrared reflective markers are taped over the joints of the lower extremities, trunk, and arms. The reflective markers are used in conjunction with the optoelectronic kinematic motion analysis system (Vicon) to allow acquisition of 3D motion data for the limb and trunk segments of subjects. Joint kinetics are determine from ground reaction forces measured by force plates embedded into the floor of the gait laboratory and requiring no specific subject setup. Foot pressure data is obtained by Fscan. Mylar pressure sensitive strips are placed in the shoe or residual limb. The strip is connected to a datalogger and battery pack that will be put on a belt and worn over the shoulder or on the waist. When electromyographic data is required, surface electrodes are placed over the motor point regions of selected muscles of the lower extremities. After placement of markers and recording electrodes, the subjects will be instructed to walk down the gait lab runway over the force platform. Simultaneous kinematic, EMG and force plate data is collected. Between 3 and 10 strides of data are collected depending on the degree of variability in the gait pattern. When assistive devices (canes etc.) or orthotic devices are used, the subject may be asked to ambulate with and without the gait aid. Additionally, in order to capture postural sway, Participants are asked to stand quietly on the force plates with their eyes opened as well as with their eyes closed. The force plates capture their Center of Pressure (COP) sway while the kinematic (marker) data calculates their Center of Mass (COM) sway. Since the patients recruited for this study will have abnormalities in their gait, the most significant risk is falling. Therefore, subjects will be screened to ensure that they can ambulate independently over level ground. During testing, standby assistance will be present to help subjects in cases of balance loss. The risks for normal subjects are negligible. Recruitment: Patients referred to the laboratory for clinical gait analysis are invited to participate in the project. If interested, subjects are informed by a study investigator of the study goals, procedures, risks and any benefits. A study investigator is responsible for obtaining informed consent. Data from normal subjects are used to establish a normative database. Data from other subjects contributes to the relevant databases of different disorders.

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。目的：本研究的总体目的是开发一种改进的步态分析系统，用于真实的时间采集、计算和解释关节运动学和动力学信息，使用链接段身体模型动画来显示和直观地描绘与正常运动和关节功能的偏差。将使用UTHSCSA/STVHCS步态分析和创新技术实验室（GB013 VAH）中用于患者评价的标准方案对受试者进行研究。 研究报告：定量步态分析系统、软件和使用的持续发展需要来自具有一系列步态障碍的患者的试点数据以及规范数据。将使用康复医学人体运动实验室用于患者评价的标准方案对受试者进行研究。标准协议包括常规收集运动学数据、动力学数据，以及在选定的情况下收集肌电图信息。所有收集的原始数据将最终处理为相关生物力学参数，并用于构建规范数据库或非规范数据库，从中提取选定病例用于教学目的、试验数据或软件开发。本项目并非旨在检验特定假设，因此未计划进行统计分析。 方法：标准协议包括常规收集运动学数据、动力学数据、足部压力数据，以及在选定的情况下收集肌电图信息。所有收集的原始数据将最终处理为相关生物力学参数，并用于构建规范数据库或非规范数据库，从中提取选定病例用于教学目的、试验数据或软件开发。本项目并非旨在检验特定假设，因此未计划进行统计分析。 为了获取运动学数据，在下肢、躯干和手臂的关节上贴上红外反射标记。反射标记与光电运动学运动分析系统（Vicon）结合使用，以采集受试者肢体和躯干段的3D运动数据。关节动力学是由嵌入步态实验室地板的测力板测量的地面反作用力确定的，不需要特定的受试者设置。足部压力数据通过Fscan获得。聚酯薄膜压力敏感条被放置在鞋或残肢中。该条连接到数据记录器和电池组，将其放在腰带上并佩戴在肩膀或腰部。当需要肌电数据时，表面电极被放置在下肢选定肌肉的运动点区域上。 放置标记和记录电极后，将指导受试者在测力平台上沿步态实验室跑道行走。同时收集运动学、EMG和测力板数据。根据步态模式的变化程度，收集3到10步之间的数据。当辅助设备（手杖等）或矫正装置时，可要求受试者在有或没有步态辅助器的情况下行走。此外，为了捕捉姿势摇摆，参与者被要求安静地站在测力板上，睁着眼睛以及闭着眼睛。测力板捕获其压力中心（COP）摆动，而运动学（标记）数据计算其质心（COM）摆动。 由于这项研究招募的患者将在他们的步态异常，最显着的风险是下降。因此，将对受试者进行筛选，以确保他们能够在平地上独立行走。在测试期间，将提供备用援助，以在受试者失去平衡时提供帮助。对正常人的风险可以忽略不计。 招募：邀请转诊到实验室进行临床步态分析的患者参与该项目。如果有兴趣，研究者将告知受试者研究目的、程序、风险和任何获益。研究者负责获得知情同意书。来自正常受试者的数据用于建立规范数据库。来自其他受试者的数据有助于不同疾病的相关数据库。