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Analysis of Kinematic Synergies in Description of Cerebral Palsy Patients' Gait

Tavassoli, Shahab | 2020

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  1. Type of Document: M.Sc. Thesis
  2. Language: Farsi
  3. Document No: 53659 (08)
  4. University: Sharif University of Technology
  5. Department: Mechanical Engineering
  6. Advisor(s): Farahmand, Farzam; Narimani, Roya
  7. Abstract:
  8. Cerebral palsy (CP) is one the most prevalent neuromusculoskeletal disease amongst children. Damage in the central nervous system (CNS) causes defective growth of the musculoskeletal system during infancy to maturity, then leading to impairment of selective motor control (SMC), spasticity and sometimes contracture of musculotendinous junction. Treatment of Cerebral Palsy is limited to reduce complications. Medical procedures such as neurosurgery and orthopaedic surgeries or rehabilitation used as a common operation. Recently studies in the field of synergy directed a new path to understanding of human motor control complexity besides identification of functionality of musculoskeletal elements. Concentrating on synergy analysis of neurologic diseases yielded to promising results in improvement of task impairments such as gait. The main goal of this thesis is to characterize gait impairments of spastic cerebral palsy patients by means of kinematic synergy analysis. To accomplish this, gait data of 33 cerebral palsy children in addition of 10 healthy adults as control group has been utilized. Synergy analysis on the motion of 8 degrees of freedom (lower limb joints) has been applied by Non-negative matrix factorization (NNMF) method, then a hierarchical clustering method has been used based on synergy weights and activation profiles. Results based on variance accounted for showed a reduction in motor complexity of cerebral palsy patients (VAF>90%) in comparison of control group (VAF<90%). Separate clustering of CP groups shows propagation of some groups to 5 characteristic modules and clustering of all data population demonstrates 2 exclusive activation patterns for CP groups. Greater synergy structure variability of results leads to increased stride-to-stride gait patterns in children with cerebral palsy. Characteristic synergies obtained from clustering method for both cerebral palsy and control group demonstrate series of specified impaired repertoire of biomechanical degrees of freedom for cerebral palsy patients based on Rodda’s qualitative classification. Robustness of kinematic synergy analysis done in this thesis supports the notion that descriptive analysis of movement coordination reveals pathologies of gait impairments for cerebral palsy patients. Knowledge of DOFs impairments specifically in gait phases, makes it possible to present novel treatment plans or rehabilitation strategies leading to recovery of biomechanical tasks such as gait for cerebral palsy patients
  9. Keywords:
  10. Clustering ; Gait Analysis ; Cerebral Palsy ; Non-Negative Matrix Factorization (NMF) ; Muscle Synergy ; Hierarchical Clustering ; Walking Kinematics

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