example: clinical gait analysis cerebral...
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TRAMA: Bruxelles (15 janvier 2008)"Motion analysis and clinics: why to set up a motion analysis lab".
J. Duysens
A gait lab to study more than gait
Motor Control Laboratory
Research Center for Movement Control and
NeuroplasticityDep. of Biomedical Kinesiology (FaBeR)
K.U. Leuven, Belgium
And : SMK-RDE,
Nijmegen , The Netherlands
Example: clinical gait analysis
Cerebral Palsy
AMTI force plate
Nijmegen Motor Unit
SPLIT-BELT
EMGEMGEMGEMG
EMG stands for electromyography. It is the study of muscle electrical signals.
Electrodes are placed on the skin overlying the muscle. Alternatively, wire or needle electrodes are used and these can be placed directly in the muscle.
When EMG is acquired from electrodes mounted directly on the skin, the signal is a composite of all the muscle fiber action potentials occurring in the muscle(s) underlying the skin. These action potentials occur at somewhat random intervals so at any one moment, the EMG signal may be either positive or negative voltage. Individual muscle fiber action potentials are sometimes acquired using wire or needle electrodes placed directly in the muscle.
EMGEMGEMGEMG
EMG stands for electromyography. It is the study of muscle electrical signals.
Electrodes are placed on the skin overlying the muscle. Alternatively, wire or needle electrodes are used and these can be placed directly in the muscle.
When EMG is acquired from electrodes mounted directly on the skin, the signal is a composite of all the muscle fiber action potentials occurring in the muscle(s) underlying the skin. These action potentials occur at somewhat random intervals so at any one moment, the EMG signal may be either positive or negative voltage. Individual muscle fiber action potentials are sometimes acquired using wire or needle electrodes placed directly in the muscle.
Telemetric EMG
VICON
Simi motion : digitale video
TRAMA: Bruxelles (15 janvier 2008)"Motion analysis and clinics: why to set up a motion analysis lab".
J. Duysens
A gait lab to study more than gait
Motor Control Laboratory
Research Center for Movement Control and
NeuroplasticityDep. of Biomedical Kinesiology (FaBeR)
K.U. Leuven, Belgium
And : SMK-RDE,
Nijmegen , The Netherlands
Project 1 Freezing in PD
Anke Snijders 16-01-07
Anke Snijders 16-01-07
Research question
• How to INDUCE freezing of gait on a treadmill?
– Obstacles
Project 2: EM-SCI
• International Multi-Center study
Peroneus Longus
Project3: SPORTS injury nr 1
Ankle sprains
REFLEXES AS DEFENSE?
PREVIOUS STUDIES: STANDING
INVERSION 30 DEG.
JOHNSON ET JOHNSON,1993
ISAKOV ET AL., 1986
50% inverting, 50 % non-inverting
Grüneberg, Nieuwenhuijzen and Duysens, JPhysiol., 2003
10
cm
2
5°
20
cm
Closer to real life
50% inverting, 50 % non-inverting
Nieuwenhuijzen and Duysens, 2007 (JN, in press)
10
cm
2
5°
20
cm
No inversion
Project 4
Project 4: Falls/ Eurokinesis
Project 4: Eurokinesis
Learn how to fall
Project 5: Balance
(Lars Oude Nijhuis/Bas Bloem)
Commissaris et al., 2002
Examples : postural responses
Project 6
ANTICIPATION PASSIVE STIFFNESS REFLEX
ACTUAL LOAD = EXPECTED LOAD
EXPECTED CONTACT
ACTUAL CONTACT
ANTICIPATION PASSIVE STIFFNESS REFLEX
E
R
R
O
R
ACTUAL LOAD < EXPECTED LOAD
EXPECTED CONTACT
ACTUAL CONTACT
• Lowering of support surface
• Lower visual field occluded
• Cadence standardized
• Infrared beam to detect expected
foot contact
• Pressure plate detects touchdown
Protocol
Expected Level EL EL 1… EL 10
Unexpected
Level
UL UL 1…. UL 7-10
UD 1, UL 1…. UL 7-10
UD 2, UL 1…. UL 7-10
:UD 10Unexpected
DownUD
Expected Down ED ED 1 … ED 10
}
CONTROL subject HH 44 y
ANTICIPATION PASSIVE STIFFNESS REFLEX
E
R
R
O
R
ACTUAL LOAD < EXPECTED LOAD
EXPECTED CONTACT
ACTUAL CONTACT
90 ms
Young adults
Actual HC
ED
Expected HC
Medial Gastrocnemius
UD
Actual HC
ED
Expected HC
in UD
(-90 ms)
Medial Gastrocnemius
MGi
UD
-0.3
0.3
0.9
Actual HC
N = 1
N = 9
ED
Subtracted (UD-ED)
Medial Gastrocnemius
Extra activation starting some 40 ms after passing through the expected contact level
-0.5
0.5
1.5
-0.5
0.5
1.5
-0.5
0.5
1.5
TA MG
-0.5
0.5
1.5
Ipsilateral
Contralateral10 ms
HC HC
10 ms
Similar responses are seen in the contralateral TA
-0.5
0.5
1.5
-0.5
0.5
1.5
-0.5
0.5
1.5
TA MG
-0.5
0.5
1.5
Ipsilateral
Contralateral
1 bin = 10 ms
10 ms
HC HC
10 ms
Similar responses are seen in the contralateral TA
Functional significance?
Hase and Stein, 1998
Experiments on adults
-age-matched controls
-hereditary motor and sensory
neuropathy; HMSNIa
Do these fast responses depend on fast afferents?
Project 6: Hereditary motor and sensory neuropathy
Why frequent falls?
HMSNIa subjectRM 44y
RTA
-0,4
0,1
0,6
1,1
1,6
-10
0
-80
-60
-40
-20 0
20
40
60
80
10
0
12
0
14
0
16
0
18
0
HMSN 1a
Healthy subjects
Onset Latencies
0
20
40
60
80
100
120
140
LTA LGM LRF LBF RTA RGM RRF RBF
On
se
t la
ten
cy
(m
s)
HMSN
Healthy subjects
* * * * *
Onset latencies of the responses after expected contactwere increased in the HMSNIa patient group
Co-workers:
M. Van der Linden
P.H.J.A. Nieuwenhuijzen
V. Weerdesteyn
C. Bastiaanse
C. Grüneberg
B. Smits-Engelsman
G.P. van Galen,
B. Nienhuis,
B. Groen,
R. Den Otter
I. Schillings
C. Hofstad
The EndThe End