QUANTITATIVE GAIT ANALYSIS FOR CLINICAL DECISION MAKING

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 目的：本研究的总体目的是开发一种改进的步态分析系统，使用链接的分段身体模型动画来实时采集、计算和解释关节运动学和动力学信息，以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用于患者评估的标准方案对受试者进行研究。 研究计划：定量步态分析系统、软件和使用的持续开发需要来自一系列步态障碍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估的标准方案对受试者进行研究。 标准协议包括运动学数据、动力学数据的常规收集，以及在选定情况下的肌电图信息。 所有收集到的原始数据最终将针对相关生物力学参数进行处理，并用于构建规范数据库或非规范数据库，从中提取选定的案例用于教学目的、试点数据或软件开发。 该项目并非旨在测试特定假设，因此未计划进行统计分析。 方法：标准方案包括常规收集运动学数据、动力学数据、足部压力数据，以及在某些情况下收集肌电图信息。所有收集到的原始数据最终将针对相关生物力学参数进行处理，并用于构建规范数据库或非规范数据库，从中提取选定的案例用于教学目的、试点数据或软件开发。该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，将红外反射标记贴在下肢、躯干和手臂的关节上。反射标记与光电运动分析系统 (Vicon) 结合使用，可以采集受试者肢体和躯干部分的 3D 运动数据。关节动力学是通过嵌入步态实验室地板上的测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。足部压力数据通过Fscan获得。聚酯薄膜压敏条放置在鞋或残肢中。该条带连接到数据记录器和电池组，将其挂在腰带上并戴在肩上或腰上。当需要肌电图数据时，将表面电极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，受试者将被指示沿着步态实验室跑道在力平台上行走。同时收集运动学、肌电图和测力台数据。根据步态模式的变异程度，收集 3 到 10 步之间的数据。当使用辅助装置（手杖等）或矫形装置时，可能会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台上，睁眼和闭眼。 测力台捕获其压力中心 (COP) 摇摆，而运动学（标记）数据计算其质心 (COM) 摇摆。 由于本研究招募的患者会出现步态异常，因此最显着的风险是跌倒。因此，将对受试者进行筛选，以确保他们能够在水平地面上独立行走。在测试期间，将提供备用援助，以帮助受试者在失去平衡的情况下。对于正常受试者来说，风险可以忽略不计。 招募：邀请转介实验室进行临床步态分析的患者参与该项目。如果感兴趣，研究调查员会告知受试者研究目标、程序、风险和任何益处。研究研究者负责获得知情同意。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。

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 open 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.