QUANTITATIVE GAIT ANALYSIS FOR CLINICAL DECISION MAKING

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 目的：本研究的总体目的是开发一种改进的步态分析系统，用于使用链接节段身体模型动画来显示和直观地描绘偏离正常运动和关节功能的情况，从而实时获取、计算和解释关节运动学和运动学信息。受试者将在UTHSCSA/STVHCS步态分析和创新技术实验室使用用于患者评估的标准方案进行研究。 研究计划：持续开发定量步态分析系统、软件和用途需要来自步态障碍谱系患者的先导数据以及标准数据。受试者将在康复医学人体运动实验室使用用于患者评估的标准方案进行研究。标准方案包括运动学数据、运动学数据的常规收集，在选定的情况下，还包括肌电信息的收集。所有收集的原始数据最终将被处理以获得相关的生物力学参数，并被用于建立一个标准数据库或非标准数据库，从中可以提取选定的案例用于教学、试点数据或软件开发。该项目不是为了测试特定的假设而设计的，因此没有计划进行统计分析。 方法：标准方案包括常规收集运动学数据、运动学数据、足底压力数据，并在选定的病例中收集肌电信息。所有收集的原始数据最终将被处理以获得相关的生物力学参数，并被用于建立标准数据库或非标准数据库，从中提取选定的案例，用于教学、试点数据或软件开发。该项目不是为了测试特定的假设而设计的，因此没有计划进行统计分析。 为了获得运动学数据，红外反射标记被贴在下肢、躯干和手臂的关节上。反射标记与光电运动运动分析系统(VICON)结合使用，以允许获取受试者肢体和躯干节段的3D运动数据。关节动力学是通过嵌入步态实验室地板的力板测量的地面反作用力来确定的，不需要特定的受试者设置。足底压力数据由FSCAN获得。Mylar压敏条被放置在鞋或残肢中。这条带子与一个数据记录器和电池组相连，电池组将被戴在腰带上，戴在肩上或腰部。当需要肌电数据时，将表面电极放置在选定的下肢肌肉的运动点区域上。 在放置标记和记录电极后，受试者将被指示走下步态实验室跑道，越过原力平台。同时采集运动学数据、肌电数据和力盘数据。根据步态模式的可变性程度，收集了3到10个步幅的数据。当辅助用具(拐杖等)或使用矫形器，则可要求受试者在步态辅助或不使用步态辅助的情况下行走。此外，为了捕捉姿势摆动，参与者被要求安静地站在测力板上，睁开眼睛和闭上眼睛。当运动学(标记)数据计算其重心(COM)摆动时，力盘捕捉其压力中心(COP)摆动。 由于这项研究招募的患者步态将出现异常，最大的风险是摔倒。因此，受试者将接受筛查，以确保他们能够在平地上独立行走。在测试期间，将提供待命援助，以帮助受试者在平衡丢失的情况下。正常受试者的风险可以忽略不计。 招募：邀请转至实验室进行临床步态分析的患者参与该项目。如果有兴趣，研究调查员会将研究的目标、程序、风险和任何好处告知受试者。研究调查员负责获得知情同意。正常受试者的数据被用来建立一个规范的数据库。来自其他受试者的数据有助于不同疾病的相关数据库。

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. 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.