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Musculoskeletal Modeling and Analysis of Gait Pattern of Paraplegic Patients

Arab Baniasad, Mina | 2018

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  1. Type of Document: Ph.D. Dissertation
  2. Language: Farsi
  3. Document No: 51285 (08)
  4. University: Sharif University of Technology
  5. Department: Mechanical Engineering
  6. Advisor(s): Farahmand, Farzam; Zohoor, Hassan
  7. Abstract:
  8. Spinal cord injury (SCI) is one of the most important causes of disability in the youth and costs enormous expenses for the government. Most SCI subjects use wheelchair as their main way of locomotion while standing and walking can benefit them in various aspects. The role of lower extremity muscles has been investigated in paraplegic gait with active orthoses or in partial weight support condition. However, due to the large expenses of active orthoses, their application have been limited to clinical trials and yet most SCI individuals use traditional AFO and KAFO for walking. The role and significance of trunk and upper extremity muscles (TUEM) has been investigated only in balance preservation and wheelchair propulsion. Therefore, the main aim of this study is to study the role of TUEM during paraplegic gait. Eight male subjects with SCI level at T12, with paralyzed lower extremity and no history of deficit or pain in trunk and upper extremities were enrolled in this study. After three months of training, all subjects were able to walk independently with the aids of bilateral AFO and walker. Kinematic, kinetic and electromyography data were recorded during gait. Based on kinematic and kinetic data a new framework based on biomechanical subtasks were proposed including four main subtasks: 1-balance adjustment; 2) walker propulsion; 3) leg raising and 4) leg swing. Kinematic maneuvers and muscle activities were analyzed in this framework and contributing muscles within each subtasks were identified using statistical methods. Kinetic results revealed that 70 percent of the body weight was supported through the walker in the leg raising phase which indicates the significant role of TUEM. To identify muscle and kinematic synergies underlying paraplegic gait, non-negative matrix factorization was obtained. Results revealed high inter-subject and intra-subject similarity and three characteristic synergies were observed in most subjects. Furthermore, the characteristic muscle synergies with 5 percent lag followed the characteristic kinematic synergies with Pearson correlation coefficient of 0.95. The results of this study provide a better insight into the paraplegic gait and provide suggestion to facilitate the rehabilitation procedure as well as designing more effective assistive devices
  9. Keywords:
  10. Synergy ; Spinal Cord Injury ; Electromyography ; Paraplegia Locomotion ; Locomotion ; Kinematics Analysis

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