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A gait stability investigation into FES-assisted paraplegic walking based on the walker tipping index

Dong Ming1,2,4, Yanru Bai1, Xiuyun Liu1, Hongzhi Qi1, Longlong Cheng1, Baikun Wan1, Yong Hu2, Yatwa Wong2, Keith D K Luk2 and John C Y Leong3

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The gait outcome measures used in clinical trials of paraplegic locomotor training determine the effectiveness of improved walking function assisted by the functional electrical stimulation (FES) system. Focused on kinematic, kinetic or physiological changes of paraplegic patients, traditional methods cannot quantify the walking stability or identify the unstable factors of gait in real time. Up until now, the published studies on dynamic gait stability for the effective use of FES have been limited. In this paper, the walker tipping index (WTI) was used to analyze and process gait stability in FES-assisted paraplegic walking. The main instrument was a specialized walker dynamometer system based on a multi-channel strain-gauge bridge network fixed on the frame of the walker. This system collected force information for the handle reaction vector between the patient's upper extremities and the walker during the walking process; the information was then converted into walker tipping index data, which is an evaluation indicator of the patient's walking stability. To demonstrate the potential usefulness of WTI in gait analysis, a preliminary clinical trial was conducted with seven paraplegic patients who were undergoing FES-assisted walking training and seven normal control subjects. The gait stability levels were quantified for these patients under different stimulation patterns and controls under normal walking with knee-immobilization through WTI analysis. The results showed that the walking stability in the FES-assisted paraplegic group was worse than that in the control subject group, with the primary concern being in the anterior–posterior plane. This new technique is practical for distinguishing useful gait information from the viewpoint of stability, and may be further applied in FES-assisted paraplegic walking rehabilitation.


PACS

87.80.-y Biophysical techniques (research methods)

87.19.R- Mechanical and electrical properties of tissues and organs

87.19.rs Movement

87.19.L- Neuroscience

Subjects

Instrumentation and measurement

Medical physics

Biological physics

Dates

Issue 6 (December 2009)

Received 27 April 2009, accepted for publication 26 October 2009

Published 17 November 2009



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